WorldWideScience

Sample records for stand-alone geriatric nursing

  1. Basic Stand Alone Skilled Nursing Facility Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Skilled Nursing Facility (SNF) Beneficiary Public Use Files (PUF) with information from Medicare SNF claims. The...

  2. Stand-alone XLIF

    DEFF Research Database (Denmark)

    Hansen, E. J.; Simony, A.; Hummel, Stefan

    2015-01-01

    and clinical/radiological results in 22 patients treated with XLIF procedure for DS or degenerative disc disease (DDD). Material and methods: 22 consecutive patients with DS underwent surgery with the XLIF stand-alone procedure, with follow-up of 24 months. Clinical outcome scores were collected. Complications......Introduction: Adult thoracolumbar degeneration is an increasing challenge in the aging population. With age the progressive degeneration of the discs leads to an asymmetric collapse and a thoracolumbar coronal plane deformity, a degenerative scoliosis (DS). Aim: To evaluate the complication rate......-year follow-up, with a 31.8% revision rate. Due to the high revision rate we recommend supplementary posterior instrumentation, to achieve a higher fusion rate. When considering XLIF-stand-alone procedure for DS or DDD without supplemental posterior instrumentation, only single-level disease should...

  3. Impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults: A Quasi-experimental study.

    Science.gov (United States)

    Koehler, Amy Reitmaier; Davies, Susan; Smith, Linda Reveling; Hooks, Tisha; Schanke, Hailee; Loeffler, April; Carr, Courtney; Ratzlaff, Nicole

    2016-11-01

    With an aging population, it is critical that nurses are educated and prepared to offer quality healthcare to this client group. Incorporating gerontology content into nursing curricula and addressing students' perceptions and career choices in relation to working with older adults are important faculty concerns. To examine the impact of a stand-alone course in gerontological nursing on undergraduate nursing students' perceptions of working with older adults and career intentions. Quasi-experimental, pre- and post-test design. Medium-sized state university in the Mid Western United States PARTICIPANTS: Data were collected from three student cohorts during the spring semesters of 2012 (n=98), 2013 (n=80) and 2014 (n=88) for a total of N=266 with an average response rate of 85%. A survey instrument was administered via Qualtrics and completed by students prior to, and following completion of the course. There was an overall significant increase (p=0.000) in positive perceptions of working with older adults among nursing students following completion of the course. The majority of participants (83.5%) reported having previous experience with older adults. Those with previous experience had higher perception scores at pre-test than those without (p=0.000). Post-test scores showed no significant difference between these two groups, with both groups having increased perception scores (p=0.120). Student preferences for working with different age groups suggested an overall increase in preference for working with older adults following the course. A course in gerontological nursing, incorporating learning partnerships with community dwelling older adults, promotes positive perceptions of working with older adults, independently of the quality of prior experience. There was some evidence that students changed their preferences of working with different age groups in favor of working with older adults. Further research should be conducted to determine the mechanisms through

  4. Enhancing geriatric nursing scholarship: specialization versus generalization.

    Science.gov (United States)

    Mezey, M; Fulmer, T; Fairchild, S

    2000-07-01

    This article explores the relative merits of encouraging preparation of more nurses with specialization in geriatrics as compared to encouraging geriatric preparation among nurses whose major field of study is outside geriatrics. The article explores two approaches to examining capacity for geriatric nursing scholarship among nurse scholars not involved in geriatrics, and in schools of nursing with strength in research but with little geriatric research. The findings show an ongoing need to strengthen geriatric nursing as an area of specialization. Faculty prepared in geriatric nursing are underrepresented in schools of nursing, and only a small number of doctoral students specialize in geriatric nursing. Academic nursing programs with strength in geriatric nursing need ongoing support to maintain and expand current geriatric programs. Data support that encouraging individual non-geriatric nurse faculty and doctoral candidates to focus their work on areas of concern to geriatric nursing, and strengthening geriatrics in research-intensive schools of nursing that have not heavily invested in geriatric scholarship are viable options for strengthening academic geriatric nursing. Establishing mechanisms to attract nurse scholars working outside the scope of geriatric nursing to address clinical issues of concern to older adults offers promise in rapidly attracting new scholars to geriatric nursing.

  5. The Stand-alone Heliostat

    International Nuclear Information System (INIS)

    Garcia Navajas, G. I.; Egea Gea, A.

    2000-01-01

    The first Autonomous Heliostat has been developed by CIEMAT at PSA facilities in Almeria. This heliostat is an innovative approach to reducing the civil engineering work costs in heliostat fields of central tower plants. Channels, cables and other electric elements have been eliminated in the new heliostat. Thus, one 70-nr, classical T glass/metal heliostat has been adapted to include all the new stand-alone concept components. A PV system is able to drive two sun-tracking DC motors between 5 and 24Vdc, 0 and 15A. The heliostat communicates with the control room 400-m away by using a radio-modem working at 9600 baud. An anemometer, a wind switcher, light and ambient temperature sensors have been installed on the heliostat for self-protection decision-making. A PV panel integrated into the heliostat reflecting surface, eliminates cabling and other elements required for a conventional power supply. Communication lines between master control and local control have been replaced by radio-modem. Testing has validated the technical feasibility of the prototype and quantified the real consumption and efficiencies of new elements. The extra costs produced.by the autonomous concepts are compared with the cost of civil work in conventional heliostat field. (Author) 8 refs

  6. Geriatric Nursing and Long Term Care Content in Baccalaureate Nursing Programs in Taiwan

    Directory of Open Access Journals (Sweden)

    Pei-Lun Hsieh

    2018-03-01

    Full Text Available Summary: Background: The population aged 65 years old and above is expected to dramatically increase annually in Taiwan. Health care professionals need to be prepared to better serve the aged and disabled population. The purpose of this study is to survey Taiwan's current Geriatric Nursing (GN or Long Term Care (LTC courses offered in baccalaureate nursing programs. Methods: A descriptive research design was used and detailed checklist review was applied. Data were obtained from the official websites for the content review of Taiwan's current baccalaureate programs in GN and/or LTC course offered in baccalaureate nursing programs. Results: The results showed that the content of the GN course included aging process, communication, ethical, elderly activity, health promotion, nutrition and dementia care. LTC courses focus on the current system of LTC, policy, management of LTC institutions, ethical issues in LTC, and various types of LTC services such as day care, home care and LTC facilities. Conclusion: The survey findings indicated that GN and LTC education must be recognized by providing required stand-alone courses and interdisciplinary education in nursing curricula. These courses should be included in curricular design and innovations to ensure nursing students to acquire strong competence for the future through education. Keywords: gerontology, geriatric nursing, long term care, baccalaureate curriculum

  7. Enhancing Geriatric Curriculum in Nursing School

    Science.gov (United States)

    Collins, Kevin

    2013-01-01

    People are living longer. The average age of the population is increasing, and is expected to keep growing. Any person age 65 and older is now considered "geriatric." However, although growing, this population is not receiving adequate nursing care, and results in increased pain, falls, and even death. Geriatric curriculum is becoming…

  8. Basic Stand Alone Medicare Outpatient Procedures PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Outpatient Procedures Public Use Files (PUF) with information from Medicare outpatient claims. The CMS BSA...

  9. Basic Stand Alone Medicare Hospice Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Hospice Beneficiary Public Use Files (PUF) with information from Medicare hospice claims. The CMS BSA Hospice...

  10. Basic Stand Alone Carrier Line Items PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Carrier Line Items Public Use Files (PUF) with information from Medicare Carrier claims. The CMS BSA Carrier Line...

  11. Basic Stand Alone Medicare Inpatient Claims PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Inpatient Public Use Files (PUF) named CMS 2008 BSA Inpatient Claims PUF with information from 2008 Medicare...

  12. Stand-alone photovoltaic applications. Lessons learned

    International Nuclear Information System (INIS)

    Loois, G.; Van Hemert, B.

    1999-02-01

    The IEA Photovoltaic Power Systems Programme (PVPS) is one of the collaborative R and D agreements established within the IEA. The objective of Task III is to promote and facilitate the exchange of information and experiences in the field of PV Systems in Stand-alone and Island Applications (SAPV). The book focuses on the practical experiences gained, and does not aim to provide a complete manual on SAPV. When Task III started its activities in 1993, a collection of 50 'State of the art' projects was published in the book 'Examples of Stand-Alone Photovoltaic Systems'. This publication marked the base line for the work of the task. Now, in 1998, the showcases from each country demonstrate the lessons learned in five years of cooperation. The book consists of two parts. The first part contains eight chapters dealing with a specific aspect of stand-alone PV. The second part introduces 14 national showcase projects in a systematic presentation. Each chapter and showcase can be read independently from the rest of the book. Chapter 2, contributed by The Netherlands, analyses the market for stand-alone PV systems. It gives an overview of the 'traditional' application of stand-alone PV, which is the electrification of remote buildings and which has been addressed in depth in other publications. The focus is on the market niches of service applications that are also interesting for more densely populated areas, e.g. in industrialised countries. The United Kingdom illustrates the economic aspects in Chapter 3. Cost comparisons are made, but more important is the illustration of the non-financial considerations that make PV the preferred choice as a power source for many applications. Switzerland explores in Chapter 4 (financing aspects) different financing mechanisms, and financial policies used to overcome the initial cost barrier. Most of these approaches have been applied in developing countries rather than in the western world. Using various examples from all over the

  13. The Filipino Nursing Students' Dilemmas in Geriatric Care

    Science.gov (United States)

    de Guzman, Allan B.; Cruz, Andrei Angelo R.; Cruz, Angela Laurice G.; Cruz, Robert Edward D.; Cuarto, Jose Mari Nino L.

    2009-01-01

    The continually rising percentage of the elderly population and the demand for geriatric nursing care are dramatically related. While it is true that most undergraduate programs prepare nurses for the care of geriatric patients, most receive limited academic preparation in the nursing curriculum (Williams & Mezey, 2000). This is particularly…

  14. Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

    Directory of Open Access Journals (Sweden)

    Peters, Claudia

    2014-09-01

    Full Text Available [english] Background: The increase of multidrug-resistant organisms (MDROs causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff.Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs.Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution.Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work.

  15. 39 CFR 122.2 - Stand-alone special services.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Stand-alone special services. 122.2 Section 122.2 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] SERVICE STANDARDS FOR MARKET-DOMINANT SPECIAL SERVICES PRODUCTS § 122.2 Stand-alone special services. (a) The service standard...

  16. Ampere hour method of sizing a stand alone photovoltaic system ...

    African Journals Online (AJOL)

    Stand-alone photovoltaic power systems are natural options for application in electrification of remote areas which are not served by the grid electricity supply system. An ampere-hour method of sizing a stand-alone PV system for application in any remote location has been presented. The design which is for both ac and dc ...

  17. Structured nursing intervention to geriatric patients discharged from Emergency Department

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie

    2010-01-01

    the nurse made relevant referrals to geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Results: 150 geriatric patients participated, mean age 81.7 (70-99). At discharge they had in mean 2 (0-9) unresolved problems, after 1 month 0.8 (0-5), and after 6...

  18. Improving efficiency of a regional stand alone bone bank.

    Science.gov (United States)

    Warnock, Jonathan M; Rowan, Clare H; Davidson, Helen; Millar, Ciara; McAlinden, M Gavan

    2016-03-01

    The introduction of a stand-alone Bone Bank in our Regional Orthopaedic Hospital has improved the availability of femoral head allograft. Benninger et al. (Bone Joint J 96-B:1307-1311, 2014), demonstrated their institutions bank to be cost effective despite a 30 % discard rate for harvested allograft. We sought to audit our own discard rates and subsequent cost-effectiveness of our bone bank. Donor recruitment. Before approaching a potential donor, our establishment's nurse specialists review their clinical notes and biochemical laboratory results, available on a regional Electronic Care Records. They view femoral head architecture on radiographs against set criteria, Patient Archive and Communication system (SECTRA, Sweden). In total 1383 femoral heads were harvested, 247 were discarded giving an overall rate of 17.9 %. The most common reasons for discard of harvested graft was a positive microbiology/bacteriology result, n = 96 (38.9 %). After a rise in discard rates in 2007, we have steadily reduced our discard rates since 2006/2007 (28.2 %), 2008/2009 (17 %), 2010/2011 (14.8 %), and finally to 10.3 % in 2012/2013. In the current financial year, our cost to harvest, test, store and release a femoral head is £ 610. With a structured donor recruitment process and unique pre-operative radiographic analysis we have successfully reduced our discard rates bi-annually making our bone bank increasingly cost-effective.

  19. Basic Stand Alone Medicare Home Health Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Home Health Agency (HHA) Beneficiary Public Use Files (PUF) with information from Medicare HHA claims. The CMS BSA...

  20. Basic Stand Alone Medicare DME Line Items PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Durable Medical Equipment (DME) Line Items Public Use Files (PUF) with information from Medicare DME claims. The...

  1. Geriatrics training for nurses in a skilled nursing facility: a GWEP feasibility study.

    Science.gov (United States)

    Hawkley, Louise C; Long, Monica; Kostas, Tia; Levine, Stacie; Molony, Jason; Thompson, Katherine

    2017-12-08

    Geriatrics knowledge and expertise is critical to the care of older adults in skilled nursing facilities. However, opportunities for ongoing geriatrics training for nurses working in skilled nursing facilities are often scarce or nonexistent. This feasibility study describes a mixed-methods analysis of nurses' educational needs and barriers to continuing education in a for-profit skilled nursing facility in an underserved, urban environment. Potential mechanisms to overcome barriers are proposed. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Geriatric Training Needs of Nursing-Home Physicians

    Science.gov (United States)

    Lubart, Emily; Segal, Refael; Rosenfeld, Vera; Madjar, Jack; Kakuriev, Michael; Leibovitz, Arthur

    2009-01-01

    Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training…

  3. Geriatric Oncology Program Development and Gero-Oncology Nursing.

    Science.gov (United States)

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

    2016-02-01

    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Models for a stand-alone PV system

    DEFF Research Database (Denmark)

    Hansen, A.D.; Sørensen, Poul Ejnar; Hansen, L.H.

    2001-01-01

    This report presents a number of models for modelling and simulation of a stand-alone photovoltaic (PV) system with a battery bank verified against a system installed at Risø National Laboratory. The work has been supported by the Danish Ministry ofEnergy, as a part of the activities in the Solar...... Energy Centre Denmark. The study is carried out at Risø National Laboratory with the main purpose to establish a library of simple mathematical models for each individual element of a stand-alone PVsystem, namely solar cells, battery, controller, inverter and load. The models for PV module and battery...

  5. PMBLDCG based stand-alone wind energy conversion system for ...

    African Journals Online (AJOL)

    This paper deals with a permanent magnet brushless DC generator (PMBLDCG) based stand-alone wind energy conversion system (WECS) for small scale power generation. A buck-boost DC-DC converter is used for controlling the PMBLDCG speed to achieve optimum energy output from the wind turbine without sensing ...

  6. The stand-alone test and decreasing serial cost sharing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Thorlund-Petersen, Lars

    2000-01-01

    The rule of decreasing serial cost sharing defined in de Frutos [1] over the class of concave cost functions may violate the important stand-alone test. Sufficient conditions for the test to be satisfied are given, in terms of individual rationality as well as coalitional stability...

  7. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    Directory of Open Access Journals (Sweden)

    João Paulo de Almeida Tavares

    2013-01-01

    Full Text Available The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES among 1,068 Portuguese registered nurses (RNs. Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α=.919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  8. Validation of geriatric care environment scale in portuguese nurses.

    Science.gov (United States)

    Paulo de Almeida Tavares, João; Leite da Silva, Alcione; Sá-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was α = .919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

  9. Validation of Geriatric Care Environment Scale in Portuguese Nurses

    OpenAIRE

    Paulo de Almeida Tavares, Jo?o; Leite da Silva, Alcione; S?-Couto, Pedro; Boltz, Marie; Capezuti, Elizabeth

    2013-01-01

    The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal...

  10. Geriatric nursing assessment and intervention in an emergency department

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Wagner, Lis; Hendriksen, Carsten

    2012-01-01

    To describe and test a model for structured nursing assessment and intervention to older people discharged from emergency department (ED). Background. Older people recently discharged from hospital are at high risk of readmission. This risk may increase when they are discharged straight home from...... assessment, the nurse made relevant referrals to the geriatric outpatient clinic, community health centre, general practitioner or made arrangements with next of kin. Results. One hundred and fifty people participated, mean age was 81.7. At discharge, they had a mean of 1.9 unresolved problems, after 1 month...

  11. Radon Monitoring in Army Stand-Alone Housing Units

    Science.gov (United States)

    1990-04-01

    Y cm a cc 0000 0003 000 000 :: - -@-I.00 cmjinu mooc . 0J~CJ~ TTTT J !8 2 T WWWW WW.000 coo 0~~ 80 Im - v ;o e I3 ec ;: C -1,4 04. -c mco : - a c W" 1 .1...Chamber ....................... 25 V U I I I viI Final Report, April 1990 Radon Monitoring in Army Stand-alone Housing Units Summary Argonne National...and analysis. The quality control protocols appli- cable to detector analysis are contained in Chapter V of the procedures manual developed by Tech

  12. Future UK markets for stand-alone renewable energy systems

    International Nuclear Information System (INIS)

    Paish, O.

    1999-01-01

    A study to identify and quantify the market for stand-alone renewable energy supplies of power (photovoltaics, wind and micro-hydro electricity systems) was described. The study focused on small systems, generally less than a few kW installed capacity. It was suggested that in the UK, the emphasis on grid-connected renewable energy technologies (RETs) has blurred the fact that it is 'off-grid' renewable systems that can offer more immediate real commercial markets for the renewables business. With the likelihood of a significant increase in demand for renewables world wide over the next ten years, the UK needs to make a special effort to become involved

  13. [Nursing care and essential oils in geriatrics].

    Science.gov (United States)

    Lobstein, Annelise; Marinier, Françoise

    2014-01-01

    Aromatherapy is a valuable complementary therapeutic tool which is increasingly being used in hospitals. Essential oils help to improve patients' quality of life. They can be used for well-being purposes as well in specific nursing procedures. Some services offer aromatherapy through diffusion, inhalation, massages or aromatic baths. The benefits for healthcare teams as well as for patients are undeniable. There is also a significant reduction in the consumption of certain drugs.

  14. 49 CFR 1111.8 - Procedural schedule in stand-alone cost cases.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Procedural schedule in stand-alone cost cases... § 1111.8 Procedural schedule in stand-alone cost cases. (a) Procedural schedule. Absent a specific order by the Board, the following general procedural schedule will apply in stand-alone cost cases: Day 0...

  15. Hydrogen Gas Production in a Stand-Alone Wind Farm

    Directory of Open Access Journals (Sweden)

    M. Naziry Kordkandy

    2017-04-01

    Full Text Available This paper is analyzing the operation of a stand-alone wind farm with variable speed turbines, permanent magnet synchronous generators (PMSG and a system for converting wind energy during wind speed variations. On this paper, the design and modeling of a wind system which uses PMSG’s to provide the required power of a hydrogen gas electrolyzer system, is discussed. This wind farm consists of three wind turbines, boost DC-DC converters, diode full bridge rectifiers, permanent magnet synchronous generators, MPPT control and a hydrogen gas electrolyzer system. The MPPT controller based on fuzzy logic is designed to adjust the duty ratio of the boost DC-DC converters to absorb maximum power. The proposed fuzzy logic controller assimilates, with (PSF MPPT algorithm which generally used to absorb maximum power from paralleled wind turbines and stores it in form of hydrogen gas. The system is modeled and its behavior is studied using the MATLAB software.

  16. DOE and AID stand-alone photovoltaic activities

    Science.gov (United States)

    Bifano, W. J.; Ratajczak, A. F.

    The NASA Lewis Research Center (LeRC) is managing stand-alone photovoltaic (PV) system activities sponsored by the U.S. Department of Energy (DOE) and the U.S. Agency for International Development (AID). The DOE project includes village PV power demonstration projects in Gabon (four sites) and the Marshall Islands, PV-powered medical refrigerators in six countries, PV system microprocessor control development activities and PV-hybrid system assessments. The AID project includes a large village system in Tunisia, a water pumping/grain grinding project in Upper Volta, five medical clinics in four countries, PV-powered remote earth station application. These PV activities and summarizes significant findings to data are reviewed.

  17. Integral type small PWR with stand-alone safety

    International Nuclear Information System (INIS)

    Makihara, Yoshiaki

    2001-01-01

    A feasibility study is achieved on an integral type small PWR with stand-alone safety. It is designed to have the following features. (1) The coolant does not leak out at any accidental condition. (2) The fuel failure does never occur while it is supposed on the large scale PWR at the design base accident. (3) At any accidental condition the safety is secured without any support from the outside (stand-alone safety secure). (4) It has self-regulating characteristics and easy controllability. The above features can be satisfied by integrate the steam generator and CRDM in the reactor vessel while the pipe line break has to be considered on the conventional PWR. Several counter measures are planned to satisfy the above features. The economy feature is also attained by several simplifications such as (1) elimination of main coolant piping and pressurizer by the integration of primary cooling system and self-pressurizing, (2) elimination of RCP by application of natural circulating system, (3) elimination of ECCS and accumulator by application of static safety system, (4) large scale volume reduction of the container vessel by application of integrated primary cooling system, (5) elimination of boric acid treatment by deletion of chemical shim. The long operation period such as 10 years can be attained by the application of Gd fuel in one batch refueling. The construction period can be shortened by the standardizing the design and the introduction of modular component system. Furthermore the applicability of the reduced modulation core is also considered. (K. Tsuchihashi)

  18. Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Brian F Gage

    2011-05-01

    Full Text Available Introduction: The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods: This was a single-center emergency department (ED survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of this anonymous survey was to evaluate ED nurse and physician perceptions about the geriatric screener feasibility and barriers to implementation. In addition, as a secondary objective, respondents reported ongoing geriatric screening efforts independent of the research screeners. Results: The survey was completed by 72% of physicians and 33% of nurses. Most nurses and physicians identified geriatric technicians as beneficial to patients without impeding ED throughput. Fewer than 25% of physicians routinely screen for any geriatric syndromes. Nurses evaluated for fall risk significantly more often than physicians, but no other significant differences were noted in ongoing screening efforts. Conclusion: Dedicated geriatric technicians are perceived by nurses and physicians as beneficial to patients with the potential to improve patient safety and clinical outcomes. Most nurses and physicians are not currently screening for any geriatric syndromes. [West J Emerg Med. 2011;12(4:489–495.

  19. Cooperative learning strategies to teach nutrition to geriatric nursing staff.

    Science.gov (United States)

    Arroyo, Marta; Rocandio, Ana Ma; Ansotegui, Laura; Pascual, Estíbaliz; Martínez de la Pera, Concepción

    2008-03-01

    The objective of this study was to test the hypothesis that cooperative learning strategies will help to increase nutrition knowledge of nurses and nursing assistants caring for the elderly in different institutional communities of the Basque Country, Spain. The target population was a sample of volunteers, 16 nurses and 28 nursing assistants. Training consisted of 12 nutrition education sessions using cooperative strategies conducted over a period of 3 consecutive weeks. The assessment instruments included two pretest and two posttest questionnaires with questions selected in multiple-choice format. The first questionnaire was about general knowledge of applied nutrition (0-88 point scale) and the second one on geriatric nutrition knowledge (0-18 point scale). Data were analyzed using SPSS vs. 11.0. The outcomes indicated a significant increase in general nutrition knowledge (difference between the pre- and post-test mean score: 14.5+/-10.1; Pcooperative learning strategies could improve the nutrition knowledge of nursing staff. Additionally, the results of this study provide direction to continuing nutrition education program planners regarding appropriate content and methodology for programs.

  20. [Geriatric nursing staff retention. Opportunities, potentials, and strategies].

    Science.gov (United States)

    Joost, A

    2013-08-01

    Retaining geriatric nurses in their line of work could be an important strategy to prevent the shortage of skilled staff in the future. A prerequisite for this is detailed knowledge of the length and structure of professional careers. The IWAK ( Institut für Wirtschaft, Arbeit und Kultur) evaluated data from the German Social Insurance and carried out a structural analysis of the professional careers of geriatric nurses. Results showed that the average duration of professional careers is 20 years, of which 11.7 years constitute the period of employment and 7.8 years account for periods of inactivity. According to these findings, there is a considerable potential in extending professional careers and reducing the periods of inactivity to make better use of the existing skilled staff and to reduce staff shortage in this area. Concrete measures could involve improvement of working conditions (with the aim of avoiding long periods of inactivity and illness-related premature career endings as well as of increasing job satisfaction), creating better conditions for a good balance between work and family life, as well as setting up individual strategies to expand weekly working hours. Key players are businesses but also local authorities and politicians.

  1. Why do nursing students not want to work in geriatric care? A national questionnaire survey.

    Science.gov (United States)

    Haron, Yafa; Levy, Sara; Albagli, Mazal; Rotstein, Ruth; Riba, Shoshana

    2013-11-01

    Given the severe shortage of nurses in geriatric care in Israel and the planned expansion of their role in the care of older people, the Israel Ministry of Health's Nursing Division decided to investigate the readiness of current students to work in geriatrics. To gather last-year student nurses' views on geriatric nursing as a career choice and identify the factors behind those views. A cross-sectional questionnaire study was designed. 486 students (70% of the total last-year student nurse population) across the whole range of study settings completed the questionnaire in 2011. On the basis of extensive data collection from focus groups of student nurses and working geriatric nurses a structured, self-administered questionnaire was compiled. The researchers distributed and collected the questionnaire in the students' classrooms. 61% of the 486 respondents had no intention of working in geriatrics while 12% considered the prospect favourably. 27% of the respondents were prepared to consider geriatric nursing as a career choice only after advanced specialist training in that field. 69% said that the planned expansion of the powers of geriatric nurses would incline them more favourably to work in geriatrics. A relatively high proportion of those interested in working in geriatrics were men. The students' appraisal of the content of their training programme and of the current state of geriatrics in Israel appeared not to influence career choice. Multiple regression analysis found that the factors most predictive of geriatric care as a career choice were a generally favourable attitude to older people, the expansion of nurse powers in the sector and previous experience in older people care. Studying on an academic programme as opposed to a diploma programme was a negative predictor. The non-influence of training programme content/design is the key finding. The chief recruitment effort should be invested in making the domain of geriatric nursing more attractive to

  2. The Stand-alone Heliostat; El Heliostato Autonomo

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Navajas, G.; Egea Gea, A. [Ciemat. Madrid (Spain)

    2000-07-01

    The first Autonomous Heliostat has been developed by CIEMAT at PSA facilities in Almeria. This heliostat is an innovative approach to reducing the civil engineering work costs in heliostat fields of central tower plants. Channels, cables and other electric elements have been eliminated in the new heliostat. Thus, one 70-m''2, classical T glass/metal heliostat has been adapted to include all the new stand-alone concept components. A PV system is able to drive two sun-tracking DC motors between 5 and 24 Vdc, 0 and 15A. The heliostat communicates with the control room 400-m away by using a radio-modern working at 9600 baud. An anemometer, a wind switcher, light and ambient temperature sensors have been installed on the heliostat for self-protection decision-making. A PV panel integrated into the heliostat reflecting surface, eliminates cabling and other elements required for a conventional power supply. Communication lines between master control and local control have been replaced by radio-modern. Testing has validated the technical feasibility of the prototype and quantified the real consumption and efficiencies of new elements. The extra costs produced by the autonomous concepts are compared with the cost of civil work in conventional heliostat field. (Author) 8 refs.

  3. A control strategy for PV stand-alone applications

    Science.gov (United States)

    Slouma, S.; Baccar, H.

    2015-04-01

    This paper proposes a stand-alone photovoltaic (PV) system study in domestic applications. Because of the decrease in power of photovoltaic module as a consequence of changes in solar radiation and temperature which affect the photovoltaic module performance, the design and control of DC-DC buck converter was proposed for providing power to the load from a photovoltaic source.In fact, the control of this converter is carried out with integrated MPPT (Maximum Power Point Tracking) algorithm which ensures a maximum energy generated by the PV arrays. Moreover, the output stage is composed by a battery energy storage system, dc-ac inverter, LCL filter which enables higher efficiency, low distortion ac waveforms and low leakage currents. The control strategy adopted is cascade control composed by two regulation loops.Simulations performed with PSIM software were able to validate the control system.The realization and testing of the photovoltaic system were achieved in the Photovoltaic laboratory of the Centre for Research and Energy Technologies at the Technopark Borj Cedria. Experimental results verify the effeciency of the proposed system.

  4. Stand-alone wind system with Vanadium Redox Battery energy storage

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Barote, L.; Weissbach, R.

    2008-01-01

    Energy storage devices are required for power balance and power quality in stand alone wind energy systems. A Vanadium Redox Flow Battery (VRB) system has many features which make its integration with a stand-alone wind energy system attractive. This paper proposes the integration of a VRB system...

  5. Integrated Three-Port DC-DC Converter for Photovoltaic (PV) Battery Stand-alone Systems

    DEFF Research Database (Denmark)

    Ouyang, Ziwei; Andersen, Michael A. E.

    2016-01-01

    Several power sources such as PV solar arrays and battery are often used to manage the power flow for a photovoltaic (PV) based stand-alone power system due to the fluctuation nature of solar energy resource, and deliver a continuous power to the users in an appropriate form. Traditionally, three...... for PV and battery stand-alone system....

  6. [Assessment of nursing needs and risk management in geriatric oncology].

    Science.gov (United States)

    Taleb, Cherifa; Landre, Thierry; Bertrand, Eric; Schlatter, Joël; Ratiney, Robert; des Guetz, Gaëtan

    2013-01-01

    In France, the incidence and rate of mortality of cancer increase with age. For elderly patients suffering from cancer, the standard geriatric assessment, together with an oncological assessment aims to optimise the treatment. This geriatric oncology assessment enables the priorities to be identified and the cancer treatment to be adapted by anticipating the risks and organising the support care.

  7. Filipino Nursing Students' Behavioral Intentions toward Geriatric Care: A Structural Equation Model (SEM)

    Science.gov (United States)

    de Guzman, Allan B.; Jimenez, Benito Christian B.; Jocson, Kathlyn P.; Junio, Aileen R.; Junio, Drazen E.; Jurado, Jasper Benjamin N.; Justiniano, Angela Bianca F.

    2013-01-01

    Anchored on the key constucts of Ajzen's Theory of Planned Behavior (1985), this paper seeks to test a model that explores the influence of knowledge, attitude, and caring behavior on nursing students' behavioral intention toward geriatric care. A five-part survey-questionnaire was administered to 839 third and fourth year nursing students from a…

  8. Development and Validation of the Geriatric In-Hospital Nursing Care Questionnaire

    NARCIS (Netherlands)

    Persoon, Anke; Bakker, Franka C.; van der Wal-Huisman, Hanneke; Rikkert, Marcel G. M. Olde

    ObjectivesTo develop a questionnaire, the Geriatric In-hospital Nursing Care Questionnaire (GerINCQ), to measure, in an integrated way, the care that older adults receive in the hospital and nurses' attitudes toward and perceptions about caring for older adults. DesignQuestionnaire development.

  9. Nursing Assessment and Intervention to Geriatric Patients Discharged From Emergency Department

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Poulsen, Ingrid; Hendriksen, Carsten

    to the geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: Primary endpoints will be presented as unplanned readmission to ED; admission to nursing home; and death. Secondary endpoints will be presented as physical function; depressive symptoms......Background: Geriatric patients recently discharged from hospital are at risk of unplanned readmissions and admission to nursing home. When discharged directly from Emergency Department (ED) the risk increases, as time pressure often requires focus on the presenting problem, although 80...... % of geriatric patients have complex and often unresolved caring needs. Objective: To examine the effect of a two-stage nursing assessment and intervention to address the patients uncompensated problems given just after discharge from ED and one and six months after. Method: We conducted a prospective...

  10. Geriatric rehabilitation of stroke patients in nursing homes: a study protocol.

    Science.gov (United States)

    Spruit-van Eijk, Monica; Buijck, Bianca I; Zuidema, Sytse U; Voncken, Frans L M; Geurts, Alexander C H; Koopmans, Raymond T C M

    2010-03-27

    Geriatric patients are typically underrepresented in studies on the functional outcome of rehabilitation after stroke. Moreover, most geriatric stroke patients do probably not participate in intensive rehabilitation programs as offered by rehabilitation centers. As a result, very few studies have described the successfulness of geriatric stroke rehabilitation in nursing home patients, although it appears that the majority of these patients are being discharged back to the community, rather than being transferred to residential care. Nevertheless, factors associated with the successfulness of stroke rehabilitation in nursing homes or skilled nursing facilities are largely unknown. The primary goal of this study is, therefore, to assess the factors that uniquely contribute to the successfulness of rehabilitation in geriatric stroke patients that undergo rehabilitation in nursing homes. A secondary goal is to investigate whether these factors are similar to those associated with the outcome of stroke rehabilitation in the literature. This study is part of the Geriatric Rehabilitation in AMPutation and Stroke (GRAMPS) study in the Netherlands. It is a longitudinal, observational, multicenter study in 15 nursing homes in the Southern part of the Netherlands that aims to include at least 200 patients. All participating nursing homes are selected based on the existence of a specialized rehabilitation unit and the provision of dedicated multidisciplinary care. Patient characteristics, disease characteristics, functional status, cognition, behavior, and caregiver information, are collected within two weeks after admission to the nursing home. The first follow-up is at discharge from the nursing home or one year after inclusion, and focuses on functional status and behavior. Successful rehabilitation is defined as discharge from the nursing home to an independent living situation within one year after admission. The second follow-up is three months after discharge in

  11. Physicians' and nurses' experiences of end-of-life decision-making in geriatric settings.

    Science.gov (United States)

    Giantin, Valter; Siviero, Paola; Simonato, Matteo; Iasevoli, Mario; Pengo, Valentina; Andrigo, Margherita; Storti, Matteo; Valentini, Elisabetta; Pegoraro, Renzo; Maggi, Stefania; Crepaldi, Gaetano; Manzato, Enzo

    2012-10-01

    In Italy there is a paucity of empirical data on practices concerning end-of-life decisions (ELDs) in geriatrics. We aimed to investigate the frequency and characteristics of ELDs made by Italian physicians and nurses in the geriatric setting. In 2009, an anonymous questionnaire was sent to 54 geriatric units, 21 hospices, and 382 nursing homes in the Veneto and Trentino Alto Adige regions, and to professionals in the area who are members of the Italian Gerontology and Geriatrics Association. This paper reports the results of 552 questionnaires answered by 171 physicians, 368 nurses and 13 professionals who did not state their profession. Death was preceded by decisions to start or continue treatments likely to prolong the patients' life in 51.3% of cases. The proportion of deaths preceded by a decision to end life (DEL) was 20.8%; 18% of DELs concerned non-treatment decisions. There were 9 cases of ending of life without patient's explicit request. No cases of doctor-assisted suicide were reported, while there were 2 cases of euthanasia, one reported by a physician and one by a nurse. In geriatrics, DELs often precede the deaths of terminally-ill Italian patients. Nurses report making DELs more often than physicians, especially in incompetent patients. Continuous deep sedation was adopted by 39.5% of the Italian physicians for deaths not occurring suddenly and unexpectedly. Our report on physicians' and nurses' experiences of ELD making in geriatric settings can offer a valuable contribution to the current debate on end-of-life treatment, an issue that goes beyond national borders.

  12. Filling the void in geriatric mental health: the Geropsychiatric Nursing Collaborative as a model for change.

    Science.gov (United States)

    Beck, Cornelia; Buckwalter, Kathleen C; Dudzik, Pamela M; Evans, Lois K

    2011-01-01

    Mental health for older adults is a looming public health problem. Yet, geriatric mental health specialists are a scarce commodity, and few generalists have had formal education in either geriatrics or mental health. A multilevel collaboration using a diffusion of innovation model served to achieve change nationally in preparing entry-and advanced practice-level nurses to improve the mental health of older Americans. The John A. Hartford Foundation Geropsychiatric Nursing Collaborative at the American Academy of Nursing is the exemplar described here. The Geropsychiatric Nursing Collaborative developed and infused mental health competency enhancements for generalist and specialist nurses; identified and disseminated teaching-learning strategies to convey related key concepts using the POGOe (Portal of Geriatric Online Education) website; raised awareness through multiple presentations and publications; and notified deans of every school of nursing about these new resources. Fully embracing diffusion of innovation principles, the Geropsychiatric Nursing Collaborative is achieving change in this critical area of nursing practice. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Developing future nursing home medical directors: a curriculum for geriatric medicine fellows.

    Science.gov (United States)

    Higuchi, Masaya; Wen, Aida; Masaki, Kamal

    2013-03-01

    Long term care facilities are important sites of care for elderly adults. Despite a growing need and interest in medical direction in nursing homes, there have been limited educational opportunities in this area for geriatric medicine fellows. This article describes a novel medical director's curriculum for first-year geriatric medicine fellows to prepare them for the role of nursing home medical director. This novel curriculum has been integrated into the Department of Geriatric Medicine's Fellowship training program at the John A. Burns School of Medicine, University of Hawaii. The curriculum consists of seven seminars that have been integrated into the didactic sessions during the first year of fellowship. Core content areas include: (1) roles and responsibilities of the medical director, (2) infection control, (3) physician documentation, (4) federal regulations and state surveys, (5) quality improvement, (6) culture change in nursing homes, and (7) transitions in care. All topics were discussed using the framework described by the American Medical Directors Association's position statement on the roles and responsibilities of the nursing home medical director. To our knowledge, this is the first curriculum in the medical literature that is designed to prepare geriatric medicine fellows for roles as medical directors in nursing homes. Copyright © 2013. Published by Elsevier Inc.

  14. Gerontology found me: gaining understanding of advanced practice nurses in geriatrics.

    Science.gov (United States)

    Campbell-Detrixhe, Dia D; Grassley, Jane S; Zeigler, Vicki L

    2013-10-01

    Examining the meanings of the experiences of advanced practice nurses (APNs) who chose to work with older adults and why they continue to work with this population was the focus of this hermeneutic qualitative research study. Twelve geriatric APNs currently practicing in two South Central states were interviewed using an open-ended interview guide. Using Gadamerian hermeneutics, the researchers identified Gerontology Found Me as the significant expression that reflected the fundamental meaning of the experience as a whole. Four themes emerged that further described the meanings of the participants' personal, educational, and professional experiences: Becoming a Gerontology Nurse, Being a Gerontology Nurse, Belonging to Gerontology, and Bringing Others to Gerontology. This study concluded that APNs' personal and professional experiences were more influential than educational experiences to become geriatric nurses, and having these personal and professional experiences of being in relationship with older individuals further contributed to their choice of gerontology.

  15. Integrated versus stand-alone second generation ethanol production from sugarcane bagasse and trash.

    Science.gov (United States)

    Dias, Marina O S; Junqueira, Tassia L; Cavalett, Otávio; Cunha, Marcelo P; Jesus, Charles D F; Rossell, Carlos E V; Maciel Filho, Rubens; Bonomi, Antonio

    2012-01-01

    Ethanol production from lignocellulosic materials is often conceived considering independent, stand-alone production plants; in the Brazilian scenario, where part of the potential feedstock (sugarcane bagasse) for second generation ethanol production is already available at conventional first generation production plants, an integrated first and second generation production process seems to be the most obvious option. In this study stand-alone second generation ethanol production from surplus sugarcane bagasse and trash is compared with conventional first generation ethanol production from sugarcane and with integrated first and second generation; simulations were developed to represent the different technological scenarios, which provided data for economic and environmental analysis. Results show that the integrated first and second generation ethanol production process from sugarcane leads to better economic results when compared with the stand-alone plant, especially when advanced hydrolysis technologies and pentoses fermentation are included. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Stand-alone wind system with Vanadium Redox Battery energy storage

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Barote, L.; Weissbach, R.

    2008-01-01

    Energy storage devices are required for power balance and power quality in stand alone wind energy systems. A Vanadium Redox Flow Battery (VRB) system has many features which make its integration with a stand-alone wind energy system attractive. This paper proposes the integration of a VRB system...... with a typical stand-alone wind energy system during wind speed variation as well as transient performance under variable load. The investigated system consists of a variable speed wind turbine with permanent magnet synchronous generator (PMSG), diode rectifier bridge, buck-boost converter, bidirectional charge...... controller, transformer, inverter, ac loads and VRB (to store a surplus of wind energy and to supply power during a wind power shortage). The main purpose is to supply domestic appliances through a single phase 230V, 50Hz inverter. Simulations are accomplished in order to validate the stability of the supply....

  17. Nursing intervention for geriatric patients dischargedhome from ED

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie

    2009-01-01

    , omfanget af hjælp registreres og der udføres funktionsevnetest (chair-stand-test, håndgrebskraft, Avlunds trætheds- og mobilitetstest, selvvurderet helbredsrelateret livskvalitet SF12, Geriatric Depression Scale DS-5 og Mini Mental State Examination MMSE). Ved baseline anvendes deskriptiv statistik...

  18. Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.

    Science.gov (United States)

    Rolland, Yves; Resnick, Barbara; Katz, Paul R; Little, Milta O; Ouslander, Joseph G; Bonner, Alice; Geary, Carol R; Schumacher, Karen L; Thompson, Sarah; Martin, Finbarr C; Wilbers, Joachim; Zúñiga, Franziska; Ausserhofer, D; Schwendimann, R; Schüssler, S; Dassen, Theo; Lohrmann, Christa; Levy, Cari; Whitfield, Emily; de Souto Barreto, Philipe; Etherton-Beer, Christopher; Dilles, Tinne; Azermai, Majda; Bourgeois, Jolyce; Orrell, Martin; Grossberg, George T; Kergoat, Hélène; Thomas, David R; Visschedijk, Jan; Taylor, Stephanie J C; Handajani, Yvonne S; Widjaja, Nelly T; Turana, Yuda; Rantz, Marilyn J; Skubic, Marjorie; Morley, John E

    2014-05-01

    The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  19. Sensorless direct voltage control of the stand-alone brushless doubly-fed generator

    DEFF Research Database (Denmark)

    Liu, Yi; Xu, Wei; Xiong, Fei

    2017-01-01

    The conventional stand-alone brushless doubly-fed generator (BDFG) control strategies need the feedback from the rotor position or speed sensors, which can reduce system reliability and increase the cost and axial volume of the machine. In this paper, a sensorless direct voltage control (DVC......) strategy is presented for the stand-alone BDFG. The satisfactory dynamic performance is verified by experimental results under four kinds of typical operation conditions. Besides, the proposed control strategy is robust due to no generator parameters being required....

  20. A Current Sensorless MPPT Control Method for a Stand-Alone-Type PV Generation System

    Science.gov (United States)

    Itako, Kazutaka; Mori, Takeaki

    In this paper, a current sensorless MPPT control method for a stand-alone-type PV generation system is proposed. This control method offers advantages of the simplified hardware configuration and the low cost, by using only one sensor to measure the PV output voltage. In the application to stand-alone-type with a battery load, the experimental results show that the estimated values of PV output current are accurate, and the use of the proposed MPPT control increases the PV generated energy by 16.3% compared to the conventional system. Furthermore, it is clarified that the proposed method has extremely high UUF (Useful utilization factor) of 98.7%.

  1. Photovoltaic Module Simulink Model for a Stand-alone PV System

    Science.gov (United States)

    Qi, Chen; Ming, Zhu

    Photovoltaic(PV) Module is indispensable of a stand-alone PV system. In this paper, a one-diode equivalent circuit-based versatile simulation model in the form of masked block PV module is proposed. By the model, it is allowed to estimate behavior of PV module with respect changes on irradiance intensity, ambient temperature and parameters of the PV module. In addition, the model is capable of function of Maximum Power Point Tracking (MPPT) which can be used in the dynamic simulation of stand-alone PV systems.

  2. A control strategy for stand-alone wound rotor induction machine

    Energy Technology Data Exchange (ETDEWEB)

    Forchetti, D.G.; Garcia, G.O. [Grupo de Electronica Aplicada (GEA), Universidad Nacional de Rio Cuarto, X5804 BYA Rio Cuarto (Argentina); Solsona, J.A. [Instituto de Investigaciones en Ingenieria Electrica?Alfredo Desages?, Departamento de Ingenieria Electrica y de Computadoras, Universidad Nacional del Sur, Bahia Blanca (Argentina); Valla, M.I. [Laboratorio de Electronica Industrial, Control e Instrumentacion (LEICI), Facultad de Ingenieria, Universidad Nacional de La Plata, 1900 La Plata (Argentina)

    2007-02-15

    A control strategy to regulate the frequency and voltage of a stand-alone wound rotor induction machine is presented. This strategy allows the machine to work as a generator in stand-alone systems (without grid connection) with variable rotor speed. A stator flux-oriented control is proposed using the rotor voltages as actuation variables. Two cascade control loops are used to regulate the stator flux and the rotor currents. A closed loop observer is designed to estimate the machine flux which is necessary to implement these control loops. The proposed control strategy is validated through simulations with satisfactory results. (author)

  3. Assessment of Stand-Alone Displays for Time Management in a Creativity-Driven Learning Environment

    DEFF Research Database (Denmark)

    Frimodt-Møller, Søren

    2017-01-01

    This paper considers the pros and cons of stand-alone displays, analog (e.g. billboards, blackboards, whiteboards, large pieces of paper etc.) as well as digital (e.g. large shared screens, digital whiteboards or similar), as tools for time management processes in a creativity-driven learning...... to storing information digitally. The findings could indicate a possible market for stand-alone, interactive digital displays combining the ‘touch and feel’ character of an analog board with the convenience of digital data storage....

  4. Stand alone solar energy harvesting and storage systems in off-grid applications

    Science.gov (United States)

    Alonso-Marroquin, Fernando; Gormly, Justin Blake; Bilbao, Jose

    2017-06-01

    The following is an implementation of a stand-alone system for solar energy harvesting and electrical energy storage systems for use in off-grid housing applications. The principal aim of this project was to construct a compact and affordable system for an off-grid house and to monitor its efficiency along the year.

  5. 11kW stand alone wind turbine based on proven wind turbine

    DEFF Research Database (Denmark)

    Bindner, H.; Wodstrup, J.; Andersen, J.

    2004-01-01

    and enable control of frequency and voltage independently on both the grid side and the generator side. The prototype has been installed at Risø. The paper will present results from test runs of the system both operating stand-alone supplying a single load and in parallel operation with a diesel genset....

  6. Linguistic and Structural Analyses of Stand-Alone Literature Reviews: Seventy-Five Years of Change

    Science.gov (United States)

    Wright, Heidi Rachel

    2016-01-01

    The purpose of this dissertation is to offer a multifaceted overview of stand-alone literature reviews. These texts, literature reviews published unattached to research articles, have existed for centuries but remained largely unstudied by linguists. Thus, the goal of this project is to present these reviews' situational, grammatical, and…

  7. Design and Operation Studies of A Stand-Alone PV Generation System

    DEFF Research Database (Denmark)

    Hu, Yanting; Chen, Zhe; Zhang, Donglai

    2013-01-01

    This paper discusses the modeling, design and operation of a PV powered stand-alone system, which includes a PV array, a battery bank, power electronic converters and the associated control system. The design considerations are analyzed and a design platform is presented. Furthermore the operatio...

  8. Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease

    DEFF Research Database (Denmark)

    Udby, Peter M.; Bech-Azeddine, Rachid

    2015-01-01

    low back pain resulting from degenerative disc disease. ALIF surgery has previously been linked with certain high risk complications and unfavorable long term fusion results. Newer studies suggest that stand-alone ALIF can possibly be advantageous compared to other types of posterior instrumented...

  9. Environmental/Climatic Effect on Stand-Alone Solar Energy Supply ...

    African Journals Online (AJOL)

    This paper investigates the climatic eects and environmental variations on the performance of a stand-alone photovoltaic system. The eects of partial shading with dierent climate conditions and load resistance variations were examined. A survey of some of the work done in this eld of environmental eect on solar panel was ...

  10. MOSFET Loss Evaluation for a Low-Power Stand-Alone Photovoltaic-LED System

    DEFF Research Database (Denmark)

    Mira Albert, Maria del Carmen; Knott, Arnold; Andersen, Michael A. E.

    2015-01-01

    This paper presents a performance evaluation and comparison of state-of-the-art low voltage Si MOSFETs for a stand-alone photovoltaic-LED Light to Light (LtL) system. The complete system is formed by two cascaded converters that will be optimized for a determined solar irradiation and LED...

  11. Integrated Three-Port DC-DC Converter for Photovoltaic (PV) Battery Stand-alone Systems

    DEFF Research Database (Denmark)

    Ouyang, Ziwei; Andersen, Michael A. E.

    2016-01-01

    Several power sources such as PV solar arrays and battery are often used to manage the power flow for a photovoltaic (PV) based stand-alone power system due to the fluctuation nature of solar energy resource, and deliver a continuous power to the users in an appropriate form. Traditionally, three...

  12. Stand-alone version of the 11kW Gaia wind turbine

    DEFF Research Database (Denmark)

    Bindner, H.; Rosas, P.A.C.; Teodorescu, R.

    2004-01-01

    This report describes the development of a stand-alone version of the 11kW Gaia wind turbine. Various possible configurations are investigated and a configuration using a back-to-back converter is chosen. A model is developed for controller design of thefast controllers of the unit. Controllers...... assessment and controller design a dynamic performance assessment model has been developed....

  13. A maximum power point tracking scheme for a 1kw stand-alone ...

    African Journals Online (AJOL)

    A maximum power point tracking scheme for a 1kw stand-alone solar energy based power supply. ... This paper elucidates one of the tracking schemes for a photovoltaic (PV) systems using Cuk converter operating in discontinuous inductor current mode (DICM) as an interface. A method for efficiently maximizing the output ...

  14. Analysis and controller design for stand-alone VSIs in synchronous reference frame

    DEFF Research Database (Denmark)

    Ramezani, Malek; Li, Shuhui; Golestan, Saeed

    2017-01-01

    The common practice for controlling the stand-alone voltage source inverters (VSIs) is to transform abc voltage and current signals to DC signals using the dq transformation, which makes it possible to control the new DC voltage and current signals just using simple proportional-integral controll...

  15. Innovative interprofessional geriatric education for medical and nursing students: focus on transitions in care.

    Science.gov (United States)

    Balogun, S A; Rose, K; Thomas, S; Owen, J; Brashers, V

    2015-06-01

    Interprofessional education (IPE) is crucial in fostering effective collaboration and optimal team-based patient care, all of which improve patient care and outcomes. Appropriate interprofessional communication is especially important in geriatrics where patients are vulnerable to adverse effects across the care continuum. Transitions in geriatric care are complex, involving several disciplines and requiring careful coordination. As part of the University of Virginia's initiative on IPE, we developed and implemented an interprofessional geriatric education workshop for nursing and medical students with a focus on transitions in care. A total of 254 students (144 medical students, 107 nursing students and 3 unknown) participated in a 90-min interactive, case-based workshop. Nursing and medical faculty facilitated the monthly workshops with small groups of medical and nursing students over 1 year. Self-perceived competencies in IPE skills and attitudes toward interprofessional teamwork were measured through post-workshop surveys. Data were analyzed using descriptive and nonparametric statistics, excluding the three unknown students. Over 90% of students were better able to describe the necessary interprofessional communication needed to develop a patient-centered care plan in transitioning patients between clinical sites. Four out of five students reported an enhanced appreciation of interprofessional teamwork. They were also able to identify legal, financial and social implications in transitions of care (75%). Nursing students consistently rated the workshop more highly than medical students across most domains (P interprofessional communication and teamwork skills required in transitions of geriatric care. Introducing these concepts in medical and nursing training may help in fostering effective interprofessional communication and collaboration. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved

  16. Advancing nursing home practice: the International Association of Geriatrics and Gerontology Recommendations.

    Science.gov (United States)

    Tolson, Debbie; Morley, John E; Rolland, Yves; Vellas, Bruno

    2011-01-01

    Recognition of the urgent need to improve the provision of long-term care, as well as the known variations in standards of nursing home care around the world, prompted the International Association of Geriatrics and Gerontology (IAGG), in association with the World Health Organization (WHO), to form a task force. This task force was charged with the identification of the key concerns, research priorities, and actions that would enhance the care provided to older people in nursing homes. Nurses are equipped with the knowledge to take a leadership role in the IAGG/WHO initiative, and the task force eagerly seeks their input. Copyright © 2011 Mosby, Inc. All rights reserved.

  17. Geriatric nursing: an idea whose time has gone? A polemic.

    Science.gov (United States)

    Nolan, M

    1994-12-01

    The future role of the nursing profession in providing health care for older people is considered. It is argued that, despite claims to holism, nursing has maintained a narrow focus, concentrating mainly on acute hospital care. The concepts of professional protectionism and professional reductionism are used to explain the manifest failure of nursing and other professions working with older people and their carers to place the needs of their clients at the top of their agendas. A reorientation of nursing practice is advocated in order that the profession fulfils its potential with respect to older people.

  18. Development and dissemination of Web-based clinical simulations for continuing geriatric nursing education.

    Science.gov (United States)

    Kowlowitz, Vicki; Davenport, Carolyn S; Palmer, Mary H

    2009-04-01

    This article describes the process of developing and disseminating a Web-based library of geriatric clinical simulations used in continuing education workshops. Twenty-six peer-reviewed clinical simulations were developed on topics reflecting prevalent acute illnesses, conditions, or sentinel events that, if left undetected or untreated, could cause further comorbidity, hospitalization, or death. Geriatric nursing competencies identified by The John A. Hartford Foundation Institute for Geriatric Nursing were also incorporated. More than 700 workshop attendees and others have used these online clinical simulations. User evaluations of realism, accuracy of the situation or problem portrayed, and relevance to practice were rated as excellent or very good by more than 85% of the users. The University of North Carolina at Chapel Hill Center for Lifelong Learning Web site will offer this library with associated American Nurses Credentialing Center contact hours. This online access provides nurses high-quality continuing education offerings to increase knowledge and improve competence in the care of aging adults.

  19. Geriatric oncology in the Netherlands: a survey of medical oncology specialists and oncology nursing specialists.

    Science.gov (United States)

    Jonker, J M; Smorenburg, C H; Schiphorst, A H; van Rixtel, B; Portielje, J E A; Hamaker, M E

    2014-11-01

    To identify ways to improve cancer care for older patients, we set out to examine how older patients in the Netherlands are currently being evaluated prior to oncological treatment and to explore the potential obstacles in the incorporation of a geriatric evaluation, using a web-based survey sent to Dutch medical oncology specialists and oncology nursing specialists. The response rate was 34% (183 out of 544). Two-thirds of respondents reported that a geriatric evaluation was being used, although primarily on an ad hoc basis only. Most respondents expressed a desire for a routine evaluation or more intensive collaboration with the geriatrician and 86% of respondents who were not using a geriatric evaluation expressed their interest to do so. The most important obstacles were a lack of time or personnel and insufficient availability of a geriatrician to perform the assessment. Thus, over 30% of oncology professionals in the Netherlands express an interest in geriatric oncology. Important obstacles to a routine implementation of a geriatric evaluation are a lack of time, or insufficient availability of geriatricians; this could be overcome with policies that acknowledge that quality cancer care for older patients requires the investment of time and personnel. © 2014 John Wiley & Sons Ltd.

  20. [Prevalence of sarcopenia in geriatric outpatients and nursing homes. The ELLI study].

    Science.gov (United States)

    Osuna-Pozo, Carmen María; Serra-Rexach, José Antonio; Viña, José; Gómez-Cabrera, María del Carmen; Salvá, Antoni; Ruiz, Domingo; Masanes, Ferrán; Lopez-Soto, Alfonso; Formiga, Francesc; Cuesta, Federico; Cruz-Jentoft, Alfonso

    2014-01-01

    There are few systematic studies on the prevalence of sarcopenia using the new diagnostic criteria in different geriatric care settings. To estimate the prevalence of sarcopenia, using the European Working Group on Sarcopenia in Older People (EWGSOP) criteria in older subjects living in nursing homes and in those who attend geriatric outpatient clinics. A single country multicentre study in two samples of older subjects: patients cared for in outpatient geriatric clinics, and individuals living in nursing homes. Data collected will include demographic variables, medical history, medication, geriatric syndromes, functional status (assessment of basic and instrumental activities of daily living), mobility, cognitive status, comorbidity, quality of life, nutritional status, and laboratory parameters. For the diagnosis of sarcopenia, 4m walking speed, handgrip strength, and body composition measured by bioelectrical impedance analysis will be assessed. Using the EWGSOP algorithm, the prevalence of sarcopenia in an elderly Spanish population will be estimated. In addition, concordance and correlation between the three parameters included in the definition (muscle mass, muscle strength, and physical performance) will be analysed, using the different existing cut-off points, and examining the diagnostic accuracy of each. Finally, demographic, anthropometric and functional data that define subjects with sarcopenia will be investigated. The ELLI study should improve knowledge on the prevalence and characteristics of sarcopenia in older people in our population. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  1. Geriatric Nursing Master’s Degree Program Overviews in Iran: Review Article

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2016-03-01

    Full Text Available ​The increasing number of elderly in recent years has led to great changes in the country's healthcare system. One of these changes is developing geriatric nursing master degree. This paper, with non-systematic approach, presents an evaluation of geriatric nursing graduate program in Iran. According to the results, mission and curriculum of the course are written in details. The number of faculties and students is rising every year. It seems that “the teacher shortage” and “determining the accurate and appropriate job status” for graduates are the main challenges. Given the young nature of the field, it is strongly recommended to reassess after some years.

  2. Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).

    Science.gov (United States)

    Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy

    2016-09-01

    The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. A Control Method for Maximum Power Point Tracking in Stand-Alone-Type PV Generation Systems

    Science.gov (United States)

    Itako, Kazutaka; Mori, Takeaki

    In this paper, a new control method for maximum power point tracking (MPPT) in stand-alone-type PV generaton systems is proposed. In this control method, the operations detecting the maximum power point and tracking its point are alternately carried out by using a step-up DC—DC converter. This method requires neither the measurement of temperature and insolation level nor PV array model. In a stand-alone-type application with a battery load, the design method for the boost inductance L of the step-up DC—DC converter is described, and the experimental results show that the use of the proposed MPPT control increases the PV generated energy by 14.8% compared to the conventional system.

  4. Graft subsidence as a predictor of revision surgery following stand-alone lateral lumbar interbody fusion.

    Science.gov (United States)

    Tempel, Zachary J; McDowell, Michael M; Panczykowski, David M; Gandhoke, Gurpreet S; Hamilton, D Kojo; Okonkwo, David O; Kanter, Adam S

    2018-01-01

    OBJECTIVE Lateral lumbar interbody fusion (LLIF) is a less invasive surgical option commonly used for a variety of spinal conditions, including in high-risk patient populations. LLIF is often performed as a stand-alone procedure, and may be complicated by graft subsidence, the clinical ramifications of which remain unclear. The aim of this study was to characterize further the sequelae of graft subsidence following stand-alone LLIF. METHODS A retrospective review of prospectively collected data was conducted on consecutive patients who underwent stand-alone LLIF between July 2008 and June 2015; 297 patients (623 levels) met inclusion criteria. Imaging studies were examined to grade graft subsidence according to Marchi criteria, and compared between those who required revision surgery and those who did not. Additional variables recorded included levels fused, DEXA (dual-energy x-ray absorptiometry) T-score, body mass index, and routine demographic information. The data were analyzed using the Student t-test, chi-square analysis, and logistic regression analysis to identify potential confounding factors. RESULTS Of 297 patients, 34 (11.4%) had radiographic evidence of subsidence and 18 (6.1%) required revision surgery. The median subsidence grade for patients requiring revision surgery was 2.5, compared with 1 for those who did not. Chi-square analysis revealed a significantly higher incidence of revision surgery in patients with high-grade subsidence compared with those with low-grade subsidence. Seven of 18 patients (38.9%) requiring revision surgery suffered a vertebral body fracture. High-grade subsidence was a significant predictor of the need for revision surgery (p subsidence following stand-alone LLIF required revision surgery. When evaluating patients for LLIF, supplemental instrumentation should be considered during the index surgery in patients with a significant risk of graft subsidence.

  5. A Three-Port Topology Comparison for a Low Power Stand-Alone Photovoltaic System

    DEFF Research Database (Denmark)

    Mira Albert, Maria del Carmen; Knott, Arnold; Andersen, Michael A. E.

    2014-01-01

    Three-port converter (TPC) topologies for renewable energy systems aim to provide higher efficiency and power density than conventional cascaded structures. This work proposes an analytical comparison of different TPC topologies for a photovoltaic LED lamp stand-alone system. A comparison using...... component stress factor (CSF) is performed, which gives a quantitative measure of the performance of the converter. The candidate topologies are compared to each other according to a defined LED lighting strategy and a solar irradiation profile....

  6. Secure stand alone positive personnel identity verification system (SSA-PPIV)

    International Nuclear Information System (INIS)

    Merillat, P.D.

    1979-03-01

    The properties of a secure stand-alone positive personnel identity verification system are detailed. The system is designed to operate without the aid of a central computing facility and the verification function is performed in the absence of security personnel. Security is primarily achieved by means of data encryption on a magnetic stripe badge. Several operational configurations are discussed. Advantages and disadvantages of this system compared to a central computer driven system are detailed

  7. Modeling, Design and Simulation of Stand-Alone Photovoltaic Power Systems with Battery Storage

    Directory of Open Access Journals (Sweden)

    Abd Essalam BADOUD

    2013-06-01

    Full Text Available Stand alone renewable energy based on photovoltaic systems accompanied with battery storage system are beginning to play an important role over the world to supply power to remote areas. The objective of the study reported in this paper is to elaborate and design a bond graphs model for sizing stand-alone domestic solar photovoltaic electricity systems and simulating the performance of the systems in a tropical climate. The systems modelled consist of an array of PV modules, a lead-acid battery, and a number of direct current appliances. This paper proposes the combination of lead acid battery system with a typical stand alone photovoltaic energy system under variable loads. The main activities of this work purpose to establish library graphical models for each individual component of standalone photovoltaic system. Control strategy has been considered to achieve permanent power supply to the load via photovoltaic/battery based on the power available from the sun. The complete model was simulated under two testing including sunny and cloudy conditions. Simulation of the system using Symbols software was performed and the results of simulation show the superior stable control system and high efficiency. These results have been contrasted with real measured data from a measurement campaign plant carried on electrical engineering laboratory of Grenoble using various interconnection schemes are presented.

  8. Geriatric Nursing Assessment and Intervention in an Emergency Department – a Pilot Study

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Wagner, Lis; Henriksen, Carsten

    2012-01-01

    Aim To describe and test a model for structured nursing assessment and intervention to older people discharged from Emergency Department (ED). Background Older people recently discharged from hospital are at high risk of readmission. This risk may increase when they are discharged straight home...... assessment the nurse made relevant referrals to the geriatric outpatient clinic, community health centre, general practitioner or made arrangements with next-of-kin. Results One hundred and fifty people participated, mean age was 81.7. At discharge they had a mean of 1.9 unresolved problems, after 1 month 0...

  9. Twitter discussions about the predicaments of robots in geriatric nursing: forecast of nursing robotics in aged care.

    Science.gov (United States)

    Eriksson, Henrik; Salzmann-Erikson, Martin

    2017-08-17

    People use social media to express perceptions, attitudes and a wide range of concerns regarding human life. This study aims at analysing the ongoing discussions on the internet microblog Twitter and offers some coming predicaments regarding developments in geriatric nursing regarding nursing robots. Data were retrospectively collected from Twitter. 1322 mentions were included in the final analyses, where principles of interpreting data by using netnography were utilized. Many ideas are presented expressing functional, psychological and social aspects of robots in nursing care. Most postings come from metropolitan cities around the globe. The discussion focuses on market-driven, science fiction solutions for aged care. Twitter users overall seem to be positive using various nursing robots in aged care. These discussions offer a window into the attitudes and ideas of this group of users. We suggest that monitoring Twitter discussions on social media can provide valuable insights into current attitudes as well as forecast coming trends.

  10. Subsidence after single-level anterior cervical fusion with a stand-alone cage.

    Science.gov (United States)

    Park, Jae-Young; Choi, Ki-Young; Moon, Bong Ju; Hur, Hyuk; Jang, Jae-Won; Lee, Jung-Kil

    2016-11-01

    To investigate the risk factors for subsidence in patients treated with stand-alone anterior cervical discectomy and fusion (ACDF) using polyetheretherketone (PEEK) cages for single-level degenerative cervical disease. Seventy-seven consecutive patients who underwent single-level stand-alone ACDF with a PEEK cage between 2005 and 2012 were included. Subsidence was defined as a decrease in the interbody height of more than 3mm on radiographs at the 1-year follow-up compared with that in the immediate post-operative image. Patients were divided into the subsidence and non-subsidence groups. The following factors were investigated in relation to the occurrence of subsidence: age, pre-operative overall cervical sagittal angle, segmental angle of the operated level, interbody height, cage height, cage devices and cage location (distance between anterior margin of the body endplate and that of the cage). The clinical outcomes were assessed with visual analog scale, modified Japanese Orthopedic Association score and neck disability index. Twenty-six out of the 77 (33.8%) patients had radiological signs of cage subsidence. Solid fusion was achieved in 25 out of the 26 patients (96.2%) in the subsidence group and in 47 out of the 51 patients (92.2%) in the non-subsidence group. More than 3mm distance between anterior margin of the vertebral body and that of the cage was significantly associated with subsidence (psubsidence did not correlate with fusion rate or clinical outcomes. Cage location was the only significant risk factor. Therefore, cage location should be taken into consideration during stand-alone ACDF using PEEK cages. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. A Simple Sizing Algorithm for Stand-Alone PV/Wind/Battery Hybrid Microgrids

    Directory of Open Access Journals (Sweden)

    Jing Li

    2012-12-01

    Full Text Available In this paper, we develop a simple algorithm to determine the required number of generating units of wind-turbine generator and photovoltaic array, and the associated storage capacity for stand-alone hybrid microgrid. The algorithm is based on the observation that the state of charge of battery should be periodically invariant. The optimal sizing of hybrid microgrid is given in the sense that the life cycle cost of system is minimized while the given load power demand can be satisfied without load rejection. We also report a case study to show the efficacy of the developed algorithm.

  12. Stand-alone and Interdisciplinary Course Design for Engineering Education for Sustainable Development

    DEFF Research Database (Denmark)

    Arsat, M.; Holgaard, Jette Egelund; de Graaff, Erik

    In order to embed ESD in the EE curriculum, several approaches has been introduced and practiced in higher education institutions. One of the approaches is to introduce a new ESD course as an add-on to the existing curriculum being either compulsory or elective and either designed for a single...... and reported examples of other ESD courses of the same kind. The presented conceptual framework is put to practice, characterising the AAU course as a stand-alone interdisciplinary course with a consensual approach. The conclusion is that the conceptual framework can provide an awareness of the design features...

  13. Information systems for the materials management department: stand-alone and enterprise resource planning systems.

    Science.gov (United States)

    2005-03-01

    Materials management information systems (MMISs) incorporate information tools that hospitals can use to automate certain business processes, increase staff compliance with these processes, and identify opportunities for cost savings. Recently, there has been a push by hospital administration to purchase enterprise resource planning (ERP) systems, information systems that promise to integrate many more facets of healthcare business. We offer this article to help materials managers, administrators, and others involved with information system selection understand the changes that have taken place in materials management information systems, decide whether they need a new system and, if so, whether a stand-alone MMIS or an ERP system will be the best choice.

  14. Solar Photovoltaic Applications Seminar: Design, installation and operation of small, stand-alone photovoltaic power systems

    Science.gov (United States)

    1980-07-01

    An introduction to photoconductivity, semiconductors, and solar photovoltaic cells is included along with a demonstration of specific applications and application identification. Small solar cell power system design engineering is discussed. Solar PV power system applications involve classical direct electrical energy conversion and electric power system analysis and synthesis. Presentations and examples involve a variety of disciplines including structural analysis, electric power and load analysis, reliability, sizing and optimization; and, installation, operation and maintenance. Four specific system designs are demonstrated: water pumping; domestic uses; navigational and aircraft aids; and telecommunications. All of the applications discussed are for small power requirement (under 2 kilowatts), stand alone systems to be used in remote locations.

  15. Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion.

    Science.gov (United States)

    Bocahut, N; Audureau, E; Poignard, A; Delambre, J; Queinnec, S; Flouzat Lachaniette, C-H; Allain, J

    2017-12-30

    Few data are available on the occurrence after stand-alone lateral lumbar interbody fusion (LLIF) of implant subsidence, whose definition and incidence vary across studies. The primary objective of this work was to determine the incidence of subsidence 1 year postoperatively, using an original measurement method, whose validity was first assessed. The secondary objective was to assess the clinical impact of subsidence. Implant subsidence after stand-alone LLIF is a common complication that can adversely affect clinical outcomes. Of 69 included patients who underwent stand-alone LLIF, 67 (97%) were re-evaluated at least 1 year later. Furthermore, 63 (91%) patients had two available computed tomography (CT) scans for assessing subsidence, one performed immediately after surgery and the other 1 year later. Reproducibility of the original measurement method was assessed in a preliminary study. Subsidence was defined as at least 4mm loss of fused space height. The incidence of subsidence was 32% (20 patients). Subsidence was global in 7 (11%) patients and partial in 13 (21%) patients. Mean loss of height was 5.5±1.5mm. Subsidence predominated anteriorly in 50% of cases. The lordotic curvature of the fused segment was altered in 50% of patients, by a mean of 8°±3°. Fusion was achieved in 67/69 (97%) patients. The Oswestry score and visual analogue scale scores for low-back and nerve-root pain were significantly improved after 1 year in the overall population and in the groups with and without subsidence. Reproducibility of our measurement method was found to be excellent. Subsidence was common but without significant clinical effects after 1 year. Nevertheless, subsidence can be associated with pain and can result in loss of lumbar lordosis, which is a potential risk factor for degenerative disease of the adjacent segments. A score for predicting the risk of subsidence will now be developed by our group as a tool for improving patient selection to stand-alone LLIF

  16. Boost converter with combined control loop for a stand-alone photovoltaic battery charge system

    DEFF Research Database (Denmark)

    Mira Albert, Maria del Carmen; Knott, Arnold; Thomsen, Ole Cornelius

    2013-01-01

    frequency avoids perturbations in the load being propagated to the photovoltaic panel and thus deviating the operating point. Linearization of the photovoltaic panel and converter state-space modeling is performed. In order to achieve stable operation under all operating conditions, the photovoltaic panel......The converter control scheme plays an important role in the performance of maximum power point tracking (MPPT) algorithms. In this paper, an input voltage control with double loop for a stand-alone photovoltaic system is designed and tested. The inner current control loop with high crossover...

  17. Feasibility and Optimal Design of a Stand-Alone Photovoltaic Energy System for the Orphanage

    Directory of Open Access Journals (Sweden)

    Vincent Anayochukwu Ani

    2014-01-01

    Full Text Available Access to electricity can have a positive psychological impact through a lessening of the sense of exclusion, and vulnerability often felt by the orphanages. This paper presented the simulation and optimization study of a stand-alone photovoltaic power system that produced the desired power needs of an orphanage. Solar resources for the design of the system were obtained from the National Aeronautics and Space Administration (NASA Surface Meteorology and Solar Energy website at a location of 6°51′N latitude and 7°35′E longitude, with annual average solar radiation of 4.92 kWh/m2/d. This study is based on modeling, simulation, and optimization of energy system in the orphanage. The patterns of load consumption within the orphanage were studied and suitably modeled for optimization. Hybrid Optimization Model for Electric Renewables (HOMER software was used to analyze and design the proposed stand-alone photovoltaic power system model. The model was designed to provide an optimal system configuration based on an hour-by-hour data for energy availability and demands. A detailed design, description, and expected performance of the system were presented in this paper.

  18. Coordination Control Strategy for AC/DC Hybrid Microgrids in Stand-Alone Mode

    Directory of Open Access Journals (Sweden)

    Dwi Riana Aryani

    2016-06-01

    Full Text Available Interest in DC microgrids is rapidly increasing along with the improvement of DC power technology because of its advantages. To support the integration process of DC microgrids with the existing AC utility grids, the form of hybrid AC/DC microgrids is considered for higher power conversion efficiency, lower component cost and better power quality. In the system, AC and DC portions are connected through interlink bidirectional AC/DC converters (IC with a proper control system and power management. In the stand-alone operation mode of AC/DC hybrid microgrids, the control of power injection through the IC is crucial in order to maintain the system security. This paper mainly deals with a coordination control strategy of IC and a battery energy storage system (BESS converter under stand-alone operation. A coordinated control strategy for the IC, which considers the state of charge (SOC level of BESS and the load shedding scheme as the last resort, is proposed to obtain better power sharing between AC and DC subgrids. The scheme will be tested with a hybrid AC/DC microgrid, using the tool of the PSCAD/EMTDC software.

  19. Fuzzy logic control of stand-alone photovoltaic system with battery storage

    Science.gov (United States)

    Lalouni, S.; Rekioua, D.; Rekioua, T.; Matagne, E.

    Photovoltaic energy has nowadays an increased importance in electrical power applications, since it is considered as an essentially inexhaustible and broadly available energy resource. However, the output power provided via the photovoltaic conversion process depends on solar irradiation and temperature. Therefore, to maximize the efficiency of the photovoltaic energy system, it is necessary to track the maximum power point of the PV array. The present paper proposes a maximum power point tracker (MPPT) method, based on fuzzy logic controller (FLC), applied to a stand-alone photovoltaic system. It uses a sampling measure of the PV array power and voltage then determines an optimal increment required to have the optimal operating voltage which permits maximum power tracking. This method carries high accuracy around the optimum point when compared to the conventional one. The stand-alone photovoltaic system used in this paper includes two bi-directional DC/DC converters and a lead-acid battery bank to overcome the scare periods. One converter works as an MPP tracker, while the other regulates the batteries state of charge and compensates the power deficit to provide a continuous delivery of energy to the load. The Obtained simulation results show the effectiveness of the proposed fuzzy logic controller.

  20. International market assessment of stand-alone photovoltaic power systems for cottage industry applications

    Science.gov (United States)

    Philippi, T. M.

    1981-01-01

    The final result of an international assessment of the market for stand-alone photovoltaic systems in cottage industry applications is reported. Nonindustrialized countries without centrally planned economies were considered. Cottage industries were defined as small rural manufacturers, employing less than 50 people, producing consumer and simple products. The data to support this analysis were obtained from secondary and expert sources in the U.S. and in-country field investigations of the Philippines and Mexico. The near-term market for photovoltaics for rural cottage industry applications appears to be limited to demonstration projects and pilot programs, based on an in-depth study of the nature of cottage industry, its role in the rural economy, the electric energy requirements of cottage industry, and a financial analysis of stand-alone photovoltaic systems as compared to their most viable competitor, diesel driven generators. Photovoltaics are shown to be a better long-term option only for very low power requirements. Some of these uses would include clay mixers, grinders, centrifuges, lathes, power saws and lighting of a workshop.

  1. A sizing method for stand-alone PV installations with variable demand

    Energy Technology Data Exchange (ETDEWEB)

    Posadillo, R. [Grupo de Investigacion en Energias y Recursos Renovables, Dpto. de Fisica Aplicada, E.P.S., Universidad de Cordoba, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Lopez Luque, R. [Grupo de Investigacion de Fisica Para las Energias y Recursos Renovables, Dpto. de Fisica Aplicada, Edificio C2 Campus de Rabanales, 14071 Cordoba (Spain)

    2008-05-15

    The practical applicability of the considerations made in a previous paper to characterize energy balances in stand-alone photovoltaic systems (SAPV) is presented. Given that energy balances were characterized based on monthly estimations, the method is appropriate for sizing installations with variable monthly demands and variable monthly panel tilt (for seasonal estimations). The method presented is original in that it is the only method proposed for this type of demand. The method is based on the rational utilization of daily solar radiation distribution functions. When exact mathematical expressions are not available, approximate empirical expressions can be used. The more precise the statistical characterization of the solar radiation on the receiver module, the more precise the sizing method given that the characterization will solely depend on the distribution function of the daily global irradiation on the tilted surface H{sub g{beta}}{sub i}. This method, like previous ones, uses the concept of loss of load probability (LLP) as a parameter to characterize system design and includes information on the standard deviation of this parameter ({sigma}{sub LLP}) as well as two new parameters: annual number of system failures (f) and the standard deviation of annual number of system failures ({sigma}{sub f}). This paper therefore provides an analytical method for evaluating and sizing stand-alone PV systems with variable monthly demand and panel inclination. The sizing method has also been applied in a practical manner. (author)

  2. Method to size photovoltaic arrays for hydrogen-PV stand-alone power stations

    Energy Technology Data Exchange (ETDEWEB)

    Barra, L.; Coiante, D. [ENEA, Casaccia (Italy). Area Energetica

    1993-11-01

    With reference to a stand alone power plant configuration, a photovoltaic (PV) system, integrated with an electrolytic hydrogen production and fuel cell reconversion line, is examined with the aim of checking the possibility of assuring energy supply for a given load with time continuity. In order to size the PV array in function of the annual load diagram, for a given site, a method, which utilizes the monthly average values of sun energy density collected on horizontal surface as input data, is presented. The results demonstrate that a PV-H{sub 2} system is suitable for a modular stand alone solar power station, able to supply continuously each generic load. This technical acquisition has to be considered as the first necessary condition to get photovoltaics to overcome the limit due to working intermittence and become a real energy option. An example of an application for a small Mediterranean island, the Volcano Island, permanently inhabited by 469 people, is also discussed. This typical case can be actually show the technical viability of the PV-H{sub 2} solution in powering a small community with the required reliability.

  3. Robust Power Management Control for Stand-Alone Hybrid Power Generation System

    International Nuclear Information System (INIS)

    Kamal, Elkhatib; Adouane, Lounis; Aitouche, Abdel; Mohammed, Walaa

    2017-01-01

    This paper presents a new robust fuzzy control of energy management strategy for the stand-alone hybrid power systems. It consists of two levels named centralized fuzzy supervisory control which generates the power references for each decentralized robust fuzzy control. Hybrid power systems comprises: a photovoltaic panel and wind turbine as renewable sources, a micro turbine generator and a battery storage system. The proposed control strategy is able to satisfy the load requirements based on a fuzzy supervisor controller and manage power flows between the different energy sources and the storage unit by respecting the state of charge and the variation of wind speed and irradiance. Centralized controller is designed based on If-Then fuzzy rules to manage and optimize the hybrid power system production by generating the reference power for photovoltaic panel and wind turbine. Decentralized controller is based on the Takagi-Sugeno fuzzy model and permits us to stabilize each photovoltaic panel and wind turbine in presence of disturbances and parametric uncertainties and to optimize the tracking reference which is given by the centralized controller level. The sufficient conditions stability are formulated in the format of linear matrix inequalities using the Lyapunov stability theory. The effectiveness of the proposed Strategy is finally demonstrated through a SAHPS (stand-alone hybrid power systems) to illustrate the effectiveness of the overall proposed method. (paper)

  4. Photovoltaic OLED Driver for Low-Power Stand-Alone Light-to-Light Systems

    DEFF Research Database (Denmark)

    Ploug, Rasmus Overgaard; Knott, Arnold

    2016-01-01

    Photovoltaic (PV) stand-alone systems need to achieve multiple energy conversion modes. I.e. the energy conversion from PV to a local energy storage as well as energy conversion from the energy storage to the load. This paper documents the practical design considerations for the development of a ...... conversion from photovoltaic panel to the battery, and 97 % in the area 1.4 W to 2 W for power delivery to the OLED.......Photovoltaic (PV) stand-alone systems need to achieve multiple energy conversion modes. I.e. the energy conversion from PV to a local energy storage as well as energy conversion from the energy storage to the load. This paper documents the practical design considerations for the development...... of a three-port-converter for this purpose optimized for the specifications for driving an Organic Light Emitting Diode (OLED) panel intended for lighting purposes. By using a three-port-converter, featuring shared components for each conversion mode, the converter reaches 97 % efficiency at 1.8 W during...

  5. Modified Chaos Particle Swarm Optimization-Based Optimized Operation Model for Stand-Alone CCHP Microgrid

    Directory of Open Access Journals (Sweden)

    Fei Wang

    2017-07-01

    Full Text Available The optimized dispatch of different distributed generations (DGs in stand-alone microgrid (MG is of great significance to the operation’s reliability and economy, especially for energy crisis and environmental pollution. Based on controllable load (CL and combined cooling-heating-power (CCHP model of micro-gas turbine (MT, a multi-objective optimization model with relevant constraints to optimize the generation cost, load cut compensation and environmental benefit is proposed in this paper. The MG studied in this paper consists of photovoltaic (PV, wind turbine (WT, fuel cell (FC, diesel engine (DE, MT and energy storage (ES. Four typical scenarios were designed according to different day types (work day or weekend and weather conditions (sunny or rainy in view of the uncertainty of renewable energy in variable situations and load fluctuation. A modified dispatch strategy for CCHP is presented to further improve the operation economy without reducing the consumers’ comfort feeling. Chaotic optimization and elite retention strategy are introduced into basic particle swarm optimization (PSO to propose modified chaos particle swarm optimization (MCPSO whose search capability and convergence speed are improved greatly. Simulation results validate the correctness of the proposed model and the effectiveness of MCPSO algorithm in the optimized operation application of stand-alone MG.

  6. Stand-alone anterior lumbar interbody fusion for treatment of degenerative spondylolisthesis.

    Science.gov (United States)

    Rao, Prashanth J; Ghent, Finn; Phan, Kevin; Lee, Keegan; Reddy, Rajesh; Mobbs, Ralph J

    2015-10-01

    We sought to evaluate the clinical and radiologic efficacy of stand-alone anterior lumbar interbody fusion (ALIF) for low grade degenerative spondylolisthesis, the favoured surgical management approach at our institution. The optimal approach for surgical management of spondylolisthesis remains contentious. We performed a prospective analysis of all consecutive patients with low grade lumbar spondylolisthesis who underwent ALIF between 2009 and 2013 by a single surgeon (n=27). The mean age was 64.9 years with a male to female ratio of 14:13. There were 32 levels operated and the average preoperative spondylolisthesis was 14.8%, which reduced to 6.4% postoperatively and 9.4% at the latest follow-up (p=0001). Postoperative disc height was increased to 175% of preoperative values and was statistically significant (pspondylolisthesis reduction (p=0.04) and the only clinical factor affecting reduction was body mass index (p=0.04). The present study provides encouraging short term results for stand-alone ALIF as a procedure for low grade lumbar degenerative spondylolisthesis. Future studies should include adequately powered, prospective, multicentre registry studies with long term follow-up to allow a better assessment of the relative benefits and risks. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. International market assessment of stand-alone photovoltaic power systems for cottage industry applications

    Science.gov (United States)

    Philippi, T. M.

    1981-11-01

    The final result of an international assessment of the market for stand-alone photovoltaic systems in cottage industry applications is reported. Nonindustrialized countries without centrally planned economies were considered. Cottage industries were defined as small rural manufacturers, employing less than 50 people, producing consumer and simple products. The data to support this analysis were obtained from secondary and expert sources in the U.S. and in-country field investigations of the Philippines and Mexico. The near-term market for photovoltaics for rural cottage industry applications appears to be limited to demonstration projects and pilot programs, based on an in-depth study of the nature of cottage industry, its role in the rural economy, the electric energy requirements of cottage industry, and a financial analysis of stand-alone photovoltaic systems as compared to their most viable competitor, diesel driven generators. Photovoltaics are shown to be a better long-term option only for very low power requirements. Some of these uses would include clay mixers, grinders, centrifuges, lathes, power saws and lighting of a workshop.

  8. Design of a Stand-Alone Photovoltaic Model for Home Lightings and Clean Environment

    International Nuclear Information System (INIS)

    Ani, Vincent Anayochukwu

    2016-01-01

    This paper gives a well-documented health risk of fuel-based lighting (kerosene lamps and fuel-powered generators) and proposed a design of a stand-alone solar PV system for sustainable home lightings in rural Nigerian area. The design was done in three different patterns of electricity consumptions with energy efficient lightings (EELs) using two different battery types (Rolls Surrette 6CS25PS and Hoppecke 10 OpzS 1000) on; (i) judicious power consumption, (ii) normal power consumption, and (iii) excess power consumption; and compared them with the incandescent light bulb consumption. The stand-alone photovoltaic energy systems were designed to match the rural Nigerian sunlight and weather conditions to meet the required lightings of the household. The objective function and constraints for the design models were formulated and optimization procedures were used to demonstrate the best solution (reliability at the lowest lifecycle cost). Initial capital costs as well as annualized costs over 5, 10, 15, 20, and 25 years were quantified and documented. The design identified the most cost-effective and reliable solar and battery array among the patterns of electricity consumption with EEL options (judicious power consumption, normal power consumption, and excess power consumption).

  9. Simulation of stand alone PV systems; Dokuritsugata taiyoko hatsuden system no simulation

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, I.; Sakuta, K. [Electrotechnical Laboratory, Tsukuba (Japan); Oshiro, T. [Japan Quality Assurance Organization, Tokyo (Japan); Kurokawa, K. [Tokyo University of Agriculture and Technology, Tokyo (Japan)

    1997-11-25

    Studies are performed to develop a simulation program for a stand-alone photovoltaic power generation system equipped with a lead acid battery. In this stand-alone photovoltaic power generation system, the load is connected in shunt with the solar cell array output through the intermediary of a lead acid battery and inverter. The program is a model in which the solar cell model is built taking parallel resistance into account, and the temperature-dependence of the constants is described using approximations experimentally obtained by Solar Techno Center of JQA (Japan Quality Assurance Organization), Hamamatsu. Insolation data for the model is described using METPV compiled by Japan Weather Association, and load data is described using data actually measured at Shizuoka. This program is compared with the data of operation at Hamamatsu, and the result is almost satisfactory. Simulations are conducted at five typical locations in Japan using this program, and it is found that the array load matching correction factor is dependent on seasonal changes rather than locality, that the battery contribution rate does not change much throughout the year, and that it is not dependent on locality. 5 refs., 7 figs., 3 tabs.

  10. Design of a Stand-Alone Photovoltaic (PV Models for Home Lightings and Clean Environment

    Directory of Open Access Journals (Sweden)

    Vincent Anayochukwu Ani

    2016-01-01

    Full Text Available This paper gives a well-documented health risks of fuel-based lighting (kerosene lamps and fuel-powered generators and proposed a design of a stand-alone solar PV system for sustainable home lightings in rural Nigerian area. The design was done in three different patterns of electricity consumptions with energy efficient lightings (EELs using two different battery types (Rolls Surrette 6CS25PS and hoppecke 10 OpzS 1000 on; i judicious power consumption, ii normal power consumption, iii excess power consumption; and compared them with the incandescent light bulb consumption. The stand-alone photovoltaic energy systems were designed to match the rural Nigerian sunlight and weather conditions to meet the required lightings of the household. The objective function and constraints for the design models were formulated and optimization procedure were used to demonstrate the best solution (reliability at the lowest lifecycle cost. Initial capital costs as well as annualized costs over 5, 10, 15, 20, and 25 years were quantified and documented. The design identified the most cost-effective and reliable solar and battery array among the patterns of electricity consumption with energy efficient lighting options (judicious power consumption, normal power consumption, and excess power consumption.

  11. Design of Stand-Alone Hybrid Power Generation System at Brumbun Beach Tulungagung East Java

    Science.gov (United States)

    Rahmat, A. N.; Hidayat, M. N.; Ronilaya, F.; Setiawan, A.

    2018-04-01

    Indonesian government insists to optimize the use of renewable energy resources in electricity generation. One of the efforts is launching Independent Energy Village plan. This program aims to fulfill the need of electricity for isolated or remote villages in Indonesia. In order to support the penetration of renewable energy resources in electricity generation, a hybrid power generation system is developed. The simulation in this research is based on the availability of renewable energy resources in Brumbun beach, Tulungagung, East Java. Initially, the electricity was supplied through stand-alone electricity generations which are installed at each house. Hence, the use of electricity between 5 p.m. – 9 p.m. requires high operational costs. Based on the problem above, this research is conducted to design a stand-alone hybrid electricity generation system, which may consist of diesel, wind, and photovoltaic. The design is done by using HOMER software to optimize the use of electricity from renewable resources and to reduce the operation of diesel generation. The combination of renewable energy resources in electricity generation resulted in NPC of 44.680, COE of 0,268, and CO2 emissions of 0,038 % much lower than the use of diesel generator only.

  12. Emotional intelligence and coping styles: An intervention in geriatric nurses.

    Science.gov (United States)

    Sarabia-Cobo, Carmen María; Suárez, Soraya González; Menéndez Crispín, Ernesto J; Sarabia Cobo, A Belén; Pérez, Victoria; de Lorena, Pablo; Rodríguez Rodríguez, Cristina; Sanlúcar Gross, Laura

    2017-06-01

    Current research indicates a relationship between EI, stress, coping strategies, well-being and mental health. Emotional intelligence skills and knowledge, and coping strategies can be increased with training. The aims of this study were to use a controlled design to test the impact of theoretically based training on the different components of EI and coping styles in a sample of nurses working with older adults. A group of 92 professionals (RN and CAN) who attended a workshop on EI were included in the study. They completed a self-reported measure of EI and coping styles on three occasions: pre- and post-workshop and at one year follow-up. The EI workshop consisted of four 4-h sessions conducted over a four-week period. Each session was held at the one-week interval. This interval allowed participants to apply what was taught during the session to their daily life. The instruments to measure the EI and coping were the Trait Meta-Mood Scale and the CAE test. There were significant differences between the pre- and post-workshop measures both at the end of the workshop and up to one year for both the Trait Meta-Mood Scale scores and the CAE test. There was a significant increase in the EI and coping styles after the workshop and one year thereafter. The workshop was useful for developing EI in the professionals. The immediate impact of the emotional consciousness of individuals was particularly significant for all participants. The long-term impact was notable for the significant increase in EI and most coping styles. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Diagnosis and management of geriatric insomnia: a guide for nurse practitioners.

    Science.gov (United States)

    Krishnan, Preetha; Hawranik, Pamela

    2008-12-01

    To discuss the assessment, diagnosis, and management of geriatric insomnia, a challenging clinical condition of older adults frequently seen by primary care providers. Extensive literature review of the published research articles and textbooks. Complaints of insomnia among older adults are frequently ignored, considered a part of the normal aging process or viewed as a difficult to treat condition. Geriatric insomnia remains a challenge for primary care providers because of the lack of evidence-based clinical guidelines and limited treatment options available. Effective management of this condition is necessary for improved quality of life, which is a primary issue for the elderly and their families. Therefore, geriatric insomnia warrants thorough attention from the nurse practitioners (NPs) who provide care for older adults. Undiagnosed or under treated insomnia can cause increased risk for falls, motor vehicle accidents, depression, and shorter survival. Insomniacs double their risk for cardiovascular disease, stroke, cancer, and suicide compared to their counterparts. Insomnia is also associated with increased healthcare utilization and institutionalization. NPs could play a central role in reducing the negative consequences of insomnia through a systematic approach for diagnosis, evaluation, and management.

  14. Subsidence and nonunion after anterior cervical interbody fusion using a stand-alone polyetheretherketone (PEEK) cage.

    Science.gov (United States)

    Yang, Jae Jun; Yu, Chang Hun; Chang, Bong-Soon; Yeom, Jin Sup; Lee, Jae Hyup; Lee, Choon-Ki

    2011-03-01

    The purposes of the present study are to evaluate the subsidence and nonunion that occurred after anterior cervical discectomy and fusion using a stand-alone intervertebral cage and to analyze the risk factors for the complications. Thirty-eight patients (47 segments) who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage and an autologous cancellous iliac bone graft from June 2003 to August 2008 were enrolled in this study. The anterior and posterior segmental heights and the distance from the anterior edge of the upper vertebra to the anterior margin of the cage were measured on the plain radiographs. Subsidence was defined as ≥ a 2 mm (minor) or 3 mm (major) decrease of the segmental height at the final follow-up compared to that measured at the immediate postoperative period. Nonunion was evaluated according to the instability being ≥ 2 mm in the interspinous distance on the flexion-extension lateral radiographs. The anterior and posterior segmental heights decreased from the immediate postoperative period to the final follow-up at 1.33 ± 1.46 mm and 0.81 ± 1.27 mm, respectively. Subsidence ≥ 2 mm and 3 mm were observed in 12 segments (25.5%) and 7 segments (14.9%), respectively. Among the expected risk factors for subsidence, a smaller anteroposterior (AP) diameter (14 mm vs. 12 mm) of cages (p = 0.034; odds ratio [OR], 0.017) and larger intraoperative distraction (p = 0.041; OR, 3.988) had a significantly higher risk of subsidence. Intervertebral nonunion was observed in 7 segments (7/47, 14.9%). Compared with the union group, the nonunion group had a significantly higher ratio of two-level fusion to one-level fusions (p = 0.001). Anterior cervical fusion using a stand-alone cage with a large AP diameter while preventing anterior intraoperative over-distraction will be helpful to prevent the subsidence of cages. Two-level cervical fusion might require more careful attention for avoiding nonunion.

  15. Charactrization of a Li-ion battery based stand-alone a-Si photovoltaic system

    International Nuclear Information System (INIS)

    Hamid Vishkasougheh, Mehdi; Tunaboylu, Bahadir

    2014-01-01

    Highlights: • An Li-ion battery based stand-alone a-Si PV was designed. The system composed of three a-Si panels with an efficiency of 7% and 40 cells of LFP batteries. • Effects of solar radiation and environmental temperature for three cities, Istanbul, Ankara, and Adana, have been investigated on a-Si panels. • Using transition formulas BSPV outputs are predictable for any location out of standard test condition. - Abstract: The number of photovoltaic (PV) system installations is increasing rapidly. As more people learn about this versatile and often cost-effective power option, this trend will accelerate. This document presents a recommended design for a battery based stand-alone photovoltaic system (BSPV). BSPV system has the ability to be applied in different areas, including warning signals, lighting, refrigeration, communication, residential water pumping, remote sensing, and cathodic protection. The presented calculation method gives a proper idea for a system sizing technique. Based on application load, different scenarios are possible for designing a BSPV system. In this study, a battery based stand-alone system was designed. The electricity generation part is three a-Si panels, which are connected in parallel, and for the storage part LFP (lithium iron phosphate) battery was used. The high power LFP battery packs are 40 cells each 8S5P (configured 8 series 5 parallel). Each individual pack weighs 0.5 kg and is 25.6 V. In order to evaluate the efficiency of a-Si panels with respect to the temperature and the solar irradiation, cities of Istanbul, Ankara and Adana in Turkey were selected. Temperature and solar irradiation were gathered from reliable sources and by using translation equations, current and voltage output of panels were calculated. As a result of these calculations, current and energy outputs were computed by considering an average efficient solar irradiation time value per day in Turkey. The calculated power values were inserted to a

  16. Chronic pain, depression symptoms and daily living independency level among geriatrics in nursing home.

    Science.gov (United States)

    Tarakcı, Ela; Zenginler, Yonca; Kaya Mutlu, Ebru

    2015-01-01

    The aim of this study was to investigate pain, depression and independence in activities of daily living in geriatric residents of nursing homes, as well as to evaluate the relationship between these parameters. 186 nursing home residents, aged 65 to 90 years, were enrolled in the study. Their socio-demographic features, depression levels, pain levels and independence in activities of daily living were evaluated using a socio-demographic assessment form, the Geriatric Depression Scale (GDS), the Visual Analogue Scale (VAS) and the Nottingham Extended Activities of Daily Living Index (NEADL), respectively. For statistical analyses, participants were divided into groups with and without chronic pain. The main finding of this study was that 55.9% of the participants reported chronic pain, and these participants had significantly higher GDS (p=0.001) and lower NEADL scores (p=0.01) than those who reported no chronic pain. We found a significant correlation between VAS and GDS (r=0.47, p=0.001), VAS and NEADL (r=-0.30, p=0.001), and GDS and NEADL scores (r=-0.50, p=0.001). Female gender (p=0.001), number of children (p=0.005), number of chronic diseases (p=0.009), and GDS score (p=0.001) were found to affect chronic pain in multivariate model. Investigation of pain, presence of depression, and independence in activities of daily living is important in determining the necessary measures to be adopted for promoting the health and well-being of the geriatric population.

  17. Evaluation of a nursing home medical director's curriculum for geriatric medicine fellows.

    Science.gov (United States)

    Higuchi, Masaya; Wen, Aida; Masaki, Kamal

    2013-08-01

    To describe the evaluation of a nursing home medical directorship curriculum for geriatric medicine fellows. Six first-year geriatric medicine fellows from the University of Hawaii program participated in this educational intervention. A medical directorship curriculum based on the American Medical Directors Association's description of the roles and responsibilities of the medical director. Seven 1-hour sessions covering core topics were delivered in case-based format, with the opportunity to practice application. The curriculum's impact on learner's knowledge, attitudes, skills, and abilities was evaluated using pretests and posttests. The curriculum was evaluated using a structured individual feedback interview after the completion of this curriculum. Pre-post mean scores for attitudes and skills/ability items were compared using paired t tests. A summary of comments from fellows' interviews was tabulated. Fellows showed a significant improvement in knowledge scores after the intervention (63.33% correct before the intervention and 76.67% correct after the intervention, mean change = 13.33%, P = .03). The mean overall scores for attitudes and skills/ability items increased from 4.72 to 5.33 (change = 0.61, P = .11), and 2.67 to 3.83 (change = 1.17, P = .009), respectively. Comments from the interviews were positive and fell into 3 categories. First, fellows felt that they achieved a good knowledge base. Second, they gained a better understanding of the roles and responsibilities. Last, all participants felt the curriculum was very practical and helped them feel more prepared to become medical directors. An innovative curriculum for nursing home medical direction provided for first-year geriatric medicine fellows had a significantly positive impact on their knowledge, ability, and skills. The curriculum was effective in helping fellows better understand and apply what they learned regarding the roles and responsibilities in medical direction. Copyright © 2013

  18. Geriatric nursing home falls: A single institution cross-sectional study.

    Science.gov (United States)

    Botwinick, Isadora; Johnson, Joshua H; Safadjou, Saman; Cohen-Levy, Wayne; Reddy, Srinivas H; McNelis, John; Teperman, Sheldon H; Stone, Melvin E

    2016-01-01

    Falls are the leading cause of fatal injury in geriatric patients. Nursing home falls occur at twice the rate of community falls, yet few studies have compared these groups. We hypothesized that nursing home residents admitted for fall would be sicker than their community counterparts on presentation and have worse outcomes. Records of 1708 patients, age 65 years and older with a documented nursing home status, admitted to our center between 2008 and 2012 were reviewed. Clinical data including injury severity score (ISS), admission Glasgow coma scale (GCS), in-hospital complications, length of stay (LOS), and in-hospital mortality were collected. Continuous data were analyzed using Mann-Whitney tests and categorical data using Fisher exact tests. Variables in the univariate tests were analyzed in a multivariate logistic regression. Nursing home patients were older than community patients, presented with lower GCS, lower hemoglobin, higher international normalized ratio (INR) and a higher percentage of patients with body mass index (BMI)nursing home patients was longer, and they suffered higher rates of in-hospital complications. ISS, rates of traumatic brain injury, operative intervention and mortality were not significantly different. In a multivariate logistic regression, ISS, GCS and age, but not nursing home status, were significant predictors of in-hospital mortality. In comparison to their community counterparts, nursing home patients presenting after fall are more debilitated and have increased morbidity as evidenced by more in-house complications and increased LOS. However, nursing home residency was not a significant predictor of mortality. Copyright © 2015. Published by Elsevier Ireland Ltd.

  19. Stand-alone differential capacitance force sensors with sub-nano-newton sensitivity

    Science.gov (United States)

    Ye, Jilong; Sun, Taotao; Huang, Dong; Li, Zhihong; Lin, Li

    2017-09-01

    This paper presents structure design, microfabrication processes, calibration techniques and experimental results of differential capacitance force sensors with features of sub-nano-newton sensitivity, up to 10 000 Hz sampling rate, and applicability as stand-alone devices. The representative sensor demonstrates a force resolution of 0.11 nN at a 19 Hz sampling rate or 1.47 nN at 10 000 Hz. A novel asymmetric differential capacitance structure proposed results in remarkable increase in the ratio of measurement range to resolution in comparison with traditional symmetric structure. In addition, the stiction between silicon and glass caused by the capillary force during dicing is eliminated by the use of hydrophobization treatment. Such a treatment is essential to successfully fabricate structures with a large ratio of overlapped area to gap in silicon/glass anodic bonding processes.

  20. Lossy Data Aggregation with Network Coding in Stand-Alone Wireless Sensor Networks

    DEFF Research Database (Denmark)

    Madsen, Tatiana Kozlova

    2011-01-01

    This work focuses on a special type of wireless sensor networks (WSNs) that we refer to as a stand alone network. These netwoks operate in harsh and extreme environments where data collection is done only occasionally. Typical examples include habitat monitoring systems, monitoring systems...... in chemical plants, etc. Given resource constrained operation of a sensor network where the nodes are battery powered and buffer sizes are limited, efficient methods for in-network data storage abd it subsequent fast and reliable transmission to a gateway is desirable. To save scarse resources and to prolong...... the lifetime of the whole network, the lossy data grregation method can be applied. It is especially viable in the networks where several sensors are measuring the same physical phenomenum and only average values of sensor readings are of interest. In this paper we present a method for efficient lossy data...

  1. Study of Stand-Alone Microgrid under Condition of Faults on Distribution Line

    Science.gov (United States)

    Malla, S. G.; Bhende, C. N.

    2014-10-01

    The behavior of stand-alone microgrid is analyzed under the condition of faults on distribution feeders. During fault since battery is not able to maintain dc-link voltage within limit, the resistive dump load control is presented to do so. An inverter control is proposed to maintain balanced voltages at PCC under the unbalanced load condition and to reduce voltage unbalance factor (VUF) at load points. The proposed inverter control also has facility to protect itself from high fault current. Existing maximum power point tracker (MPPT) algorithm is modified to limit the speed of generator during fault. Extensive simulation results using MATLAB/SIMULINK established that the performance of the controllers is quite satisfactory under different fault conditions as well as unbalanced load conditions.

  2. Solar pv fed stand-alone excitation system of a synchronous machine for reactive power generation

    Science.gov (United States)

    Sudhakar, N.; Jain, Siddhartha; Jyotheeswara Reddy, K.

    2017-11-01

    This paper presents a model of a stand-alone solar energy conversion system based on synchronous machine working as a synchronous condenser in overexcited state. The proposed model consists of a Synchronous Condenser, a DC/DC boost converter whose output is fed to the field of the SC. The boost converter is supplied by the modelled solar panel and a day time variable irradiance is fed to the panel during the simulation time. The model also has one alternate source of rechargeable batteries for the time when irradiance falls below a threshold value. Also the excess power produced when there is ample irradiance is divided in two parts and one is fed to the boost converter while other is utilized to recharge the batteries. A simulation is done in MATLAB-SIMULINK and the obtained results show the utility of such modelling for supplying reactive power is feasible.

  3. An Analysis of Stand-alone GPS Quality and Simulated GNSS Quality for Road Pricing

    DEFF Research Database (Denmark)

    Zabic, Martina; Nielsen, Otto Anker

    2006-01-01

    Use of GPS for road pricing has often been suggested as the way of creating more efficient charging strategies than existing systems based on cordon lines or time use. In Denmark, Copenhagen participated with the AKTA project in the PRoGRESS programme, sponsored by the EU. The major part...... of the AKTA project was to equip 500 cars with GPS receivers. The paper presents the methods and results from a study of GPS quality in relation to road pricing in a dense urban area. The collected data from 500 cars over a two-year period in the Copenhagen region was analyzed in order to determine whether...... the stand alone GPS quality and reliability is adequate for implementation of an operational road pricing system in Copenhagen. The results from the analysis show that the satellite availability in Copenhagen is not sufficient to form the basis for a reliable operational road pricing system. The narrow...

  4. Electrical integration of renewable energy into stand-alone power supplies incorporating hydrogen storage

    Energy Technology Data Exchange (ETDEWEB)

    Little, Matthew; Thomson, Murray

    2007-07-15

    A stand-alone renewable-energy system employing a hydrogen-based energy store is now being commissioned within the HaRI project at West Beacon Farm, Leicestershire, UK. The interconnection of the various generators, loads and storage system is made through a central DC busbar: an arrangement that is believed to be unique within systems of this type and scale. The rotating generators, such as the wind turbines, are connected through standard industrial drives operating in regenerative mode, while the DC devices - electrolyser, fuel cell and solar photovoltaic array - employ custom DC-DC converters. This paper reviews the design philosophy of the electrical system and the various converters required. Modelling and simulation of the system is discussed along with practical lessons learnt from its implementation and some initial results are presented. (author)

  5. System Simulation by Recursive Feedback: Coupling a Set of Stand-Alone Subsystem Simulations

    Science.gov (United States)

    Nixon, D. D.

    2001-01-01

    Conventional construction of digital dynamic system simulations often involves collecting differential equations that model each subsystem, arran g them to a standard form, and obtaining their numerical gin solution as a single coupled, total-system simultaneous set. Simulation by numerical coupling of independent stand-alone subsimulations is a fundamentally different approach that is attractive because, among other things, the architecture naturally facilitates high fidelity, broad scope, and discipline independence. Recursive feedback is defined and discussed as a candidate approach to multidiscipline dynamic system simulation by numerical coupling of self-contained, single-discipline subsystem simulations. A satellite motion example containing three subsystems (orbit dynamics, attitude dynamics, and aerodynamics) has been defined and constructed using this approach. Conventional solution methods are used in the subsystem simulations. Distributed and centralized implementations of coupling have been considered. Numerical results are evaluated by direct comparison with a standard total-system, simultaneous-solution approach.

  6. Stand-alone version of the 11kW Gaia wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Bindner, H.; Rosas, P.A.C.; Teodorescu, R.; Blaabjerg, F.

    2004-09-15

    This report describes the development of a stand-alone version of the 11kW Gaia wind turbine. Various possible configurations are investigated and a configuration using a back-to-back converter is chosen. A model is developed for controller design of the fast controllers of the unit. Controllers are designed and a prototype is built for testing. The report documents the performance of the prototype through measurements done on the full scale prototype installed in a test facility where it has been tested both as a standalone unit and in parallel with a diesel genset. For system wide power quality assessment and controller design a dynamic performance assessment model has been developed. (au)

  7. Energy management system for stand-alone diesel-wind-biomass microgrid with energy storage system

    International Nuclear Information System (INIS)

    Wang, Chengshan; Liu, Yixin; Li, Xialin; Guo, Li; Qiao, Lei; Lu, Hai

    2016-01-01

    An energy management system for stand-alone microgrid composed of diesel generators, wind turbine generator, biomass generator and an ESS (energy storage system) is proposed in this paper. Different operation objectives are achieved by a hierarchical control structure with different time scales. Firstly, the optimal schedules of the diesel generators, wind turbine generator, biomass generator and ESS are determined fifteen minutes ahead according to the super short-term forecast of load and wind speed in the optimal scheduling layer. Comprehensive analysis which takes the uncertainty of load and wind speed into account is conducted in this layer to minimize the operation cost of the system and ensure a desirable range of the state of charge of the ESS. Secondly, the operation points of each unit are regulated dynamically to guarantee real-time power balance and safety range of diesel generation in the real-time control layer, based on which the response capability when suffering significant forecast deviation and other emergency issues, e.g. sudden load-up can be improved. Finally, the effectiveness of the proposed energy management strategy is verified on an RT_Lab based real-time simulation platform, and the economic performances with different types of ESS are analyzed as well. - Highlights: • A hierarchical control strategy is proposed for a stand-alone microgrid. • The uncertainties of load and wind speed have been considered. • Better economic performance and high reliability of the system can be achieved. • The influences of different energy storage systems have been analyzed.

  8. Optimal expansion planning of stand-alone systems with stochastic simulations

    Energy Technology Data Exchange (ETDEWEB)

    Hoese, Alejandro [Instituto de Energia Electrica (IEE), Universidad Nacional de San Juan, (Argentina)

    1997-12-31

    Stand-alone systems in the range of 1 kW - 10 MW are taking relevance in the new (global) liberal concept of energy market. State and private investors are becoming increasingly attention on the use of renewable for these systems, but it must be shown that these non-conventional solutions are competitive with the established conventional ones. The high investment costs and the technical and economic uncertainties coupled with the use of time-dependent energy sources are the mainly inhibiting factors for the decision agents to choose these systems instead of conventional ones. In the paper a new model for optimal expansion planning of hybrid stand-alone generating systems under consideration of uncertainties is presented. This model is at present in {sup d}evelopment state{sup .} Results already obtained in the first steps of this research are promising and some of them are here presented. [Espanol] Los sistemas autocontenidos en el rango de 1 Kw a 10 MW estan tomando importancia en el nuevo (global) concepto liberal del mercado de la energia. Inversionistas privados y del Estado estan poniendo mayor atencion en el uso de energias renovables para estos sistemas, pero debe mostrarse que estas soluciones no-convencionales son competitivas con las convencionales establecidas. Los altos costos de inversion y las incertidumbres tecnicas y economicas aunadamente con el uso de fuentes de energia dependientes del tiempo son los principales factores inhibidores de los factores de decision para escoger estos sistemas en lugar de los convencionales. En este articulo se presenta un nuevo modelo de planeacion de expansion optima de sistemas hibridos autocontenidos de generacion electrica bajo la consideracion de incertidumbres. Este modelo esta actualmente en {sup e}stado de desarrollo{sup .} Los resultados ya obtenidos en las primeras etapas de esta investigacion son prometedores y se presentan algunos de ellos.

  9. Diagnostic value of the stand-alone synthetic image in digital breast tomosynthesis examinations.

    Science.gov (United States)

    Garayoa, Julia; Chevalier, Margarita; Castillo, Maria; Mahillo-Fernández, Ignacio; Amallal El Ouahabi, Najim; Estrada, Carmen; Tejerina, Alejandro; Benitez, Olivia; Valverde, Julio

    2018-02-01

    To demonstrate the non-inferiority of synthetic image (SI) mammography versus full-field digital mammography (FFDM) in breast tomosynthesis (DBT) examinations. An observational, retrospective, single-centre, multireader blinded study was performed, using 2384 images to directly compare SI and FFDM based on Breast Imaging Reporting and Data System (BIRADS) categorisation and visibility of radiological findings. Readers had no access to digital breast tomosynthesis slices. Multiple reader, multiple case (MRMC) receiver operating characteristic (ROC) methodology was used to compare the diagnostic performance of SI and FFDM images. The kappa statistic was used to estimate the inter-reader and intra-reader reliability. The area under the ROC curves (AUC) reveals the non-inferiority of SI versus FFDM based on BIRADS categorisation [difference between AUC (ΔAUC), -0.014] and lesion visibility (ΔAUC, -0.001) but the differences were not statistically significant (p=0.282 for BIRADS; p=0.961 for lesion visibility). On average, 77.4% of malignant lesions were detected with SI versus 76.5% with FFDM. Sensitivity and specificity of SI are superior to FFDM for malignant lesions scored as BIRADS 5 and breasts categorised as BIRADS 1. SI is not inferior to FFDM when DBT slices are not available during image reading. SI can replace FFDM, reducing the dose by 45%. • Stand-alone SI demonstrated performance not inferior for lesion visibility as compared to FFDM. • Stand-alone SI demonstrated performance not inferior for lesion BIRADS categorisation as compared to FFDM. • Synthetic images provide important dose savings in breast tomosynthesis examinations.

  10. Imagery rescripting as a stand-alone treatment for patients with social phobia: a case series.

    Science.gov (United States)

    Frets, Petra G; Kevenaar, Ciska; van der Heiden, Colin

    2014-03-01

    The majority of patients with social phobia reports experiencing negative images, usually linked to memories of earlier aversive social experiences. Several studies have indicated that such negative self-imagery appears to have a causal role in maintaining social phobia, which suggests that interventions aimed at dealing with these images could be beneficial in the treatment of social phobia. One potentially powerful approach is imagery rescripting (IR), a clinical intervention that focuses on changing the meaning and impact of unpleasant memories. In the treatment of social phobia IR was only used as part of a broader cognitive-behavioral treatment package. However, we propose that IR alone might also be an effective treatment for this anxiety disorder. The present study reports an initial evaluation of the application of IR as a stand-alone treatment for six adult outpatients presenting with social phobia. A single case series using an A-B replication across patients design was employed. Following a no-treatment baseline period, IR was delivered weekly and patients were followed up for 3 and 6 months. For all patients, substantial reductions were obtained on all outcome measures at post-treatment, and gains were largely maintained at 6-months follow-up. The generalizability of the effects of IR for social phobia is limited by the small number of patients treated by only one therapist. The results of this preliminary case series suggest that IR as a stand alone treatment is an apparently effective intervention in the treatment of patients with social phobia, and indicate that controlled evaluation of its efficacy might be worthwhile. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. A Meta-Analytic Review of Stand-Alone Interventions to Improve Body Image.

    Directory of Open Access Journals (Sweden)

    Jessica M Alleva

    Full Text Available Numerous stand-alone interventions to improve body image have been developed. The present review used meta-analysis to estimate the effectiveness of such interventions, and to identify the specific change techniques that lead to improvement in body image.The inclusion criteria were that (a the intervention was stand-alone (i.e., solely focused on improving body image, (b a control group was used, (c participants were randomly assigned to conditions, and (d at least one pretest and one posttest measure of body image was taken. Effect sizes were meta-analysed and moderator analyses were conducted. A taxonomy of 48 change techniques used in interventions targeted at body image was developed; all interventions were coded using this taxonomy.The literature search identified 62 tests of interventions (N = 3,846. Interventions produced a small-to-medium improvement in body image (d+ = 0.38, a small-to-medium reduction in beauty ideal internalisation (d+ = -0.37, and a large reduction in social comparison tendencies (d+ = -0.72. However, the effect size for body image was inflated by bias both within and across studies, and was reliable but of small magnitude once corrections for bias were applied. Effect sizes for the other outcomes were no longer reliable once corrections for bias were applied. Several features of the sample, intervention, and methodology moderated intervention effects. Twelve change techniques were associated with improvements in body image, and three techniques were contra-indicated.The findings show that interventions engender only small improvements in body image, and underline the need for large-scale, high-quality trials in this area. The review identifies effective techniques that could be deployed in future interventions.

  12. Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study

    NARCIS (Netherlands)

    Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

    Aim. To gain insight into a new type of nurse specialized in gerontology and geriatrics, how they find meaning in the care of older persons and how this relates to the seven professional roles derived from the CanMEDS theoretical framework. Background. To promote the quality of care for older

  13. Effect of nurse practitioner comanagement on the care of geriatric conditions.

    Science.gov (United States)

    Reuben, David B; Ganz, David A; Roth, Carol P; McCreath, Heather E; Ramirez, Karina D; Wenger, Neil S

    2013-06-01

    To determine whether community-based primary care physician (PCP)-nurse practitioner (NP) comanagement implementing the Assessing Care of Vulnerable Elders (ACOVE)-2 model: (case finding, delegation of data collection, structured visit notes, physician and patient education, and linkage to community resources) can improve the quality of care for geriatric conditions. Case study. Two community-based primary care practices. Patients aged 75 and older who screened positive for at least one condition: falls, urinary incontinence (UI), dementia, and depression. The ACOVE-2 model augmented by NP comanagement of conditions. Quality of care according to medical record review using ACOVE-3 quality indicators (QIs). Individuals receiving comanagement were compared with those who received PCP care alone in the same practices. Of 1,084 screened individuals, 658 (61%) screened positive for more than one condition; 485 of these were randomly selected for chart review and triggered a mean of seven QIs. A NP saw 49% for comanagement. Overall, individuals received 57% of recommended care. Quality scores for all conditions (falls, 80% vs 34%; UI, 66% vs 19%; dementia, 59% vs 38%) except depression (63% vs 60%) were higher for individuals who saw a NP. In analyses adjusted for sex and age of patient, number of conditions, site, and a NP estimate of medical management style, NP comanagement remained significantly associated with receiving recommended care (P NP estimate of medical management style (P = .02). NP comanagement is associated with better quality of care for geriatric conditions in community-based primary care than usual care using the ACOVE-2 model. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  14. Key factors for the implementation of successful, stand-alone village electrification schemes in Peru

    Science.gov (United States)

    Sanchez-Campos, Teodoro

    The hypothesis of this work is that there are social, financial, technical, managerial institutional and political key factors that may either support or prevent the success of small stand alone energy systems in rural areas. This research work aims at contributing to the identification of such factors and study their relevance to the performance and sustainability of stand alone energy systems in rural areas; to meet its purpose, a wide range of literature was reviewed including rural electrification programmes and projects, research and development projects on access to electricity in rural areas, impact studies and others, and a field research survey was done the Andes and Upper Jungle regions in Peru. Nineteen possible critical factors were identified, thirteen with relevance at the local context (the community or village), and six with relevance at the national (or wider) context. From literature review it was found that the possible local critical factors were relevant only to four categories of factors instead of the six considered initially (i.e. social, financial, technological and managerial): the other two categories, political and institutional were found to be more relevant to the national context, therefore those were included in the group of possible critical factors of wider context. A series of questionnaires were designed to collect field data information, which was later used to analyse and establish the relation of each identified factor with the success of the systems studied. The survey research was implemented in 14 villages, 7 with small diesel sets and 7 with small hydropower schemes, all spread in the Andes and Upper Jungle of Peru, which were carefully selected to be representative of regions with isolated stand alone systems and with different socioeconomic background. Out of the 13 possible critical factors of local context, it was found that only 3 are really critical, the others are important but not critical; one of them (technical

  15. Five-year durability of stand-alone interspinous process decompression for lumbar spinal stenosis

    Directory of Open Access Journals (Sweden)

    Nunley PD

    2017-09-01

    Full Text Available Pierce D Nunley,1 Vikas V Patel,2 Douglas G Orndorff,3 William F Lavelle,4 Jon E Block,5 Fred H Geisler6 1Spine Institute of Louisiana, Shreveport, LA, 2The Spine Center, University of Colorado Hospital, Denver, CO, 3Spine Colorado, Mercy Regional Hospital, Durango, CO, 4Upstate Bone and Joint Center, East Syracuse, NY, 5Independent Consultant, San Francisco, CA, 6Independent Consultant, Chicago, IL, USA Background: Lumbar spinal stenosis is the most common indication for spine surgery in older adults. Interspinous process decompression (IPD using a stand-alone spacer that functions as an extension blocker offers a minimally invasive treatment option for intermittent neurogenic claudication associated with spinal stenosis.Methods: This study evaluated the 5-year clinical outcomes for IPD (Superion® from a randomized controlled US Food and Drug Administration (FDA noninferiority trial. Outcomes included Zurich Claudication Questionnaire (ZCQ symptom severity (ss, physical function (pf, and patient satisfaction (ps subdomains, leg and back pain visual analog scale (VAS, and Oswestry Disability Index (ODI.Results: At 5 years, 84% of patients (74 of 88 demonstrated clinical success on at least two of three ZCQ domains. Individual ZCQ domain success rates were 75% (66 of 88, 81% (71 of 88, and 90% (79 of 88 for ZCQss, ZCQpf, and ZCQps, respectively. Leg and back pain success rates were 80% (68 of 85 and 65% (55 of 85, respectively, and the success rate for ODI was 65% (57 of 88. Percentage improvements over baseline were 42%, 39%, 75%, 66%, and 58% for ZCQss, ZCQpf, leg and back pain VAS, and ODI, respectively (all P<0.001. Within-group effect sizes were classified as very large for four of five clinical outcomes (ie, >1.0; all P<0.0001. Seventy-five percent of IPD patients were free from reoperation, revision, or supplemental fixation at their index level at 5 years.Conclusion: After 5 years of follow-up, IPD with a stand-alone spacer provides

  16. Charactrization of a Li-ion battery based stand-alone a-Si photovoltaic system

    Science.gov (United States)

    Hamid Vishkasougheh, Mehdi; Tunaboylu, Bahadir

    2014-11-01

    The number of photovoltaic (PV) system installations is increasing rapidly. As more people learn about this versatile and often cost-effective power option, this trend will accelerate. This document presents a recommended design for a battery based stand-alone photovoltaic system (BSPV). BSPV system has the ability to be applied in different areas, including warning signals, lighting, refrigeration, communication, residential water pumping, remote sensing, and cathodic protection. The presented calculation method gives a proper idea for a system sizing technique. Based on application load, different scenarios are possible for designing a BSPV system. In this study, a battery based stand-alone system was designed. The electricity generation part is three a-Si panels, which are connected in parallel, and for the storage part LFP (lithium iron phosphate) battery was used. The high power LFP battery packs are 40 cells each 8S5P (configured 8 series 5 parallel). Each individual pack weighs 0.5 kg and is 25.6 V. In order to evaluate the efficiency of a-Si panels with respect to the temperature and the solar irradiation, cities of Istanbul, Ankara and Adana in Turkey were selected. Temperature and solar irradiation were gathered from reliable sources and by using translation equations, current and voltage output of panels were calculated. As a result of these calculations, current and energy outputs were computed by considering an average efficient solar irradiation time value per day in Turkey. The calculated power values were inserted to a battery cycler system, and the behavior of high power LFP batteries in a time sequence of 7.2 h was evaluated. The charging and discharging cycles were obtained and their behavior was discussed. According to the results, Istanbul has the lowest number of peak month's energy, it followed by Ankara, and ultimately Adana has the highest number of peak months and energy storage. It was observed during the tests that values up to 4 A was

  17. Multi-objective analytical model for optimal sizing of stand-alone photovoltaic water pumping systems

    International Nuclear Information System (INIS)

    Olcan, Ceyda

    2015-01-01

    Highlights: • An analytical optimal sizing model is proposed for PV water pumping systems. • The objectives are chosen as deficiency of power supply and life-cycle costs. • The crop water requirements are estimated for a citrus tree yard in Antalya. • The optimal tilt angles are calculated for fixed, seasonal and monthly changes. • The sizing results showed the validity of the proposed analytical model. - Abstract: Stand-alone photovoltaic (PV) water pumping systems effectively use solar energy for irrigation purposes in remote areas. However the random variability and unpredictability of solar energy makes difficult the penetration of PV implementations and complicate the system design. An optimal sizing of these systems proves to be essential. This paper recommends a techno-economic optimization model to determine optimally the capacity of the components of PV water pumping system using a water storage tank. The proposed model is developed regarding the reliability and cost indicators, which are the deficiency of power supply probability and life-cycle costs, respectively. The novelty is that the proposed optimization model is analytically defined for two-objectives and it is able to find a compromise solution. The sizing of a stand-alone PV water pumping system comprises a detailed analysis of crop water requirements and optimal tilt angles. Besides the necessity of long solar radiation and temperature time series, the accurate forecasts of water supply needs have to be determined. The calculation of the optimal tilt angle for yearly, seasonally and monthly frequencies results in higher system efficiency. It is, therefore, suggested to change regularly the tilt angle in order to maximize solar energy output. The proposed optimal sizing model incorporates all these improvements and can accomplish a comprehensive optimization of PV water pumping systems. A case study is conducted considering the irrigation of citrus trees yard located in Antalya, Turkey

  18. Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion.

    Science.gov (United States)

    Marchi, Luis; Abdala, Nitamar; Oliveira, Leonardo; Amaral, Rodrigo; Coutinho, Etevaldo; Pimenta, Luiz

    2013-07-01

    Indirect decompression of the neural structures through interbody distraction and fusion in the lumbar spine is feasible, but cage subsidence may limit maintenance of the initial decompression. The influence of interbody cage size on subsidence and symptoms in minimally invasive lateral interbody fusion is heretofore unreported. The authors report the rate of cage subsidence after lateral interbody fusion, examine the clinical effects, and present a subsidence classification scale. The study was performed as an institutional review board-approved prospective, nonrandomized, comparative, single-center radiographic and clinical evaluation. Stand-alone short-segment (1- or 2-level) lateral lumbar interbody fusion was investigated with 12 months of postoperative follow-up. Two groups were compared. Forty-six patients underwent treatment at 61 lumbar levels with standard interbody cages (18 mm anterior/posterior dimension), and 28 patients underwent treatment at 37 lumbar levels with wide cages (22 mm). Standing lateral radiographs were used to measure segmental lumbar lordosis, disc height, and rate of subsidence. Subsidence was classified using the following scale: Grade 0, 0%-24% loss of postoperative disc height; Grade I, 25%-49%; Grade II, 50%-74%; and Grade III, 75%-100%. Fusion status was assessed on CT scanning, and pain and disability were assessed using the visual analog scale and Oswestry Disability Index. Complications and reoperations were recorded. Pain and disability improved similarly in both groups. While significant gains in segmental lumbar lordosis and disc height were observed overall, the standard group experienced less improvement due to the higher rate of interbody graft subsidence. A difference in the rate of subsidence between the groups was evident at 6 weeks (p = 0.027), 3 months (p = 0.042), and 12 months (p = 0.047). At 12 months, 70% in the standard group and 89% in the wide group had Grade 0 or I subsidence, and 30% in the standard group

  19. Animal assisted therapy and perception of loneliness in geriatric nursing home residents.

    Science.gov (United States)

    Vrbanac, Zoran; Zecević, Iva; Ljubić, Marijana; Belić, Maja; Stanin, Damir; Bottegaro, Nika Brkljaca; Jurkić, Gabrijela; Skrlin, Branimir; Bedrica, Ljiljana; Zubcić, Damir

    2013-09-01

    Use of animals for therapeutic purposes, animal assisted therapy or AAT is a method for improving quality of life for long-term inpatients. The object of this paper was to evaluate dog companionship as a form of AAT and its effects on perception of loneliness in geriatric nursing home residents. The participants were involved in a six-month program of dog companionship three times weekly for 90 minutes. There were 21 residents included in the program, with a mean age of 80 years. Loneliness was measured by the short version of the UCLA Scale of loneliness. Comparison of test results before and after participation in the program showed that dog companionship reduces the perception of loneliness.

  20. Flexible Control of Small Wind Turbines With Grid Failure Detection Operating in Stand-Alone and Grid-Connected Mode

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Blaabjerg, Frede

    2004-01-01

    This paper presents the development and test of a flexible control strategy for an 11-kw wind turbine with a back-to-back power converter capable of working in both stand-alone and grid-connected mode. The stand-alone control is featured with a complex output voltage controller capable of handling...... nonlinear load and excess or deficit of generated power. Grid-connection mode with current control is also enabled for the case of isolated local grid involving other dispersed power generators such as other wind turbines or diesel generators. A novel automatic mode switch method based on a phase...

  1. Design of a reliable and low-cost stand-alone micro hydropower station

    Energy Technology Data Exchange (ETDEWEB)

    Kusakana, K.; Munda, J.L. [Tshwane Univ. of Technology, Pretoria (South Africa)

    2008-07-01

    A stand-alone micro-hydropower station was presented. The plant was comprised of a squirrel cage induction machine coupled to a Kaplan water turbine. Power converters were used to control the variable frequency and voltage outputs of the generator caused by variations in water flow. The hydropower plant was installed a farm in the Kwazulu-Natal region of South Africa, and was designed to provide electricity in relation to the low power demand of users in the region as well as according to the site's hydrology and topology. Load forecasts for the 8 houses using the system were conducted. A generator with a higher output than the average power needed to feed the load was selected in order to ensure load supply during peak demand. The system was designed to shore energy generated during off-peak periods in batteries. An AC-DC-AC converter was used as an interface between the generator and the load in order to ensure voltage and frequency stabilization. Simulations of plant components were conducted to demonstrate output power supply during water flow variations. Results of the modelling study indicated that power converters are needed to stabilize generator outputs. The hydropower design is a cost-effective means of supplying power to low-income households. 10 refs., 2 tabs., 7 figs.

  2. Solar photovoltaic applications seminar: design, installation and operation of small, stand-alone photovoltaic power systems

    Energy Technology Data Exchange (ETDEWEB)

    1980-07-01

    This seminar material was developed primarily to provide solar photovoltaic (PV) applied engineering technology to the Federal community. An introduction to photoconductivity, semiconductors, and solar photovoltaic cells is included along with a demonstration of specific applications and application identification. The seminar details general systems design and incorporates most known information from industry, academia, and Government concerning small solar cell power system design engineering, presented in a practical and applied manner. Solar PV power system applications involve classical direct electrical energy conversion and electric power system analysis and synthesis. Presentations and examples involve a variety of disciplines including structural analysis, electric power and load analysis, reliability, sizing and optimization; and, installation, operation and maintenance. Four specific system designs are demonstrated: water pumping, domestic uses, navigational and aircraft aids, and telecommunications. All of the applications discussed are for small power requirement (under 2 kilowatts), stand-alone systems to be used in remote locations. Also presented are practical lessons gained from currently installed and operating systems, problems at sites and their resolution, a logical progression through each major phase of system acquisition, as well as thorough design reviews for each application.

  3. Stand-alone excitation synchronous wind power generators with power flow management strategy

    Directory of Open Access Journals (Sweden)

    Tzuen-Lih Chern

    2014-09-01

    Full Text Available This study presents a stand-alone excitation synchronous wind power generator (SESWPG with power flow management strategy (PFMS. The rotor speed of the excitation synchronous generator tracks the utility grid frequency by using servo motor tracking technologies. The automatic voltage regulator governs the exciting current of generator to achieve the control goals of stable voltage. When wind power is less than the needs of the consumptive loading, the proposed PFMS increases motor torque to provide a positive power output for the loads, while keeping the generator speed constant. Conversely, during the periods of wind power greater than output loads, the redundant power of generator production is charged to the battery pack and the motor speed remains constant with very low power consumption. The advantage of the proposed SESWPG is that the generator can directly output stable alternating current (AC electricity without using additional DC–AC converters. The operation principles with software simulation for the system are described in detail. Experimental results of a laboratory prototype are shown to verify the feasibility of the system.

  4. Simulation of stand alone PV system; Dokuritsugata taiyoko hatsuden system no simulation

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, H.; Ogawa, H.; Sekii, Y. [Chiba Institute of Technology, Chiba (Japan); Tsuda, I.; Nozaki, K. [Electrotechnical Laboratory, Tsukuba (Japan); Kurokawa, K. [Tokyo University of Agriculture and Technology, Tokyo (Japan)

    1996-10-27

    In order to evaluate the simulation results of a photovoltaic power generation system, an operation simulation was carried out using the actual measured data of a stand alone PV system in Miyakojima, Okinawa Prefecture, so as to make a comparison with the actual operation data. The electric power was supplied to 250 houses and primary/junior high schools in the surrounding villages, which had an average demand load of approximately 90kw and the maximum of approximately 200kw. The power was supplied through the PV power generation in the duration of the sunshine, with an excess power charged in storage batteries and then supplied from the batteries at night. The array capacity was made 750kWp, the output current and storage batteries being characteristic type with an actual efficiency curve used for the inverter. The weather data used were the actual inclined insolation quantity and the outside air temperature data for a period of one month of November. The power charged in excess of 100% in the batteries was termed as an overflow power. With the charging condition 30% or less, a diesel generator was run for a rated operation for one hour, the power of which was termed as a backup power. As a result, the simulation was found nearly in agreement with the actual measurements. 5 refs., 7 figs., 2 tabs.

  5. Control of a Stand-Alone Variable Speed Wind Energy Supply System †

    Directory of Open Access Journals (Sweden)

    Mohamed M. Hamada

    2013-04-01

    Full Text Available This paper presents a simple control strategy for the operation of a variable speed stand-alone wind turbine with a permanent magnet synchronous generator (PMSG. The PMSG is connected to a three phase resistive load through a switch mode rectifier and a voltage source inverter. Control of the generator side converter is used to achieve maximum power extraction from the available wind power. Control of the DC-DC bidirectional buck-boost converter, which is connected between batteries bank and DC-link voltage, is used to maintain the DC-link voltage at a constant value. It is also used to make the batteries bank stores the surplus of wind energy and supplies this energy to the load during a wind power shortage. The load side voltage source inverter uses a relatively complex vector control scheme to control the output load voltage in terms of amplitude and frequency. The control strategy works under wind speed variation as well as with variable load. Extensive simulation results have been performed using MATLAB/SIMULINK.

  6. Can aqueous hydrogen peroxide be used as a stand-alone energy source?

    International Nuclear Information System (INIS)

    Disselkamp, Robert S.

    2010-01-01

    A novel electrochemical scheme to convert a stand-alone supply of aqueous hydrogen peroxide into a fuel cell-ready stream of hydrogen gas plus aqueous hydrogen peroxide is described. The electrochemical cell, consisting of a solid base and solid acid electrocatalyst, together with a proton exchange membrane, comprise the system that converts aqueous hydrogen peroxide into separate gas streams of oxygen and hydrogen. Aqueous hydrogen peroxide is contained in the anode compartment only and exists in the region where oxygen gas is formed, whereas the cathode compartment is where hydrogen gas is generated and therefore exists in a reduced state. A near zero theoretical over-potential can be achieved by the choice of basicity and acidity of the electrode materials. The primary cost of the electrochemical cell is electrode construction and the aqueous hydrogen peroxide energy storage compound. Additional research effort is required to experimentally validate the concept and explore the full economic impact should initial studies, based on the design presented here, prove promising. (author)

  7. Comparative analysis of distributed MPPT controllers for partially shaded stand alone photovoltaic systems

    International Nuclear Information System (INIS)

    Muthuramalingam, M.; Manoharan, P.S.

    2014-01-01

    Highlights: • Analyzes the performance of ANN and ANFIS MPPT algorithms by stand alone PV system. • ISSBC with ANFIS can provide the overall efficiency higher than ANN. • CHBMLI integrate with SHE ANN modulation technique improve output voltage quality. • Simulation and hardware results show the ANFIS algorithm efficient than ANN algorithm. - Abstract: This paper presents a unique combination of an interleaved soft switched boost converter (ISSBC) run by a set of two photovoltaic panel (PV) with a distributed MPPT, suitable to guarantee MPPT even under partial shadowed conditions, managed by an adaptive neuro fuzzy inference system trained by the training data derived from a particle swarm optimization (PSO–ANFIS) unit. The ISSBC is followed by a, single phase cascaded H bridge five-level inverter (CHI) driven by the individual DC outputs of the ISSBC, with selective harmonic elimination scheme to eliminate typically the seventh order harmonics. A comparison of different intelligent distributed maximum power point tracking (MPPT) algorithms for photovoltaic (PV) system under partial shadow conditions is carried out. The use of the ISSBC guarantees mitigation of ripple and it is meant to handle higher currents with minimal switching losses. Simulation was carried out in the Matlab Simulink environment and an experimental verification with a scaled down model validated the proposed scheme. It has been thus established, by both simulation and experimental verification, that the PSO–ANFIS model of distributed MPPT scheme of control outperforms other schemes of control for MPPT

  8. Battery Storage Technologies for Electrical Applications: Impact in Stand-Alone Photovoltaic Systems

    Directory of Open Access Journals (Sweden)

    Daniel Akinyele

    2017-11-01

    Full Text Available Batteries are promising storage technologies for stationary applications because of their maturity, and the ease with which they are designed and installed compared to other technologies. However, they pose threats to the environment and human health. Several studies have discussed the various battery technologies and applications, but evaluating the environmental impact of batteries in electrical systems remains a gap that requires concerted research efforts. This study first presents an overview of batteries and compares their technical properties such as the cycle life, power and energy densities, efficiencies and the costs. It proposes an optimal battery technology sizing and selection strategy, and then assesses the environmental impact of batteries in a typical renewable energy application by using a stand-alone photovoltaic (PV system as a case study. The greenhouse gas (GHG impact of the batteries is evaluated based on the life cycle emission rate parameter. Results reveal that the battery has a significant impact in the energy system, with a GHG impact of about 36–68% in a 1.5 kW PV system for different locations. The paper discusses new batteries, strategies to minimize battery impact and provides insights into the selection of batteries with improved cycling capacity, higher lifespan and lower cost that can achieve lower environmental impacts for future applications.

  9. Approaches for developing a sizing method for stand-alone PV systems with variable demand

    Energy Technology Data Exchange (ETDEWEB)

    Posadillo, R. [Grupo de Investigacion en Energias y Recursos Renovables, Dpto. de Fisica Aplicada, E.P.S., Universidad de Cordoba, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Lopez Luque, R. [Grupo de Investigacion de Fisica para las Energias y Recursos Renovables, Dpto. de Fisica Aplicada. Edificio C2 Campus de Rabanales, 14071 Cordoba (Spain)

    2008-05-15

    Accurate sizing is one of the most important aspects to take into consideration when designing a stand-alone photovoltaic system (SAPV). Various methods, which differ in terms of their simplicity or reliability, have been developed for this purpose. Analytical methods, which seek functional relationships between variables of interest to the sizing problem, are one of these approaches. A series of rational considerations are presented in this paper with the aim of shedding light upon the basic principles and results of various sizing methods proposed by different authors. These considerations set the basis for a new analytical method that has been designed for systems with variable monthly energy demands. Following previous approaches, the method proposed is based on the concept of loss of load probability (LLP) - a parameter that is used to characterize system design. The method includes information on the standard deviation of loss of load probability ({sigma}{sub LLP}) and on two new parameters: annual number of system failures (f) and standard deviation of annual number of failures ({sigma}{sub f}). The method proves useful for sizing a PV system in a reliable manner and serves to explain the discrepancies found in the research on systems with LLP<10{sup -2}. We demonstrate that reliability depends not only on the sizing variables and on the distribution function of solar radiation, but on the minimum value as well, which in a given location and with a monthly average clearness index, achieves total solar radiation on the receiver surface. (author)

  10. On the economics of stand-alone renewable hybrid power plants in remote regions

    International Nuclear Information System (INIS)

    Petrakopoulou, Fontina

    2016-01-01

    Highlights: • Economic evaluation of three renewable hybrid power plants for off-grid operation. • The high electricity cost of remote regions increases the competitiveness of renewable energy. • The proposed plants are economically viable when compared to the existing situation. • The zero direct emissions of the plants constitute an additional advantage of the plants. - Abstract: In recent years ever more examples of regions that have managed to achieve or orientate themselves toward renewable energy sufficiency are emerging. However, actions to create energy autonomy are mainly the result of isolated activities and they are less driven from fully organized movements. In addition, total energy independence without the support of a centralized electrical grid is yet to be achieved. The objectives of this work are to investigate the associated costs of stand-alone renewable hybrid power plants on a Greek island and compare them to the cost of the currently used fossil-fuel-based conventional plant. The plants examined here are designed to fully cover the electricity needs of the island. Islands may face numerous energy problems and rely heavily on foreign and environmentally-harmful fuels. It is shown that the relatively high cost of electricity of such a remote region can increase the competitiveness and promote the wider incorporation of technologies based on renewable energy sources that may, in other cases, seem economically inferior to business-as-usual energy solutions.

  11. Use of Super-Capacitor to Enhance Charging Performance of Stand-Alone Solar PV System

    KAUST Repository

    Huang, B. J.

    2011-01-01

    Introduction: The battery charging performance in a stand-alone solar PV system affects the PV system efficiency and the load operating time. The New Energy Center of National Taiwan University has been devoted to the development of a PWM charging technique to continue charging the lead-acid battery after the overcharge point to increase the battery storage capacity by more than 10%. The present study intends to use the super-capacitor to further increase the charge capacity before the overcharge point of the battery. The super-capacitor is connected in parallel to the lead-acid battery. This will reduce the overall charging impedance during the charge and increase the charging current, especially in sunny weather. A system dynamics model of the lead-acid battery and super-capacitor was derived and the control system simulation was carried out to predict the charging performance for various weathers. It shows that the overall battery impedance decreases and charging power increases with increasing solar radiation. An outdoor comparative test for two identical PV systems with and without supercapacitor was carried out. The use of super-capacitor is shown to be able to increase the lead-acid charging capacity by more than 25% at sunny weather and 10% in cloudy weather. © Springer-Verlag Berlin Heidelberg 2011.

  12. Attitudes of nurses towards the use of physical restraints in geriatric care: a systematic review of qualitative and quantitative studies.

    Science.gov (United States)

    Möhler, Ralph; Meyer, Gabriele

    2014-02-01

    To examine nurses' attitudes towards the use of physical restraints in geriatric care. Systematic review and synthesis of qualitative and quantitative studies. The following databases were searched: Medline, CINAHL, EMBASE, Psyndex, PsychInfo, Social SciSearch, SciSearch, Forum Qualitative Social Research (1/1990 to 8/2013). We performed backward and forward citation tracking to all of the included studies. We included in the present review all qualitative and quantitative studies in English and German that investigated nurses' attitudes towards the use of physical restraints in geriatric care. Two independent reviewers selected the studies for inclusion and assessed the study quality. We performed a thematic synthesis for the qualitative studies and a content analysis of the questionnaires' items as well as a narrative synthesis for the quantitative surveys. We included 31 publications in the review: 20 quantitative surveys, 10 qualitative and 1 mixed-method study. In the qualitative studies, nurses' attitudes towards the use of physical restraints in geriatric care were predominately characterised by negative feelings towards the use of restraints; however, the nurses also described a perceived need for using restraints in clinical practice. This discrepancy led to moral conflicts, and nurses described several strategies for coping with these conflicts when restraints were used. When nurses were in doubt regarding the use of restraints, they decided predominantly in favour of using restraints. The results of the quantitative surveys were inconsistent regarding nurses' feelings towards the use of restraints in geriatric care. Prevention of falls was identified as a primary reason for using restraints. However, the items of the questionnaires focussed primarily on the reasons for the use of restraints rather than on the attitudes of nurses. Despite the lack of evidence regarding the benefits of restraints and the evidence on the adverse effects, nurses often

  13. Geriatric rehabilitation of stroke patients in nursing homes : a study protocol

    NARCIS (Netherlands)

    Spruit-van Eijk, M.; Buijck, B.I.; Zuidema, S.U.; Voncken, F.L.M.; Geurts, A.C.H.; Koopmans, R.T.C.M.

    2010-01-01

    BACKGROUND: Geriatric patients are typically underrepresented in studies on the functional outcome of rehabilitation after stroke. Moreover, most geriatric stroke patients do probably not participate in intensive rehabilitation programs as offered by rehabilitation centers. As a result, very few

  14. Determinants of rehabilitation outcome in geriatric patients admitted to skilled nursing facilities after stroke : a Dutch multi-centre cohort study

    NARCIS (Netherlands)

    Spruit-van Eijk, Monica; Zuidema, Sytse U.; Buijck, Bianca I.; Koopmans, Raymond T. C. M.; Geurts, Alexander C. H.

    2012-01-01

    Objective: to identify important demographic, clinical and functional determinants of successful discharge of geriatric patients from skilled nursing facilities (SNFs), particularly the role of multi-morbidity. Design: prospective cohort study with data collection at baseline and at discharge.

  15. Motion Sensorless Bidirectional PWM Converter Control with Seamless Switching from Power Grid to Stand Alone and Back

    DEFF Research Database (Denmark)

    Fatu, Marius; Tutelea, Lucian; Teodorescu, Remus

    2007-01-01

    This paper presents concepts and tests results on a flexible sensorless control strategy for a PMSG driven by a small wind turbine with back-to-back power converters capable to function in both stand alone and grid connection mode. A new automatic seamless transfer method, based on phase-locked...

  16. Analyzing grid extension and stand-alone photovoltaic systems for the cost-effective electrification of Kenya

    NARCIS (Netherlands)

    Zeyringer, Marianne; Pachauri, Shonali; Schmid, Erwin; Schmidt, Johannes; Worrell, Ernst; Morawetz, Ulrich B.

    2015-01-01

    The declaration of 2014-2024 as the Decade of Sustainable Energy for All has catalyzed actions towards achieving universal electricity access. The high costs of building electric infrastructure are a major impediment to improved access, making stand-alone photovoltaic (PV) systems an attractive

  17. Stand-Alone Ethics, Social Responsibility, and Sustainability Course Requirements: A Snapshot from Australia and New Zealand

    Science.gov (United States)

    Rundle-Thiele, Sharyn R.; Wymer, Walter

    2010-01-01

    This article analyzes the extent to which Australian and New Zealand marketing educators use dedicated or stand-alone courses to equip students with alternative views of business. A census of marketing programs in degree-granting universities was conducted. Program brochures were obtained via the Internet and were content analyzed. This study…

  18. 49 CFR 1109.4 - Mandatory mediation in rate cases to be considered under the stand-alone cost methodology.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Mandatory mediation in rate cases to be considered... § 1109.4 Mandatory mediation in rate cases to be considered under the stand-alone cost methodology. (a) A... methodology must engage in non-binding mediation of its dispute with the railroad upon filing a formal...

  19. An improved synchronous reference frame phase-locked loop for stand-alone variable speed constant frequency power generation systems

    DEFF Research Database (Denmark)

    Liu, Yi; Xu, Wei; Ke, Longzhang

    2017-01-01

    The phase-locked loop (PLL) based on conventional synchronous reference frame, i.e. dqPLL, is usually employed in grid-connected variable speed constant frequency (VSCF) power generation systems (PGSs). However, the voltage amplitude drop of stand-alone PGSs is often greater than that of the grid...

  20. The eBioKit, a stand-alone educational platform for bioinformatics.

    Science.gov (United States)

    Hernández-de-Diego, Rafael; de Villiers, Etienne P; Klingström, Tomas; Gourlé, Hadrien; Conesa, Ana; Bongcam-Rudloff, Erik

    2017-09-01

    Bioinformatics skills have become essential for many research areas; however, the availability of qualified researchers is usually lower than the demand and training to increase the number of able bioinformaticians is an important task for the bioinformatics community. When conducting training or hands-on tutorials, the lack of control over the analysis tools and repositories often results in undesirable situations during training, as unavailable online tools or version conflicts may delay, complicate, or even prevent the successful completion of a training event. The eBioKit is a stand-alone educational platform that hosts numerous tools and databases for bioinformatics research and allows training to take place in a controlled environment. A key advantage of the eBioKit over other existing teaching solutions is that all the required software and databases are locally installed on the system, significantly reducing the dependence on the internet. Furthermore, the architecture of the eBioKit has demonstrated itself to be an excellent balance between portability and performance, not only making the eBioKit an exceptional educational tool but also providing small research groups with a platform to incorporate bioinformatics analysis in their research. As a result, the eBioKit has formed an integral part of training and research performed by a wide variety of universities and organizations such as the Pan African Bioinformatics Network (H3ABioNet) as part of the initiative Human Heredity and Health in Africa (H3Africa), the Southern Africa Network for Biosciences (SAnBio) initiative, the Biosciences eastern and central Africa (BecA) hub, and the International Glossina Genome Initiative.

  1. Hydrogen-based energy storage unit for stand alone PV systems

    International Nuclear Information System (INIS)

    Labbe, J.

    2006-12-01

    Stand alone systems supplied only by a photovoltaic generator need an energy storage unit to be fully self sufficient. Lead acid batteries are commonly used to store energy because of their low cost, despite several operational constraints. A hydrogen-based energy storage unit (HESU) could be another candidate, including an electrolyser, a fuel cell and a hydrogen tank. However many efforts still need to be carried out for this technology to reach an industrial stage. In particular, market outlets must be clearly identified. The study of small stationary applications (few kW) is performed by numerical simulations. A simulator is developed in the Matlab/Simulink environment. It is mainly composed of a photovoltaic field and a storage unit (lead acid batteries, HESU, or hybrid storage HESU/batteries). The system component sizing is achieved in order to ensure the complete system autonomy over a whole year of operation. The simulator is tested with 160 load profiles (1 kW as a yearly mean value) and three locations (Algeria, France and Norway). Two coefficients are set in order to quantify the correlation between the power consumption of the end user and the renewable resource availability at both daily and yearly scales. Among the tested cases, a limit value of the yearly correlation coefficient came out, enabling to recommend the use of the most adapted storage to a considered case. There are cases for which using HESU instead of lead acid batteries can increase the system efficiency, decrease the size of the photovoltaic field and improve the exploitation of the renewable resource. In addition, hybridization of HESU with batteries always leads to system enhancements regarding its sizing and performance, with an efficiency increase by 10 to 40 % depending on the considered location. The good agreement between the simulation data and field data gathered on real systems enabled the validation of the models used in this study. (author)

  2. Stand-alone rolling circle amplification combined with capillary electrophoresis for specific detection of small RNA.

    Science.gov (United States)

    Li, Ni; Jablonowski, Carolyn; Jin, Hailing; Zhong, Wenwan

    2009-06-15

    Noncoding small RNAs play diverse, important biological roles through gene expression regulation. However, their low expression levels make it difficult to identify new small RNA species and study their functions, calling for the development of detection schemes with higher simplicity, sensitivity, and specificity. Herein, we reported a straightforward assay that combined the stand-alone rolling circle amplification (RCA) with capillary electrophoresis (CE) for specific and sensitive detection of small RNAs in biological samples. In order to enhance the overall reaction efficiency and simplify the procedure, RCA was not preceded with ligation, and a preformed circular probe was employed as the template for the target small RNA-primed isothermal amplification. The long RCA product was digested and analyzed by CE. Two DNA polymerases, the Phi29 and Bst, were compared for their detection performance. Bst is superior in the aspects of specificity, procedure simplicity, and reproducibility, while Phi29 leads to a 5-fold lower detection limit and is able to detect as low as 35 amol of the target small RNA. Coamplification of an internal standard with the target and employment of the RNase A digestion step allow accurate and reproducible quantification of low amounts of small RNA targets spiked into hundreds of nanograms of the plant total RNA extract with a recovery below 110% using either enzyme. Our assay can be adapted to a capillary array system for high-throughput screening of small RNA expression in biological samples. Also, the one-step isothermal process has the potential to conveniently amplify a very limited amount of the RNA samples, e.g., RNA extracted from only a few cells, inside the capillary column or on a microchip.

  3. Radiologic Assessment of Subsidence in Stand-Alone Cervical Polyetheretherketone (PEEK) Cage.

    Science.gov (United States)

    Ha, Sung-Kon; Park, Jung-Yul; Kim, Se-Hoon; Lim, Dong-Jun; Kim, Sang-Dae; Lee, Sang-Kook

    2008-12-01

    Aim of study was to find a proper method for assessing subsidence using a radiologic measurement following anterior cervical discectomy and fusion (ACDF) with stand-alone polyetheretherketone (PEEK), Solistrade mark cage. Forty-two patients who underwent ACDF with Solistrade mark cage were selected. With a minimum follow-up of 6 months, the retrospective investigation was conducted for 37 levels in 32 patients. Mean follow-up period was 18.9 months. Total intervertebral height (TIH) of two fused vertebral bodies was measured on digital radiographs with built-in software. Degree of subsidence (DeltaTIH) was reflected by the difference between the immediate postoperative and follow-up TIH. Change of postoperative disc space height (CT-MRDeltaTIH) was reflected by the difference between TIH of the preoperative mid-sagittal 2D CT and that of the preoperative mid-sagittal T1-weighted MRI. Compared to preoperative findings, postoperative disc height was increased in all cases and subsidence was observed only in 3 cases. For comparison of subsidence and non-subsidence group, TIH and CT-MRDeltaTIH of each group were analyzed. There was no statistically significant difference in TIH and CT-MRDeltaTIH between each group at 4 and 8 weeks, but a difference was observed at the last follow-up TIH (p=0.0497). ACDF with Solistrade mark cage was associated with relatively good radiologic long-term results. Fusion was achieved in 94.5% and subsidence occurred in 8.1% by the radiologic assessment. Statistical analysis reveals that the subsidence seen later than 8 weeks after surgery and the development of subsidence does not correlate statistically with the change of the postoperative disc space height.

  4. Stand-Alone Lateral Interbody Fusion for the Treatment of Low-Grade Degenerative Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Luis Marchi

    2012-01-01

    Full Text Available The purpose of this paper was to investigate the stand-alone lateral interbody fusion as a minimally invasive option for the treatment of low-grade degenerative spondylolisthesis with a minimum 24-month followup. Prospective nonrandomized observational single-center study. 52 consecutive patients (67.6±10 y/o; 73.1% female; 27.4±3.4 BMI with single-level grade I/II single-level degenerative spondylolisthesis without significant spine instability were included. Fusion procedures were performed as retroperitoneal lateral transpsoas interbody fusions without screw supplementation. The procedures were performed in average 73.2 minutes and with less than 50cc blood loss. VAS and Oswestry scores showed lasting improvements in clinical outcomes (60% and 54.5% change, resp.. The vertebral slippage was reduced in 90.4% of cases from mean values of 15.1% preoperatively to 7.4% at 6-week followup (P<0.001 and was maintained through 24 months (7.1%, P<0.001. Segmental lordosis (P<0.001 and disc height (P<0.001 were improved in postop evaluations. Cage subsidence occurred in 9/52 cases (17% and 7/52 cases (13% spine levels needed revision surgery. At the 24-month evaluation, solid fusion was observed in 86.5% of the levels treated. The minimally invasive lateral approach has been shown to be a safe and reproducible technique to treat low-grade degenerative spondylolisthesis.

  5. "Candidatus Fokinia solitaria", a Novel "Stand-Alone" Symbiotic Lineage of Midichloriaceae (Rickettsiales.

    Directory of Open Access Journals (Sweden)

    Franziska Szokoli

    Full Text Available Recently, the family Midichloriaceae has been described within the bacterial order Rickettsiales. It includes a variety of bacterial endosymbionts detected in different metazoan host species belonging to Placozoa, Cnidaria, Arthropoda and Vertebrata. Representatives of Midichloriaceae are also considered possible etiological agents of certain animal diseases. Midichloriaceae have been found also in protists like ciliates and amoebae. The present work describes a new bacterial endosymbiont, "Candidatus Fokinia solitaria", retrieved from three different strains of a novel Paramecium species isolated from a wastewater treatment plant in Rio de Janeiro (Brazil. Symbionts were characterized through the full-cycle rRNA approach: SSU rRNA gene sequencing and fluorescence in situ hybridization (FISH with three species-specific oligonucleotide probes. In electron micrographs, the tiny rod-shaped endosymbionts (1.2 x 0.25-0.35 μm in size were not surrounded by a symbiontophorous vacuole and were located in the peripheral host cytoplasm, stratified in the host cortex in between the trichocysts or just below them. Frequently, they occurred inside autolysosomes. Phylogenetic analyses of Midichloriaceae apparently show different evolutionary pathways within the family. Some genera, such as "Ca. Midichloria" and "Ca. Lariskella", have been retrieved frequently and independently in different hosts and environmental surveys. On the contrary, others, such as Lyticum, "Ca. Anadelfobacter", "Ca. Defluviella" and the presently described "Ca. Fokinia solitaria", have been found only occasionally and associated to specific host species. These last are the only representatives in their own branches thus far. Present data do not allow to infer whether these genera, which we named "stand-alone lineages", are an indication of poorly sampled organisms, thus underrepresented in GenBank, or represent fast evolving, highly adapted evolutionary lineages.

  6. Optimum capacity determination of stand-alone hybrid generation system considering cost and reliability

    International Nuclear Information System (INIS)

    Chen, Hung-Cheng

    2013-01-01

    Highlights: ► This paper presents a methodology for the installation capacity optimization. ► Hybrid generation system is optimized by application of adaptive genetic algorithm. ► A cost investigation is made under various conditions and component characteristics. ► The optimization scheme is validated to meet the annual power load demand. -- Abstract: The aim of this work is to present an optimization methodology for the installation capacity of a stand-alone hybrid generation system, taking into consideration the cost and reliability. Firstly, on the basis of derived steady state models of a wind generator (WG), a photovoltaic array (PV), a battery and an inverter, the hybrid generation system is modeled for the purpose of capacity optimization. Secondly, the power system is analyzed for determining both the system structure and the operation control strategy. Thirdly, according to hourly weather database of wind speed, temperature and solar irradiation, annual power generation capacity is estimated for the system match design in order that an annual power load demand can be met. The capacity determination of a hybrid generation system becomes complicated as a result of the uncertainty in the renewable energy together with load demand and the nonlinearity of system components. Aimed at the power system reliability and the cost minimization, the capacity of a hybrid generation system is optimized by application of an adaptive genetic algorithm (AGA) to individual power generation units. A total cost investigation is made under various conditions, such as wind generator power curves, battery discharge depth and the loss of load probability (LOLP). At the end of this work, the capacity of a hybrid generation system is optimized at two installation sites, namely the offshore Orchid Island and Wuchi in Taiwan. The optimization scheme is validated to optimize power capacities of a photovoltaic array, a battery and a wind turbine generator with a relative

  7. A Low-Power Wearable Stand-Alone Tongue Drive System for People With Severe Disabilities.

    Science.gov (United States)

    Jafari, Ali; Buswell, Nathanael; Ghovanloo, Maysam; Mohsenin, Tinoosh

    2018-02-01

    This paper presents a low-power stand-alone tongue drive system (sTDS) used for individuals with severe disabilities to potentially control their environment such as computer, smartphone, and wheelchair using their voluntary tongue movements. A low-power local processor is proposed, which can perform signal processing to convert raw magnetic sensor signals to user-defined commands, on the sTDS wearable headset, rather than sending all raw data out to a PC or smartphone. The proposed sTDS significantly reduces the transmitter power consumption and subsequently increases the battery life. Assuming the sTDS user issues one command every 20 ms, the proposed local processor reduces the data volume that needs to be wirelessly transmitted by a factor of 64, from 9.6 to 0.15 kb/s. The proposed processor consists of three main blocks: serial peripheral interface bus for receiving raw data from magnetic sensors, external magnetic interference attenuation to attenuate external magnetic field from the raw magnetic signal, and a machine learning classifier for command detection. A proof-of-concept prototype sTDS has been implemented with a low-power IGLOO-nano field programmable gate array (FPGA), bluetooth low energy, battery and magnetic sensors on a headset, and tested. At clock frequency of 20 MHz, the processor takes 6.6 s and consumes 27 nJ for detecting a command with a detection accuracy of 96.9%. To further reduce power consumption, an application-specified integrated circuit processor for the sTDS is implemented at the postlayout level in 65-nm CMOS technology with 1-V power supply, and it consumes 0.43 mW, which is 10 lower than FPGA power consumption and occupies an area of only 0.016 mm.

  8. Stand-Alone Photovoltaic System Assessment in Warmer Urban Areas in Mexico

    Directory of Open Access Journals (Sweden)

    Alberto-Jesus Perea-Moreno

    2018-01-01

    Full Text Available The aim of this study is to examine the possibility of using a stand-alone photovoltaic system (SAPVS for electricity generation in urban areas in Southern Mexico. In Mexico, an urban area is defined as an area where more than 2500 inhabitants live. Due to constant migration from the countryside to the cities, the number of inhabitants of urban localities has been increasing. Global horizontal irradiation (GHI data were recorded every 10 min during 2014–2016 in Coatzacoalcos in the state of Veracruz located on 18°08′09″ N and 94°27′48″ W. In this study, batteries represented 77% of the total cost, 12 PV panels of 310 W could export 5.41 MWh to the grid, and an inverter with an integrated controller and charger was selected, which decreased the initial cost. The city of Coatzacoalcos was chosen because the average annual temperature is 28°, with an average relative humidity of 75% and an average irradiance of 5.3 kWh/m2/day. An emission factor 0.505 tCO2/MWh of greenhouse gases (GHG were obtained, based on the power system, the reduction of net annual GHG would be 11 tCO2 and a financial revenue of 36.951 × 103 $/tCO2 would be obtained. Financial parameters such as a 36.3% Internal Rate Return (IRR and 3.4 years payback show the financial viability of this investment. SAPVSs in urban areas in Mexico could be a benefit as long as housing has a high consumption of electricity.

  9. Brackish water desalination by a stand alone reverse osmosis desalination unit powered by photovoltaic solar energy

    Energy Technology Data Exchange (ETDEWEB)

    Hrayshat, Eyad S. [Tafila Technical University, P.O. Box 66, Tafila 66110 (Jordan)

    2008-08-15

    Desalination of brackish water as a viable option to cope with water scarcity and to overcome water deficit in Jordan is assessed. A stand alone reverse osmosis (RO) desalination unit powered by photovoltaic (PV) solar energy is proposed, and a computer code in C++ was generated in order to simulate the process, and to predict the water production at 10 selected sites based on the available solar radiation data, sunshine hours and salinity of the feed water (TDS of 3000, 5000, 7000, and 10,000 mg/L). It was found that most of the selected sites showed favorable application of the proposed system in Jordan. Tafila, Queira, Ras Muneef, H-4, and H-5 are the most favorable sites. With TDS of 7000 mg/L, the highest annual water production of 1679 m{sup 3}/year was observed in Tafila, followed by Queira with production of 1473 m{sup 3}/year. Ras Muneef, H-4, and H-5 showed close to each other production of 1363, 1345, and 1340 m{sup 3}/year, respectively. Among the most favorable sites (Tafila, Queira, Ras Muneef, H-4, and H-5), Ras Muneef was found to be the best site in terms of the daily amount of water produced during the driest months of the year (May-September). Its production during these months forms about 65% of its total daily water production during a 1-year cycle, while for each of the other most favorable sites namely Tafila, Queira, H-4, and H-5, a 61% of production was observed during the same period. (author)

  10. Stand-Alone Solar Organic Rankine Cycle Water Pumping System and Its Economic Viability in Nepal

    Directory of Open Access Journals (Sweden)

    Suresh Baral

    2015-12-01

    Full Text Available The current study presents the concept of a stand-alone solar organic Rankine cycle (ORC water pumping system for rural Nepalese areas. Experimental results for this technology are presented based on a prototype. The economic viability of the system was assessed based on solar radiation data of different Nepalese geographic locations. The mechanical power produced by the solar ORC is coupled with a water pumping system for various applications, such as drinking and irrigation. The thermal efficiency of the system was found to be 8% with an operating temperature of 120 °C. The hot water produced by the unit has a temperature of 40 °C. Economic assessment was done for 1-kW and 5-kW solar ORC water pumping systems. These systems use different types of solar collectors: a parabolic trough collector (PTC and an evacuated tube collector (ETC. The economic analysis showed that the costs of water are $2.47/m3 (highest and $1.86/m3 (lowest for the 1-kW system and a 150-m pumping head. In addition, the cost of water is reduced when the size of the system is increased and the pumping head is reduced. The minimum volumes of water pumped are 2190 m3 and 11,100 m3 yearly for 1 kW and 5 kW, respectively. The payback period is eight years with a profitability index of 1.6. The system is highly feasible and promising in the context of Nepal.

  11. Feasibility study and energy conversion analysis of stand-alone hybrid renewable energy system

    International Nuclear Information System (INIS)

    Baghdadi, Fazia; Mohammedi, Kamal; Diaf, Said; Behar, Omar

    2015-01-01

    Highlights: • Hybrid stand-alone wind–solar–fossil power system is analyzed. • Measurement data are used to evaluate system performance. • The proposed system can generate about 70% from renewables. • Such a hybrid plant is very promising for remote regions in Algeria. - Abstract: There is a great interest in the development of renewable power technologies in Algeria, and more particularly hybrid concept. The present paper has investigated the performance of hybrid PV–Wind–Diesel–Battery configuration based on hourly measurements of Adrar climate (southern Algeria). Data of global solar radiation, ambient temperature and wind speed for a period of one year have been used. Firstly, the proposed hybrid system has been optimized by means of HOMER software. The optimization process has been carried out taking into account renewable resources potential and energy demand; while maximizing renewable electricity use and fuel saving are the purpose. In the second step, a mathematical model has been developed to ensure efficient energy management on the basis of various operation strategies. The analysis has shown that renewable energy system (PV–Wind) is able to supply about 70% of the demand. Wind power has ranked first with 43% of the annual total electricity production followed by diesel generator (with 31%) while the remaining fraction is being to PV panels. In this context, 69% of the fossil fuel can be saved when using the proposed hybrid configuration instead of the diesel generators that are currently installed in most remote regions in Algeria. Such a concept is very promising to meet the focus of renewable energy program announced in 2011.

  12. Probabilistic modelling and analysis of stand-alone hybrid power systems

    International Nuclear Information System (INIS)

    Lujano-Rojas, Juan M.; Dufo-López, Rodolfo; Bernal-Agustín, José L.

    2013-01-01

    As a part of the Hybrid Intelligent Algorithm, a model based on an ANN (artificial neural network) has been proposed in this paper to represent hybrid system behaviour considering the uncertainty related to wind speed and solar radiation, battery bank lifetime, and fuel prices. The Hybrid Intelligent Algorithm suggests a combination of probabilistic analysis based on a Monte Carlo simulation approach and artificial neural network training embedded in a genetic algorithm optimisation model. The installation of a typical hybrid system was analysed. Probabilistic analysis was used to generate an input–output dataset of 519 samples that was later used to train the ANNs to reduce the computational effort required. The generalisation ability of the ANNs was measured in terms of RMSE (Root Mean Square Error), MBE (Mean Bias Error), MAE (Mean Absolute Error), and R-squared estimators using another data group of 200 samples. The results obtained from the estimation of the expected energy not supplied, the probability of a determined reliability level, and the estimation of expected value of net present cost show that the presented model is able to represent the main characteristics of a typical hybrid power system under uncertain operating conditions. - Highlights: • This paper presents a probabilistic model for stand-alone hybrid power system. • The model considers the main sources of uncertainty related to renewable resources. • The Hybrid Intelligent Algorithm has been applied to represent hybrid system behaviour. • The installation of a typical hybrid system was analysed. • The results obtained from the study case validate the presented model

  13. Predictors of a nursing home placement from a non-acute geriatric hospital.

    Science.gov (United States)

    Aditya, B S; Sharma, J C; Allen, S C; Vassallo, M

    2003-02-01

    Identifying patients who need Nursing Home (NH) care following a hospital admission is important. To identify the factors that predispose to an NH discharge. Prospective observational study with blinded end-point evaluation. A non-acute geriatric hospital. Two hundred consecutive elderly patients who were admitted for rehabilitation following treatment for an acute illness. Discharge to an NH or home. Thirty-five out of the 150 live discharges (23.3%) were to an NH. NH discharges had a longer length of stay (38.5 versus 19.8 days; p falls (p = 0.02) and to have sustained a fall while in hospital (p = 0.001). Multiple logistic regression identified confusion (p = 0.001), incontinence (p = 0.02), falls in hospital (p = 0.01), gait abnormalities (p factors present: 4.28% for 0-2 factors, 25.8% for 3-4 factors and 81.8% for 5-6 factors (p factors should be the target of specific rehabilitation in an attempt to reduce the risk of discharge to a nursing home and improve patient outcome.

  14. Learnt and perceived professional roles of a new type of nurse specialized in Gerontology and Geriatrics, a qualitative study.

    Science.gov (United States)

    Huizenga, Petra; Finnema, Evelyn; Roodbol, Petrie

    2016-07-01

    To gain insight into a new type of nurse specialized in gerontology and geriatrics, how they find meaning in the care of older persons and how this relates to the seven professional roles derived from the CanMEDS theoretical framework. To promote the quality of care for older persons in the Netherlands, one of the measures taken is the training and deployment of Registered Nurses specialized in Gerontology and Geriatrics. We focus on their professional roles in this study, to gain insight into the extent to which they fulfil their professional standards. A qualitative study, consisting of seven focus group interviews. The study population included 67 Registered Nurses. Data were collected between October 2011-May 2013. Nurses work in all seven CanMEDS roles, but not with all competences associated with these seven roles. The more distant the role is from patient activities, the less frequently competences such as social networks; design; research; innovation of care; legal, financial and organizational frameworks; professional ethics and professional innovation are mentioned. Nurses engage in activities consistent with nursing care for older people; however, despite their training, they are mainly focused on direct-patient care. Their limited awareness of the complete range of professional competences risks the stagnation of their development in professional roles such as health advocate, scholar and professional, which will not lead to an improvement in the care for older persons. © 2016 John Wiley & Sons Ltd.

  15. A stand-alone demography and landscape structure module for Earth system models

    Science.gov (United States)

    Nieradzik, L. P.; Haverd, V.; Smith, B.; Cook, G. D.; Briggs, P.; Roxburgh, S.; Liedloff, A.; Meyer, C.; Canadell, J.

    2013-12-01

    component of any LSM, represents a significant advance in our ability to use in-situ and remotely sensed observations of biomass and individual level parameters (e.g. crown-size, tree-height, stem diameter) as constraints on the terrestrial carbon cycle. Haverd, V., B. Smith, G. Cook, P. Briggs, L. Nieradzik, S. Roxburgh, A. Liedloff, C. Meyer, and J. G. Canadell, A stand-alone tree demography and landscape structure module for Earth system models, submitted to Geophys. Res. Let., 2013 Wolf, A., P. Ciais, V. Bellassen, N. Delbart, C.B. Field, and J.A. Berry, Forest biomass allometry in global land surface models, Global Biogeochem. Cycles, 25, GB3015, doi:10.1029/2010GB003917, 2011

  16. prfectBLAST: a platform-independent portable front end for the command terminal BLAST+ stand-alone suite.

    Science.gov (United States)

    Santiago-Sotelo, Perfecto; Ramirez-Prado, Jorge Humberto

    2012-11-01

    prfectBLAST is a multiplatform graphical user interface (GUI) for the stand-alone BLAST+ suite of applications. It allows researchers to do nucleotide or amino acid sequence similarity searches against public (or user-customized) databases that are locally stored. It does not require any dependencies or installation and can be used from a portable flash drive. prfectBLAST is implemented in Java version 6 (SUN) and runs on all platforms that support Java and for which National Center for Biotechnology Information has made available stand-alone BLAST executables, including MS Windows, Mac OS X, and Linux. It is free and open source software, made available under the GNU General Public License version 3 (GPLv3) and can be downloaded at www.cicy.mx/sitios/jramirez or http://code.google.com/p/prfectblast/.

  17. Flexible Control of Small Wind Turbines With Grid Failure Detection Operating in Stand-Alone and Grid-Connected Mode

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Blaabjerg, Frede

    2004-01-01

    This paper presents the development and test of a flexible control strategy for an 11-kw wind turbine with a back-to-back power converter capable of working in both stand-alone and grid-connected mode. The stand-alone control is featured with a complex output voltage controller capable of handling...... nonlinear load and excess or deficit of generated power. Grid-connection mode with current control is also enabled for the case of isolated local grid involving other dispersed power generators such as other wind turbines or diesel generators. A novel automatic mode switch method based on a phase......-locked loop controller is developed in order to detect the grid failure or recovery and switch the operation mode accordingly. A flexible digital signal processor (DSP) system that allows user-friendly code development and on-line tuning is used to implement and test the different control strategies. The back...

  18. Stand-alone flat-plate photovoltaic power systems: System sizing and life-cycle costing methodology for Federal agencies

    Science.gov (United States)

    Borden, C. S.; Volkmer, K.; Cochrane, E. H.; Lawson, A. C.

    1984-01-01

    A simple methodology to estimate photovoltaic system size and life-cycle costs in stand-alone applications is presented. It is designed to assist engineers at Government agencies in determining the feasibility of using small stand-alone photovoltaic systems to supply ac or dc power to the load. Photovoltaic system design considerations are presented as well as the equations for sizing the flat-plate array and the battery storage to meet the required load. Cost effectiveness of a candidate photovoltaic system is based on comparison with the life-cycle cost of alternative systems. Examples of alternative systems addressed are batteries, diesel generators, the utility grid, and other renewable energy systems.

  19. Optimum autonomous stand-alone photovoltaic system design on the basis of energy pay-back analysis

    International Nuclear Information System (INIS)

    Kaldellis, J.K.; Zafirakis, D.; Kondili, E.

    2009-01-01

    Stand-alone photovoltaic (PV) systems comprise one of the most promising electrification solutions for covering the demand of remote consumers. However, such systems are strongly questioned due to extreme life-cycle (LC) energy requirements. For similar installations to be considered as environmentally sustainable, their LC energy content must be compensated by the respective useful energy production, i.e. their energy pay-back period (EPBP) should be found less than their service period. In this context, an optimum sizing methodology is currently developed, based on the criterion of minimum embodied energy. Various energy autonomous stand-alone PV-lead-acid battery systems are examined and two different cases are investigated; a high solar potential area and a medium solar potential area. By considering that the PV-battery (PV-Bat) system's useful energy production is equal to the remote consumer's electricity consumption, optimum cadmium telluride (CdTe) based systems yield the minimum EPBP (15 years). If achieving to exploit the net PV energy production however, the EPBP is found less than 20 years for all PV types. Finally, the most interesting finding concerns the fact that in all cases examined the contribution of the battery component exceeds 27% of the system LC energy requirements, reflecting the difference between grid-connected and stand-alone configurations.

  20. Control strategy of wind turbine based on permanent magnet synchronous generator and energy storage for stand-alone systems

    DEFF Research Database (Denmark)

    Deng, Fujin; Liu, Dong; Chen, Zhe

    2017-01-01

    This paper investigates a variable speed wind turbine based on permanent magnet synchronous generator and a full-scale power converter in a stand-alone system. An energy storage system(ESS) including battery and fuel cell-electrolyzer combination is connected to the DC link of the full-scale power...... converter through the power electronics interface. Wind is the primary power source of the system, the battery and FC-electrolyzer combination is used as a backup and a long-term storage system to provide or absorb power in the stand-alone system, respectively. In this paper, a control strategy is proposed...... for the operation of this variable speed wind turbine in a stand-alone system, where the generator-side converter and the ESS operate together to meet the demand of the loads. This control strategy is competent for supporting the variation of the loads or wind speed and limiting the DC-link voltage of the full...

  1. Methanol production via pressurized entrained flow biomass gasification – Techno-economic comparison of integrated vs. stand-alone production

    International Nuclear Information System (INIS)

    Andersson, Jim; Lundgren, Joakim; Marklund, Magnus

    2014-01-01

    The main objective with this work was to investigate techno-economically the opportunity for integrated gasification-based biomass-to-methanol production in an existing chemical pulp and paper mill. Three different system configurations using the pressurized entrained flow biomass gasification (PEBG) technology were studied, one stand-alone plant, one where the bark boiler in the mill was replaced by a PEBG unit and one with a co-integration of a black liquor gasifier operated in parallel with a PEBG unit. The cases were analysed in terms of overall energy efficiency (calculated as electricity-equivalents) and process economics. The economics was assessed under the current as well as possible future energy market conditions. An economic policy support was found to be necessary to make the methanol production competitive under all market scenarios. In a future energy market, integrating a PEBG unit to replace the bark boiler was the most beneficial case from an economic point of view. In this case the methanol production cost was reduced in the range of 11–18 Euro per MWh compared to the stand-alone case. The overall plant efficiency increased approximately 7%-units compared to the original operation of the mill and the non-integrated stand-alone case. In the case with co-integration of the two parallel gasifiers, an equal increase of the system efficiency was achieved, but the economic benefit was not as apparent. Under similar conditions as the current market and when methanol was sold to replace fossil gasoline, co-integration of the two parallel gasifiers was the best alternative based on received IRR. - Highlights: • Techno-economic results regarding integration of methanol synthesis processes in a pulp and paper mill are presented. • The overall energy efficiency increases in integrated methanol production systems compared to stand-alone production units. • The economics of the integrated system improves compared to stand-alone alternatives. • Tax

  2. Stand-Alone Personalized Normative Feedback for College Student Drinkers: A Meta-Analytic Review, 2004 to 2014.

    Directory of Open Access Journals (Sweden)

    Keri B Dotson

    Full Text Available Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF. Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention.To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF.Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted.Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students.Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation.Eight studies (13 interventions with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI [0.159, 0.423] and gender-specific PNF (dbetween = 0.284, 95% CI [0.117, 0.451] reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882] fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186] fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI [0.037, 0.278].Computer-delivered PNF is an effective stand-alone approach for reducing college student

  3. Stand-Alone Personalized Normative Feedback for College Student Drinkers: A Meta-Analytic Review, 2004 to 2014.

    Science.gov (United States)

    Dotson, Keri B; Dunn, Michael E; Bowers, Clint A

    2015-01-01

    Norms clarification has been identified as an effective component of college student drinking interventions, prompting research on norms clarification as a single-component intervention known as Personalized Normative Feedback (PNF). Previous reviews have examined PNF in combination with other components but not as a stand-alone intervention. To investigate the degree to which computer-delivered stand-alone personalized normative feedback interventions reduce alcohol consumption and alcohol-related harms among college students and to compare gender-neutral and gender-specific PNF. Electronic databases were searched systematically through November 2014. Reference lists were reviewed manually and forward and backward searches were conducted. Outcome studies that compared computer-delivered, stand-alone PNF intervention with an assessment only, attention-matched, or active treatment control and reported alcohol use and harms among college students. Between-group effect sizes were calculated as the standardized mean difference in change scores between treatment and control groups divided by pooled standard deviation. Within-group effect sizes were calculated as the raw mean difference between baseline and follow-up divided by pooled within-groups standard deviation. Eight studies (13 interventions) with a total of 2,050 participants were included. Compared to control participants, students who received gender-neutral (dbetween = 0.291, 95% CI [0.159, 0.423]) and gender-specific PNF (dbetween = 0.284, 95% CI [0.117, 0.451]) reported greater reductions in drinking from baseline to follow-up. Students who received gender-neutral PNF reported 3.027 (95% CI [2.171, 3.882]) fewer drinks per week at first follow-up and gender-specific PNF reported 3.089 (95% CI [0.992, 5.186]) fewer drinks. Intervention effects were small for harms (dbetween = 0.157, 95% CI [0.037, 0.278]). Computer-delivered PNF is an effective stand-alone approach for reducing college student drinking and

  4. Nursing Assessment and Intervention to Geriatric Patients Discharged from Emergency Departments

    DEFF Research Database (Denmark)

    Rosted, Elizabeth Emilie; Poulsen, Ingrid; Hendriksen, Carsten

    2011-01-01

    relevant referrals to geriatric outpatient clinic, community health centre, primary physician or arrangements with next-of-kin. Findings: 150 geriatric patients participated, mean age 81.7 (70-99). At discharge they had in mean 2 164 (0-9) unresolved problems, after 1 month 0.8 (0-5), and after 6 months 0...

  5. Facilitated Learning to Advance Geriatrics: Increasing the Capacity of Nurse Faculty to Teach Students About Caring for Older Adults.

    Science.gov (United States)

    Krichbaum, Kathleen; Kaas, Merrie J; Wyman, Jean F; Van Son, Catherine R

    2015-06-01

    The Facilitated Learning to Advance Geriatrics program (FLAG) was designed to increase the numbers of nurse faculty in prelicensure programs with basic knowledge about aging and teaching effectiveness to prepare students to provide safe, high quality care for older adults. Using a framework to improve transfer of learning, FLAG was designed to include: (a) a workshop to increase basic knowledge of aging and common geriatric syndromes, and effective use of evidence-based teaching/learning strategies; (b) a year-long mentoring program to support application of workshop learning and leading change in participants' schools to ensure that geriatrics is a priority. Both formative and summative evaluation methods were used, and included self-assessment of objectives, program satisfaction, and teaching self-efficacy. FLAG achieved its overall purpose by enrolling 152 participants from 19 states including 23 faculty from associate degree programs and 102 from baccalaureate programs. Self-rated teaching effectiveness improved significantly from pre- to post-workshop each year. Achievement of learning objectives was rated highly as was satisfaction. Transfer of learning was evidenced by implementation of educational projects in home schools supported by mentoring. The FLAG program provided opportunities for nurse educators to learn to teach geriatrics more effectively and to transfer learning to their work environment. Future FLAG programs will be offered in a shortened format, incorporating online content and strategies, adding other health professionals to the audience with the same goal of increasing the knowledge and abilities of educators to prepare learners to provide competent care for older adults. © The Author 2015. 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.

  6. Development of The Johns Hopkins University School of Nursing Adult/Geriatric Primary Care Nurse Practitioner Program in HIV Prevention, Treatment, and Care.

    Science.gov (United States)

    Farley, Jason E; Stewart, Jennifer; Kub, Joan; Cumpsty-Fowler, Carolyn; Lowensen, Kelly; Becker, Kathleen

    2016-01-01

    In response to the call to create an AIDS Education and Training Center for Nurse Practitioner Education by the Health Resources and Services Administration, The Johns Hopkins University School of Nursing embarked on a transformative curriculum overhaul to integrate HIV prevention, treatment, and care into the Adult/Geriatric Nurse Practitioner Program. A six-step process outlined in the Curriculum Development for Medical Education was followed. A pilot cohort of Adult/Geriatric Nurse Practitioner students were enrolled, including 50% primary care setting and 50% HIV-focused primary care through a 12-month HIV continuity clinic experience. Through this pilot, substantive changes to the program were adopted. Programmatic outcomes were not compromised with the modification in clinical hours. The model of a 12-month HIV continuity clinical experience reduced the number of required preceptors. This model has important implications for the HIV workforce by demonstrating successful integration of HIV and primary care training for nurse practitioners. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Hierarchical energy management system for stand-alone hybrid system based on generation costs and cascade control

    International Nuclear Information System (INIS)

    Torreglosa, J.P.; García, P.; Fernández, L.M.; Jurado, F.

    2014-01-01

    Highlights: • We present an energy management system for a stand-alone WT/PV/hydrogen/battery hybrid system. • Hierarchical control composed by master and slave control strategies. • Control assures reliable electricity support for stand-alone applications subject to technical and economic criteria. - Abstract: This paper presents an energy management system (EMS) for stand-alone hybrid systems composed by photovoltaic (PV) solar panels and a wind turbine (WT) as primary energy sources and two energy storage systems, which are a hydrogen system and a battery. The hydrogen system is composed of fuel cell (FC), electrolyzer and hydrogen storage tank. The EMS is a hierarchical control composed by a master control strategy and a slave control strategy. On the one hand, the master control generates the reference powers to meet several premises (such as to satisfy the load power demand, and to maintain the hydrogen tank level and the state of charge (SOC) of the battery between their target margins), taking also into account economic aspects to discriminate between using the battery or hydrogen system. On the other hand, the slave control modifies the reference powers generated by the master control according to the energy sources dynamic limitations, and maintains the DC bus voltage at its reference value. The models, implemented in MATLAB-Simulink environment, have been developed from commercially available components. To check the viability of the proposed EMS, two kinds of simulations were carried out: (1) A long-term simulation of 25 years (expected lifetime of the system) with a sample time of one hour to validate the master control of the EMS; and (2) A short-term simulation with sudden net power variations to validate the slave control of the EMS

  8. Use of stand-alone anchored intervertebral cage in the surgical treatment of patients with symptomatic cervical spondylosis

    Directory of Open Access Journals (Sweden)

    Tilen Žele

    2015-03-01

    Full Text Available Background:One of the most common surgical operations for treatment of cervical spondylosis is anterior cervical discectomy with fusion (ACDF. In order to achieve stable fusion after discectomy and avoid dysphagia the artificial stand-alone zero-profile cages with integrated screws were developed and introduced into clinical practice. Outcome and complications after ACDF with such cages were not adequately assessed yet.Methods:We analyzed 20 consecutive patients with cervical spondylosis treated in our institution with ACDF with stand-alone zero-profile cage Zero-P. Before and after surgery and then 6, 12 and 24 months after surgery we assessed the level of pain with VAS scale, severity of myelopathy with mJOA scale and dysphagia with four level scale. Treatment outcome was assessed after 2 years according to Odom's criteria.Results:No complications occurred during surgery or recovery after surgery. The VAS score after surgery and then after 6, 12 and 24 months was statistically significantly lower than before surgery (p<0.05. The mJOA scores were 6, 12 and 24 months after surgery statistically significantly higher than before surgery (p<0.05. Transient and mild dysphagia was present after surgery in 15% (3/20 of patients and 6, 12 or 24 months after surgery in none. Outcome after 2 years was excellent in 9 patients and good in 11 patients.Conclusions:Operative treatment of symptomatic cervical spondylosis with ACDF using stand-alone zero-profile cage with integrated screws is safe and efficient. Incidence of dysphagia after surgery is low and generally transient.

  9. An optimized Fuzzy Logic Controller by Water Cycle Algorithm for power management of Stand-alone Hybrid Green Power generation

    International Nuclear Information System (INIS)

    Sarvi, Mohammad; Avanaki, Isa Nasiri

    2015-01-01

    Highlights: • A new method to improve the performance of renewable power management is proposed. • The proposed method is based on Fuzzy Logic optimized by the Water Cycle Algorithm. • The proposed method characteristics are compared with two other methods. • The comparisons confirm that the proposed method is robust and effectiveness one. - Abstract: This paper aims to improve the power management system of a Stand-alone Hybrid Green Power generation based on the Fuzzy Logic Controller optimized by the Water Cycle Algorithm. The proposed Stand-alone Hybrid Green Power consists of wind energy conversion and photovoltaic systems as primary power sources and a battery, fuel cell, and Electrolyzer as energy storage systems. Hydrogen is produced from surplus power generated by the wind energy conversion and photovoltaic systems of Stand-alone Hybrid Green Power and stored in the hydrogen storage tank for fuel cell later using when the power generated by primary sources is lower than load demand. The proposed optimized Fuzzy Logic Controller based power management system determines the power that is generated by fuel cell or use by Electrolyzer. In a hybrid system, operation and maintenance cost and reliability of the system are the important issues that should be considered in studies. In this regard, Water Cycle Algorithm is used to optimize membership functions in order to simultaneously minimize the Loss of Power Supply Probability and operation and maintenance. The results are compared with the particle swarm optimization and the un-optimized Fuzzy Logic Controller power management system to prove that the proposed method is robust and effective. Reduction in Loss of Power Supply Probability and operation and maintenance, are the most advantages of the proposed method. Moreover the level of the State of Charge of the battery in the proposed method is higher than other mentioned methods which leads to increase battery lifetime.

  10. Optimization of a stand-alone Solar PV-Wind-DG Hybrid System for Distributed Power Generation at Sagar Island

    Science.gov (United States)

    Roy, P. C.; Majumder, A.; Chakraborty, N.

    2010-10-01

    An estimation of a stand-alone solar PV and wind hybrid system for distributed power generation has been made based on the resources available at Sagar island, a remote area distant to grid operation. Optimization and sensitivity analysis has been made to evaluate the feasibility and size of the power generation unit. A comparison of the different modes of hybrid system has been studied. It has been estimated that Solar PV-Wind-DG hybrid system provides lesser per unit electricity cost. Capital investment is observed to be lesser when the system run with Wind-DG compared to Solar PV-DG.

  11. Losses Evaluation for a Two-Level Three-Phase Stand-Alone Voltage Source Converter Using Model Predictive Control

    DEFF Research Database (Denmark)

    Al hasheem, Mohamed; Dragicevic, Tomislav; Rivera, Marco

    2017-01-01

    conventional and improved controller is conducted in terms of losses. The switching and conduction losses for the VSC are calculated using MATLAB/SIMULINK and PLECS software. A power level up to 1 kW is considered for the conventional and the improved schemes. All simulation and experimental results......This paper discusses a Model Predictive Control (MPC) scheme for a Voltage Source Converter (VSC) where the aim is to minimize losses and Total Harmonics distortion (THD) compared to the conventional MPC scheme. Different Cost Functions (CFs) are applied to the stand-alone VSC. A comparison between...

  12. Dynamic behavior of PEM FCPPs under various load conditions and voltage stability analysis for stand-alone residential applications

    Science.gov (United States)

    Uzunoglu, M.; Onar, O. C.; Alam, M. S.

    In this paper, dynamic behavior and performance of a fuel cell power plant (FCPP) which operates in parallel with a battery bank is tested under classified load conditions, such as mostly resistive, mostly inductive, resistive-inductive and non-linear loads. Thereafter, voltage stability analysis is performed using the dynamic response of the FCPP for stand-alone residential applications. Simulation results are obtained using the MATLAB ® and Simulink ® software packages, based on the mathematical and dynamic electrical models of the system. Using the experimental results, a validated model has been realized and voltage stability analysis is performed through this model.

  13. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    Directory of Open Access Journals (Sweden)

    Beck Barbara-Beate

    2009-12-01

    Full Text Available Abstract Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices

  14. Economic and Environmental Assessment of a Renewable Stand-Alone Energy Supply System Using Multi-objective Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dohyun; Han, Seulki; Kim, Jiyong Kim [Incheon National University, Incheon (Korea, Republic of)

    2017-06-15

    This study aims to propose a new optimization-based approach for design and analysis of the stand-alone hybrid energy supply system using renewable energy sources (RES). In the energy supply system, we include multiple energy production technologies such as Photovoltaics (PV), Wind turbine, and fossil-fuel-based AC generator along with different types of energy storage and conversion technologies such as battery and inverter. We then select six different regions of Korea to represent various characteristics of different RES potentials and demand profiles. We finally designed and analyzed the optimal RES stand-alone energy supply system in the selected regions using multiobjective optimization (MOOP) technique, which includes two objective functions: the minimum cost and the minimum CO{sub 2} emission. In addition, we discussed the feasibility and expecting benefits of the systems by comparing to conventional systems of Korea. As a result, the region of the highest RES potential showed the possibility to remarkably reduce CO{sub 2} emissions compared to the conventional system. Besides, the levelized cost of electricity (LCOE) of the RES-based energy system is identified to be slightly higher than conventional energy system: 0.35 and 0.46 $/kWh, respectively. However, the total life-cycle emission of CO{sub 2} (LCECO{sub 2}) can be reduced up to 470 gCO{sub 2}/kWh from 490 gCO{sub 2}/kWh of the conventional systems.

  15. Comparison of pulp-mill-integrated hydrogen production from gasified black liquor with stand-alone production from gasified biomass

    International Nuclear Information System (INIS)

    Andersson, E.; Harvey, S.

    2007-01-01

    When gasified black liquor is used for hydrogen production, significant amounts of biomass must be imported. This paper compares two alternative options for producing hydrogen from biomass: (A) pulp-mill-integrated hydrogen production from gasified back liquor; and (B) stand-alone production of hydrogen from gasified biomass. The comparison assumes that the same amount of biomass that is imported in Alternative A is supplied to a stand-alone hydrogen production plant and that the gasified black liquor in Alternative B is used in a black liquor gasification combined cycle (BLGCC) CHP unit. The comparison is based upon equal amounts of black liquor fed to the gasifier, and identical steam and power requirements for the pulp mill. The two systems are compared on the basis of total CO 2 emission consequences, based upon different assumptions for the reference energy system that reflect different societal CO 2 emissions reduction target levels. Ambitions targets are expected to lead to a more CO 2 -lean reference energy system, in which case hydrogen production from gasified black liquor (Alternative A) is best from a CO 2 emissions' perspective, whereas with high CO 2 emissions associated with electricity production, hydrogen from gasified biomass and electricity from gasified black liquor (Alternative B) is preferable. (author)

  16. Multi-objective optimal planning of the stand-alone microgrid system based on different benefit subjects

    International Nuclear Information System (INIS)

    Guo, Li; Wang, Nan; Lu, Hai; Li, Xialin; Wang, Chengshan

    2016-01-01

    As an important means to realize the energetic complementarity and improve the efficiency of renewable resources, the stand-alone microgrid (SAMG) system gains attention increasingly, especially in islands and remote areas. In this paper, considering the interest conflict of the distribution company and the distributed generation owner, a new multi-objective optimal planning model is formulated for medium voltage SAMG. Besides, to avoid the power constraint of distributed generation (DG) once the over-limit voltage occurs, a novel two-step power dispatch control method including the voltage regulation strategy is proposed, in which the absorption of distributed power by energy storage system (ESS) and the reactive power adjustment though its power control system are used to regulate voltage. The goal of this paper is to search the Pareto-optimal front of the site and capacity of DG as well as the contract price between both parties, and thus can provide effective references for practical planning of SAMG. Considering the high cost of ESS, the investment analysis of ESS is also discussed in the paper. - Highlights: • A multi-objective planning model based on different benefit subjects is proposed. • A two-step power dispatch method including the voltage regulation is proposed. • The economical efficiency of the proposed model is analyzed. • The effective reference for the stand-alone microgrid planning is provided.

  17. SedInConnect: a stand-alone, free and open source tool for the assessment of sediment connectivity

    Science.gov (United States)

    Crema, Stefano; Cavalli, Marco

    2018-02-01

    There is a growing call, within the scientific community, for solid theoretic frameworks and usable indices/models to assess sediment connectivity. Connectivity plays a significant role in characterizing structural properties of the landscape and, when considered in combination with forcing processes (e.g., rainfall-runoff modelling), can represent a valuable analysis for an improved landscape management. In this work, the authors present the development and application of SedInConnect: a free, open source and stand-alone application for the computation of the Index of Connectivity (IC), as expressed in Cavalli et al. (2013) with the addition of specific innovative features. The tool is intended to have a wide variety of users, both from the scientific community and from the authorities involved in the environmental planning. Thanks to its open source nature, the tool can be adapted and/or integrated according to the users' requirements. Furthermore, presenting an easy-to-use interface and being a stand-alone application, the tool can help management experts in the quantitative assessment of sediment connectivity in the context of hazard and risk assessment. An application to a sample dataset and an overview on up-to-date applications of the approach and of the tool shows the development potential of such analyses. The modelled connectivity, in fact, appears suitable not only to characterize sediment dynamics at the catchment scale but also to integrate prediction models and as a tool for helping geomorphological interpretation.

  18. A Control Approach and Supplementary Controllers for a Stand-Alone System with Predominance of Wind Generation

    Directory of Open Access Journals (Sweden)

    Tiago Lukasievicz

    2018-02-01

    Full Text Available This paper proposes a control approach and supplementary controllers for the operation of a hybrid stand-alone system composed of a wind generation unit and a conventional generation unit based on synchronous generator (CGU. The proposed controllers allow the islanded or isolated operation of small power systems with predominance of wind generation. As an advantage and a paradigm shift, the DC-link voltage of the wind unit is controlled by means of a conventional synchronous generator connected to the AC grid of the system. Two supplementary controllers, added to a diesel generator (DIG and to a DC dump load (DL, are proposed to control the DC-link voltage. The wind generation unit operates in V-f control mode and the DIG operates in PQ control mode, which allows the stand-alone system to operate either in wind-diesel (WD mode or in wind-only (WO mode. The strong influence of the wind turbine speed variations in the DC-link voltage is mitigated by a low-pass filter added to the speed control loop of the wind turbine. The proposed control approach does not require the use battery bank and ultra-capacitor to control the DC-link voltage in wind generation units based on fully rated converter.

  19. Study on Soft Phase Locked Method to Solving the Synchronization Problem of Active Power Filter in Stand-alone Power Grid

    DEFF Research Database (Denmark)

    Zhuo, Fang; Wu, Longhui; Chen, Zhe

    2009-01-01

    on zero-cross detection can't work effectively in small rating stand-alone power grid. Then a soft phase locked loop with additional filter is proposed. It can lock the phase angle on to the positive sequence of fundamental voltage accurately and rapidly. It ensures the performance of APF applied...... in the small rating stand-alone power grid. Moreover, the soft phase locked loop is easy to be implemented in a Digital Signal Processor (DSP). Simulation and experimental results validate that the soft phase locked loop has satisfactory performance.......Traditional LC filters can't work stably in small rating stand-alone power grid. So active power filter (APF) is becoming an important tool to solve the power quality problem in small rating stand-alone power grid. In most current detection algorithm of APF, it needs a synchronizing signal. Firstly...

  20. Accumulation of geriatric conditions is associated with poor nutritional status in dependent older people living in the community and in nursing homes.

    Science.gov (United States)

    Hirose, Takahisa; Hasegawa, Jun; Izawa, Sachiko; Enoki, Hiromi; Suzuki, Yuske; Kuzuya, Masafumi

    2014-01-01

    To clarify the association between nutritional status and the prevalence of geriatric conditions in dependent older adults. A cross-sectional observational study of dependent older adults aged 65years or older who were living either in the community (n = 511, mean age 81.2years) or in nursing homes (n = 587, mean age 85.2years) was carried out. Data included the participants' demographic characteristics, basic activities of daily living, Charlson Comorbidity Index and the prevalence of eight geriatric conditions (visual impairment, hearing impairment, falls, bladder control problems, cognitive impairment, impaired mobility, swallowing disturbance and loss of appetite). Nutritional status was assessed by the Mini Nutritional Assessment short form (MNA-SF). Of 1098 participants, 21.4% (n = 235) were categorized as "malnourished", according to the MNA-SF classification. Participants in the "malnourished" group had a greater number of geriatric conditions than those in the other two groups. A higher prevalence of all the geriatric conditions except for falls was detected in the group with poorer nutritional status. Multivariate logistic regression analysis showed that malnutrition was associated with the number of geriatric conditions, but not with that of comorbidities, even after controlling for confounders. Malnutrition was confirmed to have significant associations with geriatric conditions in dependent older adults. © 2013 Japan Geriatrics Society.

  1. Clinical and radiological outcome after anterior cervical discectomy and fusion with stand-alone empty polyetheretherketone (PEEK) cages.

    Science.gov (United States)

    Shiban, Ehab; Gapon, Karina; Wostrack, Maria; Meyer, Bernhard; Lehmberg, Jens

    2016-02-01

    To evaluate long-term results after one-, two-, and three-level anterior cervical discectomy and fusion (ACDF) with stand-alone empty polyetheretherketone (PEEK) cages. We performed a retrospective review of a consecutive patient cohort that underwent ACDF with stand-alone empty PEEK cages between 2007 and 2010 with a minimum follow-up of 12 months. Radiographic follow-up included static and flexion/extension radiographs. Changes in the operated segments were measured and compared to radiographs directly after surgery. Clinical outcome was evaluated by a physical examination, pain visual analog scale (VAS), and health-related quality of life (HRQL) using the EuroQOL questionnaire (EQ-5D). Analysis of associations between fusion, subsidence, cervical alignment, and clinical outcome parameters were performed. Of 407 consecutive cases, 318 met all inclusion criteria. Follow-up data were obtained from 265 (83 %) cases. The mean age at presentation was 55 years and 139 patients were male (52 %). In the sample, 127, 125, and 13 patients had one-, two-, and three-level surgeries, respectively; 132 (49 %) presented with spondylotic cervical myelopathy and 133 (50 %) with cervical radiculopathy. Fusion was achieved in 85, 95, and 94 % of segments in one-, two-, and three-level surgeries, respectively. Non-fusion was associated with higher VAS pain levels. Radiographic adjacent segment disease (ASD) was observed in 20, 29, and 15 % in one-, two-, and three-level surgeries, respectively. ASD was associated with lower HRQL. Subsidence was observed in 25, 27, and 15 % of segments in one-, two-, and three-level surgeries, respectively. However, this had no influence on clinical outcome. Follow-up operations for symptomatic adjacent disc disease and implant failure at index level were needed in 16 (6 %) and four (1.5 %) cases, respectively. Younger age was associated with better clinical outcome. Multilevel surgery favored better myelopathy outcomes and fusion reduced overall

  2. Development and validation of the Psychotropic Education and Knowledge (PEAK) test on psychotropic drugs for nurses in an acute geriatric care setting

    NARCIS (Netherlands)

    Wauters, Maartin; Azermai, Majda; Perehudoff, Sammi-Jo; Versluys, Karen; Steeman, Els; Petrovic, Mirko

    Introduction: In Belgium, psychotropic drug use is high among older people. With low proven long-term effectiveness and possible severe side effects, psychotropic drugs in geriatric patients should be prescribed with utmost caution. Nursing staff’s knowledge on psychotropic drugs can be crucial in

  3. Online retrieval of patient information by asynchronous communication between general purpose computer and stand-alone personal computer

    International Nuclear Information System (INIS)

    Tsutsumi, Reiko; Takahashi, Kazuei; Sato, Toshiko; Komatani, Akio; Yamaguchi, Koichi

    1988-01-01

    Asynchronous communication was made between host (FACOM M-340) and personal computer (OLIBETTIE S-2250) to get patient's information required for RIA test registration. The retrieval system consists of a keyboad input of six numeric codes, patient's ID, and a real time reply containing six parameters for the patient. Their identified parameters are patient's name, sex, date of birth (include area), department, and out- or inpatient. Linking this program to RIA registration program for individual patient, then, operator can input name of RIA test requested. Our simple retrieval program made a useful data network between different types of host and stand-alone personal computers, and enabled us accurate and labor-saving registration for RIA test. (author)

  4. Life cycle assessment study of a 4.2 kW{sub p} stand-alone photovoltaic system

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Valverde, R.; Miguel, C.; Urbina, A. [Universidad Politecnica de Cartagena, Departamento de Electronica, Tecnologia de Computadoras y Proyectos, Campus Muralla del Mar, 30203, Cartagena, Murcia (Spain); Martinez-Bejar, R. [Universidad de Murcia, Departamento de Ingenieria de la Informacion y las Comunicaciones, Facultad de Informatica, Campus de Espinardo, 30071, Murcia (Spain)

    2009-09-15

    The energetic and environmental life cycle assessment of a 4.2 kW{sub p} stand-alone photovoltaic system (SAPV) at the University of Murcia (south-east of Spain) is presented. PV modules and batteries are the energetically and environmentally most expensive elements. The energy pay-back time was found to be 9.08 years and the specific CO{sub 2} emissions was calculated as 131 g/kWh. The SAPV system has been environmentally compared with other supply options (diesel generator and Spanish grid) showing lower impacts in both cases. The results show the CO{sub 2}-emission reduction potential of SAPV systems in southern European countries and point out the critical environmental issues in these systems. (author)

  5. Integration of hydrogen energy technologies in stand-alone power systems analysis of the current potential for applications

    International Nuclear Information System (INIS)

    Zoulias, E.I.; Lymberopoulos, N.; Tsoutsos, T.; Glockner, R.; Mydske, H.J.; Vosseler, I.; Gavalda, O.; Taylor, P.

    2006-01-01

    The European study entitled: 'Market Potential Analysis for Introduction of Hydrogen Energy Technology in Stand-Alone Power Systems (H-SAPS)' aimed to establish a broad understanding of the market potential for H-SAPS and provide a basis for promoting in wide scale new technological applications. The scope of the study was limited to small and medium installations, up to a few hundred kW power rating and based on RE as the primary energy source. The potential for hydrogen technology in SAPS was investigated through an assessment of the technical potential for hydrogen, the market analysis and the evaluation of external factors. The results are mostly directed towards action by governments and the research community but also industry involvement is identified. The results include targeted market research, establishment of individual cost targets, regulatory changes to facilitate alternative grid solutions, information and capacity building, focused technology research and bridging the technology gaps. (author)

  6. Extra-peritoneal pressure packing without external pelvic fixation: A life-saving stand-alone surgical treatment

    Directory of Open Access Journals (Sweden)

    Guy Ron

    2015-01-01

    Full Text Available Purpose: Traditional maneuvers aim to decrease retroperitoneal bleeding in hemodynamically unstable multi-trauma patients with unstable pelvic fractures, are reportedly successful in approximately only 50%. The life-saving effect of extra-peritoneal pressure packing (EPPP is based on direct compression and control of both venous and arterial retroperitoneal bleeders. This study describes the safety and efficacy of emergent EPPP employment, as a stand-alone surgical treatment, that is, carried out without external pelvic fixation or emergent angiography. Materials and Methods: A retrospective chart review of all hemodynamic unstable, multi-trauma patients with mechanically unstable pelvic fractures treated by the EPPP technique at our medical center between the years 2005 and 2011. Survival rates, clinical, and physiological outcomes were followed prospectively. Results: Twenty-five of the 181 pelvic fracture patients had biomechanically unstable fractures that required surgical fixation. Fourteen of those 25 patients had deteriorating hemodynamic instability from massive pelvic bleeding which was resistant to resuscitation, and they underwent EPPP, as a stand-alone treatment. The procedure successfully achieved hemodynamic stability in all 14 patients and obviated the early mortality associated with massive pelvic bleeding. Three of these patients eventually succumbed to their multiple injuries. Conclusion: Implementation of EPPP improved all measured physiological outcome parameters and survival rates of hemodynamically unstable multi-trauma patients with unstable pelvic fractures in our trauma center. It provided the unique advantage of directly compressing the life-threatening retroperitoneal bleeders by applying direct pressure and causing a tamponade effect to stanch venous and arterial pelvic blood flow and obviate the early mortality associated with massive pelvic bleeding.

  7. Use of a mobile device by nursing home residents for long-term care comprehensive geriatric self-assessment: a feasibility study.

    Science.gov (United States)

    Huang, Fanpin; Chang, Polun; Hou, I-Ching; Tu, Ming-Hsiang; Lan, Chung-Fu

    2015-01-01

    Long-term-care comprehensive geriatric assessments, such as the Minimum Data Set 3.0, are used to evaluate the clinical, psychological, and personal status of residents in long-term-care nursing facilities. Nursing staff conducts assessment interviews, thereby increasing the workload of nurses and the cost of patient care. This study explored the ability of nursing home residents to use two different mobile devices for a geriatric self-assessment. Study participants were residents of long-term-care nursing homes. A modified Minimum Data Set 3.0 was converted to a format for use with a 6-inch mobile pad and a 3.7-inch mobile smartphone. The survey completion rate and the response time were measured. A Technology Assessment Model questionnaire analyzed the participants' experience. All participants were able to use a 6-inch pad, with an average completion rate of 92.9% and an average time for completion of 21 minutes. Only 20% of the participants could complete the assessment with the 3.7-inch smartphone. The participants found the 6-inch pad easier to use than the 3.7-inch smartphone. This exploratory study suggests that nursing home residents are able to use a mobile device to perform a geriatric self-assessment and delineates the importance of the ergonomics of the device.

  8. Using an Interdisciplinary Team for Geriatric Education in a Nursing Home.

    Science.gov (United States)

    Thompson, Robert F.; And Others

    1988-01-01

    In response to concerns about continuity of care, nurse practitioners and faculty members from medicine, pharmacy, and nursing developed an interdisciplinary curriculum for clinical experience in a nursing home, an educational and medical experience significantly different from those in hospital or ambulatory settings. (MSE)

  9. Leadership in Dental Hygiene Degree Completion Programs: A Pilot Study Comparing Stand-Alone Leadership Courses and Leadership-Infused Curricula.

    Science.gov (United States)

    Smith, Michelle L; Gurenlian, JoAnn R; Freudenthal, Jacqueline J; Farnsworth, Tracy J

    2016-05-01

    The aim of this study was to define the extent to which leadership and leadership skills are taught in dental hygiene degree completion programs by comparing stand-alone leadership courses/hybrid programs with programs that infuse leadership skills throughout the curricula. The study involved a mixed-methods approach using qualitative and quantitative data. Semi-structured interviews were conducted with program directors and faculty members who teach a stand-alone leadership course, a hybrid program, or leadership-infused courses in these programs. A quantitative comparison of course syllabi determined differences in the extent of leadership content and experiences between stand-alone leadership courses and leadership-infused curricula. Of the 53 U.S. dental hygiene programs that offer degree completion programs, 49 met the inclusion criteria, and 19 programs provided course syllabi. Of the program directors and faculty members who teach a stand-alone leadership course or leadership-infused curriculum, 16 participated in the interview portion of the study. The results suggested that competencies related to leadership were not clearly defined or measurable in current teaching. Reported barriers to incorporating a stand-alone leadership course included overcrowded curricula, limited qualified faculty, and lack of resources. The findings of this study provide a synopsis of leadership content and gaps in leadership education for degree completion programs. Suggested changes included defining a need for leadership competencies and providing additional resources to educators such as courses provided by the American Dental Education Association and the American Dental Hygienists' Association.

  10. A cross-sectional study of stand-alone percutaneous coronary intervention in a Nigerian cardiac catheterization laboratory.

    Science.gov (United States)

    Johnson, Adeyemi; Falase, Bode; Ajose, Ifeoluwa; Onabowale, Yemi

    2014-01-16

    There is a paucity of diagnostic and therapeutic facilities in Nigeria to confirm coronary artery disease and offer appropriate interventional therapy. There is now a private cardiac catheterization laboratory in Lagos but as there are no sustained Open Heart Surgery programmes, percutaneous coronary interventions are currently being performed without surgical backup. This study was designed to assess results of stand-alone percutaneous coronary intervention (PCI) as currently practiced in Lagos, Nigeria. This cross-sectional study was conducted between July 2009 and July 2012. The study included all patients that underwent PCI in Lagos. Data was extracted from a prospectively maintained database. Coronary artery disease was confirmed in 80 (52.6%) of 152 Nigerians referred with a diagnosis of Ischaemic Heart Disease. There were 53 males (66.2%) and 27 females (33.8%). The average age was 60.3 +/-9.6 years and average euroscore was 4.5 +/-3.1. Of the 80 patients, 77 (96.3%) had significant stenoses and were candidates for revascularization. Distribution of significant stenoses was one in 32 patients (41.5%), two in 11 patients (14.3%), three in 19 patients (24.7%), four in 13 patients (16.9%) and five in 2 patients (2.6%). PCI was performed in 48 (62.3%) of the patients eligible for revascularization as the coronary anatomy in the remaining patients was not suitable for PCI. The indication for PCI was for myocardial infarction or unstable angina in 39 patients (81.2%). PCI was performed with PTCA plus stenting in 41 patients (85.4%) and with PTCA alone in 7 patients (14.6%) with good angiographic results. Overall 29 of the 48 patients (60.4%) had complete revascularization of significant stenoses. Complications of PCI were bleeding that required blood transfusion in 1 patient (2.1%), minor femoral haematomas in 2 patients (4.2%), and a major adverse clinical event in 1 patient (2.1%). A stand-alone PCI programme has been developed in Lagos, Nigeria. Both elective

  11. Oral health care-related beliefs among Finnish geriatric home care nurses.

    Science.gov (United States)

    Pihlajamäki, T; Syrjälä, A-M; Laitala, M-L; Pesonen, P; Virtanen, J I

    2016-11-01

    The aim was to investigate beliefs about oral health care tasks among nursing staff caring for home-dwelling older people using the Nursing Dental Coping Beliefs (nursing DCBS) index. The study population comprised nursing staff working at the homes and sheltered accommodations of older people in Ylivieska, Finland (N = 141). The data were collected using the nursing DCBS index (five-point Likert scale). On average, the nurses held moderate to high Oral health care beliefs, Internal locus of control beliefs and External locus of control beliefs, but low beliefs about Self-efficacy. The nurses with an earlier adjunct education scored lower for Oral health care beliefs on the factor Knowledge about preventing gum diseases (OR = 0.3, 95% CI: 0.1-0.9) than did the others. Regarding beliefs about External locus of control, the age group 31-49 years scored lower on the factor Retaining teeth as one ages (OR = 0.2, 95% CI: 0.1-0.7), but scored higher on the factor How to prevent dental diseases (OR = 5.6, 95% CI: 1.1-29.3) than did younger nurses (≤30 years). The nurses with only a nursing education showed significantly higher mean scores on the Self-efficacy factor Confidence of the need for dental knowledge than did those with an earlier adjunct education (P = 0.034). The nursing staff mostly believed that oral diseases are preventable and teeth can be retained in advanced age, but failed to recognize the value of dental knowledge and had little confidence in their ability to manage oral diseases. Improving the oral health-related knowledge and self-efficacy beliefs of nursing staff will require additional oral health education. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. National Database of Geriatrics

    DEFF Research Database (Denmark)

    Kannegaard, Pia Nimann; Vinding, Kirsten L; Hare-Bruun, Helle

    2016-01-01

    AIM OF DATABASE: The aim of the National Database of Geriatrics is to monitor the quality of interdisciplinary diagnostics and treatment of patients admitted to a geriatric hospital unit. STUDY POPULATION: The database population consists of patients who were admitted to a geriatric hospital unit....... Geriatric patients cannot be defined by specific diagnoses. A geriatric patient is typically a frail multimorbid elderly patient with decreasing functional ability and social challenges. The database includes 14-15,000 admissions per year, and the database completeness has been stable at 90% during the past......, percentage of discharges with a rehabilitation plan, and the part of cases where an interdisciplinary conference has taken place. Data are recorded by doctors, nurses, and therapists in a database and linked to the Danish National Patient Register. DESCRIPTIVE DATA: Descriptive patient-related data include...

  13. Adaptive Artificial intelligence based fuzzy logic MPPTcontrol for stande-alone photovoltaic system under different atmospheric conditions

    Directory of Open Access Journals (Sweden)

    Zaghba Layachi

    2015-08-01

    Full Text Available there is an increased need for analysing the effect of atmospheric variables on photovoltaic (PV production and performance. The outputs from the different PV cells in different atmospheric conditions, such as irradiation and temperature , differ from each other evidencing knowledge deficiency in PV systems [14]. Maximum power point tracking (MPPT methods are used to maximize the PV array output power by tracking continuously the maximum power point (MPP. Among all MPPT methods existing in the literature, perturb and observe (P&O is the most commonly used for its simplicity and ease of implementation; however, it presents drawbacks such as slow response speed, oscillation around the MPP in steady state, and even tracking in wrong way under rapidly changing atmospheric conditions. In order to allow a functioning around the optimal point Mopt, we have inserted a DC-DC converter (Buck–Boost for a better matching between the PV and the load. This paper, we study the Maximum power point tracking using adaptive Intelligent fuzzy logic and conventional (P&O control for stande-alone photovoltaic Array system .In particular, the performances of the controllers are analyzed under variation weather conditions with are constant temperature and variable irradiation. The proposed system is simulated by using MATLAB-SIMULINK. According to the results, fuzzy logic controller has shown better performance during the optimization.

  14. Modeling and Experimental Test of Grid-Tied Photovoltaic Cell Emulating System in the Stand-alone Mode

    Directory of Open Access Journals (Sweden)

    Vu Minh Phap

    2017-06-01

    Full Text Available In recent decades, generation of electricity from solar arrays has been increased to meet the world's growing energy demand. However, the utilization rate of the power conditioner in the grid-tied solar power system is low because the operation of solar panels is dependent on sunlight. Thus, we studied the method that the small scale wind power generating system in size from a few hundred watts to two or three kilowatts can be connected to the grid-tied power conditioner of the solar power system for residential applications with low power ratings (single phase, size is limited to 10kW by emulating characteristic of the solar panel. In this paper, we introduce the application of the grid-tied PV cell emulating system in the stand-alone mode to improve the utilization rate of the power conditioner. The simulation and experimental test results verify that the PV cell emulating system can operate the power conditioner of the gridtied solar power system.

  15. Automation infrastructure and operation control strategy in a stand-alone power system based on renewable energy sources

    Science.gov (United States)

    Ziogou, Chrysovalantou; Ipsakis, Dimitris; Elmasides, Costas; Stergiopoulos, Fotis; Papadopoulou, Simira; Seferlis, Panos; Voutetakis, Spyros

    The design of the automation system and the implemented operation control strategy in a stand-alone power system in Greece are fully analyzed in the present study. A photovoltaic array and three wind generators serve as the system main power sources and meet a predefined load demand. A lead-acid accumulator is used to compensate the inherent power fluctuations (excess or shortage) and to regulate the overall system operation, based on a developed power management strategy. Hydrogen is produced by using system excess power in a proton exchange membrane (PEM) electrolyzer and is further stored in pressurized cylinders for subsequent use in a PEM fuel cell in cases of power shortage. A diesel generator complements the integrated system and is employed only in emergency cases, such as subsystems failure. The performance of the automatic control system is evaluated through the real-time operation of the power system where data from the various subsystems are recorded and analyzed using a supervised data acquisition unit. Various network protocols were used to integrate the system devices into one central control system managing in this way to compensate for the differences between chemical and electrical subunits. One of the main advantages is the ability of process monitoring from distance where users can perform changes to system principal variables. Furthermore, the performance of the implemented power management strategy is evaluated through simulated scenarios by including a case study analysis on system abilities to meet higher than expected electrical load demands.

  16. Stand-alone power systems for the future: Optimal design, operation and control of solar-hydrogen energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Ulleberg, Oeystein

    1998-12-31

    This thesis gives a systematic review of the fundamentals of energy systems, the governing physical and chemical laws related to energy, inherent characteristics of energy system, and the availability of the earth`s energy. It shows clearly why solar-hydrogen systems are one of the most viable options for the future. The main subject discussed is the modelling of SAPS (Stand-Alone Power Systems), with focus on photovoltaic-hydrogen energy systems. Simulation models for a transient simulation program are developed for PV-H{sub 2} components, including models for photovoltaics, water electrolysis, hydrogen storage, fuel cells, and secondary batteries. A PV-H{sub 2} demonstration plant in Juelich, Germany, is studied as a reference plant and the models validated against data from this plant. Most of the models developed were found to be sufficiently accurate to perform short-term system simulations, while all were more than accurate enough to perform long-term simulations. Finally, the verified simulation models are used to find the optimal operation and control strategies of an existing PV-H{sub 2} system. The main conclusion is that the simulation methods can be successfully used to find optimal operation and control strategies for a system with fixed design, and similar methods could be used to find alternative system designs. 148 refs., 78 figs., 31 tabs.

  17. Multi-Objective Optimal Design of Stand-Alone Hybrid Energy System Using Entropy Weight Method Based on HOMER

    Directory of Open Access Journals (Sweden)

    Jiaxin Lu

    2017-10-01

    Full Text Available Implementation of hybrid energy system (HES is generally considered as a promising way to satisfy the electrification requirements for remote areas. In the present study, a novel decision making methodology is proposed to identify the best compromise configuration of HES from a set of feasible combinations obtained from HOMER. For this purpose, a multi-objective function, which comprises four crucial and representative indices, is formulated by applying the weighted sum method. The entropy weight method is employed as a quantitative methodology for weighting factors calculation to enhance the objectivity of decision-making. Moreover, the optimal design of a stand-alone PV/wind/battery/diesel HES in Yongxing Island, China, is conducted as a case study to validate the effectiveness of the proposed method. Both the simulation and optimization results indicate that, the optimization method is able to identify the best trade-off configuration among system reliability, economy, practicability and environmental sustainability. Several useful conclusions are given by analyzing the operation of the best configuration.

  18. Development of a Laser-Powered Dielectric Structure-Based Accelerator as a Stand-Alone Particle Source

    International Nuclear Information System (INIS)

    Yoder, R. B.; Travish, G.; Arab, E. R.; Fong, D.; Hoyer, Z.; Lacroix, U. H.; Vartanian, N.; Rosenzweig, J. B.

    2010-01-01

    An experimental program to develop and build a dielectric-based slab-symmetric structure (the micro-accelerator platform, or MAP) for generating and accelerating low-energy electrons is underway at UCLA and Manhattanville College. This optical acceleration structure is effectively a resonant cavity powered by a side-coupled laser, and has applications as a radiation source for medicine or industry. We present recent experimental and computational results on the accelerator, and progress toward its incorporation into a self-contained particle source. Such a particle source would incorporate a micron-scale electron emitter and a non-relativistic capture region to enable self-injection into the synchronous field within the accelerator. A prototype of the accelerator itself has been constructed from candidate dielectric materials using micromanufacturing techniques; the current status of the testing program is described. A novel electron emitter incorporating pyroelectric crystals with field-enhancing tips has been demonstrated to produce steady currents; the results are dependent on tip geometry, and appear suitable for injection into a microstructure. Extension of the MAP concept to non-relativistic velocities, as in the stand-alone source, requires a tapered structure that gives rise to numerous complications including beam defocusing and manufacturing challenges; approaches for addressing these complications are mentioned.

  19. Life cycle assessment of stand-alone photovoltaic (SAPV) system under on-field conditions of New Delhi, India

    International Nuclear Information System (INIS)

    Sharma, Rakhi; Tiwari, G.N.

    2013-01-01

    In this paper, life cycle analysis has been carried out to evaluate overall performance of given rated stand-alone solar photovoltaic (SAPV) in terms of basic energy matrices, life cycle cost analysis, and earned carbon credit. Further, the experimentally calculated actual on-field life cycle performance results of existing outdoor SAPV system (i.e. almost 20 years old) have been represented with respect to the potential (max.) performance of same SAPV system estimated under same environmental conditions of solar intensity, ambient temperature, PV operating temperature as obtained during actual on-field performance evaluation. This new approach of overall performance evaluation by considering the on-field SAPV system installation as new (i.e. with potential/max. performance) and old (i.e. with actual performance) under same environmental conditions provides an inclusive comparative life cycle assessment of on-field PV system. - Highlights: • We present comparative life cycle assessment methodology for outdoor PV system. • We evaluate on-field PV system life performance by considering it as new and old. • We examine fall in actual on-field PV performance compared to potential performance. • PV system techno-economic performance reduces with the long term exposure or aging. • We observe fall in earned carbon credit and rise in cost/kWh as PV system ages

  20. Comparison of Turkey’s Geographical Regions in terms of Stand-Alone PV System Design and Cost Parameters

    Directory of Open Access Journals (Sweden)

    Nevzat Onat

    2017-01-01

    Full Text Available Stand-alone photovoltaic (SAPV systems are widely used in rural areas where there is no national grid or as a precaution against power outages. In this study, technical and economic analysis of a SAPV system was carried out using meteorological data for 75 province centers in seven geographical regions of Turkey. Obtained results for each province center were separated by geographical area. The averages of the centers for each region are taken as output. A calculation algorithm based on MsExcel has been established for these operations. The analyses made with the developed algorithm are repeated for five different scenarios that they cover periods of time when a constant strong load is active for all seasons (winter, spring, summer, and autumn and all year round. The developed algorithm calculates the life-cycle cost, the unit energy cost, the electrical capacity utilization rate, the amount of generated/excess energy per month, the initial investment/replacement, and operating and maintenance (O&M costs of each element. As a result, geographical regions of Turkey are compared in terms of these outputs graphically. Further investigations may include the sale of excess energy generated, small-scale PV system cost factors parallel to the grid, and the effects of government incentives.

  1. Geriatric palliative care in long-term care settings with a focus on nursing homes.

    Science.gov (United States)

    Ersek, Mary; Carpenter, Joan G

    2013-10-01

    Almost 1.7 million older Americans live in nursing homes, representing a large proportion of the frailest, most vulnerable elders needing long-term care. In the future, increasing numbers of older adults are expected to spend time and to die in nursing homes. Thus, understanding and addressing the palliative care needs of this population are critical. The goals of this paper are to describe briefly the current state of knowledge about palliative care needs, processes, and outcomes for nursing home residents; identify gaps in this knowledge; and propose priorities for future research in this area.

  2. Developing positive attitudes toward geriatric nursing among Millennials and Generation Xers.

    Science.gov (United States)

    Heise, Barbara A; Johnsen, Vickie; Himes, Deborah; Wing, Debra

    2012-01-01

    Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults.With the understanding that younger adults see a need to balance work and play, a baccalaureate nursing program provides examples of ways to accomplish this through integration of courses, simulations, positive images of aging, and learning activities that enhance empathy for both frail and healthy older adults.

  3. Adult Degenerative Scoliosis with Spinal Stenosis Treated with Stand-Alone Cage via an Extreme Lateral Transpsoas Approach; a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Arvind von Keudell

    2015-04-01

    Full Text Available We report the case of a 73-year-old female with severe degenerative scoliosis and back and leg pain that wassuccessfully treated with stand- alone cages via an extreme lateral transpsoas approach. This patient had declinedopen surgery and instrumentation due to her advanced age concerns about potential side effects.

  4. Stand-alone Inverter: Reviews, Models and Tests the exist system in Term of the Power Quality, and Suggestions to Design it

    Directory of Open Access Journals (Sweden)

    Ali Algaddafi

    2016-10-01

    Full Text Available Developments in power electronics have enabled the widespread application of Pulse Width Modulation (PWM inverters, notably for obtaining electricity from renewable systems. This paper critical review the previous studies in designing stand-alone inverter and modelling the inverter with two control loops to improve and provide a high-quality power of a stand-alone inverter. Multi-loop control techniques for a stand-alone inverter are utilised as the first loop is a capacitor current control to provide active damping and improve transient and steady state inverter performance. The capacitor current control is cheaper than inductor current control, where a small current sensing resistor is used. The second loop is the output voltage control that is used to improve the system performance and also control the output voltage. The power quality of the off-grid system is measured experimentally and compared with the grid power, showing power quality of off-grid system to be better than that of the grid. The suggestions and key findings to design the stand-alone inverter are given based in the reviewing of previous publications and from the literature’s point of view.

  5. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    OpenAIRE

    Suijker, Jacqueline J; Buurman, Bianca M; ter Riet, Gerben; van Rijn, Marjon; de Haan, Rob J; de Rooij, Sophia E; Moll van Charante, Eric P

    2012-01-01

    Abstract Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and n...

  6. Energetic and financial investigation of a stand-alone solar-thermal Organic Rankine Cycle power plant

    International Nuclear Information System (INIS)

    Tzivanidis, Christos; Bellos, Evangelos; Antonopoulos, Kimon A.

    2016-01-01

    Highlights: • A stand-alone solar driven Organic Rankine Cycle is optimized parametrically. • The system is optimized energetically and financially. • Nine working fluids are tested with cyclohexane to be the most suitable. • A collecting area of 25,000 m 2 parabolic trough collectors is the optimum solution. • The maximum IRR is 13.46% and the payback period is about 9 years. - Abstract: The use of solar thermal energy for electricity production is a clean and sustainable way to cover the increasing energy needs of our society. The most mature technology for capturing solar energy in high temperature levels is the parabolic trough collectors (PTC). In this study, an Organic Rankine Cycle (ORC) coupled with PTC is analyzed parametrically in order to be optimized financially and energetically. The first step is the thermodynamic investigation of the ORC by using various working fluids. The second step is the energetic and financial investigation of the total system which includes the solar field, the storage tank and the ORC module. By testing many combinations of collecting areas and storage tank volumes, finally cyclohexane proved to be the most suitable working fluid for producing 1 MW el with PTC. Specifically, in the optimum situation a solar field of 25,000 m 2 with storage tank of about 300 m 3 leads to a payback period of 9 years and to an internal rate of return (IRR) equal to 13.46%. Moreover, an economic comparison for different commercial collectors is presented, with Eurotrough ET-150 being the financially optimum solution for this case study.

  7. An adaptive artificial neural network model for sizing stand-alone photovoltaic systems: Application for isolated sites in Algeria

    International Nuclear Information System (INIS)

    Mellit, A.; Benghanem, M.; Hadj Arab, A.; Guessoum, G.

    2004-07-01

    In this paper we investigate, by using an adaptive Artificial Neural Network (ANN), in order to find a suitable model for sizing Stand-Alone Photovoltaic (SAPV) systems, based on a minimum of input data. This model combines Radial Basis Function (RBF) network and Infinite Impulse Response (IIR) filter in order to accelerate the convergence of the network. For the sizing of a photovoltaic (PV) system, we need to determine the optimal sizing coefficients (K PV , K B . These coefficients allow us to determine the number of solar panels and storage batteries necessary to satisfy a given consumption, especially in isolated sites where the global solar radiation data is not always available and which are considered the most important parameters for sizing a PV system. Obtained results by classical models (analytical, numerical, analytical- numerical, B-spline function) and new models like feed-forward (MLP), radial basis function (RBF), MLP-IIR and RBF-IIR have been compared with experimental sizing coefficients in order to illustrate the accuracy of the results of the new developed model. This model has been trained by using 200 known optimal sizing coefficients corresponding to 200 locations in Algeria. In this way, the adaptive model was trained to accept and even handle a number of unusual cases, the unknown validation sizing coefficients set produced very set accurate estimation and a correlation coefficient of 98% was obtained between the calculated and that estimated by the RBF-IIR model. This result indicates that the proposed method can be successfully used for the estimation of optimal sizing coefficients of SAPV systems for any locations in Algeria, but the methodology can be generalized using different locations over the world. (author)

  8. System dynamic model and charging control of lead-acid battery for stand-alone solar PV system

    KAUST Repository

    Huang, B.J.

    2010-05-01

    The lead-acid battery which is widely used in stand-alone solar system is easily damaged by a poor charging control which causes overcharging. The battery charging control is thus usually designed to stop charging after the overcharge point. This will reduce the storage energy capacity and reduce the service time in electricity supply. The design of charging control system however requires a good understanding of the system dynamic behaviour of the battery first. In the present study, a first-order system dynamics model of lead-acid battery at different operating points near the overcharge voltage was derived experimentally, from which a charging control system based on PI algorithm was developed using PWM charging technique. The feedback control system for battery charging after the overcharge point (14 V) was designed to compromise between the set-point response and the disturbance rejection. The experimental results show that the control system can suppress the battery voltage overshoot within 0.1 V when the solar irradiation is suddenly changed from 337 to 843 W/m2. A long-term outdoor test for a solar LED lighting system shows that the battery voltage never exceeded 14.1 V for the set point 14 V and the control system can prevent the battery from overcharging. The test result also indicates that the control system is able to increase the charged energy by 78%, as compared to the case that the charging stops after the overcharge point (14 V). © 2010 Elsevier Ltd. All rights reserved.

  9. Techno-economic analysis of stand-alone photovoltaic/wind/battery/hydrogen systems for very small-scale applications

    Directory of Open Access Journals (Sweden)

    Stojković Saša M.

    2016-01-01

    Full Text Available The paper presents the results of a technical and economic analysis of three stand-alone hybrid power systems based on renewable energy sources which supply a specific group of low-power consumers. This particular case includes measuring sensors and obstacle lights on a meteorological mast for wind measurements requiring an uninterrupted power supply in cold climate conditions. Although these low-power (100 W measuring sensors and obstacle lights use little energy, their energy consumption is not the same as the available solar energy obtained on a daily or seasonal basis. In the paper, complementarity of renewable energy sources was analysed, as well as one of short-term lead-acid battery-based storage and seasonal, hydrogen-based (electrolyser, H2 tank, and fuel cells storage. These relatively complex power systems were proposed earlier for high-power consumers only, while this study specifically highlights the role of the hydrogen system for supplying low-power consumers. The analysis employed a numerical simulation method using the HOMER software tool. The results of the analysis suggest that solar and wind-solar systems, which involve meteorological conditions as referred to in this paper, include a relatively large number of lead-acid batteries. Additionally, the analysis suggests that the use of hydrogen power systems for supplying low power-consumers is entirely justifiable, as it significantly reduces the number of batteries (two at minimum in this particular case. It was shown that the increase in costs induced by the hydrogen system is acceptable.

  10. Ensuring a nurse practitioner workforce prepared to care for older adults: findings from a national survey of adult and geriatric nurse practitioner programs.

    Science.gov (United States)

    Auerhahn, Carolyn; Mezey, Mathy; Stanley, Joan; Wilson, Laurie Dodge

    2012-04-01

    To present the findings from a needs assessment of adult primary care (ANP), gerontological (GNP), and adult acute care (ACNP) nurse practitioner faculty regarding the transition to adult-gerontology NP (A-GNP) programs. Data were obtained from two sources: (a) an online survey to identify the faculty's primary needs in order to facilitate success in this transition and (b) telephone focus groups to explore survey responses in greater depth. The survey and the focus group findings indicate that there is a strong need for (a) access to a set of nationally recognized competencies for A-GNPs; (b) teaching/learning resources to support faculty in implementation of A-GNP programs; and (c) formal faculty development opportunities to facilitate faculty efforts to engage in curricular redesign and innovations and assure that NP students acquire strong competence in gerontology content. The transition to A-GNP has implications not only for NP faculty but also for practicing NPs. Almost all NPs care for older adults in a variety of settings. However, most of these NPs are not specialists in geriatrics. This article provides a context for self-assessment by these NPs of their own needs related to this transition. ©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners.

  11. Correlates of Geriatric Loneliness in Philippine Nursing Homes: A Multiple Regression Model

    Science.gov (United States)

    de Guzman, Allan B.; Maravilla, Katrina N.; Maravilla, Veniza Anne M.; Marfil, Jomille D. V.; Marinas, Janine Angelica R.; Marquez, Jorelle Michael B.

    2012-01-01

    Numerous studies have been conducted worldwide about loneliness in older adults living in nursing homes and the factors associated with it. However, only a few studies have focused on social factors that may predispose these older adults to experience loneliness. The purpose of this study was to examine the interplay between and among loneliness,…

  12. Effect of an interactive E-learning tool for delirium on patient and nursing outcomes in a geriatric hospital setting: findings of a before-after study.

    Science.gov (United States)

    Detroyer, Elke; Dobbels, Fabienne; Teodorczuk, Andrew; Deschodt, Mieke; Depaifve, Yves; Joosten, Etienne; Milisen, Koen

    2018-01-19

    Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium. A before-after study in a sample of patients enrolled pre-intervention (non-intervention cohort (NIC); n = 81) and post-intervention (intervention cohort (IC); n = 79), and nurses (n = 17) of a geriatric ward (university hospital). The intervention included an information session about using the e-learning tool, which consisted of 11 e-modules incorporating development of knowledge and skills in the prevention, detection and management of delirium, and the completion of a delirium e-learning tool during a three-month period. Key patient outcomes included in-hospital prevalence and duration of delirium (Confusion Assessment Method), delirium severity (Delirium Index) and mortality (in-hospital; 12 months post-admission); key nurse outcomes included delirium knowledge (Delirium Knowledge Questionnaire) and recognition (Case vignettes). Logistic regression and linear mixed models were used to analyse patient data; Wilcoxon Signed Rank tests, McNemar's or paired t-tests for nursing data. No significant difference was found between the IC and NIC for in-hospital prevalence (21.5% versus 25.9%; p = 0.51) and duration of delirium (mean 4.2 ± SD 4.8 days versus 4.9 ± SD 4.8 days; p = 0.38). A trend towards a statistically significant lower delirium severity (IC versus NIC: difference estimate

  13. Post-processing in cardiovascular computed tomography. Performance of a client server solution versus a stand-alone solution

    International Nuclear Information System (INIS)

    Luecke, C.; Foldyna, B.; Andres, C.; Grothoff, M.; Nitzsche, S.; Gutberlet, M.; Lehmkuhl, L.; Boehmer-Lasthaus, S.

    2014-01-01

    Purpose: To compare the performance of server-based (CSS) versus stand-alone post-processing software (ES) for the evaluation of cardiovascular CT examinations (cvCT) and to determine the crucial steps. Data of 40 patients (20 patients for coronary artery evaluation and 20 patients prior to transcatheter aortic valve implantation [TAVI]) were evaluated by 5 radiologists with CSS and ES. Data acquisition was performed using a dual-source 128-row CT unit (SOMATOM Definition Flash, Siemens, Erlangen, Germany) and a 64-row CT unit (Brilliance 64, Philips, Hamburg, Germany). The following workflow was evaluated: Data loading, aorta and coronary segmentation, curved multiplanar reconstruction (cMPR) and 3 D volume rendering technique (3D-VRT), measuring of coronary artery stenosis and planimetry of the aortic annulus. The time requirement and subjective quality for the workflow were evaluated. The coronary arteries as well as the TAVI data could be evaluated significantly faster with CSS (5.5 ± 2.9 min and 8.2 ± 4.0 min, respectively) than with ES (13.9 ± 5.2 min and 15.2 ± 10.9 min, respectively, p = 0.01). Segmentation of the aorta (CSS: 1.9 ± 2.0 min, ES: 3.7 ± 3.3 min), generating cMPR of coronaries (CSS: 0.5 ± 0.2 min, ES: 5.1 ± 2.6 min), aorta and iliac vessels (CSS: 0.5 ± 0.4 min and 0.4 ± 0.4 min, respectively, ES: 1.6 ± 0.7 min and 2.8 ± 3 min, respectively) could be performed significantly faster with CSS than with ES with higher quality of cMPR, measuring of coronary stenosis and 3D-VRT (p < 0.05). Evaluation of cvCT can be accomplished significantly faster and better with CSS than with ES. The segmentation remains the most time-consuming workflow step, so optimization of segmentation algorithms could improve performance even further.

  14. An efficient sizing method for a stand-alone PV system in terms of the observed block extremes

    International Nuclear Information System (INIS)

    Chen, Shin-Guang

    2012-01-01

    Highlights: ► A fast optimal sizing method under climate change. ► It provides the method of creating climate cycles for PV system applications. ► It proposes a new reliability indicator to denote the upper bound probability of a PV application. ► It presents a premiere economic optimization for such approach. ► It gives examples to illustrate the proposed approach. -- Abstract: This paper proposes a novel and fast sizing method under the constant daily load profile for sizing a stand-alone PV system. The term “efficient sizing” means that the approach did not use simulation but could get the result as good as those employing simulation. So, the sizing method is more efficient than the others. Traditionally, a typical day or a typical year’s solar irradiation profile is employed for the sizing task. However, facing the global warming crisis as well as the fact that no 2 years would have the same weather condition for a single site, this approach statistically models the trend of climate change year by year and put it into the sizing formula, so that the results are optimal for the current weather condition and for the future as well. Hence, the suitable size for the PV array and the number of batteries are obtained by purely computation. This is different from the traditional sizing curve method. Although the traditional sizing curve method were satisfactory in the normal cases, they might fail in the extreme climate condition. This paper concludes the behavior of the extreme climate for at least 20 years. So, the derived system may have statistical confidence for at least 20 years of operation. A new reliability index (Loss of Power Probability) in terms of Extreme Value Theory is introduced. LPP provides upper bound reliability for application and rich information for many extreme events. A technological and economical comparison among the traditional daily energy balance method, sizing curve method and this approach is conducted and shows the

  15. Post-processing in cardiovascular computed tomography: performance of a client server solution versus a stand-alone solution.

    Science.gov (United States)

    Lücke, C; Foldyna, B; Andres, C; Boehmer-Lasthaus, S; Grothoff, M; Nitzsche, S; Gutberlet, M; Lehmkuhl, L

    2014-12-01

    To compare the performance of server-based (CSS) versus stand-alone post-processing software (ES) for the evaluation of cardiovascular CT examinations (cvCT) and to determine the crucial steps. Data of 40 patients (20 patients for coronary artery evaluation and 20 patients prior to transcatheter aortic valve implantation [TAVI]) were evaluated by 5 radiologists with CSS and ES. Data acquisition was performed using a dual-source 128-row CT unit (SOMATOM Definition Flash, Siemens, Erlangen, Germany) and a 64-row CT unit (Brilliance 64, Philips, Hamburg, Germany). The following workflow was evaluated: Data loading, aorta and coronary segmentation, curved multiplanar reconstruction (cMPR) and 3 D volume rendering technique (3D-VRT), measuring of coronary artery stenosis and planimetry of the aortic annulus. The time requirement and subjective quality for the workflow were evaluated. The coronary arteries as well as the TAVI data could be evaluated significantly faster with CSS (5.5  ±  2.9  min and 8.2  ±  4.0  min, respectively) than with ES (13.9  ±  5.2  min and 15.2  ±  10.9  min, respectively, p ≤  0.01). Segmentation of the aorta (CSS: 1.9 ±  2.0  min, ES: 3.7  ±  3.3  min), generating cMPR of coronaries (CSS: 0.5  ±  0.2  min, ES: 5.1  ±  2.6  min), aorta and iliac vessels (CSS: 0.5  ±  0.4  min and 0.4  ±  0.4  min, respectively, ES: 1.6  ±  0.7  min and 2.8  ±  3  min, respectively) could be performed significantly faster with CSS than with ES with higher quality of cMPR, measuring of coronary stenosis and 3D-VRT (p < 0.05). Evaluation of cvCT can be accomplished significantly faster and better with CSS than with ES.  The segmentation remains the most time-consuming workflow step, so optimization of segmentation algorithms could improve performance even further. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Valoración enfermera geriátrica: Un modelo de registro en residencias de ancianos Geriatric nurse assessment: A model of register in nursing home care

    Directory of Open Access Journals (Sweden)

    Jesús Manuel Vallejo Sánchez

    2007-06-01

    detect the needs of the elder, to consider the risk of geriatric syndromes appearance and to plan the suitable care. Methods: Creation of workgroup, establishment of aims by consensus, bibliographical review, development of elaboration's criteria, coordination with the rest of the staff and validation of the document. Results: We obtain a nurse assessment register for elder institutionalized in nursing home care, of 8 pages, with opened and closed items, based on the model of Virginia Henderson's 14 needs and supported by nine scales of valuation, with its own cumplimentation guide. Conclusions: The time used in the geriatric nurse assessment is a necessary investment to assure a suitable and adequate assistance. It represents a useful tool for the nurses and the rest of the staff, as it allows to individualize the care, to quantify the disabilities and to provide the most adapted level of assistance to every single resident.

  17. A compact seven switches topology and reduced DC-link capacitor size for single-phase stand-alone PV system with hybrid energy storages

    DEFF Research Database (Denmark)

    Liu, Xiong; Wang, Peng; Loh, Poh Chiang

    2011-01-01

    Single-phase stand-alone PV system is suitable for household applications in remote area. Hybrid battery/ultra-capacitor energy storage can reduce charge and discharge cycles and avoid deep discharges of battery. This paper proposes a compact seven switches structure for stand-alone PV system......-order harmonic current caused by single-phase inverter. In the proposed compact topology, a small size DC-link capacitor can achieve the same function through charging/discharging control of ultra-capacitor to mitigate second-order ripple current. Simulation results are provided to validate the effectiveness......, which otherwise needs nine switches configuration, inclusive of one switch for boost converter, four switches for single-phase inverter and four switches for two DC/DC converters of battery and ultra-capacitor. It is well-known that a bulky DC-link capacitor is always required to absorb second...

  18. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Suijker Jacqueline J

    2012-04-01

    Full Text Available Abstract Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. Methods/Design In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC score (≥ 2. These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP. The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. Discussion This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. Trial registration NTR2653 Grant Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201

  19. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial.

    Science.gov (United States)

    Suijker, Jacqueline J; Buurman, Bianca M; ter Riet, Gerben; van Rijn, Marjon; de Haan, Rob J; de Rooij, Sophia E; Moll van Charante, Eric P

    2012-04-01

    Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC) score (≥ 2). These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP). The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. NTR2653 GRANT: Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201.

  20. Is Stand-Alone Anterior Lumbar Interbody Fusion a Safe and Efficacious Treatment for Isthmic Spondylolisthesis of L5-S1?

    OpenAIRE

    Viglione, Luke L.; Chamoli, Uphar; Diwan, Ashish D.

    2017-01-01

    Study Design: A systematic review. Objective: The objective of this study was to determine the safety and efficacy of stand-alone anterior lumbar interbody fusion (sa-ALIF) for the treatment of symptomatic isthmic spondylolisthesis of L5-S1 by assessing the level of available clinical and radiographic evidence. Methods: A systematic review utilizing Medline, Embase, and Scopus online databases was undertaken. Clinical, radiographic, and adverse outcome data were extracted for the relevant ist...

  1. Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion contractures in people with traumatic brain injury: a randomised trial

    Directory of Open Access Journals (Sweden)

    Joan Leung

    2014-12-01

    Full Text Available Question: Is a combination of standing, electrical stimulation and splinting more effective than standing alone for the management of ankle contractures after severe brain injury? Design: A multi-centre randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis. Participants: Thirty-six adults with severe traumatic brain injury and ankle plantarflexion contractures. Intervention: All participants underwent a 6-week program. The experimental group received tilt table standing, electrical stimulation and ankle splinting. The control group received tilt table standing alone. Outcome measures: The primary outcome was passive ankle dorsiflexion with a 12 Nm torque. Secondary outcomes included: passive dorsiflexion with lower torques (3, 5, 7 and 9 Nm; spasticity; the walking item of the Functional Independence Measure; walking speed; global perceived effect of treatment; and perceived treatment credibility. Outcome measures were taken at baseline (Week 0, end of intervention (Week 6, and follow-up (Week 10. Results: The mean between-group differences (95% CI for passive ankle dorsiflexion at Week 6 and Week 10 were –3 degrees (–8 to 2 and –1 degrees (–6 to 4, respectively, in favour of the control group. There was a small mean reduction of 1 point in spasticity at Week 6 (95% CI 0.1 to 1.8 in favour of the experimental group, but this effect disappeared at Week 10. There were no differences for other secondary outcome measures except the physiotherapists’ perceived treatment credibility. Conclusion: Tilt table standing with electrical stimulation and splinting is not better than tilt table standing alone for the management of ankle contractures after severe brain injury. Trial registration: ACTRN12608000637347. [Leung J, Harvey LA, Moseley AM, Whiteside B, Simpson M, Stroud K (2014 Standing with electrical stimulation and splinting is no better than standing alone for management of ankle plantarflexion

  2. A comparative sizing analysis of a renewable energy supplied stand-alone house considering both demand side and source side dynamics

    International Nuclear Information System (INIS)

    Elma, Onur; Selamogullari, Ugur Savas

    2012-01-01

    Highlights: ► Backup sizing analyses for PV–Wind energy supplied stand-alone house are completed. ► Source and demand side dynamics are considered for the first time in backup sizing. ► Backup size is reduced by 10% compared to backup size found with hourly values. ► The importance of data resolution on sizing study in such systems is shown. -- Abstract: Solar and wind energy use to supply the electrical demand of a stand-alone residential house is investigated. Combining solar and wind energy sources provide more reliable power source for stand-alone applications since they complement each other. Backup units (battery/supercapacitor) are also needed for uninterrupted energy. For a proper backup sizing in such systems, high resolution load data, wind speed and solar radiation data must be used as compared to the use of hourly averaged data found in literature. In this study, high resolution data on both load side and source side are collected experimentally. Then, collected data used as input to system simulations in Matlab/Simulink for sizing the backup in the considered hybrid power system. Backup state of the charge (SOC) is used as decision criteria. It is shown that, when load and source dynamics are considered, approximately 10% less backup size is required compared to backup size found with hourly averaged values. The study shows the importance of data resolution on backup sizing in such systems and could be a guide for renewable energy system designers.

  3. Supervisory control applied to stand-alone photovoltaic systems based on multi string topology; Controle supervisorio aplicado a sistemas fotovoltaicos autonomos com topologia multi string

    Energy Technology Data Exchange (ETDEWEB)

    Candido, Diogo Brum

    2010-07-01

    This master thesis analyses and implements a stand-alone photovoltaic system based on decentralized 'Multi String' topology. The proposed system is composed of a set of DC-DC converters linked to the PV arrays of panels, a bidirectional converter to perform the control of the charge/discharge process of the battery bank and ensure the specifications of DC link and a full-bridge inverter that feed the AC loads. Therefore, all operation modes that the stand-alone PV system can work are presented and analyzed. As the chief aim is to ensure the energy balance of the stand-alone PV system, are presented independents control loops for each converter of the PV system and a propose of a supervisory control that, based on information about the conditions of the DC link and the bank of batteries, defines each operation mode should be active, in order to maximize the power extracted from the PV arrays, the life cycle of the battery bank and ensuring the uninterrupted feeding of energy to the loads. Finally, simulation and experimental results validate the operation of the proposed system under different load and solar radiation conditions. (author)

  4. Anterior cervical discectomy and fusion using a stand-alone polyetheretherketone cage packed with local autobone : assessment of bone fusion and subsidence.

    Science.gov (United States)

    Park, Jeong-Ill; Cho, Dae-Chul; Kim, Kyoung-Tae; Sung, Joo-Kyung

    2013-09-01

    It remains debatable whether cervical spine fusion cages should be filled with any kind of bone or bone substitute. Cortical and subcortical bone from the anterior and posterior osteophytes of the segment could be used to fill the cage. The purposes of the present study are to evaluate the clinical outcomes and radiological outcomes including bone fusion and subsidence that occurred after anterior cervical discectomy and fusion using a stand-alone cage packed with local autobone graft. Thirty-one patients who underwent anterior cervical fusion using a stand-alone polyetheretherketone (PEEK) cage packed with local autobone graft from July 2009 to december 2011 were enrolled in this study. Bone fusion was assessed by cervical plain radiographs and computed tomographic scan. Nonunion was evaluated according to the absence of bony bridge on computed tomographic scan. Subsidence was defined as a ≥2 mm decrease of the interbody height at the final follow-up compared to that measured at the immediate postoperative period. Subsidence was observed in 7 patients (22.6%). Of 7 patients with subsidence greater 2 mm, nonunion was developed in 3. Three patients with subsidence greater 2 mm were related with endplate damage during intraoperative endplate preparation. Solid bone fusion was achieved in 28 out of 31 patients (90.3%). With proper patient selection and careful endplate preparation, anterior cervical discectomy and fusion (ACDF) using a stand-alone PEEK cage packed with local autobone graft could be a good alternative to the standard ACDF techniques with plating.

  5. Fracture of the L-4 vertebral body after use of a stand-alone interbody fusion device in degenerative spondylolisthesis for anterior L3-4 fixation.

    Science.gov (United States)

    Kwon, Yoon-Kwang; Jang, Ju-Hee; Lee, Choon-Dae; Lee, Sang-Ho

    2014-06-01

    Many studies attest to the excellent results achieved using anterior lumbar interbody fusion (ALIF) for degenerative spondylolisthesis. The purpose of this report is to document a rare instance of L-4 vertebral body fracture following use of a stand-alone interbody fusion device for L3-4 ALIF. The patient, a 55-year-old man, had suffered intractable pain of the back, right buttock, and left leg for several weeks. Initial radiographs showed Grade I degenerative spondylolisthesis, with instability in the sagittal plane (upon 15° rotation) and stenosis of central and both lateral recesses at the L3-4 level. Anterior lumbar interbody fusion of the affected vertebrae was subsequently conducted using a stand-alone cage/plate system. Postoperatively, the severity of spondylolisthesis diminished, with resolution of symptoms. However, the patient returned 2 months later with both leg weakness and back pain. Plain radiographs and CT indicated device failure due to anterior fracture of the L-4 vertebral body, and the spondylolisthesis had recurred. At this point, bilateral facetectomies were performed, with reduction/fixation of L3-4 by pedicle screws. Again, degenerative spondylolisthesis improved postsurgically and symptoms eased, with eventual healing of the vertebral body fracture. This report documents a rare instance of L-4 vertebral body fracture following use of a stand-alone device for ALIF at L3-4, likely as a consequence of angular instability in degenerative spondylolisthesis. Under such conditions, additional pedicle screw fixation is advised.

  6. [Mobile geriatric rehabilitation in nursing homes, in short-term care facilities and private homes : Setting-specific analysis of nationwide treatment documentation (Part 2)].

    Science.gov (United States)

    Pippel, Kristina; Meinck, M; Lübke, N

    2017-06-01

    Mobile geriatric rehabilitation can be provided in the setting of nursing homes, short-term care (STC) facilities and exclusively in private homes. This study analyzed the common features and differences of mobile rehabilitation interventions in various settings. Stratified by setting 1,879 anonymized mobile geriatric rehabilitation treatments between 2011 and 2014 from 11 participating institutions were analyzed with respect to patient, process and outcome-related features. Significant differences between the settings nursing home (n = 514, 27 %), STC (n = 167, 9 %) and private homes (n = 1198, 64 %) were evident for mean age (83 years, 83 years and 80 years, respectively), percentage of women (72 %, 64 % and 55 %), degree of dependency on pre-existing care (92 %, 76 % and 64 %), total treatment sessions (TS, 38 TS, 42 TS and 41 TS), treatment duration (54 days, 61 days and 58 days) as well as the Barthel index at the start of rehabilitation (34 points, 39 points and 46 points) and the gain in the Barthel index (15 points, 21 points and 18 points), whereby the gain in the capacity for self-sufficiency was significant in all settings. The setting-specific evaluation of mobile geriatric rehabilitation showed differences for relevant patient, process and outcome-related features. Compared to inpatient rehabilitation mobile rehabilitation in all settings made an above average contribution to the rehabilitation of patients with pre-existing dependency on care. The gains in the capacity for self-sufficiency achieved in all settings support the efficacy of mobile geriatric rehabilitation under the current prerequisites for applicability.

  7. Performance of a small stand alone photovoltaic-wind system at El Oyameyo D.F., Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez Juarez, A.; Campos, J. [Centro de Investigacion en Energia, UNAM, Mexico, D. F. (Mexico); Tiburcio Silver, A. [Instituto Tecnologico de Toluca-Division de Posgrado, Toluca (Mexico)

    1997-12-31

    El Oyameyo, is an ecological site located to the South-West of the Topilejo town, D.F., 19 degree 25` North latitude, 99 degree 5` West longitude and at an altitude of 3100 m. At present, there are 10 families living at this place. They have energy generators to produce their own electricity by means of solar or wind energy using photovoltaic (PV) technology and eolic systems, respectively. There are three different configurations of energy generators: DC regulated PV systems, AC regulated PV systems and one PV-Wind hybrid system. The electrical power installed for the stand alone PV systems are from 48 W-p up to 768 W-p range. Among these, there are 4 PV systems that are configurated in DC regulated systems, and other 6 are AC regulated systems. All these systems use lead-acid battery (scaled or vented) banks to store the energy produced daily by the systems. The PV-Wind hybrid system in formed, at present, by a 5.0 kW wind generator, a PV array of 768 W-p, a 37.8 kW-h storage battery bank and a 5.0 kW DC/AC inverter. In this work, we report the electricity generated, load pattern and overall system performance of the photovoltaic-wind hybrid system. The technical characteristics, energy test on the hybrid system and the experience obtained from energy handling and system maintenance for all the systems are presented. We found that all the systems had shown good performance and users` satisfaction. [Espanol] El Oyameyo es un lugar ecologico localizado al Sur-Oeste del pueblo de Topilejo, D. F., 19 grados 25` de latitud Norte 99 grados 5` de longitud Oeste y a una altitud de 3100m. Actualmente hay 10 familias viviendo en este lugar. Tienen generadores de energia para producir su propia electricidad mediante la energia solar y la del viento usando sistemas fotovoltaicos (FV) y sistemas eolicos, respectivamente. Hay tres diferentes configuraciones de generadores de energia: sistemas fotovoltaicos de CD regulados, sistemas fotovoltaicos de CA regulados y un sistema

  8. Neuropsychiatric symptoms in geriatric patients admitted to skilled nursing facilities in nursing homes for rehabilitation after stroke: a longitudinal multicenter study.

    Science.gov (United States)

    Buijck, Bianca I; Zuidema, Sytse U; Spruit-van Eijk, Monica; Geurts, Alexander C H; Koopmans, Raymond T C M

    2012-07-01

    To investigate the prevalence and course of neuropsychiatric symptoms (NPS) in geriatric patients admitted to skilled nursing facilities (SNFs) for rehabilitation after stroke. This was a longitudinal multicenter study within 15 SNFs in the Netherlands. NPS were assessed in 145 patients with stroke through the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) with measurements on admission and at discharge. The prevalence and course of NPS were described in terms of cumulative prevalence (symptoms either on admission or at discharge), conversion (only symptoms at discharge), remission (only symptoms on admission), and persistence (symptoms both on admission and at discharge) for patients who were discharged to an independent living situation within one year after admission and patients who had to stay in the SNF for long term care. Eighty percent had a first-ever stroke and 74% could be successfully discharged. Overall, the most common NPS were depression (33%), eating changes (18%), night-time disturbances (19%), anxiety (15%), irritability (12%), and disinhibition (12%). One year after admission, the patients who were still in the SNF showed significantly more hallucinations (p = 0.016), delusions (p = 0.016), agitation (p = 0.004), depression (p = 0.000), disinhibition (p = 0.004), irritability (p = 0.018), and night-time disturbances (p = 0.001) than those who had been discharged. The overall prevalence of NPS in this study was lower than reported by other studies in different settings. There was a high prevalence of NPS in patients that could not be successfully discharged. The findings suggest that NPS should be optimally treated to improve outcome of rehabilitation. Copyright © 2011 John Wiley & Sons, Ltd.

  9. The patient's vulnerability, dependence and exposed situation in the discharge process: experiences of district nurses, geriatric nurses and social workers.

    Science.gov (United States)

    Rydeman, IngBritt; Törnkvist, Lena

    2006-10-01

    The aim of the study was to obtain a deeper understanding of the experiences of the discharge process among different professionals. An optimal discharge process for hospitalized elderly to other forms of care is of crucial importance, especially since health and medical policies encourages shorter hospital stays and increased healthcare service in outpatient care. Nurses and social workers from inpatient care, outpatient care, municipal care and social services were interviewed. Eight focus-group interviews with a total of 31 persons were conducted. The subsequent analyses followed a phenomenological approach. The findings revealed three themes, Framework, Basic Values and Patient Resources, which influenced the professionals' actions in the discharge process. The overall emerging structure comprised the patient's vulnerability, dependence and exposed situation in the discharge process. In conclusion some factors are of special importance for the co-operation and the actions of professionals involved in the discharge process. Firstly, a distinct and common framework, with conscious and organizationally based values. Secondly the need to take the patient resources into consideration. Together these factors could contribute to secure the patients involvement in the discharge process and to design an optimal, safe and good care. Collaborative approaches among a range of professionals within a variety of organizations are common, especially in the care of the elderly. The role and support of both the organizations and the educational units are decisive factors in this area.

  10. Studying feasibility and effects of a two-stage nursing staff training in residential geriatric care using a 30 month mixed-methods design [ISRCTN24344776

    Directory of Open Access Journals (Sweden)

    Hantikainen Virpi

    2011-05-01

    Full Text Available Abstract Background Transfer techniques and lifting weights often cause back pain and disorders for nurses in geriatric care. The Kinaesthetics care conception claims to be an alternative, yielding benefits for nurses as well as for clients. Starting a multi-step research program on the effects of Kinaesthetics, we assess the feasibility of a two-stage nursing staff training and a pre-post research design. Using quantitative and qualitative success criteria, we address mobilisation from the bed to a chair and backwards, walking with aid and positioning in bed on the staff level as well as on the resident level. In addition, effect estimates should help to decide on and to prepare a controlled trial. Methods/Design Standard basic and advanced Kinaesthetics courses (each comprising four subsequent days and an additional counselling day during the following four months are offered to n = 36 out of 60 nurses in a residential geriatric care home, who are in charge of 76 residents. N = 22 residents needing movement support are participating to this study. On the staff level, measurements include focus group discussions, questionnaires, physical strain self-assessment (Borg scale, video recordings and external observation of patient assistance skills using a specialised instrument (SOPMAS. Questionnaires used on the resident level include safety, comfort, pain, and level of own participation during mobilisation. A functional mobility profile is assessed using a specialised test procedure (MOTPA. Measurements will take place at baseline (T0, after basic training (T1, and after the advanced course (T2. Follow-up focus groups will be offered at T1 and 10 months later (T3. Discussion Ten criteria for feasibility success are established before the trial, assigned to resources (missing data, processes (drop-out of nurses and residents and science (minimum effects criteria. This will help to make rational decision on entering the next stage of the research

  11. Outcomes of contemporary use of rectangular titanium stand-alone cages in anterior cervical discectomy and fusion: cage subsidence and cervical alignment.

    Science.gov (United States)

    Yamagata, Toru; Takami, Toshihiro; Uda, Takehiro; Ikeda, Hidetoshi; Nagata, Takashi; Sakamoto, Shinichi; Tsuyuguchi, Naohiro; Ohata, Kenji

    2012-12-01

    Cervical intervertebral disc replacement using a rectangular titanium stand-alone cage has become a standard procedure for anterior cervical discectomy and fusion (ACDF). We examined outcomes resulting from the contemporary use of rectangular titanium stand-alone cages for ACDF, particularly focusing on cage subsidence and subsequent kyphotic malalignment. Patient data were collected prospectively, and a total of 47 consecutive patients who underwent periodic follow-up of at least 1 year's duration after ACDF were studied retrospectively. Sixty-three rectangular titanium cages were implanted during 31 1-level and 16 2-level procedures. None of the patients developed surgery-related complications (including cage displacement or extrusion). Mean Neurosurgical Cervical Spine Scale scores were significantly improved at 1 year after surgery. Twelve of the 63 inserted cages (19.0%) were found to have cage subsidence, occurring in 11 of 47 patients (23.4%). There was no significant difference in functional recovery between patients with and without cage subsidence. Logistic regression analysis indicated that fusion level, cage size and cage position were significantly related to cage subsidence. The distraction ratio among patients with cage subsidence was significantly higher than that among patients without cage subsidence. Cage subsidence resulted in early deterioration of local angle and total alignment of the cervical spine. Although a longer follow-up is warranted, a good surgical outcome with negligible complications appears to justify the use of rectangular titanium stand-alone cages in 1- and 2-level ACDF. Excessive distraction at the fusion level should be avoided, and cage position should be adjusted to the anterior vertical line. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Fusion and subsidence rate of stand alone anterior lumbar interbody fusion using PEEK cage with recombinant human bone morphogenetic protein-2.

    Science.gov (United States)

    Behrbalk, Eyal; Uri, Ofir; Parks, Ruth M; Musson, Rachel; Soh, Reuben Chee Cheong; Boszczyk, Bronek Maximilian

    2013-12-01

    Anterior lumbar interbody fusion (ALIF) is an established treatment for structural instability associated with symptomatic disk degeneration (SDD). Stand-alone ALIF offers many advantages, however, it may increase the risk of non-union. Recombinant human bone morphogenetic protein-2 (BMP-2) may enhance fusion rate but is associated with postoperative complication. The optimal dose of BMP-2 remains unclear. This study assessed the fusion and subsidence rates of stand-alone ALIF using the SynFix-LR interbody cage with 6 ml/level of BMP-2. Thirty-two ALIF procedures were performed by a single surgeon in 25 patients. Twenty-five procedures were performed for SDD without spondylolisthesis (SDD group) and seven procedures were performed for SDD with grade-I olisthesis (SDD-olisthesis group). Patients were followed-up for a mean of 17 ± 6 months. Solid fusion was achieved in 29 cases (90.6 %) within 6 months postoperatively. Five cases of implant subsidence were observed (16 %). Four of these occurred in the SDD-olisthesis group and one occurred in the SDD group (57 % vs. 4 % respectively; p = 0.004). Three cases of subsidence failed to fuse and required revision. The body mass index of patients with olisthesis who developed subsidence was higher than those who did not develop subsidence (29 ± 2.6 vs. 22 ± 6.5 respectively; p = 0.04). No BMP-2 related complications occurred. The overall fusion rate of stand-alone ALIF using the SynFix-LR system with BMP-2 was 90.6 %, comparable with other published series. No BMP-2 related complication occurred at a dose of 6 mg/level. Degenerative spondylolisthesis and obesity seemed to increase the rate of implant subsidence, and thus we believe that adding posterior fusion for these cases should be considered.

  13. Segmental kyphosis after cervical interbody fusion with stand-alone polyetheretherketone (PEEK) cages: a comparative study on 2 different PEEK cages.

    Science.gov (United States)

    Kim, Chi Heon; Chung, Chun Kee; Jahng, Tae-Ahn; Park, Sung Bae; Sohn, Seil; Lee, Sungjoon

    2015-02-01

    Retrospective comparative study. Two polyetheretherketone (PEEK) cages of different designs were compared in terms of the postoperative segmental kyphosis after anterior cervical discectomy and fusion. Segmental kyphosis occasionally occurs after the use of a stand-alone cage for anterior cervical discectomy and fusion. Although PEEK material seems to have less risk of segmental kyphosis compared with other materials, the occurrence of segmental kyphosis for PEEK cages has been reported to be from 0% to 29%. There have been a few reports that addressed the issue of PEEK cage design. A total of 41 consecutive patients who underwent single-level anterior discectomy and fusion with a stand-alone cage were included. Either a round tube-type (Solis; 18 patients, S-group) or a trapezoidal tube-type (MC+; 23 patients, M-group) cage was used. The contact area between the cage and the vertebral body is larger in MC+ than in Solis, and anchoring pins were present in the Solis cage. The effect of the cage type on the segmental angle (SA) (lordosis vs. kyphosis) at postoperative month 24 was analyzed. Preoperatively, segmental lordosis was present in 12/18 S-group and 16/23 M-group patients (P=0.84). The SA was more lordotic than the preoperative angle in both groups just after surgery, with no difference between groups (P=0.39). At 24 months, segmental lordosis was observed in 9/18 S-group and 20/23 M-group patients (P=0.01). The patients in M-group were 7.83 times more likely than patients in S-group (P=0.04; odds ratio, 7.83; 95% confidence interval, 1.09-56.28) not to develop segmental kyphosis. The design of the PEEK cage used may influence the SA, and this association needs to be considered when using stand-alone PEEK cages.

  14. Clinician's perspectives of the relocation of a regional child and adolescent mental health service from co-located to stand alone premises.

    Science.gov (United States)

    Francis, K J; Boyd, C P; Sewell, J; Nurse, S

    2008-01-01

    Australia's National Mental Health Strategy's statement of rights and responsibilities states that children and adolescents admitted to a mental health facility or community program have the right to be separated from adult patients and provided with programs suited to their developmental needs. However, in rural Australia, where a lack of healthcare services, financial constraints, greater service delivery areas and fewer mental healthcare specialists represent the norm, Child and Adolescent Mental Health Services (CAMHS) are sometimes co-located with adult mental health services. The aim of the present study was to evaluate the impact of a recent relocation of a regional CAMHS in Victoria from co-located to stand alone premises. Six CAMHS clinicians who had experienced service delivery at a co-located setting and the current stand-alone CAMHS setting were interviewed about their perceptions of the impact of the relocation on service delivery. An exploratory interviewing methodology was utilized due to the lack of previous research in this area. Interview data were transcribed and analysed according to interpretative phenomenological analysis techniques. Findings indicated a perception that the relocation was positive for clients due to the family-friendly environment at the new setting and separation of CAMHS from adult psychiatric services. However, the impact of the relocation on clinicians was marked by a perceived loss of social capital from adult psychiatric service clinicians. These results provide increased understanding of the effects of service relocation and the influence of co-located versus stand-alone settings on mental health service delivery - an area where little prior research exists.

  15. Single anterior cervical discectomy and fusion (ACDF) using self- locking stand-alone polyetheretherketone (PEEK) cage: evaluation of pain and health-related quality of life.

    Science.gov (United States)

    Kapetanakis, Stylianos; Thomaidis, Tryfon; Charitoudis, George; Pavlidis, Pavlos; Theodosiadis, Panagiotis; Gkasdaris, Grigorios

    2017-09-01

    Anterior cervical discectomy and fusion (ACDF) constitutes the conventional treatment of cervical disc herniation due to degenerative disc disease (DDD). ACDF with plating presents a variety of complications postoperatively and stand-alone cages are thought to be a promising alternative. The aim of this study was firstly, to analyze prospectively collected data from a sample of patients treated with single ACDF using C-Plus self-locking stand-alone PEEK cage system, without the use of plates or screws, in order to evaluate pain levels of patients, utilizing Neck and Arm Pain scale as an expression of visual analogue scale (VAS). Secondly, we aimed to evaluate health-related quality of life, via the short-form 36 (SF-36) and Neck Disability Index (NDI). Thirty-six patients (19 male and 17 female) with mean age 49.6±7 years old who underwent successful single ACDF using self-locking stand-alone PEEK cage for symptomatic cervical DDD were selected for the study. Neck and Arm pain, as well as SF-36 and NDI were estimated preoperatively and 1, 3, 6, and 12 months postoperatively. Patients underwent preoperative and postoperative clinical, neurological and radiological evaluation. The clinical and radiological outcomes were satisfactory after a minimum 1-year follow-up. All results were statistically important (P<0.05), excluding improvement in NDI measured between 6 and 12 months. SF-36, Neck Pain, as well as Arm Pain featured gradual and constant improvement during follow-up, with best scores presenting at 12 months after surgery, while NDI reached its best at 6 months postoperatively. Generally, all scores showed improvement postoperatively during the different phases of the follow-up. Subsequently, ACDF using C-Plus cervical cage constitutes an effective method for cervical disc herniation treatment, in terms of postoperative improvement on pain levels and health-related quality of life and a safe alternative to the conventional method of treatment for cervical DDD.

  16. Techno-economic assessment of FT unit for synthetic diesel production in existing stand-alone biomass gasification plant using process simulation tool

    DEFF Research Database (Denmark)

    Hunpinyo, Piyapong; Narataruksa, Phavanee; Tungkamani, Sabaithip

    2014-01-01

    such as Fischer-Tropsch (FT) diesel. The embedding of the FT plant into the stand-alone based on power mode plants for production of a synthetic fuel is a promising practice, which requires an extensive adaptation of conventional techniques to the special chemical needs found in a gasified biomass. Because...... there are currently no plans to engage the FT process in Thailand, the authors have targeted that this work focus on improving the FT configurations in existing biomass gasification facilities (10 MWth). A process simulation model for calculating extended unit operations in a demonstrative context is designed...

  17. Effect of State Feedback Coupling and System Delays on the Transient Performance of Stand-Alone VSI with LC Output Filter

    DEFF Research Database (Denmark)

    Federico, de Bosio; de Sousa Ribeiro, Luiz Antonio; Freijedo Fernandez, Francisco Daniel

    2016-01-01

    The influence of state feedback coupling in the dynamics performance of power converters for stand-alone microgrids is investigated. Computation and PWM delays are the main factors that limit the achievable bandwidth of current regulators in digital implementations. In particular, the performance...... provided. A proportional resonant voltage controller is designed according to Nyquist criterion taking into account application requirements. For this purpose, a mathematical expression based on root locus analysis is proposed to find the minimum value of the fundamental resonant gain. Experimental tests...

  18. DCE-MRI of the breast in a stand-alone setting outside a complementary strategy - results of the TK-study

    Energy Technology Data Exchange (ETDEWEB)

    Kaiser, Clemens G.; Krammer, J.; Wasser, K.; Schoenberg, S.O. [University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Institute of Clinical Radiology and Nuclear Medicine, Mannheim (Germany); Reich, C.; Kaiser, W.A. [Friedrich-Schiller-University Hospital Jena, Institute of Diagnostic and Interventional Radiology I, Jena (Germany); Dietzel, M. [Friedrich-Alexander-University Hospital Erlangen-Nuernberg, Department of Neuroradiology, Erlangen (Germany); Baltzer, P.A.T. [Medical University Vienna, Institute of Radiology and Nuclear Medicine, Vienna (Austria)

    2015-06-01

    To evaluate the accuracy of MRI of the breast (DCE-MRI) in a stand-alone setting with extended indications. According to the inclusion criteria, breast specialists were invited to refer patients to our institution for DCE-MRI. Depending on the MR findings, patients received either a follow-up or biopsy. Between 04/2006 and 12/2011 a consecutive total of 1,488 women were prospectively examined. Of 1,488 included patients, 393 patients were lost to follow-up, 1,095 patients were evaluated. 124 patients were diagnosed with malignancy by DCE-MRI (76 TP, 48 FP, 971 TN, 0 FN cases). Positive cases were confirmed by histology, negative cases by MR follow-ups or patient questionnaires over the next 5 years in 1,737 cases (sensitivity 100 %; specificity 95.2 %; PPV 61.3 %; NPV 100 %; accuracy 95.5 %). For invasive cancers only (DCIS excluded), the results were 63 TP; 27 FP; 971 TP and 0 FN (sensitivity 100 %; specificity 97.2 %; PPV 70 %; NPV 100 %; accuracy 97.5 %). The DCE-MRI indications tested imply that negative results in DCE-MRI reliably exclude cancer. The results were achieved in a stand-alone setting (single modality diagnosis). However, these results are strongly dependent on reader experience and adequate technical standards as prerequisites for optimal diagnoses. (orig.)

  19. Risk factors for subsidence in anterior cervical fusion with stand-alone polyetheretherketone (PEEK) cages: a review of 82 cases and 182 levels.

    Science.gov (United States)

    Kao, Ting-Hsien; Wu, Chen-Hao; Chou, Yu-Ching; Chen, Hsien-Te; Chen, Wen-Hsien; Tsou, Hsi-Kai

    2014-10-01

    To determine risk factors for subsidence in patients treated with anterior cervical discectomy and fusion (ACDF) and stand-alone polyetheretherketone (PEEK) cages. Records of patients with degenerative spondylosis or traumatic disc herniation resulting in radiculopathy or myelopathy between C2 and C7 who underwent ACDF with stand-alone PEEK cages were retrospectively reviewed. Cages were filled with autogenous cancellous bone harvested from iliac crest or hydroxyapatite. Subsidence was defined as a decrease of 3 mm or more of anterior or posterior disc height from that measured on the postoperative radiograph. Eighty-two patients (32 males, 50 females; 182 treatment levels) were included in the analysis. Most patients had 1-2 treatment levels (62.2 %), and 37.8 % had 3-4 treatment levels. Treatment levels were from C2-7. Of the 82 patients, cage subsidence occurred in 31 patients, and at 39 treatment levels. Multivariable analysis showed that subsidence was more likely to occur in patients with more than two treatment levels, and more likely to occur at treatment levels C5-7 than at levels C2-5. Subsidence was not associated with postoperative alignment change but associated with more disc height change (relatively oversized cage). Subsidence is associated with a greater number of treatment levels, treatment at C5-7 and relatively oversized cage use.

  20. [Biomechanicsl evaluation of a stand-alone interbody fusion cage based on porous TiO2/glass-ceramic on the human cervical spine].

    Science.gov (United States)

    Korinth, M C; Moersch, S; Ragoss, C; Schopphoff, E

    2003-12-01

    Recently, there has been a rapid increase in the use of cervical spine interbody fusion cages, differing in design and biomaterial used, in competition to autologous iliac bone graft and bone cement (PMMA). Limited biomechanical differences in primary stability, as well as advantages and disadvantages of each cage or material have been investigated in studies, using an in vitro human cervical spine model. 20 human cervical spine specimens were tested after fusion with either a cubical stand-alone interbody fusion cage manufactured from a new porous TiO2/glass composite (Ecopore) or PMMA after discectomy. Non-destructive biomechanical testing was performed, including flexion/extension and lateral bending using a spine testing apparatus. Three-dimensional segmental range of motion (ROM) was evaluated using an ultrasound measurement system. ROM increased more in flexion/extension and lateral bending after PMMA fusion (26.5%/36.1%), then after implantation of the Ecopore-cage (8.1%/7.8%). In this first biomechanical in vitro examination of a new porous ceramic bone replacement material a) the feasibility and reproducibility of biomechanical cadaveric cervical examination and its applicability was demonstrated, b) the stability of the ceramic cage as a stand alone interbody cage was confirmed in vitro, and c) basic information and knowledge for our intended biomechanical and histological in vivo testing, after implantation of Ecopore in cervical sheep spines, were obtained.

  1. Geriatric trauma.

    Science.gov (United States)

    Adams, Sasha D; Holcomb, John B

    2015-12-01

    The landscape of trauma is changing due to an aging population. Geriatric patients represent an increasing number and proportion of trauma admissions and deaths. This review explores recent literature on geriatric trauma, including triage criteria, assessment of frailty, fall-related injury, treatment of head injury complicated by coagulopathy, goals of care, and the need for ongoing education of all surgeons in the care of the elderly. Early identification of high-risk geriatric patients is imperative to initiate early resuscitative efforts. Geriatric patients are typically undertriaged because of their baseline frailty being underappreciated; however, centers that see more geriatric patients do better. Rapid reversal of anticoagulation is important in preventing progression of brain injury. Anticipation of difficult disposition necessitates early involvement of physical therapy for rehabilitation and case management for appropriate placement. Optimal care of geriatric trauma patients will be based on the well established tenets of trauma resuscitation and injury repair, but with distinct elements that address the physiological and anatomical challenges presented by geriatric patients.

  2. Clinical and radiological outcomes after stand-alone ALIF for single L5-S1 degenerative discopathy using a PEEK cage filled with hydroxyapatite nanoparticles without bone graft.

    Science.gov (United States)

    Norotte, Gilles; Barrios, Carlos

    2018-05-01

    Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). Sixty-five patients who required surgery for DDD were evaluated. Clinical outcome evaluations included back and leg pain (VAS), disability (Oswestry Disability Index), and patient satisfaction (Macnab's criteria). Radiological outcomes include the assessment of disc height, the L5-S1 intervertebral disc angle, and anterior intervertebral fusion through standard and functional sagittal X-rays of the lumbar spine. Clinical and radiological measurements were assessed 2, 6, 12, and 24 months after surgery. Clinical outcomes improved progressively and stabilized from 12- to 24-month follow-up. Final postoperative ODI scores showed a notable improvement (95%CI = 36.1-48.9 points; p < .001). Similarly, 24-month postoperative VAS scores revealed a significant decrease in pain (95%CI = 5.4-6.2; p < .001). The fusion rate was 95.4%. Anterior disc height was restored from 4.1 ± 3.2 mm at baseline to 9.5 ± 1.6 mm in the immediate postoperative period (p < .001). A small collapse (17.9%) of the disc height was detected from the 2- and 24-month follow-ups. Cage subsidence (more than 3 mm collapse) was detected in 4 cases (6.2%) and was related to cage size (more than 11 mm height; P < .05). There were no serious bone substitute-related adverse events and no revision surgeries. Stand-alone anterior lumbar interbody fusion using hydroxyapatite nanoparticles without an autologous bone graft is an effective and safe treatment option for L5-S1 degenerative pathology. Clinical outcomes were very satisfactory with a high fusion rate. Copyright © 2018

  3. Solution and crystal structure of BA42, a protein from the Antarctic bacterium Bizionia argentinensis comprised of a stand-alone TPM domain.

    Science.gov (United States)

    Aran, Martin; Smal, Clara; Pellizza, Leonardo; Gallo, Mariana; Otero, Lisandro H; Klinke, Sebastián; Goldbaum, Fernando A; Ithurralde, Esteban R; Bercovich, Andrés; Mac Cormack, Walter P; Turjanski, Adrián G; Cicero, Daniel O

    2014-11-01

    The structure of the BA42 protein belonging to the Antarctic flavobacterium Bizionia argentinensis was determined by nuclear magnetic resonance and X-ray crystallography. This is the first structure of a member of the PF04536 family comprised of a stand-alone TPM domain. The structure reveals a new topological variant of the four β-strands constituting the central β-sheet of the αβα architecture and a double metal binding site stabilizing a pair of crossing loops, not observed in previous structures of proteins belonging to this family. BA42 shows differences in structure and dynamics in the presence or absence of bound metals. The affinity for divalent metal ions is close to that observed in proteins that modulate their activity as a function of metal concentration, anticipating a possible role for BA42. © 2014 Wiley Periodicals, Inc.

  4. Grid parity analysis of stand-alone hybrid microgrids: A comparative study of Germany, Pakistan, South Africa and the United States

    Science.gov (United States)

    Siddiqui, Jawad M.

    Grid parity for alternative energy resources occurs when the cost of electricity generated from the source is lower than or equal to the purchasing price of power from the electricity grid. This thesis aims to quantitatively analyze the evolution of hybrid stand-alone microgrids in the US, Germany, Pakistan and South Africa to determine grid parity for a solar PV/Diesel/Battery hybrid system. The Energy System Model (ESM) and NREL's Hybrid Optimization of Multiple Energy Resources (HOMER) software are used to simulate the microgrid operation and determine a Levelized Cost of Electricity (LCOE) figure for each location. This cost per kWh is then compared with two distinct estimates of future retail electricity prices at each location to determine grid parity points. Analysis results reveal that future estimates of LCOE for such hybrid stand-alone microgrids range within the 35-55 cents/kWh over the 25 year study period. Grid parity occurs earlier in locations with higher power prices or unreliable grids. For Pakistan grid parity is already here, while Germany hits parity between the years 2023-2029. Results for South Africa suggest a parity time range of the years 2040-2045. In the US, places with low grid prices do not hit parity during the study period. Sensitivity analysis results reveal the significant impact of financing and the cost of capital on these grid parity points, particularly in developing markets of Pakistan and South Africa. Overall, the study helps conclude that variations in energy markets may determine the fate of emerging energy technologies like microgrids. However, policy interventions have a significant impact on the final outcome, such as the grid parity in this case. Measures such as eliminating uncertainty in policies and improving financing can help these grids overcome barriers in developing economies, where they may find a greater use much earlier in time.

  5. PR2ALIGN: a stand-alone software program and a web-server for protein sequence alignment using weighted biochemical properties of amino acids.

    Science.gov (United States)

    Kuznetsov, Igor B; McDuffie, Michael

    2015-05-07

    Alignment of amino acid sequences is the main sequence comparison method used in computational molecular biology. The selection of the amino acid substitution matrix best suitable for a given alignment problem is one of the most important decisions the user has to make. In a conventional amino acid substitution matrix all elements are fixed and their values cannot be easily adjusted. Moreover, most existing amino acid substitution matrices account for the average (dis)similarities between amino acid types and do not distinguish the contribution of a specific biochemical property to these (dis)similarities. PR2ALIGN is a stand-alone software program and a web-server that provide the functionality for implementing flexible user-specified alignment scoring functions and aligning pairs of amino acid sequences based on the comparison of the profiles of biochemical properties of these sequences. Unlike the conventional sequence alignment methods that use 20x20 fixed amino acid substitution matrices, PR2ALIGN uses a set of weighted biochemical properties of amino acids to measure the distance between pairs of aligned residues and to find an optimal minimal distance global alignment. The user can provide any number of amino acid properties and specify a weight for each property. The higher the weight for a given property, the more this property affects the final alignment. We show that in many cases the approach implemented in PR2ALIGN produces better quality pair-wise alignments than the conventional matrix-based approach. PR2ALIGN will be helpful for researchers who wish to align amino acid sequences by using flexible user-specified alignment scoring functions based on the biochemical properties of amino acids instead of the amino acid substitution matrix. To the best of the authors' knowledge, there are no existing stand-alone software programs or web-servers analogous to PR2ALIGN. The software is freely available from http://pr2align.rit.albany.edu.

  6. Effects of ozone as a stand-alone and coagulation-aid treatment on the reduction of trihalomethanes precursors from high DOC and hardness water.

    Science.gov (United States)

    Sadrnourmohamadi, Mehrnaz; Gorczyca, Beata

    2015-04-15

    This study investigates the effect of ozone as a stand-alone and coagulation aid on the removal of dissolved organic carbon (DOC) from the water with a high level of DOC (13.8 mgL(-1)) and calcium hardness (270 mgL(-1)) CaCO3. Natural water collected from the Assiniboine River (Manitoba, Canada) was used in this study. Effectiveness of ozone treatment was evaluated by measurement of DOC, DOC fractions, UV254, and trihalomethane formation potential (THMFP). Additionally, zeta potential and dissolved calcium concentration were measured to discern the mechanism of ozone reactions. Results indicated that 0.8 mg O3/mg DOC ozone stand-alone can cause up to 86% UV254 reduction and up to 27% DOC reduction. DOC fractionation results showed that ozone can change the composition of DOC in the water samples, converting the hydrophobic fractions into hydrophilic ones and resulting in the reduction of THMFP. Also, ozone caused a decrease in particle stability and dissolved calcium concentration. These simultaneous ozonation effects caused improved water flocculation and enhanced removal of DOC. This resulted in reduction of the coagulant dosage when ozone doses higher than 0.2 mg O3/mg DOC were applied prior to coagulation with ferric sulfate. Also, pre-ozonation-coagulation process achieved preferential THMFP removal for all of the ozone doses tested (0-0.8 mg O3/mg DOC), leading to a lower specific THMFP in pre-ozonated-coagulated waters than in the corresponding ozonated waters. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Correlates and management of nonmalignant pain in the nursing home. SAGE Study Group. Systematic Assessment of Geriatric drug use via Epidemiology.

    Science.gov (United States)

    Won, A; Lapane, K; Gambassi, G; Bernabei, R; Mor, V; Lipsitz, L A

    1999-08-01

    Nonmalignant pain is a common problem among older people. The prevalence of pain in the nursing home is not well studied. We looked at the association between nonmalignant pain, psychological and functional health, and the practice patterns for pain management in the nursing home. A cross-sectional study. Nursing Home in four US states. A total of 49,971 nursing home residents from 1992 to 1995. We used the SAGE database (Systematic Assessment of Geriatric drug use via Epidemiology), which linked information from the Minimum Data Set and nursing home drug utilization data. The MDS items measured included pain, activities of daily living (ADL) function, mood, and time involved in activities. The use of analgesics, anxiolytics, and antidepressants was also documented. Daily pain was reported in 26% of nursing home residents. The prevalence was lower among men, persons more than age 85, and racial minorities. Persons suffering pain daily were more likely to have severe ADL impairment, odds ratio (OR) (2.47 (95% CI, 2.34-2.60)), more depressive signs and symptoms (OR 1.66 (95% CI, 1.57-1.75)), and less frequent involvement in activities (OR 1.35 (95% CI, 1.29-1.40)). Approximately 25% of persons with daily pain received no analgesics. Residents who were more than 85 years old (OR 1.15 (95% CI 1.02-1.28)), cognitively impaired, (OR 1.44 (95% CI, 1.29-1.61)), of male gender (OR 1.17 (95% CI, 1.06-1.29)), or a racial minority (OR 1.69 (95% CI, 1.40-2.05) and OR 1.56 (95% CI, 0.70-1.04) for blacks and Hispanics, respectively) were at greater risk of not receiving analgesics. Approximately 50% of those in pain used physical and occupational therapies, which was more than two times higher (OR 2.44 (95% CI, 2.34-2.54)), than use for those not in pain. Daily nonmalignant pain is prevalent among nursing home residents and is often associated with impairments in ADL, mood, and decreased activity involvement. Even when pain was recognized, men, racial minorities, and cognitively

  8. Geriatric imaging

    International Nuclear Information System (INIS)

    Guglielmi, Giuseppe; Peh, Wilfred C.G.; Guermazi, Ali

    2013-01-01

    Considers all aspect of geriatric imaging. Explains clearly how to distinguish the healthy elderly from those in need of treatment. Superbly illustrated. Written by recognized experts in field. In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent ''the norm.'' It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

  9. Competencies in Geriatric Nursing: Empirical Evidence from a Computer-Based Large-Scale Assessment Calibration Study

    Science.gov (United States)

    Kaspar, Roman; Döring, Ottmar; Wittmann, Eveline; Hartig, Johannes; Weyland, Ulrike; Nauerth, Annette; Möllers, Michaela; Rechenbach, Simone; Simon, Julia; Worofka, Iberé

    2016-01-01

    Valid and reliable standardized assessment of nursing competencies is needed to monitor the quality of vocational education and training (VET) in nursing and evaluate learning outcomes for care work trainees with increasingly heterogeneous learning backgrounds. To date, however, the modeling of professional competencies has not yet evolved into…

  10. Geriatric nutrition.

    Science.gov (United States)

    Markham, R W; Hodgkins, E M

    1989-01-01

    In recent decades, veterinary medicine has become more successful in prolonging the healthy, useful lives of pets. As a result, the practitioner spends a greater part of each practice day caring for the geriatric animal, both healthy and unhealthy. Because of their longevity, older pets are typically regular family members, with owners who seek the finest health care possible for their pets. The practice of geriatric medicine most properly should begin not when the dog or cat reaches some specific "golden" age, but rather when the wiggly, robust puppy or kitten receives its first examination. Like all parts of a sound preventive program, geriatric nutrition best follows from a well-considered juvenile and adult nutrition program. Furthermore, once it becomes senior, the "well" geriatric is as much a candidate for a diet designed especially to accommodate old age changes as is his unhealthy contemporary. In fact, evidence suggests that appropriate dietary management of the healthy, but often subclinical, patient may help postpone the signs of dysfunction and increase quality and length of life. A knowledge of the most significant nutrients and the impact of each on aging systems is now, and will become increasingly more, important to the progressive, skillful veterinarian.

  11. Analysis of the impact of batteries behaviour on stand-alone photovoltaic systems; Analise do impacto do comportamento de baterias em sistemas fotovoltaicos autonomos

    Energy Technology Data Exchange (ETDEWEB)

    Vera, Luis Horacio

    2009-08-15

    Stand-alone photovoltaic systems are a suitable alternative for rural electrification. However, there are still problems to be solved, mainly related to the system design and the technical quality of the equipment and facilities, which impacts the systems reliability. To determine the factors that affect the reliability of these systems it were studied the most common configurations and associated failures. The Laboratory experimental research, together with an extensive literature review, show the basic technical problems that occur to each of the elements of the installation and the dependence between them. These studies have shown that the storage the system, considering system reliability and economy, is the weakest element due to the decrease of their storage capacity. This led to consider the storage systems as the focus of this study and, through the analysis of their behavior, to develop a procedure to size systems with high reliability, lower cost and appropriate configuration. The impact of batteries on the technical reliability and economic viability of photovoltaic systems is determined. It was achieved through experimental testing and the development and adjustment of mathematical models. These models were implemented to preexisting software called PVSize. The improved software allows the calculation of different configurations of systems and to determine the loss of load probability and the figures of merit associated to the chosen economic-financial project. On this work was installed a photovoltaic system and was developed a battery testing system. The values measured in these systems allow to verify the mathematical models that describe the behavior of each device and characterize the components of the system. Experimental analysis of the behavior of a bank of batteries along a year showed that the connection of batteries in parallel accelerates the batteries degradation process, and this degradation has differentiated impact on the loss of

  12. A practical multi-objective design approach for optimum exhaust heat recovery from hybrid stand-alone PV-diesel power systems

    International Nuclear Information System (INIS)

    Yousefi, Moslem; Kim, Joong Hoon; Hooshyar, Danial; Yousefi, Milad; Sahari, Khairul Salleh Mohamed; Ahmad, Rodina Binti

    2017-01-01

    Highlights: • Heat recovery exchanger is designed based on practical conditions of a hybrid power system. • Off-the-grid electricity system modeling and analysis using micro-grid analysis software HOMER. • NSGA-II is used for the multi-objective design optimization task. • A new local search is proposed to incorporate the engineering knowledge in NSGA-II. • The proposed approach outperforms the existing ones. - Abstract: Integration of solar power and diesel generators (DGs) together with battery storage has proven to be an efficient choice for stand-alone power systems (SAPS). For higher energy efficiency, heat recovery from exhaust gas of the DG can also be employed to supply all or a portion of the thermal energy demand. Although the design of such heat recovery systems (HRSs) has been studied, the effect of solar power integration has not been taken into account. In this paper, a new approach for practical design of these systems based on varying engine loads is presented. Fast and elitist non-dominated sorting genetic algorithm (NSGA-II) equipped with a novel local search was used for the design process, considering conflicting objectives of annual energy recovery and total cost of the system, and six design variables. An integrated power system, designed for a remote SAPS, was used to evaluate the design approach. The optimum power supply system was first designed using the commercial software Hybrid Optimization of Multiple Energy Resources (HOMER), based on power demand and global solar energy in the region. Heat recovery design was based on the outcome of HOMER for DG hourly load, considering different power scenarios. The proposed approach improves the annual heat recovery of the PV/DG/battery system by 4%, PV/battery by 1.7%, and stand-alone DG by 1.8% when compared with a conventional design based on nominal DG load. The results prove that the proposed approach is effective and that load calculations should be taken into account prior to

  13. Stand-alone photovoltaic (PV) integrated with earth to air heat exchanger (EAHE) for space heating/cooling of adobe house in New Delhi (India)

    International Nuclear Information System (INIS)

    Chel, Arvind; Tiwari, G.N.

    2010-01-01

    This paper deals with an experimental outdoor annual performance evaluation of 2.32 kW P photovoltaic (PV) power system located at solar energy park in New Delhi composite climatic conditions. This PV system operates the daily electrical load nearly 10 kW h/day which comprises of various applications such as electric air blower of an earth to air heat exchanger (EAHE) used for heating/cooling of adobe house, ceiling fan, fluorescent tube-light, computer, submersible water pump, etc. The outdoor efficiencies, power generated and lost in PV system components were determined using hourly experimental measured data for 1 year on typical clear day in each month. These realistic data are useful for design engineers for outdoor assessment of PV system components. The energy conservation, mitigation of CO 2 emission and carbon credit potential of the existing PV integrated EAHE system is presented in this paper. Also, the energy payback time (EPBT) and unit cost of electricity were determined for both stand-alone PV (SAPV) and building roof integrated PV (BIPV) systems.

  14. Development of Stand Alone Application Tool for Processing and Quality Measurement of Weld Imperfection Image Captured by μ-Focused Digital Radiography Using MATLAB- Based Graphical User Interface

    Directory of Open Access Journals (Sweden)

    PZ Nadila

    2012-12-01

    Full Text Available Digital radiography incresingly is being applied in the fabrication industry. Compared to film- based radiography, digitally radiographed images can be acquired with less time and fewer exposures. However, noises can simply occur on the digital image resulting in a low-quality result. Due to this and the system’s complexity, parameters’ sensitivity, and environmental effects, the results can be difficult to interpret, even for a radiographer. Therefore, the need of an application tool to improve and evaluate the image is becoming urgent. In this research, a user-friendly tool for image processing and image quality measurement was developed. The resulting tool contains important components needed by radiograph inspectors in analyzing defects and recording the results. This tool was written by using image processing and the graphical user interface development environment and compiler (GUIDE toolbox available in Matrix Laboratory (MATLAB R2008a. In image processing methods, contrast adjustment, and noise removal, edge detection was applied. In image quality measurement methods, mean square error (MSE, peak signal-to-noise ratio (PSNR, modulation transfer function (MTF, normalized signal-to-noise ratio (SNRnorm, sensitivity and unsharpness were used to measure the image quality. The graphical user interface (GUI wass then compiled to build a Windows, stand-alone application that enables this tool to be executed independently without the installation of MATLAB.

  15. The Research on Second-Order ADRC Algorithm of Using Wind Turbine Virtual Inertia to Participate in Primary Frequency Regulation in a Small Stand-Alone Microgrid

    Directory of Open Access Journals (Sweden)

    Wang Yi

    2018-01-01

    Full Text Available In order to improve the transient stability of frequency in a small stand-alone microgrid (SSM, this paper takes a SSM composed of a direct-drive permanent magnet synchronous generator (D-PMSG and a micro gas turbine (MGT as the background and uses wind turbine generator (WTG virtual inertia (VI to participate in the primary (short-term system frequency regulation. First of all, this paper constructs a grid-connected model composed of a WTG and a MGT, analyzes the WTG virtual inertia frequency regulation mechanism, and explains the principle of proportional-differentiation (PD virtual inertia control (VIC and its shortcomings. Secondly, the paper introduces the structure principle of n-order active disturbance rejection control (ADRC and deduces the design process of second-order ADRC-VIC. Finally, through the simulation and experimental verification, comparing the frequency perturbation of without-VIC, PD-VIC, and ADRC-VIC, it is concluded that PD-VIC and ADRC-VIC both can use the WTG virtual inertia to participate in the primary frequency regulation. The frequency regulation effect of ADRC-VIC is better than PD-VIC, ADRC-VIC can extend the rotor speed recovery time and avoid overshoot, and its frequency fluctuation amplitude and settling time are obviously improved, and ADRC-VIC can effectively avoid the overshoot phenomenon of the MGT output power.

  16. Optimal Sizing of a Stand-Alone Hybrid Power System Based on Battery/Hydrogen with an Improved Ant Colony Optimization

    Directory of Open Access Journals (Sweden)

    Weiqiang Dong

    2016-09-01

    Full Text Available A distributed power system with renewable energy sources is very popular in recent years due to the rapid depletion of conventional sources of energy. Reasonable sizing for such power systems could improve the power supply reliability and reduce the annual system cost. The goal of this work is to optimize the size of a stand-alone hybrid photovoltaic (PV/wind turbine (WT/battery (B/hydrogen system (a hybrid system based on battery and hydrogen (HS-BH for reliable and economic supply. Two objectives that take the minimum annual system cost and maximum system reliability described as the loss of power supply probability (LPSP have been addressed for sizing HS-BH from a more comprehensive perspective, considering the basic demand of load, the profit from hydrogen, which is produced by HS-BH, and an effective energy storage strategy. An improved ant colony optimization (ACO algorithm has been presented to solve the sizing problem of HS-BH. Finally, a simulation experiment has been done to demonstrate the developed results, in which some comparisons have been done to emphasize the advantage of HS-BH with the aid of data from an island of Zhejiang, China.

  17. Geriatric imaging

    Energy Technology Data Exchange (ETDEWEB)

    Guglielmi, Giuseppe [Scientific Institute Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo (Italy). Dept. of Radiology; Peh, Wilfred C.G. [Khoo Teck Puat Hospital, Singapore (Singapore). Dept. of Diagnostic Radiology; Guermazi, Ali (eds.) [Boston Univ. School of Medicine, Boston, MA (United States). Dept. of Radiology

    2013-08-01

    Considers all aspect of geriatric imaging. Explains clearly how to distinguish the healthy elderly from those in need of treatment. Superbly illustrated. Written by recognized experts in field. In the elderly, the coexistence of various diseases, the presence of involutional and degenerative changes, and the occurrence of both physical and cognitive problems represent ''the norm.'' It is therefore important to know how to distinguish the healthy elderly from those in need of treatment as a sound basis for avoiding overdiagnosis and overtreatment. This aspect is a central theme in Geriatric Imaging, which covers a wide range of applications of different imaging techniques and clearly explains both the potential and the limitations of diagnostic imaging in geriatric patients. Individual sections are devoted to each major region or system of the body, and a concluding section focuses specifically on interventional procedures. The book, written by recognized experts in the field, is superbly illustrated and will be an ideal resource for geriatricians, radiologists, and trainees.

  18. The international phase 4 validation study of the EORTC QLQ-SWB32: A stand-alone measure of spiritual well-being for people receiving palliative care for cancer

    NARCIS (Netherlands)

    Vivat, B.; Young, T. E.; Winstanley, J.; Arraras, J. I.; Black, K.; Boyle, F.; Bredart, A.; Costantini, A.; Guo, J.; Irarrazaval, M. E.; Kobayashi, K.; Kruizinga, R.; Navarro, M.; Omidvari, S.; Rohde, G. E.; Serpentini, S.; Spry, N.; van Laarhoven, H. W. M.; Yang, G. M.

    2017-01-01

    The EORTC Quality of Life Group has just completed the final phase (field-testing and validation) of an international project to develop a stand-alone measure of spiritual well-being (SWB) for palliative cancer patients. Participants (n = 451)-from 14 countries on four continents; 54% female; 188

  19. The Impact of Course Delivery Systems on Student Achievement and Sense of Community: A Comparison of Learning Community versus Stand-Alone Classroom Settings in an Open-Enrollment Inner City Public Community College

    Science.gov (United States)

    Bandyopadhyay, Pamela

    2010-01-01

    This study examined the effects of two types of course delivery systems (learning community classroom environments versus stand-alone classroom environments) on the achievement of students who were simultaneously enrolled in remedial and college-level social science courses at an inner city open-enrollment public community college. This study was…

  20. Hydrogen-based energy storage unit for stand alone PV systems; L'hydrogene electrolytique comme moyen de stockage d'electricite pour systemes photovoltaiques isoles

    Energy Technology Data Exchange (ETDEWEB)

    Labbe, J

    2006-12-15

    Stand alone systems supplied only by a photovoltaic generator need an energy storage unit to be fully self sufficient. Lead acid batteries are commonly used to store energy because of their low cost, despite several operational constraints. A hydrogen-based energy storage unit (HESU) could be another candidate, including an electrolyser, a fuel cell and a hydrogen tank. However many efforts still need to be carried out for this technology to reach an industrial stage. In particular, market outlets must be clearly identified. The study of small stationary applications (few kW) is performed by numerical simulations. A simulator is developed in the Matlab/Simulink environment. It is mainly composed of a photovoltaic field and a storage unit (lead acid batteries, HESU, or hybrid storage HESU/batteries). The system component sizing is achieved in order to ensure the complete system autonomy over a whole year of operation. The simulator is tested with 160 load profiles (1 kW as a yearly mean value) and three locations (Algeria, France and Norway). Two coefficients are set in order to quantify the correlation between the power consumption of the end user and the renewable resource availability at both daily and yearly scales. Among the tested cases, a limit value of the yearly correlation coefficient came out, enabling to recommend the use of the most adapted storage to a considered case. There are cases for which using HESU instead of lead acid batteries can increase the system efficiency, decrease the size of the photovoltaic field and improve the exploitation of the renewable resource. In addition, hybridization of HESU with batteries always leads to system enhancements regarding its sizing and performance, with an efficiency increase by 10 to 40 % depending on the considered location. The good agreement between the simulation data and field data gathered on real systems enabled the validation of the models used in this study. (author)

  1. Diagnostic performance of a stand-alone central blood pressure monitor: application of central blood pressure in the diagnosis of high blood pressure.

    Science.gov (United States)

    Cheng, Hao-Min; Sung, Shih-Hsien; Chuang, Shao-Yuan; Pearson, Alan; Tufanaru, Catalin; White, Sarahlouise; Yu, Wen-Chung; Chen, Chen-Huan

    2014-03-01

    Oscillometric central blood pressure (CBP) monitors have emerged as a new technology for blood pressure (BP) measurements. With a newly proposed diagnostic threshold for CBP, we investigated the diagnostic performance of a novel CBP monitor. We recruited a consecutive series of 138 subjects (aged 30-93 years) without previous use of antihypertensive agents for simultaneous invasive and noninvasive measurements of BP in a catheterization laboratory. With the cutoff (CBP ≥130/90 mm Hg) for high blood pressure (HBP), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the novel CBP monitor were calculated with reference to the measured CBP. In comparison, the diagnostic performance of the conventional cuff BP was also evaluated. The noninvasive CBP for detecting HBP in a sample with a prevalence of 52% showed a sensitivity of 93% (95% confidence interval (CI) = 91-95), specificity of 95% (95% CI = 94-97), PPV of 96% (95% CI = 94-97), and NPV of 93% (95% CI = 90-95). In contrast, with cuff BP and the traditional HBP criterion (cuff BP ≥140/90 mm Hg), the sensitivity, specificity, PPV, and NPV were 49% (95% CI = 44-53), 94% (95% CI = 92-96), 90% (95% CI = 86-93), and 63% (95% CI 59-66), respectively. A stand-alone oscillometric CBP monitor may provide CBP values with acceptable diagnostic accuracy. However, with reference to invasively measured CBP, cuff BP had low sensitivity and NPV, which could render possible management inaccessible to a considerable proportion of HBP patients, who may be identifiable through noninvasive CBP measurements from the CBP monitor.

  2. A Lower T1 Slope as a Predictor of Subsidence in Anterior Cervical Discectomy and Fusion with Stand-Alone Cages.

    Science.gov (United States)

    Lee, Su Hun; Lee, Jun Seok; Sung, Soon Ki; Son, Dong Wuk; Lee, Sang Weon; Song, Geun Sung

    2017-09-01

    Preoperative parameters including the T1 slope (T1S) and C2-C7 sagittal vertical axis (SVA) have been recognized as predictors of kyphosis after laminoplasty, which is accompanied by posterior neck muscle damage. The importance of preoperative parameters has been under-estimated in anterior cervical discectomy and fusion (ACDF) because there is no posterior neck muscle damage. We aimed to determine whether postoperative subsidence and pseudarthrosis could be predicted according to specific parameters on preoperative plain radiographs. We retrospectively analyzed 41 consecutive patients (male: female, 22: 19; mean age, 51.15±9.25 years) who underwent ACDF with a stand-alone polyether-ether-ketone (PEEK) cage (>1 year follow-up). Parameters including SVA, T1S, segmental angle and range of motion (ROM), C2-C7 cervical angle and ROM, and segmental inter-spinous distance were measured on preoperative plain radiographs. Risk factors of subsidence and pseudarthrosis were determined using multivariate logistic regression. Fifty-five segments (27 single-segment and 14 two-segment fusions) were included. The subsidence and pseudarthrosis rates based on the number of segments were 36.4% and 29.1%, respectively. Demographic data and fusion level were unrelated to subsidence. A greater T1S was associated with a lower risk of subsidence (p=0.017, odds ratio=0.206). A cutoff value of T1Ssubsidence (sensitivity: 70%, specificity: 68.6%). There were no preoperative predictors of pseudarthrosis except old age. A lower T1S (T1Ssubsidence following ACDF. Surgeons need to be aware of this risk factor and should consider various supportive procedures to reduce the subsidence rates for such cases.

  3. Performance of natural curaua fiber-reinforced polyester composites under 7.62 mm bullet impact as a stand-alone ballistic armor

    Directory of Open Access Journals (Sweden)

    Fábio de Oliveira Braga

    2017-10-01

    Full Text Available A multilayered armor system (MAS is intended to personal protection against high kinetic energy ammunition. MAS layers are composed of materials such as a front ceramic and a back composite that must show both high impact resistance and low weight, usually conflicting characteristics. Synthetic fiber fabrics, such as Kevlar™ and Dyneema™, are the favorite materials to back the front ceramic, due to their high strength, high modulus and relatively low weight. Recently, composites reinforced with natural fibers have been considered as MAS second layer owing to their good performance associated with other advantages as being cheaper and environmentally friendly. Among the natural fibers, those extracted from the leaves of the Ananas erectifolius plant, known as curaua, stand out due to its exceptional high strength and high modulus. Thus, the objective of the present work is to evaluate the performance of curaua fiber-reinforced polyester composites subjected to ballistic impact of high energy 7.62 mm ammunition. Composites reinforced with 0, 10, 20 and 30 vol.% of curaua fibers were produced and stand-alone tested as armor target to evaluate the absorbed energy. Analysis of variance (Anova and Tukey's honest significant difference test (HSD made it possible to compare the results to Kevlar™ laminates. Among the tested materials, the 30 vol.% fiber composites were found to be the best alternative to Kevlar™. Keywords: Composite, Natural fiber, Curaua fiber, Ballistic test

  4. Effects of a stand-alone web-based electronic screening and brief intervention targeting alcohol use in university students of legal drinking age: A randomized controlled trial.

    Science.gov (United States)

    Ganz, Thomas; Braun, Michael; Laging, Marion; Schermelleh-Engel, Karin; Michalak, Johannes; Heidenreich, Thomas

    2018-02-01

    Many intervention efforts targeting student drinking were developed to address US college students, which usually involves underage drinking. It remains unclear, if research evidence from these interventions is generalizable to university and college students of legal drinking age, e.g., in Europe. To evaluate the effectiveness of a translated and adapted version of the eCHECKUP TO GO, applied as stand-alone web-based electronic screening and brief intervention (e-SBI), in German university students at risk for hazardous drinking. A fully automated web-based two-arm parallel-group randomized controlled trial was conducted. Participants were randomized to an e-SBI or assessment-only (AO) condition. The current paper analyzed students with baseline AUDIT-C scores ≥3 for women and ≥4 for men (sample at baseline: e-SBI [n=514], AO [n=467]; 3-month follow-up: e-SBI [n=194], AO [n=231]; 6-month follow-up: e-SBI [n=146], AO [n=200]). The primary outcome was prior four weeks' alcohol consumption. Secondary outcomes were frequency of heavy drinking occasions, peak blood alcohol concentration, and number of alcohol-related problems. Mixed linear model analyses revealed significant interaction effects between groups and time points on the primary outcome after 3 and 6months. Compared to students in the AO condition, students in the e-SBI condition reported consuming 4.11 fewer standard drinks during the previous four weeks after 3months, and 4.78 fewer standard drinks after 6months. Mixed results were found on secondary outcomes. The results indicate that evidence on and knowledge of web-based e-SBIs based on US college student samples is transferable to German university students of legal drinking age. However, knowledge of what motivates students to complete programs under voluntary conditions, although rare, is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Comparison of a Stand-Alone Anchored Spacer Versus Plate-Cage Construct in the Treatment of Two Noncontiguous Levels of Cervical Spondylosis: A Preliminary Investigation.

    Science.gov (United States)

    Shi, Sheng; Zheng, Shuang; Li, Xin-Feng; Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-05-01

    The application of stand-alone anchored spacer (SAAS) in anterior cervical discectomy and fusion (ACDF) has been proven to be safe and effective to treat cervical spondylosis. Skip-level ACDF with SAAS, fusing only the involved levels without anterior plates, may be the optimal treatment. The aim of the study was to compare the clinical outcomes, radiologic results of SAAS, and plate-cage construct in the treatment of 2 noncontiguous levels of cervical spondylosis. A total of 65 patients with 2 noncontiguous levels of cervical spondylosis were included in the retrospective review of prospective collected data. The clinical and radiologic outcomes were assessed with the Japanese Orthopaedic Association score, Neck Disability Index, cervical alignment, and range of motion and disc height of intermediate segment, respectively. All the aforementioned parameters were compared before and after surgery in the respective group, which also were compared between the 2 groups. Complications also were recorded, and correlations between the surgical outcome and various factors were analyzed. No significant differences existed in clinical results between the 2 groups (P > 0.05). In addition, no statistical significance was observed in fusion rate, cervical alignment, and range of motion and disc height of intermediate segment, dysphagia, and hoarseness (P > 0.05). Preoperative Japanese Orthopaedic Association score and high-intensity signal in T2-weighted images were important predictors for surgical outcome. Skip-level ACDF with SAAS is a safe and effective treatment of 2 noncontiguous levels of cervical spondylosis without obvious contraindications, which can keep the IS intact, and have a low impact on the IS. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. CANGS DB: a stand-alone web-based database tool for processing, managing and analyzing 454 data in biodiversity studies.

    Science.gov (United States)

    Pandey, Ram Vinay; Nolte, Viola; Boenigk, Jens; Schlötterer, Christian

    2011-06-30

    Next generation sequencing (NGS) is widely used in metagenomic and transcriptomic analyses in biodiversity. The ease of data generation provided by NGS platforms has allowed researchers to perform these analyses on their particular study systems. In particular the 454 platform has become the preferred choice for PCR amplicon based biodiversity surveys because it generates the longest sequence reads. Nevertheless, the handling and organization of massive amounts of sequencing data poses a major problem for the research community, particularly when multiple researchers are involved in data acquisition and analysis. An integrated and user-friendly tool, which performs quality control, read trimming, PCR primer removal, and data organization is desperately needed, therefore, to make data interpretation fast and manageable. We developed CANGS DB (Cleaning and Analyzing Next Generation Sequences DataBase) a flexible, stand alone and user-friendly integrated database tool. CANGS DB is specifically designed to organize and manage the massive amount of sequencing data arising from various NGS projects. CANGS DB also provides an intuitive user interface for sequence trimming and quality control, taxonomy analysis and rarefaction analysis. Our database tool can be easily adapted to handle multiple sequencing projects in parallel with different sample information, amplicon sizes, primer sequences, and quality thresholds, which makes this software especially useful for non-bioinformaticians. Furthermore, CANGS DB is especially suited for projects where multiple users need to access the data. CANGS DB is available at http://code.google.com/p/cangsdb/. CANGS DB provides a simple and user-friendly solution to process, store and analyze 454 sequencing data. Being a local database that is accessible through a user-friendly interface, CANGS DB provides the perfect tool for collaborative amplicon based biodiversity surveys without requiring prior bioinformatics skills.

  7. CANGS DB: a stand-alone web-based database tool for processing, managing and analyzing 454 data in biodiversity studies

    Directory of Open Access Journals (Sweden)

    Schlötterer Christian

    2011-06-01

    Full Text Available Abstract Background Next generation sequencing (NGS is widely used in metagenomic and transcriptomic analyses in biodiversity. The ease of data generation provided by NGS platforms has allowed researchers to perform these analyses on their particular study systems. In particular the 454 platform has become the preferred choice for PCR amplicon based biodiversity surveys because it generates the longest sequence reads. Nevertheless, the handling and organization of massive amounts of sequencing data poses a major problem for the research community, particularly when multiple researchers are involved in data acquisition and analysis. An integrated and user-friendly tool, which performs quality control, read trimming, PCR primer removal, and data organization is desperately needed, therefore, to make data interpretation fast and manageable. Findings We developed CANGS DB (Cleaning and Analyzing Next Generation Sequences DataBase a flexible, stand alone and user-friendly integrated database tool. CANGS DB is specifically designed to organize and manage the massive amount of sequencing data arising from various NGS projects. CANGS DB also provides an intuitive user interface for sequence trimming and quality control, taxonomy analysis and rarefaction analysis. Our database tool can be easily adapted to handle multiple sequencing projects in parallel with different sample information, amplicon sizes, primer sequences, and quality thresholds, which makes this software especially useful for non-bioinformaticians. Furthermore, CANGS DB is especially suited for projects where multiple users need to access the data. CANGS DB is available at http://code.google.com/p/cangsdb/. Conclusion CANGS DB provides a simple and user-friendly solution to process, store and analyze 454 sequencing data. Being a local database that is accessible through a user-friendly interface, CANGS DB provides the perfect tool for collaborative amplicon based biodiversity surveys

  8. Size-exclusion chromatography as a stand-alone methodology identifies novel markers in mass spectrometry analyses of plasma-derived vesicles from healthy individuals

    Directory of Open Access Journals (Sweden)

    Armando de Menezes-Neto

    2015-07-01

    Full Text Available Plasma-derived vesicles hold a promising potential for use in biomedical applications. Two major challenges, however, hinder their implementation into translational tools: (a the incomplete characterization of the protein composition of plasma-derived vesicles, in the size range of exosomes, as mass spectrometric analysis of plasma sub-components is recognizably troublesome and (b the limited reach of vesicle-based studies in settings where the infrastructural demand of ultracentrifugation, the most widely used isolation/purification methodology, is not available. In this study, we have addressed both challenges by carrying-out mass spectrometry (MS analyses of plasma-derived vesicles, in the size range of exosomes, from healthy donors obtained by 2 alternative methodologies: size-exclusion chromatography (SEC on sepharose columns and Exo-Spin™. No exosome markers, as opposed to the most abundant plasma proteins, were detected by Exo-Spin™. In contrast, exosomal markers were present in the early fractions of SEC where the most abundant plasma proteins have been largely excluded. Noticeably, after a cross-comparative analysis of all published studies using MS to characterize plasma-derived exosomes from healthy individuals, we also observed a paucity of “classical exosome markers.” Independent of the isolation method, however, we consistently identified 2 proteins, CD5 antigen-like (CD5L and galectin-3-binding protein (LGALS3BP, whose presence was validated by a bead-exosome FACS assay. Altogether, our results support the use of SEC as a stand-alone methodology to obtain preparations of extracellular vesicles, in the size range of exosomes, from plasma and suggest the use of CD5L and LGALS3BP as more suitable markers of plasma-derived vesicles in MS.

  9. Attachment and coping of dementia care staff: The role of staff attachment style, geriatric nursing self-efficacy, and approaches to dementia in burnout.

    Science.gov (United States)

    Kokkonen, Taru-Maija; Cheston, Richard I L; Dallos, Rudi; Smart, Cordet A

    2014-07-01

    Past research suggests that dementia care staff are vulnerable to the development of burnout, which has implications for staff well-being and hence the quality of care for people with dementia. Studying personal vulnerability factors in burnout is important as it can guide staff training and support. Attachment theory suggests that adult attachment styles affect caregiving relationships and individuals' responses to stress, providing a framework for understanding caregivers' styles of coping. This cross-sectional survey study examined relationships between staff attachment styles, geriatric nursing self-efficacy, and approaches to dementia in burnout. Seventy-seven members of dementia care staff working on inpatient wards for older people completed self-report questionnaires. Insecure attachment, lower levels of self-efficacy, and more optimistic attitudes in staff were related to higher levels of burnout. Staff training on the role of attachment in dementia care is recommended. Further research is required to explore mediating factors between adult attachment styles and burnout. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Do we need community geriatrics?

    LENUS (Irish Health Repository)

    O'Hanlon, S

    2012-01-30

    Community geriatrics has evolved as a specific aspect of geriatric medicine in the UK. In Ireland there is uncertainty as to how it should be planned. This is the first national survey of consultants, specialist registrars and general practitioners to seek their opinions. Most consultants and GPs reported already having a community aspect to their current practice, e.g. nursing home visits or community hospital visits, whereas most SpRs did not. Forty three of 62 respondents (69%) agreed that there is a need for community geriatricians and that there should be integration with hospital medicine. Fifty seven of 62 respondents (92%) felt that there would be a beneficial effect on GP services, though some expressed concern about work overlap. Thirteen of the 25 SpRs (52%) in training hoped to begin practice in community geriatrics in the future.

  11. [Assessment of geriatric patients' care needs based on sosia classification: the reality of the lombardy region in nursing home.

    Science.gov (United States)

    Vanalli, Mariangela

    2016-11-01

    The increased demand to care that originates from demographic changes called in Italy a rapid development in Nursing Home with particular emergency the problem of programme the welfare response. It is essential the development of a classification system able to describe the stratification of the case mix on the basis of the care requirements, allowing a remuneration in function of the complexity care. Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini-Mental State Examination on the basis of three indicators (mobility, cognition, comorbidity) is evaluated in eight classes of frailty. However, it is not any research project was published in order to assess the agreement between SOSIA classification and other measuring instruments. Although various methods exist by which researchers have attempted to measure the need for nursing care, there is no nationally accepted system for determining the total amount of registered nursing resources required by residents in long-term care. The aim of this study was to evaluate the correlation between SOSIA and filing systems widely used, such as the degree of Barthel disability rating scale, the Mini-Mental State Examination to offer care appropriate for the case-mix. Only the higher complexity care has classified in the first two classes, while the remaining levels has categorized in the lowest paid. Misclassification therefore induces an underestimation of the real care needs and, consequently, inadequate remuneration.

  12. Stand-alone containment analysis of Phébus FPT tests with ASTEC and MELCOR codes: the FPT-2 test

    Directory of Open Access Journals (Sweden)

    Bruno Gonfiotti

    2018-03-01

    Full Text Available During the last 40 years, many studies have been carried out to investigate the different phenomena occurring during a Severe Accident (SA in a Nuclear Power Plant (NPP. Such efforts have been supported by the execution of different experimental campaigns, and the integral Phébus FP tests were probably some of the most important experiments in this field. In these tests, the degradation of a Pressurized Water Reactor (PWR fuel bundle was investigated employing different control rod materials and burn-up levels in strongly or weakly oxidizing conditions. From the findings on these and previous tests, numerical codes such as ASTEC and MELCOR have been developed to analyze the evolution of a SA in real NPPs. After the termination of the Phébus FP campaign, these two codes have been furthermore improved to implement the more recent findings coming from different experimental campaigns. Therefore, continuous verification and validation is still necessary to check that the new improvements introduced in such codes allow also a better prediction of these Phébus tests. The aim of the present work is to re-analyze the Phébus FPT-2 test employing the updated ASTEC and MELCOR code versions. The analysis focuses on the stand-alone containment aspects of this test, and three different spatial nodalizations of the containment vessel (CV have been developed. The paper summarizes the main thermal-hydraulic results and presents different sensitivity analyses carried out on the aerosols and fission products (FP behavior. When possible, a comparison among the results obtained during this work and by different authors in previous work is also performed. This paper is part of a series of publications covering the four Phébus FP tests using a PWR fuel bundle: FPT-0, FPT-1, FPT-2, and FPT-3, excluding the FPT-4 one, related to the study of the release of low-volatility FP and transuranic elements from a debris bed and a pool of melted fuel. Keywords: Safety

  13. [Nursing as a situative activity. A realistic concept for the assurance of quality and efficiency in geriatric care].

    Science.gov (United States)

    Böhle, F; Brater, M; Maurus, A

    1997-02-01

    In institutional care for the elderly effective and efficient professional action is needed as well as in acute care settings. That means rational-systematic acting. This includes the establishment of goals, systematic planning and realization of these plans, deductive-logical thinking, objective perception and gaining an unbiased objective relationship towards the work to be done. However, an explorative investigation of the ways, how successful and experienced nurses do their job-being viewed by their colleagues as qualitatively effective and efficient concerning their time budget-provides the following results. In direct care procedures which go beyond rational-systematic action prove to be more economic and successful. This type of action is characterized by interactive procedures of dialogical nature, the patterns of rationality tend to be associative, the perception of the elderly to be taken care of can be considered as intuitive-subjective and the relationship towards them as personal-empathic. Those patterns of professional action we refer to as "subjectifying" or "situative" patterns of action. They can also be found in the process of an artist's work. The consequences of this change of paradigma concerning training and cost-effective nursing are discussed in this paper.

  14. Wireless network of stand-alone end effect probes for soil in situ permittivity measurements over the 100MHZ-6GHz frequency range

    Science.gov (United States)

    Demontoux, François; Bircher, Simone; Ruffié, Gilles; Bonnaudiin, Fabrice; Wigneron, Jean-Pierre; Kerr, Yann

    2017-04-01

    , it should be useful to install many probes on the same site to obtain permittivity measurements over a large area. To reach this goal, the probes should communicate with each other to send data to a record device. Furthermore, it is needed to record measurements over a long time period (many months) to study the in-situ dielectric soil property variations according to changing weather conditions and seasonal trends. The goal of the research work presented is to develop a dielectric sensor system based on end effect probes able to communicate the data using wireless technology. It must be stand-alone from an electric and data recording point of view so it must integrate a VNA circuit instead of the ANRITSU VNA used for the moment. The LoRa wireless technology has been selected because of its low electric consumption and the large distance between equipment available. LoRaWAN™ is a Low Power Wide Area Network specification intended for wireless battery operated devices. The LoRaWAN data rates range from 0.3 kbps to 50 kbps which is sufficient for our probes' data exchanges. We will present the work done to perform the VNA and the LoRa communication board as well as the work done to improve the probes and the permittivity computation algorithm.

  15. Is patient-grouping on basis of condition on admission indicative for discharge destination in geriatric stroke patients after rehabilitation in skilled nursing facilities? The results of a cluster analysis.

    Science.gov (United States)

    Buijck, Bianca I; Zuidema, Sytse U; Spruit-van Eijk, Monica; Bor, Hans; Gerritsen, Debby L; Koopmans, Raymond T C M

    2012-12-04

    Geriatric stroke patients are generally frail, have an advanced age and co-morbidity. It is yet unclear whether specific groups of patients might benefit differently from structured multidisciplinary rehabilitation programs. Therefore, the aims of our study are 1) to determine relevant patient characteristics to distinguish groups of patients based on their admission scores in skilled nursing facilities (SNFs), and (2) to study the course of these particular patient-groups in relation to their discharge destination. This is a longitudinal, multicenter, observational study. We collected data on patient characteristics, balance, walking ability, arm function, co-morbidity, activities of daily living (ADL), neuropsychiatric symptoms, and depressive complaints of 127 geriatric stroke patients admitted to skilled nursing facilities with specific units for geriatric rehabilitation after stroke. Cluster analyses revealed two groups: cluster 1 included patients in poor condition upon admission (n = 52), and cluster 2 included patients in fair/good condition upon admission (n = 75). Patients in both groups improved in balance, walking abilities, and arm function. Patients in cluster 1 also improved in ADL. Depressive complaints decreased significantly in patients in cluster 1 who were discharged to an independent- or assisted-living situation. Compared to 80% of the patients in cluster 2, a lower proportion (46%) of the patients in cluster 1 were discharged to an independent- or assisted-living situation. Stroke patients referred for rehabilitation to SNFs could be clustered on the basis of their condition upon admission. Although patients in poor condition on admission were more likely to be referred to a facility for long-term care, this was certainly not the case in all patients. Almost half of them could be discharged to an independent or assisted living situation, which implied that also in patients in poor condition on admission, discharge to an independent or

  16. EMR-based TeleGeriatric system.

    Science.gov (United States)

    Pallawala, P M; Lun, K C

    2001-01-01

    As medical services improve due to new technologies and breakthroughs, it has lead to an increasingly aging population. There has been much discussion and debate on how to solve various aspects such as psychological, socio-economic and medical problems related to aging. Our effort is to implement a feasible telegeriatric medical service with the use of the state of the art technology to deliver medical services efficiently to remote sites where elderly homes are based. The TeleGeriatric system will lead to rapid decision-making in the presence of acute or subacute emergencies. This triage will also lead to a reduction of unnecessary admission. It will enable the doctors who visit these elderly homes once a week basis to improve their geriatric management skills by communication with geriatric specialist. Nursing skills in the geriatric care will also benefit from this system. Integrated electronic medical record (EMR) system will be indispensable in the face of emergency admissions to hospitals. Evolution of EMR database would lead to future research in telegeriatrics and will help to identify the areas where telegeriatrics can be optimally used. This system is based on current web browsing technology and broadband communication. The TeleGeriatric web based server is developed using Java Technology. The TeleGeriatric database server was developed using Microsoft SQL server. Both are based at the Medical Informatics Programme, National University of Singapore. Two elderly homes situated in the periphery of Singapore and a leading government hospital in geriatric care have been chosen for the project. These 3 institutions and National University of Singapore are connected via ADSL protocol. ADSL connection supports high bandwidth, which is necessary for high quality videoconferencing. Each time a patient needs a teleconsultation a nurse or a doctor in the remote site sends the patient's record to the TeleGeriatric server. The TeleGeriatric server forwards the request

  17. IEA PVPS Task 3. Use of photovoltaic systems in stand-alone and island applications. 'Swiss participation'; IEA PVPS Task 3. Use of photovoltaic systems in stand-alone and island applications. 'Participation Suisse'

    Energy Technology Data Exchange (ETDEWEB)

    Villoz, M. [Dynatex SA, Morges (Switzerland)

    2004-07-01

    This report describes the work done during five years of the second phase of Task 3 of the photovoltaic power systems programme of the International Energy Agency (IEA-PVPS). Task 3 activities were concentrated on stand-alone photovoltaic systems with the main effort on improving the quality and reducing the cost of these systems. The work was divided in 2 sub-tasks whose first one was concentrated on quality insurance schemes and second one on technical recommendations coming from practical experience. Twelve original reports have been published covering topics that can be sorted in 4 categories: the first one is dedicated on quality issues with a review of existing standards in the participating countries and a double paper giving quality assurance recommendations on project management and examples of applying these rules in practical cases. The second category dwelled on photovoltaic systems with papers on charge controllers, on lightning protection and monitoring of systems. The third category presents interesting studies on the storage of energy which remains the main subject where improvements should be made in order to lower the cost of energy; four papers describe the management and the test procedures of lead-acid batteries, how to choose a lead-acid battery and finally are there alternatives to lead-acid batteries for the storage of photovoltaic electricity. The last category worked on loads and users of renewable energy and gives a large amount of experience with loads, how to choose them and how the energy can be better used through demand side management. (author)

  18. Geriatric medical education in Louisiana: current status and future needs.

    Science.gov (United States)

    Cefalu, Charles A

    2002-01-01

    Despite the impending explosion in the size of American's elderly population, physicians remain undertrained in geriatric medicine. In Louisiana, this training is especially important for the family physician and internist, many of whom practice primarily in rural areas and carry the bulk of nursing home patient care on their shoulders. Louisiana's medical schools offer little in the way of training in geriatric medicine, despite the author's finding that there is a strong interest for such training among practitioners and residents. Meanwhile, at the national level, leaders in geriatric medicine are working to develop new ways to encourage participation in geriatric educational opportunities.

  19. [Contribution of psychoanalysis to geriatric care for institutionalized patients].

    Science.gov (United States)

    Charazac, Pierre-Marie

    2014-06-01

    The contribution of psychoanalysis to geriatric care in nursing home is discussed in three directions: its conception of care, specially on its negative sides; its implication in geriatric units, in their conception and in the analysis of their management of care; the holding of care-givers and nurses by making clear what we call transference and conter-transference and their reflection on their function.

  20. Emerging geriatric challenge.

    Science.gov (United States)

    Dhar, H L

    2005-10-01

    India is a vast country with diversity, both physical and cultural. 72% of World's second largest population live in rural experiencing varying degrees of socioeconomic change. However, there is no nationwide registry of older people and exact statistics about elderly population is not available. Community-based data on morbidity and disability are also not available. India is one of the few countries in the world where men out number women at all ages till about 70 years and only in very old age (80+) there are more women than men. One of the main social effect of extension of life in later years is the extended period of widowhood for women mainly due to cultural practice of men marrying younger women and widow marriage as well as divorce are uncommon. Much progress has been made in the health care services in the last 50 years giving much emphasis to mother and child programme with special emphasis on controlling population. But elderly population has been neglected, there is no separate ward for elderly in hospitals, no specialized courses in the Universities for training doctors and nurses for elderly care. Recently, Indian Medical Association has organized an ambitious project for rural elderly with emphasis on Geriatric care. Still recently, emphasis has been given for developing infrastructural facilities including creating training, courses on Geriatric Medicine and integrating with alternative system for better care of elderly. However, due to increasing awareness of policy makers to multiple issues related to aging, some progress has been made like old age pension scheme, income tax rebate for elderly, old homes and day care centers and law to help retired citizens in evicting tenants etc. but environment is not as elderly-friendly as in European countries, as the State is not likely to have adequate resources in the presence of other priorities in the country.

  1. Broadly tunable, high-power terahertz radiation up to 73 K from a stand-alone Bi{sub 2}Sr{sub 2}CaCu{sub 2}O{sub 8+δ} mesa

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, T.; Watanabe, C.; Ishida, K.; Sekimoto, S.; Asanuma, K.; Yasui, T.; Nakade, K.; Shibano, Y.; Saiwai, Y. [Graduate School of Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8573 (Japan); Kashiwagi, T.; Minami, H.; Kadowaki, K. [Graduate School of Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8573 (Japan); Division of Materials Science, Faculty of Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8573 (Japan); Yamamoto, T. [Wide Bandgap Materials Group, Optical and Electronic Materials Unit, Environment and Energy Materials Division, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044 (Japan); Tsujimoto, M. [Department of Electronic Science and Engineering, Kyoto University, Nishikyo-ku, Kyoto 615-8510 (Japan); Klemm, R. A. [Department of Physics, University of Central Florida, Orlando, Florida 32816-2385 (United States)

    2014-11-17

    High-power, continuous, broadly tunable THz radiation from 0.29 to 1.06 THz, was obtained from the outer current-voltage characteristic (IVC) branch of a single stand-alone mesa of the high-transition temperature T{sub c} superconductor Bi{sub 2}Sr{sub 2}CaCu{sub 2}O{sub 8+δ}. The particular metallic film structures placed both beneath and atop the mesas resulted in more efficient heat dissipation, higher allowed applied dc voltages, larger IVC loops, wider emission temperature ranges, and much broader emission frequency tunability than obtained previously.

  2. Minimally invasive lateral transpsoas interbody fusion using a stand-alone construct for the treatment of adjacent segment disease of the lumbar spine: review of the literature and report of three cases.

    Science.gov (United States)

    Palejwala, Sheri K; Sheen, Whitney A; Walter, Christina M; Dunn, Jack H; Baaj, Ali A

    2014-09-01

    We describe 3 patients who presented with radiographic signs and clinical symptoms of adjacent segment disease several years after undergoing L4-S1 posterior pedicle screw fusion. All patients underwent successful lateral lumbar interbody fusion (LLIF) at 1-2 levels above their previous constructs, using stand-alone cages, with complete resolution of radiculopathy and a significant improvement in low-back pain. In addition to a thorough analysis of these cases, we review the pertinent literature regarding treatment options for adjacent segment disease and the applications of the lateral lumbar interbody technique. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Training Internal Medicine Residents in Geriatrics.

    Science.gov (United States)

    Wolf-Klein, Gisele P.; And Others

    1983-01-01

    A four-week geriatric rotation in a nursing home that emphasized rehabilitation for stroke victims, patients with fractured hips, and amputees, and the team approach in care for the elderly is described. Student response was very positive, student sensitivity was improved, and all students felt the team approach could be applied to later practice.…

  4. Seminario integrado como metodología complementaria en la asignatura de Enfermería Geriátrica Seminar integrated as a supplementary method in the subject of geriatric nursing

    Directory of Open Access Journals (Sweden)

    Trinidad Ruiz Márquez

    2011-09-01

    Full Text Available El método del aprendizaje denominado Seminario Integrado se incorporó como metodología complementaria en la formación de los alumnos de 3º de Enfermería de la Universidad de Almería, durante el desarrollo de la experiencia piloto realizada en la titulación, para ir adaptando los nuevos planes de estudio de grado al Marco del Espacio Europeo de Educación Superior. Este método se fundamenta en el Aprendizaje Basado en Problemas (ABP y forma parte de las asignaturas de Enfermería Geriátrica, Enfermería Psiquiátrica, Enfermería Comunitaria y Enfermería Médico-Quirúrgica, como un seminario que complementa la formación adquirida. En la asignatura de Enfermería Geriátrica permite que el alumno integre en un anciano conocimientos de tercer curso que forman parte de distintas asignaturas para evitar repeticiones en el logro de competencias transversales y enseñar al alumno la importancia de integrar los conocimientos del currículo enfermero necesarios para el cuidado de los mayores. El objetivo de este artículo es describir el seminario integrado como metodología complementaria en la asignatura de Enfermería Geriátrica y conocer el grado de satisfacción y la opinión de los alumnos participantes. Los resultados muestran una elevada satisfacción con esta metodología y ponen de manifiesto las principales ventajas e inconvenientes de su utilización.The learning method know as "Integrated Seminar", was incorporated as a complementary method in the 3rd year Nursing students' training at the University of Almería, during the development of a research conducted in the degree. It aim was to adapt new degree curricula within the European Higher Education Area framework. This method is based on Problem Based Learning (PBL, and it is part of the subjects of Geriatrics Nursing, Psychiatric Nursing, Community Nursing and Medical-Surgical Nursing, as a seminar that complements the received training. Within the subject of Geriatrics

  5. Feasibility Analysis and Simulation of a Stand-Alone Photovoltaic Energy System for Electricity Generation and Environmental Sustainability – equivalent to 650VA fuel-powered generator - popularly known as I pass my neighbour

    Directory of Open Access Journals (Sweden)

    Vincent Anayochukwu Ani

    2015-09-01

    Full Text Available Photovoltaic (PV power system can be used to replace wholly 650VA generator for electricity generation for household use in Nigeria. This paper presented the feasibility analysis of load data and simulation study of a stand-alone PV power system that produced the electrical needs of a household. This study is based on designing of PV energy system for household use. The patterns of load consumption within the household were studied and suitably modeled for simulation. The simulation study indicates that energy requirements to provide electricity which is equivalent to 650VA generator for household use in Nigeria can be accomplished by 520W solar PV array, 2312 Ah nominal capacity battery, and a 1kW DC/AC inverter. This would be suitable for deployment of 100% clean energy for environmental sustainability and uninterruptable power performance in the household. The results of this research show that, with a low-power consuming appliances, it is possible to meet the entire annual electricity demand of a single household solely through a stand-alone PV energy supply. Installing solar panels by most Nigerian home can significantly reduce home reliance on government power thereby reduce the strain on the current capacity of our power generation infrastructure. A detailed design and description of the system were presented in this paper.

  6. Feasibility Analysis and Simulation of a Stand-Alone Photovoltaic Energy System for Electricity Generation and Environmental Sustainability – Equivalent to 650VA Fuel-Powered Generator – Popularly Known as “I Pass My Neighbour”

    International Nuclear Information System (INIS)

    Ani, Vincent Anayochukwu

    2015-01-01

    Photovoltaic (PV) power system can be used to replace wholly 650VA generator for electricity generation for household use in Nigeria. This paper presented the feasibility analysis of load data and simulation study of a stand-alone PV power system that produced the electrical needs of a household. This study is based on designing of PV energy system for household use. The patterns of load consumption within the household were studied and suitably modeled for simulation. The simulation study indicates that energy requirements to provide electricity, which is equivalent to 650VA generator for household use in Nigeria, can be accomplished by 520 W solar PV array, 2312 Ah nominal capacity battery, and a 1 kW DC/AC inverter. This would be suitable for deployment of 100% clean energy for environmental sustainability and uninterruptable power performance in the household. The results of this research show that, with a low-power consuming appliances, it is possible to meet the entire annual electricity demand of a single household solely through a stand-alone PV energy supply. Installing solar panels by most Nigerian home can significantly reduce home reliance on government power thereby reduce the strain on the current capacity of our power generation infrastructure. A detailed design and description of the system were presented in this paper.

  7. [Geriatric day hospital: what evidence? A systematic review].

    Science.gov (United States)

    Petermans, Jean; Velghe, Anja; Gillain, Daniel; Boman, Xavier; Van Den Noortgate, Nele

    2011-09-01

    A systematic review of the international literature concerning the organisation of the Geriatric Day Hospital (GDH) was performed. From 1987 till now, few papers were found describing the activity and the effectiveness of the GDH. All the studies comparing specific geriatric approaches to regular medicine demonstrate the efficiency of geriatric care, particularly the geriatric assessment. So, with a degree of evidence 1a, a better outcome is found for patients undergoing a geriatric assessment and intervention, compared to patients having no geriatric assessment at all. However, there is no evidence of benefit for the geriatric day hospital compared to patients treated in a geriatric ward or other location of geriatric care. Moreover, there is no clear consensus on the settings and activities of a geriatric day hospital. Terms as day unit, day hospital, day care, are used interchangeably and are not always covering the same activity. The same remark can be made on the exact composition of the geriatric multidisciplinary team and its role. However nurses and paramedical workers are always mentioned as all performing geriatric assessment. The diagnostic activities on the GDH are seldom described and studied. More information is available on rehabilitation activity, often developed in specific patient populations such as stroke patients, dementia patients, cardiac patients or patients with other chronic diseases. In this selected patient populations positive effects on outcome are shown in the GDH (level of evidence 1a). Another problem is the heterogeneity of the population. For scientific reason the GDH should focus on organising care for specific medical problems. Diseases as dementia, stroke, cardiac insufficiency, could be good models to investigate the efficiency of geriatric assessment and interventions within the setting of a GDH.

  8. Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion? An observational cohort study with 2-year follow-up outcome scoring.

    Science.gov (United States)

    Zajonz, Dirk; Franke, Anne-Catherine; von der Höh, Nicolas; Voelker, Anna; Moche, Michael; Gulow, Jens; Heyde, Christoph-Eckhard

    2014-01-01

    The stand-alone treatment of degenerative cervical spine pathologies is a proven method in clinical practice. However, its impact on subsidence, the resulting changes to the profile of the cervical spine and the possible influence of clinical results compared to treatment with additive plate osteosynthesis remain under discussion until present. This study was designed as a retrospective observational cohort study to test the hypothesis that radiographic subsidence of cervical cages is not associated with adverse clinical outcomes. 33 cervical segments were treated surgically by ACDF with stand-alone cage in 17 patients (11 female, 6 male), mean age 56 years (33-82 years), and re-examined after eight and twenty-six months (mean) by means of radiology and score assessment (Medical Outcomes Study Short Form (MOS-SF 36), Oswestry Neck Disability Index (ONDI), painDETECT questionnaire and the visual analogue scale (VAS)). Subsidence was observed in 50.5% of segments (18/33) and 70.6% of patients (12/17). 36.3% of cases of subsidence (12/33) were observed after eight months during mean time of follow-up 1. After 26 months during mean time of follow-up 2, full radiographic fusion was seen in 100%. MOS-SF 36, ONDI and VAS did not show any significant difference between cases with and without subsidence in the two-sample t-test. Only in one type of scoring (painDETECT questionnaire) did a statistically significant difference in t-Test emerge between the two groups (p = 0.03; α = 0.05). However, preoperative painDETECT score differ significantly between patients with subsidence (13.3 falling to 12.6) and patients without subsidence (7.8 dropped to 6.3). The radiological findings indicated 100% healing after stand-alone treatment with ACDF. Subsidence occurred in 50% of the segments treated. No impact on the clinical results was detected in the medium-term study period.

  9. Organization of the clinical activity of geriatric oncology: report of a SIOG (International Society of Geriatric Oncology) task force.

    Science.gov (United States)

    Monfardini, Silvio; Aapro, M S; Bennett, J M; Mori, M; Regenstreif, D; Rodin, M; Stein, B; Zulian, G B; Droz, J P

    2007-04-01

    Management for elderly cancer patients world wide is far from being optimal and few older patients are entering clinical trials. A SIOG Task Force was therefore activated to analyze how the clinical activity of Geriatric Oncology is organized. A structured questionnaire was circulated among the SIOG Members. Fifty eight answers were received. All respondents identified Geriatric Oncology, as an area of specialization, however the organization of the clinical activity was variable. Comprehensive Geriatric Assessment (CGA) was performed in 60% of cases. A Geriatric Oncology Program (GOP) was identified in 21 centers, 85% located in Oncology and 15% in Geriatric Departments. In the majority of GOP scheduled case discussion conferences dedicated to elderly cancer patients took regular place, the composition of the multidisciplinary team involved in the GOP activity included Medical Oncologists, Geriatricians, Nurses, Pharmacists, Social Workers. Fellowships in Geriatric Oncology were present in almost half of GOPs. Over 60% of respondents were willing to recruit patients over 70 years in clinical trials, while the proportion of cases included was only 20%. Enrolment in clinical trials was perceived as more difficult by 52% and much more difficult in 12% of the respondents. In conclusion, a better organization of the clinical activity in Geriatric Oncology allows a better clinical practice and an optimal clinical research. The GOP which can be set up in the oncological as well as in the geriatric environment thought a multidisciplinary coordinator effort. Future plans should also concentrate on divisions, units or departments of Geriatric Oncology.

  10. Cage subsidence does not, but cervical lordosis improvement does affect the long-term results of anterior cervical fusion with stand-alone cage for degenerative cervical disc disease: a retrospective study.

    Science.gov (United States)

    Wu, Wen-Jian; Jiang, Lei-Sheng; Liang, Yu; Dai, Li-Yang

    2012-07-01

    Clinical outcomes of the stand-alone cage have been encouraging when used in anterior cervical discectomy and fusion (ACDF), but concerns remain regarding its complications, especially cage subsidence. This retrospective study was undertaken to investigate the long-term radiological and clinical outcomes of the stand-alone titanium cage and to evaluate the incidence of cage subsidence in relation to the clinical outcome in the surgical treatment of degenerative cervical disc disease. A total of 57 consecutive patients (68 levels) who underwent ACDF using a titanium box cage for the treatment of cervical radiculopathy and/or myelopathy were reviewed for the radiological and clinical outcomes. They were followed for at least 5 years. Radiographs were obtained before and after surgery, 3 months postoperatively, and at the final follow-up to determine the presence of fusion and cage subsidence. The Cobb angle of C2-C7 and the vertebral bodies adjacent to the treated disc were measured to evaluate the cervical sagittal alignment and local lordosis. The disc height was measured as well. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score for cervical myelopathy, before and after surgery, and at the final follow-up. The recovery rate of JOA score was also calculated. The Visual Analogue Scale (VAS) score of neck and radicular pain were evaluated as well. The fusion rate was 95.6% (65/68) 3 months after surgery. Successful bone fusion was achieved in all patients at the final follow-up. Cage subsidence occurred in 13 cages (19.1%) at 3-month follow-up; however, there was no relation between fusion and cage subsidence. Cervical and local lordosis improved after surgery, with the improvement preserved at the final follow-up. The preoperative disc height of both subsidence and non-subsidence patients was similar; however, postoperative posterior disc height (PDH) of subsidence group was significantly greater than of non-subsidence group

  11. A Survey of Knowledge and Attitudes of Nurses About Pain Management in End-Stage Liver Disease in a Geriatric Palliative Care Unit.

    Science.gov (United States)

    Perri, Giulia-Anna; Yeung, Herman; Green, Yoel; Bezant, Abby; Lee, Carman; Berall, Anna; Karuza, Jurgis; Khosravani, Houman

    2018-01-01

    Palliative care is often initiated late for patients with end stage liver disease (ESLD) with pain being a common morbidity that is under-treated throughout the disease trajectory. When admitted to a palliative care unit (PCU), nurses play a pivotal role and must be highly informed to ensure effective pain management. The aim of this study is to determine the baseline level of knowledge and attitudes of PCU nurses regarding pain management in patients with ESLD. A descriptive, cross-sectional self-administered survey design was used for this study. The sample comprised 35 PCU nurses working at a continuing chronic care facility in Toronto, Ontario, Canada. Data on the knowledge and attitudes of the nurses regarding pain management in patients with ESLD, was obtained using a modified version of the "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKASRP) tool. Thirty-one PCU nurses were included for the analysis, giving a response rate of 89%. The mean total percentage score for the nurses on the modified version of the NKASRP was 72%. Only 26% of the nurse participants obtained a passing score of 80% or greater. There were no significant differences in mean total scores by age, gender, years of nursing experience or education level. The findings of this study provide important information about the inadequate knowledge and attitude in nurses regarding pain management for patients with ESLD. It is suggested that targeted educational programs and quality improvement initiatives in pain management for patients with ESLD could improve knowledge and attitudes for PCU nurses.

  12. Cultural competence in the baccalaureate degree nursing curriculum

    Science.gov (United States)

    Silvestri, Angela

    were analyzed and reported. The results of the study indicated the following: (a) a low number of schools incorporating a stand-alone nursing course in the curriculum; (b) differences among various teaching methods among regions and program types; (c) differences among the incorporation of Campinha-Bacote's (2007b) cultural constructs in the curriculum; and (d) differences among various evaluation methods among regions and program types. Implications for nursing education include the following: (a) programs should make an effort to incorporate one-to-one instruction and simulation when planning teaching encounters in order to adequately address all learning domains; (b) when planning curriculum structure, programs should consider using a theoretical framework such as Campinha-Bacote's (2007b) "The Process of Cultural Competence in the Delivery of Health Care Service" in order to address student learning needs thoroughly; (c) nursing faculty members need to be creative in their teaching and make a conscious effort to continually address cultural learning needs of their students; and (d) concept mapping should be used to determine where and how many times cultural concepts are addressed in the curriculum. Recommendations for future research include: (a) determining which teaching methods are most effective in promoting cultural competence; (b) determining the use and effectiveness of curriculum methods that incorporate Campinha-Bacote's (2007b) cultural constructs; (c) determining which evaluation methods are most effective in determining student ability to care for others of another culture; and (d) learning about faculty comfort and preparedness to teach culture-related nursing content. It is also recommended that the relationship between a stand-alone nursing course versus and integrated course and cultural competence be investigated.

  13. Chapter 2: Stand-alone Applications - TOPCAT

    Science.gov (United States)

    Miller, C. J.

    Tool for OPerations on Catalogues And Tables or TOPCAT is a graphical viewer for table data. It offers a variety of ways to work with data tables, including a browser for the cell data, viewers for information about table and column metadata, dataset visualization, and even analysis. We discuss a small subset of TOPCAT's functionalities in this chapter. TOPCAT was originally developed as part of the Starlink program in the United Kingdom. It is now maintained by AstroGrid. The program is written in pure Java and available under the GNU General Public License. It is available for download and a version is included in the software distribution accompanying this book. TOPCAT is a GUI interface on top of the STIL library. A command line interface to this library, STILTS, described in Chapter 21 provides scriptable access to many of the capabilities described here. The purpose of this tutorial is to provide an overview of TOPCAT to the novice user. The best place to look for and learn about TOPCAT is the web page maintained by Mark B. Taylor. There, TOPCAT documentation is provided in HTML, PDF, via screen shots, etc. In this chapter we take the user through a few examples that give the general idea of how TOPCAT works. The majority of the functionality of TOPCAT is not included in this short tutorial. Our goal in this tutorial is to lead the reader through an exercise that would result in a publication quality figure (e.g. for a journal article). Specifically, we will use TOPCAT to show how the color-magnitude relation of a galaxy cluster compares to that of all galaxies in the Sloan Digital Sky Survey (York et al. 2000). This diagnostic is used not only in cluster finding, but its linear fit can provide insight into the age and/or metallicity of the oldest galaxies in galaxy clusters (which are some of the oldest galaxies in the Universe). The data we need for this exercise are: 1) the entire spectroscopic galaxy catalog from the SDSS, with galaxy positions, galaxy redshifts, and galaxy magnitudes and 2) galaxy members of a known galaxy cluster. For the former, we will download data directly from the SDSS servers to our local machine for analysis. For the latter, we will use TOPCAT's ability to call live cone search services.

  14. Informing Approaches in Establishing Stand Alone Community ...

    African Journals Online (AJOL)

    Literacy is usually considered the ability to read at a basic level. Now it is beginning to be defined more broadly to include applying reading, writing, and mathematical skills to obtain and use information and solve problems at levels of proficiency necessary to function in society, to achieve one's goals and develop one's ...

  15. Stand Alone Battery Thermal Management System

    Energy Technology Data Exchange (ETDEWEB)

    Brodie, Brad [Denso International America, Incorporated, Southfield, MI (United States)

    2015-09-30

    The objective of this project is research, development and demonstration of innovative thermal management concepts that reduce the cell or battery weight, complexity (component count) and/or cost by at least 20%. The project addresses two issues that are common problems with current state of the art lithium ion battery packs used in vehicles; low power at cold temperatures and reduced battery life when exposed to high temperatures. Typically, battery packs are “oversized” to satisfy the two issues mentioned above. The first phase of the project was spent making a battery pack simulation model using AMEsim software. The battery pack used as a benchmark was from the Fiat 500EV. FCA and NREL provided vehicle data and cell data that allowed an accurate model to be created that matched the electrical and thermal characteristics of the actual battery pack. The second phase involved using the battery model from the first phase and evaluate different thermal management concepts. In the end, a gas injection heat pump system was chosen as the dedicated thermal system to both heat and cool the battery pack. Based on the simulation model. The heat pump system could use 50% less energy to heat the battery pack in -20°C ambient conditions, and by keeping the battery cooler at hot climates, the battery pack size could be reduced by 5% and still meet the warranty requirements. During the final phase, the actual battery pack and heat pump system were installed in a test bench at DENSO to validate the simulation results. Also during this phase, the system was moved to NREL where testing was also done to validate the results. In conclusion, the heat pump system can improve “fuel economy” (for electric vehicle) by 12% average in cold climates. Also, the battery pack size, or capacity, could be reduced 5%, or if pack size is kept constant, the pack life could be increased by two years. Finally, the total battery pack and thermal system cost could be reduced 5% only if the system is integrated with the vehicle cabin air conditioning system. The reason why we were not able to achieve the 20% reduction target is because of the natural decay of the battery cell due to the number of cycles. Perhaps newer battery chemistries that are not so sensitive to cycling would have more potential for reducing the battery size due to thermal issues.

  16. Stand alone biofuel production from algae

    NARCIS (Netherlands)

    Wijffels, R.H.; Janssen, M.G.J.; Barbosa, M.J.

    2011-01-01

    In this feature, leading researchers in the field of microbial biotechnology speculate on the technical and conceptual developments that will drive innovative research and open new vistas over the next few years

  17. Stand-alone tsunami alarm equipment

    Science.gov (United States)

    Katsumata, Akio; Hayashi, Yutaka; Miyaoka, Kazuki; Tsushima, Hiroaki; Baba, Toshitaka; Catalán, Patricio A.; Zelaya, Cecilia; Riquelme Vasquez, Felipe; Sanchez-Olavarria, Rodrigo; Barrientos, Sergio

    2017-05-01

    One of the quickest means of tsunami evacuation is transfer to higher ground soon after strong and long ground shaking. Ground shaking itself is a good initiator of the evacuation from disastrous tsunami. Longer period seismic waves are considered to be more correlated with the earthquake magnitude. We investigated the possible application of this to tsunami hazard alarm using single-site ground motion observation. Information from the mass media is sometimes unavailable due to power failure soon after a large earthquake. Even when an official alarm is available, multiple information sources of tsunami alert would help people become aware of the coming risk of a tsunami. Thus, a device that indicates risk of a tsunami without requiring other data would be helpful to those who should evacuate. Since the sensitivity of a low-cost MEMS (microelectromechanical systems) accelerometer is sufficient for this purpose, tsunami alarm equipment for home use may be easily realized. Amplitude of long-period (20 s cutoff) displacement was proposed as the threshold for the alarm based on empirical relationships among magnitude, tsunami height, hypocentral distance, and peak ground displacement of seismic waves. Application of this method to recent major earthquakes indicated that such equipment could effectively alert people to the possibility of tsunami.

  18. [Geriatric medicine in future].

    Science.gov (United States)

    Kameyama, M

    1989-01-01

    Geriatrics in future will be most concerned with persons aged 80 years or more (very elderly) in Japan. Clinical and pathological features of very elderly patients were reported with comparison to the 65-79 age group. Many very elderly do not show clear-cut clinical signs and symptoms, but have serious underlying diseases. We propose here a concept of "clinical threshold". On evaluating the laboratory data, we must consider the grades of "activity of daily living (ADL)" of the aged patients, because ADL may significantly modify the test results. Furthermore in clinical practice, we should pay attention to both the psychosocial states and physical findings of the patients. "The old age syndrome" proposed by Parker is useful in geriatric medicine. Extensive studies on dementia, especially of Alzheimer's type are required urgently. Molecular biology approaches to this disease have shown great advances in geriatrics. To prevent geriatric disease, well-controlled exercise and diet are important as well as reasonable psychosocial integrity.

  19. [Geriatrics or geriatricization of medicine : Quo vadis geriatrics?

    Science.gov (United States)

    Kolb, G F

    2017-12-01

    This article examines the question whether and how geriatrics will change in the future and whether in view of the demographic changes the trend will go more in the direction of a further expansion of geriatrics or more towards a geriatricization of individual specialist medical fields. The different development of geriatrics in the individual Federal States can only be understood historically and is absolutely problematic against the background of the new hospital remuneration system. Geriatrics is a typical cross-sectional faculty and still has demarcation problems with other faculties but has also not yet clearly defined the core competence. This certainly includes the increasing acquisition of decentralized joint treatment concepts and geriatric counselling services in the future, in addition to the classical assessment instruments. Keywords in association with this are: traumatology and othopedics of the elderly, geriatric neurology and geriatric oncology. Interdisciplinary geriatric expertise is increasingly being requested. Outpatient structures have so far not been prioritized in geriatrics. An independent research is under construction and it is gratifying that academic interest in geriatrics seems to be increasing and new professorial chairs have been established. It is not possible to imagine our hospital without geriatrics; however, there is still a certain imbalance between the clearly increased number of geriatric hospital beds, the representation of geriatrics in large hospitals (e.g. specialized and maximum care hospitals and university clinics), the secure establishment in further education regulations and the lack of a uniform nationwide concept of geriatrics.

  20. The international phase 4 validation study of the EORTC QLQ-SWB32: A stand-alone measure of spiritual well-being for people receiving palliative care for cancer.

    Science.gov (United States)

    Vivat, B; Young, T E; Winstanley, J; Arraras, J I; Black, K; Boyle, F; Bredart, A; Costantini, A; Guo, J; Irarrazaval, M E; Kobayashi, K; Kruizinga, R; Navarro, M; Omidvari, S; Rohde, G E; Serpentini, S; Spry, N; Van Laarhoven, H W M; Yang, G M

    2017-11-01

    The EORTC Quality of Life Group has just completed the final phase (field-testing and validation) of an international project to develop a stand-alone measure of spiritual well-being (SWB) for palliative cancer patients. Participants (n = 451)-from 14 countries on four continents; 54% female; 188 Christian; 50 Muslim; 156 with no religion-completed a provisional 36-item measure of SWB plus the EORTC QLQ-C15-PAL (PAL), then took part in a structured debriefing interview. All items showed good score distribution across response categories. We assessed scale structure using principal component analysis and Rasch analysis, and explored construct validity, and convergent/divergent validity with the PAL. Twenty-two items in four scoring scales (Relationship with Self, Relationships with Others, Relationship with Someone or Something Greater, and Existential) explained 53% of the variance. The measure also includes a global SWB item and nine other items. Scores on the PAL global quality-of-life item and Emotional Functioning scale weakly-moderately correlated with scores on the global SWB item and two of the four SWB scales. This new validated 32-item SWB measure addresses a distinct aspect of quality-of-life, and is now available for use in research and clinical practice, with a role as both a measurement and an intervention tool. © 2017 John Wiley & Sons Ltd.

  1. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    NARCIS (Netherlands)

    Suijker, Jacqueline J.; Buurman, Bianca M.; ter Riet, Gerben; van Rijn, Marjon; de Haan, Rob J.; de Rooij, Sophia E.; Moll van Charante, Eric P.

    2012-01-01

    Background: Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this

  2. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    Science.gov (United States)

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  3. [Activating therapeutic care in geriatrics : Evaluation of a practice concept].

    Science.gov (United States)

    Acklau, Stefanie; Gödecker, Lisa; Kaden, Andrea; Jahn, Patrick

    2016-10-01

    The special feature of the concept of activating therapeutic care in geriatrics (ATP-G) is based on the focus of nursing and therapeutic elements specifically related to the elderly. Further significance lies in the bottom-up development of this concept, which shows a close proximity to the nursing practice. The research project targeted the characteristics of ATP-G from a nursing point of view. Furthermore, the resulting elements of professional nursing care understanding for inpatient geriatric rehabilitation were used to build a scientific and theoretical foundation of the ATP-G concept. In this study 12 semi-structured interviews with professional caregivers were realized. The data collection was undertaken in three different facilities of inpatient geriatric (early) rehabilitation, chosen by lot. The data analysis was based on the methodology of qualitative content analysis according to Mayring. The research project showed that the basic elements described in the ATP-G concept are consistent with the view of nursing practitioners and therefore reflect the characteristic features of routine daily practice; nonetheless, some new aspects were found, primarily the importance of interdisciplinary teamwork in geriatric settings. There were also difficulties related to the ATP-G concept which were experienced as restraints by the questioned professionals. Further research should therefore investigate the structures for optimal implementation of the ATP-G concept into standard practice.

  4. American Association for Geriatric Psychiatry

    Science.gov (United States)

    ... Position Statements Publications Bookstore American Journal of Geriatric Psychiatry Legislative & Regulatory Agenda AAGP eNews (Members Only) Tools ... Funding Training Resources and Curricula For Clinicians >> Geriatric Psychiatry Identifier Webinar: Billing and Coding Consumer Material Clinical ...

  5. Alternative route of process modification for biofuel production by embedding the Fischer-Tropsch plant in existing stand-alone power plant (10 MW) based on biomass gasification - Part I: A conceptual modeling and simulation approach (a case study in Thailand)

    DEFF Research Database (Denmark)

    Hunpinyo, Piyapong; Cheali, Peam; Narataruksa, Phavanee

    2014-01-01

    The utilization of syngas shows a highly potential to improve the economic potential of the stand-alone power unit-based gasification plants as well as enhancing the growing demand of transportation fuels. The thermochemical conversion of biomass via gasification to heat and power generations from...

  6. Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals: A scoping review.

    Science.gov (United States)

    Deschodt, Mieke; Claes, Veerle; Van Grootven, Bastiaan; Van den Heede, Koen; Flamaing, Johan; Boland, Benoit; Milisen, Koen

    2016-03-01

    Interdisciplinary geriatric consultation teams are implemented in the acute hospital setting in several high-income countries to provide comprehensive geriatric assessment for the increasing numbers of older patients with a geriatric profile hospitalized on non-geriatric units. Given the inconclusive evidence on this care model's effectiveness to improve patient outcomes, health care policy and practice oriented recommendations to redesign the structure and process of care provided by interdisciplinary geriatric consultation teams are needed. A scoping review was conducted to explore the structure and processes of interdisciplinary geriatric consultation teams in an international context. As nurses are considered key members of these teams, their roles and responsibilities were specifically explored. The revised scoping methodology framework of Arksey and O'Malley was applied. An electronic database search in Ovid MEDLINE, CINAHL and EMBASE and a hand search were performed for the identification of descriptive and experimental studies published in English, French or Dutch until April 2014. Thematic reporting with descriptive statistics was performed and study findings were validated through interdisciplinary expert meetings. Forty-six papers reporting on 25 distinct interdisciplinary geriatric consultation teams in eight countries across three continents were included. Eight of the 12 teams (67%) reporting on their composition, stated that nurses and physicians were the main core members with head counts varying from 1 to 4 members per profession. In 80% of these teams nurses were required to have completed training in geriatrics. Advanced practice nurses were integrated in eleven out of fourteen interdisciplinary geriatric consultation teams from the USA. Only 32% of teams used formal screening to identify patients most likely to benefit from their intervention, using heterogeneous screening methods, and scarcely providing information on the responsibilities of

  7. Geriatric fall-related injuries.

    African Journals Online (AJOL)

    Conclusion: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk fac- tors for falls including home hazards is essential for prevention of geriatric fall-related injuries. Keywords: Accidental fall, geriatrics, injury, trauma registry. DOI: http://dx.doi.org/10.4314/ahs.v16i2.24.

  8. [Legal aspects of geriatric rehabilitation].

    Science.gov (United States)

    Klie, T

    1992-01-01

    Nowadays geriatric rehabilitation is recognized as a matter of social law performance. Nevertheless there are very small chances to realize corresponding legal claims in view of the infra-structural deficits. This subscription works out the claims of social law for geriatric rehabilitation, names questions of delineation between illness, prevention and care indigence and discusses problems of geriatric rehabilitant institutions and services.

  9. Poster - Thurs Eve-17: Stand alone software for deforming delivered dose distributions to account for daily anatomical variations in prostate patients treated on the TomoTherapy Hi-Art II system.

    Science.gov (United States)

    Rivest, R; Riauka, T; Murtha, A; Fallone, G

    2008-07-01

    The acquisition of daily megavoltage (MV)-CT images provides an invaluable tool in the delivery of adaptive radiotherapy (ART) on the TomoTherapy Hi-ART II system. Using TomoTherapy's Planned Adaptive software, delivery sinograms can be applied to pre-treatment MVCT images to generate daily delivered dose distributions, allowing for the potential comparison of planned and delivered doses. However, daily patient anatomical variations complicate the task and accurate comparison requires that daily doses be evaluated in the same references frame as the planned dose. Each anatomical point in daily MVCT images must be mapped to its corresponding point in the patient planning CT and that deformation map must be applied to the daily dose distribution. Stand alone software has been developed for the comparison of planned and delivered doses for TomoTherapy prostate patients. Software inputs are the planning CT, planning structure data, planned dose distribution, daily MVCT and delivered dose distribution. The software uses an in-house developed automatic voxel-based deformable registration algorithm designed and optimized specifically for the registration of prostate CT images to achieve anatomical correspondence between MVCT and planning images. The resultant deformation map is applied to the daily dose distribution and the software outputs the deformed daily dose distribution in the planning CT's reference frame, as well as a delivered DVH for each of the planning CT's ROI. The software allows for a number of potential research opportunities, in particular, the calculation of the cumulative dose delivered over the course of treatment for prostate patients treated on the Hi-Art II system. © 2008 American Association of Physicists in Medicine.

  10. Nutraceuticals for geriatrics

    Directory of Open Access Journals (Sweden)

    Charu Gupta

    2015-01-01

    Full Text Available Geriatrics is a medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. Treatment of geriatric patients requires a different strategy and is very complex. Geriatric medicines aim to promote health by preventing and treating diseases and disabilities in older adults. Development of effective dietary interventions for promoting healthy aging is an active but challenging area of research because aging is associated with an increased risk of chronic disease, disability, and death. Aging populations are a global phenomenon. The most widespread conditions affecting older people are hypertension, congestive heart failure, dementia, osteoporosis, breathing problems, cataract, and diabetes to name a few. Decreased immunity is also partially responsible for the increased morbidity and mortality resulting from infectious agents in the elderly. Nutritional status is one of the chief variables that explains differences in both the incidence and pathology of infection. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating. Thus there is an urgent need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with aging. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. The present review thus focuses on the phytochemicals of nutraceutical importance for the geriatric population.

  11. The portal of geriatrics online education: a 21st-century resource for teaching geriatrics.

    Science.gov (United States)

    Ramaswamy, Ravishankar; Leipzig, Rosanne M; Howe, Carol L; Sauvigne, Karen; Usiak, Craig; Soriano, Rainier P

    2015-02-01

    The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner-centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time-consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better-prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case-based teaching, self-directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web-Geriatric Education Modules, a peer-reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  12. Immunity, aging, and geriatric depression.

    Science.gov (United States)

    Morimoto, Sarah Shizuko; Alexopoulos, George S

    2011-06-01

    Inflammatory processes are likely to play a causal role in geriatric depression. Geriatric depression occurs in the context of illnesses in which inflammatory processes are part of the pathogenesis. Both aging and depression are associated with immune responses, and the connectivity among mood-regulating structures may be modulated by inflammatory responses. Geriatric depression exacerbates the symptoms of comorbid disorders. Geriatric depression often occurs in persons exposed to chronic stress, a state precipitating geriatric depression and triggering proinflammatory responses. The successful treatment of comorbid conditions that increase central nervous system inflammatory responses has general health benefits and should be part of clinical practice. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. STAND-ALONE WIND ENERGY CONVERSION SYSTEM WITH MAXIMUM POWER TRANSFER CONTROL SISTEMA AISLADO DE CONVERSIÓN EÓLICA CON CONTROL DE MÁXIMA TRANSFERENCIA DE POTENCIA

    Directory of Open Access Journals (Sweden)

    Miguel López

    2009-12-01

    Full Text Available A controlled wind generation system for a stand alone application is presented in this paper. A cascaded step-up/step-down power electronic converters topology is proposed to control the wind power system in the whole wind speed range. For the low wind speed range, the control strategy is aimed to follow the wind turbine’s maximal power coefficient by adjusting the generator’s rotational speed. For high wind speeds, the system power regulation is also made by controlling the generator speed. This control is made by the DC/DC power electronic converter, which modifies its input voltage, changing the machine voltage and consequently varying the generator’s rotor speed. The proposed system is validated by computer simulation. The proposed control system shows a good performance for its application in autonomous wind energy systems.Un sistema de generación eólica para una aplicación aislada es presentado en este artículo. Una topología de convertidores electrónicos de potencia elevador y reductor conectados en cascada es propuesta para controlar la producción eólica en todo el rango de velocidades del viento. Para el rango de vientos suaves, la estrategia de control permite seguir el máximo coeficiente de potencia de turbina eólica mediante el ajuste de la velocidad de rotación del generador. En el rango de vientos fuertes, la regulación de la potencia del sistema se hace igualmente por control de la velocidad de giro del generador. La acción de control es realizada mediante el convertidor DC/DC de potencia el cual modifica su tensión de entrada, cambiando así la tensión en los terminales de la máquina y por consecuencia variando la velocidad de rotación del generador. El sistema propuesto es validado mediante simulación por computador. Los resultados muestran que el sistema de control propuesto actúa de buena manera para su aplicación en sistemas autónomos de generación eólica.

  14. La necesidad de un informe de enfermería al alta o traslado en una residencia geriátrica The need of a nursing report at discharge or transfer to a geriatric residence

    Directory of Open Access Journals (Sweden)

    Elvira Hernández Martínez-Esparza

    2006-09-01

    Full Text Available Frecuentemente el personal de enfermería se encuentra que al ingreso de un anciano la transmisión de información es deficiente o escasa para el abordaje integral e individualizado de éste. Con el objetivo de salvaguardar este problema y mejorar la continuidad asistencial de los ancianos dados de alta a su domicilio o trasladados a otro centro asistencial, el equipo de enfermería de la Residencia Clínica "Los Robles" ha elaborado un instrumento de registro que denominamos "Informe de enfermería al alta o traslado de una residencia geriátrica". En el mismo se pretende recoger de una forma esquemática, ágil y completa la realidad y situación biopsicosocial del anciano garantizando una adecuada transmisión de la información y la continuidad de los cuidados de enfermería. Dicha hoja se elaboró basándonos en gran medida en el Modelo de Necesidades de Virginia Henderson (1. En ella se recogen los aspectos básicos del anciano a través de una serie de ítems cerrados y abiertos, abarcando tanto el estado basal del anciano como los procesos agudos si los hubiere, estando dirigida tanto al personal sanitario del centro asistencial de destino como a los propios cuidadores del anciano en el caso de traslado a domicilio.It is very common for the nursing staff to find out that the information flow regarding an elderly patient on admission is deficient or scarce. To resolve this problem and improve the attendance continuity of the elderly people when they are discharged or transfered from our Center Residence Clinic Geriatric "Los Robles", the nursing staff have developed an instrument for a better register that we have denominated "Nursing inform for the discharge or transfer to a resident for old people". In that inform we try to collect in a schematic, agile, and complete way the reality and the bio-psycho-social situation of the old people guaranteeing an adequate transmission of the information and the continuity of nursing cares. This

  15. [Introduction to geriatric oncology].

    Science.gov (United States)

    Wedding, U; Höffken, K

    2002-01-01

    The demographic changes will result in a profound increase of the number of elderly people within the next years. As a consequence of the age dependent increase of the incidence and mortality rate of cancer these changes will bring an increase in the number of elderly people with cancer. There is a number of differences between young and old patients diagnosed with cancer. This must result in an adaption of standardised oncological procedures, mainly designed for younger patients, to the special situation of elderly patients. The differences between young and old patients with cancer may be depicted by a structured geriatric assessment. Suggestions for the structure of such an assessment exist. Ongoing clinical trials have to demonstrate, whether or not the inclusion of a geriatric oncological assessment in the decision making process will result in an improvement of treatment results in elderly cancer patients diagnosed with cancer.

  16. [Medical short stay unit for geriatric patients in the emergency department: clinical and healthcare benefits].

    Science.gov (United States)

    Pareja, Teresa; Hornillos, Mercedes; Rodríguez, Miriam; Martínez, Javier; Madrigal, María; Mauleón, Coro; Alvarez, Bárbara

    2009-01-01

    To evaluate the impact of comprehensive geriatric assessment and management of high-risk elders in a medical short stay unit located in the emergency department of a general hospital. We performed a descriptive, prospective study of patients admitted to the medical short stay unit for geriatric patients of the emergency department in 2006. A total of 749 patients were evaluated, with a mean (standard deviation) stay in the unit of 37 (16) h. The mean age was 86 (7) years; 57% were women, and 50% had moderate-severe physical impairment and dementia. Thirty-five percent lived in a nursing home. The most frequent reason for admission was exacerbation of chronic cardiopulmonary disease. Multiple geriatric syndromes were identified. The most frequent were immobility, pressure sores and behavioral disorders related to dementia. Seventy percent of the patients were discharged to home after being stabilized and were followed-up by the geriatric clinic and day hospital (39%), the home care medical team (11%), or the nursing home or primary care physician (20%). During the month after discharge, 17% were readmitted and 7.7% died, especially patients with more advanced age or functional impairment. After the unit was opened, admissions to the acute geriatric unit fell by 18.2%. Medical short stay units for geriatric patients in emergency departments may be useful for geriatric assessment and treatment of exacerbations of chronic diseases. These units can help to reduce the number of admissions and optimize the care provided in other ambulatory and domiciliary geriatric settings.

  17. Geriatric syndromes: medical misnomer or progress in geriatrics?

    NARCIS (Netherlands)

    Olde Rikkert, M.G.M.; Rigaud, A.S.; Hoeyweghen, R.J. van; Graaf, J. de

    2003-01-01

    Both in geriatric and internal medicine journals, and in medical textbooks certain (aggregates of) symptoms are labelled as 'geriatric syndromes'. In frail elderly patients a large number of diseases present with well-known and highly prevalent atypical symptoms (e.g. immobility, instability,

  18. Geriatric Cardiology: An Emerging Discipline.

    Science.gov (United States)

    Dodson, John A; Matlock, Daniel D; Forman, Daniel E

    2016-09-01

    Given changing demographics, patients with cardiovascular (CV) disease in developed countries are now older and more complex than even a decade ago. This trend is expected to continue into the foreseeable future; accordingly, cardiologists are encountering patients with a greater number of comorbid illnesses as well as "geriatric conditions," such as cognitive impairment and frailty, which complicate management and influence outcomes. Simultaneously, technological advances have widened the therapeutic options available for patients, including those with the most advanced CV disease. In the setting of these changes, geriatric cardiology has recently emerged as a discipline that aims to adapt principles from geriatric medicine to everyday cardiology practice. Accordingly, the tasks of a "geriatric cardiologist" may include both traditional evidence-based CV management plus comprehensive geriatric assessment, medication reduction, team-based coordination of care, and explicit incorporation of patient goals into management. Given that the field is still in its relative infancy, the training pathways and structure of clinical programs in geriatric cardiology are still being delineated. In this review, we highlight the rationale behind geriatric cardiology as a discipline, several current approaches by geriatric cardiology programs, and future directions for the field. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  19. Rest break organization in geriatric care and turnover: a multimethod cross-sectional study.

    Science.gov (United States)

    Wendsche, Johannes; Hacker, Winfried; Wegge, Jürgen; Schrod, Nadine; Roitzsch, Katharina; Tomaschek, Anne; Kliegel, Matthias

    2014-09-01

    Various determinants of nurses' work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization. We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses' turnover assessed over a period of one year. We designed a multimethod cross-sectional study. 80 nursing units (n=45 nursing homes, n=35 home care) in 51 German geriatric care services employing 597 registered nurses. We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses' turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio). The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses' turnover and affected indirectly the relation between care setting and registered nurses' turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses' turnover was higher in for-profit care units than in public or non-profit units. This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Endodontic treatment in geriatric patients

    Directory of Open Access Journals (Sweden)

    Milly Armilya Andang

    2007-11-01

    Full Text Available With the increased number of geriatric population, it is predicted that the need for dental treatment also increases. The needs for esthetic factors and function of geriatric patient are maybe similar to young patient. The number of geriatric patients who refuse dental extraction is increasing if there are still other alternative. They can be more convinced when the clinician said that the dental disease experienced is a focal infection so that the loss of the tooth can be accepted as the best option. But if it is possible, they will prefer endodontic treatment, because they want to keep their teeth according to the treatment plan or based on patient's request, as a less traumatic alternative compared to extraction.Endodontic treatment consideration for geriatric patient is quite similar to younger patients. The technique is also the same, although the problem may be bigger. The problem or obstacle that may arise in endodontic treatment for geriatric patient relates to the visit duration, problems during x-ray, problems in defining root canal location, vertical root fracture, and in some cases, decreased pulp tissue recovery ability. Due to the fact that the challenge is quite big, the success of endodontic treatment in geriatric patients needs to be considered. This paper will explain the endodontic treatment prognosis for geriatric patients.

  1. Education in geriatric medicine for community hospital staff.

    LENUS (Irish Health Repository)

    O'Hanlon, Shane

    2010-12-01

    Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

  2. [The geriatric assessment].

    Science.gov (United States)

    Friedrich, Christoph; Schultheis, Beate S; Pientka, Ludger

    2009-01-01

    Due to demographic changes there is an increasing number of elderly and old patients with cancer. This group of patients shows a significant heterogeneity and differs from the average young patient. Identification of relevant functional deficits and comorbidities remains crucial for an efficient treatment strategy of this patient group. For this reason, the geriatric assessment has been developed and integrated in daily oncological practice. Within this diagnostic approach oncologists can for example identify elderly fit patients suitable for aggressive treatments or identify at-risk patients for complications. Recent studies have shown that this approach is feasible in daily practice and capable of improving outcome. There is still the need for more specific instruments for different cancers. Copyright 2009 S. Karger AG, Basel.

  3. Home geriatric physiological measurements

    International Nuclear Information System (INIS)

    Tamura, Toshiyo

    2012-01-01

    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the ‘smart-house’ project. This review concludes by discussing future challenges of the future aged society. (topical review)

  4. Psychosocial Issues in Geriatric Rehabilitation.

    Science.gov (United States)

    Rodriguez, Ricardo M

    2017-11-01

    Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation. An argument is made for the importance of comprehensive geriatric assessment in older adults to identify salient issues that may impact rehabilitation and quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Geriatric Fever Score: a new decision rule for geriatric care.

    Directory of Open Access Journals (Sweden)

    Min-Hsien Chung

    Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

  6. A comparison of anterior cervical discectomy and fusion (ACDF) using self-locking stand-alone polyetheretherketone (PEEK) cage with ACDF using cage and plate in the treatment of three-level cervical degenerative spondylopathy: a retrospective study with 2-year follow-up.

    Science.gov (United States)

    Chen, Yuqiao; Lü, Guohua; Wang, Bing; Li, Lei; Kuang, Lei

    2016-07-01

    To evaluate the clinical efficacy and radiological outcomes of anterior cervical discectomy and fusion (ACDF) using self-locking polyetheretherketone (PEEK) cages for treatment of three-level cervical degenerative spondylopathy. Twenty-eight patients underwent three-level ACDF using self-locking stand-alone PEEK cages (group A), and 26 patients underwent three-level ACDF using cages and plate fixation (group B) were reviewed retrospectively. Clinical efficacy was evaluated by pre- and post-operative Japanese Orthopedic Association (JOA) scores and Neck Disability Index (NDI). The operation time, blood loss, surgical results according to Odom's criteria and post-operative dysphagia status were also recorded. Radiological outcomes including fusion, cervical Cobb's lordosis, fused segment angle, disc height, and cage subsidence were assessed. Clinical outcome measures such as dysphagia and fusion rate and the results of surgery evaluated according to Odom's criteria were not statistically significant (P > 0.05) between groups. The operation time was shorter and blood loss was less in group A (P  0.05). Post-operative cage subsidence, the loss of disc height, cervical lordosis and the fused segment angle were relatively higher in group A than group B (P < 0.05). ACDF using self-locking stand-alone cages showed similar clinical results as compared to ACDF using cages and plate fixation for the treatment of three-level cervical degenerative spondylopathy. However, potential long-term problems such as cage subsidence, loss of cervical lordosis and fused segment angle post-operatively were shown to be associated with patients who underwent ACDF using self-locking stand-alone cages.

  7. [The development and benefits of working together in geriatric short stay units].

    Science.gov (United States)

    Dumont, Magali

    2014-01-01

    Ambroise-Paré hospital (AP-HP, 92) set up a new work organisation based on the nurse/nursing auxiliary partnership in the geriatric short stay unit in response to the wishes of the healthcare manager and nursing team. It was introduced over three months and in several stages in order to limit sticking points and support the team in its new practice.

  8. A strategy to address the nursing faculty shortage.

    Science.gov (United States)

    Ganley, Barbara J; Sheets, Ingrid

    2009-07-01

    This article describes one university's experience in creating a master's geriatric clinical nurse specialist-nurse educator program to address the nursing faculty shortage and the need for geriatric clinical nurse specialists. The successes and challenges are outlined, and curricular ideas that may be beneficial to other nursing programs also are presented. This program has enhanced the university's pool of clinical instructors, increased its ability to provide services to older adults, and allowed faculty to instruct and focus undergraduates in the distinctions of geriatric nursing care. The biggest challenges faced were marketing and recruitment of nurses; these challenges were addressed, and possible solutions are offered. The most immediate benefit of this program was the generation of geriatric clinical nurse specialists.

  9. Factors That Impact Registered Nurses' Decisions to Continue Providing Care to Older Adults

    Science.gov (United States)

    Bosfield, Saundra

    2013-01-01

    The purpose of this study was to investigate if there is a significant difference in the following: (a) nurses' likelihood to remain in geriatrics between age groups (those over 40 years of age and those under 40 years of age); (b) nurses' likelihood to remain in geriatrics and personality traits; (c) nurses' likelihood to remain in geriatrics…

  10. A Typology of Interprofessional Teamwork in Acute Geriatric Care: A Study in 55 units in Belgium.

    Science.gov (United States)

    Piers, Ruth D; Versluys, Karen J J; Devoghel, Johan; Lambrecht, Sophie; Vyt, André; Van Den Noortgate, Nele J

    2017-09-01

    To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. Cross-sectional multicenter study. Acute geriatric units in Belgium. Team members of different professional backgrounds. Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents. Cluster analysis was used to determine types of interprofessional teamwork. Professions and clusters were compared using analysis of variance. The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% other allied health professionals, 5% physicians, and 4% logistic and administrative staff. More than 70% of respondents scored highly on interprofessional teamwork competencies, consultation, experiences, meetings, management, and results. Fewer than 55% scored highly on items about shared reflection and decision-making, reporting incidents from a colleague, and patient files facilitating interprofessional teamwork. Nurses in this study rated shared reflection and decision-making lower than physicians on the same acute geriatric units (P teamwork in acute geriatric units is satisfactory, but shared reflection and decision-making needs improvement. Four types of interprofessional teamwork are identified and can be used to benchmark the teamwork of individual teams. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  11. An interprofessionally developed geriatric oncology curriculum for hematology–oncology fellows

    Science.gov (United States)

    Eid, Ahmed; Hughes, Caren; Karuturi, Meghan; Reyes, Connie; Yorio, Jeffrey; Holmes, Holly

    2016-01-01

    Objective Because the cancer population is aging, interprofessional education incorporating geriatric principles is essential to providing adequate training for oncology fellows. We report the targeted needs assessment, content, and evaluation tools for our geriatric oncology curriculum at MD Anderson Cancer Center. Methods A team comprising a geriatrician, a medical oncologist, an oncology PharmD, an oncology advanced nurse practitioner, and two oncology chief fellows developed the geriatric oncology curriculum. First, a general needs assessment was conducted by reviewing the literature and medical societies’ publications and by consulting experts. A targeted needs assessment was then conducted by reviewing the fellows’ evaluations of the geriatric oncology rotation and by interviewing fellows and recently graduated oncology faculty. Results Geriatric assessment, pharmacology, and psychosocial knowledge skills were the three identified areas of educational need. Curriculum objectives and an evaluation checklist were developed to evaluate learners in the three identified areas. The checklist content was validated by consulting experts in the field. Online materials, including a curriculum, a geriatric pharmacology job aid, and pharmacology cases, were also developed and delivered as part of the curriculum. Conclusion An interprofessional team approach was a successful method for identifying areas of learners’ educational needs, which in turn helped us develop an integrated geriatric oncology curriculum. The curriculum is currently being piloted and evaluated. PMID:25487037

  12. Geriatric health care in India - Unmet needs and the way forward

    Directory of Open Access Journals (Sweden)

    Prabha Adhikari

    2017-01-01

    Full Text Available India has nearly 120 million elderly people with various physical, psychosocial, economic, and spiritual problems. While the functionally and cognitively fit can access usual health-care facilities provided by the government, these people need active aging program to keep them independent. Health ministry has created geriatric centers and geriatric clinics in most of the states; however, these centers may not serve the functionally and cognitively impaired elderly. There is great need for mobile units, day-care centers and hospices, and need for training of personnel in home nursing. Routine care clinics cannot handle the burden of geriatric population to address their multimorbidity and several other age-related problems. There is a need for a rapid training of health-care professionals of various disciplines in geriatric care. Government must support nongovernmental organizations and other agencies which provide day care, home care, and palliative care so that these services become affordable to all the elderly.

  13. A New Model of Delirium Care in the Acute Geriatric Setting: Geriatric Monitoring Unit

    Directory of Open Access Journals (Sweden)

    Chong Mei

    2011-08-01

    Full Text Available Abstract Background Delirium is a common and serious condition, which affects many of our older hospitalised patients. It is an indicator of severe underlying illness and requires early diagnosis and prompt treatment, associated with poor survival, functional outcomes with increased risk of institutionalisation following the delirium episode in the acute care setting. We describe a new model of delirium care in the acute care setting, titled Geriatric Monitoring Unit (GMU where the important concepts of delirium prevention and management are integrated. We hypothesize that patients with delirium admitted to the GMU would have better clinical outcomes with less need for physical and psychotropic restraints compared to usual care. Methods/Design GMU models after the Delirium Room with adoption of core interventions from Hospital Elder Life Program and use of evening bright light therapy to consolidate circadian rhythm and improve sleep in the elderly patients. The novelty of this approach lies in the amalgamation of these interventions in a multi-faceted approach in acute delirium management. GMU development thus consists of key considerations for room design and resource planning, program specific interventions and daily core interventions. Assessments undertaken include baseline demographics, comorbidity scoring, duration and severity of delirium, cognitive, functional measures at baseline, 6 months and 12 months later. Additionally we also analysed the pre and post-GMU implementation knowledge and attitude on delirium care among staff members in the geriatric wards (nurses, doctors and undertook satisfaction surveys for caregivers of patients treated in GMU. Discussion This study protocol describes the conceptualization and implementation of a specialized unit for delirium management. We hypothesize that such a model of care will not only result in better clinical outcomes for the elderly patient with delirium compared to usual geriatric care

  14. Caregiving behind bars: correctional officer reports of disability in geriatric prisoners.

    Science.gov (United States)

    Williams, Brie A; Lindquist, Karla; Hill, Terry; Baillargeon, Jacques; Mellow, Jeff; Greifinger, Robert; Walter, Louise C

    2009-07-01

    Despite increasing numbers of geriatric prisoners, little is known about geriatric disability or health care in prison. Although correctional officers often act as a liaison between prisoners and the healthcare system, the role of officers in recognizing geriatric disability has not been characterized. The goals of this study were to assess officers' assessment of disability in their assigned geriatric prisoners and to contrast their views with reports from the California Department of Corrections and Rehabilitation (CDCR). Questionnaires were given to 71 officers assigned to 618 randomly selected geriatric prisoners in 11 prisons. Information about 41 additional prisoners identified by correctional officers as "high risk" was also analyzed. Prisoner disability and health were determined through correctional officer questionnaires (activity of daily living (ADL) impairment, geriatric syndromes, level of care), chart review (medical diagnoses), and CDCR data (demographics, disability designation). Overall, 211 (34.1%) geriatric prisoners were unknown to their officer. Of the 407 known prisoners, officers reported that 5.0% had ADL impairment and 3.1% were unsafe. Discordance between officer and CDCR reports of disability was common, with officers reporting higher disability rates. The 41 high-risk prisoners were more likely to have ADL impairment (22.0% vs 5.2%, P<.01) and geriatric syndromes such as falls and incontinence than the random sample. Overall, nearly one-third of geriatric prisoners were unknown to their assigned officer. Officers identified more disability than the CDCR, and prisoners they identified as high risk had nursing home-level functional impairments. Significant improvement in disability assessment is needed for officers and the CDCR.

  15. Virtual patients in geriatric education.

    Science.gov (United States)

    Tan, Zaldy S; Mulhausen, Paul L; Smith, Stephen R; Ruiz, Jorge G

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction.

  16. Virtual Patients in Geriatric Education

    Science.gov (United States)

    Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…

  17. Nurses' Learning Experiences with the Kinaesthetics Care Concept Training in a Nursing Home: A Qualitative Descriptive Study

    Science.gov (United States)

    Fringer, André; Huth, Martina; Hantikainen, Virpi

    2015-01-01

    In geriatric care, movement support skills of nurses are often limited, resulting in unnecessary functional decline of older adult residents and physical strain of nurses. Kinaesthetics training aims to improve movement competences of nurses and residents. The aim of this qualitative descriptive study is to describe nursing teams' experience with…

  18. Exercise Promotion in Geriatric Oncology.

    Science.gov (United States)

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.

  19. Feasibility and impact of telemonitor-based depression care management for geriatric homecare patients.

    Science.gov (United States)

    Sheeran, Thomas; Rabinowitz, Terry; Lotterman, Jennifer; Reilly, Catherine F; Brown, Suzanne; Donehower, Patricia; Ellsworth, Elizabeth; Amour, Judith L; Bruce, Martha L

    2011-10-01

    The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services. Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM and received biweekly supervision. On-site trained research assistants conducted in-home research interviews on depression diagnosis and severity and patient satisfaction with the protocol. An ethnically diverse sample of 48 English- and Spanish-only-speaking patients participated, along with seven telehealth nurses. Both patients and telehealth nurses reported high levels of protocol acceptance. Among 19 patients meeting diagnostic criteria for major depression, the mean depression severity was in the "markedly severe" range at baseline and in the "mild" range at follow-up. Results of this pilot support the feasibility of using homecare's existing telemonitoring technology to deliver DCM to their elderly homebound patients. This was true for both English- and Spanish-speaking patients. Preliminary clinical outcomes suggest improvement in depression severity, although these findings require testing in a randomized clinical trial. Implications for the science and service of telehealth-based depression care for elderly patients are discussed.

  20. [Geriatrics and gerontology in Senegal].

    Science.gov (United States)

    Coumé, Mamadou; Touré, Kamadore; Faye, Atoumane; Moreira, Therese Diop

    2013-01-01

    Senegal is dealing positively with its demographic transition. On September 1st 2006, the Senegalese government introduced the "Plan Sesame", a national free health care program for elderly people aged 60 years and over. The University of Dakar academic authorities support the Sesame plan through an innovative training program in geriatrics and gerontology. Such programs aim to address the challenge of ageing in a developing country.

  1. Geriatric issues in renal transplantation.

    Science.gov (United States)

    Bia, M J

    1999-01-01

    There are an increasing amount of data which are compelling us to consider the issue of age in dealing with decisions regarding both renal transplant recipients and donors. These geriatric issues in transplantation can be summarized as follows: (1) The explosion of a geriatric population of patients with ESRD, in association with data showing a survival advantage of transplantation over wait-listed dialysis patients, demands an increase in expertise in transplantating patients over 60 years old. (2) The critical shortage in cadaveric organ supply is creating a variety of solutions including expanding the donor pool with older kidneys in which long term survival may be shorter than in kidneys from younger donors. (3) The donor shortage, in association with data demonstrating improved survival of living related and unrelated donor transplants, is generating an increased number of older (> 60 years old) individuals who want to donate to a relative, spouse or friend. Future efforts should be directed toward continued research designed to evaluate the efficacy and safety of these trends. We also need to provide improved training in geriatrics for nephrologists so that we and transplant surgeons can deliver better medical care to an aging population of patients with ESRD.

  2. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help......, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have......, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...

  3. Basic Stand Alone Medicare Prescription Drug Events PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This is a Public Use File for Prescription Drug Events drawn from the 2008 Beneficiary Summary File of Medicare beneficiaries enrolled during the calendar year 2008,...

  4. Closure of army stand alone housing areas: An environmental adventure

    International Nuclear Information System (INIS)

    Ricci, J.A.

    1992-01-01

    In October 1988, Congress passed the Defense Authorization Amendments and Base Closure and Realignment Act, Public Law 100-526. This legislation provided the framework for making decisions about military base closures and realignments. The overall objective of the legislation was to close and realign bases to maximize savings without impairing the Army's overall military mission. In December 1988, the Defense Secretary's ad hoc Commission on Base Realignment and Closure issued its final report nominating candidate installations. Among the installations affected by the commission's recommendations, which were subsequently approved by Congress, were 53 military housing areas. The paper recounts the process by which each of the 53 housing areas was assessed to determine if any environmental restoration was to be performed prior to property sale. Each phase of the program is addressed from the Enhanced Preliminary Assessment through the issuance of a 'Statement of Condition' which, in accordance with Army real property regulations, is required prior to property transfer. The unique challenges presented by the housing areas are high-lighted; where materials such as asbestos, radon and fuel oil predominated, as opposed to laboratory chemicals and hazardous waste from industrial operations. In addition, attention is given to the myriad disciplines which interface in preparing a housing area for closure. Forty-three Statements of Condition have been issued to date, with the remainder to be prepared upon completion of remediation activities at each site

  5. Basic Stand Alone Medicare Claims Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is committed to increasing access to its Medicare claims data through the release of de-identified data files available for public use. They contain...

  6. A stand-alone tidal prediction application for mobile devices

    Science.gov (United States)

    Tsai, Cheng-Han; Fan, Ren-Ye; Yang, Yi-Chung

    2017-04-01

    It is essential for people conducting fishing, leisure, or research activities at the coasts to have timely and handy tidal information. Although tidal information can be found easily on the internet or using mobile device applications, this information is all applicable for only certain specific locations, not anywhere on the coast, and they need an internet connection. We have developed an application for Android devices, which allows the user to obtain hourly tidal height anywhere on the coast for the next 24 hours without having to have any internet connection. All the necessary information needed for the tidal height calculation is stored in the application. To develop this application, we first simulate tides in the Taiwan Sea using the hydrodynamic model (MIKE21 HD) developed by the DHI. The simulation domain covers the whole coast of Taiwan and the surrounding seas with a grid size of 1 km by 1 km. This grid size allows us to calculate tides with high spatial resolution. The boundary conditions for the simulation domain were obtained from the Tidal Model Driver of the Oregon State University, using its tidal constants of eight constituents: M2, S2, N2, K2, K1, O1, P1, and Q1. The simulation calculates tides for 183 days so that the tidal constants for the above eight constituents of each water grid can be extracted by harmonic analysis. Using the calculated tidal constants, we can predict the tides in each grid of our simulation domain, which is useful when one needs the tidal information for any location in the Taiwan Sea. However, for the mobile application, we only store the eight tidal constants for the water grids on the coast. Once the user activates the application, it reads the longitude and latitude from the GPS sensor in the mobile device and finds the nearest coastal grid which has our tidal constants. Then, the application calculates tidal height variation based on the harmonic analysis. The application also allows the user to input location and time to obtain tides for any historic or future dates for the input location. The predicted tides have been verified with the historic tidal records of certain tidal stations. The verification shows that the tides predicted by the application match the measured record well.

  7. PMBLDCG based stand-alone wind energy conversion system for ...

    African Journals Online (AJOL)

    International Journal of Engineering, Science and Technology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (2012) >. Log in or Register to get access to full text downloads.

  8. Performance evaluation of stand alone hybrid PV-wind generator

    Energy Technology Data Exchange (ETDEWEB)

    Nasir, M. N. M.; Saharuddin, N. Z.; Sulaima, M. F.; Jali, Mohd Hafiz; Bukhari, W. M.; Bohari, Z. H. [Faculty of Electrical Engineering, Universiti Teknikal Malaysia Melaka (UTeM), Hang Tuah Jaya, 76100 Melaka (Malaysia); Yahaya, M. S. [Faculty of Engineering Technology, Universiti Teknikal Malaysia Melaka (UTeM), Hang Tuah Jaya, 76100 Melaka (Malaysia)

    2015-05-15

    This paper presents the performance evaluation of standalone hybrid system on Photovoltaic (PV)-Wind generator at Faculty of Electrical Engineering (FKE), UTeM. The hybrid PV-Wind in UTeM system is combining wind turbine system with the solar system and the energy capacity of this hybrid system can generate up to charge the battery and supply the LED street lighting load. The purpose of this project is to evaluate the performance of PV-Wind hybrid generator. Solar radiation meter has been used to measure the solar radiation and anemometer has been used to measure the wind speed. The effectiveness of the PV-Wind system is based on the various data that has been collected and compared between them. The result shows that hybrid system has greater reliability. Based on the solar result, the correlation coefficient shows strong relationship between the two variables of radiation and current. The reading output current followed by fluctuate of solar radiation. However, the correlation coefficient is shows moderate relationship between the two variables of wind speed and voltage. Hence, the wind turbine system in FKE show does not operate consistently to produce energy source for this hybrid system compare to PV system. When the wind system does not fully operate due to inconsistent energy source, the other system which is PV will operate and supply the load for equilibrate the extra load demand.

  9. PMBLDCG based stand-alone wind energy conversion system for ...

    African Journals Online (AJOL)

    user

    David et al 2001, Simoes and Farret 2004,. Bhadra et al 2004, Ackermann 2005). The permanent magnet ..... David Sharpe Burton, Jenkins Nick and Bossanyi Ervin, 2001. “Wind Energy Handbook,” John Wiley & Sons. Ltd. Gieras J. F. and ...

  10. Performance evaluation of stand alone hybrid PV-wind generator

    Science.gov (United States)

    Nasir, M. N. M.; Saharuddin, N. Z.; Sulaima, M. F.; Jali, Mohd Hafiz; Bukhari, W. M.; Bohari, Z. H.; Yahaya, M. S.

    2015-05-01

    This paper presents the performance evaluation of standalone hybrid system on Photovoltaic (PV)-Wind generator at Faculty of Electrical Engineering (FKE), UTeM. The hybrid PV-Wind in UTeM system is combining wind turbine system with the solar system and the energy capacity of this hybrid system can generate up to charge the battery and supply the LED street lighting load. The purpose of this project is to evaluate the performance of PV-Wind hybrid generator. Solar radiation meter has been used to measure the solar radiation and anemometer has been used to measure the wind speed. The effectiveness of the PV-Wind system is based on the various data that has been collected and compared between them. The result shows that hybrid system has greater reliability. Based on the solar result, the correlation coefficient shows strong relationship between the two variables of radiation and current. The reading output current followed by fluctuate of solar radiation. However, the correlation coefficient is shows moderate relationship between the two variables of wind speed and voltage. Hence, the wind turbine system in FKE show does not operate consistently to produce energy source for this hybrid system compare to PV system. When the wind system does not fully operate due to inconsistent energy source, the other system which is PV will operate and supply the load for equilibrate the extra load demand.

  11. Performance evaluation of stand alone hybrid PV-wind generator

    International Nuclear Information System (INIS)

    Nasir, M. N. M.; Saharuddin, N. Z.; Sulaima, M. F.; Jali, Mohd Hafiz; Bukhari, W. M.; Bohari, Z. H.; Yahaya, M. S.

    2015-01-01

    This paper presents the performance evaluation of standalone hybrid system on Photovoltaic (PV)-Wind generator at Faculty of Electrical Engineering (FKE), UTeM. The hybrid PV-Wind in UTeM system is combining wind turbine system with the solar system and the energy capacity of this hybrid system can generate up to charge the battery and supply the LED street lighting load. The purpose of this project is to evaluate the performance of PV-Wind hybrid generator. Solar radiation meter has been used to measure the solar radiation and anemometer has been used to measure the wind speed. The effectiveness of the PV-Wind system is based on the various data that has been collected and compared between them. The result shows that hybrid system has greater reliability. Based on the solar result, the correlation coefficient shows strong relationship between the two variables of radiation and current. The reading output current followed by fluctuate of solar radiation. However, the correlation coefficient is shows moderate relationship between the two variables of wind speed and voltage. Hence, the wind turbine system in FKE show does not operate consistently to produce energy source for this hybrid system compare to PV system. When the wind system does not fully operate due to inconsistent energy source, the other system which is PV will operate and supply the load for equilibrate the extra load demand

  12. Algal Hydrogen Production -- Stand Alone or Integrated System?

    Energy Technology Data Exchange (ETDEWEB)

    Ghirardi, Maria L.; Maness, Pin Ching; Kosourovo, Sergey

    2016-01-01

    Photosynthetic bacteria and green algae photoproduce H2. but do so utilizing different catalysts and substrates. Green algae use reductant generate mostly by water oxidation to catalyze the reduction of protons to H2 gas, while photosynthetic bacteria catalyze H2 production from organic acids using the nitrogenase enzyme. Moreover, these two organisms utilize different regions of the solar spectrum to perform photosynthesis: green algae's light harvesting antenna is comprised of chlorophyll molecules that absorb mostly blue and red light; photosynthetic bacteria harvest blue and far-red light through their light-harvesting pigments to run its non-oxygenic photosynthetic reactions. There is thus an opportunity to increase the range of solar spectrum used to photoproduce H2 by combining the light-harvesting and catalytic properties of these two organisms in a single process. In the current manuscript, we describe an experimental system that validates this hypothesis and demonstrates quantitatively the advantages of a two organism process for production of higher amounts of H2 and thus achieving solar light conversion efficiencies.

  13. She stands alone: Pakistani woman film director, Shireen Pasha.

    Science.gov (United States)

    Mustafa, A

    1995-01-01

    This article describes the activities of film director Shireen Pasha in promoting truth in the mass media in Pakistan. Pasha is described as one who finds it inexcusable in a state-subsidized system that national problems of poverty are not aired openly. Pasha has pursued the goal of exposing the real lives of Pakistanis on film in contrast to the publicly aired segments of "pretty girls in nice drawing rooms." Foreign channels available through satellite communications technology are viewed by Pasha as inappropriate with regard to people's needs and uncreative. Pakistan began with one channel, PTV, which recently refused to air her documentary on living conditions in Pakistan's rural areas "The Travelogue Pakistan." "The Walled City of Lahore" was her film about life in the old city. Both films poetically depicted the honor of humans and their struggle to stay alive. Some of her documentaries are made to show the value of indigenous skills, centuries old know-how, and traditions, regardless of the poverty. Pasha is described as fighting with PTV management over use of resources. Pasha desires to invest in training people to do documentaries or be more field-oriented rather than investing in equipment. Pasha joined PTV in 1975 and left in 1990. Pasha is recognized for her isolation as a woman in the business world, her commitment to exposing remote cultures and truth, and the odds she must confront in attaining her goals. Pasha is committed to doing extensive research, usually conducted during the summer months, in order to construct a credible story line that is produced usually during the winter months. One model of film story line is defined as one where women are portrayed as starting from an indigenous skill or knowledge and shifting to a greater position of power and control over their lives. Pasha believes that people who make films have the responsibility to evoke a reaction in people and to offer solutions. Two acclaimed films, which were supported by USAID and the government, were "Before It's Too Late" and "Only One Way." Both deal with resource issues and the environment. She is currently director of her own film house, The Film Makers, in Lahore. After graduating from the National College of Arts in 1968, she furthered her education in the US in the history of art.

  14. Deterrents on the Over Utilisation of Stand Alone Photovoltaic (PV ...

    African Journals Online (AJOL)

    At inception of the programme, systems were either undersized, or over utilised as clients did not reveal their usage needs in an attempt to reduce costs. This resulted in battery failures and other system breakdowns. The NPVREP categorised systems in order to alleviate the problem of under sizing and/or over utilization of ...

  15. 28 CFR 2.78 - Geriatric parole.

    Science.gov (United States)

    2010-07-01

    ... for violence; (6) Criminal history; and (7) Alternatives to maintaining geriatric long-term prisoners in traditional prison settings. (f) A prisoner, the prisoner's representative, or the institution...

  16. International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

    NARCIS (Netherlands)

    Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L. G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

    2014-01-01

    Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the

  17. Building a comprehensive geriatric health care system: a case study.

    Science.gov (United States)

    Bleiweiss, L; Simson, S

    1976-01-01

    This case study focuses on the efforts of three urban medical care institutions--a Health Maintenance Organization, a nursing home, and a university hospital--to form an interorganizational relationship. The purpose of the relationship was to utilize the services of the three organizations in order to respond to the comprehensive health needs of an urban geriatric population. Movements in this triadic organizational relationship are described and analyzed in terms of four conceptual stages--exploration, negotiation, interaction and performance, and termination. Problems arising during these stages were not resolved and the relationship was terminated after approximately two years of existence. A sociological discussion of the case focuses on why the relationship failed. The organizational relationship was disrupted by three stresses that occurred during the four stages of the relationship. Stresses emerged for each organization in the areas of organizational integration, professional coordination, and environmental adaptation, making it difficult for the three to become integrated into an organizational system. As a result, the HMO, the nursing home, and the hospital did not benefit from relationships that could have enabled them to develop the multi-organizational system necessary to sustain an innovative, comprehansive geriatric health project. If, as Whitehead said, the greatest invention of the nineteenth century was the invention of the method of invention, the task of the succedding century has been to organize inventiveness. The difference is not in the nature of invention or of inventors, but in the manner in which the context of social institutions is organized for their support.

  18. Interdisciplinary geriatric and palliative care team narratives: collaboration practices and barriers.

    Science.gov (United States)

    Goldsmith, Joy; Wittenberg-Lyles, Elaine; Rodriguez, Dariela; Sanchez-Reilly, Sandra

    2010-01-01

    Despite the development and implementation of team training models in geriatrics and palliative care, little attention has been paid to the nature and process of teamwork. Geriatrics and palliative care in the clinical setting offer an interdisciplinary approach structured to meet the comprehensive needs of a patient and his or her family. Fellowship members of an interdisciplinary geriatric and palliative care team participated in semistructured interviews. Team members represented social work, chaplaincy, psychology, nursing, and medicine. A functional narrative analysis revealed four themes: voice of the lifeworld, caregiver teamwork, alone on a team, and storying disciplinary communication. The content-ordering function of narratives revealed a divergence in team members' conceptualization of teamwork and team effectiveness, and group ordering of narratives documented the collaborative nature of teams. The study findings demonstrate the potential for narratives as a pedagogical tool in team training, highlighting the benefits of reflective practice for improving teamwork and sustainability.

  19. [Nutritional management in geriatric traumatology].

    Science.gov (United States)

    Singler, K; Goisser, S; Volkert, D

    2016-08-01

    The prevalence of malnutrition or the risk of malnourishment is high among orthogeriatric patients and a poor nutritional status is associated with a negative outcome. A comprehensive management of preoperative and postoperative nutritional and fluid intake in these patients can help to improve the situation. The management includes identification of patients affected, a thorough assessment of the nutritional status, work-up of possible underlying causes, documentation of nutritional and fluid intake and, most importantly, procedures to improve the preoperative and postoperative nutritional situation. This article gives an overview of the recently updated recommendations on nutritional management in orthogeriatric patients as published by the orthogeriatric working group of the German Geriatric Society.

  20. Depression in Geriatric and Adult Medical Inpatients.

    Science.gov (United States)

    Magni, Guido; And Others

    1985-01-01

    Administered two scales for the evaluation of depression to two groups of medical inpatients: adults (N=201) and geriatric subjects (N=178). Results confirmed a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects. Factors most predictive of depressive symptoms are identified. (JAC)

  1. gerIatrIc ImperatIve

    African Journals Online (AJOL)

    gerIatrIc. •. •. ImperatIve. A major challenge to health professionals. D. GLAJCHEN. In recent years I have noted, with increasing envy, the inherent strength as well as the impressive clinical and ... ments of geriatrics in this country will form the basis of a separate .... effects of nutrition (quantity, under-nutrition without malnutri-.

  2. Job Openings Projected in Nursing Home Industry

    Science.gov (United States)

    Maust, Ann Parker

    1977-01-01

    Most nurses employed in nursing homes today have little or no training in geriatrics and the special needs of the chronically ill patient. Community colleges can play a vital role in upgrading presently employed personnel and in producing a supply of trained manpower to meet the future projected demand. (DC)

  3. [The world of the oldest old: is the effectiveness of an intervention measurable? Geriatric occupational therapy program created by a group of nurses as described by Paola D'Ovidio and Francesca Perego].

    Science.gov (United States)

    2013-01-01

    A group of women who assumed the role of providing an integration of the routine care of a nursing home through the activation of various laboratories (from writing, to painting, to manual activities, to music), report on the criteria and the methodologies of their intervention, as well as the results obtained, over a period of three years, by giving a central place to the testimony of the "oldest old" population. The narrative of this experience is proposed not only as a strategy which can be reproduced but also as a methodology of evaluation for a setting which could be hardly assessed with standardized instruments based on quantitative rules and scores.

  4. Psychosocial work load and stress in the geriatric care.

    Science.gov (United States)

    Nübling, Matthias; Vomstein, Martin; Schmidt, Sascha G; Gregersen, Sabine; Dulon, Madeleine; Nienhaus, Albert

    2010-07-21

    Due to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession. The German version of the COPSOQ (Copenhagen Psychosocial Questionnaire) was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain.Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database).Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p worked in Home Care (HC), 313 in Geriatric Nursing Homes (GNH), 164 in other professions (e.g. administration).Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195) and the total mean across all professions, COPSOQ-total (N = 11.168), the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the high rating for job insecurity.A supplementary subgroup analysis showed that the degree of negative evaluation of psychosocial factors concerning demands was related to the amount of working hours per week and the

  5. Psychosocial work load and stress in the geriatric care

    Directory of Open Access Journals (Sweden)

    Dulon Madeleine

    2010-07-01

    Full Text Available Abstract Background Due to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession. Methods The German version of the COPSOQ (Copenhagen Psychosocial Questionnaire was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain. Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database. Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p Results In total 889 respondents from 36 institutions took part in the study. 412 worked in Home Care (HC, 313 in Geriatric Nursing Homes (GNH, 164 in other professions (e.g. administration. Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195 and the total mean across all professions, COPSOQ-total (N = 11.168, the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the high rating for job insecurity. A supplementary subgroup analysis showed that the degree of

  6. [Geriatrics].

    Science.gov (United States)

    Büla, C; Gold, G

    2007-01-10

    A new vaccine reduces the incidence and severity of zoster and its complications in older persons. A cost-effectiveness analysis highlights the implication of CDC's recent recommendation to vaccinate all persons aged 60 years and over. A meta-analysis confirms that the chronic use of sedatives in older persons provides modest benefits and important risks. Unfortunately, melatonin does not seem to be a useful alternative. A systematic review of interventions to prevent pressure ulcers provides scientific support to measures empirically used in most institutions. Finally, a randomized controlled trial questions the clinical benefit of atypical neuroleptics in Alzheimer's disease and a comprehensive review of pharmacological trials in mild cognitive impairment reports no benefit of any of the tested drugs on conversion rate to Alzheimer's disease.

  7. US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow: a qualitative study

    NARCIS (Netherlands)

    Vandenberg, Ann E.; van Beijnum, Bernhard J.F.; Overdevest, Vera G.P.; Capezuti, Elizabeth; Johnson II, Theodore M.

    2017-01-01

    Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning

  8. Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model

    Science.gov (United States)

    Adelman, Ronald D.; Ansell, Pamela; Breckman, Risa; Snow, Caitlin E.; Ehrlich, Amy R.; Greene, Michele G.; Greenberg, Debra F.; Raik, Barrie L.; Raymond, Joshua J.; Clabby, John F.; Fields, Suzanne D.; Breznay, Jennifer B.

    2011-01-01

    Geriatric psychosocial problems are prevalent and significantly affect the physical health and overall well-being of older adults. Geriatrics fellows require psychosocial education, and yet to date, geriatrics fellowship programs have not developed a comprehensive geriatric psychosocial curriculum. Fellowship programs in the New York tristate area…

  9. Geriatric Dermatoses In Southern Orissa

    Directory of Open Access Journals (Sweden)

    Sahoo A

    2000-01-01

    Full Text Available Two hundred geriatric patients, aged 55 years and above, studied at Medical College, Berhampur accounted for 3% of Skin & VD OPD attendance with a male preponderance (M: F: 4:1. Majority (97% of these patients were literate, 55% belonged to low socio-economic group. Among them 32.5% of males were farmers and all females were housewives. Forty-nine dermatologic diseases were encountered, twenty-nine patients presented with multiple complaints and the rest had single complaint. Pruritus was the commonest symptom (54%, 41.5% of which was associated with different dermatoses and the rest 12.5% with senile xerosis. Fungal infection was the commonest dermatosis. Senile xerosis (12.5%, seborrhoeic keratosis (10%, psoriasis (9%, idiopathic guttate hypomelanosis (6.5%, malignant and premalignant conditions (5%, vitiligo (3.5% and lichen planus (3% were some of the other dermatoses seen. Diabetes was the commonest systemic disease (10.5%.

  10. Practice of geriatric oncology in the setting of a comprehensive cancer center

    International Nuclear Information System (INIS)

    Droz, J.

    2004-01-01

    subjectively appreciate performance status. Folstein’s Mini Mental State Examination (MMSE) was used to evaluate patient cognitive status. Depressive symptoms were detected with the Geriatric Depression Scale (GDS). Nutritional status was assessed through the Mini-Nutritional Assessment (MNA). The Performance-Oriented Assessment of Mobility instrument provided information on patient physical ability and fall risk. Co morbidity, that corresponds to all medical conditions a patient may have, excluding the disease of primary interest, was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G). This scale classifies co morbid events by organ system affected, and rates their severity from 0 to 4, with a grading similar to that of the Common Toxicity Criteria scale (none, mild, moderate, severe, extremely severe/life-threatening). This scale has 14 organ system categories and collects information such as the total number of categories involved, total score, severity index (total score/total number of categories involved), the number of categories at level 3 severity, the number of categories at level 4 severity. We also assessed biological functions such as hemoglobin, white blood cell count and differential, creatinine clearance, serum albumin level. Mini-CGA is performed by a multidisciplinary team, including a geriatric ian, a medical oncologist (geriatrics certified), a social worker, a dietician, a physiotherapist, a pharmacist and a research nurse. Each mini-CGA evaluation lasts from ninety to one hundred and twenty minutes. At the end of the procedure, both the geriatric ian and the oncologist draw up an inventory of the different problems identified, and propose an individualized intervention program with specific advice on cancer treatment options

  11. Academic detailing to teach aging and geriatrics.

    Science.gov (United States)

    Duckett, Ashley; Cuoco, Theresa; Pride, Pamela; Wiley, Kathy; Iverson, Patty J; Marsden, Justin; Moran, William; Caton, Cathryn

    2015-01-01

    Geriatric education is a required component of internal medicine training. Work hour rules and hectic schedules have challenged residency training programs to develop and utilize innovative teaching methods. In this study, the authors examined the use of academic detailing as a teaching intervention in their residents' clinic and on the general medicine inpatient wards to improve clinical knowledge and skills in geriatric care. The authors found that this teaching method enables efficient, directed education without disrupting patient care. We were able to show improvements in medical knowledge as well as self-efficacy across multiple geriatric topics.

  12. Rest break organization in geriatric care and turnover: A multimethod cross-sectional study

    OpenAIRE

    Wendsche, Johannes; Hacker, Winfried; Wegge, Jürgen; Schrod, Nadine; Roitzsch, Katharina; Tomaschek, Anne; Kliegel, Matthias

    2014-01-01

    Background Various determinants of nurses’ work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization. Objectives We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses’ turnover assessed over a period of one year. Design We designed...

  13. Abstracts from the 35th Annual Scientific Meeting of the Canadian Geriatrics Society, Montreal, April 2015

    OpenAIRE

    Cetin-Sahin, D.; McCusker, J.; Ciampi, A.; Vu, T.T.M.; Cossette, S.; Veillette, N.; Vadeboncoeur, A.; Belzile, E.; Ducharme, F.; Arvisais, K.; Bergeron-Wolff, S.; Bouffard, C.; Michaud, A.-S.; Bergeron, J.; Brazeau, S.

    2015-01-01

    Optimizing heath care services for seniors in emergency departments (ED) is a core component of the “Senior Friendly Hospital Approach” being implemented in Quebec. We measured the availability of geriatric expertise in Quebec EDs and its relationship with ED characteristics such as university affiliation, number of stretchers, and geographical location. We surveyed (2013–2014) head nurses and head physicians at 116 adult, non-psychiatric Quebec EDs. We defined high level of availability in t...

  14. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    , all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...... and barriers, stating important differences between multidisciplinary and interdisciplinary processes. Checklists and assessment scales may be very useful when performing a geriatric work-up, but they should be used with caution. Specific scales covering different functional areas of the geriatric patient...

  15. [Definition and outline on geriatric oncology].

    Science.gov (United States)

    Terret, C; Droz, J-P

    2009-11-01

    Geriatric oncology is the concept for management of elderly cancer patients. It is an equal approach of the health status problems and of cancer in a patient considered as a whole. Therefore it is not a subspecialty but a practice which can be translated in the elderly cancer patient's care. The treatment of cancer is based on the same principles than this of younger patients; recommendations used are those of the scientific oncological societies. Health problems of elderly patients are screened by specific tools. Patients without major health problems are managed by the oncological team in the routine; those for whom screening have demonstrated problems are first evaluated in the geriatrics setting and then oncological decisions are adapted to the patient situation. Decisions are made in specific geriatric oncology conferences. Specific clinical trials are required to build an Evidence Based Medicine background. Geriatric oncology teaching programs are warranted. (c) 2009 Elsevier Masson SAS. All rights reserved.

  16. A review of geriatric education in Singapore.

    Science.gov (United States)

    Koh, Gerald C H

    2007-08-01

    The United Nations has identified the training and education of healthcare professionals and care providers involved in the care of older persons as a global priority. Singapore is no exception as it faces a rapidly ageing population. Older people have many medical needs of varying dimensions and their care requires a multidisciplinary healthcare team. The current status of geriatric education of health professionals involved in elderly care in Singapore is discussed in this paper. Important issues raised include the disparity between professions in the stages of development of geriatric education, questions on the adequacy of numbers and training of healthcare professionals providing geriatric care, as well as the need for geriatric education of caregivers.

  17. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Cokorda Istri Devi Larayanthi

    2013-04-01

    Full Text Available Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, general medical conditions, medications, certain substances, and others. Management of insomnia in geriatric patients were divided into 3 method: 1 manage underlying cause, 2 nonpharmacological therapies such as cognitive behavior therapy (CBT, and 3 pharmacological therapies such as benzodiazepine and non-benzodiazepine that eszopiclone and Ramelteon. Pharmacological treatment in geriatrics should follow the rule "start low, go slow", starting dose of ½ of the adult dose, and its use in the short term.

  18. Geriatric Family Support and Diabetic Type-2 Glycemic Control

    Directory of Open Access Journals (Sweden)

    Shiva Heidari

    2008-07-01

    Full Text Available Objectives: As the most part of geriatric (65 years and older diabetic care is given at home, family support has an important role in their blood sugar level control care. This study aimed to assess the relationship between family support and blood sugar level control in such elderly suffering type-2 diabetes. Methods & Materials: Via descriptive-correlative study, one hundred fifty geriatric patients with type-2 diabetes, who referred to Institute of Endocrinology and Metabolism in Iran University of Medical Sciences were selected. Samplings based on nonrandomized and convenience. The questionnaire consisted of three sections: demographic data glucose-labeled hemoglobin (HbA1C and received-perceived family support by applying the standard questionnaire of "Diabetes Social Support-Family Version" format. Data were analyzed by SPSS version 15 by using Chi-square and Pierson Tests. Results: Results showed a significant relationship between family support and glycemic control (r=-0.56, P<0.0001. Also there were significant relationships between family support, gender and marital status (P<0.0001. There were also significant relationships between glycemic control and marital status (P=0.02, financial status (P=0.04 and educational level (P=0.05. Conclusion: Findings of this research added further evidence about the impact of family support on the health of older adults with diabetes. These findings suggest using family centered nursing interventions and collaboration of family members in care of the elderly with type-2 diabetes.

  19. Research Ethics Issues in Geriatric Psychiatry

    OpenAIRE

    Dunn, Laura B.; Misra, Sahana

    2009-01-01

    With an aging population, and the prevalence of psychiatric illness in the older population expected to rise dramatically in coming decades, advances in geriatric psychiatry research are urgently needed. Ethical issues in the design, conduct, and monitoring of research involving older adults parallel these same issues related to human subjects research generally. Yet a number of special issues relevant to geriatric psychiatry research merit further discussion. These special issues include the...

  20. [The mobile geriatrics team, global patient management].

    Science.gov (United States)

    Bach, Fréderiue; Bloch, Frédéric

    2013-01-01

    The mobile geriatric team of Cochin hospital in Paris is responsible for the management and orientation of fragile elderly patients over the age of 75 admitted to emergency departments. It carries out a multi-disciplinary assessment, contributes to the creation of the care project and life project of geriatric patients and is involved in organising the patient's return home. This article focuses on the role of the social assistant through two clinical cases.

  1. MANAJEMENT OF INSOMNIA IN GERIATRIC PATIENTS

    OpenAIRE

    Cokorda Istri Devi Larayanthi

    2013-01-01

    Sleep is an unconscious condition that is relatively more responsive to internal stimuli. Insomnia is a sleep disorder with characteristic difficulty of initiating sleep or difficulty in maintaining sleep. Insomnia is divided into 2 primary insomnia and secondary insomnia. Conection with age, the function of organs in the body decreases. So that geriatric patients are susceptible to illnesses, especially insomnia. Many of the causes of insomnia in geriatric mental disorders, psychiatric, gene...

  2. [Assessment of patient satisfaction in geriatric hospitals: a methodological pilot study].

    Science.gov (United States)

    Huber, Jean Pierre; Saldutto, Biagio; Hürny, Christoph; Conzelmann, Martin; Beutler, Monique; Fusek, Milos; Münzer, Thomas

    2008-04-01

    The assessment of patient satisfaction using mailed questionnaires is an established method of quality management in acute care hospitals in our health care system. The needs of aged patients and the inter-professional approach of geriatric medicine are, however, not taken into account by such surveys. To date, validated German instruments to assess patient opinions in geriatric in-hospital care are rare. We report the results of a multi-center feasibility study of a questionnaire developed especially for such needs. We examined 1918 patients with a median age of 82 years and a mean Mini- Mental Score (MMS) of 25 points in 3 Swiss geriatric hospitals. We examined the results of all completed written questionnaires for their psychometric properties. In parallel, we assessed the satisfaction of the patient's spouses or family members applying the same instrument. The return rate was 32% when the instrument was applied as a questionnaire and 60% when applied as an interview. In questionnaires, the return rate was dependent on cognition with lower return in patients with low MMS scores. The return rate of questionnaires mailed to family members was 35%. The theoretical construct patient satisfaction was reliable and valid. The Cronbach-Alpha values in different item areas ranked between 0.67 (hotel services, room quality) and 0.92 (physicians). We were not able to assess the quality of medical therapies and of pain treatment due to low answer frequencies. Overall, patients were satisfied with all medical services in the participating hospitals. In contrast, satisfaction was low in family members regarding the quality of information flow between family members and physicians or nurses. An instrument to assess patient opinions can easily be introduced into a geriatric hospital. Such an instrument can provide important information for the improvement of quality in different areas of geriatric care such as medical, nursing care or guest services.

  3. Student nurses' motivation to choose gerontological nursing as a career in China: a survey study.

    Science.gov (United States)

    Cheng, Min; Cheng, Cheng; Tian, Yan; Fan, Xiuzhen

    2015-07-01

    The world's population is aging, and the need for nurses is increasing. Working with older adults, however, has always been an unpopular career choice among student nurses. It is important to understand student nurses' motivation for choosing gerontological nursing as a career. The purpose of this study was to examine the motivation for choosing gerontological nursing as a career and to identify the associated factors among student nurses. Cross-sectional survey. Participants were last-semester student nurses from 7 universities offering nursing undergraduate programs in Shandong, China. Of the 1290 student nurses, 916 completed the survey (a response rate of 71.0%). The outcome variable was the motivation to choose gerontological nursing as a career. This was measured using a motivation questionnaire that included expectancy and value subscales. Other instruments included the Chinese version of the Facts on Aging Quiz I, the Geriatrics Attitudes Scale, the Anxiety about Aging Scale, a clinical practice environment questionnaire and a self-administered general information questionnaire. Student nurses' expectancy and value aspects of motivation for choosing gerontological nursing as a career were both at a moderate level; the highest value they held was of personal interest. Clinical practice environment, anxiety about aging and the attitudes about geriatrics were the main factors influencing student nurses' motivation to choose gerontological nursing as a career in China. It is imperative for nurse educators to improve the gerontological nursing clinical practice environment for student nurses. Moreover, cultivating student nurses' positive attitudes about geriatrics and relieving anxiety about aging could be beneficial. Copyright © 2015. Published by Elsevier Ltd.

  4. Associations of Various Health-Ratings with Geriatric Giants, Mortality and Life Satisfaction in Older People

    DEFF Research Database (Denmark)

    Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn

    2016-01-01

    -rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus...... Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms...

  5. Geriatric simulation: practicing management and leadership in care of the older adult.

    Science.gov (United States)

    Miller, Sally; Overstreet, Maria

    2015-06-01

    According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Attitudes of Nursing Facilities' Staff Toward Pharmacy Students' Interaction with its Residents.

    Science.gov (United States)

    Adkins, Donna; Gavaza, Paul; Deel, Sharon

    2017-06-01

    All Appalachian College of Pharmacy second-year students undertake the longitudinal geriatric early pharmacy practice experiences (EPPE) 2 course, which involves interacting with geriatric residents in two nursing facilities over two semesters. The study investigated the nursing staff's perceptions about the rotation and the pharmacy students' interaction with nursing facility residents. Cross-sectional study. Academic setting. 63 nursing facility staff. A 10-item attitude survey administered to nursing staff. Nursing staff attitude toward pharmacy students' interaction with geriatric residents during the course. Sixty-three responses were received (84% response rate). Most respondents were female (95.2%), who occasionally interacted with pharmacy students (54.8%) and had worked at the facilities for an average of 6.8 years (standard deviation [SD] = 6.7) years. Staff reported that pharmacy students practiced interacting with geriatric residents and nursing facility staff, learned about different medications taken by residents as well as their life as a nursing facility resident. In addition, the student visits improved the mood of residents and staff's understanding of medicines, among others. Staff suggested that students spend more time with their residents in the facility as well as ask more questions of staff. The nursing facility staff generally had favorable attitudes about pharmacy students' visits in their nursing facility. Nursing facility staff noted that the geriatric rotation was a great learning experience for the pharmacy students.

  7. Feasibility and Impact of Telemonitor-Based Depression Care Management for Geriatric Homecare Patients

    Science.gov (United States)

    Rabinowitz, Terry; Lotterman, Jennifer; Reilly, Catherine F.; Brown, Suzanne; Donehower, Patricia; Ellsworth, Elizabeth; Amour, Judith L.; Bruce, Martha L.

    2011-01-01

    Abstract Objective The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services. Materials and Methods Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM and received biweekly supervision. On-site trained research assistants conducted in-home research interviews on depression diagnosis and severity and patient satisfaction with the protocol. Results An ethnically diverse sample of 48 English- and Spanish-only–speaking patients participated, along with seven telehealth nurses. Both patients and telehealth nurses reported high levels of protocol acceptance. Among 19 patients meeting diagnostic criteria for major depression, the mean depression severity was in the “markedly severe” range at baseline and in the “mild” range at follow-up. Conclusions Results of this pilot support the feasibility of using homecare's existing telemonitoring technology to deliver DCM to their elderly homebound patients. This was true for both English- and Spanish-speaking patients. Preliminary clinical outcomes suggest improvement in depression severity, although these findings require testing in a randomized clinical trial. Implications for the science and service of telehealth-based depression care for elderly patients are discussed. PMID:21780942

  8. The Future of Gero-Oncology Nursing.

    Science.gov (United States)

    Kagan, Sarah H

    2016-02-01

    To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Factores de riesgo psicosociales en el profesorado de Enfermería Geriátrica de universidades españolas (2.ª parte Psychosocial risk factors in the faculty of Nursing Geriatric universities Spanish (Part 2

    Directory of Open Access Journals (Sweden)

    M.ª Jesús Rojas Ocaña

    2011-06-01

    evaluations suffered this group are important aspects that exert great influence on psychological well-being and directly affect physical health. The objective of our study is an assessment of psychosocial factors in a group of university professors in the Degree in Nursing, through the vehicle ISTAS21 a tool for risk assessment of psychosocial work that supports a methodology for prevention half version. The problems encountered are exhibitions including the double presence, quantity and cognitive psychological demands, requiring all early interventions to prevent health problems.

  10. Factores de riesgo psicosociales en el profesorado de Enfermería Geriátrica de universidades españolas (1ª parte Psychosocial risk factors in the faculty of Nursing Geriatric universities Spanish (Part 1

    Directory of Open Access Journals (Sweden)

    Mª. Jesús Rojas Ocaña

    2010-12-01

    evaluations suffered this group are important aspects that exert great influence on psychological well-being and directly affect physical health. The objective of our study is an assessment of psychosocial factors in a group of university professors in the Degree in Nursing, through the vehicle ISTAS21 a tool for risk assessment of psychosocial work that supports a methodology for prevention half version. The problems encountered are exhibitions including the double presence, quantity and cognitive psychological demands, requiring all early interventions to prevent health problems.

  11. Geriatric oral and maxillofacial dysfunctions in the context of geriatric syndrome.

    Science.gov (United States)

    Nam, Y; Kim, N-H; Kho, H-S

    2018-04-01

    To propose the application of the concept of geriatric syndrome for common geriatric oral and maxillofacial dysfunctions and to suggest the necessity of developing effective evaluation methods for oral and maxillofacial frailty. The concepts of frailty and geriatric syndrome based on multi-morbidity and polypharmacy were applied to five common geriatric oral medicinal dysfunctional problems: salivary gland hypofunction (dry mouth), chronic oral mucosal pain disorders (burning mouth symptoms), taste disorders (taste disturbances), swallowing disorders (dysphagia), and oral and maxillofacial movement disorders (oromandibular dyskinesia and dystonia). Each of the dysfunctions is caused by various kinds of diseases and/or conditions and medications, thus the concept of geriatric syndrome could be applied. These dysfunctions, suggested as components of oral and maxillofacial geriatric syndrome, are associated and interacted with each other in a complexity of vicious cycle. The resulting functional impairments caused by this syndrome can cause oral and maxillofacial frailty. Geriatric oral and maxillofacial dysfunctions could be better appreciated in the context of geriatric syndrome. The development of effective methods for evaluating the severity of these dysfunctions and the resulting frailty is essential. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Comprehensive geriatric assessment : recognition of identified geriatric conditions by community-dwelling older persons

    NARCIS (Netherlands)

    van Rijn, Marjon; Suijker, Jacqueline J.; Bol, Wietske; Hoff, Eva; ter Riet, Gerben; de Rooij, Sophia E.; van Charante, Eric P. Moll; Buurman, Bianca M.

    2016-01-01

    Objectives: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. Methods: trained

  13. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    Science.gov (United States)

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on internal medicine…

  14. Effect of Physician Delegation to Other Healthcare Providers on the Quality of Care for Geriatric Conditions.

    Science.gov (United States)

    Lichtenstein, Brian J; Reuben, David B; Karlamangla, Arun S; Han, Weijuan; Roth, Carol P; Wenger, Neil S

    2015-10-01

    The quality of care of older adults in the United States has been consistently shown to be inadequate. This gap between recommended and actual care provides an opportunity to improve the value of health care for older adults. Prior work from the Assessing Care of Vulnerable Elders (ACOVE) investigators first defined, and then sought to improve, clinical practice for common geriatric conditions. A critical component of the ACOVE intervention for practice improvement was an emphasis on the delegation of specific care processes, but the independent effect of delegation on the quality of care has not been evaluated. This study analyzed the pooled results of prior ACOVE projects from 1998 to 2010. Totaled, these studies included 4,776 individuals aged 65 and older of mixed demographic backgrounds and 16,204 ACOVE quality indicators (QIs) for three geriatric conditions: falls, urinary incontinence, and dementia. In unadjusted analyses, QI pass probabilities were 0.36 for physician-performed tasks, 0.55 for nurse practitioner (NP)-, physician assistant (PA)-, and registered nurse (RN)-performed tasks; and 0.61 for medical assistant- and licensed vocational nurse-performed tasks. In multiply adjusted models, the independent pass-probability effect of delegation to NPs, PAs, and RNs was 1.37 (P = .05). These findings suggest that delegation of selected tasks to nonphysician healthcare providers is associated with higher quality of care for these geriatric conditions in community practices and supports the value of interdisciplinary team management for common outpatient conditions in older adults. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  15. Senile anorexia in different geriatric settings in Italy.

    Science.gov (United States)

    Donini, L M; Dominguez, L J; Barbagallo, M; Savina, C; Castellaneta, E; Cucinotta, D; Fiorito, A; Inelmen, E M; Sergi, G; Enzi, G; Cannella, C

    2011-11-01

    Anorexia is the most frequent modification of eating habits in old age, which may lead to malnutrition and consequent morbidity and mortality in older adults. We aimed to estimate the prevalence and factors associated to anorexia in a sample of Italian older persons living in different settings. Our secondary aim was to evaluate the impact of senile anorexia on nutritional status and on eating habits, as well as on functional status. Observational study in nursing homes, in rehabilitation and acute geriatric wards, and in the community in four Italian regions (Lazio, Sicily, Emilia-Romagna, and Veneto). 526 over 65 years old participants were recruited; 218 free-living subjects, 213 from nursing homes, and 96 patients from rehabilitation and acute geriatric wards in the context of a National Research Project (PRIN) from the Italian Ministry of Instruction, University and Research (2005-067913 "Cause e Prevalenza dell'Anoressia senile"). Anthropometric and nutritional evaluation, olfactory, chewing, and swallowing capacity, food preferences, cognitive function, functional status, depression, quality of life, social aspects, prescribed drugs, and evaluation of gastrointestinal symptoms and pain. Laboratory parameters included prealbumin, albumin, transferrin, C-reactive protein, mucoprotein, lymphocyte count, as well as neurotransmitters leptin, and ghrelin. Anorexia was considered as ≥50% reduction in food intake vs. a standard meal (using 3-day "Club Francophone de Gériatrie et Nutrition" form), in absence of oral disorders preventing mastication. The overall prevalence of anorexia was 21.2% with higher values among hospitalized patients (34.1% women and 27.2% men in long-term facilities; 33.3% women and 26.7% men in rehabilitation and geriatric wards; 3.3% women and 11.3% men living in the community) and in the oldest persons. Anorexic subjects were significantly less self-sufficient and presented more often a compromised nutritional and cognitive status. Diet

  16. Alternative route of process modification for biofuel production by embedding the Fischer–Tropsch plant in existing stand-alone power plant (10 MW) based on biomass gasification – Part I: A conceptual modeling and simulation approach (a case study in Thailand)

    International Nuclear Information System (INIS)

    Hunpinyo, Piyapong; Cheali, Peam; Narataruksa, Phavanee; Tungkamani, Sabaithip; Chollacoop, Nuwong

    2014-01-01

    Graphical abstract: SynBiofuel production through existing gasification plants in Thailand, using waste agricultural biomass as raw material, was studied. The process design was initiated conceptually in the areas of gas phase reaction system via Fischer-Tropsch (FT) synthesis. The development of FT configurations on syngas conversion to transportation fuels (e.g., diesel range) was investigated. In order to develop a techno-economic assessment, the three different capacities corresponding to 1 MW, 2 MW and 3 MW based on thermal input of syngas were evaluated. Once-through FT concept was proposed in which the unconverted syngas was combusted with air in an externally fired gas turbine (EFGT) to produce surplus electricity. The results of process simulation were discussed open-mindedly including the overall plant design and energy efficiency. Preliminary economics, and some site specific situations under which additional capital cost savings on existing infrastructure was realized. - Highlights: • Experimental results were used and integrated with a reactor model for SynBiofuel. • Process simulation with the lumped reaction rate was used to achieve accurate results. • Process simulation was performed using ASPEN Plus to design FT configurations. • Maximum energy FT efficiency was approximately 37%. • Economic potential was computed by ROI and PBP resulting in the attractive solutions. - Abstract: The utilization of syngas shows a highly potential to improve the economic potential of the stand-alone power unit-based gasification plants as well as enhancing the growing demand of transportation fuels. The thermochemical conversion of biomass via gasification to heat and power generations from the earlier study is further enhanced by integrating Fischer–Tropsch (FT) synthesis with the existing gasification pilot scale studied previously. To support the potential and perspectives in major economies due to scaling up in developing countries such as Thailand

  17. Evaluation of geriatric changes in dogs

    Directory of Open Access Journals (Sweden)

    Soumyaranjan Pati

    2015-03-01

    Full Text Available Aim: The present study has been envisaged to ascertain the old age for critical management of geriatric dogs considering the parameters of externally visible changes, haemato-biochemical alterations and urine analysis in geriatric dogs approaching senility. Materials and Methods: The study was undertaken in the Department of Veterinary Pathology in collaboration with Teaching Veterinary Clinic complex spanning a period of 1 year. For screening of geriatric dogs, standard geriatric age chart of different breeds was followed. The external characteristics such as hair coat texture, dental wear and tear, skin texture and glaucoma were taken as a marker of old age. Haematology, serum biochemistry and urine analysis were also included in the study. Results: External visible changes like greying of hair, dull appearance of hair coat, glaucoma, osteoarthritis, dental wear and tear were commonly encountered in the aged dogs. The haemoglobin, total erythrocyte count and packed cell volume showed a decreasing trend in the geriatric groups. Biochemical values like total protein, albumin, calcium level showed a decreasing trend while urea level with an increasing trend in geriatric dogs without any much alteration in serum glutamicoxaloacetic transaminse, serum glutamic-pyruvate transaminase, cholesterol and creatinine. Physical examination of urine revealed yellow, amber, red, deep red color with turbidity and higher specific gravity. Chemical examination revealed presence of protein, glucose, ketone bodies, blood and bilirubin on some cases. The culture and sensitivity test of the urine samples revealed presence of bacteria with sensitive and resistance to some antibiotics. Conclusion: External visible changes are still the golden standard of determining the old age in dogs. Haemato-biochemical evaluation can be useful for correlating with the pathophysiological status of the animal. Biochemical analysis of urine can be employed rightly as kidney

  18. Nutritional screening and perceived health in a group of geriatric rehabilitation patients.

    Science.gov (United States)

    Söderhamn, Ulrika; Bachrach-Lindström, Margareta; Ek, Anna-Christina

    2007-11-01

    (i) To perform a nutritional screening using the Nutritional Form For the Elderly and relate the results to perceived health in a group of geriatric rehabilitation patients; and (ii) to compare the screening results and nurses' nutritional notes in the nursing documentation. Undernutrition is an under-recognized problem among older patients. Using a screening instrument is a way to detect patients at risk for undernutrition. A cross-sectional study conducted in Sweden. A sample of 147 geriatric rehabilitation patients was consecutively included and was interviewed with the screening instrument, questions about background variables, perceived health and health-related issues. Higher screening scores indicate higher risk for undernutrition. Parametric and nonparametric statistical tests were used. When nurses' nutritional notes in the nursing documentation were corresponding to the content in any of the response alternatives for each screening item, the notes were marked as existent. The screening results showed that 55% of the patients were at medium risk and 14% at high risk for undernutrition. Patients in perceived ill health had higher screening scores than those in perceived good health. Associations were also found between receiving help, perceiving helplessness, not being active and not feeling satisfied and higher screening scores. The content of nine of 15 items in the instrument was mentioned in a number of nursing records. The prevalence of older patients at medium or high risk for undernutrition was high. To be at high risk for undernutrition was associated with perceived ill health. Nurses' nutritional notes in the nursing documentation showed deficiencies, indicating that all patients at medium or high risk for undernutrition were not identified. The results suggest that nurses need a screening instrument to highlight older nutritional at-risk patients in need of further awareness and investigation.

  19. Diagnósticos de enfermagem identificados em idosos hospitalizados: associação com as síndromes geriátricas Diagnósticos de enfermería identificados en ancianos hospitalizados: asociación con las síndromes geriátricas Nursing diagnoses identified in hospitalized elderly: association with geriatrics' syndromes

    Directory of Open Access Journals (Sweden)

    Renata Miranda de Sousa

    2010-12-01

    promedio dos síndromes se producen en personas de edad avanzada, aumentando el riesgo de debilidad, y por lo tanto la probabilidad de complicaciones, mayor costo, y las readmisiones. CONCLUSIÓN: Por lo tanto la atención de enfermería para ancianos hospitalizados dirigidas a facilitar la identificación de riesgos potenciales, con el fin de propiciar la independencia y el mantenimiento de la autonomía, para reducir las complicaciones, el tiempo de hospitalización y futuros reingresos.OBJECTIVE: Identify and analyze the nursing diagnoses relates to the presence of geriatric syndromes in hospitalized elderly. METHODS: This is a study of a quantitative approach, using researching techniques, semi-structured interviews and specific forms from gerontology. The subjects were 66 individuals over 65 years old, admitted to the clinical and surgical units of the University Hospital Antonio Pedro, Niterói-RJ, Brazil. RESULTS: We identified 394 nursing diagnoses related to five major geriatric syndromes, Social Isolation 129 (32,8%, Iatrogenic 113 (28,6%, Postural Instability 81 (20,6% Cerebral Insufficiency 44 (11,1%, and Urinary Incontinence 27 (6,9%. DISCUSSION: We can infer that on average two syndromes occur in elderly, increasing the risk of weakness, and consequently the likelihood of complications, increased cost, and re-admissions. CONCLUSION: Therefore nursing care for hospitalized elderly should be directed to facilitate the identification of potential risks, in order to promote independence and the maintenance of autonomy, to reduce complications, hospitalization time and future re-admissions.

  20. Mortality after trauma laparotomy in geriatric patients.

    Science.gov (United States)

    Joseph, Bellal; Zangbar, Bardiya; Pandit, Viraj; Kulvatunyou, Narong; Haider, Ansab; O'Keeffe, Terence; Khalil, Mazhar; Tang, Andrew; Vercruysse, Gary; Gries, Lynn; Friese, Randall S; Rhee, Peter

    2014-08-01

    Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy. A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006-2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality. A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2-4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy. Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies. Published by Elsevier Inc.

  1. Nutrition and feeding of the geriatric horse.

    Science.gov (United States)

    Siciliano, Paul D

    2002-12-01

    Little is known regarding nutrient requirements and feeding of geriatric horses, and more effort should be placed on this area of equine nutrition research. That which is known suggests that some geriatric horses may not have different requirements than other mature horses, whereas others affected by disease or poor dentition may have special nutritional needs. In general, rations for geriatric horses should be based on high-quality roughage supplemented with complementary minerals and vitamins. The need for additional energy aside from that provided by the forage can be supplied by adding energy concentrates, such as cereal grains or fat, to the ration. Processing techniques involving heat, such as pelleting and extruding, are advised when cereal grains are included in the ration so as to improve starch digestibility in the small intestine and avoid starch overload in the hindgut and it subsequent problem (ie, colic, laminitis). In addition, the environment in which geriatric horses are fed should be one that promotes ease of ration consumption and eliminates factors thar impair feed consumption, such as competition from other horses and the need to travel relatively long distances (eg, grazing marginal pastures). Finally, strict attention should be paid to the body condition of geriatric horses so as to evaluate adequacy of the ration and the general health of the horse.

  2. Early geriatric consultation increases adherence to TQIP Geriatric Trauma Management Guidelines.

    Science.gov (United States)

    Southerland, Lauren T; Gure, Tanya R; Ruter, Daniel I; Li, Michael M; Evans, David C

    2017-08-01

    The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation. Secondary analyses evaluated adherence by service: trauma service (Trauma) or a trauma service with early geriatric consultation (GeriTrauma). The average age of the 245 patients was 76.7 years, 47% were women, and mean Injury Severity Score was 9.5 (SD ±8.1). Implementation of the GeriTrauma collaborative increased geriatric consultation rates from 2% to 48% but had minimal effect on overall adherence to TQIP quality measures. A secondary analysis comparing those in the post implementation group who received geriatric consultation (n = 94) to those who did not (n = 103) demonstrated higher rates of delirium diagnosis (36.2% vs 14.6%, P quality indicators is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. The oncologic and the geriatric patient

    International Nuclear Information System (INIS)

    Philotheou, Geraldine M

    2002-01-01

    The oncologic and the geriatric patient have special needs in the nuclear medicine department. The nuclear medicine technologists must be knowledgeable and compassionate when dealing with these patients. The diagnosis of cancer will have a sociological and psychological impact on the patient, to which the technologist must relate in an empathetic way. Furthermore, the technologist should take cognisance of the patient's physical condition and be able to modify the examination accordingly. Dealing with the geriatric patient should be correctly placed on the continuum between a gerontological and geriatric approach taking into consideration normal changes due to aging. The patient experience when undergoing the high technology nuclear medicine diagnostic procedure is unique and all effort must be made to ensure the success of the examination and the satisfaction of the patient (Au)

  4. Co-creation by the ABIM Geriatric Medicine Board and the AGS - Helping Move Geriatrics Forward.

    Science.gov (United States)

    Leff, Bruce; Lundjeberg, Nancy E; Brangman, Sharon A; Dubow, Joyce; Levine, Sharon; Morgan-Gouveia, Melissa; Schlaudecker, Jeffrey; Lynn, Lorna; McDonald, Furman S

    2017-10-01

    The American board of internal medicine (ABIM) establishes standards for physicians. The American geriatrics society (AGS) is a not-for-profit membership organization of nearly 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. Beginning in 2013, ABIM redesigned its governance structure, including the role of the specialty boards. Specialty boards are charged with responsibilities for oversight in four main areas: (1) the assessments used in initial certification and maintenance of certification (MOC); (2) medical knowledge self-assessment and practice assessment in the specialty; (3) building relationships with relevant professional societies and other organizational stakeholders; and (4) issues related to training requirements for initial certification eligibility within the specialty. The aim of this paper is to inform the geriatrics community regarding the function of geriatric medicine board (GMB) of the ABIM, and to invite the geriatrics community to fully engage with and leverage the GMB as a partner to: (1) develop better certification examinations and processes, identifying better knowledge and practice assessments, and in establishing appropriate training and MOC requirements for geriatric medicine; (2) leverage ABIM assets to conduct applied research to guide the field in the areas of training and certification and workforce development in geriatric medicine; (3) make MOC relevant for practicing geriatricians. Active engagement of the geriatrics community with ABIM and the GMB will ensure that certification in geriatric medicine provides the greatest possible value and meaning to physicians, patients, and the public. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  5. Prevalence and determinants for malnutrition in geriatric outpatients

    NARCIS (Netherlands)

    van Bokhorst-de van der Schueren, M.A.E.; Lonterman-Monasch, S.; de Vries, O.J.; Danner, S.A.; Kramer, M.H.H.; Muller, M.

    2013-01-01

    Background & aims: Few data is available on the nutritional status of geriatric outpatients. The aim of this study is to describe the nutritional status and its clinical correlates of independently living geriatric older individuals visiting a geriatric outpatient department. Methods: From 2005 to

  6. The relationship between geriatric depression and health-promoting behaviors among community-dwelling seniors.

    Science.gov (United States)

    Chang, Chyong-Fang; Lin, Mei-Hsiang; Wang, Jeng; Fan, Jun-Yu; Chou, Li-Na; Chen, Mei-Yen

    2013-06-01

    People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

  7. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients.

    Directory of Open Access Journals (Sweden)

    Liesbeth Hempenius

    Full Text Available The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined.A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life.Data of 260 patients (intervention n = 127, Control n = 133 were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02-6.88, an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02-5.87 and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07-0.49.A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed.Nederlands Trial Register, Trial ID NTR 823.

  8. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients.

    Science.gov (United States)

    Hedman, S; Nydahl, M; Faxén-Irving, G

    2016-06-01

    Malnutrition is a well-recognized problem in geriatric patients. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients. The objective of this study was to investigate routines regarding dietary prescriptions and monitoring of food intake in geriatric patients and to see how well the prescribed diet conforms to the patients' nutritional status and ability to eat. A further aim was to identify the most common reasons and factors interacting with patients not finishing a complete meal. This study combines two methods using both qualitative and quantitative analysis. Patients (n = 43; 82.5 ± 7.5 yrs; 60% females) at four geriatric wards performed a two-day dietary record, assisted by a dietician. Nurses and assistant nurses at each ward participated in a semi-structured interview regarding prescription of diets and portion size for the patients. The prescribed diet differed significantly (P nutritional status and ability to eat. Only 30% of the patients were prescribed an energy-enriched diet in contrast to 60% that was in need of it. The most common reason for not finishing the meal was lack of appetite. Diet prescription for the patient was based upon information about eating difficulties identified in the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and the type of diet that was prescribed on a previous ward. Monitoring of the patients' food intake was described as a continuous process discussed daily between the staff. Patients' nutritional status and to what extent they were able to eat a complete meal was not routinely considered when prescribing food and monitoring food intake in this study. By making use of this information the diet could be tailored to the patients' needs, thereby improving their nutritional treatment. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  9. [Nutritional status of Cuban elders in three different geriatric scenarios: community, geriatrics service, nursery home].

    Science.gov (United States)

    González Hernández, Alina; Cuyá Lantigua, Magdalena; González Escudero, Hilda; Sánchez Gutiérrez, Ramón; Cortina Martínez, Rafael; Barreto Penié, Jesús; Santana Porbén, Sergio; Rojas Pérez, Alberto

    2007-09-01

    The undernutrition rates observed in Cuban elders surveyed in three different geriatric scenarios: Community: coastal town of Cojímar (City of Havana); Geriatrics Service ("Hermanos Ameijeiras" Hospital, City of Havana); and Nursery Home (city of Cárdenas, province of Matanzas) by means of the Mini Nutritional Assessment (MNA) of the Elderly are presented. Undernutrition rates were 2.7% among elders surveyed in the coastal community of Cojímar, but increased to become 91.6% among those admitted to the hospital Geriatrics Service, and 95.3% for those institutionalized in the Nursery Home, respectively. The occurrence of undernutrition can be low among elders living freely in the community, but it might affect a vast number of those seeking medical assistance at the public health institutions. Extent of undernutrition among elders in geriatric assistance scenarios should lead to the adoption of the required measures for early identification, and timely treatment, of this health problem.

  10. Experience with dedicated geriatric surgical consult services: Meeting the need for surgery in the frail elderly

    Directory of Open Access Journals (Sweden)

    Rosemarie E Hardin

    2009-01-01

    in this population such as dementia, end stage disease, multiple comorbidities, polypharmacy, decreased functional and nutritional status are not frequently encountered by general surgeons. But the surgery is safe, and survival data is comparable to those in geriatric centers who did not undergo surgery. A multidisciplinary team approach gives the most effective care, with a primary goal of palliation.Keywords: surgery in the elderly, geriatrics, surgical consultations, nursing home residents, congestive heart failure, frailty, palliative care, dementia, coronary artery disease, survival

  11. Geriatric-focused educational offerings in the Department of Veterans Affairs from 1999 to 2009.

    Science.gov (United States)

    Thielke, Stephen; Tumosa, Nina; Lindenfeld, Rivkah; Shay, Kenneth

    2011-01-01

    The scope of geriatrics-related educational offerings in large health care systems, in either the target audiences or topics covered, has not previously been analyzed or reported in the professional literature. The authors reviewed the geriatrics-related educational sessions that were provided between 1999 and 2009 by the Geriatrics Research, Education, and Clinical Centers (GRECCs) and the Employee Education System (EES) of the United States' largest integrated health care system, the Veterans Health Administration (VHA). Using records of attendance and content at local training events and regional and national conferences, the authors estimated the number of attendees in different health disciplines and the number and types of lectures. During the past 11 years, GRECCs and EES provided geriatric-related educational sessions to about one third of a million attendees, most of them nurses and physicians, in about 15,000 lectures. About three-fourths of the educational events occurred through local, rather than regional or national, events. Lectures covered a wide variety of topics, with a particular emphasis on dementia and other mental health topics. A comparison of the number of potential learners in VHA with the number of geriatric-related educational presentations over this time period yields an average of one offering per VHA provider every 3 years; most providers likely never received any. Since 1999 the GRECCs have been the dominant source for geriatrics-related education for VHA health professionals, but given that about one half of VHA patients are older than age 65, there is still a large unmet need to provide geriatric education to VHA providers. Examination of the GRECC resources that have been put to use in the past to develop and deliver the face-to-face education experiences described sheds light on the magnitude of resources that might be required to address remaining unmet need in the future, and supports the prediction that there will need to be

  12. Poor oral health, a potential new geriatric syndrome.

    Science.gov (United States)

    van der Putten, Gert-Jan; de Baat, Cees; De Visschere, Luc; Schols, Jos

    2014-02-01

    This article presents a brief introduction to the medical aspects of ageing and age-related diseases, and to some geriatric syndromes, followed by a discussion on their impact on general and oral healthcare provision to community-dwelling older people. Recent investigations suggest that inflammation constitutes a biological foundation of ageing and the onset of age-related diseases. Multimorbidity and polypharmacy, together with alterations in pharmacokinetics and pharmacodynamics, make older people at risk of adverse medication reactions. A side effect of several medications is causing xerostomia and hyposalivation, and both the type and number of medications used are relevant. New options of general healthcare provision to community-dwelling older people are the use of mobility aids and assistive technology devices, domiciliary health care, respite care and telecare. Their oral health status may be jeopardised by frailty, disability, care dependency and limited access to professional oral health care. Recommendations for improvement are the following: better integrating oral health care into general health care, developing and implementing an oral healthcare guideline, providing customised oral hygiene care aids, domiciliary oral healthcare provision, visiting dental hygienists and/or nurses, oral hygiene telecare, easily and safely accessible dental offices, transforming dentistry into medical oral health care and upgrading dentists to oral physicians. In case oral healthcare providers do not take the responsibility of persuading society of the importance of adequate oral health, weakened oral health of community-dwelling older people will become a potential new geriatric syndrome. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  13. Impaired nutritional status in geriatric trauma patients.

    Science.gov (United States)

    Müller, F S; Meyer, O W; Chocano-Bedoya, P; Schietzel, S; Gagesch, M; Freystaetter, G; Neuhaus, V; Simmen, H-P; Langhans, W; Bischoff-Ferrari, H A

    2017-05-01

    Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score23.5=normal). At the same examination, we assessed mental (Geriatric Depression Scale; GDS) and cognitive function (Mini-Mental State Examination; MMSE), frailty status (Fried Scale), and number of comorbidities and medications. Further, discharge destination was documented. All analyses were adjusted for age and gender. A total of 7.1% of patients were malnourished and 49.1% were ARM. Patients with reduced mental health (GDS⩾5: 30.5 vs 11.5%; P=0.004), impaired cognitive function (MMSE⩽26: 23.6±0.5 vs 26.0±0.6; P=0.004), prevalent frailty (32.5 vs 8%; Pnutritional status (M+ARM). Further, M+ARM patients were twice as likely to be discharged to destinations different to home (odds ratio=2.08; confidence interval 1.07-4.05). In this consecutive sample of geriatric trauma patients, 56.2% had an M+ARM upon admission to acute care, which was associated with indicators of worse physical, mental and cognitive health and predicted a more than twofold greater odds of being discharged to a destination other than home.

  14. The Magnitude of Atherogenic Dyslipidaemia among Geriatric ...

    African Journals Online (AJOL)

    BACKGROUND: The relevance of dyslipidaemia in the management of cardiovascular diseases especially hypertension is an important health care challenge that is increasing worldwide. Of great concern in Nigeria is that most geriatric hypertensives with dylipidaemia are not routinely diagnosed and therefore do not ...

  15. Geriatric Optometry--Today and Tomorrow.

    Science.gov (United States)

    Verma, Satya B.

    1982-01-01

    Although there is some geriatric content in optometry curriculum, such as pathology and diseases associated with aging, the emphasis would be better placed on aging as a normal process. Further education about the elderly population as a whole and further legislation for comprehensive care are needed. (MSE)

  16. Geriatric oral health issues in India.

    Science.gov (United States)

    Shah, N

    2001-06-01

    An overview of the demographics and oral health status of the elderly population of India is presented. India is a vast country with a population of one billion people. Of this, people older than 60 years constitute 7.6%, which in actual number is 76 million. There are several factors that affect the oral health of elderly. The dentist:population ratio is 1:27,000 in urban areas and 1:300,000 in rural areas, whereas 80% of the elderly population reside in rural India. Forty per cent of the elderly live below the poverty line and 73% are illiterate. Ninety per cent of the elderly have no social security and the dependency ratio is 12.26. Incidence of oral cancer, which is considered an old-age disease, is highest in India, 13.5% of all body cancers are oral cancers. Preventive dental care is almost nonexistent to the rural masses and very limited in urban areas. Above all, there is no orientation of dental graduates towards the special needs of the geriatric population. Recommendations include: the establishment of Continuing Dental Education programmes on geriatric oral care; inclusion of a geriatric component in undergraduate and postgraduate curricula; initiation of a diploma, certificate and degree courses in geriatric dentistry; research on various aspects of ageing and age-related oral health problems; provision of preventive and curative treatment for various oral diseases to the elderly.

  17. Hierachy of needs of geriatric patients.

    Science.gov (United States)

    Majercsik, E

    2005-01-01

    The aim of the study is to contribute to the improvement of the quality of care of geriatric patients. In order to be able to improve the geriatric care we have to know clearly the needs of the elderly patients. The hierarchy of needs of geriatric patients in clinical circumstances had to be assessed by a psychometric technique based on a motivational approach. The process was based on the method of paired comparisons, and a duly composed questionnaire was administered to the geriatric patients who were proven to have consistent thinking and surpassed a pre-established threshold in the Mini Mental State Examination. The evaluation of the responds leads to a numerical derivation (on an interval scale) of the hierarchy of needs. The received hierarchy of needs proved to oppose the general hypothesis of Maslow's motivation theory. This may induce a necessary shift in the approach to the care of the elderly, and accentuate the self-actualization and esteem needs beside the overtly emphasized physiological care. Copyright (c) 2005 S. Karger AG, Basel

  18. Comanagement of Geriatric Patients With Hip Fractures

    Science.gov (United States)

    Rocca, Gregory J. Della; Moylan, Kyle C.; Crist, Brett D.; Volgas, David A.; Stannard, James P.; Mehr, David R.

    2013-01-01

    The objective of this 3-year retrospective, controlled, cohort study is to characterize an interdisciplinary method of managing geriatric patients with hip fracture. All patients aged 65 years or older admitted to a single academic level I trauma center during a 3-year period with an isolated hip fracture were included as participants for this study. Thirty-one geriatric patients with hip fracture were treated with historical methods of care (cohort 1). The comparison group of 115 similar patients was treated under a newly developed, institutional comanagement hip fracture protocol (cohort 2). There were no differences in age, sex distribution, or comorbidity distribution between the 2 cohorts. Patients requiring intensive care unit (ICU) admission decreased significantly from 48% in cohort 1 to 23% in cohort 2 (P = .0091). Length of ICU stay for patients requiring ICU admission also decreased significantly, from a mean of 8.1 days in cohort 1 to 1.8 days in cohort 2 (P = .024). Total hospital stay decreased significantly, from a mean of 9.9 days in cohort 1 to 7.1 days in cohort 2 (P = .021). Although no decrease in in-hospital mortality rates was noted from cohort 1 to cohort 2, a trend toward decreased 1-year mortality rates was seen after implementation of the hip fracture protocol. Hospital charges decreased significantly, from US$52 323 per patient in cohort 1 to US$38 586 in cohort 2 (P = .0183). Implementation of a comanagement protocol for care of geriatric patients with hip fracture, consisting of admission to a geriatric primary care service, standardized perioperative assessment regimens, expeditious surgical treatment, and continued primary geriatric care postoperatively, resulted in reductions in lengths of stay, ICU admissions, and hospital costs per patient. On an annualized basis, this represented a savings of over US$700 000 for our institution. PMID:23936734

  19. Systematic review of traditional Chinese medicine for geriatrics.

    Science.gov (United States)

    Takayama, Shin; Iwasaki, Koh

    2017-05-01

    The Japan Geriatrics Society revised its criteria for the medical treatment and safety of the elderly in 2015. The Japan Geriatrics Society guidelines contain a chapter for traditional Chinese medicine (TCM; traditional medicines in East Asian countries, such as China, Japan, Korea, Taiwan, Vietnam and Singapore), because it is widely used for elderly patients and is sometimes covered by national medical insurance in Japan. The updated guidelines should be improved based on a comprehensive, systematic review and evidence grading. TCM is rapidly expanding in the literature, and is under intensive investigation in clinical trials. The objective of the present trial was to review TCM systematically and reflect the results to update the TCM chapter of the Japan Geriatrics Society guidelines. Here, we introduce the results of the systemic review of TCM for geriatrics. Geriatr Gerontol Int 2017; 17: 679-688. © 2016 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  20. Home hospitalization in the spectrum of community geriatric care.

    Science.gov (United States)

    Stessman, J; Hammerman-Rozenberg, R; Cohen, A

    1997-04-01

    The Home Hospitalization Programme was initiated in Jerusalem in 1991 to provide intensive medical care at home in order to prevent or shorten hospitalizations. The programme was based upon regular home visits by physicians, and nursing assessment to determine the need for regular nursing care. Primary-care physicians and nurses were renumerated by a global monthly fee, and were on 24-h call in addition to their periodic visits. Patients were recruited by senior geriatric physicians from acute hospital wards, as well as from the community, at the family doctor's request. Ancillary services available to the home hospitalization team included laboratory and electrocardiographic testing, specialty consultations, physical occupational or speech therapy, social work and home help up to 3 h daily. Monthly visits by a senior physician provided oversight and further consultation. Home hospitalization grew out of the continuing care division of the Clalit Sick Fund, a health maintenance organization providing umbrella medical insurance and ambulatory care. The programme grew synergistically with the other facilities of continuing care to encompass a network of comprehensive services to acute, subacute and chronic patients both at home and in institutional settings. In 4 years this network succeeded in establishing the focus of subacute intensive care in the community, achieving high levels of patient and family satisfaction, as well as striking economic advantages. In its first 2 years of operation home hospitalization saved S4 million due to reduced hospital utilization, and preliminary data for the subsequent 2 years indicated that this trend continued. Home hospitalization became the hub of a far-reaching system of supportive, intensive and humane care in the community.

  1. One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment

    Directory of Open Access Journals (Sweden)

    Daphne Eschbach

    2016-01-01

    Full Text Available Purpose. Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU treatment, including invasive ventilatory management (IVM and hemodiafiltration (CVVHDF, is sparse. Methods. Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA classification, and the Barthel index (BI were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care. Results. 15% were treated > 3 days and 68% 3d cohort were significantly increased (p=0.001. Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort.

  2. End-of-Life Care and Quality of Dying in 23 Acute Geriatric Hospital Wards in Flanders, Belgium.

    Science.gov (United States)

    Verhofstede, Rebecca; Smets, Tinne; Cohen, Joachim; Eecloo, Kim; Costantini, Massimo; Van Den Noortgate, Nele; Deliens, Luc

    2017-04-01

    To describe the nursing and medical interventions performed in the last 48 hours of life and the quality of dying of patients dying in acute geriatric hospital wards. Cross-sectional descriptive study between October 1, 2012 and September 30, 2013. Twenty-three acute geriatric wards in 13 hospitals in Flanders, Belgium. Patients hospitalized for more than 48 hours before dying in the participating wards. Structured after-death questionnaires, filled out by the nurse, the physician, and the family carer most involved in end-of-life care. Main outcome measures were several nursing and medical interventions reported to be performed in the last 48 hours of life and the quality of dying. Of 993 patients, we included 338 (mean age 85.7 years; 173 women). Almost 58% had dementia and nearly half were unable to communicate in the last 48 hours of their life. The most frequently continued or started nursing and medical interventions in the last 48 hours of life were measuring temperature (91.6%), repositioning (83.3%), washing (89.5%), oxygen therapy (49.7%), and intravenous fluids and nutrition (30%). Shortness of breath, lack of serenity, lack of peace, and lack of calm were symptoms reported most frequently by nurses and family carers. Many nursing and medical interventions are continued or started in the last hours of a patient's life, which may not always be in their best interests. Furthermore, patients dying in acute geriatric wards are often affected by several symptoms. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Artrodese cervical anterior em três e quatro níveis com dispositivo intersomático não associado à placa cervical Artrodesis cervical anterior en tres y cuatro niveles con dispositivo intersomático no asociado a placa cervical Anterior cervical arthrodesis for three and four levels using stand-alone interbody cages without cervical plates

    Directory of Open Access Journals (Sweden)

    Marcel Luiz Benato

    2009-06-01

    en tercer y cuarto niveles; dolor axial y/o irradiada; con mínimo seis meses de postoperatorio. El criterio de exclusión fue la presencia de inestabilidad cervical traumática. Fueron evaluadas las tasas de consolidación, la presencia de síntomas, la tasa de complicaciones y la posición de los dispositivos intersomáticos (subsidente después de seis meses. RESULTADOS: todos los pacientes obtuvieron consolidación en tres meses, sin embargo, dos pacientes presentaron el fenómeno de subsidente, o sea, migración con consolidación en cifosis, sin alterar los resultados clínicos y la consolidación de la artrodesis a los seis meses de postoperatorio. Los pacientes presentaron mejoría del dolor preoperatorio y solo tres (15% presentaron dolor residual. No hubo complicaciones mayores. El tiempo de hospitalización fue de dos días. No fue utilizada inmovilización rígida en el postoperatorio. CONCLUSIÓN: fue obtenida consolidación con esta técnica en todos los casos. La técnica se mostró segura y promovió buenos resultados radiológicos y clínicos.evaluate the rates of fusion of the anterior cervical discectomy and arthrodesis for three and four levels using interbody cages (stand-alone without cervical plates six months after post-operative. METHODS: from November 2005 to July 2008, 20 patients were treated as proposed. The inclusion criteria were: cervical degenerative disease of three and four levels; axial and/or irradiated pain at least six months of follow-up. The exclusion criteria were: cervical traumatic instability. The fusion rate, clinical symptoms, rate of complications and the implant position were evaluated six months after post-operative. RESULTS: results were favorable in 100% of the patients, with residual pain in two cases. Fusion was found in 100% of the patients, except for two cases with minimum subsidence and fusion in a slight kyphotic position. There were not significant complications. The discharge of the hospital was performed

  4. International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

    Science.gov (United States)

    Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L.G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

    2014-01-01

    Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base. PMID:25071125

  5. [Geriatric assessment prior to oncological therapy].

    Science.gov (United States)

    Wedding, U

    2013-06-01

    Ageing is the single most important risk factor for cancer. This is also true for most cancer diseases of the genitourinary tract. In combination with the demographic changes in Germany and most other countries, the consequence is a substantial increase in the number of elderly patients with cancer. Most therapies in oncology have a high risk for toxic side effects. Ageing is a very heterogeneous process. The chronological age of a patient insufficiently reflects the individual resources, deficits and risk factors but this can be assessed by a structured geriatric assessment. Integration of geriatric assessment into oncological treatment decisions is still low and is one of the major tasks in cancer care in the future.

  6. Using Facebook Within a Geriatric Pharmacotherapy Course

    Science.gov (United States)

    2010-01-01

    Objective To evaluate using an Internet-based social networking site within an elective geriatric pharmacotherapy course. Design Thirty pharmacy students enrolled in a geriatric pharmacotherapy elective course were invited to join a closed Facebook (Facebook Inc, Palo Alto, CA) group to enhance communication among students and faculty members within the course. Creating a discussion board was the primary activity in the course. Each week, 3 students were assigned to post a healthy aging topic, and other students in the class were expected to post their comments and reactions. The healthy aging topics also were discussed during class. Assessment Students wrote reflections about their experiences using Facebook for the activities within this course. A survey instrument also measured students' opinions about using Facebook for educational purposes. Conclusion Using Facebook allowed students to discuss topics more openly and encouraged classroom discussions of healthy aging topics. PMID:21179256

  7. Using facebook within a geriatric pharmacotherapy course.

    Science.gov (United States)

    Estus, Erica L

    2010-10-11

    To evaluate using an Internet-based social networking site within an elective geriatric pharmacotherapy course. Thirty pharmacy students enrolled in a geriatric pharmacotherapy elective course were invited to join a closed Facebook (Facebook Inc, Palo Alto, CA) group to enhance communication among students and faculty members within the course. Creating a discussion board was the primary activity in the course. Each week, 3 students were assigned to post a healthy aging topic, and other students in the class were expected to post their comments and reactions. The healthy aging topics also were discussed during class. Students wrote reflections about their experiences using Facebook for the activities within this course. A survey instrument also measured students' opinions about using Facebook for educational purposes. Using Facebook allowed students to discuss topics more openly and encouraged classroom discussions of healthy aging topics.

  8. Orthopedic problems in geriatric dogs and cats.

    Science.gov (United States)

    Beale, Brian S

    2005-05-01

    Senior dogs and cats with orthopedic injuries and diseases often require a treatment plan that differs from that of younger patients. Injured bone and soft tissues tend to heal more slowly in the geriatric patient. The older animal is likely to have a less competent immune system and may have compromised metabolic and endocrine function. Pre-existing musculoskeletal problems may make ambulation difficult for an animal convalescing from a new orthopedic problem. Special attention is often needed when treating these patients for fractures, joint instability, infection, and neoplasia. In general, issues that should be addressed in the geriatric patient include reducing intraoperative and anesthesia time, enhancing bone and soft tissue healing, return to early function, control of postoperative pain, physical therapy, and proper nutrition.

  9. Outcomes of Geriatric Burns Treated as Outpatients.

    Science.gov (United States)

    Tanizaki, Shinsuke

    2017-10-01

    Most literature about geriatric burns has focused on inpatient management; therefore, our study investigated the effects of burn characteristics and preexisting medical comorbidities on treatment outcomes for geriatric burn patients treated as outpatients. A retrospective review was conducted for 391 patients over 65 years of age seen in the emergency department of Fukui Prefectural Hospital over a 10-year period. Charts were reviewed for age, sex, burn characteristics, burn mechanisms, preexisting medical comorbidities, and treatment outcomes. Multivariate regression analysis was used to examine the relationship between outcomes of outpatients and comorbidities, which were calculated by the Charlson comorbidity index. Seventy-three patients aged 65 years and older were treated as outpatients at Fukui Prefectural Hospital. The majority (80%) of these patients had burns on less than 5% of their total body surface area. Scald burns accounted for 63% of burn mechanisms, with burns to the lower extremities being the most frequent. The mean percentage of total burn surface area was 4% in the outpatient group and 28% for the inpatient group. The mean time to healing was 24.3 days in outpatients. Of the 73 outpatients, 17 (23%) showed delayed healing. Of these 17 patients, 3 patients experienced wound infection and 2 patients had documented hypertrophic scarring. Four patients ultimately underwent excision and grafting. The common preexisting medical comorbidities in the outpatient group were congestive heart failure and diabetic mellitus. There were no significant differences for medical comorbidities between outpatients and inpatients. The Charlson comorbidity index for outpatients with delayed healing was higher than that for those without delayed healing. The Charlson comorbidity index was associated with delayed healing of outpatients, but age or total burn surface area were not. The characteristics of geriatric burn outpatients were distinct from those of inpatients

  10. [Rational physiotherapy in geriatrics (author's transl)].

    Science.gov (United States)

    Dörfler, R; Seifert, M

    1977-01-01

    According to the economical principle to obtain the highest advantage with the minimalst engagement for the society we passed over in geriatrics from the individual physiotherapy to the therapy in the group, which was very successful in our institution. Four important groups of diseases of the second part of the life have been taken into consideration: Patients with chronic bronchitis, with movement-diseases of the shoulder, the sameone of the hips and the knees and with arterial obturative disease of the extremities.

  11. Redefining the Economics of Geriatric Orthopedics.

    Science.gov (United States)

    Truntzer, Jeremy; Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-12-01

    The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios.

  12. Redefining the Economics of Geriatric Orthopedics

    Science.gov (United States)

    Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-01-01

    Introduction: The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. Materials and Methods: A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. Results: In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. Conclusion: The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios. PMID:26246943

  13. Hemangiosarcoma in a geriatric Labrador retriever

    Science.gov (United States)

    Sharma, Diya

    2012-01-01

    A geriatric Labrador retriever dog was presented for acute collapse. The dog was conscious but lethargic, tachypneic, tachycardic with weak femoral pulses, occasional pulse deficits, and pale mucous membranes. Radiography, ultrasonography, quick assessment tests, and a complete blood (cell) count (CBC)/biochemistry panel indicated internal hemorrhage and potential problems with hemostasis. The dog was euthanized. A necropsy, histopathology, and immunohistochemistry for CD31 and Factor VIII-related antigen cell markers supported a diagnosis of splenic hemangiosarcoma. PMID:23372199

  14. Study of cutaneous manifestations in geriatrics

    OpenAIRE

    Shashikant B. Dhumale; Rajesh Khyalappa

    2016-01-01

    Background: Cutaneous signs and symptoms increases as the age advances. These are physiological as well as pathological changes. They can be due to systemic diseases present in old age. Methods: All the 200 geriatric patients have cutaneous manifestations. Results: Pruritus, eczema, stasis eczema, fungal infections were common. Diabetes was found in large incidence i.e. 27.5%, which show certain skin manifestations like pruritus, skin tag etc. Conclusions: Poor hygiene and systemic ...

  15. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  16. Preparing tomorrow's nursing home nurses: the wisconsin long term care clinical scholars program.

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J

    2015-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This article reports on the development, implementation, and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working both with older adults and in nursing homes, while increasing the capacity of nursing homes to provide a positive student experience.

  17. Geriatric evaluation of oncological elderly patients.

    Science.gov (United States)

    Malaguarnera, Michele; Frazzetto, Paola Mariangela; Erdogan, Ozyalcn; Cappellani, Alessandro; Cataudella, Emanuela; Berretta, Massimiliano

    2013-11-01

    Cancer has a high prevalence in older age. The management of cancer in the older aged person is an increasingly common problem. Age may be construed as a progressive loss of stress tolerance, due to decline in functional reserve of multiple organ systems, high prevalence of comorbid conditions, limited socioeconomic support, reduced cognition, and higher prevalence of depression. In the elderly, the comorbidities and physiological changes in the pharmacokinetics reduce the prospective for therapy and suggest the importance of a multidimensional assessment of cancer patients as well as the formulation of predictive models of risk, in order to estimate the life expectancy and tolerance to treatment. The pharmacological changes of age include decreased renal excretion of drugs and increased susceptibility to myelosuppression, mucositis, cardio toxicity and neurotoxicity. The chemotherapy in patients older than 75 years is very limited. The geriatric assessment is considered a valid tool in geriatric medical. It is important for two main reasons: first of all, for the need to distinguish the features linked to the geriatric syndromes from those ones which are strictly connected to the cancer pathology; secondly, for its potential prognostic value.

  18. Gerontology and geriatrics in Dutch medical education.

    Science.gov (United States)

    Tersmette, W; van Bodegom, D; van Heemst, D; Stott, D; Westendorp, R

    2013-01-01

    The world population is ageing and healthcare services require trained staff who can address the needs of older patients. In this study we determined how current medical education prepares Dutch students of medicine in the field of Gerontology and Geriatrics (G&G). Using a checklist of the essentials of G&G, we assessed Dutch medical education on three levels. On the national level we analysed the latest National Blueprint for higher medical education (Raamplan artsopleiding 2009). On the faculty level we reviewed medical curricula on the basis of interviews with program directors and inspection of course materials. On the student level we assessed the topics addressed in the questions of the cross-institutional progress test (CIPT). The National Bluepr int contains few specific G&G objectives. Obligatory G&G courses in medical schools on average amount to 2.2% of the total curriculum measured as European Credit Transfer System units (ECTS). Only two out of eight medical schools have practical training during the Master phase in the form of a clerkship in G&G. In the CIPT, on average 1.5% of questions cover G&G. Geriatric education in the Netherlands does not seem to be in line with current demographic trends. The National Blueprint falls short of providing sufficiently detailed objectives for education on the care of older people. The geriatric content offered by medical schools is varied and incomplete, and students are only marginally tested on their knowledge of G&G in the CIPT.

  19. Assesment of Disabled Geriatric Health Council Reports

    Directory of Open Access Journals (Sweden)

    Cem Sahin

    2014-12-01

    Full Text Available Aim: In this study it is aimed to evaluate geriatric patients who apply to health council. Material and Method:The study retrospectively assessed 3112 patients admitted to the disability ward, of which 601 geriatric patients were included in the study. Results: Of the 601 patients, 53.1% were men and 46.9% were women. The mean age of these patients was 60 (std ± 18.35 years. Some of the reasons for admission in the hospital were need for social services (45.6% and determination of disability rate (21.6%. Most common diseases in patients aged %u226565 years were hypertension (21.6%, diabetes (12.6%, and chronic obstructive lung disease and dilated cardiomyopathy (3.7%; p 0.05. Internal disability rate was not statistically significant (p > 0.05, but total disability was statistically significant (p < 0.05. Moreover, prevalence of additional conditions was statistically significant (p < 0.05 in patients aged %u226565 years.Discussion: Rapid increases in life expectancy and number of older people has increased the prevalence of disabilities among older people. Being diagnosed with chronic diseases should not be the end of life for geriatric populations. Their mood, social life, general health, and mental profile should progress. Sufficient attention should be paid to the special needs of older patients thereby leading to a wider use of facilities.

  20. Toward the realization of a better aged society: messages from gerontology and geriatrics.

    Science.gov (United States)

    Arai, Hidenori; Ouchi, Yasuyoshi; Yokode, Masayuki; Ito, Hideki; Uematsu, Hiroshi; Eto, Fumio; Oshima, Shinichi; Ota, Kikuko; Saito, Yasushi; Sasaki, Hidetada; Tsubota, Kazuo; Fukuyama, Hidenao; Honda, Yoshihito; Iguchi, Akihisa; Toba, Kenji; Hosoi, Takayuki; Kita, Toru

    2012-01-01

    . (2) Fostering medical specialists for aging Older people often suffer from many diseases, together with geriatric syndromes with multiple etiologies. Signs and symptoms vary according to each individual, and are often atypical; therefore, the patients visit different hospitals and receive many screening tests and prescriptions at the same time. To solve this problem, an effective screening system carried out by a primary-care doctor, and privacy-preserving medical data sharing among hospitals and clinics are needed. In a geriatric clinical setting, health-care professionals should be aware of the physical traits of older people who often develop not only dementia, but also geriatric syndromes, such as depression, falls and urinary incontinence, so that a holistic approach with consideration of nursing care is required. However, the existing Japanese medical education system is not prepared for medical professionals enabled to respond to the aforementioned requirements. Thus, the fostering of medical professionals who can provide comprehensive care - especially for the oldest-old - such as geriatric specialists and medical professionals who understand the principles of elderly care, is urgently needed. (3) Diagnosis of elderly-specific diseases and reform of medical-care services In Japan, the diagnostic system for elderly-specific diseases, including dementia, and reform of medical care services are markedly delayed. The current status concerning diagnosis, care and nursing should be investigated to collect academic data. In order to accumulate evidence for providing safe elderly care and nursing, the promotion of clinical research and a marked expansion of geriatric medical centers with high-level medical services are eagerly awaited. (4) Promotion of home-based care and multidisciplinary care To reduce the length of stay in acute hospitals, to reduce the physical burden of health-care professionals working at acute hospitals and to meet the demand of older people

  1. Why geriatric medicine? A survey of UK specialist trainees in geriatric medicine.

    Science.gov (United States)

    Fisher, James Michael; Garside, Mark J; Brock, Peter; Gibson, Vicky; Hunt, Kelly; Briggs, Sally; Gordon, Adam Lee

    2017-07-01

    there is concern that there are insufficient numbers of geriatricians to meet the needs of the ageing population. A 2005 survey described factors that influenced why UK geriatricians had chosen to specialise in the field-in the decade since, UK postgraduate training has undergone a fundamental restructure. to explore whether the reasons for choosing a career in geriatric medicine in the UK had changed over time, with the goal of using this knowledge to inform recruitment and training initiatives. an online survey was sent to all UK higher medical trainees in geriatric medicine. survey questions that produced categorical data were analysed with simple descriptive statistics. For the survey questions that produced free-text responses, an inductive, iterative approach to analysis, in keeping with the principles of framework analysis, was employed. two hundred and sixty-nine responses were received out of 641 eligible respondents. Compared with the previous survey, a substantially larger number of respondents regarded geriatric medicine to be their first-choice specialty and a smaller number regretted their career decision. A greater number chose geriatric medicine early in their medical careers. Commitments to the general medical rota and the burden of service provision were considered important downsides to the specialty. there are reasons to be optimistic about recruitment to geriatric medicine. Future attempts to drive up recruitment might legitimately focus on the role of the medical registrar and perceptions that geriatricians shoulder a disproportionate burden of service commitments and obligations to the acute medical take. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  2. Factors Influencing Depression among Elderly Patients in Geriatric Hospitals

    OpenAIRE

    Jee, Young Ju; Lee, Yun Bok

    2013-01-01

    [Purpose] The purpose of this study was to investigate the prevalence of depression among elderly patients and identify the factors influencing depression in a geriatric hospital in Korea. [Subjects] A self-report questionnaire was administered to the patients in community geriatric hospitals. Participants were 195 elderly patients. [Methods] The instruments utilized in this study were the Geriatric Depression Scale Short Form Korea (GDSSF-K), an activity of daily living scale, a self-esteem ...

  3. 71. Depression an adverse prognostic factor in geriatric cardiac inpatients

    OpenAIRE

    S. Mekdad; F. Sakr; Y. Asiri

    2016-01-01

    Depression is very common among ill geriatric inpatients and could be a major factor responsible for delayed recovery, hospitalization and increased health care utilization. Study the prevalence of depression in geriatric cardiac inpatients. Determine the relationships between depression and hospitalization. A cross sectional study included 200 geriatrics (⩾65 years) inpatients in cardiac wards at King Fahad Medical City from 20th of March 2015 to 29th of April 2015. We employed the modified ...

  4. Assessment of Clinical Practices for Crushing Medication in Geriatric Units.

    Science.gov (United States)

    Fodil, M; Nghiem, D; Colas, M; Bourry, S; Poisson-Salomon, A-S; Rezigue, H; Trivalle, C

    2017-01-01

    To assess the modification of the form of medication and evaluate staff observance of good clinical practices. One-day assessment of clinical practices. 17 geriatrics units in the 3 Teaching Hospitals of Paris-Sud (APHP), France. Elderly in-patients with difficulties swallowing capsules and tablets. Assessment of target-patient prescriptions and direct observation of nurses' medical rounds. 155/526 in-patients (29.5%) were unable to swallow tablets or capsules: 98 (40.3%) in long-term care, 46 patients (23.8%) in the rehabilitation unit and 11 (12.2%) in the acute care unit (p = .005). In thirty-nine (27.3%) of the 143 prescriptions studied all tablets were safe to crush and all capsules were safe to open. In 104 cases, at least one medication could not be safely modified, including 26 cases (18.2%) in which none of the prescribed drugs were safe to crush or open. In 48.2% of the 110 medications that were crushed, crushing was forbidden, and presented a potential threat in 12.7% of cases or a reduced efficacy in 8.2% of cases. Crushing methods were rarely appropriate: no specific protective equipment was used (81.8%), crushing equipment was shared between patients without cleaning (95.1%), medications were spilled or lost (69.9%). The method of administration was appropriate (water, jellified water) in 25% of the cases, questionable (soup, coffee, compote, juice, cream) in 55% of the cases and unacceptable (laxative) in 21% of the cases. Management of drug prescriptions in patients with swallowing difficulties is not optimal, and may even have iatrogenic effects. In this study, 12.7% of the modifications of the drug form could have been harmful. Doctors, pharmacists and nurses need to reevaluate their practices.

  5. Geriatric and Student Perceptions following Student-led Educational Sessions

    Directory of Open Access Journals (Sweden)

    Kristin Janzen

    2018-01-01

    Full Text Available Objective: The objective of this study was to measure the effect of student-led educational events on geriatric patient and student participant perceptions in a community setting. Methods: Students led three events at a senior community center, focusing on learning and memory, sleep hygiene, and arthritis pain. The participants were geriatric patients who themselves were providers of support to homebound peers (“clients” through an independently organized program. Geriatric participants completed pre- and post-event surveys to measure changes in familiarity with the topics. Student participants also completed pre- and post-event surveys that tracked changes in their comfort in working with the geriatric population. Results: Each event demonstrated at least one positive finding for geriatric patients and/or their clients. Students reported increased comfort in working with and teaching the geriatric population following the first and third events, but not the second. Conclusion: Student-led educational sessions can improve perceived health-related knowledge of geriatric participants while simultaneously exposing students to the geriatric patient population. Overall, both students and geriatric participants benefited from these events. Practice Implications: Incorporation of single, student-led educational events could be mutually beneficial to students and the elderly population in the community and easily incorporated into any healthcare curriculum. Funding:This work was supported by a Butler University Innovation Fund Grant. Treatment of Human Subjects: IRB review/approval required and obtained   Type: Original Research

  6. The use of story as a teaching strategy: When educating students in geriatric oncology.

    Science.gov (United States)

    Overcash, Janine

    2010-07-01

    Story is a creative teaching strategy that can highlight the unique and complex needs of older adults diagnosed with cancer. Story as a means for delivering educational content can enhance recall and memory of details discussed in lecture. The purpose of this article is to describe the use of story as a teaching strategy and to offer suggestions on using story in educating undergraduate nursing students. To construct an effective story, a teaching point must be identified to be the "lesson learned." The story must be constructed around the teaching point and be relevant to the lecture material. Other suggestions for effective use of story are to rehearse, be succinct, and to inject humor if possible. The central goal of using story is to have an impact on nursing students so they will incorporate geriatric best practices throughout their career. Copyright 2010, SLACK Incorporated.

  7. Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

    Directory of Open Access Journals (Sweden)

    Sang Heon Lee

    2017-01-01

    Full Text Available Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458 and 77.5% (779/1,031 of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367, 189.1 patients (range, 90–345, and 40.2 nurses (range, 10–83. The average number of physicians was 6.2 (range, 3–11, but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%, indwelling catheters (19.5%, clean intermittent catheters (12.2%, and external collection urinary drainage (7.9%. However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals.

  8. [Why should Byzantium be considered as a cradle of clinical geriatrics?].

    Science.gov (United States)

    Lapin, Alexander

    2008-01-01

    Generally, roots of today's medical ethics are thought to have sprouted from antiquity and from classical Hebraic consciousness, while the origin of hospital medicine and institutional nursing of the elderly was assumed in Middle Age and in modern times, respectively. But even between these two periods, notably in Byzantium (324-1453) there were many famous physicians working with surprising skills in many disciplines such as surgery and ophthalmology. The most important achievement of that time, however, was in public health care. Following the Christian ideal of philanthropy, numerous hospitals (nosokomeia), hospices (xenodocheia) and asylums for the elderly (gerokomeia) of a remarkable organisation and professionalism were founded in many cities of the Byzantine Empire. Concerning the elderly patients, interesting findings were obtained concerning ageing process (eschatogeria), geriatric symptoms, multimorbidity, marasm and typically occurring diseases. Interesting approaches were realized with regard to the nursing care, diet and recommended life style for the elderly. By the end of the Byzantium Empire in 1453 and due to the different cultural development in the West, which was sometimes marked by conflicts between church and science and by the regulations of medicine, the knowledge about the Byzantine health care was almost lost. It survived, however, only in hospitals of occidental monastic orders, which brought their experience from East-Mediterranean area. Their hospitals were than a base for modern health care and for geriatrics.

  9. Undergraduate teaching in geriatric medicine: mapping the British Geriatrics Society undergraduate curriculum to Tomorrow's Doctors 2009.

    Science.gov (United States)

    Forrester-Paton, Calum; Forrester-Paton, Jayne; Gordon, Adam Lee; Mitchell, Hannah K; Bracewell, Nicola; Mjojo, Jocelyn; Masud, Tahir; Gladman, John R F; Blundell, Adrian

    2014-05-01

    in 2008, the British Geriatrics Society (BGS) developed the Recommended Undergraduate Curriculum in Geriatric Medicine. This was subsequently mapped to the second edition of Tomorrows' Doctors (TD2, 2003). Following the publication of the third edition of Tomorrow's Doctors in 2009 (TD3), the mapping exercise was repeated to verify the extent to which the updated General Medical Council recommendations supported teaching in ageing and geriatric medicine. we analysed TD3 and identified 48 aspects of its general guidance that were relevant to the teaching of medicine for older people. We then mapped these to the 2009 BGS curriculum. the BGS curriculum was supported in full by TD3. However, learning outcomes relating to the interpretation and conduct of research in TD3 had no corresponding outcomes in the BGS curriculum. the BGS curriculum for medical undergraduates continues to provide a specific and complete list of learning objectives, all of which could help to operationalise the general statements made in TD3 with relation to ageing and geriatric medicine. Learning outcomes in research in frail older patients have been added following this mapping exercise.

  10. Comprehensive Geriatric Assessment in the Office: Uncovering all the problems of geriatric patients

    OpenAIRE

    Pereles, Laurie R.M.; Boyle, Neil G.H.

    1991-01-01

    Because of their increased incidence of illness and disability, geriatric patients require extra time and diligence to assess and track medical problems. This article describes a comprehensive geriatirc assessment, organized on a one-page, easily updated checklist, that can be used to generate a medical and functional problem list and a risk assessment.

  11. [Progress in geriatric care through telemedicine].

    Science.gov (United States)

    Jürgens, C; Tost, F

    2006-09-01

    A constantly aging population leads to an increasing number of elderly patients. As a result, the treatment of chronic illnesses becomes a significant part of daily routine. Today's concepts in social services and healthcare require time consuming and barely cost-effective efforts for the special needs of geriatric care. The use of telemedicine offers a possible solution, because telemedical methods may help to realize improved monitoring systems for optimized and effective patient management. This report provides an overview of the scenarios and advantages of telemedicine in general. In addition, we provide information on practical experiences in a project on telemedical glaucoma management in Mecklenburg-Vorpommern.

  12. Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors.

    Science.gov (United States)

    Rivera, Veronica; Yukawa, Michi; Aronson, Louise; Widera, Eric

    2014-12-01

    The entire healthcare workforce needs to be educated to better care for older adults. The purpose of this study was to determine whether fellows are being trained to teach, to assess the attitudes of fellowship directors toward training fellows to be teachers, and to understand how to facilitate this type of training for fellows. A nine-question survey adapted from a 2001 survey issued to residency program directors inquiring about residents-as-teachers curricula was developed and administered. The survey was issued electronically and sent out three times over a 6-week period. Of 144 ACGME-accredited geriatric fellowship directors from geriatric, internal medicine, and family medicine departments who were e-mailed the survey, 101 (70%) responded; 75% had an academic affiliation, 15% had a community affiliation, and 10% did not report. Academic and community programs required their fellows to teach, but just 55% of academic and 29% of community programs offered teaching skills instruction as part of their fellowship curriculum; 67% of academic programs and 79% of community programs felt that their fellows would benefit from more teaching skill instruction. Program directors listed fellow (39%) and faculty (46%) time constraints as obstacles to creation and implementation of a teaching curriculum. The majority of fellowship directors believe that it is important for geriatric fellows to become competent educators, but only approximately half of programs currently provide formal instruction in teaching skills. A reproducible, accessible curriculum on teaching to teach that includes a rigorous evaluation component should be created for geriatrics fellowship programs. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  13. Development of an Interview-Based Geriatric Depression Rating Scale.

    Science.gov (United States)

    Jamison, Christine; Scogin, Forrest

    1992-01-01

    Developed interview-based Geriatric Depression Rating Scale (GDRS) and administered 35-item GDRS to 68 older adults with range of affective disturbance. Found scale to have internal consistency and split-half reliability comparable to those of Hamilton Rating Scale for Depression and Geriatric Depression Scale. Concurrent validity, construct…

  14. An under-diagnosed geriatric syndrome: sleep disorders among ...

    African Journals Online (AJOL)

    Introduction: Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Methods: Two hundred and three patients (136 female) older than 75 years of age were included in the study.

  15. Valproic Acid Suppositories for Management of Seizures for Geriatric Patients.

    Science.gov (United States)

    DiScala, Sandra L; Tran, Nhi N; Silverman, Michael A

    This case describes the use of valproic acid suppositories for secondary seizure prophylaxis in a geriatric veteran with a feeding and swallowing disorder. The effectiveness of valproic acid suppositories is outlined to reinforce the need for compounding pharmacies to have this formulation available to meet the needs of geriatric patients.

  16. Implementation of functional assessment scales in geriatric practice

    DEFF Research Database (Denmark)

    Poulsen, Ingrid; Hesselbo, Bjørn; Pietersen, Inge

    2005-01-01

    A study was undertaken to evaluate the feasibility of functional assessment scales regarding completion rate and ability to document functional changes in geriatric rehabilitation patients.......A study was undertaken to evaluate the feasibility of functional assessment scales regarding completion rate and ability to document functional changes in geriatric rehabilitation patients....

  17. An under-diagnosed geriatric syndrome: sleep disorders among ...

    African Journals Online (AJOL)

    Abstract. Introduction: Sleep disorders are commonly under-diagnosed in the geriatric population. We aimed to determine the prevalence of sleep problems among older adults admitted to the geriatrics out-patient clinic. Methods: Two hundred and three patients (136 female) older than 75 years of age were included in the ...

  18. Pharmacists' Perceptions of Major Difficulties in Geriatric Pharmacy Practice.

    Science.gov (United States)

    Pratt, Clara Collette; And Others

    1982-01-01

    Pharmacists (N=233) responded to the question "What is the most difficult aspect of geriatric pharmacy practice?" Most commonly cited problems were (1) inadequate professional skills or knowledge in geriatrics; (2) patient compliance; (3) physician functioning (including overprescribing of medications); (4) communication with the elderly; (5) lack…

  19. A case study of teamwork in a Maltese geriatric hospital

    OpenAIRE

    Buttigieg, Sandra; ; XII European Congress of Work and Organisational Psychology

    2005-01-01

    A conference presentation entitled "A Case Study of Teamwork in a Maltese Geriatric Hospital". This study aims to explore the nature of and implementation of interdisciplinary teamwork in a local geriatric rehabilitative hospital. Additionally, it aims to raise the consciousness and conscientiousness towards interdisciplinary team working in hospitals.

  20. PALLIATIVE CARE IN GERIATRICS: CURRENT ISSUES AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    I. P. Рonomareva

    2016-01-01

    Full Text Available The purpose of the study is to identify the main problems and prospects of development of palliative care in geriatrics at the present stage. Method of research was to analyze the printed and electronic databases that meet the stated issues. The results of the study highlight the problems of the development of palliative care in geriatric practice: the lack of a developed procedure of rendering palliative care and adequate elderly patient selection criteria, the lack of trained professional staff. The main prospects-association of palliative practices and concepts of modern geriatrics required specialized geriatric assessment and the provision of clinical, medical, social and socio-psychological geriatric syndromes. While promising option for the development of palliative care geriatrics is the integration into the existing health care system, acceptance of the fact that it is a part of the specialized geriatric care. This requires the involvement and training of not only specialists with medical education, but also persons without medical training from among social workers and volunteers working in palliative care. Therefore, the obtained data allowed to conclude that topical is the development of palliative care in geriatrics, taking into account not only clinical but medico-social, socio-psychological features.

  1. Geriatric Medical Education and Training in the United States

    Directory of Open Access Journals (Sweden)

    Michéle J. Saunders

    2005-12-01

    Full Text Available Medical education in geriatrics is an important requirement to ready the profession to provide comprehensive health care to the world's and also Taiwan's aging population. The predoctoral curricula and postdoctoral training programs in the United States were developed and supported by government agencies and professional education societies. Geriatric medical education in American medical schools has improved in the past 20 years, yet is still facing many challenges. The purposes of this paper are to review the current progress of, and propose some main principles and policies for the development of geriatric medical education and current progress in the United States. Geriatric medical education should be mandatory to adequately prepare medical students, residents, fellows, and practicing physicians to treat the elderly. The current progress and practice of geriatric medical education at the University of Texas Health Science Center at San Antonio are presented as an example.

  2. WATER AND SALT METABOLISM IN THE GERIATRIC SYNDROMES

    Directory of Open Access Journals (Sweden)

    Carlos G. Musso

    2010-01-01

    Full Text Available Geriatrics has already described four syndromes of its own: confusional syndrome, incontinence (fecal and/or urinary, and gait disorders and immobility syndrome, naming them geriatric giants. This name reflects their prevalence and great importance in the elderly. Ageing process induces many changes in renal physiology such as a reduction in glomerular filtration rate (senile hyponatremia, and water and sodium reabsorbtion capability. Besides, there are particular water and salt metabolism alteration characteristics of the geriatric syndromes, such as dehydration and hypernatremia in psychiatric disturbances as well as hyponatremia in patients suffering from immobility syndrome. The geriatric giants and nephrogeriatric physiology changes, are a good example of feed-back between geriatric syndromes, clinical entities characteristics in the elderly that predispose and potentiate each other, leading to catastrophic clinical events.

  3. [Patients with severe dementia in geriatric facilities].

    Science.gov (United States)

    Feteanu, Dorin; Lopez-Tourres, Fabienne; Trivalle, Christophe

    2005-03-01

    The institutional management for demented patients has been improved by new specific treatments, behavioural approach, better architectural adaptation, and environmental characteristics. This management must be global, including patients, families and nursing staffs. The nursing staff must be diversified, motivated, and specifically trained to manage demented patients.

  4. ESPEN Guidelines on Enteral Nutrition: Geriatrics.

    Science.gov (United States)

    Volkert, D; Berner, Y N; Berry, E; Cederholm, T; Coti Bertrand, P; Milne, A; Palmblad, J; Schneider, St; Sobotka, L; Stanga, Z; Lenzen-Grossimlinghaus, R; Krys, U; Pirlich, M; Herbst, B; Schütz, T; Schröer, W; Weinrebe, W; Ockenga, J; Lochs, H

    2006-04-01

    Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.

  5. [Cost accounting of a geriatric perioperative unit].

    Science.gov (United States)

    Boddaert, Jacques; Barondeau, Marie-Laure; Khiami, Frédéric; Nion, Nathalie; Frandji, Didier; Riou, Bruno

    2015-01-01

    Hip fracture management in a dedicated geriatric perioperative unit improves long-term mortality. In this "we report the" health economics evaluation of this geriatric perioperative care unit (UPOG). This study was conducted in 2011. Direct expenditures were obtained from the Assistance Publique-Hopitaux de Paris database, indirect expenditures from the hospital cost accounting,and financial incomes from the PMSI Pilot programme. Emergency department incomes and expenditures were estimated together with additional incomes related to orthopaedic surgery. We estimated expenditures related to operating room (OR) activities in the framework of several models, one with an emergency OR open 24h/24, and one with a standard OR. Lastly, we compared incomes/expenditures according to regular paramedical staff or according to the paramedical staff that would appear to be necessary to ensure patient care. 253 patients were admitted to the UPOG during the study J215 (84%) of whom underwent surgery. The income statement was positive for both an emergency OR (+741,000 Euros) and a standard OR ( +490,000 Euros) and remained positive when paramedical staff was increased (+629,000 and +156,000 Euros, respectively). The UPOG income statement shows a positive result regardless of the model used, emergency 24h/24 OR or standard OR, and even when paramedical staff is increased

  6. Geriatric management in medieval Persian medicine.

    Science.gov (United States)

    Emami, Morteza; Sadeghpour, Omid; Zarshenas, Mohammad M

    2013-10-01

    In Iran, a large group of patients are elderly people and they intend to have natural remedies as treatment. These remedies are rooted in historical of Persian and humoral medicine with a backbone of more than 1000 years. The current study was conducted to draw together medieval pharmacological information related to geriatric medicine from some of the most often manuscripts of traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plants through a search of the PubMed, Scopus and Google Scholar databases. In the medieval Persian documents, digestible and a small amount of food such as chicken broth, honey, fig and plum at frequent intervals as well as body massage and morning unctioning are highly recommended. In the field of pharmacotherapy, 35 herbs related to 25 families were identified. Plants were classified as tonic, anti-aging, appetizer, memory and mood enhancer, topical analgesic and laxative as well as health improvement agents. Other than historical elucidation, this paper presents medical and pharmacological approaches that medieval Persian practitioners applied to deal with geriatric complications.

  7. The educational challenge of dental geriatrics.

    Science.gov (United States)

    MacEntee, Michael I

    2010-01-01

    Education in dentistry as in medicine is guided principally by the ontology and theory of science, which provides definitions of health and disease, legitimizes research methods, and influences the role of the clinician. The challenge of managing chronic oral disease and disability prompts interest in social theory as much as science. Therefore, dental geriatrics requires a solid foundation in the humanities from the belief that the determinants of health and the cause of chronic diseases lie within an intermingling of biology, economics, sociocultural structure, and human behavior. The dental curriculum in many places is reorganizing from the horizontal foundation of basic sciences to an integration of foundational and clinical knowledge focused on clinical competencies and integrated care. The impact of this integration on dental geriatrics necessitates a more humanistic and naturalistic perspective in dental education to balance and challenge the current evidence for best clinical practice, which at present is based almost exclusively on science. Consequently, dental students should be exposed to a consilience of the science and the humanities if dentists are to address effectively the needs of an aging population.

  8. Rethinking Teaching Nursing Homes: Potential for Improving Long-Term Care

    Science.gov (United States)

    Mezey, Mathy D.; Mitty, Ethel L.; Burger, Sarah Green

    2008-01-01

    To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

  9. Validation of a Geriatric Trauma Prognosis Calculator: A P.A.L.Li.A.T.E. Consortium Study.

    Science.gov (United States)

    Cook, Allyson C; Joseph, Bellal; Mohler, M Jane; Inaba, Kenji; Bruns, Brandon R; Nakonezny, Paul A; Kerby, Jeff D; Brasel, Karen J; Wolf, Steven E; Cuschieri, Joseph; Paulk, M Elizabeth; Rhodes, Ramona L; Brakenridge, Scott C; Ekeh, A Peter; Phelan, Herb A

    2017-10-01

    The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. Retrospective cohort. Four geographically diverse Level 1 trauma centers. Trauma admissions aged 65 to 102 years surviving to discharge from 2000 to 2013. None. Age, injury severity score (ISS), transfusion at 24 hours post-admission, discharge dichotomized as favorable (home/rehabilitation) or unfavorable (skilled nursing/long term acute care/hospice). Training and testing samples were created using the holdout method. A multiple logistic mixed model (GTOS II) was created to estimate the odds of unfavorable disposition then re-specified using the GTOS II as the sole predictor in a logistic mixed model using the testing sample. The final dataset was 16,114 subjects (unfavorable discharge status = 15.4%). Training (n = 8,057) and testing (n = 8,057) samples had similar demographics. The formula based on the training sample was (GTOS II = Age + [0.71 × ISS] + 8.79 [if transfused by 24 hours]). Misclassification rate and AUC were 15.63% and 0.67 for the training sample, respectively, and 15.85% and 0.67 for the testing sample. GTOS II estimates the probability of unfavorable discharge in injured elders with moderate accuracy. With the GTOS mortality calculator, it can help in goal setting conversations after geriatric injury. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. [Shared Care Plan: convergence between the educational problematizing perspective and the theory of nursing cultural care].

    Science.gov (United States)

    Martins, Paula Alvarenga de Figueiredo; Alvim, Neide Aparecida Titonelli

    2012-01-01

    This report is a reflection that marks a change of perspective in the care relation between nurse and client, in the implementation context of the educative process. It emerged a Shared Care Plan as an educational-caring proposal, in the convergence among theorists Paulo Freire and Leininger, regarding the dialogical pedagogy and nursing cultural care. With regard to the elements considered essential to the care, learning together allows the unveiling of a peculiar reality of possibilities for integration and transformation of the reality revealed, by choice of the person. Autonomy planned becomes real, so that customers no longer carry fragmented practices, stemming from traditional pedagogy. The stand-alone client reaches, then, the fullness of the action.

  11. The geriatric patient: use of acute geriatrics units in the emergency care of elderly patients in France.

    Science.gov (United States)

    Somme, D; Lazarovici, C; Dramé, M; Blanc, P; Lang, P O; Gauvain, J B; Voisin, T; Gonthier, R; De Wazières, B; Jeandel, C; Couturier, P; Blanchard, F; Saint-Jean, O

    2011-01-01

    We studied the factors influencing the choice of admission to Geriatrics units, instead of other acute hospital units after an emergency visit. We report the results from a cohort of 1283 randomly selected patients aged >75 years hospitalized in emergency and representative of the French University hospital system. All patients underwent geriatric assessment. Baseline characteristics of patients admitted to Geriatrics and other units were compared. A center effect influencing the use of Geriatrics units during emergencies was also investigated. Admission to a Geriatrics unit during the acute care episode occurred in 499 cases (40.3%). By multivariate analysis, 4 factors were related to admission to a Geriatrics unit: cognitive disorder: odds ratio (OR)=1.79 (1.38-2.32) (95% confidence interval=95% CI); "failure to thrive" syndrome OR=1.54 (1.01-2.35), depression: OR=1.42 (1.12-1.83) or loss of Activities of Daily Living (ADL): OR=1.35 (1.04-1.75). The emergency volume of the hospital was inversely related to the use of Geriatrics units, with high variation that could be explained by other unstudied factors. In the French University Emergency Healthcare system, the "geriatrics patient" is defined by the existence of cognitive disorder, psychological symptoms or installed loss of autonomy. Nevertheless, considerable nation-wide variation was observed underlining the need to clarify and reinforce this discipline in the emergency healthcare system. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. [Geriatric intensive care patients : Perspectives and limits of geriatric intensive care medicine].

    Science.gov (United States)

    Müller-Werdan, U; Heppner, H-J; Michels, G

    2018-04-18

    Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age. The main reasons for changes in therapeutic targets are the will of the patient and risk-benefit considerations. The guidelines of the ethics section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) provide assistance and suggestions for a structured decision-making process.

  13. An innovative educational clinical experience promoting geriatric exercise.

    Science.gov (United States)

    Manning, Kenneth M; McNeill, Darien L; Pinheiro, Sandro O; Heflin, Mitchell T; Valencia, Willy M; Lee, Cathy C; Castle, Steven C; Katzel, Leslie; Giffuni, Jamie; Morey, Miriam C

    2017-10-13

    Formal educational training in physical activity promotion is relatively sparse throughout the medical education system. The authors describe an innovative clinical experience in physical activity directed at medical clinicians on a geriatrics rotation. The experience consists of a single 2 1/2 hour session, in which learners are partnered with geriatric patients engaged in a formal supervised exercise program. The learners are guided through an evidence-based exercise regimen tailored to functional status. This experience provides learners with an opportunity to interact with geriatric patients outside the hospital environment to counterbalance the typical geriatric rotation in which geriatric patients are often seen in clinics or hospitals. In this experience, learners are exposed to fit and engaged geriatric patients successfully living in the community despite chronic or disabling conditions. A survey of 105 learners highlighted positive responses to the experience, with 96% of survey respondents indicating that the experience increased their confidence in their ability to serve as advocates for physical activity for older adults, and 89.5% of responders to a follow-up survey indicating that the experience changed their perception of geriatric patients. Modifications to the experience, implemented at partnering facilities are described. The positive feedback from this experience warrants consideration for implementation in other settings.

  14. Watching television in later life: a deeper understanding of TV viewing in the homes of old people and in geriatric care contexts.

    Science.gov (United States)

    Ostlund, Britt

    2010-06-01

    A secret among staff at nursing homes is that they are often ambivalent about old residents spending more time in watching TV as it is a common cultural perception that it makes the viewer passive. The purpose of this paper is to highlight the importance of reflecting on the TV viewing habits that old people bring with them when they move into geriatric care. The findings are based on a study involving qualitative interviews and observations in two nursing home settings - urban and rural - of 20 persons between 82 and 100 years of age. The results confirm that TV viewing is far from a passive activity. Instead, it contributes to structuring daily life, to satisfying old peoples' needs for reflection and contemplation and to remain socially integrated. As such, TV viewing makes a significant contribution to their capacity to cope with disengagement in old age and can be used as a way of promoting communication and well-being in geriatric care.

  15. Ethical issues in geriatric feline medicine.

    Science.gov (United States)

    Rollin, Bernard E

    2007-08-01

    Most veterinarians hold a 'pediatric' rather than 'garage mechanic' view of their function. In recent years, sophisticated medical modalities have allowed veterinarians to keep animals alive, and increased value of companion animals in society has increased demand for such treatment. But whereas humans can choose to trade current suffering for extended life, animals seem to lack the cognitive apparatus required to do so. Thus, veterinarians must guard against keeping a suffering animal alive for too long. Clients may be emotionally tied to the animal and blind to its suffering. Part of the veterinarian's role, therefore, is to lead the client to 'recollect' quality of life issues. A second major role for the veterinarian in treating geriatric or chronically ill animals is control of pain and distress. Unfortunately, pain and distress have historically been neglected in both human and veterinary medicine for ideological reasons. It is ethically necessary to transcend this ideology which leads to both bad medicine and bad ethics.

  16. Periorbital Rejuvenation Surgery in the Geriatric Population

    Directory of Open Access Journals (Sweden)

    Ann Yi-Chiun Chuang

    2010-09-01

    Full Text Available Periorbital aging is an unavoidable, progressive process that is often accompanied by visual obscurations and ocular discomfort. With surgical correction, patients may benefit not only functionally but also psychosocially when an aesthetic outcome is obtained. The periorbital anatomical structures in elderly patients are complex and interlocking, requiring a thorough evaluation and systematic approach. Most elderly patients are reluctant to undergo procedures that require prolonged surgical and recovery times if they think it is only for cosmetic improvement. We review contemporary periorbital surgical methods suitable for a geriatric population, namely procedures that are low-cost, low-risk, with short operative and recovery times, and that have excellent patient acceptability. It is feasible to select procedures that can be customized to the needs of the elderly.

  17. [Functional geriatric assessment in primary health care].

    Science.gov (United States)

    Muñoz Silva, Carolina Andrea; Rojas Orellana, Pedro Antonio; Marzuca-Nassr, Gabriel Nasri

    2015-05-01

    The functional assessment of moderately or severely dependent older people encompasses social, psychological and biological aspects that may influence their quality of life and their degree of independence. This paper reviews the global geriatric assessment that should be performed in primary health care (PHC) for moderately or severely dependent older people. Since 2012 in PHC in Chile, the norm establishes that the degree of independence of older people should be assessed using the Barthel scale and caregiver stress should be evaluated using Zarit scale. People with severe disability should receive home care. We recommend to evaluate also cognitive aspects using the Mini-Mental State Examination (MMSE) to Barthel Index or using the Functional Independence Measure (FIM), since they are closely associated with functional capacity.

  18. New challenges of geriatric cardiology: from clinical to preclinical research

    Science.gov (United States)

    Malavolta, Marco; Caraceni, Daniele; Olivieri, Fabiola; Antonicelli, Roberto

    2017-01-01

    The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases (CVD). The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research. PMID:28663759

  19. Emergency general surgery in the geriatric patient.

    Science.gov (United States)

    Desserud, K F; Veen, T; Søreide, K

    2016-01-01

    Emergency general surgery in the elderly is a particular challenge to the surgeon in charge of their care. The aim was to review contemporary aspects of managing elderly patients needing emergency general surgery and possible alterations to their pathways of care. This was a narrative review based on a PubMed/MEDLINE literature search up until 15 September 2015 for publications relevant to emergency general surgery in the geriatric patient. The number of patients presenting as an emergency with a general surgical condition increases with age. Up to one-quarter of all emergency admissions to hospital may be for general surgical conditions. Elderly patients are a particular challenge owing to added co-morbidity, use of drugs and risk of poor outcome. Frailty is an important potential risk factor, but difficult to monitor or manage in the emergency setting. Risk scores are not available universally. Outcomes are usually severalfold worse than after elective surgery, in terms of both higher morbidity and increased mortality. A care bundle including early diagnosis, resuscitation and organ system monitoring may benefit the elderly in particular. Communication with the patient and relatives throughout the care pathway is essential, as indications for surgery, level of care and likely outcomes may evolve. Ethical issues should also be addressed at every step on the pathway of care. Emergency general surgery in the geriatric patient needs a tailored approach to improve outcomes and avoid futile care. Although some high-quality studies exist in related fields, the overall evidence base informing perioperative acute care for the elderly remains limited. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  20. Urinary tract infections in the geriatric patients.

    Science.gov (United States)

    Alpay, Yesim; Aykin, Nevil; Korkmaz, Pinar; Gulduren, Hakki Mustafa; Caglan, Figen Cevik

    2018-01-01

    Urinary tract infections (UTI) are the second most common infection in geriatric population. This study investigated clinical findings, diagnostic approaches, complicating factors, prognosis, causative microorganisms and antimicrobial susceptibility in geriatric patients diagnosed with UTI. A total of 140 hospitalised patients with UTIs were evaluated within three years between January 2011-January 2015 at the Eskisehir Yunus Emre State Hospital. UTI diagnosed when there were systemic and urinary signs and symptoms and a positive dipstick test and urine culture result, leukocyte and CRP like serum parameters. Among the studied patients, 41.4% had urological diseases, 20.7% had diabetes mellitus and 19.2% had neurological diseases. The most common symptoms and signs were fever, dysuria nausea/vomiting, general condition impairment, pyuria, haematuria. The laboratory values for CRP, ESR and leukocyte count were 84 mg/dL, 56 mm/s and 11.9 (10^3μL), with mean values being determined. Among patients having a urinary catheter (17.1%), 27.9% had a history of UTI, while 29.3% had been hospitalised. Escherichia coli and Klebsiella pneumoniae were the most commonly identified microorganisms. The mean duration for hospitalisation was 7.6 days, while a 5% mortality rate was observed over the course of the disease. Because of the potential for serious complications and mortality, elderly patients with urinary tract infection, should receive immediate empirical treatment based on anamnesis, clinical evaluation and urinalysis and should be re-examined using results from cultures and antibiograms upon follow-up.