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Sample records for surrounding assessment provide

  1. Methods of Assessing Noise Nuisance of Real Estate Surroundings

    Directory of Open Access Journals (Sweden)

    Szopińska Kinga

    2016-03-01

    Full Text Available Testing what factors create the market value of real estate is key information when preparing property valuations as well as other opinions and professional evaluations on the basis of which court verdicts or administrative decisions are made. One of the factors influencing the value of some real estate is the level of noise present in the surroundings, which can lead to the occurrence of noise nuisance negatively affecting social relations.

  2. An Assessment of Air Quality in the Surrounding Holy Places of Mecca, Saudi Arabia during Hajj

    Science.gov (United States)

    Khwaja, H. A.; Aburizaiza, O. S.; Siddique, A.; Hussain, M. M.; Khatib, F.; Zeb, J.; Blake, D. R.

    2014-12-01

    The associations of exposure to air pollution and adverse human health effects have been demonstrated in many epidemiologic studies. Hajj, an annual pilgrimage of Islam, draws millions of pilgrims from more than 200 countries for religious rituals in Mecca, Saudi Arabia. The city is surrounded by mountains with a population of 1.7 million, which gets doubles or even more during Hajj. The city centers on the Grand Mosque (Masjid Al-haram), connected with the network of tunnels. Main Hajj pilgrimage route for five days extends 20 km to the east and includes "Mina", "Arafat", and "Muzdalifah". A detailed study was conducted in Mecca, its tunnels, and surrounding holy places during Hajj (October 13-17, 2013). Spatial and temporal variations in total suspended particulate (TSP), PM10 , PM7 , PM2.5 , PM1 , ozone (O3), and black carbon (BC) levels along the route were recorded using portable monitors and GPS to assess the status of air quality. This is the first study to elucidate the exposure to air pollutants among pilgrims. Extremely high levels of all pollutants were observed during the intensive measuring periods. For example, the PM7 , PM2.5 , O3, and BC concentrations of up to 9,433 µg/m3, 484 µg/m3, 444 ppb, and 468 µg/m3, respectively, were observed. Results of this investigation revealed that most routes had on average exceeded the World Health Organization (WHO) standards for PM10 and PM2.5 . The reasons for the high air pollutants concentrations are most probably high volume of traffic, construction work, re-suspension of particles, and geographical conditions (arid regions). The pilgrim's longer trip duration lead to their highest whole trip exposure to air pollutants, which indicate that they are possibly subject to higher health risk. Better understanding of air pollution exposure and their determinants in the environments will contribute to the development of more appropriate exposure reductive strategies and have significant public health meanings.

  3. Behavior Assessment Battery: A Pilot Study of the Affective, Behavioral, and Cognitive Correlates Surrounding Spasmodic Dysphonia.

    Science.gov (United States)

    Vanryckeghem, Martine; Hoffman Ruddy, Bari; Lehman, Jeffrey

    2016-01-01

    This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data. Published by Elsevier Inc.

  4. Assessment of land degradation and its spatial and temporal variation in Beijing surrounding area

    Science.gov (United States)

    Li, Shuang; Dong, Suocheng; Zhang, Xiaojun; Zhiqiang, Gao

    2005-08-01

    The indulgence in willful persecution of sandstorm had made great attention of many countries around the world. Chinese government and the Chinese academy of science going with some other countries have devoted a large amount of vigor to study the crucial environment problem. Due to the main source areas of sandstorm all located in the arid and semi-arid regions where there have great area, hard natural condition and bad traffic condition, it's very difficult to accomplish source area and the reason of sandstorm. For this destination, a international cooperation organization has been established to clarify the occur mechanism, transfer process and the following environment impact of sandstorm. The organization includes many researchers come form USA, Japan, Korea, and so on. Beijing surrounding area is one of the main sandstorm sources in recent years. In order to understand fully of the sandstorm form and development, we analyzed the land use degradation of Beijing surrounding area during the last ten years. 71 scenes Landsat TM/ETM, 611 scenes DRG and DEM data had been processed in our study. This paper made a detail describe of using Landsat image data and high resolution DEM data to construe the soil erosion and vegetation degenerate. The result shows that the irrational human activities and land use style are the main factors of land use degradation. In case of Beijing surrounding area, the land degradation directly impacted the frequency and intensity of sand & dust storm in Northern China. The case study region of Beijing surrounding area includes 51 counties that belong to three provinces and autonomous regions.

  5. Sampling and analysis plan for assessment of beryllium in soils surrounding TA-40 building 15

    Energy Technology Data Exchange (ETDEWEB)

    Ruedig, Elizabeth [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-19

    Technical Area (TA) 40 Building 15 (40-15) is an active firing site at Los Alamos National Laboratory. The weapons facility operations (WFO) group plans to build an enclosure over the site in 2017, so that test shots may be conducted year-round. The enclosure project is described in PRID 16P-0209. 40-15 is listed on LANL OSH-ISH’s beryllium inventory, which reflects the potential for beryllium in/on soils and building surfaces at 40-15. Some areas in and around 40-15 have previously been sampled for beryllium, but past sampling efforts did not achieve complete spatial coverage of the area. This Sampling and Analysis Plan (SAP) investigates the area surrounding 40-15 via 9 deep (≥1-ft.) soil samples and 11 shallow (6-in.) soil samples. These samples will fill the spatial data gaps for beryllium at 40-15, and will be used to support OSH-ISH’s final determination of 40-15’s beryllium registry status. This SAP has been prepared by the Environmental Health Physics program in consultation with the Industrial Hygiene program. Industrial Hygiene is the owner of LANL’s beryllium program, and will make a final determination with regard to the regulatory status of beryllium at 40-15.

  6. Smart Surroundings

    NARCIS (Netherlands)

    Havinga, Paul J.M.; Jansen, P.G.; Lijding, M.E.M.; Scholten, Johan

    2004-01-01

    Ambient systems are networked embedded systems integrated with everyday environments and supporting people in their activities. These systems will create a Smart Surrounding for people to facilitate and enrich daily life and increase productivity at work. Such systems will be quite different from

  7. Assessment of some heavy metals in the surrounding soils of an ...

    African Journals Online (AJOL)

    OYELEKE PETER

    soils of an automobile battery factory in Ibadan, Nigeria. Peter Olaoye Oyeleke ... The levels of heavy metals (Pd, Zn, Cr, Cd, Fe and Cu in mg/kg) in soils were assessed with respect to distance in ... potential health risk. ..... Management, Nigeria (2004). ... heavy metals in sediments in the vicinity of Ashaka Cement Factory,.

  8. Assessment of some heavy metals in the surrounding soils of an ...

    African Journals Online (AJOL)

    ... elevate the normal background level and thereby contaminate the soils and make it unfit for agricultural purposes as plant take up the leached metals and ultimately find its way into animals and human body through the food chain. Keywords: Food chain, Battery Company, lead pollutant, assessment, agricultural purposes ...

  9. Assessing Local and Surrounding Threats to the Protected Area Network in a Biodiversity Hotspot: The Hengduan Mountains of Southwest China.

    Science.gov (United States)

    Ye, Xin; Liu, Guohua; Li, Zongshan; Wang, Hao; Zeng, Yuan

    2015-01-01

    Protected areas (PAs) not only serve as refuges of biodiversity conservation but are also part of large ecosystems and are vulnerable to change caused by human activity from surrounding lands, especially in biodiversity hotspots. Assessing threats to PAs and surrounding areas is therefore a critical step in effective conservation planning. We apply a threat framework as a means of quantitatively assessing local and surrounding threats to different types of PAs with gradient buffers, and to main ecoregions in the Hengduan Mountain Hotspot of southwest China. Our findings show that national protected areas (NPAs) have lower and significantly lower threat values (pprotected areas (PPAs) and other protected areas (OPAs), respectively, which indicates that NPAs are lands with a lower threat level and higher levels of protection and management. PAs have clear edge effects, as the proportion of areas with low threat levels decline dramatically in the 5-kilometer buffers just outside the PAs. However, NPAs suffered greater declines (58.3%) than PPAs (34.8%) and OPAs (33.4%) in the 5-kilometer buffers. Moreover, a significant positive correlation was found between the size of PAs and the proportion of areas with low threat levels that they contained in both PAs and PA buffers (p<0.01). To control or mitigate current threats at the regional scale, PA managers often require quantitative information related to threat intensities and spatial distribution. The threat assessment in the Hengduan Mountain Hotspot will be useful to policy makers and managers in their efforts to establish effective plans and target-oriented management strategies.

  10. Study on dose assessment in surrounding environment of the Tono Mine associated with closure activity

    International Nuclear Information System (INIS)

    Sasao, Eiji

    2012-07-01

    Dose assessment associated with closure activity of the Tono Mine has been performed. In this assessment, exposure dose has been calculated on groundwater and surface water migration of radionuclide from 1) waste rock in the waste rock dump facility, 2) mining waste in the mining waste facility, and 3) uranium ore and waste rock backfilled in the shafts and galleries. Direct and skyshine gamma rays and exposure of exhalated radon from the waste rock dump has also been evaluated. An evaluation tool developed for safety assessment for sub-surface disposal of radioactive waste is utilized for this assessment. Localities for dose evaluation are selected at the Higashihoragawa and Hiyoshigawa based on the topography around the Tono Mine and groundwater flow simulation. Evaluation scenarios are classified into 'Scenario for intake of agricultural product' as the base scenario, and 'Scenario for intake of groundwater' as the alternative scenario. Parameters for dose assessment are set-up based on the existing data. But the range and uncertainty of parameters are taken into account in the 'alternative cases'. As the result of dose assessment, maximum exposure dose of the base scenario is 0.08mSv/year, and 0.09mSv/year including direct and skyshine gamma rays and exposure of exhalatedradon at the Higashihoragawa. Maximum exposure dose of the alternative scenario is 0.08mSv/year (0.09mSv/year including direct and skyshine gamma rays and exposure of exhalated radon). On the alternative cases, exposure doses are calculated as 0.05-0.14mSv/year in both of the base and alternative scenarios. At the Hiyoshigawa, maximum exposure dose is less than 0.001mSv/year (1x10 -6 mSv/year) for the base scenario, and 0.001mSv/year for the alternative scenario. On the alternative cases, maximum exposure doses are less than 0.001mSv/year for all cases of the base scenario and 0.0006-0.002mSv/year for the alternative scenario. (author)

  11. Spectrophotometer is useful for assessing vitiligo and chemical leukoderma severity by quantifying color difference with surrounding normally pigmented skin.

    Science.gov (United States)

    Hayashi, M; Okamura, K; Araki, Y; Suzuki, M; Tanaka, T; Abe, Y; Nakano, S; Yoshizawa, J; Hozumi, Y; Inoie, M; Suzuki, T

    2018-05-01

    Acquired skin hypopigmentation has many etiologies, including autoimmune melanocyte destruction, skin aging, inflammation, and chemical exposure. Distinguishing lesions from normally pigmented skin is clinically important to precisely assess disease severity. However, no gold standard assessment method has been reported. We aimed to investigate whether spectrophotometers are useful for assessing vitiligo and rhododendrol (4-(4-hydroxyphenol)-2-butanol) (Rhododenol ® )-induced leukoderma disease severity by quantifying skin color. Mexameter ® MX18 and CM-700d spectrophotometer were used for assessing vitiligo/leukoderma by measuring melanin index, L*a*b* color space, and ΔE*ab value, which represents the color difference between two subjects and is calculated by the values of L*a*b*. MX18 and CM-700d can quantitatively distinguish vitiligo/leukoderma from normally pigmented skin based on melanin index. CM-700d consistently quantified the color of vitiligo/leukoderma lesions and surrounding normally pigmented skin in L*a*b* color spaces and ΔE*ab. ΔE*ab is well correlated with melanin index and clinical appearance. ΔE*ab has been frequently used in aesthetic dentistry; however, current study is the first to use it in the measurement of skin color. ΔE*ab seems to be a useful parameter to evaluate the color contrast between vitiligo/leukoderma and surrounding normally pigmented skin and can be used to evaluate disease severity and patient's quality of life. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Non-invasive MR assessment of macroscopic and microscopic vascular abnormalities in the rectal tumour-surrounding mesorectum

    Energy Technology Data Exchange (ETDEWEB)

    Kluza, Ewelina; Kleijnen, Jean-Paul J.E.; Maas, Monique; Jeukens, Cecile R.L.P.N.; Beets-Tan, Regina G.H. [Maastricht University Medical Center, Department of Radiology, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Martens, Milou H. [Maastricht University Medical Center, Department of Radiology, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center, Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Rennspiess, Dorit; Riedl, Robert G.; Hausen, Axel zur [Maastricht University Medical Center, Department of Pathology, Maastricht (Netherlands); Beets, Geerard L. [Maastricht University Medical Center, Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2016-05-15

    To evaluate the MRI macroscopic and microscopic parameters of mesorectal vasculature in rectal cancer patients. Thirteen patients with rectal adenocarcinoma underwent a dynamic contrast-enhanced MRI at 1.5 T using a blood pool agent at the primary staging. Mesorectal macrovascular features, i.e., the number of vascular branches, average diameter and length, were assessed from baseline-subtracted post-contrast images by two independent readers. Mesorectal microvascular function was investigated by means of area under the enhancement-time curve (AUC). Histopathology served as reference standard of the tumour response to CRT. The average vessel branching in the mesorectum around the tumour and normal rectal wall was 8.2 ± 3.8 and 1.7 ± 1.3, respectively (reader1: p = 0.001, reader2: p = 0.002). Similarly, the tumour-surrounding mesorectum displayed circa tenfold elevated AUC (p = 0.01). Interestingly, patients with primary node involvement had a twofold higher number of macrovascular branches compared to those with healthy nodes (reader1: p = 0.005 and reader2: p = 0.03). A similar difference was observed between good and poor responders to CRT, whose tumour-surrounding mesorectum displayed 10.7 ± 3.4 and 5.6 ± 1.5 vessels, respectively (reader1/reader2: p = 0.02). We showed at baseline MRI of rectal tumours a significantly enhanced macrovascular structure and microvascular function in rectal tumour-surrounding mesorectum, and the association of primary mesorectal macrovascular parameters with node involvement and therapy response. (orig.)

  13. Assessment of ecological Process in Chashma wetland and its surroundings using isotopic techniques

    International Nuclear Information System (INIS)

    Latif, Z.; Rasul, B.; Ahmad, M.; Fazil, M.; Butt, S.; Qureshi, R.M.; Akram, W.; Choudhry, M.A.

    2010-03-01

    Wetlands are ecologically and functionally substantial elements of the water environment. Pakistan presently has 19 sites designated as Wetlands of International Importance (Rarnsar Sites), which are associated with essential ecosystem services and often support a wide variety of natural ecologic resources that are significant in socio-economic development. The main objective is to apply geochemical and isotopic techniques in the estimation of water to and from Chashma wetlands, and to provide insight on how protection and management of wetlands might improve the water quality and associated ecological functions. Sampling is performed from fresh water wetland at Chashma Barrage Punjab site before Monsoon. The site is comprised of a large barrage, a water storage reservoir and a series of embankments which divide the reservoir into five shallow lakes at low water levels. The study area is located on the left bank of the river Indus between latitudes 32 deg. 11' 43' and 32 deg. 38' 25' north and longitudes 71 deg. 23' 53' and 71 deg. 45' 40' east. Aqueous samples for /sup 2/H, ISO and /sup 13/C analysis, plant and soil samples for /sup 2/H, ISO and /sup 13/C analysis and fish samples to study /sup 13/C-isotopic fractionation in different organs of various fish are collected from Chashma Lake. The EC of some parts of the Chashma Lake is enriched due to salt dissolution and evaporation. Isotopic composition of Lake gamma /sup 18/O and gamma /sup 2/H is enriched due to evaporation. Gamma /sup 13/C values of bicarbonates of water samples have a trend towards sediment carbonates dissolution and high dissolved oxygen concentration is due to the photosynthesis phenomena of algae and aqueous plants. It is observed that gamma/sup 13/C of leaves in most of the C-3 and C-4 plants is more depleted as compare to gamma/sup 13/C of stem. A vast variety of fishes are distributed in the rivers, lakes etc. depending upon water movement, temperature, oxygen content and characteristics

  14. ENVIRONMENTAL ASSESSMENT FOR THE PROPOSED WITHDRAWAL OF PUBLIC LANDS WITHIN AND SURROUNDING THE CALIENTE RAIL CORRIDOR, NEVADA

    International Nuclear Information System (INIS)

    DOE

    2005-01-01

    The purpose for agency action is to preclude surface entry and the location of new mining claims, subject to valid existing rights, within and surrounding the Caliente rail corridor as described in the Yucca Mountain FEIS (DOE 2002). This protective measure is needed to enhance the safe, efficient, and uninterrupted evaluation of land areas for potential rail alignments within the Caliente rail corridor. The evaluation will assist the DOE in determining, through the Rail Alignment environmental impact statement (EIS) process, whether to construct a branch rail line, and to provide support to the BLM in deciding whether or not to reserve a ROW for the rail line under the Federal Land Policy and Management Act (FLPMA). The BLM participated as a cooperating agency in preparing this EA because it is the responsible land manager and BLM staff could contribute resource specific expertise

  15. ENVIRONMENTAL ASSESSMENT FOR THE PROPOSED WITHDRAWAL OF PUBLIC LANDS WITHIN AND SURROUNDING THE CALIENTE RAIL CORRIDOR, NEVADA

    Energy Technology Data Exchange (ETDEWEB)

    DOE

    2005-12-01

    The purpose for agency action is to preclude surface entry and the location of new mining claims, subject to valid existing rights, within and surrounding the Caliente rail corridor as described in the Yucca Mountain FEIS (DOE 2002). This protective measure is needed to enhance the safe, efficient, and uninterrupted evaluation of land areas for potential rail alignments within the Caliente rail corridor. The evaluation will assist the DOE in determining, through the Rail Alignment environmental impact statement (EIS) process, whether to construct a branch rail line, and to provide support to the BLM in deciding whether or not to reserve a ROW for the rail line under the Federal Land Policy and Management Act (FLPMA). The BLM participated as a cooperating agency in preparing this EA because it is the responsible land manager and BLM staff could contribute resource specific expertise.

  16. Using Remote Sensing and Gis Techniques For Assessment The Environmental Changes in The Area Surrounding Suez Canal, Egypt

    International Nuclear Information System (INIS)

    Youssef, A.M.; EL Baroudy, A.A.

    2008-01-01

    Multi-temporal Landsat Thematic Mapper (TM) and Enhanced Thematic Mapper Plus (ETM+) data were utilized in a Geographic Information System (GIS) to evaluate changes in landuse II and cover in the area surrounds the Suez Canal, Egypt. The area is bounded by the Great Bitter Lake from the south, El Qantara city from the north, Nile Delta from the west, and Sinai Peninsula from the east. The area witnessed a rapid development in the past three decades, and the environmental changes were very remarkable. The data collected by Landsat sensors, TM (1984) and ETM+ (2000) were used to conduct a change detection and landuse analysis over the area of study. Both images were spatially registered and band four (Near Infra-Red) was radiometrically normalized to eliminate the atmospheric and sun luminance variation. Band algebra techniques were implemented to generate a reflectance difference image. On the other hand, the images were classified with supervised (maximum likelihood) technique with the help of ground truth data to provide the landuse maps for 1984 and 2000 periods. These maps were converted to GIS environment and final landuse changes have been provided

  17. Forensic assessment of polycyclic aromatic hydrocarbons at the former Sydney Tar Ponds and surrounding environment using fingerprint techniques

    International Nuclear Information System (INIS)

    MacAskill, N. Devin; Walker, Tony R.; Oakes, Ken; Walsh, Margaret

    2016-01-01

    Polycyclic aromatic hydrocarbons (PAHs) were assessed spatially and temporally within and adjacent to a former coking and steel manufacturing facility in Sydney, Nova Scotia, Canada. Concentrations of PAHs were measured in surface soils, marine and estuary sediments prior to and during remediation of the Sydney Tar Ponds (STPs) site which was contaminated by nearly a century of coking and steel production. Previous studies identified PAHs in surficial marine sediments within Sydney Harbour, which were considered to be derived from STP discharges. Numerous PAH fingerprint techniques (diagnostic ratios, principal component analysis, quantitative and qualitative analysis) were applied to soil and sediment samples from the STPs and surrounding area to identify common source apportionment of PAHs. Results indicate coal combustion (from historical residential, commercial and industrial uses) and coal handling (from historic on-site stockpiling and current coal transfer and shipment facilities) are likely the principal source of PAHs found in urban soils and marine sediments, consistent with current and historical activities near these sites. However, PAH fingerprints associated with STP sediments correlated poorly with those of urban soils and marine sediments, but were similar to coal tar, historically consistent with by-products produced by the former coking operations. This study suggests PAH contamination of Sydney Harbour sediments and urban soils is largely unrelated to historic coking operations or recent remediation of the STPs site, but rather a legacy of extensive use of coal for a variety of activities. - Highlights: • PAHs were measured in soils and sediments near a former coking and steel facility. • Previous studies identified tar residues as main source of PAHs in marine sediments. • PAH fingerprint techniques were used to identify common source apportionment. • Fingerprint techniques indicated common sources derived from coal, not tar residues

  18. Human dynamics and forest management: a baseline assessment of the socioeconomic characteristics of the region surrounding the El Yunque National Forest

    Science.gov (United States)

    Kathleen McGinley

    2016-01-01

    In this paper, I examine the socioeconomic dynamics and human–environment interactions in the region surrounding the El Yunque National Forest (EYNF) in northeastern Puerto Rico and their implications for policy development and sustainable resource use. As part of a larger, comprehensive assessment of the conditions and trends of the EYNF and broader region, I...

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

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

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

  20. Ethical issues surrounding the provider initiated opt--Out prenatal HIV screening practice in Sub-Saharan Africa: a literature review.

    Science.gov (United States)

    Bain, Luchuo Engelbert; Dierickx, Kris; Hens, Kristien

    2015-10-24

    Prevention of mother to child transmission of HIV remains a key public health priority in most developing countries. The provider Initiated Opt - Out Prenatal HIV Screening Approach, recommended by the World Health Organization (WHO) lately has been adopted and translated into policy in most Sub - Saharan African countries. To better ascertain the ethical reasons for or against the use of this approach, we carried out a literature review of the ethics literature. Papers published in English and French Languages between 1990 and 2015 from the following data bases were searched: Pubmed, Cochrane literature, Embase, Cinhal, Web of Science and Google Scholar. After screening from 302 identified relevant articles, 21 articles were retained for the critical review. Most authors considered this approach ethically justifiable due to its potential benefits to the mother, foetus and society (Beneficence). The breaching of respect for autonomy was considered acceptable on the grounds of libertarian paternalism. Most authors considered the Opt - Out approach to be less stigmatizing than the Opt - In. The main arguments against the Opt - Out approach were: non respect of patient autonomy, informed consent becoming a meaningless concept and the HIV test becoming compulsory, risk of losing trust in health care providers, neglect of social and psychological implications of doing an HIV test, risk of aggravation of stigma if all tested patients are not properly cared for and neglect of sociocultural peculiarities. The Opt - Out approach could be counterproductive in case gender sensitive issues within the various sociocultural representations are neglected, and actions to offer holistic care to all women who shall potentially test positive for HIV were not effectively ascertained. The Provider Initiated Opt - Out Prenatal HIV Screening option remains ethically acceptable, but deserves caution, active monitoring and evaluation within the translation of this approach into to practice.

  1. Assessment of Heavy Metal Contamination in the Surrounding Soils and Surface Sediments in Xiawangang River, Qingshuitang District

    Science.gov (United States)

    Jiang, Min; Zeng, Guangming; Zhang, Chang; Ma, Xiaoying; Chen, Ming; Zhang, Jiachao; Lu, Lunhui; Yu, Qian; Hu, Langping; Liu, Lifeng

    2013-01-01

    Xiawanggang River region is considered to be one of the most polluted areas in China due to its huge amount discharge of pollutants and accumulation for years. As it is one branch of Xiang River and the area downstream is Changsha city, the capital of Hunan Province, the ecological niche of Xiawangang River is very important. The pollution treatment in this area was emphasized in the Twelfth Five-Year Plan of Chinese government for Xiang River Water Environmental Pollution Control. In order to assess the heavy metal pollution and provide the base information in this region for The Twelfth Five-Year Plan, contents and fractions of four heavy metals (Cd, Cu, Pb and Zn) covering both sediments and soils were analyzed to study their contamination state. Three different indexes were applied to assess the pollution extent. The results showed this area was severely polluted by the four heavy metals, and the total concentrations exceeded the Chinese environmental quality standard for soil, grade III, especially for Cd. Moreover, Cd, rated as being in high risk, had a high mobility as its great contents of exchangeable and carbonates fractions in spite of its relative low content. Regression analysis revealed clay could well explain the regression equation for Cd, Cu and Zn while pH and sand could significantly interpret the regression equation for Pb. Moreover, there was a significant correlation between Non-residual fraction and Igeo for all the four metals. Correlation analysis showed four metals maybe had similar pollution sources. PMID:23951103

  2. Environmental impacts assessment of industrial estate providing with managerial process

    Energy Technology Data Exchange (ETDEWEB)

    Nouri, J.; Mahvi, A.H.; Younesian, M.; Nabizadeh, R.; Hashemi, I. [Univ. of Tehran (Iran)

    2007-07-01

    The existence of balance, coordination and required order among natural elements is one of the key factors in the ecosystem. If this balance is disturbed under certain circumstances, it will damage the structure of living existences and more specifically human beings. Since a half century ago, factors such as important economical and industrial activites, advanced technologies together with growing population and lack of concordance among different couhntries to take optimal advantage of the existing natural resources have distrubed the balance in the ecosystem. As a result, man has caused many problems such as high death tolls and arduous diseases due to the different pollutions in water, air, land, sound, temperature, etc and factors such as erosion, desert, expansion, floods, extinction of plant and animal species, ozone layer destruction, global warming, sea level rise and greenhouse gases increase. Environmental Impact Assessment (EIA) is to recognize and assess systematic consequences of projects and programs on elements like physicochemical, biological, cultural, economical and social phenomena in th environment; in other words it is a way or method to determine the direction of predication and assessment of environmental impacts of activities on the environmental health of the ecosystem affecting human lives. In this study, and environmental impact assessment of the establishment of the Shahzand Industrial Estate in Arak at the central part of Iran was investigated. After collection of data and analysis of the findings, the positive and negative impacts resulting from establishment of the indutrial estate were investigated using the Leopold Matrix and Scaling checklist methods providing the managerial solutions in order to minimize the harmful environmental impacts. The existing environmental situation was investigated and then environmental impact alternatives were determined. This was done in regard to the amount and kind of predicted pollution for the

  3. Lithological and land-use based assessment of heavy metal pollution in soils surrounding a cement plant in SW Europe.

    Science.gov (United States)

    Cutillas-Barreiro, Laura; Pérez-Rodríguez, Paula; Gómez-Armesto, Antía; Fernández-Sanjurjo, María José; Álvarez-Rodríguez, Esperanza; Núñez-Delgado, Avelino; Arias-Estévez, Manuel; Nóvoa-Muñoz, Juan Carlos

    2016-08-15

    We study the influence of phasing out a cement plant on the heavy metal (Hg, Pb and Cr) content in the surrounding soils, taking into account factors often neglected, such as contributions due to local lithology or land use. The range of total Hg was 10-144µg kg(-1), reaching up to 41 and 145mgkg(-1) for total contents of Pb and Cr, respectively. Forest soils showed higher concentration of Hg than prairie soils, indicating the importance of land use on the accumulation of volatile heavy metals in soils. In forest soils, total Hg showed a trend to decrease with soil depth, whereas in prairie soils the vertical pattern of heavy metal concentrations was quite homogeneous. In most cases, the distance to the cement plant was not a factor of influence in the soils content of the analyzed heavy metals. Total Pb and Cr contents in soils nearby the cement plant were quite similar to those found in the local lithology, resulting in enrichment factor values (EF's) below 2. This suggests that soil parent material is the main source of these heavy metals in the studied soils, while the contribution of the cement plant to Pb and Cr soil pollution was almost negligible. On the contrary, the soils surrounding the cement plant accumulate a significant amount of Hg, compared to the underlying lithology. This was especially noticeable in forest soils, where Hg EF achieved values up to 36. These results are of relevance, bearing in mind that Hg accumulation in soils may be an issue of environmental concern, particularly in prairie soils, where temporal flooding can favor Hg transformation to highly toxic methyl-Hg. In addition, the concurrence of acid soils and total-Cr concentrations in the range of those considered phytotoxic should be also stressed. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Assessing the Financial Condition of Provider-Sponsored Health Plans.

    Science.gov (United States)

    McCue, Michael J

    2015-06-01

    The aim of this study was to assess the performance of health plans sponsored by provider organizations, with respect to plans generating strong positive cash flow relative to plans generating weaker cash flow. A secondary aim was to assess their capital adequacy. The study identified 24 provider-sponsored health plans (PSHPs) with an average positive cash flow margin from 2011 through 2013 at or above the top 75th percentile, defined as "strong cash flow PSHPs:" This group was compared with 72 PSHPs below the 75th percentile, defined as "weak cash flow PSHPs:" Atlantic Information Services Directory of Health Plans was used to identify the PSHPs. Financial ratios were computed from 2013 National Association of Insurance Commissioners Financial Filings. The study conducted a t test mean comparison between strong and weak cash flow PSHPs across an array of financial performance and capital adequacy measures. In 2013, the strong cash flow PSHPs averaged a cash-flow margin ratio of 6.6%. Weak cash flow PSHPs averaged a cash-flow margin of -0.4%. The net worth capital position of both groups was more than 4.5 times authorized capital. The operational analysis shows that strong cash-flow margin PSHPs are managing their medical costs to achieve this position. Although their medical loss ratio increased by almost 300 basis points from 2011 to 2013, it was still statistically significantly lower than the weaker cash flow PSHP group (P<.001). In terms of capital adequacy, both strong and weak cash-flow margin PSHP groups possessed sufficient capital to ensure the viability of these plans.

  5. Assessing the quality of healthcare provided to children.

    Science.gov (United States)

    Mangione-Smith, R; McGlynn, E A

    1998-10-01

    To present a conceptual framework for evaluating quality of care for children and adolescents, summarize the key issues related to developing measures to assess pediatric quality of care, examine some existing measures, and present evidence about their current level of performance. Assessing the quality of care for children poses many challenges not encountered when making these measurements in the adult population. Children and adolescents (from this point forward referred to collectively as children unless differentiation is necessary) differ from adults in two clinically important ways (Jameson and Wehr 1993): (1) their normal developmental trajectory is characterized by change, and (2) they have differential morbidity. These factors contribute to the limitations encountered when developing measures to assess the quality of care for children. The movement of a child through the various stages of development makes it difficult to establish what constitutes a "normal" outcome and by extension what constitutes a poor outcome. Additionally, salient developmental outcomes that result from poor quality of care may not be observed for several years. This implies that poor outcomes may be observed when the child is receiving care from a delivery system other than the one that provided the low-quality care. Attributing the suboptimal outcome to the new delivery system would be inappropriate. Differential morbidity refers to the fact that the type, prevalence, and severity of illness experienced by children is measurably different from that observed in adults. Most children experience numerous self-limited illness of mild severity. A minority of children suffer from markedly more severe diseases. Thus, condition-specific measures in children are problematic to implement for routine assessments because of the extremely low incidence and prevalence of most severe pediatric diseases (Halfon 1996). However, children with these conditions are potentially the segment of the

  6. Preliminary assessment of the thermal effects of an annular air space surrounding an emplaced nuclear waste canister

    International Nuclear Information System (INIS)

    Davis, B.W.

    1979-01-01

    Modeling results have previously shown that the presence of a large air space (e.g., a repository room) within a nuclear waste repository is expected to cause a waste canister's temperature to remain cooler than it would otherwise be. Results presented herein show that an annular air space surrounding the waste canisters can have similar cooling effects under certain prescribable conditions; for a 16 ft x 1 ft diameter canister containing 650 PWR rods which initially generate a total of 4.61 kw, analysis will show that annular air spaces greater than 11 in will permit the canister surface to attain peak temperatures lower than that which would result from a zero-gap/perfect thermal contact. It was determined that the peak radial temperature gradient in the salt varies in proportion to the inverse of the drill hole radius. Thermal radiation is shown to be the dominant mode of heat transfer across an annular air space during the first two years after emplacement. Finally, a methodology is presented which will allow investigators to easily model radiation and convection heat transfer through air spaces by treating the space as a conduction element that possesses non-linear temperature dependent conductivity

  7. Investigation, assessment and remediation of the water pathway in the surroundings of the Culmitzsch A tailings impoundment

    International Nuclear Information System (INIS)

    Schulze, G.; Paul, M.; Priester, J.; Schoepfer, C.

    1998-01-01

    Several large tailings impoundments in Saxony and Thuringia are the result of the extensive uranium mining and milling in Eastern Germany after World War II. The Culmitzsch tailings pond in Eastern Thuringia was constructed within a former uranium open pit mine and is located within the Culmitzsch trench fault. The tailings impoundment includes two ponds (Culmitzsch A and B) which are separated by an internal dam with an impervious core. The Culmitzsch A pond covers an area of 158 ha, the maximum tailings thickness is 70 m. Between this pond (elevation of up to 340 m above sea-level) and the Lerchenbach creek (265.. 280 m above sea-level) a steep gradient exists. So the valley of the Lerchenbach is the general discharge area for the seepage of the pond which is a result of dewatering by gravity and consolidation. The seepage water migrates through the southern dam of the impoundment and through permeable layers which are in contact with the tailings. About 400 groundwater wells were installed within three aquifers in order to clarify the flow direction and the degree of contamination of the groundwater as well as to investigate the geohydraulic properties of the rocks in the surroundings of the pond. Based on the results of this investigation programme a three-dimensional hydrogeological model was built up which reflects the general relationships between the pond and its geological setting as well as the water balance of the whole system. Presently a catchment system exists which gathers all surface waters with significant uranium and salt concentrations. Moreover dewatering wells on the beach zone of the pond and catchment wells in the downstream area of the impoundment have been installed. Before being released to the receiving streams seepage and freewater are treated in a two-step water treatment plant in order to decrease their uranium, radium and arsenic contents. (orig.) [de

  8. Assessment of the Quality of Drinking water of Thari Mirwah Town and Surrounding villages, District Khairpur, Sindh, Pakistan

    Directory of Open Access Journals (Sweden)

    Abdul Raheem Shar

    2014-12-01

    Full Text Available The ground water of Thari Mirwah town, Sindh, Pakistan and its surrounding villages was studied to check the chemical and physical suitability for drinking purpose. We measured several physico-chemical parameters; such as total dissolved salts (TDS, electrical conductivity (EC, chlorides, sulfate, phosphorus, nitrate-nitrogen, total hardness, alkalinity and total organic matter. The obtained results were in the range of: pH 6.9-8.1, temperature 25-30 0C, electrical conductivity 540-3140 µS/cm, total dissolved solids 362-2104 mg/L, chlorides 14.8-1657 mg/L, sulfate 69-308 mg/L, phosphate-phosphorus 0.003-0.56 mg/L, nitrate-nitrogen 0.00-9.9 mg/L, total hardness 58-760 mg/L, alkalinity 383-950 mg/L and total organic matter 0.022-0.89 mg/L. All these samples were analyzed using the standard methods of American Public Health Association (APHA by atomic absorption spectrometer (AAS. The concentration of analyzed metals was found in the range of: sodium (Na 2.57-1066.74 mg/L, calcium (Ca 8.35-329.33 mg/L, manganese (Mn 0.003-0.401 mg/L, nickel (Ni 0.006-0.154 mg/L, zinc (Zn 0.002-0.533 mg/L, copper (Cu 0.004-0.169 mg/L, cobalt (Co 0.00-0.040 mg/L, chromium (Cr 0.0054-0.0322 mg/L, iron (Fe 0.002-0.499 mg/L and cadmium (Cd 0.00-0.014 mg/L. Study reveals that above parameters are not within safe limits of WHO/EPA/EU guidelines and all ground water samples were not fit for drinking and irrigation purposes.

  9. Technical report on dismantling of incinerator building of JNC with strict environmental assessments especially for the contamination of surroundings of incinerator by Dioxin's in soil

    International Nuclear Information System (INIS)

    Aizawa, Masanori; Ohmori, Koji; Nomura, Takeshi; Numano, Tatuo; Usui, Kazuya; Irinouchi, Shigenori

    2003-03-01

    Building of incinerator for general waste located at Tokai of Japan Nuclear Cycle Development Institute (JNC in short) were dismantled form April 2002 to March 2003 under environmental control According to the regulation entitled 'Outline for the prevention of exposure of Dioxin's to operators engaged in dismantling of waste incinerator' issued on June 01, 2000 by Ministry of Health, Labor and Welfare in Japan, the regulation requests proper protection methodology to dismantling the incinerator and surroundings contaminated by Dioxin's. This report consists of Environmental assessment under Japanese law and regulations and Procedure of actual dismantling of incinerator building with law-abiding stand point. 1. Environmental assessment; Survey of several laws and regulations concerning on the Dioxin's and actual site assessment to analyze the content of Dioxin's for surroundings of incinerator building. Ground design of dismantling procedures, waste management for disposed during dismantling and scheduling for dismantling of building. 2. Dismantling procedures; Prior to dismantling operation, contamination map by Dioxin's were established then restricted areas were determined. Protection methodology to dioxin's exposure for operators were selected and started dismantling operation after getting permission from the Labor Standards Bureau of Ibaraki Prefecture. Dismantling operations were carried out with respect o above mentioned regulations to prevent the operators exposure to Dioxin's if they are exists in soil or surroundings of building. Finally, dismantling operations were completed without accidents and confirmed no-exposure of Dioxin's to operators of dismantling. Waste generated during dismantling were recycled using specialized recycling companies in Ibaraki prefecture. Dismantling operation of incinerator was first experience at Ibaraki Prefecture, so the officials of Labor Standards Bureau were carried out on-the-spot inspection and have no claim from

  10. Office of Academic Assessment provides workshops on the program assessment process

    OpenAIRE

    Williams, Meghan

    2008-01-01

    The Office of Academic Assessment is once again providing a series of workshops on the program assessment process during the spring semester. The workshops will offer a wide range of resources to assist faculty and administrators as they focus on teaching and learning in their programs.

  11. SEARCHING FOR URBAN PATTERNS; AN ASSESSMENT OF HISTORIC EDGES AND ITS SURROUNDING CONTEXT: HISTORIC CAIRO AS A CASE STUDY

    OpenAIRE

    Nabil Mohareb

    2016-01-01

    This paper analyzes the urban edges of historic cities. Managing these edges would enhance the success of any intervention projects inside the historic fabric. The paper develops and tests a method of analytical assessment framework that is applicable for quantitative analysis within an urban edge. It is capable of measuring micro and macro levels of analysis of historic urban edges with reference to their spatial configuration. In addition, the paper searches for repetitive spatial configura...

  12. Assessment of electromagnetic fields intensity emitted by cellular phone base stations in surrounding flats - a preliminary study

    International Nuclear Information System (INIS)

    Zmyslony, M.; Politanski, P.; Mamrot, P.; Bortkiewicz, A.

    2006-01-01

    A rapid development of mobile telecommunications (MT) has resulted in an increased concern about possible detrimental health effects of electromagnetic fields (EMFs) emitted by MT systems, and by MT base stations in particular. Research into EMFs effects on the health of inhabitants living in their vicinity requires first of all a solid assessment of the exposure level. Up to now, the reports in this field have been rather scant. This article presents the results of preliminary measurements of EMFs fields in selected flats around selected base stations in the city of Lodz. Measurements of electric field strength, E, to assess EMF exposure were based on the standard procedures currently in force in Poland. As the study is regarded as a preliminary one, the measurements were conducted in buildings with the expected largest radiation. The measurements show that in the flats located up to 500 m from the base station, EMFs are within the limits specified by relevant Polish regulations on the general public and environmental protection. It was also observed that in a few (less than 10%) flats the field with E exceeded 0.8 V/m. The results show that there are no correlations between electric field strength and distance between the flat and the base station. Therefore, the distance from the base station cannot be used to represent the exposure rate; to determine the latter, EMF measurements are necessary. (author)

  13. SEARCHING FOR URBAN PATTERNS; AN ASSESSMENT OF HISTORIC EDGES AND ITS SURROUNDING CONTEXT: HISTORIC CAIRO AS A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Nabil Mohareb

    2016-07-01

    Full Text Available This paper analyzes the urban edges of historic cities. Managing these edges would enhance the success of any intervention projects inside the historic fabric. The paper develops and tests a method of analytical assessment framework that is applicable for quantitative analysis within an urban edge. It is capable of measuring micro and macro levels of analysis of historic urban edges with reference to their spatial configuration. In addition, the paper searches for repetitive spatial configuration patterns. The main case study is Historic Cairo. The paper reveals that there are apparent patterns of cause and effect of both spatial configurations and related activities along the urban edges, forming different type of barriers. The paper discovers the repetitive spatial, architectural, and land-use patterns that exist on various edges. These patterns enable the possibility of learning and acquiring from other successful interventions that have been applied to similar patterns, without being limited to cultural or contextual differences.

  14. The first temporal and spatial assessment of Vibrio diversity of the surrounding seawater of coral reefs in Ishigaki, Japan

    Directory of Open Access Journals (Sweden)

    AKM Rohul Amin

    2016-08-01

    Full Text Available Coral reefs perform a major role in regulating marine biodiversity and serve as hotspot for highly dynamic and diverse microbiomes as holobionts. Corals around Ishigaki, however, are at risk due to tremendous stressors including elevation of seawater temperature, eutrophication and so on. However, no information is currently available on how Vibrio diversity fluctuates spatially and temporally due to environmental determinants in Ishigaki coral reef ecosystems. The aim of this study is to elucidate spatiotemporal Vibrio diversity dynamic at both community and population levels and to assess the environmental drivers correlated to Vibrio abundance and diversity. The Vibrio community identified based on pyrH gene phylogeny of 685 isolates from seawater directly connecting to Ishigaki coral holobionts consisted of 22 known and 12 potential novel Vibrionaceae species. The most prominent species were V. hyugaensis, V. owensii and V. harveyi followed by V. maritimus/V. variabillis, V. campbellii, V. coralliilyticus and P. rosenbergii. The Vibrio community fluctuations, assessed by PCoA with UniFrac distance and clustering with Euclidiean distance were varied less not only by year but also by site. Interestingly, significant positive correlation was observed between rising seawater temperature and the abundance of V. campbellii (r=0.62; P<0.05 whereas the opposite was observed for V. owensii (r=-0.58; P<0.05 and the C6 group of V. hyugaensis (r=-0.62; P<0.05. AdaptML-based microhabitat differentiation revealed that V. harveyi, V. campbellii, P. rosenbergii and V. coralliilyticus populations were less-ecologically distinctive whereas V. astriarenae and V. ishigakensis were ecologically diverse. This knowledge could be important clue for the future actions coral conservation.

  15. Assessing the surroundings for effects of ionising radiation on the granting of permits, DOVIS A. Emissions to air and water

    CERN Document Server

    Blaauboer, R O

    2002-01-01

    In the Netherlands, as in most other countries, one generally needs a permit to produce (including the manufacture, processing, control and storage), to apply or to dispose of radioactive materials, or to use equipment that produces ionising radiation. This permit must be in accordance with the Nuclear Energy Act. Limits that are set for radioactive material can be found in the Decree on radiation protection ('Besluit stralings-bescherming') which has been in force since March 1, 2002. Along with the application for a permit, calculation results have to be submitted on the radiation dose that members of the public receive as a consequence of (possible) emissions of radioactive material (into the atmosphere or surface water) or as a consequence of external irradiation. Fairly rough estimates, based on simple rules, will often be satisfactory. These rules can be found in an annex of a Ministerial Order on the assessment of consequences of ionising radiation (mr-AGIS). However, in some cases this will not be ade...

  16. Nonspecialist Raters Can Provide Reliable Assessments of Procedural Skills

    DEFF Research Database (Denmark)

    Mahmood, Oria; Dagnæs, Julia; Bube, Sarah

    2018-01-01

    was significant (p Pearson's correlation of 0.77 for the nonspecialists and 0.75 for the specialists. The test-retest reliability showed the biggest difference between the 2 groups, 0.59 and 0.38 for the nonspecialist raters and the specialist raters, respectively (p ... was chosen as it is a simple procedural skill that is crucial to master in a resident urology program. RESULTS: The internal consistency of assessments was high, Cronbach's α = 0.93 and 0.95 for nonspecialist and specialist raters, respectively (p correlations). The interrater reliability...

  17. Haptic feedback can provide an objective assessment of arthroscopic skills.

    Science.gov (United States)

    Chami, George; Ward, James W; Phillips, Roger; Sherman, Kevin P

    2008-04-01

    The outcome of arthroscopic procedures is related to the surgeon's skills in arthroscopy. Currently, evaluation of such skills relies on direct observation by a surgeon trainer. This type of assessment, by its nature, is subjective and time-consuming. The aim of our study was to identify whether haptic information generated from arthroscopic tools could distinguish between skilled and less skilled surgeons. A standard arthroscopic probe was fitted with a force/torque sensor. The probe was used by five surgeons with different levels of experience in knee arthroscopy performing 11 different tasks in 10 standard knee arthroscopies. The force/torque data from the hand and tool interface were recorded and synchronized with a video recording of the procedure. The torque magnitude and patterns generated were analyzed and compared. A computerized system was used to analyze the force/torque signature based on general principles for quality of performance using such measures as economy in movement, time efficiency, and consistency in performance. The results showed a considerable correlation between three haptic parameters and the surgeon's experience, which could be used in an automated objective assessment system for arthroscopic surgery. Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

  18. Assessment of provider attitudes toward #naloxone on Twitter.

    Science.gov (United States)

    Haug, Nancy A; Bielenberg, Jennifer; Linder, Steven H; Lembke, Anna

    2016-01-01

    As opioid overdose rates continue to pose a major public health crisis, the need for naloxone treatment by emergency first responders is critical. Little is known about the views of those who administer naloxone. The current study examines attitudes of health professionals on the social media platform Twitter to better understand their perceptions of opioid users, the role of naloxone, and potential training needs. Public comments on Twitter regarding naloxone were collected for a period of 3 consecutive months. The occupations of individuals who posted tweets were identified through Twitter profiles or hashtags. Categories of emergency service first responders and medical personnel were created. Qualitative analysis using a grounded theory approach was used to produce thematic content. The relationships between occupation and each theme were analyzed using Pearson chi-square statistics and post hoc analyses. A total of 368 individuals posted 467 naloxone-related tweets. Occupations consisted of professional first responders such as emergency medical technicians (EMTs), firefighters, and paramedics (n = 122); law enforcement officers (n = 70); nurses (n = 62); physicians (n = 48); other health professionals including pharmacists, pharmacy technicians, counselors, and social workers (n = 31); naloxone-trained individuals (n = 12); and students (n = 23). Primary themes included burnout, education and training, information seeking, news updates, optimism, policy and economics, stigma, and treatment. The highest levels of burnout, fatigue, and stigma regarding naloxone and opioid overdose were among nurses, EMTs, other health care providers, and physicians. In contrast, individuals who self-identified as "naloxone-trained" had the highest optimism and the lowest amount of burnout and stigma. Provider training and refinement of naloxone administration procedures are needed to improve treatment outcomes and reduce provider stigma. Social networking sites such as Twitter

  19. Credibility assessment of testimonies provided by victims with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Antonio L. MANZANERO

    2017-09-01

    Full Text Available One of the main obstacles in the way of access to justice for the victims with intellectual disability comes from the stereotypes referred to their ability to produce a statement at police legal procedures, with the consequence that some consider their statements less reliable than the rest of the victims, and others considerate their statements more reliable given their inability to create complex lies. This article reviews three of the most recent studies done by the UCM group of Psychology of Testimony, with the objective of analyzing the role of experience and intuition in the evaluation of credibility in people with intellectual disability (ID, and also it aims to prove whether the credibility analysis procedures such as Reality Monitoring (RM and Statement Validity Assessment (SVA would be valid procedures to discriminate between real and false statements within these collectives. From the results of these studies, it can be deducted that experience may not seem to be enough in order to discriminate between real and simulated victims, but analyzing the characteristics of the statements as the only indicator doesn’t seem to be enough either. As an alternative, the general procedure HELPT is proposed for the evaluation of credibility of people with ID.

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

    Science.gov (United States)

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

    2008-07-01

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

  1. Assessment of the long-term impacts of PM10 and PM2.5 particles from construction works on surrounding areas.

    Science.gov (United States)

    Azarmi, Farhad; Kumar, Prashant; Marsh, Daniel; Fuller, Gary

    2016-02-01

    Construction activities are common across cities; however, the studies assessing their contribution to airborne PM10 (≤10 μm) and PM2.5 (≤2.5 μm) particles on the surrounding air quality are limited. Herein, we assessed the impact of PM10 and PM2.5 arising from construction works in and around London. Measurements were carried out at 17 different monitoring stations around three construction sites between January 2002 and December 2013. Tapered element oscillating microbalance (TEOM 1400) and OSIRIS (2315) particle monitors were used to measure the PM10 and PM2.5 fractions in the 0.1-10 μm size range along with the ambient meteorological data. The data was analysed using bivariate concentration polar plots and k-means clustering techniques. Daily mean concentrations of PM10 were found to exceed the European Union target limit value of 50 μg m(-3) at 11 monitoring stations but remained within the allowable 35 exceedences per year, except at two monitoring stations. In general, construction works were found to influence the downwind concentrations of PM10 relatively more than PM2.5. Splitting of the data between working (0800-1800 h; local time) and non-working (1800-0800 h) periods showed about 2.2-fold higher concentrations of PM10 during working hours when compared with non-working hours. However, these observations did not allow to conclude that this increase was from the construction site emissions. Together, the polar concentration plots and the k-means cluster analysis applied to a pair of monitoring stations across the construction sites (i.e. one in upwind and the other in downwind) confirmed the contribution of construction sources on the measured concentrations. Furthermore, pairing the monitoring stations downwind of the construction sites showed a logarithmic decrease (with R(2) about 0.9) in the PM10 and PM2.5 concentration with distance. Our findings clearly indicate an impact of construction activities on the nearby downwind areas and a need

  2. Assessing vegetation response to climatic variations and human activities: spatiotemporal NDVI variations in the Hexi Corridor and surrounding areas from 2000 to 2010

    Science.gov (United States)

    Guan, Qingyu; Yang, Liqin; Guan, Wenqian; Wang, Feifei; Liu, Zeyu; Xu, Chuanqi

    2018-03-01

    Vegetation cover is a commonly used indicator for evaluating terrestrial environmental conditions, and for revealing environmental evolution and transitions. Spatiotemporal variations in the vegetation cover of the Hexi Corridor and surrounding areas from 2000 to 2010 were investigated using MODIS NDVI data, and the causes of vegetation cover changes were analyzed, considering both climatic variability and human activities. The vegetation cover of the study area increased during 2000-2010. The greenness of the vegetation showed a significant increase from the northwest to the southeast, which was similar to the spatial distribution of the annual precipitation. Variations in vegetation have a close relationship with those in precipitation within the Qilian Mountains region, but the NDVI is negatively correlated with precipitation in oasis areas. Increasing temperatures led to drought, inhibiting vegetation growth in summer; however, increasing temperatures may have also advanced and prolonged the growing periods in spring and autumn. The NDVI showed a slight degradation in March and July, primarily in the Qilian Mountains, and especially the Wushao Mountains. In March, due to low temperatures, the metabolism rate of vegetation was too slow to enable strong plant growth in high elevations of the Qilian Mountains. In July, increasing temperatures enhanced the intensity of transpiration and decreasing precipitation reduced the moisture available to plants, producing a slight degradation of vegetation in the Qilian Mountains. In May and August, the NDVI showed a significant improvement, primarily in the artificial oases and the Qilian Mountains. Abundant precipitation provided the necessary water for plant growth, and suitable temperatures increased the efficiency of photosynthesis, resulting in a significant improvement of vegetation in the Qilian Mountains. The improvement of production technologies, especially in irrigation, has been beneficial to the growth of

  3. Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills

    Science.gov (United States)

    Armstrong, Kirk J.; Jarriel, Amanda J.

    2016-01-01

    Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our…

  4. Client perspective assessment of women?s satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia

    OpenAIRE

    Dewana, Zeritu; Fikadu, Teshale; G/ Mariam, Abebe; Abdulahi, Misra

    2016-01-01

    Background A woman?s satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women?s satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women?s towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zon...

  5. High contamination in the areas surrounding abandoned mines and mining activities: An impact assessment of the Dilala, Luilu and Mpingiri Rivers, Democratic Republic of the Congo.

    Science.gov (United States)

    Atibu, Emmanuel K; Lacroix, Pierre; Sivalingam, Periyasamy; Ray, Nicolas; Giuliani, Gregory; Mulaji, Crispin K; Otamonga, Jean-Paul; Mpiana, Pius T; Slaveykova, Vera I; Poté, John

    2018-01-01

    Abandoned mines and mining activities constitute important sources of toxic metals and Rare Earth Elements (REEs) affecting surrounding environmental compartments and biota. This study investigates the contamination degree and distribution of toxic metals and REEs in contrasting sediment, soil and plant samples surrounding rivers in the African copperbelt area characterized by the presence of numerous abandoned mines, artisanal and industrial mining activities. ICP-MS results highlighted the highest concentration of Cu, Co and Pb in sediments reaching values of 146,801, 18,434 and 899 mg kg -1 , respectively. In soil, the values of 175,859, 21,134 and 1164 mg kg -1 were found for Cu, Co and Pb, respectively. These values are much higher than the sediment guidelines for the protection of aquatic life and international soil clean-up standards. Enrichment factor and geoaccumulation index results indicated important contribution of mining activities to the study sites pollution in addition to natural background. Highest metal accumulation in leaves of Phalaris arundinacea L., was observed, reaching values of 34,061, 5050 and 230 mg kg -1 for Cu, Co, and Pb, respectively. The ∑REE concentration reached values of 2306, 733, 2796 mg kg -1 in sediment, soil and plant samples, respectively. The above results were combined with geographical information including satellite imagery, hydrography and mining concessions. Maps were produced to present the results in a comprehensive and compelling visual format. The results will be disseminated through an innovative mapping online platform to simplify access to data and to facilitate dialogue between stakeholders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Development and evaluation of CAHPS survey items assessing how well healthcare providers address health literacy.

    Science.gov (United States)

    Weidmer, Beverly A; Brach, Cindy; Hays, Ron D

    2012-09-01

    The complexity of health information often exceeds patients' skills to understand and use it. To develop survey items assessing how well healthcare providers communicate health information. Domains and items for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Item Set for Addressing Health Literacy were identified through an environmental scan and input from stakeholders. The draft item set was translated into Spanish and pretested in both English and Spanish. The revised item set was field tested with a randomly selected sample of adult patients from 2 sites using mail and telephonic data collection. Item-scale correlations, confirmatory factor analysis, and internal consistency reliability estimates were estimated to assess how well the survey items performed and identify composite measures. Finally, we regressed the CAHPS global rating of the provider item on the CAHPS core communication composite and the new health literacy composites. A total of 601 completed surveys were obtained (52% response rate). Two composite measures were identified: (1) Communication to Improve Health Literacy (16 items); and (2) How Well Providers Communicate About Medicines (6 items). These 2 composites were significantly uniquely associated with the global rating of the provider (communication to improve health literacy: PLiteracy composite accounted for 90% of the variance of the original 16-item composite. This study provides support for reliability and validity of the CAHPS Item Set for Addressing Health Literacy. These items can serve to assess whether healthcare providers have communicated effectively with their patients and as a tool for quality improvement.

  7. A first aid training course for primary health care providers in Nagorno Karabagh: assessing knowledge retention.

    Science.gov (United States)

    Thompson, Michael E; Harutyunyan, Tsovinar L; Dorian, Alina H

    2012-12-01

    Conflict in the South Caucasus' Nagorno Karabagh region has damaged health facilities and disrupted the delivery of services and supplies as well as led to depletion of human and fixed capital and weakened the de facto government's ability to provide training for health care providers. In response to documented medical training deficits, the American University of Armenia organized a first aid training course (FATC) for primary health care providers within the scope of the USAID-funded Humanitarian Assistance Project in Nagorno Karabagh. This paper reports the follow-up assessments conducted to inform policy makers regarding FATC knowledge and skill retention and the potential need for periodic refresher training. Follow-up assessments were conducted six months and 18 months following the FATC to assess the retention of knowledge, attitudes, and self-reported practices. Eighty-four providers participated in the first follow-up and 210 in the second. The assessment tool contained items addressing the use and quality of the first aid skills, trainee's evaluation of the course, and randomly selected test questions to assess knowledge retention. At both follow-up points, the participants' assessment of the course was positive. More than 85% of the trainees self-assessed their skills as "excellent" or "good" and noted that skills were frequently practiced. Scores of approximately 58% on knowledge tests at both the first and second follow-ups indicated no knowledge decay between the first and second survey waves, but substantial decline from the immediate post-test assessment in the classroom. The trainees assessed the FATC as effective, and the skills covered as important and well utilized. Knowledge retention was modest, but stable. Refresher courses are necessary to reverse the decay of technical knowledge and to ensure proper application in the field.

  8. Ecological mechanisms linking protected areas to surrounding lands.

    Science.gov (United States)

    Hansen, Andrew J; DeFries, Ruth

    2007-06-01

    Land use is expanding and intensifying in the unprotected lands surrounding many of the world's protected areas. The influence of this land use change on ecological processes is poorly understood. The goal of this paper is to draw on ecological theory to provide a synthetic framework for understanding how land use change around protected areas may alter ecological processes and biodiversity within protected areas and to provide a basis for identifying scientifically based management alternatives. We first present a conceptual model of protected areas embedded within larger ecosystems that often include surrounding human land use. Drawing on case studies in this Invited Feature, we then explore a comprehensive set of ecological mechanisms by which land use on surrounding lands may influence ecological processes and biodiversity within reserves. These mechanisms involve changes in ecosystem size, with implications for minimum dynamic area, species-area effect, and trophic structure; altered flows of materials and disturbances into and out of reserves; effects on crucial habitats for seasonal and migration movements and population source/sink dynamics; and exposure to humans through hunting, poaching, exotics species, and disease. These ecological mechanisms provide a basis for assessing the vulnerability of protected areas to land use. They also suggest criteria for designing regional management to sustain protected areas in the context of surrounding human land use. These design criteria include maximizing the area of functional habitats, identifying and maintaining ecological process zones, maintaining key migration and source habitats, and managing human proximity and edge effects.

  9. A framework to assess landscape structural capacity to provide regulating ecosystem services in West Africa.

    Science.gov (United States)

    Inkoom, Justice Nana; Frank, Susanne; Greve, Klaus; Fürst, Christine

    2018-03-01

    The Sudanian savanna landscapes of West Africa are amongst the world's most vulnerable areas to climate change impacts. Inappropriate land use and agriculture management practices continuously impede the capacity of agricultural landscapes to provide ecosystem services (ES). Given the absence of practical assessment techniques to evaluate the landscape's capacity to provide regulating ES in this region, the goal of this paper is to propose an integrative assessment framework which combines remote sensing, geographic information systems, expert weighting and landscape metrics-based assessment. We utilized Analytical Hierarchical Process and Likert scale for the expert weighting of landscape capacity. In total, 56 experts from several land use and landscape management related departments participated in the assessment. Further, we adapted the hemeroby concept to define areas of naturalness while landscape metrics including Patch Density, Shannon's Diversity, and Shape Index were utilized for structural assessment. Lastly, we tested the reliability of expert weighting using certainty measurement rated by experts themselves. Our study focused on four regulating ES including flood control, pest and disease control, climate control, and wind erosion control. Our assessment framework was tested on four selected sites in the Vea catchment area of Ghana. The outcome of our study revealed that highly heterogeneous landscapes have a higher capacity to provide pest and disease control, while less heterogeneous landscapes have a higher potential to provide climate control. Further, we could show that the potential capacities to provide ecosystem services are underestimated by 15% if landscape structural aspects assessed through landscape metrics are not considered. We conclude that the combination of adapted land use and an optimized land use pattern could contribute considerably to lower climate change impacts in West African agricultural landscapes. Copyright © 2017 Elsevier

  10. The Assessment of Athletic Training Students' Knowledge and Behavior to Provide Culturally Competent Care

    Science.gov (United States)

    Nynas, Suzette Marie

    2015-01-01

    Context: Culturally competent knowledge and skills are critical for all healthcare professionals to possess in order to provide the most appropriate health care for their patients and clients. Objective: To investigate athletic training students' knowledge of culture and cultural differences, to assess the practice of culturally competent care,…

  11. Scope of practice review: providers for triage and assessment of spine-related disorders

    Directory of Open Access Journals (Sweden)

    Boakye O

    2016-05-01

    Full Text Available Omenaa Boakye,1 Arden Birney,1 Esther Suter,1 Leah Adeline Phillips,2 Victoria YM Suen3 1Workforce Research and Evaluation, Alberta Health Services, Calgary, 2College of Licensed Practical Nurses of Alberta, Edmonton, 3Addiction and Mental Health SCN, Alberta Health Services, Edmonton, AB, Canada Purpose: This study explored which health care providers could be involved in centralized intake for patients with nonspecific low back pain to enhance access, continuity, and appropriateness of care. Methods: We reviewed the scope of practice regulations for a range of health care providers. We also conducted telephone interviews with 17 individuals representing ten provincial colleges and regulatory bodies to further understand providers' legislated scopes of practice. Activities relevant to triaging and assessing patients with low back pain were mapped against professionals' scope of practice. Results: Family physicians and nurse practitioners have the most comprehensive scopes and can complete all restricted activities for spine assessment and triage, while the scope of registered nurses and licensed practical nurses are progressively narrower. Chiropractors, occupational therapists, physiotherapists, and athletic therapists are considered experts in musculoskeletal assessments and appear best suited for musculoskeletal specific assessment and triage. Other providers may play a complementary role depending on the individual patient needs. Conclusion: These findings indicate that an interprofessional assessment and triage team that includes allied health professionals would be a feasible option to create a centralized intake model. Implementation of such teams would require removing barriers that currently prevent providers from delivering on their full scope of practice. Keywords: scope of practice review, low back pain, integrated service model, centralized intake, interprofessional team

  12. Measuring patient-provider communication skills in Rwanda: Selection, adaptation and assessment of psychometric properties of the Communication Assessment Tool.

    Science.gov (United States)

    Cubaka, Vincent Kalumire; Schriver, Michael; Vedsted, Peter; Makoul, Gregory; Kallestrup, Per

    2018-04-23

    To identify, adapt and validate a measure for providers' communication and interpersonal skills in Rwanda. After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed. Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted. Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients. Eleven providers and 291 patients were involved in the field-testing. Confirmatory factor analysis showed a good fit for the original one factor model. Test-retest reliability assessment revealed a mean quadratic weighted Kappa = 0.81 (range: 0.69-0.89, N = 57). The average proportion of excellent scores was 15.7% (SD: 24.7, range: 9.9-21.8%, N = 180). Differential item functioning was not observed except for item 1, which focuses on greetings, for age groups (p = 0.02, N = 180). The Kinyarwanda version of CAT (K-CAT) is a reliable and valid patient-reported measure of providers' communication and interpersonal skills. K-CAT was validated on nurses and its use on other types of providers may require further validation. K-CAT is expected to be a valuable feedback tool for providers in practice and in training. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Optimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.

    Science.gov (United States)

    Foster, Cortney B; Simone, Shari; Bagdure, Dayanand; Garber, Nan A; Bhutta, Adnan

    2016-09-01

    The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. PubMed, CINAHL, OVID MEDLINE, and Cochrane Review from 2002 to 2015. Experimental study designs conducted in an ICU setting. Two reviewers screened articles for eligibility and independently abstracted data using the identified search terms. We found 21 articles describing ICU team structure and outcomes. Four articles were found describing the impact of advanced practice providers on resident or fellow education. Two articles were found discussing strategies to promote collaboration between advanced practice providers and critical care fellows or residents. Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.

  14. Combined student ratings and self-assessment provide useful feedback for clinical teachers

    Science.gov (United States)

    Dolmans, Diana H. J. M.; Wolfhagen, Ineke H. A. P.; Peters, Wim G.; van Coppenolle, Lieve; Scherpbier, Albert J. J. A.

    2009-01-01

    Many evaluation instruments have been developed to provide feedback to physicians on their clinical teaching but written feedback alone is not always effective. We explored whether feedback effectiveness improved when teachers’ self-assessment was added to written feedback based on student ratings. 37 physicians (10 residents, 27 attending physicians) from different specialties (Internal Medicine, Surgery, Obstetrics/Gynecology, Pediatrics, Neurology, Dermatology, Ophthalmology, ENT, and Psychiatry) were invited to fill out a self-assessment questionnaire on their teaching skills. Students completed an almost identical questionnaire to evaluate the same teachers based on their experiences during clerkships. After receiving written feedback incorporating their self-assessment and the student ratings, the teachers indicated their perceptions of the self-assessment exercise and the written feedback in a questionnaire (five-point Likert scale items) and next, in more detail, in semi-structured interviews with a purposive sample of 12 of the participating teachers. 25 physicians participated (67%). The results showed that self-assessment and student feedback were both perceived as useful (3.7, SD 1.0) but the latter was considered more effective. The physicians we interviewed considered the combination of self-assessment with student ratings more effective than either self-assessment or written feedback alone. Notably, discrepancies between student ratings and self-assessment were deemed a strong incentive for change. We conclude that self-assessment can be a useful tool to stimulate improvement of clinical teaching when it is combined with written feedback based on student ratings. Future research among larger groups is needed to confirm our findings and examine whether these combined tools actually lead to improved teaching. PMID:19779976

  15. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service.

    Science.gov (United States)

    Bath, Brenna; Janzen, Bonnie

    2012-01-01

    To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons. People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding. A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were "very satisfied" with the service and 55% were "very satisfied" with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were "very satisfied" with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction), negative (ie, lack of detail, time to follow-up, cost) and neutral related to the triage service, and an "other" category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.) The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given the low response rate, these results should be interpreted with caution. Qualitative analysis of participant and provider comments revealed a diverse range of themes. These other issues may be important contextual factors that have the potential to impact patient relevant outcomes.

  16. Training needs assessment of service providers: targeted intervention for HIV/AIDS in Jharkhand, India.

    Science.gov (United States)

    Kumar, Anant; Kumar, Prakash

    2013-01-01

    Training needs assessments are pivotal for any capacity building program. Building capacity of service providers and staff involved in HIV/AIDS intervention programs is crucial because of the distinct nature of such programs. It requires specific knowledge, skills, and attitudes that are of utmost importance, influencing the reach of the program and its impact in halting and reversing the epidemic. This study was conducted to identify the training needs assessment of personnel involved in targeted intervention for high risk populations vulnerable to HIV infection in Jharkhand, India. Through the study the authors critically examine the existing training needs and gaps and suggest strategies to address them.

  17. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers

    Directory of Open Access Journals (Sweden)

    Murtomaa Heikki

    2011-05-01

    Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion

  18. Assessing implementation difficulties in tobacco use prevention and cessation counselling among dental providers.

    Science.gov (United States)

    Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H

    2011-05-26

    Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55

  19. Assessing Capacity for Providing Culturally Competent Services to LGBT Older Adults

    Science.gov (United States)

    Portz, Jennifer Dickman; Retrum, Jessica H.; Wright, Leslie A.; Boggs, Jennifer M.; Wilkins, Shari; Grimm, Cathy; Gilchrist, Kay; Gozansky, Wendolyn S.

    2014-01-01

    This qualitative, interview-based study assessed the cultural competence of health and social service providers to meet the needs of LGBT older adults in an urban neighborhood in Denver, Colorado, known to have a large LGBT community. Only 4 of the agencies were categorized as “high competency” while 12 were felt to be “seeking improvement” and 8 were considered “not aware.” These results indicate significant gaps in cultural competency for the majority of service providers. Social workers are well-suited to lead efforts directed at improving service provision and care competencies for the older LGBT community. PMID:24798180

  20. Readability assessment of online patient education materials provided by the European Association of Urology.

    Science.gov (United States)

    Betschart, Patrick; Zumstein, Valentin; Bentivoglio, Maico; Engeler, Daniel; Schmid, Hans-Peter; Abt, Dominik

    2017-12-01

    To assess the readability of the web-based patient education material provided by the European Association of Urology. English patient education materials (PEM) as available in May 2017 were obtained from the EAU website. Each topic was analyzed separately using six well-established readability assessment tools, including Flesch-Kincaid Grade Level (FKGL), SMOG Grade Level (SMOG), Coleman-Liau Index (CLI), Gunning Fog Index (GFI), Flesch Reading Ease Formula (FRE) and Fry Readability Graph (FRG). A total of 17 main topics were identified of which separate basic and in-depth information is provided for 14 topics. Calculation of grade levels (FKGL, SMOG, CLI, GFI) showed readability scores of 7th-13th grade for basic information, 8th-15th grade for in-depth information and 7th-15th grade for single PEM. Median FRE score was 54 points (range 45-65) for basic information and 56 points (41-64) for in-depth information. The FRG as a graphical assessment revealed only 13 valid results with an approximate 8th-17th grade level. The EAU provides carefully worked out PEM for 17 urological topics. Although improved readability compared to similar analyses was found, a simplification of certain chapters might be helpful to facilitate better patient understanding.

  1. Development and Psychometric Assessment of the Healthcare Provider Cultural Competence Instrument

    Directory of Open Access Journals (Sweden)

    Joshua L. Schwarz PhD

    2015-04-01

    Full Text Available This study presents the measurement properties of 5 scales used in the Healthcare Provider Cultural Competence Instrument (HPCCI. The HPCCI measures a health care provider’s cultural competence along 5 primary dimensions: (1 awareness/sensitivity, (2 behaviors, (3 patient-centered communication, (4 practice orientation, and (5 self-assessment. Exploratory factor analysis demonstrated that the 5 scales were distinct, and within each scale items loaded as expected. Reliability statistics indicated a high level of internal consistency within each scale. The results indicate that the HPCCI effectively measures the cultural competence of health care providers and can provide useful professional feedback for practitioners and organizations seeking to increase a practitioner’s cultural competence.

  2. Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

    Science.gov (United States)

    Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

    2018-06-01

    The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  3. Landscapes‘ Capacities to Provide Ecosystem Services – a Concept for Land-Cover Based Assessments

    Directory of Open Access Journals (Sweden)

    Benjamin Burkhard

    2009-12-01

    Full Text Available Landscapes differ in their capacities to provide ecosystem goods and services, which are the benefits humans obtain from nature. Structures and functions of ecosystems needed to sustain the provision of ecosystem services are altered by various human activities. In this paper, a concept for the assessment of multiple ecosystem services is proposed as a basis for discussion and further development of a respective evaluation instrument. Using quantitative and qualitative assessment data in combination with land cover and land use information originated from remote sensing and GIS, impacts of human activities can be evaluated. The results reveal typical patterns of different ecosystems‘ capacities to provide ecosystem services. The proposed approach thus delivers useful integrative information for environmental management and landscape planning, aiming at a sustainable use of services provided by nature. The research concept and methodological framework presented here for discussion have initially been applied in different case studies and shall be developed further to provide a useful tool for the quantification and spatial modelling of multiple ecosystem services in different landscapes. An exemplary application of the approach dealing with food provision in the Halle-Leipzig region in Germany is presented. It shows typical patterns of ecosystem service distribution around urban areas. As the approach is new and still rather general, there is great potential for improvement, especially with regard to a data-based quantification of the numerous hypotheses, which were formulated as base for the assessment. Moreover, the integration of more detailed landscape information on different scales will be needed in future in order to take the heterogeneous distribution of landscape properties and values into account. Therefore, the purpose of this paper is to foster critical discussions on the methodological development presented here.

  4. Patient and referring health care provider satisfaction with a physiotherapy spinal triage assessment service

    Directory of Open Access Journals (Sweden)

    Bath B

    2011-12-01

    Full Text Available Brenna Bath1, Bonnie Janzen21School of Physical Therapy, College of Medicine, University of Saskatchewan, 2Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, CanadaPurpose: To evaluate participant and referring care provider satisfaction associated with a spinal triage assessment service delivered by physiotherapists in collaboration with orthopedic surgeons.Methods: People with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists. Measures of patient and provider satisfaction were completed at approximately 4 weeks after the assessment. The satisfaction surveys were analyzed quantitatively with descriptive statistics and qualitatively with an inductive thematic approach of open and axial coding.Results: A total of 108/115 participants completed the posttest satisfaction survey. Sixty-six percent of participants were “very satisfied” with the service and 55% were “very satisfied” with the recommendations that were made. Only 18% of referring care providers completed the satisfaction survey and 90.5% of those were “very satisfied” with the recommendations. Sixty-one participants and 14 care providers provided comments which revealed a diverse range of themes which were coded into positive (ie, understanding the problem, communication, customer service, efficiency, and management direction, negative (ie, lack of detail, time to follow-up, cost and neutral related to the triage service, and an “other” category unrelated to the service (ie, chronic symptoms, comorbidities, and limited access to health care.Conclusion: The quantitative results of the participant survey demonstrated very high levels of satisfaction with the service and slightly less satisfaction with the recommendations that were made. Satisfaction of referring care providers with the recommendations and report was also high, but given

  5. Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania.

    Science.gov (United States)

    Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

    2017-12-01

    Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women's use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities' capacity to provide newborn care services in low and middle income countries. In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally-representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn-related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to substantial equity gaps in the availability of essential

  6. Best Practices in Physics Program Assessment: Should APS Provide Accreditation Standards for Physics?

    Science.gov (United States)

    Hodapp, Theodore

    The Phys21 report, ``Preparing Physics Students for 21st Century Careers,'' provides guidance for physics programs to improve their degree programs to make them more relevant for student career choices. Undertaking such changes and assessing impact varies widely by institution, with many departments inventing assessments with each periodic departmental or programmatic review. American Physical Society has embarked on a process to integrate information from Phys21, the results of other national studies, and educational research outcomes to generate a best-practices guide to help physics departments conduct program review, assessment, and improvement. It is anticipated that departments will be able to use this document to help with their role in university-level accreditation, and in making the case for improvements to departmental programs. Accreditation of physics programs could stem from such a document, and I will discuss some of the thinking of the APS Committee on Education in creating this guide, and how they are advising APS to move forward in the higher education landscape that is increasingly subject to standards-based evaluations. I will describe plans for the design, review, and dissemination of this guide, and how faculty can provide input into its development. This material is based upon work supported by the National Science Foundation under Grant No. 1540570. Opinions expressed do not necessarily reflect those of the NSF.

  7. Assessing the environmental fate of selected polybrominated diphenyl ethers in the region surrounding the Zhuoshui River of Taiwan based on an Equilibrium Constant fugacity model

    Science.gov (United States)

    O'Driscoll, Kieran; Doherty, Rory; Robinson, Jill; Chiang, Wen-Son; Kao Kao, Ruey-Chy

    2015-04-01

    Polybrominated diphenyl ethers (PBDEs) are a group of flame retardants that have been in use since the 1970s. They are included in the list of hazardous substances known as persistent organic pollutants (POPs) because they are extremely hazardous to the environment and human health. PBDEs have been extensively used in industry and manufacturing in Taiwan, thus its citizens are at high risk of exposure to these chemicals. An assessment of the environmental fate of these compounds in the Zhuoshui river and Changhua County regions of western Taiwan, and also including the adjacent area of the Taiwan Strait, was conducted for three high risk congeners, BDE-47, -99 and -209, to obtain information regarding the partitioning, advection, transfer and long range transport potential of the PBDEs in order to identify the level of risk posed by the pollutants in this region. The results indicate that large amounts of PBDEs presently reside in all model compartments - air, soil, water, and sediment - with particularly high levels found in air and especially in sediment. The high levels found in sediment, particularly for BDE-209, are significant, since there is the threat of these pollutants entering the food chain, either directly through benthic feeding, or through resuspension and subsequent feeding in the pelagic region of the water column which is a distinct possibility in the strong currents found within the Taiwan Strait. Another important result is that a substantial portion of emissions leave the model domain directly through advection, particularly for BDE-47 (58%) and BDE-209 (75%), thus posing a risk to adjacent communities. Model results were generally in reasonable agreement with available measured concentrations. In air, model concentrations are in reasonably good agreement with available measured values. For both BDE-47 and -99, model concentrations are a factor of 2-3 higher and BDE-209 within the range of measured values. In soil, model results are somewhat

  8. Assessment of the impact of a nuclear waste repository at Yucca Mountain on the economic development potential of Las Vegas, Clark County, and the surrounding area

    International Nuclear Information System (INIS)

    Boyle, M.R.

    1989-01-01

    Growth Strategies Organization has completed an assessment of the Las Vegas MSA's competitiveness in the attraction of new business facilities to the area. That report found that under current business climate conditions and in the present economic development market place, the region is a competitive site for about one hundred of the six hundred types of primary businesses studied. It is almost competitive as a location for another 80 to 90 types of businesses and is a marginal choice for another 200 business groups. In other words, Clark County, as is, fully satisfies the basic requirements of almost a sixth of the businesses in this study. With minor improvements in areas such as the skill mix of its work force and the quality of its educational facilities and with an effective campaign to improve the area's image, the Las Vegas area could become a competitive location for about two-thirds of all business groups -- a very large shift in marketability. The proposed nuclear waste repository that he Federal government has proposed for siting at Yucca Mountain more than a hundred miles from Las Vegas would become operational after the turn of the century, more than fifteen years from now. Its influence on business investment decisions would be felt in the mid- to late-1990s if the final decision were made and announced. To measure that impact it would be desirable to establish a baseline that reflects Clark County's competitiveness as a business facility location in the middle of the next decade. In constructing that baseline, several variables could be considered -- changes in business climate conditions in the area other than the nuclear waste repository; and changes in the location decision process itself resulting from changes in technology and in market pressures

  9. Assessment of quality of water provided for wildlife in the Central Kalahari Game Reserve, Botswana

    Science.gov (United States)

    Selebatso, Moses; Maude, Glyn; Fynn, Richard W. S.

    2018-06-01

    Arid and semi-arid environments have low and unpredictable rainfall patterns resulting in limited availability of surface water for wildlife. In the Central Kalahari Game Reserve (CKGR) wildlife populations have lost access to natural surface water through cordon fences, livestock and human encroachment along the access routes. Artificial waterholes have been developed in the reserve to compensate for this loss. However, there have not been any assessments of the quality of water provided for wildlife and how that may be contributing to populations declines in the CKGR. We assessed water quality from 12 artificial waterholes against both Botswana and international livestock standards for drinking. Overall the quality of water provided is poor and poses a health risk to both animals and humans. Eight out of twelve boreholes tested exceeded the maximum acceptable Total Dissolved Solids (TDS) limits while three and four boreholes have toxic levels of lead and arsenic, respectively. Thus, pumping ground water could have more negative than positive impacts on wildlife thus defeating the intended management purpose. Failure to provide water of acceptable quality is a major concern for wildlife management in the CKGR and it may underlie some wildlife declines in the reserve. These findings confirm that restriction of populations from natural water sources create complex management challenges, especially where safe and sustainable alternative sources are scarce. Restriction of access of the population to natural water sources by fences and provision of poor quality water could compromise the overall fitness of wildlife populations and contribute to their decline.

  10. Proximity of the Triangular Fibrocartilage Complex to Key Surrounding Structures and Safety Assessment of an Arthroscopic Repair Technique: A Cadaveric Study.

    Science.gov (United States)

    Kuremsky, Marshall A; Habet, Nahir; Peindl, Richard D; Gaston, R Glenn

    2016-12-01

    To quantify the distance of the dorsal ulnar sensory branch, floor of the extensor carpi ulnaris (ECU) subsheath, and ulnar neurovascular bundles from the triangular fibrocartilage complex (TFCC), and secondarily to assess the safety of an all-inside arthroscopic repair of the TFCC with a commonly used meniscal repair device with respect to the aforementioned structures. A custom K-wire with 1-mm gradation was used to determine the distance of at-risk structures from the periphery of the TFCC in 13 above-elbow human cadaver specimens. An all-inside repair of the TFCC at the location of a Palmer 1B tear was then performed using a commonly employed meniscal repair device. The distance from the deployed devices to the structure in closest proximity was then measured using digital calipers. The mean distance from the deployed device to the nearest structure of concern for iatrogenic injury was 9.4 mm (range, 5-15 mm). The closest structure to iatrogenic injury was usually, but not always, the dorsal ulnar sensory nerve in 9 of 13 wrists (69.2%) at 9.3 mm (range, 5-15 mm); on 3 occasions it was instead the ulnar nerve (23.1%) at 9.5 mm (range, 9-10 mm), and on 1 occasion 6 mm from the flexor digitorum profundus to the little finger (7.7%). Forearm rotation had no significant effect on measured distances (ulnar nerve: P = .98; dorsal sensory: P = .89; ECU: P = .90). The largest influence of forearm rotation was a 0.4-mm difference between pronation and supination with respect to the distance of the TFCC periphery on the ECU subsheath. An all-inside arthroscopic TFCC repair using a commonly used meniscal repair device appears safe with respect to nearby neurovascular structures and tendons under typical arthroscopic conditions. An all-inside arthroscopic TFCC repair using a commonly employed meniscal repair device appears safe in terms of proximity to important structures although further clinical investigation is warranted. Copyright © 2016 Arthroscopy

  11. EMS Provider Assessment of Vehicle Damage Compared to a Professional Crash Reconstructionist

    Science.gov (United States)

    Lerner, E. Brooke; Cushman, Jeremy T.; Blatt, Alan; Lawrence, Richard; Shah, Manish N.; Swor, Robert; Brasel, Karen; Jurkovich, Gregory J.

    2011-01-01

    Objective To determine the accuracy of EMS provider assessments of motor vehicle damage, when compared to measurements made by a professional crash reconstructionist. Methods EMS providers caring for adult patients injured during a motor vehicle crash and transported to the regional trauma center in a midsized community were interviewed upon ED arrival. The interview collected provider estimates of crash mechanism of injury. For crashes that met a preset severity threshold, the vehicle’s owner was asked to consent to having a crash reconstructionist assess their vehicle. The assessment included measuring intrusion and external auto deformity. Vehicle damage was used to calculate change in velocity. Paired t-test and correlation were used to compare EMS estimates and investigator derived values. Results 91 vehicles were enrolled; of these 58 were inspected and 33 were excluded because the vehicle was not accessible. 6 vehicles had multiple patients. Therefore, a total of 68 EMS estimates were compared to the inspection findings. Patients were 46% male, 28% admitted to hospital, and 1% died. Mean EMS estimated deformity was 18” and mean measured was 14”. Mean EMS estimated intrusion was 5” and mean measured was 4”. EMS providers and the reconstructionist had 67% agreement for determination of external auto deformity (kappa 0.26), and 88% agreement for determination of intrusion (kappa 0.27) when the 1999 Field Triage Decision Scheme Criteria were applied. Mean EMS estimated speed prior to the crash was 48 mph±13 and mean reconstructionist estimated change in velocity was 18 mph±12 (correlation -0.45). EMS determined that 19 vehicles had rolled over while the investigator identified 18 (kappa 0.96). In 55 cases EMS and the investigator agreed on seatbelt use, for the remaining 13 cases there was disagreement (5) or the investigator was unable to make a determination (8) (kappa 0.40). Conclusions This study found that EMS providers are good at estimating

  12. Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

    Science.gov (United States)

    Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

    2015-01-01

    Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi

  13. Assessing endothelial function and providing calibrated UFMD data using a blood pressure cuff

    Science.gov (United States)

    Maltz, Jonathan S.

    2017-08-22

    Methods and apparatus are provided for assessing endothelial function in a mammal. In certain embodiments the methods involve using a cuff to apply pressure to an artery in a subject to determine a plurality of baseline values for a parameter related to endothelial function as a function of applied pressure (P.sub.m); b) applying a stimulus to the subject; and applying external pressure P.sub.m to the artery to determine a plurality of stimulus-effected values for the parameter related to endothelial function as a function of applied pressure (P.sub.m); where the baseline values are determined from measurements made when said mammal is not substantially effected by said stimulus and differences in said baseline values and said stimulus-effected values provide a measure of endothelial function in said mammal.

  14. Pop-rock musicians: assessment of their satisfaction provided by hearing protectors.

    Science.gov (United States)

    Santoni, Cristiane Bolzachini; Fiorini, Ana Claudia

    2010-01-01

    Pop-rock musicians are at risk of developing hearing loss and other symptoms related to amplified music. The aim of the present study was to assess the satisfaction provided by the use of hearing protection in pop-rock musicians. Contemporary cohort study. A study of 23 male pop-rock musicians, aged between 25 to 45 years. After audiological evaluation (pure tone audiometry, middle ear analysis, TEOAE and DPOAE) hearing protective devices were provided to be used for three months. After that musicians answered a satisfaction assessment questionnaire. The prevalence of hearing loss was of 21.7%. The most common complaints about the hearing protectors were: autophonia, pressure in the ears, interference in high frequencies perception and full time use of the hearing protector during concerts. There was a positive correlation between a reduction in tinnitus after the use of the HPD with the following complaints: tinnitus after beginning the career (p= 0.044), discomfort with the sound intensity in the work place (p= 0.009) and intolerance to loud sound (p= 0.029). There was a high prevalence of hearing loss and a positive tendency towards the use of the ear protector device among the sample population.

  15. OMARC: An online multimedia application for training health care providers in the assessment of respiratory conditions.

    Science.gov (United States)

    Meruvia-Pastor, Oscar; Patra, Pranjal; Andres, Karen; Twomey, Creina; Peña-Castillo, Lourdes

    2016-05-01

    OMARC, a multimedia application designed to support the training of health care providers for the identification of common lung sounds heard in a patient's thorax as part of a health assessment, is described and its positive contribution to user learning is assessed. The main goal of OMARC is to effectively help health-care students become familiar with lung sounds as part of the assessment of respiratory conditions. In addition, the application must be easy to use and accessible to students and practitioners over the internet. OMARC was developed using an online platform to facilitate access to users in remote locations. OMARC's unique contribution as an educational software tool is that it presents a narrative about normal and abnormal lung sounds using interactive multimedia and sample case studies designed by professional health-care providers and educators. Its interface consists of two distinct components: a sounds glossary and a rich multimedia interface which presents clinical case studies and provides access to lung sounds placed on a model of a human torso. OMARC's contents can be extended through the addition of sounds and case studies designed by health-care educators and professionals. To validate OMARC and determine its efficacy in improving learning and capture user perceptions about it, we performed a pilot study with ten nursing students. Participants' performance was measured through an evaluation of their ability to identify several normal and adventitious/abnormal sounds prior and after exposure to OMARC. Results indicate that participants are able to better identify different lung sounds, going from an average of 63% (S.D. 18.3%) in the pre-test evaluation to an average of 90% (S.D. of 11.5%) after practising with OMARC. Furthermore, participants indicated in a user satisfaction questionnaire that they found the application helpful, easy to use and that they would recommend it to other persons in their field. OMARC is an online multimedia

  16. Vasculature surrounding a nodule: A novel lung cancer biomarker.

    Science.gov (United States)

    Wang, Xiaohua; Leader, Joseph K; Wang, Renwei; Wilson, David; Herman, James; Yuan, Jian-Min; Pu, Jiantao

    2017-12-01

    To investigate whether the vessels surrounding a nodule depicted on non-contrast, low-dose computed tomography (LDCT) can discriminate benign and malignant screen detected nodules. We collected a dataset consisting of LDCT scans acquired on 100 subjects from the Pittsburgh Lung Screening study (PLuSS). Fifty subjects were diagnosed with lung cancer and 50 subjects had suspicious nodules later proven benign. For the lung cancer cases, the location of the malignant nodule in the LDCT scans was known; while for the benign cases, the largest nodule in the LDCT scan was used in the analysis. A computer algorithm was developed to identify surrounding vessels and quantify the number and volume of vessels that were connected or near the nodule. A nonparametric receiver operating characteristic (ROC) analysis was performed based on a single nodule per subject to assess the discriminability of the surrounding vessels to provide a lung cancer diagnosis. Odds ratio (OR) were computed to determine the probability of a nodule being lung cancer based on the vessel features. The areas under the ROC curves (AUCs) for vessel count and vessel volume were 0.722 (95% CI=0.616-0.811, plung cancer group 9.7 (±9.6) compared to the non-lung cancer group 4.0 (±4.3) CONCLUSION: Our preliminary results showed that malignant nodules are often surrounded by more vessels compared to benign nodules, suggesting that the surrounding vessel characteristics could serve as lung cancer biomarker for indeterminate nodules detected during LDCT lung cancer screening using only the information collected during the initial visit. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. IAEA technical meeting: Assess and co-ordinate modelling needs and data providers. Summary report

    International Nuclear Information System (INIS)

    Clark, R.E.H.

    2004-05-01

    This report briefly describes the proceedings, conclusions and recommendations of the Technical Meeting to 'Assess and Co-ordinate Modelling Needs and Data Providers', held on 4-5 December 2003. Eight international experts on atomic and molecular data related to fusion energy research activities participated in the meeting. Each participant reviewed the current status of their own speciality and current lines of research as well as anticipated needs in new data for nuclear fusion energy research. Current CRPs on related topics were reviewed. In light of current research activities and anticipated data needs for fusion, a detailed set of tasks appropriate for a new CRP was developed. This meeting completely fulfilled the specified goals. (author)

  18. Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

    Science.gov (United States)

    Piper, Llewellyn E; Tallman, Erin

    2016-01-01

    This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

  19. Assessing the quality of websites providing information on multiple sclerosis: evaluating tools and comparing sites.

    Science.gov (United States)

    Harland, Juliet; Bath, Peter

    2007-09-01

    The quality of health information available on the Internet has proved difficult to assess objectively. The Internet's growing popularity as a source of health information, accompanied by the lack of regulation of websites, has resulted in research that has developed and tested tools to evaluate health website quality. However, only a few studies have tested the validity and reliability of these tools. There is a lack of consensus about appropriate indicators with which to operationalize the concept of quality health information. This study aimed to contribute to this research by testing the validity and reliability of existing tools, through their application to websites that provided information about multiple sclerosis. Furthermore, a specific tool for evaluating multiple sclerosis information was developed, contributing to the debate about suitable criteria for measuring the ;quality' of health information on the web.

  20. CT provides precise size assessment of implanted titanium alloy pedicle screws.

    Science.gov (United States)

    Elliott, Michael J; Slakey, Joseph B

    2014-05-01

    After performing instrumented spinal fusion with pedicle screws, postoperative imaging using CT to assess screw position may be necessary. Stainless steel implants produce significant metal artifact on CT, and the degree of distortion is at least partially dependent on the cross-sectional area of the implanted device. If the same effect occurs with titanium alloy implants, ability to precisely measure proximity of screws to adjacent structures may be adversely affected as screw size increases. We therefore asked whether (1) CT provides precise measurements of true screw widths; and (2) precision degrades based on the size of the titanium implant imaged. CT scans performed on 20 patients after instrumented spinal fusion for scoliosis were reviewed. The sizes of 151 titanium alloy pedicle screws were measured and compared with known screw size. The amount of metal bloom artifact was determined for each of the four screw sizes. ANOVA with Tukey's post hoc test were performed to evaluate differences in scatter, and Spearman's rho coefficient was used to measure relationship between screw size and scatter. All screws measured larger than their known size, but even with larger 7-mm screws the size differential was less than 1 mm. The four different screw sizes produced scatter amounts that were different from each other (p titanium alloy pedicle screws produces minimal artifact, thus making this the preferred imaging modality to assess screw position after surgery. Although the amount of artifact increases with the volume of titanium present, the degree of distortion is minimal and is usually less than 1 mm.

  1. Circumstances surrounding aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Schievink, W. I.; Karemaker, J. M.; Hageman, L. M.; van der Werf, D. J.

    1989-01-01

    The circumstances surrounding aneurysmal subarachnoid hemorrhage were investigated in a group of 500 consecutive patients admitted to a neurosurgical center. Subarachnoid hemorrhage occurred during stressful events in 42.8% of the patients, during nonstrenuous activities in 34.4%, and during rest or

  2. Utility of providing a concussion definition in the assessment of concussion history in former NFL players.

    Science.gov (United States)

    Alosco, Michael L; Jarnagin, Johnny; Tripodis, Yorghos; Martin, Brett; Chaisson, Christine; Baugh, Christine M; Torres, Alcy; Nowinski, Christopher J; Cantu, Robert C; Stern, Robert A

    2017-01-01

    Former National Football League (NFL) players' working knowledge of concussion has not yet been evaluated, despite this population being a major clinical research target due to the association between repetitive head impacts (RHI) and long-term clinical impairments. This study examined former NFL players' understanding of the current concussion definition, and the association between number of concussions with clinical function. 95 former NFL players (mean age = 55.29; mean NFL year = 8.10) self-reported number of concussions before being provided with a concussion definition and after being read a modern definition of concussion. Subjects reported number of concussions with loss of consciousness (LOC). Principal Component Analysis of a battery of tests generated behaviour/mood, psychomotor speed/executive function, and verbal and visual memory factor scores. Post-definition number of concussions (median = 50) was five times the pre-definition (median = 10; p football played, with specific effects for depressive symptoms and impulsivity. LOC did not account for variance beyond number of concussions. Practitioners and clinical researchers should provide a definition of concussion in the assessment of concussion history in former football players to facilitate accuracy and standardization.

  3. Intraoperative angiography provides objective assessment of skin perfusion in complex knee reconstruction.

    Science.gov (United States)

    Wyles, Cody C; Taunton, Michael J; Jacobson, Steven R; Tran, Nho V; Sierra, Rafael J; Trousdale, Robert T

    2015-01-01

    Wound necrosis is a potentially devastating complication of complex knee reconstruction. Laser-assisted indocyanine green angiography (LA-ICGA) is a technology that has been described in the plastic surgery literature to provide an objective assessment of skin perfusion in the operating room. This novel technology uses a plasma protein bound dye (ICG) and a camera unit that is calibrated to view the frequency emitted by the dye. The intention of this technology is to offer real-time visualization of blood flow to skin and soft tissue in a way that might help surgeons make decisions about closure or coverage of a surgical site based on blood flow, potentially avoiding soft tissue reconstruction while preventing skin necrosis or wound breakdown after primary closures, but its efficacy is untested in the setting of complex TKA. The purpose of this study was to evaluate perfusion borders and tension ischemia in a series of complex knee reconstructions to guide optimal wound management. Beginning in mid-2011, an LA-ICGA system was used to evaluate soft tissue viability in knee reconstruction procedures that were considered high risk for wound complications. Seven patients undergoing complex primary or revision TKA from 2011 to 2013 were included. These patients were chosen as a convenience sample of knee reconstruction procedures for which we obtained consultation with the plastic surgery service. The perfusion of skin and soft tissue coverage was evaluated intraoperatively for all patients with the LA-ICGA system, and the information was used to guide wound management. Followup was at a mean of 9 months (range, 6-17 months), no patients were lost to followup, and the main study endpoint was uneventful healing of the surgical incision. All seven closures went on to heal without necrosis. One patient, however, was subsequently revised for a deep periprosthetic infection 4 months after their knee reconstruction and underwent flap coverage at the time of that revision

  4. Assessment of Barriers to Providing Introductory Pharmacy Practice Experiences (IPPEs in the Hospital Setting

    Directory of Open Access Journals (Sweden)

    Matthew J Gibson

    2016-07-01

    Full Text Available Objectives: The primary objective of the study is to identify the barriers to providing Introductory Pharmacy Practice Experiences (IPPEs in the hospital setting. Methods: Potential barriers to IPPEs were identified via literature review and interviews with current IPPE preceptors from various institutions. Based on this information, an electronic survey was developed and distributed to IPPE preceptors in order to assess student, preceptor, logistical and college or school of pharmacy related barriers that potentially exist for providing IPPE in the hospital setting. Results: Sixty-eight of the 287 eligible survey respondents (24% completed the electronic survey. Seventy-six percent of respondents agreed or strongly agreed that available time was a barrier to precepting IPPE students even though a majority of respondents reported spending a third or more of their day with an IPPE student when on rotation. Seventy-three percent of respondents disagreed or strongly disagreed that all preceptors have consistent performance expectations for students, while just 46% agreed or strongly agreed that they had adequate training to precept IPPEs. Sixty-five percent of respondents agreed that IPPE students have the ability to be a participant in patient care and 70% of preceptors believe that IPPE students should be involved in patient care. Conclusions: Conducting IPPEs in the institutional setting comes with challenges. Based on the results of this study, experiential directors and colleges/schools of pharmacy could make a positive impact on the quality and consistency of IPPEs by setting student expectations and training preceptors on appropriate and consistent expectations for students.   Type: Original Research

  5. Provider perceptions concerning use of chest x-ray studies in adult blunt trauma assessments.

    Science.gov (United States)

    Calderon, Georgina; Perez, Daniel; Fortman, Jonathan; Kea, Bory; Rodriguez, Robert M

    2012-10-01

    Although they infrequently lead to management changing diagnoses, chest x-rays (CXRs) are the most commonly ordered imaging study in blunt trauma evaluation. To determine: 1) the reasons physicians order chest X-ray studies (CXRs) in blunt trauma assessments; 2) what injuries they expect CXRs to reveal; and 3) whether physicians can accurately predict low likelihood of injury on CXR. At a Level I Trauma Center, we asked resident and attending physicians treating adult blunt trauma patients: 1) the primary reason(s) for getting CXRs; 2) what, if any, significant intrathoracic injuries (SITI) they expected CXRs to reveal; and 3) the likelihood of these injuries. An expert panel defined SITI as two or more rib fractures, sternal fracture, pulmonary contusion, pneumothorax, hemothorax, or aortic injury on official CXR readings. There were 484 patient encounters analyzed--65% of participating physicians were residents and 35% were attendings; 16 (3.3%) patients had SITI. The most common reasons for ordering CXRs were: "enough concern for significant injury" (62.9%) and belief that CXR is a "standard part of trauma work-up" (24.8%). Residents were more likely than attendings to cite "standard trauma work-up" (mean difference = 13.5%, p = 0.003). When physicians estimated a 25% likelihood, 9.1% (95% CI 3.0-20.0%) had SITI. Physicians order CXRs in blunt trauma patients because they expect to find injuries and believe that CXRs are part of a "standard" work-up. Providers commonly do not expect CXRs to reveal SITI. When providers estimated low likelihood of SITI, the rate of SITI was very low. Published by Elsevier Inc.

  6. Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

    2016-01-01

    Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

  7. Consumer assessment of healthcare providers and systems surgical care survey: benefits and challenges.

    Science.gov (United States)

    Schulz, Kristine A; Rhee, John S; Brereton, Jean M; Zema, Carla L; Witsell, David L

    2012-10-01

    To describe the feasibility and initial results of the implementation of a continuous quality improvement project using the newly available Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS), in a small cohort of otolaryngology-head and neck surgery practices. Prospective observational study using a newly validated health care consumer survey. Two community-based and 2 university-based otolaryngology-head and neck surgery outpatient clinic practices. Fourteen board-certified otolaryngology, head and neck surgeons from 4 practice sites voluntarily participated in this project. All adult patients scheduled for surgery during a 12-month period were asked to complete the S-CAHPS survey through an electronic data capture (EDC) system 7 to 28 days after surgery. The surgeons were not directly involved in administration or collection of survey data. Three sites successfully implemented the S-CAHPS project. A 39.9% response rate was achieved for the cohort of surgical patients entered into the EDC system. While most patients rated their surgeons very high (mean of 9.5 or greater out of 10), subanalysis revealed there is variability among sites and surgeons in communication practices. From these data, a potential surgeon Quality Improvement report was developed that highlights priority areas to improve surgeon-patient rapport. The S-CAHPS survey can be successfully implemented in most otolaryngology practices, and our initial work holds promise for how the survey can be best deployed and analyzed for the betterment of both the surgeon and the patient.

  8. Assessment of the quality of service provided by a national regulatory institution

    Directory of Open Access Journals (Sweden)

    Adetunji, O.

    2013-05-01

    Full Text Available Government institutions need to assess how well they meet the needs of their customers, and what their customers think about the quality of the services they provide. This is aligned with the Batho Pele principle of the South African government. The SERVQUAL scale, augmented with a qualitative survey, was used to determine how the National Home Builders Registration Council (NHBRC is perceived by its clients, which key factors drive such perceptions, and whether the perceptions are consistent across the different client groups of this regulatory institution. The complementary role of qualitative data in illuminating issues driving quantitative results is highlighted. Service quality scores are computed for the NHBRC. The convergence of opinions of different customer groups was studied using correlation analysis. The significance of service quality perception gaps was tested using the multivariate analysis of variance, and the reliability of the SERVQUAL scale was examined using exploratory factor analysis. It was observed that by improving the feedback mechanism of the NHBRC, their clients customer service quality perceptions could be enhanced.

  9. [Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].

    Science.gov (United States)

    Cordero, José Manuel; Nuño-Solinís, Roberto; Orueta, Juan F; Polo, Cristina; Del Río-Cámara, Mario; Alonso-Morán, Edurne

    2016-01-01

    To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Multi-color autofluorescence and scattering spectroscopy provides rapid assessment of kidney function following ischemic injury

    Science.gov (United States)

    Raman, Rajesh N.; Pivetti, Chris D.; Ramsamooj, Rajendra; Troppmann, Christoph; Demos, Stavros G.

    2018-02-01

    A major source of kidneys for transplant comes from deceased donors whose tissues have suffered an unknown amount of warm ischemia prior to retrieval, with no quantitative means to assess function before transplant. Toward addressing this need, non-contact monitoring of optical signatures in rat kidneys was performed in vivo during ischemia and reperfusion. Kidney autofluorescence images were captured under ultraviolet illumination (355 nm, 325 nm, and 266 nm) in order to provide information on related metabolic and non-metabolic response. In addition, light scattering images under 355 nm, 325 nm, and 266 nm, 500 nm illumination were monitored to report on changes in kidney optical properties giving rise to the observed autofluorescence signals during these processes. During reperfusion, various signal ratios were generated from the recorded signals and then parametrized. Time-dependent parameters derived from the ratio of autofluorescence under 355 nm excitation to that under 266 nm excitation, as well as from 500 nm scattered signal, were found capable of discriminating dysfunctional kidneys from those that were functional (p Kidney dysfunction was confirmed by subsequent survival study and histology following autopsy up to a week later. Physiologic changes potentially giving rise to the observed signals, including those in cellular metabolism, vascular response, tissue microstructure, and microenvironment chemistry, are discussed.

  11. An Assessment of Dialysis Provider's Attitudes towards Timing of Dialysis Initiation in Canada

    Directory of Open Access Journals (Sweden)

    Bikaramjit S Mann

    2014-04-01

    Full Text Available Background: Physicians' perceptions and opinions may influence when to initiate dialysis. Objective: To examine providers' perspectives and opinions regarding the timing of dialysis initiation. Design: Online survey. Setting: Community and academic dialysis practices in Canada. Participants: A nationally-representative sample of dialysis providers. Measurements and Methods: Dialysis providers opinions assessing reasons to initiate dialysis at low or high eGFR. Responses were obtained using a 9-point Likert scale. Early dialysis was defined as initiation of dialysis in an individual with an eGFR greater than or equal to 10.5 ml/min/m 2 . A detailed survey was emailed to all members of the Canadian Society of Nephrology (CSN in February 2013. The survey was designed and pre-tested to evaluate duration and ease of administration. Results: One hundred and forty one (25% response rate physicians participated in the survey. The majority were from urban, academic centres and practiced in regionally administered renal programs. Very few respondents had a formal policy regarding the timing of dialysis initiation or formally reviewed new dialysis starts (N = 4, 3.1%. The majority of respondents were either neutral or disagreed that late compared to early dialysis initiation improved outcomes (85–88%, had a negative impact on quality of life (89%, worsened AVF or PD use (84–90%, led to sicker patients (83% or was cost effective (61%. Fifty-seven percent of respondents felt uremic symptoms occurred earlier in patients with advancing age or co-morbid illness. Half (51.8% of the respondents felt there was an absolute eGFR at which they would initiate dialysis in an asymptomatic patient. The majority of respondents would initiate dialysis for classic indications for dialysis, such as volume overload (90.1% and cachexia (83.7% however a significant number chose other factors that may lead them to early dialysis initiation including avoiding an emergency (28

  12. An assessment of care provided by a public sector STD clinic in Cape Town.

    Science.gov (United States)

    Mathews, C; van Rensburg, A; Schierhout, G; Coetzee, N; Lombard, C J; Fehler, H G; Ballard, R C

    1998-11-01

    A study was undertaken in a Cape Town public sector STD clinic to evaluate the content and quality of care provided since it has been recognized that appropriate improvements in the management of conventional sexually transmitted diseases (STDs), including provision of correct therapy, health education, condom promotion and partner notification, could result in a reduced incidence of HIV infection. Our objectives were to assess patients' needs for health education and to assess the quality of STD management in terms of health education, condom promotion, partner notification, the validity of the clinical diagnoses and the adequacy of the treatments prescribed. The study subjects were sampled systematically, according to their gender. Patients included in the study were given a standardized interview and their clinical records reviewed. Specimens were collected for laboratory investigations. For each STD detected, the treatment was defined as adequate if drugs currently known to be active against that infection were prescribed. One hundred and seventy men and 161 women were included in the study (median age: females 22 years, males 26 years). While almost all patients believed their STD may have been caused by unprotected sexual intercourse, many also believed it may have been caused by other factors, such as bewitchment with traditional medicine. Only 21% of male and 37% of female patients received any education about STD transmission during the clinic visit, and only 25% of male and 36% of female patients received education about condom use. As a result of the low sensitivity of the clinicians' diagnoses, 16% of men and 61% of women left the clinic with at least one infection inadequately treated. The majority of patients were not receiving education for the prevention of STDs including HIV. Many were not receiving adequate treatment for their infections. The introduction of a syndromic management protocol in this setting would substantially reduce the proportion

  13. Educational Needs Assessment of Family Health Providers in Tabriz Health Care Centers in 2015

    Directory of Open Access Journals (Sweden)

    Faranak Ghoreyshyzadeh

    2017-06-01

    at the same period, staff performance were not desirable in some processes and/or sub-processes. Conclusion: This study demonstrated the educational needs of family health providers in 6 task processes and prioritized them according to their views. Regular and comprehensive educational needs assessments are required to revise staff training programs, in order to give quality services to general population.

  14. Assessing the effects of Climate Change on Urban Pluvial Flooding to provide a Risk Management Framework

    Science.gov (United States)

    Rianna, G.; Mercogliano, P.

    2017-12-01

    Urbanization increases the flood risk because of heightened vulnerability, stemming from population concentration and hazard due to soil sealing affecting the largest part of urban settlements and reducing the concentration time of interested basins. Furthermore, current and future hazards are exacerbated by expected increases in extreme rainfall events due to Climate Changes (CC) making inadequate urban drainage infrastructures designed under the assumption of steady conditions. In this work, we present a modeling chain/algorithm to assess potential increase in pluvial flood hazard able to take into account CC forcing. The adopted simulation chain reckon on three main elements: Regional Climate Model, COSMO_CLM, dynamically downscaling GCM CMCC_CM (Scoccimarro et al., 2011) and optimized, at high resolution (about 8km), by Bucchignani et al. (2015) on Italy provide projections about precipitation up to 2100 under two concentration scenarios (RCP4.5 and RCP8.5). Such projections are used in Equidistance Quantile Mapping (EQM) approach, developed by Srivastav et al. (2014) to estimate expected variations in IDF (Intensity-Duration-Frequency) curves calculated through Generalized Extreme Value (GEV) approach on the basis of available rainfall data. To this aim, 1971-2000 observations are used as reference. Finally, a 1-D/2-D coupled urban drainage/flooding model forced by IDF (current and projected) is used to simulate storm-sewer surcharge and surface inundation to establish the variations in urban flooding risk. As test case is considered the city center of Naples (Southern Italy). In this respective, the sewage and urban drainage network is highly complex due to the historical and subsequent transformations of the city. Under such constraints, the reliability of the results maybe deeply conditioned by uncertainties not undermining the illustrative purposes of the work. Briefly, EQM returns a remarkable increase in extreme precipitations; such increase is driven by

  15. Opportunity's Surroundings on Sol 1818

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  16. Guidelines for Providing Accommodations Using CASAS Assessment for Learners with Disabilities

    Science.gov (United States)

    CASAS - Comprehensive Adult Student Assessment Systems (NJ1), 2005

    2005-01-01

    These guidelines address methods for administering Comprehensive Adult Student Assessment System (CASAS) assessments using accommodations for learners with documented disabilities. The suggested accommodations for disability categories include provisions for: (1) Accommodations in test administration procedures; and (2) Use of appropriate CASAS…

  17. 9: ADAPTATION OF PREGNANCY RISK ASSESSMENT MONITORING SYSTEM (PRAMS) AND PROVIDE A MODEL ON IT

    Science.gov (United States)

    Kharaghani, Roghieh; Shariati, Mohammad; Keramat, Afsaneh; Yunesian, Masud; Moghisi, Alireza

    2017-01-01

    Background and aims A surveillance system helps to detect epidemics and the pattern of the problems incidence in the community and it is essential part of evidence based decision making process. This study aimed to adapt of PRAMS and provide a model on it. Methods This study was performed in 7 steps as follows: Surveillance systems in pregnancy were reviewed and appropriate system was selected for Iran by nominal group technique. Two comparative studies were conducted to determine the similarities and differences between Iran and the selected community. PRAMS method and system were adapted based on the results of the comparative studies and experts opinions. The study tool was adapted. A field trial was conducted to assess adapted PRAMS feasibility based on TELOS (technical, economic, legal, operational, and schedule) model in the city of Shahriar, located in the west of Tehran, and to compare data collection methods. Then, based on the results and consultation with related executive managers, the final model of PRAMS was suggested for Iranian health system. Results Review of the surveillance systems in pregnancy, identified six models. The results of the nominal group technique showed that, the appropriate model for Iran is PRAMS. Based on the comparative studies and expert opinions, the appropriate system and method for program was as follows: the sampling frame was composed of data in thyroid screening forms and hospital records, the sampling method was systematic, data collection methods were home and phone based surveys, and participants were women within 2 to 6 months postpartum who had a live or still birth. The study tool was adapted. Thirty-seven health volunteers collected the data in this study (technical feasibility). Any home based completed questionnaire cost 2.45 and a phone cost 1.89 USD. Many indices were achieved from the study, which were worth much more than the expenses (economic feasibility). The project was consistent with legal requirements

  18. Assessment of Abilities of Gastroenterology Fellows to Provide Information to Patients With Liver Disease.

    Science.gov (United States)

    Chaudhary, Noami; Lucero, Catherine; Villanueva, Gerald; Poles, Michael; Gillespie, Colleen; Zabar, Sondra; Weinshel, Elizabeth

    2017-07-01

    Patient education is critical in ensuring patient compliance and good health outcomes. Fellows must be able to effectively communicate with their patients, delivering enough information for the patient to understand their medical problem and maximize patient compliance. We created an objective structured clinical examination (OSCE) with 4 liver disease cases to assess fellows' knowledge and ability to inform standardized patients (SPs) about their clinical condition. We developed 4 cases highlighting different aspects of liver disease and created a 4-station OSCE: hepatitis B, acute hepatitis C, new diagnosis of cirrhosis, and an end-stage cirrhotic nontransplant candidate. The SP with hepatitis B was minimizing the fact that she could not read English. The acute hepatitis C SP was a nursing student who is afraid that having hepatitis C might jeopardize her career. The SP with the new diagnosis of alcoholic cirrhosis needed to stop drinking, and the end-stage liver disease patient had to grapple with his advanced directives. Twelve fellows from 4 GI training programs participated. Our focus was to assess the fellows' knowledge about liver diseases and the Accreditation Council for Graduate Medical Education competencies of health literacy, shared decision making, advanced directives, and goals of care. The goal for the fellows was to communicate effectively with the SPs, and acknowledge that each patient had an emotionally charged issue to overcome. The SPs used a checklist to rate fellows' performance. Faculty and the SPs observed the cases and provided feedback. The fellows were surveyed on their performance regarding the case. The majority of fellows were able to successfully summarize findings and discuss a plan with the patient in the new diagnosis of cirrhosis (76.92%) and hepatitis C case (100%), but were less successful in the hepatitis B case (30.77%) and the end-of-life case (41.67%). Overall, a small percentage of fellows reflected that they did a good

  19. Weighting and Aggregation in Life Cycle Assessment: Do Present Aggregated Single Scores Provide Correct Decision Support?

    DEFF Research Database (Denmark)

    Kalbar, Pradip; Birkved, Morten; Nygaard, Simon Elsborg

    2016-01-01

    This study investigates the prevailing practice of obtaining single scores in life cycle assessment (LCA) and identifies potential lacunas in impact assessment methodology related to the results of aggregation into endpoints and single scores. In order to conduct this investigation, a detailed...... approach was adopted to facilitate identification of three main problems related to the single-score calculation approach. The prevailing ReCiPe single-score calculation method does not account for either the effect of so-called dominating alternatives (i.e., alternatives having high values across all...

  20. Opportunity's Surroundings on Sol 1687

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a cylindrical projection with geometric seam correction.

  1. Opportunity's Surroundings on Sol 1798

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  2. Can Research Homework Provide a Vehicle for Assessment for Learning in Science Lessons?

    Science.gov (United States)

    Newby, Louise; Winterbottom, Mark

    2011-01-01

    Many English schools have a homework policy which prescribes how much homework should be set for each pupil each week, irrespective of whether it can be made meaningful. Research recommends "Assessment for Learning" (AfL) as supportive of students' learning, but teachers can find it difficult to incorporate AfL techniques into their…

  3. Assessing impacts of intensified biomass production and biodiversity protection on ecosystem services provided by European forests

    NARCIS (Netherlands)

    Verkerk, P.J.; Mavsar, R.; Giergiczny, M.; Lindner, M.; Edwards, D.; Schelhaas, M.J.

    2014-01-01

    To develop viable strategies for intensifying the use of forest biomass and for increasing forest protection, impacts on ecosystem services need to be assessed. We investigated the biophysical and economic impacts of increased forest biomass production and biodiversity protection on forest ecosystem

  4. Assessing the effects of USDA conservation programs on ecosystem services provided by wetlands

    Science.gov (United States)

    The Conservation Effects Assessment Project (CEAP) is led by the U.S. Department of Agriculture (USDA) in an effort to quantify the environmental effects of conservation programs and practices on privately owned agricultural landscapes across the United States. CEAP’s approach includes application ...

  5. Comparative Assessment of Goods and Services Provided by Grazing Regulation and Reforestation in Degraded Mediterranean Rangelands

    NARCIS (Netherlands)

    Papanastasis, Vasilios P.; Bautista, Susana; Chouvardas, Dimitrios; Mantzanas, Konstantinos; Papadimitriou, Maria; Garcia Mayor, Angeles; Koukioumi, Polina; Papaioannou, Athanasios; Vallejo, Ramon V.

    2017-01-01

    Several management actions are applied to restore ecosystem services in degraded Mediterranean rangelands, which range from adjusting the grazing pressure to the removal of grazers and pine plantations. Four such actions were assessed in Quercus coccifera L. shrublands in northern Greece: (i)

  6. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

    Directory of Open Access Journals (Sweden)

    Monica Zolezzi

    2017-02-01

    Full Text Available Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorst achieved similar knowledge scores, less than half (n = 38, 47% were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32% were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3. Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as major by nursing students. Future integration of interprofessional educational (IPE activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  7. Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management.

    Science.gov (United States)

    Zolezzi, Monica; Abdallah, Oraib; Aden, Suad; Major, Stella; White, Diana; El-Awaisi, Alla

    2017-02-21

    Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing health care students' (HCSs) knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorts achieved similar knowledge scores, less than half ( n = 38, 47%) were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32%) were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3). Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as a major by nursing students. Future integration of interprofessional educational (IPE) activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

  8. [Assessment of financial performance improves the quality of healthcare provided by medical organizations].

    Science.gov (United States)

    Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

    2009-01-01

    Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

  9. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of ambulatory surgical center ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey....

  10. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS)...

  11. Pediatric Emergency Department and Primary Care Provider Attitudes on Assessing Childhood Adversity.

    Science.gov (United States)

    Schilling, Samantha; Murray, Ashlee; Mollen, Cynthia J; Wedin, Tara; Fein, Joel A; Scribano, Philip V

    2017-07-03

    The purpose of this study was to understand pediatric emergency department (ED) and primary care (PC) health care provider attitudes and beliefs regarding the intersection between childhood adversities and health care. We conducted in-depth, semistructured interviews in 2 settings (ED and PC) within an urban health care system. Purposive sampling was used to balance the sample among 3 health care provider roles. Interview questions were based on a modified health beliefs model exploring the "readiness to act" among providers. Interviews were recorded, transcribed, and coded. Interviews continued until theme saturation was reached. Saturation was achieved after 26 ED and 19 PC interviews. Emergency department/primary care providers were similar in their perception of patient susceptibility to childhood adversity. Childhood mental health problems were the most frequently referenced adverse outcome, followed by poor childhood physical health. Adult health outcomes because of childhood adversity were rarely mentioned. Many providers felt that knowing about childhood adversity in the medical setting was important because it relates to provision of tangible resources. There were mixed opinions about whether or not pediatric health care providers should be identifying childhood adversities at all. Although providers exhibited knowledge about childhood adversity, the perceived effect on health was only immediate and tangible. The effect of childhood adversity on lifelong health and the responsibility and potential accountability health systems have in addressing these important health determinants was not recognized by many respondents in our study. Addressing these provider perspectives will be a critical component of successful transformation toward more accountable health care delivery systems.

  12. Decree Law No. 38/90 of 8 November 1990 providing for environmental impact assessments

    International Nuclear Information System (INIS)

    1990-01-01

    This Decree, made in implementation of Decree-Law No. 186/90 on environmental protection, provides that prior to any licence being granted to any project, including nuclear installations, the licensing authority must be provided with an environmental impact study of the planned installation. This study must include a description of the project, its site, its operational characteristics, physical, geological, hydrological, ecological, demographic data, as well as information on the quality of the environment [fr

  13. Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers

    Directory of Open Access Journals (Sweden)

    Seeleman Conny

    2012-07-01

    Full Text Available Abstract Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years with paediatricians (n = 13 and nurses (n = 3 in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters. Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of.

  14. The Assessment of Romanian Customers’ Level of Satisfaction with Pharmaceutical Providers

    OpenAIRE

    Călin Cherecheş Marius; Paula Timofe Mara; Ovidiu Oniga

    2015-01-01

    The aim of the current study is to assess the level of satisfaction towards pharmaceutical services among Romanian customers. Moreover, we were interested in building the socio-demographical profile of a Romanian satisfied customer. The study has a transversal design and uses a quantitative approach. Data was collected at the national level in June 2012 by using Computer Assisted Telephone Interviews (CATI) and resulted in 1,478 valid questionnaires. Descriptive statistics were performed in o...

  15. Transient ischaemic attacks clinics provide equivalent and more efficient care than early in-hospital assessment.

    Science.gov (United States)

    Martínez-Martínez, M M; Martínez-Sánchez, P; Fuentes, B; Cazorla-García, R; Ruiz-Ares, G; Correas-Callero, E; Lara-Lara, M; Díez-Tejedor, E

    2013-02-01

    Clinics for early management of transient ischaemic attacks (TIAs) have been developed in some stroke centres, resulting in reduced recurrence rates compared to appointment-based outpatient management, thus saving on hospitalization. We analysed the care process, recurrence rates and economic impact of the first year of work in our early-management TIA clinic and compared these with our previous in-hospital study protocols for low- and moderate-risk TIA patients. This was a prospective evaluation of the management of low- to moderate-risk TIA patients, comparing a new TIA clinic model (2010) with a previous hospitalization model (2009). Demographic data, vascular risk factor profiles, diagnostic test performance, secondary prevention measures, final aetiological diagnoses and cerebrovascular recurrences at 7 and 90 days were compared between in-hospital and TIA clinic assessed patients. We also carried out an economic comparison of the costs of each model's process. Two hundred and eleven low- to moderate-risk TIA patients were included, of whom 40.8% were hospitalized. There were no differences between the TIA clinic assessed and in-hospital assessed patients in terms of risk factor diagnosis and secondary prevention measures. The stroke recurrence rate (2.4% vs. 1.2%; P = 0.65) was low and similar for both groups (CI 95%, 0.214-20.436; P = 0.52). Cost per patient was €393.28 for clinic versus €1931.18 for in-hospital management. Outpatient management resulted in a 77.8% reduction in hospitalizations. Transient ischaemic attacks clinics are efficient for the early management of low- to moderate-risk TIA patients compared to in-hospital assessment, with no higher recurrence rates and at almost one-fifth the cost. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  16. METHODOLOGIES FOR ASSESSING THE EFFECTIVENESS OF MEDICAL ORGANIZATIONS THAT PROVIDE OUTPATIENT CARE

    Directory of Open Access Journals (Sweden)

    Mikhail Georgievich Karailanov

    2016-08-01

    Full Text Available The aim of this study is to analyze the data in the literature, allows to define the basic methodological approaches to the assessment of the effectiveness of health care organizations, as well as important problems of studying the effectiveness of primary health care at the moment. Primary health care is an integral part of the national health system, as a basis for health care delivery system, and includes measures for prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, monitoring of pregnancy, healthy lifestyles, including reduce risk factors for disease. In the modern development of the health priority and remains the problem of assessing the effectiveness of the medical organization. Health Management is impossible without the identification of priority targets, indicators and parameters to achieve their efficient use of financial, material and human resources, which leads to the need for a methodology for assessing the effectiveness of health interventions that will ensure the relationship management processes and planning, as well as to solve practical problems of the industry.

  17. Examining HIV/AIDS provider stigma: assessing regional concerns in the islands of the Eastern Caribbean.

    Science.gov (United States)

    Abell, N; Rutledge, S E; McCann, T J; Padmore, J

    2007-02-01

    HIV/AIDS provider stigma has been understudied in the context of prevention, testing, and treatment. Results of a survey of persons associated with HIV/AIDS education, health care, and social service delivery in the Eastern Caribbean are described. Reliable constructs were observed for warmth towards PLHA, comfort in association with them, tendencies to distance from or condemn them, beliefs in viral transmission myths, and perceived capacity to counsel effectively. Most discrimination was directed towards MSM and IDUs. Providers whose roles were likely to involve touch felt less comfortable around PLHA and more likely to distance from and condemn them than providers whose roles were not. Implications for improved measurement and incorporation of mindfulness techniques in stigma intervention are discussed.

  18. Insights provided by Probabilistic Safety Assessment Relating to the Loss of Electrical Sources

    International Nuclear Information System (INIS)

    Lanore, Jeanne-Marie

    2015-01-01

    The loss of electrical sources is generally an important contributor to the risk related to nuclear plants. In particular the external hazards initiating events lead generally to a loss of electrical sources. This importance was underscored by the Fukushima accident. A strength of PSA is to provide insights not only into the causes of the event but also into the potential consequences (core damage prevention, large release prevention, and mitigation) with the corresponding risk impact. PSA could provide a measure of Defence-in-Depth in case of loss of a safety function. The task intends to illustrate the PSA capabilities with outstanding practical examples. The task will rely on a survey of existing PSAs. It will provide a complementary view for ROBELSYS task. The content and status of the task are summarized in 2 slides

  19. Assessing an Infant Feeding Web Site as a Nutrition Education Tool for Child Care Providers

    Science.gov (United States)

    Clark, Alena; Anderson, Jennifer; Adams, Elizabeth; Baker, Susan; Barrett, Karen

    2009-01-01

    Objective: Determine child care providers' infant feeding knowledge, attitude and behavior changes after viewing the infant feeding Web site and determine the effectiveness of the Web site and bilingual educational materials. Design: Intervention and control groups completed an on-line pretest survey, viewed a Web site for 3 months, and completed…

  20. Email Between Patient and Provider: Assessing the Attitudes and Perspectives of 624 Primary Health Care Patients.

    Science.gov (United States)

    Seth, Puneet; Abu-Abed, Mohamed Ismail; Kapoor, Vikram; Nicholson, Kathryn; Agarwal, Gina

    2016-12-22

    Email between patients and their health care providers can serve as a continuous and collaborative forum to improve access to care, enhance convenience of communication, reduce administrative costs and missed appointments, and improve satisfaction with the patient-provider relationship. The main objective of this study was to investigate the attitudes of patients aged 16 years and older toward receiving email communication for health-related purposes from an academic inner-city family health team in Southern Ontario. In addition to exploring the proportion of patients with a functioning email address and interest in email communication with their health care provider, we also examined patient-level predictors of interest in email communication. A cross-sectional study was conducted using a self-administered, 1-page survey of attitudes toward electronic communication for health purposes. Participants were recruited from attending patients at the McMaster Family Practice in Hamilton, Ontario, Canada. These patients were aged 16 years and older and were approached consecutively to complete the self-administered survey (N=624). Descriptive analyses were conducted using the Pearson chi-square test to examine correlations between variables. A logistic regression analysis was conducted to determine statistically significant predictors of interest in email communication (yes or no). The majority of respondents (73.2%, 457/624) reported that they would be willing to have their health care provider (from the McMaster Family Practice) contact them via email to communicate health-related information. Those respondents who checked their personal email more frequently were less likely to want to engage in this electronic communication. Among respondents who check their email less frequently (fewer than every 3 days), 46% (37/81) preferred to communicate with the McMaster Family Practice via email. Online applications, including email, are emerging as a viable avenue for patient

  1. Assessing CPR training: The willingness of teaching credential candidates to provide CPR in a school setting.

    Science.gov (United States)

    Winkelman, Jack L; Fischbach, Ronald; Spinello, Elio F

    2009-12-01

    The study explores the anticipated willingness of teacher credential candidates at one California public university in the U.S. to perform cardiopulmonary resuscitation (CPR) or foreign body airway obstruction (FBAO) skills in a school setting. Objectives included (1) identifying reasons that credential candidates would elect or decline to perform CPR, (2) assisting schools to remediate cardiac/respiratory emergency preparedness, and (3) assessing CPR training courses to determine how they may influence teachers' willingness to perform CPR. Participants included 582 teacher credential candidates, who were 95.2% of those surveyed after completion of a health science course and CPR certification. Participants described their attitudes regarding the importance of CPR, the CPR training course, and their willingness to perform CPR in a school environment. Based upon chi-square analysis, an association was found between the willingness to perform CPR and the presence of any one concern regarding training, with 68.6% of those expressing concerns willing to perform CPR compared to 81.9% of those expressing no concerns (pteachers (76.9% vs. 43.5%, pteachers' willingness to perform CPR. Recommendations based on these findings include pedagogical changes to CPR curricula, focusing on the importance of CPR as a teacher skill and additional time for hands-on practice. Future research should include U.S. and international participants from a broader geographic area and assessment of both learning and affective outcomes.

  2. Citation analysis did not provide a reliable assessment of core outcome set uptake.

    Science.gov (United States)

    Barnes, Karen L; Kirkham, Jamie J; Clarke, Mike; Williamson, Paula R

    2017-06-01

    The aim of the study was to evaluate citation analysis as an approach to measuring core outcome set (COS) uptake, by assessing whether the number of citations for a COS report could be used as a surrogate measure of uptake of the COS by clinical trialists. Citation data were obtained for COS reports published before 2010 in five disease areas (systemic sclerosis, rheumatoid arthritis, eczema, sepsis and critical care, and female sexual dysfunction). Those publications identified as a report of a clinical trial were examined to identify whether or not all outcomes in the COS were measured in the trial. Clinical trials measuring the relevant COS made up a small proportion of the total number of citations for COS reports. Not all trials citing a COS report measured all the recommended outcomes. Some trials cited the COS reports for other reasons, including the definition of a condition or other trial design issues addressed by the COS report. Although citation data can be readily accessed, it should not be assumed that the citing of a COS report indicates that a trial has measured the recommended COS. Alternative methods for assessing COS uptake are needed. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Microbiota and Particulate Matter Assessment in Portuguese Optical Shops Providing Contact Lens Services

    Directory of Open Access Journals (Sweden)

    Carla Viegas

    2017-05-01

    Full Text Available The aim of this work was to assess the microbiota (fungi and bacteria and particulate matter in optical shops, contributing to a specific protocol to ensure a proper assessment. Air samples were collected through an impaction method. Surface and equipment swab samples were also collected side-by-side. Measurements of particulate matter were performed using portable direct-reading equipment. A walkthrough survey and checklist was also applied in each shop. Regarding air sampling, eight of the 13 shops analysed were above the legal requirement and 10 from the 26 surfaces samples were overloaded. In three out of the 13 shops fungal contamination in the analysed equipment was not detected. The bacteria air load was above the threshold in one of the 13 analysed shops. However, bacterial counts were detected in all sampled equipment. Fungi and bacteria air load suggested to be influencing all of the other surface and equipment samples. These results reinforce the need to improve air quality, not only to comply with the legal requirements, but also to ensure proper hygienic conditions. Public health intervention is needed to assure the quality and safety of the rooms and equipment in optical shops that perform health interventions in patients.

  4. Binaural Rendering in MPEG Surround

    Directory of Open Access Journals (Sweden)

    Kristofer Kjörling

    2008-04-01

    Full Text Available This paper describes novel methods for evoking a multichannel audio experience over stereo headphones. In contrast to the conventional convolution-based approach where, for example, five input channels are filtered using ten head-related transfer functions, the current approach is based on a parametric representation of the multichannel signal, along with either a parametric representation of the head-related transfer functions or a reduced set of head-related transfer functions. An audio scene with multiple virtual sound sources is represented by a mono or a stereo downmix signal of all sound source signals, accompanied by certain statistical (spatial properties. These statistical properties of the sound sources are either combined with statistical properties of head-related transfer functions to estimate “binaural parameters” that represent the perceptually relevant aspects of the auditory scene or used to create a limited set of combined head-related transfer functions that can be applied directly on the downmix signal. Subsequently, a binaural rendering stage reinstates the statistical properties of the sound sources by applying the estimated binaural parameters or the reduced set of combined head-related transfer functions directly on the downmix. If combined with parametric multichannel audio coders such as MPEG Surround, the proposed methods are advantageous over conventional methods in terms of perceived quality and computational complexity.

  5. Assessing Trauma Care Provider Judgement in the Prediction of Need for Life-saving Interventions

    Science.gov (United States)

    2015-01-13

    suggest that agreement among groups of clinicians is far less dependable. The overall patterns of agreement among provider groups in our study are not...Gabbe BJ, Cameron P, Victorian State Trauma Outcomes Registry and Monitoring Group (VSTORM). Is paramedic judgement useful in prehospital trauma triage...2007;63:1338–46. [13] Gruen RL, Jurkovich GJ, McIntyre LK, Foy HM, Maier RV. Patterns of errors contributing to trauma mortality: lessons learned from

  6. A qualitative assessment of ante-natal care provided by auxillary nurse midwives.

    Science.gov (United States)

    Prasad, B; Gupta, V M

    1999-01-01

    Two hundred sixty eight antenatal mothers were observed for the quality of services provided by Auxillary Nurse Midwives (ANMs). History taking was found to be satisfactory in only 2.6% women. Obstetric examination was done unsatisfactorily in majority (52.6%) of the mothers. General physical examination was not done in 69% women. ANMs in all 31 sub-centres were not performing investigation like haemoglobin estimation, urine testing, foetal heart sound monitoring and blood pressure recording.

  7. Assessing the adequacy of contribution rates towards employees' provident fund in Malaysia

    Science.gov (United States)

    Saidi, Nurul Athirah Nabila; Yusuf, Mazlynda Md; Basah, Mohamad Yazis Ali

    2017-04-01

    The vital role of Malaysian Employees' Provident Fund (EPF) is to provide financial support for its participants during retirement years. However, the issues of inadequacy have risen and EPF has been through various improvements in order to cope with current living situations, including making adjustment in the contribution rates. This study intends to provide the projection of EPF accumulations for three different types of contribution rates namely contribution rates at current fixed rate, increasing and decreasing proportion. Then, the replacement ratio is calculated and is used as an indicator to determine the adequacy of retirement income delivered by EPF. The ideal replacement ratio recommended by financial advisors is at 70%. Based on the findings in this study, contribution rates following a decreasing proportion gives replacement ratio that exceeds or nearest to the ideal replacement ratio, while contribution rates at current fixed rate gives replacement rates that fall far from 70%. Therefore, this study shows that the accumulated amount in the fund with contribution rates following a decreasing proportion gives higher replacement ratio and is recommended to be applied by the Malaysian EPF.

  8. iTRAQ analysis of hepatic proteins in free-living Mus spretus mice to assess the contamination status of areas surrounding Doñana National Park (SW Spain)

    Energy Technology Data Exchange (ETDEWEB)

    Abril, Nieves; Chicano-Gálvez, Eduardo; Michán, Carmen; Pueyo, Carmen; López-Barea, Juan, E-mail: bb1lobaj@uco.es

    2015-08-01

    This work aims to develop and integrate new -omics tools that would be applicable to different ecosystem types for a technological updating of environmental evaluations. We used a 2nd-generation (iTRAQ-8plex) proteomic approach to identify/quantify proteins differentially expressed in the liver of free-living Mus spretus mice from Doñana National Park or its proximities. Mass spectrometry was performed in an LTQ Orbitrap system for iTRAQ reporter ion quantitation and protein identification using a Mus musculus database as reference. A prior IEF step improved the separation of the complex peptide mixture. Over 2000 identified proteins were altered, of which 118 changed by ≥ 2.5-fold in mice from at least two problem sites. Part of the results obtained with the iTRAQ analysis was confirmed by Western blot. Over 75% of the 118 proteins were upregulated in animals captured at polluted sites and only 16 proteins were downregulated. Upregulated proteins were involved in stress response; cell proliferation and apoptosis; signal transduction; metastasis or tumour suppression; xenobiotic export or vesicular trafficking; and metabolism. The downregulated proteins, all potentially harmful, were classified as oncoproteins and proteins favouring genome instability. The iTRAQ results presented here demonstrated that the survival of hepatic cells is compromised in animals living at polluted sites, which showed deep alterations in metabolism and the signalling pathways. The identified proteins may be useful as biomarkers of environmental pollution and provide insight about the metabolic pathways and/or physiological processes affected by pollutants in DNP and its surrounding areas. - Highlights: • iTRAQ quantitation was used for the first time to monitor a wildlife reserve • Over 2,000 proteins with altered expression were identified in problem Doñana sites • Of them, 118 changed over 2.5-fold in, at least, two problem sites • Upregulation of protective proteins

  9. Response distortion in personality measurement: born to deceive, yet capable of providing valid self-assessments?

    Directory of Open Access Journals (Sweden)

    STEPHAN DILCHERT

    2006-09-01

    Full Text Available This introductory article to the special issue of Psychology Science devoted to the subject of “Considering Response Distortion in Personality Measurement for Industrial, Work and Organizational Psychology Research and Practice” presents an overview of the issues of response distortion in personality measurement. It also provides a summary of the other articles published as part of this special issue addressing social desirability, impression management, self-presentation, response distortion, and faking in personality measurement in industrial, work, and organizational settings.

  10. Improving health care strategy planning through assessment of perceptions of consumers, providers and administrators.

    Science.gov (United States)

    Scammon, D; Kennard, L

    1983-01-01

    Perceptions of consumers, health care administrators, and physicians regarding health care providers are analyzed. Ratings on 26 dimensions of health care services were obtained from members of the three participant groups using measures of image and satisfaction of both physicians in general, and of specific physicians. Discriminant analysis reveals significantly different perceptions of the health care system among the three groups of respondents. These differences suggest some changes in health care administration which could lead to increased consumer satisfaction and competitive advantages for physicians and health care institutions.

  11. Assessing the economic potential of electric vehicles to provide ancillary services. The case of Germany

    Energy Technology Data Exchange (ETDEWEB)

    Schuller, Alexander; Rieger, Fabian [Karlsruhe Institute of Technology, Karlsruhe (Germany)

    2013-09-15

    The Vehicle-to-Grid (V2G) concept is a promising possibility for the integration of electric vehicles (EVs) into the power grid. This article presents an economic evaluation of EVs participating in the ancillary service market (primary, secondary and tertiary regulation) for the case of Germany, based on a price data set from 2011 and 2012. We examine the economic potential of nine general options to participate in the regulation market based on real-life EV specifications, connection powers and regulation energy prices. Results show that in the most profitable case a maximum average yearly profit of 730.31 Euro per vehicle is possible for negative regulation with payment direction TSO to provider in the secondary regulation market. Furthermore a sensitivity analysis is performed for all of the analyzed participation scenarios in order to identify crucial parameters for a possible V2G implementation. Major parameters for the successful implementation of V2G are the provided power per vehicle, the time an EV is available to the grid and the variable energy storage costs it incurs.

  12. Remember the Drive Home? An Assessment of Emergency Providers' Sleep Deficit.

    Science.gov (United States)

    Ferguson, Brian A; Shoff, Hugh W; McGowan, Jennifer E; Huecker, Martin R

    2018-01-01

    Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. In March-June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75% stated poor sleep impedes effectiveness as a physician while 53% noted difficulty falling asleep before a night shift. In the last three months, 39% of subjects forgot driving home from a shift, and 34% had fallen asleep while driving. 34% used medications to assist with sleep (including melatonin (36%), alcohol (27%), and prescription drugs (9%)). Most providers attested to phone (88%) and television exposure (69%) immediately prior to goal sleep onset. Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.

  13. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus

    Directory of Open Access Journals (Sweden)

    Susan Trang

    2015-11-01

    Full Text Available Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI and Canada’s Food Guide (CFG recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day. Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

  14. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus.

    Science.gov (United States)

    Trang, Susan; Fraser, Jackie; Wilkinson, Lori; Steckham, Katherine; Oliphant, Heather; Fletcher, Heather; Tzianetas, Roula; Arcand, JoAnne

    2015-11-11

    Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada's Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9-1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

  15. Direct Measurement of Tree Height Provides Different Results on the Assessment of LiDAR Accuracy

    Directory of Open Access Journals (Sweden)

    Emanuele Sibona

    2016-12-01

    Full Text Available In this study, airborne laser scanning-based and traditional field-based survey methods for tree heights estimation are assessed by using one hundred felled trees as a reference dataset. Comparisons between remote sensing and field-based methods were applied to four circular permanent plots located in the western Italian Alps and established within the Alpine Space project NewFor. Remote sensing (Airborne Laser Scanning, ALS, traditional field-based (indirect measurement, IND, and direct measurement of felled trees (DIR methods were compared by using summary statistics, linear regression models, and variation partitioning. Our results show that tree height estimates by Airborne Laser Scanning (ALS approximated to real heights (DIR of felled trees. Considering the species separately, Larix decidua was the species that showed the smaller mean absolute difference (0.95 m between remote sensing (ALS and direct field (DIR data, followed by Picea abies and Pinus sylvestris (1.13 m and 1.04 m, respectively. Our results cannot be generalized to ALS surveys with low pulses density (<5/m2 and with view angles far from zero (nadir. We observed that the tree heights estimation by laser scanner is closer to actual tree heights (DIR than traditional field-based survey, and this was particularly valid for tall trees with conical shape crowns.

  16. Crop to wild gene flow: Does more sophisticated research provide better risk assessment?

    International Nuclear Information System (INIS)

    Jong, Tom J. de; Rong, Jun

    2013-01-01

    Highlights: ► Genes can sometimes flow from genetically modified crops to wild plants. ► The probability can be predicted from seed production of hybrids and backcrosses. ► Nevertheless predictions about introgression remain uncertain. ► One should be reluctant to ask too much detail in Environmental Risk Assessment. ► Instead possible harm should have a more central place. -- Abstract: Research into introgression, the permanent incorporation of alleles of one species into another, is flourishing and gives new insights into evolution and speciation. The possible transfer of transgenes from crop species to wild relatives is of major concern for regulators. Applicants that want to introduce a genetically modified (GM) crop on the European market need to indicate the likelihood of introgression and its anticipated effects in an Environmental Risk Analysis (ERA). The European Food Safety Association (EFSA) and competent authorities of different countries evaluate the ERA. Predicting which crop alleles will or will not be permanently incorporated into wild populations requires, apart from information on seed production of hybrids, information on how these crop alleles are associated with fitness. Advances in genetics open new avenues to address this question in more detail. We argue, however, that, even with the best techniques, predicting introgression from crop to wild species will always have a considerable margin of uncertainty. One must therefore be prudent to demand more detailed research for the ERA, especially since the possible harm of transgenes in natural populations remains so poorly defined by regulators

  17. Factors Affecting Gynecologic and Sexual Assessment in Older Women: A Lesson for Primary Care Providers

    Directory of Open Access Journals (Sweden)

    Ayasha Thomason

    2015-08-01

    Full Text Available Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S. and potential ramifications of these recent changes. Peer reviewed guidelines from the American College of Obstetrics and Gynecology, U.S. Preventative Task Force Services, the American Cancer Society, The Centers for Disease Control, and multiple original research articles and reviews were reviewed for this manuscript. Women over 65 are at greatest risk to develop late stage diagnoses of cancers, pelvic organ disease, incontinence, and infections. Clinicians will need to acutely consider this fact when communicating and screening this population. We conclude that practitioners should be aware of the new guidelines and should consider including gynecologic health history and symptom analysis as part of annual exams in women of all ages.

  18. Quality assessment of websites providing educational content for patients with rheumatoid arthritis.

    Science.gov (United States)

    Siddhanamatha, Harish Rajashekarappa; Heung, Eric; Lopez-Olivo, Maria de Los Angeles; Abdel-Wahab, Noha; Ojeda-Prias, Ana; Willcockson, Irmgard; Leong, Amye; Suarez-Almazor, Maria Eugenia

    2017-06-01

    We performed an environmental scan of currently available websites providing educational information about rheumatoid arthritis (RA) and evaluated the quality of these websites. We searched three separate search engines, Google, Bing, and Ask.com, on August 27, 2015, using two search terms, "arthritis" and "rheumatoid." Only patient education websites were included. Two independent investigators evaluated the accuracy, completeness, technical elements, design and esthetics, readability, usability, and accessibility of the websites. The navigation experience was also evaluated by an adult training expert. We identified 46 websites. Nearly all websites (98%) provided accurate information. However, no website covered all essential RA topics. Common essential topics not covered included epidemiology, pathogenesis, treatment and disease monitoring, complications, self-management, risks and benefits of treatment, prognosis, treatment adherence, questions for patients to ask their doctors, and costs. For the technical elements, all websites disclosed their ownership, but the date that the content was last updated was mentioned in only 10 websites, ranging from 2007 to 2015. The mean reading level was grade 12.1 (standard deviation ±2.3). Most websites (78%) were easy to navigate but only 33% were friendly for people with visual and/or hearing impairments. The navigation experience was rated fair or poor in 41% of the websites. Current patient information on the Internet does not comprehensively address all educational needs of patients with RA, and is often outdated. The findings from our study highlight potential areas for improvement in online education materials for patients with RA. Copyright © 2017. Published by Elsevier Inc.

  19. Assessing a nephrology-focused YouTube channel's potential to educate health care providers.

    Science.gov (United States)

    Desai, Tejas; Sanghani, Vivek; Fang, Xiangming; Christiano, Cynthia; Ferris, Maria

    2013-01-01

    YouTube has emerged as a potential teaching tool. Studies of the teaching potential of YouTube videos have not addressed health care provider (HCP) satisfaction; a necessary prerequisite for any teaching tool. We conducted a 4-month investigation to determine HCP satisfaction with a nephrology-specific YouTube channel. The Nephrology On-Demand YouTube channel was analyzed from January 1 through April 30, 2011. Sixty-minute nephrology lectures at East Carolina University were compressed into 10-minute videos and uploaded to the channel. HCPs were asked to answer a 5-point Likert questionnaire regarding the accuracy, currency, objectivity and usefulness of the digital format of the teaching videos. Means, standard deviations and 2-sided chi-square testing were performed to analyze responses. Over 80% of HCPs considered the YouTube channel to be accurate, current and objective. A similar percentage considered the digital format useful despite the compression of videos and lack of audio. The nephrology-specific YouTube channel has the potential to educate HCPs of various training backgrounds. Additional studies are required to determine if such specialty-specific channels can improve knowledge acquisition and retention.

  20. Assessing implicit mate preferences among Chinese and Japanese women by providing love, sex, or money cues.

    Science.gov (United States)

    Jin, Zheng; Shiomura, Kimihiro; Jiang, Lizhu

    2015-02-01

    Love, sex, and money are the most direct cues involved in the fundamental forms of mate preferences. These fundamental forms are not mutually exclusive but are interrelated. As a result, humans base their mate choices on multiple cues. In this study, 62 undergraduate women (M age = 20.4 yr., SD = 1.4) from China and Japan served as the participants. They performed a variation of the semantic priming task, in which they were instructed to decide by means of a key-press whether the target was human or non-human. The primes were images that portrayed potent evolutionary factors for mate preference (i.e., love, sex, and money), and the manipulation was based on whether the prime and target matched regarding gender, independent of the target decision task (human vs non-human). Participants gave faster responses to male targets than to female targets under priming. The results generally supported the evolutionary premises that assume mate preference is determined by fundamental forms of providing emotional (love), material (money), and fertility support (sex). The money priming effect was stronger in the Chinese women than in the Japanese women, suggesting that social context may influence mate preferences.

  1. Cytoplasmic movement profiles of mouse surrounding nucleolus and not-surrounding nucleolus antral oocytes during meiotic resumption.

    Science.gov (United States)

    Bui, Thi Thu Hien; Belli, Martina; Fassina, Lorenzo; Vigone, Giulia; Merico, Valeria; Garagna, Silvia; Zuccotti, Maurizio

    2017-05-01

    Full-grown mouse antral oocytes are classified as surrounding nucleolus (SN) or not-surrounding nucleolus (NSN), depending on the respective presence or absence of a ring of Hoechst-positive chromatin surrounding the nucleolus. In culture, both types of oocytes resume meiosis and reach the metaphase II (MII) stage, but following insemination, NSN oocytes arrest at the two-cell stage whereas SN oocytes may develop to term. By coupling time-lapse bright-field microscopy with image analysis based on particle image velocimetry, we provide the first systematic measure of the changes to the cytoplasmic movement velocity (CMV) occurring during the germinal vesicle-to-MII (GV-to-MII) transition of these two types of oocytes. Compared to SN oocytes, NSN oocytes display a delayed GV-to-MII transition, which can be mostly explained by retarded germinal vesicle break down and first polar body extrusion. SN and NSN oocytes also exhibit significantly different CMV profiles at four main time-lapse intervals, although this difference was not predictive of SN or NSN oocyte origin because of the high variability in CMV. When CMV profile was analyzed through a trained artificial neural network, however, each single SN or NSN oocyte was blindly identified with a probability of 92.2% and 88.7%, respectively. Thus, the CMV profile recorded during meiotic resumption may be exploited as a cytological signature for the non-invasive assessment of the oocyte developmental potential, and could be informative for the analysis of the GV-to-MII transition of oocytes of other species. © 2017 Wiley Periodicals, Inc.

  2. Research Needs Assessment in the Health Insurance Organization: Level of Health Care Provider

    Directory of Open Access Journals (Sweden)

    Mohammadkarim Bahadori

    2011-12-01

    Full Text Available Objective: Setting research priorities in the research management cycle is a key. It is important to set the research priorities to make optimal use of scarce resources. The aim of this research was to determine the research needs of Health Insurance Organization based on its health care centers research needs.Methods: This is a qualitative, descriptive and cross-sectional study that was conducted in 2011. A purposeful sample of 60 participants from 14 hospitals, seven dispensaries, five dental clinics, two rehabilitation centers, four radiology centers, six medical diagnostic laboratories, 12 pharmacies, and 20 medical offices that were contracted with the Health Insurance Organization in Iran was interviewed. The framework analysis method (a qualitative research method was used for analysis of interviews. Atlas-Ti software was used to analyze quantitative data, respectively. The topics were prioritized using the Analytical Hierarchy Process (AHP method through Expert Choice software.Results: Based on the problems extracted in our qualitative study, 12 research topics were proposed by the experts. Among these “Design of standard treatment protocols,” “Designing model of ranking the health care centers under contract,” and “Pathology of payment system” took the priority ranks of 1 to 3, earning the scores of 0.44, 0.42, and 0.37, respectively.Conclusion: Considering limited resources and unlimited needs and to prevent research resource wasting, conducting research related to health care providers in the Health Insurance Organization can help it achieve its goals.

  3. Client perspective assessment of women's satisfaction towards labour and delivery care service in public health facilities at Arba Minch town and the surrounding district, Gamo Gofa zone, south Ethiopia.

    Science.gov (United States)

    Dewana, Zeritu; Fikadu, Teshale; G/Mariam, Abebe; Abdulahi, Misra

    2016-02-11

    A woman's satisfaction with labour and delivery care service has a good effect on her health and subsequent utilization of the services. Thus knowledge about women's satisfaction on labour and delivery care used to enhances the services utilization. The objective of this study was to assess the satisfaction of women's towards labour and delivery care service and identify factors associated it at public health facilities in Arba Minch town and the surrounding district, Gamo Gofa zone, southern Ethiopia. Facility based cross sectional study was conducted among women who gave birth at public health facility. A total 256 women who gave birth during the study period were included in the study. Data was collected using a structured questionnaire. Satisfaction level was measured using a 5 point-Likert scale questions. Data were entered using Epi data version 3.5.1 and analyzed using SPSS 20.0 statistical software. Factor analysis was employed for Likert scale questions to extract factor represented each of the scale which facilitate treatment of variable as continuous for further analysis. Bi-variate and multivariable logistic regression analysis was employed to identify association between women's satisfaction and predicator variables. Statistical significance was declared at P value labour and delivery care. Factors associated with women's satisfaction with labour and delivery care services include: not attending formal education [AOR = 8.00, 95% CI = (1.52, 12.27)] attending antenatal care four times and more [AOR = 5.00, 95% CI = (1.76, 14.20)] waiting below 15 minutes to be seen by health professional [AOR = 3.37, 95% CI = (1.14, 9.97)] and not paying for drugs and supplies [AOR = 6.19, 95% CI = (1.34, 18.59)]. Although majority of women were satisfied with the labour and delivery service they got, their level of satisfaction was influenced by educational status, number of ANC visits, waiting time, and payment for drug and supplies

  4. Routine outcome measurement in mental health service consumers: who should provide support for the self-assessments?

    Science.gov (United States)

    Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David

    2015-06-01

    This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Why We Need Reliable, Valid, and Appropriate Learning Disability Assessments: The Perspective of a Postsecondary Disability Service Provider

    Science.gov (United States)

    Wolforth, Joan

    2012-01-01

    This paper discusses issues regarding the validity and reliability of psychoeducational assessments provided to Disability Services Offices at Canadian Universities. Several vignettes illustrate some current issues and the potential consequences when university students are given less than thorough disability evaluations and ascribed diagnoses.…

  6. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-01-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. © 2016 Wiley Periodicals, Inc.

  7. Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool.

    Science.gov (United States)

    Aydin Er, Rahime; Sehiralti, Mine

    2014-07-01

    To compare assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool. This study was carried out at the psychiatry clinic of Kocaeli University Hospital from June 2007 to February 2008. The decision-making competence of the 83 patients who participated in the study was assessed by physicians, nurses, relatives and MacCAT-T. Of the 83 patients, the relatives of 73.8% of them, including the parents of 47.7%, were interviewed during the study. A moderately good consistency between the competency assessments of the nurses versus those of the physicians, but a poor consistency between the assessments of the physicians and nurses versus those of the patients' relatives, was determined. The differences in the competency assessment obtained with the MacCAT-T versus the evaluations of the physicians, nurses and patients' relatives were statistically significant. Our findings demonstrate those physicians, nurses and the patients' relatives have difficulty in identifying patients lacking decision-making competence. Therefore, an objective competence assessment tool should be used along with the assessments of physicians and nurses, both of whom can provide clinical data, as well as those of relatives, who can offer insights into the patient's moral values and expectations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Developing a tool to assess motivation among health service providers working with public health system in India.

    Science.gov (United States)

    Purohit, Bhaskar; Maneskar, Abhishek; Saxena, Deepak

    2016-04-14

    Addressing the shortage of health service providers (doctors and nurses) in rural health centres remains a huge challenge. The lack of motivation of health service providers to serve in rural areas is one of the major reasons for such shortage. While many studies have aimed at analysing the reasons for low motivation, hardly any studies in India have focused on developing valid and reliable tools to measure motivation among health service providers. Hence, the objective of the study was to test and develop a valid and reliable instrument to assess the motivation of health service providers working with the public health system in India and the extent to which the motivation factors included in the study motivate health service providers to perform better at work. The present study adapted an already developed tool on motivation. The reliability and validity of the tool were established using different methods. The first stage of the tool development involved content development and assessment where, after a detailed literature review, a predeveloped tool with 19 items was adapted. However, in light of the literature review and pilot test, the same tool was modified to suit the local context by adding 7 additional items so that the final modified tool comprised of 26 items. A correlation matrix was applied to check the pattern of relationships among the items. The total sample size for the study was 154 health service providers from one Western state in India. To understand the sampling adequacy, the Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's test of sphericity were applied and finally factor analysis was carried out to calculate the eigenvalues and to understand the relative impact of factors affecting motivation. A correlation matrix value of 0.017 was obtained narrating multi-co-linearity among the observations. Based on initial factor analysis, 8 out of 26 study factors were excluded from the study components with a cutoff range of less than

  9. A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers

    Energy Technology Data Exchange (ETDEWEB)

    Manish M Patel, Alan P Janssen, Richard Tardif, Mark Herring, Umesh Parashar

    2007-10-18

    In 2006, a new rotavirus vaccine (RotaTeq) was licensed in the US and recommended for routine immunization of all US infants. Because a previously licensed vaccine (Rotashield) was withdrawn from the US for safety concerns, identifying barriers to uptake of RotaTeq will help develop strategies to broaden vaccine coverage. Our qualitative assessment provides complementary data to recent quantitative surveys and suggests that physicians and parents are likely to adopt the newly licensed rotavirus vaccine. Increasing parental awareness of the rotavirus disease burden and providing physicians with timely post-marketing surveillance data will be integral to a successful vaccination program.

  10. A combined usage of stochastic and quantitative risk assessment methods in the worksites: Application on an electric power provider

    International Nuclear Information System (INIS)

    Marhavilas, P.K.; Koulouriotis, D.E.

    2012-01-01

    An individual method cannot build either a realistic forecasting model or a risk assessment process in the worksites, and future perspectives should focus on the combined forecasting/estimation approach. The main purpose of this paper is to gain insight into a risk prediction and estimation methodological framework, using the combination of three different methods, including the proportional quantitative-risk-assessment technique (PRAT), the time-series stochastic process (TSP), and the method of estimating the societal-risk (SRE) by F–N curves. In order to prove the usefulness of the combined usage of stochastic and quantitative risk assessment methods, an application on an electric power provider industry is presented to, using empirical data.

  11. AN OVERVIEW AT MACROECONOMIC LEVEL THROUGH ACCOUNTING FIGURES PROVIDED BY THE ECB ASSESSMENT ON EUROZONE BANKING SYSTEM

    Directory of Open Access Journals (Sweden)

    Olivera Ecaterina OROS

    2014-05-01

    Full Text Available Along with the main macroeconomic indicators, the credit risk indicators became an important leverage in monitoring and evaluating the standard of living at a national level and the country’s economic evolution. These two types of indicators show a strong interconnection, and the correct assessment of the credit risk indicators becomes a must. As a consequence, the central banks and the main regulators in the Europe aria provided for a strict monitoring of such indicators and further on, for constant update of the banking supervisory regulations. In October 2013, the European Central bank (ECB issued the Note of Comprehensive Assessment that will be carried out during 2014, on the Euro-zone1 banking system. The outcome of the assessment will impact not only the accounting figures of the banking system, but also might change the macroeconomic overview of Euro-zone and the IASB's Conceptual Framework for Financial Reporting.

  12. Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira

    2013-11-01

    Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

  13. Persian version of frontal assessment battery: Correlations with formal measures of executive functioning and providing normative data for Persian population.

    Science.gov (United States)

    Asaadi, Sina; Ashrafi, Farzad; Omidbeigi, Mahmoud; Nasiri, Zahra; Pakdaman, Hossein; Amini-Harandi, Ali

    2016-01-05

    Cognitive impairment in patients with Parkinson's disease (PD) mainly involves executive function (EF). The frontal assessment battery (FAB) is an efficient tool for the assessment of EFs. The aims of this study were to determine the validity and reliability of the psychometric properties of the Persian version of FAB and assess its correlation with formal measures of EFs to provide normative data for the Persian version of FAB in patients with PD. The study recruited 149 healthy participants and 49 patients with idiopathic PD. In PD patients, FAB results were compared to their performance on EF tests. Reliability analysis involved test-retest reliability and internal consistency, whereas validity analysis involved convergent validity approach. FAB scores compared in normal controls and in PD patients matched for age, education, and Mini-Mental State Examination (MMSE) score. In PD patients, FAB scores were significantly decreased compared to normal controls, and correlated with Stroop test and Wisconsin Card Sorting Test (WCST). In healthy subjects, FAB scores varied according to the age, education, and MMSE. In the FAB subtest analysis, the performances of PD patients were worse than the healthy participants on similarities, fluency tasks, and Luria's motor series. Persian version of FAB could be used as a reliable scale for the assessment of frontal lobe functions in Iranian patients with PD. Furthermore, normative data provided for the Persian version of this test improve the accuracy and confidence in the clinical application of the FAB.

  14. Written advice can provide a safe and acceptable alternative to new patient assessment for selected referrals to haematologists.

    Science.gov (United States)

    Ganly, Peter S; Keeman, Helen; Spearing, Ruth L; Smith, Mark P; Patton, Nigel; Merriman, Eileen G; Gibbons, Steve S

    2008-01-07

    To measure the safety and acceptability of providing written advice (WA) for selected patients referred to a haematology service, as an alternative to inpatient or outpatient assessment. Review of the initial management and subsequent course of patients newly referred to a tertiary referral hospital in Christchurch, New Zealand, between 16 October 2003 and 8 June 2006. Structured questionnaires were sent to all referring doctors and patients recently managed with WA. Numbers and diagnoses of patients managed with WA, early assessment or delayed assessment; re-referral and treatment details; characteristics of WA letters; and opinions of referring doctors and their patients on the WA process. 26% of new referrals (714/2785) were managed with prompt WA, while 16% (455/2785) received the alternative of delayed assessment. After a median follow-up of 23 months (range, 8-40 months), 13% of those managed with WA (91/714) were re-referred back to the same haematologists; 7% (52/714) were assessed in hospital and 2% (15/714) eventually required treatment. There were no deaths due to haematological causes. Over 90% of responding referring doctors said the WA process was rapid and effective, and 77% of recently managed patients were pleased to be treated by their own doctors. Using WA to manage a substantial minority of patients referred to haematologists can be rapid and safe. It is widely accepted by referring doctors.

  15. Online medical books: their availability and an assessment of how health sciences libraries provide access on their public Websites.

    Science.gov (United States)

    MacCall, Steven L

    2006-01-01

    The objective of this study was to determine the number and topical range of available online medical books and to assess how health sciences libraries were providing access to these resources on their public Websites. The collection-based evaluative technique of list checking was used to assess the number and topical range of online medical books of the six largest publishers. Publisher inventory lists were downloaded over a two-day period (May 16-17, 2004). Titles were counted and compared with the 2003 Brandon/Hill list. A sample of health sciences libraries was subsequently derived by consulting the 2004 "Top Medical Schools-Research" in U.S. News & World Report. Bibliographic and bibliothecal access methods were evaluated based on an inspection of the publicly available Websites of the sample libraries. Of 318 currently published online medical books, 151 (47%) were Brandon/Hill titles covering 42 of 59 Brandon/Hill topics (71%). These 151 titles represented 22% (N = 672) of the Brandon/Hill list, which further broke down as 52 minimal core, 41 initial purchase, and 58 other recommended Brandon/Hill titles. These numbers represented 50%, 28%, and 12%, respectively, of all Brandon/Hill titles corresponding to those categories. In terms of bibliographic access, 20 of 21 of sampled libraries created catalog records for their online medical books, 1 of which also provided analytical access at the chapter level, and none provided access at the chapter section level. Of the 21 libraries, 19 had library Website search engines that provided title-level access and 4 provided access at the chapter level and none that at the chapter section level. For bibliothecal access, 19 of 21 libraries provided title-level access to medical books, 8 of which provided classified and alphabetic arrangements, 1 provided a classified arrangement only, and 10 provided an alphabetic arrangement only. No library provided a bibliothecal arrangement for medical book chapters or chapter

  16. Lack of patient risk counselling and a broader provider training affect malaria control in remote Somalia Kenya border: Qualitative assessment.

    Science.gov (United States)

    Asgary, Ramin; Grigoryan, Zoya; Naderi, Ramesh; Allan, Richard

    2012-01-01

    Effectiveness of providing health education solely via mass media and the providers' targeted training in malaria control needs further exploration. During pre-epidemic season, we conducted a qualitative study of 40 providers and community leaders using focus groups, comprehensive semi-structured interviews and consultation observations. Interviews were transcribed, coded and analysed for major themes. Community leaders believe that they can acquire malaria from contaminated water, animal products, air or garbage. Consequently, they under-utilise bed nets and other protective measures due to perceived continued exposure to other potential malaria sources. Practitioners do not provide individualised health counselling and risk assessment to patients during sick visits, leading to a range of misconceptions about malaria based on limited knowledge from rumours and mass media, and a strong belief in the curative power of traditional medicine. Providers overdiagnose malaria clinically and underutilise available tests due to time constraints, and the lack of training and resources to correctly diagnose other illnesses. Subsequently, misdiagnoses lead them to question the efficacy of recommended treatments. Promoting counselling during clinical encounters to address patient misconception and change risky behaviour is warranted. Wider-ranging ongoing training could enable providers to properly diagnose and manage differential diagnoses to manage malaria better.

  17. A simple simulation model as a tool to assess alternative health care provider payment reform options in Vietnam.

    Science.gov (United States)

    Cashin, Cheryl; Phuong, Nguyen Khanh; Shain, Ryan; Oanh, Tran Thi Mai; Thuy, Nguyen Thi

    2015-01-01

    Vietnam is currently considering a revision of its 2008 Health Insurance Law, including the regulation of provider payment methods. This study uses a simple spreadsheet-based, micro-simulation model to analyse the potential impacts of different provider payment reform scenarios on resource allocation across health care providers in three provinces in Vietnam, as well as on the total expenditure of the provincial branches of the public health insurance agency (Provincial Social Security [PSS]). The results show that currently more than 50% of PSS spending is concentrated at the provincial level with less than half at the district level. There is also a high degree of financial risk on district hospitals with the current fund-holding arrangement. Results of the simulation model show that several alternative scenarios for provider payment reform could improve the current payment system by reducing the high financial risk currently borne by district hospitals without dramatically shifting the current level and distribution of PSS expenditure. The results of the simulation analysis provided an empirical basis for health policy-makers in Vietnam to assess different provider payment reform options and make decisions about new models to support health system objectives.

  18. KEY FUNDAMENTAL ASPECTS FOR MAPPING AND ASSESSING ECOSYSTEM SERVICES: PREDICTABILITY OF ECOSYSTEM SERVICE PROVIDERS AT SCALES FROM LOCAL TO GLOBAL.

    Directory of Open Access Journals (Sweden)

    G. Zurlini

    2014-04-01

    Full Text Available How an apparent static and ordered landscape condition in social ecological landscapes (SELs, can be made sustainable in terms of maintenance and improvement of the provision of ecosystem services (ESs in face of unpredictable disturbance and change? Our contribution to the Mapping and Assessment of Ecosystem Services (MAES working group is to advance some recommendations on how to approach the dynamic analysis of complex adaptive systems to improve ecosystem resilience, habitat connectivity and the delivery of ESs. We show exemplary cases where we utilize the NDVI provided by remote sensing to evaluate land cover transformations and processes and ES provisioning. We focus on NDVI because it allows the supply of information on net primary production, i.e., the energetic foundation of nearly all ecosystems and that provides the basis of most of ESs. The use of spectral entropy, and nonlinear analysis of spatial temporal dynamics to investigate trajectory predictability of SELs provide very useful insight into the dynamics of SELs and can assist in the characterization of the links between land cover patterns with ecological processes to support more reliable assessments and accountings of ESs.

  19. Assessment of systems for paying health care providers in Vietnam: implications for equity, efficiency and expanding effective health coverage.

    Science.gov (United States)

    Phuong, Nguyen Khanh; Oanh, Tran Thi Mai; Phuong, Hoang Thi; Tien, Tran Van; Cashin, Cheryl

    2015-01-01

    Provider payment arrangements are currently a core concern for Vietnam's health sector and a key lever for expanding effective coverage and improving the efficiency and equity of the health system. This study describes how different provider payment systems are designed and implemented in practice across a sample of provinces and districts in Vietnam. Key informant interviews were conducted with over 100 health policy-makers, purchasers and providers using a structured interview guide. The results of the different payment methods were scored by respondents and assessed against a set of health system performance criteria. Overall, the public health insurance agency, Vietnam Social Security (VSS), is focused on managing expenditures through a complicated set of reimbursement policies and caps, but the incentives for providers are unclear and do not consistently support Vietnam's health system objectives. The results of this study are being used by the Ministry of Health and VSS to reform the provider payment systems to be more consistent with international definitions and good practices and to better support Vietnam's health system objectives.

  20. ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS CONSANGUINEOUS MARRIAGES AMONG A COHORT OF MULTIETHNIC HEALTH CARE PROVIDERS IN SAUDI ARABIA.

    Science.gov (United States)

    Alnaqeb, Dhekra; Hamamy, Hanan; Youssef, Amira M; Al-Rubeaan, Khalid

    2018-01-01

    This study aimed to assess knowledge, attitude and practice related to consanguinity among multiethnic health care providers in the Kingdom of Saudi Arabia. Using a cross-sectional study design, a validated, self-administered close-ended questionnaire was randomly distributed to health care providers in different health institutions in the country between 1st August 2012 and 31st July 2013. A total of 1235 health care providers completed the study questionnaire. Of the 892 married participants (72.23% of total), 11.43% were married to a first cousin, and were predominantly Arabs, younger than 40 years and male. Only 17.80% of the patients seen by the health care providers requested consanguinity related counselling. A knowledge barrier was expressed by 27.49% of the participants, and 85.67% indicated their willingness to have more training in basic genetic counselling. A language barrier was expressed as a limiting factor to counselling for consanguinity among non-Arabs. The health care providers had a major dearth of knowledge that was reflected in their attitude and practice towards consanguinity counselling. This finding indicates the need for more undergraduate and postgraduate medical and nursing education and training in the counselling of consanguineous couples. It is recommended that consanguinity counselling is included in the current premarital screening and counselling programmes in the Kingdom.

  1. Assessment of provider competence and quality of maternal/newborn care in selected Latin American and Caribbean countries

    Directory of Open Access Journals (Sweden)

    Joyce E Thompson

    2015-05-01

    Full Text Available OBJECTIVE: To obtain a snapshot of the maternal and newborn care provided by different types of maternal and child health providers in Latin America and the Caribbean (LAC to 1 better inform advocacy and programmatic strategies and interventions to improve the quality of those services in the region, and 2 determine the need for more rigorous study of the issues. METHODS: A rapid assessment of 83 health workers providing antepartum, intrapartum, and immediate postpartum and newborn care (within two hours of birth in eight LAC countries was conducted in November and December of 2011. Health workers were observed by two-person expert maternal/newborn clinician teams using pretested forms based on international quality-of-care standards. A total of 105 care encounters were observed, primarily in urban, public, referral-level settings. Providers of care included obstetricians, midwives, generalist physicians, medical residents, registered nurses, auxiliary nurses, and students of medicine, midwifery, and nursing. RESULTS: Hand washing, as an indicator of quality of antepartum care, was observed in only 41% of the observed encounters. Labor management often lacked certain elements of respectful maternity care across all provider groups. Several clinical tasks of high importance in the identification and prevention of common complications of antepartum, intrapartum, and immediate postpartum/newborn care were not documented as performed during the observation periods. Providers self-reported limited competence (ability to perform to a defined level of proficiency in manual removal of the placenta, bimanual compression of the uterus, and newborn resuscitation. CONCLUSIONS: The findings suggest that 1 the quality of maternal and newborn care and 2 the competence of maternal and child health providers in the diverse selection of LAC countries that were studied require substantial attention.

  2. Neutron spectrum in small iron pile surrounded by lead reflector

    International Nuclear Information System (INIS)

    Kimura, Itsuro; Hayashi, S.A.; Kobayashi, Katsuhei; Matsumura, Tetsuo; Nishihara, Hiroshi.

    1978-01-01

    In order to save the quantity of sample material, a possibility to assess group constants of a reactor material through measurement and analysis of neutron spectrum in a small sample pile surrounded by a reflector of heavy moderator, was investigated. As the sample and the reflector, we chose iron and lead, respectively. Although the time dispersion in moderation of neutrons was considerably prolonged by the lead reflector, this hardly interferes with the assessment of group constants. Theoretical calculation revealed that both the neutron flux spectrum and the sensitivity coefficient of group constants in an iron sphere, 35 cm in diameter surrounded by the lead reflector, 25 cm thick, were close to those of the bare iron sphere, 108 cm in diameter. The neutron spectra in a small iron pile surrounded by a lead reflector were experimentally obtained by the time-of-flight method with an electron linear accelerator and the result was compared with the predicted values. It could be confirmed that a small sample pile surrounded by a reflector, such as lead, was as useful as a much larger bulk pile for the assessment of group constants of a reactor material. (auth.)

  3. Key findings: a qualitative assessment of provider and patient perceptions of HIV/AIDS in South Africa.

    Science.gov (United States)

    Ransom, James; Johnson, Anton F

    2009-01-01

    In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages.

  4. Testosterone replacement therapy and the internet: an assessment of providers' health-related web site information content.

    Science.gov (United States)

    Oberlin, Daniel T; Masson, Puneet; Brannigan, Robert E

    2015-04-01

    To compare how providers of testosterone replacement therapy (TRT) in large metropolitan cities promote androgen replacement on their patient-oriented Web sites. TRT provider Web sites were identified using Google search and the terms "Testosterone replacement" and the name of the 5 most populous US cities. These Web sites were assessed for (1) type or specialty of medical provider, (2) discussion of the benefits and risks of TRT, and (3) industry affiliations. In total, 75 Web sites were evaluated. Twenty-seven of the 75 clinics (36%) were directed by nonphysicians, 35 (47%) were overseen by nonurology or nonendocrine physicians, and only 13 (17%) were specialist managed. Fourteen of 75 (18.6%) Web sites disclosed industry relationships. Ninety-five percent of Web sites promoted the benefits of TRT including improved sex drive, cognitive improvement, increased muscle strength, and/or improved energy. Only 20 of 75 Web sites (26.6%) described any side effect of TRT. Web sites directed by specialists were twice as likely to discuss risks of TRT compared with nonspecialist providers (41% vs 20%; odds ratio = 2.77; P <.01). Nine of 75 (12%) of all Web sites actually refuted that TRT was associated with significant side effects. Urologists and endocrinologists are in the minority of providers promoting TRT on the Internet. Specialists are more likely to discuss risks associated with TRT although the majority of surveyed Web sites that promote TRT do not mention treatment risks. There is substantial variability in quality and quantity of information on provider Web sites, which may contribute to misinformation regarding this prevalent health issue. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Effect of a Neonatal Resuscitation Course on Healthcare Providers' Performances Assessed by Video Recording in a Low-Resource Setting.

    Science.gov (United States)

    Trevisanuto, Daniele; Bertuola, Federica; Lanzoni, Paolo; Cavallin, Francesco; Matediana, Eduardo; Manzungu, Olivier Wingi; Gomez, Ermelinda; Da Dalt, Liviana; Putoto, Giovanni

    2015-01-01

    We assessed the effect of an adapted neonatal resuscitation program (NRP) course on healthcare providers' performances in a low-resource setting through the use of video recording. A video recorder, mounted to the radiant warmers in the delivery rooms at Beira Central Hospital, Mozambique, was used to record all resuscitations. One-hundred resuscitations (50 before and 50 after participation in an adapted NRP course) were collected and assessed based on a previously published score. All 100 neonates received initial steps; from these, 77 and 32 needed bag-mask ventilation (BMV) and chest compressions (CC), respectively. There was a significant improvement in resuscitation scores in all levels of resuscitation from before to after the course: for "initial steps", the score increased from 33% (IQR 28-39) to 44% (IQR 39-56), pproviders improved after participation in an adapted NRP course. Video recording was well-accepted by the staff, useful for objective assessment of performance during resuscitation, and can be used as an educational tool in a low-resource setting.

  6. An interdisciplinary visual team in an acute and sub-acute stroke unit: Providing assessment and early rehabilitation.

    Science.gov (United States)

    Norup, Anne; Guldberg, Anne-Mette; Friis, Claus Radmer; Deurell, Eva Maria; Forchhammer, Hysse Birgitte

    2016-07-15

    To describe the work of an interdisciplinary visual team in a stroke unit providing early identification and assessment of patients with visual symptoms, and secondly to investigate frequency, type of visual deficits after stroke and self-evaluated impact on everyday life after stroke. For a period of three months, all stroke patients with visual or visuo-attentional deficits were registered, and data concerning etiology, severity and localization of the stroke and initial visual symptoms were registered. One month after discharge patients were contacted for follow-up. Of 349 acute stroke admissions, 84 (24.1%) had visual or visuo-attentional deficits initially. Of these 84 patients, informed consent was obtained from 22 patients with a mean age of 67.7 years(SD 10.1), and the majority was female (59.1%). Based on the initial neurological examination, 45.4% had some kind of visual field defect, 27.2% had some kind of oculomotor nerve palsy, and about 31.8% had some kind of inattention or visual neglect. The patients were contacted for a phone-based follow-up one month after discharge, where 85.7% reported changes in their vision since their stroke. In this consecutive sample, a quarter of all stroke patients had visual or visuo-attentional deficits initially. This emphasizes how professionals should have increased awareness of the existence of such deficits after stroke in order to provide the necessary interdisciplinary assessment and rehabilitation.

  7. Religion's relationship with social boundaries surrounding gender ...

    African Journals Online (AJOL)

    Religion's relationship with social boundaries surrounding gender. ... is associated with segregation, marginalization and differentiation between men and women. ... are necessary in the society it should not be mistaken for gender inequality.

  8. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques.

    Science.gov (United States)

    Chien, Tsair-Wei; Chou, Ming-Ting; Wang, Wen-Chung; Tsai, Li-Shu; Lin, Weir-Sen

    2012-05-15

    Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan's year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. ICCs were generated for Taiwan's year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. We recommend using the ICC to annually assess a nation's year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  9. A qualitative assessment of factors influencing acceptance of a new rotavirus vaccine among health care providers and consumers

    Directory of Open Access Journals (Sweden)

    Herring Mark

    2007-10-01

    Full Text Available Abstract Background In 2006, a new rotavirus vaccine (RotaTeq was licensed in the US and recommended for routine immunization of all US infants. Because a previously licensed vaccine (Rotashield was withdrawn from the US for safety concerns, identifying barriers to uptake of RotaTeq will help develop strategies to broaden vaccine coverage. Methods We explored beliefs and attitudes of parents (n = 57 and providers (n = 10 towards rotavirus disease and vaccines through a qualitative assessment using focus groups and in-depth interviews. Results All physicians were familiar with safety concerns about rotavirus vaccines, but felt reassured by RotaTeq's safety profile. When asked about likelihood of using RotaTeq on a scale of one to seven (1 = "absolutely not;" 7 = "absolutely yes" the mean score was 5 (range = 3–6. Physicians expressed a high likelihood of adopting RotaTeq, particularly if recommended by their professional organizations and expressed specific interest in post-marketing safety data. Similarly, consumers found the RotaTeq safety profile to be favorable and would rely on their physician's recommendation for vaccination. However, when asked to rank likelihood of having their child vaccinated against rotavirus (1 = "definitely not get;" 7 = "definitely get", 29% ranked 1 or 2, 36% 3 or 4, and 35% 5 to 7. Conclusion Our qualitative assessment provides complementary data to recent quantitative surveys and suggests that physicians and parents are likely to adopt the newly licensed rotavirus vaccine. Increasing parental awareness of the rotavirus disease burden and providing physicians with timely post-marketing surveillance data will be integral to a successful vaccination program.

  10. An exploratory qualitative assessment of factors influencing childhood vaccine providers' intention to recommend immunization in the Netherlands

    Directory of Open Access Journals (Sweden)

    Mollema Liesbeth

    2012-02-01

    Full Text Available Abstract Background Under the Dutch national immunization program (NIP, childhood vaccination is not mandatory, but its recommendation by childhood vaccine providers (CVP is important for maintaining high vaccination coverage. We therefore examined factors related to providers' intentions to recommend vaccinations to parents of young children. Methods We conducted four focus group discussions with nurses and physicians who provide vaccines to children 0-4 years old in diverse regions of the Netherlands. Three groups represented CVPs at child welfare centers (CWCs serving the general population, with the fourth representing anthroposophical CWCs. Elements of the Theory of Planned Behaviour (TPB were used to design the groups; thematic analysis was used to structure and analyze the dataset. Results Four main themes emerged, including 1 perceived responsibility: to promote vaccines and discuss pros and cons with parents (although this was usually not done if parents readily accepted the vaccination; 2 attitudes toward the NIP: mainly positive, but doubts as to NIP plans to vaccinate against diseases with a low perceived burden; 3 organizational factors: limited time and information can hamper discussions with parents; 4 relationship with parents: crucial and based mainly on communication to establish trust. Compared to CVPs at standard CWCs, the anthroposophical CWCs spent more time communicating and were more willing to adapt the NIP to individual cases. Conclusions Our qualitative assessment provides an overview of beliefs associated with providers' intention to recommend vaccinations. They were motivated to support the NIP, but their intentions to recommend vaccinations were affected by the perceived relevance of the vaccines, practical issues like limited time and by certain types of resistant parents. These results will inform future studies to test the magnitude and relative impact of these factors.

  11. Tailored stakeholder products help provide a vulnerability and adaptation assessment of Greek forests due to climate change

    Science.gov (United States)

    Giannakopoulos, Christos; Karali, Anna; Roussos, Anargyros

    2014-05-01

    Greece, being part of the eastern Mediterranean basin, is an area particularly vulnerable to climate change and associated forest fire risk. The aim of this study is to assess the vulnerability of Greek forests to fire risk occurrence and identify potential adaptation options within the context of climate change through continuous interaction with local stakeholders. To address their needs, the following tools for the provision of climate information services were developed: 1. An application providing fire risk forecasts for the following 3 days (http://cirrus.meteo.noa.gr/forecast/bolam/index.htm) was developed from NOA to address the needs of short term fire planners. 2. A web-based application providing long term fire risk and other fire related indices changes due to climate change (time horizon up to 2050 and 2100) was developed in collaboration with the WWF Greece office to address the needs of long term fire policy makers (http://www.oikoskopio.gr/map/). 3. An educational tool was built in order to complement the two web-based tools and to further expand knowledge in fire risk modeling to address the needs for in-depth training. In particular, the second product provided the necessary information to assess the exposure to forest fires. To this aim, maps depicting the days with elevated fire risk (FWI>30) both for the control (1961-1990) and the near future period (2021-2050) were created by the web-application. FWI is a daily index that provides numerical ratings of relative fire potential based solely on weather observations. The meteorological inputs to the FWI System are daily noon values of temperature, air relative humidity, 10m wind speed and precipitation during the previous 24 hours. It was found that eastern lowlands are more exposed to fire risk followed by eastern high elevation areas, for both the control and near future period. The next step towards vulnerability assessment was to address sensitivity, ie the human-environmental conditions that

  12. An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

    Directory of Open Access Journals (Sweden)

    Sibanda Euphemia L

    2012-05-01

    Full Text Available Abstract Background Provider-initiated HIV testing and counselling (PITC is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1 assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2 in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3 Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics. All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.

  13. Enhancement of Afterimage Colors by Surrounding Contours

    Directory of Open Access Journals (Sweden)

    Takao Sato

    2011-05-01

    Full Text Available Presenting luminance contours surrounding the adapted areas in test phase enhances color afterimages in both duration and color appearance. The presence of surrounding contour is crucial to some color phenomenon such as van Lier's afterimage, but the contour-effect itself has not been seriously examined. In this paper, we compared the contour-effect to color afterimages and to actually colored patches to examine the nature of color information subserving color-aftereffect. In the experiment, observers were adapted for 1 sec to a small colored square (red, green, yellow, or blue presented on a gray background. Then, a test field either with or without surrounding contour was presented. Observers matched the color of a test-patch located near the afterimage to the color of afterimage. It was found that the saturation of negative afterimage was almost doubled by the presence of surrounding contours. There was no effect of luminance contrast or polarity of contours. In contrast, no enhancement of saturation by surrounding contours was observed for actually colored patches even though the colors of patches were equalized to that of afterimage without contours. This dissociation in the contour-effect demonstrates the crucial difference between the color information for aftereffects and for ordinary bottom-up color perception.

  14. Assessment of women, infants and children providers' perceptions of oral health counseling and availability of associated resources.

    Science.gov (United States)

    Mendryga, Tiffany A; Gwozdek, Anne E

    2014-01-01

    Children from low-income families and ethnic minority groups are associated with an increased risk of developing dental disease and are often enrolled in the Women, Infants and Children (WIC) nutritional program. It has been an intention of the Michigan Department of Community Health (MDCH) Oral Health Program (OHP) to collaborate with WIC to provide preventive oral health resources and education to their population. This project focused on achieving the goals outlined in the Michigan 2010 State Oral Health Plan. An 18 question survey was designed to identify gaps existing in oral health counseling in Michigan WIC agencies. The survey was disseminated to 56 MI WIC agencies. WIC providers perceive oral health risk assessment to be important and are asking oral health questions during certification and re-certification appointments. Seventy-nine percent of participants indicated they never had training in oral health counseling, and 79% are interested in learning more about oral health. Agencies are interested in obtaining oral health education resources for their clients. The 2010 State Oral Health Plan's goals recognized the need for oral health related resources and education within community-based programs like WIC. The results of the survey support the need for additional oral health counseling and associated resources in WIC agencies. This information will be used to help the MDCH OHP find ways to address these gaps. Copyright © 2014 The American Dental Hygienists’ Association.

  15. Sound Environments Surrounding Preterm Infants Within an Occupied Closed Incubator.

    Science.gov (United States)

    Shimizu, Aya; Matsuo, Hiroya

    2016-01-01

    Preterm infants often exhibit functional disorders due to the stressful environment in the neonatal intensive care unit (NICU). The sound pressure level (SPL) in the NICU is often much higher than the levels recommended by the American Academy of Pediatrics. Our study aims to describe the SPL and sound frequency levels surrounding preterm infants within closed incubators that utilize high frequency oscillation (HFO) or nasal directional positive airway pressure (nasal-DPAP) respiratory settings. This is a descriptive research study of eight preterm infants (corrected agenoise levels were observed and the results were compared to the recommendations made by neonatal experts. Increased noise levels, which have reported to affect neonates' ability to self-regulate, could increase the risk of developing attention deficit disorder, and may result in tachycardia, bradycardia, increased intracranial pressure, and hypoxia. The care provider should closely assess for adverse effects of higher sound levels generated by different modes of respiratory support and take measures to ensure that preterm infants are protected from exposure to noise exceeding the optimal safe levels. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Explaining preferences for home surroundings and locations

    DEFF Research Database (Denmark)

    Andersen, Hans Skifter

    2011-01-01

    This article is based on a survey carried out in Denmark that asked a random sample of the population about their preferences for home surroundings and locations. It shows that the characteristics of social surroundings are very important and can be divided into three independent dimensions......: avoiding social nuisances, preferring social homogeneity and living close to one’s social network and place of origin. The study shows that most people have many detailed preferences, whereas some have very few. This confirms an earlier theory that some people are very connected to certain places...... with given characteristics and thus do not have priorities regarding home surroundings and locations. For others, mostly young people and singles, home is just a place to sleep and relax, whereas life is lived elsewhere. For this group, there are only preferences for location and there are few specific...

  17. Daily FOUR score assessment provides accurate prognosis of long-term outcome in out-of-hospital cardiac arrest.

    Science.gov (United States)

    Weiss, N; Venot, M; Verdonk, F; Chardon, A; Le Guennec, L; Llerena, M C; Raimbourg, Q; Taldir, G; Luque, Y; Fagon, J-Y; Guerot, E; Diehl, J-L

    2015-05-01

    The accurate prediction of outcome after out-of-hospital cardiac arrest (OHCA) is of major importance. The recently described Full Outline of UnResponsiveness (FOUR) is well adapted to mechanically ventilated patients and does not depend on verbal response. To evaluate the ability of FOUR assessed by intensivists to accurately predict outcome in OHCA. We prospectively identified patients admitted for OHCA with a Glasgow Coma Scale below 8. Neurological assessment was performed daily. Outcome was evaluated at 6 months using Glasgow-Pittsburgh Cerebral Performance Categories (GP-CPC). Eighty-five patients were included. At 6 months, 19 patients (22%) had a favorable outcome, GP-CPC 1-2, and 66 (78%) had an unfavorable outcome, GP-CPC 3-5. Compared to both brainstem responses at day 3 and evolution of Glasgow Coma Scale, evolution of FOUR score over the three first days was able to predict unfavorable outcome more precisely. Thus, absence of improvement or worsening from day 1 to day 3 of FOUR had 0.88 (0.79-0.97) specificity, 0.71 (0.66-0.76) sensitivity, 0.94 (0.84-1.00) PPV and 0.54 (0.49-0.59) NPV to predict unfavorable outcome. Similarly, the brainstem response of FOUR score at 0 evaluated at day 3 had 0.94 (0.89-0.99) specificity, 0.60 (0.50-0.70) sensitivity, 0.96 (0.92-1.00) PPV and 0.47 (0.37-0.57) NPV to predict unfavorable outcome. The absence of improvement or worsening from day 1 to day 3 of FOUR evaluated by intensivists provides an accurate prognosis of poor neurological outcome in OHCA. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia.

    Science.gov (United States)

    Villamil, María Del Pilar; Barrera, David; Velasco, Nubia; Bernal, Oscar; Fajardo, Esteban; Urango, Carlos; Buitrago, Sebastian

    2017-09-15

    While, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system. In particular, as a case study, the quality of the treatment of stomach cancer is analyzed. The study uses two complementary techniques to address the problem. These techniques are applied based on data of the treatment of gastric cancer collected on a nation-wide scale by the Colombian Ministry of Health and Welfare. First, Data Envelopment Analysis (DEA) and the Malmquist Index (MI) are used to establish the most efficient EPS's within the system, according to indicators such as opportunity indicators. Second, sequential clustering algorithm, related to process mining a field of data mining, is used to determine the medical history of all patients and to construct typical care pathways of the patients belonging to efficient and inefficient EPS's. Lastly, efforts are made to identify traits and differences between efficient and inefficient EPS's. Efficient and inefficient EPS were identified for the years 2010 and 2011. Additionally, a Malmquist Index was used to calculate the relative changes in the efficiency of the health providers. Using these efficiency rates, the typical treatment path of patients with gastric cancer was found for two EPSs: one efficient and another inefficient. Finally, the typical traits of the care pathways were established. Combining DEA and process mining proved to be a powerful approach understanding the problem and gaining valuable

  19. Ventricular kinetic energy may provide a novel noninvasive way to assess ventricular performance in patients with repaired tetralogy of Fallot.

    Science.gov (United States)

    Jeong, Daniel; Anagnostopoulos, Petros V; Roldan-Alzate, Alejandro; Srinivasan, Shardha; Schiebler, Mark L; Wieben, Oliver; François, Christopher J

    2015-05-01

    Ventricular kinetic energy measurements may provide a novel imaging biomarker of declining ventricular efficiency in patients with repaired tetralogy of Fallot. Our purpose was to assess differences in ventricular kinetic energy with 4-dimensional flow magnetic resonance imaging between patients with repaired tetralogy of Fallot and healthy volunteers. Cardiac magnetic resonance, including 4-dimensional flow magnetic resonance imaging, was performed at rest in 10 subjects with repaired tetralogy of Fallot and 9 healthy volunteers using clinical 1.5T and 3T magnetic resonance imaging scanners. Right and left ventricular kinetic energy (KERV and KELV), main pulmonary artery flow (QMPA), and aortic flow (QAO) were quantified using 4-dimensional flow magnetic resonance imaging data. Right and left ventricular size and function were measured using standard cardiac magnetic resonance techniques. Differences in peak systolic KERV and KELV in addition to the QMPA/KERV and QAO/KELV ratios between groups were assessed. Kinetic energy indices were compared with conventional cardiac magnetic resonance parameters. Peak systolic KERV and KELV were higher in patients with repaired tetralogy of Fallot (6.06 ± 2.27 mJ and 3.55 ± 2.12 mJ, respectively) than in healthy volunteers (5.47 ± 2.52 mJ and 2.48 ± 0.75 mJ, respectively), but were not statistically significant (P = .65 and P = .47, respectively). The QMPA/KERV and QAO/KELV ratios were lower in patients with repaired tetralogy of Fallot (7.53 ± 5.37 mL/[cycle mJ] and 9.65 ± 6.61 mL/[cycle mJ], respectively) than in healthy volunteers (19.33 ± 18.52 mL/[cycle mJ] and 35.98 ± 7.66 mL/[cycle mJ], respectively; P tetralogy of Fallot. Quantification of ventricular kinetic energy in patients with repaired tetralogy of Fallot is a new observation. Future studies are needed to determine whether changes in ventricular kinetic energy can provide earlier evidence of ventricular dysfunction and guide future medical and

  20. ARABIC TRANSLATION AND ADAPTATION OF THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) PATIENT SATISFACTION SURVEY INSTRUMENT.

    Science.gov (United States)

    Dockins, James; Abuzahrieh, Ramzi; Stack, Martin

    2015-01-01

    To translate and adapt an effective, validated, benchmarked, and widely used patient satisfaction measurement tool for use with an Arabic-speaking population. Translation of survey's items, survey administration process development, evaluation of reliability, and international benchmarking Three hundred-bed tertiary care hospital in Jeddah, Saudi Arabia. 645 patients discharged during 2011 from the hospital's inpatient care units. INTERVENTIONS; The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) instrument was translated into Arabic, a randomized weekly sample of patients was selected, and the survey was administered via telephone during 2011 to patients or their relatives. Scores were compiled for each of the HCAHPS questions and then for each of the six HCAHPS clinical composites, two non-clinical items, and two global items. Clinical composite scores, as well as the two non-clinical and two global items were analyzed for the 645 respondents. Clinical composites were analyzed using Spearman's correlation coefficient and Cronbach's alpha to demonstrate acceptable internal consistency for these items and scales demonstrated acceptable internal consistency for the clinical composites. (Spearman's correlation coefficient = 0.327 - 0.750, P quarterly to US national averages with results that closely paralleled the US benchmarks. . The Arabic translation and adaptation of the HCAHPS is a valid, reliable, and feasible tool for evaluation and benchmarking of inpatient satisfaction in Arabic speaking populations.

  1. Providing a Framework for E-readiness Assessment and Action for E-Commerce in Ramak Dairy Company in Shiraz

    Directory of Open Access Journals (Sweden)

    Ali Mohammadi

    2016-12-01

    Full Text Available This study aimed to provide a framework to assess the e-readiness of Ramak Company in Shiraz. To that end, after reviewing the related literature in the field of e-readiness and selecting the proper model, the model parameters were distributed among experts in the form of a questionnaire, and with the help of fuzzy screening, 49 indicators were finalized. Then, using the combination method of DEMATEL and Analysis of Network process, weight of the indicators was obtained. Finally, e-readiness of the indicators was investigated through proper statistical tests. The analysis indicated that the company had necessary preparation in the following indicators “market share of company” and “compliance with quality of ICT international standards”, “high bandwidth availability” and “diversity of communication channels available”, “quality of national wide ICT infrastructures” and “obstacles of trade investment” and any other observation. By doing the gap analysis, it was found that the dimensions of external environment readiness, the ICT readiness and external environment readiness, respectively had the highest priorities for enforcement action.

  2. Smart Chips for Smart Surroundings -- 4S

    NARCIS (Netherlands)

    Schuler, Eberhard; König, Ralf; Becker, Jürgen; Rauwerda, G.K.; van de Burgwal, M.D.; Smit, Gerardus Johannes Maria; Cardoso, João M.P.; Hübner, Michael

    2011-01-01

    The overall mission of the 4S project (Smart Chips for Smart Surroundings) was to define and develop efficient flexible, reconfigurable core building blocks, including the supporting tools, for future Ambient System Devices. Reconfigurability offers the needed flexibility and adaptability, it

  3. Childhood Suicide and Myths Surrounding It.

    Science.gov (United States)

    Greene, Dorothea B.

    1994-01-01

    Dispels five misconceptions surrounding the suicide of children: that children under the age of six do not commit suicide; that suicide in latency years is extremely rare; that psychodynamically and developmentally true depression is not possible in childhood; that child cannot understand finality of death; and that children are cognitively and…

  4. Assessment in the Private Studio Setting: Supporting Student Learning, Providing Effective Instruction, and Building Faculty-Student Interaction

    Science.gov (United States)

    Laubenthal, Jennifer

    2018-01-01

    A significant amount of literature exists about how to design and implement an effective assessment process for students in a music program, specifically in the classroom setting. This article suggests a framework for incorporating individualized assessment in the private-lesson setting based on effective classroom assessment practices. Many…

  5. Proliferation Resistance and Safeguards by Design: The Safeguardability Assessment Tool Provided by the INPRO Collaborative Project ''INPRO'' (Proliferation Resistance and Safeguardability Assessment)

    International Nuclear Information System (INIS)

    Haas, E.; Chang, H.-L.; Phillips, J.R.; Listner, C.

    2015-01-01

    Since the INPRO Collaborative Project on Proliferation Resistance and Safeguardability Assessment Tools (PROSA) was launched in 2011, Member State experts have worked with the INPRO Section and the IAEA Department of Safeguards to develop a revised methodology for self-assessment of sustainability in the area of proliferation resistance of a nuclear energy system (NES). With the common understanding that there is ''no proliferation resistance without safeguards'' the revised approach emphasizes the evaluation of a new 'User Requirement' for ''safeguardability'', that combines metrics of effective and efficient implementation of IAEA Safeguards including ''Safeguards-by-Design'' principles. The assessment with safeguardability as the key issue has been devised as a linear process evaluating the NES against a ''Basic Principle'' in the area of proliferation resistance, answering fundamental questions related to safeguards: 1) Do a State's legal commitments, policies and practices provide credible assurance of the exclusively peaceful use of the NES, including a legal basis for verification activities by the IAEA? 2) Does design and operation of the NES facilitate the effective and efficient implementation of IAEA safeguards? To answer those questions, a questionnaire approach has been developed that clearly identifies gaps and weaknesses. Gaps include prospects for improvements and needs for research and development. In this context, the PROSA approach assesses the safeguardability of a NES using a layered ''Evaluation Questionnaire'' that defines Evaluation Parameters (EP), EP-related questions, Illustrative Tests and Screening Questions to present and structure the evidence of findings. An integral part of the assessment process is Safeguards-by-Design, the identification of potential diversion, misuse and concealment strategies (coarse diversion path

  6. Identification of β-SiC surrounded by relatable surrounding diamond ...

    Indian Academy of Sciences (India)

    β-SiC is identified in the presence of a relatable surrounding diamond medium using subtle, but discernible Raman ... Change in the nature of the surrounding material structure and its .... intensity implies very low graphite content in thin film. In.

  7. Adiponectin provides additional information to conventional cardiovascular risk factors for assessing the risk of atherosclerosis in both genders.

    Directory of Open Access Journals (Sweden)

    Jin-Ha Yoon

    Full Text Available BACKGROUND: This study evaluated the relation between adiponectin and atherosclerosis in both genders, and investigated whether adiponectin provides useful additional information for assessing the risk of atherosclerosis. METHODS: We measured serum adiponectin levels and other cardiovascular risk factors in 1033 subjects (454 men, 579 women from the Korean Genomic Rural Cohort study. Carotid intima-media-thickness (CIMT was used as measure of atherosclerosis. Odds ratios (ORs with 95% confidence intervals (95% CI were calculated using multiple logistic regression, and receiver operating characteristic curves (ROC, the category-free net reclassification improvement (NRI and integrated discrimination improvement (IDI were calculated. RESULTS: After adjustment for conventional cardiovascular risk factors, such as age, waist circumference, smoking history, low-density and high-density lipoprotein cholesterol, triglycerides, systolic blood pressure and insulin resistance, the ORs (95%CI of the third tertile adiponectin group were 0.42 (0.25-0.72 in men and 0.47 (0.29-0.75 in women. The area under the curve (AUC on the ROC analysis increased significantly by 0.025 in men and 0.022 in women when adiponectin was added to the logistic model of conventional cardiovascular risk factors (AUC in men: 0.655 to 0.680, p = 0.038; AUC in women: 0.654 to 0.676, p = 0.041. The NRI was 0.32 (95%CI: 0.13-0.50, p<0.001, and the IDI was 0.03 (95%CI: 0.01-0.04, p<0.001 for men. For women, the category-free NRI was 0.18 (95%CI: 0.02-0.34, p = 0.031 and the IDI was 0.003 (95%CI: -0.002-0.008, p = 0.189. CONCLUSION: Adiponectin and atherosclerosis were significantly related in both genders, and these relationships were independent of conventional cardiovascular risk factors. Furthermore, adiponectin provided additional information to conventional cardiovascular risk factors regarding the risk of atherosclerosis.

  8. Mechanical Characteristics Analysis of Surrounding Rock on Anchor Bar Reinforcement

    Science.gov (United States)

    Gu, Shuan-cheng; Zhou, Pan; Huang, Rong-bin

    2018-03-01

    Through the homogenization method, the composite of rock and anchor bar is considered as the equivalent material of continuous, homogeneous, isotropic and strength parameter enhancement, which is defined as reinforcement body. On the basis of elasticity, the composite and the reinforcement are analyzed, Based on strengthening theory of surrounding rock and displacement equivalent conditions, the expression of reinforcement body strength parameters and mechanical parameters is deduced. The example calculation shows that the theoretical results are close to the results of the Jia-mei Gao[9], however, closer to the results of FLAC3D numerical simulation, it is proved that the model and surrounding rock reinforcement body theory are reasonable. the model is easy to analyze and calculate, provides a new way for determining reasonable bolt support parameters, can also provides reference for the stability analysis of underground cavern bolting support.

  9. Impacts of Artificial Reefs on Surrounding Ecosystems

    Science.gov (United States)

    Manoukian, Sarine

    Artificial reefs are becoming a popular biological and management component in shallow water environments characterized by soft seabed, representing both important marine habitats and tools to manage coastal fisheries and resources. An artificial reef in the marine environment acts as an open system with exchange of material and energy, altering the physical and biological characteristics of the surrounding area. Reef stability will depend on the balance of scour, settlement, and burial resulting from ocean conditions over time. Because of the unstable nature of sediments, they require a detailed and systematic investigation. Acoustic systems like high-frequency multibeam sonar are efficient tools in monitoring the environmental evolution around artificial reefs, whereas water turbidity can limit visual dive and ROV inspections. A high-frequency multibeam echo sounder offers the potential of detecting fine-scale distribution of reef units, providing an unprecedented level of resolution, coverage, and spatial definition. How do artificial reefs change over time in relation to the coastal processes? How accurately does multibeam technology map different typologies of artificial modules of known size and shape? How do artificial reefs affect fish school behavior? What are the limitations of multibeam technology for investigating fish school distribution as well as spatial and temporal changes? This study addresses the above questions and presents results of a new approach for artificial reef seafloor mapping over time, based upon an integrated analysis of multibeam swath bathymetry data and geoscientific information (backscatter data analysis, SCUBA observations, physical oceanographic data, and previous findings on the geology and sedimentation processes, integrated with unpublished data) from Senigallia artificial reef, northwestern Adriatic Sea (Italy) and St. Petersburg Beach Reef, west-central Florida continental shelf. A new approach for observation of fish

  10. 53 Piloting patch - providing assessment and treatment for children at home - and piecing together what works.

    Science.gov (United States)

    Ward, Caroline; Knight, Katie; Ballard, Mary-Rose; Keogh, Georgina; Samuel, Miriam; Buttle, Sara; Robb, Claire; Cleugh, Francesca

    2017-12-01

    PATCH is a pilot acute community children's nurse led service delivering assessment and treatment for children at home who are moderately unwell and might otherwise be admitted to hospital or attend Paediatric Emergency Department (PED). Children are referred by PED or GP and followed up via telephone support and home visits depending on clinical need for duration of acute illness. Pilot year funded by Imperial Charity. Using evaluation to build business case for sustained commissioned service. Phase 1 Sept 2016 - May 2017 : reduced short stay admissions and re-attendances to PED for common mild-moderate respiratory conditions e.g., viral wheeze, bronchiolitis. Phase 2 from May 2017 : piloting direct GP referrals to PATCH team to evaluate impact in reducing attendances to PED for children needing further assessment or support beyond GP consultation, and enabling families to manage common acute conditions at home.Using QI methodology, Model for Improvement we developed a driver diagram and used real-time PDSA cycles to capture our learning and inform small iterative changes of service development. Process mapping and world cafe style events were held with local community nurses, health visitor leads, GPs and commissioners to co-design referral pathways and explore more widely how PATCH fits into the whole urgent care system.emermed;34/12/A895-b/F1F1F1Figure 1Parental feedback evaluated via semi structured interviews. Activity - Appendix 1Phase 1 - Concentrated on respiratory conditions from PED.Total 188 referrals in first 7 months. Bronchiolitis 45%; viral wheeze 37.5%; asthma 7%; lower respiratory tract infections 5.4%.emermed;34/12/A895-b/F2F2F2Figure 250% of patients received home visits and telephone consultations; 50% only telephone support.Successes: Cost effective - Appendix 273 acute admissions avoided, costing c£400 per/night97 PED re-attendances prevented at £117 per attendance.Projected cost avoidance within acute care provider £3 27 640

  11. Integration of Density Dependence and Concentration Response Models Provides an Ecologically Relevant Assessment of Populations Exposed to Toxicants

    Science.gov (United States)

    The assessment of toxic exposure on wildlife populations involves the integration of organism level effects measured in toxicity tests (e.g., chronic life cycle) and population models. These modeling exercises typically ignore density dependence, primarily because information on ...

  12. An assessment of market and policy barriers for demand response providing ancillary services in U.S. electricity markets

    International Nuclear Information System (INIS)

    Cappers, Peter; MacDonald, Jason; Goldman, Charles; Ma, Ookie

    2013-01-01

    An impact of increased variable renewable generation is the need for balancing authorities to procure more ancillary services. While demand response resources are technically capable of providing these services, current experience across the U.S. illustrates they are relatively minor players in most regions. Accessing demand response resources for ancillary services may require a number of changes to policies and common practices at multiple levels. Regional reliability councils must first define ancillary services such that demand response resources may provide them. Once the opportunity exists, balancing authorities define and promulgate rules that set the infrastructure investments and performance attributes of a resource wishing to provide such services. These rules also dictate expected revenue streams which reveal the cost effectiveness of these resources. The regulatory compact between utility and state regulators, along with other statutes and decisions by state policymakers, may impact the interest of demand response program providers to pursue these resources as ancillary service providers. This paper identifies within these broad categories specific market and policy barriers to demand response providing ancillary services in different wholesale and retail environments, with emphasis on smaller customers who must be aggregated through a program provider to meet minimum size requirements for wholesale transactions. - Highlights: • We identify barriers keeping demand response from providing ancillary services. • Institutional, financial and program provider business model barriers exist. • Product definitions and rules do not always accommodate demand response well. • Expected revenues are uncertain and may not exceed required investments costs. • Regulatory compact and state statutes limit opportunities for program providers

  13. Opportunity's Surroundings on Sol 1818 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view is presented as a vertical projection with geometric seam correction. North is at the top. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  14. Opportunity's Surroundings on Sol 1818 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view is presented as a polar projection with geometric seam correction. North is at the top. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  15. Providing Formative Assessment to Students Solving Multipath Engineering Problems with Complex Arrangements of Interacting Parts: An Intelligent Tutor Approach

    Science.gov (United States)

    Steif, Paul S.; Fu, Luoting; Kara, Levent Burak

    2016-01-01

    Problems faced by engineering students involve multiple pathways to solution. Students rarely receive effective formative feedback on handwritten homework. This paper examines the potential for computer-based formative assessment of student solutions to multipath engineering problems. In particular, an intelligent tutor approach is adopted and…

  16. A study to assess whether fixed-width beam walking provides sufficient challenge to assess balance ability across lower limb prosthesis users.

    Science.gov (United States)

    Sawers, Andrew; Hafner, Brian J

    2018-04-01

    To evaluate the feasibility of fixed-width beam walking for assessing balance in lower limb prosthesis users. Cross-sectional. Laboratory. Lower limb prosthesis users. Participants attempted 10 walking trials on three fixed-width beams (18.6, 8.60, and 4.01 wide; 5.5 m long; 3.8 cm high). Beam-walking performance was quantified using the distance walked to balance failure. Heuristic rules applied to each participant's beam-walking distance to classify each beam as "too easy," "too hard," or "appropriately challenging" and determine whether any single beam provided an appropriate challenge to all participants. The number of trials needed to achieve stable beam-walking performance was quantified for appropriately challenging beams by identifying the last inflection point in the slope of each participant's trial-by-trial cumulative performance record. In all, 30 unilateral lower limb prosthesis users participated in the study. Each of the fixed-width beams was either too easy or too hard for at least 33% of the sample. Thus, no single beam was appropriately challenging for all participants. Beam-walking performance was stable by trial 8 for all participants and by trial 6 for 90% of participants. There was no significant difference in the number of trials needed to achieve stable performance among beams ( P = 0.74). Results suggest that a clinical beam-walking test would require multiple beams to evaluate balance across a range of lower limb prosthesis users, emphasizing the need for adaptive or progressively challenging balance tests. While the administrative burden of a multiple-beam balance test may limit clinical feasibility, alternatives to ease this administrative burden are proposed.

  17. 42 CFR 495.364 - Review and assessment of administrative activities and expenses of Medicaid provider health...

    Science.gov (United States)

    2010-10-01

    ... its approved HIT planning advance planning document and health information technology implementation... and expenses of Medicaid provider health information technology adoption and operation. 495.364... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY...

  18. Crust Structure Data of Seas Surrounding Turkey

    International Nuclear Information System (INIS)

    Maden, N.; Gelisli, K.

    2007-01-01

    Black Sea, Aegean, Mediterranean and Marmara Sea, which surround the Turkey, have not been examined with respect to the Geological, Geophysical and other natural sciences sufficiently. In fact, it is not attach importance the Turkish seas adequately and abandoned with respect to the scientific researches. The most important reason of this situation is the lack of the education of the Marine Sciences in the Turkish Universities. In this study, it is tried to construct a crustal structure data base of the surrounding seas of the Turkey by collecting crustal structure data sets done by different authors in different times so far. The data acquired in the base are collected from different data base sources by dragging. The Moho depth in the eastern and western basin of the Black sea is 22 km and 19 km, respectively. In the Marmara Sea the Moho depth is 24 km. The moho value in the southern Aegean is 20 km, in the northern Aegean the moho depth is 30 km. on the other hand, the moho depth value in the eastern and western basin of the Mediterranean Sea are 15-20 km and 25-30 km, respectively

  19. Induced radioactivity in a 4 MW target and its surroundings

    CERN Document Server

    Agosteo, Stefano; Otto, Thomas; Silari, Marco

    2003-01-01

    An important aspect of a future CERN Neutrino Factory is the material activation arising from a 2.2 GeV, 4 MW proton beam striking a mercury target. An estimation of the hadronic inelastic interactions and the production of residual nuclei in the target, the magnetic horn, the decay tunnel, the surrounding rock and a downstream dump was performed by the Monte Carlo hadronic cascade code FLUKA. The aim was both to assess the dose equivalent rate to be expected during maintenance work and to evaluate the amount of residual radioactivity, which will have to be disposed of after the facility has ceased operation.

  20. Assessment of soil contamination in area surrounding Tuwaitha nuclear facilities

    International Nuclear Information System (INIS)

    Al-Taii, A.A.F.; AI-Jobori, S.H.; Al-Maadhidi, J.F.

    2012-01-01

    The wide spread looting of the Tuwaitha Nuclear Facilities as well as damaging of some buildings in 2003, had offered possibilities of contamination of soil environment inside the Site. The objective of the present work was to investigate soil contamination to help in future decontamination programs. A total of 25 soil surface samples (including one reference sample) covered different locations in the Site were collected in March 2011. High purity Ge detector was used for gamma spectrometry of soil samples. Data of total and spectral gamma for U series, Th series, 40 K and 137 Cs are presented. Slight variations were observed in specific activity of the U series 214 Bi or 214 Pb and 226 Ra among measured soil samples where the range was 10.3-12.7 for 214 Bi as compared with 12.2-33.4 Bq/kg for 226 Ra. Values of both 214 Bi and 226 Ra are in the range of reference sample specific activity indicating that no evidence of contamination had occurred in the investigated area. Results of activity concentrations of thorium series 228 Ac or 208 Tl, 212 Pb, and 212 Bi are in the range of reference sample and close to those values given worldwide for natural uranium in soil. The levels of 40 K in soil are within the natural abundance of this isotope in the soil where the range was 207.6-266.1 with 220.3 Bq/kg for the reference sample. On the other hand, 137 Cs specific activities showed great variation among measured samples. The minimum value for 137 Cs was 0.6 and the maximum 7.6 compared with 0.8 Bq/kg for the control soil sample. The non-uniformity of radioactivity concentration of 137 Cs suggest the presence of contamination in some locations although this level is considered as an acceptable level and no hazardous effect will be generated.

  1. Assessment of urinary concentrations of hepcidin provides novel insight into disturbances in iron homeostasis during malarial infection

    NARCIS (Netherlands)

    Mast, de Q.; Nadjm, B.; Reyburn, H.; Kemna, E.H.J.M.; Amos, B.; Laarakkers, C.M.M.; Silalye, S.; Verhoef, H.; Sauerwein, R.W.; Swinkels, D.W.; Ven, van der A.J.A.M.

    2009-01-01

    Disturbances in iron homeostasis are frequently observed in individuals with malaria. To study the effect of malaria and its treatment on iron homeostasis and to provide a mechanistic explanation for observed alterations in iron distribution, we studied the course of the iron regulatory hormone

  2. Assessment of ecosystem services provided by urban trees: public lands within the Urban Growth Boundary of Corvallis, OR

    Science.gov (United States)

    Public lands within the Urban Growth Boundary of Corvallis, Oregon contain a diverse population of about 440,000 trees that include over 300 varieties and have an estimated tree cover of 31%. While often unrecognized, urban trees provide a variety of “ecosystem services” or dire...

  3. Patient satisfaction as a predictor of return-to-provider behavior: analysis and assessment of financial implications.

    Science.gov (United States)

    Garman, Andrew N; Garcia, Joanne; Hargreaves, Marcia

    2004-01-01

    Although customer loyalty is frequently cited as a benefit of patient satisfaction, an empirical link between the two has not, to our knowledge, ever been statistically established in a hospital setting. The goal of the present study was to evaluate the relationship between self-reported patient satisfaction measures and subsequent return to the provider for care at a large academic medical center. Data from all adult medical patients responding to a patient satisfaction survey distributed by a large midwestern academic medical center during fiscal year 1997 (n = 1485) were analyzed. Response patterns were examined as they related to whether patients returned to the provider during the subsequent 2-year period. Analyses suggested that return-to-provider was associated with only a minority of the satisfaction items (approx. 11%). All items showing a significant relationship measured perceptions of how well physicians and nurses attended to, and provided information to, patients and their families. Although the size of these relationships was generally small, the estimated financial implications are substantial. Other implications of these findings for planning effective service improvement initiatives as well as improving patient survey design are discussed.

  4. Methodical assessment of all non-ionizing radiation sources that can provide a relevant contribution to public exposure. Final report

    International Nuclear Information System (INIS)

    Bornkessel, Christian; Schubert, Markus; Wuschek, Matthias; Brueggemeyer, Hauke; Weiskopf, Daniela

    2011-01-01

    The aim of the research project was to systematically identify artificial sources on non-ionizing radiation (electric, magnetic or electromagnetic fields in a frequency range from 0 Hz to 300 GHz, as well optical radiation in a wavelength range from 100 nm to 1 mm), that have relevant contribution to public exposure. The report includes the following chapters: (1) Concept for the relevance assessment for non-ionizing radiation sources; (2) concept for the systematic identification of sources from establishes technologies; (3) concept for the systematic identification of sources from new or foreseeable technologies; (4)overview of relevant radiation sources.

  5. Training Sessional Academic Staff to Provide Quality Feedback on University Students' Assessment: Lessons from a Faculty of Law Learning and Teaching Project

    Science.gov (United States)

    Richards, Kelly; Bell, Tamara; Dwyer, Angela

    2017-01-01

    The quality of feedback provided to university students has long been recognised as the most important predictor of student learning and satisfaction. However, providing quality feedback to students is challenging in the current context, in which universities increasingly rely on casualised and inexperienced academic staff to assess undergraduate…

  6. Opportunity's Surroundings on Sol 1798 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view is presented as a polar projection with geometric seam correction. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  7. Opportunity's Surroundings After Sol 1820 Drive (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view is presented as a polar projection with geometric seam correction. North is at the top. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock.

  8. Opportunity's Surroundings on Sol 1798 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view is presented as a vertical projection with geometric seam correction. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  9. Opportunity's Surroundings on Sol 1687 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a vertical projection with geometric seam correction.

  10. Opportunity's Surroundings After Sol 1820 Drive (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view is presented as a vertical projection with geometric seam correction. North is at the top. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock.

  11. Opportunity's Surroundings on Sol 1687 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a polar projection with geometric seam correction.

  12. Opportunity's Surroundings After Sol 1820 Drive

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). South is at the center; north at both ends. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  13. Towards Semantic Understanding of Surrounding Vehicular Maneuvers

    DEFF Research Database (Denmark)

    Kristoffersen, Miklas Strøm; Dueholm, Jacob Velling; Satzoda, Ravi K.

    2016-01-01

    This paper proposes the use of multiple low-cost visual sensors to obtain a surround view of the ego-vehicle for semantic understanding. A multi-perspective view will assist the analysis of naturalistic driving studies (NDS), by automating the task of data reduction of the observed sequences...... into events. A user-centric vision-based framework is presented using a vehicle detector and tracker in each separate perspective. Multi-perspective trajectories are estimated and analyzed to extract 14 different events, including potential dangerous behaviors such as overtakes and cut-ins. The system...... is tested on ten sequences of real-world data collected on U. S. highways. The results show the potential use of multiple low-cost visual sensors for semantic understanding around the ego-vehicle....

  14. Lovelock black holes surrounded by quintessence

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, Sushant G. [University of KwaZulu-Natal, Astrophysics and Cosmology Research Unit, School of Mathematics, Statistics and Computer Science, Durban (South Africa); Centre for Theoretical Physics, Multidisciplinary Centre for Advanced Research and Studies (MCARS), New Delhi (India); Maharaj, Sunil D.; Baboolal, Dharmanand; Lee, Tae-Hun [University of KwaZulu-Natal, Astrophysics and Cosmology Research Unit, School of Mathematics, Statistics and Computer Science, Durban (South Africa)

    2018-02-15

    Lovelock gravity consisting of the dimensionally continued Euler densities is a natural generalization of general relativity to higher dimensions such that equations of motion are still second order, and the theory is free of ghosts. A scalar field with a positive potential that yields an accelerating universe has been termed quintessence. We present exact black hole solutions in D-dimensional Lovelock gravity surrounded by quintessence matter and also perform a detailed thermodynamical study. Further, we find that the mass, entropy and temperature of the black hole are corrected due to the quintessence background. In particular, we find that a phase transition occurs with a divergence of the heat capacity at the critical horizon radius, and that specific heat becomes positive for r{sub h} < r{sub c} allowing the black hole to become thermodynamically stable. (orig.)

  15. Lovelock black holes surrounded by quintessence

    Science.gov (United States)

    Ghosh, Sushant G.; Maharaj, Sunil D.; Baboolal, Dharmanand; Lee, Tae-Hun

    2018-02-01

    Lovelock gravity consisting of the dimensionally continued Euler densities is a natural generalization of general relativity to higher dimensions such that equations of motion are still second order, and the theory is free of ghosts. A scalar field with a positive potential that yields an accelerating universe has been termed quintessence. We present exact black hole solutions in D-dimensional Lovelock gravity surrounded by quintessence matter and also perform a detailed thermodynamical study. Further, we find that the mass, entropy and temperature of the black hole are corrected due to the quintessence background. In particular, we find that a phase transition occurs with a divergence of the heat capacity at the critical horizon radius, and that specific heat becomes positive for r_h

  16. Towards a common disability assessment framework: theoretical and methodological issues for providing public services and benefits using ICF.

    Science.gov (United States)

    Francescutti, Carlo; Frattura, Lucilla; Troiano, Raffaella; Gongolo, Francesco; Martinuzzi, Andrea; Sala, Marina; Meucci, Paolo; Raggi, Alberto; Russo, Emanuela; Buffoni, Mara; Gorini, Giovanna; Conclave, Mario; Petrangeli, Agostino; Solipaca, Alessandro; Leonardi, Matilde

    2009-01-01

    To report on the preliminary results of an Italian project on the implementation of an ICF-based protocol for providing public services and benefits for persons with disabilities. The UN Convention on the Rights of persons with disabilities (UNC) was mapped to the ICF, and core elements were implemented in an ICF-based evaluation protocol. A person-environment interaction classification (PEIC) tree was also developed for defining evaluation outputs. The PEIC and the ICF-based protocol are the guideline and the data interpretation source, respectively, for providing public services and benefits. They enable to assign persons to different services, from surveillance and monitoring to facilitator provision or sustain over time, to barrier removal or to the reorganisation of environmental factors provision. A detailed description of the target intervention is made available through the implementation of a protocol, which points out the effect of personal support and other environmental factors. The detailed description of functioning and disability provided by our methodology can help policy makers and administrators in decision making, on the basis of a description of real needs, and in targeting person-tailored interventions.

  17. Technology assessment and resource allocation for predictive genetic testing: A study of the perspectives of Canadian genetic health care providers

    Directory of Open Access Journals (Sweden)

    Einsiedel Edna

    2009-06-01

    Full Text Available Abstract Background With a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing robust decision rules or guidelines to allocate a finite number of public resources. The objective of this study was to gain Canadian genetic health providers' perspectives on factors and criteria that influence and shape resource allocation decisions for publically funded predictive genetic testing in Canada. Methods The authors conducted semi-structured interviews with 16 senior lab directors and clinicians at publically funded Canadian predictive genetic testing facilities. Participants were drawn from British Columbia, Alberta, Manitoba, Ontario, Quebec and Nova Scotia. Given the community sampled was identified as being relatively small and challenging to access, purposive sampling coupled with snowball sampling methodologies were utilized. Results Surveyed lab directors and clinicians indicated that predictive genetic tests were funded provincially by one of two predominant funding models, but they themselves played a significant role in how these funds were allocated for specific tests and services. They also rated and identified several factors that influenced allocation decisions and patients' decisions regarding testing. Lastly, participants provided recommendations regarding changes to existing allocation models and showed support for a national evaluation process for predictive testing. Conclusion Our findings suggest that largely local and relatively ad hoc decision making processes are being made in relation to resource allocations for predictive genetic tests and that a more coordinated and, potentially, national approach to allocation decisions in this context may be appropriate.

  18. On the assessment of performance and emissions characteristics of a SI engine provided with a laser ignition system

    Science.gov (United States)

    Birtas, A.; Boicea, N.; Draghici, F.; Chiriac, R.; Croitoru, G.; Dinca, M.; Dascalu, T.; Pavel, N.

    2017-10-01

    Performance and exhaust emissions of spark ignition engines are strongly dependent on the development of the combustion process. Controlling this process in order to improve the performance and to reduce emissions by ensuring rapid and robust combustion depends on how ignition stage is achieved. An ignition system that seems to be able for providing such an enhanced combustion process is that based on plasma generation using a Q-switched solid state laser that delivers pulses with high peak power (of MW-order level). The laser-spark devices used in the present investigations were realized using compact diffusion-bonded Nd:YAG/Cr4+:YAG ceramic media. The laser igniter was designed, integrated and built to resemble a classical spark plug and therefore it could be mounted directly on the cylinder head of a passenger car engine. In this study are reported the results obtained using such ignition system provided for a K7M 710 engine currently produced by Renault-Dacia, where the standard calibrations were changed towards the lean mixtures combustion zone. Results regarding the performance, the exhaust emissions and the combustion characteristics in optimized spark timing conditions, which demonstrate the potential of such an innovative ignition system, are presented.

  19. Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

    Science.gov (United States)

    Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

    2012-03-01

    The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  20. WHY DO YOU NEED TO USE A CARIES RISK ASSESSMENT PROTOCOL TO PROVIDE AN EFFECTIVE CARIES PREVENTIVE REGIME?

    Science.gov (United States)

    Afuakwah, Charles; Welbury, Richard

    2015-11-01

    Clinical guidelines recommend an individual is given a caries risk status based on analysis of defined clinical and social criteria before implementing a tailored preventive plan. Improve documentation of caries risk assessment (CRA) in a general dental practice setting, using a systems-based approach to quality improvement methods. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. Identify barriers to delivery of CRA and provision of preventive care. Data for patients aged 0-16 years was collected over two cycles using standard audit methodology. The first cycle was a retrospective analysis (n = 400) using random sampling. The second cycle a prospective analysis (n = 513) using consecutive sampling over a 15-week period. Five staff meetings with feedback occurred between cycles. In cycle one, no specific CRA system was identified. CRA status was not stated widely, risk factors were not analysed and there was variation with respect to the prescription and delivery of preventive strategies. These discrepancies were demonstrable for all four participating dentists and at all ages. In cycle two, 100% recorded CRA. All risk factors were analysed and individual caries risk was correctly annotated. There was 100% compliance with the protocol for preventive plans. The use of CRA improved documentation of caries risk status. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals.

  1. Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Amiri-Abchuyeh, Maryam; Gholipour-Baradari, Afshin; Yazdani-Cherati, Jamshid; Nikkhah, Attieh

    2015-08-01

    The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP. The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran. This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability. The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all. The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.

  2. Electrochemical and micro-gravimetric corrosion studies on spent fuel provide relevant source term data for a repository performance assessment

    International Nuclear Information System (INIS)

    Wegen, Detlef H.; Bottomley, Paul D. W.; Glatz, Jean-Paul

    2004-01-01

    Various electrochemical methods (corrosion potential monitoring, AC impedance analysis and electrochemical noise monitoring) were used in the investigation of UO 2 samples: natural and doped with two different levels of 238 Pu (0.1 and 10 wt%) simulating the increasing α-intensities seen with time in the repository. The results were compared and were able to show the intense, but also the very local nature of the radiolysis and to demonstrate that corrosion rates were proportional to α-radiolysis and hence the 238 Pu content; the corrosion rates were in accordance with earlier work at ITU. By contrast it was seen that the redox potentials only gave information as to the bulk solution that did not reflect the true conditions at the electrode interface that were driving the corrosion processes of UO 2 dissolution in groundwaters. The study shows how electrochemical techniques can provide vital information on the corrosion mechanism at the UO 2 /solution interface

  3. Providing Limited Local Electric Service During a Major Grid Outage: A First Assessment Based on Customer Willingness to Pay.

    Science.gov (United States)

    Baik, Sunhee; Morgan, M Granger; Davis, Alexander L

    2018-02-01

    While they are rare, widespread blackouts of the bulk power system can result in large costs to individuals and society. If local distribution circuits remain intact, it is possible to use new technologies including smart meters, intelligent switches that can change the topology of distribution circuits, and distributed generation owned by customers and the power company, to provide limited local electric power service. Many utilities are already making investments that would make this possible. We use customers' measured willingness to pay to explore when the incremental investments needed to implement these capabilities would be justified. Under many circumstances, upgrades in advanced distribution systems could be justified for a customer charge of less than a dollar a month (plus the cost of electricity used during outages), and would be less expensive and safer than the proliferation of small portable backup generators. We also discuss issues of social equity, extreme events, and various sources of underlying uncertainty. © 2017 Society for Risk Analysis.

  4. Assessment of the impact of market regulation in Mali on the price of essential medicines provided through the private sector.

    Science.gov (United States)

    Maïga, Diadié; Williams-Jones, Bryn

    2010-10-01

    In 1998, the government of Mali adopted a national pharmaceutical policy aimed at promoting a supply system for generic essential medicines that would guarantee equal access for all citizens. Distribution and delivery is a shared responsibility of both public and private sectors (wholesalers and pharmacies). To influence private sector behaviour, the national policy uses a combination of government regulation and market forces. In 2006, the government issued a decree fixing maximum prices in the private sector for 107 prescription drugs from the national list of 426 essential medicines. The current study assessed the impact of this intervention on the evolution of market prices (wholesale and retail), and the subsequent availability and public access to essential medicines in Mali. A cross-sectional descriptive survey was conducted in February and May 2006, and January 2009, with 16 wholesalers and 30 private drugstores in Bamako, Mali. The overall availability of essential medicines at private wholesalers (p=1) and pharmacies (p=0.53) was identical before and after the enforcement of the 2006 decree fixing maximum drug prices. Contrary to concerns expressed by wholesalers and pharmacies, and the other stakeholders, the decree did not impact negatively on availability of essential medicines. In fact, median wholesale prices in 2009 were 25.6% less than those fixed by the decree. In private pharmacies, retail prices were only 3% more expensive than the recommended prices, compared with being 25.5% more expensive prior to enforcement of the decree. The study shows that prices of essential medicines in Mali have evolved favourably towards the prices recommended by the government decree. Further, the study contributes to mounting evidence that market regulation by governments does not necessarily negatively affect drug availability; in fact, given the reduction in prices, the study shows that Malians arguably have better access to more affordable essential medicines

  5. Pullman transportation plan : a transportation and access plan for Pullman National Monument and the surrounding neighborhood

    Science.gov (United States)

    2017-09-01

    The Pullman Transportation Plan provides a holistic set of recommendations to improve access to and from Pullman National Monument and its surrounding neighborhoods for both visitors and residents. In this plan, we identify short-, medium-, and long-...

  6. Projection of needs for gamma radiation sources and other radioisotopes and assessment of alternatives for providing radiation sources

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.A.; Jensen, G.A.; Clark, L.L.; Eakin, D.E.; Jarrett, J.H.; Katayama, Y.B.; McKee, R.W.; Morgan, L.G.; Nealey, S.M.; Platt, A.M.; Tingey, G.L.

    1989-06-01

    Pacific Northwest Laboratory reviewed the projected uses and demands for a variety of nuclear byproducts. Because the major large-scale near-term demand is for gamma irradiation sources, this report concentrates on the needs for gamma sources and evaluates the options for providing the needed material. Projections of possible growth in the irradiation treatment industry indicate that there will be a need for 180 to 320 MCi of /sup 60/Co (including /sup 137/Cs equivalent) in service in the year 2000. The largest current and projected use of gamma irradiation is for the sterilization of medical devices and disposable medical supplies. Currently, 40% of US disposable medical products are treated by irradiation, and within 10 years it is expected that 90% will be treated in this manner. Irradiation treatment of food for destruction of pathogens or parasites, disinfestation, or extension of allowable storage periods is estimated to require an active inventory of 75 MCi of /sup 60/Co-equivalent gamma source in about a decade. 90 refs., 7 figs., 25 tabs.

  7. Assessment of different biomarkers provides valuable diagnostic standards in the evaluation of the risk of acute rejection.

    Science.gov (United States)

    Zheng, Jin; Ding, Xiaoming; Tian, Xiaohui; Jin, Zhankui; Pan, Xiaoming; Yan, Hang; Feng, Xinshun; Hou, Jun; Xiang, Heli; Ren, Li; Tian, Puxun; Xue, Wujun

    2012-09-01

    Acute rejection (AR) is a strong risk factor for chronic rejection in renal transplant recipients. Accurate and timely diagnosis of AR episodes is very important for disease control and prognosis. Therefore, objectively evaluated the immune status of patients is essential in the field of post-transplantation treatment. This longitudinal study investigated the usefulness of five biomarkers, human leukocyte antigen (HLA)-G5 and sCD30 level in sera, intracellular adenosine triphosphate (iATP) release level of CD4(+) T cells, and granzyme B/perforin expression in peripheral blood mononuclear cells (PBMCs) and biopsies, to detect AR and the resolution of biomarkers in a total of 84 cases of renal transplantation. The data demonstrated that recipients with clinical or biopsy proven rejection significantly increased iATP release level of CD4(+) T cells, and elevated sCD30 but lowered HLA-G5 level in sera compared with individuals with stable graft function. Expression levels of granzyme B and perforin were also elevated in PBMCs and graft biopsies of AR patients. Taken together, we identified that upregulation of sCD30, iATP, granzyme B, perforin, and downregulation of HLA-G5 could provide valuable diagnostic standards to identify those recipients in the risk of AR. And iATP may be a better biomarker than others for predicting the graft rejection episode.

  8. Projection of needs for gamma radiation sources and other radioisotopes and assessment of alternatives for providing radiation sources

    International Nuclear Information System (INIS)

    Ross, W.A.; Jensen, G.A.; Clark, L.L.

    1989-06-01

    Pacific Northwest Laboratory reviewed the projected uses and demands for a variety of nuclear byproducts. Because the major large-scale near-term demand is for gamma irradiation sources, this report concentrates on the needs for gamma sources and evaluates the options for providing the needed material. Projections of possible growth in the irradiation treatment industry indicate that there will be a need for 180 to 320 MCi of 60 Co (including 137 Cs equivalent) in service in the year 2000. The largest current and projected use of gamma irradiation is for the sterilization of medical devices and disposable medical supplies. Currently, 40% of US disposable medical products are treated by irradiation, and within 10 years it is expected that 90% will be treated in this manner. Irradiation treatment of food for destruction of pathogens or parasites, disinfestation, or extension of allowable storage periods is estimated to require an active inventory of 75 MCi of 60 Co-equivalent gamma source in about a decade. 90 refs., 7 figs., 25 tabs

  9. Schistosomiasis mansoni incidence data in Rwanda can improve prevalence assessments, by providing high-resolution hotspot and risk factors identification.

    Science.gov (United States)

    Nyandwi, E; Veldkamp, A; Amer, S; Karema, C; Umulisa, I

    2017-10-25

    Schistosomiasis mansoni constitutes a significant public health problem in Rwanda. The nationwide prevalence mapping conducted in 2007-2008 revealed that prevalence per district ranges from 0 to 69.5% among school children. In response, mass drug administration campaigns were initiated. However, a few years later some additional small-scale studies revealed the existence of areas of high transmission in districts formerly classified as low endemic suggesting the need for a more accurate methodology for identification of hotspots. This study investigated if confirmed cases of schistosomiasis recorded at health facility level can be used to, next to existing prevalence data, detect geographically more accurate hotspots of the disease and its associated risk factors. A GIS-based spatial and statistical analysis was carried out. Confirmed cases, recorded at primary health facilities level, were combined with demographic data to calculate incidence rates for each of 367 health facility service area. Empirical Bayesian smoothing was used to deal with rate instability. Incidence rates were compared with prevalence data to identify their level of agreement. Spatial autocorrelation of the incidence rates was analyzed using Moran's Index, to check if spatial clustering occurs. Finally, the spatial relationship between schistosomiasis distribution and potential risk factors was assessed using multiple regression. Incidence rates for 2007-2008 were highly correlated with prevalence values (R 2  = 0.79), indicating that in the case of Rwanda incidence data can be used as a proxy for prevalence data. We observed a focal distribution of schistosomiasis with a significant spatial autocorrelation (Moran's I > 0: 0,05-0.20 and p ≤ 0,05), indicating the occurrence of hotspots. Regarding risk factors, it was identified that the spatial pattern of schistosomiasis is significantly associated with wetland conditions and rice cultivation. In Rwanda the high density of health

  10. Opportunity's Surroundings on Sol 1798 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11850 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11850 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this stereo 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  11. Opportunity's Surroundings on Sol 1818 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11846 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11846 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  12. Opportunity's Surroundings on Sol 1687 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11739 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11739 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this stereo, 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). The view appears three-dimensional when viewed through red-blue glasses. Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This panorama combines right-eye and left-eye views presented as cylindrical-perspective projections with geometric seam correction.

  13. Opportunity's Surroundings After Sol 1820 Drive (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11841 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11841 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  14. The lithosphere-asthenosphere: Italy and surroundings

    International Nuclear Information System (INIS)

    Panza, G.F.; Aoudia, A.; Pontevivo, A.; Chimera, G.; Raykova, R.

    2003-02-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by surface wave velocity tomography and non-linear inversion. Maps of the Moho depth, of the thickness of the lithosphere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, identified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the principal recent volcanoes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria a lithospheric doubling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenosphere properties delineate a differentiation between the northern and the southern sectors of the Adriatic Sea, likely attesting the fragmentation of Adria. (author)

  15. The lithosphere-asthenosphere Italy and surroundings

    CERN Document Server

    Panza, G F; Chimera, G; Pontevivo, A; Raykova, R

    2003-01-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by surface wave velocity tomography and non-linear inversion. Maps of the Moho depth, of the thickness of the lithosphere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, identified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the principal recent volcanoes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria a lithospheric doubling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenosphere properties delineat...

  16. INTERSTELLAR MAGNETIC FIELD SURROUNDING THE HELIOPAUSE

    International Nuclear Information System (INIS)

    Whang, Y. C.

    2010-01-01

    This paper presents a three-dimensional analytical solution, in the limit of very low plasma β-ratio, for the distortion of the interstellar magnetic field surrounding the heliopause. The solution is obtained using a line dipole method that is the integration of point dipole along a semi-infinite line; it represents the magnetic field caused by the presence of the heliopause. The solution allows the variation of the undisturbed magnetic field at any inclination angle. The heliosphere is considered as having blunt-nosed geometry on the upwind side and it asymptotically approaches a cylindrical geometry having an open exit for the continuous outflow of the solar wind on the downwind side. The heliopause is treated as a magnetohydrodynamic tangential discontinuity; the interstellar magnetic field lines at the boundary are tangential to the heliopause. The interstellar magnetic field is substantially distorted due to the presence of the heliopause. The solution shows the draping of the field lines around the heliopause. The magnetic field strength varies substantially near the surface of the heliopause. The effect on the magnetic field due to the presence of the heliopause penetrates very deep into the interstellar space; the depth of penetration is of the same order of magnitude as the scale length of the heliosphere.

  17. Effectively Communicating the Uncertainties Surrounding Ebola Virus Transmission.

    Directory of Open Access Journals (Sweden)

    Andy Kilianski

    2015-10-01

    Full Text Available The current Ebola virus outbreak has highlighted the uncertainties surrounding many aspects of Ebola virus virology, including routes of transmission. The scientific community played a leading role during the outbreak-potentially, the largest of its kind-as many of the questions surrounding ebolaviruses have only been interrogated in the laboratory. Scientists provided an invaluable resource for clinicians, public health officials, policy makers, and the lay public in understanding the progress of Ebola virus disease and the continuing outbreak. Not all of the scientific communication, however, was accurate or effective. There were multiple instances of published articles during the height of the outbreak containing potentially misleading scientific language that spurred media overreaction and potentially jeopardized preparedness and policy decisions at critical points. Here, we use articles declaring the potential for airborne transmission of Ebola virus as a case study in the inaccurate reporting of basic science, and we provide recommendations for improving the communication about unknown aspects of disease during public health crises.

  18. Effectively Communicating the Uncertainties Surrounding Ebola Virus Transmission.

    Science.gov (United States)

    Kilianski, Andy; Evans, Nicholas G

    2015-10-01

    The current Ebola virus outbreak has highlighted the uncertainties surrounding many aspects of Ebola virus virology, including routes of transmission. The scientific community played a leading role during the outbreak-potentially, the largest of its kind-as many of the questions surrounding ebolaviruses have only been interrogated in the laboratory. Scientists provided an invaluable resource for clinicians, public health officials, policy makers, and the lay public in understanding the progress of Ebola virus disease and the continuing outbreak. Not all of the scientific communication, however, was accurate or effective. There were multiple instances of published articles during the height of the outbreak containing potentially misleading scientific language that spurred media overreaction and potentially jeopardized preparedness and policy decisions at critical points. Here, we use articles declaring the potential for airborne transmission of Ebola virus as a case study in the inaccurate reporting of basic science, and we provide recommendations for improving the communication about unknown aspects of disease during public health crises.

  19. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

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

  20. Understanding community norms surrounding tobacco sales.

    Directory of Open Access Journals (Sweden)

    Patricia A McDaniel

    Full Text Available In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization.We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales.Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative.Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  1. Understanding community norms surrounding tobacco sales.

    Science.gov (United States)

    McDaniel, Patricia A; Malone, Ruth E

    2014-01-01

    In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization. We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales. Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative. Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  2. The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia

    DEFF Research Database (Denmark)

    Pinder, Margeret; Conteh, Lesong; Jeffries, David

    2016-01-01

    ) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. Methods/design A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide...

  3. Anodal transcranial direct current stimulation reduces psychophysically measured surround suppression in the human visual cortex.

    Directory of Open Access Journals (Sweden)

    Daniel P Spiegel

    Full Text Available Transcranial direct current stimulation (tDCS is a safe, non-invasive technique for transiently modulating the balance of excitation and inhibition within the human brain. It has been reported that anodal tDCS can reduce both GABA mediated inhibition and GABA concentration within the human motor cortex. As GABA mediated inhibition is thought to be a key modulator of plasticity within the adult brain, these findings have broad implications for the future use of tDCS. It is important, therefore, to establish whether tDCS can exert similar effects within non-motor brain areas. The aim of this study was to assess whether anodal tDCS could reduce inhibitory interactions within the human visual cortex. Psychophysical measures of surround suppression were used as an index of inhibition within V1. Overlay suppression, which is thought to originate within the lateral geniculate nucleus (LGN, was also measured as a control. Anodal stimulation of the occipital poles significantly reduced psychophysical surround suppression, but had no effect on overlay suppression. This effect was specific to anodal stimulation as cathodal stimulation had no effect on either measure. These psychophysical results provide the first evidence for tDCS-induced reductions of intracortical inhibition within the human visual cortex.

  4. The dorsal skinfold chamber: window into the dynamic interaction of biomaterials with their surrounding host tissue

    Directory of Open Access Journals (Sweden)

    MW Laschke

    2011-09-01

    Full Text Available The implantation of biomaterials into the human body has become an indispensable part of almost all fields of modern medicine. Accordingly, there is an increasing need for appropriate approaches, which can be used to evaluate the suitability of different biomaterials for distinct clinical indications. The dorsal skinfold chamber is a sophisticated experimental model, which has been proven to be extremely valuable for the systematic in vivo analysis of the dynamic interaction of small biomaterial implants with the surrounding host tissue in rats, hamsters and mice. By means of intravital fluorescence microscopy, this chronic model allows for repeated analyses of various cellular, molecular and microvascular mechanisms, which are involved in the early inflammatory and angiogenic host tissue response to biomaterials during the initial 2-3 weeks after implantation. Therefore, the dorsal skinfold chamber has been broadly used during the last two decades to assess the in vivo performance of prosthetic vascular grafts, metallic implants, surgical meshes, bone substitutes, scaffolds for tissue engineering, as well as for locally or systemically applied drug delivery systems. These studies have contributed to identify basic material properties determining the biocompatibility of the implants and vascular ingrowth into their surface or internal structures. Thus, the dorsal skinfold chamber model does not only provide deep insights into the complex interactions of biomaterials with the surrounding soft tissues of the host but also represents an important tool for the future development of novel biomaterials aiming at an optimisation of their biofunctionality in clinical practice.

  5. Availability of limited service food outlets surrounding schools in British Columbia.

    Science.gov (United States)

    Black, Jennifer L; Day, Meghan

    2012-06-05

    The purpose of this study was to provide a descriptive profile of the availability of limited service food outlets surrounding public schools in British Columbia, Canada. Data from the 2010 Canadian Business Data Files were used to identify limited service food outlets including fast food outlets, beverage and snack food stores, delis and convenience stores. The number of food outlets within 800 metres of 1,392 public schools and the distance from schools to the nearest food outlets were assessed. Multivariate regression models examined the associations between food outlet availability and school-level characteristics. In 2010, over half of the public schools in BC (54%) were located within a 10-12 minute walk from at least one limited service food outlet. The median closest distance to a food outlet was just over 1 km (1016 m). Schools comprised of students living in densely populated urban neighbourhoods and neighbourhoods characterized by lower socio-economic status were more likely to have access to limited service food outlets within walking distance. After adjusting for school-level median family income and population density, larger schools had higher odds of exposure to food vendors compared to schools with fewer students. The availability of and proximity to limited service food outlets vary widely across schools in British Columbia and school-level characteristics are significantly associated with food outlet availability. Additional research is needed to understand how food environment exposures inside and surrounding schools impact students' attitudes, food choices and dietary quality.

  6. Deformation at longyao ground fissure and its surroundings, north China plain, revealed by ALOS PALSAR PS-InSAR

    Science.gov (United States)

    Yang, Chengsheng; Lu, Zhong; Zhang, Qin; Zhao, Chaoying; Peng, Jianbing; Ji, Lingyun

    2018-05-01

    The Longyao ground fissure (LGF) is the longest and most active among more than 1000 ground fissures on the North China Plain. There have been many studies on the formation mechanism of the LGF, due to its scientific importance and its potential for damage to the environment. These studies have been based on both regional tectonic analysis and numerical simulations. In order to provide a better understanding of the formation mechanism, the deformation of the crack and its surrounding environment should be taken into consideration. In this paper, PS-InSAR technology was employed to assess the ground deformation of LGF and its surrounding area, using L-band ALOS-1 PALSAR images from 2007 to 2011. The characteristics of ground deformation, relationships between fissure activity and surrounding faults and groundwater exploitation were analyzed. This study shows that the north side of Longyao fault (LF) is uplifting while the south side is subsiding. This provides the tectonic conditions responsible for the activity of the ground fissure. Local groundwater exploitation also plays an important role in the development of ground fissures. InSAR observations were modeled to infer the loading depth (-2.8 km) and the slip rate (31.1 mm/yr) of LF.

  7. Confronting, Confirming, and Dispelling Myths Surrounding ERP-in-the-Cloud

    DEFF Research Database (Denmark)

    Beaulieu, Tanya; C. Martin, Todd; Sarker, Saonee

    2015-01-01

    on the topic, there is substantial uncertainty surrounding the benefits and challenges of ERP cloud computing. Consequently, as often is the case with new technologies, popular myths surrounding the technology are used to make adoption and implementation decisions. As a first step toward providing an informed...... with stakeholders related to an ERP cloud-based solution. Our results dispel some of the myths, while supporting others, and highlight how ERP vendors work around the different types of challenges surrounding this technology. Our study also helps understand the benefits of ERP cloud computing, and informs about how...

  8. Physical geography of the Nete basin and surroundings

    International Nuclear Information System (INIS)

    Beerten, K.

    2011-01-01

    The report briefly describes the main features of the physical geography of the Nete basin (Campine region, Belgium) and its immediate surroundings. First, an integrated overview of the topography, morphology and hydrography is given. This overview serves as the basis for the assessment of the morphological stability of the region and also explains the relationship between the topography and the hydrology. Furthermore, special attention is paid to soil science including a quantitative survey of some soil characteristics data. Another part of this report deals with erosion processes caused by water and wind action, and the (potential) impact on the morphology. Finally, the palaeogeographical evolution during the Quaternary is discussed. This evolution shows that the environment is stable over 10 000 years or more in the current and similar climatic conditions. Altering climatic conditions, notably glacial-interglacial periods, have impacted erosion with periods of strong erosion.

  9. Cortical Surround Interactions and Perceptual Salience via Natural Scene Statistics.

    Directory of Open Access Journals (Sweden)

    Ruben Coen-Cagli

    Full Text Available Spatial context in images induces perceptual phenomena associated with salience and modulates the responses of neurons in primary visual cortex (V1. However, the computational and ecological principles underlying contextual effects are incompletely understood. We introduce a model of natural images that includes grouping and segmentation of neighboring features based on their joint statistics, and we interpret the firing rates of V1 neurons as performing optimal recognition in this model. We show that this leads to a substantial generalization of divisive normalization, a computation that is ubiquitous in many neural areas and systems. A main novelty in our model is that the influence of the context on a target stimulus is determined by their degree of statistical dependence. We optimized the parameters of the model on natural image patches, and then simulated neural and perceptual responses on stimuli used in classical experiments. The model reproduces some rich and complex response patterns observed in V1, such as the contrast dependence, orientation tuning and spatial asymmetry of surround suppression, while also allowing for surround facilitation under conditions of weak stimulation. It also mimics the perceptual salience produced by simple displays, and leads to readily testable predictions. Our results provide a principled account of orientation-based contextual modulation in early vision and its sensitivity to the homogeneity and spatial arrangement of inputs, and lends statistical support to the theory that V1 computes visual salience.

  10. Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey.

    Science.gov (United States)

    Passey, Megan E; D'Este, Catherine A; Sanson-Fisher, Robert W

    2012-03-07

    As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Addressing knowledge of smoking risks and cessation counselling is a priority

  11. Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Passey Megan E

    2012-03-01

    Full Text Available Abstract Background As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. Methods This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. Results The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70. The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79% indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025; cessation knowledge score (p = 0.011; and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011. Conclusions Addressing

  12. Agroforestry practice in villages surrounding Nyamure former ...

    African Journals Online (AJOL)

    cntaganda

    Household surveys were conducted in the three administrative cells ... In order to be more concise, only those villages (settlements) within 5-10 km radius .... Market. 3. 1.9. Firewood collection from public land consumed a lot of time from ... in order to assess the extent of agroforestry practice so as to guide in planning.

  13. Modifying Provider Practice To Improve Assessment of Unhealthy Weight and Lifestyle in Young Children: Translating Evidence in a Quality Improvement Initiative for At-Risk Children.

    Science.gov (United States)

    Camp, Nadine L; Robert, Rebecca C; Nash, Jessica E; Lichtenstein, Cara B; Dawes, Candice S; Kelly, Katherine Patterson

    2017-06-01

    We designed a quality improvement (QI) project to address the high prevalence of childhood overweight and obesity (OW/OB) in our patient population and the inconsistencies among primary care providers in recognizing and addressing OW/OB. We used mixed methods data collection approach to evaluate a QI project, the Childhood Healthy Behaviors Intervention (CHBI), to improve provider obesity prevention practice in two low-income, predominantly African American pediatric primary care clinics. Electronic record data were extracted from all 2-9 year well visits pre- and postintervention for frequency of appropriate diagnostic coding of OW/OB. We reviewed a random sample of records for details of health habit assessment and counseling documentation. Focused interviews were conducted to elicit provider responses regarding impressions of the intervention. The preintervention sample of records (n = 267) was extracted from 18 providers and the postsample (n = 253) from 19 providers. Providers showed improvement in the recognition of OW/OB with appropriate diagnostic coding (52% pre, 68% post), improvement in assessment of health habits informed by the habit survey (0% pre, 76% post), improvement in counseling of healthy behaviors (86% pre, 92% post), and improvement in goal setting of healthy behaviors (12% pre, 70% post). Our findings suggest that implementing a time efficient primary care intervention with brief provider training can improve provider recognition of OW/OB, as well as improve provider behavior targeted at childhood obesity prevention. This project contributes needed QI evidence on interventions to prevent and address OW/OB in primary care settings and calls for further work to strengthen implementation in similar contexts.

  14. A Factor Analytic Investigation of the Person-in-Recovery and Provider Versions of the Revised Recovery Self-Assessment (RSA-R).

    Science.gov (United States)

    Konkolÿ Thege, Barna; Ham, Elke; Ball, Laura C

    2017-12-01

    Recovery is understood as living a life with hope, purpose, autonomy, productivity, and community engagement despite a mental illness. The aim of this study was to provide further information on the psychometric properties of the Person-in-Recovery and Provider versions of the Revised Recovery Self-Assessment (RSA-R), a widely used measure of recovery orientation. Data from 654 individuals were analyzed, 519 of whom were treatment providers (63.6% female), while 135 were inpatients (10.4% female) of a Canadian tertiary-level psychiatric hospital. Confirmatory and exploratory techniques were used to investigate the factor structure of both versions of the instrument. Results of the confirmatory factor analyses showed that none of the four theoretically plausible models fit the data well. Principal component analyses could not replicate the structure obtained by the scale developers either and instead resulted in a five-component solution for the Provider and a four-component solution for the Person-in-Recovery version. When considering the results of a parallel analysis, the number of components to retain dropped to two for the Provider version and one for the Person-in-Recovery version. We can conclude that the RSA-R requires further revision to become a psychometrically sound instrument for assessing recovery-oriented practices in an inpatient mental health-care setting.

  15. Providing Culturally Competent Care for LGBTQ Youth in School-Based Health Centers: A Needs Assessment to Guide Quality of Care Improvements.

    Science.gov (United States)

    Garbers, Samantha; Heck, Craig J; Gold, Melanie A; Santelli, John S; Bersamin, Melina

    2017-01-01

    School-based health centers (SBHCs) can take specific steps to provide culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, potentially impacting well-being. A needs assessment survey was conducted among a convenience sample of SBHC administrators and medical directors to assess climates and actions supportive of LGBTQ quality medical care. Half (53%) of the SBHCs surveyed ( N = 66) reviewed print materials for negative LGBTQ stereotypes, and 27.3% conducted exhaustive materials review. Regional differences were detected: 46.2% of Southern SBHCs conducted any materials review compared to 91.3% in the West and all in the East and Midwest (χ 2 , p LGBTQ youth. On intake forms, 85.4% included preferred names, but only 23.5% included preferred pronoun. There are significant gaps in the extent to which SBHCs provide culturally competent care. These findings can guide future training and advocacy.

  16. Developing a Tool to Assess the Capacity of Out-of-School Time Program Providers to Implement Policy, Systems, and Environmental Change.

    Science.gov (United States)

    Leeman, Jennifer; Blitstein, Jonathan L; Goetz, Joshua; Moore, Alexis; Tessman, Nell; Wiecha, Jean L

    2016-08-11

    Little is known about public health practitioners' capacity to change policies, systems, or environments (PSEs), in part due to the absence of measures. To address this need, we partnered with the Alliance for a Healthier Generation (Alliance) to develop and test a theory-derived measure of the capacity of out-of-school time program providers to improve students' level of nutrition and physical activity through changes in PSEs. The measure was developed and tested through an engaged partnership with staff working on the Alliance's Healthy Out-of-School Time (HOST) Initiative. In total, approximately 2,000 sites nationwide are engaged in the HOST Initiative, which serves predominantly high-need children and youths. We partnered with the Alliance to conduct formative work that would help develop a survey that assessed attitudes/beliefs, social norms, external resources/supports, and self-efficacy. The survey was administered to providers of out-of-school time programs who were implementing the Alliance's HOST Initiative. Survey respondents were 185 out-of-school time program providers (53% response rate). Exploratory factor analysis yielded a 4-factor model that explained 44.7% of the variance. Factors pertained to perceptions of social norms (6 items) and self-efficacy to build support and engage a team (4 items) and create (5 items) and implement (3 items) an action plan. We report initial development and factor analysis of a tool that the Alliance can use to assess the capacity of after-school time program providers, which is critical to targeting capacity-building interventions and assessing their effectiveness. Study findings also will inform the development of measures to assess individual capacity to plan and implement other PSE interventions.

  17. Practices surrounding children's photos in homes

    NARCIS (Netherlands)

    Vyas, Dhaval; van der Veer, Gerrit C.; Nijholt, Antinus; Grassel, Guido; Chi, E.H.; Höök, K,

    2012-01-01

    New parents cherish photos of their children. In their homes one can observe a varied set of arrangements of their young ones' photos. We studied eight families with young children to learn about their practices related to photos. We provide preliminary results from the field study and elaborate on

  18. The daily life of patients with dementia: A comparative study between the information provided by the caregiver and direct patient assessment

    Directory of Open Access Journals (Sweden)

    Lucia Aparecida Bressan

    Full Text Available Abstract The functionality concept is very important, as the diagnosis of dementia presupposes the existence of functional impairment. Instruments assessing functional performance present some limitations. In most cases, the assessment is based on the caregiver's report. Some studies in international literature have evaluated this issue and concluded that a difference exists between the caregiver's report and direct patient assessment. American and European caregivers tend to underestimate the patient's functional limitations. However, this issue has hitherto not been investigated in our context. Objective: To compare the caregiver's information with direct assessment of the patient's performance based on the same functional assessment questionnaire. Methods: Seventy-two patients and caregivers were attended by the Occupational Therapy service of the Behavioral Neurology Outpatient Clinic between 1999 and 2001, 25 of whom fulfilled the inclusion criteria: having a confirmed diagnosis of dementia according to the DSM-IV; having attended three or more return appointments, and where the caregiver belonged to the patient's family nucleus. The remaining subjects were excluded because of non-adherence to treatment or refusal to participate in the study. The Functional Activities Questionnaire by Pfeffer et al., 1982 was applied to patients in a laboratory simulation, while another evaluator interviewed the respective caregivers. The data were analyzed based on the weighted Kappa coefficient, and Wilcoxon test. Results: There were significative differences between caregiver's answers and direct observation of the patient's performance. The information provided by the caregivers proved unreliable since caregivers underestimated the patient's functional capacity.

  19. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Science.gov (United States)

    McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

    2015-01-01

    Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (pmobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  20. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

    Science.gov (United States)

    Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France

    2015-08-01

    We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.

  1. Biomedical health assessments of the Florida manatee in Crystal River - providing opportunities for training during the capture, handling, and processing of this endangered aquatic mammal

    Science.gov (United States)

    Bonde, Robert K.; Garrett, Andrew; Belanger, Michael; Askin, Nesime; Tan, Luke; Wittnich, Carin

    2012-01-01

    Federal and state researchers have been involved in manatee (Trichechus manatus) biomedical health assessment programs for a couple of decades. These benchmark studies have provided a foundation for the development of consistent capture, handling, and processing techniques and protocols. Biologists have implemented training and encouraged multi-agency participation whenever possible to ensure reliable data acquisition, recording, sample collection, publication integrity, and meeting rigorous archival standards. Under a U.S. Fish and Wildlife Service wildlife research permit granted to the U.S. Geological Survey (USGS) Sirenia Project, federal biologists and collaborators are allowed to conduct research studies on wild and captive manatees detailing various aspects of their biology. Therefore, researchers with the project have been collaborating on numerous studies over the last several years. One extensive study, initiated in 2006 has focused on health and fitness of the winter manatee population located in Crystal River, Florida. During those health assessments, capture, handling, and work-up training has been afforded to many of the participants. That study has successfully captured and handled 123 manatees. The data gathered have provided baseline information on manatee health, reproductive status, and nutritional condition. This research initiative addresses concerns and priorities outlined in the Florida Manatee Recovery Plan. The assessment teams strive to continue this collaborative effort to help advance our understanding of health-related issues confronting manatees throughout their range and interlacing these findings with surrogate species concepts.

  2. Impedance function study for cylindrical tanks surrounded by an earthen embankment

    International Nuclear Information System (INIS)

    Houston, T.W.; Mertz, G.E.

    1995-01-01

    The Department of Energy (DOE) operates many which are used to store radioactive waste material. The original design of the tanks was often based on criteria which did not meet current seismic codes. As a result DOE is undertaking a comprehensive review of the adequacy of these structures to meet current seismic standards. This comprehensive review includes an evaluation of soil-structure interaction. One method available for performing soil structure interaction analyses of structures couples a discrete model of the structure to a lumped parameter model of the soil. This method requires the knowledge of the expected dynamic stiffness and damping functions of the rigid, massless structure resting on the soil. These are commonly referred to as the impedance functions. Lumped parameter analysis is cost effective for the surface and embedded structure cases where impedance functions are available in the literature. For a complex case with the structure located on the surface surrounded by an embankment, the impedance functions must be established prior to using a lumped parameter model approach. The present paper describes the development of horizontal impedance functions for the structure surrounded by an embankment which are developed using a finite element approach as implemented by SASSI. Impedance functions for vertical, torsional, and rocking degrees of freedom can be developed in a similar manner. These functions are easily incorporated into simple models which provide conceptual and physical insight to the response of structures. These models provide both a check of more sophisticated methods, and, due to their simplicity, permit assessment of a wide range of site and structural parameters that my affect the dynamic response of structural systems

  3. Risks, values, and decision making surrounding pregnancy.

    Science.gov (United States)

    Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M; Harris, Lisa H; Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret Olivia

    2007-04-01

    Assessing, communicating, and managing risk are among the most challenging tasks in the practice of medicine and are particularly difficult in the context of pregnancy. We analyze common scenarios in medical decision making around pregnancy, from reproductive health policy and clinical care to research protections. We describe three tendencies in these scenarios: 1) to consider the probabilities of undesirable outcomes alone, in isolation from women's values and social contexts, as determinative of individual clinical decisions and health policy; 2) to regard any risk to the fetus, including incremental risks that would in other contexts be regarded as acceptable, as trumping considerations that may be substantially more important to the wellbeing of the pregnant woman; and 3) to focus on the risks associated with undertaking medical interventions during pregnancy to the exclusion of demonstrable risks to both woman and fetus of failing to intervene. These tendencies in the perception, communication, and management of risk can lead to care that is neither evidence-based nor patient-centered, often to the detriment of both women and infants.

  4. Precipitation Depth-Duration-Frequency Analysis for the Nevada National Security Site and Surrounding Areas

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Li [Desert Research Inst. (DRI), Las Vegas, NV (United States). Division of Hydrologic Sciences; Miller, Julianne J. [Desert Research Inst. (DRI), Las Vegas, NV (United States). Division of Hydrologic Sciences

    2016-08-01

    Accurate precipitation frequency data are important for Environmental Management Soils Activities on the Nevada National Security Site (NNSS). These data are important for environmental assessments performed for regulatory closure of Soils Corrective Action Unit (CAU) Sites, as well as engineering mitigation designs and post-closure monitoring strategies to assess and minimize potential contaminant migration from Soils CAU Sites. Although the National Oceanic and Atmospheric Administration (NOAA) Atlas 14 (Bonnin et al., 2011) provides precipitation frequency data for the NNSS area, the NNSS-specific observed precipitation data were not consistent with the NOAA Atlas 14 predicted data. This is primarily due to the NOAA Atlas 14 products being produced from analyses without including the approximately 30 NNSS precipitation gage records, several of which approach or exceed 50 year of record. Therefore, a study of precipitation frequency that incorporated the NNSS precipitation gage records into the NOAA Atlas 14 dataset, was performed specifically for the NNSS to derive more accurate site-specific precipitation data products. Precipitation frequency information, such as the depth-duration-frequency (DDF) relationships, are required to generate synthetic standard design storm hydrographs and assess actual precipitation events. In this study, the actual long-term NNSS precipitation gage records, some of which are the longest gage records in southern and central Nevada, were analyzed to allow for more accurate precipitation DDF estimates to be developed for the NNSS. Gridded maps of precipitation frequency for the NNSS and surrounding areas were then produced.

  5. Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

    Directory of Open Access Journals (Sweden)

    Marion McNabb

    Full Text Available Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre.Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care.Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001, out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education.These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

  6. Numerous dilemmas surrounding the 1917 nickel coins

    Directory of Open Access Journals (Sweden)

    Pantelić Svetlana

    2017-01-01

    Full Text Available The Law on Extraordinary Loans Amounting to 200 Million Dinars and the Minting of Silver and Nickel Coins in 1916 was the legal basis for minting the 5-, 10-, and 20-para nickel coins of the Kingdom of Serbia featuring the year 1917 as their minting year. Some authors believe that these coins were minted in the Minting House in Paris, whereas the others agree that they were certainly minted in France, but in a still unidentified minting house. There are authors who in recent reference literature underline the possibility of their minting in the USA Gorham Company, in Providence, Rhode Island. These coins had all the characteristics of the nickel coins of the Kingdom of Serbia from 1883, 1884, 1904 and 1912. Although, according to the Law, the Minister of Finance was authorized to mint 10 million dinars of these nickel coins, only 5 million pieces in each denomination were actually minted, in the total nominal value of just 1,750,000 dinars. The general opinion is that after the war only a small amount of these nickel coins reached Serbia, because the ships transporting the Serbian coins from the minting house sank on their way. The only varying aspect in this explanation is the location from which the ships were sailing towards Corfu, i.e. from the USA or from France. These coins stopped being legal tender as of 30 November 1931.

  7. Child Care Provider Adherence to Infant and Toddler Feeding Recommendations: Findings from the Baby Nutrition and Physical Activity Self-Assessment for Child Care (Baby NAP SACC) Study

    Science.gov (United States)

    Davison, Kirsten K.; Hesketh, Kathryn; Taveras, Elsie M.; Gillman, Matthew W.; Benjamin Neelon, Sara E.

    2015-01-01

    Abstract Background: Identifying characteristics associated with the Institute of Medicine's (IOM) recommended feeding practices among infant and toddler care providers in child care centers could help in preventing childhood obesity. Methods: In 2009, at baseline in a pilot intervention study of 29 licensed Massachusetts child care centers with at least 50% of enrolled children identified as racial minorities, 57 infant and 109 toddler providers completed feeding questionnaires. To assess provider adherence to six IOM-recommended behaviors, we used cluster-adjusted multivariable logistic regression models including provider type (infant or toddler), race, education, and center Child and Adult Care Food Program (CACFP) participation. Results: In multivariable analysis, CACFP participation was associated with providers sitting with children at meals (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2–21.7), offering fruits and vegetables (OR, 3.3; 95% CI 1.7–6.2), and limiting fast food (OR, 3.5; 95% CI, 1.8–6.7). Providers at centers serving meals family style were less likely to allow children to leave food unfinished (OR, 0.27; 95% CI, 0.09–0.77). Infant providers were more likely than toddler providers to sit with children at meals (OR, 6.98; 95% CI, 1.51–32.09), allow children to eat when hungry (OR, 3.50; 95% CI, 1.34–9.16), and avoid serving sugary (OR, 8.74; 95% CI, 3.05–25.06) or fast foods (OR, 11.56; 95% CI, 3.20–41.80). Conclusions: CACFP participation may encourage IOM-recommended feeding practices among infant and toddler providers. Child care providers may benefit from education about how to feed infants and toddlers responsively, especially when offering foods family style. Future research should explore ways to promote child-centered feeding practices, while addressing barriers to providing children with nutrient-rich foods. PMID:25918873

  8. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

    Directory of Open Access Journals (Sweden)

    Noortgate Nele

    2009-12-01

    Full Text Available Abstract Background The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. Methods A cross-sectional mail survey was sent to all acute hospitals (67 main campuses in Flanders (Belgium. The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. Results The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%. While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%. More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Conclusions Most Flemish acute hospitals have developed a policy on end-of-life practices

  9. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

    Science.gov (United States)

    D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

    2009-12-30

    The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care

  10. Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment.

    Science.gov (United States)

    Damian, April Joy; Gallo, Joseph; Leaf, Philip; Mendelson, Tamar

    2017-11-21

    While there is increasing support for training youth-serving providers in trauma-informed care (TIC) as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers' professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Government workers and nonprofit professionals (N = 90) who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16) was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Analysis of survey data indicated significant improvements in participants' organizational culture and professional satisfaction at training completion. Participants' perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including "Implementation of more flexible, less-punitive policies towards clients," "Adoption of trauma-informed workplace design," "Heightened awareness of own traumatic stress and need for self-care," and "Greater sense of camaraderie and empathy for colleagues." Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and individual factors including providers' compassion satisfaction, burnout, and secondary

  11. The analysis of creep characteristics of the surrounding rock of the carbonaceous rock tunnel based on Singh-Mitchell model

    Science.gov (United States)

    Luo, Junhui; Mi, Decai; Ye, Qiongyao; Deng, Shengqiang; Zeng, Fuquan; Zeng, Yongjun

    2018-01-01

    Carbonaceous rock has the characteristics of easy disintegration, softening, swelling and environmental sensitivity, which belongs to soft surrounding rock, and the deformation during excavation and long-term stability of the surrounding rock of carbonaceous rock tunnel are common problems in the construction of carbonaceous rock tunnel. According to the above, the Monitor and measure the displacement, temperature and osmotic pressure of the surrounding carbonaceous rock of the tunnel of Guangxi Hebai highway. Then it based on the obtaining data to study the creep mechanism of surrounding rock using Singh-Mitchell model and predict the deformation of surrounding rock before the tunnel is operation. The results show that the Singh-Mitchell creep model can effectively analyse and predict the deformation development law of surrounding rock of tunnel without considering temperature and osmotic pressure, it can provide reference for the construction of carbonaceous rock tunnel and the measures to prevent and reinforce it..

  12. HIV behavioural surveillance among refugees and surrounding host ...

    African Journals Online (AJOL)

    We used a standardised behavioural surveillance survey (BSS), modified to be directly relevant to populations in conflict and post-conflict settings as well as to their surrounding host populations, to survey the populations of a refugee settlement in south-western Uganda and its surrounding area. Two-stage probability ...

  13. Investigation of the readout electronics of DELPHI surround muon chamber

    International Nuclear Information System (INIS)

    Khovanskij, N.; Krumshtejn, Z.; Ol'shevskij, A.; Sadovskij, A.; Sedykh, Yu.; Molnar, J.; Sicho, P.; Tomsa, Z.

    1995-01-01

    The characteristics of the readout electronics of the DELPHI surround muon chambers with various AMPLEX chips (AMPLEX 16 and AMPLEX-SICAL) are presented. This electronics is studied in a cosmic rays test of the real surround muon chamber model. 4 refs., 6 figs., 1 tab

  14. Stimulus size dependence of hue changes induced by chromatic surrounds.

    Science.gov (United States)

    Kellner, Christian Johannes; Wachtler, Thomas

    2016-03-01

    A chromatic surround induces a change in the perceived hue of a stimulus. This shift in hue depends on the chromatic difference between the stimulus and the surround. We investigated how chromatic induction varies with stimulus size and whether the size dependence depends on the surround hue. Subjects performed asymmetric matching of color stimuli with different sizes in surrounds of different chromaticities. Generally, induced hue shifts decreased with increasing stimulus size. This decrease was quantitatively different for different surround hues. However, when size effects were normalized to an overall induction strength, the chromatic specificity was largely reduced. The separability of inducer chromaticity and stimulus size suggests that these effects are mediated by different neural mechanisms.

  15. Marine Resource Survey in waters surrounding Guam and the Commonwealth of the Northern Mariana Islands (SE1002, EK60)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The goals of the cruise were to collect a variety of data to assess the status of marine resources in waters surrounding Guam and CNMI. Marine resource habitats were...

  16. Evaluation of LLNL BSL-3 Maximum Credible Event Potential Consequence to the General Population and Surrounding Environment

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2010-08-16

    The purpose of this evaluation is to establish reproducibility of the analysis and consequence results to the general population and surrounding environment in the LLNL Biosafety Level 3 Facility Environmental Assessment (LLNL 2008).

  17. Effect of Hospital Case Mix on the Hospital Consumer Assessment of Healthcare Providers and Systems Star Scores: Are All Stars the Same?

    Science.gov (United States)

    Thiels, Cornelius A; Hanson, Kristine T; Yost, Kathleen J; Zielinski, Martin D; Habermann, Elizabeth B; Cima, Robert R

    2016-10-01

    We aimed to evaluate variations in patient experience measures across different surgical specialties and to assess the impact of further case-mix adjustment. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a publicly reported survey of patients' hospital experiences that directly influence Medicare reimbursement. All adult surgical inpatients meeting criteria for HCAHPS sampling from 2013 to 2014 at a single academic center were identified. HCAHPS measures were analyzed according to published top-box and Star-rating methodologies, and were dichotomized ("high" vs "low"). Multivariable logistic regression was used to identify independent associations of high patient scores on various HCAHPS measures with specialty, diagnosis-related group complexity, cancer diagnosis, sex, and emergency admission after adjusting for HCAHPS case-mix adjusters (education, overall health status, language, and age). We identified 36,551 eligible patients, of which 30.8% (n = 11,273) completed HCAHPS. Women [odds ratio (OR) 0.78, 95% confidence interval (CI) 0.72-0.85, P cases (OR 0.90, 95% CI 0.82-0.99, P = 0.02), and emergency admissions (OR 0.67, 95% CI 0.55-0.82, P case-mix adjustment does not include adjustment for specialty or diagnosis, which may result in artificially lower scores for centers that provide a high level of complex care. Further research is needed to ensure that the HCAHPS is an unbiased comparison tool.

  18. The Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS): Establishing a New Interdisciplinary Self-Assessment for Health Providers.

    Science.gov (United States)

    Bidell, Markus P

    2017-01-01

    These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), a new interdisciplinary LGBT clinical self-assessment for health and mental health providers. Research participants were voluntarily recruited in the United States and United Kingdom and included trainees, clinicians, and educators from applied psychology, counseling, psychotherapy, and primary care medicine. Study 1 (N = 602) used exploratory and confirmatory factor analytic techniques, revealing an 18-item three-factor structure (Clinical Preparedness, Attitudinal Awareness, and Basic Knowledge). Study 2 established internal consistency for the overall LGBT-DOCSS (α = .86) and for each of the three subscales (Clinical Preparedness = .88, Attitudinal Awareness = .80, and Basic Knowledge = .83) and 2-week test-retest reliability (.87). In study 3 (N = 564), participant criteria (sexual orientation and education level) and four established scales that measured LGBT prejudice, assessment skills, and social desirability were used to support initial content and discriminant validity. Psychometric properties, limitations, and recommendations are discussed.

  19. Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

    Science.gov (United States)

    Dean, M; Levis, A

    2016-12-01

    To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  20. How A Black Hole Lights Up Its Surroundings

    Science.gov (United States)

    Kohler, Susanna

    2017-10-01

    How do the supermassive black holes that live at the centers of galaxies influence their environments? New observations of a distant active galaxy offer clues about this interaction.Signs of CoevolutionPlot demonstrating the m-sigma relation, the empirical correlation between the stellar velocity dispersion of a galactic bulge and the mass of the supermassive black hole at its center. [Msigma]We know that the centers of active galaxies host supermassive black holes with masses of millions to billions of suns. One mystery surrounding these beasts is that they are observed to evolve simultaneously with their host galaxies for instance, an empirical relationship is seen between the growth of a black hole and the growth of its host galaxys bulge. This suggests that there must be a feedback mechanism through which the evolution of a black hole is linked to that of its host galaxy.One proposed source of this coupling is the powerful jets emitted from the poles of these supermassive black holes. These jets are thought to be produced as some of the material accreting onto the black hole is flung out, confined by surrounding gas and magnetic fields. Because the jets of hot gas and radiation extend outward through the host galaxy, they provide a means for the black hole to influence the gas and dust of its surroundings.In our current model of a radio-loud active galactic nuclei,a region of hot, ionized gas the narrow-line region lies beyond the sphere of influence of the supermassive black hole. [C.M. Urry and P. Padovani]Clues in the Narrow-Line RegionThe region of gas thought to sit just outside of the black holes sphere of influence (at a distance of perhaps a thousand to a few thousand light-years) is known as the narrow line region so named because we observe narrow emission lines from this gas. Given its hot, ionized state, this gas must somehow be being pummeled with energy. In the canonical picture, radiation from the black hole heats the gas directly in a process

  1. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana, and Tanzania

    Directory of Open Access Journals (Sweden)

    Helen Prytherch

    2012-10-01

    Full Text Available Background: The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective: To develop a common instrument to monitor any changes in maternal and neonatal health (MNH care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design: Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion: This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions: It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not

  2. The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania

    Science.gov (United States)

    Prytherch, Helen; Leshabari, Melkidezek T.; Wiskow, Christiane; Aninanya, Gifty A.; Kakoko, Deodatus C.V.; Kagoné, Moubassira; Burghardt, Juliane; Kynast-Wolf, Gisela; Marx, Michael; Sauerborn, Rainer

    2012-01-01

    Background The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated. PMID

  3. Organizational and provider level factors in implementation of trauma-informed care after a city-wide training: an explanatory mixed methods assessment

    Directory of Open Access Journals (Sweden)

    April Joy Damian

    2017-11-01

    Full Text Available Abstract Background While there is increasing support for training youth-serving providers in trauma-informed care (TIC as a means of addressing high prevalence of U.S. childhood trauma, we know little about the effects of TIC training on organizational culture and providers’ professional quality of life. This mixed-methods study evaluated changes in organizational- and provider-level factors following participation in a citywide TIC training. Methods Government workers and nonprofit professionals (N = 90 who participated in a nine-month citywide TIC training completed a survey before and after the training to assess organizational culture and professional quality of life. Survey data were analyzed using multiple regression analyses. A subset of participants (n = 16 was interviewed using a semi-structured format, and themes related to organizational and provider factors were identified using qualitative methods. Results Analysis of survey data indicated significant improvements in participants’ organizational culture and professional satisfaction at training completion. Participants’ perceptions of their own burnout and secondary traumatic stress also increased. Four themes emerged from analysis of the interview data, including “Implementation of more flexible, less-punitive policies towards clients,” “Adoption of trauma-informed workplace design,” “Heightened awareness of own traumatic stress and need for self-care,” and “Greater sense of camaraderie and empathy for colleagues.” Conclusion Use of a mixed-methods approach provided a nuanced understanding of the impact of TIC training and suggested potential benefits of the training on organizational and provider-level factors associated with implementation of trauma-informed policies and practices. Future trainings should explicitly address organizational factors such as safety climate and morale, managerial support, teamwork climate and collaboration, and

  4. Concept development and techno-economic assessment for a solar home system using lithium-ion battery for developing regions to provide electricity for lighting and electronic devices

    International Nuclear Information System (INIS)

    Zubi, Ghassan; Dufo-López, Rodolfo; Pardo, Nicolás; Pasaoglu, Guzay

    2016-01-01

    Highlights: • Solar home systems using light emitting diode lamps could substitute kerosene lamps. • This implies major improvement in life quality in developing regions. • The economic advantage of solar home systems is substantial and incremental. • This shift implies a cut of more than 200 mega tons of carbon dioxide annually. • Implementation barriers can be overcome by early consideration in system engineering. - Abstract: Around 18% of the world’s population still don’t have access to electricity, most of them living in rural areas in South Asia, Southeast Asia, and Sub-Saharan Africa. Kerosene lamps are widely used for lighting in these regions, but imply a big number of disadvantages including low light quality, reduced indoor air quality and safety concerns. Furthermore, the consumption of kerosene for lighting is very energy inefficient and implies a relatively high cost for the added value it provides, while its price volatility is a major concern for dependant developing regions. Global carbon dioxide emissions from kerosene lamps exceed 200 mega tons annually. A solar home system using light emitting diode lamps provides an effective solution for this problem. This paper elaborates such a solar home system while focusing on overcoming implementation barriers including lack of technical support and affordability. An evolutionary techno-economic assessment, considering the time period 2015–2030, is provided for the proposed system. This emphasizes not only the existing but also the increasing advantage of solar home systems over kerosene lamps.

  5. Changes in unique hues induced by chromatic surrounds.

    Science.gov (United States)

    Klauke, Susanne; Wachtler, Thomas

    2016-03-01

    A chromatic surround can have a strong influence on the perceived hue of a stimulus. We investigated whether chromatic induction has similar effects on the perception of colors that appear pure and unmixed (unique red, green, blue, and yellow) as on other colors. Subjects performed unique hue settings of stimuli in isoluminant surrounds of different chromaticities. Compared with the settings in a neutral gray surround, unique hue settings altered systematically with chromatic surrounds. The amount of induced hue shift depended on the difference between stimulus and surround hues, and was similar for unique hue settings as for settings of nonunique hues. Intraindividual variability in unique hue settings was roughly twice as high as for settings obtained in asymmetric matching experiments, which may reflect the presence of a reference stimulus in the matching task. Variabilities were also larger with chromatic surrounds than with neutral gray surrounds, for both unique hue settings and matching of nonunique hues. The results suggest that the neural representations underlying unique hue percepts are influenced by the same neural processing mechanisms as the percepts of other colors.

  6. Computational toxicology as implemented by the U.S. EPA: providing high throughput decision support tools for screening and assessing chemical exposure, hazard and risk.

    Science.gov (United States)

    Kavlock, Robert; Dix, David

    2010-02-01

    Computational toxicology is the application of mathematical and computer models to help assess chemical hazards and risks to human health and the environment. Supported by advances in informatics, high-throughput screening (HTS) technologies, and systems biology, the U.S. Environmental Protection Agency EPA is developing robust and flexible computational tools that can be applied to the thousands of chemicals in commerce, and contaminant mixtures found in air, water, and hazardous-waste sites. The Office of Research and Development (ORD) Computational Toxicology Research Program (CTRP) is composed of three main elements. The largest component is the National Center for Computational Toxicology (NCCT), which was established in 2005 to coordinate research on chemical screening and prioritization, informatics, and systems modeling. The second element consists of related activities in the National Health and Environmental Effects Research Laboratory (NHEERL) and the National Exposure Research Laboratory (NERL). The third and final component consists of academic centers working on various aspects of computational toxicology and funded by the U.S. EPA Science to Achieve Results (STAR) program. Together these elements form the key components in the implementation of both the initial strategy, A Framework for a Computational Toxicology Research Program (U.S. EPA, 2003), and the newly released The U.S. Environmental Protection Agency's Strategic Plan for Evaluating the Toxicity of Chemicals (U.S. EPA, 2009a). Key intramural projects of the CTRP include digitizing legacy toxicity testing information toxicity reference database (ToxRefDB), predicting toxicity (ToxCast) and exposure (ExpoCast), and creating virtual liver (v-Liver) and virtual embryo (v-Embryo) systems models. U.S. EPA-funded STAR centers are also providing bioinformatics, computational toxicology data and models, and developmental toxicity data and models. The models and underlying data are being made publicly

  7. Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counselling (PITC) in Malawi.

    Science.gov (United States)

    Ahmed, Saeed; Schwarz, Monica; Flick, Robert J; Rees, Chris A; Harawa, Mwelura; Simon, Katie; Robison, Jeff A; Kazembe, Peter N; Kim, Maria H

    2016-04-01

    To assess implementation of provider-initiated testing and counselling (PITC) for HIV in Malawi. A review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected programme data. Reported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5293/5615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics and 49.4% (6871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71) and inadequate number of HIV counsellors (32/71) while providers from inpatient units cited the inability to test on weekends. Various models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests that routine PITC is feasible. These results underscore the need to develop clear, standardised PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure and human resources. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  8. Energy buildup factor for ICRU 33 sphere surrounded by an air layer

    International Nuclear Information System (INIS)

    Ochiana, G.; Oncescu, M.

    1994-01-01

    The buildup factor due to the air surrounding an ICRU 33 sphere is a desirable quantity in the assessment of the air kerma rate for external exposure to gamma emitters distributed on the ground. A Monte Carlo algorithm has been developed to perform the photon transport calculation within the air layer around the sphere. The energy buildup factor due to the air layer has been calculated for an extended radioactive source - the contaminated ground. The transport of photons within the air layer surrounding a sphere -ICRU 33 phantom - is done by calculating separately the energies deposited by photons into the sphere when this one is in vacuum and when it is surrounded by the air, respectively. The results are given for an air layer of 100 m thickness and photon energy between 0.01 and 3.0 MeV. (Author) 1 Fig., 1 Tab., 9 Refs

  9. Techno-economic assessment of an off-grid PV system for developing regions to provide electricity for basic domestic needs: A 2020–2040 scenario

    International Nuclear Information System (INIS)

    Zubi, Ghassan; Dufo-López, Rodolfo; Pasaoglu, Guzay; Pardo, Nicolás

    2016-01-01

    Highlights: • Off-grid PV has a huge potential to provide effective solutions for energy poverty. • Its implementation barrier is economic, but paths to effectively tackle this exist. • The implementation barriers will be reduced by a favourable technological evolution. • Cost reductions to the level of grid-connected power will be eventually achieved. - Abstract: While in the developed countries electrification is paving the way for progress and prosperity, nowadays electricity is still not accessible for about 18% of the world’s population. Lack of power grids is the main reason that prevents millions in remote areas in developing countries from using electricity for the daily basic needs. PV systems provide an effective solution for these regions, but affordability remains an issue. This barrier can be widely overcome on the short term by limiting PV power supply to very high added value applications and by properly exploiting innovations, especially in energy efficiency and cost reductions. Additional to that, the long-term perspectives of off-grid PV are very favourable based on its ongoing technological improvements and cost reductions. This paper studies four off-grid PV cases of which each could cover a combination of basic energy needs regarding light, cooking, food conservation and electronic appliances. Case I considers a system that supplies power for LED lamps and electronic devices. Accordingly, Case II adds a fridge and Case III an electric rice cooker to Case I, while Case IV adds both. The paper elaborates on available technologies and future developments regarding all components in order to assess the long term evolution and potential of these applications, most specifically how their affordability would evolve over time. The modelling and optimization of the four cases are performed using the software iHOGA, which is an efficient tool to provide the lowest cost solution for off-grid PV systems. The use of iHOGA for the four cases and

  10. Increasing faculty participation in resident education and providing cost-effective self-assessment module credit to faculty through resident-generated didactics.

    Science.gov (United States)

    Kim, Hyun; Malatesta, Theresa M; Anné, Pramila R; McAna, John; Bar-Ad, Voichita; Dicker, Adam P; Den, Robert B

    Board certified radiation oncologists and medical physicists are required to earn self-assessment module (SAM) continuing medical education (CME) credit, which may require travel costs or usage fees. Data indicate that faculty participation in resident teaching activities is beneficial to resident education. Our hypothesis was that providing the opportunity to earn SAM credit in resident didactics would increase faculty participation in and improve resident education. SAM applications, comprising CME certified category 1 resident didactic lectures and faculty-generated questions with respective answers, rationales, and references, were submitted to the American Board of Radiology for formal review. Surveys were distributed to assess main academic campus physician, affiliate campus physician, physicist, and radiation oncology resident impressions regarding the quality of the lectures. Survey responses were designed in Likert-scale format. Sign-test was performed with P motivation to attend resident didactics (P = .004). Residents reported an increased amount of time required to prepare lectures (P = .008). We are the first department, to our knowledge, to offer SAM credit to clinical faculty for participation in resident-generated didactics. Offering SAM credit at resident lectures is a cost-effective alternative to purchasing SAM resources, increases faculty attendance, and may improve the quality of radiation oncology resident education. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  11. What can offer us reclaimed landscape surrounding future lake Medard

    Energy Technology Data Exchange (ETDEWEB)

    Hrajnohova-Gillarova, H.; Kazmierski, T.; Martis, M. [Czech Univ. of Life Sciences, Prague (Czech Republic); Pecharova, E. [Czech Univ. of Life Sciences, Prague (Czech Republic); South-Bohemian Univ., Ceske Budejovice (Czech Republic)

    2010-07-01

    Soon after closing down a mine, the landscape that had been systematically disturbed by mining, should start to serve people from neighbouring towns and villages. This study characterized the Medard site located in the western part of the Czech Republic. The future Lake Medard includes the area of the former Medard-Libik Mine. Medard was an opencast brown coal mine, where mining finished in 2000 and reclamation plans involve its flooding until the year 2013. Forestry reclamation was also in progress. This paper presented a survey that was designed to help determine what the reclaimed landscape surrounding the future Lake Medard could offer. The paper provided background information on Medard Lake and outlined the methodology and results of the study. The methodology involved use of recent orthophotomaps, a study of the future lake Medard and data from the field survey. The study examined the long-term impacts on the social and environmental situation in the area. It was concluded that, once the reclamations are finished, there should be natural trails with information and educational infrastructure so that visitors to the area can learn about the places of interest. 17 refs., 6 figs.

  12. A synchronous surround increases the motion strength gain of motion.

    Science.gov (United States)

    Linares, Daniel; Nishida, Shin'ya

    2013-11-12

    Coherent motion detection is greatly enhanced by the synchronous presentation of a static surround (Linares, Motoyoshi, & Nishida, 2012). To further understand this contextual enhancement, here we measured the sensitivity to discriminate motion strength for several pedestal strengths with and without a surround. We found that the surround improved discrimination of low and medium motion strengths, but did not improve or even impaired discrimination of high motion strengths. We used motion strength discriminability to estimate the perceptual response function assuming additive noise and found that the surround increased the motion strength gain, rather than the response gain. Given that eye and body movements continuously introduce transients in the retinal image, it is possible that this strength gain occurs in natural vision.

  13. Surrounding Moving Obstacle Detection for Autonomous Driving Using Stereo Vision

    Directory of Open Access Journals (Sweden)

    Hao Sun

    2013-06-01

    Full Text Available Detection and tracking surrounding moving obstacles such as vehicles and pedestrians are crucial for the safety of mobile robotics and autonomous vehicles. This is especially the case in urban driving scenarios. This paper presents a novel framework for surrounding moving obstacles detection using binocular stereo vision. The contributions of our work are threefold. Firstly, a multiview feature matching scheme is presented for simultaneous stereo correspondence and motion correspondence searching. Secondly, the multiview geometry constraint derived from the relative camera positions in pairs of consecutive stereo views is exploited for surrounding moving obstacles detection. Thirdly, an adaptive particle filter is proposed for tracking of multiple moving obstacles in surrounding areas. Experimental results from real-world driving sequences demonstrate the effectiveness and robustness of the proposed framework.

  14. Contamination of nebulisers and surrounding air at the bedside of ...

    African Journals Online (AJOL)

    An air sampler was used to collect air samples from the surrounding bedside environment. .... individualised resealable plastic bags and stored upside down in a cooler .... conventional and mesh technology nebulisers used at home by adults.

  15. Glow phenomenon surrounding the vertical stabilizer and OMS pods

    Science.gov (United States)

    1994-01-01

    This 35mm frame, photographed as the Space Shuttle Columbia was orbiting Earth during a 'night' pass, documents the glow phenomenon surrounding the vertical stabilizer and the Orbital Maneuvering System (OMS) pods of the spacecraft.

  16. Surrounding land cover types as predictors of palustrine wetland vegetation quality in conterminous USA

    Science.gov (United States)

    Stapanian, Martin A.; Gara, Brian; Schumacher, William

    2018-01-01

    The loss of wetland habitats and their often-unique biological communities is a major environmental concern. We examined vegetation data obtained from 380 wetlands sampled in a statistical survey of wetlands in the USA. Our goal was to identify which surrounding land cover types best predict two indices of vegetation quality in wetlands at the regional scale. We considered palustrine wetlands in four regions (Coastal Plains, North Central East, Interior Plains, and West) in which the dominant vegetation was emergent, forested, or scrub-shrub. For each wetland, we calculated weighted proportions of eight land cover types surrounding the area in which vegetation was assessed, in four zones radiating from the edge of the assessment area to 2 km. Using Akaike's Information Criterion, we determined the best 1-, 2- and 3-predictor models of the two indices, using the weighted proportions of the land cover types as potential predictors. Mean values of the two indices were generally higher in the North Central East and Coastal Plains than the other regions for forested and emergent wetlands. In nearly all cases, the best predictors of the indices were not the dominant surrounding land cover types. Overall, proportions of forest (positive effect) and agriculture (negative effect) surrounding the assessment area were the best predictors of the two indices. One or both of these variables were included as predictors in 65 of the 72 models supported by the data. Wetlands surrounding the assessment area had a positive effect on the indices, and ranked third (33%) among the predictors included in supported models. Development had a negative effect on the indices and was included in only 28% of supported models. These results can be used to develop regional management plans for wetlands, such as creating forest buffers around wetlands, or to conserve zones between wetlands to increase habitat connectivity.

  17. Monitoring program of surrounding of the NPP SE-EBO

    International Nuclear Information System (INIS)

    Dobis, L.; Kostial, J.

    1997-01-01

    The paper dealt with monitoring program of radiation control of surrounding of the NPP Bohunice, which has the aim: (1) to ensure the control of influence of work of the NPP Bohunice on the environment in their surrounding; (2) to ensure the back-ground for regular brief of control and supervisory organs about condition of the environment in surrounding of the NPP Bohunice; (3) to maintain the expected technical level of control of the NPP Bohunice and to exploit optimally the technical means; (4) to solicit permanently the data about the radioactivity of environment in surrounding of the NPP Bohunice for forming of files of the data; (5) to exploit purposefully the technical equipment, technical workers and to maintain their in permanent emergency and technical eligibility for the case of the breakdown; (6) to obtain permanently the files of the values for qualification of the reference levels. This program of monitoring includes the radiation control of surrounding of the NPP Bohunice, in the time of normal work of power-station's blocks, inclusively of all types of trouble-shooting and repairer works in surrounding of the NPP Bohunice, up to distance 20 km from power-station. The monitoring includes: outlets from the NPP Bohunice, monitoring of radiation characteristics in surrounding of the NPP Bohunice, (aerosols, fall-outs, soil), the links of food chains: (grass and fodder, milk, agriculture products), hydrosphere in surrounding (surface waters, drink water, bores of radiation control in complex of the NPP Bohunice, components of the hydrosphere), measurement of radiation from external sources (measurement of the dose rates, measurement of the doses [sk

  18. Chromatic induction from surrounding stimuli under perceptual suppression.

    Science.gov (United States)

    Horiuchi, Koji; Kuriki, Ichiro; Tokunaga, Rumi; Matsumiya, Kazumichi; Shioiri, Satoshi

    2014-11-01

    The appearance of colors can be affected by their spatiotemporal context. The shift in color appearance according to the surrounding colors is called color induction or chromatic induction; in particular, the shift in opponent color of the surround is called chromatic contrast. To investigate whether chromatic induction occurs even when the chromatic surround is imperceptible, we measured chromatic induction during interocular suppression. A multicolor or uniform color field was presented as the surround stimulus, and a colored continuous flash suppression (CFS) stimulus was presented to the dominant eye of each subject. The subjects were asked to report the appearance of the test field only when the stationary surround stimulus is invisible by interocular suppression with CFS. The resulting shifts in color appearance due to chromatic induction were significant even under the conditions of interocular suppression for all surround stimuli. The magnitude of chromatic induction differed with the surround conditions, and this difference was preserved regardless of the viewing conditions. The chromatic induction effect was reduced by CFS, in proportion to the magnitude of chromatic induction under natural (i.e., no-CFS) viewing conditions. According to an analysis with linear model fitting, we revealed the presence of at least two kinds of subprocesses for chromatic induction that reside at higher and lower levels than the site of interocular suppression. One mechanism yields different degrees of chromatic induction based on the complexity of the surround, which is unaffected by interocular suppression, while the other mechanism changes its output with interocular suppression acting as a gain control. Our results imply that the total chromatic induction effect is achieved via a linear summation of outputs from mechanisms that reside at different levels of visual processing.

  19. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria.

    Science.gov (United States)

    Ujuju, Chinazo; Adebayo, Samson B; Anyanti, Jennifer; Oluigbo, Obi; Muhammad, Fatima; Ankomah, Augustine

    2014-01-01

    In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs). This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills); user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go to health care facilities (for various reasons) necessitated the provision of oral contraceptive pills to 41% of the first time users. Some PPMVs prescribed treatment to mystery clients who presented with perceived complications arising from the use of pills, while 49% were referred to a health facility. The advice given by PPMVs often falls short of safety guidelines related to the use of oral contraceptive pills. There is a need to continuously update knowledge among the PPMVs to ensure that they provide quality oral contraceptive services as PPMVs bridge the gap between medical experts and users in rural communities.

  20. On the transition to the normal phase for superconductors surrounded by normal conductors

    DEFF Research Database (Denmark)

    Fournais, Søren; Kachmar, Ayman

    2009-01-01

    For a cylindrical superconductor surrounded by a normal material, we discuss transition to the normal phase of stable, locally stable and critical configurations. Associated with those phase transitions, we define critical magnetic fields and we provide a sufficient condition for which those...

  1. Forest Fragments Surrounded by Sugar Cane Are More Inhospitable to Terrestrial Amphibian Abundance Than Fragments Surrounded by Pasture

    Directory of Open Access Journals (Sweden)

    Paula Eveline Ribeiro D’Anunciação

    2013-01-01

    Full Text Available In recent years, there has been increasing interest in matrix-type influence on forest fragments. Terrestrial amphibians are good bioindicators for this kind of research because of low vagility and high philopatry. This study compared richness, abundance, and species composition of terrestrial amphibians through pitfall traps in two sets of semideciduous seasonal forest fragments in southeastern Brazil, according to the predominant surrounding matrix (sugar cane and pasture. There were no differences in richness, but fragments surrounded by sugar cane had the lowest abundance of amphibians, whereas fragments surrounded by pastures had greater abundance. The most abundant species, Rhinella ornata, showed no biometric differences between fragment groups but like many other amphibians sampled showed very low numbers of individuals in fragments dominated by sugar cane fields. Our data indicate that the sugar cane matrix negatively influences the community of amphibians present in fragments surrounded by this type of land use.

  2. Models and Approaches for Integrating Protected Areas with Their Surroundings: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Wenwu Du

    2015-06-01

    Full Text Available Several studies have identified threats that originate in areas surrounding protected areas (PAs. While there have been various efforts to integrate PAs with their surroundings, considerable challenges remain. Here we summarize these efforts to date, discuss their effectiveness, and provide recommendations for future research. Based on a broad literature review of theoretical and applied approaches, we have outlined 68 models for balancing conservation and sustainable development in PAs. We comprehensively analyzed 23 of these models for integrating PAs with their surroundings. They were divided into two categories: area-oriented and process-oriented approaches. This review reveals the absolute necessity of combining these two approaches for future conservation and sustainable development of PAs.

  3. Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

    Science.gov (United States)

    Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-01-01

    Background Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users’ experiences in using secure email messaging. Objective To quantitatively assess veteran patients’ experiences in using secure email messaging in a large patient sample. Methods A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations’ Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. Results The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy

  4. Large-Scale Survey Findings Inform Patients' Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment.

    Science.gov (United States)

    Haun, Jolie N; Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-12-21

    Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users' experiences in using secure email messaging. To quantitatively assess veteran patients' experiences in using secure email messaging in a large patient sample. A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations' Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy-to-use (P≤.001) communication tool, compared

  5. Assessment of the current status of playground safety in the midwestern region of Turkey: an effort to provide a safe environment for children.

    Science.gov (United States)

    Uskun, Ersin; Kişioğlu, Ahmet Nesimi; Altay, Tülin; Cikinlar, Rengül; Kocakaya, Asuman

    2008-01-01

    This study aimed to identify and evaluate the degree of conformity to the playground standards and the level of compliance with current safety specifications of the playgrounds in the midwestern region of Turkey. An observational technique was used at a total of 57 public playgrounds. A playground safety control form was prepared based on the United States National Program for Playground Safety and the Consumer Product Safety Commission security standards, since there is no national law covering playground equipment and safety in Turkey. The study evaluated the surroundings of the playground, arrangement of equipment in the playground, and characteristics of the equipment. The percentage of playgrounds surveyed with inadequate or hard surfacing was 80.7%. Fifty-two percent of the equipment was found to be inappropriate. Equipment was higher than the recommended heights. The results of our study unfortunately point out that playgrounds for children do not meet many of the safety criteria.

  6. An assessment of the quality of advice provided by patent medicine vendors to users of oral contraceptive pills in urban Nigeria

    Directory of Open Access Journals (Sweden)

    Ujuju C

    2014-04-01

    Full Text Available Chinazo Ujuju,1 Samson B Adebayo,2 Jennifer Anyanti,3 Obi Oluigbo,3 Fatima Muhammad,4 Augustine Ankomah5 1Research and Evaluation Division, Society for Family Health, Abuja, Nigeria; 2Planning, Research and Statistics Directorate, National Agency for Food and Drug Administration and Control, Abuja, Nigeria; 3Technical Services Directorate, Society for Family Health, Abuja, Nigeria; 4Family Planning Directorate, Society for Family Health, Abuja, Nigeria; 5Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana Introduction: In Nigeria about 50% of oral contraceptive pill users obtain their products from proprietary patent medicine vendors (PPMVs. This group of service providers are poorly trained and have very limited knowledge about contraception. This paper investigated the nature of the advice offered to simulated current and potential users of oral contraceptive pills. The main objective was to assess the nature and quality of advice provided by PPMVs to pill users. Method: This study is based on findings from a 'mystery client' approach in which three scenarios related to contraceptive pill use were simulated. Each of the 12 mystery clients simulated one of the following three scenarios: new pill users (new to family planning or switching from condom to pills; user seeking a resupply of pills; and dissatisfied pill users intending to discontinue use. Simple random sampling was used to select 410 PPMVs from a total of 1,826 in four states in Nigeria. Qualitative study using in-depth interviews was also conducted. Results: A majority of the PPMVs had pills in stock on the day of the survey and resupplied pills to the clients. PPMVs also understood the reason and importance of referring clients who were new adopters of oral contraceptive methods to a health facility; 30% of the PPMVs referred new adopters to a health facility. However, demand from clients who do not want to go

  7. Rain Simulation for the Test of Automotive Surround Sensors

    Science.gov (United States)

    Hasirlioglu, Sinan; Riener, Andreas; Doric, Igor

    2017-04-01

    The WHO Global Health Observatory data indicates that over 1.25 million people die in traffic accidents annually. To save lives, car manufacturers spend lot of efforts on the development of novel safety systems aiming to avoid or mitigate accidents and provide maximum protection for vehicle occupants as well as vulnerable road users. All the safety features mainly rely on data from surround sensors such as radar, lidar and camera and intelligent vehicles today use these environmental data for instant decision making and vehicle control. As already small errors in sensor data measurements could lead to catastrophes like major injuries or road traffic fatalities, it is of utmost importance to ensure high reliability and accuracy of sensors and safety systems. This work focuses on the influence of environmental factors such as rain conditions, as it is known that rain drops scatter the electromagnetic waves. The result is incorrect measurements with a direct negative impact on environment detection. To identify potential problems of sensors under varying environmental conditions, systems are today tested in real-world settings with two main problems: First, tests are time-consuming and second, environmental conditions are not reproducible. Our approach to test the influence of weather on automotive sensors is to use an indoor rain simulator. Our artificial rain maker, installed at CARISSMA (Center of Automotive Research on Integrated Safety Systems and Measurement Area), is parametrized with rain characteristics measured in the field using a standard disdrometer. System behavior on artificial rain is compared and validated with natural rainfall. With this simulator it is finally possible to test environmental influence at various levels and under reproducible conditions. This saves lot of efforts required for the test process itself and furthermore has a positive impact on the reliability of sensor systems due to the fact that test driven development is enabled.

  8. AFAL: a web service for profiling amino acids surrounding ligands in proteins

    Science.gov (United States)

    Arenas-Salinas, Mauricio; Ortega-Salazar, Samuel; Gonzales-Nilo, Fernando; Pohl, Ehmke; Holmes, David S.; Quatrini, Raquel

    2014-11-01

    With advancements in crystallographic technology and the increasing wealth of information populating structural databases, there is an increasing need for prediction tools based on spatial information that will support the characterization of proteins and protein-ligand interactions. Herein, a new web service is presented termed amino acid frequency around ligand (AFAL) for determining amino acids type and frequencies surrounding ligands within proteins deposited in the Protein Data Bank and for assessing the atoms and atom-ligand distances involved in each interaction (availability: http://structuralbio.utalca.cl/AFAL/index.html). AFAL allows the user to define a wide variety of filtering criteria (protein family, source organism, resolution, sequence redundancy and distance) in order to uncover trends and evolutionary differences in amino acid preferences that define interactions with particular ligands. Results obtained from AFAL provide valuable statistical information about amino acids that may be responsible for establishing particular ligand-protein interactions. The analysis will enable investigators to compare ligand-binding sites of different proteins and to uncover general as well as specific interaction patterns from existing data. Such patterns can be used subsequently to predict ligand binding in proteins that currently have no structural information and to refine the interpretation of existing protein models. The application of AFAL is illustrated by the analysis of proteins interacting with adenosine-5'-triphosphate.

  9. Evaluation of Optic Canal and Surrounding Structures Using Cone Beam Computed Tomography: Considerations for Maxillofacial Surgery.

    Science.gov (United States)

    Sinanoglu, Alper; Orhan, Kaan; Kursun, Sebnem; Inceoglu, Beste; Oztas, Bengi

    2016-07-01

    The optic canal connects the anterior cranial fossa and the orbit and maintains the optic nerve and the ophthalmic artery. Within the extent of the surgical approach of the region, risk of iatrogenic injury of the neural and vascular structures increases. The aim of this retrospective morphometric study is to investigate the radiological anatomy of orbita, optic canal, and its surrounding using cone beam computed tomography (CBCT) scans in a group of Turkish population.Cone beam computed tomography images of a total of 182 patients were evaluated by 2 observers. Anatomical parameters regarding optic canal and orbita were measured for all patients from axial, sagittal, and three-dimensional reconstructed images. To assess intraobserver reliability, the Wilcoxon matched-pairs test was used. Pearson χ test and Student t test were performed for statistical analysis of differences, sex, localization, and measurements (P  0.05). The orbita width and height were larger for the males than females (P  0.05). Examination CBCT scans revealed that the shape of the optic canal was 70% funnel and 28% Hourglass shape, 2% amorph type round.These results provide detailed knowledge of the anatomical characteristics in the orbital area which may be of assistance for surgeons preoperatively. Cone beam computed tomography scans can be an alternative modality for multislice computed tomography with submillimeter resolution and lower dose in preoperative imaging of the orbit.

  10. Impacts of emerging contaminants on surrounding aquatic environment from a youth festival.

    Science.gov (United States)

    Jiang, Jheng-Jie; Lee, Chon-Lin; Fang, Meng-Der; Tu, Bo-Wen; Liang, Yu-Jen

    2015-01-20

    The youth festival as we refer to Spring Scream, a large-scale pop music festival, is notorious for the problems of drug abuse and addiction. The origin, temporal magnitudes, potential risks and mass inputs of emerging contaminants (ECs) were investigated. Thirty targeted ECs were analyzed by solid-phase extraction and liquid chromatography coupled to tandem mass spectrometry (SPE-LC-MS/MS). Sampling strategy was designed to characterize EC behavior in different stages (before and after the youth festival), based on multivariate data analysis to explore the contributions of contaminants from normal condition to the youth festival. Wastewater influents and effluents were collected during the youth festival (approximately 600 000 pop music fans and youth participated). Surrounding river waters are also sampled to illustrate the touristic impacts during peak season and off-season. Seasonal variations were observed, with the highest concentrations in April (Spring Scream) and the lowest in October (off-season). Acetaminophen, diclofenac, codeine, ampicillin, tetracycline, erythromycin-H2O, and gemfibrozil have significant pollution risk quotients (RQs > 1), indicating ecotoxicological concerns. Principal component analysis (PCA) and weekly patterns provide a perspective in assessing the touristic impacts and address the dramatic changes in visitor population and drug consumption. The highest mass loads discharged into the aquatic ecosystem corresponded to illicit drugs/controlled substances such as ketamine and MDMA, indicating the high consumption of ecstasy during Spring Scream.

  11. Placental vascular responses are dependent on surrounding tissue

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn Halle

    -depth understanding of the mechanism regulating blood flow and perfusion is necessary if we are to come up with new ideas for intervention and treatment. Method: From fresh born placentas stem villi arteries were carefully dissected. The artery branches were divided. The surrounding tissue was removed from one end...... and was left untouched in the other end. Then using wire myography they were investigated in terms of contractility and sensitivity to physiological relevant human-like agonists. Results: Sensitivity to PGF2α, Tx-analog, 5-HT and endothelin-1 was significantly lower in arteries with intact surrounding tissue...... compared to arteries stripped of the tissue. The maximal force development was also significantly lower in arteries with surrounding tissue, when they were depolarized high extracellular [K+] or stimulated with PGF2α or endotheline-1. Conclusion: The perivascular tissue significantly alters stem villi...

  12. Placental vascular responses are dependent on surrounding tissue

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn Halle

    . Materials and methods. From fresh born placentas, stem villi arteries were carefully dissected. The artery branches were divided. The surrounding tissue was removed from one end and was left untouched in the other end.Then, using wire myography, they were investigated in terms of contractility...... and sensitivity to physiological relevant human-like agonists. Results. Sensitivity to PGF2α, Tx-analog, 5-HT and endothelin-1 was significantly lower in arteries with intact surrounding tissue compared to arteries stripped of the tissue. The maximal force development was also significantly lower in arteries...... with surrounding tissue when they were depolarized high extracellular [K+] or stimulated with PGF2α or endotheline-1. Conclusion. The perivascular tissue significantly alters stem villi arteries' sensitivity and force development in a suppressive way. This implicates a new aspect of blood flow regulation...

  13. Surrounding rock stress analysis of underground high level waste repository

    International Nuclear Information System (INIS)

    Liu Wengang; Wang Ju; Wang Guangdi

    2006-01-01

    During decay of nuclear waste, enormous energy was released, which results in temperature change of surrounding rock of depository. Thermal stress was produced because thermal expansion of rock was controlled. Internal structure of surrounding rock was damaged and strength of rock was weakened. So, variation of stress was a dynamic process with the variation of temperature. BeiShan region of Gansu province was determined to be the depository field in the future, it is essential to make research on granite in this region. In the process of experiment, basic physical parameters of granite were analyzed preliminary with MTS. Long range temperature and stress filed was simulated considering the damage effect of surrounding rock, and rules of temperature and stress was achieved. (authors)

  14. Nursing students' preferences of strategies surrounding cinenurducation in a first year child growth and development courses: A mixed methods study.

    Science.gov (United States)

    Oh, Jina; Steefel, Lorraine

    2016-01-01

    Use of film in the classroom (cinenurducation) promotes nursing students' motivation and understanding of concepts about child growth and development; however, consensus has not been reached regarding students' preferred strategies and what they view as effective. To identify nursing students' preferences for pedagogical strategies surrounding film use in a Child Growth and Development course. A mixed methods study encompassing a concurrent triangulation strategy was undertaken. Eighty-three students attending the first year nursing class in the fall semester 2012 at a private University in South Korea participated. Films or film clips were shown either before or after pedagogical strategies including lecture, presentation, personal essay, group report, or group discussion, followed by a questionnaire to assess student preferences and their opinions on the impact of strategies on motivation and learning. A focus group with 10 participants provided their opinions. Although the preference for the time when films were watched showed no significant difference (t=.388, p=.699), participants preferred the following pedagogical methods: watching films with a group, saying this was more effective compared to watching films alone (t=5.488, pstrategies surrounding cinenurducation helped them gain conceptual knowledge in a Child Growth and Development course. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Association of Patient-Reported Readiness for Discharge and Hospital Consumer Assessment of Health Care Providers and Systems Patient Satisfaction Scores: A Retrospective Analysis.

    Science.gov (United States)

    Schmocker, Ryan K; Holden, Sara E; Vang, Xia; Leverson, Glen E; Cherney Stafford, Linda M; Winslow, Emily R

    2015-12-01

    Patient-reported outcomes (PRO) have been increasingly emphasized, however, determining clinically valuable PRO has been problematic and investigation limited. This study examines the association of readiness for discharge, which has been described previously, with patient satisfaction and readmission. Data from adult patients admitted to our institution from 2009 to 2012 who completed both the Hospital Consumer Assessment of Healthcare Providers and Systems and the Press Ganey surveys post discharge were extracted from an existing database of patients (composed of 220 patients admitted for small bowel obstruction and 98 patients with hospital stays ≥ 21 days). Using the survey question, "Did you feel ready for discharge?" (RFD), 2 groups were constructed, those RFD and those with lesser degrees of readiness (ie, less ready for discharge [LRFD]) using topbox methodology. Outcomes, readmission rates, and satisfaction were compared between RFD and LRFD groups. Three hundred and eighteen patients met the inclusion criteria; 45% were female and 94% were Caucasian. Median age was 62.3 years (interquartile range 52.5 to 70.8 year). Median length of stay was 10 days (interquartile range 6.0 to 24.0 days) and 69.2% were admitted with small bowel obstruction. The 30-day readmission rate was 14.3% and 55% indicated they were RFD. Those RFD and LRFD had similar demographics, comorbidity scores, and rates of surgery. Those RFD had higher overall hospital satisfaction (87.3% RFD vs 62.4% LRFD; p patient-reported metric, as those RFD have higher satisfaction with the hospital and physicians. Prospective investigation into variables affecting patient satisfaction in those LRFD is needed. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  16. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    Science.gov (United States)

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  17. Ornitocenosis of the Sursky pond and its close the surroundings

    International Nuclear Information System (INIS)

    Lacko, J.; Ambrus, B.; Fupso, A.

    2013-01-01

    The paper focuses on the qualitative-quantitative research of fishpond bird community of the Sursky and its surroundings as well as on analysis of seasonal population dynamics of the avifauna as well as on placing the determined species into environmental groups and guilds. Another object is the comparison of our results with recent work focused on research of bird communities on this site.

  18. Review of Ordered Anarchy: Jasay and his Surroundings

    Directory of Open Access Journals (Sweden)

    Aschwin de Wolf

    2009-02-01

    Full Text Available Anthony de Jasay is among the most important social thinkers of our time. His oeuvre offers a sustained critique of government and its defenders. In the book Ordered Anarchy: Jasay and His Surroundings, colleagues and friends pay tribute to the man in the form of an inspiring collection of essays.

  19. Linking disadvantaged housing areas to the surrounding city

    DEFF Research Database (Denmark)

    Stender, Marie

    Several disadvantaged social housing areas in Denmark are currently undergo-ing thorough physical refurbishments, aiming to integrate them better with the surrounding city. The ambition is to attract new users and residents by opening up the borders of the area and establish attractive, new...

  20. The bird species of pandam wildlife park and the surrounding ...

    African Journals Online (AJOL)

    The effect of time of day as well as vegetation variables on bird species diversity in the park and surrounding farmlands was also conducted. 10 transects in each study site were surveyed twice between during the dry season and vegetation variables (trees, fingers, finger-rings two- hand, grazing, farming, canopy cover, ...

  1. Experiences during the decontamination process of areas surrounding to Fukushima

    International Nuclear Information System (INIS)

    Molina, G.

    2014-10-01

    In this work the experience gained during the decontamination of areas surrounding to Fukushima NPP, rugged during the earthquake and tsunami in 2011 and caused the contamination with fission products in these areas is described. Actions taken by the Japanese government are reported and some of the techniques used, the intervention levels and the progress made and disposal techniques considered are presented. (Author)

  2. Traditional Indian customs surrounding birth A review | Chalmers ...

    African Journals Online (AJOL)

    Since 1960, only a few studies have been made of traditional custOIns surrounding birth in Indian culture. Very few of these have described customs followed by Indians in South Africa. A review of these publications is presented here. Customs described include religious, social and psychological aspects of behaviour in ...

  3. Behavioural aspects surrounding medicine purchases from pharmacies in Australia

    Directory of Open Access Journals (Sweden)

    Emmerton L

    2008-09-01

    Full Text Available Objective: This study aimed to produce current data regarding behavioural aspects of non-prescription (over-the-counter medicine purchases, in light of changes in the pharmaceutical market and increasing provision of professional services in pharmacies.Methods: Data were collected in 15 community pharmacies in South-East Queensland, Australia, over 540 hours in five days in August, 2006. The method, previously validated, involved documentation of both observational and interview data. Fifteen trained researchers were stationed in a selected pharmacy each to unobtrusively observe all eligible sales of non-prescription medicines, and, where possible, interview the purchasers post-sale. Non-response was supplemented by observational data and recall by the salesperson. The data included details of the purchase and purchasing behaviour, while new questions addressed issues of topical importance, including customers’ privacy concerns. A selection of the analyses is reported here.Results: In total, 3470 purchases were documented (135-479 per pharmacy, with customers of 67.5% of purchases (74.7% excluding an outlier pharmacy participating in the survey. Customers averaged 1.2 non-prescription medicines per transaction. Two-thirds (67.2% of customers were female, and 38.8% of the customers were aged 31-45 years. Analgesics and respiratory medicines accounted for two-thirds of the sales data (33.4% and 32.4%, respectively. Intended-brand purchases comprised 71% of purchases (2004/2824; in-store substitution then occurred in 8.8% of these cases, mainly following recommendations by pharmacy staff. Medicines intended for self-use comprised 62.9% of purchases (1752/2785. First-time purchases (30.8%, 799/2594 were more commonly influenced by pharmacy staff than by advertising.Conclusions: This study used validated methods adapted to a changing marketplace, thus providing data that both confirm and add to knowledge surrounding medicine purchases. Despite the

  4. Mammographic image quality in relation to positioning of the breast: A multicentre international evaluation of the assessment systems currently used, to provide an evidence base for establishing a standardised method of assessment.

    Science.gov (United States)

    Taylor, K; Parashar, D; Bouverat, G; Poulos, A; Gullien, R; Stewart, E; Aarre, R; Crystal, P; Wallis, M

    2017-11-01

    Optimum mammography positioning technique is necessary to maximise cancer detection. Current criteria for mammography appraisal lack reliability and validity with a need to develop a more objective system. We aimed to establish current international practice in assessing image quality (IQ), of screening mammograms then develop and validate a reproducible assessment tool. A questionnaire sent to centres in countries undertaking population screening identified practice, participants for an expert panel (EP) of radiologists/radiographers and a testing panel (TP) of radiographers. The EP developed category criteria and descriptors using a modified Delphi process to agree definitions. The EP scored 12 screening mammograms to test agreement then a main set of 178 cases. Weighted scores were derived for each descriptor enabling calculation of numerical parameters for each new category. The TP then scored the main set. Statistical analysis included ANOVA, t-tests and Kendall's coefficient. 11 centres in 8 countries responded forming an EP of 7 members and TP of 44 members. The EP showed moderate agreement when the scoring the mini test set W = 0.50 p < 0.001 and the main set W = 0.55 p < 0.001, 'posterior nipple line' being the most difficult descriptor. The weighted total scores differentiated the 4 new categories Perfect, Good, Adequate and Inadequate (p < 0.001). We have developed an assessment tool by Delphi consensus and weighted consensus criteria. We have successfully tabulated a range of numerical scores for each new category providing the first validated and reproducible mammography IQ scoring system. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  5. A Multimodal, Full-Surround Vehicular Testbed for Naturalistic Studies and Benchmarking: Design, Calibration and Deployment

    OpenAIRE

    Rangesh, Akshay; Yuen, Kevan; Satzoda, Ravi Kumar; Rajaram, Rakesh Nattoji; Gunaratne, Pujitha; Trivedi, Mohan M.

    2017-01-01

    Recent progress in autonomous and semi-autonomous driving has been made possible in part through an assortment of sensors that provide the intelligent agent with an enhanced perception of its surroundings. It has been clear for quite some while now that for intelligent vehicles to function effectively in all situations and conditions, a fusion of different sensor technologies is essential. Consequently, the availability of synchronized multi-sensory data streams are necessary to promote the d...

  6. Ultrastructural relationship of the phagophore with surrounding organelles.

    Science.gov (United States)

    Biazik, Joanna; Ylä-Anttila, Päivi; Vihinen, Helena; Jokitalo, Eija; Eskelinen, Eeva-Liisa

    2015-01-01

    Phagophore nucleates from a subdomain of the endoplasmic reticulum (ER) termed the omegasome and also makes contact with other organelles such as mitochondria, Golgi complex, plasma membrane and recycling endosomes during its formation. We have used serial block face scanning electron microscopy (SB-EM) and electron tomography (ET) to image phagophore biogenesis in 3 dimensions and to determine the relationship between the phagophore and surrounding organelles at high resolution. ET was performed to confirm whether membrane contact sites (MCSs) are evident between the phagophore and those surrounding organelles. In addition to the known contacts with the ER, we identified MCSs between the phagophore and membranes from putative ER exit sites, late endosomes or lysosomes, the Golgi complex and mitochondria. We also show that one phagophore can have simultaneous MCSs with more than one organelle. Future membrane flux experiments are needed to determine whether membrane contacts also signify lipid translocation.

  7. Trajectories and Maneuvers of Surrounding Vehicles with Panoramic Camera Arrays

    DEFF Research Database (Denmark)

    Dueholm, Jacob Velling; Kristoffersen, Miklas Strøm; Satzoda, Ravi K.

    2016-01-01

    Vision-based research for intelligent vehicles have traditionally focused on specific regions around a vehicle, such as a front looking camera for, e.g., lane estimation. Traffic scenes are complex and vital information could be lost in unobserved regions. This paper proposes a framework that uses...... four visual sensors for a full surround view of a vehicle in order to achieve an understanding of surrounding vehicle behaviors. The framework will assist the analysis of naturalistic driving studies by automating the task of data reduction of the observed trajectories. To this end, trajectories...... are estimated using a vehicle detector together with a multiperspective optimized tracker in each view. The trajectories are transformed to a common ground plane, where they are associated between perspectives and analyzed to reveal tendencies around the ego-vehicle. The system is tested on sequences from 2.5 h...

  8. Diversity of vascular plants of Piestany and surroundings (presentation)

    International Nuclear Information System (INIS)

    Penzesova, A.; Galusova, T.

    2013-01-01

    In this presentation is a summary of the results of floristic research aimed at determining diversity of vascular plants of Piestany and its surroundings. Plant taxa we determined using the designation keys. We have compiled a list of plant species occurring in the monitored area, we evaluated the selected botanical-phytogeographical characteristics of flora, we've put together a list of local protected, endangered and rare species and a list of local invasive and expansive species according to sources. (Authors)

  9. Should governments subsidize tuition at public universities? Assessing the benefits of tuition subsidies provided by the University of Minnesota and the Minnesota State Colleges and Universities system.

    OpenAIRE

    Damon, Amy L.; Glewwe, Paul

    2008-01-01

    Chapter titles: Introduction; Higher education in Minnesota; Private benefits from a university education; Public benefits of university education-conceptual and practical issues; Distribution of private and public benefits; An assessment of the private and public benefits of subsidies of higher education in Minnesota; Conclusions and suggestions for further research; References.

  10. Assessing the capacity for newborn resuscitation and factors associated with providers' knowledge and skills: a cross-sectional study in Afghanistan

    NARCIS (Netherlands)

    Kim, Y.M.; Ansari, N.; Kols, A.; Tappis, H.; Currie, S.; Zainullah, P.; Bailey, P.; Semba, R.; Sun, K.; van Roosmalen, J.; Stekelenburg, J.

    2013-01-01

    Background: Resuscitation with bag and mask is a high-impact intervention that can reduce neonatal deaths in resource-poor countries. This study assessed the capacity to perform newborn resuscitation at facilities offering comprehensive emergency obstetric and newborn care (EmONC) in Afghanistan, as

  11. 'To use or not to use': a qualitative study to evaluate experiences of healthcare providers and patients with the assessment of burden of COPD (ABC) tool

    NARCIS (Netherlands)

    Slok, A.H.; Twellaar, M.; Jutbo, L.; Kotz, D.; Chavannes, N.H.; Holverda, S.; Salome, P.L.; Dekhuijzen, P.N.R.; Molken, M.P. Rutten-van; Schuiten, D.; Veen, J.C. In 't; Schayck, O.C. van

    2016-01-01

    In the management of chronic conditions, such as chronic obstructive pulmonary disease (COPD), there is a shift from doctor-driven care to patient-centred integrated care with active involvement of and self-management by the patient. A recently developed tool, the assessment of burden of COPD (ABC)

  12. 'To use or not to use': A qualitative study to evaluate experiences of healthcare providers and patients with the assessment of burden of COPD (ABC) tool

    NARCIS (Netherlands)

    A.H.M. Slok (Annerika); M. Twellaar (Mascha); Jutbo, L. (Leslie); D. Kotz (Daniel); N.H. Chavannes (Nicolas); S. Holverda (Sebastiaan); P.L. Salome´ (Philippe); Dekhuijzen, P.N.R. (P N Richard); M.P.M.H. Rutten-van Mölken (Maureen); D. Schuiten (Denise); J.C.C.M. in 't Veen (Johannes); O.C.P. Schayck (Onno)

    2016-01-01

    textabstractIn the management of chronic conditions, such as chronic obstructive pulmonary disease (COPD), there is a shift from doctor-driven care to patient-centred integrated care with active involvement of and self-management by the patient. A recently developed tool, the assessment of burden of

  13. Numerical Simulation on Zonal Disintegration in Deep Surrounding Rock Mass

    Directory of Open Access Journals (Sweden)

    Xuguang Chen

    2014-01-01

    Full Text Available Zonal disintegration have been discovered in many underground tunnels with the increasing of embedded depth. The formation mechanism of such phenomenon is difficult to explain under the framework of traditional rock mechanics, and the fractured shape and forming conditions are unclear. The numerical simulation was carried out to research the generating condition and forming process of zonal disintegration. Via comparing the results with the geomechanical model test, the zonal disintegration phenomenon was confirmed and its mechanism is revealed. It is found to be the result of circular fracture which develops within surrounding rock mass under the high geostress. The fractured shape of zonal disintegration was determined, and the radii of the fractured zones were found to fulfill the relationship of geometric progression. The numerical results were in accordance with the model test findings. The mechanism of the zonal disintegration was revealed by theoretical analysis based on fracture mechanics. The fractured zones are reportedly circular and concentric to the cavern. Each fracture zone ruptured at the elastic-plastic boundary of the surrounding rocks and then coalesced into the circular form. The geometric progression ratio was found to be related to the mechanical parameters and the ground stress of the surrounding rocks.

  14. Numerical simulation on zonal disintegration in deep surrounding rock mass.

    Science.gov (United States)

    Chen, Xuguang; Wang, Yuan; Mei, Yu; Zhang, Xin

    2014-01-01

    Zonal disintegration have been discovered in many underground tunnels with the increasing of embedded depth. The formation mechanism of such phenomenon is difficult to explain under the framework of traditional rock mechanics, and the fractured shape and forming conditions are unclear. The numerical simulation was carried out to research the generating condition and forming process of zonal disintegration. Via comparing the results with the geomechanical model test, the zonal disintegration phenomenon was confirmed and its mechanism is revealed. It is found to be the result of circular fracture which develops within surrounding rock mass under the high geostress. The fractured shape of zonal disintegration was determined, and the radii of the fractured zones were found to fulfill the relationship of geometric progression. The numerical results were in accordance with the model test findings. The mechanism of the zonal disintegration was revealed by theoretical analysis based on fracture mechanics. The fractured zones are reportedly circular and concentric to the cavern. Each fracture zone ruptured at the elastic-plastic boundary of the surrounding rocks and then coalesced into the circular form. The geometric progression ratio was found to be related to the mechanical parameters and the ground stress of the surrounding rocks.

  15. Enhanced sources of acoustic power surrounding AR 11429

    International Nuclear Information System (INIS)

    Donea, Alina; Hanson, Christopher

    2013-01-01

    Multi-frequency power maps of the local acoustic oscillations show acoustic enhancements (''acoustic-power halos'') at high frequencies surrounding large active region. Computational seismic holography reveals a high-frequency ''acoustic-emission halo'', or ''seismic glory'' surrounding large active regions. In this study, we have applied computational seismic holography to map the seismic seismic source density surrounding AR 11429. Studies of HMI/SDO Doppler data, shows that the ''acoustic halos'' and the ''seismic glories'' are prominent at high frequencies 5–8 mHz. We investigate morphological properties of acoustic-power and acoustic emission halos around an active region to see if they are spatially correlated. Details about the local magnetic field from vectormagnetograms of AR 11429 are included. We identify a 15'' region of seismic deficit power (dark moat) shielding the white-light boundary of the active region. The size of the seismic moat is related to region of intermediate magnetic field strength. The acoustic moat is circled by the halo of enhanced seismic amplitude as well as enhanced seismic emission. Overall, the results suggest that features are related. However, if we narrow the frequency band to 5.5 – 6.5 mHz, we find that the seismic source density dominates over the local acoustic power, suggesting the existence of sources that emit more energy downward into the solar interior than upward toward the solar surface.

  16. Tissue reaction surrounding miniscrews for orthodontic anchorage: An animal experiment

    Directory of Open Access Journals (Sweden)

    Stephanie Shih-Hsuan Chen

    2012-03-01

    Results and conclusions: (1 Tissue surrounding roots damaged by a miniscrew showed a significant inflammatory response. (2 Root resorption was occasionally observed after 3 weeks following insertion of a miniscrew even if the miniscrew was not in direct contact with the root. (3 Root repair was noted with a cementoblast lining along the resorption surface at as early as 3 weeks after miniscrew insertion. Alveolar bone filled in the lesion when the root damage was large so that the contour of the alveolar bone followed that of the damaged root, with the width of the periodontal ligament space being maintained. (4 Stable miniscrews were mainly those which did not contact adjacent roots, and for which the surrounding tissue showed only a small inflammatory response with some extent of direct bone contact around the miniscrew. On the contrary, most of the failed miniscrews were those which had direct contact with adjacent roots, and which exhibited severe tissue inflammation and were covered by thick layers of soft tissue. Failure was detected 3 weeks after insertion. Surprisingly, the epithelial lining surrounding the miniscrews might not have spontaneously resolved 6 weeks after screw removal. Persistent infection in the sinus tract was noted, and this would require attention.

  17. A permeability barrier surrounds taste buds in lingual epithelia

    Science.gov (United States)

    Dando, Robin; Pereira, Elizabeth; Kurian, Mani; Barro-Soria, Rene; Chaudhari, Nirupa

    2014-01-01

    Epithelial tissues are characterized by specialized cell-cell junctions, typically localized to the apical regions of cells. These junctions are formed by interacting membrane proteins and by cytoskeletal and extracellular matrix components. Within the lingual epithelium, tight junctions join the apical tips of the gustatory sensory cells in taste buds. These junctions constitute a selective barrier that limits penetration of chemosensory stimuli into taste buds (Michlig et al. J Comp Neurol 502: 1003–1011, 2007). We tested the ability of chemical compounds to permeate into sensory end organs in the lingual epithelium. Our findings reveal a robust barrier that surrounds the entire body of taste buds, not limited to the apical tight junctions. This barrier prevents penetration of many, but not all, compounds, whether they are applied topically, injected into the parenchyma of the tongue, or circulating in the blood supply, into taste buds. Enzymatic treatments indicate that this barrier likely includes glycosaminoglycans, as it was disrupted by chondroitinase but, less effectively, by proteases. The barrier surrounding taste buds could also be disrupted by brief treatment of lingual tissue samples with DMSO. Brief exposure of lingual slices to DMSO did not affect the ability of taste buds within the slice to respond to chemical stimulation. The existence of a highly impermeable barrier surrounding taste buds and methods to break through this barrier may be relevant to basic research and to clinical treatments of taste. PMID:25209263

  18. A permeability barrier surrounds taste buds in lingual epithelia.

    Science.gov (United States)

    Dando, Robin; Pereira, Elizabeth; Kurian, Mani; Barro-Soria, Rene; Chaudhari, Nirupa; Roper, Stephen D

    2015-01-01

    Epithelial tissues are characterized by specialized cell-cell junctions, typically localized to the apical regions of cells. These junctions are formed by interacting membrane proteins and by cytoskeletal and extracellular matrix components. Within the lingual epithelium, tight junctions join the apical tips of the gustatory sensory cells in taste buds. These junctions constitute a selective barrier that limits penetration of chemosensory stimuli into taste buds (Michlig et al. J Comp Neurol 502: 1003-1011, 2007). We tested the ability of chemical compounds to permeate into sensory end organs in the lingual epithelium. Our findings reveal a robust barrier that surrounds the entire body of taste buds, not limited to the apical tight junctions. This barrier prevents penetration of many, but not all, compounds, whether they are applied topically, injected into the parenchyma of the tongue, or circulating in the blood supply, into taste buds. Enzymatic treatments indicate that this barrier likely includes glycosaminoglycans, as it was disrupted by chondroitinase but, less effectively, by proteases. The barrier surrounding taste buds could also be disrupted by brief treatment of lingual tissue samples with DMSO. Brief exposure of lingual slices to DMSO did not affect the ability of taste buds within the slice to respond to chemical stimulation. The existence of a highly impermeable barrier surrounding taste buds and methods to break through this barrier may be relevant to basic research and to clinical treatments of taste. Copyright © 2015 the American Physiological Society.

  19. Linking student performance in Massachusetts elementary schools with the "greenness" of school surroundings using remote sensing.

    Science.gov (United States)

    Wu, Chih-Da; McNeely, Eileen; Cedeño-Laurent, J G; Pan, Wen-Chi; Adamkiewicz, Gary; Dominici, Francesca; Lung, Shih-Chun Candice; Su, Huey-Jen; Spengler, John D

    2014-01-01

    Various studies have reported the physical and mental health benefits from exposure to "green" neighborhoods, such as proximity to neighborhoods with trees and vegetation. However, no studies have explicitly assessed the association between exposure to "green" surroundings and cognitive function in terms of student academic performance. This study investigated the association between the "greenness" of the area surrounding a Massachusetts public elementary school and the academic achievement of the school's student body based on standardized tests with an ecological setting. Researchers used the composite school-based performance scores generated by the Massachusetts Comprehensive Assessment System (MCAS) to measure the percentage of 3rd-grade students (the first year of standardized testing for 8-9 years-old children in public school), who scored "Above Proficient" (AP) in English and Mathematics tests (Note: Individual student scores are not publically available). The MCAS results are comparable year to year thanks to an equating process. Researchers included test results from 2006 through 2012 in 905 public schools and adjusted for differences between schools in the final analysis according to race, gender, English as a second language (proxy for ethnicity and language facility), parent income, student-teacher ratio, and school attendance. Surrounding greenness of each school was measured using satellite images converted into the Normalized Difference Vegetation Index (NDVI) in March, July and October of each year according to a 250-meter, 500-meter, 1,000-meter, and 2000-meter circular buffer around each school. Spatial Generalized Linear Mixed Models (GLMMs) estimated the impacts of surrounding greenness on school-based performance. Overall the study results supported a relationship between the "greenness" of the school area and the school-wide academic performance. Interestingly, the results showed a consistently positive significant association between the

  20. Radiological impact of phosphogypsum in the Surrounding Ecosystem

    International Nuclear Information System (INIS)

    Al-Attar, L.; Al-Oudat, M.; Budier, Y.; Khalili, H.; Hamwi, A.; Kanakri, S.

    2011-01-01

    This study was carried out to assess the radiological impact of Syrian PG piles in the compartments of the surrounding ecosystem. Therefore, estimating the distribution of naturally occurring radionuclides (i.e. 2 26 Ra, 2 38 U, 2 32 Th, 2 10 Po and 2 10 Pb) in the raw materials, product and by-product of the Syrian phosphate fertilizer industry was essential. The obtained data revealed that 2 26 Ra retained in PG with a mean activity of 318 Bq kg-1. Uranium content in PG was low since it remained in the produced phosphoric acid. However, over 80% of 2 32 Th, 2 10 Po and 2 10 Pb partitioned in PG. The presence of PG piles did not increase the concentration of 2 22 Rn nor gamma rays exposure dose in the studied area. The annual effective dose was only 0.082 mSv y-1. The geometric mean of total suspended solids was ca. 85 g m-3. The concentration of the radionuclides in filtration and runoff waters were below the detection limits; and were much lower than the permissible limits set for drinking water by the WHO in ground and Qattina Lake waters. Eastern sites soil samples of PG piles were of the highest activity concentrations, due to the characterised western and north-western wind in the area, but remained within the natural levels reported in Syrian soil. The impact of PG piles on plants varied upon the plant species. Significantly, higher concentrations of the radionuclides were recorded for grass in comparison to broad-leaved plants. Among the species that naturally grown on PG piles, Inula, Ecballium and Polygonium may be radionuclides accumulators. Nevertheless, a determined effort is needed on national level to achieve a common and coherent approach to regulate PG piles or to consider it a resource material rather than waste or residue. The presence of PG piles did not increase the concentration of 2 22 Rn nor gamma rays exposure dose in the studied area. The annual effective dose was only 0.082 mSv y -1 . The geometric mean of total suspended solids was ca

  1. Summary of Epidemiology Studies or Activities Involving Workers at the Savannah River Site or the Surrounding Public: An Update

    Energy Technology Data Exchange (ETDEWEB)

    Brown, K.T.

    2002-10-18

    There have been numerous health studies or related activities over time that have involved workers at the Savannah River Site (SRS) or the surrounding public. While most of these epidemiology studies or activities have been performed by external agencies, it has proved useful to provide interested parties an overall summary of such activities. The first such summary was provided in an October 1998 report. The 1998 summary was updated in a February 2000 report. This report provides an update on the status or findings of epidemiology studies or activities involving SRS workers or the surrounding public, as an update to the previous summaries.

  2. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

    Science.gov (United States)

    Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

    2014-01-30

    As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

  3. A national evaluation of workplace-based assessment tools (WPBAs) in foundation dental training: a UK study. Effective and useful but do they provide an equitable training experience?

    Science.gov (United States)

    Kirton, J A; Palmer, N O A; Grieveson, B; Balmer, M C

    2013-03-01

    A questionnaire study was undertaken with trainers and trainees from 12 deaneries in England and Northern Ireland in June 2010 to evaluate workplace-based assessments (WPBAs) in foundation training. From the sample consisting of 741 trainers and 643 foundation trainees, experience of WPBAs was positive overall, playing an important role in trainees' learning during foundation training and building confidence. However, there is a need for comprehensive training in the WPBA tools used to ensure their efficacy.

  4. Orientation-specific surround suppression in the primary visual cortex varies as a function of autistic tendency

    Directory of Open Access Journals (Sweden)

    Anastasia V Flevaris

    2015-01-01

    Full Text Available Individuals with autism spectrum disorder (ASD exhibit superior performance on tasks that rely on local details in an image, and they exhibit deficits in tasks that require integration of local elements into a unified whole. These perceptual abnormalities have been proposed to underlie many of the characteristic features of ASD, but the underlying neural mechanisms are poorly understood. Here, we investigated the degree to which orientation-specific surround suppression, a well-known form of contextual modulation in visual cortex, is associated with autistic tendency in neurotypical individuals. Surround suppression refers to the phenomenon that the response to a stimulus in the receptive field of a neuron is suppressed when it is surrounded by stimuli just outside the receptive field. The suppression is greatest when the center and surrounding stimuli share perceptual features such as orientation. Surround suppression underlies a number of fundamental perceptual processes that are known to be atypical in individuals with ASD, including perceptual grouping and perceptual pop-out. However, whether surround suppression in the primary visual cortex (V1 is related to autistic traits has not been directly tested before. We used fMRI to measure the neural response to a center Gabor when it was surrounded by Gabors having the same or orthogonal orientation, and calculated a suppression index (SI for each participant that denoted the magnitude of suppression in the same versus orthogonal conditions. SI was positively correlated with degree of autistic tendency in each individual, as measured by the Autism Quotient (AQ scale, a questionnaire designed to assess autistic traits in the general population. Age also correlated with SI and with autistic tendency in our sample, but did not account for the correlation between SI and autistic tendency. These results suggest a reduction in orientation-specific surround suppression in V1 with increasing autistic

  5. Weight and its relationship to adolescent perceptions of their providers (WRAP): a qualitative and quantitative assessment of teen weight-related preferences and concerns.

    Science.gov (United States)

    Cohen, Marc L; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A

    2005-08-01

    To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 +/- 8.4 kg/m2) and 29 normal weight (BMI 22.5 +/- 4.0 kg/m2) adolescents (age 13.9 +/- 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = -.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider's office scale. Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one's provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term "overweight" for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction.

  6. Surrounding information consideration promotes cooperation in Prisoner’s dilemma game

    International Nuclear Information System (INIS)

    Shu, Gang; Du, Xia; Li, Ya

    2016-01-01

    Highlights: • A new method of strategy updating is proposed in the Prisoner’s dilemma game. • The stochastic players only consider their neighbor’s payoff and update strategy by classical Fermi rule. • The advanced player would consider not only the neighbor’s payoff but also the neighbors’ local surrounding information. • The simulation result illustrates that with the increase of advanced players in the network, the fraction of cooperation increases. - Abstract: Evolutionary game theory provides a useful, integrative framework for studying the evolution of cooperation. A new strategy updating method is proposed in our model. Due to people with diversified thinking, players are divided into two categories based on their different strategy updating method: ordinary players and advanced players. The former players only consider their neighbor’s payoff and updating strategy by classical Fermi rule, while the latter players take both the neighbors’ surrounding information and payoff into account. The results show that the neighbors surrounding information consideration contributes to the evolution of cooperation and finds the fraction of cooperation grows evidently with the increase of advanced players numbers. Our model may provide a pragmatic approach to the research of cooperation in social network.

  7. Group 12: Related Service Providers. IMPACT: The District of Columbia Public Schools Effectiveness Assessment System for School-Based Personnel, 2012-2013

    Science.gov (United States)

    District of Columbia Public Schools, 2012

    2012-01-01

    The 2012-2013 school year represents a pivotal juncture for DC Public Schools. Last spring, Mayor Gray and Chancellor Kaya Henderson introduced "A Capital Commitment," their ambitious plan to dramatically accelerate student achievement in the district over the next five years by providing all of their students with a safe, academically…

  8. Stability Evaluation on Surrounding Rocks of Underground Powerhouse Based on Microseismic Monitoring

    Directory of Open Access Journals (Sweden)

    Feng Dai

    2015-01-01

    Full Text Available To study the stability of underground powerhouse at Houziyan hydropower station during excavation, a microseismic monitoring system is adopted. Based on the space-time distribution characteristics of microseismic events during excavation of the main powerhouse, the correlation between microseismic events and blasting construction is established; and the microseismic clustering areas of the underground powerhouse are identified and delineated. The FLAC3D code is used to simulate the deformation of main powerhouse. The simulated deformation characteristics are consistent with that recorded by microseismic monitoring. Finally, the correlation between the macroscopic deformation of surrounding rock mass and microseismic activities is also revealed. The results show that multiple faults between 1# and 3# bus tunnels are activated during excavation of floors V and VI of the main powerhouse. The comprehensive method combining microseismic monitoring with numerical simulation as well as routine monitoring can provide an effective way to evaluate the surrounding rock mass stability of underground caverns.

  9. A Markov model assessing the impact on primary care practice revenues and patient's health when using mid-level providers, lesson learned from the United Kingdom.

    Science.gov (United States)

    Hill, Harry; Macey, Richard; Brocklehurst, Paul

    2017-09-01

    To evaluate the cost-effectiveness of using mid-level providers for dental "check-up" examinations and the treatment of caries in different NHS settings in the United Kingdom. Mid-level providers are a broad category that describes non-dentist members of dental teams. This study focused on the potential use of Dental Hygiene Therapists undertaking dental "check-up" examinations and simple restorative treatment, instead of dentists. A Markov model was used to construct the natural history of caries development in adults that visit a dental practice every six months over a five-year period. Three cost perspectives are taken: those borne to dental healthcare providers in England and Wales, Northern Ireland and Scotland. These represent three separate forms of retrospective payment system that are currently in use in the United Kingdom. The cost outcome was the average amount of retained practice earnings required to provide healthcare per patient visit. The health outcome was the average length of time in a cavity-free state and the cost-effectiveness outcome was incremental cost for six months in a cavity-free state. No statistical difference was found between dentists and mid-level providers in the length of time in a cavity-free state but the use of the latter saved money in all three NHS health system jurisdictions. This ranged from £7.85 (England and Wales) to £9.16 (Northern Ireland) per patient visit ($10.20 to $11.90, respectively) meaning the incremental cost for six month in a cavity-free state ranged from £261.67 ($339.93) in England and Wales to £305.33 ($369.68) in Northern Ireland. Further, changes in baseline assumptions and parameter values did not change mid-level providers being the dominant service intervention. In a time of limited funds for dental services, these results suggest that resources in public funded systems could be saved using mid-level providers in dental practices, without any health risk to patients or capital investment.

  10. Subtracted dynamic MR perfusion source images (sMRP-SI) provide collateral blood flow assessment in MCA occlusions and predict tissue fate

    International Nuclear Information System (INIS)

    Villringer, Kersten; Serrano-Sandoval, Rafael; Galinovic, Ivana; Ostwaldt, Ann-Christin; Brunecker, Peter; Fiebach, Jochen B.; Grittner, Ulrike; Schneider, Alice; Rocco, Andrea

    2016-01-01

    Collateral blood flow is accepted as a predictive factor of tissue fate in ischemic stroke. Thus, we aimed to evaluate a new method derived from MR perfusion source images to assess collateral flow in patients with ICA/MCA occlusions. A total of 132 patients of the prospective 1000+ study were examined. MR perfusion source images were assessed according to Δimg n = img n + 1 - img n - 1 using the five-grade Higashida collateral flow rating system. Higashida scores were correlated to mismatch (MM) volume, mismatch ratio, day 6 FLAIR lesion volumes and day 90 mRS. Patients with Higashida scores 3 and 4 had significantly lower admission NIHSS, smaller FLAIR day 6 lesion volumes (p < 0.001) and higher rates of better long-term outcome (mRS 0-2, p = 0.002). There was a linear trend for the association of Higashida grade 1 (p = 0.002) and 2 (p = 0.001) with unfavourable outcome (day 90 mRS 3-6), but no significant association was found for MM volume, MM ratio and day 90 mRS. Inter-rater agreement was 0.58 (95 % CI 0.43-0.73) on day 1, 0.70 (95 % CI 0.58-0.81) on day 2. sMRP-SI Higashida score offers a non-invasive collateral vessel and tissue perfusion assessment of ischemic tissue. The predictive value of Higashida rating proved superior to MM with regard to day 90 mRS. (orig.)

  11. Subtracted dynamic MR perfusion source images (sMRP-SI) provide collateral blood flow assessment in MCA occlusions and predict tissue fate

    Energy Technology Data Exchange (ETDEWEB)

    Villringer, Kersten; Serrano-Sandoval, Rafael; Galinovic, Ivana; Ostwaldt, Ann-Christin; Brunecker, Peter; Fiebach, Jochen B. [Charite-Universitaetsmedizin, Academic Neuroradiology, Center for Stroke Research (CSB), Berlin (Germany); Grittner, Ulrike [Charite, Universitaetsmedizin Berlin, Center for Stroke Research, Berlin (Germany); Charite, Department for Biostatistics and Clinical Epidemiology, Berlin (Germany); Schneider, Alice [Charite, Universitaetsmedizin Berlin, Center for Stroke Research, Berlin (Germany); Rocco, Andrea [Charite, Department of Neurology and Center for Stroke Research, Berlin (Germany)

    2016-05-15

    Collateral blood flow is accepted as a predictive factor of tissue fate in ischemic stroke. Thus, we aimed to evaluate a new method derived from MR perfusion source images to assess collateral flow in patients with ICA/MCA occlusions. A total of 132 patients of the prospective 1000+ study were examined. MR perfusion source images were assessed according to Δimg{sub n} = img{sub n} + 1 - img{sub n} - 1 using the five-grade Higashida collateral flow rating system. Higashida scores were correlated to mismatch (MM) volume, mismatch ratio, day 6 FLAIR lesion volumes and day 90 mRS. Patients with Higashida scores 3 and 4 had significantly lower admission NIHSS, smaller FLAIR day 6 lesion volumes (p < 0.001) and higher rates of better long-term outcome (mRS 0-2, p = 0.002). There was a linear trend for the association of Higashida grade 1 (p = 0.002) and 2 (p = 0.001) with unfavourable outcome (day 90 mRS 3-6), but no significant association was found for MM volume, MM ratio and day 90 mRS. Inter-rater agreement was 0.58 (95 % CI 0.43-0.73) on day 1, 0.70 (95 % CI 0.58-0.81) on day 2. sMRP-SI Higashida score offers a non-invasive collateral vessel and tissue perfusion assessment of ischemic tissue. The predictive value of Higashida rating proved superior to MM with regard to day 90 mRS. (orig.)

  12. Coordination of International Standards with Implementation of the IECRE Conformity Assessment System to Provide Multiple Certification Offerings for PV Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, George; Haring, Adrian; Spooner, Ted; Ball, Greg; Kurtz, Sarah; Heinze, Matthias; Yamamichi, Masaaki; Eguchi, Yoshihito; Ramu, Govind

    2016-11-21

    To help address the industry's needs for assuring the value and reducing the risk of investments in PV power plants; the International Electrotechnical Commission (IEC) has established a new conformity assessment system for renewable energy (IECRE). There are presently important efforts underway to define the requirements for various types of PV system certificates, and publication of the international standards upon which these certifications will be based. This paper presents a detailed analysis of the interrelationship of these activities and the timing for initiation of IECRE PV system certifications.

  13. Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians. PMID:24479405

  14. Weight and its relationship to adolescent perceptions of their providers (WRAP): A qualitative and quantitative assessment of teen weight-related preferences and concerns

    Science.gov (United States)

    Cohen, Marc L.; Tanofsky-Kraff, Marian; Young-Hyman, Deborah; Yanovski, Jack A.

    2008-01-01

    Purpose To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. Methods The Weight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 ± 8.4 kg/m2) and 29 normal weight (BMI 22.5 ± 4.0 kg/m2) adolescents (age 13.9 ± 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic). Results The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = −.22, p teens. Seventy-nine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p teens expressed concerns regarding the public location of their provider’s office scale. Conclusions Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one’s provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term “overweight” for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction. PMID:16026727

  15. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    Directory of Open Access Journals (Sweden)

    Hoffman Steven J

    2011-12-01

    Full Text Available Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs. Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140, Laos (136, Senegal (100 and Tanzania (121. Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497 across Ghana (107/140, Laos (136/136, Senegal (51/100 and Tanzania (78/121. Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13% or self-reported performing all five clinical practices according to established evidence (2%. Statistically significant factors associated with higher knowledge within each country included: 1 training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73; and 2 ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70. Statistically significant factors associated with better clinical practices within each country include: 1 reading scientific journals from their own country (OR

  16. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania.

    Science.gov (United States)

    Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric J A; Sidibe, Mintou Fall; Boupha, Boungnong

    2011-12-13

    Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working

  17. INTERACTION OF A LONG PILE OF FINITE STIFFNESS WITH SURROUNDING SOIL AND FOUNDATION CAP

    Directory of Open Access Journals (Sweden)

    Ter-Martirosyan Zaven Grigor’evich

    2015-09-01

    Full Text Available The article presents the formulation and analytical solution to a quantification of stress strain state of a two-layer soil cylinder enclosing a long pile, interacting with the cap. The solution of the problem is considered for two cases: with and without account for the settlement of the heel and the underlying soil. In the first case, the article is offering equations for determining the stresses of pile’s body and the surrounding soil according to their hardness and the ratio of radiuses of the pile and the surrounding soil cylinder, as well as formulating for determining equivalent deformation modulus of the system “cap-pile-surrounding soil” (the system. Assessing the carrying capacity of the soil under pile’s heel is of great necessity. In the second case, the article is solving a second-order differential equation. We gave the formulas for determining the stresses of the pile at its top and heel, as well as the variation of stresses along the pile’s body. The article is also formulating for determining the settlement of the foundation cap and equivalent deformation modulus of the system. It is shown that, pushing the pile into underlying layer results in the reducing of equivalent modulus of the system.

  18. Lead identification in soil surrounding a used lead acid battery smelter area in Banten, Indonesia

    International Nuclear Information System (INIS)

    Adventini, N; Santoso, M; Lestiani, D D; Syahfitri, W Y N; Rixson, L

    2017-01-01

    A used lead acid battery smelter generates particulates containing lead that can contaminate the surrounding environment area. Lead is a heavy metal which is harmful to health if it enters the human body through soil, air, or water. An identification of lead in soil samples surrounding formal and informal used lead acid battery smelters area in Banten, Indonesia using EDXRF has been carried out. The EDXRF accuracy and precision evaluated from marine sediment IAEA 457 gave a good agreement to the certified value. A number of 16 soil samples from formal and informal areas and 2 soil samples from control area were taken from surface and subsurface soils. The highest lead concentrations from both lead smelter were approximately 9 folds and 11 folds higher than the reference and control samples. The assessment of lead contamination in soils described in C f index was in category: moderately and strongly polluted by lead for formal and informal lead smelter. Daily lead intake of children in this study from all sites had exceeded the recommended dietary allowance. The HI values for adults and children living near both lead smelter areas were greater than the value of safety threshold 1. This study finding confirmed that there is a potential health risk for inhabitants surrounding the used lead acid battery smelter areas in Banten, Indonesia. (paper)

  19. INTERACTIONS OF THE INFRARED BUBBLE N4 WITH ITS SURROUNDINGS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hong-Li; Li, Jin-Zeng; Yuan, Jing-Hua; Huang, Maohai; Huang, Ya-Fang; Zhang, Si-Ju [National Astronomical Observatories, Chinese Academy of Sciences, 20A Datun Road, Chaoyang District, Beijing 100012 (China); Wu, Yuefang [Department of Astronomy, Peking University, 100871 Beijing (China); Liu, Tie [Korea Astronomy and Space Science Institute 776, Daedeokdae-ro, Yuseong-gu, Daejeon, 305-348 (Korea, Republic of); Dubner, G.; Paron, S.; Ortega, M. E. [1Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), CC 67, Suc. 28, 1428 Buenos Aires (Argentina); Molinari, Sergio [Istituto di Astrofisica e Planetologia Spaziali—IAPS, Istituto Nazionale di Astrofisica—INAF, via Fosso del Cavaliere 100, I-00133 Roma (Italy); Zavagno, Annie; Samal, Manash R., E-mail: hlliu@nao.cas.cn [Aix Marseille Universit, CNRS, LAM (Laboratoire d’Astrophysique de Marseille) UMR 7326, F-13388, Marseille (France)

    2016-02-10

    The physical mechanisms that induce the transformation of a certain mass of gas in new stars are far from being well understood. Infrared bubbles associated with H ii regions have been considered to be good samples for investigating triggered star formation. In this paper we report on the investigation of the dust properties of the infrared bubble N4 around the H ii region G11.898+0.747, analyzing its interaction with its surroundings and star formation histories therein, with the aim of determining the possibility of star formation triggered by the expansion of the bubble. Using Herschel PACS and SPIRE images with a wide wavelength coverage, we reveal the dust properties over the entire bubble. Meanwhile, we are able to identify six dust clumps surrounding the bubble, with a mean size of 0.50 pc, temperature of about 22 K, mean column density of 1.7 × 10{sup 22} cm{sup −2}, mean volume density of about 4.4 × 10{sup 4} cm{sup −3}, and a mean mass of 320 M{sub ⊙}. In addition, from PAH emission seen at 8 μm, free–free emission detected at 20 cm, and a probability density function in special regions, we could identify clear signatures of the influence of the H ii region on the surroundings. There are hints of star formation, though further investigation is required to demonstrate that N4 is the triggering source.

  20. Blooming Trees: Substructures and Surrounding Groups of Galaxy Clusters

    Science.gov (United States)

    Yu, Heng; Diaferio, Antonaldo; Serra, Ana Laura; Baldi, Marco

    2018-06-01

    We develop the Blooming Tree Algorithm, a new technique that uses spectroscopic redshift data alone to identify the substructures and the surrounding groups of galaxy clusters, along with their member galaxies. Based on the estimated binding energy of galaxy pairs, the algorithm builds a binary tree that hierarchically arranges all of the galaxies in the field of view. The algorithm searches for buds, corresponding to gravitational potential minima on the binary tree branches; for each bud, the algorithm combines the number of galaxies, their velocity dispersion, and their average pairwise distance into a parameter that discriminates between the buds that do not correspond to any substructure or group, and thus eventually die, and the buds that correspond to substructures and groups, and thus bloom into the identified structures. We test our new algorithm with a sample of 300 mock redshift surveys of clusters in different dynamical states; the clusters are extracted from a large cosmological N-body simulation of a ΛCDM model. We limit our analysis to substructures and surrounding groups identified in the simulation with mass larger than 1013 h ‑1 M ⊙. With mock redshift surveys with 200 galaxies within 6 h ‑1 Mpc from the cluster center, the technique recovers 80% of the real substructures and 60% of the surrounding groups; in 57% of the identified structures, at least 60% of the member galaxies of the substructures and groups belong to the same real structure. These results improve by roughly a factor of two the performance of the best substructure identification algorithm currently available, the σ plateau algorithm, and suggest that our Blooming Tree Algorithm can be an invaluable tool for detecting substructures of galaxy clusters and investigating their complex dynamics.

  1. Radiological impact on the surrounding area of Cernavoda NPP operation

    International Nuclear Information System (INIS)

    Busnita, M.; Penescu, M.; Neacsu, L.; Ion, M.; Moldoveanu, E.

    1996-01-01

    The objective of this paper is to present the protective measures provided to Cernavoda NPP for population and environment in case of normal operation and accidental situations. The paper describes the nuclear safety concept with the two aspects, the technical safety and the radiation protection, respectively, which represent the theoretical basis of the NPP design, construction and operation. The assessment of the potential radiological effects of Cernavoda NPP operation on the population and other environmental factors have been done by using the following input data: the natural and social characteristics of the site and the technical characteristics of the plant. The effects of Cernavoda NPP operation are also exposed in health risks which are compared with the daily risks of the population exposed of the natural phenomena or to the activities like transportation, domestics or industrial. (author). 1 tab., 6 refs

  2. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    OpenAIRE

    Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Ndossi, Godwin D; Osei, Eric JA; Sidibe, Mintou Fall; Boupha, Boungnong

    2011-01-01

    Abstract Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization ...

  3. Process assessment associated to microbial community response provides insight on possible mechanism of waste activated sludge digestion under typical chemical pretreatments

    DEFF Research Database (Denmark)

    Zhou, Aijuan; Zhang, Jiaguang; Varrone, Cristiano

    2017-01-01

    was dominated by microorganisms that anaerobically hydrolyze organics to acids, while that in NaOH and SDS was mainly associated to biogas production. This study proved that the overall performance of WAS digestion was substantially depended on the initial chemical pretreatments, which in turn influenced...... and was related to the microbial community structures. Although the economic advantage might not be clear yet, the findings obtained in this work may provide a scientific basis for the potential implementation of chemicals for WAS treatment....

  4. Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr).

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S

    2015-08-01

    This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'scommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Rapid assessment of ecosystem services provided by two mineral extraction sites restored for nature conservation in an agricultural landscape in eastern England.

    Science.gov (United States)

    Blaen, Phillip J; Jia, Li; Peh, Kelvin S-H; Field, Rob H; Balmford, Andrew; MacDonald, Michael A; Bradbury, Richard B

    2015-01-01

    Despite growing recognition that mineral sites restored for nature conservation can enhance local biodiversity, the wider societal benefits provided by this type of restoration relative to alternative options are not well understood. This study addresses this research gap by quantifying differences in ecosystem services provision under two common mineral site after-uses: nature conservation and agriculture. Using a combination of site-specific primary field data, benefits transfer and modelling, we show that for our sites restoration for nature conservation provides a more diverse array of ecosystem services than would be delivered under an agricultural restoration scenario. We also explore the effects of addressing different conservation targets, which we find alter the provision of ecosystem services on a service-specific basis. Highly species-focused intervention areas are associated with increased carbon storage and livestock grazing provision, whereas non-intervention areas are important for carbon sequestration, fishing, recreation and flood risk mitigation. The results of this study highlight the wider societal importance of restored mineral sites and may help conservation managers and planners to develop future restoration strategies that provide benefits for both biodiversity and human well-being.

  6. Impact of Family History Assessment on Communication with Family Members and Health Care Providers: A report from the Family Healthware™ Impact Trial (FHITr)

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.

    2015-01-01

    Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (psfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453

  7. Earthquakes in Switzerland and surrounding regions during 2007

    Energy Technology Data Exchange (ETDEWEB)

    Baer, M.; Deichmann, N.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S

    2008-12-15

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2007. During this period, 531 earthquakes and 92 quarry blasts were detected and located in the region under consideration. Of these earthquakes, 30 are aftershocks of the stimulation of a proposed geothermal reservoir beneath the city of Basel in December of 2006. With 20 events with {mu}{sub {iota}} {>=} 2.5, four of which were artificially induced, the seismic activity in the year 2007 was far below the average over the previous 32 years. (author)

  8. Isoperimetric inequalities in surround system and space science

    OpenAIRE

    JiaJin Wen; Jun Yuan; ShanHe Wu

    2016-01-01

    Abstract By means of the algebraic, analysis, convex geometry, computer, and inequality theories we establish the following isoperimetric inequality in the centered 2-surround system S ( 2 ) { P , Γ , l } $S^{(2)} \\{P,\\varGamma ,l \\}$ : ( 1 | Γ | ∮ Γ r ¯ P p ) 1 / p ⩽ | Γ | 4 π sin l π | Γ | [ csc l π | Γ | + cot 2 l π | Γ | ln ( tan l π | Γ | + sec l π | Γ | ) ] , ∀ p ⩽ − 2 . $$\\begin{aligned}& \\biggl(\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\bar{r}_{P}^{p} \\biggr)^{1/p}\\leqslant\\frac{|\\varG...

  9. Mutual seismic interaction between tunnels and the surrounding granular soil

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Abdel-Motaal

    2014-12-01

    Study results show that the maximum exerted straining actions in tunnel lining are directly proportional to the relative stiffness between tunnel and surrounding soil (lining thickness and soil shear modulus. Moreover, it is highly affected by the peak ground acceleration and the tunnel location (embedment depth. A comprehensive study is performed to show the effect of tunnel thickness and tunnel diameter on both the induced bending moment and lining deformation. In general, it is concluded that seismic analysis should be considered in regions subjected to peak ground acceleration greater than 0.15g.

  10. Earthquakes in Switzerland and surrounding regions during 2007

    International Nuclear Information System (INIS)

    Baer, M.; Deichmann, N.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S.

    2008-01-01

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2007. During this period, 531 earthquakes and 92 quarry blasts were detected and located in the region under consideration. Of these earthquakes, 30 are aftershocks of the stimulation of a proposed geothermal reservoir beneath the city of Basel in December of 2006. With 20 events with Μ ι ≥ 2.5, four of which were artificially induced, the seismic activity in the year 2007 was far below the average over the previous 32 years. (author)

  11. Diversity of vascular plants of Piestany and surroundings

    International Nuclear Information System (INIS)

    Penzesova, A.; Galusova, T.

    2013-01-01

    In the present work is a summary of the results of floristic research aimed at determining diversity of vascular plants of Piestany and its surroundings. Plant taxa we determined using the designation keys. We have compiled a list of plant species occurring in the monitored area, we evaluated the selected botanical-phytogeographical characteristics of flora, we've put together a list of local protected, endangered and rare species and a list of local invasive and expansive species according to sources. (Authors)

  12. One Japanese case on taxation surrounding foreign trust

    OpenAIRE

    SUZUKI, Yuya

    2015-01-01

    Taxation surrounding trust at cross-border situation is paid attention to byworldwide basis. Japan is not exception. According to recent Japanesejurisprudence, where a trust had been established in accordance with State law ofNew Jersey, the U.S., it was disputed whether or not the act settling that trust fellwithin “shintaku koui (an act of trust)” and one of the related members, who had beena minor child at that time, fell within “jyueki sha (beneficiary)” under JapaneseInheritance Tax Act....

  13. MicroCT Bone Densitometry: Context Sensitivity, Beam Hardening Correction and the Effect of Surrounding Media

    Directory of Open Access Journals (Sweden)

    Philip L. Salmon

    2014-12-01

    Full Text Available The context-sensitivity of microCT bone densitometry due to beam hardening artefacts was assessed. Bones and teeth are scanned with varying thickness of surrounding media (water, alcohol, biological tissue and it is important to understand how this affects reconstructed attenuation (“density” of the mineralized tissue. Aluminium tubes and rods with thickness 0.127mm–5mm were scanned both in air or surrounded by up to 2cm of water. Scans were performed with different energy filters and degrees of software beam hardening correction (BHC. Also tested were the effects of signal-to-noise ratio, magnification and truncation. The thickness of an aluminium tube significantly affected its mean reconstructed attenuation. This effect of thickness could be reduced substantially by BHC for scans in air, but not for scans in water. Varying thickness of surrounding water also changed the mean attenuation of an aluminium tube. This artefact could be almost eliminated by an optimal BHC value. The “cupping” artefact of heterogeneous attenuation (elevated at outer surfaces could be corrected if aluminium was scanned in air, but in water BHC was much less effective. Scan truncation, changes to magnification and signal-to-noise ratio also caused artificial changes to measured attenuation. Measurement of bone mineral density by microCT is highly context sensitive. A surrounding layer of liquid or biological tissue reduces the ability of software BHC to remove bone density artefacts. Sample thickness, truncation, magnification and signal to noise ratio also affect reconstructed attenuation. Thus it is important for densitometry that sample and calibration phantom dimensions and mounting materials are standardised.

  14. Myocardial multilayer strain does not provide additional value for detection of myocardial viability assessed by SPECT imaging over and beyond standard strain.

    Science.gov (United States)

    Orloff, Elisabeth; Fournier, Pauline; Bouisset, Frédéric; Moine, Thomas; Cournot, Maxime; Elbaz, Meyer; Carrié, Didier; Galinier, Michel; Lairez, Olivier; Cognet, Thomas

    2018-05-14

    The aim of this study was to evaluate the value of multilayer strain analysis to the assessment of myocardial viability (MV) through the comparison of both speckle tracking echocardiography and single-photon emission computed tomography (SPECT) imaging. We also intended to determine which segmental longitudinal strain (LS) cutoff value would be optimal to discriminate viable myocardium. We included 47 patients (average age: 61 ± 11 years) referred to our cardiac imaging center for MV evaluation. All patients underwent transthoracic echocardiography with measures of LS, SPECT, and coronary angiography. In all, 799 segments were analyzed. We correlated myocardial tracer uptake by SPECT with sub-endocardial, sub-epicardial, and mid-segmental LS values with r = .514 P Multilayer strain analysis does not evaluate MV with more accuracy than standard segmental LS analysis. © 2018 Wiley Periodicals, Inc.

  15. The perceived value of clinical pharmacy service provision by pharmacists and physicians: an initial assessment of family medicine and internal medicine providers.

    Science.gov (United States)

    Wietholter, Jon P; Ponte, Charles D; Long, Dustin M

    2017-10-01

    Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists. The secondary objective was to evaluate perceived differences of clinical pharmacist benefit between IM and FM physicians. An eight-item questionnaire assessed the attitudes and beliefs of pharmacists and physicians regarding the value of clinical pharmacy services. Surveys were emailed and participants marked their responses using a 7-point Likert scale for each item. Demographic data and overall comments were collected from each participant. Overall, 167 surveys were completed. When comparing cumulative physician and pharmacist responses, none of the eight questions showed significant differences. Statistically significant differences were noted when comparing IM and FM clinical pharmacists on five of the eight survey items; for each of these items, FM pharmacists had more favourable perceptions than their IM counterparts. No statistically significant differences were noted when comparing responses of IM and FM physicians. This study found that FM pharmacists perceived a greater benefit regarding participation in inpatient acute care rounds when compared to their IM pharmacist counterparts. Future studies are necessary to determine if other medical specialties' perceptions of clinical pharmacy provision differ from our findings and to evaluate the rationale behind specific attitudes and behaviours. © 2016 Royal Pharmaceutical Society.

  16. Transcranial magnetic stimulation provides means to assess cortical plasticity and excitability in humans with fragile X syndrome and autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Lindsay M Oberman

    2010-06-01

    Full Text Available Fragile X Syndrome (FXS is the most common heritable cause of intellectual disability. In vitro electrophysiologic data from mouse models of FXS suggest that loss of Fragile X Mental Retardation Protein (FMRP affects intracortical excitability and synaptic plasticity. Specifically, the cortex appears hyperexcitable, and use-dependent long-term potentiation (LTP and long-term depression (LTD of synaptic strength are abnormal. Though animal models provide important information, FXS and other neurodevelopmental disorders are human diseases and as such translational research to evaluate cortical excitability and plasticity must be applied in the human. Transcranial magnetic stimulation (TMS paradigms have recently been developed to noninvasively investigate cortical excitability using paired-pulse stimulation, as well as LTP- and LTD-like synaptic plasticity in response to theta burst stimulation (TBS in vivo in the human. TBS applied on consecutive days can be used to measure metaplasticity (the ability of the synapse to undergo a second plastic change following a recent induction of plasticity. The current study investigated intracortical inhibition, plasticity and metaplasticity in full mutation females with FXS, participants with autism spectrum disorders (ASD, and neurotypical controls. Results suggest that intracortical inhibition is normal in participants with FXS, while plasticity and metaplasticity appear abnormal. ASD participants showed abnormalities in plasticity and metaplasticity, as well as heterogeneity in intracortical inhibition. Our findings highlight the utility of noninvasive neurophysiological measures to translate insights from animal models to humans with neurodevelopmental disorders, and thus provide direct confirmation of cortical dysfunction in patients with FXS and ASD.

  17. Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol.

    Science.gov (United States)

    Oostendorp, Linda J M; Ottevanger, Petronella B; van der Graaf, Winette T A; Stalmeier, Peep F M

    2011-02-14

    There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group. This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will

  18. REMOTE SENSING EFFICIENCY FOR URBAN ANALYSIS OF MECCA AND SURROUNDS

    Directory of Open Access Journals (Sweden)

    A. Imam

    2016-06-01

    Full Text Available Situated in the southwest of Saudi Arabia, Mecca is considered the spiritual capital of one and a half billion worldwide Muslims. The city is visited by millions of pilgrims every year. It has undergone significant changes in land cover (LC since the government first embarked on a series of ambitious development projects 20 years ago to accommodate the growing number of pilgrims and citizens. The main objective of our study is to detect, identify, analyze and measure the evolving land cover and urban morphology composition from multi-temporal satellite images. To characterize the morphological change during a period of twenty years, four satellite images, acquired in 1998 by Landsat TM and in 2003, 2008 and 2013 by Landsat ETM+, were classified into five main categories: Urban, Street, Soil and Vegetation. In addition, DEM has been extracted and included as Mountain. Change detection (CD analysis is applied using post-classification comparison and GIS. As part of the study, morphological index, such as, Entropy is included for better understanding of urban structures behaviour. Mecca and its surroundings show a noticeable increase in urban and vegetation cover. Urban cover (UC changes were divided into five radial directions: Northeast, Southeast, Southwest, East, and Northwest. These changes are influenced by mountain ranges surrounding the city and the highways. These revelations can play a significant role towards future planning and development activities, which may further promote urban growth.

  19. Remote Sensing Efficiency for Urban Analysis of Mecca and Surrounds

    Science.gov (United States)

    Imam, Ayman; Alhaddad, Bahaa; Roca, Josep

    2016-06-01

    Situated in the southwest of Saudi Arabia, Mecca is considered the spiritual capital of one and a half billion worldwide Muslims. The city is visited by millions of pilgrims every year. It has undergone significant changes in land cover (LC) since the government first embarked on a series of ambitious development projects 20 years ago to accommodate the growing number of pilgrims and citizens. The main objective of our study is to detect, identify, analyze and measure the evolving land cover and urban morphology composition from multi-temporal satellite images. To characterize the morphological change during a period of twenty years, four satellite images, acquired in 1998 by Landsat TM and in 2003, 2008 and 2013 by Landsat ETM+, were classified into five main categories: Urban, Street, Soil and Vegetation. In addition, DEM has been extracted and included as Mountain. Change detection (CD) analysis is applied using post-classification comparison and GIS. As part of the study, morphological index, such as, Entropy is included for better understanding of urban structures behaviour. Mecca and its surroundings show a noticeable increase in urban and vegetation cover. Urban cover (UC) changes were divided into five radial directions: Northeast, Southeast, Southwest, East, and Northwest. These changes are influenced by mountain ranges surrounding the city and the highways. These revelations can play a significant role towards future planning and development activities, which may further promote urban growth.

  20. MRI of normal pituitary glands and their surrounding structures

    International Nuclear Information System (INIS)

    Sato, Yoshiyuki

    1991-01-01

    Normal MRI appearances of the pituitary glands and their surrounding structures were evaluated in 332 patients without sellar and parasellar diseases. The height of the pituitary gland was maximum at 10-19 years of age reflecting hormonal activity. The width of the pituitary gland decreased, while that of the cavernous sinus increased with aging. This is probably due to atherosclerotic change of the internal carotid artery. Females younger than 30 years of age tended to show a convex upper surface of the pituitary gland and the displacement of the pituitary stalk was common after 50 years of age. Almost all of the anterior lobe of the pituitary gland showed isointensity relative to the pons or cerebral cortex and the majority (85.1%) of the posterior lobe showed hyperintensity. However, the anterior lobe in 2 newborns showed hyperintensity similar to the normal posterior lobe in adults. The posterior lobe was located off the midline in 19.1% of the subjects. One case of pars intermedia cyst was discovered among 14 subjects who were administered Gd-DTPA. The dural membrane between the pituitary gland and cavernous sinus was recognizable only in 8.6% on the right side and 7.5% on the left side. Primary empty sella was identified in 4.5%. Knowledge of the above normal ranges and variations of the pituitary gland and its surrounding structures is important in diagnosing sellar and parasellar lesions. (author) 52 refs

  1. TRIGGERED STAR FORMATION SURROUNDING WOLF-RAYET STAR HD 211853

    Energy Technology Data Exchange (ETDEWEB)

    Liu Tie; Wu Yuefang; Zhang Huawei [Department of Astronomy, Peking University, 100871 Beijing (China); Qin Shengli, E-mail: liutiepku@gmail.com [I. Physikalisches Institut, Universitaet zu Koeln, Zuelpicher Str. 77, 50937 Koeln (Germany)

    2012-05-20

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 10{sup 3} cm{sup -3} and kinematic temperature {approx}20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core 'A', which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the 'collect and collapse' process functions in this region. The star-forming activities in core 'A' seem to be affected by the 'radiation-driven implosion' process.

  2. TRIGGERED STAR FORMATION SURROUNDING WOLF-RAYET STAR HD 211853

    International Nuclear Information System (INIS)

    Liu Tie; Wu Yuefang; Zhang Huawei; Qin Shengli

    2012-01-01

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 10 3 cm –3 and kinematic temperature ∼20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core 'A', which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the 'collect and collapse' process functions in this region. The star-forming activities in core 'A' seem to be affected by the 'radiation-driven implosion' process.

  3. Complex monitoring of the surroundings of the Dukovany nuclear power plant

    International Nuclear Information System (INIS)

    Tylova, E.

    1993-01-01

    Based on a Resolution of the Government of the Czech Republic, the Ministry of the Environment and the Ministry of Health of the Czech Republic shall develop a project of complex environmental pollution and contamination monitoring in the surroundings of the Dukovany nuclear power plant and shall discuss this project with municipalities there till the end of 1993. The objective of the project is to assess in a complex manner the situation in the Dukovany area with respect to all risks and their simultaneous effects, so as to ensure that the population in the area concerned is not burdened to an intolerable extent. (Z.S.)

  4. Assessing the value and pest management window provided by neonicotinoid seed treatments for management of soybean aphid (Aphis glycines Matsumura) in the Upper Midwestern United States.

    Science.gov (United States)

    Krupke, Christian H; Alford, Adam M; Cullen, Eileen M; Hodgson, Erin W; Knodel, Janet J; McCornack, Brian; Potter, Bruce D; Spigler, Madeline I; Tilmon, Kelley; Welch, Kelton

    2017-10-01

    A 2-year, multi-state study was conducted to assess the benefits of using soybean seed treated with the neonicotinoid thiamethoxam to manage soybean aphid in the upper Midwestern USA and compare this approach with an integrated pest management (IPM) approach that included monitoring soybean aphids and treating with foliar-applied insecticide only when the economic threshold was reached. Concentrations of thiamethoxam in soybean foliage were also quantified throughout the growing season to estimate the pest management window afforded by insecticidal seed treatments. Both the IPM treatment and thiamethoxam-treated seed resulted in significant reductions in cumulative aphid days when soybean aphid populations reached threshold levels. However, only the IPM treatment resulted in significant yield increases. Analysis of soybean foliage from thiamethoxam-treated seeds indicated that tissue concentrations of thiamethoxam were statistically similar to plants grown from untreated seeds beginning at the V2 growth stage, indicating that the period of pest suppression for soybean aphid is likely to be relatively short. These data demonstrate that an IPM approach, combining scouting and foliar-applied insecticide where necessary, remains the best option for treatment of soybean aphids, both in terms of protecting the yield potential of the crop and of break-even probability for producers. Furthermore, we found that thiamethoxam concentrations in foliage are unlikely to effectively manage soybean aphids for most of the pests' activity period across the region. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  5. Normalized STEAM-based diffusion tensor imaging provides a robust assessment of muscle tears in football players: preliminary results of a new approach to evaluate muscle injuries.

    Science.gov (United States)

    Giraudo, Chiara; Motyka, Stanislav; Weber, Michael; Karner, Manuela; Resinger, Christoph; Feiweier, Thorsten; Trattnig, Siegfried; Bogner, Wolfgang

    2018-02-08

    To assess acute muscle tears in professional football players by diffusion tensor imaging (DTI) and evaluate the impact of normalization of data. Eight football players with acute lower limb muscle tears were examined. DTI metrics of the injured muscle and corresponding healthy contralateral muscle and of ROIs drawn in muscle tears (ROI tear ) in the corresponding healthy contralateral muscle (ROI hc_t ) in a healthy area ipsilateral to the injury (ROI hi ) and in a corresponding contralateral area (ROI hc_i ) were compared. The same comparison was performed for ratios of the injured (ROI tear /ROI hi ) and contralateral sides (ROI hc_t /ROI hc_i ). ANOVA, Bonferroni-corrected post-hoc and Student's t-tests were used. Analyses of the entire muscle did not show any differences (p>0.05 each) except for axial diffusivity (AD; p=0.048). ROI tear showed higher mean diffusivity (MD) and AD than ROI hc_t (ptear than in ROI hi and ROI hc_t (ptear than in any other ROI (pmuscle tears in athletes especially after normalization to healthy muscle tissue. • STEAM-based DTI allows the investigation of muscle tears affecting professional football players. • Fractional anisotropy and mean diffusivity differ between injured and healthy muscle areas. • Only normalized data show differences of fibre tracking metrics in muscle tears. • The normalization of DTI-metrics enables a more robust characterization of muscle tears.

  6. Caving thickness effects of surrounding rocks macro stress shell evolving characteristics

    Institute of Scientific and Technical Information of China (English)

    XIE Guang-xiang; YANG Ke

    2009-01-01

    In order to explore the influence of different caving thicknesses on the MSS dis-tribution and evolving characteristics of surrounding rocks in unsymmetrical disposal and fully mechanized top-coal caving (FMTC), based on unsymmetrical disposal characteris-tics, the analyses of numerical simulation, material simulation and in-situ observation were synthetically applied according to the geological and technical conditions of the 1151(3) working face in Xieqiao Mine. The results show that the stress peak value of the MSS-base and the ratio of MSS-body height to caving thickness are nonlinear and inversely proportional to the caving thickness. The MSS-base width, the MSS-body height, the MSS-base distance to working face wall and the rise distance of MSS-base beside coal pillar are nonlinear and directly proportional to the caving thickness. The characteristics of MSS distribution and its evolving rules of surrounding rocks and the integrated caving thickness effects are obtained. The investigations will provide lots of theoretic references to the surrounding rocks' stability control of the working face and roadway, roadway layout, gas extraction and exploitation, and efficiency of caving, etc.

  7. Three-dimensional numerical analysis of stress and deformation of surrounding soil in safety construction of metro station

    International Nuclear Information System (INIS)

    Fung, I W H; Wang, J A; Au, A S K; Zhou, Y F

    2008-01-01

    Utilizing underground spaces synthetically has become an important task in urban planning and civil engineering in this century. Due to the complexity and uncertainty of technical issues in underground construction and soil engineering, construction safety arouses a great concern in underground construction industry. This paper focused on construction of an underground metro station, numerical analyses are carried out to estimate the possible stresses and deformations of surrounding soil and underground structures under the worse loading conditions to assess the structural design and construction safety. Influences of pit excavation on existing tunnel and surrounding spaces are discussed and the stability of main structure of metro station will be analyzed

  8. Quality Assessment of Process Measures in Antimicrobial Stewardship: Concordance of Valacyclovir Indication and Automatic Prospective Approval in Computerized Provider Order Entry

    Science.gov (United States)

    Lee, Tiffany; McCoy, Christopher; Mahoney, Monica V

    2017-01-01

    Abstract Background The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recommend computerized decision support at the time of prescribing as an antimicrobial stewardship (AST) tool. Providing antimicrobial indications during prescribing can optimize infection-specific therapy through appropriate antimicrobial selection, dosing, and frequency. The Leapfrog group identifies this as a quality measure for their report card system. At Beth Israel Deaconess Medical Center (BIDMC), indication-based dosing has been incorporated in the computerized provider order entry (CPOE) system since 2006. At BIDMC, valacyclovir is only approved for the treatment of varicella zoster (VZV) infection or prophylaxis of solid organ transplant (SOT) patients at low risk for cytomegalovirus. These indications bypass the need for AST approval. Accuracy validation of the selected indications has not been formally performed. Methods A retrospective chart review was performed in patients prescribed valacyclovir during an 8-month period in 2016. Electronic medical records, laboratory reports, and pharmacy records were reviewed to identify the suspected/confirmed infection. The primary outcome was the concordance rate of selected CPOE valacyclovir indication compared with suspected/confirmed infection at the time of ordering. The secondary outcome was the proportion of valacyclovir use per institutional protocol. Results Overall, 117 patients were included, with a median age of 57.9 years, 51 (43.6%) were male, and 4 (3.4%) were located in an intensive care unit. Fifty-nine orders (50.4%) selected VZV as the indication, followed by 21 orders (17.9%) for SOT prophylaxis. Of orders with any CPOE indication, only 59/101 (58.4%) were concordant with suspected/confirmed infection. Of the valacyclovir orders with a VZV indication, 37 (62.7%) were concordant. Of the orders with SOT prophylaxis indications, 5 (23.8%) were concordant

  9. TeleWound care – providing remote wound assessment and treatment in the home care setting: current status and future directions

    Directory of Open Access Journals (Sweden)

    Santamaria N

    2013-11-01

    Full Text Available Nick Santamaria,1 Suzanne Kapp2 1University of Melbourne and Melbourne Health, Royal Melbourne Hospital, Melbourne, VIC, Australia; 2Royal District Nursing Service Institute, Melbourne, VIC, Australia Abstract: The use of wound telemedicine systems in the home care environment has been expanding for the last decade. These systems can generally be grouped into two main types: store and forward systems and video conference type systems; additionally, there are also hybrid systems available that include elements of both. Evidence to date suggests that these systems provide significant benefits to patients, clinicians, and to the health care system generally. Reductions in resource use, visit substitution, costs, and high patient and clinician satisfaction have been reported; however, there is a lack of integration with existing health care technology and no clearly defined technical or clinical standards as yet. Similarly, the legalities associated with wound telemedicine and remote consultation remain unclear. As wound telemedicine systems continue to evolve and be deployed in different locations, there remains significant potential to harness their power to benefit patients being treated at home. Keywords: telemedicine, home care, e-health

  10. Field assessment of semi-aerobic condition and the methane correction factor for the semi-aerobic landfills provided by IPCC guidelines

    International Nuclear Information System (INIS)

    Jeong, Sangjae; Nam, Anwoo; Yi, Seung-Muk; Kim, Jae Young

    2015-01-01

    Highlights: • CH 4 /CO 2 and CH 4 + CO 2 % are proposed as indices to evaluate semi-aerobic landfills. • A landfill which CH 4 /CO 2 > 1.0 is difficult to be categorized as semi-aerobic landfill. • Field conditions should be carefully investigated to determine landfill types. • The MCF default value for semi-aerobic landfills underestimates the methane emissions. - Abstract: According to IPCC guidelines, a semi-aerobic landfill site produces one-half of the amount of CH 4 produced by an equally-sized anaerobic landfill site. Therefore categorizing the landfill type is important on greenhouse gas inventories. In order to assess semi-aerobic condition in the sites and the MCF value for semi-aerobic landfill, landfill gas has been measured from vent pipes in five semi-aerobically designed landfills in South Korea. All of the five sites satisfied requirements of semi-aerobic landfills in 2006 IPCC guidelines. However, the ends of leachate collection pipes which are main entrance of air in the semi-aerobic landfill were closed in all five sites. The CH 4 /CO 2 ratio in landfill gas, indicator of aerobic and anaerobic decomposition, ranged from 1.08 to 1.46 which is higher than the values (0.3–1.0) reported for semi-aerobic landfill sites and is rather close to those (1.0–2.0) for anaerobic landfill sites. The low CH 4 + CO 2 % in landfill gas implied air intrusion into the landfill. However, there was no evidence that air intrusion has caused by semi-aerobic design and operation. Therefore, the landfills investigated in this study are difficult to be classified as semi-aerobic landfills. Also MCF of 0.5 may significantly underestimate methane emissions compared to other researches. According to the carbon mass balance analyses, the higher MCF needs to be proposed for semi-aerobic landfills. Consequently, methane emission estimate should be based on field evaluation for the semi-aerobically designed landfills

  11. Field assessment of semi-aerobic condition and the methane correction factor for the semi-aerobic landfills provided by IPCC guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Sangjae [Department of Civil and Environmental Engineering, College of Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 (Korea, Republic of); Nam, Anwoo [Korea Environment Corporation, 42 Hwangyeong-ro, Seo-gu, Incheon 404-170 (Korea, Republic of); Yi, Seung-Muk [Department of Environmental Health, School of Public Health, Seoul National University, Seoul 151-742 (Korea, Republic of); Kim, Jae Young, E-mail: jaeykim@snu.ac.kr [Department of Civil and Environmental Engineering, College of Engineering, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742 (Korea, Republic of)

    2015-02-15

    Highlights: • CH{sub 4}/CO{sub 2} and CH{sub 4} + CO{sub 2}% are proposed as indices to evaluate semi-aerobic landfills. • A landfill which CH{sub 4}/CO{sub 2} > 1.0 is difficult to be categorized as semi-aerobic landfill. • Field conditions should be carefully investigated to determine landfill types. • The MCF default value for semi-aerobic landfills underestimates the methane emissions. - Abstract: According to IPCC guidelines, a semi-aerobic landfill site produces one-half of the amount of CH{sub 4} produced by an equally-sized anaerobic landfill site. Therefore categorizing the landfill type is important on greenhouse gas inventories. In order to assess semi-aerobic condition in the sites and the MCF value for semi-aerobic landfill, landfill gas has been measured from vent pipes in five semi-aerobically designed landfills in South Korea. All of the five sites satisfied requirements of semi-aerobic landfills in 2006 IPCC guidelines. However, the ends of leachate collection pipes which are main entrance of air in the semi-aerobic landfill were closed in all five sites. The CH{sub 4}/CO{sub 2} ratio in landfill gas, indicator of aerobic and anaerobic decomposition, ranged from 1.08 to 1.46 which is higher than the values (0.3–1.0) reported for semi-aerobic landfill sites and is rather close to those (1.0–2.0) for anaerobic landfill sites. The low CH{sub 4} + CO{sub 2}% in landfill gas implied air intrusion into the landfill. However, there was no evidence that air intrusion has caused by semi-aerobic design and operation. Therefore, the landfills investigated in this study are difficult to be classified as semi-aerobic landfills. Also MCF of 0.5 may significantly underestimate methane emissions compared to other researches. According to the carbon mass balance analyses, the higher MCF needs to be proposed for semi-aerobic landfills. Consequently, methane emission estimate should be based on field evaluation for the semi-aerobically designed landfills.

  12. MAPPING THE SURROUNDINGS AS A REQUIREMENT FOR AUTONOMOUS DRIVING

    Directory of Open Access Journals (Sweden)

    M. Steininger

    2016-11-01

    Full Text Available Motivated by the hype around driverless cars and the challenges of the sensor integration and data processing, this paper presents a model for using a XBox One Microsoft Kinect stereo camera as sensor for mapping the surroundings. Today, the recognition of the environment of the car is mostly done by a mix of sensors like LiDAR, RADAR and cameras. In the case of the outdoor delivery challenge Robotour 2016 with model cars in scale 1:5, it is our goal to solve the task with one camera only. To this end, a three-stage approach was developed. The test results show that our approach can detect and locate objects at a range of up to eight meters in order to incorporate them as barriers in the navigation process.

  13. Natural occurring radioactivity in Palmyra and its surrounding

    International Nuclear Information System (INIS)

    Al-Masri, M. S.; Shwekani, R.; Raja, G.; Hushari, M.; Al-Hent, R.; Issa, M.

    2006-06-01

    In this work, the natural radiation background has been carried out for Palmyra city and its surroundings area. The study has covered gamma radiation measurements, indoor radon gas concentration and radionuclides levels in environmental samples (soil, water, plat). The results showed that indoor radon gas concentrations and radiation exposure rates are within the background levels. Also, the results showed that there is no artificial radiation in the area and there is no correlation between the natural radiation levels and the reported cancer cases. Therefore, the reported cancer cases in this area may be due to non-radiation cases, which must be investigated, or they are within the natural levels in Syria unless accurate statistics proves the opposite. (author)

  14. Precision Security: Integrating Video Surveillance with Surrounding Environment Changes

    Directory of Open Access Journals (Sweden)

    Wenfeng Wang

    2018-01-01

    Full Text Available Video surveillance plays a vital role in maintaining the social security although, until now, large uncertainty still exists in danger understanding and recognition, which can be partly attributed to intractable environment changes in the backgrounds. This article presents a brain-inspired computing of attention value of surrounding environment changes (EC with a processes-based cognition model by introducing a ratio value λ of EC-implications within considered periods. Theoretical models for computation of warning level of EC-implications to the universal video recognition efficiency (quantified as time cost of implication-ratio variations from λk to λk+1, k=1,2,… are further established. Imbedding proposed models into the online algorithms is suggested as a future research priority towards precision security for critical applications and, furthermore, schemes for a practical implementation of such integration are also preliminarily discussed.

  15. A Study of the Flow Field Surrounding Interacting Line Fires

    Directory of Open Access Journals (Sweden)

    Trevor Maynard

    2016-01-01

    Full Text Available The interaction of converging fires often leads to significant changes in fire behavior, including increased flame length, angle, and intensity. In this paper, the fluid mechanics of two adjacent line fires are studied both theoretically and experimentally. A simple potential flow model is used to explain the tilting of interacting flames towards each other, which results from a momentum imbalance triggered by fire geometry. The model was validated by measuring the velocity field surrounding stationary alcohol pool fires. The flow field was seeded with high-contrast colored smoke, and the motion of smoke structures was analyzed using a cross-correlation optical flow technique. The measured velocities and flame angles are found to compare reasonably with the predicted values, and an analogy between merging fires and wind-blown flames is proposed.

  16. Teacher Leadership: Everyday Practices Surrounding Work- Related Stress

    Directory of Open Access Journals (Sweden)

    Chiweshe Nigel

    2015-06-01

    Full Text Available This interpretivist study contributes to our scholarly understanding of how everyday practices surrounding work-related stress in education affect teacher leadership and successful learning outcomes. Insights are drawn from our long-standing engagement in the field where we observed how teaching staff, students, and management interacted. These observations were supplemented by in-depth interviews with 20 teaching staff. Our findings reveal competing demands and practices across the individual intrapersonal environment and the work related environment. There were three key themes that emerged in answer to the core research question: 1 the role of relational practices in managing teacher burnout, 2 the role of surveillance practices in education and 3 the role of assimilating practices in education. Drawing insights from these practices, we develop a conceptual framework that will help us to see relations at work anew, and develop a deeper understanding of ‘sickies’, motivation, learning outcomes and teacher leadership opportunities in education

  17. Biogeography of azooxanthellate corals in the Caribbean and surrounding areas

    Science.gov (United States)

    Dawson, J.

    2002-04-01

    Biogeographic patterns for azooxanthellate corals are not as well known as those of zooxanthellate (primarily reef-building) corals. I analyzed occurrences of 129 species of azooxanthellate corals in 19 geopolitical regions in the Caribbean and surrounding areas. I performed an unweighted pair-group method with arithmetic averages (UPGMA) cluster analysis using Bray-Curtis' similarity measure on the complete data set and shallow- and deep-water subsets of the data. The results indicate two provinces, each with a widespread (tropical and subtropical distributions) component to its fauna. One province has a tropical and primarily insular component to it, while the other has a subtropical and primarily continental component. By contrast, zooxanthellate corals have a uniform faunal composition throughout the Caribbean. Moreover, zooxanthellate corals have half as many species in the Caribbean as the azooxanthellate corals even though their global diversities are equal. These differences in diversity and geographic distribution patterns should be considered when developing conservation strategies.

  18. The surrounding tissue modifies the placental stem villous vascular responses

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn; Forman, Axel; Aalkjær, Christian

    2014-01-01

    is available. In-depth understanding of the mechanisms involved in control of placental vascular tone are needed to develop new tissue targets for therapeutic intervention. Method: From fresh born placentas segments of stem villous arteries were carefully dissected. The artery branches were divided....... The surrounding trophoblast was removed from one end and left intact in the other, and the segment was divided to give two ring preparations, with or without trophoblast. The preparations were mounted in wire myographs and responses to vasoactive agents were compared. Results: pD2values for PGF2α, Tx-analog U...... or endotheline-1. These differences partly disappeared in the presence of L-NAME. Conclusion: The perivascular tissue significantly reduces sensitivity and force development of stem villous arteries, partly due to release of NO This represents a new mechanism for control of human stem villous artery tone....

  19. Comparison of Provider-Assessed and Patient-Reported Outcome Measures of Acute Skin Toxicity During a Phase III Trial of Mometasone Cream Versus Placebo During Breast Radiotherapy: The North Central Cancer Treatment Group (N06C4)

    International Nuclear Information System (INIS)

    Neben-Wittich, Michelle A.; Atherton, Pamela J.; Schwartz, David J.; Sloan, Jeff A.; Griffin, Patricia C.; Deming, Richard L.; Anders, Jon C.; Loprinzi, Charles L.; Burger, Kelli N.; Martenson, James A.; Miller, Robert C.

    2011-01-01

    Purpose: Considerable interobserver variability exists among providers and between providers and patients when measuring subjective symptoms. In the recently published Phase III N06C4 trial of mometasone cream vs. placebo to prevent radiation dermatitis, the primary provider-assessed (PA) endpoint, using the Common Toxicity Criteria for Adverse Events (CTCAE), was negative. However, prospectively planned secondary analyses of patient-reported outcomes (PROs), using the Skindex-16 and Skin Toxicity Assessment Tool (STAT), were positive. This study assesses the relationship between PA outcomes and PROs. Methods and Materials: Pearson correlation coefficients were calculated to compare the three tools. Statistical correlations were defined as follows: 0.7, strong. Results: CTCAE dermatitis moderately correlated with STAT erythema, and CTCAE pruritus strongly correlated with STAT itching. CTCAE pruritus had a moderate correlation with Skindex-16 itching. Comparing the 2 PRO tools, Skindex-16 itching correlated moderately with STAT itching. Skindex-16 burning, hurting, irritation, and persistence all showed the strongest correlation with STAT burning; they showed moderate correlations with STAT itching and tenderness. Conclusions: The PRO Skindex-16 correlated well with the PRO portions of STAT, but neither tool correlated well with CTCAE. PROs delineated a wider spectrum of toxicity than PA measures and provided more information on rash, redness, pruritus, and annoyance measures compared with CTCAE findings of rash and pruritus. PROs may provide a more complete measure of patient experience than single-symptom, PA endpoints in clinical trials assessing radiation skin toxicity.

  20. Influence of surrounding environment on subcritical crack growth in marble

    Science.gov (United States)

    Nara, Yoshitaka; Kashiwaya, Koki; Nishida, Yuki; , Toshinori, Ii

    2017-06-01

    Understanding subcritical crack growth in rock is essential for determining appropriate measures to ensure the long-term integrity of rock masses surrounding structures and for construction from rock material. In this study, subcritical crack growth in marble was investigated experimentally, focusing on the influence of the surrounding environment on the relationship between the crack velocity and stress intensity factor. The crack velocity increased with increasing temperature and/or relative humidity. In all cases, the crack velocity increased with increasing stress intensity factor. However, for Carrara marble (CM) in air, we observed a region in which the crack velocity still increased with temperature, but the increase in the crack velocity with increasing stress intensity factor was not significant. This is similar to Region II of subcritical crack growth observed in glass in air. Region II in glass is controlled by mass transport to the crack tip. In the case of rock, the transport of water to the crack tip is important. In general, Region II is not observed for subcritical crack growth in rock materials, because rocks contain water. Because the porosity of CM is very low, the amount of water contained in the marble is also very small. Therefore, our results imply that we observed Region II in CM. Because the crack velocity increased in both water and air with increasing temperature and humidity, we concluded that dry conditions at low temperature are desirable for the long-term integrity of a carbonate rock mass. Additionally, mass transport to the crack tip is an important process for subcritical crack growth in rock with low porosity.

  1. Quasars Probing Quasars: the Circumgalactic Medium Surrounding z ~ 2 Quasars

    Science.gov (United States)

    Lau, Marie; Quasars Probing Quasars survey

    2018-01-01

    Understanding the circumgalactic medium--the gaseous halo surrounding a galaxy, is an integral part to understanding galaxy evolution. The z ~ 2-3 universe is interesting as this is when the star formation rate and AGN activity peak. My thesis concludes the decade-long Quasars Probing Quasars survey designed for studying massive galaxy formation and quasar feedback. I use background quasar sightlines that pass close to foreground quasars to study the circumgalactic medium of quasar-host galaxies in absorption. My sample of 149 quasar pairs involve spectra taken with 17 different optical and near IR instruments. I present results on the statistical and physical properties of the circumgalactic medium. The circumgalactic medium is enriched even beyond the virial radius. The alpha/Fe abundance ratio is enhanced, suggesting enrichment from core-collapse supernovae. The cool gas mass within the virial radius is enough to fuel star formation for another Gyr, and may account for 1/3 of the baryonic budget of the galaxy halo. The ionization state increases with projected distance from the quasar, which implies the quasar does not dominate the ionizing radiation flux. However, detection of fluorescent Lyman-alpha emission and NV absorption imply these transverse absorbers are partially illuminated by the quasar. In one peculiar case, the absorbing clump has density >100 cm^-3 and sub-parsec size. The average absorption in the circumgalactic medium exhibits large velocity widths, and is asymmetric about the systemic redshift of the galaxies. The widths are consistent with gravitational motions and Hubble flow, and outflows are not required to explain them. The asymmetry can be explained if the ionizing radiation from the quasar is anisotropic or intermittent and the gas is not in inflow. My results pose challenges for cosmological hydrodynamic simulations to produce a substantial cool gas reservoir surrounding quasars, that is also enriched and shows extreme kinematics.

  2. Conserving Prairie Pothole Region wetlands and surrounding grasslands: evaluating effects on amphibians

    Science.gov (United States)

    Mushet, David M.; Neau, Jordan L.

    2014-01-01

    The maintenance of viable and genetically diverse populations of amphibians in the Prairie Pothole Region of the United States depends on upland as well as wetland over-wintering and landscape level habitat features.Prairie pothole wetlands provide important amphibian breeding habitat while grasslands surrounding these wetlands provide foraging habitat for adults, overwintering habitat for some species, and important connectivity among breeding wetlands.Grasslands surrounding wetlands were found to be especially important for wood frogs and northern leopard frogs, while croplands dominated habitat utilized by Great Plains toads and Woodhouse’s toads.Habitat suitability mapping highlighted (1) the influence of deep-water overwintering wetlands on suitable habitat for four of five anuran species encountered; (2) the lack of overlap between areas of core habitat for both the northern leopard frog and wood frog compared to the core habitat for both toad species; and (3) the importance of conservation programs in providing grassland components of northern leopard frog and wood frog habitat.Currently, there are approximately 7.2 million acres (2.9 million hectares, ha) of habitat in the PPR identified as suitable for amphibians. WRP and CRP wetland and grassland habitats accounted for approximately 1.9 million acres (0.75 million ha) or 26 percent of this total area.Continued loss of amphibian habitat resulting from an ongoing trend of returning PPR conservation lands to crop production, will likely have significant negative effects on the region’s ability to maintain amphibian biodiversity. Conversely, increases in conservation wetlands and surrounding grasslands on the PPR landscape have great potential to positively influence the region’s amphibian populations.

  3. Greenhouse effect: temperature of a metal sphere surrounded by a glass shell and heated by sunlight

    International Nuclear Information System (INIS)

    Nguyen, Phuc H; Matzner, Richard A

    2012-01-01

    We study the greenhouse effect on a model satellite consisting of a tungsten sphere surrounded by a thin spherical, concentric glass shell, with a small gap between the sphere and the shell. The system sits in vacuum and is heated by sunlight incident along the z-axis. This development is a generalization of the simple treatment of the greenhouse effect given by Kittel and Kroemer (1980 Thermal Physics (San Francisco: Freeman)) and can serve as a very simple model demonstrating the much more complex Earth greenhouse effect. Solution of the model problem provides an excellent pedagogical tool at the Junior/Senior undergraduate level.

  4. Territorial ordering in Toay area and surroundings, La Pampa province, Argentina

    International Nuclear Information System (INIS)

    Carballo, O.; Sbrocco; J; Calmels, A.; Sotorres, E.; Miglianelli, C.

    2004-01-01

    This present work aims to provide a territorial ordering in an area limited by the 36 grades 39 minutes and 36 grades 43 minutes Southern Parallels and the 64 grades 20 minutes and 64 grades 27 minutes. Meridians from the same hemisphere; within such area, the population from Toay and surroundings are held/contained. The empiric method employed was taken from Gomez Orea (1993). The area was divided into environmental synthesis units and through the use of different proposed tasks it was possible to reach an objective description of the area with the distribution of its varied units [es

  5. Method and apparatus for measuring neutron characteristics of material surrounding a borehole

    International Nuclear Information System (INIS)

    Hopkinson, E.C.

    1983-01-01

    This invention relates to methods and apparatus for determining the macroscopic thermal neutron absorption cross section of the formations surrounding a borehole as determined by radiation measurements using optimized measurement intervals. A measurement of the decline of the thermal neutron population in the formation is derived by counting the detected radiation within a first pair of measurement intervals occurring at a fixed time after the neutron burst. A ratio of the two counting rates provides the rate of change over the selected time interval. The counting ratio is converted into a natural logarithm representative of the Sigma calculation

  6. Communication and surrounding of Asco and Vandellos II nuclear power plants

    International Nuclear Information System (INIS)

    2004-01-01

    The Asco and Vandellos-II power plants have always been integrated into the regions where they are located, and they take an active part in the development of surrounding towns through quality employment provided by our facilities, social and cultural support and aid to development promoted by regional councils. Communication to media is a corporate priority defined in our strategic plant, to ensure openness, rigour and punctuality. We also attend to the visitors who want to learn more about our facilities in the visitor center, and we have agreements with agrarian institutions in the area so that students can de practical training in the farms we own for agricultural production. (Author)

  7. The enforcement order for the law for arrangement of surrounding areas of power generating facilities

    International Nuclear Information System (INIS)

    1984-01-01

    The enforcement order provides for grants concerning the arrangement of various public facilities in the areas surrounding a power generating facility; the public facilities in the arrangement for which the grants are given include communication, recreation activities, environmental sanitation, culture, medicine, etc. The prefectural governor concerned submits his plan for the arrangement to the Government, which then decides on the grants. Then, the grants are given to local governments concerned. The sums of the grants are determined on the basis of the output, construction cost of the nuclear power facility. (Mori, K.)

  8. Perceived spatial positioning of self-footstep sounds in three surround sound speaker setups for immersive virtual reality

    DEFF Research Database (Denmark)

    Sikström, Erik; Nilsson, Niels Christian; Nordahl, Rolf

    2013-01-01

    Are there differences in how well loudspeaker setups are able to provide a believable illusion of footstep sounds originating from the user of an immersive virtual reality? To investigate this performance in spatial positioning via loudspeakers, a comparison of the three surround sound loudspeaker...

  9. A checklist of plant and animal species at Los Alamos National Laboratory and surrounding areas

    Energy Technology Data Exchange (ETDEWEB)

    Hinojosa, H. [comp.

    1998-02-01

    Past and current members of the Biology Team (BT) of the Ecology Group have completed biological assessments (BAs) for all of the land that comprises Los Alamos National Laboratory (LANL). Within these assessments are lists of plant and animal species with the potential to exist on LANL lands and the surrounding areas. To compile these lists, BT members examined earlier published and unpublished reports, surveys, and data bases that pertained to the biota of this area or to areas that are similar. The species lists that are contained herein are compilations of the lists from these BAs, other lists that were a part of the initial research for the performance of these BAs, and more recent surveys.

  10. Tomography images of the Alpine roots and surrounding upper mantle

    Science.gov (United States)

    Plomerova, Jaroslava; Babuska, Vladislav

    2017-04-01

    Teleseismic body-wave tomography represents powerful tool to study regional velocity structure of the upper mantle and to image velocity anomalies, such as subducted lithosphere plates in collisional zones. In this contribution, we recapitulate 3D models of the upper mantle beneath the Alps, which developed at a collision zone of the Eurasian and African plates. Seismic tomography studies indicate a leading role of the rigid mantle lithosphere that functioned as a major stress guide during the plate collisions. Interactions of the European lithosphere with several micro-plates in the south resulted in an arcuate shape of this mountain range on the surface and in a complicated geometry of the Alpine subductions in the mantle. Early models with one bended lithosphere root have been replaced with more advanced models showing two separate lithosphere roots beneath the Western and Eastern Alps (Babuska et al., Tectonophysics 1990; Lippitsch et al., JGR 2003). The standard isotropic velocity tomography, based on pre-AlpArray data (the currently performed passive seismic experiment in the Alps and surroundings) images the south-eastward dipping curved slab of the Eurasian lithosphere in the Western Alps. On the contrary, beneath the Eastern Alps the results indicate a very steep northward dipping root that resulted from the collision of the European plate with the Adriatic microplate. Dando et al. (2011) interpret high-velocity heterogeneities at the bottom of their regional tomographic model as a graveyard of old subducted lithospheres. High density of stations, large amount of rays and dense ray-coverage of the volume studied are not the only essential pre-requisites for reliable tomography results. A compromise between the amount of pre-processed data and the high-quality of the tomography input (travel-time residuals) is of the high importance as well. For the first time, the existence of two separate roots beneath the Alps has been revealed from carefully pre

  11. In-depth assessment of the situation of the textile and clothing sector in the EU and prospects : Task 5: assess what type of training has been provided to textile and clothing workers

    NARCIS (Netherlands)

    Scheffer, M.R. (Michiel)

    2012-01-01

    The in-depth assessment of the situation of the European textile and clothing sector is composed by six independent reports with a close focus on key aspects useful to understand the dynamics and the development of the textile and clothing industry, drivers of change – most notably the impact

  12. A nebula of gases from Io surrounding Jupiter.

    Science.gov (United States)

    Krimigis, Stamatios M; Mitchell, Donald G; Hamilton, Douglas C; Dandouras, Jannis; Armstrong, Thomas P; Bolton, Scott J; Cheng, Andrew F; Gloeckler, George; Hsieh, K C; Keath, Edwin P; Krupp, Norbert; Lagg, Andreas; Lanzerotti, Louis J; Livi, Stefano; Mauk, Barry H; McEntire, Richard W; Roelof, Edmond C; Wilken, Berend; Williams, Donald J

    2002-02-28

    Several planetary missions have reported the presence of substantial numbers of energetic ions and electrons surrounding Jupiter; relativistic electrons are observable up to several astronomical units (au) from the planet. A population of energetic (>30[?]keV) neutral particles also has been reported, but the instrumentation was not able to determine the mass or charge state of the particles, which were subsequently labelled energetic neutral atoms. Although images showing the presence of the trace element sodium were obtained, the source and identity of the neutral atoms---and their overall significance relative to the loss of charged particles from Jupiter's magnetosphere---were unknown. Here we report the discovery by the Cassini spacecraft of a fast (>103[?]km[?]s-1) and hot magnetospheric neutral wind extending more than 0.5[?]au from Jupiter, and the presence of energetic neutral atoms (both hot and cold) that have been accelerated by the electric field in the solar wind. We suggest that these atoms originate in volcanic gases from Io, undergo significant evolution through various electromagnetic interactions, escape Jupiter's magnetosphere and then populate the environment around the planet. Thus a 'nebula' is created that extends outwards over hundreds of jovian radii.

  13. Earthquakes in Switzerland and surrounding regions during 2006

    Energy Technology Data Exchange (ETDEWEB)

    Baer, M.; Deichmann, N.; Braunmiller, J.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S

    2007-12-15

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2006. During this period, 572 earthquakes and 91 quarry blasts were detected and located in the region under consideration. Of these earthquakes, two occurred in conjunction with the construction of the new Gotthard railway tunnel and 165 were induced artificially by the stimulation of a proposed geothermal reservoir beneath the city of Basel. With 20 events with {mu}{sub {iota}} {>=} 2.5, five of which were artificially induced, the seismic activity in the year 2006 was far below the average over the previous 31 years. Nevertheless, six events were felt by the public, most prominently the strongest of the induced Basel events ({mu}{sub {iota}} 3.4), which caused some non-structural building damage. Noteworthy are also the two earthquakes near Cortaillod ({mu}{sub {iota}} 3.2), on the shore of Lake Neuchatel, and in Val Mora ({mu}{sub {iota}} 3.5), between the Engadin and Val Muestair, as well as the 42 aftershocks of the {mu}{sub {iota}} 4.9 Vallorcine earthquake, between Martigny and Chamonix, of September 2005. (author)

  14. Mercury's interior, surface, and surrounding environment latest discoveries

    CERN Document Server

    Clark, Pamela Elizabeth

    2015-01-01

    This SpringerBrief details the MESSENGER Mission, the findings of which present challenges to widely held conventional views and remaining mysteries surrounding the planet. The work answers the question of why Mercury is so dense, and the implications from geochemical data on its planetary formation. It summarizes imaging and compositional data from the terrestrial planet surface processes and explains the geologic history of Mercury.  It also discusses the lack of southern hemisphere coverage. Our understanding of the planet Mercury has been in a transitional phase over the decades since Mariner 10. The influx of new data from the NASA MESSENGER Mission since it was inserted into the orbit of Mercury in March of 2011 has greatly accelerated that shift. The combined compositional data of relatively high volatiles (S, K), relatively low refractories (Al, Ca), and low crustal iron, combined with an active, partially molten iron rich core, has major implications for Mercury and Solar System formation. From a s...

  15. Groundwater quality in Taiz City and surrounding area, Yemen Republic

    International Nuclear Information System (INIS)

    Metwali, R.

    2002-01-01

    Fifty one water samples were collected from production wells used for human consumption from Taiz City and its surroundings, Yemen Republic. The water quality was investigated with respect to bacteriological and physico-chemical parameters. The achieved results revealed that most water samples, especially from private wells, contain a high number of total coliforms (TC) which exceed the permissible limit recommended by the World Health Organization, WHO (1996). Also faecal coliforms (FC) were recorded in the majority of polluted samples. A quantitative estimation was done for each of temperature (18-26C), pH (6.12-8.79), total hardness (58-2200 mg/L), electrical conductivity (218-4600 m.Mohs), total dissolved solids (117-3700mg/L), nitrate (10-187mg/L) and type of aquifer (rocky and alluvium). It is worthy to notice that from the total of fifty-one wells, there was pollution in (65%) of them. Recommendations were suggested for the treatment of the water of such polluted wells and rigid government control in a trial to prevent human and animal illness. (author)

  16. Motor training reduces surround inhibition in the motor cortex.

    Science.gov (United States)

    Akkad, Haya; Di Stasio, Flavio; Tibold, Robert; Kassavetis, Panagiotis; Rothwell, John C; Edwards, Mark J

    2016-06-01

    Surround inhibition (SI) is thought to facilitate focal contraction of a hand muscle by keeping nearby muscles silent. Unexpectedly, SI is reduced in skilled pianists. We tested whether repeated practice of focal contraction in non-pianists could reduce SI. Motor-evoked potentials were elicited by transcranial magnetic stimulation in the relaxed abductor digiti minimi randomly at the onset and 5s after offset of a 2s focal contraction (10% maximum) of the first dorsal interosseous (FDI). Over 5 blocks of 40 trials participants obtained points for increasing contraction speed and stability in FDI. In a final block, the interval between contractions was varied randomly to increase attention to the task. Over the first 5 blocks, SI declined as performance (points scored) improved. In the final "attention" block SI increased towards baseline without affecting performance. Although SI may be useful during the early stages of learning, skilled focal finger movement does not require SI to prevent activity in non-involved muscles. This could be due to better targeting of the excitatory command to move. Results from the final block suggest that increased attention can re-engage SI when task parameters change. SI is not necessary for successful focal contraction, but may contribute during learning and during attention to task. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Democratizing rendering for multiple viewers in surround VR systems

    KAUST Repository

    Schulze, Jürgen P.

    2012-03-01

    We present a new approach for how multiple users\\' views can be rendered in a surround virtual environment without using special multi-view hardware. It is based on the idea that different parts of the screen are often viewed by different users, so that they can be rendered from their own view point, or at least from a point closer to their view point than traditionally expected. The vast majority of 3D virtual reality systems are designed for one head-tracked user, and a number of passive viewers. Only the head tracked user gets to see the correct view of the scene, everybody else sees a distorted image. We reduce this problem by algorithmically democratizing the rendering view point among all tracked users. Researchers have proposed solutions for multiple tracked users, but most of them require major changes to the display hardware of the VR system, such as additional projectors or custom VR glasses. Our approach does not require additional hardware, except the ability to track each participating user. We propose three versions of our multi-viewer algorithm. Each of them balances image distortion and frame rate in different ways, making them more or less suitable for certain application scenarios. Our most sophisticated algorithm renders each pixel from its own, optimized camera perspective, which depends on all tracked users\\' head positions and orientations. © 2012 IEEE.

  18. Thermoelectric Performance Enhancement by Surrounding Crystalline Semiconductors with Metallic Nanoparticles

    Science.gov (United States)

    Kim, Hyun-Jung; King, Glen C.; Park, Yeonjoon; Lee, Kunik; Choi, Sang H.

    2011-01-01

    Direct conversion of thermal energy to electricity by thermoelectric (TE) devices may play a key role in future energy production and utilization. However, relatively poor performance of current TE materials has slowed development of new energy conversion applications. Recent reports have shown that the dimensionless Figure of Merit, ZT, for TE devices can be increased beyond the state-of-the-art level by nanoscale structuring of materials to reduce their thermal conductivity. New morphologically designed TE materials have been fabricated at the NASA Langley Research Center, and their characterization is underway. These newly designed materials are based on semiconductor crystal grains whose surfaces are surrounded by metallic nanoparticles. The nanoscale particles are used to tailor the thermal and electrical conduction properties for TE applications by altering the phonon and electron transport pathways. A sample of bismuth telluride decorated with metallic nanoparticles showed less thermal conductivity and twice the electrical conductivity at room temperature as compared to pure Bi2Te3. Apparently, electrons cross easily between semiconductor crystal grains via the intervening metallic nanoparticle bridges, but phonons are scattered at the interfacing gaps. Hence, if the interfacing gap is larger than the mean free path of the phonon, thermal energy transmission from one grain to others is reduced. Here we describe the design and analysis of these new materials that offer substantial improvements in thermoelectric performance.

  19. Preliminary Analysis of Slope Stability in Kuok and Surrounding Areas

    Directory of Open Access Journals (Sweden)

    Dewandra Bagus Eka Putra

    2016-12-01

    Full Text Available The level of slope influenced by the condition of the rocks beneath the surface. On high level of slopes, amount of surface runoff and water transport energy is also enlarged. This caused by greater gravity, in line with the surface tilt from the horizontal plane. In other words, topsoil eroded more and more. When the slope becomes twice as steep, then the amount of erosion per unit area be 2.0 - 2.5 times more. Kuok and surrounding area is the road access between the West Sumatra and Riau which plays an important role economies of both provinces. The purpose of this study is to map the locations that have fairly steep slopes and potential mode of landslides. Based on SRTM data obtained,  the roads in Kuok area has a minimum elevation of + 33 m and a maximum  + 217.329 m. Rugged road conditions with slope ranging from 24.08 ° to 44.68 ° causing this area having frequent landslides. The result of slope stability analysis in a slope near the Water Power Plant Koto Panjang, indicated that mode of active failure is toppling failure or rock fall and the potential zone of failure is in the center part of the slope.

  20. Democratizing rendering for multiple viewers in surround VR systems

    KAUST Repository

    Schulze, Jü rgen P.; Acevedo-Feliz, Daniel; Mangan, John; Prudhomme, Andrew; Nguyen, Phi Khanh; Weber, Philip P.

    2012-01-01

    We present a new approach for how multiple users' views can be rendered in a surround virtual environment without using special multi-view hardware. It is based on the idea that different parts of the screen are often viewed by different users, so that they can be rendered from their own view point, or at least from a point closer to their view point than traditionally expected. The vast majority of 3D virtual reality systems are designed for one head-tracked user, and a number of passive viewers. Only the head tracked user gets to see the correct view of the scene, everybody else sees a distorted image. We reduce this problem by algorithmically democratizing the rendering view point among all tracked users. Researchers have proposed solutions for multiple tracked users, but most of them require major changes to the display hardware of the VR system, such as additional projectors or custom VR glasses. Our approach does not require additional hardware, except the ability to track each participating user. We propose three versions of our multi-viewer algorithm. Each of them balances image distortion and frame rate in different ways, making them more or less suitable for certain application scenarios. Our most sophisticated algorithm renders each pixel from its own, optimized camera perspective, which depends on all tracked users' head positions and orientations. © 2012 IEEE.

  1. Ultrastructural study of tissues surrounding replanted teeth and dental implants.

    Science.gov (United States)

    Shioya, Kazuhiro; Sawada, Takashi; Miake, Yasuo; Inoue, Sadayuki; Yanagisawa, Takaaki

    2009-03-01

    The aim of this study was to describe the ultrastructure of the dentogingival border at replanted teeth and implants. Wistar rats (8 weeks old) were divided into groups for replantation and implantation experiments. In the former, the upper right first molars were extracted and then immediately replanted. In the latter, pure titanium implants were used. All tissues were fixed, demineralized and embedded in epoxy resin for ultrastructural observations. One week after replantation, the junctional epithelium was lost, and the oral sulcular epithelium covered the enamel surface. The amount of the epithelium increased in 2 weeks, and resembled the junctional epithelium, and the internal basal lamina and hemidesmosomes were formed in 4 weeks. One week after implantation, peri-implant epithelium was formed, and in 2 and 4 weeks, this epithelium with aggregated connective tissue cells were observed. In 8 weeks, the peri-implant epithelium receded, and aligned special cells with surrounding elongated fibroblasts and bundles of collagen fibers appeared to seal the implant interface. In replantation of the tooth, the internal basal lamina remained at the surface of the enamel of the replanted tooth, which is likely to be related to regeneration of the junctional epithelium and the attachment apparatus at the epithelium-tooth interface. Following implantation, a layer of cells with characteristics of connective tissue cells, but no junctional epithelium and attachment apparatus, was formed to seal the site of the implant.

  2. Earthquakes in Switzerland and surrounding regions during 2006

    International Nuclear Information System (INIS)

    Baer, M.; Deichmann, N.; Braunmiller, J.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S.

    2007-01-01

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2006. During this period, 572 earthquakes and 91 quarry blasts were detected and located in the region under consideration. Of these earthquakes, two occurred in conjunction with the construction of the new Gotthard railway tunnel and 165 were induced artificially by the stimulation of a proposed geothermal reservoir beneath the city of Basel. With 20 events with Μ ι ≥ 2.5, five of which were artificially induced, the seismic activity in the year 2006 was far below the average over the previous 31 years. Nevertheless, six events were felt by the public, most prominently the strongest of the induced Basel events (Μ ι 3.4), which caused some non-structural building damage. Noteworthy are also the two earthquakes near Cortaillod (Μ ι 3.2), on the shore of Lake Neuchatel, and in Val Mora (Μ ι 3.5), between the Engadin and Val Muestair, as well as the 42 aftershocks of the Μ ι 4.9 Vallorcine earthquake, between Martigny and Chamonix, of September 2005. (author)

  3. Natural Ecosystem Surrounding a Conventional Banana Crop Improves Plant Health and Fruit Quality

    Directory of Open Access Journals (Sweden)

    Florence P. Castelan

    2018-06-01

    Full Text Available Natural ecosystems near agricultural landscapes may provide rich environments for growing crops. However, the effect of a natural ecosystem on crop health and fruit quality is poorly understood. In the present study, it was investigated whether the presence of a natural ecosystem surrounding a crop area influences banana plant health and fruit postharvest behavior. Plants from two conventional banana crop areas with identical planting time and cultural practices were used; the only difference between banana crop areas is that one area was surrounded by a natural forest (Atlantic forest fragment (Near-NF, while the other area was inserted at the center of a conventional banana crop (Distant-NF. Results showed that bananas harvested from Near-NF showed higher greenlife and a more homogeneous profile during ripening compared to fruits harvested from Distant-NF. Differences in quality parameters including greenlife, carbohydrate profile, and pulp firmness between fruits harvested from Near-NF and Distant-NF are explained, at least partly, by differences in the balance of plant growth regulators (indole-3-acetic acid and abscisic acid in bananas during ripening. Furthermore, plants from Near-NF showed a lower severity index of black leaf streak disease (BLSD and higher levels of phenolic compounds in leaves compared to plants from Distant-NF. Together, the results provide additional evidence on how the maintenance of natural ecosystems near conventional crop areas could be a promising tool to improve plant health and fruit quality.

  4. Logistics system as an effort of integration in the Mandalika Special Economic Zone and its surroundings

    Science.gov (United States)

    Suheri, T.; Melinda, W. G.

    2018-05-01

    Indonesia as one of the maritime countries with its territory in the form of an archipelago. A SEZ with an integrated logistics system is very influential on the value of tourism, especially marine tourism. The creation of logistics activities in the Mandalika SEZ as a tourism area formed from the export and import of products as a form of tourism promotion will attract many domestic and foreign tourists. The importance of a logistics system for both people and goods can support the investment system in the area of Mandalika SEZ. The logistics system can provide agglomeration of facilities and infrastructure to support tourist activities in terms of cargo distribution both locally and globally. Mandalika SEZ requires an integrated logistics system to improve national competitiveness in the form of physical system support such as commodity availability and city/regional infrastructure as well as non-physical infrastructure such as service providers and regulation in order to be sustainable. The logistics system also plays a strategic role in synchronizing and harmonizing progress between economies and between regions in order to avoid an imbalance with the surrounding area. This study aims to find out the performance of the existing logistics systems in the Mandalika area and its surrounding areas in order to formulate policies to integrate the logistics systems within and outside the region. This research used content analysis methodology.

  5. Rockfalls in cliffs surrounding waterfall revealed by high-definition topographic measurements

    Science.gov (United States)

    Hayakawa, Y. S.; Obanawa, H.

    2017-12-01

    Bedrock rivers of volcanic terrain often comprise numerous knickpoints. Erosion of bedrock at knickpoints is an essential process of fluvial dissection of volcanic landforms, which also affects the deformations of surrounding slopes. However, short term (less than decadal) changes in bedrock landforms have often been limited to examine in a spatiotemporal framework. Here we use terrestrial laser scanning and SfM-MVS photogrammetry to detect recent annual changes in the morphology of cliffs surrounding a waterfall (Kegon Falls) on jointed andesite lava and conglomerates. The amount of bedrock deformation caused by small rockfalls and surface lowering are assessed in volume, which often appears in a relatively lower portion of the cliff. Such the changes are supposed to be affected by the enhanced supply of water and weathering following the latest major rockfall in 1986 which caused 8-m recession of the waterfall lip. The three-dimensional point cloud data is also utilized to construct a 3D model using cardboards, which is useful for understanding the topography and its changes of the waterfall as educational resources.

  6. Trace Elements Speciation of Submicron Particulate Matter (PM1) Collected in the Surroundings of Power Plants.

    Science.gov (United States)

    Zajusz-Zubek, Elwira; Kaczmarek, Konrad; Mainka, Anna

    2015-10-16

    This study reports the concentrations of PM1 trace elements (As, Cd, Co, Cr, Hg, Mn, Ni, Pb, Sb and Se) content in highly mobile (F1), mobile (F2), less mobile (F3) and not mobile (F4) fractions in samples that were collected in the surroundings of power plants in southern Poland. It also reports source identification by enrichment factors (EF) and a principal component analysis (PCA). There is limited availability of scientific data concerning the chemical composition of dust, including fractionation analyses of trace elements, in the surroundings of power plants. The present study offers important results in order to fill this data gap. The data collected in this study can be utilized to validate air quality models in this rapidly developing area. They are also crucial for comparisons with datasets from similar areas all over the world. Moreover, the identification of the bioavailability of selected carcinogenic and toxic elements in the future might be used as output data for potential biological and population research on risk assessment. This is important in the context of air pollution being hazardous to human health.

  7. Trace Elements Speciation of Submicron Particulate Matter (PM1 Collected in the Surroundings of Power Plants

    Directory of Open Access Journals (Sweden)

    Elwira Zajusz-Zubek

    2015-10-01

    Full Text Available This study reports the concentrations of PM1 trace elements (As, Cd, Co, Cr, Hg, Mn, Ni, Pb, Sb and Se content in highly mobile (F1, mobile (F2, less mobile (F3 and not mobile (F4 fractions in samples that were collected in the surroundings of power plants in southern Poland. It also reports source identification by enrichment factors (EF and a principal component analysis (PCA. There is limited availability of scientific data concerning the chemical composition of dust, including fractionation analyses of trace elements, in the surroundings of power plants. The present study offers important results in order to fill this data gap. The data collected in this study can be utilized to validate air quality models in this rapidly developing area. They are also crucial for comparisons with datasets from similar areas all over the world. Moreover, the identification of the bioavailability of selected carcinogenic and toxic elements in the future might be used as output data for potential biological and population research on risk assessment. This is important in the context of air pollution being hazardous to human health.

  8. The human health impact of Nyiragongo and Nyamulagira eruptions on Goma city and its surrounding area

    Science.gov (United States)

    Michellier, C.; Dramaix, M.; Arellano, S. R.; Kervyn, F.; Kahindo, J. B.

    2012-04-01

    of higher health risk for the population living under the plume. Additionally, time series analysis helps us to disregard any seasonal effect of certain pathologies and to derive a 12-year risk trend. For 2004-2010, our results are compared to SO2 gas emission rates and plume location data measured by using Differential Optical Absorption Spectroscopic (DOAS) sensors located around Nyiragongo volcano. Finally, the areas identified as more hazardous are highlighted through a geographical approach (using GIS tools), to generate maps and other relevant information that can be of direct use for risk assessment authorities. Our preliminary analysis suggests that the impact of SO2 emissions doesn't seem to be severe, being its most important effect an increase of ARI in the area surrounding the volcanoes (up to 50km). Our on-going study will help us to better determine the magnitude and geographical extent of the impact of volcanic plumes on the health of the population, as well as locate the areas that are most affected. This will contribute to provide the appropriate sanitation recommendations (water treatment, early warning system, etc.) and lead to a more effective volcanic impact reduction on human health.

  9. Morphological Segregation in the Surroundings of Cosmic Voids

    Energy Technology Data Exchange (ETDEWEB)

    Ricciardelli, Elena; Tamone, Amelie [Laboratoire d’Astrophysique, École Polytechnique Fédérale de Lausanne (EPFL), 1290 Sauverny (Switzerland); Cava, Antonio [Observatoire de Genève, Université de Genève, 51 Ch. des Maillettes, 1290 Versoix (Switzerland); Varela, Jesus, E-mail: elena.ricciardelli@epfl.ch [Centro de Estudios de Física del Cosmos de Aragón (CEFCA), Plaza San Juan 1, E-44001 Teruel (Spain)

    2017-09-01

    We explore the morphology of galaxies living in the proximity of cosmic voids, using a sample of voids identified in the Sloan Digital Sky Survey Data Release 7. At all stellar masses, void galaxies exhibit morphologies of a later type than galaxies in a control sample, which represent galaxies in an average density environment. We interpret this trend as a pure environmental effect, independent of the mass bias, due to a slower galaxy build-up in the rarefied regions of voids. We confirm previous findings about a clear segregation in galaxy morphology, with galaxies of a later type being found at smaller void-centric distances with respect to the early-type galaxies. We also show, for the first time, that the radius of the void has an impact on the evolutionary history of the galaxies that live within it or in its surroundings. In fact, an enhanced fraction of late-type galaxies is found in the proximity of voids larger than the median void radius. Likewise, an excess of early-type galaxies is observed within or around voids of a smaller size. A significant difference in galaxy properties in voids of different sizes is observed up to 2 R {sub void}, which we define as the region of influence of voids. The significance of this difference is greater than 3 σ for all the volume-complete samples considered here. The fraction of star-forming galaxies shows the same behavior as the late-type galaxies, but no significant difference in stellar mass is observed in the proximity of voids of different sizes.

  10. Isoperimetric inequalities in surround system and space science

    Directory of Open Access Journals (Sweden)

    JiaJin Wen

    2016-02-01

    Full Text Available Abstract By means of the algebraic, analysis, convex geometry, computer, and inequality theories we establish the following isoperimetric inequality in the centered 2-surround system S ( 2 { P , Γ , l } $S^{(2} \\{P,\\varGamma ,l \\}$ : ( 1 | Γ | ∮ Γ r ¯ P p 1 / p ⩽ | Γ | 4 π sin l π | Γ | [ csc l π | Γ | + cot 2 l π | Γ | ln ( tan l π | Γ | + sec l π | Γ | ] , ∀ p ⩽ − 2 . $$\\begin{aligned}& \\biggl(\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\bar{r}_{P}^{p} \\biggr^{1/p}\\leqslant\\frac{|\\varGamma |}{4\\pi}\\sin\\frac{l\\pi}{|\\varGamma |} \\biggl[ \\csc \\frac{l\\pi}{|\\varGamma |}+\\cot^{2} \\frac{l\\pi}{|\\varGamma |} \\ln \\biggl(\\tan \\frac{l\\pi}{|\\varGamma |}+\\sec\\frac{l\\pi}{|\\varGamma |} \\biggr \\biggr], \\\\& \\quad \\forall p\\leqslant -2. \\end{aligned}$$ As an application of the inequality in space science, we obtain the best lower bounds of the mean λ-gravity norm ∥ F λ ( Γ , P ∥ ‾ $\\overline{\\Vert {\\mathbf{F}}_{\\lambda} ( \\varGamma ,P \\Vert }$ as follows: ∥ F λ ( Γ , P ∥ ‾ ≜ 1 | Γ | ∮ Γ 1 ∥ A − P ∥ λ ⩾ ( 2 π | Γ | λ , ∀ λ ⩾ 2 . $$\\overline{\\bigl\\Vert {\\mathbf{F}}_{\\lambda} ( \\varGamma ,P \\bigr\\Vert } \\triangleq\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\frac{1}{\\|A-P\\|^{\\lambda }}\\geqslant \\biggl(\\frac{2\\pi}{|\\varGamma |} \\biggr^{\\lambda},\\quad \\forall \\lambda\\geqslant2. $$

  11. Issues surrounding orphan disease and orphan drug policies in Europe.

    Science.gov (United States)

    Denis, Alain; Mergaert, Lut; Fostier, Christel; Cleemput, Irina; Simoens, Steven

    2010-01-01

    An orphan disease is a disease with a very low prevalence. Although there are 5000-7000 orphan diseases, only 50 orphan drugs (i.e. drugs developed to treat orphan diseases) were marketed in the EU by the end of 2008. In 2000, the EU implemented policies specifically designed to stimulate the development of orphan drugs. While decisions on orphan designation and the marketing authorization of orphan drugs are made at the EU level, decisions on drug reimbursement are made at the member state level. The specific features of orphan diseases and orphan drugs make them a high-priority issue for policy makers. The aim of this article is to identify and discuss several issues surrounding orphan disease and drug policies in Europe. The present system of orphan designation allows for drugs for non-orphan diseases to be designated as orphan drugs. The economic factors underlying orphan designation can be questioned in some cases, as a low prevalence of a certain indication does not equal a low return on investment for the drug across its indications. High-quality evidence about the clinical added value of orphan drugs is rarely available at the time of marketing authorization, due to the low number of patients. A balance must be struck between ethical and economic concerns. To this effect, there is a need to initiate a societal dialogue on this issue, to clarify what society wants and accepts in terms of ethical and economic consequences. The growing budgetary impact of orphan drugs puts pressure on drug expenditure. Indications can be extended for an orphan drug and the total prevalence across indications is not considered. Finally, cooperation needs to be fostered in the EU, particularly through a standardized approach to the creation and use of registries. These issues require further attention from researchers, policy makers, health professionals, patients, pharmaceutical companies and other stakeholders with a view to optimizing orphan disease and drug policies in

  12. The number and type of food retailers surrounding schools and their association with lunchtime eating behaviours in students.

    Science.gov (United States)

    Seliske, Laura; Pickett, William; Rosu, Andrei; Janssen, Ian

    2013-02-07

    The primary study objective was to examine whether the presence of food retailers surrounding schools was associated with students' lunchtime eating behaviours. The secondary objective was to determine whether measures of the food retail environment around schools captured using road network or circular buffers were more strongly related to eating behaviours while at school. Grade 9 and 10 students (N=6,971) who participated in the 2009/10 Canadian Health Behaviour in School Aged Children Survey were included in this study. The outcome was determined by students' self-reports of where they typically ate their lunch during school days. Circular and road network-based buffers were created for a 1 km distance surrounding 158 schools participating in the HBSC. The addresses of fast food restaurants, convenience stores and coffee/donut shops were mapped within the buffers. Multilevel logistic regression was used to determine whether there was a relationship between the presence of food retailers near schools and students regularly eating their lunch at a fast food restaurant, snack-bar or café. The Akaike Information Criteria (AIC) value, a measure of goodness-of-fit, was used to determine the optimal buffer type. For the 1 km circular buffers, students with 1-2 (OR= 1.10, 95% CI: 0.57-2.11), 3-4 (OR=1.45, 95% CI: 0.75-2.82) and ≥5 nearby food retailers (OR=2.94, 95% CI: 1.71-5.09) were more likely to eat lunch at a food retailer compared to students with no nearby food retailers. The relationships were slightly stronger when assessed via 1 km road network buffers, with a greater likelihood of eating at a food retailer for 1-2 (OR=1.20, 95% CI:0.74-1.95), 3-4 (OR=3.19, 95% CI: 1.66-6.13) and ≥5 nearby food retailers (OR=3.54, 95% CI: 2.08-6.02). Road network buffers appeared to provide a better measure of the food retail environment, as indicated by a lower AIC value (3332 vs. 3346). There was a strong relationship between the presence of food retailers near

  13. The number and type of food retailers surrounding schools and their association with lunchtime eating behaviours in students

    Directory of Open Access Journals (Sweden)

    Seliske Laura

    2013-02-01

    Full Text Available Abstract Background The primary study objective was to examine whether the presence of food retailers surrounding schools was associated with students’ lunchtime eating behaviours. The secondary objective was to determine whether measures of the food retail environment around schools captured using road network or circular buffers were more strongly related to eating behaviours while at school. Methods Grade 9 and 10 students (N=6,971 who participated in the 2009/10 Canadian Health Behaviour in School Aged Children Survey were included in this study. The outcome was determined by students’ self-reports of where they typically ate their lunch during school days. Circular and road network-based buffers were created for a 1 km distance surrounding 158 schools participating in the HBSC. The addresses of fast food restaurants, convenience stores and coffee/donut shops were mapped within the buffers. Multilevel logistic regression was used to determine whether there was a relationship between the presence of food retailers near schools and students regularly eating their lunch at a fast food restaurant, snack-bar or café. The Akaike Information Criteria (AIC value, a measure of goodness-of-fit, was used to determine the optimal buffer type. Results For the 1 km circular buffers, students with 1–2 (OR= 1.10, 95% CI: 0.57-2.11, 3–4 (OR=1.45, 95% CI: 0.75-2.82 and ≥5 nearby food retailers (OR=2.94, 95% CI: 1.71-5.09 were more likely to eat lunch at a food retailer compared to students with no nearby food retailers. The relationships were slightly stronger when assessed via 1 km road network buffers, with a greater likelihood of eating at a food retailer for 1–2 (OR=1.20, 95% CI:0.74-1.95, 3–4 (OR=3.19, 95% CI: 1.66-6.13 and ≥5 nearby food retailers (OR=3.54, 95% CI: 2.08-6.02. Road network buffers appeared to provide a better measure of the food retail environment, as indicated by a lower AIC value (3332 vs. 3346. Conclusions There

  14. Detecting aberrant opioid behavior in the emergency department: a prospective study using the screener and Opioid Assessment for Patients with Pain-Revised (SOAPP®-R), Current Opioid Misuse Measure (COMM)™, and provider gestalt.

    Science.gov (United States)

    Varney, Shawn M; Perez, Crystal A; Araña, Allyson A; Carey, Katherine R; Ganem, Victoria J; Zarzabal, Lee A; Ramos, Rosemarie G; Bebarta, Vikhyat S

    2018-03-03

    Emergency department (ED) providers have limited time to evaluate patients at risk for opioid misuse. A validated tool to assess the risk for aberrant opioid behavior may mitigate adverse sequelae associated with prescription opioid misuse. We sought to determine if SOAPP-R, COMM, and provider gestalt were able to identify patients at risk for prescription opioid misuse as determined by pharmacy records at 12 months. We conducted a prospective observational study of adult patients in a high volume US ED. Patients completed the SOAPP-R and COMM, and treating EM providers evaluated patients' opioid misuse risk. We performed variable-centered, person-centered, and hierarchical cluster analyses to determine whether provider gestalt, SOAPP-R, or COMM, or a combination, predicted higher misuse risk. The primary outcome was the number of opioid prescriptions at 12 months according to pharmacy records. For 169 patients (mean age 43 years, 51% female, 73% white), correlation analysis showed a strong relationship between SOAPP-R and COMM with predicting the number of opioid prescriptions dispensed at 12 months. Provider scores estimating opioid misuse were not related to SOAPP-R and only weakly associated with COMM. In our adjusted regression models, provider gestalt and SOAPP-R uniquely predicted opioid prescriptions at 6 and 12 months. Using designated cutoff scores, only SOAPP-R detected a difference in the number of opioid prescriptions. Cluster analysis revealed that provider gestalt, SOAPP-R, and COMM scores jointly predicted opioid prescriptions. Provider gestalt and self-report instruments uniquely predicted the number of opioid prescriptions in ED patients. A combination of gestalt and self-assessment scores can be used to identify at-risk patients who otherwise miss the cutoff scores for SOAPP-R and COMM.

  15. Earthquake hypocenter relocation using double difference method in East Java and surrounding areas

    International Nuclear Information System (INIS)

    C, Aprilia Puspita; Nugraha, Andri Dian; Puspito, Nanang T

    2015-01-01

    Determination of precise hypocenter location is very important in order to provide information about subsurface fault plane and for seismic hazard analysis. In this study, we have relocated hypocenter earthquakes in Eastern part of Java and surrounding areas from local earthquake data catalog compiled by Meteorological, Climatological, and Geophysical Agency of Indonesia (MCGA) in time period 2009-2012 by using the double-difference method. The results show that after relocation processes, there are significantly changes in position and orientation of earthquake hypocenter which is correlated with the geological setting in this region. We observed indication of double seismic zone at depths of 70-120 km within the subducting slab in south of eastern part of Java region. Our results will provide useful information for advance seismological studies and seismic hazard analysis in this study

  16. Earthquake hypocenter relocation using double difference method in East Java and surrounding areas

    Energy Technology Data Exchange (ETDEWEB)

    C, Aprilia Puspita [Geophysical Engineering Program, Faculty of Mining and Petroleum Engineering, Institute of Technology Bandung (Indonesia); Meteorological, Climatological, and Geophysical Agency (MCGA) of Indonesian, Jakarta (Indonesia); Nugraha, Andri Dian, E-mail: nugraha@gf.itb.ac.id [Geophysical Engineering Program, Faculty of Mining and Petroleum Engineering, Institute of Technology Bandung (Indonesia); Puspito, Nanang T [Global Geophysical Research Group, Faculty of Mining and Petroleum Engineering, Institute of Technology Bandung (Indonesia)

    2015-04-24

    Determination of precise hypocenter location is very important in order to provide information about subsurface fault plane and for seismic hazard analysis. In this study, we have relocated hypocenter earthquakes in Eastern part of Java and surrounding areas from local earthquake data catalog compiled by Meteorological, Climatological, and Geophysical Agency of Indonesia (MCGA) in time period 2009-2012 by using the double-difference method. The results show that after relocation processes, there are significantly changes in position and orientation of earthquake hypocenter which is correlated with the geological setting in this region. We observed indication of double seismic zone at depths of 70-120 km within the subducting slab in south of eastern part of Java region. Our results will provide useful information for advance seismological studies and seismic hazard analysis in this study.

  17. Detained and Dying: Ethical Issues Surrounding End-of-Life Care in Prison.

    Science.gov (United States)

    Stensland, Meredith; Sanders, Sara

    2016-01-01

    Prisons are increasingly being called upon to provide end-of-life (EOL) care within the restrictive correctional environment. Several relatively recent phenomena have brought medical ethics to the forefront of prison EOL care-including aging behind bars, a paradigm shift in prison culture, the increasing rate of in-prison deaths, and the corresponding prison hospice movement. This article examines prominent ethical issues that emerge for prison personnel who are tasked with providing care to terminally ill offenders by presenting three offender composite characters that exemplify dying offenders and emergent ethical issues surrounding their care. Identification and critical analysis of these ethical issues demonstrate the need for strong commitment to ethical practice and highlights specific issues for prisons to examine in their own EOL care practice.

  18. Urban land use in Natura 2000 surrounding areas in Vilnius Region, Lithuania.

    Science.gov (United States)

    Pereira, Paulo; Misiūnė, Ieva; Depellegrin, Daniel

    2015-04-01

    regarding the land use of the Natura 2000 buffer areas is contributing to the degradation of the services provide by these areas. Acknowledgments RECARE (Preventing and Remediating Degradation of Soils in Europe Through Land Care, FP7-ENV-2013-TWO STAGE), funded by the European Commission, for the COST action ES1306 (Connecting European connectivity research) and COST Action IS1204 Tourism, Wellbeing and Ecosystem Services (TObeWELL) References Dasselaar, I.V. (2013) The impact of a buffer zone. The influence of the introduction of buffer zones surrounding Natura 2000 areas on local actors, the case of het Boetelerveld in the Netherlands. Master Thesis Forest and Nature Conservation, Forest and Nature Conservation Policy group, 69 p. Hansen, A.J. (2007) Ecological mechanisms linking protected areas to surrounding lands. Ecological Applications, 17, 974-978. McDonald, R.I., Kareiva, P., Forman, R.T.T. (2008) The implications of current and future urbanization for global protected areas and biodiversity conservation. Biological Conservation, 141, 1695-1703. Pereira, P., Monkevicius, A., Siarova, A. (2014) Public perception of the Environmental, Social and Economic impacts of Urban Sprawl in Vilnius. Societal Studies, 6, 256-290. Salvati, L., Sabbi, A. (2011) Exploring long-term land cover changes in an urban region of southern of Europe. International Journal of Sustainable Development & World Ecology, 18, 273-282.

  19. Highly Enriched Uranium Metal Cylinders Surrounded by Various Reflector Materials

    International Nuclear Information System (INIS)

    Bernard Jones; J. Blair Briggs; Leland Monteirth

    2007-01-01

    A series of experiments was performed at Los Alamos Scientific Laboratory in 1958 to determine critical masses of cylinders of Oralloy (Oy) reflected by a number of materials. The experiments were all performed on the Comet Universal Critical Assembly Machine, and consisted of discs of highly enriched uranium (93.3 wt.% 235U) reflected by half-inch and one-inch-thick cylindrical shells of various reflector materials. The experiments were performed by members of Group N-2, particularly K. W. Gallup, G. E. Hansen, H. C. Paxton, and R. H. White. This experiment was intended to ascertain critical masses for criticality safety purposes, as well as to compare neutron transport cross sections to those obtained from danger coefficient measurements with the Topsy Oralloy-Tuballoy reflected and Godiva unreflected critical assemblies. The reflector materials examined in this series of experiments are as follows: magnesium, titanium, aluminum, graphite, mild steel, nickel, copper, cobalt, molybdenum, natural uranium, tungsten, beryllium, aluminum oxide, molybdenum carbide, and polythene (polyethylene). Also included are two special configurations of composite beryllium and iron reflectors. Analyses were performed in which uncertainty associated with six different parameters was evaluated; namely, extrapolation to the uranium critical mass, uranium density, 235U enrichment, reflector density, reflector thickness, and reflector impurities. In addition to the idealizations made by the experimenters (removal of the platen and diaphragm), two simplifications were also made to the benchmark models that resulted in a small bias and additional uncertainty. First of all, since impurities in core and reflector materials are only estimated, they are not included in the benchmark models. Secondly, the room, support structure, and other possible surrounding equipment were not included in the model. Bias values that result from these two simplifications were determined and associated

  20. Severe blood-brain barrier disruption and surrounding tissue injury.

    Science.gov (United States)

    Chen, Bo; Friedman, Beth; Cheng, Qun; Tsai, Phil; Schim, Erica; Kleinfeld, David; Lyden, Patrick D

    2009-12-01

    Blood-brain barrier opening during ischemia follows a biphasic time course, may be partially reversible, and allows plasma constituents to enter brain and possibly damage cells. In contrast, severe vascular disruption after ischemia is unlikely to be reversible and allows even further extravasation of potentially harmful plasma constituents. We sought to use simple fluorescent tracers to allow wide-scale visualization of severely damaged vessels and determine whether such vascular disruption colocalized with regions of severe parenchymal injury. Severe vascular disruption and ischemic injury was produced in adult Sprague Dawley rats by transient occlusion of the middle cerebral artery for 1, 2, 4, or 8 hours, followed by 30 minutes of reperfusion. Fluorescein isothiocyanate-dextran (2 MDa) was injected intravenously before occlusion. After perfusion-fixation, brain sections were processed for ultrastructure or fluorescence imaging. We identified early evidence of tissue damage with Fluoro-Jade staining of dying cells. With increasing ischemia duration, greater quantities of high molecular weight dextran-fluorescein isothiocyanate invaded and marked ischemic regions in a characteristic pattern, appearing first in the medial striatum, spreading to the lateral striatum, and finally involving cortex; maximal injury was seen in the mid-parietal areas, consistent with the known ischemic zone in this model. The regional distribution of the severe vascular disruption correlated with the distribution of 24-hour 2,3,5-triphenyltetrazolium chloride pallor (r=0.75; P<0.05) and the cell death marker Fluoro-Jade (r=0.86; P<0.05). Ultrastructural examination showed significantly increased areas of swollen astrocytic foot process and swollen mitochondria in regions of high compared to low leakage, and compared to contralateral homologous regions (ANOVA P<0.01). Dextran extravasation into the basement membrane and surrounding tissue increased significantly from 2 to 8 hours of

  1. Impact of mechanical stretch on the cell behaviors of bone and surrounding tissues

    Directory of Open Access Journals (Sweden)

    Hye-Sun Yu

    2016-02-01

    Full Text Available Mechanical loading is recognized to play an important role in regulating the behaviors of cells in bone and surrounding tissues in vivo. Many in vitro studies have been conducted to determine the effects of mechanical loading on individual cell types of the tissues. In this review, we focus specifically on the use of the Flexercell system as a tool for studying cellular responses to mechanical stretch. We assess the literature describing the impact of mechanical stretch on different cell types from bone, muscle, tendon, ligament, and cartilage, describing individual cell phenotype responses. In addition, we review evidence regarding the mechanotransduction pathways that are activated to potentiate these phenotype responses in different cell populations.

  2. Uranium in the Surrounding of San Marcos-Sacramento River Environment (Chihuahua, Mexico)

    Science.gov (United States)

    Rentería-Villalobos, Marusia; Cortés, Manuel Reyes; Mantero, Juan; Manjón, Guillermo; García-Tenorio, Rafael; Herrera, Eduardo; Montero-Cabrera, Maria Elena

    2012-01-01

    The main interest of this study is to assess whether uranium deposits located in the San Marcos outcrops (NW of Chihuahua City, Mexico) could be considered as a source of U-isotopes in its surrounding environment. Uranium activity concentrations were determined in biota, ground, and surface water by either alpha or liquid scintillation spectrometries. Major ions were analyzed by ICP-OES in surface water and its suspended matter. For determining uranium activity in biota, samples were divided in parts. The results have shown a possible lixiviation and infiltration of uranium from geological substrate into the ground and surface water, and consequently, a transfer to biota. Calculated annual effective doses by ingestion suggest that U-isotopes in biota could not negligibly contribute to the neighboring population dose. By all these considerations, it is concluded that in this zone there is natural enhancement of uranium in all environmental samples analyzed in the present work. PMID:22536148

  3. Physical geography of the Nete basin and surroundings; Fysische geografie van het Netebekken en omgeving

    Energy Technology Data Exchange (ETDEWEB)

    Beerten, K.

    2011-05-15

    The report briefly describes the main features of the physical geography of the Nete basin (Campine region, Belgium) and its immediate surroundings. First, an integrated overview of the topography, morphology and hydrography is given. This overview serves as the basis for the assessment of the morphological stability of the region and also explains the relationship between the topography and the hydrology. Furthermore, special attention is paid to soil science including a quantitative survey of some soil characteristics data. Another part of this report deals with erosion processes caused by water and wind action, and the (potential) impact on the morphology. Finally, the palaeogeographical evolution during the Quaternary is discussed. This evolution shows that the environment is stable over 10 000 years or more in the current and similar climatic conditions. Altering climatic conditions, notably glacial-interglacial periods, have impacted erosion with periods of strong erosion.

  4. Groundwater quality surrounding Lake Texoma during short-term drought conditions

    International Nuclear Information System (INIS)

    Kampbell, Donald H.; An, Youn-Joo; Jewell, Ken P.; Masoner, Jason R.

    2003-01-01

    Stressors such as nitrates and total salts in ground water could potentially become a health or environmental problem during drought conditions. - Water quality data from 55 monitoring wells during drought conditions surrounding Lake Texoma, located on the border of Oklahoma and Texas, was compared to assess the influence of drought on groundwater quality. During the drought month of October, water table levels were three feet (0.9 m) lower compared with several months earlier under predrought climate conditions. Detection frequencies of nitrate (> 0.1 mg/l), orthophosphates (> 0.1 mg/l), chlorides (> MCL), and sulfates (> MCL) all increased during drought. Orthophosphate level was higher during drought. Largest increases in concentration were nitrate under both agriculture lands and in septic tank areas. An increase in ammonium-nitrogen was only detected in the septic tank area. The study showed that stressors such as nitrate and total salts could potentially become a health or environmental problem during drought

  5. WAP Based An Alternative Solution for Traffic Transportation Problem in Sidoarjo Surrounding Area Using AHP

    Directory of Open Access Journals (Sweden)

    Arna Fariza

    2009-08-01

    Full Text Available In line with the increasing interest on Lapindo mud disaster which causes several roadway covered by mud, there is a need to give an alternative solution for traffic transportation problem in surrounding area. The possible criteria for the solution of this road way are length, surface, traffic, and width of the road. Types of vehicle across the road also give a contribution to the criteria. By using Geography Information System (GIS, it is easy to all drivers to take decision which way has to be chosen based on the real condition. GIS is used to visualize the alternative road, which is possible to take. Analytic Hierarchy Processing (AHP is a decision method which is based on many criteria and alternatives. The input of AHP can be a preference or real value. Applied AHP to decide value of each alternative is based on application of Wireless Application Protocol (WAP assessment.

  6. Impact of mechanical stretch on the cell behaviors of bone and surrounding tissues

    Science.gov (United States)

    Yu, Hye-Sun; Kim, Jung-Ju; Kim, Hae-Won; Lewis, Mark P; Wall, Ivan

    2016-01-01

    Mechanical loading is recognized to play an important role in regulating the behaviors of cells in bone and surrounding tissues in vivo. Many in vitro studies have been conducted to determine the effects of mechanical loading on individual cell types of the tissues. In this review, we focus specifically on the use of the Flexercell system as a tool for studying cellular responses to mechanical stretch. We assess the literature describing the impact of mechanical stretch on different cell types from bone, muscle, tendon, ligament, and cartilage, describing individual cell phenotype responses. In addition, we review evidence regarding the mechanotransduction pathways that are activated to potentiate these phenotype responses in different cell populations. PMID:26977284

  7. Environmental impacts of coal mine and thermal power plant to the surroundings of Barapukuria, Dinajpur, Bangladesh.

    Science.gov (United States)

    Hossain, Md Nazir; Paul, Shitangsu Kumar; Hasan, Md Muyeed

    2015-04-01

    The study was carried out to analyse the environmental impacts of coal mine and coal-based thermal power plant to the surrounding environment of Barapukuria, Dinajpur. The analyses of coal, water, soil and fly ash were carried out using standard sample testing methods. This study found that coal mining industry and coal-based thermal power plant have brought some environmental and socio-economic challenges to the adjacent areas such as soil, water and air pollution, subsidence of agricultural land and livelihood insecurity of inhabitants. The pH values, heavy metal, organic carbon and exchangeable cations of coal water treated in the farmland soil suggest that coal mining deteriorated the surrounding water and soil quality. The SO4(2-) concentration in water samples was beyond the range of World Health Organisation standard. Some physico-chemical properties such as pH, conductivity, moisture content, bulk density, unburned carbon content, specific gravity, water holding capacity, liquid and plastic limit were investigated on coal fly ash of Barapukuria thermal power plant. Air quality data provided by the Barapukuria Coal Mining Company Limited were contradictory with the result of interview with the miners and local inhabitants. However, coal potentially contributes to the development of economy of Bangladesh but coal mining deteriorates the environment by polluting air, water and soil. In general, this study includes comprehensive baseline data for decision makers to evaluate the feasibility of coal power industry at Barapukuria and the coalmine itself.

  8. Establishing the NeuroRecovery Network Community Fitness and Wellness facilities: multi-site fitness facilities provide activity-based interventions and assessments for evidence-based functional gains in neurologic disorders.

    Science.gov (United States)

    Tolle, Heather; Rapacz, Andrew; Weintraub, Barry; Shogren, Carrie; Harkema, Susan J; Gibson, Jeremy L

    2017-08-17

    Physical fitness is a necessity for those living with a spinal cord injury, yet access to fitness facilities, equipment, and specially trained fitness experts are limited. This article introduces the concept of a network of fitness facilities specially geared towards individuals with spinal cord injury and other neurological disorders. The Community Fitness and Wellness branch of the NeuroRecovery Network was created to provide a continuum of care after traditional rehabilitation for individuals living with a spinal cord injury and other neurological disorders. Community Fitness and Wellness facilities translate activity-based interventions performed during rehabilitation into a community setting as well as provide other fitness and wellness opportunities. Community Fitness and Wellness facilities are staffed by professionals with training on the specialized needs of individuals living with spinal cord injury or other neurological disorders. Standardized assessments evaluate functional, health, and quality of life gains at regular intervals. A national database gathers information on standardized interventions and assessment outcomes providing a mechanism for evaluation of interventions performed in the community setting. The establishment of Community Fitness and Wellness facilities allows for the quick translation and evaluation of novel, effective approaches from research to individuals in the community. Implications for Rehabilitation Fitness needs of individuals with spinal cord injury living in the community necessitate the use of special equipment and trained staff. Community Fitness and Wellness Programs offer specially trained staff and adaptive equipment providing a continuity of care for those with spinal cord injuries and other neurological disorders.

  9. Therapy Provider Phase Information

    Data.gov (United States)

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

  10. Convenience stores surrounding urban schools: an assessment of healthy food availability, advertising, and product placement.

    Science.gov (United States)

    Gebauer, Hilary; Laska, Melissa Nelson

    2011-08-01

    Adolescent obesity is a national public health problem, particularly among urban populations. Recent evidence has linked neighborhood food environments to health and nutrition status, with easier access to convenience stores being associated with increased risk for obesity. Little is known about the availability of healthy purchasing options within small, urban food stores, or the extent to which these factors are relevant to youth. The objective of this research was to characterize various features of the food environment within small convenience stores located nearby urban junior high and high schools. In-store audits were conducted in 63 stores located within 800 m of 36 urban Minnesota public secondary schools. Results indicated that a limited number of healthier beverages (i.e., water and 100% fruit juice) and snack options (i.e., nuts and pretzels) were available at most stores (≥85%). However, a wide range of healthy snack options were typically not available, with many specific items stocked in less than half of stores (e.g., low-fat yogurt in 27% of stores and low-fat granola bars in 43%). Overall, 51% of stores had fresh fruit and 49% had fresh vegetables. Few stores carried a range of healthier snack alternatives in single-serving packages. All stores had less healthful impulse purchase items available (e.g., candy) while only 46% carried healthier impulse items (e.g., fruit). Most stores (97%) had food/beverage advertising. Overall, convenience stores located in close proximity to secondary schools represent an important and understudied component of the youth food environment.

  11. Assessing the effect of publicly assisted brownfield redevelopment on surrounding property values

    Science.gov (United States)

    Christopher A. De Sousa; Changson Wu; Lynne M. Westphal

    2009-01-01

    This study measures and compares the impact of publicly assisted brownfield redevelopment on nearby residential property values in Milwaukee and Minneapolis. It also examines the influence of land use, neighborhood characteristics, and other redevelopment factors on this impact. The research approach incorporates a hedonic method to quantify nearby property value...

  12. Assessing the geologic and climatic forcing of biodiversity and evolution surrounding the Gulf of California

    Science.gov (United States)

    Dolby, Greer; Bennett, Scott E. K.; Lira-Noriega, Andres; Wilder, Benjamin T.; Munguia-Vega, Adrian

    2015-01-01

    For almost a century the Baja California peninsula (Peninsula), Gulf of California (Gulf), and broader Sonoran Desert region (figure 1) have drawn geologists and biologists alike to study its unique physical and evolutionary processes (e.g., Wittich 1920; Darton 1921; Nelson 1921; Johnston 1924; Beal 1948; Durham and Allison 1960). The challenge remains to untangle the long, intricate, and at times enigmatic geological and climatological histories that have shaped the high levels of endemism and biodiversity observed in the region today (Van Devender 1990; Grismer 2000; Riddle et al. 2000).

  13. Assessing Tourist Resorts Surrounding Metropolitans Applying SWOT- AHP Models Case study: Malaga Resort

    OpenAIRE

    A. Movahed; S. Amanpoor; R. Zarei

    2013-01-01

    Extended abstract1-IntroductionToday, the urban concept is not understandable without resorts in different forms and the results of urban development and environmental problems have made the development ad existence of resorts unavoidable.Ahvaz is one of the metropolitan cities. For the reason of its pollution, oil-dependent industries, hot and humid weather, having a long hot and dusty season, the citizens have been encouraged to travel to other areas with better climate. Therefore, it is ne...

  14. Generic assessment of radiation exposures to workers in a portable smelter and to the surrounding population

    International Nuclear Information System (INIS)

    Randolph, M.L.; Watson, A.P.; O'Donnell, F.R.

    1978-10-01

    A scenario for operation of a proposed portable smelter has been developed by National Lead Company of Ohio to recycle radioactively contaminated ferrous scrap arising from modifications at nuclear facilities of the Department of Energy. The current generic study complements that work by developing tables of radiation dose conversion factors for estimation of external whole-body doses and 50-year whole-body internal dose commitments to routine workers in the smelter and to the public within 50 miles of the smelter. Applications of the tables to specific cases require site-specific source terms consisting of amounts of radionuclides present in scrap metal, separation efficiency for radionuclides, concentration of contaminated airborne particulates, ingested amount of contaminated material, and amount of metal released through the stack. Equations relating doses to tabular values and these source terms are developed, and hypothetical sample calculations are given. Assumptions, approximations, and limitations of the methods are discussed as well as nonroutine operations and nonradioactive hazards

  15. Clinical assessment of demineralization and remineralization surrounding orthodontic brackets with FluoreCam

    Directory of Open Access Journals (Sweden)

    Bora Korkut

    2017-04-01

    Conclusions: This study demonstrated that demineralization is measurable around orthodontic brackets and the demineralization can be completely inhibited and/or reversed by the use of commercially available remineralization products.

  16. Supplement: The Rate of Binary Black Hole Mergers Inferred from Advanced LIGO Observations Surrounding GW150914

    Science.gov (United States)

    Abbott, B. P.; Abbott, R.; Abbott, T. D.; Abernathy, M. R.; Acernese, F.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; hide

    2016-01-01

    This article provides supplemental information for a Letter reporting the rate of (BBH) coalescences inferred from 16 days of coincident Advanced LIGO observations surrounding the transient (GW) signal GW150914. In that work wereported various rate estimates whose 90% confidence intervals fell in the range 2600 Gpc(exp -3) yr(exp -1). Here we givedetails on our method and computations, including information about our search pipelines, a derivation of ourlikelihood function for the analysis, a description of the astrophysical search trigger distribution expected frommerging BBHs, details on our computational methods, a description of the effects and our model for calibrationuncertainty, and an analytic method for estimating our detector sensitivity, which is calibrated to our measurements.

  17. Centre-surround organization of fast sensorimotor integration in human motor hand area

    DEFF Research Database (Denmark)

    Dubbioso, Raffaele; Raffin, Estelle; Karabanov, Anke

    2017-01-01

    Using the short-latency afferent inhibition (SAI) paradigm, transcranial magnetic stimulation (TMS) of the primary motor hand area (M1HAND) can probe how sensory input from limbs modulates corticomotor output in humans. Here we applied a novel TMS mapping approach to chart the spatial representat......Using the short-latency afferent inhibition (SAI) paradigm, transcranial magnetic stimulation (TMS) of the primary motor hand area (M1HAND) can probe how sensory input from limbs modulates corticomotor output in humans. Here we applied a novel TMS mapping approach to chart the spatial...... in M1HAND. Like homotopic SAI, heterotopic SAF was somatotopically expressed in M1HAND. Together, the results provide first-time evidence that fast sensorimotor integration involves centre-inhibition and surround-facilitation in human M1HAND....

  18. The impacts of nuclear facilities on property values and other factors in the surrounding communities

    International Nuclear Information System (INIS)

    Bezdek, R.H.; Wendling, R.M.

    2006-01-01

    This paper addresses the issue of the impact of the siting of nuclear facilities on the adjacent communities. It reviews previous studies on the issue and then empirically examines the impacts of seven major nuclear facilities located throughout the USA on the surrounding communities. The analysis focuses on the effects on local property values, economic growth, tax revenues, public services, community development, jobs and employment, and schools. Using published data, economic and statistical analyses, literature reviews and interviews, it finds that the impacts of these facilities have been largely positive. The findings are placed in perspective, caveats are noted concerning the generalisation of the conclusions derived and recommendations for required further research are provided. (author)

  19. Anisotropic surroundings effects on photo absorption of partially embedded Au nanospheroids in silica glass substrate

    Energy Technology Data Exchange (ETDEWEB)

    Meng, Xuan; Shibayama, Tamaki, E-mail: shiba@qe.eng.hokudai.ac.jp; Watanabe, Seiichi [Center for Advanced Research of Energy and Materials, Faculty of Engineering, Hokkaido University, Sapporo, Hokkaido 060–8628 (Japan); Yu, Ruixuan; Ishioka, Junya [Graduate School of Engineering, Hokkaido University, Sapporo, Hokkaido 060–8628 (Japan)

    2015-02-15

    The influence of a directly adjacent or an anisotropic surrounding medium alters the plasmonic properties of a nanoparticle because it provides a mechanism for symmetry breaking of the scattering. Given the success of ion irradiation induced embedment of rigid metallic nanospheroids into amorphous substrate, it is possible to examine the effect of the silica glass substrate on the plasmonic properties of these embedded nanospheroids. In this work presented here, discrete dipole approximation (DDA) calculations for the Au nanospheroids’ optical properties were performed based on 3–dimensional (3D) configuration extracted from planar SEM micrographs and cross–sectional TEM micrographs of the Au nanospheroids partially embedded in the silica glass, and the well–matched simulations with respect to the experimental measurements could demonstrate the dielectric constant at the near surface of silica glass decreased after Ar–ion irradiation.

  20. Optical and infrared study of the region surrounding Herbig-Haro objects 1 and 2

    International Nuclear Information System (INIS)

    Strom, S.E.; Strom, K.M.; Grasdalen, G.L.; Sellgren, K.; Wolff, S.; Wyoming Univ., Laramie; Hawaii Univ., Honolulu)

    1985-01-01

    Optical and near-IR observations of the environs of H-H objects 1 and 2 provide the basis for identifying a recently discovered radio continuum as the star responsible for powering the highly collimated mass outflow traced by these objects. Polarimetric observations show that the source (designated as VLA 1), located at the midpoint between HH 1 and 2, illuminates a biconical reflection nebula. It is suggested that VLA 1 is probably surrounded by an optically thick disk viewed edge on; an optical jet emanates from the vicinity of HH 1 and is directed along the axis of the putative disk toward HH 1; its spectrum resembles that of HH 1 and other Herbig-Haro objects. 37 references

  1. Factual biosphere database for Dounreay and the surrounding area

    International Nuclear Information System (INIS)

    Broderick, M.A.

    1991-12-01

    This report documents from open published sources a factual database appropriate to the Dounreay region including the coastal marine environment for present day biosphere conditions. A detailed description of the present day environment in the Dounreay area is provided. This includes a description of the natural environment and climate. Site specific data required for biosphere modelling are also outlined. (author)

  2. Chemical Variations in a Granitic Pluton and Its Surrounding Rocks.

    Science.gov (United States)

    Baird, A K; McIntyre, D B; Welday, E E; Madlem, K W

    1964-10-09

    New techniques of x-ray fluorescence spectrography have provided, for the first time, abundant data regarding chemical variability of granitic rocks on different scales. The results suggest that current designs of sampling plans for trend surface analysis should be modified; in particular several specimens, preferably drillcores, may be required at each locality.

  3. Factual biosphere database for Dounreay and the surrounding area

    Energy Technology Data Exchange (ETDEWEB)

    Broderick, M A [ANS Consultants Ltd., Epsom (United Kingdom)

    1991-12-01

    This report documents from open published sources a factual database appropriate to the Dounreay region including the coastal marine environment for present day biosphere conditions. A detailed description of the present day environment in the Dounreay area is provided. This includes a description of the natural environment and climate. Site specific data required for biosphere modelling are also outlined. (author).

  4. Factual biosphere database for Sellafield and the surrounding area

    Energy Technology Data Exchange (ETDEWEB)

    Broderick, M A [ANS Consultants Ltd., Epsom (United Kingdom)

    1991-12-01

    This report documents from open published sources a factual database appropriate to the Sellafield region including the coastal marine environment for present day biosphere conditions. A detailed description of the present day environment in the Sellafield area is provided. This includes a description of the natural environment and climate. Site specific data required for biosphere modelling are also outlined. (author).

  5. Factual biosphere database for Sellafield and the surrounding area

    International Nuclear Information System (INIS)

    Broderick, M.A.

    1991-12-01

    This report documents from open published sources a factual database appropriate to the Sellafield region including the coastal marine environment for present day biosphere conditions. A detailed description of the present day environment in the Sellafield area is provided. This includes a description of the natural environment and climate. Site specific data required for biosphere modelling are also outlined. (author)

  6. An Examination of Issues Surrounding Information Security in California Colleges

    Science.gov (United States)

    Butler, Robert D.

    2013-01-01

    Technological advances have provided increasing opportunities in higher education for delivering instruction and other services. However, exposure to information security attacks has been increasing as more organizations conduct their businesses online. Higher education institutions have one of the highest frequencies of security breaches as…

  7. Issues Surrounding the Use of Virtual Reality in Geographic Education

    Science.gov (United States)

    Lisichenko, Richard

    2015-01-01

    As with all classroom innovations intended to improve geographic education, the adoption of virtual reality (VR) poses issues for consideration prior to endorsing its use. Of these, effectiveness, implementation, and safe use need to be addressed. Traditionally, sense of place, geographic knowledge, and firsthand experiences provided by field…

  8. Child-headed households because of the trauma surrounding HIV ...

    African Journals Online (AJOL)

    Misinformation, ignorance and prejudice concerning HIV/AIDS limit the willingness of a community to provide for the orphans who have been affected by the disease. This article aims to address the question why this is also the case in South Africa and why the African philosophy of “ubuntu” (humaneness), does not seem to ...

  9. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

    OpenAIRE

    Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

    2017-01-01

    This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present w...

  10. VESUVIUS PENTALOGUE: Interdisciplinary Science for Disaster Resilience and Sustainability of Populations Surrounding Vesuvius

    Science.gov (United States)

    Dobran, F.

    2015-12-01

    VESUVIUS PENTALOGUE is an elaboration of VESUVIUS 2000 scientific initiative aimed at volcanic risk reduction in the Vesuvius area. Its 5 building blocks are: (1) The current strategy of volcanic risk management (massive deportation of population) is both problematic and unacceptable. (2) A continuing close habitation of the population with the volcano should be the crucial cultural point to be pursued. This can be accomplished through a redefinition of the danger zone around Summa-Vesuvius as follows: (a) An exclusion nucleus should be established that prohibits all future human settlements and discourage the existing ones; (b) A resilience belt, housing most of the current population, should be established; (c) A sustainable area should be established beyond the resilience belt, allowing for both sustainable practices and temporary resettlements of the "resilience belt" citizens. (3) The built environment construction codes for the population of the danger zone should be established by utilizing Plinian eruption scenarios, scenario-based seismic hazard assessment and zonation, (c) dynamic structural analyses, (d) global volcanic simulations modeling of thermo-fluid dynamic eruption processes. (4) The volcanic risk information and education should involve an effective volcanic risk information campaign and active public preparedness strategy. This should be implemented for the exclusion nucleus, resilience belt, and sustainable area regions surrounding Summa-Vesuvius. A Volcanic Risk Education Safety Program should be implemented in all schools located within each of the above areas surrounding the volcano. (5)The political Authorities and the scientific community should produce a "memorandum of understanding" that univocally establishes an effective collaboration, and periodic progress reports that keep the populations informed on the improvements leading to the realization of the above objectives. For further details see www.gvess.org.

  11. To assess whether indoor residual spraying can provide additional protection against clinical malaria over current best practice of long-lasting insecticidal mosquito nets in The Gambia: study protocol for a two-armed cluster-randomised trial

    Directory of Open Access Journals (Sweden)

    Parker David

    2011-06-01

    Full Text Available Abstract Background Recently, there has been mounting interest in scaling-up vector control against malaria in Africa. It needs to be determined if indoor residual spraying (IRS with DDT will provide significant marginal protection against malaria over current best practice of long-lasting insecticidal nets (LLINs and prompt treatment in a controlled trial, given that DDT is currently the most persistent insecticide for IRS. Methods A 2 armed cluster-randomised controlled trial will be conducted to assess whether DDT IRS and LLINs combined provide better protection against clinical malaria in children than LLINs alone in rural Gambia. Each cluster will be a village, or a group of small adjacent villages; all clusters will receive LLINs and half will receive IRS in addition. Study children, aged 6 months to 13 years, will be enrolled from all clusters and followed for clinical malaria using passive case detection to estimate malaria incidence for 2 malaria transmission seasons in 2010 and 2011. This will be the primary endpoint. Exposure to malaria parasites will be assessed using light and exit traps followed by detection of Anopheles gambiae species and sporozoite infection. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection and the prevalence of anaemia. Discussion Practical issues concerning intervention implementation, as well as the potential benefits and risks of the study, are discussed. Trial Registration ISRCTN01738840 - Spraying And Nets Towards malaria Elimination (SANTE

  12. Laser and biological methods of biomonitoring of surrounding waters

    Science.gov (United States)

    Posudin, Yuri I.

    1994-02-01

    Three main methods are proposed for the biomonitoring of chemicals in water medium: laser spectrofluorometry, which is based on the excitation and recording of the spectra of fluorescence; laser scattering, which is connected with measurement of the Doppler shifts of the scattered light from the motile cells; videomicrography, which provides the analysis of parameters of photomovement of motile cells via microscope and video system. Such chemicals as surface-active substances, heavy metals and pesticides were determined in water medium due to these methods.

  13. Study on water migration of tunnel surrounding rock in nuclear waste repository based on coupling theory

    International Nuclear Information System (INIS)

    Jiang Zhongming; Zhang Xinmin

    2008-01-01

    Excavation of tunnel changes not only the stresses and deformation of tunnel surrounding rock, but also disturbs the underground water environment in tunnel surrounding rock Water migration happens due to variation of pore water pressure and redistribution. Based on the mechanics of porous media, saturated and unsaturated hydro-mechanical coupling analysis method is employed to study the variation of the stresses, deformation and pore pressure of the surrounding rock. Case study indicates that the excavation of tunnel will induce redistribution of stress and pore water pressure. Redistribution of pore water pressure will seriously affect on evaluation of surrounding rock stability and diffusion of nucleon in the pore water. (authors)

  14. Cultural aspects and mythologies surrounding menstruation and abnormal uterine bleeding.

    Science.gov (United States)

    Tan, Delfin A; Haththotuwa, Rohana; Fraser, Ian S

    2017-04-01

    The objective of this chapter is to present an overview of how menstruation, a normal bodily function, was and is perceived in various ethnic groups and cultures in the world, from ancient mythology, historical, or traditional practices to contemporary belief systems. Mythical tales about menstruation abound in the legends and prehistory of ancient cultures. These tales characterize menstrual blood variously as sacred, a gift from the gods, or a punishment for sin, but it is almost always magical and powerful. In contrast, most world religions view menstruation, with varying degrees of severity, as a major problem, a sign of impurity and uncleanliness, and therefore, menstruating women are isolated, prohibited from polluting the holy places, and shunned. Many of these myths and cultural misperceptions persist to the present day, reflected in a wide range of negative attitudes toward menstruation, which can have serious and direct implications for reproductive health. In view of the increasingly globalized nature of current clinical practice, it is crucial that health care providers are familiar with existing cultural and social views and attitudes toward the menstrual function. The ultimate goal is to be able to provide women culturally sensitive and medically appropriate therapies for their menstrual disorders. This biocultural approach to menstruation management is desirable in contemporary medical practice. Copyright © 2016. Published by Elsevier Ltd.

  15. Issues Surrounding the Evaluation of Teacher Internship Programs

    Science.gov (United States)

    Barrett, D.

    2006-12-01

    Georgia Intern-Fellowships for Teachers (GIFT) is a collaborative effort designed to enhance mathematics and science experiences of Georgia teachers and their students through summer research internships for teachers. By offering business, industry, public science institute and research summer fellowships to teachers, GIFT provides educators with first-hand exposure to the skills and knowledge necessary for the preparation of our future workforce. Since 1991, GIFT has placed middle and high school math, science and technology teachers in over 1100 positions throughout the state. In these fellowships, teachers are involved in cutting edge scientific and engineering research, data analysis, curriculum development and real-world inquiry and problem solving, and create Action Plans to assist them in translating the experience into changed classroom practice. Since 2004, an increasing number of high school students have worked with their teachers in research laboratories. The GIFT program has an advisory board composed of university researchers, business and education leaders. The board members work in various subcommittees assisting the program with areas such as sponsor recruitment, evaluation and long term planning. The evaluation subcommittee has been actively involved in providing direction regarding the evaluation of the GIFT program's impact on teachers and their students. The program recently conducted a survey of its former participants. This presentation will discuss the results of the survey and the challenges associated with program evaluation of teacher internship programs.

  16. The impact of green stormwater infrastructure installation on surrounding health and safety.

    Science.gov (United States)

    Kondo, Michelle C; Low, Sarah C; Henning, Jason; Branas, Charles C

    2015-03-01

    We investigated the health and safety effects of urban green stormwater infrastructure (GSI) installments. We conducted a difference-in-differences analysis of the effects of GSI installments on health (e.g., blood pressure, cholesterol and stress levels) and safety (e.g., felonies, nuisance and property crimes, narcotics crimes) outcomes from 2000 to 2012 in Philadelphia, Pennsylvania. We used mixed-effects regression models to compare differences in pre- and posttreatment measures of outcomes for treatment sites (n=52) and randomly chosen, matched control sites (n=186) within multiple geographic extents surrounding GSI sites. Regression-adjusted models showed consistent and statistically significant reductions in narcotics possession (18%-27% less) within 16th-mile, quarter-mile, half-mile (P<.001), and eighth-mile (P<.01) distances from treatment sites and at the census tract level (P<.01). Narcotics manufacture and burglaries were also significantly reduced at multiple scales. Nonsignificant reductions in homicides, assaults, thefts, public drunkenness, and narcotics sales were associated with GSI installation in at least 1 geographic extent. Health and safety considerations should be included in future assessments of GSI programs. Subsequent studies should assess mechanisms of this association.

  17. Natural radionuclides in soil profiles surrounding the largest coal-fired power plant in Serbia

    Directory of Open Access Journals (Sweden)

    Tanić Milan N.

    2016-01-01

    Full Text Available This study evaluates the influence of the largest Serbian coal-fired power plant on radionuclide concentrations in soil profiles up to 50 cm in depth. Thirty soil profiles were sampled from the plant surroundings (up to 10 km distance and analyzed using standard methods for soil physicochemical properties and gamma ray spectrometry for specific activities of natural radionuclides (40K, 226Ra and 232Th. Spatial and vertical distribution of radionuclides was determined and analyzed to show the relations between the specific activities in the soil and soil properties and the most influential factors of natural radionuclide variability were identified. The radiological indices for surface soil were calculated and radiological risk assessment was performed. The measured specific activities were similar to values of background levels for Serbia. The sampling depth did not show any significant influence on specific activities of natural radionuclides. The strongest predictor of specific activities of the investigated radionuclides was soil granulometry. All parameters of radiological risk assessment were below the recommended values and adopted limits. It appears that the coal-fired power plant does not have a significant impact on the spatial and vertical distribution of natural radionuclides in the area of interest, but technologically enhanced natural radioactivity as a consequence of the plant operations was identified within the first 1.5 km from the power plant. [Projekat Ministarstva nauke Republike Srbije br. III43009 i br. III41005

  18. The physical characteristics of the sediments on and surrounding Dauphin Island, Alabama

    Science.gov (United States)

    Ellis, Alisha M.; Marot, Marci E.; Smith, Christopher G.; Wheaton, Cathryn J.

    2017-06-20

    Scientists from the U.S. Geological Survey, St. Petersburg Coastal and Marine Science Center collected 303 surface sediment samples from Dauphin Island, Alabama, and the surrounding water bodies in August 2015. These sediments were processed to determine physical characteristics such as organic content, bulk density, and grain-size. The environments where the sediments were collected include high and low salt marshes, washover deposits, dunes, beaches, sheltered bays, and open water. Sampling by the USGS was part of a larger study to assess the feasibility and sustainability of proposed restoration efforts for Dauphin Island, Alabama, and assess the island’s resilience to rising sea level and storm events. The data presented in this publication can be used by modelers to attempt validation of hindcast models and create predictive forecast models for both baseline conditions and storms. This study was funded by the National Fish and Wildlife Foundation, via the Gulf Environmental Benefit Fund.This report serves as an archive for sedimentological data derived from surface sediments. Downloadable data are available as Excel spreadsheets, JPEG files, and formal Federal Geographic Data Committee metadata.

  19. Microbiological monitoring of acid mine drainage treatment systems and aquatic surroundings using real-time PCR.

    Science.gov (United States)

    Han, J S; Kim, C G

    2009-01-01

    In general, acid mine drainage (AMD) causes low pH and high metal concentrations in mining areas and surroundings. The aim of this research was to achieve microbiological monitoring for AMD and to assess whether mine water outflows have any ecological effects on the aqueous ecosystem receiving effluents from different types of treatment system. The water quality of aquatic sample was analyzed and the molecular biological diversity of the samples was assessed using 16S rRNA methods, which were implemented to determine which bacteria existed throughout various unit processes for different AMD treatment systems and their receiving water environments. Acidiphilium cryptum, a heterotrophic acidophile, was found at the AMD sites, and Rhodoferax ferrireducens, which can reduce iron using insoluble Fe(III) as an electron acceptor, was detected at many AMD treatment facilities and downstream of the treatment processes. Subsequently, quantitative real-time PCR was conducted on specific genes of selected bacteria. Surprisingly, obvious trends were observed in the relative abundance of the various bacteria that corresponded to the water quality analytical results. The copy number of Desulfosporosinus orientus, a sulfate reducing bacteria, was also observed to decrease in response to decreases in metals according to the downstream flow of the AMD treatment system.

  20. P3-23: Center/Surround Motion Interactions Measured Using a Nulling Procedure

    Directory of Open Access Journals (Sweden)

    Soo Hyun Park

    2012-10-01

    Full Text Available Many direction-selective neurons have a receptive field structure that promotes suppressive interactions between center and surround regions. These interactions sculpt the overall pattern of activity among those neurons and, therefore, presumably impact perceived direction of motion. To test this conjecture, we have assessed the effect of motion signals produced by a moving stimulus on perceived motion within a neighboring region. On each trial a vertical bar (inducer appeared at 8 eccentricity in the upper visual field, moving either leftward or rightward, and a circular shaped random dot kinematogram (test appeared at 4 eccentricity. The test dots moved randomly except when the inducer passed nearby the test, at which time a pulse of coherent motion occurred in one of the two directions within the test. Coherence strength was adjusted by QUEST to maintain equal likelihood (point of subjective equality: PSE of leftward and rightward reports of perceived direction during this motion pulse. The inducer caused a substantial shift in PSE: it was necessary for the test to contain 50% coherent motion in the same direction as that of the inducer to nullify the illusory motion within the test caused by the inducer. The effect of the inducer could also be offset by simultaneously presenting a second inducer moving in the opposite direction. This pattern of results implies substantial suppressive interactions between neighboring moving stimuli, interactions whose strength and direction can be assessed psychophysically using nulling procedures.

  1. The Halo surrounding native English speaker teachers in Indonesia

    Directory of Open Access Journals (Sweden)

    Angga Kramadibrata

    2016-01-01

    Full Text Available The Native Speaker Fallacy, a commonly held belief that Native English Speaker Teachers (NESTs are inherently better than Non-NESTs, has long been questioned by ELT researchers. However, this belief still stands strong in the general public. This research looks to understand how much a teacher’s nativeness affects a student’s attitude towards them, as well as the underlying reasons for their attitudes. Sixty seven respondents in two groups were asked to watch an animated teaching video, after which they completed a questionnaire that used Likert-scales to assess comprehensibility, clarity of explanation, engagement, and preference. The videos for both groups were identical apart from the narrator; one spoke in British English, while the other, Indian English. In addition, they were also visually identified as Caucasian and Asian, respectively. The video was controlled for speed of delivery. The quantitative data were then triangulated using qualitative data collected through open questions in the questionnaire as well as from a semi-structured interview conducted with 10 respondents. The data show that there is a significant implicit preference for NEST teachers in the video, as well as in respondent’s actual classes. However, when asked explicitly, respondents didn’t rank nativeness as a very important quality in English teachers. This discrepancy between implicit and explicit attitudes might be due to a subconscious cognitive bias, namely the Halo Effect, in which humans tend to make unjustified presumptions about a person based on known but irrelevant information.

  2. Comparison between zircaloy oxidation in steam and air surroundings

    International Nuclear Information System (INIS)

    Shawkat, M.E.; Hasaneln, H.; Ali, M.; Parlatan, Y.; Albasha, H.

    2013-01-01

    The available experimental data for Zircaloy oxidation in air were reviewed. The behavior of the oxidation kinetics at different temperature ranges was described. It was shown that maintaining the oxidation kinetics within the oxide pre-breakaway region can prevent elevated sheath temperatures due to the oxidation process during postulated accidents. The available correlations to model the oxidation kinetics for pre-breakaway region were reviewed and assessed. Zircaloy-air oxidation correlation based on Leistikow-Berg data was determined to be the most suitable correlation to model pre-breakaway kinetics and it was compared to Urbanic-Heidrick correlation which is widely used for Zircaloy oxidation in steam environment. The results showed that the energy release due to the Zircaloy-steam oxidation bounds the energy released due to Zircaloy-air oxidation up to a sheath temperature referred as the “crossover temperature”. Below this temperature, the impact of Zircaloy-air oxidation on fuel sheath temperature transient can be predicted conservatively using the Urbanic-Heidrick steam correlation. The crossover temperature was calculated for isothermal sheath heating as well as transient sheath heat-up assuming three linear heating rates of 0.6, 1.0, and 1.3 K/s. (author)

  3. Comparison of Socioeconomic Factors between Surrounding and Non-Surrounding Areas of the Qinghai–Tibet Railway before and after Its Construction

    Directory of Open Access Journals (Sweden)

    Shicheng Li

    2016-08-01

    Full Text Available As the world’s highest railway, and the longest highland railway, the Qinghai–Tibet Railway (QTR has been paid considerable attention by researchers. However, most attention has been paid to the ecological and environmental issues affecting it, and sustainable ecological, social, and economic development-related studies of the QTR are rare. In this study, by analyzing the passenger traffic, freight traffic, passenger-kilometers, and freight-kilometers of the QTR for the period 1982–2013 and the transport structure of the Tibetan Plateau (TP for 1990–2013, the evolutionary process of the transport system in the TP following the construction of the QTR has been revealed. Subsequently, by comparing Gross Domestic Product (GDP, population, industrial structure, and urbanization level at the county and 1 km scales between surrounding and non-surrounding areas of the QTR, the differences in socioeconomic performance before and after its construction were detected. The results show that (1 in the TP, the highway-dominated transport system will break up and an integrated and sustainable transport system will form; (2 at the county scale, the annual growth rates of GDP of counties surrounding the QTR were greater than those of non-surrounding counties for the period 2000–2010. At the 1 km scale, following the opening of the completed line, the GDP of surrounding areas had a greater growth rate than before; (3 analysis at the county and 1 km scales indicated that population was not aggregated into the surrounding areas of the QTR in the period 2000–2010; (4 in terms of industrial structure, the proportion of primary industry decreased continuously, while the proportion of secondary and tertiary industries increased overall in the period 1984–2012. The QTR had no obvious impact on changes in the urbanization level of its surrounding areas.

  4. Linguistic markers of psychological change surrounding September 11, 2001.

    Science.gov (United States)

    Cohn, Michael A; Mehl, Matthias R; Pennebaker, James W

    2004-10-01

    The diaries of 1,084 U.S. users of an on-line journaling service were downloaded for a period of 4 months spanning the 2 months prior to and after the September 11 attacks. Linguistic analyses of the journal entries revealed pronounced psychological changes in response to the attacks. In the short term, participants expressed more negative emotions, were more cognitively and socially engaged, and wrote with greater psychological distance. After 2 weeks, their moods and social referencing returned to baseline, and their use of cognitive-analytic words dropped below baseline. Over the next 6 weeks, social referencing decreased, and psychological distancing remained elevated relative to baseline. Although the effects were generally stronger for individuals highly preoccupied with September 11, even participants who hardly wrote about the events showed comparable language changes. This study bypasses many of the methodological obstacles of trauma research and provides a fine-grained analysis of the time line of human coping with upheaval.

  5. Medical service provider networks.

    Science.gov (United States)

    Mougeot, Michel; Naegelen, Florence

    2018-05-17

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

  6. Social and Economic Burden Associated With Typhoid Fever in Kathmandu and Surrounding Areas: A Qualitative Study.

    Science.gov (United States)

    Kaljee, Linda M; Pach, Alfred; Garrett, Denise; Bajracharya, Deepak; Karki, Kshitu; Khan, Imran

    2017-07-29

    Typhoid fever is a significant contributor to infectious disease mortality and morbidity in low- and middle-income countries, particularly in South Asia. With increasing antimicrobial resistance, commonly used treatments are less effective and risks increase for complications and hospitalizations. During an episode of typhoid fever, households experience multiple social and economic costs that are often undocumented. In the current study, qualitative interview data from Kathmandu and surrounding areas provide important insights into the challenges that affect those who contract typhoid fever and their caregivers, families, and communities, as well as insight into prevention and treatment options for health providers and outreach workers. When considering typhoid fever cases confirmed by blood culture, our data reveal delays in healthcare access, financial and time costs burden on households, and the need to increase health literacy. These data also illustrate the impact of limited laboratory diagnostic equipment and tools on healthcare providers' abilities to distinguish typhoid fever from other febrile conditions and treatment challenges associated with antimicrobial resistance. In light of these findings, there is an urgent need to identify and implement effective preventive measures including vaccination policies and programs focused on at-risk populations and endemic regions such as Nepal. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  7. Combined use of inactivated and oral poliovirus vaccines in refugee camps and surrounding communities - Kenya, December 2013.

    Science.gov (United States)

    Sheikh, Mohamed A; Makokha, Frederick; Hussein, Abdullahi M; Mohamed, Gedi; Mach, Ondrej; Humayun, Kabir; Okiror, Samuel; Abrar, Leila; Nasibov, Orkhan; Burton, John; Unshur, Ahmed; Wannemuehler, Kathleen; Estivariz, Concepcion F

    2014-03-21

    Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, circulation of indigenous wild poliovirus (WPV) has continued without interruption in only three countries: Afghanistan, Nigeria, and Pakistan. During April-December 2013, a polio outbreak caused by WPV type 1 (WPV1) of Nigerian origin resulted in 217 cases in or near the Horn of Africa, including 194 cases in Somalia, 14 cases in Kenya, and nine cases in Ethiopia (all cases were reported as of March 10, 2014). During December 14-18, 2013, Kenya conducted the first-ever campaign providing inactivated poliovirus vaccine (IPV) together with oral poliovirus vaccine (OPV) as part of its outbreak response. The campaign targeted 126,000 children aged ≤59 months who resided in Somali refugee camps and surrounding communities near the Kenya-Somalia border, where most WPV1 cases had been reported, with the aim of increasing population immunity levels to ensure interruption of any residual WPV transmission and prevent spread from potential new importations. A campaign evaluation and vaccination coverage survey demonstrated that combined administration of IPV and OPV in a mass campaign is feasible and can achieve coverage >90%, although combined IPV and OPV campaigns come at a higher cost than OPV-only campaigns and require particular attention to vaccinator training and supervision. Future operational studies could assess the impact on population immunity and the cost-effectiveness of combined IPV and OPV campaigns to accelerate interruption of poliovirus transmission during polio outbreaks and in certain areas in which WPV circulation is endemic.

  8. Vision and the representation of the surroundings in spatial memory.

    Science.gov (United States)

    Tatler, Benjamin W; Land, Michael F

    2011-02-27

    One of the paradoxes of vision is that the world as it appears to us and the image on the retina at any moment are not much like each other. The visual world seems to be extensive and continuous across time. However, the manner in which we sample the visual environment is neither extensive nor continuous. How does the brain reconcile these differences? Here, we consider existing evidence from both static and dynamic viewing paradigms together with the logical requirements of any representational scheme that would be able to support active behaviour. While static scene viewing paradigms favour extensive, but perhaps abstracted, memory representations, dynamic settings suggest sparser and task-selective representation. We suggest that in dynamic settings where movement within extended environments is required to complete a task, the combination of visual input, egocentric and allocentric representations work together to allow efficient behaviour. The egocentric model serves as a coding scheme in which actions can be planned, but also offers a potential means of providing the perceptual stability that we experience.

  9. Vision and the representation of the surroundings in spatial memory

    Science.gov (United States)

    Tatler, Benjamin W.; Land, Michael F.

    2011-01-01

    One of the paradoxes of vision is that the world as it appears to us and the image on the retina at any moment are not much like each other. The visual world seems to be extensive and continuous across time. However, the manner in which we sample the visual environment is neither extensive nor continuous. How does the brain reconcile these differences? Here, we consider existing evidence from both static and dynamic viewing paradigms together with the logical requirements of any representational scheme that would be able to support active behaviour. While static scene viewing paradigms favour extensive, but perhaps abstracted, memory representations, dynamic settings suggest sparser and task-selective representation. We suggest that in dynamic settings where movement within extended environments is required to complete a task, the combination of visual input, egocentric and allocentric representations work together to allow efficient behaviour. The egocentric model serves as a coding scheme in which actions can be planned, but also offers a potential means of providing the perceptual stability that we experience. PMID:21242146

  10. [Toxic fungi in Buenos Aires City and surroundings].

    Science.gov (United States)

    Romano, Gonzalo M; Iannone, Leopoldo; Novas, María V; Carmarán, Cecilia; Romero, Andrea I; López, Silvia E; Lechner, Bernardo E

    2013-01-01

    In Facultad de Ciencias Exactas y Naturales,Universidad de Buenos Aires there is a service called Servicio de Identificación de Hongos Tóxicos, directed by researchers of the Program of Medicinal Plants and Fungi Involved in Biological Degradation (PROPLAME-PRHIDEB, CONICET) that assist hospitals and other health establishments, identifying the different samples of fungi and providing information about their toxicity, so that patients can receive the correct treatment. The objective of