Technology assessment of various coal-fuel options

International Nuclear Information System (INIS)

Coenen, R.; Findling, B.; Klein-Vielhauer, S.; Nieke, E.; Paschen, H.; Tangen, H.; Wintzer, D.

1991-01-01

The technology assessment (TA) study of coal-based fuels presented in this report was performed for the Federal Ministry for Research and Technology. Its goal was to support decision-making of the Federal Ministry for Research and Technology in the field of coal conversion. Various technical options of coal liquefaction have been analyzed on the basis of hard coal as well as lignite -- direct liquefaction of coal (hydrogenation) and different possibilities of indirect liquefaction, that is the production of fuels (methanol, gasoline) by processing products of coal gasification. The TA study takes into consideration the entire technology chain from coal mining via coal conversion to the utilization of coal-based fuels in road transport. The analysis focuses on costs of the various options, overall economic effects, which include effects on employment and public budgets, and on environmental consequences compared to the use of liquid fuels derived from oil. Furthermore, requirements of infrastructure and other problems of the introduction of coal-based fuels as well as prospects for the export of technologies of direct and indirect coal liquefaction have been analyzed in the study. 14 figs., 10 tabs

The research on teaching reformation of photoelectric information science and engineering specialty experiments

Science.gov (United States)

Zhu, Zheng; Yang, Fan; Zhang, Yang; Geng, Tao; Li, Yuxiang

2017-08-01

This paper introduced the idea of teaching reformation of photoelectric information science and engineering specialty experiments. The teaching reformation of specialty experiments was analyzed from many aspects, such as construction of specialized laboratory, experimental methods, experiment content, experiment assessing mechanism, and so on. The teaching of specialty experiments was composed of four levels experiments: basic experiments, comprehensive and designing experiments, innovative research experiments and engineering experiments which are aiming at enterprise production. Scientific research achievements and advanced technology on photoelectric technology were brought into the teaching of specialty experiments, which will develop the students' scientific research ability and make them to be the talent suitable for photoelectric industry.

Technological substitution options for controlling greenhouse gas emissions

International Nuclear Information System (INIS)

Barbier, E.B.; Burgess, J.C.; Pearce, D.W.

1991-01-01

This chapter is concerned with technological options for greenhouse gas substitution. The authors interpret the term substitution to exclude energy conservation/efficiency measures, investments in afforestation (sinks), and greenhouse gas removal or abatement technologies. Their working definition of greenhouse gas substitution includes (1) replacement technologies, for example, substituting a greenhouse gas technology with a nongreenhouse gas technology; and (2) reduction technologies, for example, substituting a greenhouse gas technology with an alternative technology that reduces greenhouse gas emissions. Essentially, replacement technologies involve 100 percent reduction in CO 2 ; reduction technologies involve a partial reduction in CO 2 . Of the man-made sources of greenhouse gases, energy is the most important and is expected to contribute to at least half of the global warming effect in the near future. The majority of this impact is from fossil fuel combustion as a source of carbon dioxide (CO 2 ), although fossil fuels also contribute significantly to methane (CH 4 ), to nitrous oxide (N 2 O), and to low-level ozone (O 3 ) through production of various nitrogen gases (NO x ) and carbon monoxide (CO). This study analyzes the available greenhouse gas substitutions and their costs. The authors concentrate particularly on substitutions for fossil-fuel combustion and CFC production and consumption. They conclude by summarizing the potential for greenhouse gas substitution, the cost-effectiveness of the various options and the design of incentives for substitution

effectiveness of technological options for minimising production risks

African Journals Online (AJOL)

ACSS

preferred technologies in reducing production risk related to climate variability in Eastern Uganda. Data for this study were ..... Set of technological options employed by farmers to reduce climate-induced production risk. Dummy = 1 if farmer. 0.71. 0.46 ..... cation exchange capacity for holding nutrients against leaching loss.

Recent trends in specialty pharma business model

Directory of Open Access Journals (Sweden)

Mannching Sherry Ku

2015-12-01

Full Text Available The recent rise of specialty pharma is attributed to its flexible, versatile, and open business model while the traditional big pharma is facing a challenging time with patent cliff, generic threat, and low research and development (R&D productivity. These multinational pharmaceutical companies, facing a difficult time, have been systematically externalizing R&D and some even establish their own corporate venture capital so as to diversify with more shots on goal, with the hope of achieving a higher success rate in their compound pipeline. Biologics and clinical Phase II proof-of-concept (POC compounds are the preferred licensing and collaboration targets. Biologics enjoys a high success rate with a low generic biosimilar threat, while the need is high for clinical Phase II POC compounds, due to its high attrition/low success rate. Repurposing of big pharma leftover compounds is a popular strategy but with limitations. Most old compounds come with baggage either in lackluster clinical performance or short in patent life. Orphan drugs is another area which has gained popularity in recent years. The shorter and less costly regulatory pathway provides incentives, especially for smaller specialty pharma. However, clinical studies on orphan drugs require a large network of clinical operations in many countries in order to recruit enough patients. Big pharma is also working on orphan drugs starting with a small indication, with the hope of expanding the indication into a blockbuster status. Specialty medicine, including orphan drugs, has become the growth engine in the pharmaceutical industry worldwide. Big pharma is also keen on in-licensing technology or projects from specialty pharma to extend product life cycles, in order to protect their blockbuster drug franchises. Ample opportunities exist for smaller players, even in the emerging countries, to collaborate with multinational pharmaceutical companies provided that the technology platforms or

Recent trends in specialty pharma business model.

Science.gov (United States)

Ku, Mannching Sherry

2015-12-01

The recent rise of specialty pharma is attributed to its flexible, versatile, and open business model while the traditional big pharma is facing a challenging time with patent cliff, generic threat, and low research and development (R&D) productivity. These multinational pharmaceutical companies, facing a difficult time, have been systematically externalizing R&D and some even establish their own corporate venture capital so as to diversify with more shots on goal, with the hope of achieving a higher success rate in their compound pipeline. Biologics and clinical Phase II proof-of-concept (POC) compounds are the preferred licensing and collaboration targets. Biologics enjoys a high success rate with a low generic biosimilar threat, while the need is high for clinical Phase II POC compounds, due to its high attrition/low success rate. Repurposing of big pharma leftover compounds is a popular strategy but with limitations. Most old compounds come with baggage either in lackluster clinical performance or short in patent life. Orphan drugs is another area which has gained popularity in recent years. The shorter and less costly regulatory pathway provides incentives, especially for smaller specialty pharma. However, clinical studies on orphan drugs require a large network of clinical operations in many countries in order to recruit enough patients. Big pharma is also working on orphan drugs starting with a small indication, with the hope of expanding the indication into a blockbuster status. Specialty medicine, including orphan drugs, has become the growth engine in the pharmaceutical industry worldwide. Big pharma is also keen on in-licensing technology or projects from specialty pharma to extend product life cycles, in order to protect their blockbuster drug franchises. Ample opportunities exist for smaller players, even in the emerging countries, to collaborate with multinational pharmaceutical companies provided that the technology platforms or specialty medicinal

Medical specialty preferences in early medical school training in Canada.

Science.gov (United States)

Vo, Anthony; McLean, Laurie; McInnes, Matthew D F

2017-11-14

To understand what medical students consider when choosing their specialty, prior to significant clinical exposure to develop strategies to provide adequate career counseling. A cross-sectional study was performed by distributing optional questionnaires to 165 first-year medical students at the University of Ottawa in their first month of training with a sample yield of 54.5% (n=90).  Descriptive statistics, analysis of variance, Spearman's rank correlation, Cronbach's alpha coefficient, Kaiser-Meyer-Olkin Measure, and exploratory factor analyses were used to analyze the anonymized results. "Job satisfaction", "lifestyle following training" and, "impact on the patient" were the three highest rated considerations when choosing a specialty.  Fifty-two and seventeen percent (n=24) and 57.89% (n=22) of males and females ranked non-surgical specialties as their top choice. Student confidence in their specialty preferences was moderate, meaning their preference could likely change (mean=2.40/5.00, SD=1.23). ANOVA showed no significant differences between confidence and population size (F(2,86)=0.290, p=0.75) or marital status (F(2,85)=0.354, p=0.70) in both genders combined. Five underlying factors that explained 44.32% of the total variance were identified. Five themes were identified to enhance career counseling. Medical students in their first month of training have already considered their specialty preferences, despite limited exposure. However, students are not fixed in their specialty preference. Our findings further support previous results but expand what students consider when choosing their specialty early in their training. Medical educators and administrators who recognize and understand the importance of these considerations may further enhance career counseling and medical education curricula.

The long overdue medical specialty: bioethiatrics.

Science.gov (United States)

Kevorkian, J

1986-11-01

Traditional bioethical codes have been unable to cope with the results of modern technology and the drastic changes in life patterns. The medical profession can reestablish bioethical order and reassert leadership through a new and urgently needed medical specialty, which the author tentatively calls bioethiatrics or bioethiatry. Bioethiatrics embodies a unique combination of ethical action and moral judgment.Training for the specialty would start with a residency program, consisting of thorough training in philosophy and religion coupled with continued experience in clinical medicine and indoctrination in contemporary research. Requirements would include the practice of general medicine for at least two years after internship, the passing of oral and written examinations after four years of residency, board certification, and subsequent periodic evaluations.Bioethiatricians would assume all the usual privileges, obligations, and risks associated with the practice of any medical specialty, thereby averting unnecessary ethical crises and ensuring a more rational response to present and future moral challenges.

An exploration of options and functions of climate technology centres and networks. Discussion paper

International Nuclear Information System (INIS)

De Coninck, H.C.; Wuertenberger, L.; Cochran, J.; Cox, S.; Benioff, R.

2010-11-01

This paper responds to a request to UNEP from the UNFCCC Expert Group on Technology Transfer to examine operational modalities for climate technology centres and networks. The paper first discusses possible dimensions for the climate technology centre and network, and it reviews a number of existing networks and centres. It then distinguishes five options for the organizational structure and describes potential operational characteristics for each of these options. All options examined seek to build from existing climate and non-climate-related public and private technology centres, networks, and initiatives. Consistent with the UNFCCC negotiating text and draft technology decision, the paper evaluates potential implementation options and outcomes for each of the functions tentatively assigned to the climate technology centre and network, as well as selected functions of the technology executive committee. Approaches are offered for integrating delivery of these functions through coordinated programmes, and hypothetical examples are given to explain how the technology mechanism might add value in practice. The options presented in this paper are not an exhaustive treatment of potential structures or implementation approaches, and other approaches can be considered.

The impact of endovascular repair on specialties performing abdominal aortic aneurysm repair

NARCIS (Netherlands)

Ultee, Klaas H J; Hurks, Rob; Buck, Dominique B.; Dasilva, George S.; Soden, Peter A.; Van Herwaarden, Joost A.; Verhagen, Hence J M; Schermerhorn, Marc L.

2015-01-01

Background Abdominal aortic aneurysm (AAA) repair has been performed by various surgical specialties for many years. Endovascular aneurysm repair (EVAR) may be a disruptive technology, having an impact on which specialties care for patients with AAA. Therefore, we examined the proportion of AAA

The impact of endovascular repair on specialties performing abdominal aortic aneurysm repair

NARCIS (Netherlands)

K.H.J. Ultee (Klaas); R. Hurks (Rob); D.B. Buck (Dominique B.); G.S. Dasilva (George S.); P.A. Soden (Peter A.); J.A. van Herwaarden (Joost); H.J.M. Verhagen (Hence); M.L. Schermerhorn (Marc)

2015-01-01

textabstractBackground Abdominal aortic aneurysm (AAA) repair has been performed by various surgical specialties for many years. Endovascular aneurysm repair (EVAR) may be a disruptive technology, having an impact on which specialties care for patients with AAA. Therefore, we examined the proportion

Solar pumped laser technology options for space power transmission

Science.gov (United States)

Conway, E. J.

1986-01-01

An overview of long-range options for in-space laser power transmission is presented. The focus is on the new technology and research status of solar-pumped lasers and their solar concentration needs. The laser options include gas photodissociation lasers, optically-pumped solid-state lasers, and blackbody-pumped transfer lasers. The paper concludes with a summary of current research thrusts.

Solar Power System Options for the Radiation and Technology Demonstration Spacecraft

Science.gov (United States)

Kerslake, Thomas W.; Haraburda, Francis M.; Riehl, John P.

2000-01-01

The Radiation and Technology Demonstration (RTD) Mission has the primary objective of demonstrating high-power (10 kilowatts) electric thruster technologies in Earth orbit. This paper discusses the conceptual design of the RTD spacecraft photovoltaic (PV) power system and mission performance analyses. These power system studies assessed multiple options for PV arrays, battery technologies and bus voltage levels. To quantify performance attributes of these power system options, a dedicated Fortran code was developed to predict power system performance and estimate system mass. The low-thrust mission trajectory was analyzed and important Earth orbital environments were modeled. Baseline power system design options are recommended on the basis of performance, mass and risk/complexity. Important findings from parametric studies are discussed and the resulting impacts to the spacecraft design and cost.

Evaluation of feedback given to trainees in medical specialties.

Science.gov (United States)

Tham, Tony Ck; Burr, Bill; Boohan, Mairead

2017-07-01

The aim of this study was to evaluate the quality of feedback provided to specialty trainees (ST3 or higher) in medical specialties during their workplace-based assessments (WBAs). The feedback given in WBAs was examined in detail in a group of 50 ST3 or higher trainees randomly selected from those taking part in a pilot study of changes to the WBA system conducted by the Joint Royal Colleges of Physicians Training Board. They were based in Health Education Northeast (Northern Deanery) and Health Education East of England (Eastern Deanery). Thematic analysis was used to identify commonly occurring themes. Feedback was mainly positive but there were differences in quality between specialties. Problems with feedback included insufficient detail, such that it was not possible to map the progression of the trainee, insufficient action plans made and the timing of feedback not being contemporaneous (feedback not being given at the time of assessment). Recommendations included feedback should be more specific; there need to be more options in the feedback forms for the supervisor to compare the trainee's performance to what is expected and action plans need to be made. © Royal College of Physicians 2017. All rights reserved.

Technologies options for acid-rain control. Book chapter

International Nuclear Information System (INIS)

Princiotta, F.T.

1992-01-01

The report discusses acid rain control options available to the electric utility industry. They include coal switching, flue gas desulfurization, and such emerging lower cost technologies as Limestone Injection Multistage Burners (LIMB) and Advanced Silicate (ADVACATE), both developed by EPA, selective use of gas to reduce nitrogen oxides (NOx) and sulfur dioxide (SO2) in coal-fired boilers, and the use of Integrated Coal Gasification Combined Cycle (IGCC) technology

Dental students' perceptions of dental specialties and factors influencing specialty and career choices.

Science.gov (United States)

Dhima, Matilda; Petropoulos, Vicki C; Han, Rita K; Kinnunen, Taru; Wright, Robert F

2012-05-01

The goals of this study were to 1) evaluate dental students' perceptions of dental specialties, 2) identify factors that play an important role in students' decision to pursue specialty training or career choices, and 3) establish a baseline of students' perceptions of the dental fields with the best future in terms of salary, personal and patient quality of life, and overall impact on the dental profession. Surveys were distributed to 494 students at the University of Pennsylvania School of Dental Medicine. Data were collected from 380 traditional four-year students and thirty advanced standing students. Chi-square tests, multivariate analysis, and logistic regressions were used to determine associations and independent contributions of student demographics to their perceptions of dental specialties and factors influencing specialty training or career choices. Debt was a statistically significant factor (p<0.001) in choosing specialty training or career independent of gender, age, or class year. Enjoyment of providing care in a specialty or field was identified as the single most important factor in choosing a specialty career. Half of the respondents had decided not to specialize. Pursuing postdoctoral general dentistry training and private practice in general dentistry were the most commonly reported plans after completion of dental school. Suggestions are made for ways to inform students about specialty training.

Multi-technology option strategy for long term R and D programs on plutonium technologies. Minimizing proliferation risks and preparing for the future

International Nuclear Information System (INIS)

Suzuki, Tatsujiro

1997-01-01

Plutonium programs worldwide are now facing major economic, political and technical challenges. New strategies need to address two distinctive global concerns: minimizing proliferation risks associated with plutonium use, and keeping the options alive to prepare for uncertain energy future. In order to meet those challenges, this paper proposes the introduction of 'multi-technology option strategy'. Such strategy is designed to keep so-called 'technological readiness' state of plutonium technologies worldwide without committing to a fixed technology option and exploring more innovative various technology options. This paper also suggests that such R and D programs can be coordinated and shared among nations that are interested in future plutonium use, and such cooperation can improve transparency of sensitive R and D programs. (author)

Prospects for natural gas in Europe. Market potential, political intervention and technological options

International Nuclear Information System (INIS)

Kabelitz, K.R.

1997-01-01

The potential market demand, the emerging fundamental political intervention in the European gas and electricity markets and the technological options available will give the gas industry in Europe a different appearance at the beginning of the 21. century. One of the key questions is: will the political intervention and technological options and innovations assist and promote the realisation of market potential? At the moment, it cannot be stated definitely whether the currently available technological options will allow the significant cost reductions hoped for in the entire gas chain to become reality in good time. Under these circumstances, a major mismatch would emerge between the market potential predicted for natural gas in Europe and the actual market development. (R.P.)

Factors considered by undergraduate medical students when selecting specialty of their future careers.

Science.gov (United States)

Alawad, Awad Ali Mohamed Ahmed; Khan, Waleed Shabeer; Abdelrazig, Yousif Mohammed; Elzain, Yamin Ibrahim; Khalil, Hassan Osman; Ahmed, Omer Bakri Elsayed; Adam, Omeralfaroug Ahmed Ibrahim

2015-01-01

Medical students are the source of a country's physicians. Determining how medical students select their areas of specialization is the key to achieve a balanced distribution of doctors among all specialties. The objective is to identify the number of medical students who have decided their postgraduate specialty career, their career specialties preference, and factors that may influence their decision to select a particular specialty. A facility based cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self-administered semi-structured questionnaire comprising demographic data and questions about future specialties preferences and factors influencing those preferences was distributed to 887 male and female students, (from first to fifth academic years) recruited in the study. Response rate was 73% with 647 questionnaires collected, out of 887 eligible medical students. Of the returned questionnaires, 604 were valid. The majority of students (541, 89.6%) have chosen a specialty. Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. The least selected specialty was anaesthesiology. A significant association was found between gender and specialty choice using Chi-square test (p = 0.00). There was no association between undergraduate level and specialty choice (p = 0.633). The most common reason for choosing a specific specialty was "Personal Interest" (215, 39.7%) followed by being "Helpful to the community" (144, 26.6%). Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties.

STRATEGIC EXERCISE OF REAL OPTIONS:INVESTMENT DECISIONS IN TECHNOLOGICAL SYSTEMS

Institute of Scientific and Technical Information of China (English)

Kevin ZHU; John WEYANT

2003-01-01

Viewing investment projects in new technologies as real options, this paper studies the effects of endogenous competition and asymmetric information on the strategic exercise of real options. We first develop a multi-period, game-theoretic model and show how competition leads to early exercise and aggressive investment behaviors and how competition erodes option values. We then relax the typical full-information assumption found in the literature and allow information asymmetry to exist across firms. Our model shows, in contrast to the literature that payoff is independent of the ordering of exercise, that the sequential exercise of real options may generate both informational and payoff externalities. We also find some surprising but interesting results such as having more information is not necessarily better.

The Right Tools for the Job--Technology Options for Adult Online Learning and Collaboration

Science.gov (United States)

Regional Educational Laboratory, 2014

2014-01-01

Many options exist for using technology as a tool for adult learning, and each day, it becomes easier to share information online than it ever has been. Online learning technology has grown from one-sided communications to numerous options for audience engagement and interactivity. This guide introduces a variety of tools, online platforms, and…

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

Science.gov (United States)

Pachankis, John E.

2016-01-01

Abstract Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P gender identity strongly influenced specialty choice (P work–life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate.

Science.gov (United States)

Sitkin, Nicole A; Pachankis, John E

2016-12-01

Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P gender identity strongly influenced specialty choice (P role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

Technological options for management of hazardous wastes from US Department of Energy facilities

Energy Technology Data Exchange (ETDEWEB)

Chiu, S.; Newsom, D.; Barisas, S.; Humphrey, J.; Fradkin, L.; Surles, T.

1982-08-01

This report provides comprehensive information on the technological options for management of hazardous wastes generated at facilities owned or operated by the US Department of Energy (DOE). These facilities annually generate a large quantity of wastes that could be deemed hazardous under the Resource Conservation and Recovery Act (RCRA). Included in these wastes are liquids or solids containing polychlorinated biphenyls, pesticides, heavy metals, waste oils, spent solvents, acids, bases, carcinogens, and numerous other pollutants. Some of these wastes consist of nonnuclear hazardous chemicals; others are mixed wastes containing radioactive materials and hazardous chemicals. Nearly 20 unit processes and disposal methods are presented in this report. They were selected on the basis of their proven utility in waste management and potential applicability at DOE sites. These technological options fall into five categories: physical processes, chemical processes, waste exchange, fixation, and ultimate disposal. The options can be employed for either resource recovery, waste detoxification, volume reduction, or perpetual storage. Detailed descriptions of each technological option are presented, including information on process performance, cost, energy and environmental considerations, waste management of applications, and potential applications at DOE sites. 131 references, 25 figures, 23 tables.

Technological options for management of hazardous wastes from US Department of Energy facilities

International Nuclear Information System (INIS)

Chiu, S.; Newsom, D.; Barisas, S.; Humphrey, J.; Fradkin, L.; Surles, T.

1982-08-01

This report provides comprehensive information on the technological options for management of hazardous wastes generated at facilities owned or operated by the US Department of Energy (DOE). These facilities annually generate a large quantity of wastes that could be deemed hazardous under the Resource Conservation and Recovery Act (RCRA). Included in these wastes are liquids or solids containing polychlorinated biphenyls, pesticides, heavy metals, waste oils, spent solvents, acids, bases, carcinogens, and numerous other pollutants. Some of these wastes consist of nonnuclear hazardous chemicals; others are mixed wastes containing radioactive materials and hazardous chemicals. Nearly 20 unit processes and disposal methods are presented in this report. They were selected on the basis of their proven utility in waste management and potential applicability at DOE sites. These technological options fall into five categories: physical processes, chemical processes, waste exchange, fixation, and ultimate disposal. The options can be employed for either resource recovery, waste detoxification, volume reduction, or perpetual storage. Detailed descriptions of each technological option are presented, including information on process performance, cost, energy and environmental considerations, waste management of applications, and potential applications at DOE sites. 131 references, 25 figures, 23 tables

Lifetime earnings for physicians across specialties.

Science.gov (United States)

Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Romano, Patrick S; Kravitz, Richard L

2012-12-01

Earlier studies estimated annual income differences across specialties, but lifetime income may be more relevant given physicians' long-term commitments to specialties. Annual income and work hours data were collected from 6381 physicians in the nationally representative 2004-2005 Community Tracking Study. Data regarding years of residency were collected from AMA FREIDA. Present value models were constructed assuming 3% discount rates. Estimates were adjusted for demographic and market covariates. Sensitivity analyses included 4 alternative models involving work hours, retirement, exogenous variables, and 1% discount rate. Estimates were generated for 4 broad specialty categories (Primary Care, Surgery, Internal Medicine and Pediatric Subspecialties, and Other), and for 41 specific specialties. The estimates of lifetime earnings for the broad categories of Surgery, Internal Medicine and Pediatric Subspecialties, and Other specialties were $1,587,722, $1,099,655, and $761,402 more than for Primary Care. For the 41 specific specialties, the top 3 (with family medicine as reference) were neurological surgery ($2,880,601), medical oncology ($2,772,665), and radiation oncology ($2,659,657). The estimates from models with varying rates of retirement and including only exogenous variables were similar to those in the preferred model. The 1% discount model generated estimates that were roughly 150% larger than the 3% model. There was considerable variation in the lifetime earnings across physician specialties. After accounting for varying residency years and discounting future earnings, primary care specialties earned roughly $1-3 million less than other specialties. Earnings' differences across specialties may undermine health reform efforts to control costs and ensure adequate numbers of primary care physicians.

Lessons Learned in Pilot Testing Specialty Consultations to Benefit Individuals with Lower Limb Loss

Directory of Open Access Journals (Sweden)

Christine Elnitsky

2012-12-01

Full Text Available Telerehabilitation technologies enable the delivery of rehabilitation services from providers to people with disabilities as well as specialty care consultations. This article discusses the barriers experienced when planning and pilot testing a telerehabilitation multi-site specialty consultation for specialists in their medical centers, and the lessons learned. The barriers included integration and participation, coordination across organizational units, and privacy and information security. Lessons learned included the need for collaboration across multiple departments, telerehabilitation equipment back-ups, and anonymous and private communication protocols. Despite delays resulting from coordination at multiple levels of a national organization, we developed a program plan and successfully implemented a pilot test of the southeast region program.  Specialty consultation using telerehabilitation delivery methods requires identifying provider preferences for technological features. Lessons learned could inform development of outpatient telerehabilitation for patients with amputations and studies of patients and providers involved in telerehabilitation.

A survey of sub-specialty preferences of radiography students of the University of Lagos, Nigeria

Directory of Open Access Journals (Sweden)

E T Namah

2013-01-01

Full Text Available Background: Technological advances and computing have expanded both the scope and capacity of diagnostic medical imaging (the radiography profession. This has created many diverse imaging modalities which in turn, have culminated in different sub-specialties in the profession. Objective: The aims of the study were to determine the level of awareness of imaging sub-specialties, preferred sub specialties and reasons for preferences of sub-specialties in senior level radiography students of the University of Lagos. Methods: The study was a prospective cross-sectional survey. Consents were obtained before the students were recruited for the study. Data Collection and Analysis: A questionnaire semi-structured in line with objectives of the study was used in data collection. A computer software Epi Info version 3.3 was used to analyze data while results were expressed as percentages of responses and were presented in tables and pie charts. Results : Greater than 90% showed awareness of sub-specialties in the radiography profession whereas 35% preferred ultrasonography to other sub-specialties. The least preferred sub-specialty was conventional radiography (4.3%. Remuneration (73.3% and less physical exertion (73.3% were major attractors to preferred sub-specialties whereas concerns over radiation hazard were major detractors (58.3%. Conclusion : Awareness of sub-specialties in the radiography profession was high amongst students studied. Furthermore, ultrasonography was the most preferred sub-specialty among the respondents. Remuneration was the main attractor to sub-specialties whereas fears over effects of ionizing radiation were the major detractors to some sub-specialties.

History of Medical Specialty Interest Assessment

Science.gov (United States)

Burns, Stephanie T.

2016-01-01

Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

8. Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences; 8. Seminario IMP-IIE-ININ sobre especialidades tecnologicas. Mesa 10: Ciencias de la Tierra

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-31

The document contains two papers within INIS subject scope which were presented at the 8th Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences. A separate abstract was prepared for each paper.

Artificial intelligence in radiation oncology: A specialty-wide disruptive transformation?

Science.gov (United States)

Thompson, Reid F; Valdes, Gilmer; Fuller, Clifton D; Carpenter, Colin M; Morin, Olivier; Aneja, Sanjay; Lindsay, William D; Aerts, Hugo J W L; Agrimson, Barbara; Deville, Curtiland; Rosenthal, Seth A; Yu, James B; Thomas, Charles R

2018-06-12

Artificial intelligence (AI) is emerging as a technology with the power to transform established industries, and with applications from automated manufacturing to advertising and facial recognition to fully autonomous transportation. Advances in each of these domains have led some to call AI the "fourth" industrial revolution [1]. In healthcare, AI is emerging as both a productive and disruptive force across many disciplines. This is perhaps most evident in Diagnostic Radiology and Pathology, specialties largely built around the processing and complex interpretation of medical images, where the role of AI is increasingly seen as both a boon and a threat. In Radiation Oncology as well, AI seems poised to reshape the specialty in significant ways, though the impact of AI has been relatively limited at present, and may rightly seem more distant to many, given the predominantly interpersonal and complex interventional nature of the specialty. In this overview, we will explore the current state and anticipated future impact of AI on Radiation Oncology, in detail, focusing on key topics from multiple stakeholder perspectives, as well as the role our specialty may play in helping to shape the future of AI within the larger spectrum of medicine. Published by Elsevier B.V.

Arms Control and nonproliferation technologies: Technology options and associated measures for monitoring a Comprehensive Test Ban, Second quarter

Energy Technology Data Exchange (ETDEWEB)

Casey, Leslie A.

1994-01-01

This newsletter contains reprinted papers discussing technology options and associated measures for monitoring a Comprehensive Test Ban Treaty (CTBT). These papers were presented to the Conference on Disarmament (CD) in May and June 1994. An interagency Verification Monitoring Task Force developed the papers. The task force included participants from the Arms Control and Disarmament Agency, the Department of Defense, the Department of Energy, the Intelligence Community, the Department of Interior, and the Department of State. The purpose of this edition of Arms Control and Nonproliferation Technologies is to share these papers with the broad base of stakeholders in a CTBT and to facilitate future technology discussions. The papers in the first group discuss possible technology options for monitoring a CTBT in all environments (underground, underwater, atmosphere, and space). These technologies, along with on-site inspections, would facilitate CTBT monitoring by treaty participants. The papers in the second group present possible associated measures, e.g., information exchanges and transparency measures, that would build confidence among states participating in a CTBT.

Dealing with uncertainty and pursuing superior technology options in risk management-The inherency risk analysis

International Nuclear Information System (INIS)

Helland, Aasgeir

2009-01-01

Current regulatory systems focus on the state of scientific evidence as the predominant factor for how to handle risks to human health and the environment. However, production and assessment of risk information are costly and time-consuming, and firms have an intrinsic disincentive to produce and distribute information about risks of their products as this could endanger their production opportunities and sales. An emphasis on more or better science may result in insufficient thought and attention going into the exploration of technology alternatives, and that risk management policies miss out on the possible achievement of a more favorable set of consequences. In this article, a method is proposed that combines risk assessment with the search for alternative technological options as a part of the risk management procedure. The method proposed is the inherency risk analysis where the first stage focuses on the original agent subject to investigation, the second stage focuses on identifying technological options whereas the third stage reviews the different alternatives, searching for the most attractive tradeoffs between costs and inherent safety. This is then used as a fundament for deciding which technology option to pursue. This method aims at providing a solution-focused, systematic technology-based approach for addressing and setting priorities for environmental problems. By combining risk assessment with a structured approach to identify superior technology options within a risk management system, the result could very well be a win-win situation for both company and the environment.

The acceptance of dental operating microscope among advance education specialty programs in endodontics in the middle east

Directory of Open Access Journals (Sweden)

Mansour Alrejaie

2012-01-01

Full Text Available Aim: To present the current situation of dental operating microscopy (DOM training in the available Advance Specialty Education Programs in Endodontics in Arab Middle-Eastern countries. Materials and Methods: A web-based survey was sent to the electronic mail address of Advance Specialty Education programs of 15 Arab and middle east countries. The questions were limited to those who have an advanced specialty education program in Endodontics at their University if they are using an operating microscope? Results: Out of 15 countries, only 4 countries have microscopic technology in their Advance Education Programs in Endodontics. Conclusion: Few Arab Middle-Eastern countries have DOM in their advance education programs in endodontics. The highest authority in advancing endodontic education in the Arab Middle-East should consider in the near future the importance of this technology as standard care in teaching advance endodontics. An advance workshops should be organized regularly to provide enough knowledge about this standard educational technology.

Nuclear technology options

International Nuclear Information System (INIS)

Salvatores, Massimo

2013-01-01

Different strategies and motivations in different countries have led to diverse options. In Europe the SNETP (Sustainable Nuclear Energy Technology Platform) has the objective of developing R&D supporting GEN-II (present) and GEN-III nuclear systems under development; allowing sustainability and minimisation of waste burden, promoting advanced Gen-IV Fast Reactors; and accounting for a Nuclear Cogeneration Industrial Initiative. A remarkable initiative in the USA has been the promotion of small modular reactors (SMRs) – at less than 300 MWe in capacity, much smaller than typical reactors – which can be an ideal choice for (remote) areas which cannot support a larger reactor. Compact scalable design offers a host of potential safety, construction and economic benefits. More “upbeat” strategies are expected in other areas of the world where significant increase in nuclear energy demand is predicted in the next decades. If this growth materialises, future fuel cycles characteristics, feasibility and acceptability will be crucial. This paper will discuss different scenarios for future fuel cycles, resources optimisation and/or waste minimization, the range from full fast reactor deployment to phase-out, management of spent nuclear fuel and the significant potential benefits of advanced cycles. The next 45 years will be dominated by deployment of standard large or medium size plants operating for 60 years. Available resources do allow it. However, fuel cycle will be a growing and most challenging issue and early assessments will be needed for public acceptance and policy decisions.

Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

Directory of Open Access Journals (Sweden)

Seung Ju Kim

Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty.

Science.gov (United States)

Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko

2018-03-27

Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with

How Computer Technology Expands Educational Options: A Rationale, Recommendations, and a Pamphlet for Administrators.

Science.gov (United States)

Kelch, Panette Evers; Karr-Kidwell, PJ

The purpose of this paper is to provide a historical rationale on how computer technology, particularly the Internet, expands educational options for administrators and teachers. A review of the literature includes a brief history of computer technology and its growing use, and a discussion of computer technology for distance learning, for…

Controlling air pollution from passenger ferries: cost-effectiveness of seven technological options.

Science.gov (United States)

Farrell, Alexander E; Corbett, James J; Winebrake, James J

2002-12-01

Continued interest in improving air quality in the United States along with renewed interest in the expansion of urban passenger ferry service has created concern about air pollution from ferry vessels. This paper presents a methodology for estimating the air pollution emissions from passenger ferries and the costs of emissions control strategies. The methodology is used to estimate the emissions and costs of retrofitting or re-powering ferries with seven technological options (combinations of propulsion and emission control systems) onto three vessels currently in service in San Francisco Bay. The technologies include improved engine design, cleaner fuels (including natural gas), and exhaust gas cleanup devices. The three vessels span a range of ages and technologies, from a 25-year-old monohull to a modern, high-speed catamaran built only four years ago. By looking at a range of technologies, vessel designs, and service conditions, a sense of the broader implications of controlling emissions from passenger ferries across a range of vessels and service profiles is provided. Tier 2-certified engines are the most cost-effective choice, but all options are cost-effective relative to other emission control strategies already in place in the transportation system.

The value of product flexibility in nuclear hydrogen technologies: A real options analysis

International Nuclear Information System (INIS)

Botterud, Audun; Yildiz, Bilge; Conzelmann, Guenter; Petri, Mark C.

2009-01-01

Previous economic studies of nuclear hydrogen technologies focused on levelized costs without accounting for risks and uncertainties faced by potential investors. To address some of these risks and uncertainties, we used real options theory to assess the profitability of three nuclear hydrogen production technologies in evolving electricity and hydrogen markets. Monte-Carlo simulations are used to represent the uncertainty in hydrogen and electricity prices. The model computes both the expected value and the distribution of discounted profits from the production plant. It also quantifies the value of the option to switch between hydrogen and electricity production. Under these assumptions, we conclude that investors will find significant value in the capability to switch plant output between electricity and hydrogen. (author)

Theoretical Model of Professional Competence Development in Dual-Specialty Students (On the Example of the "History, Religious Studies" Specialty)

Science.gov (United States)

Karimova, A. E.; Amanova, A. S.; Sadykova, A. M.; Kuzembaev, N. E.; Makisheva, A. T.; Kurmangazina, G. Zh.; Sakenov, Janat

2016-01-01

The article explores the significant problem of developing a theoretical model of professional competence development in dual-specialty students (on the example of the "History, Religious studies" specialty). In order to validate the specifics of the professional competence development in dual-specialty students (on the example of the…

Specialty glass development for radiation shielding windows and nuclear waste immobilization

International Nuclear Information System (INIS)

Mandal, S.; Ghorui, S.; Roy Chowdhury, A.; Sen, R.; Chakraborty, A.K.; Sen, S.; Maiti, H.S.

2015-01-01

The technology of two important varieties of specialty glasses, namely high density Radiation Shielding Window (RSW) glass and specialty glass beads of borosilicate composition have been successfully developed in CGCRI with an aim to meet the countries requirement. Radiation Shielding Windows used in nuclear installations, are viewing devices, which allow direct viewing into radioactive areas while still providing adequate protection to the operating personnel. The glass blocks are stabilized against damage from radiation by introducing cerium in definite proportions. Considering the essentially of developing an indigenous technology to make the country self-sufficient for this critical item, CGCRI has taken up a major programme to develop high lead containing glasses required for RSWs under a MoD with BARC. On the other hand, the specialty glass bead of specific composition and properties is a critical material required for management of radioactive waste in a closed nuclear fuel cycle that is followed by India. During reprocessing of the spent nuclear fuel, high level radio-active liquid waste (HLW) is produced containing unwanted radio isotopes some of which remain radioactive for thousands of years. The need is to immobilize them within a molecular structure so that they will not come out and be released to the ambience and thereby needs to be resolved if nuclear power is to make a significant contribution to the country's power requirement. Borosilicate glass has emerged as the material of choice for immobilization due to its unique random network structure

A qualitative study on physicians' perceptions of specialty characteristics.

Science.gov (United States)

Park, Kwi Hwa; Jun, Soo-Koung; Park, Ie Byung

2016-09-01

There has been limited research on physicians' perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. The findings have implications for the design of career planning programs for medical students.

The Value of Specialty Oncology Drugs

Science.gov (United States)

Goldman, Dana P; Jena, Anupam B; Lakdawalla, Darius N; Malin, Jennifer L; Malkin, Jesse D; Sun, Eric

2010-01-01

Objective To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high-cost specialty medications treating metastatic disease or hematologic malignancies. Data Source/Study Setting Claims data from 71 private health plans from 1997 to 2005. Study Design This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out-of-pocket costs. Data Collection/Extraction Methods We extracted key variables from administrative health insurance claims records. Principal Findings A 25 percent reduction in out-of-pocket costs leads to a 5 percent increase in the probability that a patient initiates specialty cancer drug therapy. Among patients who initiate, a 25 percent reduction in out-of-pocket costs reduces the number of treatments (claims) by 1–3 percent, depending on the drug. On average, the value of these drugs to patients who use them is about four times the total cost paid by the patient and his or her insurer, although this ratio may be lower for oral specialty therapies. Conclusions The decision to initiate therapy with specialty oncology drugs is responsive to price, but not highly so. Among patients who initiate therapy, the amount of treatment is equally responsive. The drugs we examine are highly valued by patients in excess of their total costs, although oral agents warrant further scrutiny as copayments increase. PMID:19878344

Integration of specialties: An institutional and organizational view.

Science.gov (United States)

Gerson, Elihu M

2013-12-01

By what mechanisms of organizational and institutional change do different specialties succeed in accommodating and working with one another? How do these mechanisms function over time to support and retard the emergence and stability of new knowledge? This paper considers two such mechanisms, metawork (work that determines the organization of work) and common knowledge (knowledge that participants know is known by all participants). These mechanisms integrate specialties by making the activities of multiple specialties dependent upon one another, and by segmenting the common effort from the parent specialties. Integration of specialties can lead to the development of new specialties. Integration is facilitated and impeded by the anchoring of specialties in the system of institutions that participate in research. Host organizations, degree programs, sponsors, associations, regulators, and other organizations provide resources and impose demands that shape research. Some of these impacts are obvious and direct; others are indirect and more subtle. The research specialties form a network (not a hierarchy) in which connections constantly form and reform, and in which the influence of different anchoring institutions are constantly waxing and waning. The complexity of connections and their pattern of change are especially obvious in the life sciences, which are an especially good place to study problems of integration. Copyright © 2012 Elsevier Ltd. All rights reserved.

Dental student perceptions of oral and maxillofacial surgery as a specialty.

Science.gov (United States)

Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

2013-05-01

fracture repair. Almost all the dental classes believed that the specialty of OMS was both medical and dental in nature and that it is a very important dental specialty. Dental student perceptions of OMS change throughout their undergraduate training. The reasons for such a change are multivariate and might include factors such as the amount of didactic training and clinical exposure. It is vital to both recognize and address this change at an undergraduate level of training in an effort to increase educated referrals to a surgeon who might provide the best treatment options for the patient. A stronger understanding of the dental students' perception of OMS provides an opportunity for the oral and maxillofacial academic faculty to better educate students and, ultimately, strengthen our specialty. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The role of nuclear power in the option zero emission technologies for fossil fuels

International Nuclear Information System (INIS)

Corak, Z.

2006-01-01

The energy sector is one of the main sources of greenhouse gas (GHG) emissions particularly carbon dioxide (CO2) increasing concerns due to their potential risk to induce global warming and climate change. The Parties having signed the Kyoto Protocol in December 1997, committed to decrease their GHG emissions. The Protocol states that countries shall undertake promotion, research, development and increased use of new and renewable forms of energy, of carbon dioxide sequestration technologies and of advanced and innovative environmentally sound technologies. The one significant option that is not specifically mentioned is nuclear energy which is essentially carbon-free. There are a number of technical options that could help reducing, or at least slowing the increase of, GHG emissions from the energy sector. The list of options includes: improving the efficiency of energy conversion and end-use processes; shifting to less carbon intensive energy sources (e.g. shifting from coal to natural gas); developing carbon-free or low-carbon energy sources; and carbon sequestration (e.g. planting forests or capturing and storing carbon dioxide). It must be pointed out that nuclear power is one of the few options that are currently available on the market, competitive in a number of countries, especially if global costs to society of alternative options are considered; practically carbon-free; and sustainable at large-scale deployment. The nuclear power could play significant role in alleviating the risk of global climate change. The main objective of the article is to present sequestration options, their cost evaluation as well as comparation with alternative possibilities of nuclear energy production. (author)

A qualitative study on physicians' perceptions of specialty characteristics

Directory of Open Access Journals (Sweden)

Kwi Hwa Park

2016-09-01

Full Text Available Purpose: There has been limited research on physicians’ perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Methods: Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Results: Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. Conclusion: The findings have implications for the design of career planning programs for medical students.

Nursing specialty and burnout.

Science.gov (United States)

Browning, Laura; Ryan, Carey S; Thomas, Scott; Greenberg, Martin; Rolniak, Susan

2007-03-01

We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest burnout, whereas nurse practitioners had the most control and the least burnout. Mediational analyses showed that expected control, hostility, and stressor frequency explained differences between specialties in burnout. The implications of these findings for interventions that reduce burnout and promote nursing retention are discussed.

Decision-making model of generation technology under uncertainty based on real option theory

International Nuclear Information System (INIS)

Ming, Zeng; Ping, Zhang; Shunkun, Yu; Ge, Zhang

2016-01-01

Highlights: • A decision-making model of generation technology investment is proposed. • The irreversible investment concept and real option theory is introduced. • Practical data was used to prove the validity of the model. • Impact of electricity and fuel price fluctuation on investment was analyzed. - Abstract: The introduction of market competition and the increased uncertainty factors makes the generators have to decide not only on whether to invest generation capacity or not but also on what kind of generation technology to choose. In this paper, a decision-making model of generation technology investment is proposed. The irreversible investment concept and real option theory is introduced as the fundamental of the model. In order to explain the decision-making process of generator’s investment, the decision-making optimization model was built considering two generation technologies, i.e., the heat-only system and the combined heat and power generation. Also, we discussed the theory deducing process, which explained how to eliminate the overrated economic potential caused by risk hazard, based on economic evaluation of both generation technologies. Finally, practical data from electricity market of Inner Mongolia was used to prove the validity of the model and the impact of uncertainties of electricity and fuel price fluctuation on investment was analyzed according to the simulated results.

The professional orientation to the masonry specialty: a system of activities

Directory of Open Access Journals (Sweden)

Jóse Andrés Gómez Torres

2018-03-01

Full Text Available The specialty Masonry in Technical and Vocational Education is of great importance given the mission that has to train workers who have to use the most efficient and updated techniques and technologies for the construction of buildings and other construction works. In the pedagogical practice manifested a contradiction expressed in the need to raise the quality of the professional training of the workers in the specialty Masonry, however, there were inadequacies in the work of professional guidance with students who attend the first year in the Polytechnical center "Leonides Blanco", reflected in the insufficient inclination towards the study profile, which led to the failure of a percentage of students. The objective of the work was to elaborate a system of activities that perfected the process of professional orientation towards the specialty Albañilería the first year at the "Leonides Blanco" PolytechnicCenter. In the investigative process, the dialectical-materialist method was assumed as the general method, which supported the theoretical methods, the application of statistical techniques that made possible the study and systematization of the theoretical and methodological foundations of the process under investigation. The practical significance is expressed in a system of activities that contributed to the professional orientation of the first-year students of the specialty Masonry, which guarantees a relevant initial training process, depending on the demands of the professional model and the needs educational and social

Specialty choice among dental students in Ibadan, Nigeria ...

African Journals Online (AJOL)

The majority of dental students at the University of Ibadan preferred the oral and maxillofacial surgery (OMS) specialty above all other dental specialties, while prosthetic dentistry was least preferred. Of all the factors to take into consideration when choosing a dental specialty, personal interest was the only factor considered ...

Experience with DICOM for the clinical specialties in the healthcare enterprise

Science.gov (United States)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2003-05-01

DICOM is a success for radiology and cardiology and it is now beginning to be used for other clinical specialties. The US Department of Veterans Affairs has been instrumental in promoting this technological advancement. We have worked with a number of non-radiology imaging vendors over the past several years, encouraging them to support DICOM, providing requirement specifications, validating their implementations, installing their products, and integrating their systems with the VA healthcare enterprise. We require each new non-radiology vendor to support the DICOM Modality Worklist and Storage services, as specified in the IHE Technical Framework, and insist that they perform validation testing with us over the Internet before installing at a VA site. Three years ago we began working with commercial DICOM image acquisition applications in ophthalmology and endoscopy. Today we are interfacing with six vendors in ophthalmology, six in dental, and two in endoscopy. Getting imaging modality vendors to support DICOM is only part of the story, however. We have also developed the capabilities of the VistA hospital information system to properly handle DICOM interfaces to the different clinical specialties. The workflow in the clinical specialties is different than that of radiology, and is much more diverse. We designed the VistA DICOM image acquisition and display interface to use the generic order entry, result entry, result reporting, and appointment scheduling applications of our hospital information system, which are common to other hospital information systems, in order to maintain existing clinical workflow, minimize operational disruptions, simplify training, and win user acceptance. This software is now being field tested with dental and ophthalmology systems at a large number of VA medical centers. We have learned several things from this field test. The DICOM Modality Worklist and Storage services can be successfully used for image acquisition in the clinical

Medical Imaging Field of Magnetic Resonance Imaging: Identification of Specialties within the Field

Science.gov (United States)

Grey, Michael L.

2009-01-01

This study was conducted to determine if specialty areas are emerging in the magnetic resonance imaging (MRI) profession due to advancements made in the medical sciences, imaging technology, and clinical applications used in MRI that would require new developments in education/training programs and national registry examinations. In this…

Physician wages across specialties: informing the physician reimbursement debate.

Science.gov (United States)

Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

2010-10-25

Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

Commercial production of specialty chemicals and pharmaceuticals from biomass

Energy Technology Data Exchange (ETDEWEB)

McChesney, J.D. [Univ. of Mississippi, University, MS (United States)

1993-12-31

The chemical substances utilized in consumer products, and for pharmaceutical and agricultural uses are generally referred to as specialty chemicals. These may be flavor or fragrance substances, intermediates for synthesis of drugs or agrochemicals or the drugs or agrochemicals themselves, insecticides or insect pheromones or antifeedants, plant growth regulators, etc. These are in contrast to chemicals which are utilized in large quantities for fuels or preparation of plastics, lubricants, etc., which are usually referred to as industrial chemicals. The specific utilization of specialty chemicals is associated with a specific important physiochemical or biological property. They may possess unique properties as lubricants or waxes or have a very desirable biological activity such as a drug, agrochemical or perfume ingredient. These unique properties convey significant economic value to the specific specialty chemical. The economic commercial production of specialty chemicals commonly requires the isolation of a precursor or the specialty chemical itself from a natural source. The discovery, development and commercialization of specialty chemicals is presented and reviewed. The economic and sustainable production of specialty chemicals is discussed.

Transfer of technology to developing countries: unilateral and multilateral policy options

International Nuclear Information System (INIS)

Hockman, B.M.; Maskus, K.E.; Saggi, K.

2005-01-01

This paper analyzes national and international policy options to encourage the international transfer of technology, distinguishing between four major channels of such transfer: trade in products, trade in knowledge and technology, foreign direct investment, and intranational and international movement of people. A typology of countries and appropriate policy rules of thumb are developed as a guide to both national policymakers and multilateral rule making in the WTO. We argue that the optimal policy mix varies across countries and that there is a need for differentiation in the design and application of rules in trade agreements as well as for a more explicit focus on evaluation of the impacts of policies. (author)

Factors affecting future specialty choice among medical students in Kuwait.

Science.gov (United States)

Al-Fouzan, Rawan; Al-Ajlan, Sarah; Marwan, Yousef; Al-Saleh, Mervat

2012-01-01

Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students' sociodemographic and academic factors. Of the 422 students approached, 387 (91.7%) decided to participate. A total of 144 (37.2%) students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties - 18 (12.5%), 17 (11.8%), and 16 (11.1%) students requested these specialties, respectively. Only 61 (42.4%) of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8%) and a challenging specialty (58; 40.3%) were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498-6.065) more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002). A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

Low cost options for tissue culture technology in developing countries. Proceedings of a technical meeting

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-02-01

Tissue culture technology is used for the production of doubled haploids, cryopreservation, propagating new plant varieties, conserving rare and endangered plants, difficult-to-propagate plants, and to produce secondary metabolites and transgenic plants. The production of high quality planting material of crop plants and fruit trees, propagated from vegetative parts, has created new opportunities in global trading, benefited growers, farmers, and nursery owners, and improved rural employment. However, there are still major opportunities to produce and distribute high quality planting material, e.g. crops like banana, date palm, cassava, pineapple, plantain, potato, sugarcane, sweet potato, yams, ornamentals, fruit and forest trees. The main advantage of tissue culture technology lies in the production of high quality and uniform planting material that can be multiplied on a year-round basis under disease-free conditions anywhere irrespective of the season and weather. However, the technology is capital, labor and energy intensive. Although, labor is cheap in many developing countries, the resources of trained personnel and equipment are often not readily available. In addition, energy, particularly electricity, and clean water are costly. The energy requirements for tissue culture technology depend on day temperature, day-length and relative humidity, and they have to be controlled during the process of propagation. Individual plant species also differ in their growth requirements. Hence, it is necessary to have low cost options for weaning, hardening of micropropagated plants and finally growing them in the field. This publication describes options for reducing costs to establish and operate tissue culture facilities and primarily focus on plant micropropagation. It includes papers on the basics of tissue culture technology, low cost options for the design of laboratories, use of culture media and containers, energy and labor saving, integration and adoption of

Low cost options for tissue culture technology in developing countries. Proceedings of a technical meeting

International Nuclear Information System (INIS)

2004-02-01

Tissue culture technology is used for the production of doubled haploids, cryopreservation, propagating new plant varieties, conserving rare and endangered plants, difficult-to-propagate plants, and to produce secondary metabolites and transgenic plants. The production of high quality planting material of crop plants and fruit trees, propagated from vegetative parts, has created new opportunities in global trading, benefited growers, farmers, and nursery owners, and improved rural employment. However, there are still major opportunities to produce and distribute high quality planting material, e.g. crops like banana, date palm, cassava, pineapple, plantain, potato, sugarcane, sweet potato, yams, ornamentals, fruit and forest trees. The main advantage of tissue culture technology lies in the production of high quality and uniform planting material that can be multiplied on a year-round basis under disease-free conditions anywhere irrespective of the season and weather. However, the technology is capital, labor and energy intensive. Although, labor is cheap in many developing countries, the resources of trained personnel and equipment are often not readily available. In addition, energy, particularly electricity, and clean water are costly. The energy requirements for tissue culture technology depend on day temperature, day-length and relative humidity, and they have to be controlled during the process of propagation. Individual plant species also differ in their growth requirements. Hence, it is necessary to have low cost options for weaning, hardening of micropropagated plants and finally growing them in the field. This publication describes options for reducing costs to establish and operate tissue culture facilities and primarily focus on plant micropropagation. It includes papers on the basics of tissue culture technology, low cost options for the design of laboratories, use of culture media and containers, energy and labor saving, integration and adoption of

Opioid Prescriptions by Specialty in Ohio, 2010-2014.

Science.gov (United States)

Weiner, Scott G; Baker, Olesya; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Kreiner, Peter W; Schuur, Jeremiah D

2018-05-01

The current US opioid epidemic is attributed to the large volume of prescribed opioids. This study analyzed the contribution of different medical specialties to overall opioids by evaluating the pill counts and morphine milligram equivalents (MMEs) of opioid prescriptions, stratified by provider specialty, and determined temporal trends. This was an analysis of the Ohio prescription drug monitoring program database, which captures scheduled medication prescriptions filled in the state as well as prescriber specialty. We extracted prescriptions for pill versions of opioids written in the calendar years 2010 to 2014. The main outcomes were the number of filled prescriptions, pill counts, MMEs, and extended-released opioids written by physicians in each specialty, and annual prescribing trends. There were 56,873,719 prescriptions for the studied opioids dispensed, for which 41,959,581 (73.8%) had prescriber specialty type available. Mean number of pills per prescription and MMEs were highest for physical medicine/rehabilitation (PM&R; 91.2 pills, 1,532 mg, N = 1,680,579), anesthesiology/pain (89.3 pills, 1,484 mg, N = 3,261,449), hematology/oncology (88.2 pills, 1,534 mg, N = 516,596), and neurology (84.4 pills, 1,230 mg, N = 573,389). Family medicine (21.8%) and internal medicine (17.6%) wrote the most opioid prescriptions overall. Time trends in the average number of pills and MMEs per prescription also varied depending on specialty. The numbers of pills and MMEs per opioid prescription vary markedly by prescriber specialty, as do trends in prescribing characteristics. Pill count and MME values define each specialty's contribution to overall opioid prescribing more accurately than the number of prescriptions alone.

Association of medical student burnout with residency specialty choice.

Science.gov (United States)

Enoch, Lindsey; Chibnall, John T; Schindler, Debra L; Slavin, Stuart J

2013-02-01

Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. The purpose of this study was to examine the associations between burnout and residency specialty choice in terms of provision for a less versus more controllable lifestyle (e.g. internal medicine versus dermatology) and a lower versus higher income (e.g. paediatrics versus anaesthesiology). A survey was sent to 165 Year 4 medical students who had entered the residency matching system. Students answered questions about specialty choice, motivating factors (lifestyle, patient care and prestige) and perceptions of medicine as a profession. They completed the Maslach Burnout Inventory-Human Services (MBI), which defines burnout in relation to emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Burnout and other variables were tested for associations with specialty lifestyle controllability and income. A response rate of 88% (n = 145) was achieved. Experiences of MBI-EE, MBI-DP and MBI-PA burnout were reported by 42 (29%), 26 (18%) and 30 (21%) students, respectively. Specialties with less controllable lifestyles were chosen by 87 (60%) students and lower-income specialties by 81 (56%). Adjusted odds ratios (ORs) indicated that the choice of a specialty with a more controllable lifestyle was associated with higher MBI-EE burnout (OR = 1.77, 95% confidence interval [CI] 1.06-2.96), as well as stronger lifestyle- and prestige-related motivation, and weaker patient care-related motivation. The choice of a higher-income specialty was associated with lower MBI-PA burnout (OR = 0.56, 95% CI 0.32-0.98), weaker lifestyle- and patient care-related motivation, and stronger prestige-related motivation. Specialty choices regarding lifestyle controllability and income were associated with the amount and type of

An Alternative Option to Dedicated Braille Notetakers for People with Visual Impairments: Universal Technology for Better Access

Science.gov (United States)

Hong, Sunggye

2012-01-01

Technology provides equal access to information and helps people with visual impairments to complete tasks more independently. Among various assistive technology options for people with visual impairments, braille notetakers have been considered the most significant because of their technological innovation. Braille notetakers allow users who are…

A scenario analysis of future energy systems based on an energy flow model represented as functionals of technology options

International Nuclear Information System (INIS)

Kikuchi, Yasunori; Kimura, Seiichiro; Okamoto, Yoshitaka; Koyama, Michihisa

2014-01-01

Highlights: • Energy flow model was represented as the functionals of technology options. • Relationships among available technologies can be visualized by developed model. • Technology roadmapping can be incorporated into the model as technical scenario. • Combination of technologies can increase their contribution to the environment. - Abstract: The design of energy systems has become an issue all over the world. A single optimal system cannot be suggested because the availability of infrastructure and resources and the acceptability of the system should be discussed locally, involving all related stakeholders in the energy system. In particular, researchers and engineers of technologies related to energy systems should be able to perform the forecasting and roadmapping of future energy systems and indicate quantitative results of scenario analyses. We report an energy flow model developed for analysing scenarios of future Japanese energy systems implementing a variety of feasible technology options. The model was modularized and represented as functionals of appropriate technology options, which enables the aggregation and disaggregation of energy systems by defining functionals for single technologies, packages integrating multi-technologies, and mini-systems such as regions implementing industrial symbiosis. Based on the model, the combinations of technologies on both energy supply and demand sides can be addressed considering not only the societal scenarios such as resource prices, economic growth and population change but also the technical scenarios including the development and penetration of energy-related technologies such as distributed solid oxide fuel cells in residential sectors and new-generation vehicles, and the replacement and shift of current technologies such as heat pumps for air conditioning and centralized power generation. The developed model consists of two main modules; namely, a power generation dispatching module for the

Gender variations in specialties among medical doctors working in ...

African Journals Online (AJOL)

Background: Gender variations exist in the choice of specialties among ... as it affects the distribution of doctors in public health institutions and patient care. ... For female doctors,pediatrics was the topmost specialty (25%) followed by ... Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforce ...

Factors affecting future specialty choice among medical students in Kuwait

Directory of Open Access Journals (Sweden)

Rawan Al-Fouzan

2012-12-01

Full Text Available Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students’ sociodemographic and academic factors. Results: Of the 422 students approached, 387 (91.7% decided to participate. A total of 144 (37.2% students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties – 18 (12.5%, 17 (11.8%, and 16 (11.1% students requested these specialties, respectively. Only 61 (42.4% of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8% and a challenging specialty (58; 40.3% were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498–6.065 more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002. Conclusion : A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

Using marketing research concepts to investigate specialty selection by medical students.

Science.gov (United States)

Weissman, Charles; Schroeder, Josh; Elchalal, Uriel; Weiss, Yoram; Tandeter, Howard; Zisk-Rony, Rachel Y

2012-10-01

This study was intended to examine whether a marketing research approach improves understanding of medical specialty selection by medical students. This approach likens students to consumers who are deciding whether or not to purchase a product (specialty). This approach proposes that when consumers' criteria match their perceptions of a product's features, the likelihood that they will purchase it (select the specialty) increases. This study examines whether exploring students' selection criteria and perceptions of various specialties provides additional insights into the selection process. Using a consumer behaviour model as a framework, a questionnaire was designed and administered to Year 6 (final-year) students in 2008 and 2009 to elicit information on their knowledge about and interests in various specialties, the criteria they used in specialty selection, and their perceptions of six specialties. A total of 132 (67%) questionnaires were returned. In many instances, consistency between selection criteria and perceptions of a specialty was accompanied by interest in pursuing the specialty. Exceptions were noted and pointed to areas requiring additional research. For example, although > 70% of female students replied that the affordance of a controllable lifestyle was an important selection criterion, many were interested in obstetrics and gynaecology despite the fact that it was not perceived as providing a controllable lifestyle. Minimal overlap among students reporting interest in primary specialties that possess similar characteristics (e.g. paediatrics and family medicine) demonstrated the need to target marketing (recruitment) efforts for each specialty individually. Using marketing research concepts to examine medical specialty selection may precipitate a conceptual shift among health care leaders which acknowledges that, to attract students, specialties must meet students' selection criteria. Moreover, if consumers (students) deem a product (specialty

Should France invest in new nuclear technology? The enhancement of the EPR project using 'real option' method

International Nuclear Information System (INIS)

Epaulard, A.; Gallon, St.

2000-01-01

The mathematical tools developed to enhance financial options can also be used to calculate the economics value of investment projects which offer flexibility but whose return is uncertain (like options offered on the stock exchange). In this article, an enhancement method of this kind is applied to a construction project (in 2000) for an EPR nuclear prototype. This prototype will make it possible to use EPR to renew the French electrical infrastructure in 2020 (flexibility), but its economic value will depend upon competitiveness vis-a-vis other production methods available at this time (hence an uncertain return). We demonstrate that investing in EPR technology in 2000 will provide sufficient flexibility in 2020 to be considered profitable, even though it is improbable that the EPR technology will be used at the end of this period. The investment agreed in 2000 to expand EPR technology therefore effectively has the role of an option, or of an insurance policy (guaranteeing against the risk that traditional electricity production methods will be expensive in 2020). (authors)

A real options evaluation model for the diffusion prospects of new renewable power generation technologies

International Nuclear Information System (INIS)

Kumbaroglu, Guerkan; Madlener, Reinhard; Demirel, Mustafa

2008-01-01

This study presents a policy planning model that integrates learning curve information on renewable power generation technologies into a dynamic programming formulation featuring real options analysis. The model recursively evaluates a set of investment alternatives on a year-by-year basis, thereby taking into account that the flexibility to delay an irreversible investment expenditure can profoundly affect the diffusion prospects of renewable power generation technologies. Price uncertainty is introduced through stochastic processes for the average wholesale price of electricity and for input fuel prices. Demand for electricity is assumed to be increasingly price-sensitive, as the electricity market deregulation proceeds, reflecting new options of consumers to react to electricity price changes (such as time-of-use pricing, unbundled electricity services, and choice of supplier). The empirical analysis is based on data for the Turkish electricity supply industry. Apart from general implications for policy-making, it provides some interesting insights about the impact of uncertainty and technical change on the diffusion of various emerging renewable energy technologies

Specialty-service lines: salvos in the new medical arms race.

Science.gov (United States)

Berenson, Robert A; Bodenheimer, Thomas; Pham, Hoangmai H

2006-01-01

Hospitals and physicians are developing and marketing discrete and profitable specialty-service lines. Although closely affiliated specialist physicians are central to hospitals' service-line products, other physicians compete directly with hospitals via physician-owned specialty facilities. Specialty-service lines may be provided in a variety of settings, both inside and outside traditional hospital walls. Thus far, the escalating battle between hospitals and physicians for control over specialty services has not affected hospital profitability. However, as the scope of care that can be safely performed in the outpatient arena expands, physician competition for control over specialty services may threaten hospitals' financial health.

Options for Gas-to-Liquids Technology in Alaska

Energy Technology Data Exchange (ETDEWEB)

Robertson, Eric Partridge

1999-10-01

The purposes of this work was to assess the effect of applying new technology to the economics of a proposed natural gas-to-liquids (GTL) plant, to evaluate the potential of a slower-paced, staged deployment of GTL technology, and to evaluate the effect of GTL placement of economics. Five scenarios were economically evaluated and compared: a no-major-gas-sales scenario, a gas-pipeline/LNG scenario, a fast-paced GTL development scenario, a slow-paced GTL development scenario, and a scenario which places the GTL plant in lower Alaska, instead of on the North Slope. Evaluations were completed using an after-tax discounted cash flow analysis. Results indicate that the slow-paced GTL scenario is the only one with a rate of return greater than 10 percent. The slow-paced GTL development would allow cost saving on subsequent expansions. These assumed savings, along with the lowering of the transportation tariff, combine to distinquish this option for marketing the North Slope gas from the other scenarios. Critical variables that need further consideration include the GTL plant cost, the GTL product premium, and operating and maintenance costs.

BIOCHEMISTRY IN THE SPECIALTY IN VISUAL FUNCTION, AND VIRTUAL ENVIRONMENTS IN THE CICS UMA-IPN

Directory of Open Access Journals (Sweden)

Blanca Elisa Pérez-Magaña

2014-07-01

Full Text Available The higher education and postgraduate in Mexico." delivered at the National Polytechnic Institute is located in a period of constant modification and sustained that has led to the creation of new pedagogical proposals aimed at the promotion of learning emphasizing virtual education. The development of ICT (Information Technologies and Communication in the last few years has favored the emergence and consolidation of degrees, diplomas, Specialties, Master's Degrees among other, using the distance learning based on a web environment. This work analyzes the importance that had the Biochemistry course taught in the specialty of Visual Function in the CICS and UMA that allowed both to the students as the teachers try to virtually eliminate the disadvantages theoretical to traditional teaching. The results obtained in addition to the skills and competences acquired the students were highly successful, and it is hoped to be able to continue implementing such environments in other specialties and master's degrees.

Factors affecting membership in specialty nursing organizations.

Science.gov (United States)

White, Mary Joe; Olson, Rhonda S

2004-01-01

A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

Implementation of a Cross-specialty Training Program in Basic Laparoscopy

DEFF Research Database (Denmark)

Bjerrum, Flemming; Sorensen, Jette Led; Thinggaard, Jette

2015-01-01

BACKGROUND AND OBJECTIVES: Several surgical specialties use laparoscopy and share many of the same techniques and challenges, such as entry approaches, equipment, and complications. However, most basic training programs focus on a single specialty. The objective of this study was to describe the ...... laparoscopy is feasible. There are several logistic benefits of using a cross-specialty approach; however, it is important that local departments include specialty-specific components, together with clinical departmental follow-up....

Social Dominance Theory and Medical Specialty Choice

Science.gov (United States)

Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

2016-01-01

Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social…

medical students' preference for choice of clinical specialties

African Journals Online (AJOL)

Zamzar

This study seeks to determine the medical student preference for the clinical specialty and the factors that they consider in making ... undergraduates in selecting these specialties is important. .... effect of National Health Insurance on changes.

A review on technological options of waste to energy for effective management of municipal solid waste.

Science.gov (United States)

Kumar, Atul; Samadder, S R

2017-11-01

Approximately one-fourth population across the world rely on traditional fuels (kerosene, natural gas, biomass residue, firewood, coal, animal dung, etc.) for domestic use despite significant socioeconomic and technological development. Fossil fuel reserves are being exploited at a very fast rate to meet the increasing energy demands, so there is a need to find alternative sources of energy before all the fossil fuel reserves are depleted. Waste to energy (WTE) can be considered as a potential alternative source of energy, which is economically viable and environmentally sustainable. The present study reviewed the current global scenario of WTE technological options (incineration, pyrolysis, gasification, anaerobic digestion, and landfilling with gas recovery) for effective energy recovery and the challenges faced by developed and developing countries. This review will provide a framework for evaluating WTE technological options based on case studies of developed and developing countries. Unsanitary landfilling is the most commonly practiced waste disposal option in the developing countries. However, developed countries have realised the potential of WTE technologies for effective municipal solid waste management (MSWM). This review will help the policy makers and the implementing authorities involved in MSWM to understand the current status, challenges and barriers for effective management of municipal solid waste. This review concluded WTE as a potential renewable source of energy, which will partly meet the energy demand and ensure effective MSWM. Copyright © 2017 Elsevier Ltd. All rights reserved.

In-gap discounts in Medicare Part D and specialty drug use.

Science.gov (United States)

Jung, Jeah; Xu, Wendy Yi; Cheong, Chelim

2017-09-01

Specialty drugs can bring significant benefits to patients, but they can be expensive. Medicare Part D plans charge relatively high cost-sharing costs for specialty drugs. A provision in the Affordable Care Act reduced cost sharing in the Part D coverage gap phase in an attempt to mitigate the financial burden of beneficiaries with high drug spending. We examined the early impact of the Part D in-gap discount on specialty cancer drug use and patients' out-of-pocket (OOP) spending. Natural experimental design. We compared changes in outcomes before and after the in-gap discount among beneficiaries with and without low-income subsidies (LIS). Beneficiaries with LIS, who were not affected by the in-gap discount, made up the control group. We studied a random sample of elderly standalone prescription drug plan enrollees with relatively uncommon cancers (eg, leukemia, skin, pancreas, kidney, sarcomas, and non-Hodgkin lymphoma) between 2009 and 2013. We constructed 4 outcome variables annually: 1) use of any specialty cancer drug, 2) the number of specialty cancer drug fills, 3) total specialty drug spending, and 4) OOP spending for specialty cancer drugs. The in-gap discount did not influence specialty cancer drug use, but reduced annual OOP spending for specialty cancer drugs among users without LIS by $1108. In-gap discounts in Part D decreased patients' financial burden to some extent, but resulted in no change in specialty drug use. As demand for specialty drugs increases, it will be important to ensure patients' access to needed drugs, while simultaneously reducing their financial burden.

Factors Influencing Medical Students' Choice of Specialty

Directory of Open Access Journals (Sweden)

Pei-Yeh Chang

2006-01-01

Conclusion: This study found that personal intelligence/ability preference and career opportunities were more important factors to the current generation of students in choosing a specialty. Knowledge of these students' attitudes could form the basis for the development of strategies to enhance the attractiveness of specialties facing the problem of a shortage of manpower.

Technological Literacy Education and Technological and Vocational Education in Taiwan

Science.gov (United States)

Lee, Lung-Sheng Steven

2010-01-01

Technology education in Taiwan is categorized into the following two types: (1) technological literacy education (TLE)--the education for all people to become technological literates; and (2) technological specialty education (TSE)--the education for specific people to become technicians and professionals for technology-related jobs. This paper…

Collaboration between paediatric surgery and other medical specialties in Nigeria

Directory of Open Access Journals (Sweden)

Philemon E Okoro

2012-01-01

Full Text Available Background: The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. Materials and Methods: This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Results: Forty-seven respondents were included in the survey. Forty-five (95.7% respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%, lack of awareness of the need for collaboration 32 (68.1%, tendency to apportion blames for bad outcome 13 (27.7%, and mutual suspicion 8 (17%. Conclusion: There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

Seashell specialties and food handling in Slovene Istria restaurants

Directory of Open Access Journals (Sweden)

Tamara POKLAR VATOVEC

2015-11-01

Full Text Available The purpose of the research was to evaluate the offer of seashell specialties in Slovene Istria restaurants, and to assess food safety knowledge (gained through formal and informal education as well as to assess the behaviour of food handlers in preparing shell dishes. A self-administered questionnaire was designed that included four sections: a demographic section, a general section, a restaurant menu offer, and a food safety section related to preparation of seashell specialties. Seashell specialties were offered in 41 restaurants, of which the employed food handlers 24 attended formal education and 17 informal education. Seashells specialties and seashell menus are commonly part of the culinary and gastronomic specialties along the Slovene coast, with the most frequently offered main dish being “Blue Mussels alla Busara”. Results the questionnaire indicated poor food safety knowledge and poor behaviour regardless of the (informal education of those who prepared the dishes. We propose that formal education for catering workers preparing shell dishes should be much more emphasized.

Knowledge silos: assessing knowledge sharing between specialties through the vestibular schwannoma literature.

Science.gov (United States)

Schnurman, Zane; Golfinos, John G; Roland, J Thomas; Kondziolka, Douglas

2017-12-01

OBJECTIVE It is common for a medical disorder to be managed or researched by individuals who work within different specialties. It is known that both neurosurgeons and neurotologists manage vestibular schwannoma (VS) patients. While overlap in specialty focus has the potential to stimulate multidisciplinary collaboration and innovative thinking, there is a risk of specialties forming closed-communication loops, called knowledge silos, which may inhibit knowledge diffusion. This study quantitatively assessed knowledge sharing between neurosurgery and otolaryngology on the subject of VS. METHODS A broad Web of Science search was used to download details for 4439 articles related to VS through 2016. The publishing journal's specialty and the authors' specialties (based on author department) were determined for available articles. All 114,647 of the article references were categorized by journal specialty. The prevalence of several VS topics was assessed using keyword searches of titles. RESULTS For articles written by neurosurgeons, 44.0% of citations were from neurosurgery journal articles and 23.4% were from otolaryngology journals. The citations of otolaryngology authors included 11.6% neurosurgery journals and 56.5% otolaryngology journals. Both author specialty and journal specialty led to more citations of the same specialty, though author specialty had the largest effect. Comparing the specialties' literature, several VS topics had significantly different levels of coverage, including radiosurgery and hearing topics. Despite the availability of the Internet, there has been no change in the proportions of references for either specialty since 1997 (the year PubMed became publicly available). CONCLUSIONS Partial knowledge silos are observed between neurosurgery and otolaryngology on the topic of VS, based on the peer-reviewed literature. The increase in access provided by the Internet and searchable online databases has not decreased specialty reference bias

New directions for veterinary technology.

Science.gov (United States)

Chadderdon, Linda M; Lloyd, James W; Pazak, Helene E

2014-01-01

Veterinary technology has generally established itself well in companion-animal and mixed-animal veterinary medical practice, but the career's growth trajectory is uncertain. Michigan State University (MSU) convened a national conference, "Creating the Future of Veterinary Technology-A National Dialogue," in November 2011 to explore ways to elevate the veterinary technician/technologist's role in the veterinary medical profession and to identify new directions in which the career could expand. Veterinary technicians/technologists might advance their place in private practice by not only improving their clinical skills, but by also focusing on areas such as practice management, leadership training, business training, conflict resolution, information technology, and marketing/communications. Some new employment settings for veterinary technicians/technologists include more participation within laboratory animal medicine and research, the rural farm industry, regulatory medicine, and shelter medicine. Achieving these ends would call for new training options beyond the current 2-year and 4-year degree programs. Participants suggested specialty training programs, hybrid programs of various types, online programs, veterinary technician residency programs of 12-18 months, and more integration of veterinary technician/technology students and veterinary medicine students at colleges of veterinary medicine.

Orthopedic specialty hospitals: centers of excellence or greed machines?

Science.gov (United States)

Badlani, Neil; Boden, Scott; Phillips, Frank

2012-03-07

Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. Copyright 2012, SLACK Incorporated.

Pakistani medical students' specialty preference and the influencing factors.

Science.gov (United States)

Rehman, Anis; Rehman, Tariq; Shaikh, Muhammad Ateeb; Yasmin, Haleema; Asif, Ammara; Kafil, Hina

2011-07-01

To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad Medical College, were included in the cross-sectional survey during the period of July 2008 to Jan' 2009. After ethical acceptance, data was collected using convenient sampling technique. The questionnaire covered the following demographic details: 13 common specialties and 15 influencing factors. Questionnaires included in the analysis were 771. Most students gave preference to surgery and its associated sub-specialties (50.3%) followed by internal medicine (26.8%), paediatrics (23.2%), dermatology (16.7%), gynaecology and obstetrics (16.7%), psychiatry (13.1%), radiology (10.8%), ENT (8.8%), anaesthesiology (8.7%), administrative medicine (8.6%), orthopaedics (8.2%), ophthalmology (7.5%), and laboratory medicine (6.1%). The highly considered factors (regarding specialties) chosen by 70% of the medical students were: applicable to respective personalities of the individuals, prestige and respect, international opportunities, and time commitment. Surgical-skills, job availability, financial rating, academic performance, and a role model were moderately influencing factors. Hospital environment, parents, general practice, peer-pressure and personal health were the least influential. This trend suggests competition in surgery and its sub-specialties along with internal medicine, paediatrics, dermatology, gynaecology and obstetrics. Specialty suited to personality, time commitment, prestige/respect and international opportunity, influenced more than 70% of the students.

Specialty and full-service hospitals: a comparative cost analysis.

Science.gov (United States)

Carey, Kathleen; Burgess, James F; Young, Gary J

2008-10-01

To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

New power generation technology options under the greenhouse gases mitigation scenario in China

Energy Technology Data Exchange (ETDEWEB)

Liu, Qiang [Graduate University of Chinese Academy of Science, 19A Yu Quan Road, Beijing 100049 (China); Energy Research Institute, Guohong Mansion, Xicheng District, Beijing 100038 (China); Shi, Minjun [Graduate University of Chinese Academy of Science, 19A Yu Quan Road, Beijing 100049 (China); Jiang, Kejun [Energy Research Institute, Guohong Mansion, Xicheng District, Beijing 100038 (China)

2009-06-15

Climate change has become a global issue. Almost all countries, including China, are now considering adopting policies and measures to reduce greenhouse gas (GHG) emissions. The power generation sector, as a key source of GHG emissions, will also have significant potential for GHG mitigation. One of the key options is to use new energy technologies with higher energy efficiencies and lower carbon emissions. In this article, we use an energy technology model, MESSAGE-China, to analyze the trend of key new power generation technologies and their contributions to GHG mitigation in China. We expect that the traditional renewable technologies, high-efficiency coal power generation and nuclear power will contribute substantially to GHG mitigation in the short term, and that solar power, biomass energy and carbon capture and storage (CCS) will become more important in the middle and long term. In the meantime, in order to fully bring the role of technology progress into play, China needs to enhance the transfer and absorption of international advanced technologies and independently strengthen her ability in research, demonstration and application of new power generation technologies. (author)

New power generation technology options under the greenhouse gases mitigation scenario in China

Energy Technology Data Exchange (ETDEWEB)

Qiang, Liu [Graduate University of Chinese Academy of Science, 19A Yu Quan Road, Beijing 100049 (China); Energy Research Institute, Guohong Mansion, Xicheng District, Beijing 100038 (China)], E-mail: liuqiang@eri.org.cn; Minjun, Shi [Graduate University of Chinese Academy of Science, 19A Yu Quan Road, Beijing 100049 (China); Kejun, Jiang [Energy Research Institute, Guohong Mansion, Xicheng District, Beijing 100038 (China)

2009-06-15

Climate change has become a global issue. Almost all countries, including China, are now considering adopting policies and measures to reduce greenhouse gas (GHG) emissions. The power generation sector, as a key source of GHG emissions, will also have significant potential for GHG mitigation. One of the key options is to use new energy technologies with higher energy efficiencies and lower carbon emissions. In this article, we use an energy technology model, MESSAGE-China, to analyze the trend of key new power generation technologies and their contributions to GHG mitigation in China. We expect that the traditional renewable technologies, high-efficiency coal power generation and nuclear power will contribute substantially to GHG mitigation in the short term, and that solar power, biomass energy and carbon capture and storage (CCS) will become more important in the middle and long term. In the meantime, in order to fully bring the role of technology progress into play, China needs to enhance the transfer and absorption of international advanced technologies and independently strengthen her ability in research, demonstration and application of new power generation technologies.

A theoretical model to explain the smart technology adoption behaviors of elder consumers (Elderadopt).

Science.gov (United States)

Golant, Stephen M

2017-08-01

A growing global population of older adults is potential consumers of a category of products referred to as smart technologies, but also known as telehealth, telecare, information and communication technologies, robotics, and gerontechnology. This paper constructs a theoretical model to explain whether older people will adopt smart technology options to cope with their discrepant individual or environmental circumstances, thereby enabling them to age in place. Its proposed constructs and relationships are drawn from multiple academic disciplines and professional specialties, and an extensive literature focused on the factors influencing the acceptance of these smart technologies. It specifically examines whether older adults will substitute these new technologies for traditional coping solutions that rely on informal and formal care assistance and low technology related products. The model argues that older people will more positively evaluate smart technology alternatives when they feel more stressed because of their unmet needs, have greater resilience (stronger perceptions of self-efficacy and greater openness to new information), and are more strongly persuaded by their sources of outside messaging (external information) and their past experiences (internal information). It proposes that older people distinguish three attributes of these coping options when they appraise them: perceived efficaciousness, perceived usability, and perceived collateral damages. The more positively older people evaluate these attributes, the more likely that they will adopt these smart technology products. Copyright © 2017 Elsevier Inc. All rights reserved.

Biofuels Fuels Technology Pathway Options for Advanced Drop-in Biofuels Production

Energy Technology Data Exchange (ETDEWEB)

Kevin L Kenney

2011-09-01

Advanced drop-in hydrocarbon biofuels require biofuel alternatives for refinery products other than gasoline. Candidate biofuels must have performance characteristics equivalent to conventional petroleum-based fuels. The technology pathways for biofuel alternatives also must be plausible, sustainable (e.g., positive energy balance, environmentally benign, etc.), and demonstrate a reasonable pathway to economic viability and end-user affordability. Viable biofuels technology pathways must address feedstock production and environmental issues through to the fuel or chemical end products. Potential end products include compatible replacement fuel products (e.g., gasoline, diesel, and JP8 and JP5 jet fuel) and other petroleum products or chemicals typically produced from a barrel of crude. Considering the complexity and technology diversity of a complete biofuels supply chain, no single entity or technology provider is capable of addressing in depth all aspects of any given pathway; however, all the necessary expert entities exist. As such, we propose the assembly of a team capable of conducting an in-depth technology pathway options analysis (including sustainability indicators and complete LCA) to identify and define the domestic biofuel pathways for a Green Fleet. This team is not only capable of conducting in-depth analyses on technology pathways, but collectively they are able to trouble shoot and/or engineer solutions that would give industrial technology providers the highest potential for success. Such a team would provide the greatest possible down-side protection for high-risk advanced drop-in biofuels procurement(s).

2005 resource options report

International Nuclear Information System (INIS)

Morris, T.

2005-01-01

This resource options report (ROR) fulfils regulatory requirements in British Columbia's two-year resource planning process. It identifies a wide range of resources and technologies that could be used to meet BC Hydro's future electricity demand. As such, it facilitates a transparent public review of resource options which include both supply-side and demand-side options. The resource options that will be used in the 2005 integrated electricity plan (IEP) were characterized. This ROR also documents where there is a general agreement or disagreement on the resource type characterization, based on the First Nations and Stakeholder engagement. BC Hydro used current information to provide realistic ranges on volume and cost to characterize environmental and social attributes. The BC Hydro system was modelled to assess the benefit and cost of various resource options. The information resulting from this ROR and IEP will help in making decisions on how to structure competitive acquisition calls and to determine the level of transmission services needed to advance certain BC Hydro projects. The IEP forecasts the nature and quantity of domestic resources required over the next 20 years. A strategic direction on how those needs will be met has been created to guide the management of BC Hydro's energy resources. Supply-side options include near-commercial technologies such as energy storage, ocean waves, tidal, fuel cells and integrated coal gasification combined cycle technology. Supply-side options also include natural gas, coal, biomass, geothermal, wind, and hydro. 120 refs., 39 tabs., 21 figs., 6 appendices

Empathy differences by gender and specialty preference in medical students: a study in Brazil.

Science.gov (United States)

Santos, Mariana A; Grosseman, Suely; Morelli, Thiago C; Giuliano, Isabela C B; Erdmann, Thomas R

2016-05-21

We have conducted this study to assess medical students' empathy and to examine empathy differences by students' socio-demographic characteristics, including gender, and specialty preference. We have conducted a cross-sectional and descriptive research. Among 595 medical students registered at the Federal University of Santa Catarina (Brazil) in 2012, we have selected a sample of 320 enrolled in the first, third, fifth, seventh, ninth, eleventh, and in the last semester of the course. The response rate obtained was 70.6% (n=226). Data was collected by using a self-report questionnaire, and the variables analyzed included course semester, socio-demographic characteristics (such as age, gender, household monthly income and parents level of education), students' specialty preference, and empathy assessed by the Jefferson Scale of Empathy. We have used descriptive statistics, 95% Confidence Interval for percentages, Student's t-test, and Analysis of Variance to analyze the data. Mean empathy among students was (M=119.7, SD=9.9), with no difference by according to semester (F=1.5, p=.2). Empathy means were higher among females (M=118.3, SD=10.6) than among males (M=121.0, SD=9.3, t=-2.1, p=.032). Students who preferred a people-oriented specialty obtained significantly higher mean scores (M=121.5, SD=8.1) in comparison to students who preferred technology-oriented specialties (M=118.0, SD=11.3, t=2.4, p=.02). Our study has found consistently high scores of empathy among medical students enrolled in all levels of training at the Federal University of Santa Catarina, and higher empathy among women and students who intend to pursue a people-oriented specialty. Conclusions on higher empathy among medical students require further study.

Medical specialty considerations by medical students early in their clinical experience

Directory of Open Access Journals (Sweden)

Weissman Charles

2012-03-01

Full Text Available Abstract Background Specialty selection by medical students determines the future composition of the physician workforce. Selection of career specialties begins in earnest during the clinical rotations with exposure to the clinical and intellectual environments of various specialties. Career specialty selection is followed by choosing a residency program. This is the period where insight into the decision process might help healthcare leaders ascertain whether, when, and how to intervene and attempt to influence students' decisions. The criteria students consider important in selecting a specialty and a residency program during the early phases of their clinical rotations were examined. Methods Questionnaires distributed to fifth-year medical students at two Israeli medical schools. Results 229 of 275 (83% questionnaires were returned. 80% of the students had considered specialties; 62% considered one specialty, 25% two, the remainder 3-5 specialties. Students took a long-range view; 55% considered working conditions after residency more important than those during residency, another 42% considered both equally important. More than two-thirds wanted an interesting and challenging bedside specialty affording control over lifestyle and providing a reasonable relationship between salary and lifestyle. Men were more interested in well-remunerated procedure-oriented specialties that allowed for private practice. Most students rated as important selecting a challenging and interesting residency program characterized by good relationships between staff members, with positive treatment by the institution, and that provided much teaching. More women wanted short residencies with few on-calls and limited hours. More men rated as important residencies affording much responsibility for making clinical decisions and providing research opportunities. More than 50% of the students considered it important that their residency be in a leading department, and in

Embracing a competency-based specialty curriculum for community-based nursing roles.

Science.gov (United States)

Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

2013-01-01

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

81 options. Technology for sustainable development; 81 mogelijkheden. Technologie voor duurzame ontwikkeling

Energy Technology Data Exchange (ETDEWEB)

Weterings, R.; Kuijper, J.; Smeets, E. [TNO Studiecentrum voor Technologie en Beleid TNO-STB, Apeldoorn (Netherlands); Annokee, G.J. [TNO Milieu, Energie en Procesinnovatie TNO-MEP, Apeldoorn (Netherlands); Minne, B. [Centraal Planbureau CPB, The Hague (Netherlands)

1997-03-01

An outline is given of the chances and threats of technological developments for the environment in the next 25 years. First, the most important technological supply-side developments were inventorized and assessed for their environmental relevance and in the light of three CPB-scenarios. From the results of the analysis it appears that their are many options to improve the environmental efficiency of products and processes. An important motive to develop environment-efficient technology is the price of energy. A higher price for energy will stimulate the development of energy efficient products and processes. Also the interest for dematerialization will increase while the processing of basic materials and the use of materials requires energy too. A second important motive is the demand for environment-efficient products. The market introduction of new environment-friendly products strongly depends on the quality consciousness (including the environmental quality) of the consumer. With respect to the environmental policy it can be concluded that technological innovation is important in the transfer of a decontamination-based policy to a prevention-based policy. 95 refs.

Options Study - Phase II

Energy Technology Data Exchange (ETDEWEB)

R. Wigeland; T. Taiwo; M. Todosow; W. Halsey; J. Gehin

2010-09-01

The Options Study has been conducted for the purpose of evaluating the potential of alternative integrated nuclear fuel cycle options to favorably address the issues associated with a continuing or expanding use of nuclear power in the United States. The study produced information that can be used to inform decisions identifying potential directions for research and development on such fuel cycle options. An integrated nuclear fuel cycle option is defined in this study as including all aspects of the entire nuclear fuel cycle, from obtaining natural resources for fuel to the ultimate disposal of used nuclear fuel (UNF) or radioactive wastes. Issues such as nuclear waste management, especially the increasing inventory of used nuclear fuel, the current uncertainty about used fuel disposal, and the risk of nuclear weapons proliferation have contributed to the reluctance to expand the use of nuclear power, even though it is recognized that nuclear power is a safe and reliable method of producing electricity. In this Options Study, current, evolutionary, and revolutionary nuclear energy options were all considered, including the use of uranium and thorium, and both once-through and recycle approaches. Available information has been collected and reviewed in order to evaluate the ability of an option to clearly address the challenges associated with the current implementation and potential expansion of commercial nuclear power in the United States. This Options Study is a comprehensive consideration and review of fuel cycle and technology options, including those for disposal, and is not constrained by any limitations that may be imposed by economics, technical maturity, past policy, or speculated future conditions. This Phase II report is intended to be used in conjunction with the Phase I report, and much information in that report is not repeated here, although some information has been updated to reflect recent developments. The focus in this Options Study was to

Health plan utilization and costs of specialty drugs within 4 chronic conditions.

Science.gov (United States)

Gleason, Patrick P; Alexander, G Caleb; Starner, Catherine I; Ritter, Stephen T; Van Houten, Holly K; Gunderson, Brent W; Shah, Nilay D

2013-09-01

Drugs are most typically defined as specialty because they are expensive; however, other criteria used to define a drug as specialty include biologic drugs, the need to inject or infuse the drug, the requirement for special handling, or drug availability only via a limited distribution network. Specialty drugs play an increasingly important role in the treatment of chronic conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding the comprehensive medical and pharmacy benefit utilization and cost trends for these conditions. To describe MS, RA, psoriasis, and IBD trends for condition prevalence, treatment with specialty drugs, specialty costs, nonspecialty costs, and total direct costs of care within the medical and pharmacy benefits. This was a descriptive analysis of a commercially insured population made up of 1 million members, using integrated medical and pharmacy administrative claims data from 2008 to 2010. Analyses were limited to continuously enrolled commercially insured individuals less than 65 years of age. Condition-specific cohorts for MS, RA, psoriasis, and IBD were defined using standardized criteria. Trends in condition prevalence, specialty drug use for the conditions, and direct total cost of care were analyzed. The direct costs were subcategorized into the following: medical benefit specialty drug costs, medical benefit all other costs, pharmacy benefit specialty drug costs, and pharmacy benefit all other costs. Trends and compound annual growth rates were calculated for the total cost of care and subcategory costs from 2008 through 2010. Condition prevalence ranged from a low of 1,720 per million members for MS to a high of 4,489 per million members for RA. Psoriasis and MS condition prevalence rates were unchanged over the 3 years; however, IBD prevalence increased 7.0%, and RA prevalence increased 9.7%. The rate of specialty drug use was lowest for IBD

Sampling and farm stories prompt consumers to buy specialty cheeses

OpenAIRE

Reed, Barbara A.; Bruhn, Christine M.

2003-01-01

California specialty cheese makers need information on what drives product sales so they can effectively market their products. Focus group and telephone research revealed that specialty cheese consumers have a strong preference for sampling cheese before making a purchase. Consumers also rely heavily on staff recommendations to select cheese. They appreciate unlimited sampling in an unhurried, low-pressure environment. Specialty cheese consumers consider themselves “food experimenters”; they...

Factors Influencing Medical Students' Choice of Specialty

OpenAIRE

Chang, Pei-Yeh; Hung, Chih-Young; Wang, Kuei-lng; Huang, Yuan-Huei; Chang, King-Jen

2006-01-01

Medical school graduates are the source of a country's physicians. Determining how the graduates of these schools select their areas of specialization is the key to achieving a balanced distribution of doctors among all specialties. The purposes of this study were to determine the factors that influence medical students' choice of medical specialty, and to derive the relative weight of each factor. Methods: We constructed a two-tiered analytic hierarchy process (AHP) model which was repres...

Technological Options to Ameliorate Waste Treatment of Intensive Pig Production in China：An Analysis Based on Bio-Economic Model

Institute of Scientific and Technical Information of China (English)

LU Wen-cong; MA Yong-xi; Holger Bergmann

2014-01-01

Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment beneifts of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental beneifts of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efifciency, the waste treatment capacity and the economic beneifts could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.

Economic, energy and greenhouse emissions impacts of some consumer choice, technology and government outlay options

International Nuclear Information System (INIS)

Lenzen, Manfred; Dey, Christopher J.

2002-01-01

The impacts of selected spending options in the Australian economy are determined in terms of energy consumption, greenhouse gas emissions and a range of economic parameters. Six case studies of one current-practice and one alternative, environmentally motivated spending option are carried out, describing consumer choices, technologies and government outlays. The assessment method is based on input-output theory and, as such, enables both the direct and indirect effects of spending to be quantified. In general, the results indicate that pro-environmental objectives, such as reductions in energy consumption and greenhouse gas emissions, are compatible with broad socio-economic benefits, such as increases in employment and income, and reductions in imports

Two interesting cases highlighting an oblivious specialty of psychoneuroendocrinology.

Science.gov (United States)

Hari Kumar, K V S; Dhull, Pawan; Somasekharan, Manoj; Seshadri, K

2012-01-01

Psychoneuroendocrinology deals with the overlap disorders pertaining to three different specialties. Awareness about the somatic manifestations of psychiatric diseases and vice versa is a must for all the clinicians. The knowledge of this interlinked specialty is essential because of the obscure presentation of certain disorders. Our first case was treated as depressive disorder, whereas the diagnosis was hypogonadism with empty sella. Our second patient was managed as schizophrenia and the evaluation revealed bilateral basal ganglia calcification and a diagnosis of Fahr's disease. We report these cases for their unusual presentation and to highlight the importance of this emerging specialty.

Proceedings of the 1999 Oil and Gas Conference: Technology Options for Producer Survival

Energy Technology Data Exchange (ETDEWEB)

None available

2000-04-12

The 1999 Oil & Gas Conference was cosponsored by the U.S. Department of Energy (DOE), Office of Fossil Energy, Federal Energy Technology Center (FETC) and National Petroleum Technology Office (NPTO) on June 28 to 30 in Dallas, Texas. The Oil & Gas Conference theme, Technology Options for Producer Survival, reflects the need for development and implementation of new technologies to ensure an affordable, reliable energy future. The conference was attended by nearly 250 representatives from industry, academia, national laboratories, DOE, and other Government agencies. Three preconference workshops (Downhole Separation Technologies: Is it Applicable for Your Operations, Exploring and developing Naturally Fractured Low-Permeability Gas Reservoirs from the Rocky Mountains to the Austin Chalk, and Software Program Applications) were held. The conference agenda included an opening plenary session, three platform sessions (Sessions 2 and 3 were split into 2 concurrent topics), and a poster presentation reception. The platform session topics were Converting Your Resources Into Reserves (Sessions 1 and 2A), Clarifying Your Subsurface Vision (Session 2B), and High Performance, Cost Effective Drilling, Completion, Stimulation Technologies (Session 3B). In total, there were 5 opening speakers, 30 presenters, and 16 poster presentations.

[Infectious diseases - a specialty of internal medicine].

Science.gov (United States)

Fätkenheuer, G; Jung, N; Kern, W V; Fölsch, U R; Salzberger, B

2018-04-01

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

Gender Distribution Among American Board of Medical Specialties Boards of Directors.

Science.gov (United States)

Walker, Laura E; Sadosty, Annie T; Colletti, James E; Goyal, Deepi G; Sunga, Kharmene L; Hayes, Sharonne N

2016-11-01

Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards. Association of American Medical Colleges and American Medical Association data were utilized to identify current and future trends in gender composition. Although represented by a common board, neurology and psychiatry were evaluated separately because of their very different practices and gender demographic characteristics. A total of 25 specialties were evaluated. Of the 25 specialties analyzed, 12 BODs have proportional gender representation compared with their constituency. Seven specialties have a larger proportion of women serving on their boards compared with physicians in practice, and 6 specialties have a greater proportion of men populating their BODs. Based on the most recent trainee data (2013), women have increasing workforce representation in almost all specialties. Although women in both training and practice are approaching equal representation, there is variability in gender ratios across specialties. Directorship within ABMS BODs has a more equitable gender distribution than other areas of leadership in medicine. Further investigation is needed to determine the reasons behind this difference and to identify opportunities to engage women in leadership in medicine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Hybrid options for treating cardiac disease.

Science.gov (United States)

Umakanthan, Ramanan; Leacche, Marzia; Zhao, David X; Gallion, Anna H; Mishra, Prabodh C; Byrne, John G

2011-01-01

The options for treating heart disease have greatly expanded during the course of the last 2 1/2 decades with the advent of hybrid technology. The hybrid option for treating cardiac disease implies using the technology of both interventional cardiology and cardiac surgery to treat cardiac disease. This rapidly developing technology has given rise to new and creative techniques to treat cardiac disease involving coronary artery disease, coronary artery disease and cardiac valve disease, and atrial fibrillation. It has also led to the establishment of new procedural suites called hybrid operating rooms that facilitate the integration of technologies of interventional cardiology catheterization laboratories with those of cardiac surgery operating rooms. The development of hybrid options for treating cardiac disease has also greatly augmented teamwork and collaboration between interventional cardiologists and cardiac surgeons. Copyright © 2011 Elsevier Inc. All rights reserved.

BUSINESS DEVELOPMENT STRATEGY FOR SPECIALTY COFFEE

Directory of Open Access Journals (Sweden)

Vharessa Aknesia

2015-01-01

Full Text Available Specialty coffee is a coffee of premium quality that has been made through various stages of post-harvest processing and strictly controlled to produce distinctive taste of origins. PT Sinar Mayang Lestari is one of the companies that currently produce and develop specialty coffee type, Arabica Java Preanger. The objectives of the study are to examine competitive advantages and develop an alternative strategy that need to be done by PT Sinar Mayang Lestari for their business development. The research methods used are value chain analysis and VRIO framework to explore competitive advantage owned by the company. The result shows the company currently has a temporary competitive advantage of the technological resources and reputation. By using SWOT-AHP technique, the alternative strategies that can be done by company are as follows: 1 increasing the production of natural and honey coffee  type; 2 building coffee center in plantation site for sharing knowledge and innovation media to the farmers; 3 improving the competency of human resource in plantation, post harvest, and promoting area; 4 building management system gradually 5 forwarding integration by building roast and ground coffee business; and 6 maximizing the ability of the land and human resources through research and development.Keywords: competitive advantage, specialty coffee, SWOT-AHP, value chain, VRIOABSTRAKKopi special merupakan kopi dengan kualitas premium yang sudah melalui berbagai tahapan pengolahan pascapanen yang diawasi dengan ketat sehingga menghasilkan cita rasa yang khas sesuai dengan daerah asalnya. PT Sinar Mayang Lestari adalah salah satu perusahaan yang saatini memproduksi dan mengembangkan kopi spesial jenis Arabika Java Preanger. Tujuan dari penelitian ini adalah menganalisis keunggulan bersaing yang dimiliki dan mengembangkan alternative strategi yang perlu dilakukanoleh PT Sinar Mayang Lestari untuk pengembangan usahanya. Penelitian ini menggunakan analisis rantai

Option value of electricity demand response

Energy Technology Data Exchange (ETDEWEB)

Sezgen, Osman; Goldman, C.A. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley CA 94720 (United States); Krishnarao, P. [Citigroup Energy Inc., 1301 Fannin St, Houston, TX 77002 (United States)

2007-02-15

As electricity markets deregulate and energy tariffs increasingly expose customers to commodity price volatility, it is difficult for energy consumers to assess the economic value of investments in technologies that manage electricity demand in response to changing energy prices. The key uncertainties in evaluating the economics of demand-response technologies are the level and volatility of future wholesale energy prices. In this paper, we demonstrate that financial engineering methodologies originally developed for pricing equity and commodity derivatives (e.g., futures, swaps, options) can be used to estimate the value of demand-response technologies. We adapt models used to value energy options and assets to value three common demand-response strategies: load curtailment, load shifting or displacement, and short-term fuel substitution-specifically, distributed generation. These option models represent an improvement to traditional discounted cash flow methods for assessing the relative merits of demand-side technology investments in restructured electricity markets. (author)

Option value of electricity demand response

International Nuclear Information System (INIS)

Sezgen, Osman; Goldman, C.A.; Krishnarao, P.

2007-01-01

As electricity markets deregulate and energy tariffs increasingly expose customers to commodity price volatility, it is difficult for energy consumers to assess the economic value of investments in technologies that manage electricity demand in response to changing energy prices. The key uncertainties in evaluating the economics of demand-response technologies are the level and volatility of future wholesale energy prices. In this paper, we demonstrate that financial engineering methodologies originally developed for pricing equity and commodity derivatives (e.g., futures, swaps, options) can be used to estimate the value of demand-response technologies. We adapt models used to value energy options and assets to value three common demand-response strategies: load curtailment, load shifting or displacement, and short-term fuel substitution-specifically, distributed generation. These option models represent an improvement to traditional discounted cash flow methods for assessing the relative merits of demand-side technology investments in restructured electricity markets. (author)

Specialties differ in which aspects of doctor communication predict overall physician ratings.

Science.gov (United States)

Quigley, Denise D; Elliott, Marc N; Farley, Donna O; Burkhart, Q; Skootsky, Samuel A; Hays, Ron D

2014-03-01

Effective doctor communication is critical to positive doctor-patient relationships and predicts better health outcomes. Doctor communication is the strongest predictor of patient ratings of doctors, but the most important aspects of communication may vary by specialty. To determine the importance of five aspects of doctor communication to overall physician ratings by specialty. For each of 28 specialties, we calculated partial correlations of five communication items with a 0-10 overall physician rating, controlling for patient demographics. Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) 12-month Survey data collected 2005-2009 from 58,251 adults at a 534-physician medical group. CG-CAHPS includes a 0 ("Worst physician possible") to 10 ("Best physician possible") overall physician rating. Five doctor communication items assess how often the physician: explains things; listens carefully; gives easy-to-understand instructions; shows respect; and spends enough time. Physician showing respect was the most important aspect of communication for 23/28 specialties, with a mean partial correlation (0.27, ranging from 0.07 to 0.44 across specialties) that accounted for more than four times as much variance in the overall physician rating as any other communication item. Three of five communication items varied significantly across specialties in their associations with the overall rating (p importance of other aspects of communication varied significantly by specialty. Quality improvement efforts by all specialties should emphasize physicians showing respect to patients, and each specialty should also target other aspects of communication that matter most to their patients. The results have implications for improving provider quality improvement and incentive programs and the reporting of CAHPS data to patients. Specialists make important contributions to coordinated patient care, and thus customized approaches to measurement

Temperamental traits may be associated with medical students’ specialty preferences – pilot study

Directory of Open Access Journals (Sweden)

Agnieszka Pawełczyk

2010-06-01

Full Text Available Objective: This study was aimed at checking a hypothesis about a possible correlation between medical students’ temperamental traits and specialty preferences. Material and methods: The study was carried out among 202 students of the 6th year at the Medical University of Łódź in academic year 2008/2009. The examined group consisted of 140 women (69% and 62 men (31%. The average age of the students included into the study was 24.7 years (range: 23-29. The subjects were asked to fill in a questionnaire on demographic variables and the Formal Characteristics of BehaviourTemperament Inventory (FCB-TI by Zawadzki and Strelau. Results: The students taking part in the study preferred specialties in internal diseases (22%, surgery (18% and paediatrics (11%. Two point five percent of the students were indecisive in the specialty choice, 26% preferred surgical specialty and 71% – non-surgical specialty. Differences in temperamental traits were indicated between the students preferring different specialties. Students preferring surgery scored higher than those preferring internal medicine in Endurance (p=0.0036, d=0.63 and Activity (p=0.0292, d=0.63. Significantly higher average values were observed within two temperamental traits: Briskness (p=0.0083, d=0.5 and Endurance (p=0.0070, d=0.49 in students preferring surgical specialties, as compared to those choosing non-surgical specialties. Conclusions: Students’ preferring different medical specialties differ in temperamental traits. They obtained different results on the scales of Briskness, Endurance and Activity. The obtained results may be useful in vocational guidance within the choice of medical specialty.

Specialty Drug Spending Trends Among Medicare And Medicare Advantage Enrollees, 2007–11

OpenAIRE

Trish, Erin; Joyce, Geoffrey; Goldman, Dana P.

2014-01-01

Specialty pharmaceuticals include most injectable and biologic agents used to treat complex conditions such as rheumatoid arthritis, multiple sclerosis, and cancer. We analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007–11 pharmacy claims data from a 20 percent sample of Medicare beneficiaries. Annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, from $2,641 to $8,976. H...

Veteran satisfaction and treatment preferences in response to a posttraumatic stress disorder specialty clinic orientation group.

Science.gov (United States)

Schumm, Jeremiah A; Walter, Kristen H; Bartone, Anne S; Chard, Kathleen M

2015-06-01

To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options. Published by Elsevier Ltd.

Options For The Disposition Of UK Civil Plutonium Stocks

Energy Technology Data Exchange (ETDEWEB)

Moore, R.G.; Zimmerman, C.H.; Scales, C.; Worrall, A.; Sims, H.E.; Fowler, L. [Nexia Solutions Ltd (United Kingdom)

2008-07-01

The UK Civil Pu Disposition project will identify and assess the viability of several technical options for dealing with the UK's civil separated Pu stockpile and the discriminators that will support technology option down-selection decisions. The overall aim will be to deliver feasible technical options and comprehensive information on political, economic, sociological, environmental and technical factors for each strategic option. This paper briefly describes the work completed to date to assess immobilisation and re-use technologies as disposition strategies and on the work that will identify discriminators to support technology down-selection. The Pu disposition project is anticipated to continue for several years while the necessary investigations are made to fully understand the various options. The work planned over this period is discussed. (authors)

Options For The Disposition Of UK Civil Plutonium Stocks

International Nuclear Information System (INIS)

Moore, R.G.; Zimmerman, C.H.; Scales, C.; Worrall, A.; Sims, H.E.; Fowler, L.

2008-01-01

The UK Civil Pu Disposition project will identify and assess the viability of several technical options for dealing with the UK's civil separated Pu stockpile and the discriminators that will support technology option down-selection decisions. The overall aim will be to deliver feasible technical options and comprehensive information on political, economic, sociological, environmental and technical factors for each strategic option. This paper briefly describes the work completed to date to assess immobilisation and re-use technologies as disposition strategies and on the work that will identify discriminators to support technology down-selection. The Pu disposition project is anticipated to continue for several years while the necessary investigations are made to fully understand the various options. The work planned over this period is discussed. (authors)

The Price Elasticity of Specialty Drug Use: Evidence from Cancer Patients in Medicare Part D.

Science.gov (United States)

Jung, Jeah Kyoungrae; Feldman, Roger; McBean, A Marshall

2017-12-01

Specialty drugs can bring substantial benefits to patients with debilitating conditions, such as cancer, but their costs are very high. Insurers/payers have increased patient cost-sharing for specialty drugs to manage specialty drug spending. We utilized Medicare Part D plan formulary data to create the initial price (cost-sharing in the initial coverage phase in Part D), and estimated the total demand (both on- and off-label uses) for specialty cancer drugs among elderly Medicare Part D enrollees with no low-income subsidies (non-LIS) as a function of the initial price. We corrected for potential endogeneity associated with plan choice by instrumenting the initial price of specialty cancer drugs with the initial prices of specialty drugs in unrelated classes. We report three findings. First, we found that elderly non-LIS beneficiaries with cancer were less likely to use a Part D specialty cancer drug when the initial price was high: the overall price elasticity of specialty cancer drug spending ranged between -0.72 and -0.75. Second, the price effect in Part D specialty cancer drug use was not significant among newly diagnosed patients. Finally, we found that use of Part B-covered cancer drugs was not responsive to the Part D specialty cancer drug price. As the demand for costly specialty drugs grows, it will be important to identify clinical circumstances where specialty drugs can be valuable and ensure access to high-value treatments.

Specialty Guidelines for Forensic Psychology

Science.gov (United States)

American Psychologist, 2013

2013-01-01

In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

VAMOS: The verification and monitoring options study: Current research options for in-situ monitoring and verification of contaminant remediation and containment within the vadose zone

International Nuclear Information System (INIS)

Betsill, J.D.; Gruebel, R.D.

1995-09-01

The Verification and Monitoring Options Study Project (VAMOS) was established to identify high-priority options for future vadose-zone environmental research in the areas of in-situ remediation monitoring, post-closure monitoring, and containment emplacement and verification monitoring. VAMOS examined projected needs not currently being met with applied technology in order to develop viable monitoring and verification research options. The study emphasized a compatible systems approach to reinforce the need for utilizing compatible components to provide user friendly site monitoring systems. To identify the needs and research options related to vadose-zone environmental monitoring and verification, a literature search and expert panel forums were conducted. The search included present drivers for environmental monitoring technology, technology applications, and research efforts. The forums included scientific, academic, industry, and regulatory environmental professionals as well as end users of environmental technology. The experts evaluated current and future monitoring and verification needs, methods for meeting these needs, and viable research options and directions. A variety of high-priority technology development, user facility, and technology guidance research options were developed and presented as an outcome of the literature search and expert panel forums

The popularity of neurology in Spain: An analysis of specialty selection.

Science.gov (United States)

Curbelo, J; Romeo, J M; Galván-Román, J M; Vega-Villar, J; Martinez-Lapiscina, E H; Jiménez-Fonseca, P; Villacampa, T; Sánchez-Lasheras, F; Fernández-Somoano, A; Baladrón, J

2017-12-23

Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

75 FR 42431 - Onyx Specialty Papers, Inc; Notice Soliciting Applications

Science.gov (United States)

2010-07-21

... Papers, Inc; Notice Soliciting Applications July 14, 2010. On April 29, 2009, Onyx Specialty Papers, Inc... is located in the basement of MeadWestvaco's paper mill. There are no transmission lines associated... information from the licensee, please contact Mr. John Clements, Counsel for Onyx Specialty Papers, Inc., Van...

The primary assessment tool at Philips electronics : capturing real options and organizational risk in technology portfolio management

NARCIS (Netherlands)

Lint, L.J.O.

2000-01-01

I develop an extended scoring approach to build a balanced portfolio of new technology projects under uncertainty at early stages of development. My contribution is twofold. First, I show how the tool incorporates the option approach to decision making to create contingent claims on future market

Environmental and technology policy options in the electricity sector. Interactions and outcomes

International Nuclear Information System (INIS)

Fischer, Carolyn; Newell, Richard G.; Preonas, Louis

2014-01-01

Myriad policy measures aim to reduce greenhouse gas emissions from the electricity sector, promote generation from renewable sources, and encourage energy conservation. To what extent do innovation and energy efficiency (EE) market failures justify additional interventions when a carbon price is in place? We extend the model of Fischer and Newell (2008) with advanced and conventional renewable energy technologies and short and long-run EE investments. We incorporate both knowledge spillovers and imperfections in the demand for energy efficiency. We conclude that some technology policies, particularly correcting R and D market failures, can be useful complements to emissions pricing, but ambitious renewable targets or subsidies seem unlikely to enhance welfare when placed alongside sufficient emissions pricing. The desirability of stringent EE policies is highly sensitive to the degree of undervaluation of EE by consumers, which also has implications for policies that tend to lower electricity prices. Even with multiple market failures, emissions pricing remains the single most cost-effective option for reducing emissions.

Environmental and technology policy options in the electricity sector. Interactions and outcomes

Energy Technology Data Exchange (ETDEWEB)

Fischer, Carolyn [Resources for the Future, Inc., Washington, DC (United States); Newell, Richard G. [Duke Univ., Durham, NC (United States); Preonas, Louis [California Univ., Berkeley, CA (United States); Resources for the Future, Inc., Washington, DC (United States)

2014-04-15

Myriad policy measures aim to reduce greenhouse gas emissions from the electricity sector, promote generation from renewable sources, and encourage energy conservation. To what extent do innovation and energy efficiency (EE) market failures justify additional interventions when a carbon price is in place? We extend the model of Fischer and Newell (2008) with advanced and conventional renewable energy technologies and short and long-run EE investments. We incorporate both knowledge spillovers and imperfections in the demand for energy efficiency. We conclude that some technology policies, particularly correcting R and D market failures, can be useful complements to emissions pricing, but ambitious renewable targets or subsidies seem unlikely to enhance welfare when placed alongside sufficient emissions pricing. The desirability of stringent EE policies is highly sensitive to the degree of undervaluation of EE by consumers, which also has implications for policies that tend to lower electricity prices. Even with multiple market failures, emissions pricing remains the single most cost-effective option for reducing emissions.

Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?

Science.gov (United States)

Mitchell, Jean M

2008-07-01

Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.

The Orientation and Development of the Public Affair Management Specialty

Science.gov (United States)

Li, Chenghui; Fu, Yongxian; Chen, Rongxiang; Hu, Xueqi

2010-01-01

Though the specialty of the public affair management has been developed for ten years, but it is still facing the actuality that the orientation and development are difficult. Only by confirming the cultivation target and the development orientation, the development of the specialty could find the development approach and method. According to the…

Stability of and Factors Related to Medical Student Specialty Choice of Psychiatry.

Science.gov (United States)

Goldenberg, Matthew N; Williams, D Keith; Spollen, John J

2017-09-01

Targeted efforts are needed to increase the number of medical students choosing psychiatry, but little is known about when students decide on their specialty or what factors influence their choice. The authors examined the timing and stability of student career choice of psychiatry compared with other specialties and determined what pre- and intra-medical school factors were associated with choosing a career in psychiatry. Using survey data from students who graduated from U.S. allopathic medical schools in 2013 and 2014 (N=29,713), the authors computed rates of psychiatry specialty choice at the beginning and end of medical school and assessed the stability of that choice. A multivariate-adjusted logistic regression and recursive partitioning were used to determine the association of 29 factors with psychiatry specialty choice. Choice of psychiatry increased from 1.6% at the start of medical school to 4.1% at graduation. The stability of psychiatry specialty choice from matriculation to graduation, at just over 50%, was greater than for any other specialty. However, almost 80% of future psychiatrists did not indicate an inclination toward the specialty at matriculation. A rating of "excellent" for the psychiatry clerkship (odds ratio=2.66), a major in psychology in college (odds ratio=2.58), and valuing work-life balance (odds ratio=2.25) were the factors most strongly associated with psychiatry career choice. Students who enter medical school planning to become psychiatrists are likely to do so, but the vast majority of students who choose psychiatry do so during medical school. Increasing the percentage of medical students with undergraduate psychology majors and providing an exemplary psychiatry clerkship are modifiable factors that may increase the rate of psychiatry specialty choice.

Process and technological options for odorous emissions control in wastewater treatment plants

International Nuclear Information System (INIS)

Cernuschi, S.; Torretta, V.

1996-01-01

The emissions of odorous substances together with noise and issues related to proper architectural design within the existing territorial context, have certainly to be considered one of the most significant environmental effects determined by wastewater treatment plants particularly in the most frequent case of their localization in dense urban areas. Following a brief introduction on the chemical properties of odorous compounds and the corresponding methods for representing their concentration levels in air, present work reports on the main qualitative and quantitative characteristics of odorous emissions originating from single unit operations of typical wastewater treatment plants and on the technological and process options available for their control

VOCATIONAL AND PATRIOTIC EDUCATION OF STUDENTS OF DEFENSE SPECIALTIES AT A TECHNICAL UNIVERSITY

Directory of Open Access Journals (Sweden)

N. P. Ustinova

2016-01-01

of students of defense specialties at Izhevsk State Technical University named after M. T. Kalashnikov (Izhevsk, Tula State University (Tula, Kovrov State Technological Academy named after V. A. Degtjarjov (Kovrov, Ryazan Higher Airborne Command School named after V. F. Margelov (Ryazan.

Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys.

Science.gov (United States)

Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

2012-04-01

To report doctors' rejection of specialties as long-term careers and reasons for rejection. Postal questionnaires. United Kingdom. Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.

Women otolaryngologist representation in specialty society membership and leadership positions.

Science.gov (United States)

Choi, Sukgi S; Miller, Robert H

2012-11-01

To determine the proportion of female otolaryngologists in leadership positions relative to their number in the specialty, their membership in various otolaryngology organizations, and age. Cross-sectional analyses of otolaryngology organization membership with a subgroup analysis on female membership and leadership proportion comparing 5-year male/female cohort groups. Information on the number of members and leaders was obtained from various specialty societies by direct communication and from their Web sites between June and December 2010. The number of female and male otolaryngologists and their age distribution in 5-year age groups was obtained from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Statistical analyses were used to determine whether women had proportional membership and leadership representation in various specialty societies. Additionally, female representation in other leadership roles was analyzed using the male/female ratio within the 5-year cohort groups. Female otolaryngologists were found to constitute approximately 11% of practicing otolaryngologists. The American Society of Pediatric Otolaryngology had a higher proportion of female members (22%) compared to five other societies. When the gender composition within each organization was taken into account, female representation in specialty society leadership positions was proportionate to their membership across all societies. When gender and age were considered, women have achieved proportionate representation in each of the specialty societies' leadership positions. There was also proportionate representation of females as program directors, American Board of Otolaryngology directors, Residency Review Committee members, and journal editors/editorial board members. Finally, fewer female chairs or chiefs of departments/divisions were seen, but when age was taken into consideration, this difference was no longer significant. Women have achieved parity in

Specialty pharmacy: an emerging area of interest for medical management.

Science.gov (United States)

Dong, Xiaoli; Fetterolf, Donald

2005-04-01

Specialty pharmaceuticals are expensive injectable and infusion therapies used to treat patients with chronic or life-threatening diseases. The high cost of these agents and their frequent usage in chronic diseases represent not only challenges, but also opportunities for medical management programs to improve the quality of care and moderate the rapid cost escalation seen in the industry. The number and variety of these agents have been increasing significantly, with hundreds of drug candidates in the development pipeline. The specialty pharmacy industry also is going through a consolidation stage, both horizontally and vertically. Industry approaches to medical management include the acquisition of specialty pharmacy companies, restrictive contracting to achieve concentrated buying power, and the development of utilization management strategies.

78 FR 60766 - Clarification on Fireworks Policy Regarding Approvals or Certifications for Specialty Fireworks...

Science.gov (United States)

2013-10-02

... 173 [Docket No. PHMSA-2013-0206; Notice No. 13-15] Clarification on Fireworks Policy Regarding Approvals or Certifications for Specialty Fireworks Devices AGENCY: Pipeline and Hazardous Materials Safety... applications for specialty fireworks devices. Specialty fireworks devices are fireworks devices in various...

Online examiner calibration across specialties.

Science.gov (United States)

Sturman, Nancy; Wong, Wai Yee; Turner, Jane; Allan, Chris

2017-09-26

Integrating undergraduate medical curricula horizontally across clinical medical specialties may be a more patient-centred and learner-centred approach than rotating students through specialty-specific teaching and assessment, but requires some interspecialty calibration of examiner judgements. Our aim was to evaluate the acceptability and feasibility of an online pilot of interdisciplinary examiner calibration. Fair clinical assessment is important to both medical students and clinical teachers METHODS: Clinical teachers were invited to rate video-recorded student objective structured clinical examination (OSCE) performances and join subsequent online discussions using the university's learning management system. Post-project survey free-text and Likert-scale participant responses were analysed to evaluate the acceptability of the pilot and to identify recommendations for improvement. Although 68 clinicians were recruited to participate, and there were 1599 hits on recordings and discussion threads, only 25 clinical teachers rated at least one student performance, and 18 posted at least one comment. Participants, including rural doctors, appeared to value the opportunity for interdisciplinary rating calibration and discussion. Although the asynchronous online format had advantages, especially for rural doctors, participants reported considerable IT challenges. Our findings suggest that fair clinical assessment is important to both medical students and clinical teachers. Interspecialty discussions about assessment may have the potential to enrich intraspecialty perspectives, enhance interspecialty engagement and collaboration, and improve the quality of clinical teacher assessment. Better alignment of university and hospital systems, a face to face component and other modifications may have enhanced clinician engagement with this project. Findings suggest that specialty assessment cultures and content expertise may not be barriers to pursuing more integrated

Graduate diplomas in nuclear technology

Energy Technology Data Exchange (ETDEWEB)

Bereznai, G. [Univ. of Ontario Inst. of Tech., Oshawa, Ontario (Canada)

2009-07-01

The University of Ontario Institute of Technology (UOIT) offers a graduate diploma program in nuclear technology that consists of a suite of six sub-specialties: Fuel, Materials and Chemistry; Reactor Systems; Operation and Maintenance; Safety, Licensing and Regulatory Affairs; Health Physics; and Radiological Applications. Four courses selected from a list that covers the knowledge and skill set of each sub-specialty have to be completed in order to gain a graduate diploma in the specific area. The program is designed to accommodate the needs of people working in the nuclear industry to upgrade their knowledge and skills, to promote career advancement and to provide a framework for lifelong learning. (author)

Report of the ASHP Task Force on Caring for Patients Served by Specialty Suppliers.

Science.gov (United States)

Caselnova, Dominick; Donley, Kathy; Ehlers, Diane; Hyduk, Amy E; Koontz, Susannah E; Nowobilski-Vasilios, Anna; Pawlicki, Kathleen S; Poikonen, John C; Poremba, Art C; Sasser, Cathy L; Schell, Kenneth H; Schwab, Jay L; Swinarski, Dave; Chen, David; Kirschenbaum, Bonnie; Armitstead, John

2010-10-01

Task Force recommendations are discussed in more detail in eAppendix A (available at www.ajhp.org). What follows is a brief summary of those recommendations. In very abbreviated terms, the Task Force suggested that ASHP: 1. Consider creating and maintaining a Web resource center on ASHP's website to provide information about restricted drug distributions systems (RDDSs), risk evaluation and mitigation strategies (REMSs), risk assessment and minimization plans (RiskMAPs), and specialty suppliers and products. 2. Provide comprehensive education to members, other health professionals, regulators, third-party payers, patients, and other stakeholders about RDDSs, REMSs, RiskMAPs, and specialty suppliers and products. 3. Develop policies to advocate that a. Pharmacists serve as the institutional leaders in compliance and utilization challenges of safely managing externally supplied medications and related drug administration devices, b. Agencies, organizations, and associations that influence the distribution, sale, and dispensing of medications under these alternative distribution models address issues these models create in continuity of care, reimbursement, and patient safety, c. The Centers for Medicare and Medicaid Services and the Joint Commission develop standards and interpretations that accommodate hospital use of these products and devices when currently available technology (e.g., cold-chain storage, e-pedigree) is used to ensure patient safety, d. Group purchasing organizations negotiate contractual arrangements for specialty pharmaceuticals for both acquisition costs and distribution arrangements, and e. Information technology (IT) be used to resolve issues created by alternative distribution models and that ASHP work with IT vendors to ensure that programs are designed to meet the needs of these evolving models. 4. Quantify through research, perhaps in cooperation with entities such as the Agency for Healthcare Research and Quality, the Institute of

The management of gout in different clinical specialties in Turkey: a patient-based survey.

Science.gov (United States)

Öztürk, Mehmet Akif; Mercan, Rıdvan; Gök, Kevser; Onat, Ahmet Mesut; Kısacık, Bünyamin; Kimyon, Gezmiş; Balkarlı, Ayşe; Kaya, Arif; Çobankara, Veli; Balcı, Mehmet Ali; Pamuk, ÖmerNuri; Yıldırım Çetin, Gözde; Sayarlıoğlu, Mehmet; Şenel, Soner; Tezcan, Mehmet Engin; Küçük, Adem; Üreten, Kemal; Şahin, Şafak; Tufan, Abdurrahman

2016-12-01

Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications. Forty patients were referred to another center without any treatment (12.8 %), and referral rate is most common among the primary care physicians (28.8 %). Colchicine was more commonly used for attack prophylaxis than allopurinol. Ninety-two patients had never been treated with allopurinol (28.8 %). Allopurinol prescription was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. Recommendation of diet and life style modifications was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. The rates of life style modification recommendation and long-term allopurinol prescription were 83.7 and 77.6 %, respectively, among the rheumatologists. Both acute and chronic management of gout is suboptimal in Turkey especially among the primary care physicians and orthopedists. Moreover, chronic treatment is even suboptimal among rheumatologists.

Nuclear Knowledge Preservation Initiative: Strategies, Information Technology Options And The Future

International Nuclear Information System (INIS)

Mundu, M.A

2004-01-01

The launching of National Nuclear Programme and the designation of OAU Ife and Ahmadu Bello University, Zaria as centers of excellence in nuclear research in 1977 marked the beginning of a systematic development of manpower and physical infrastructure for the peaceful application of nuclear science and technology are carried out in the Universities Research Institutes and the Industry, in Health, Hydrology, Agriculture, Petroleum, Mineral Development and Environmental Management. A major challenge arising form these development, is the collection, accumulated over the years. The resolution adopted on nuclear knowledge at the IAEA General Conference in 2002 and 2003 has given us the impetus to reposition the INIS centre toward the establishment of an information resource capable of meeting the needs of our scientists and engineers. A necessary step toward this end is to build a network of Universities and Research Institutes in nuclear science that will be used to pool, analyze and share national nuclear knowledge and experience, address preservation and promotion of knowledge, maintain competence and avoid duplication wherever necessary. This paper discusses the strategies, information technology options, stake holders and their responsibilities and the way forward

76 FR 2148 - Specialty Minerals, Inc., Franklin, VA; Notice of Revised Determination on Reconsideration

Science.gov (United States)

2011-01-12

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,057] Specialty Minerals, Inc...) applicable to workers of Specialty Minerals, Inc., Franklin, Virginia (the subject firm). The Notice was... workers of Specialty Minerals, Inc., Franklin, Virginia, who are engaged in employment related to the...

Questionnaire survey on the process of specialty training in neurology in Japan.

Science.gov (United States)

Sonoo, Masahiro; Nishiyama, Kazutoshi; Ando, Tetsuo; Shindo, Katsuro; Kanda, Takashi; Aoki, Masashi; Kamei, Satoshi; Kikuchi, Seiji; Kusunoki, Susumu; Suzuki, Norihiro; Sobue, Gen; Nakashima, Kenji; Hara, Hideo; Hirata, Koichi; Mizusawa, Hidehiro; Murai, Hiroyuki; Murata, Miho; Mochizuki, Hideki; Takahashi, Ryosuke; Kira, Jun-Ichi

2017-07-29

Documentation of the current status of specialty training to become a neurologist in Japan would represent an important basis for constructing better neurology training program in the planned reform of the specialty training system in Japan. The committee for future neurology specialty system of Japanese Society of Neurology (JSN) conducted a questionnaire survey on the process of specialty training of each trainee for neurology in board-certified educational facilities and semi-educational facilities throughout Japan. The response rate was 46.2% in all facilities and 87.5% in medical universities. The training process of 905 trainees over 5 grades was clarified, which was estimated to be about 80% of all the relevant subjects. Specialty training dedicated to neurology was started at the 3rd year of residency in 87.8% of subjects. During the 3 years following junior residency, 51.3% of subjects ran the rotation training between university and city hospital, whereas 36.5% was trained within the same institution throughout the 3 years of training period.

Nazareth College: Specialty Preparation for Speech-Language Pathologists to Work with Children Who Are Deaf and Hard of Hearing

Science.gov (United States)

Brown, Paula M.; Quenin, Cathy

2010-01-01

The specialty preparation program within the speech-language pathology master's degree program at Nazareth College in Rochester, New York, was designed to train speech-language pathologists to work with children who are deaf and hard of hearing, ages 0 to 21. The program is offered in collaboration with the Rochester Institute of Technology,…

Sociological Portrait of Applicants and Students of the Most Popular and Perspective Specialties of Secondary Vocational Education: A Comparative Aspect

Science.gov (United States)

Novikova, Svetlana S.; Romanova, Galina M.; Simonyan, Arsen R.; Ukraintseva, Irina I.; Khachaturova, Natalya Yu.

2018-01-01

The relevance of the study is caused by the necessity to form a plan for the development of secondary vocational education that provides training of the most popular and promising specialties and working professions in accordance with international standards and advanced technologies on the basis of the leading professional educational…

Gendered Perceptions of Typical Engineers across Specialties for Engineering Majors

Science.gov (United States)

Kelley, Margaret S.; Bryan, Kimberley K.

2018-01-01

Young women do not choose to be engineers nearly as often as young men, and they tend to cluster in particular specialties when they do. We examine these patterns and the role of gender schemas as applied to perceptions of typical engineers in understanding the choices that women make in terms of engineering specialties. We use Part 1 of two waves…

Next Generation Melter Optioneering Study - Interim Report

International Nuclear Information System (INIS)

Gray, M.F.; Calmus, R.B.; Ramsey, G.; Lomax, J.; Allen, H.

2010-01-01

The next generation melter (NOM) development program includes a down selection process to aid in determining the recommended vitrification technology to implement into the WTP at the first melter change-out which is scheduled for 2025. This optioneering study presents a structured value engineering process to establish and assess evaluation criteria that will be incorporated into the down selection process. This process establishes an evaluation framework that will be used progressively throughout the NGM program, and as such this interim report will be updated on a regular basis. The workshop objectives were achieved. In particular: (1) Consensus was reached with stakeholders and technology providers represented at the workshop regarding the need for a decision making process and the application of the D 2 0 process to NGM option evaluation. (2) A framework was established for applying the decision making process to technology development and evaluation between 2010 and 2013. (3) The criteria for the initial evaluation in 2011 were refined and agreed with stakeholders and technology providers. (4) The technology providers have the guidance required to produce data/information to support the next phase of the evaluation process. In some cases it may be necessary to reflect the data/information requirements and overall approach to the evaluation of technology options against specific criteria within updated Statements of Work for 2010-2011. Access to the WTP engineering data has been identified as being very important for option development and evaluation due to the interface issues for the NGM and surrounding plant. WRPS efforts are ongoing to establish precisely data that is required and how to resolve this Issue. It is intended to apply a similarly structured decision making process to the development and evaluation of LAW NGM options.

THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY

Directory of Open Access Journals (Sweden)

WK Mallon

2017-03-01

Full Text Available Chile is uniquely situated to be a leader in South American development of the specialty of Emergency Medicine. Chilean emergency medicine has successfully transitioned from a novelty training idea to a nationally and internationally recognized entity with serious public health goals. There are more residency training programs in Chile than in any other South American or Latin American country, and the specialty is formally recognized by the Ministry of Health. Chilean emergency medicine thought leaders have networked internationally with multiple groups, intelligently used outside resources, and created durable academic relationships. While focusing on locally important issues and patient care they have successfully advanced their agenda. Despite this, the specialty faces many new challenges and remains fragile but sustainable. Policy makers and the Chilean MOH need to be acutely aware of this fragility to preserve the progress achieved so far, and support ongoing maturation of the specialty of Emergency Medicine.

Geo-spatial technologies in urban environments policy, practice, and pixels

CERN Document Server

Jensen, Ryan R; McLean, Daniel

2004-01-01

Using Geospatial Technologies in Urban Environments simultaneously fills two gaping vacuums in the scholarly literature on urban geography. The first is the clear and straightforward application of geospatial technologies to practical urban issues. By using remote sensing and statistical techniques (correlation-regression analysis, the expansion method, factor analysis, and analysis of variance), the - thors of these 12 chapters contribute significantly to our understanding of how geospatial methodologies enhance urban studies. For example, the GIS Specialty Group of the Association of American Geographers (AAG) has the largest m- bership of all the AAG specialty groups, followed by the Urban Geography S- cialty Group. Moreover, the Urban Geography Specialty Group has the largest number of cross-memberships with the GIS Specialty Group. This book advances this important geospatial and urban link. Second, the book fills a wide void in the urban-environment literature. Although the Annals of the Association of ...

Telestroke a viable option to improve stroke care in India.

Science.gov (United States)

Srivastava, Padma V; Sudhan, Paulin; Khurana, Dheeraj; Bhatia, Rohit; Kaul, Subash; Sylaja, P N; Moonis, Majaz; Pandian, Jeyaraj Durai

2014-10-01

In India, stroke care services are not well developed. There is a need to explore alternative options to tackle the rising burden of stroke. Telemedicine has been used by the Indian Space Research Organization (ISRO) to meet the needs of remote hospitals in India. The telemedicine network implemented by ISRO in 2001 presently stretches to around 100 hospitals all over the country, with 78 remote/rural/district health centers connected to 22 specialty hospitals in major cities, thus providing treatment to more than 25 000 patients, which includes stroke patients. Telemedicine is currently used in India for diagnosing stroke patients, subtyping stroke as ischemic or hemorrhagic, and treating accordingly. However, a dedicated telestroke system for providing acute stroke care is needed. Keeping in mind India's flourishing technology sector and leading communication networks, the hub-and-spoke model could work out really well in the upcoming years. Until then, simpler alternatives like smartphones, online data transfer, and new mobile applications like WhatsApp could be used. Telestroke facilities could increase the pool of patients eligible for thrombolysis. But this primary aim of telestroke can be achieved in India only if thrombolysis and imaging techniques are made available at all levels of health care. © 2014 World Stroke Organization.

Spent fuel reprocessing options

International Nuclear Information System (INIS)

2008-08-01

The objective of this publication is to provide an update on the latest developments in nuclear reprocessing technologies in the light of new developments on the global nuclear scene. The background information on spent fuel reprocessing is provided in Section One. Substantial global growth of nuclear electricity generation is expected to occur during this century, in response to environmental issues and to assure the sustainability of the electrical energy supply in both industrial and less-developed countries. This growth carries with it an increasing responsibility to ensure that nuclear fuel cycle technologies are used only for peaceful purposes. In Section Two, an overview of the options for spent fuel reprocessing and their level of development are provided. A number of options exist for the treatment of spent fuel. Some, including those that avoid separation of a pure plutonium stream, are at an advanced level of technological maturity. These could be deployed in the next generation of industrial-scale reprocessing plants, while others (such as dry methods) are at a pilot scale, laboratory scale or conceptual stage of development. In Section Three, research and development in support of advanced reprocessing options is described. Next-generation spent fuel reprocessing plants are likely to be based on aqueous extraction processes that can be designed to a country specific set of spent fuel partitioning criteria for recycling of fissile materials to advanced light water reactors or fast spectrum reactors. The physical design of these plants must incorporate effective means for materials accountancy, safeguards and physical protection. Section four deals with issues and challenges related to spent fuel reprocessing. The spent fuel reprocessing options assessment of economics, proliferation resistance, and environmental impact are discussed. The importance of public acceptance for a reprocessing strategy is discussed. A review of modelling tools to support the

DETERMINANTS OF SPECIALTY CHOICE OF RESIDENT DOCTORS; CASE STUDY--AMONG RESIDENT DOCTORS IN NIGERIA.

Science.gov (United States)

Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A

2015-01-01

This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

Medical specialty selection criteria of Israeli medical students early in their clinical experience: subgroups.

Science.gov (United States)

Avidan, Alexander; Weissman, Charles; Elchalal, Uriel; Tandeter, Howard; Zisk-Rony, Rachel Yaffa

2018-04-18

Israeli medical school classes include a number of student subgroups. Therefore, interventions aimed at recruiting medical students to the various specialties should to be tailored to each subgroup. Questionnaires, distributed to 6 consecutive 5th-year classes of the Hebrew University - Hadassah School of Medicine, elicited information on criteria for choosing a career specialty, criteria for choosing a residency program and the importance of finding a specialty interesting and challenging when choosing a residency. Completed questionnaires were returned by 540 of 769 (70%) students. The decision processes for choosing a medical specialty and choosing a residency program were different. Family and colleagues had minimal influence on choosing a specialty, while family and their residential locality had much influence on choosing a residency, especially among women. Older age, marriage, and spousal influence were positively associated with choice of a specialty. Two-thirds of the students had completed military service, 20% were attending medical school prior to military service, 5% had completed national service and 9% had entered medical school without serving. Despite the pre-military subgroup being younger and having another 7 years of medical school, internship and military service before residency, they had begun thinking about which specialty to choose, just like the post-military students. When choosing a residency program, post-military women were more influenced by their families and family residential locality than their pre-military counterparts; differences ascribed to the older and often married post-military women having or wanting to begin families. This difference was reinforced by fewer post- than pre-military women willing to wait 2-3 years for a residency in the specialty that interested them most and were willing to begin residency immediately after internship in a specialty that interested them less. Medical school classes are composed of

Career motivations, perceptions of the future of dentistry and preferred dental specialties among saudi dental students.

Science.gov (United States)

Halawany, Hassan S

2014-01-01

The purpose of this study was to determine the career motivations, perceptions of the future of dentistry and preferred postgraduate specialties of Saudi dental students. A pretested, self-administered, 16-item questionnaire was distributed to first- through fifth-year dental students at King Saud University in Saudi Arabia. Descriptive statistics were calculated, and the level of significance was set at 5%. Of the 530 potential participants, 329 students (198 male and 131 female respondents) completed the questionnaire. High professional status (71.4%), a secure career (67.8%), a high income (78.1%), flexible working hours (54.4%), a wide range of career options after graduation (59.3%), opportunities for self-employment (69.3%) and good job opportunities abroad (65.3%) were endorsed to a great/considerable extent by the respondents. "It takes time to establish a practice" (62.3%), "Postgraduate education is a necessity" (72.4%) and "The increasing number of dental institutions is a threat to the profession" (59.3%) were endorsed to a great or considerable extent by the respondents. The most popular specialty among the male students was oral maxillofacial surgery (20.1%) and among female students was operative dentistry (23.4%). The career motivations of this group of dental students seemed to relate to socioeconomic aspects of dentistry and perceptions of the future of dentistry seemed to relate to the need for postgraduate education.

Fuel price and technological uncertainty in a real options model for electricity planning

International Nuclear Information System (INIS)

Fuss, Sabine; Szolgayova, Jana

2010-01-01

Electricity generation is an important source of total CO 2 emissions, which in turn have been found to relate to an acceleration of global warming. Given that many OECD countries have to replace substantial portions of their electricity-generating capacity over the next 10-20 years, investment decisions today will determine the CO 2 -intensity of the future energy mix. But by what type of power plants will old (mostly fossil-fuel-fired) capacity be replaced? Given that modern, less carbon-intensive technologies are still expensive but can be expected to undergo improvements due to technical change in the near future, they may become more attractive, especially if fossil fuel price volatility makes traditional technologies more risky. At the same time, technological progress is an inherently uncertain process itself. In this paper, we use a real options model with stochastic technical change and stochastic fossil fuel prices in order to investigate their impact on replacement investment decisions in the electricity sector. We find that the uncertainty associated with the technological progress of renewable energy technologies leads to a postponement of investment. Even the simultaneous inclusion of stochastic fossil fuel prices in the same model does not make renewable energy competitive compared to fossil-fuel-fired technology in the short run based on the data used. This implies that policymakers have to intervene if renewable energy is supposed to get diffused more quickly. Otherwise, old fossil-fuel-fired equipment will be refurbished or replaced by fossil-fuel-fired capacity again, which enforces the lock-in of the current system into unsustainable electricity generation. (author)

How are the different specialties represented in the major journals in general medicine?

Science.gov (United States)

Gehanno, Jean-Francois; Ladner, Joel; Rollin, Laetitia; Dahamna, Badisse; Darmoni, Stefan J

2011-01-21

General practitioners and medical specialists mainly rely on one "general medical" journal to keep their medical knowledge up to date. Nevertheless, it is not known if these journals display the same overview of the medical knowledge in different specialties. The aims of this study were to measure the relative weight of the different specialties in the major journals of general medicine, to evaluate the trends in these weights over a ten-year period and to compare the journals. The 14,091 articles published in The Lancet, the NEJM, the JAMA and the BMJ in 1997, 2002 and 2007 were analyzed. The relative weight of the medical specialities was determined by categorization of all the articles, using a categorization algorithm which inferred the medical specialties relevant to each article MEDLINE file from the MeSH terms used by the indexers of the US National Library of Medicine to describe each article. The 14,091 articles included in our study were indexed by 22,155 major MeSH terms, which were categorized into 81 different medical specialties. Cardiology and Neurology were in the first 3 specialties in the 4 journals. Five and 15 specialties were systematically ranked in the first 10 and first 20 in the four journals respectively. Among the first 30 specialties, 23 were common to the four journals. For each speciality, the trends over a 10-year period were different from one journal to another, with no consistency and no obvious explanatory factor. Overall, the representation of many specialties in the four journals in general and internal medicine included in this study may differ, probably due to different editorial policies. Reading only one of these journals may provide a reliable but only partial overview.

75 FR 34418 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-06-17

... Notice of the Specialty Crop Committee's Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening session. SUMMARY: The notice announces the Specialty Crop Committee's Stakeholder Listening Session. The document contained the wrong date for the...

Current and future funding sources for specialty mental health and substance abuse treatment providers.

Science.gov (United States)

Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

2013-06-01

Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

Integrating energy and environmental goals. Investment needs and technology options

International Nuclear Information System (INIS)

2004-04-01

, since their shares of global energy demand and emissions are expected to grow rapidly. Over the next thirty years, developing countries are expected to account for 70% of the growth in global energy demand and for two-thirds of the growth in global emissions. Section six looks at some of the challenges regarding investment and energy access. Security of energy supply is an important component in the planning of future technology options, because long-term security calls for a balance between energy sources and technologies. Governments have a role to play in tipping this balance, and this role is examined in section seven. A final section examines the uncertainties and costs of various policy initiatives over the long term

Care coordination and unmet specialty care among children with special health care needs.

Science.gov (United States)

Boudreau, Alexy Arauz; Perrin, James M; Goodman, Elizabeth; Kurowski, Daniel; Cooley, W Carl; Kuhlthau, Karen

2014-06-01

Care coordination and the medical home may ensure access to specialty care. Children with special health care needs (CSHCN) have higher rates of specialty care use and unmet need compared with the general pediatric population. We hypothesized that care coordination, regardless of whether it was provided in a medical home, would decrease unmet specialty care needs among CSHCN and that the effect of care coordination would be greater among low-income families. Secondary data analysis of participants in the 2009–2010 National Survey of CSHCN who reported unmet specialty care needs and for whom care coordination and medical home status could be determined (n = 18 905). Logistic regression models explored the association of unmet need with care coordination and medical home status adjusting for household income. Approximately 9% of CSHCN reported having unmet specialty care needs. Care coordination was associated with reduced odds of unmet specialty care need (without a medical home, odds ratio: 0.63, 95% confidence interval: 0.47–0.86; within a medical home, odds ratio: 0.22, 95% confidence interval: 0.16–0.29) with a greater reduction among those receiving care coordination within a medical home versus those receiving care coordination without a medical home. We did not find differences in the impact of care coordination by percentage of the federal poverty level. Care coordination is associated with family report of decreased unmet specialty care needs among CSHCN independent of household income. The effect of care coordination is greater when care is received in a medical home.

CURRENT DIRECTIONS OF RESEARCH IN INFORMATION- COMMUNICATION TECHNOLOGIES IN THE FIELD OF PEDAGOGICAL SCIENCE.

Directory of Open Access Journals (Sweden)

O.N. Spirin

2010-11-01

Full Text Available In the publication modern research areas of information-communication technologies in pedagogical science are identified. The basic requirements of the new passport for the specialty 13.00.10 - Information and Communication Technologies in Education are described. On this specialty the defence of the degree of doctor and candidate of pedagogical science may be carried out.

The impact of clerkships on students' specialty preferences: what do undergraduates learn for their profession?

NARCIS (Netherlands)

Maiorova, T.; Stevens, F.; Scherpbier, A.; Zee, J. van der

2008-01-01

OBJECTIVE: Clinical experiences and gender have been shown to influence medical students' specialty choices. It remains unclear, however, which aspects of experiences make students favour some specialties and reject others. This study aimed to clarify the effects of clerkships on specialty choice

Retrospective insights from real options in R&D

NARCIS (Netherlands)

Lint, L.J.O.

2000-01-01

Absent empirical validation of real option pricing in R&D, we discuss the evolution of three cases in R&D option valuation. The first case concerns an option on conversion of an existing production process. The other two cases concern R&D to develop new product technology in the consumer electronics

75 FR 27536 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-05-17

... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

75 FR 32735 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

Science.gov (United States)

2010-06-09

... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

Science.gov (United States)

Monroe, C Douglas; Chin, Karen Y

2013-05-01

The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

Factors affecting future specialty choice among medical students in Kuwait

OpenAIRE

Marwan, Yousef; Al-Fouzan, Rawan; Al-Ajlan, Sarah; Al-Saleh, Mervat

2012-01-01

Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression wer...

Much ado about nothing? The financial impact of physician-owned specialty hospitals.

Science.gov (United States)

Chakravarty, Sujoy

2016-06-01

The U.S. hospital industry has recently witnessed a number of policy changes aimed at aligning hospital payments to costs and these can be traced to significant concerns regarding selection of profitable patients and procedures by physician-owned specialty hospitals. The policy responses to specialty hospitals have alternated between payment system reforms and outright moratoriums on hospital operations including one in the recently enacted Affordable Care Act. A key issue is whether physician-owned specialty hospitals pose financial strain on the larger group of general hospitals through cream-skimming of profitable patients, yet there is no study that conducts a systematic analysis relating such selection behavior by physician-owners to financial impacts within hospital markets. The current paper takes into account heterogeneity in specialty hospital behavior and finds some evidence of their adverse impact on profit margins of competitor hospitals, especially for-profit hospitals. There is also some evidence of hospital consolidation in response to competitive pressures by specialty hospitals. Overall, these findings underline the importance of the payment reforms aimed at correcting distortions in the reimbursement system that generate incentives for risk-selection among providers groups. The identification techniques will also inform empirical analysis on future data testing the efficacy of these payment reforms.

[A new specialty is born: Vascular medicine].

Science.gov (United States)

Laroche, J-P

2016-05-01

On the 4th of December 2015, the French authorities officially recognized the birth of a specialty in vascular medicine entitled CO-DES cardiology-vascular/vascular Medicine. France is the 7th country to obtain this specialty after Switzerland, Germany, Austria, Czech Republic, Slovakia and Slovenia, six countries in the EEC. It has taken years to achieve a long but exciting experience: we went from hopes to disappointments, sometimes with the blues, but lobbying helping… with sustained confidence. This article tells the story of 30 years of struggle to achieve this vascular medicine specialty. Gaston Bachelard wrote: "Nothing is obvious, nothing is given, all is built." For the construction of vascular medicine, we had to overcome many obstacles, nothing was given to us, everything was conquered. Beware "The specialist is one who knows more and more things about an increasingly restricted field, up to 'knowing everything about nothing"' recalled Ralph Barton Ferry, philosopher; so there is room for modesty and humility but also convictions. The physical examination will remain the basis of our exercise. But let us recall the contributions of all those vascular physicians who practiced in the past, together with those currently active, who built day after day, year after year, a vascular medicine of quality. It is because of the trust of our colleagues and our patients that we can occupy the place that is ours today. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors.

Directory of Open Access Journals (Sweden)

Ligia Correia Lima de Souza

Full Text Available Choosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.A cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2 = 107.2. The choice mainly occurred during the internship period in medical school (n = 466; 38.7%. An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%, which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3 and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2. With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3 and "personal time" (3.1 ± 1.3; median = 4 were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both, and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4 and "social commitment" (2.6 ± 1.3, median = 3.The present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the

Specialty Choices: Patterns and Determinants among Medical ...

African Journals Online (AJOL)

2017-07-18

Jul 18, 2017 ... Methods: This was a cross‑sectional questionnaire‑based survey carried out ... were preferentially influenced by family/societal expectations (P = 0.03) and ..... Table 5: Distribution of specialties of first choice by age, parent's ...

Gender difference in preference of specialty as a career choice among Japanese medical students.

Science.gov (United States)

Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

2016-11-10

In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18-34) years and 227 men aged 22 ± 4 (range, 18-44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons). Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of "technical & research specialty" and a low OR for "personal reasons" were associated with preference for surgery. "Technical & research specialty" was positively associated with preference for special internal medicine and negatively for pediatrics. "Work-life balance" was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, "technical & research specialty" was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and "job security" was positively associated for general medicine/family medicine and negatively for psychology. Among men only, "educational experience" and "personal reasons" were positively, and "job security" was negatively associated with preference for pediatrics. For both genders, "work-life balance" was positively associated with preference for controllable lifestyle specialties. We

CLASSIFICATION OF SPECIALTIES AND QUALIFICATIONS IN REPUBLIC OF BELARUS: TENDENCIES AND PROSPECTS

Directory of Open Access Journals (Sweden)

O. A. Oleks

2016-01-01

Full Text Available In the present publication short data on the system of specialties and qualifications functioning in Republic of Belarus, her features, scope of application are given. The purpose and problems of the revision of the National classifier of the Republic of Belarus «Specialties and qualifications», its orientation to reduce the gap between the content of education and content of activity of graduates of establishments of education are described. The main tendencies of change of the operating classification – on the basis of types of economic activity and international standard classification of education taking into account requirements of employers, minimization of economic expenses for education, including due to minimization of classification units, rapprochement of positions with educational systems of other states are revealed. Prospects of development of national system of specialties and qualifications are disclosed. Tendencies and prospects of the expected changes are shown on the examples of the certain specialties offered by BNTU (Belarusian National Technical University.

Meta-Analysis of Surgeon Burnout Syndrome and Specialty Differences.

Science.gov (United States)

Bartholomew, Alex J; Houk, Anna K; Pulcrano, Marisa; Shara, Nawar M; Kwagyan, John; Jackson, Patrick G; Sosin, Michael

2018-02-27

Surgeon burnout compromises the quality of life of physicians and the delivery of care to patients. Burnout rates and interpretation of the Maslach Burnout Inventory (MBI) complicates the interpretation of surgeon burnout. The purpose of this study is to apply a standardized interpretation of severe surgeon burnout termed, "burnout syndrome" to analyze inherent variation within surgical specialties. A systematic literature search was performed using MEDLINE, PsycINFO, and EMBASE to identify studies reporting MBI data by surgical specialty. Data extraction was performed to isolate surgeon specific data. A meta-analysis was performed. A total of 16 cross-sectional studies were included in this meta-analysis, totaling 3581 subjects. A random effects model approximated burnout syndrome at 3.0% (95% CI: 2.0%-5.0%; I 2 = 78.1%). Subscale analysis of emotional exhaustion, depersonalization, and personal accomplishment indicated subscale burnout in 30.0% (CI: 25.0%-36.0%; I 2 = 93.2%), 34.0% (CI: 25.0%-43.0%; I 2 = 96.9%), and 25.0% (CI: 18.0%-32.0%; I 2 = 96.5%) of surgeons, respectively. Significant differences (p burnout termed "burnout syndrome," although surgeon burnout may occur in up to 34% of surgeons, characterized by high burnout in 1 of 3 subscales. Surgical specialties have significantly different rates of burnout subscales. Future burnout studies should target the specialty-specific level to understand inherent differences in an effort to better understand methods of improving surgeon burnout. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Lipid components and oxidative status of selected specialty oils

Energy Technology Data Exchange (ETDEWEB)

Madawala, S. R. P.; Kochhar, S. P.; Dutta, P. C.

2012-11-01

Many vegetable oils are marketed as specialty oils because of their retained flavors, tastes and distinct characteristics. Specialty oil samples which were commercially produced and retailed were purchased from local superstores in Reading, UK, and Uppsala, Sweden and profiled for detailed lipid composition and oxidative status. These oil samples include: almond, hazelnut, walnut, macadamia nut, argan, avocado, grape seed, roasted sesame, rice bran, cold pressed, organic and cold pressed, warm pressed and refined rapeseed oils. The levels of PV were quite low (0.5-1.3mEq O{sub 2}/kg) but AV and Rancimat values at 100 degree centigrade (except for rapeseed oils) varied considerably at (0.5-15.5) and (4.2-37.0 h) respectively. Macadamia nut oil was found to be the most stable oil followed by argan oil, while walnut oil was the least stable. Among the specialty oils, macadamia nut oil had the lowest (4%) and walnut oil had the highest (71%) level of total PUFA. The organic cold pressed rapeseed oil had considerably lower PUFA (27%) compared with other rapeseed oils (28- 35%). In all the samples, {alpha}- and {gamma}- tocopherols were the major tocopherols; nut oils had generally lower levels. Total sterols ranged from 889 to 15,106 {mu}g/g oil. The major sterols were {beta}-sitosterol (61-85%) and campesterol (6-20%). Argan oil contained schottenol (35%) and spinasterol (32%). Compared with literature values, no marked differences were observed among the differently processed, organically grown or cold pressed rapeseed oils and other specialty oils in this study. (Author) 33 refs.

Educational debt: does it have an influence on initial job location and specialty choice?

Science.gov (United States)

Snyder, Jennifer; Nehrenz, Guy; Danielsen, Randy; Pedersen, Donald

2014-01-01

This study applied a quantitative design and analyzed the impact of educational debt on initial specialty and location choices for physician assistant (PA) graduates in Indiana. PAs who graduated between January 1, 2000, and December 31, 2010, and actively practice in Indiana were surveyed. Descriptive statistics and chi-square analyses were performed to determine whether any significant relationships existed among practice specialty, location, and gender. 157 participants (33%) responded to the survey and were considered in the final analysis. Males were more likely than females to be influenced by debt in choosing their specialty and the location of their initial job. A majority of PAs would have reconsidered rural practice if they had received federal and or state loan forgiveness for educational debt. This study provides evidence that debt may influence practice specialty and location choice. Further studies are needed to determine how gender might account for decisions to practice in certain specialties and location.

Physician work intensity among medical specialties: emerging evidence on its magnitude and composition.

Science.gov (United States)

Horner, Ronnie D; Szaflarski, Jerzy P; Ying, Jun; Meganathan, Karthikeyan; Matthews, Gerald; Schroer, Brian; Weber, Debra; Raphaelson, Marc

2011-11-01

Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. To determine the magnitude and important dimensions of physician work intensity for 4 specialties. Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). Level of physician work intensity seems to be similar among specialties.

Challenges in referral communication between VHA primary care and specialty care.

Science.gov (United States)

Zuchowski, Jessica L; Rose, Danielle E; Hamilton, Alison B; Stockdale, Susan E; Meredith, Lisa S; Yano, Elizabeth M; Rubenstein, Lisa V; Cordasco, Kristina M

2015-03-01

Poor communication between primary care providers (PCPs) and specialists is a significant problem and a detriment to effective care coordination. Inconsistency in the quality of primary-specialty communication persists even in environments with integrated delivery systems and electronic medical records (EMRs), such as the Veterans Health Administration (VHA). The purpose of this study was to measure ease of communication and to characterize communication challenges perceived by PCPs and primary care personnel in the VHA, with a particular focus on challenges associated with referral communication. The study utilized a convergent mixed-methods design: online cross-sectional survey measuring PCP-reported ease of communication with specialists, and semi-structured interviews characterizing primary-specialty communication challenges. 191 VHA PCPs from one regional network were surveyed (54% response rate), and 41 VHA PCPs and primary care staff were interviewed. PCP-reported ease of communication mean score (survey) and recurring themes in participant descriptions of primary-specialty referral communication (interviews) were analyzed. Among PCPs, ease-of-communication ratings were highest for women's health and mental health (mean score of 2.3 on a scale of 1-3 in both), and lowest for cardiothoracic surgery and neurology (mean scores of 1.3 and 1.6, respectively). Primary care personnel experienced challenges communicating with specialists via the EMR system, including difficulty in communicating special requests for appointments within a certain time frame and frequent rejection of referral requests due to rigid informational requirements. When faced with these challenges, PCPs reported using strategies such as telephone and e-mail contact with specialists with whom they had established relationships, as well as the use of an EMR-based referral innovation called "eConsults" as an alternative to a traditional referral. Primary-specialty communication is a continuing

77 FR 40644 - Specialty Bar Products Company; A Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of...

Science.gov (United States)

2012-07-10

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,511] Specialty Bar Products... Application for Reconsideration for the workers and former workers of Specialty Bar Products Company, a... resulted in reduction of work force within Specialty Bar Products.'' Information obtained during the...

Novel Technological and Management Options for Accelerating Transformational Changes in Rice and Livestock Systems

Directory of Open Access Journals (Sweden)

Ngonidzashe Chirinda

2017-10-01

Full Text Available Agricultural producers grapple with low farm yields and declining ecosystem services within their landscapes. In several instances, agricultural production systems may be considered largely unsustainable in socioeconomic and ecological (resource conservation and use and impact on nature terms. Novel technological and management options that can serve as vehicles to promote the provision of multiple benefits, including the improvement of smallholder livelihoods, are needed. We call for a paradigm shift to allow designing and implementing agricultural systems that are not only efficient (serving as a means to promote development based on the concept of creating more goods and services while using fewer resources and creating less waste but can also be considered synergistic (symbiotic relationship between socio-ecological systems by simultaneously contributing to major objectives of economic, ecological, and social (equity improvement of agro-ecosystems. These transformations require strategic approaches that are supported by participatory system-level research, experimentation, and innovation. Using data from several studies, we here provide evidence for technological and management options that could be optimized, promoted, and adopted to enable agricultural systems to be efficient, effective, and, indeed, sustainable. Specifically, we present results from a study conducted in Colombia, which demonstrated that, in rice systems, improved water management practices such as Alternate Wetting and Drying (AWD reduce methane emissions (~70%. We also show how women can play a key role in AWD adoption. For livestock systems, we present in vitro evidence showing that the use of alternative feed options such as cassava leaves contributes to livestock feed supplementation and could represent a cost-effective approach for reducing enteric methane emissions (22% to 55%. We argue that to design and benefit from sustainable agricultural systems, there is a

Cloud Computing: A Free Technology Option to Promote Collaborative Learning

Science.gov (United States)

Siegle, Del

2010-01-01

In a time of budget cuts and limited funding, purchasing and installing the latest software on classroom computers can be prohibitive for schools. Many educators are unaware that a variety of free software options exist, and some of them do not actually require installing software on the user's computer. One such option is cloud computing. This…

Career Motivations, Perceptions of the Future of Dentistry and Preferred Dental Specialties Among Saudi Dental Students

Science.gov (United States)

Halawany, Hassan S

2014-01-01

Aim: The purpose of this study was to determine the career motivations, perceptions of the future of dentistry and preferred postgraduate specialties of Saudi dental students. Methods: A pretested, self-administered, 16-item questionnaire was distributed to first- through fifth-year dental students at King Saud University in Saudi Arabia. Descriptive statistics were calculated, and the level of significance was set at 5%. Results: Of the 530 potential participants, 329 students (198 male and 131 female respondents) completed the questionnaire. High professional status (71.4%), a secure career (67.8%), a high income (78.1%), flexible working hours (54.4%), a wide range of career options after graduation (59.3%), opportunities for self-employment (69.3%) and good job opportunities abroad (65.3%) were endorsed to a great/considerable extent by the respondents. “It takes time to establish a practice” (62.3%), “Postgraduate education is a necessity” (72.4%) and “The increasing number of dental institutions is a threat to the profession” (59.3%) were endorsed to a great or considerable extent by the respondents. The most popular specialty among the male students was oral maxillofacial surgery (20.1%) and among female students was operative dentistry (23.4%). Conclusion: The career motivations of this group of dental students seemed to relate to socioeconomic aspects of dentistry and perceptions of the future of dentistry seemed to relate to the need for postgraduate education. PMID:25246989

15 CFR 2011.204 - Entry of specialty sugars.

Science.gov (United States)

2010-01-01

... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND... present a certificate to the appropriate customs official at the date of entry of specialty sugars. Entry...

Fast Spectrum Molten Salt Reactor Options

Energy Technology Data Exchange (ETDEWEB)

Gehin, Jess C [ORNL; Holcomb, David Eugene [ORNL; Flanagan, George F [ORNL; Patton, Bruce W [ORNL; Howard, Rob L [ORNL; Harrison, Thomas J [ORNL

2011-07-01

During 2010, fast-spectrum molten-salt reactors (FS-MSRs) were selected as a transformational reactor concept for light-water reactor (LWR)-derived heavy actinide disposition by the Department of Energy-Nuclear Energy Advanced Reactor Concepts (ARC) program and were the subject of a preliminary scoping investigation. Much of the reactor description information presented in this report derives from the preliminary studies performed for the ARC project. This report, however, has a somewhat broader scope-providing a conceptual overview of the characteristics and design options for FS-MSRs. It does not present in-depth evaluation of any FS-MSR particular characteristic, but instead provides an overview of all of the major reactor system technologies and characteristics, including the technology developments since the end of major molten salt reactor (MSR) development efforts in the 1970s. This report first presents a historical overview of the FS-MSR technology and describes the innovative characteristics of an FS-MSR. Next, it provides an overview of possible reactor configurations. The following design features/options and performance considerations are described including: (1) reactor salt options-both chloride and fluoride salts; (2) the impact of changing the carrier salt and actinide concentration on conversion ratio; (3) the conversion ratio; (4) an overview of the fuel salt chemical processing; (5) potential power cycles and hydrogen production options; and (6) overview of the performance characteristics of FS-MSRs, including general comparative metrics with LWRs. The conceptual-level evaluation includes resource sustainability, proliferation resistance, economics, and safety. The report concludes with a description of the work necessary to begin more detailed evaluation of FS-MSRs as a realistic reactor and fuel cycle option.

Specialty-specific admission: a cost-effective intervention?

LENUS (Irish Health Repository)

Slattery, E

2012-02-01

INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

CRADA Payment Options | NCI Technology Transfer Center | TTC

Science.gov (United States)

NCI TTC CRADA PAYMENT OPTIONS: Electronic Payments by Wire Transfer via Fedwire, Mail a check to the Institute or Center, or Automated Clearing House (ACH)/Electronic Funds Transfer (ETF) payments via Pay.gov (NCI ONLY).

Cost-effective and low-technology options for simulation and training in neonatology.

Science.gov (United States)

Bruno, Christie J; Glass, Kristen M

2016-11-01

The purpose of this review is to explore low-cost options for simulation and training in neonatology. Numerous cost-effective options exist for simulation and training in neonatology. Lower cost options are available for teaching clinical skills and procedural training in neonatal intubation, chest tube insertion, and pericardiocentesis, among others. Cost-effective, low-cost options for simulation-based education can be developed and shared in order to optimize the neonatal simulation training experience. Copyright © 2016 Elsevier Inc. All rights reserved.

77 FR 40353 - Onyx Specialty Papers, Inc; Notice of Availability of Environmental Assessment

Science.gov (United States)

2012-07-09

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2985-008 Massachusetts] Onyx Specialty Papers, Inc; Notice of Availability of Environmental Assessment In accordance with the...), Commission staff has reviewed the Onyx Specialty Papers, Inc.'s application for surrender of project license...

76 FR 45397 - Export Inspection and Weighing Waiver for High Quality Specialty Grain Transported in Containers

Science.gov (United States)

2011-07-29

...-AB18 Export Inspection and Weighing Waiver for High Quality Specialty Grain Transported in Containers... permanent a waiver due to expire on July 31, 2012, for high quality specialty grain exported in containers... of high quality specialty grain exported in containers are small entities that up until recently...

Influence of gender and other factors on medical student specialty interest.

Science.gov (United States)

Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

2014-09-12

Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

Specialty choice preference of medical students according to personality traits by Five-Factor Model.

Science.gov (United States)

Kwon, Oh Young; Park, So Youn

2016-03-01

The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

Specialty choice preference of medical students according to personality traits by Five-Factor Model

Directory of Open Access Journals (Sweden)

Oh Young Kwon

2016-03-01

Full Text Available Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods: A questionnaire survey of Year 4 medical students (n=110 in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Results: Of the 110 eligible medical students, 105 (95.4% response rate completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010 and more Openness students preferred medical departments to others (p=0.031. Personal interest was the significant motivational factors in more Openness students (p=0.003 and Conscientiousness students (p=0.003. Conclusion: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

Combination of real options and game-theoretic approach in investment analysis

Science.gov (United States)

Arasteh, Abdollah

2016-09-01

Investments in technology create a large amount of capital investments by major companies. Assessing such investment projects is identified as critical to the efficient assignment of resources. Viewing investment projects as real options, this paper expands a method for assessing technology investment decisions in the linkage existence of uncertainty and competition. It combines the game-theoretic models of strategic market interactions with a real options approach. Several key characteristics underlie the model. First, our study shows how investment strategies rely on competitive interactions. Under the force of competition, firms hurry to exercise their options early. The resulting "hurry equilibrium" destroys the option value of waiting and involves violent investment behavior. Second, we get best investment policies and critical investment entrances. This suggests that integrating will be unavoidable in some information product markets. The model creates some new intuitions into the forces that shape market behavior as noticed in the information technology industry. It can be used to specify best investment policies for technology innovations and adoptions, multistage R&D, and investment projects in information technology.

Analysis of technological options for electric energy generation from urban solid wastes; Analise de opcoes tecnologicas para geracao de energia eletrica a partir de residuos solidos urbanos

Energy Technology Data Exchange (ETDEWEB)

Furtado, J.G. de M.; Serra, E.T. [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil)], Emails: furtado@cepel.br, etserra@cepel.br

2010-07-01

This paper evaluates technologically of the options existents for generation of electric power from the urban solid wastes (USW), based on application of factoring method for estimation of investments based on basic description of the plant, it main equipment and technological complexity, viewing to contribute for determination of better technical and economical form, and the energy using. The results of the effectuated analyses indicates that the most technological complexity of the gasification and thermal plasma, and be encountered on non commercial in great scale as well, make the the option present the greatest index of investment and relative cost, determining the greatest costs of electric power generated through this process.

Advanced Reactor Technology Options for Utilization and Transmutation of Actinides in Spent Nuclear Fuel

International Nuclear Information System (INIS)

2009-09-01

Renewed interest in the potential of nuclear energy to contribute to a sustainable worldwide energy mix is strengthening the IAEA's statutory role in fostering the peaceful uses of nuclear energy, in particular the need for effective exchanges of information and collaborative research and technology development among Member States on advanced nuclear power technologies (Articles III-A.1 and III-A.3). The major challenges facing the long term development of nuclear energy as a part of the world's energy mix are improvement of the economic competitiveness, meeting increasingly stringent safety requirements, adhering to the criteria of sustainable development, and public acceptability. The concern linked to the long life of many of the radioisotopes generated from fission has led to increased R and D efforts to develop a technology aimed at reducing the amount of long lived radioactive waste through transmutation in fission reactors or accelerator driven hybrids. In recent years, in various countries and at an international level, more and more studies have been carried out on advanced and innovative waste management strategies (i.e. actinide separation and elimination). Within the framework of the Project on Technology Advances in Fast Reactors and Accelerator Driven Systems (http://www.iaea.org/inisnkm/nkm/aws/fnss/index.html), the IAEA initiated a number of activities on utilization of plutonium and transmutation of long lived radioactive waste, accelerator driven systems, thorium fuel options, innovative nuclear reactors and fuel cycles, non-conventional nuclear energy systems, and fusion/fission hybrids. These activities are implemented under the guidance and with the support of the IAEA Nuclear Energy Department's Technical Working Group on Fast Reactors (TWG-FR). This publication compiles the analyses and findings of the Coordinated Research Project (CRP) on Studies of Advanced Reactor Technology Options for Effective Incineration of Radioactive Waste (2002

Agile Model Driven Development of Electronic Health Record-Based Specialty Population Registries

Science.gov (United States)

Kannan, Vaishnavi; Fish, Jason C.; Willett, DuWayne L.

2018-01-01

The transformation of the American healthcare payment system from fee-for-service to value-based care increasingly makes it valuable to develop patient registries for specialized populations, to better assess healthcare quality and costs. Recent widespread adoption of Electronic Health Records (EHRs) in the U.S. now makes possible construction of EHR-based specialty registry data collection tools and reports, previously unfeasible using manual chart abstraction. But the complexities of specialty registry EHR tools and measures, along with the variety of stakeholders involved, can result in misunderstood requirements and frequent product change requests, as users first experience the tools in their actual clinical workflows. Such requirements churn could easily stall progress in specialty registry rollout. Modeling a system’s requirements and solution design can be a powerful way to remove ambiguities, facilitate shared understanding, and help evolve a design to meet newly-discovered needs. “Agile Modeling” retains these values while avoiding excessive unused up-front modeling in favor of iterative incremental modeling. Using Agile Modeling principles and practices, in calendar year 2015 one institution developed 58 EHR-based specialty registries, with 111 new data collection tools, supporting 134 clinical process and outcome measures, and enrolling over 16,000 patients. The subset of UML and non-UML models found most consistently useful in designing, building, and iteratively evolving EHR-based specialty registries included User Stories, Domain Models, Use Case Diagrams, Decision Trees, Graphical User Interface Storyboards, Use Case text descriptions, and Solution Class Diagrams. PMID:29750222

[Medical student perception of physician values in practice by individual characteristics and preferred medical specialty field].

Science.gov (United States)

Park, Kwi Hwa; Yoo, Hyo Hyun; Yim, Jun

2014-12-01

Medical students' values figure prominently in their choice of medical specialty; yet, little research has been performed on this topic. The purpose of this study was to analyze the differences in values according to medical students' individual characteristics (medical educational system, gender, and grade) and preferred medical specialty. A total of 905 medical students participated in the study; 426 were graduate-entry medical students (GEMS), and 479 were undergraduate medical students (UMS). Further, 561 were male and 316 were female; 356 were in year 1, 219 were in year 2, 230 were in year 3, and 100 were in year 4. Students completed the Physician Values in Practice Scale (PVIPS). The PVIPS comprises six dimensions: autonomy, management, prestige, service, lifestyle, and scholarly pursuits. The data were analyzed by t-test and analysis of variance. GEMS had higher scores for service, management, and scholarly pursuits than UMS. Males had higher scores for prestige, lifestyle, and management, whereas female scored higher on service and scholarly pursuits. Higher grade was associated with increased scores for prestige, lifestyle, and management. The differences in lifestyle and scholarly pursuits were significant between preferred specialties. Students in support specialties scored significantly higher on lifestyle. With regard to scholarly pursuits, basic science specialties scored significantly higher than other specialties. There were significant differences in PVIPS according to individual characteristics and preferred medical specialty. This result could be useful in developing a medical specialty choice program for medical students.

An Overview of Chain of Custody Options for LETTERPRESS.

Energy Technology Data Exchange (ETDEWEB)

Smartt, Heidi A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-11-01

This purpose of this document is to provide an overview of Chain of Custody (CoC) technology options that could be made available for the LETTERPRESS exercise as part of the Quad Working Group. The Quad Working Group comprises five sub-working groups (Management, Protocol, Simulation, Technology, and Training) with members from the U.S., U.K., Norway, and Sweden having the goal of providing a repeatable, realistic arms control exercise (dubbed LETTERPRESS) to be executed in representative facilities and using non-proliferative but representative treaty items. The Technology Working Group is responsible for supporting the technology requirements of the LETTERPRESS exercise and as such the technologies presented here are possible options to meet those requirements.

An Overview of Chain of Custody Options for LETTERPRESS

International Nuclear Information System (INIS)

Smartt, Heidi A.

2016-01-01

This purpose of this document is to provide an overview of Chain of Custody (CoC) technology options that could be made available for the LETTERPRESS exercise as part of the Quad Working Group. The Quad Working Group comprises five sub-working groups (Management, Protocol, Simulation, Technology, and Training) with members from the U.S., U.K., Norway, and Sweden having the goal of providing a repeatable, realistic arms control exercise (dubbed LETTERPRESS) to be executed in representative facilities and using non-proliferative but representative treaty items. The Technology Working Group is responsible for supporting the technology requirements of the LETTERPRESS exercise and as such the technologies presented here are possible options to meet those requirements.

Idaho's Energy Options

Energy Technology Data Exchange (ETDEWEB)

Robert M. Neilson

2006-03-01

This report, developed by the Idaho National Laboratory, is provided as an introduction to and an update of the status of technologies for the generation and use of energy. Its purpose is to provide information useful for identifying and evaluating Idaho’s energy options, and for developing and implementing Idaho’s energy direction and policies.

Transformation towards a Renewable Energy System in Brazil and Mexico—Technological and Structural Options for Latin America

OpenAIRE

Sonja Simon; Tobias Naegler; Hans Christian Gils

2018-01-01

Newly industrialized countries face major challenges to comply with the Paris Treaty targets as economic growth and prosperity lead to increasing energy demand. Our paper analyses technological and structural options in terms of energy efficiency and renewable energies for a massive reduction of energy-related CO2 emissions in Latin America. Brazil and Mexico share similar growth prospects but differ significantly with respect to renewable energy potentials. We identify, how this leads to dif...

Nuclear Fuel Cycle Options Catalog: FY16 Improvements and Additions

Energy Technology Data Exchange (ETDEWEB)

Price, Laura L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Barela, Amanda Crystal [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Schetnan, Richard Reed [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walkow, Walter M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-08-31

The United States Department of Energy, Office of Nuclear Energy, Fuel Cycle Technology Program sponsors nuclear fuel cycle research and development. As part of its Fuel Cycle Options campaign, the DOE has established the Nuclear Fuel Cycle Options Catalog. The catalog is intended for use by the Fuel Cycle Technologies Program in planning its research and development activities and disseminating information regarding nuclear energy to interested parties. The purpose of this report is to document the improvements and additions that have been made to the Nuclear Fuel Cycle Options Catalog in the 2016 fiscal year.

Nuclear Fuel Cycle Options Catalog FY15 Improvements and Additions.

Energy Technology Data Exchange (ETDEWEB)

Price, Laura L. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Barela, Amanda Crystal [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Schetnan, Richard Reed [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Walkow, Walter M. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States)

2015-11-01

The United States Department of Energy, Office of Nuclear Energy, Fuel Cycle Technology Program sponsors nuclear fuel cycle research and development. As part of its Fuel Cycle Options campaign, the DOE has established the Nuclear Fuel Cycle Options Catalog. The catalog is intended for use by the Fuel Cycle Technologies Program in planning its research and development activities and disseminating information regarding nuclear energy to interested parties. The purpose of this report is to document the improvements and additions that have been made to the Nuclear Fuel Cycle Options Catalog in the 2015 fiscal year.

Information Security: A Scientometric Study of the Profile, Structure, and Dynamics of an Emerging Scholarly Specialty

Science.gov (United States)

Olijnyk, Nicholas Victor

2014-01-01

The central aim of the current research is to explore and describe the profile, dynamics, and structure of the information security specialty. This study's objectives are guided by four research questions: 1. What are the salient features of information security as a specialty? 2. How has the information security specialty emerged and evolved from…

27 CFR 6.84 - Point of sale advertising materials and consumer advertising specialties.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Point of sale advertising materials and consumer advertising specialties. 6.84 Section 6.84 Alcohol, Tobacco Products and Firearms....84 Point of sale advertising materials and consumer advertising specialties. (a) General. The act by...

Does Specialty Bias Trump Evidence in the Management of High-risk Prostate Cancer?

Science.gov (United States)

Kishan, Amar U; Duchesne, Gillian; Wang, Pin-Chieh; Rwigema, Jean-Claude M; Saigal, Christopher; Rettig, Matthew; Steinberg, Michael L; King, Christopher R

2018-06-01

The objective was to query how specialty influences treatment recommendations for high-risk prostate cancer in 3 clinical settings: upfront management, postoperative management, and management of biochemical recurrences (BCRs) after radiotherapy (RT). We hypothesized that specialty bias would manifest in all settings, trumping available evidence. A survey of practicing urologists and radiation oncologists was distributed through electronic mail. Questions pertained to upfront management, postoperative treatment, and local salvage for postradiation BCRs. The associations between 26 selected categorical responses and specialty were assessed using multivariate logistic regression. Training level/expertise, practice setting, percentage of consultation caseload consisting of prostate cancer, and nationality were set as effect modifiers. One thousand two hundred fifty-three physicians (846 radiation oncologists and 407 urologists) completed the survey. Radiation oncologists were more likely to recommend adjuvant RT and consider it to be underutilized, and more likely to recommend salvage RT at lower prostate-specific antigen thresholds (P<0.0001). Urologists were more likely to recommend salvage radical prostatectomy or cryoablation for local salvage after RT, whereas radiation oncologists were more likely to recommend RT-based modalities and more likely to report that local salvage was underutilized after RT (P<0.0001). Urologists were more likely to report that upfront radical prostatectomy was a better definitive treatment (P<0.0001), whereas radiation oncologists were more likely to report the opposite (P=0.005). Specialty biases permeate recommendations for upfront management and management in the postoperative and post-RT BCR setting, irrespective of available evidence. These data reveal the critical need for multidisciplinary clinics and cross-specialty training as potential solutions for overcoming specialty bias.

Declining average daily census. Part 1: Implications and options.

Science.gov (United States)

Weil, T P

1985-12-01

A national trend toward declining average daily (inpatient) census (ADC) started in late 1982 even before the Medicare prospective payment system began. The decrease in total days will continue despite an increasing number of aged persons in the U.S. population. This decline could have been predicted from trends during 1978 to 1983, such as increasing available beds but decreasing occupancy, 100 percent increases in hospital expenses, and declining lengths of stay. Assuming that health care costs will remain as a relatively fixed part of the gross national product and no major medical advances will occur in the next five years, certain implications and options exist for facilities experiencing a declining ADC. This article discusses several considerations: Attempts to improve market share; Reduction of full-time equivalent employees; Impact of greater acuity of illness among remaining inpatients; Implications of increasing the number of physicians on medical staffs; Option of a closed medical staff by clinical specialty; Unbundling with not-for-profit and profit-making corporations; Review of mergers, consolidations, and multihospital systems to decide when this option is most appropriate; Sale of a not-for-profit hospital to an investor-owned chain, with implications facing Catholic hospitals choosing this option; Impact and difficulty of developing meaningful alternative health care systems with the hospital's medical staff; Special problems of teaching hospitals; The social issue of the hospital shifting from the community's health center to a cost center; Increased turnover of hospital CEOs; With these in mind, institutions can then focus on solutions that can sometimes be used in tandem to resolve this problem's impact. The second part of this article will discuss some of them.

Impact of a national specialty e-consultation implementation project on access.

Science.gov (United States)

Kirsh, Susan; Carey, Evan; Aron, Dacid C; Cardenas, Omar; Graham, Glenn; Jain, Rajiv; Au, David H; Tseng, Chin-Lin; Franklin, Heather; Ho, P Michael

2015-12-01

To assess the early impact of implementation of the electronic consults (e-consults) initiative by the Veterans Health Administration (VHA), designed to improve specialty care access. Observational cohort study exploiting a natural experiment begun in May 2011 at 12 VHA medical centers and expanded to 122 medical centers by December 2013. The following were assessed: 1) growth of e-consults by VHA regional networks, medical centers, and specialty; 2) location of patient's primary care provider (medical center vs community-based outpatient clinic [CBOC]); 3) potential patient miles needed to travel for a specialty care face-to-face consult in place of the observed e-consults using estimated geodesic distance; 4) use of specialty care subsequent to the e-consult. Of 11,270,638 consults completed in 13 clinics of interest, 217,014 were e-consults (adjusted rate, 1.93 e-consults per 100 consults). The e-consult rate was highest in endocrinology (5.0 per 100), hematology (3.0 per 100), and gastroenterology (3.0 per 100). The percentage of e-consult patients with CBOC-based primary care grew from 28.5% to 44.4% in the first year of implementation and to 45.6% at year 3. Of those e-consult patients from community clinics, the average potential miles needed to travel was 72.1 miles per patient (SD = 72.6; median = 54.6; interquartile range = 17.1-108), translating to a potential savings of 6,875,631 total miles and travel reimbursement costs of $2,853,387. E-consult volume increased significantly since inception within many medical and surgical specialties. For patients receiving primary care at one of more than 800 CBOCs, e-consults may decrease travel burden and direct travel costs for patients.

The value of independent specialty designation for interventional cardiology.

Science.gov (United States)

Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

2017-01-01

Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Essential Tremor (ET): Surgical Options

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... option for severe depression, epilepsy, Tourette’s syndrome, stroke, addiction, and dementia. Top Focused Ultrasound Thalamotomy The FDA ... ultrasound but in a very different way. This technology uses multiple beams of sound focused in on ...

Study on the Higher Vocational and Professional Specialty Ability Module of "Construction Management"

Science.gov (United States)

Gao, Qun

2008-01-01

The higher vocational and professional specialty of "construction management" of China begun late, and the talent training mode of various colleges are different, especially the analysis to the specialty ability modules on the higher vocational and professional layer is not mature. In this article, combining with the practice of Manjing…

Formation of Professional Competence of Legal Specialty Students in the Elective Courses Studying

Science.gov (United States)

Akhmejanova, Gulnara; Olzhabayev, Bulat; Grigoryeva, Roza; Karibaeva, Zhanara; Avilkhan, Akmamyk; Sakenov, Janat

2016-01-01

This article examines the scientific problem of the formation of professional competence of legal specialty students in the elective courses studying. The analysis has been conducted and the content of professional competence of legal specialty students has been substantiated. This work substantiates the role of elective courses in the formation…

Comparison of Technological Options for Distributed Generation-Combined Heat and Power in Rajasthan State of India

Directory of Open Access Journals (Sweden)

Ram Kumar Agrawal

2013-01-01

Full Text Available Distributed generation (DG of electricity is expected to become more important in the future electricity generation system. This paper reviews the different technological options available for DG. DG offers a number of potential benefits. The ability to use the waste heat from fuel-operated DG, known as combined heat and power (CHP, offers both reduced costs and significant reductions of CO2 emissions. The overall efficiency of DG-CHP system can approach 90 percent, a significant improvement over the 30 to 35 percent electric grid efficiency and 50 to 90 percent industrial boiler efficiency when separate production is used. The costs of generation of electricity from six key DG-CHP technologies; gas engines, diesel engines, biodiesel CI engines, microturbines, gas turbines, and fuel cells, are calculated. The cost of generation is dependent on the load factor and the discount rate. It is found that annualized life cycle cost (ALCC of the DG-CHP technologies is approximately half that of the DG technologies without CHP. Considering the ALCC of different DG-CHP technologies, the gas I.C. engine CHP is the most effective for most of the cases but biodiesel CI engine CHP seems to be a promising DG-CHP technology in near future for Rajasthan state due to renewable nature of the fuel.

Technological options for the management of biosolids.

Science.gov (United States)

Wang, Hailong; Brown, Sally L; Magesan, Guna N; Slade, Alison H; Quintern, Michael; Clinton, Peter W; Payn, Tim W

2008-06-01

provide a complete management for biosolids. A number of advanced thermal conversion technologies (e.g., supercritical water oxidation process and pyrolysis) are under development for biosolids management with a goal to generate useful products, such as higher quality fuels and recovery of phosphorus. With an ever-increasing demand for renewable energy, growing bioenergy crops and forests using biosolids as a fertilizer and soil amendment can not only contribute to the low-carbon economy but also maximize the nutrient and carbon value of the biosolids. Land application of biosolids achieves a complete reuse of its nutrients and organic carbon at a relatively low cost. Therefore, land application should become a preferred management option where there is available land, the quality of biosolids meet regulatory requirements, and it is socially acceptable. Intensive energy cropping and forest production using biosolids can help us meet the ever-increasing demand for renewable energy, which can eliminate the contamination potential for food sources, a common social concern about land application of biosolids. In recent years, increasing numbers of national and local governments have adopted more stringent regulations toward biosolid management. Under such a political climate, biosolids producers will have to develop multireuse strategies for biosolids to avoid being caught because a single route management practice might be under pressure at a short notice. Conventional incineration systems for biosolids management generally consume more energy than they produce and, although by-products may be used in manufacturing, this process cannot be regarded as a beneficial use of biosolids. However, biosolids are likely to become a source of renewable energy and produce 'carbon credits' under the increasingly popular, low-carbon economy policy. To manage biosolids in a sustainable manner, there is a need for further research in the following areas: achieving a higher degree of public

Fiber Fabrication Facility for Non-Oxide and Specialty Glasses

Data.gov (United States)

Federal Laboratory Consortium — FUNCTION: Unique facility for the research, development, and fabrication of non-oxide and specialty glasses and fibers in support of Navy/DoD programs.DESCRIPTION:...

Psychiatric specialty training in Greece.

Science.gov (United States)

Margariti, M; Kontaxakis, V; Ploumpidis, D

2017-01-01

The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system. This multifaceted role requires the continuous education of modern psychiatrists, but above all a broad, substantial and comprehensive training regime in the initial stage of their professional career, that is to say during specialization. Training in Psychiatry, as indeed has happened in all other medical specialties, has evolved considerably in recent decades, both in the content of education due to scientific advances in the fields of neurobiology, cognitive neuroscience, genetics, psychopharmacology, epidemiology and psychiatric nosology, and also because of advances in the educational process itself. Simple apprenticeship next to an experienced clinician, despite its importance in the clinical training of young psychiatrists, is no longer sufficient to meet the increased demands of the modern role of psychiatrists, resulting in the creation of educational programs defined by setting and pursuing minimum, though comprehensive educational objectives. This development has created the global need to develop organizations intended to supervise training programs. These organizations have various forms worldwide. In the European Union, the competent supervising body for medical specialties is the UEMS (European Union of Medical Specialities) and particularly in the case of the psychiatric

Comparative assessment of electricity generation options for Mexico

International Nuclear Information System (INIS)

Cecilia, Martin Del Campo; Francois, Juan Luis

2009-01-01

This paper presents an approach to the evaluation of sustainability of energy options for the electricity generation in Mexico. The study evaluated technologies that could be planned in the short term because their high maturity. The purpose was to rank the energy options based on the evaluation of a set of criteria grouped in impact areas for each dimension of the sustainability: economic, environmental and social. Obviously, no single technology exhibited superior performance on the basis of all the criteria and it was necessary to apply a mult criteria decision analysis (MCDA). In total this study all the decision elements were combined and integrated in an inference fuzzy logic system that takes into account the weights of different indicators. The methodology was applied to compare five technologies based on wind, nuclear, natural gas, coal, hydro and oil resources under the current Mexican conditions. In view of the features of the energy options, oil and gas are subject to limited energy resources. Coal and oil show relatively unfavorable ecological and accident risk characteristics. Gas is by far the option with the best performance among the fossil fuel options. In the case of nuclear energy, the economic, environmental and health indicators are highly favorable, however, social indicators for nuclear energy are unfavorable but they are also very controversial and additional studies must be carried out. The global sustainability of hydro, nuclear, wind and natural gas resulted very close; so these energy options must be considered in the generation expansion planning studies to search the expansion plans with the better combination of generation, energetic diversification and emissions, between other criteria

Design and Implementation of the Automatic Assessment System for the Command and Control Specialty in Ships

Directory of Open Access Journals (Sweden)

Zhang Hao

2017-01-01

Full Text Available On the basis of analyzing the actual demand of automated assessment system for the command and control specialty in ships, the thought of the overall design of automated assessment system for the command and control specialty in ships is given, and the concrete realization methods of the user login module, test paper operation module and system maintenance module are studied and demonstrated. The proposed design idea and implementation method of automated assessment system for the command and control specialty in ships is scientific, efficient and practical, and provides reference for the exploitation of automated assessment system for the command and control specialty in ships.

Organizational readiness in specialty mental health care.

Science.gov (United States)

Hamilton, Alison B; Cohen, Amy N; Young, Alexander S

2010-01-01

Implementing quality improvement efforts in clinics is challenging. Assessment of organizational "readiness" for change can set the stage for implementation by providing information regarding existing strengths and deficiencies, thereby increasing the chance of a successful improvement effort. This paper discusses organizational assessment in specialty mental health, in preparation for improving care for individuals with schizophrenia. To assess organizational readiness for change in specialty mental health in order to facilitate locally tailored implementation strategies. EQUIP-2 is a site-level controlled trial at nine VA medical centers (four intervention, five control). Providers at all sites completed an organizational readiness for change (ORC) measure, and key stakeholders at the intervention sites completed a semi-structured interview at baseline. At the four intervention sites, 16 administrators and 43 clinical staff completed the ORC, and 38 key stakeholders were interviewed. The readiness domains of training needs, communication, and change were the domains with lower mean scores (i.e., potential deficiencies) ranging from a low of 23.8 to a high of 36.2 on a scale of 10-50, while staff attributes of growth and adaptability had higher mean scores (i.e., potential strengths) ranging from a low of 35.4 to a high of 41.1. Semi-structured interviews revealed that staff perceptions and experiences of change and decision-making are affected by larger structural factors such as change mandates from VA headquarters. Motivation for change, organizational climate, staff perceptions and beliefs, and prior experience with change efforts contribute to readiness for change in specialty mental health. Sites with less readiness for change may require more flexibility in the implementation of a quality improvement intervention. We suggest that uptake of evidence-based practices can be enhanced by tailoring implementation efforts to the strengths and deficiencies of the

Sustainable uranium energy - an optional future

International Nuclear Information System (INIS)

Meneley, D.

2015-01-01

After 50 plus years of working on uranium fission principles and application, it is a bit hard for me to talk about anything else - but I'll give it a try. To start, I solemnly promise not to recommend to you any new reactor design - be it small, medium, modular, or large. The Uranium-fuelled power plant will be discussed ONLY as a finished product. Note that this sketch is an optional future. Ontario will, of course, take it or leave it, in whole or in part. This paper concentrates on future potential achievements of the CANDU nuclear energy systems. In the past, this venture has produced several modular systems, ranging from small (NPD and CANDU 3), medium (CANDU 6 and 6E) and large (Bruce, Darlington, and CANDU 9). All of these projects are more Ol' less finished products, and yet the CANDU concept still has broad scope for refinement and upgrading. This paper is, however, not about nuclear technology per se, but rather it is about what nuclear energy can do, both now and in the future. What does Ontario need to do next, in the line of technology applications that can help deal with the negative aspects of human-induced climate change? What energy systems can be installed to sustain the wealth and prosperity that Ontario's citizens now enjoy? What are the opportunities and the engineering challenges ahead of us? I do wish to apologize in advance for errors and omissions, and can only hope that missed details do not detract nor completely destroy an optimistic vision. Energy engineering is my game. Economics is not my specialty though it is an integral part of every engineering project. It is likely that the topic of economics will dominate the future choice of world energy supply, whatever that choice may be. Some people claim that the decisive factor dominating decisions with respect to uranium energy will be fear. In fact many opponents of the associated technology aim to induce fear as their main guiding theme. On the contrary, it is more reasonable to expect

Sustainable uranium energy - an optional future

Energy Technology Data Exchange (ETDEWEB)

Meneley, D. [Univ. of Ontario Inst. of Tech., Oshawa, Ontario (Canada)

2015-06-15

After 50 plus years of working on uranium fission principles and application, it is a bit hard for me to talk about anything else - but I'll give it a try. To start, I solemnly promise not to recommend to you any new reactor design - be it small, medium, modular, or large. The Uranium-fuelled power plant will be discussed ONLY as a finished product. Note that this sketch is an optional future. Ontario will, of course, take it or leave it, in whole or in part. This paper concentrates on future potential achievements of the CANDU nuclear energy systems. In the past, this venture has produced several modular systems, ranging from small (NPD and CANDU 3), medium (CANDU 6 and 6E) and large (Bruce, Darlington, and CANDU 9). All of these projects are more Ol' less finished products, and yet the CANDU concept still has broad scope for refinement and upgrading. This paper is, however, not about nuclear technology per se, but rather it is about what nuclear energy can do, both now and in the future. What does Ontario need to do next, in the line of technology applications that can help deal with the negative aspects of human-induced climate change? What energy systems can be installed to sustain the wealth and prosperity that Ontario's citizens now enjoy? What are the opportunities and the engineering challenges ahead of us? I do wish to apologize in advance for errors and omissions, and can only hope that missed details do not detract nor completely destroy an optimistic vision. Energy engineering is my game. Economics is not my specialty though it is an integral part of every engineering project. It is likely that the topic of economics will dominate the future choice of world energy supply, whatever that choice may be. Some people claim that the decisive factor dominating decisions with respect to uranium energy will be fear. In fact many opponents of the associated technology aim to induce fear as their main guiding theme. On the contrary, it is more

Prescription patterns and costs of acne/rosacea medications in Medicare patients vary by prescriber specialty.

Science.gov (United States)

Zhang, Myron; Silverberg, Jonathan I; Kaffenberger, Benjamin H

2017-09-01

Prescription patterns for acne/rosacea medications have not been described in the Medicare population, and comparisons across specialties are lacking. To describe the medications used for treating acne/rosacea in the Medicare population and evaluate differences in costs between specialties. A cross-sectional study was performed of the 2008 and 2010 Centers for Medicare and Medicaid Services Prescription Drug Profiles, which contains 100% of Medicare part D claims. Topical antibiotics accounted for 63% of all prescriptions. Patients ≥65 years utilized more oral tetracycline-class antibiotics and less topical retinoids. Specialists prescribed brand name drugs for the most common topical retinoids and most common topical antibiotics more frequently than family medicine/internal medicine (FM/IM) physicians by 6%-7%. Topical retinoids prescribed by specialists were, on average, $18-$20 more in total cost and $2-$3 more in patient cost than the same types of prescriptions from FM/IM physicians per 30-day supply. Specialists (60%) and IM physicians (56%) prescribed over twice the rate of branded doxycycline than FM doctors did (27%). The total and patient costs for tetracycline-class antibiotics were higher from specialists ($18 and $4 more, respectively) and IM physicians ($3 and $1 more, respectively) than they were from FM physicians. The data might contain rare prescriptions used for conditions other than acne/rosacea, and suppression algorithms might underestimate the number of specialist brand name prescriptions. Costs of prescriptions for acne/rosacea from specialists are higher than those from primary care physicians and could be reduced by choosing generic and less expensive options. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Searching for Educational Technology Faculty.

Science.gov (United States)

Barrow, Lloyd H.

2003-01-01

Identifies the types of positions available at domestic four-year institutions of higher education for faculty whose specialty is educational technology. Analyzes educational job postings listed in the "Chronicle of Higher Education" from August, 2000, through July, 2001. (Author/SOE)

Surgery or general medicine: a study of the reasons underlying the choice of medical specialty

Directory of Open Access Journals (Sweden)

Patrícia Lacerda Bellodi

Full Text Available CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP. METHODS: A randomized sample of resident doctors in general medicine (30 and surgery (30 was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30% choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%. Most residents in both fields (73% general medicine, 70% surgery said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%, intellectual activities (30% and knowledge of the field (27%. For surgeons the main reasons were practical intervention (43%, manual activities (43% and the results obtained (40%. Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries

Medical student debt and major life choices other than specialty

Directory of Open Access Journals (Sweden)

James Rohlfing

2014-11-01

Full Text Available Background: Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Methods: Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students. No incentives were offered for survey completion. Results: Responses were recorded from 102 US Allopathic medical schools (n=3,032, with 22 institutions (11 public, 11 private meeting inclusion criteria of 10% student body response proportion (n=1,846. Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Conclusions: Medical student debt and particularly debt

Medical student debt and major life choices other than specialty.

Science.gov (United States)

Rohlfing, James; Navarro, Ryan; Maniya, Omar Z; Hughes, Byron D; Rogalsky, Derek K

2014-01-01

Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students). No incentives were offered for survey completion. Responses were recorded from 102 US Allopathic medical schools (n=3,032), with 22 institutions (11 public, 11 private) meeting inclusion criteria of 10% student body response proportion (n=1,846). Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Medical student debt and particularly debt relative to peers at the same institution appears to

Benchmarking specialty hospitals, a scoping review on theory and practice.

Science.gov (United States)

Wind, A; van Harten, W H

2017-04-04

Although benchmarking may improve hospital processes, research on this subject is limited. The aim of this study was to provide an overview of publications on benchmarking in specialty hospitals and a description of study characteristics. We searched PubMed and EMBASE for articles published in English in the last 10 years. Eligible articles described a project stating benchmarking as its objective and involving a specialty hospital or specific patient category; or those dealing with the methodology or evaluation of benchmarking. Of 1,817 articles identified in total, 24 were included in the study. Articles were categorized into: pathway benchmarking, institutional benchmarking, articles on benchmark methodology or -evaluation and benchmarking using a patient registry. There was a large degree of variability:(1) study designs were mostly descriptive and retrospective; (2) not all studies generated and showed data in sufficient detail; and (3) there was variety in whether a benchmarking model was just described or if quality improvement as a consequence of the benchmark was reported upon. Most of the studies that described a benchmark model described the use of benchmarking partners from the same industry category, sometimes from all over the world. Benchmarking seems to be more developed in eye hospitals, emergency departments and oncology specialty hospitals. Some studies showed promising improvement effects. However, the majority of the articles lacked a structured design, and did not report on benchmark outcomes. In order to evaluate the effectiveness of benchmarking to improve quality in specialty hospitals, robust and structured designs are needed including a follow up to check whether the benchmark study has led to improvements.

Radioisotopes and radiation technology

International Nuclear Information System (INIS)

Ramamoorthy, N.

2011-01-01

The field of radioisotopes and radiation processing has grown enormously all over the world with India being no exception. The chemistry and radiochemistry related inputs to the overall technology development and achievements have been, and will continue to be, of considerable value and importance in this multi-disciplinary and multi-specialty field. Harnessing further benefits as well as sustaining proven applications should be the goal in planning for the future. An objective analysis of the socio-economic impact and benefits from this field to the society at large will undoubtedly justify assigning continued high priority, and providing adequate resources and support, to relevant new projects and programmes on the anvil in the area of radioisotopes and radiation technology. It is necessary to nurture and strengthen inter-disciplinary and multi-specialty collaborations and cooperation - at both national and international level as a rule (not as exception) - for greater efficiency, cost-effectiveness and success of ongoing endeavors and future developments in this important field

Awareness and perception of the specialty of family medicine ...

African Journals Online (AJOL)

Background: Family Medicine is the medical specialty that provides ... the World Health Organization (WHO) has acknowledged the critical importance and positive ... This study evaluated the awareness, knowledge and perception of Family ...

Multibunch feedback: Strategy, technology and implementation options

International Nuclear Information System (INIS)

Fox, J.D.; Eisen, N.; Hindi, H.; Oxoby, G.; Sapozhnikov, L.; Linscott, I.; Serio, M.

1992-10-01

The proposed next generation accelerator and synchrotron light facilities will require active feedback systems to control multi-bunch instabilities. These feedback systems must operate in machines with thousands of circulating bunches and with short (2--4 ns) interbunch intervals. The functional requirements for transverse (betatron) and longitudinal (synchrotron) feedback systems are presented. Several possible implementation options are discussed and system requirements developed. Results are presented from a digital signal processing based synchrotron oscillation damper operating at the SSRL/SLAC SPEAR storage ring

Some theoretic elements about vocational guidance in the specialty Carpintería

Directory of Open Access Journals (Sweden)

Odelmi Miló García

2016-03-01

Full Text Available Presently article the methodological conceptual theoretical bases are presented that sustain in an essential way the cultural historical theory, The objective of the same one is to elaborate a methodological strategy for the development of the professional orientation toward the specialty carpentry in students of the first year of the Polytechnic Leonides Blanco González, being given the problem that the students are not motivated by the specialty.

Gender differences in specialty preference and mismatch with real needs in Japanese medical students

Directory of Open Access Journals (Sweden)

Harada Tadanari

2010-02-01

Full Text Available Abstract Background The shortage of doctors and maldistribution among specialties are of great concern in the Japanese health care system. This study investigated specialty preference in medical students of one university, and examined gender differences and compared their preference with real needs. Methods We conducted a self-administered questionnaire including specialty preference in all students of one medical university. Preference was assessed by the five-level probability of their future choice: 1 = very low, 2 = low, 3 = moderate, 4 = high, and 5 = very high. The proportion of 4 or 5 was calculated as the preference rate. The real needs (magnitude of doctor shortage in the prefecture were drawn from two different surveys. The relationship between the sex-specific preference rate by specialty and real needs was assessed by Spearman's correlation coefficient. Results Internal medicine showed the highest preference rate, followed by general surgery, pediatrics, and emergency medicine. There was no significant correlation between the preference rates of men and women (r = 0.27, p = 0.34. The preference rates for general surgery, orthopedics, neurosurgery, and emergency medicine were significantly higher in men than in women, while those of obstetrics & gynecology, pediatrics, and dermatology were significantly higher in women. The magnitude of doctor shortage by specialty from two surveys were significantly correlated with the total preference rate and men's preference rate (r = 0.54 to 0.74, but not with women's preference rate (r = 0.06 and 0.32. Conclusions This study elucidated not only gender differences in specialty preference but also the relationship to real needs. Critical gender differences and mismatch with real needs were found in women. In addition to traditional gender roles and insufficient support for women's participation in Japan, gender differences and mismatch influence the current and future maldistribution of

Emergency medicine journal impact factor and change compared to other medical and surgical specialties.

Science.gov (United States)

Reynolds, Joshua C; Menegazzi, James J; Yealy, Donald M

2012-11-01

A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time. The 2010 impact factors and 5-year impact factors for each journal indexed by the Thomson Reuters ISI Web of Knowledge Journal Citation Reports (JCR) were collected, and EM, medical, and surgical specialties were evaluated. The maximum, median, and interquartile range (IQR) of the current impact factor and 5-year impact factor in each journal category were determined, and specialties were ranked according to the summary statistics. The "top three" impact factor journals for each specialty were analyzed, and growth trends from 2001 through 2010 were examined with random effects linear regression. Data from 2,287 journals in 31 specialties were examined. There were 23 EM journals with a current maximum impact factor of 4.177, median of 1.269, and IQR of 0.400 to 2.176. Of 23 EM journals, 57% had a 5-year impact factor available, with a maximum of 4.531, median of 1.325, and IQR of 0.741 to 2.435. The top three EM journals had a mean standard deviation (±SD) impact factor of 3.801 (±0.621) and median of 4.142 and a mean (±SD) 5-year impact factor of 3.788 (±1.091) and median of 4.297, with a growth trend of 0.211 (95% confidence interval [CI] = 0.177 to 0.245; p journals ranked no higher than 24th among 31 specialties. Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties. © 2012 by the Society for Academic Emergency Medicine.

Technology options for future recycling

International Nuclear Information System (INIS)

Kikuchi, T.

2001-01-01

Recycling of nuclear material is indispensable, not only for using valuable resources but also for reducing the debt which we may leave to the next generations. Advanced reprocessing technologies have been developed in several countries to deal with the diversification of nuclear fuels. Also technologies derived from reprocessing or other fuel cycle areas have continued to be developed in terms of recycling. Cost effectiveness and waste-free processing are increasingly important factors in the applicable of an alternate recycling policy. This paper introduces an example of the studies in this field conducted in some countries including Japan and considers the establishment of effective recycling methodologies taking into account the uncertainty of future recycling policy. (author)

[The Problems with Domestic Introduction of rTMS from the Three Viewpoints of Scientific Evidence, Specialty and Social Responsibility].

Science.gov (United States)

Shinosaki, Kazuhiro

2015-01-01

The domestic introduction of rTMS is expected as a new treatment option for treatment-resistant depression. I discussed some problems with the introduction from three viewpoints : scientific evidence, specialty, and social responsibility. I surveyed scientific evidence for rTMS regarding the action mechanism, effectiveness, side effects, and its positioning in the treatment guidelines. To secure the quality of rTMS treatment, I proposed rTMS guidelines, nurturing of the specialists, and a center hospital plan, and pointed out some medium-term problems after its introduction and the consistency of rTMS treatment and standard depression treatment. From the viewpoint of social responsibility, rTMS treatment should be a medical service covered by health insurance to avoid its misuse. We should prepare to overcome the public suspicion of brain stimulation treatment for mental disease.

The hardness of the nuclear option in the Netherlands. A study on the occurrence of an abused technology

International Nuclear Information System (INIS)

Van Vugt, F.

2004-01-01

The central theme in this master's thesis is the tension between attempts aimed at phasing out the nuclear option and the resistance of the implied sociotechnical structures to this fundamental change. Nuclear option is the choice of a particular country for the generation of electricity by means of nuclear fission. This study is inspired by an empirical question: why is the intention of certain countries to phase out the nuclear option so difficult to realize. This intention is constantly the object of debate. This is shown by the delay of the planned decommissioning of the Barsebaeck-plant in Sweden, the statements of the director of Electrabel (the company that manages the Belgian nuclear plants) that the plants will not be closed on the dates that were dictated by the Belgian government and by the fact that the Borssele-plant in the Netherlands is still up and running despite a parliamentary decree dictating the closure of the plant on 31st of December 2003. Did policymakers responsible for the decision to phase out make a mistake concerning the constructability of reality? Why is it so difficult to change the technological status quo? What factors play a role in this resistance? These questions form the core of this study. To answer these questions use is made of the theoretical work of Anique Hommels. In her doctoral thesis (Unbuilding Cities: Obduracy in Urban Sociotechnical Change) she poses similar questions in relation to urban structures. Why are certain urban structures so hard to change? This resistance to change is expressed in the notion of obduracy. Hommels identifies four causations of this obduracy, which she expresses in four theoretical categories: (1) material obduracy, (2) obduracy caused by dominant ways of thinking, (3) obduracy as constituted by embeddedness, and (4) obduracy explained by persistent traditions. These notions are derived from the interdisciplinary research field of Science Technology and Society studies (STS). In this report

Emergency Contraception: A multi-specialty survey of clinician knowledge and practices

Science.gov (United States)

Batur, Pelin; Cleland, Kelly; McNamara, Megan; Wu, Justine; Pickle, Sarah

2015-01-01

Objectives To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods. Study Design A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3,260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression. Results The final sample included 1,684 providers (response rate = 51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide levonorgestrel EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide levonorgestrel, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods (UPA and copper IUD) were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC. Conclusions Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider-dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health. Implications In our sample of 1,684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of emergency contraception

Perception of 1 st year medical students towards career choices and specialty of psychiatry

Directory of Open Access Journals (Sweden)

Suneet Kumar Upadhyaya

2015-01-01

Full Text Available Background: Shortage of psychiatrists is a worldwide phenomenon. If the factors that attract or repel students towards a specialty can be identified, it may be possible to encourage them towards it. Choice of specialty as a career depends on the complex interplay of experiences before, during or after exposure to the specialty. Objectives: The aim was to understand perceptions of 1 st year medical students regarding career choices and the specialty of psychiatry through a cross-sectional questionnaire-based study. Materials and Methods: Perceptions of 137 1 st year medical students from the Government Medical College were recorded using a semi-structured questionnaire. Students provided their opinions about future career choices; perspective of these specialties in terms of financial reward, reputation, work-life balance, challenging aspect, ability to help patients effectively and emotional stability; their preferences in life and interaction with psychiatrist and its impact. Statistical Analysis Used: One-way analysis of variance (ANOVA with post-hoc analysis by Tukey-Kramer test. Results: Surgery was a high priority for 69 (50% while psychiatry was a high priority only for 11 (8%. Surgery was highest for financial reward and reputation, but lowest for work-life balance. Psychiatry had higher emotional stability, however, its the reputation was lower than surgery, medicine, obstetrics and gynaecology and paediatrics. Students preferred reputation (41% over social service opportunities (43%, work-life balance (16%, and high-income (11%. Interaction with psychiatrist increased inclination for psychiatry in 69% (9/13 students. Conclusions: Psychiatry is not a preferred specialty among 1 st year medical students due to its poor reputation.

When to Wait for More Evidence? Real Options Analysis in Proton Therapy

Science.gov (United States)

Abrams, Keith R.; de Ruysscher, Dirk; Pijls-Johannesma, Madelon; Peters, Hans J.M.; Beutner, Eric; Lambin, Philippe; Joore, Manuela A.

2011-01-01

Purpose. Trends suggest that cancer spending growth will accelerate. One method for controlling costs is to examine whether the benefits of new technologies are worth the extra costs. However, especially new and emerging technologies are often more costly, while limited clinical evidence of superiority is available. In that situation it is often unclear whether to adopt the new technology now, with the risk of investing in a suboptimal therapy, or to wait for more evidence, with the risk of withholding patients their optimal treatment. This trade-off is especially difficult when it is costly to reverse the decision to adopt a technology, as is the case for proton therapy. Real options analysis, a technique originating from financial economics, assists in making this trade-off. Methods. We examined whether to adopt proton therapy, as compared to stereotactic body radiotherapy, in the treatment of inoperable stage I non-small cell lung cancer. Three options are available: adopt without further research; adopt and undertake a trial; or delay adoption and undertake a trial. The decision depends on the expected net gain of each option, calculated by subtracting its total costs from its expected benefits. Results. In The Netherlands, adopt and trial was found to be the preferred option, with an optimal sample size of 200 patients. Increase of treatment costs abroad and costs of reversal altered the preferred option. Conclusion. We have shown that real options analysis provides a transparent method of weighing the costs and benefits of adopting and/or further researching new and expensive technologies. PMID:22147003

Technology options for future recycling

International Nuclear Information System (INIS)

Kikuchi, T.

2000-01-01

It goes without saying that recycling of nuclear material is indispensable, not only for the effective use of valuable resources but also to reduce the debt which we may leave to the next generations. Many developments in advanced reprocessing technologies have been carried out in several countries to deal with the diversification of nuclear fuels. Also technologies derived from reprocessing or other fuel cycle areas have continued to be developed in terms of recycling. Cost effectiveness and waste-free processing are increasingly important factors in the applicable of an alternate recycling policy. This paper introduces an example of the studies in this field, which has been conducted in Japan and considers the establishment of effective recycling methodologies taking into account the uncertainty of future policy. (authors)

Costing the EPR Project Using the Real Options Method

International Nuclear Information System (INIS)

Epaulard, Anne; Gallon, Stephane

2001-01-01

Real options theory makes it possible to cost investments which offer flexibility but whose returns are uncertain, such as the construction in 2000 of an EPR prototype; this prototype will enable the European pressurised-water reactor (EPR) to be used to renew EDF's nuclear power stations in 2020 (flexibility) but its economic worth will then depend on the cost of the competing gas-fired power plants (uncertain return). Options theory shows that investing in EPR technology in 2000 provides sufficient flexibility in 2020 to be considered cost-effective, even though use of EPRs is unlikely by that date. The investment made in 2000 to develop EPR technology therefore actually plays the part of an option or, in other words, insurance (against the risk of high gas prices)

[Prosthodontic specialty training in the United States: what can we learn].

Science.gov (United States)

Qing, H

2017-12-09

Prosthodontics is one of the nine recognized specialties by American Dental Association. The postgraduate prosthodontic program used to train prosthodontic specialists in U S A started about 70 years ago. Compared to China which just launched the dental residency programs, the programs in U S A have more developed and relatively more mature education system. It is worthwhile for China to study and learn the U S A prosthodontic residency education program. Prosthodontics is a specialty to diagnose and treat complex dental problems, and is often considered as the 'orchestrator' directing and coordinating all the other dental specialists to manage complex situations. This specialty plays an important role in a nation's oral health system. The present article is aimed to introduce the history of US prosthodontic residency program, initial accreditation, curriculum, education standards and mechanisms of the residency program, and how the program is monitored and managed post initial accreditation, with the hope that this system can serve as a reference for China's developing its own residency program.

Options for rural electrification in Mexico

International Nuclear Information System (INIS)

Vera, J.G.

1992-01-01

This paper summarizes a study which examined 19 commercially available options for electrifying remote communities in Mexico. Characteristics of a typical community are defined and, using 7 of the technologies, power systems are designed capable of supporting this community. The performance of these systems is evaluated with respect to their ability to satisfy 11 technical design objectives, 5 socioeconomic objectives, and their impact on the environment. A photovoltaic- diesel generator hybrid system with wind generator option is recommended for the typical community

An analysis of the medical specialty training system in Spain.

Science.gov (United States)

Freire, José-Manuel; Infante, Alberto; de Aguiar, Adriana Cavalcanti; Carbajo, Pilar

2015-06-02

In this paper, we analyse the medical specialty training system in Spain (the so-called "residency system"). In order to do so, we a) summarize its historical evolution; b) describe the five major architectural pillars on which the system is currently based; c) analyse the special contract of the specialist-in-training; d) discuss the three major challenges for the medical specialist training future: the evolution and expansion of the residency system to other health professions, the issue of grouping specialties with a common core trunk and the continuity of the learning process; and e) draw four conclusions that may be relevant for those who are in the process of developing or revising their own medical specialization systems.

International Medical Graduates in Radiation Oncology: Historical Trends and Comparison With Other Medical Specialties

Energy Technology Data Exchange (ETDEWEB)

Verma, Vivek, E-mail: vivek333@gmail.com [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Lautenschlaeger, Tim [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Lin, Chi [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Beriwal, Sushil [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Mehta, Minesh P. [Department of Radiation Oncology, Miami Cancer Institute, Coral Gables, Florida (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2016-07-15

Purpose: This is the first National Resident Matching Program analysis evaluating historical patterns of international medical graduates (IMGs) in radiation oncology (RO) and providing comparison with American (MD) medical graduates (AMGs), osteopathic students (DOs), unfilled positions, and other specialties. Methods and Materials: National Resident Matching Program data for IMGs were available from 2003 to 2015, with limited data for other specialty matches. The following RO-specific figures were obtained per year: total positions available; total matched positions; number of unfilled positions; and number of IMG, AMG, and DO matches. In addition, the number of IMG matches and total matched positions were obtained for 19 other specialties. Fisher exact tests and χ{sup 2} tests were considered significant at α <.05. Results: From 2010 to 2015, 0.8% of RO matches were IMGs, a decline from 2.4% in 2003 to 2009 (P=.006). Proportions of DO matches during these intervals increased by 40% (from 1.0% to 1.4%), significantly lower than IMGs for 2003 to 2009 (P=.03) but not 2010 to 2015 (P=.26). From 2003 to 2015, the percentage of IMG matches, at 1.5%, was significantly lower than the percentage of unfilled seats, at 3.5% (P<.001). In comparison with other specialties (2003-2015), RO had the fewest IMG matches (1.5%), followed by otolaryngology (1.9%) and orthopedics (2.2%); specialties with the highest IMG proportions were internal medicine (37.1%), family medicine (35.7%), and neurology (31.1%). Conclusions: Presently, IMGs represent <1% of RO matches, the lowest among major specialties. There are several speculative factors associated with this low proportion. There are significantly more unfilled positions than those filled by IMGs; programs at risk of not matching could weigh the advantages and disadvantages of interviewing IMGs.

The Implications of Real Options on ERP-Enabled Adoption

Science.gov (United States)

Nwankpa, Joseph K.

2012-01-01

Current research on Enterprise Resource Planning (ERP) systems and real options focuses on valuation and justification issues that manager's face prior to project approval with existing literature attempting to demonstrate that ERP systems as technology positioning investments have option-like characteristics thus making such ERP systems…

Technological and economic potential of poly(lactic acid) and lactic acid derivatives

Energy Technology Data Exchange (ETDEWEB)

Datta, R.; Tsai, S.P.; Bonsignore, P.; Moon, S.H.; Frank, J.R.

1993-10-01

Lactic acid has been an intermediate-volume specialty chemical (world production {approximately}40,000 tons/yr) used in a wide range of food processing and industrial applications. lactic acid h,as the potential of becoming a very large volume, commodity-chemical intermediate produced from renewable carbohydrates for use as feedstocks for biodegradable polymers, oxygenated chemicals, plant growth regulators, environmentally friendly ``green`` solvents, and specially chemical intermediates. In the past, efficient and economical technologies for the recovery and purification of lactic acid from crude fermentation broths and the conversion of tactic acid to the chemical or polymer intermediates had been the key technology impediments and main process cost centers. The development and deployment of novel separations technologies, such as electrodialysis (ED) with bipolar membranes, extractive distillations integrated with fermentation, and chemical conversion, can enable low-cost production with continuous processes in large-scale operations. The use of bipolar ED can virtually eliminate the salt or gypsum waste produced in the current lactic acid processes. In this paper, the recent technical advances in tactic and polylactic acid processes are discussed. The economic potential and manufacturing cost estimates of several products and process options are presented. The technical accomplishments at Argonne National Laboratory (ANL) and the future directions of this program at ANL are discussed.

[Impact of the Core Training Law on preventive medicine and public health training and other common medical specialties].

Science.gov (United States)

Latasa, Pello; Gil-Borrelli, Christian; Aguilera, José Antonio; Reques, Laura; Barreales, Saúl; Ojeda, Elena; Alemán, Guadalupe; Iniesta, Carlos; Gullón, Pedro

2016-01-01

The purpose of the Core Training Law (CTL) is to amend specialised medical training to include 24 months of common training. The aim of this study is to assess its potential impact on the Preventive Medicine and Public Health (PM&PH) training programme and other medical specialties. The programmes of the 21 common medical specialties were analysed and the recommended training periods for each specialty collected, before the information was agreed upon by three observers. The training impact was calculated as the percentage of months that should be amended per specialty to adapt to the common training schedule. The Preventive Medicine and Public Health training programme is the specialty most affected by the Core Training Law (100%, 24 months). Intensive medicine (0%, 0 months) and medical oncology (17%, 4 months) is the least affected. The CTL affects the common medical specialties in different ways and requires a complete reorganisation of the activities and competencies of PM&PH professionals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Knowledge of Medical House Officers about Dental Specialties ...

African Journals Online (AJOL)

Background: Some patients with oral diseases present initially to a general medical practitioner who is expected to refer the patients to the appropriate dental specialist for management. Thus they are expected to have a good knowledge of the different specialties in dentistry. This study was designed to determine the ...

Burnout Comparison among Residents in Different Medical Specialties

Science.gov (United States)

Martini, Shahm; Arfken, Cynthia L.; Churchill, Amy; Balon, Richard

2004-01-01

Objective: To investigate resident burnout in relation to work and home-related factors. Method: Maslach Burnout Inventory was mailed to residents in eight different medical specialties, with a response rate of 35%. Results: Overall, 50% of residents met burnout criteria, ranging from 75% (obstetrics/gynecology) to 27% (family medicine). The first…

Social media in the mentorship and networking of physicians: Important role for women in surgical specialties.

Science.gov (United States)

Luc, Jessica G Y; Stamp, Nikki L; Antonoff, Mara B

2018-04-01

Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described. A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics. 282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p media to build a network of same-sex mentorship (p = 0.031). Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution. Copyright © 2018 Elsevier Inc. All rights reserved.

Choice Options to Meet Household Food Security in the Cattle Corridor of Uganda

Directory of Open Access Journals (Sweden)

Betty Mbolanyi

2017-01-01

Full Text Available This study identified the major options adopted by households in the rangelands of Uganda to meet their food needs, the factors that affect their choices and barriers to making use of various choices. A cross-sectional survey using semi-structured questionnaires was administered among 180 pastoral households in selected rangeland area of Uganda. The options identified include restocking animals, changing planting dates, soil conservation, harnessing new technologies, planting trees and buying food stuffs. Analysis of results from the multinomial logistic model indicated that age, level of education, size of household, years in current location, farm income, non-farm income, livestock ownership, access to extension services and climate and weather information were key determinants of farmers’ choice of options to realize household food security. The major perceived barriers to choice options were lack of information on alternative options, poor technologies, climate variability, inadequate land, high food prices and low income. The analysis of choice of options to meet household food security suggests a number of different policy options such as strengthening production facilitation options available to pastoral communities including among others access to affordable credit, investing in yield-increasing technologies, introduction of livestock species that are better suited to drier conditions, raising awareness on climate related variations, creating opportunities for off-farm employment, encouraging pastoralists to grow more crops, and investing in irrigation.

Value-creating investment strategies to manage risk from structural market uncertainties: Switching and compound options in (V)HTR technologies - HTR2008-58157

International Nuclear Information System (INIS)

Lauferts, U.; Halbe, C.; Van Heek, A.

2008-01-01

To measure the value of a technology investment under uncertainty with standard techniques like net present value (NPV) or return on investment (ROI) will often uncover the difficulty to present convincing business case. Projected cash flows are inefficient or the discount rate chosen to compensate for the risk is so high, that it is disagreeable to the investor s requirements. Decision making and feasibility studies have to look beyond traditional analysis to reveal the strategic value of a technology investment. Here, a Real Option Analysis (ROA) offers a powerful alternative to standard discounted cash-flow (DCF) methodology by risk-adjusting the cash flow along the decision path rather than risk adjusting the discount rate. Within the GEN IV initiative attention is brought not only towards better sustainability, but also to broader industrial application and improved financing. Especially the HTR design is full of strategic optionalities: The high temperature output facilitates penetration into other non-electricity energy markets like industrial process heat applications and the hydrogen market. The flexibility to switch output in markets with multi-source uncertainties reduces downside risk and creates an additional value of over 50% with regard to the Net Present Value without flexibility. The supplement value of deploying a modular (V)HTR design adds over 100% to the project value using real option evaluation tools. Focus of this paper was to quantify the strategic value that comes along a) with the modular design; a design that offers managerial flexibility adapting a step-by-step investment strategy to the actual market demand and b) with the option to switch between two modes of operation, namely electricity and hydrogen production. We will demonstrate that the effect of uncertain electricity prices can be dampened down with a modular HTR design. By using a real option approach, we view the project as a series of compound options - each option depending

Propulsive options for a manned Mars transportation system

International Nuclear Information System (INIS)

Braun, R.D.; Blersch, D.J.

1989-01-01

In this investigation, five potential manned Mars transportation systems are compared. These options include: (1) a single vehicle, chemically propelled (CHEM) option, (2) a single vehicle, nuclear thermal propulsion (NTP) option, (3) a single vehicle solar electric propulsion (SEP) option, (4) a single vehicle hybrid nuclear electric propulsion (NEP)/CHEM option, and (5) a dual vehicle option (NEP cargo spacecraft and CHEM manned vehicle). In addition to utilizing the initial vehicle weight in low-earth orbit as a measure of mission feasibility, this study addresses the major technological barriers each propulsive scenario must surpass. It is shown that instead of a single clearly superior propulsion system, each means of propulsion may be favored depending upon the specified program policy and the extent of the desired manned flight time. Furthermore, the effect which aerobraking and multiple transfer cycles have upon mission feasibility is considered. 18 refs

Valuating Privacy with Option Pricing Theory

Science.gov (United States)

Berthold, Stefan; Böhme, Rainer

One of the key challenges in the information society is responsible handling of personal data. An often-cited reason why people fail to make rational decisions regarding their own informational privacy is the high uncertainty about future consequences of information disclosures today. This chapter builds an analogy to financial options and draws on principles of option pricing to account for this uncertainty in the valuation of privacy. For this purpose, the development of a data subject's personal attributes over time and the development of the attribute distribution in the population are modeled as two stochastic processes, which fit into the Binomial Option Pricing Model (BOPM). Possible applications of such valuation methods to guide decision support in future privacy-enhancing technologies (PETs) are sketched.

Gender inflexion in the construction of a new medical specialty

Directory of Open Access Journals (Sweden)

Rachel Aisengart Menezes

2008-01-01

Full Text Available This article presents the constitution of a new medical specialty, Palliative Care, directed to patients "out of therapeutic possibilities". The concept emerged around 1960 in England and was implemented in Brazil a couple of years before 1990. It is characterized by an active attendance of the dying process. It postulates a "spiritual assistance" to the patient and his/her family members, including the emotional universe. Ethnographical observation and interviews with Brazilian professionals showed a majority of women among the health teams involved in this proposal. This article discusses and analyses the connection between the construction of the specialty and gender representation among these professionals that reflects popular social images about death, beliefs, emotions and the roles played by women and men in these subjects.

Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

Science.gov (United States)

Kirschenbaum, Bonnie E

2009-12-15

To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a

Comparison of Women in Department Leadership in Obstetrics and Gynecology With Those in Other Specialties.

Science.gov (United States)

Hofler, Lisa G; Hacker, Michele R; Dodge, Laura E; Schutzberg, Rose; Ricciotti, Hope A

2016-03-01

To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of anesthesiology, diagnostic radiology, general surgery, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, and psychiatry. Each specialty's representation ratio-proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women-and 95% confidence interval (CI) were calculated. A ratio of 1 indicates proportionate representation. Women were significantly underrepresented among chairs for all specialties (ratios 0.60 or less, P≤.02) and division directors for all specialties except anesthesiology (ratio 1.13, 95% CI 0.87-1.46) and diagnostic radiology (ratio 0.97, 95% CI 0.81-1.16). The representation ratio for vice chair was below 1.0 for all specialties except anesthesiology; this finding reached statistical significance only for pathology, pediatrics, and psychiatry. Women were significantly overrepresented as residency program directors in general surgery, anesthesiology, obstetrics and gynecology, and pediatrics (ratios greater than 1.19, P≤.046). Obstetrics and gynecology and pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women. Despite having the largest proportion of leaders who were women, representation ratios demonstrate obstetrics and gynecology is behind other specialties in progression of women to departmental leadership. Women's overrepresentation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles.

Residents' views about family medicine specialty education in Turkey

Directory of Open Access Journals (Sweden)

Uzuner Arzu

2010-04-01

Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

Resident and program director gender distribution by specialty.

Science.gov (United States)

Long, Timothy R; Elliott, Beth A; Warner, Mary Ellen; Brown, Michael J; Rose, Steven H

2011-12-01

Although enrollment of women in U.S. medical schools has increased, women remain less likely to achieve senior academic rank, lead academic departments, or be appointed to national leadership positions. The purpose of this paper is to compare the gender distribution of residency program directors (PDs) with residents and faculty in the 10 largest specialties. The gender distribution of residents training in the 10 specialties with the largest enrollment was obtained from the annual education issue of Journal of the American Medical Association. The gender distribution of the residents was compared with the gender distribution of PDs and medical school faculty. The number of programs and the names of the PDs were identified by accessing the Accreditation Council for Graduate Medical Education web site. Gender was confirmed through electronic search of state medical board data, program web sites, or by using internet search engines. The gender distribution of medical school faculty was determined using the Association of American Medical Colleges faculty roster database (accessed June 15, 2011). The correlation between female residents and PDs was assessed using Pearson's product-moment correlation. The gender distribution of female PDs appointed June 1, 2006, through June 1, 2010, was compared with the distribution appointed before June 1, 2006, using chi square analysis. Specialties with higher percentages of female PDs had a higher percentage of female residents enrolled (r=0.81, p=0.005). The number of female PDs appointed from July 1, 2006, through June 30, 2010, was greater than the number appointed before July 1, 2006, in emergency medicine (pWomen remain underrepresented in PD appointments relative to the proportion of female medical school faculty and female residents. Mechanisms to address gender-based barriers to advancement should be considered.

76 FR 42112 - Specialty Crop Committee Stakeholder Listening Sessions

Science.gov (United States)

2011-07-18

... Specialty Crop Committee Stakeholder Listening Sessions AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening sessions. SUMMARY: In accordance with the Federal Advisory Committee Act, 5 U.S.C. App 2, the United States Department of Agriculture announces two stakeholder...

[A historical view of the specialty of clinical microbiology].

Science.gov (United States)

Pérez, Evelio Perea; Álvarez, Rogelio Martín

2010-10-01

Clinical microbiology today is a well established specialty in Spain whose development has necessarily been linked to improvements in the diagnosis, treatment and prevention of infectious diseases. Over time, clinical, teaching, and research structures have been organized around these diseases. In addition, a scientific society for specialists in infectious diseases (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica) has been set up, which in turn, publishes the journal ENFERMEDADES INFECCIOSAS Y MICROBIOLOGÍA CLÍNICA, and organizes congresses, meetings, working groups and a quality control program, etc. Clinical microbiologists will continue to be needed to meet future challenges (identification of new pathogenic microorganisms, methodological changes, diagnostic quality and speed, nosocomial infections, the development of antimicrobial resistance, etc.), which constitute a well-defined area of knowledge specific to our specialty. Copyright © 2010 Elsevier España S.L. All rights reserved.

Comparison of options for distributed generation in India

International Nuclear Information System (INIS)

Banerjee, Rangan

2006-01-01

There is renewed interest in distributed generation (DG). This paper reviews the different technological options available for DG, their current status and evaluates them based on the cost of generation and future potential in India. The non-renewable options considered are internal combustion engines fuelled by diesel, natural gas and microturbines and fuel cells fired by natural gas. The renewable technologies considered are wind, solar photovoltaic, biomass gasification and bagasse cogeneration. The cost of generation is dependent on the load factor and the discount rate. Gas engines and Bagasse based cogeneration are found to be the most cost effective DG options while wind and biomass gasifier fired engines are viable under certain conditions. PEM Fuel cells and micro turbines based on natural gas need a few demonstrations projects and cost reductions before becoming viable. A strategy involving pilot projects, tracking of costs and dissemination of information is likely to result in DG meeting 10% of India's power needs by 2012

Option valuation for energy issues

International Nuclear Information System (INIS)

Ostertag, K.; Llerena, P.; Richard, A.

2004-01-01

In many industrial and economic situations, decision processes, both individual and collective, have to simultaneously face uncertainty and irreversibility of some kind. This is particularly valid for energy choices if they are linked to technological alternatives. The purpose of this book is to highlight specific aspects of these situations. This is done from the particular perspective of option valuation. The contributions to this book grew out of an international workshop on ''Option valuation in energy and environmental issues'' held at the Fraunhofer ISI in February 2003. This workshop brought together reseachers from energy economics, but also researchers working on option valuation in other empirical fields or with a more theoretical perspective. This is reflected in the organisation of the book, which starts with some theory-oriented contributions and subsequently presents more applied contributions in the field of energy economics with an extension to water infrastructure in the annex. (orig.)

Energy options for residential buildings assessment

International Nuclear Information System (INIS)

Rezaie, Behnaz; Dincer, Ibrahim; Esmailzadeh, Ebrahim

2013-01-01

Highlights: ► Studying various building energy options. ► Assessing these options from various points. ► Comparing these options for better environment and sustainability. ► Proposing renewable energy options as potential solutions. - Abstract: The building sector, as one of the major energy consumers, demands most of the energy research to assess different energy options from various aspects. In this paper, two similar residential buildings, with either low or high energy consumption patterns, are chosen as case studies. For these case studies, three different renewable energy technology and three different hybrid systems are designed for a specified size. Then, the environmental impact indices, renewable energy indices, and the renewable exergy indices have been estimated for every energy options. Results obtained show that the hybrid systems (without considering the economics factors) are superior and having top indices. The importance of the energy consumption patterns in buildings are proven by the indices. By cutting the energy consumption to about 40% the environment index would increase by more than twice (2.1). Utilization of the non-fossil fuels is one part of the solution to environmental problems while energy conservation being the other. It has been shown that the re-design of the energy consumption model is less complex but more achievable for buildings.

Ideal versus real conditions for type 2 diabetes care : diabetes specialty nurses’ perspectives

OpenAIRE

Jutterström, Lena; Hällgren Graneheim, Ulla; Isaksson, Ulf; Hörnsten, Åsa

2012-01-01

Background: Since diabetes specialty nurses are the professionals who spend the most time with patients living with diabetes, they probably have the greatest influence on the quality of diabetes care. Therefore, their personal perceptions about what constitutes “good care” in type 2 diabetes care are important to explore. Aim: The aim of this study was to describe conditions for “good care” in type 2-diabetes as perceived by diabetes specialty nurses. Method: Twenty-one experienced diabetes s...

Providing Specialty Care for the Poor and Underserved at Student-Run Free Clinics in the San Francisco Bay Area.

Science.gov (United States)

Liu, Max Bolun; Xiong, Grace; Boggiano, Victoria Lynn; Ye, Patrick Peiyong; Lin, Steven

2017-01-01

This report describes the model of specialty clinics implemented at Stanford University's two student-run free clinics, Arbor Free Clinic and Pacific Free Clinic, in the San Francisco Bay Area. We describe our patient demographic characteristics and the specialty services provided. We discuss challenges in implementing specialty care at student-run free clinics.

Meals at medical specialty society annual meetings: a preliminary assessment.

Science.gov (United States)

La Puma, John; Schiedermayer, David; Becker, Jennifer

2003-01-01

Little isd known about how meals are chosen for medical meetings. We surveyed the annual meeting planners for 20 major specialty societies. Thirteen (65%) responded; all were currently planning their next meeting. Attendance in 2000 was reported at 113,477 physicians, with 2 million planned meals and snacks. No physician was named as responsible for food choices; the meeting planner and staff were primarily responsible for deciding what food to serve, excluding exhibit halls. Twelve (92%) respondents rated "available budget" as the most important factor. "Nutritional guidelines" were rated "very important" by eight of 13 (63%). However, no specific nutritional guidelines could be identified by any planner. All respondents indicated that members would attend a meeting if "healthy" food were the only option. For 2000, 100% of respondents indicated that for each lunch and for each dinner, a dessert had been included. No annual meeting and no planned 2001 meeting excluded potato chips, snack mixes, or candies at breaks; soda pop was offered at each break. Most respondents (89%) relied on a concluding questionnaire about the meeting facilities to evaluate the food. Respondents reported no difference in charges for "special meals," including vegetarian and kosher meals. Physicians may be unaware that some food served at medical meetings may impair learning, with excessive calorie, fat, and carbohydrate consumption. Small changes can improve the quality of food and beverages selected, without increased cost, and provide choices that conform to national nutritional guidelines. Medical meetings should serve flavorful, healthful food.

Improving the communication between teams managing boarded patients on a surgical specialty ward.

Science.gov (United States)

Puvaneswaralingam, Shobitha; Ross, Daniella

2016-01-01

Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope

The safeguards options study

Energy Technology Data Exchange (ETDEWEB)

Hakkila, E.A.; Mullen, M.F.; Olinger, C.T.; Stanbro, W.D. [Los Alamos National Lab., NM (United States); Olsen, A.P.; Roche, C.T.; Rudolph, R.R. [Argonne National Lab., IL (United States); Bieber, A.M.; Lemley, J. [Brookhaven National Lab., Upton, NY (United States); Filby, E. [Idaho National Engineering Lab., Idaho Falls, ID (United States)] [and others

1995-04-01

The Safeguards Options Study was initiated to aid the International Safeguards Division (ISD) of the DOE Office of Arms Control and Nonproliferation in developing its programs in enhanced international safeguards. The goal was to provide a technical basis for the ISD program in this area. The Safeguards Options Study has been a cooperative effort among ten organizations. These are Argonne National Laboratory, Brookhaven National Laboratory, Idaho National Engineering Laboratory, Lawrence Livermore National Laboratory, Los Alamos National Laboratory, Mound Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratories, Sandia National Laboratories, and Special Technologies Laboratory. Much of the Motivation for the Safeguards Options Study is the recognition after the Iraq experience that there are deficiencies in the present approach to international safeguards. While under International Atomic Energy Agency (IAEA) safeguards at their declared facilities, Iraq was able to develop a significant weapons program without being noticed. This is because negotiated safeguards only applied at declared sites. Even so, their nuclear weapons program clearly conflicted with Iraq`s obligations under the Nuclear Nonproliferation Treaty (NPT) as a nonnuclear weapon state.

The safeguards options study

International Nuclear Information System (INIS)

Hakkila, E.A.; Mullen, M.F.; Olinger, C.T.; Stanbro, W.D.; Olsen, A.P.; Roche, C.T.; Rudolph, R.R.; Bieber, A.M.; Lemley, J.; Filby, E.

1995-04-01

The Safeguards Options Study was initiated to aid the International Safeguards Division (ISD) of the DOE Office of Arms Control and Nonproliferation in developing its programs in enhanced international safeguards. The goal was to provide a technical basis for the ISD program in this area. The Safeguards Options Study has been a cooperative effort among ten organizations. These are Argonne National Laboratory, Brookhaven National Laboratory, Idaho National Engineering Laboratory, Lawrence Livermore National Laboratory, Los Alamos National Laboratory, Mound Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratories, Sandia National Laboratories, and Special Technologies Laboratory. Much of the Motivation for the Safeguards Options Study is the recognition after the Iraq experience that there are deficiencies in the present approach to international safeguards. While under International Atomic Energy Agency (IAEA) safeguards at their declared facilities, Iraq was able to develop a significant weapons program without being noticed. This is because negotiated safeguards only applied at declared sites. Even so, their nuclear weapons program clearly conflicted with Iraq's obligations under the Nuclear Nonproliferation Treaty (NPT) as a nonnuclear weapon state

77 FR 6584 - Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of...

Science.gov (United States)

2012-02-08

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,511] Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of Affirmative Determination Regarding... Assistance (TAA) applicable to workers and former workers of Specialty Bar Products Company, a subsidiary of...

Contemplating future energy options

International Nuclear Information System (INIS)

Pooley, D.

2005-01-01

All political parties in the UK accept that we should move away from our reliance on fossil fuels towards a much greater use of alternative energy technologies. Nuclear power is one of these but finds minimal support in the political spectrum. The article reviews the European Commission's Advisory Group on Energy submission to the EC's report entitled 'Key Tasks for European Energy R and D'. The 'strength and weaknesses' of the various 'alternative energy' systems (including nuclear power) are summarised and then the key R and D tasks which, if they are carried out successfully, should make the eight selected technologies significantly more attractive. However, the message here is clear enough: there are no easy options, only a range of very imperfect possibilities, despite what enthusiastic proponents of each may say. Nuclear fission is certainly one of the most attractive options available, but the industry needs to continue to strive to eliminate the possibility of significant off-site releases, whether caused by plant failure or by human error or intention, and to prove beyond reasonable doubt the safety of high-level radioactive waste disposal. (author)

Options for electric power generation and distribution in developing countries: proceedings of the GTDC symposium'95

International Nuclear Information System (INIS)

1995-01-01

This book contains the proceedings of the symposium on options for electric power generation and distribution in developing countries organised by Global Technology Development Centre (GTDC), Vienna in cooperation with Agency for Non-Conventional Energy and Rural Technology (ANERT), Thiruvananthapuram. The focus of the symposium was on problems of electricity generation and distribution mainly in the developing countries of the world and the issues addressed included : 1) an overview of existing electric power services; 2) options on fuel and technology; 3) options on operation of electricity utilities; 4) options on financing investments and planning of capacity extension or replacement. Papers relevant to INIS are indexed separately

Emergency medicine as a specialty in Asia.

Science.gov (United States)

Pek, Jen Heng; Lim, Swee Han; Ho, Hiu Fai; Ramakrishnan, T V; Jamaluddin, Sabariah Faizah; Mesa-Gaerlan, Faith Joan C; Tiru, Mohan; Hwang, Sung Oh; Choi, Wai-Mau; Kanchanasut, Somchai; Khruekarnchana, Pairoj; Avsarogullari, Levent; Shimazu, Takeshi; Hori, Shingo

2016-04-01

We aim to examine the similarities and differences in areas of EM development, workload, workforce, and capabilities and support in the Asia region. Emerging challenges faced by our EM community are also discussed. The National Societies for Emergency Medicine of Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand and Turkey participated in the joint Japanese Association of Acute Medicine (JAAM) and Asian Conference of Emergency Medicine (ACEM) Special Symposium held in October 2013 at Tokyo, Japan. The findings are reviewed in this paper. Emergency medicine (EM) has over the years evolved into a distinct and recognized medical discipline requiring a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. EM has contributed to healthcare by providing effective, safe, efficient and cost-effective patient care. Integrated systems have developed to allow continuity of emergency care from the community into emergency departments. Structured training curriculum for undergraduates, and specialty training programs for postgraduates are in place to equip trainees with the knowledge and skills required for the unique practice of EM. The practice of EM still varies among the Asian countries. However, as a region, we strive to continue in our efforts to develop the specialty and improve the delivery of EM.

Gender difference in preference of specialty as a career choice among Japanese medical students

Directory of Open Access Journals (Sweden)

Ryuichi Kawamoto

2016-11-01

Full Text Available Abstract Background In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. Methods A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34 years and 227 men aged 22 ± 4 (range, 18–44 years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons. Results Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR of “technical & research specialty” and a low OR for “personal reasons” were associated with preference for surgery. “Technical & research specialty” was positively associated with preference for special internal medicine and negatively for pediatrics. “Work-life balance” was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, “technical & research specialty” was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and “job security” was positively associated for general medicine/family medicine and negatively for psychology. Among men only, “educational experience” and “personal reasons” were positively, and “job security” was negatively associated with preference for pediatrics. For both genders, �

Operational experience with DICOM for the clinical specialties in the healthcare enterprise

Science.gov (United States)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2004-04-01

A number of clinical specialties routinely use images in treating patients, for example ophthalmology, dentistry, cardiology, endoscopy, and surgery. These images are captured by a variety of commercial digital image acquisition systems. The US Department of Veterans Affairs has been working for several years on advancing the use of the Digital Imaging and Communications in Medicine (DICOM) Standard in these clinical specialties. This is an effort that has involved several facets: (1) working with the vendors to ensure that they satisfy existing DICOM requirements, (2) developing interface software to the VistA hospital information system (HIS), (3) field testing DICOM systems, (4) deploying these DICOM interfaces nation-wide to all VA medical centers, (5) working with the healthcare providers using the system, and (6) participating in the DICOM working groups to improve the standard. The VA is now beginning to develop clinical applications that make use of the DICOM interfaces in the clinical specialties. The first of these will be in ophthalmology to remotely screen patients for diabetic retinopathy.

E-cigarette specialty retailers: Data to assess the association between retail environment and student e-cigarette use

OpenAIRE

Georgiana Bostean; Catherine M. Crespi; Patsornkarn Vorapharuek; William J. McCarthy

2017-01-01

The retail environment is a major social determinant of health, yet little is known about the e-cigarette specialty retailer environment. The e-cigarette specialty retail environment may be associated with e-cigarette use by middle and high school students, an issue that was addressed in a recent article entitled, ?E-cigarette use among students and e-cigarette specialty retailer presence near schools,? by Bostean and colleagues (G. Bostean, C.M. Crespi, P. Vorapharuek, W.J. McCarthy, 2016 [1...

Gender Inflexion in the Construction of a New Medical Specialty

Directory of Open Access Journals (Sweden)

Rachel Aisengart Menezes

2007-09-01

Full Text Available This article presents the constitution of a new medical specialty, Palliative Care, directed to patients “out of therapeutic possibilities”. The concept emerged around 1960 in England and was implemented in Brazil a couple of years before 1990. It is characterized by an active attendance of the dying process. It postulates a “spiritual assistance” to the patient and his/her family members, including the emotional universe. Ethnographical observation and interviews with Brazilian professionals showed a majority of women among the health teams involved in this proposal. This article discusses and analyses the connection between the construction of the specialty and gender representation among these professionals that reflects popular social images about death, beliefs, emotions and the roles played by women and men in these subjects.

Adjust or invest : what is the best option to green a supply chain?

NARCIS (Netherlands)

Bouchery, Y.; Ghaffari, A.; Jemai, Z.; Dallery, Y.

2011-01-01

Greening a supply chain can be achieved by considering several options. However, companies lack of clear guidelines to assess and compare these options. In this paper, we propose to use multiobjective optimization to assess operational adjustment and technology investment options in terms of cost

Are new medical students' specialty preferences gendered? Related motivational factors at a Dutch medical school.

Science.gov (United States)

van Tongeren-Alers, Margret; van Esch, Maartje; Verdonk, Petra; Johansson, Eva; Hamberg, Katarina; Lagro-Janssen, Toine

2011-01-01

Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know importance stipulated to motivational factors. Our study investigates new medical students' early specialization preferences and motivational factors. New students at a Dutch medical school (n = 657) filled in a questionnaire about specialty preferences (response rate = 94%; 69.5% female, 30.5% male). The students chose out of internal medicine, psychiatry, neurology, pediatrics, surgery, gynecology and family medicine, "other" or "I don't know." Finally, they valued ten motivational factors. Forty percent of the medical students reported no specialty preference yet. Taken together, female medical students preferred pediatrics and wished to combine work and care, whereas male students opted for surgery and valued career opportunities. Gender-driven professional preferences in new medical students should be noticed in order to use competencies. Changes in specialty preferences and motivational factors in pre- and post graduates should further assess the role of medical education.

Future European Expendable Launcher Options and Technology Preparation

OpenAIRE

Sippel, Martin; van Foreest, Arnold; Klevanski, Josef; Gerstmann, Jens; Dutheil, Jean-Philippe; Jäger, Markus; Philip, Peter

2008-01-01

The paper describes latest results of the most recent activities in Germany in the technical assessment of future European launcher architecture. In a joint effort of DLR-SART with German launcher industry a next generation upper-medium class expendable TSTO and options for new liquid fuel upper stages for the small VEGA-launcher are addressed. The WOTAN study has investigated fully cryogenic launchers as well as those with a combination of solid and cryogenic stages, fulfilling a requirement...

APPLICATION OF CLOUD TECHNOLOGY IN THE STOMATOLOGISTS EDUCATIONAL PROCESS

Directory of Open Access Journals (Sweden)

Oksana A. Zorina

2016-01-01

Full Text Available Study the possibility of applying cloud technologies for the control of knowledge and the certification of specialists has been studied in the framework of realization of educational programs of internship and residency training in dental specialties. It was found that the management of the educational process in online mode is possible on the basis of distance education technologies using cloud technology. 

Beyond yields: Climate change effects on specialty crop quality and agroecological management

Directory of Open Access Journals (Sweden)

Selena Ahmed

2016-03-01

Full Text Available Abstract Climate change is impacting the sustainability of food systems through shifts in natural and human dimensions of agroecosystems that influence farmer livelihoods, consumer choices, and food security. This paper highlights the need for climate studies on specialty crops to focus not only on yields, but also on quality, as well as the ability of agroecological management to buffer climate effects on quality parameters. Crop quality refers to phytonutrient and secondary metabolite profiles and associated health and sensory properties that influence consumer buying decisions. Through two literature reviews, we provide examples of specialty crops that are vulnerable to climate effects on quality and examples of climate-resilient agroecological strategies. A range of specialty crops including fruits, vegetables, tree nuts, stimulants, and herbs were identified to respond to climate variables with changes in quality. The review on climate-resilient strategies to mitigate effects on crop quality highlighted a major gap in the literature. However, agricultural diversification emerged as a promising strategy for climate resilience more broadly and highlights the need for future research to assess the potential of diversified agroecosystems to buffer climate effects on crop quality. We integrate the concepts from our literature review within a socio-ecological systems framework that takes into account feedbacks between crop quality, consumer responses, and agroecosystem management. The presented framework is especially useful for two themes in agricultural development and marketing, nutrition-sensitive agriculture and terroir, for informing the design of climate-change resilient specialty crop systems focused on management of quality and other ecosystem services towards promoting environmental and human wellbeing.

Pain medicine: The case for an independent medical specialty and training programs.

Science.gov (United States)

Dubois, Michel Y; Follett, Kenneth A

2014-06-01

Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety.

Preparation for a postgraduate specialty examination by medical students in Turkey: processes and sources of anxiety.

Science.gov (United States)

Turan, Sevgi; Üner, Sarp

2015-01-01

PHENOMENON: Interns in Turkey must endeavor to study for a specialty exam during their internship. The preparation process for the specialty exam and the effect of this process on the students' anxiety has not been studied comprehensively. The purpose of this study was to evaluate the interns' preparation time for the specialty exam, their perception of how the preparation process affects their training, and which factors are related to their test anxiety. A cross-sectional study was conducted with 6th-year students (interns). A questionnaire asked participants to report health status, academic achievement, exam-related anxiety, and trait anxiety. Two open-ended questions asked about views regarding the specialty exam. Multiple linear regression was used to identify the significant predictors of anxiety level due to the exam. The average duration of exam preparations of participating interns (n = 214) was 16.8 months and 14.3 hours/week. Participating interns' health status, economic level, perception of academic achievement, time allocated to study for the exam, time remaining until the exam, and trait anxiety level demonstrated a relationship with anxiety level due to the exam (R =.35, R(2) =.13, p anxiety level. The internship curriculum, requirements, and timing of the specialty exam should be reconsidered.

The preference of radiology as a postgraduate medical specialty ...

African Journals Online (AJOL)

Background: Recruitment into medical specialties outside the core clinical departments remains a stumbling block to advancing medical practice in Nigeria. We set out to determine the factors influencing choice of diagnostic radiology as a field of specialization by the final year medical students in Usmanu Danfodiyo ...

[A scintillating specialty. Excerpts from the history of nuclear medicine in Denmark].

Science.gov (United States)

Hess, Søren

2010-01-01

Nuclear medicine is among the youngest medical specialties but its history spans more than a century. From the earliest discoveries of radioactivity and the establishment of the novel field of nuclear physics at the turn of the twentieth century and via the developments in radiochemistry set in motion by George de Hevesy from his base in Copenhagen to the specialty of today offering a multitude of diagnostic procedures. The present work is not intended to cover the entire history of nuclear medicine exhaustively but focus on pivotal events in the development of the field with special reference to Denmark.

Urology – a specialty that will be faced by all future doctors

Directory of Open Access Journals (Sweden)

Miah S

2016-01-01

Full Text Available Saiful Miah,1 Karl H Pang2 1Department of Urology, Royal Hallamshire Hospital, 2Academic Urology Unit, School of Medicine and Biomedical Sciences at the University of Sheffield, Sheffield, UKWe read with great interest the articles by Shah, and Ah-kee and Khan regarding the various potential methods that could increase the exposure of undergraduate medical students to smaller specialties.1,2 We would like to draw attention to a small but high clinical volume specialty, ie, urology.Read the original article by ShahRead the original article by Ah-kee and Khan 

Impact of Cost-Sharing Increases on Continuity of Specialty Drug Use: A Quasi-Experimental Study.

Science.gov (United States)

Li, Pengxiang; Hu, Tianyan; Yu, Xinyan; Chahin, Salim; Dahodwala, Nabila; Blum, Marissa; Pettit, Amy R; Doshi, Jalpa A

2017-07-24

To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). Five percent Medicare claims data (2007-2010). Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6.30 copayment) in both the pre- and postperiods. Key variables were extracted from Medicare data. Relative to the LIS group, the non-LIS group had a greater increase in incidence of 30-day continuous gaps in any Part D treatment from the lower cost-sharing period to the higher cost-sharing period (MS, absolute increase = 10.1 percent, OR = 1.61, 95% CI 1.19-2.17; RA, absolute increase = 21.9 percent, OR = 2.75, 95% CI 2.15-3.51). The increase in Part D treatment gaps was not offset by increased Part B specialty drug use. Cost-sharing increases due to specialty tier-level cost sharing were associated with interruptions in MS and RA specialty drug treatments. © Health Research and Educational Trust.

Effectiveness of technological options for minimising production ...

African Journals Online (AJOL)

Farmer perceptions of technology effectiveness, to some extent, agreed with econometric evidence from this study. Study results have two implications: firstly, the need to develop and disseminate location specific adaptation technologies to reduce production risks, instead of blanket recommendations of similar adaptation ...

Energy options

International Nuclear Information System (INIS)

Hampton, Michael

1999-01-01

This chapter focuses on energy options as a means of managing exposure to energy prices. An intuitive approach to energy options is presented, and traditional definitions of call and put options are given. The relationship between options and swaps, option value and option exercises, commodity options, and option pricing are described. An end-user's guide to energy option strategy is outlined, and straight options, collars, participating swaps and collars, bull and bear spreads, and swaption are examined. Panels explaining the defining of basis risk, and discussing option pricing and the Greeks, delta hedging, managing oil options using the Black-Scholes model, caps, floors and collars, and guidelines on hedging versus speculation with options are included in the paper

Fuel options for oil sands

International Nuclear Information System (INIS)

Wise, T.

2005-01-01

This presentation examined fuel options in relation to oil sands production. Options include steam and hydrogen (H 2 ) for upgrading; natural gas by pipeline; bitumen; petroleum coke; and coal. Various cost drivers were also considered for each of the fuel options. It was noted that natural gas has high energy value but the capital cost is low, and that coke's energy value is very low but the capital cost is high. A chart forecasting energy prices was presented. The disposition of Western Canada's northern gas situation was presented. Issues concerning rail transportation for coal were considered. Environmental concerns were also examined. A chart of typical gas requirements for 75,000 B/D oil sands projects was presented. Issues concerning steam generation with gas and mining cogeneration with gas fuel and steam turbines were discussed, as well as cogeneration and H 2 with gas fuels and steam turbines. Various technology and fuel utility options were examined, along with details of equipment and processes. Boiler technologies were reviewed by type as well as fuel and steam quality and pressure. Charts of cogeneration with gas turbine and circulation fluid bed boilers were presented. Gasification processes were reviewed and a supply cost basis was examined. Cost drivers were ranked according to energy, operating considerations and capital investment. Results indicated that fuel costs were significant for gas and coal. Capital costs and capital recovery charge was most significant with coal and gasification technology. Without capital recovery, cash costs favour the use of bitumen and coke. Gasification would need lower capital and lower capital recovery to compete with direct burning. It was concluded that direct burning of bitumen can compete with natural gas. With price volatility anticipated, dual fuel capability for bitumen and gas has merit. Petroleum coke can be produced or retrieved from stockpiles. Utility supply costs of direct burning of coke is

Future Choice of Specialty among Students in a Caribbean Medical ...

African Journals Online (AJOL)

Background: The medical specialities chosen by medical students for their careers play an important part in ... data, generic factors considered as important in their specialty choice as well as factors that influence the students\\' attractiveness to ...

High and specialty-related musculoskeletal disorders afflict dental professionals even since early training years

Directory of Open Access Journals (Sweden)

Jianru YI

2013-07-01

Full Text Available OBJECTIVE: To determine how early musculoskeletal disorders (MSDs develop in dental professionals and to explore the potential differences among distinct dental specialties. MATERIAL AND METHODS: 271 dental postgraduates majoring in five dental specialties were recruited, i.e., orthodontics, prosthodontics, endodontics, periodontics and alveolar surgery. 254 age-matched non-dental postgraduates served as the control. The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors (only for dental postgraduates were answered through emails. Reliability of responses was assessed applying test-retest method. RESULTS: The intraclass correlation coefficient of participants' answers ranged from 0.89 to 0.96. Dental postgraduates had significantly higher prevalence of MSDs than the control group, especially at neck, upper back and lower back. In all dental specialties included, high prevalence of MSDs was reported at neck (47.5%-69.8%, shoulders (50.8%-65.1%, lower back (27.1%-51.2% and upper back (25.6%-46.5%, with lower prevalence at elbows (5.1%-18.6%, hips (3.4%-16.3% and ankles (5.1%-11.6%. Periodontics students reported the worst MSDs in most body regions except wrists and knees, which were more prevalent for prosthodontic and alveolar surgery students, respectively. Furthermore, year of clinical work, clinical hours per week and desk hours per week were found as risk factors for MSDs, whereas physical exercise and rest between patients as protective factors. CONCLUSIONS: High and specialty-related MSDs afflict dental professionals even since very early stage of careers. Prevention aimed at the specialty-related characteristics and the risk/protective factors revealed in this study should be introduced to dental personnel as early as possible.

Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

Science.gov (United States)

Ward, Lawrence; Powell, Rhea E; Scharf, Michael L; Chapman, Andrew; Kavuru, Mani

2017-04-01

Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption. Copyright © 2017. Published by Elsevier Inc.

Surgical resident perceptions of trauma surgery as a specialty.

Science.gov (United States)

Hadzikadic, Lejla; Burke, Peter A; Esposito, Thomas J; Agarwal, Suresh

2010-05-01

Presenting the opinions of surgical residents about the appeal of trauma surgery as a specialty may influence current reform. Survey study. Academic research. General surgery residents (postgraduate years 1-5 and recent graduates) registered with the American College of Surgeons. A 22-item survey. Career plans and perceptions about trauma surgery as a specialty. Of 6006 mailed surveys, we had a 20.1% response rate. Midlevel residents comprised most of the respondents, and most were undecided about their career choice or planned to enter general surgical private practice. The typical residency programs represented were academic (81.7%), urban (90.6%), and level I trauma centers (78.7%), and included more than 6 months of trauma experience (77.6%). Most respondents (70.6%) thought that trauma surgery was unappealing. The most important deterrents to entering the field were lifestyle, poor reimbursement, and limited operating room exposure, while increased surgical critical care was not seen as a restriction. When questioned about the future of trauma surgery, they believed that trauma surgeons should perform elective (86.8%) and nontrauma emergency (91.5%) cases and would benefit from active association with an outpatient clinic (76.0%). Intellectual challenge and exciting nature of the field were listed as the most appealing aspects, and ideal practice characteristics included guaranteed salary and time away from work. As demand for trauma surgeons increases, resident interest has dwindled. As a specialty, trauma surgery must undergo changes that reflect the needs of the incoming generation. We present a sampling of current surgical resident opinion and offer these data to assist the changing discipline and the evolving field of acute care surgery.

Integrated assessment of bioelectricity technology options

International Nuclear Information System (INIS)

Thornley, Patricia; Upham, Paul; Huang, Ye; Rezvani, Sina; Brammer, John; Rogers, John

2009-01-01

Power generation from biomass is a sustainable energy technology which can contribute to substantial reductions in greenhouse gas emissions, but with greater potential for environmental, economic and social impacts than most other renewable energy technologies. It is important therefore in assessing bioenergy systems to take account of not only technical, but also environmental, economic and social parameters on a common basis. This work addresses the challenge of analysing, quantifying and comparing these factors for bioenergy power generation systems. A life-cycle approach is used to analyse the technical, environmental, economic and social impacts of entire bioelectricity systems, with a number of life-cycle indicators as outputs to facilitate cross-comparison. The results show that similar greenhouse gas savings are achieved with the wide variety of technologies and scales studied, but land-use efficiency of greenhouse gas savings and specific airborne emissions varied substantially. Also, while specific investment costs and electricity costs vary substantially from one system to another the number of jobs created per unit of electricity delivered remains roughly constant. Recorded views of stakeholders illustrate that diverging priorities exist for different stakeholder groups and this will influence appropriate choice of bioenergy systems for different applications

Advanced Demonstration and Test Reactor Options Study

Energy Technology Data Exchange (ETDEWEB)

Petti, David Andrew [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hill, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Gehin, J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Gougar, Hans David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Strydom, Gerhard [Idaho National Lab. (INL), Idaho Falls, ID (United States); Heidet, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Kinsey, J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Grandy, Christopher [Argonne National Lab. (ANL), Argonne, IL (United States); Qualls, A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brown, Nicholas [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Powers, J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hoffman, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Croson, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2017-01-01

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power’s share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercialization of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy’s (DOE’s) broader commitment to pursuing an “all of the above” clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate “advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy�

Advanced Demonstration and Test Reactor Options Study

International Nuclear Information System (INIS)

Petti, David Andrew; Hill, R.; Gehin, J.; Gougar, Hans David; Strydom, Gerhard; Heidet, F.; Kinsey, J.; Grandy, Christopher; Qualls, A.; Brown, Nicholas; Powers, J.; Hoffman, E.; Croson, D.

2017-01-01

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power's share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercialization of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy's (DOE's) broader commitment to pursuing an 'all of the above' clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate 'advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy'. Advanced reactors are

Topical anaesthesia in children: reducing the need for specialty referral.

LENUS (Irish Health Repository)

O'Connor, Gabrielle

2012-01-31

OBJECTIVE: The management of wounds in children is stressful, not only for the child, but also for parents and staff. In our Emergency Department (ED), we currently do not have a paediatric sedation policy, and thus children requiring suturing, not amenable to distraction and infiltrative anaesthesia, are referred to specialty teams for general anaesthesia. We proposed that the introduction of a topical anaesthetic gel (lidocaine, adrenaline, tetracaine - LAT) might help to reduce the number of referrals, by allowing the ED staff to perform the procedures, in combination with nonpharmacological approaches. METHODS: We carried out a retrospective review of ED records of all children aged 14 years or less attending with wounds, over an 8-month period, from 01 May 2007 to 31 January 2008. RESULTS: Two hundred and one (50.6%) patients presented before the introduction of LAT gel, whereas 196 (49.3%) patients presented afterwards. A total of 39 (19.4%) patients were referred for specialty review pre-LAT, whereas only 19 (9.7%) patients were referred in the LAT group. Of these, 31 (15.4%) pre-LAT and 15 (7.7%) LAT group required general anaesthesia. There is a significant difference between these two groups, using Fischer\\'s exact test, P=0.018. CONCLUSION: We have found that the introduction of topical anaesthetic gel in ED has significantly reduced the number of children with wounds referred to specialty teams for general anaesthesia. This has important implications for patient safety and hospital resources.

Shale oil specialty markets: Screening survey for United States applications

Energy Technology Data Exchange (ETDEWEB)

1987-12-01

EG and G requested J. E. Sinor Consultants Inc. to carry out an initial screening study on the possibilities for producing specialty chemicals from oil shale. Raw shale oil is not an acceptable feedstock to refineries and there are not enough user of heavy fuel oil in the western oil shale region to provide a dependable market. The only alternatives are to hydrotreat the oil, or else ship it long distances to a larger market area. Either of these alternatives results in a cost penalty of several dollars per barrel. Instead of attempting to enter the large-volume petroleum products market, it was hypothesized that a small shale oil facility might be able to produce specialty chemicals with a high enough average value to absorb the high costs of shipping small quantities to distant markets and still provide a higher netback to the plant site than sales to the conventional petroleum products market. This approach, rather than attempting to refine shale oil or to modify its characteristics to satisfy the specifications for petroleum feedstocks or products, focuses instead on those particular characteristics which distinguish shale oil from petroleum, and attempts to identify applications which would justify a premium value for those distinctive characteristics. Because byproducts or specialty chemicals production has been a prominent feature of oil shale industries which have flourished for periods of time in various countries, a brief review of those industries provides a starting point for this study. 9 figs., 32 tabs.

Nurse specialty subcultures and patient outcomes in acute care hospitals: A multiple-group structural equation modeling.

Science.gov (United States)

Mallidou, Anastasia A; Cummings, Greta G; Estabrooks, Carole A; Giovannetti, Phyllis B

2011-01-01

Hospital organizational culture is widely held to matter to the delivery of services, their effectiveness, and system performance in general. However, little empirical evidence exists to support that culture affects provider and patient outcomes; even less evidence exists to support how this occurs. To explore causal relationships and mechanisms between nursing specialty subcultures and selected patient outcomes (i.e., quality of care, adverse patient events). Martin's differentiation perspective of culture (nested subcultures within organizations) was used as a theoretical framework to develop and test a model. Hospital nurse subcultures were identified as being reflected in formal practices (i.e., satisfactory salary, continuing education, quality assurance program, preceptorship), informal practices (i.e., autonomy, control over practice, nurse-physician relationships), and content themes (i.e., emotional exhaustion). A series of structural equation models were assessed using LISREL on a large nurse survey database representing four specialties (i.e., medical, surgical, intensive care, emergency) in acute care hospitals in Alberta, Canada. Nursing specialty subcultures differentially influenced patient outcomes. Specifically, quality of care (a) was affected by nurses' control over practice, (b) was better in intensive care than in medical specialty, and (c) was related to lower adverse patient events; nurses in intensive care and emergency specialties reported fewer adverse events than did their counterparts in medical specialties. Understanding the meaning of subcultures in clinical settings would influence nurses and administrators efforts to implement clinical change and affect outcomes. More research is needed on nested subcultures within healthcare organizations for better understanding differentiated subspecialty effects on complexity of care and outcomes in hospitals. Copyright © 2010 Elsevier Ltd. All rights reserved.

PTV VISSIM SIMULATION SOFTWARE USE FOR PROFESSIONALS IN «TRANSPORT TECHNOLOGIES» AND «AUTOMOBILE TRANSPORT» SPECIALTIES TRAINING

Directory of Open Access Journals (Sweden)

Volodymyr O. Sistuk

2016-05-01

Full Text Available The prospect of training quality improving of bachelors and masters in «Automobile transport» and «Transport technologies» specialties was considered, basing on the use of simulation software in the educational process. A review of the software products market was prepared, with the result of the component PTV VISSIM pre-selection. The simulation model of a real crossroad was developed to demonstrate its capabilities. Based on the analysis of application functions aptness to the city transport network complex objects simulation requirements, the expediency of the solution use during vocational certificate credit courses of students of Transport Faculty of Kryvyi Rih National University was grounded.

The Effect of Medical Student Volunteering in a Student-Run Clinic on Specialty Choice for Residency.

Science.gov (United States)

Brown, Ashley; Ismail, Rahim; Gookin, Glenn; Hernandez, Caridad; Logan, Grace; Pasarica, Magdalena

2017-01-09

 Student-run free clinics (SRFCs) are a recent popular addition to medical school education, and a subset of studies has looked at the influence of SRFC volunteering on the medical student's career development. The majority of the research done in this area has focused on understanding if these SRFCs produce physicians who are more likely to practice medicine in underserved communities, caring for the uninsured. The remainder of the research has investigated if volunteering in an SRFC influences the specialty choice of medical school students. The results of these specialty choice studies give no definitive answer as to whether medical students chose primary or specialty care residencies as a result of their SRFC experience. Keeping Neighbors in Good Health through Service (KNIGHTS) is the SRFC of the University of Central Florida College of Medicine (UCF COM). Both primary and specialty care is offered at the clinic. It is the goal of this study to determine if volunteering in the KNIGHTS SRFC influences UCF COM medical students to choose primary care, thereby helping to meet the rising need for primary care physicians in the United States.  A survey was distributed to first, second, and third-year medical students at the UCF COM to collect data on demographics, prior volunteering experience, and specialty choice for residency. Responses were then combined with records of volunteer hours from the KNIGHTS Clinic and analyzed for correlations. We analyzed the frequency and Pearson's chi-squared values. A p value of less than 0.05 was considered statistically significant.  Our survey had a total response rate of 39.8%. We found that neither the act of becoming a KNIGHTS Clinic volunteer nor the hours volunteered at the KNIGHTS Clinic influenced the UCF COM student's choice to enter a primary care specialty (p = NS). Additionally, prior volunteering/clinical experience or the gender of the medical school student did not influence a student's choice to volunteer at

Just fun or a prejudice? - physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students.

Science.gov (United States)

Harendza, Sigrid; Pyra, Martin

2017-07-26

Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search. In total, 36 characteristics of the five specialties of anesthesia, general surgery, internal medicine, orthopedics, and psychiatry were extracted from the jokes and they constituted the basis for the development of an online questionnaire. The questionnaire allowed each characteristic to be assigned to one of the five specialties and was sent to 999 undergraduate medical students from semester 1, 7, and 12 at the Medical Faculty of Hamburg University. Three hundred eight (30.8%) of the invited students completed the survey. The characteristics of general surgeons and psychiatrists were assigned congruently most frequently (>50%). For internists and orthopedics, there was a significantly more congruent assignment of the characteristics by final year students versus students in their first semester. Male students assigned the characteristics of anesthetists and internists significantly more congruently than female students. The three characteristics "…are a bit slow on the uptake", "…consider income to be relatively unimportant", and "...apologize a lot" were not assigned to any of the five specialties by more than 50% of the students. While stereotypes about physicians from certain specialties seem to exist commonly, medical educators need to be aware that stereotypes about specialties might develop during undergraduate medical training. In order to support students in their

The dynamics of triads in aggregated journal-journal citation relations: specialty developments at the above-journal level

NARCIS (Netherlands)

de Nooy, W.; Leydesdorff, L.

2015-01-01

Dyads of journals—related by citations—can agglomerate into specialties through the mechanism of triadic closure. Using the Journal Citation Reports 2011, 2012, and 2013, we analyze triad formation as indicators of integration (specialty growth) and disintegration (restructuring). The strongest

CANDU Digital Control Computer upgrade options

International Nuclear Information System (INIS)

De Jong, M.S.; De Grosbois, J.; Qian, T.

1997-01-01

This paper reviews the evolution of Digital Control Computers (DCC) in CANDU power plants to the present day. Much of this evolution has been to meeting changing control or display requirements as well as the replacement of obsolete, or old and less reliable technology with better equipment that is now available. The current work at AECL and Canadian utilities to investigate DCC upgrade options, alternatives, and strategies are examined. The dependence of a particular upgrade strategy on the overall plant refurbishment plans are also discussed. Presently, the upgrade options range from replacement of individual obsolete system components, to replacement of the entire DCC hardware without changing the software, to complete replacement of the DCCs with a functionally equivalent system using new control computer equipment and software. Key issues, constraints and objectives associated with these DCC upgrade options are highlighted. (author)

76 FR 22733 - Cable Statutory License: Specialty Station List

Science.gov (United States)

2011-04-22

... Counsel, Copyright GC/I&R, P.O. Box 70400, Southwest Station, Washington, DC 20024. Telephone: (202) 707... foreign- language, religious, and/or automated programming in one-third of the hours of an average... programming comports with the 1981 FCC definition, and hence, qualifies it as a specialty station. 55 FR 40021...

Personality and Values as Predictors of Medical Specialty Choice

Science.gov (United States)

Taber, Brian J.; Hartung, Paul J.; Borges, Nicole J.

2011-01-01

Research rarely considers the combined influence of personality traits and values in predicting behavioral outcomes. We aimed to advance a germinal line of inquiry that addresses this gap by separately and simultaneously examining personality traits and physician work values to predict medical specialty choice. First-year medical students (125…

Disposal options for disused radioactive sources

International Nuclear Information System (INIS)

2005-01-01

This report presents a review of relevant information on the various technical factors and issues, as well as approaches and relevant technologies, leading to the identification of potential disposal options for disused radioactive sources. The report attempts to provide a logical 'road map' for the disposal of disused radioactive sources, taking into consideration the high degree of variability in the radiological properties of such types of radioactive waste. The use of borehole or shaft type repositories is highlighted as a potential disposal option, particularly for those countries that have limited resources and are looking for a simple, safe and cost effective solution for the disposal of their radioactive source inventories. It offers information about usage and characteristics of radioactive sources, disposal considerations, identification and screening of disposal options as well as waste packaging and acceptance criteria for disposal. The information provided in the report could be adapted or adopted to identify and develop specific disposal options suitable for the type and inventory of radioactive sources kept in storage in a given Member State

Detecting clinically relevant new information in clinical notes across specialties and settings.

Science.gov (United States)

Zhang, Rui; Pakhomov, Serguei V S; Arsoniadis, Elliot G; Lee, Janet T; Wang, Yan; Melton, Genevieve B

2017-07-05

Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient. A corpus of 591 progress notes over 40 inpatient admissions was annotated for new information longitudinally by physicians to generate a reference standard. Note redundancy between various specialties was evaluated on 71,021 outpatient notes and 64,695 inpatient notes from 500 solid organ transplant patients (April 2015 through August 2015). Our best method achieved at best performance of 0.87 recall, 0.62 precision, and 0.72 F-measure. Addition of semantic similarity metrics compared to baseline improved recall but otherwise resulted in similar performance. While outpatient and inpatient notes had relatively similar levels of high redundancy (61% and 68%, respectively), redundancy differed by author specialty with mean redundancy of 75%, 66%, 57%, and 55% observed in pediatric, internal medicine, psychiatry and surgical notes, respectively. Automated techniques with statistical language models for detecting redundant versus clinically relevant new information in clinical notes do not improve with the addition of semantic similarity measures. While levels of redundancy seem relatively similar in the inpatient and ambulatory settings in the Fairview Health Services, clinical note redundancy appears to vary significantly with different medical specialties.

Advanced radioisotope power source options for Pluto Express

International Nuclear Information System (INIS)

Underwood, M.L.

1995-01-01

In the drive to reduce mass and cost, Pluto Express is investigating using an advanced power conversion technology in a small Radioisotope Power Source (RPS) to deliver the required mission power of 74 W(electric) at end of mission. Until this year the baseline power source under consideration has been a Radioisotope Thermoelectric Generator (RTG). This RTG would be a scaled down GPHS RTG with an inventory of 6 General Purpose Heat Sources (GPHS) and a mass of 17.8 kg. High efficiency, advanced technology conversion options are being examined to lower the power source mass and to reduce the amount of radioisotope needed. Three technologies are being considered as the advanced converter technology: the Alkali Metal Thermal-to-Electric Converter (AMTEC), Thermophotovoltaic (TPV) converters, and Stirling Engines. Conceptual designs for each of these options have been prepared. Each converter would require only 2 GPHSs to provide the mission power and would have a mass of 6.1, 7.2, and 12.4 kg for AMTEC, TPV, and Stirling Engines respectively. This paper reviews the status of each technology and the projected performance of an advanced RPS based on each technology. Based on the projected performance and spacecraft integration issues, Pluto Express would prefer to use the AMTEC based RPS. However, in addition to technical performance, selection of a power technology will be based on many other factors

IPM of specialty crops and community gardens in north Florida

Science.gov (United States)

Insect pests post serious challenges to specialty crops (vegetables, fruits and nut crops) and community gardens in North Florida. The major vegetable pests include silverleaf whitefly, Bemisia argentifolii; the green peach aphid, Myzus persicae; southeastern green stinkbug, Nezara viridula; brown s...

Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

Science.gov (United States)

Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

2007-08-01

Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

48 CFR 552.217-71 - Notice Regarding Option(s).

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

‎ Factors Affecting the Choice of Psychiatry as a Specialty in ‎Psychiatry Residents in Iran

Science.gov (United States)

Sadr, Seyed Saeed; Nayerifard‎‎, Razieh; Samimi Ardestani, Seyed Mehdi; Namjoo, Massood

2016-01-01

Objective: The aim of this study was to investigate the current factors affecting the choice of ‎psychiatry as a specialty and to detect the main factors in their choice.‎ Method: This descriptive study included 75 first year psychiatry residents in the academic year of ‎‎2014/2015. A Likert-type anonymous questionnaire consisting of academic and ‎demographic data with 43 questions, which evaluated the reason for choosing ‎psychiatry as a specialty, was given to the residents.‎ Results: The participants had a positive opinion about 28 items of the questionnaire, meaning that ‎these items had a positive effect in choosing psychiatry as a specialty (questions with P ‎value less than 0.05 and a positive mean). More than 80% of the residents had a positive ‎opinion about six items of the questionnaire (amount of intellectual challenge, variety of ‎knowledge fields relevant to psychiatry, emphasis on the patient as a whole person, the ‎importance of treating mental illnesses in the future, work pressure and stress of the ‎field during residency and coordinating with the person's life style). The participants ‎had a negative opinion about two items of the questionnaire (questions with a P value ‎less than 0.05 and a negative mean). They included experiencing mental illness ‎personally through relatives or close friends as well as the income in psychiatry. ‎Moreover, 36% of the residents with a more definite opinion mentioned that they chose ‎psychiatry as a specialty because of the limitations in residency exam.‎ Conclusion: Assistants had a positive opinion about most of the questions and this positive attitude ‎seemed to be an important factor in their specialty choice. However, attending to the ‎preventing factors may increase the selection of psychiatry as a specialty.‎ PMID:27928251

Bioenergy options. Multidisciplinary participatory method for assessing bioenergy options for rural villages in Tanzania

Energy Technology Data Exchange (ETDEWEB)

Kauzeni, A S; Masao, H P; Sawe, E N; Shechambo, F C [Dar Es Salaam Univ. (Tanzania). Inst. of Resource Assessment; Ellegaard, A [Stockholm Environment Inst. (Sweden)

1999-12-31

In Tanzania, like in many other developing countries in Southern and Eastern Africa, bioenergy planning has received relatively little attention, compared to planning for `modern` energy sources, although it accounts for about 90% of the country`s energy supply. As a result there is less understanding of the complexity and diversity of bioenergy systems. There is a lack of reliable data and information on bio-resources, their consumption and interaction with social, economic, institutional and environmental factors. This is largely due to lack of adequately developed and easily understood methods of data and information development, analysis and methods of evaluating available bioenergy options. In order to address the above constraints a project was initiated where the general objective was to develop and test a multi-disciplinary research method for identifying bioenergy options that can contribute to satisfying the energy needs of the rural household, agricultural and small scale industrial sectors, promote growth and facilitate sustainable development. The decision on the development and testing of a multidisciplinary research method was based on the fact that in Tanzania several bioenergy programmes have been introduced e.g. tree planting, improved cookstoves, biogas, improved charcoal making kilns etc. for various purposes including combating deforestation; promoting economic growth, substitution of imported petroleum fuels, health improvement, and raising standards of living. However efforts made in introducing these programmes or interventions have met with limited success. This situation prevails because developed bioenergy technologies are not being adopted in adequate numbers by the target groups. There are some indications from the study that some of the real barriers to effective bioenergy interventions or adoption of bioenergy technologies lie at the policy level and not at the project level. After the development and testing of the methodology

Bioenergy options. Multidisciplinary participatory method for assessing bioenergy options for rural villages in Tanzania

Energy Technology Data Exchange (ETDEWEB)

Kauzeni, A.S.; Masao, H.P.; Sawe, E.N.; Shechambo, F.C. [Dar Es Salaam Univ. (Tanzania). Inst. of Resource Assessment; Ellegaard, A. [Stockholm Environment Inst. (Sweden)

1998-12-31

In Tanzania, like in many other developing countries in Southern and Eastern Africa, bioenergy planning has received relatively little attention, compared to planning for `modern` energy sources, although it accounts for about 90% of the country`s energy supply. As a result there is less understanding of the complexity and diversity of bioenergy systems. There is a lack of reliable data and information on bio-resources, their consumption and interaction with social, economic, institutional and environmental factors. This is largely due to lack of adequately developed and easily understood methods of data and information development, analysis and methods of evaluating available bioenergy options. In order to address the above constraints a project was initiated where the general objective was to develop and test a multi-disciplinary research method for identifying bioenergy options that can contribute to satisfying the energy needs of the rural household, agricultural and small scale industrial sectors, promote growth and facilitate sustainable development. The decision on the development and testing of a multidisciplinary research method was based on the fact that in Tanzania several bioenergy programmes have been introduced e.g. tree planting, improved cookstoves, biogas, improved charcoal making kilns etc. for various purposes including combating deforestation; promoting economic growth, substitution of imported petroleum fuels, health improvement, and raising standards of living. However efforts made in introducing these programmes or interventions have met with limited success. This situation prevails because developed bioenergy technologies are not being adopted in adequate numbers by the target groups. There are some indications from the study that some of the real barriers to effective bioenergy interventions or adoption of bioenergy technologies lie at the policy level and not at the project level. After the development and testing of the methodology

Bioengineering in renal transplantation: technological advances and novel options.

Science.gov (United States)

Yeo, Wee-Song; Zhang, Yao-Chun

2017-06-06

End-stage kidney disease (ESKD) is one of the most prevalent diseases in the world with significant morbidity and mortality. Current modes of renal replacement therapy include dialysis and renal transplantation. Although dialysis is an acceptable mode of renal replacement therapy, it does have its shortcomings, which include poorer life expectancy compared with renal transplantation, risk of infections and vascular thrombosis, lack of vascular access and absence of biosynthetic functions of the kidney. Renal transplantation, in contrast, is the preferred option of renal replacement therapy, with improved morbidity and mortality rates and quality of life, compared with dialysis. Renal transplantation, however, may not be available to all patients with ESKD. Some of the key factors limiting the availability and efficiency of renal transplantation include shortage of donor organs and the constant risk of rejection with complications associated with over-immunosuppression respectively. This review focuses chiefly on the potential roles of bioengineering in overcoming limitations in renal transplantation via the development of cell-based bioartificial dialysis devices as bridging options before renal transplantation, and the development of new sources of organs utilizing cell and organ engineering.

The Impact of HIV/AIDS Epidemic on the Choice of Specialties ...

African Journals Online (AJOL)

The Impact of HIV/AIDS Epidemic on the Choice of Specialties among Medical ... satisfaction and favourable work schedule respectively. ... We recommend improvements in the work environment and adherence to universal precautions to

The recognition of radiation protection training as a professional specialty

International Nuclear Information System (INIS)

Touzet, R. E.

2003-01-01

After Chernobyl accident, the radiation protection training was recognized as a professional specialty. To improve this training we focussed the project in 3 points: - The recognition of radiation protective in the legislation. - Stablishment of minimum programs - Different categories: nuclear facilities, radioisotopes and radiopharmaceuticals

Assessing Student Interest and Familiarity with Professional Psychology Specialty Areas

Science.gov (United States)

Stark-Wroblewski, Kimberly; Wiggins, Tina L.; Ryan, Joseph J.

2006-01-01

The present study examined undergraduate psychology students' (N = 83) self-reported interest in and familiarity with five specialty areas in professional psychology: counseling psychology, clinical psychology, school psychology, forensic psychology, and criminal profiling. Results suggest that although students are quite interested in careers…

Identification of the real options in a program of nuclear plants

International Nuclear Information System (INIS)

Camacho G, D.; Diaz N, M. J.; Reinking C, A.

2008-01-01

The development of our societies and our economies this intimately related to electric power and this as well with the generating sources, due to the projection of world-wide growth should go associate with a strategy of growth of energy generation. Considering to the nuclear power as an option to satisfy the energy needs that a country can provide two main immediate benefits: The stabilization of prices of security of provision of electric power of the nation. The care of the environment, since the gas discharges greenhouse are almost null. At the moment nuclear energy represents economically a viable option for the capital investment, taking into account the development from technology, the policies implemented by the state and the prices of other fuels. Due to the great investment that its require for the nuclear plants are necessary to use financial tools that allow to analyze the future scenes in which ours investment can be seen affected and to value the flexibility of being able to enlarge, to postpone or to stop our project in order to have majors profits or to diminish the lost ones. This valuation of the flexibility can be obtained from the called method Real Options. By analysis of Real Options the process is understood to apply to the methodology of the Financial Options to the valuation of projects or the management of real assets. The Real Options appear in flexible plans, projects, activities or enterprise investments, like for example, to leave or to sell the investment project before concluding it, changing to their use or its technology, to prolong their life, the option to choose, one or the other capacity, among others possibilities. In this work is an example of the application of the method of Real Options in the decision to invest or to defer the investment for the construction of a nuclear plant following the behavior of the tariffs in the market or the costs of generation of other technologies with which a nuclear plant competes. (Author)

Robotic technologies in surgical oncology training and practice.

Science.gov (United States)

Orvieto, Marcelo A; Marchetti, Pablo; Castillo, Octavio A; Coelho, Rafael F; Chauhan, Sanket; Rocco, Bernardo; Ardila, Bobby; Mathe, Mary; Patel, Vipul R

2011-09-01

The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor. Since the first reported robot-assisted surgical procedure performed in 1985, the technology has dramatically evolved and currently multiple surgical specialties have incorporated RS into their daily clinical armamentarium. With this exponential growth, it should not come as a surprise the ever growing requirement for surgeons trained in RS as well as the interest from residents to receive robotic exposure during their training. For this reason, the establishment of set criteria for adequate and standardized training and credentialing of surgical residents, fellows and those trained surgeons wishing to perform RS has become a priority. In this rapidly evolving field, we herein review the past, present and future of robotic technologies and its penetration into different surgical specialties. Copyright © 2010 Elsevier Ltd. All rights reserved.

Best practices across surgical specialties relating to simulation-based training.

Science.gov (United States)

Gardner, Aimee K; Scott, Daniel J; Pedowitz, Robert A; Sweet, Robert M; Feins, Richard H; Deutsch, Ellen S; Sachdeva, Ajit K

2015-11-01

Simulation-based training is playing an increasingly important role in surgery. However, there is insufficient discussion among the surgical specialties regarding how simulation may best be leveraged for training. There is much to be learned from one another as we all strive to meet new requirements within the context of Undergraduate Medical Education, Graduate Medical Education, and Continuing Medical Education. To address this need, a panel was convened at the 6th Annual Meeting of the Consortium of the American College of Surgeons-Accredited Education Institutes consisting of key leaders in the field of simulation from 4 surgical subspecialties, namely, general surgery, orthopedic surgery, cardiothoracic surgery, urology, and otolaryngology. An overview of how the 5 surgical specialties are using simulation-based training to meet a wide array of educational needs for all levels of learners is presented. Copyright © 2015 Elsevier Inc. All rights reserved.

Is hybridic positron emission tomography/computerized tomography the only option? The future of nuclear medicine and molecular imaging.

Science.gov (United States)

Grammaticos, Philip; Zerva, Cherry; Asteriadis, Ioannis; Trontzos, Christos; Hatziioannou, Kostas

2007-01-01

sources of radiation" b) nuclear radiation and c) molecular nuclear medicine. The "European Journal of Nuclear Medicine and Molecular Imaging" shall have to erase the three last words of its title and be renamed. As Professor Abass Alavi et al (2007), have mentioned: "Is PET/CT the only option?" In favor of PET/CT are the following: Attenuation correction (AC) and better anatomical localization of lesions visualized with PET. Also PET/CT can be used as a diagnostic CT scanner (dCT). Against using the PET/CT scanners are the following arguments: a) This equipment is not necessary because we can always ask the Radiologists for a dCT scan. Many patients have already done a dCT scan at the time they are referred for a PET scan to the Nuclear Medicine Department. b) The absolute clinical indications for PET/CT with the use of a contrast agent, are under investigation. c) Although there is at present a list of indications suggested for the PET/CT scanner, there are studies disputing some of these indications, as for example in metastatic colon cancer where a high diagnostic accuracy for PET study alone, has been reported. d) The option of AC performed by the PET/CT scanner has also been questioned. Artifacts may be up to 84%. e) The PET/CT is expensive, time consuming, space occupying, and needs additional medical and technical personnel. f) Not to mention the extra radiation dose to the patients. g) Shall we inform those young medical students who wish to become nuclear medicine physicians, to hold their decision till the content of future Nuclear Medicine is clarified? We may suggest that: Our specialty could be renamed as: "Clinical Nuclear Medicine" and include additional "proper certified education" on the PET/CT equipment. The PET/CT scanner should remain in the Nuclear Medicine Department where Radiologists could act as advisors.

Analysis of Technology Options to Reduce the Fuel Consumption of Idling Trucks; FINAL

International Nuclear Information System (INIS)

Stodolsky, F.; Gaines, L.; Vyas, A.

2000-01-01

Long-haul trucks idling overnight consume more than 838 million gallons (20 million barrels) of fuel annually. Idling also emits pollutants. Truck drivers idle their engines primarily to (1) heat or cool the cab and/or sleeper, (2) keep the fuel warm in winter, and (3) keep the engine warm in the winter so that the engine is easier to start. Alternatives to overnight idling could save much of this fuel, reduce emissions, and cut operating costs. Several fuel-efficient alternatives to idling are available to provide heating and cooling: (1) direct-fired heater for cab/sleeper heating, with or without storage cooling; (2) auxiliary power units; and (3) truck stop electrification. Many of these technologies have drawbacks that limit market acceptance. Options that supply electricity are economically viable for trucks that are idled for 1,000-3,000 or more hours a year, while heater units could be used across the board. Payback times for fleets, which would receive quantity discounts on the prices, would be somewhat shorter

An Investigation into the Current State and Direction of the Development of the Russian Language as a Specialty in China’s Comprehensive Universities

Directory of Open Access Journals (Sweden)

Guo Lijun

2014-06-01

Full Text Available Chinese comprehensive universities will face the stern tenet of the development of Russian as a specialty. Connecting this specialty with the advantage of the development of university disciplines and taking one’s own path of building the Russian language specialty using one’s own know-hows and accomplishments is an important issue instructors of Russians are going to have to tackle. This article analyzes the major tenet of the development of the Russian language specialty in comprehensive universities. The article provides the author’s speculations and proposes a countermeasure in respect of the development of the Russian language specialty in comprehensive universities, which, the author hopes, will help the cause of the development of the Russian language specialty in comprehensive universities.

Access to specialty mental health services among women in California.

Science.gov (United States)

Kimerling, Rachel; Baumrind, Nikki

2005-06-01

The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.

Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

Science.gov (United States)

Hay, Casey M; Lefkowits, Carolyn; Crowley-Matoka, Megan; Bakitas, Marie A; Clark, Leslie H; Duska, Linda R; Urban, Renata R; Creasy, Stephanie L; Schenker, Yael

2017-09-01

Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016. Thirty-four gynecologic oncologists participated in semistructured telephone interviews focusing on attitudes, experiences, and practices related to outpatient palliative care. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework. This analysis focuses on practices for introducing palliative care. Mean participant age was 47 years (standard deviation, 10 years). Mean interview length was 25 minutes (standard deviation, 7 minutes). Gynecologic oncologists described the following three main strategies for introducing outpatient specialty palliative care: focus initial palliative care referral on symptom management to dissociate palliative care from end-of-life care and facilitate early relationship building with palliative care clinicians; use a strong physician-patient relationship and patient trust to increase acceptance of referral; and explain and normalize palliative care referral to address negative associations and decrease patient fear of abandonment. These strategies aim to decrease negative patient associations and encourage acceptance of early referral to palliative care specialists. Gynecologic oncologists have developed strategies for introducing palliative care services to alleviate patient concerns. These strategies provide groundwork for developing system-wide best practice approaches to the presentation of palliative care referral.

Options for Energy Conservation and Emission Reductions in Transportation Means for Goods Distribution

DEFF Research Database (Denmark)

Jørgensen, Kaj

1996-01-01

The report contains an analysis of the technological options and potentials for development of transportation means with low energy consumption and emissions. The main focus is on transportation means utilised in the distribution of groceries.......The report contains an analysis of the technological options and potentials for development of transportation means with low energy consumption and emissions. The main focus is on transportation means utilised in the distribution of groceries....

Factors influencing medical students' choice of emergency medicine as a career specialty-a descriptive study of Saudi medical students.

Science.gov (United States)

Alkhaneen, Hadeel; Alhusain, Faisal; Alshahri, Khalid; Al Jerian, Nawfal

2018-03-07

Choosing a medical specialty is a poorly understood process. Although studies conducted around the world have attempted to identify the factors that affect medical students' choice of specialty, data is scarce on the factors that influence the choice of specialty of Saudi Arabian medical students, in particular those planning a career in emergency medicine (EM). In this study, we investigated whether Saudi medical students choosing EM are influenced by different factors to those choosing other specialties. A cross-sectional survey was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia. The questionnaire distributed among all undergraduate and postgraduate medical students of both sexes in the second and third phases (57% were males and 43% were females). A total of 436 students answered the questionnaire, a response rate of 53.4%. EM group was most influenced by hospital orientation and lifestyle and least influenced by social orientation and prestige provided by their specialty. Unlike controllable lifestyle (CL) group and primary care (PC) group, EM reported lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical subspecialties (SS), EM group were less likely to report prestige as an important influence. Moreover, students interested in SS reported a leaser influence of medical lifestyle in comparison to EM group. When compared with CL group, EM group reported more interest in medical lifestyle. We found that students primarily interested in EM had different values and career expectations to other specialty groups. The trends in specialty choice should be appraised to meet future needs.

Chapter 7: Renewable Energy Options and Considerations for Net Zero Installations

Energy Technology Data Exchange (ETDEWEB)

Booth, Samuel

2017-03-15

This chapter focuses on renewable energy options for military installations. It discusses typical renewable technologies, project development, and gives examples. Renewable energy can be combined with conventional energy sources to provide part or all of the energy demand at an installation. The appropriate technology mix for an installation will depend on site-specific factors such as renewable resources, energy costs, local energy policies and incentives, available land, mission compatibility, and other factors. The objective of this chapter is to provide basic background information and resources on renewable energy options for NATO leaders and energy personnel.

48 CFR 252.225-7008 - Restriction on Acquisition of Specialty Metals.

Science.gov (United States)

2010-10-01

... CLAUSES Text of Provisions And Clauses 252.225-7008 Restriction on Acquisition of Specialty Metals. As... more of the following limits: Manganese, 1.65 percent; silicon, 0.60 percent; or copper, 0.60 percent...

Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children

Science.gov (United States)

... Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children Past Issues / Fall 2014 Table of ... old problem: the fertility needs of young cancer patients. The word itself was coined through NIH-sponsored ...

Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools.

Science.gov (United States)

Abdulrahman, Mahera; Makki, Maryam; Shaaban, Sami; Al Shamsi, Maryam; Venkatramana, Manda; Sulaiman, Nabil; Sami, Manal M; Abdelmannan, Dima K; Salih, AbdulJabbar M A; AlShaer, Laila

2016-01-01

Workforce planning is critical for being able to deliver appropriate health service and thus is relevant to medical education. It is, therefore, important to understand medical students' future specialty choices and the factors that influence them. This study was conducted to identify, explore, and analyze the factors influencing specialty preferences among medical students of the United Arab Emirates (UAE). A multiyear, multicenter survey of medical student career choice was conducted with all five UAE medical schools. The questionnaire consisted of five sections. Chi-squared tests, regression analysis, and stepwise logistic regression were performed. The overall response rate was 46% (956/2079). Factors that students reported to be extremely important when considering their future career preferences were intellectual satisfaction (87%), work-life balance (71%), having the required talent (70%), and having a stable and secure future (69%). The majority of students (60%) preferred internal medicine, surgery, emergency medicine, or family Medicine. The most common reason given for choosing a particular specialty was personal interest (21%), followed by flexibility of working hours (17%). The data show that a variety of factors inspires medical students in the UAE in their choice of a future medical specialty. These factors can be used by health policymakers, university mentors, and directors of residency training programs to motivate students to choose specialties that are scarce in the UAE and therefore better serve the health-care system and the national community.

Choosing a career in paediatrics: do trainees' views change over the first year of specialty training?

Science.gov (United States)

Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2014-09-01

To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. West Midlands Deanery, UK. Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work-life balance and a growing feeling that family came first. Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.

Specialty satisfaction, positive psychological capital, and nursing professional values in nursing students: A cross-sectional survey.

Science.gov (United States)

Woo, Chung Hee; Park, Ju Young

2017-10-01

Ideally, college majors should be chosen to achieve self-realization and correspond to self-concept. However, some students select a major based on extrinsic factors, rather than aptitude or interests, because of a lack of employment opportunities. If they have negative college experiences with an unsatisfactory major, they might not engage fully in their occupation following graduation. This study aimed to identify factors affecting specialty satisfaction in preclinical practice nursing-college students. A cross-sectional descriptive survey. A nonprobability convenience sample of 312 nursing-college students at colleges in Deajeon City, South Korea. The survey questionnaire was distributed to those who agreed to participate. Freshmen and sophomore nursing students (n=312). Participants were 312 students at colleges in Deajeon City. A structured questionnaire was used to collect data, which were analyzed using SPSS/WIN. Positive psychological capital and nursing professional values were positively correlated with specialty satisfaction. Significant predictors for specialty satisfaction included hope and optimism (as components of positive psychological capital), the roles of nursing service and originality of nursing (as nursing professional values), and aptitude/interests and job value (as motives for selecting a major). The findings suggested that nursing students' specialty satisfaction was partially linked to positive psychological capital and professional values. Therefore, the promotion of positive factors should be useful in enhancing specialty satisfaction in preclinical-practice nursing-college students. Copyright © 2017 Elsevier Ltd. All rights reserved.

New Technological Options to Manage High Level Waste

International Nuclear Information System (INIS)

Gonzalez Romero, E. M.

2007-01-01

Nuclear energy renaissance and its expansion in time and space has renewed the need for minimization technologies applicable to nuclear wastes. The minimization technologies include new power reactor concepts, Generation IV, and dedicated technologies like Partitioning and Transmutation of the actinides contained in the spent fuel. These technologies apply the principle of classification and recycling to the spent fuel to transform what at present is an environmental hazard into an energy source. the waste minimization technologies are also relevant for countries planning the reduction or phase-out of nuclear energy, as they will allow minimizing the size and number of the final waste repositories. Present estimations indicate that reductions as large as a factor 100 in the amount (radiotoxicity) of long lived nuclear waste are feasibly, with a modest increase on the final electricity cost. (Author)

The Effect of Teaching Experience and Specialty (Vocal or Instrumental) on Vocal Health Ratings of Music Teachers

Science.gov (United States)

Hackworth, Rhonda S.

2010-01-01

The current study sought to determine the relationship among music teachers' length of teaching experience, specialty (vocal or instrumental), and ratings of behaviors and teaching activities related to vocal health. Participants (N = 379) were experienced (n = 208) and preservice (n = 171) music teachers, further categorized by specialty, either…

Low Carbon Technology Options for the Natural Gas ...

Science.gov (United States)

The ultimate goal of this task is to perform environmental and economic analysis of natural gas based power production technologies (different routes) to investigate and evaluate strategies for reducing emissions from the power sector. It is a broad research area. Initially, the research will be focused on the preliminary analyses of hydrogen fuel based power production technologies utilizing hydrogen fuel in a large size, heavy-duty gas turbines in integrated reformer combined cycle (IRCC) and integrated gasification combined cycle (IGCC) for electric power generation. The research will be expanded step-by-step to include other advanced (e.g., Net Power, a potentially transformative technology utilizing a high efficiency CO2 conversion cycle (Allam cycle), and chemical looping etc.) pre-combustion and post-combustion technologies applied to natural gas, other fossil fuels (coal and heavy oil) and biomass/biofuel based on findings. Screening analysis is already under development and data for the analysis is being processed. The immediate action on this task include preliminary economic and environmental analysis of power production technologies applied to natural gas. Data for catalytic reforming technology to produce hydrogen from natural gas is being collected and compiled on Microsoft Excel. The model will be expanded for exploring and comparing various technologies scenarios to meet our goal. The primary focus of this study is to: 1) understand the chemic

The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

Science.gov (United States)

Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

2018-06-01

To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

Science.gov (United States)

Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

2007-01-01

Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

Rethinking Worklife Options for Older Persons.

Science.gov (United States)

Habib, Jack, Ed.; Nusberg, Charlotte, Ed.

This volume contains 19 papers that were presented at a conference addressing critical issues related to employment options for older persons. They are arranged in four sections that cover early retirement policies and their implications; older workers of Asia and the Pacific; the impact of technological change on the employment prospects of older…

Dental specialty, career preferences and their influencing factors among final year dental students in Saudi Arabia

Directory of Open Access Journals (Sweden)

Hassan Suliman Halawany

2017-01-01

Conclusion: The results of this study show the top preferred specialties and career choices which can be a baseline for establishing national policies and for the improvement of graduate programs. There seems to be a need to promote mentoring activities and provide guidance and encouragement to pre-doctoral dental students in selecting the most appropriate specialty within their capability domain.

Marketing of specialty forest products in the southeast: opportunities for research, education and outreach (poster abstract)

Science.gov (United States)

A.L. Hammett; J.L. Chamberlain

1999-01-01

The specialty forest products sector in the Southeast is growing rapidly - perhaps faster than in other sections of the country. In 1993, the state of Virginia exported almost 10 percent of the national total of wild harvested ginseng. On a yearly basis, the value of the specialty forest products extracted from Virginia?s forests has been estimated at $35 million. The...

Perceived Health Status and Utilization of Specialty Care: Racial and Ethnic Disparities in Patients with Chronic Diseases

Science.gov (United States)

Glover, Saundra; Bellinger, Jessica D.; Bae, Sejong; Rivers, Patrick A.; Singh, Karan P.

2010-01-01

Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality…

Synthetic Biology for Specialty Chemicals.

Science.gov (United States)

Markham, Kelly A; Alper, Hal S

2015-01-01

In this review, we address recent advances in the field of synthetic biology and describe how those tools have been applied to produce a wide variety of chemicals in microorganisms. Here we classify the expansion of the synthetic biology toolbox into three different categories based on their primary function in strain engineering-for design, for construction, and for optimization. Next, focusing on recent years, we look at how chemicals have been produced using these new synthetic biology tools. Advances in producing fuels are briefly described, followed by a more thorough treatment of commodity chemicals, specialty chemicals, pharmaceuticals, and nutraceuticals. Throughout this review, an emphasis is placed on how synthetic biology tools are applied to strain engineering. Finally, we discuss organism and host strain diversity and provide a future outlook in the field.

Innovation and risk-averse firms: Options on carbon allowances as a hedging tool

International Nuclear Information System (INIS)

Szolgayová, Jana; Golub, Alexander; Fuss, Sabine

2014-01-01

In a regulated world where government seeks to decarbonize the energy sector, firms face both indirect and direct costs of emitting CO 2 . This study seeks to take the perspective of the firm, which needs to maximize profits implying minimization of (carbon) cost as well. In this study, the firm can compose the cost-optimal portfolio of (a) investing into carbon-saving technology, which is currently expensive, (b) investing into carbon-saving technology R and D and adopt this technology at a later point, (c) buying allowances per ton of emitted CO 2 in a carbon market (alternatively this could be formulated as a tax), and (d) buying offsets traded in the same market, which are based on reduced emissions from deforestation and degradation (REDD+). Uncertainties in the cost of carbon coming from a lack of commitment in policy-making leading to fluctuations in markets and uncertainty in the payoff of R and D activities could provide disincentives to incur large up-front sunk cost and raise the economic value of being flexible. We apply a real options approach with stochastic carbon-saving technology costs and stochastic CO 2 costs. Assuming that firms are risk-averse, they will not only value flexibility, but also risk reductions from diversification over the different (carbon mitigation) options. - Highlights: • We study the compliance problem of a private firm under both regulatory and technological uncertainty in an optimal control setting. • When firms are risk-averse, forest-backed offset options will be part of the compliance portfolio. • R and D creates valuable options on new technology

Toward the establishment of a forensic nursing specialty in Brazil: an integrative literature review.

Science.gov (United States)

Esteves, Rafael Braga; Lasiuk, Gerri C; Cardoso, Lucilene; Kent-Wilkinson, Arlene

2014-01-01

Over the past two decades, Brazil has made progress in bringing political and community attention to issues related to violence. The recognition of links between violence and health has intensified calls to accelerate the development of a forensic nursing specialty in Brazil. The aim of this study was to systematically examine and synthesize the literature on the development of the forensic nursing specialty around the globe and to extract important lessons for the establishment of a forensic nursing specialty in Brazil. An integrative review was conducted according to the method described by Whittmore and Knafl (2005). Electronic searches of the following databases were conducted between December 2012 and March 2013: CINAHL Plus with Full Text, Criminal Justice, Index to Legal periodicals, MEDLINE, Soc Index with Full Text, Social Work Abstracts, SCOPUS, and PsycINFO. The search terms used were: [(TI nurs* or SU nurs*) and [TI (forensic* or penal or prison*) or SU (forensic* or penal or prison*)] and (sexual assault nurse examiner*). Preestablished inclusion/exclusion criteria were used to select published articles for review. Twenty-three articles met inclusion criteria and were included in the full review. Important lessons for Brazil are discussed in terms of education and curricular issues and forensic psychiatric nursing. In Brazil, there is a window of opportunity to contribute the theoretical foundations of forensic nursing science and to advance nursing specialty practice in the areas of Sexual Assault Nurse Examiners and forensic psychiatric nurses.

Energy exotic options

International Nuclear Information System (INIS)

Kaminski, V.; Gibner, S.; Pinnamaneni, K.

1999-01-01

This chapter with 88 references focuses on the use of exotic options to control exposure to energy prices. Exotic options are defined, and the conversion of a standard option into an exotic option and pricing models are examined. Pricing and hedging exotic options, path-dependent options, multi-commodity options, options on the minimum-or-maximum of two commodities, compound options, digital options, hybrid and complex structures, and natural gas daily options are described. Formulas for option pricing for vanilla, barrier, compound, options on minimum or maximum of two assets, and look back options are given in an appendix

Forecasting U.S. Marine Corps Reenlistments by Military Occupational Specialty and Grade

National Research Council Canada - National Science Library

Conatser, Dean G

2006-01-01

.... Currently the First Term Alignment Plan (FTAP) Model and Subsequent Term Alignment Plan (STAP) Model are used to determine the number of required reenlistments by Marine military occupational specialty...

[The specialty program as a training tool: an individual training plan for each resident].

Science.gov (United States)

Rodríguez González, R; Capilla Cabezuelo, E

2010-01-01

The official training program for the specialty "Diagnostic Imaging" establishes minimum learning objectives that must be fulfilled. Each accredited teaching unit is responsible for designing and carrying out a curriculum to ensure that these objectives are met, and this approach permits a degree of flexibility. Various aspects must be considered in the individual training plans for each resident: the rotation scheme according to the way the department is organized, plans for recovering missed material or reinforcing weak points, optional rotations, increasing degrees of responsibility as skills are acquired during training, and accommodating special needs of handicapped persons. Nevertheless, the individual plan must be fitted to the established curriculum and guarantee that the content of the official program is covered and that the objectives stipulated therein are met. Furthermore, the methods of teaching must be adapted to the individual characteristics of the residents, and this is the most important aspect of the individualization of training. To this end, it is fundamental for residents to take on an active role in their training, guided by their tutor and with the participation of all the radiologists in the department including the other residents, all of whom should act as teachers. Copyright © 2010 SERAM. Published by Elsevier Espana. All rights reserved.

[Modern technologies in cranio-maxillofacial surgery].

Science.gov (United States)

Lübbers, Heinz-Theo; Matthews, Felix; Kruse, Astrid L

2014-02-26

Modern technologies are influencing medicine everyday. The oral and maxillofacial surgery meet the worlds from medicine and dentistry. So technologies from both fields are utilized. This article provides an overview about technologies in clinical use, which are typical for the specialty. Their principles and indications are described as well as benefits and limitations. Based on Cone Beam Computed Tomography image fusion and mirroring techniques are explained as well as patient specific models and implants, template guided and free surgical navigation with and without intraoperative three-dimensional imaging. An overall assessment reveals further need of research regarding indications and patient benefit.

Biofuels development in China: Technology options and policies needed to meet the 2020 target

International Nuclear Information System (INIS)

Chang, Shiyan; Zhao, Lili; Timilsina, Govinda R.; Zhang, Xiliang

2012-01-01

China promulgated the Medium and Long-Term Development Plan for Renewable Energy in 2007, which included sub-targets of 2010 and 2020 for various renewable energy technologies. Almost all the 2010 sub-targets have been met and even surpassed except non-grain fuel ethanol. There is debate surrounding the questions of whether and how the country will be able to meet the 2020 biofuels target. This paper provides the assessment of potential technology pathways to achieve the 2020 target regarding their respective resource potential and supply cost. Barriers and policy options are identified based on broad literatures review. And an overview of biofuels projections is presented to provide insight into the comparison of various policy scenarios. The study shows that China can potentially satisfy non-grain fuel ethanol target by 2020 from technology perspective. But she will probably fall far short of this target if current situations continue. Additional policy efforts are needed. Meanwhile, the target of biodiesel production has high probability to be achieved. However, if given support policies, it will develop better. - Highlights: ► I. Non-grain feedstocks such as cassava, sweet sorghum and sweet potato grown in low productive arable lands or unutilized lands have enough potential to meet ethanol targets in 2020. ► II. If current situations continue, China will fall far short of the 2020 target. ► III. The target of biodiesel production has high probability to be achieved, while, if given support policies, it will develop better. ► IV. Supply cost is one of the major barriers faced by all biofuels pathways. ► V. Various policy measures would be necessary to overcome the costs barriers to biofuels in China.

Gender difference in preference of specialty as a career choice among Japanese medical students

OpenAIRE

Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

2016-01-01

Abstract Background In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. Methods A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34) years and 227 men aged 22 ± 4 ...

The database for aggregate analysis of ClinicalTrials.gov (AACT and subsequent regrouping by clinical specialty.

Directory of Open Access Journals (Sweden)

Asba Tasneem

Full Text Available BACKGROUND: The ClinicalTrials.gov registry provides information regarding characteristics of past, current, and planned clinical studies to patients, clinicians, and researchers; in addition, registry data are available for bulk download. However, issues related to data structure, nomenclature, and changes in data collection over time present challenges to the aggregate analysis and interpretation of these data in general and to the analysis of trials according to clinical specialty in particular. Improving usability of these data could enhance the utility of ClinicalTrials.gov as a research resource. METHODS/PRINCIPAL RESULTS: The purpose of our project was twofold. First, we sought to extend the usability of ClinicalTrials.gov for research purposes by developing a database for aggregate analysis of ClinicalTrials.gov (AACT that contains data from the 96,346 clinical trials registered as of September 27, 2010. Second, we developed and validated a methodology for annotating studies by clinical specialty, using a custom taxonomy employing Medical Subject Heading (MeSH terms applied by an NLM algorithm, as well as MeSH terms and other disease condition terms provided by study sponsors. Clinical specialists reviewed and annotated MeSH and non-MeSH disease condition terms, and an algorithm was created to classify studies into clinical specialties based on both MeSH and non-MeSH annotations. False positives and false negatives were evaluated by comparing algorithmic classification with manual classification for three specialties. CONCLUSIONS/SIGNIFICANCE: The resulting AACT database features study design attributes parsed into discrete fields, integrated metadata, and an integrated MeSH thesaurus, and is available for download as Oracle extracts (.dmp file and text format. This publicly-accessible dataset will facilitate analysis of studies and permit detailed characterization and analysis of the U.S. clinical trials enterprise as a whole. In

Uranium enrichment: investment options for the long term

International Nuclear Information System (INIS)

Anon.

1983-01-01

The US government supplies a major portion of the enriched uranium used to fuel most of the nuclear power plants that furnish electricity in the free world. As manager of the US uranium enrichment concern, the Department of Energy (DOE) is investigating a number of technological choices to improve enrichment service and remain a significant world supplier. The Congress will ultimately select a strategy for federal investment in the uranium enrichment enterprise. A fundamental policy choice between possible future roles - that of the free world's main supplier of enrichment services, and that of a mainly domestic supplier - will underlie any investment decision the Congress makes. The technological choices are gaseous diffusion, gas centrifuge, and atomic vapor laser isotope separation (AVLIS). A base plan and four alternatives were examined by DOE and the Congressional Budget Office. In terms of total enterprise costs, Option IV, ultimately relying on advanced gas centrifuges for enrichment services, would offer the most economic approach, with costs over the full projection period totaling $123.5 billion. Option III, ultimately relying on AVLIS without gas centrifuge enrichment or gaseous diffusion, falls next in the sequence, with costs of $128.2 billion. Options I and II, involving combinations of the gas centrifuge and AVLIS technologies, follow closely with costs of $128.7 and $129.6 billion. The base plan has costs of $136.8 billion over the projection period. 1 figure, 22 tables

Energy and the environment: Technology assessment and policy options

International Nuclear Information System (INIS)

Silveira, M.P.W.

1990-01-01

While the energy crisis of the 1970s stimulated technological innovation in developed countries, it often had the opposite effect in the third world. However, developing countries can be considered to have two types of energy systems: ''connected'' and ''disconnected''. The connected system is affected by changes in the price of commercial energy, but the disconnected system is usually rural and remote. Commercial forms of energy may be needed in the disconnected system, but they are largely unavailable. In some of the developing countries, new energy technologies have therefore been developed which adapt traditional technologies still existing in the disconnected sector. In this article some of the work of the United National Centre for Science and Technology for Development is described. Through its ATAS (Advance Technology Alert System) programme, international and regional workshops are held to discuss policy questions arising in regard to new technologies and developments. Workshops have been held in Moscow on new energy technologies in the industry subsystem (connected), in Guatemala City on new energy technologies and the disconnected system, and in Ottawa on new energy technologies, transportation and development. Initial assessments made by or through these workshops are outlined here. A fourth workshop will be held in June 1990 in Saarbrucken on energy technologies and climate change. (author). 3 figs

Access to specialty care in autism spectrum disorders-a pilot study of referral source

Directory of Open Access Journals (Sweden)

West Therese

2011-05-01

Full Text Available Abstract Background In the United States, a medical home model has been shown to improve the outcomes for children with special health care needs. As part of this model, primary care physicians provide comprehensive medical care that includes identification of delayed and/or atypical development in children and coordination of care with specialists. However, it is not clear if families of children with Autism Spectrum Disorder (ASD rely on the medical home model for care of their child to the same extent as families of children with other special health care needs. This study aims to add to the understanding of medical care for children with ASD by examining the referral source for specialty care. Methods This retrospective study was accomplished by evaluating parent completed intake data for children with ASD compared to those with other neurological disorders in a single physician Pediatric Neurology Practice at a major urban medical center in Northern New Jersey. To account for referral bias, a similar comparison study was conducted using a multispecialty ASD practice at the same medical center. Parent reported "source of referral" and "reason for the referral" of 189 ASD children and 108 non-ASD neurological disordered children were analyzed. Results The specialty evaluations of ASD were predominantly parent initiated. There were significantly less referrals received from primary care physicians for children with ASD compared to children with other neurodevelopmental disorders. Requirement of an insurance referral was not associated with a primary care physician prompted specialty visit.We identified different patterns of referral to our specialty clinics for children with ASD vs. children with other neurolodevelopmental disorders. Conclusion The majority of the families of children with ASD evaluated at our autism center did not indicate that a primary care physician initiated the specialty referral. This study suggests that families of

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

Science.gov (United States)

Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

2015-01-01

Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Fisher's two-tailed t-test. Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

On-Site or Off-Site Renewable Energy Supply Options?

DEFF Research Database (Denmark)

Marszal, Anna Joanna; Heiselberg, Per; Jensen, Rasmus Lund

2012-01-01

The concept of a Net Zero Energy Building (Net ZEB) encompasses two options of supplying renewable energy, which can offset energy use of a building, in particular on-site or off-site renewable energy supply. Currently, the on-site options are much more popular than the off-site; however, taking...... into consideration the limited area of roof and/or façade, primarily in the dense city areas, the Danish weather conditions, the growing interest and number of wind turbine co-ops, the off-site renewable energy supply options could become a meaningful solution for reaching ‘zero’ energy goal in the Danish context...... five technologies, i.e., two on-site options: (1) photovoltaic, (2) micro combined heat and power, and three off-site options: (1) off-site windmill, (2) share of a windmill farm and (3) purchase of green energy from the 100% renewable utility grid. The results indicate that in case of the on...

Investigation on the learning interest of senior undergraduate students in optoelectronics specialty

Science.gov (United States)

Wu, Shenjiang; Wang, Na; Li, Dangjuan; Liu, Chanlao

2017-08-01

With the increasing number of the graduate students, many of them have some troubles in job finding. This situation make a huge pressure on the senior students and loss them the interesting in study. This work investigate the reasons by questionnaire survey, panel discussion, interview, etc. to achieve the factors influence their learning interesting. The main reason of students do not have the motivation on study is that they do not understand the development and competition of photoelectric specialty, lack of innovation and entrepreneurship training, hysteresis of the learning knowledge and practical application. Finally, the paper gives some suggestions through teaching reform on how to improve students' learning enthusiasm. This work will contribute to the teaching and training of senior undergraduate students of optoelectronics specialty.

Optimizing the Level of Renewable Electric R&D Expenditures Using Real Options Analysis

Energy Technology Data Exchange (ETDEWEB)

Davis, G.; Owens, B.

2003-02-01

One of the primary objectives of the United States' federal non-hydro renewable electric R&D program is to promote the development of technologies that have the potential to provide consumers with stable and secure energy supplies. In order to quantify the benefits provided by continued federal renewable electric R&D, this paper uses ''real option'' pricing techniques to estimate the value of renewable electric technologies in the face of uncertain fossil fuel prices. Within the real options analysis framework, the current value of expected future supply from renewable electric technologies, net of federal R&D expenditures, is estimated to be $30.6 billion. Of this value, 86% can be attributed to past federal R&D efforts, and 14% can be attributed to future federal R&D efforts, assuming continued federal R&D funding at $300 million/year. In addition, real options analysis shows that the value of renewable electric technologies increases as current and future R&D funding levels increase. This indicates that the current level of federal renewable electric R&D funding is sub-optimal low.

Green micro-resistojet research at Delft University of Technology: new options for Cubesat propulsion

Science.gov (United States)

Cervone, A.; Zandbergen, B.; Guerrieri, D. C.; De Athayde Costa e Silva, M.; Krusharev, I.; van Zeijl, H.

2017-03-01

The aerospace industry is recently expressing a growing interest in green, safe and non-toxic propellants for the propulsion systems of the new generation of space vehicles, which is especially true in the case of Cubesat micro-propulsion systems. Demanding requirements are associated to the future missions and challenges offered by this class of spacecraft, where the availability of a propulsion system might open new possibilities for a wide range of applications including orbital maintenance and transfer, formation flying and attitude control. To accomplish these requirements, Delft University of Technology is currently developing two different concepts of water-propelled micro-thrusters based on MEMS technologies: a free molecular micro-resistojet operating with sublimating solid water (ice) at low plenum gas pressure of less than 600 Pa, and a more conventional micro-resistojet operating with liquid water heated and vaporized by means of a custom designed silicon heating chamber. In this status review paper, the current design and future expected developments of the two micro-propulsion concepts is presented and discussed, together with an initial analysis of the expected performance and potential operational issues. Results of numerical simulations conducted to optimize the design of the heating and expansion slots, as well as a detailed description of the manufacturing steps for the conventional micro-resistojet concept, are presented. Some intended steps for future research activities, including options for thrust intensity and direction control, are briefly introduced.

Potential for the development of a marketing option for the specialty local Ban pork of a Thai ethnic smallholder cooperative group in Northwest Vietnam.

Science.gov (United States)

Le, Thi Thanh Huyen; Muth, Philipp C; Markemann, André; Schöll, Kerstin; Zárate, Anne Valle

2016-02-01

Based on 12 years of research (SFB 564 "The Uplands Program"), a community-based breeding and marketing cooperative group was transferred to an ethnic farmer group. This study analyses the potential for developing a marketing channel for specialty local Ban pork as an alternative to supplying the local markets to ensure long-term sustainability of the communal local pig breeding and production system. Data on pig-keeping were investigated from 378 farmers who wanted to enroll in the cooperative group in 10 villages (near town, intermediate, and remote zones) in Son La province. The data on Ban pig marketing activities of the cooperative group were investigated for all of its 180 members. Information on the market demand for Ban pigs were collected by interviewing 57 traders in Hanoi city and Son La province. The results show a dominance of local Ban in remote areas, and a preference for crossbreds with exotics in closer-to-town areas. Before farmers joined the cooperative group, the commercialization of pigs in remote villages accounted for only 3.0 pigs/farm/year compared to 9.3 pigs/farm/year in the intermediate zone and 11.2 pigs/farm/year near town. Potential markets have been identified for each product category of the cooperative group. Pure Ban pigs with a weight of 10-15 kg were preferred most by customers in Hanoi city. The regular feedback of information on niche markets for different products has increased the awareness of farmers about the competitiveness of the local pig products, and the power of collective action in the market. Selected pure Ban pigs were increasingly sold to food stores in Hanoi with high prices. Farmers received an average of 9000 VND more compared to the local market price for each kg of live weight. The respective added value for the cooperative group amounted to 11,300 VND/kg live weight. The added value from selling specialty Ban pigs regularly to markets, encouraged farmers toward a market in local pig production and

Survey results show that adults are willing to pay higher insurance premiums for generous coverage of specialty drugs.

Science.gov (United States)

Romley, John A; Sanchez, Yuri; Penrod, John R; Goldman, Dana P

2012-04-01

Generous coverage of specialty drugs for cancer and other diseases may be valuable not only for sick patients currently using these drugs, but also for healthy people who recognize the potential need for them in the future. This study estimated how healthy people value insurance coverage of specialty drugs, defined as high-cost drugs that treat cancer and other serious health conditions like multiple sclerosis, by quantifying willingness to pay via a survey. US adults were estimated to be willing to pay an extra $12.94 on average in insurance premiums per month for generous specialty-drug coverage--in effect, $2.58 for every dollar in out-of-pocket costs that they would expect to pay with a less generous insurance plan. Given the value that people assign to generous coverage of specialty drugs, having high cost sharing on these drugs seemingly runs contrary to what people value in their health insurance.

Treatment options for active removal of renal stones

NARCIS (Netherlands)

Warmerdam, G.J.J.; Laet, De K.; Wijn, R.P.W.F.; Wijn, P.F.F.

2012-01-01

This study provides an update on the technological aspects of the methods for active removal of renal stones. Currently, extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) are the available options. Findings are based upon recent literature from

Sustainability Features of Nuclear Fuel Cycle Options

Directory of Open Access Journals (Sweden)

Stefano Passerini

2012-09-01

Full Text Available The nuclear fuel cycle is the series of stages that nuclear fuel materials go through in a cradle to grave framework. The Once Through Cycle (OTC is the current fuel cycle implemented in the United States; in which an appropriate form of the fuel is irradiated through a nuclear reactor only once before it is disposed of as waste. The discharged fuel contains materials that can be suitable for use as fuel. Thus, different types of fuel recycling technologies may be introduced in order to more fully utilize the energy potential of the fuel, or reduce the environmental impacts and proliferation concerns about the discarded fuel materials. Nuclear fuel cycle systems analysis is applied in this paper to attain a better understanding of the strengths and weaknesses of fuel cycle alternatives. Through the use of the nuclear fuel cycle analysis code CAFCA (Code for Advanced Fuel Cycle Analysis, the impact of a number of recycling technologies and the associated fuel cycle options is explored in the context of the U.S. energy scenario over 100 years. Particular focus is given to the quantification of Uranium utilization, the amount of Transuranic Material (TRU generated and the economics of the different options compared to the base-line case, the OTC option. It is concluded that LWRs and the OTC are likely to dominate the nuclear energy supply system for the period considered due to limitations on availability of TRU to initiate recycling technologies. While the introduction of U-235 initiated fast reactors can accelerate their penetration of the nuclear energy system, their higher capital cost may lead to continued preference for the LWR-OTC cycle.

This Specialty Line of Clothing Really Is the "Bee's Knees"

Science.gov (United States)

Hollingsworth, Jan Carter

2009-01-01

This article features "Bee's Knees," a specialty line of clothing. While not the typical product one would think of when considering mobility equipment, this line of clothing certainly does aid in helping those with disabilities access their world more safely and comfortably. "Bee's Knees" offers pint-sized pants made of kid-friendly, durable…

The assessment of clinical skills is imperative in postgraduate specialty training

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Ostergaard, Doris; Konge, Lars

2014-01-01

According to the Danish Ministry of Health recommendations, workplace-based assessment (WPBA) should be a central component in postgraduate specialty training. In this review the potential impact of WPBA with regard to patient safety, medical licensing and effects on doctors' learning is explored...

Vulnerability of California specialty crops to projected mid-century temperature changes

Science.gov (United States)

Increasing global temperatures are likely to have major impacts on agriculture, but the effects will vary by crop and location. This paper describes the temperature sensitivity and exposure of selected specialty crops in California. We used literature synthesis to create several sensitivity indices ...

Specialty pharmaceuticals: policy initiatives to improve assessment, pricing, prescription, and use.

Science.gov (United States)

Robinson, James C; Howell, Scott

2014-10-01

The value of "specialty pharmaceuticals" for cancer and other complex conditions depends not merely on their molecular structures but also on the manner in which the drugs are assessed, insured, priced, prescribed, and used. This article analyzes the five principal stages through which a specialty drug must pass on its journey from the laboratory to the bedside. These include regulatory approval by the Food and Drug Administration for market access, insurance coverage, pricing and payment, physician prescription, and patient engagement. If structured appropriately, each stage improves performance and supports continued research and development. If structured inappropriately, however, each stage adds to administrative burdens, distorts clinical decision making, and weakens incentives for innovation. Cautious optimism is in order, but neither the continued development of breakthrough products nor their use according to evidence-based guidelines can be taken for granted. Project HOPE—The People-to-People Health Foundation, Inc.

76 FR 50285 - Fiscal Year 2012 Tariff-Rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

Science.gov (United States)

2011-08-12

... for Raw Cane Sugar, Refined and Specialty Sugar and Sugar-Containing Products AGENCY: Office of the... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar and sugar...), the United States maintains tariff-rate quotas (TRQs) for imports of raw cane sugar and refined sugar...

40 CFR 407.80 - Applicability; description of the canned and miscellaneous specialties subcategory.

Science.gov (United States)

2010-07-01

... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS CANNED AND PRESERVED FRUITS AND VEGETABLES PROCESSING POINT SOURCE CATEGORY Canned and Miscellaneous Specialties Subcategory § 407.80...

Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

Science.gov (United States)

Baldini, Christopher G; Culley, Eric J

2011-01-01

A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

The microbiological safety of ready-to-eat specialty meats from markets and specialty food shops: a UK wide study with a focus on Salmonella and Listeria monocytogenes.

Science.gov (United States)

Gormley, F J; Little, C L; Grant, K A; de Pinna, E; McLauchlin, J

2010-04-01

From 2359 specialty meats (continental sausages, cured/fermented, dried meats) sampled from markets and specialty food shops, 98.9% of samples were of satisfactory or acceptable microbiological quality. However, 16 (0.7%) were unsatisfactory as a result of Escherichia coli, Staphylococcus aureus or Listeria spp. contamination (>or=10(2) CFU/g), and nine (0.4%) were unacceptable due to presence of Salmonella spp. or Listeria monocytogenes (>10(2) CFU/g). Meats with unacceptable levels of L. monocytogenes were within shelf life (range: 8-143 days remaining). Nine different subtypes of L. monocytogenes were detected with sero/AFLP type 1/2c VII predominating (37%), although this subtype was not overrepresented in any particular meat type (P > 0.05). Ninety-six percent of continental sausages and cured/fermented products were stored at potential for L. monocytogenes to be present at levels hazardous to health at the point of sale.

20 CFR 416.2035 - Optional supplementation: Additional State options.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State or...

Roadmap for a Smart Factory: A Modular, Intelligent Concept for the Production of Specialty Chemicals.

Science.gov (United States)

Reitze, Arnulf; Jürgensmeyer, Nikolas; Lier, Stefan; Kohnke, Marco; Riese, Julia; Grünewald, Marcus

2018-04-09

Digitalization and increasing the flexibility of production concepts offer the possibility to react to market challenges in the field of specialty chemicals. Shorter product lifetimes, increasing product individualization, and the resulting market volatility impose new requirements on plant operators. Novel concepts such as modular production plants and developments in digitalization (Industry 4.0) are able to assist the implementation of smart factories in specialty chemicals. These essential concepts will be presented in this Minireview. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Prevalence of dry eye syndrome in residents of surgical specialties.

Science.gov (United States)

Castellanos-González, José Alberto; Torres-Martínez, Verónica; Martínez-Ruiz, Adriana; Fuentes-Orozco, Clotilde; Rendón-Félix, Jorge; Irusteta-Jiménez, Leire; Márquez-Valdez, Aída Rebeca; Cortés-Lares, José Antonio; González-Ojeda, Alejandro

2016-07-16

The aim of this study was to determine the prevalence and severity of dry eye syndrome in a group of Mexican residents of different surgical specialties. A cross-sectional descriptive study where the residents were studied using the Ocular Surface Disease Index, together with diagnostic tests for dry eye syndrome, such as tear breakup time, Oxford Schema, Schirmer's test I, and meibomian gland dysfunction testing. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value eyes); 90 (73 %) were male and 33 (27 %) were female. The mean age was 27.8 ± 2.1 years. A higher number of residents with dry eye syndrome was found in the cardiothoracic surgery (75 %) and otorhinolaryngology (71 %) specialties; 70 % of them reported ocular symptoms, with teardrop quality involvement in >50 % of them. We found a prevalence of 56 % for mild-to-moderate/severe stages of the condition. Their presence in the operating room predisposes surgical residents to dry eye syndrome because of environmental conditions.

Analysis of Options Contract, Option Pricing in Agricultural Products

Directory of Open Access Journals (Sweden)

H. Tamidy

2016-03-01

Full Text Available Introduction: Risk is an essential component in the production and sale of agricultural products. Due to the nature of agricultural products, the people who act in this area including farmers and businesspersons encounter unpredictable fluctuations of prices. On the other hand, the firms that process agricultural products also face fluctuation of price of agricultural inputs. Given that the Canola is considered as one of the inputs of product processing factories, control of unpredictable fluctuations of the price of this product would increase the possibility of correct decision making for farmers and managers of food processing industries. The best available tool for control and management of the price risk is the use of future markets and options. It is evident that the pricing is the main pillar in every trade. Therefore, offering a fair price for the options will be very important. In fact, options trading in the options market create cost insurance stopped. In this way, which can reduce the risks of deflation created in the future, if the person entitled to the benefits of the price increase occurs in the future. Unlike the futures, market where the seller had to deliver the product on time, in the options market, there is no such compulsion. In addition, this is one of the strengths of this option contract, because if there is not enough product for delivery to the futures market as result of chilling, in due course, the farmers suffer, but in the options market there will be a loss. In this study, the setup options of rape, as a product, as well as inputs has been paid for industry. Materials and Methods: In this section. The selection criteria of the disposal of asset base for valuation of European put options and call option is been introduced. That for obtain this purpose, some characteristics of the goods must considered: 1-Unpredictable fluctuations price of underlying asset 2 -large underlying asset cash market 3- The possibility

Strategic Technology Adoptation Taking into Account Future Technological Improvements : A Real Options Approach

NARCIS (Netherlands)

Huisman, K.J.M.; Kort, P.M.

2000-01-01

This paper studies a dynamic duopoly in which firms compete in the adoption of new technologies. The innovation process is exogenous to the firms. Both firms have the possibility to adopt a current technology or to wait for a better technology that arrives at an unknown point of time in the future.

77 FR 57180 - Fiscal Year 2013 Tariff-rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

Science.gov (United States)

2012-09-17

... Sugar, Refined and Specialty Sugar, and Sugar-Containing Products AGENCY: Office of the United States... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar, and sugar... imports of raw cane sugar and refined sugar. Pursuant to Additional U.S. Note 8 to Chapter 17 of the HTS...

Optional part-time and longer GP training modules in GP practices associated with more trainees becoming GPs - a cohort study in Switzerland.

Science.gov (United States)

Studerus, Lara; Ahrens, Regina; Häuptle, Christian; Goeldlin, Adrian; Streit, Sven

2018-01-05

Switzerland, like many other countries, has a shortage of General Practitioners (GPs). Optional GP training modules in GP practices were offered during the at least 5-year GP training program to increase student and trainee interest in becoming a GP. The training modules had not yet been evaluated. We determined how many Swiss GP trainees became practicing GPs after they completed optional training modules, and if longer modules were associated with higher rates of GP specialization. In this population-based cohort study, we included GP trainees who chose an optional GP training module in GP practice, provided by the Foundation to Promote Training in General Practice (WHM) between 2006 and 2015. GP trainees were invited to complete an online survey to assess the primary outcome (becoming a practicing GP by 2016). Data on non-responders was collected via an internet search. We calculated univariate time-to-event curves to become a practicing GP, stratified by trainee's gender, length, part-time training, and number of years after graduation until training modules were completed. We used a multivariate model to adjust for characteristics of participants, training, and satisfaction with training modules. We assessed primary outcome for 351 (92.1%) of 381 former GP trainees who participated in a WHM program between 2006 and 2015. Of these 218 (57%) were practicing GPs by 2016. When focusing on the trainees who had completed training between 2006 and 2010, the rate of practicing GPs was even 73%. Longer (p = 0.018) and part-time training modules (p = 0.003) were associated with higher rates of being a practicing GP. Most (81%) practicing GPs thought their optional GP training module was (very) important in their choice of specialty. GP trainees who spent more time training in a GP practice, or who trained part-time were more likely to become practicing GPs. Most (80%) rated their training module as (very) important in their choice of career, highlighting that

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

Science.gov (United States)

Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

2015-01-01

Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher's two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed. PMID:25829909

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

Directory of Open Access Journals (Sweden)

Parmeshwar Kumar

2015-01-01

Full Text Available Context: Though intensive care units (ICUs only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher′s two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

Nuclear Waste Vitrification in the U.S.: Recent Developments and Future Options

International Nuclear Information System (INIS)

Vienna, John D.

2010-01-01

Nuclear power plays a key role in maintaining current world wide energy growth while minimizing the greenhouse gas emissions. A disposition path for used nuclear fuel (UNF) must be found for this technology to achieve its promise. One likely option is the recycling of UNF and immobilization of the high-level waste (HLW) by vitrification. Vitrification is the technology of choice for immobilizing HLW from defense and commercial fuel reprocessing around the world. Recent advances in both recycling technology and vitrification show great promise in closing the nuclear fuel cycle in an efficient and economical fashion. This article summarizes the recent trends developments and future options in waste vitrification for both defense waste cleanup and closing the nuclear fuel cycle in the U.S.

Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

Science.gov (United States)

Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

2017-02-01

To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [ P = .005], acceptable on-call demands [ P = .012], and lifestyle flexibility [ P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [ P = .014] and the opportunity to form long-term relationships [ P  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be

Retrieval options study

International Nuclear Information System (INIS)

1980-03-01

This Retrieval Options Study is part of the systems analysis activities of the Office of Nuclear Waste Isolation to develop the scientific and technological bases for radioactive waste repositories in various geologic media. The study considers two waste forms, high level waste and spent fuel, and defines various classes of waste retrieval and recovery. A methodology and data base are developed which allow the relative evaluation of retrieval and recovery costs and the following technical criteria: safety; technical feasibility; ease of retrieval; probable intact retrieval time; safeguards; monitoring; criticality; and licensability. A total of 505 repository options are defined and the cost and technical criteria evaluated utilizing a combination of facts and engineering judgments. The repositories evaluated are selected combinations of the following parameters: Geologic Media (salt, granite, basalt, shale); Retrieval Time after Emplacement (5 and 25 years); Emplacement Design (nominal hole, large hole, carbon steel canister, corrosion resistant canister, backfill in hole, nominal sleeves, thick wall sleeves); Emplacement Configuration (single vertical, multiple vertical, single horizontal, multiple horizontal, vaults; Thermal Considerations; (normal design, reduced density, once-through ventilation, recirculated ventilation); Room Backfill; (none, run-of-mine, early, 5 year delay, 25 year delay, decommissioned); and Rate of Retrieval;

Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study.

Science.gov (United States)

Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

2016-01-01

Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. To compare three options, four options, and five options MCQs test for the quality parameters - reliability, validity, item analysis, distracter analysis, and time analysis. Participants were 3 rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants' option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Students score more ( P = 0.000) and took less time ( P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more ( P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Assessment based on three option MCQs is can be preferred over four option and five option MCQs.

Neurology as career option among postgraduate medical students

Directory of Open Access Journals (Sweden)

Namit B Gupta

2013-01-01

Full Text Available Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1 To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2 To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics. Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%, inspired by role model teachers (63%, better quality-of-life (51% and scope for independent practice without expensive infrastructure (48%. Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%, neurology is mainly an academic specialty (40%, neurophobia (43% and lack of procedures (57%. Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%. 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, "role model" teachers of neurology could interact and teach students extensively. Neurologists′ efforts to shed their diagnostician′s image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student′s career. Procedures attract students; hence, they should be made conversant with procedures and

Perspective on long-range nuclear energy options

International Nuclear Information System (INIS)

Harms, W.O.

1977-01-01

The study group whose effort is presented here concluded that the United States urgently needs to have a breeder option available for possible deployment before the year 2000 primarily because of uncertainties in the availability of fossil fuels and uranium supplies. It was recommended that the U/Pu LMFBR program proceed as planned, including prompt construction of the CRBRP and its associated fuel cycle facilities. Alternative cycle studies should be pursued, but without significantly delaying the current program. There are technological choices which, in suitable political contexts, may somewhat reduce proliferation risks; of these, only those that employ breeders preserve the breeder option (and the nuclear option in the long term. These alternatives must be coupled with political agreements to have any significant effect on proliferation potential internationally. These same political agreements should suffice to control the U/Pu breeder cycle; there is only a difference in degree between the U/Pu and the denatured Th/U-233 cycles

Construction and Practice of the New Business Specialty Talent Cultivation Mode

Science.gov (United States)

Xiao, Xiaokong

2009-01-01

The vocational education of business should actively adapt the demands of the domestic and foreign business development to cultivate high-quality applicable talents with international knowledge. The traditional business specialty teaching and the talent cultivation mode have not followed the domestic and foreign market demands, and are difficult…

R&D as an option on market introduction

NARCIS (Netherlands)

Lint, L.J.O.; Pennings, H.P.G.

1998-01-01

Discounted cash flow methods for making R&D investment decisions cannot properly capture the option value in R&D. Since market and technology uncertainties change expectations about the viability of many new products, the value of projects is frequently adjusted during the R&D stages. Capturing the

Careers in medicine at Vanderbilt University School of Medicine: an innovative approach to specialty exploration and selection.

Science.gov (United States)

Sweeney, Kyle R; Fritz, Ryan A; Rodgers, Scott M

2012-07-01

Research on resident attrition rates suggests that medical students would benefit from more comprehensive career advising programs during medical school. Responding to this need, students and administrators at the Vanderbilt University School of Medicine (Vanderbilt) introduced a broad Careers in Medicine (CiM) program in 2005 to complement the CiM resources offered by the Association of American Medical Colleges (AAMC). In this article, the authors detail the Vanderbilt CiM program's four core components: career-related events, an elective course, specialty interest groups, and career advising. The authors discuss the program's implementation and its student-led organizational structure, and they provide a critical assessment of important lessons learned. Using data from internal satisfaction surveys and the AAMC's Medical School Graduation Questionnaire (GQ), they demonstrate the success of Vanderbilt's career counseling efforts. According to recent GQ data, Vanderbilt ranks above the U.S. medical school average on graduating students' ratings of overall satisfaction with career services and of the usefulness of key programming. The authors present this description of the Vanderbilt CiM model as a framework for other medical schools to consider adopting or adapting as they explore options for expanding their own career counseling services.

PM10 standards and nontraditional particulate source controls: A summary of the A ampersand WMA/EPA international specialty conference

International Nuclear Information System (INIS)

Chow, J.C.; Watson, J.G.; Ono, D.M.; Mathai, C.V.

1993-01-01

An international specialty conference, jointly sponsored by the Air ampersand Waste Management Association (A ampersand WMA) and the US Environmental Protection Agency (EPA), entitled open-quotes PM 10 Standards and Nontraditional Particulate Source Controls,close quotes was held in Scottsdale, Arizona, January 12-15, 1992. The conference included 92 presentations in 17 technical sessions. Eight-one peer-reviewed technical papers, two keynote addresses and one panel session summary describing novel applications, measurement processes, modeling techniques and control measures for nontraditional pollution sources are assembled in the Transactions. The technical issues addressed during the conference included: (1) measurement methods and data bases; (2) emissions source characterization; (3) source apportionment of nontraditional sources; (4) fugitive dust characterization and control technologies; (5) vegetative burning characterization and control technologies; (6) sources and controls of secondary aerosol and motor vehicle precursors; and (7) regulatory policies and State Implementation Plan (SIP) development. This paper gives an overview of the technical program. 105 refs., 1 tab

Multirole cargo aircraft options and configurations. [economic analysis

Science.gov (United States)

Conner, D. W.; Vaughan, J. C., III

1979-01-01

A future requirements and advanced market evaluation study indicates derivatives of current wide-body aircraft, using 1980 advanced technology, would be economically attractive through 2008, but new dedicated airfreighters incorporating 1990 technology, would offer little or no economic incentive. They would be economically attractive for all payload sizes, however, if RD and T costs could be shared in a joint civil/military arrangement. For the 1994-2008 cargo market, option studies indicate Mach 0.7 propfans would be economically attractive in trip cost, aircraft price and airline ROI. Spanloaders would have an even lower price and higher ROI but would have a relatively high trip cost because of aerodynamic inefficiencies. Dedicated airfreighters using propfans at Mach 0.8 cruise, laminar flow control, or cryofuels, would not provide any great economic benefits. Air cushion landing gear configurations are identified as an option for avoiding runway constraints on airport requirements and/or operational constraints are noted.

Risk Assessment of Arsenic Mitigation Options in Bangladesh

Science.gov (United States)

Ahmed, M. Feroze; Shamsuddin, Abu Jafar; Mahmud, Shamsul Gafur; Deere, Daniel

2006-01-01

The provision of alternative water sources is the principal arsenic mitigation strategy in Bangladesh, but can lead to risk substitution. A study of arsenic mitigation options was undertaken to assess water quality and sanitary condition and to estimate the burden of disease associated with each technology in disability-adjusted life years (DALYs). Dugwells and pond-sand filters showed heavy microbial contamination in both dry and monsoon seasons, and the estimated burden of disease was high. Rainwater was of good quality in the monsoon but deteriorated in the dry season. Deep tubewells showed microbial contamination in the monsoon but not in the dry season and was the only technology to approach the World Health Organization's reference level of risk of 10-6 DALYs. A few dugwells and one pond-sand filter showed arsenic in excess of 50 μg/L. The findings suggest that deep tubewells and rainwater harvesting provide safer water than dugwells and pond-sand filters and should be the preferred options. PMID:17366776

Specialty Practice and Cost Considerations in the Management of Uveitis Associated With Juvenile Idiopathic Arthritis.

Science.gov (United States)

Palestine, Alan G; Singh, Jasleen K; Kolfenbach, Jason R; Ozzello, Daniel J

2016-07-01

To evaluate whether cost, prior insurance authorization concerns, and subspecialty practice influence therapeutic decisions in the treatment of uveitis associated with juvenile idiopathic arthritis. A total of 2,965 pediatric ophthalmologists, uveitis specialists, retina specialists, and rheumatologists across the United States were surveyed via e-mail regarding their choice in long-term therapy for a hypothetical patient with uveitis associated with juvenile idiopathic arthritis. Outcomes of interest were differences in therapy choice based on cost/prior authorization and specialty practice. There were significant differences in the use of methotrexate and biologics among specialists, both with and without consideration for cost and prior authorization. Physicians in four different specialties who treat uveitis associated with juvenile idiopathic arthritis agree on methotrexate as a first-line treatment choice and a biologic immunosuppressive medication as a second choice, but there are significant differences between the specialties in their use of these medications. Cost and insurance considerations did not affect therapy selection. [J Pediatr Ophthalmol Strabismus. 2016;53(4):246-251.]. Copyright 2016, SLACK Incorporated.

Emerging Options and Opportunities in Civilian Aeronautics

Science.gov (United States)

Bushnell, Dennis M.

2012-01-01

This paper addresses the major problems/issues with civilian aeronautics going forward, the contextual ongoing technology revolutions, the several emerging civilian aeronautical "Big Ideas" and associated enabling technological approaches. The ongoing IT Revolution is increasingly providing, as 5 senses virtual presence/reality becomes available, along with Nano/Molecular Manufacturing, virtual alternatives to Physical transportation for both people and goods. Paper examines the potential options available to aeronautics to maintain and perhaps grow "market share" in the context of this evolving competition. Many of these concepts are not new, but the emerging technology landscape is enhancing their viability and marketability. The concepts vary from the "interesting" to the truly revolutionary and all require considerable research. Paper considers the speed range from personal/general aviation to supersonic transports and technologies from energetics to fabrication.

Comparison of Specialty Medication Use for Common Chronic Inflammatory Diseases Among Health Exchange and Other Commercially Insured Members.

Science.gov (United States)

Chen, Xiaoxue; Gautam, Santosh; Ruggieri, Alexander; Richards, Thomas; Devries, Andrea; Sylwestrzak, Gosia

2018-01-01

The Affordable Care Act of 2010 allows the purchase of health insurance through special marketplaces called "health exchanges." The majority of individuals enrolling in the exchanges were previously uninsured, older, and sicker than other commercially insured members. Early evidence also suggests that exchange plan members use more costly specialty drugs compared with other commercially insured members. To (a) examine patient characteristics and specialty drug use for common chronic inflammatory diseases (CIDs) among exchange plan members compared with other commercially insured members and (b) explore variations in specialty drug use within exchange plans by metal tiers (bronze, silver, gold, and platinum), as well as across local markets. This analysis included adults aged ≥ 18 years who were enrolled in exchange plans (exchange population) and other commercial health plans (nonexchange population). The primary outcome was the likelihood of using specialty drugs prescribed to treat common CIDs, such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriatic arthritis, and psoriasis. The adjusted likelihood of using CID specialty drugs was calculated from logistic regression controlling for prevalence of CIDs and other health risk factors. A total of 931,384 exchange plan members and 2,682,855 nonexchange plan members were included in the analysis. Compared with the nonexchange population, the exchange population was older, more likely to be female, had more comorbid conditions, but filled fewer prescriptions. The 2 groups were similar in terms of CID prevalence. The observed likelihood of CID specialty drug use was 20.0% lower in the exchange versus the nonexchange populations (341 users per 100,000 exchange members vs. 427 users per 100,000 nonexchange members; P exchange population, the observed likelihood of CID specialty drug use was 132 per 100,000 bronze plan members (69.1% lower than nonexchange); 326 per 100

Clean coal technology roadmap: issues paper

Energy Technology Data Exchange (ETDEWEB)

Pearson, B. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Energy Technology Centre

2003-07-01

The need for the Clean Coal Technology Roadmap is based on the climate change threat, Canada's commitment to the Kyoto protocol, and the need to keep options open in determining the future position of coal in Canada's energy mix. The current role of coal, issues facing coal-fired utilities, and greenhouse gas emission policies and environmental regulations are outlined. The IEA energy outlook (2002) and a National Energy Board draft concerning Canada's energy future are outlined. Environmental, market, and technical demands facing coal, technology options for existing facilities, screening new developments in technology, and clean coal options are considered. 13 figs. 5 tabs.

Internet privacy options for adequate realisation

CERN Document Server

2013-01-01

A thorough multidisciplinary analysis of various perspectives on internet privacy was published as the first volume of a study, revealing the results of the achatech project "Internet Privacy - A Culture of Privacy and Trust on the Internet." The second publication from this project presents integrated, interdisciplinary options for improving privacy on the Internet utilising a normative, value-oriented approach. The ways in which privacy promotes and preconditions fundamental societal values and how privacy violations endanger the flourishing of said values are exemplified. The conditions which must be fulfilled in order to achieve a culture of privacy and trust on the internet are illuminated. This volume presents options for policy-makers, educators, businesses and technology experts how to facilitate solutions for more privacy on the Internet and identifies further research requirements in this area.

Adherence of randomized trials within children's surgical specialties published during 2000 to 2009 to standard reporting guidelines.

Science.gov (United States)

Blakely, Martin L; Kao, Lillian S; Tsao, Kuojen; Huang, Eunice Y; Tsai, Anthony; Tanaka, Stacy; Younas, Shiraz; Lu, Zengqi; Lally, Kevin P

2013-09-01

Randomized clinical trials (RCTs) are uncommon in pediatric surgical specialties and the quality of reporting is unknown. Our primary purpose was to analyze published surgical RCTs involving children to measure adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Published RCTs from January 1, 2000 through December 31, 2009 were reviewed. The trials were evaluated for the presence of 7 CONSORT guidelines and also graded according to the Jadad scale. Two hundred and twenty-eight trials were included. Five trials met all 7 CONSORT criteria (2%) and 53 had a Jadad score of ≥3 (23%). Slightly more than 50% of all trials specified primary outcomes and guidelines for allocation concealment, randomization description, and attrition details was even lower. There were significant differences between surgical specialties with regard to CONSORT adherence to the majority of the guidelines. Pediatric general surgery had the largest number of published RCTs. Pediatric orthopaedic surgery had the highest proportion of trials with a Jadad score ≥3 (40%). Adherence to CONSORT guidelines is low across the spectrum of children's surgical specialties, although significant differences do exist. Future RCTs in children's surgical specialties should specifically focus on areas of low adherence to reporting guidelines. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

Science.gov (United States)

Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira

2016-01-01

The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

The choice of surgery as a future career specialty among medical ...

African Journals Online (AJOL)

Aim: To determine the factors affecting the choice of surgery as a future career specialty among medical interns in a regional hospital in Nigeria. Method: A total of 74 junior doctors who completed internship training at the university of Benin teaching Hospital in 2012 were interviewed in this cross sectional study.

Personality Patterns of Physicians in Person-Oriented and Technique-Oriented Specialties

Science.gov (United States)

Borges, Nicole J.; Gibson, Denise D.

2005-01-01

This study investigated differences in personality patterns between person-oriented and technique-oriented physicians. It tested an integrative framework by converting the scores on the Personality Research Form (PRF) to the Big-Five factors and built a predictive model of group membership in clinical specialty area. PRF scores from 238 physicians…

A patient group based business planning model for a surgical specialty

NARCIS (Netherlands)

Adan, I.J.B.F.; Vissers, J.M.H.; van den Heuvel, M.N.; Wiersema, K.; Vissers, J.M.H.; Beech, R.

2005-01-01

In this contribution we present an approach for a business planning model for a surgical specialty, based on modelling of all patient processes as well as of the dynamics involved in planning and managing resources. An important basis of the model is the description of the processes of all patient

[Changing the teaching of neurosurgery with information technology].

Science.gov (United States)

Moreau, Jean-Jacques; Caire, François; Kalamarides, Michel; Mireau, Etienne; Dauger, Frédéric; Coignac, Marie-Jo; Charlin, Bernard

2009-10-01

A digital campus is a distance learning site that uses the potential of information and communication technologies to disseminate and improve educational services. This website, with open and free access, is built from free software with Web 2.0 technology. It is hosted at the University of Limoges. It functions as a digital library, containing scanned books, slide shows, more than 200 hours of recorded courses and round tables accessible by streaming video. The site is indexed according to the users' needs, by level of knowledge, specialty, keywords, and supplementary MeSH terms. The campus is organized as the College of Neurosurgery (http://college.neurochirurgie.fr). The durability of this type of training (in existence for 9 years now) is made possible by a powerful and committed consortium: the French Society of Neurosurgery, which has created high-quality intellectual and scientific resources, the University of Limoges, the Dupuytren University Hospital Center in Limoges, the region of Limousin, and the French-language Virtual Medical University, which have provided logistic and financial support. To target appropriate levels at various users, we distinguished four groups: medical students, neurosurgery students, neurosurgeons (continuing medical education), and students in allied health fields. All areas of neurosurgery are concerned. All the courses, including tests for self-evaluation and scientific meetings (organized with information and communication technologies) are digitally recorded for the site. The principles that make it possible for a medical discipline to organize around an online project are: a pedagogical conception of projects built in the form of models reusable by other health specialties; a stronghold within professional societies of the relevant specialties able to create high-quality intellectual and scientific resources; an organization by educational levels that can be extended transversally to other health disciplines; and free

Publication trends of research articles from infectious diseases specialty in a medical journal from India

Directory of Open Access Journals (Sweden)

KVS Hari Kumar

2012-01-01

Full Text Available Background: Details about research productivity in the infectious diseases specialty from India are lacking. Objective: To analyse publishing trends and research productivity of articles related to infectious diseases in the Journal of the Association of Physicians of India (JAPI. Materials and Methods : We carried out bibliometric analysis of articles related to infectious diseases specialty from JAPI published between 2000 and 2011. Data were derived from the journal′s website and the articles were analysed for type (original article, case reports, etc., microorganism (bacterial, viral, etc. place of the research and timelines for publication. Results : Out of 2977 articles published in JAPI over last 12 years, 256 articles belong to infectious diseases subspecialty. Infectious diseases contributed 11-18% of the published articles per year in JAPI during the last decade. Original articles (31%, case reports (38% and correspondence (22% constitute the majority of article types, while remaining 9% was made up by images. Bacterial (22%, protozoal and helminthic (20%, HIV (15% and mycobacterial (16% diseases lead the type of microorganisms represented in the research articles. Mumbai (16%, Delhi (9% and Kolkata (7% are the top three places contributing to the articles, followed by Chandigarh and Chennai. Original articles and case reports took approximately 14 months for publication, as compared to 6 months for an image (P < 0.0001. Conclusion : Infectious diseases specialty contributes about 15% of articles per annum in JAPI. HIV and tuberculosis together account for 30% of published litearture with fair representation from other organisms. Mumbai and Delhi are the leading contributors towards research productivity in this specialty.

A Call to Action to Address Gender Equity Within Our Specialty: Time's Up on Waiting for Change.

Science.gov (United States)

Baecher-Lind, Laura; Abbott, Jodi; Atkins, Katharyn Meredith; Nijjar, J Biba; Royce, Celeste; Schiff, Lauren; Ricciotti, Hope A

2018-06-01

Although national attention has been focused on sexual harassment and gender inequity in the United States, leaders within the obstetrics and gynecology community have remained relatively silent. Sexual harassment and gender inequity remain pervasive in our specialty. This article serves as a call to action for leadership as well as physicians within obstetrics and gynecology to implement ethical and evidence-based approaches to reduce gender inequity and improve workplace culture within our specialty.

Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

Directory of Open Access Journals (Sweden)

Ken Russell Coelho

2011-01-01

Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?

Science.gov (United States)

Stratton, Terry D; McLaughlin, Margaret A; Witte, Florence M; Fosson, Sue E; Nora, Lois Margaret

2005-04-01

To examine the role of gender discrimination and sexual harassment in medical students' choice of specialty and residency program. Anonymous, self-administered questionnaires were distributed in 1997 to fourth-year students enrolled in 14 public and private U.S. medical schools. In addition to reporting the frequency of gender discrimination and sexual harassment encountered during preclinical coursework, core clerkships, elective clerkships, and residency selection, students assessed the impact of these exposures (none, a little, some, quite a bit, the deciding factor) on their specialty choices and rankings of residency programs. A total of 1,314 (69%) useable questionnaires were returned. Large percentages of men (83.2%) and women (92.8%) experienced, observed, or heard about at least one incident of gender discrimination and sexual harassment during medical school, although more women reported such behavior across all training contexts. Compared with men, significantly (p harassment influenced their specialty choices (45.3% versus 16.4%) and residency rankings (25.3% versus 10.9%). Across all specialties, more women than men experienced gender discrimination and sexual harassment during residency selection, with one exception: a larger percentage of men choosing obstetrics and gynecology experienced such behavior. Among women, those choosing general surgery were most likely to experience gender discrimination and sexual harassment during residency selection. Interestingly, correlations between exposure to gender discrimination and sexual harassment and self-assessed impact on career decisions tended to be larger for men, suggesting that although fewer men are generally affected, they may weigh such experiences more heavily in their choice of specialty and residency program. This study suggests that exposure to gender discrimination and sexual harassment during undergraduate education may influence some medical students' choice of specialty and, to a lesser

Discrimination of several Indonesian specialty coffees using Fluorescence Spectroscopy combined with SIMCA method

Science.gov (United States)

Suhandy, D.; Yulia, M.

2018-03-01

Indonesia is one of the important producers of several specialty coffees, which have a particularly high economic value, including Civet coffee (‘kopi luwak’ in Indonesian language) and Peaberry coffee (‘kopi lanang’ in Indonesian language). The production of Civet and Peaberry coffee is very limited. In order to provide authentication of Civet and Peaberry coffee and protect consumers from adulteration, a robust and easy method for evaluating ground Civet and Peaberry coffee and detection of its adulteration is needed. In this study, we investigate the use of fluorescence spectroscopy combined with SIMCA (soft independent modelling of class analogies) method to discriminate three Indonesian specialty coffee: ground Peaberry, Civet and Pagar Alam coffee. Total 90 samples were used (30 samples for Civet, Peaberry and Pagar Alam coffee, respectively). All coffee samples were ground using a home-coffee-grinder. Since particle size in coffee powder has a significant influence on the spectra obtained, we sieved all coffee samples through a nest of U. S. standard sieves (mesh number of 40) on a Meinzer II sieve shaker for 10 minutes to obtain a particle size of 420 µm. The experiments were performed at room temperature (around 27-29°C). All samples were extracted with distilled water and then filtered. For each samples, 3 mL of extracted sample then was pipetted into 10 mm cuvettes for spectral data acquisition. The EEM (excitation-emission matrix) spectral data of coffee samples were acquired using JASCO FP-8300 Fluorescence Spectrometer. The principal component analysis (PCA) result shows that it is possible to discriminate types of coffee based on information from EEM (excitation-emission matrix) spectral data. Using SIMCA method, the discrimination model of Indonesian specialty coffee was successfully developed and resulted in high performance of discrimination with 100% of sensitivity and specificity for Peaberry, Civet and Pagar Alam coffee. This research

Some wind-energy storage options

Energy Technology Data Exchange (ETDEWEB)

Eldridge, F R; Ljungstroem, O [ed.

1976-01-01

Systems capable of storing energy generated from the wind can be categorized in terms of electrochemical energy storage systems, thermal energy storage systems, kinetic energy systems, and potential energy systems. Recent surveys of energy storage systems have evaluated some of these available storage technologies in terms of the minimum economic sizes for utility applications, estimated capital costs of these units, expected life, dispersed storage capabilities, and estimated turn-around efficiencies of the units. These are summarized for various types of energy storage options.

Emerging Technologies Integrating Technology into Study Abroad

Science.gov (United States)

Godwin-Jones, Robert

2016-01-01

"Ready access to travel and to technology-enhanced social networking (e.g., Facebook or Skype) has changed the nature of study abroad to the point where today's experiences are fundamentally different from those of earlier eras" (Kinginger, 2013a, p. 345). In addition to more travel options and greater technology availability, study…

Developing a made-in-Canada climate change option

International Nuclear Information System (INIS)

Lakeman, B.

2002-01-01

A federal paper on Kyoto options served as a basis for this presentation. The author outlines the Alberta perspective on the federal options paper: (1) Alberta is impacted inequitably under all scenarios, (2) incomplete analysis, (3) export of Canadian capital, (4) open-ended liability, and (5) options need to reflect principles developed by Premiers and conveyed to Prime Minister in February. The principles for climate change action are: shared understanding of range of real costs, informed consultation, avoid competitive disadvantage, collaboration at all levels of government, no unreasonable share of the burden, encourage the use of new technology, Canadians need to be part of climate change solution, and focus on energy conservation and efficiency. The Alberta plan of action calls for a longer time frame and consultation with Albertans. With the topic of greenhouse gases (GHG), government leadership is required in the following areas: mandatory GHG reporting program, facilitate and negotiate agreements with key sectors, develop approach to emissions trading, and continue to pursue reductions in government operations. Some of the key initiatives include technology and innovation through the Alberta Energy Research Institute (AERI), build critical mass through partnerships, focus on clean hydrocarbon development and the transition to the hydrogen economy, carbon dioxide capture and storage, aggressive energy conservation, agricultural and forestry sinks, and adaptation. The consultation strategy is described. figs

Energy conservation and end-use technologies for the 21. Century

International Nuclear Information System (INIS)

Maass, G.; Wagner, H.F.

1994-01-01

This paper deals with technology options which are: deployed, demonstrated, prospective and conceivable technology. Then, it explains where these options are most important: electricity production and distribution, transport technologies and fuels, residential and commercial buildings, industry. (TEC)

Gender in clinical neuropsychology: practice survey trends and comparisons outside the specialty.

Science.gov (United States)

Sweet, Jerry J; Lee, Catherine; Guidotti Breting, Leslie M; Benson, Laura M

2018-02-01

This paper describes gender-related trends within clinical neuropsychology, based primarily on recurrent practice surveys within the specialty and, to a lesser extent, job-related information from medical specialties and the general U.S. labor market. Chronological and cross-sectional analyses of professional practice survey data from 2005, 2010, and 2015 relevant to gender. As is common with survey data, descriptive analysis and independent samples t-tests were conducted. Longitudinal data allowed for examination of gender trends, as well as observations of change and stability of factors associated with gender, over time. Women have become dominant in number in clinical neuropsychology, and also comprise a vast majority of practitioners entering the specialty. Gender differences are noted in professional identity, work status, work settings, types of career satisfaction, and retirement expectations. Women are more likely to identify work environment and personal/family obstacles to aspects of career satisfaction. A gender pay gap was found at all time points and is not narrowing. As is true nationally, multiple factors appear related to the gender pay gap in clinical neuropsychology. Women in neuropsychology are now dominant in number, and their presence is strongly associated with specific practice patterns, such as greater institutional employment, less involvement in forensic practice, and strong involvement in pediatric practice, which may be maintaining the sizeable gender pay gap in neuropsychology. As the proportion of women neuropsychologists continues to increase, flexible work hours, and alternative means of remuneration may be needed to offset current disproportionate family-related responsibilities.

Options identification programme for demonstration of nuclear desalination

International Nuclear Information System (INIS)

1996-08-01

This report responds to Resolutions GC(XXXVIII)/RES/7 in 1994 and GC(XXXIX)/RES/15 in 1995 at the IAEA General Conference, which requested the Director General to initiate a two year Options Identification Programme to identify and define practical options for demonstration of nuclear desalination and to submit a report on this programme to the General Conference of 1996. This programme was implemented by a Working Group, consisting of experts from interested Member States and IAEA staff, through a combination of periodic meetings and individual work assignments. It resulted in identification of a few practical options, based on reactor and desalination technologies which are themselves readily available without further development being required at the time of demonstration. The report thus provides a perspective how to proceed with demonstration of nuclear desalination, which is expected to help solving the potable water supply problem in the next century. Refs, figs, tabs

Power plants 2020+. Power plant options for the future and the related demand for research

International Nuclear Information System (INIS)

2010-01-01

This short overview already demonstrates that in the foreseeable future all generation options - nuclear power, fossil-fired power plants and renewable sources of energy - will continue to be applied. If, however, due to climate protection targets, energy conversion processes are to be to switched to CO 2 -free or -low carbon energy sources, comprehensive research endeavours will be required in order to advance existing technology options and to adjust them to changing conditions. This paper is bound to recommend individual fields of research from the viewpoint of the VGB Scientific Advisory Board for the period 2020 and beyond. Firstly, the generation structure in the European high-voltage grid and its development until 2020 will be considered, then the research demand for - Hard coal- and lignite-fired power plants, - Renewables-based electricity generation (wind, solar energy) and - Nuclear-based electricity generation will be outlined briefly, listing the main technology issues to be answered by researchers in order to increase efficiency and to settle any ''loose ends''. Apart from generation technologies, the options for storing electrical energy will also be dealt with. These options can contribute to make the feed-in of renewables-based electricity more permanent and sustainable. (orig.)

Routine Prenatal Care Visits by Provider Specialty in the United States, 2009-2010

Science.gov (United States)

... and are not in the specialties of anesthesiology, pathology, or radiology. The NAMCS physician response rate was ... last reviewed: November 6, 2015 Page last updated: March 13, 2014 Content source: Email Recommend Tweet YouTube ...

Spent fuel storage options: a critical appraisal

International Nuclear Information System (INIS)

Singh, K.P.; Bale, M.G.

1990-01-01

The delayed decisions on nuclear fuel reprocessing strategies in the USA and other countries have forced the development of new long-term irradiated fuel storage techniques, to allow a larger volume of fuel to be held on the nuclear station site after removal from the reactor. The nuclear power industry has responded to the challenge by developing several viable options for long-term onsite storage, which can be employed individually or in tandem. They are: densification of storage in the existing spent fuel pool; building another fuel pool facility at the plant site; onsite cask park, and on site vault clusters. Desirable attributes of a storage option are: Safety: minimise the number of fuel handling steps; Economy: minimise total installed, and O and M cost; Security: protection from anti-nuclear protesters; Site adaptability: available site space, earthquake characteristics of the region and so on; Non-intrusiveness: minimise required modifications to existing plant systems; Modularisation: afford the option to adapt a modular approach for staged capital outlays; and Maturity: extent of industry experience with the technology. A critical appraisal is made of each of the four aforementioned storage options in the light of these criteria. (2 figures, 1 table, 4 references) (Author)

Retrieval options study

Energy Technology Data Exchange (ETDEWEB)

1980-03-01

This Retrieval Options Study is part of the systems analysis activities of the Office of Nuclear Waste Isolation to develop the scientific and technological bases for radioactive waste repositories in various geologic media. The study considers two waste forms, high level waste and spent fuel, and defines various classes of waste retrieval and recovery. A methodology and data base are developed which allow the relative evaluation of retrieval and recovery costs and the following technical criteria: safety; technical feasibility; ease of retrieval; probable intact retrieval time; safeguards; monitoring; criticality; and licensability. A total of 505 repository options are defined and the cost and technical criteria evaluated utilizing a combination of facts and engineering judgments. The repositories evaluated are selected combinations of the following parameters: Geologic Media (salt, granite, basalt, shale); Retrieval Time after Emplacement (5 and 25 years); Emplacement Design (nominal hole, large hole, carbon steel canister, corrosion resistant canister, backfill in hole, nominal sleeves, thick wall sleeves); Emplacement Configuration (single vertical, multiple vertical, single horizontal, multiple horizontal, vaults; Thermal Considerations; (normal design, reduced density, once-through ventilation, recirculated ventilation); Room Backfill; (none, run-of-mine, early, 5 year delay, 25 year delay, decommissioned); and Rate of Retrieval; (same as emplacement, variably slower depending on repository/canister condition).

An options approach to investment in a hydrogen infrastructure

International Nuclear Information System (INIS)

Benthem, A.A. van; Kramer, G.J.; Ramer, R.

2006-01-01

This paper discusses the investments needed for the introduction of hydrogen as a transport fuel. Using option theory, we develop a model to calculate the value and optimal timing of a first commercial rollout of hydrogen vehicles in a larger area, taking Japan as a specific example. We find that the project is best viewed as an out-of-the-money call option with a small but positive option value. We estimate this value at approximately 1.5 billion euros, without tax advantages. An important finding is that the moment of investment is first and foremost determined by the maturing of the technology. By contrast, the investment timing is not as much affected by deployment strategy as is frequently thought: in particular, whether or not the hydrogen retail infrastructure is introduced smoothly does not sensitively influence the investment timing. Fairly independent of parameter assumptions, the project value at the moment of deployment is negative for the retailer and positive for the car manufacturer. This implies the need for a negotiated partnership. Finally, we assess various forms of government support, e.g. subsidies or tax cuts. Looking at the effectiveness of this support spending in relation to the advancement of hydrogen deployment, we find, again because investment timing is primarily determined by technology maturation, that tax incentives are relatively ineffective. We are lead to believe that government subsidy for technology development is a more effective means to achieve earlier investment, as faster production cost reductions for hydrogen and fuel cell vehicles lead to accelerated investment

The Emergence and Development of the Sociology of Sport as an Academic Specialty.

Science.gov (United States)

Loy, John W.; And Others

1980-01-01

Sport sociology as an academic specialty and its stages of development are described. Problems confronting future developments in sport sociology include critical mass, academic status, and ideological orientation, both in physical education and in sociology. (CJ)

Application-specific specialty microstructured optical fibers for mid-IR and THz photonics (Invited)

DEFF Research Database (Denmark)

Pal, Bishnu P.; Barh, Ajanta; Varshney, Ravi K.

2016-01-01

A review of several of our designed specialty microstructured optical fibers (MOFs) for mid-IR and THz generation and transmission including high power transmission is presented. Extensive results on performance of the designed MOFs are described....

Wind energy technology: an option for a renewable clean environment energy. Low impact renewable energy: options for a clean environment and healthy Canadian economy

International Nuclear Information System (INIS)

Salmon, J.

1999-01-01

As Canada debates ways to address climate change, the country's low-impact renewable energy industries want to ensure that Canadians are provided with all of the options available to them. Accordingly, they have come together to create Options for a Clean Environment and Healthy Canadian Economy. Recognizing there is no 'silver bullet' solution to climate change, this document identifies an important suite of measures that, along with others, will allow Canada to achieve its long-term economic and environmental goals. The measures described in this document represent an investment in Canada's future. If implemented, they will reduce annual greenhouse gas (GHG) emissions by more than 12 million tonnes (Mt) by the year 2010 (roughly 8% of Canada's reduction target), create thousands of new jobs, and reduce health-care costs by millions of dollars each year. The most significant dividends from these measures, however, will occur after 2010 as a result of having set in motion fundamental changes in the attitudes of Canadians and the nature of the Canadian energy market. By 2020, the spin-off actions prompted by these measures will likely have resulted in GHG reductions twice as great as those achieved in 2010. This document highlights the opportunities associated specifically with Canada's low-impact renewable energy resources. These are non-fossil-fuel resources that are replenished through the earth's natural cycles and have a minimal impact on the environment and human health. They include wind, solar, earth energy, run-of-river hydro and sustainable biomass fuels. These resources can replace fossil fuels in a variety of areas, including electricity and space and water heating. Fuel cells, although not a renewable resource in themselves, are a promising technology that in combination with renewables have the potential to deliver versatile low-impact electricity. The document also identifies opportunities associated with the increased use of passive renewable energy

Designing flexible engineering systems utilizing embedded architecture options

Science.gov (United States)

Pierce, Jeff G.

This dissertation develops and applies an integrated framework for embedding flexibility in an engineered system architecture. Systems are constantly faced with unpredictability in the operational environment, threats from competing systems, obsolescence of technology, and general uncertainty in future system demands. Current systems engineering and risk management practices have focused almost exclusively on mitigating or preventing the negative consequences of uncertainty. This research recognizes that high uncertainty also presents an opportunity to design systems that can flexibly respond to changing requirements and capture additional value throughout the design life. There does not exist however a formalized approach to designing appropriately flexible systems. This research develops a three stage integrated flexibility framework based on the concept of architecture options embedded in the system design. Stage One defines an eight step systems engineering process to identify candidate architecture options. This process encapsulates the operational uncertainty though scenario development, traces new functional requirements to the affected design variables, and clusters the variables most sensitive to change. The resulting clusters can generate insight into the most promising regions in the architecture to embed flexibility in the form of architecture options. Stage Two develops a quantitative option valuation technique, grounded in real options theory, which is able to value embedded architecture options that exhibit variable expiration behavior. Stage Three proposes a portfolio optimization algorithm, for both discrete and continuous options, to select the optimal subset of architecture options, subject to budget and risk constraints. Finally, the feasibility, extensibility and limitations of the framework are assessed by its application to a reconnaissance satellite system development problem. Detailed technical data, performance models, and cost estimates

The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.

Science.gov (United States)

Salgia, Reena J; Mullan, Patricia B; McCurdy, Heather; Sales, Anne; Moseley, Richard H; Su, Grace L

2014-11-01

With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation. Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases. This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.

Factors Affecting the Choice of Anesthesiology by Medical Students for Specialty Training.

Science.gov (United States)

Chandra, Phool; Hughes, Mark

1984-01-01

A study of medical students' choice of anesthesiology as a specialty and the quality of clerkships available established several factors in students' choice, including the negative effect of certified registered nurse anesthetists on the operating room floor. A study of relationships with nurse practitioners, physician's assistants, and…

On the Development of Professional Competence in Students of Creative Pedagogical Specialties

Science.gov (United States)

Makhashova, Patima; Meirmanov, Asylbek; Zhunusbekov, Zhaxybek; Makasheva, Orynkul; Mirzaliyeva, Elmira; Ermuratova, Almagul; Sakenov, Janat

2016-01-01

The relevance of the topic revealed is caused by necessity to update the organization of professional activity for pedagogical higher education institution on a competence-based basis, creating conditions for developing the corresponding professional competences in students of creative pedagogical specialties. The paper addresses the structure,…

Association of gender and specialty interest with video-gaming, three-dimensional spatial analysis, and entry-level laparoscopic skills in third-year veterinary students.

Science.gov (United States)

Bragg, Heather R; Towle Millard, Heather A; Millard, Ralph P; Constable, Peter D; Freeman, Lyn J

2016-06-15

OBJECTIVE To determine whether gender or interest in pursuing specialty certification in internal medicine or surgery was associated with video-gaming, 3-D spatial analysis, or entry-level laparoscopic skills in third-year veterinary students. DESIGN Cross-sectional study. SAMPLE A convenience sample of 68 (42 female and 26 male) third-year veterinary students. PROCEDURES Participants completed a survey asking about their interest in pursuing specialty certification in internal medicine or surgery. Subsequently, participants' entry-level laparoscopic skills were assessed with 3 procedures performed in box trainers, their video-gaming skills were tested with 3 video games, and their 3-D spatial analysis skills were evaluated with the Purdue University Visualization of Rotations Spatial Test. Scores were assigned for laparoscopic, video-gaming, and 3-D spatial analysis skills. RESULTS Significantly more female than male students were interested in pursuing specialty certification in internal medicine (23/42 vs 7/26), and significantly more male than female students were interested in pursuing specialty certification in surgery (19/26 vs 19/42). Males had significantly higher video-gaming skills scores than did females, but spatial analysis and laparoscopic skills scores did not differ between males and females. Students interested in pursuing specialty certification in surgery had higher video-gaming and spatial analysis skills scores than did students interested in pursuing specialty certification in internal medicine, but laparoscopic skills scores did not differ between these 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE For this group of students, neither gender nor interest in specialty certification in internal medicine versus surgery was associated with entry-level laparoscopy skills.

Getting the right balance? A mixed logit analysis of the relationship between UK training doctors' characteristics and their specialties using the 2013 National Training Survey.

Science.gov (United States)

Rodriguez Santana, Idaira; Chalkley, Martin

2017-08-11

To analyse how training doctors' demographic and socioeconomic characteristics vary according to the specialty that they are training for. Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors' characteristics and their specialty. Doctors in training in the United Kingdom in 2013. 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-valuevalue<0.01). There are systematic and substantial differences between specialties in respect of training doctors' gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

Systems engineering study: tank 241-C-103 organic skimming,storage, treatment and disposal options

Energy Technology Data Exchange (ETDEWEB)

Klem, M.J.

1996-10-23

This report evaluates alternatives for pumping, storing, treating and disposing of the separable phase organic layer in Hanford Site Tank 241-C-103. The report provides safety and technology based preferences and recommendations. Two major options and several varations of these options were identified. The major options were: 1) transfer both the organic and pumpable aqueous layers to a double-shell tank as part of interim stabilization using existing salt well pumping equipment or 2) skim the organic to an above ground before interim stabilization of Tank 241-C-103. Other options to remove the organic were considered but rejected following preliminary evaluation.

Survey and selection of assessment methodologies for GAVE options

International Nuclear Information System (INIS)

Weterings, R.

1999-05-01

The Dutch government is interested in the possibilities for a market introduction of new gaseous and liquid energy carriers. To this purpose the GAVE-programme was recently set up. This study is carried out within the framework of the GAVE-programme and aims at the selection of methodologies for assessing the technological, economic, ecological and social perspectives of these new energy options (so-called GAVE-options). Based on the results of these assessments the Dutch ministries of Housing, Planning and Environment (VROM) and Economic Affairs (EZ) will decide at the end of 1999 about starting demonstration projects of promising energy carriers

Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties.

Science.gov (United States)

Baker-Genaw, Kimberly; Kokas, Maria S; Ahsan, Syed F; Darnley-Fisch, Deborah; Drake, Sean; Goyal, Nikhil; Inamdar, Kedar; Moutzouros, Vasilios; Prabhakar, Deepak; Rolland, Laurie; Sangha, Roopina; Shreve, Maria; Woodward, Ann

2016-07-01

Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones. We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties. The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool-the Kalamazoo Essential Elements of Communication Checklist-Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared. The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs. The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.

History of technology in the intensive care unit.

Science.gov (United States)

Puri, Nitin; Puri, Vinod; Dellinger, R P

2009-01-01

Critical care medicine is a young specialty and since its inception has been heavily reliant upon technology. Invasive monitoring has its humble beginnings in the continuous monitoring of heart rate and rhythm. From the development of right heart catheterization to the adaption of the echocardiogram for use in shock, intensivists have used technology to monitor hemodynamics. The care of the critically ill has been buoyed by investigators who sought to offer renal replacement therapy to unstable patients and worked to improve the monitoring of oxygen saturation. The evolution of mechanical ventilation for the critically ill embodies innumerable technological advances. More recently, critical care has insisted upon rigorous testing and cost-benefit analysis of technological advances.

Hedging Yield with Weather Derivatives: A Role for Options

OpenAIRE

Manfredo, Mark R.; Richards, Timothy J.

2005-01-01

While there are few risk management alternatives available to specialty crop growers, weather derivatives provide an important advancement. As with the use of any derivatives contract, the behavior of the basis will ultimately determine the net-hedged outcome. However, when using weather derivatives to hedge yield risks for specialty crops, growers face a unique form of basis risk because weather (temperature) and yield are nonlinearly related. Using the forecast encompassing principle, this ...

Interventional radiology as clinical specialty and how this affects the radiology specialty as a whole

International Nuclear Information System (INIS)

Tsetis, D.

2015-01-01

Full text: Interventional Radiologists (IRs) are medical doctors who are trained in imaging but have undergone additional specialist training in highly demanding image-guided techniques. For this reason they play an increasingly important clinical role which is expanding beyond IR/angiography suite. As IR practice is fundamentally different from diagnostic imaging, the Radiology departments should be adapted to facilitate this special task. Interventional Radiologists should be able to fulfil their task as patient’s primary doctor and exert direct clinical responsibility for the patient under their care. They should be able to clinically assess and counsel patients before a procedure, inform them about the risks of the procedure and possible alternative treatment options, obtain valid consent and follow-up them after the procedure. they should also effectively communicate with referring physicians and develop strategies to deal with complex clinical situations and difficult clinical scenarios. In this context it is imperative for IRs to participate regularly in multidisciplinary clinical meetings and multidisciplinary forums to ensure optimum care. As clinicians, IR’s must be involved with the day to day management of their patients’ care to ensure optimal outcomes for patients. This may involve shared care with a broad range of specialists, however IR’s should aim to have direct access to inpatients beds where they can admit and discharge patients as necessary, with sufficient time allocated for this activity. As the number and demand of IR day cases steadily increases, IR units should organize day case facilities staffed with nursing and clerical staff which can result in major cost savings to hospitals. In this context the Head of Radiology department should convince hospital authorities to establish outpatient clinic facilities with nursing and clerical support where referred patients can be counselled and reviewed in a quiet environment. In order to

Exotic Options: a Chooser Option and its Pricing

Directory of Open Access Journals (Sweden)

Raimonda Martinkutė-Kaulienė

2012-12-01

Full Text Available Financial instruments traded in the markets and investors’ situation in such markets are getting more and more complex. This leads to more complex derivative structures used for hedging that are harder to analyze and which risk is harder managed. Because of the complexity of these instruments, the basic characteristics of many exotic options may sometimes be not clearly understood. Most scientific studies have been focused on developing models for pricing various types of exotic options, but it is important to study their unique characteristics and to understand them correctly in order to use them in proper market situations. The paper examines main aspects of options, emphasizing the variety of exotic options and their place in financial markets and risk management process. As the exact valuation of exotic options is quite difficult, the article deals with the theoretical and practical aspects of pricing of chooser options that suggest a broad range of usage and application in different market conditions. The calculations made in the article showed that the price of the chooser is closely correlated with the choice time and low correlated with its strike price. So the first mentioned factor should be taken into consideration when making appropriate hedging and investing decisions.

Safeguardability of the vitrification option for disposal of plutonium

Energy Technology Data Exchange (ETDEWEB)

Pillay, K.K.S. [Los Alamos National Lab., NM (United States)

1996-05-01

Safeguardability of the vitrification option for plutonium disposition is rather complex and there is no experience base in either domestic or international safeguards for this approach. In the present treaty regime between the US and the states of the former Soviet Union, bilaterial verifications are considered more likely with potential for a third-party verification of safeguards. There are serious technological limitations to applying conventional bulk handling facility safeguards techniques to achieve independent verification of plutonium in borosilicate glass. If vitrification is the final disposition option chosen, maintaining continuity of knowledge of plutonium in glass matrices, especially those containing boron and those spike with high-level wastes or {sup 137}Cs, is beyond the capability of present-day safeguards technologies and nondestructive assay techniques. The alternative to quantitative measurement of fissile content is to maintain continuity of knowledge through a combination of containment and surveillance, which is not the international norm for bulk handling facilities.

Real options valuation of fusion energy R and D programme

International Nuclear Information System (INIS)

Bednyagin, Denis; Gnansounou, Edgard

2011-01-01

This paper aims to perform a real options valuation of fusion energy R and D programme. Strategic value of thermonuclear fusion technology is estimated here based on the expected cash flows from construction and operation of fusion power plants and the real options value arising due to managerial flexibility and the underlying uncertainty. First, a basic investment option model of Black-Scholes type is being considered. Then, a fuzzy compound real R and D option model is elaborated, which reflects in a better way the multi-stage nature of the programme and takes into account the imprecision of information as one of the components of the overall programme uncertainty. Two different strategies are compared: 'Baseline' corresponding to a relatively moderate pace of fusion research, development, demonstration and deployment activities vs. 'Accelerated' strategy, which assumes a rapid demonstration and massive deployment of fusion. The conclusions are drawn from the model calculations regarding the strategic value of fusion energy R and D and the advantages of accelerated development path. - Research highlights: → Real options analysis of fusion R and D, demonstration and deployment (RDDD) programme. → ENPV of fusion RDDD programme is calculated using stochastic probabilistic simulation. → Fusion RDDD programme exhibits substantial positive real options value: Euro 245 billion. → Fuzzy compound real option valuation method provides more robust results.

Multi-criteria Evaluation of Nuclear Option

International Nuclear Information System (INIS)

Feretic, D.; Tomsic, Z.; Jaksic, D.

2002-01-01

When evaluating power system expansion scenarios there is a need to take into consideration a range of measurable and non-measurable impacts. Measurable impacts are fixed and variable production costs and, recently, external costs. Non-measurable impacts include public attitude to certain energy technology and investor's risk in achieving the expected profit (regulatory and political risk). Public attitude has a large and sometimes essential impact on decision-making. It is mostly associated with the expected environmental impact of a potential power plant and can be divided in rational and non-rational part. Rational part, which is in proportion with scientifically approved environmental impact of energy options (inversely proportional to external costs) is relatively small, while the other, non-rational category which is not proportional with the actual environmental impact (especially in the case of nuclear power), is much larger. Investor's risk in achieving the expected profit is mostly associated with possible changes of domestic or foreign regulations or policy that can influence power plant operation and long-term fuel availability and price. Two factors that affect decision-making should be distinguished. The first is the total impact of certain non-measurable factor and the other is the impact of certain technology on that non-measurable factor like public impact, for example. The objective of multi-criteria evaluation, after weighting and quantification of all impacts is to determine the most acceptable power system expansion option. In the article a simplified quantification will be made of measurable (investment costs, annual maintenance costs, fuel price, indirect costs of power plants) and non-measurable (public attitude, investor's risk) elements that affect future investment decision. For that purpose possible relative values of non-measurable impacts of different options will be determined (their weights and impact on relative increase of annual

Eco-efficiency assessment of options for metal recovery from incineration residues: a conceptual framework.

Science.gov (United States)

Meylan, Grégoire; Spoerri, Andy

2014-01-01

Residues from municipal solid waste (MSW) incineration in Switzerland have been a hot topic in recent years, both in the research and practice communities. Regarded by many as an economically and environmentally sound solution to this issue, technological retrofitting of existing grate incinerators has the dual purpose of enhancing the metal recovery of bottom and fly ashes and improving the inertization of residues to be landfilled. How does context influence the economic and environmental performance of this particular technological option? Under which conditions would this technological option be implemented nationwide in the future? What are stakeholders' views on sustainable transitions of MSW incineration? We propose a three-stage methodological procedure to address these questions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Real Options Analysis of Electricity Investments

Energy Technology Data Exchange (ETDEWEB)

Heggedal, Ane Marte

2012-07-01

This thesis utilizes real options analysis for evaluating investment opportunities in the electricity sector. It also formally tests how investors in hydropower plants have included uncertainty when considering their investment opportunities. The real options method applies financial options theory to quantify the value of management flexibility and is chosen due to three important characteristics of investments in the electricity sector. First; the investment is completely or partially irreversible, second; the investor can choose when to invest in the facility, and third; there is uncertainty in several factors affecting the cash flows of the investments. Factors of uncertainty include the development of electricity prices, policies, technological advances, and macroeconomics measures.Four papers are included in this thesis. Paper 1, Upgrading hydropower plants with storage: Timing and capacity choice, presents a valuation framework for deciding when to upgrade an existing hydropower plant and which capacity to choose. The second paper, Transmission capacity between Norway and Germany: A real options analysis, sheds light on when two electricity markets, in this case Norway and Germany, should be connected through a sub sea cable. The investor can choose when to invest and the capacity of the cable, and may also choose to invest sequentially. Paper 3, Optimal timing and capacity choice for pumped hydropower storage, investigates when investment in a pumped hydropower plant with storage should be undertaken and what the capacity of the facility should be. Whereas the three first papers investigate investment opportunities, Paper 4, Uncertain climate policy decisions and investment timing: Evidence from small hydropower plants, studies when investors in small hydropower plants chose to invest. The analyses disclose whether the net present value approach or the real options method best describe the investment decisions made by the investors. Viewing investment

Oral speech teaching to students of mathematic specialties: a grammatical aspect

Directory of Open Access Journals (Sweden)

Ibragimov I.I.

2016-08-01

Full Text Available the paper considers teaching features of English speech grammar aspects. The case studies include undergraduates of mathematical specialties. The content of students’ educational activity at the final stage of language teaching is pointed out. Besides the structure of grammar section, a special didactic training unit in which framework mastering grammar phenomena used in oral speech takes place is described.

NASA 20th Century Explorer . . . Into the Sea of Space. A Guide to Careers in Aero-Space Technology.

Science.gov (United States)

National Aeronautics and Space Administration, Washington, DC.

This pamphlet lists career opportunities in aerospace technology announced by the Boards of the U. S. Civil Service for the National Aeronautics and Space Administration (NASA). Information given includes (1) the work of the NASA, (2) technical and administrative specialties in aerospace technology, (3) educational and experience requirements, and…

Prediction of specialty coffee cup quality based on near infrared spectra of green coffee beans.

Science.gov (United States)

Tolessa, Kassaye; Rademaker, Michael; De Baets, Bernard; Boeckx, Pascal

2016-04-01

The growing global demand for specialty coffee increases the need for improved coffee quality assessment methods. Green bean coffee quality analysis is usually carried out by physical (e.g. black beans, immature beans) and cup quality (e.g. acidity, flavour) evaluation. However, these evaluation methods are subjective, costly, time consuming, require sample preparation and may end up in poor grading systems. This calls for the development of a rapid, low-cost, reliable and reproducible analytical method to evaluate coffee quality attributes and eventually chemical compounds of interest (e.g. chlorogenic acid) in coffee beans. The aim of this study was to develop a model able to predict coffee cup quality based on NIR spectra of green coffee beans. NIR spectra of 86 samples of green Arabica beans of varying quality were analysed. Partial least squares (PLS) regression method was used to develop a model correlating spectral data to cupping score data (cup quality). The selected PLS model had a good predictive power for total specialty cup quality and its individual quality attributes (overall cup preference, acidity, body and aftertaste) showing a high correlation coefficient with r-values of 90, 90,78, 72 and 72, respectively, between measured and predicted cupping scores for 20 out of 86 samples. The corresponding root mean square error of prediction (RMSEP) was 1.04, 0.22, 0.27, 0.24 and 0.27 for total specialty cup quality, overall cup preference, acidity, body and aftertaste, respectively. The results obtained suggest that NIR spectra of green coffee beans are a promising tool for fast and accurate prediction of coffee quality and for classifying green coffee beans into different specialty grades. However, the model should be further tested for coffee samples from different regions in Ethiopia and test if one generic or region-specific model should be developed. Copyright © 2015 Elsevier B.V. All rights reserved.

A Methodology for Comparative Assessment of Energy Options: The Case of Mexico

International Nuclear Information System (INIS)

Martin-del-Campo, Cecilia; Francois, Juan-Luis

2008-01-01

This paper presents the development of a methodology to measure the sustainability of alternatives for electricity generation. It is based on the evaluation of indicators in three dimensions of sustainability. No single technology exhibited superior performance on the basis of all indicators and it was necessary the application of a method to make the aggregation of all the indicators, taking into account the relative importance in the decision. In this study, a fuzzy logic inference system was developed to build a decision function that depends on all the indicators. The purpose is to rank the energy options in terms of economic, environmental and social sustainability. All the decision elements are combined and integrated in an inference logic system that takes into account weights of different indicators. The methodology was applied to evaluate the sustainability of nuclear, wind, natural gas, coal, hydro and oil technologies under Mexican conditions. When only the economic dimension is considered nuclear is the best option, if the environmental dimension is also considered the nuclear option is the best alternative too. When the social dimension is also taken into account the nuclear option is the worst. These results are obtained using the same weight to each dimension to accomplish with the equilibrium principle of the sustainability. (authors)

78 FR 17140 - Upholstered Furniture Fire Safety Technology; Meeting and Request for Comments

Science.gov (United States)

2013-03-20

... retardant (FR) chemicals, specialty fibers/fabrics without FR chemicals, inherently fire resistant materials... Furniture Fire Safety Technology; Meeting and Request for Comments AGENCY: Consumer Product Safety... Commission (CPSC, Commission, or we) is announcing its intent to hold a meeting on upholstered furniture fire...

Physician attitudes toward industry: a view across the specialties

Science.gov (United States)

Korenstein, Deborah; Keyhani, Salomeh; Ross, Joseph S.

2010-01-01

Objectives Physician relationships with industry are receiving attention as government and professional organizations move toward restrictive policies and financial transparency. Our objective was to explore attitudes of physicians from all specialties toward gifts from and interactions with the pharmaceutical and device industries. Design Anonymous cross sectional survey. Setting Hospitals in the Mount Sinai School of Medicine consortium, in the New York City metro area Participants Faculty and trainee physicians from all clinical departments Main Outcome Measures Attitudes toward industry interactions and gifts and their appropriateness, measured on 4-point Likert scales. Results Five hundred ninety physicians and medical students completed the survey (response rate=67%); 59% were male, 39% were attendings, and 24% were from surgical specialties. Attitudes toward industry and gifts were generally positive. More than 65% found educational materials and sponsored lunches appropriate, whereas fewer than 25% considered vacations or large gifts appropriate. Surgeons, trainees, and those unfamiliar with institutional policies on industry interactions held more positive attitudes than others and were more likely to deem some gifts appropriate, including industry funding of residency programs and, among surgeons, receiving meals, travel expenses, and payments for attending lectures. Non-attendings held more positive attitudes toward meals in clinical settings, textbooks and samples. Conclusions Physicians continue to hold positive attitudes toward marketing-oriented activities of the pharmaceutical and device industries. Changes in medical culture and physician education focused on surgeons and trainees may align physician attitudes with current policy trends. PMID:20566978

Municipal solid waste options : integrating organics management and residual disposal treatment : executive summary

Energy Technology Data Exchange (ETDEWEB)

Cant, M. (comp.) [Totten Sims Hubicki Associates Ltd., Calgary, AB (Canada); Van der Werf, P. [2cg Inc., Edmonton, AB (Canada); Kelleher, M. [Kelleher Environmental, Toronto, ON (Canada); Merriman, D. [MacViro Consultants, Markham, ON (Canada); Fitcher, K. [Gartner Lee Ltd., Toronto, ON (Canada); MacDonald, N. [CH2M Hill Engineering Ltd., Calgary, AB (Canada)