34 CFR 300.101 - Free appropriate public education (FAPE).

Science.gov (United States)

2010-07-01

... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility Fape Requirements § 300.101 Free appropriate... ensure that FAPE is available to any individual child with a disability who needs special education and... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education (FAPE). 300.101...

78 FR 22501 - Designation of Areas for Air Quality Planning Purposes; State of Nevada; Total Suspended Particulate

Science.gov (United States)

2013-04-16

... Areas for Air Quality Planning Purposes; State of Nevada; Total Suspended Particulate AGENCY... designations for total suspended particulate within the State of Nevada because the designations are no longer necessary. These designations relate to the attainment or unclassifiable areas for total suspended...

Measuring the Total Economic Value of State-Funded Higher Education in Iowa

OpenAIRE

Swenson, David A.

2011-01-01

This is an evaluation of the statewide total economic value of state-funded higher education in Iowa. The analysis is based on Fiscal Year 2010 final budgeted values for Iowa's three Board of Regents universities and their teaching hospital, as well as the state's 15 community colleges. Final budget year data were obtained from the respective state universities' web sites, from the Board of Regents, and from the Annual Condition of Iowa's Community Colleges, 2010, report published by the Iowa...

Total hip arthroplasty in chronic dialysis patients in the United States.

Science.gov (United States)

Abbott, Kevin C; Bucci, Jay R; Agodoa, Lawrence Y

2003-01-01

The national incidence of and factors associated with total hip arthroplasty (THA) in chronic dialysis patients has never been reported. We therefore performed an historical cohort study of 375,857 chronic dialysis patients listed in the 2000 United States Renal Data System between 1 April 1995 and 31 December 1999 and followed-up until 14 May 2000. Primary outcomes were associations with hospitalizations for a primary discharge code of THA (ICD9 procedure code 81.51x) after initiation of dialysis. Dialysis patients had a cumulative incidence of THA of 35 episodes/10,000 person-years, compared to 5.3/10,000 in the general population. The leading indication for THA was osteoarthritis of the hip and pelvis (58% of cases). However, the strongest risk factor for THA in dialysis patients was end-stage renal disease (ESRD) due to systemic lupus erythematosus (SLE, adjusted rate ratio (ARR), 6.80, 95% CI 4.62-10.03, in whom avascular necrosis of the hip was the most common indication, 68.4%). The database did not include information on use of corticosteroids. Diabetic recipients were significantly less likely to receive THA, as were males, and African Americans. Mortality after THA was 0.25% at thirty days and 30% at three years, not significantly different from the expected mortality of dialysis, adjusted for comorbidity. The most common indication for THA in dialysis patients is osteoarthritis of the hip, similar to the general population. Patients with SLE are more likely to receive THA which is well tolerated and not associated with increased mortality in this population, perhaps reflecting selection bias due to appropriate screening for this elective procedure.

Flood risk management in Flanders: from flood risk objectives to appropriate measures through state assessment

Directory of Open Access Journals (Sweden)

Verbeke Sven

2016-01-01

Full Text Available In compliance with the EU Flood Directive to reduce flood risk, flood risk management objectives are indispensable for the delineation of necessary measures. In Flanders, flood risk management objectives are part of the environmental objectives which are judicially integrated by the Decree on Integrated Water Policy. Appropriate objectives were derived by supporting studies and extensive consultation on a local, regional and policy level. Under a general flood risk objective sub-objectives are formulated for different aspects: water management and safety, shipping, ecology, and water supply. By developing a risk matrix, it is possible to assess the current state of flood risk and to judge where action is needed to decrease the risk. Three different states of flood risk are distinguished: a acceptable risk, where no action is needed, b intermediate risk where the risk should be reduced by cost efficient actions, and c unacceptable risk, where action is necessary. For each particular aspect, the severity of the consequences of flooding is assessed by quantifiable indicators, such as economic risk, people at risk and ecological flood tolerance. The framework also allows evaluating the effects of the implemented measures and the autonomous development such as climate change and land use change. This approach gives a quantifiable assessment of state, and enables a prioritization of flood risk measures for the reduction of flood risk in a cost efficient and sustainable way.

Budget estimates fiscal year 1989: Appropriation, Salaries and expenses

International Nuclear Information System (INIS)

1988-02-01

The budget estimates for Salaries and Expenses for FY 1989 provide for obligations of $450,000,000 to be funded in total by a new appropriation. The sum appropriated shall be reduced by the amount of revenues received during fiscal year 1989 from licensing fees, inspection services, and other services and collections, excluding those monies received for the cooperative nuclear safety research program, services rendered to foreign governments and international organizations, and the material and information access authorization programs, so as to result in a final fiscal year 1989 appropriation estimated at not more than $247,500,000

The Concept of Appropriateness in Issuing Administrative Acts

Directory of Open Access Journals (Sweden)

Iulian Nedelcu

2011-05-01

Full Text Available Administrative acts are a legal way of organizing the execution and enforcement of the law. Law can not and should not establish all cases and all the ways, by means of which public administration bodies interfere with administrative actions, therefore administrative public bodies must have some initiative and ought to be able to assess the situations in which they will issue these acts and to appreciate their appropriateness. The appropriateness principle of administrative acts must be correlated with the legality principle. It can be concluded that the appropriateness principle underscores the power conferred by public administration, permitted in accordance with which it has the right and duty to judge when issuing an administrative compliance of the state of lawand facts, an appreciation that public administration is based on a single criterion: the interests of the community that they represent. Also, the very organization of the state as a state of law leads to the conclusion that the law – which is the materialization of the idea of justice – should be the standard on which the activity of human individuals report both to the quality of beneficiaries of the provisions and benefits of public administration and on the other hand as officials, public servants or ordinary employees in public administration system.

Geometric measure of quantum discord and total quantum correlations in an N-partite quantum state

International Nuclear Information System (INIS)

Hassan, Ali Saif M; Joag, Pramod S

2012-01-01

Quantum discord, as introduced by Ollivier and Zurek (2001 Phys. Rev. Lett. 88 017901), is a measure of the discrepancy between quantum versions of two classically equivalent expressions for mutual information and is found to be useful in quantification and application of quantum correlations in mixed states. It is viewed as a key resource present in certain quantum communication tasks and quantum computational models without containing much entanglement. An early step toward the quantification of quantum discord in a quantum state was by Dakic et al (2010 Phys. Rev. Lett. 105 190502) who introduced a geometric measure of quantum discord and derived an explicit formula for any two-qubit state. Recently, Luo and Fu (2010 Phys. Rev. A 82 034302) introduced a generic form of the geometric measure of quantum discord for a bipartite quantum state. We extend these results and find generic forms of the geometric measure of quantum discord and total quantum correlations in a general N-partite quantum state. Further, we obtain computable exact formulas for the geometric measure of quantum discord and total quantum correlations in an N-qubit quantum state. The exact formulas for the N-qubit quantum state can be used to get experimental estimates of the quantum discord and the total quantum correlation. (paper)

TOTAL user manual

Science.gov (United States)

Johnson, Sally C.; Boerschlein, David P.

1994-01-01

Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

Wastes to Resources: Appropriate Technologies for Sewage Treatment and Conversion.

Science.gov (United States)

Anderson, Stephen P.

Appropriate technology options for sewage management systems are explained in this four-chapter report. The use of appropriate technologies is advocated for its health, environmental, and economic benefits. Chapter 1 presents background information on sewage treatment in the United States and the key issues facing municipal sewage managers.…

A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

Science.gov (United States)

Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

2018-07-01

Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

Science.gov (United States)

Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

2017-09-01

1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

Certification of Public Librarians in the United States. A Detailed Summary of Legally Mandated and Voluntary Certification Plans for Public Librarians Based on Information Supplied by the Various Certificating State Agencies or Other Appropriate Sources. 3rd Edition.

Science.gov (United States)

Coe, Mary J., Ed.

This report contains summaries of legally mandated and voluntary certification plans for public librarians in the United States based on information supplied by the various certifying state agencies or other appropriate sources in April 1979. Each plan is identified by the descriptive terms "mandatory" (certification required by law--23 states),…

Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

Science.gov (United States)

Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

2014-04-16

Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

State, Foreign Operations, and Related Programs: FY2008 Appropriations

National Research Council Canada - National Science Library

Veillette, Connie; Epstein, Susan B

2007-01-01

... an unprecedented level compared with the past 40 years. Emergency supplementals enacted since the September 11, 2001, terrorist attacks to assist the front-line states in the war on terrorism, fund Afghanistan and Iraq reconstruction, and upgrade State...

Association of Radon Background and Total Background Ionizing Radiation with Alzheimer's Disease Deaths in U.S. States.

Science.gov (United States)

Lehrer, Steven; Rheinstein, Peter H; Rosenzweig, Kenneth E

2017-01-01

Exposure of the brain to ionizing radiation might promote the development of Alzheimer's disease (AD). Analysis of AD death rates versus radon background radiation and total background radiation in U.S. states. Total background, radon background, cosmic and terrestrial background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States and Report No. 160 - Ionizing Radiation Exposure of the Population of the United States. 2013 AD death rates by U.S. state are from the Alzheimer's Association. Radon background ionizing radiation was significantly correlated with AD death rate in 50 states and the District of Columbia (r = 0.467, p = 0.001). Total background ionizing radiation was also significantly correlated with AD death rate in 50 states and the District of Columbia (r = 0.452, p = 0.001). Multivariate linear regression weighted by state population demonstrated that AD death rate was significantly correlated with radon background (β= 0.169, p ionizing radiation is a risk factor for AD. Intranasal inhalation of radon gas could subject the rhinencephalon and hippocampus to damaging radiation that initiates AD. The damage would accumulate over time, causing age to be a powerful risk factor.

Total generating costs: coal and nuclear plants

International Nuclear Information System (INIS)

1979-02-01

The study was confined to single and multi-unit coal- and nuclear-fueled electric-generating stations. The stations are composed of 1200-MWe PWRs; 1200-MWe BWRs; 800-and 1200-MWe High-Sulfur Coal units, and 800- and 1200-MWe Low-Sulfur Coal units. The total generating cost estimates were developed for commercial operation dates of 1985 and 1990; for 5 and 8% escalation rates, for 10 and 12% discount rates; and, for capacity factors of 50, 60, 70, and 80%. The report describes the methodology for obtaining annualized capital costs, levelized coal and nuclear fuel costs, levelized operation and maintenance costs, and the resulting total generating costs for each type of station. The costs are applicable to a hypothetical Middletwon site in the Northeastern United States. Plant descriptions with general design parameters are included. The report also reprints for convenience, summaries of capital cost by account type developed in the previous commercial electric-power cost studies. Appropriate references are given for additional detailed information. Sufficient detail is given to allow the reader to develop total generating costs for other cases or conditions

34 CFR 300.17 - Free appropriate public education.

Science.gov (United States)

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Free appropriate public education. 300.17 Section 300.17 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF...

Total Economic Consequences of an Influenza Outbreak in the United States.

Science.gov (United States)

Prager, Fynnwin; Wei, Dan; Rose, Adam

2017-01-01

Pandemic influenza represents a serious threat not only to the population of the United States, but also to its economy. In this study, we analyze the total economic consequences of potential influenza outbreaks in the United States for four cases based on the distinctions between disease severity and the presence/absence of vaccinations. The analysis is based on data and parameters on influenza obtained from the Centers for Disease Control and the general literature. A state-of-the-art economic impact modeling approach, computable general equilibrium, is applied to analyze a wide range of potential impacts stemming from the outbreaks. This study examines the economic impacts from changes in medical expenditures and workforce participation, and also takes into consideration different types of avoidance behavior and resilience actions not previously fully studied. Our results indicate that, in the absence of avoidance and resilience effects, a pandemic influenza outbreak could result in a loss in U.S. GDP of $25.4 billion, but that vaccination could reduce the losses to $19.9 billion. When behavioral and resilience factors are taken into account, a pandemic influenza outbreak could result in GDP losses of $45.3 billion without vaccination and $34.4 billion with vaccination. These results indicate the importance of including a broader set of causal factors to achieve more accurate estimates of the total economic impacts of not just pandemic influenza but biothreats in general. The results also highlight a number of actionable items that government policymakers and public health officials can use to help reduce potential economic losses from the outbreaks. © 2016 Society for Risk Analysis.

Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States

Science.gov (United States)

Bhadra, Arup K.; Altman, Roy; Dasa, Vinod; Myrick, Karen; Rosen, Jeffrey; Vad, Vijay; Vitanzo, Peter; Bruno, Michelle; Kleiner, Hillary; Just, Caryn

2016-01-01

Objective: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. Methods: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy. This workgroup utilized the results of a systematic review of evidence, expert clinical opinion, and current evidence-based clinical practice guidelines to develop appropriateness criteria for the use of intra-articular HA for knee OA in 17 real-world clinical scenarios. Results: The workgroup scored the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (7-9), uncertain (4-6), or inappropriate (1-3). Six scenarios were scored as appropriate, 10 scenarios were scored as uncertain, and 1 scenario was scored as inappropriate. Conclusion: This article can assist clinicians in shared decision-making by providing best practices in considering HA injections for knee OA treatment. Moreover, this AUC article can aid payers and policy makers in determining reimbursement and preauthorization policies and more appropriately managing health care resources. It is clear that further research is still necessary—particularly in patient populations differentiated by OA severity—that may benefit the greatest from the use of HA injections for the treatment of knee OA. PMID:28618868

Budget estimates, fiscal year 1984/85. Appropriation: salaries and expenses

International Nuclear Information System (INIS)

1983-01-01

This report contains the fiscal year budget justifications to Congress. The budget estimates for salaries and expenses for fiscal year 1984 to 1985 provide for obligations of $466,800,000 to be funded in total by a new appropriation

A Pilot Food Bank Intervention Featuring Diabetes-Appropriate Food Improved Glycemic Control Among Clients In Three States.

Science.gov (United States)

Seligman, Hilary K; Lyles, Courtney; Marshall, Michelle B; Prendergast, Kimberly; Smith, Morgan C; Headings, Amy; Bradshaw, Georgiana; Rosenmoss, Sophie; Waxman, Elaine

2015-11-01

Food insecurity--defined as not having adequate quantity and quality of food at all times for all household members to have an active, healthy life--is a risk factor for poor diabetes control, yet few diabetes interventions address this important factor. Food pantries, which receive food from food banks and distribute it to clients in need, may be ideal sites for diabetes self-management support because they can provide free diabetes-appropriate food to people in low-income communities. Between February 2012 and March 2014, we enrolled 687 food pantry clients with diabetes in three states in a six-month pilot intervention that provided them with diabetes-appropriate food, blood sugar monitoring, primary care referral, and self-management support. Improvements were seen in pre-post analyses of glycemic control (hemoglobin A1c decreased from 8.11 percent to 7.96 percent), fruit and vegetable intake (which increased from 2.8 to 3.1 servings per day), self-efficacy, and medication adherence. Among participants with elevated HbA1c (at least 7.5 percent) at baseline, HbA1c improved from 9.52 percent to 9.04 percent. Although food pantries are nontraditional settings for diabetes support, this pilot study suggests a promising health promotion model for vulnerable populations. Policies supporting such interventions may be particularly effective because of food pantries' food access and distribution capacity. Project HOPE—The People-to-People Health Foundation, Inc.

Oscillatory behaviour of Rydberg state total cross sections in the collisions Ne+-He and He+-Ne

International Nuclear Information System (INIS)

Andresen, B.; Jensen, K.; Veje, E.

1976-01-01

The Ne + -He and He + -Ne collisions have been studied by means of optical spectrometry in the projectile energy range 10-150 keV. Very similar and regular oscillations in the Rydberg state total cross sections are found for HeI in both collisions and for singlet as well as triplet excitation. These oscillations are well described by the Rosenthal model. The HeI 4d sup(1,3)D states display two superimposed oscillations for center-of-mass collision energies above 6.4 keV. This is interpreted as the opening of a third exit channel, believed to be the HeI 4f sup(1,3)F. No, or very little structure is found in the Rydberg state total cross sections for HeII, NeI, NeII and NeIII levels. (Auth.)

Phase Transitions in Definite Total Spin States of Two-Component Fermi Gases.

Science.gov (United States)

Yurovsky, Vladimir A

2017-05-19

Second-order phase transitions have no latent heat and are characterized by a change in symmetry. In addition to the conventional symmetric and antisymmetric states under permutations of bosons and fermions, mathematical group-representation theory allows for non-Abelian permutation symmetry. Such symmetry can be hidden in states with defined total spins of spinor gases, which can be formed in optical cavities. The present work shows that the symmetry reveals itself in spin-independent or coordinate-independent properties of these gases, namely as non-Abelian entropy in thermodynamic properties. In weakly interacting Fermi gases, two phases appear associated with fermionic and non-Abelian symmetry under permutations of particle states, respectively. The second-order transitions between the phases are characterized by discontinuities in specific heat. Unlike other phase transitions, the present ones are not caused by interactions and can appear even in ideal gases. Similar effects in Bose gases and strong interactions are discussed.

Optimising performance in steady state for a supermarket refrigeration system

DEFF Research Database (Denmark)

Green, Torben; Kinnaert, Michel; Razavi-Far, Roozbeh

2012-01-01

Using a supermarket refrigeration system as an illustrative example, the paper postulates that by appropriately utilising knowledge of plant operation, the plant wide performance can be optimised based on a small set of variables. Focusing on steady state operations, the total system performance...

Discordance between age- and size-based criteria of child passenger restraint appropriateness.

Science.gov (United States)

Smiley, Mary L; Bingham, C Raymond; Jacobson, Peter D; Macy, Michelle L

2018-04-03

In this study, we sought to accomplish the following objectives: to (1) calculate the percentage of children considered appropriately restrained across 8 criteria of increasing restrictiveness; (2) examine agreement between age- and size-based appropriateness criteria; (3) assess for changes in the percentage of children considered appropriately restrained by the 8 criteria between 2011 (shortly after updates to U.S. guidelines) and 2015. Data from 2 cross-sectional surveys of 928 parents of children younger than 12 years old (n = 591 in 2011, n = 337 in 2015) were analyzed in 2017. Child age, weight, and height were measured at an emergency department visit and used to determine whether the parent-reported child passenger restraint was considered appropriate according to 8 criteria. Age-based criteria were derived from Michigan law and U.S. Weight, height, and size-based criteria were derived from typical restraints available in the United States in 2007 and 2011. The percentage appropriate restraint use was calculated for each criterion. The kappa statistic was used to measure agreement between criteria. Change in appropriateness from 2011 to 2015 was assessed with chi-square statistics. Percentage appropriate restraint use varied from a low of 19% for higher weight limits in 2011 to a high of 91% for Michigan law in 2015. Agreement between criteria was slight to moderate. The lowest kappa was for Michigan law and higher weight limits in 2011 (κ = 0.06) and highest for U.S. guidelines and lower weight limits in 2011 (κ = 0.60). Percentage appropriate restraint use was higher in 2015 than 2011 for the following criteria: U.S. guidelines (74 vs. 58%, P consistency in reporting results from studies of child passenger safety in the United States. Potential explanations for the increased percentage of children considered appropriately restrained between 2011 and 2015 include adoption of the updated U.S. guidelines and the use of child passenger restraints with

Leadership and Total Quality Management

Science.gov (United States)

1992-04-15

leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Consultation with appropriate officials; negotiation. 1261.403 Section 1261.403 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PROCESSING OF MONETARY CLAIMS (GENERAL) Collection of Civil Claims of the United States Arising Out of the Activities of the National Aeronautic...

Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States

International Nuclear Information System (INIS)

Hopkins, Katharine L.; Vajtai, Petra L.; Pettersson, David R.; Spinning, Kristopher; Beckett, Brooke R.; Koudelka, Caroline W.; Bardo, Dianna M.E.

2013-01-01

During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI vol ). SSDE was calculated and differences among groups were compared by regression analysis. Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged. (orig.)

Size-appropriate radiation doses in pediatric body CT: a study of regional community adoption in the United States

Energy Technology Data Exchange (ETDEWEB)

Hopkins, Katharine L.; Vajtai, Petra L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Pettersson, David R.; Spinning, Kristopher; Beckett, Brooke R. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Koudelka, Caroline W. [Oregon Health and Science University, Division of Biostatistics, Department of Public Health and Preventive Medicine, Portland, OR (United States); Bardo, Dianna M.E. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Cardiovascular Medicine, Portland, OR (United States)

2013-09-15

During the last decade, there has been a movement in the United States toward utilizing size-appropriate radiation doses for pediatric body CT, with smaller doses given to smaller patients. This study assesses community adoption of size-appropriate pediatric CT techniques. Size-specific dose estimates (SSDE) in pediatric body scans are compared between community facilities and a university children's hospital that tailors CT protocols to patient size as advocated by Image Gently. We compared 164 pediatric body scans done at community facilities (group X) with 466 children's hospital scans. Children's hospital scans were divided into two groups: A, 250 performed with established pediatric weight-based protocols and filtered back projection; B, 216 performed with addition of iterative reconstruction technique and a 60% reduction in volume CT dose index (CTDI{sub vol}). SSDE was calculated and differences among groups were compared by regression analysis. Mean SSDE was 1.6 and 3.9 times higher in group X than in groups A and B and 2.5 times higher for group A than group B. A model adjusting for confounders confirmed significant differences between group pairs. Regional community hospitals and imaging centers have not universally adopted child-sized pediatric CT practices. More education and accountability may be necessary to achieve widespread implementation. Since even lower radiation doses are possible with iterative reconstruction technique than with filtered back projection alone, further exploration of the former is encouraged. (orig.)

The appropriateness of health services for adolescents: youth's opinions and attitudes.

Science.gov (United States)

Resnick, M; Blum, R W; Hedin, D

1980-12-01

Minnesota high school students were surveyed about their attitudes, beliefs, and opinions about health, illness, and medical care. Data were obtained from small group discussions conducted by the adolescents themselves in schools and agencies throughout the state. This paper reports their views toward adolescent medical services. Teenagers emphasized the idea of service appropriateness as central to promoting service utilization. Key to the concept of appropriateness were the components of staff, cost and confidentiality. Each of these dimensions is examined from the view of youth as to implications for increased appropriateness of services for both utilization and improved health. Findings are discussed in terms of differences in problem definition between the adolescent and professional, and their implications for medical care in conventional and alternative settings.

Distribution (State Allotment) of Drinking Water State Revolving Fund Appropriation from the American Recovery and Reinvestment Act of 2009 (ARRA)

Data.gov (United States)

U.S. Environmental Protection Agency — The ARRA appropriation for the DWSRF program is $2,000,000,000. DWSRF allotments are based on percentages derived from the 2003 Drinking Water Infrastructure Needs...

Carl Schmitt's attitude towards total war and total enemy on the eve of the outbreak of WWII

Directory of Open Access Journals (Sweden)

Molnar Aleksandar

2010-01-01

Full Text Available Carl Schmitt is usually perceived as the theorist of total state, total war and total hostility. In the article, the author however tries to show that from 1937 to 1944, Schmitt was arguing that total war and total hostility were dangerous for Germany (as well as for the rest of Europe and warned against perpetuation of all efforts to totalize enemy that started in 1914. In his theoretical endeavors in this period there was place for the total state only - and especially for the total state strong enough to resist temptation of declaring total war on total enemy. The total state he recommended Hitler and his Nazi comrades was German Reich, as a part of Europe ordered and divided in the huge spaces (Grossraumordnung. Positioned in the centre of Europe, between the rest of the powers (France, Italy, USSR as well as the Scandinavian states, Germany should be careful enough to wage war only against its Eastern enemies (Poland and maybe USSR and only in order to achieve 'just' borders. Occupying in this way its huge space Germany should devote itself to the task of exploitation of various peoples such as Poles, Chechs and Slovaks, which were perceived as incapable of having their states and doomed to serve the master race - the Germans.

Deterministic Assisted Clone of an Arbitrary Two- and Three-qubit States via Multi-qubit Brown State

Science.gov (United States)

Hou, Kui; Zhu, Cheng-Jie; Yang, Ya-Ping

2017-08-01

We present two schemes for deterministic assisted clone(DAC) of an unknown two- and three-qubit entangled states with assistance via muti-qubit Brown state. In the schemes, the sender wish to teleport an unknown original entangled state which from the state preparer, and then create a perfect copy of the unknown state at her place. The DAC schemes include two stages. The first stage requires teleportation with Bell-state measurements via a five-qubit Brown state(or seven-qubit Brown state) as the quantum channel. In the second stage, to help the sender realize the quantum cloning, the state preparer performs projective measurements on their own particles which from the sender, then the sender can acquire a perfect copy of the unknown state by means of some appropriate unitary operations. Furthermore, the total success probability for assisted cloning a perfect copy of the unknown state can reach 1 in our schemes.

Neural mechanism for judging the appropriateness of facial affect.

Science.gov (United States)

Kim, Ji-Woong; Kim, Jae-Jin; Jeong, Bum Seok; Ki, Seon Wan; Im, Dong-Mi; Lee, Soo Jung; Lee, Hong Shick

2005-12-01

Questions regarding the appropriateness of facial expressions in particular situations arise ubiquitously in everyday social interactions. To determine the appropriateness of facial affect, first of all, we should represent our own or the other's emotional state as induced by the social situation. Then, based on these representations, we should infer the possible affective response of the other person. In this study, we identified the brain mechanism mediating special types of social evaluative judgments of facial affect in which the internal reference is related to theory of mind (ToM) processing. Many previous ToM studies have used non-emotional stimuli, but, because so much valuable social information is conveyed through nonverbal emotional channels, this investigation used emotionally salient visual materials to tap ToM. Fourteen right-handed healthy subjects volunteered for our study. We used functional magnetic resonance imaging to examine brain activation during the judgmental task for the appropriateness of facial affects as opposed to gender matching tasks. We identified activation of a brain network, which includes both medial frontal cortex, left temporal pole, left inferior frontal gyrus, and left thalamus during the judgmental task for appropriateness of facial affect compared to the gender matching task. The results of this study suggest that the brain system involved in ToM plays a key role in judging the appropriateness of facial affect in an emotionally laden situation. In addition, our result supports that common neural substrates are involved in performing diverse kinds of ToM tasks irrespective of perceptual modalities and the emotional salience of test materials.

Appropriability, services and reputation

NARCIS (Netherlands)

Dolfsma, W.A.

2011-01-01

The appropriability regime (Teece 1986) that innovating service firms face is generally weaker than what firms in manufacturing sectors face. An important means to appropriate benefits from innovation that service firms can use is their reputation. This conceptual paper offers insights into how a

Value Appropriation in Business Exchange

DEFF Research Database (Denmark)

Ellegaard, Chris; Medlin, Christopher J.; Geersbro, Jens

2014-01-01

value creation. Originality/value – To the authors’ knowledge, this paper represents the first attempt at reviewing the management literature on value appropriation in business exchange. The authors provide overview, details, comparisons, and frame a research agenda as a first step towards establishing......Purpose – Value appropriation is a central, yet neglected aspect in business exchange research. The purpose of the paper is to generate an overview of research on active value appropriation in business exchange and provide the foundation for further research into value appropriation, as well...... as some initial guidance for managers. Design/methodology/approach – Literatures investigating value appropriation were identified by the means of a systematic review of the overall management literature. Findings – The authors provide an overview and comparison of the literatures and find that they apply...

Unauthorized Appropriations and Expiring Authorizations

Science.gov (United States)

2015-01-15

Unauthorized FY 2015 Appropriations: Not Available Organ Donation and Recovery Improvement ActP.L. 108-216 Reimbursement of travel and subsistence...FY 2013 Appropriation Authorized: Indefinite Unauthorized FY 2015 Appropriations: Not Available Capital investment grants to support intercity ...priority rail corridor projects necessary to reduce congestion or facilitate ridership growth in intercity rail passenger transportation * FY 2013

Appropriering, system, bogobjekt

DEFF Research Database (Denmark)

Kromann, Thomas Hvid

og en afpersonaliseringens poetik bliver konstrueret og typologiseret ud fra et heterogent og spredt tekstmateriale. En poetik, der er kendetegnet af en vidtdreven afmytologisering og afpersonalisering af kunstnerrollen og værket. I kapitel 2, Appropriering, analyseres approprieringsteknikker som...... værker af Bjørn Nørgaard, Hans-Jørgen Nielsen, Henning Christiansen, Vagn Steen og Per Kirkeby (i kap. 2, 3 og 4) analyseres eksempler på appropriering, systemer og bogobjekter. Afpersonalisering er som strategi ikke en homogen metode, men derimod en heterogen og individuel praksis, der spænder fra...

Narrative self-appropriation

DEFF Research Database (Denmark)

Køster, Allan

2017-01-01

is profoundly saturated by an alienness regarding the person’s own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through e.g. psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important...... role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing...

Appropriate working hours for surgical training according to Australasian trainees.

Science.gov (United States)

O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

2012-04-01

The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Creating a University System for the 21st Century. Analysis of 2009-2011 Legislative Appropriation

Science.gov (United States)

North Dakota University System, 2009

2009-01-01

The 2009-11 state general fund appropriation is $597.9 million for the eleven campuses, University of North Dakota (UND) School of Medicine and Health Sciences (SMHS), Forest Service and North Dakota University System Office, which is an increase of $153.4 million over the 2007-09 adjusted appropriation, less 07-09 one-time funding. This includes…

Developing appropriate criteria for Benign Prostatic Hyperplasia Surgery Using RAND Appropriateness Method (RAM

Directory of Open Access Journals (Sweden)

R Ostovar

2009-07-01

Full Text Available ABSTRACT: Introduction & Objective: Results of different studies show that a relatively large number of healthcare services offered are inappropriate or unnecessary. Benign prostatic hyperplasia is a benign enlargement of the prostate gland. Clinical features of this disease are one of the most common problems encountered by elderly males. The aim of this study was to assess the appropriateness of benign prostatic hyperplasia surgery. Materials & Methods: In this qualitative study which was conducted in 2008-9, in Tehran University of Medical Sciences, the RAN/UCLA method was used, which was designed in 1980 by the RAND institute and the University of California in Los Angeles. Regarding the stages of our method, scenarios and indications for benign prostatic hyperplasia surgery were chosen from the latest approved scientific resources and subsequently sent to urology specialists, who were chosen as members of the specialized panel. Panel members gave scores ranging from 1 to 9 to each indication and scenario based on scientific resources, clinical experiences and patient’s condition in two separate panel sessions. After compilation, the indications were finally grouped as appropriate, equivocal, and inappropriate so that they could be used to determine appropriateness of benign prostatic hyperplasia surgery in hospitals. In this study, the most suitable and most approved clinical guidelines related to benign prostatic hyperplasia, the Guidelines Evaluation and Research Appraisal (AGREE were used.The selected guidelines were used as scientific resources for choosing the indications of benign prostatic hyperplasia surgery. SPSS version 16 and kappa weighted value were used in analysis process of the study. Results: Out of 282 scenarios grouped as 9 conditions related to benign prostatic hyperplasia surgery, which were extracted from scientific sources, 73 cases (25.9% were considered as appropriate, 14 cases (5% as equivocal and 7 cases (2

Modeling networks of coupled enzymatic reactions using the total quasi-steady state approximation.

Directory of Open Access Journals (Sweden)

Andrea Ciliberto

2007-03-01

Full Text Available In metabolic networks, metabolites are usually present in great excess over the enzymes that catalyze their interconversion, and describing the rates of these reactions by using the Michaelis-Menten rate law is perfectly valid. This rate law assumes that the concentration of enzyme-substrate complex (C is much less than the free substrate concentration (S0. However, in protein interaction networks, the enzymes and substrates are all proteins in comparable concentrations, and neglecting C with respect to S0 is not valid. Borghans, DeBoer, and Segel developed an alternative description of enzyme kinetics that is valid when C is comparable to S0. We extend this description, which Borghans et al. call the total quasi-steady state approximation, to networks of coupled enzymatic reactions. First, we analyze an isolated Goldbeter-Koshland switch when enzymes and substrates are present in comparable concentrations. Then, on the basis of a real example of the molecular network governing cell cycle progression, we couple two and three Goldbeter-Koshland switches together to study the effects of feedback in networks of protein kinases and phosphatases. Our analysis shows that the total quasi-steady state approximation provides an excellent kinetic formalism for protein interaction networks, because (1 it unveils the modular structure of the enzymatic reactions, (2 it suggests a simple algorithm to formulate correct kinetic equations, and (3 contrary to classical Michaelis-Menten kinetics, it succeeds in faithfully reproducing the dynamics of the network both qualitatively and quantitatively.

Crowding as appropriation

DEFF Research Database (Denmark)

Thelle, Mikkel

2016-01-01

This article seeks to address the relation between crowds andpublic space as a question of appropriation. With the newliberal constitutions in Europe, several phenomena of crowdingemerge in major cities, of which Copenhagen is taken as anexample. By focusing on the crowd as an agglomeration...... ofbodies, it is assessed how the agency of the crowd works on animmediate level and in its more lasting effects on urban space.The notion of appropriation is related to the crowd’s claim,formal and informal, as resulting from a negotiation of this,mostly public, space, and articulated in empirical cases...

Dosing of Appropriate Antibiotics and Time to Administration of First Doses in the Pediatric Emergency Department.

Science.gov (United States)

Bailey, Abby M; Stephan, Maria; Weant, Kyle A; Justice, Stephanie Baker

2015-01-01

Emergency department (ED) providers are faced with the challenge of diagnosing and treating patients in a timely fashion given many obstacles including limited patient information, complex disease states, and high patient turnover. Time delays in administration or selection of appropriate drug therapies have been associated with negative outcomes in severe infections. This study was conducted to assess the impact of an emergency medicine pharmacist (EPh) on the selection of appropriate antibiotics and the timeliness of administration in pediatric patients in the ED. Patients younger than 18 years were evaluated who were admitted through the ED and received 1 dose of intravenous antibiotic for the following conditions: community-acquired pneumonia, complicated skin and soft tissue infection (SSTI), meningitis, and sepsis. To evaluate the impact of the presence of an EPh, patients with orders placed during the EPh's hours of 1 pm and 11 pm were compared to those with an order placed between 11 pm and 1 pm. A total of 142 patients were included in the study. Patients seen during EPh hours received an appropriate first antibiotic 93.4% of the time (p = 0.157) and second antibiotic 96.8% of the time (p = 0.023). Time from order to verification was significantly shorter for the first 2 antimicrobials in the EPh group (10.5 minutes [p = 0.003] and 11.4 minutes [p = 0.047], respectively). The days from discharge to return to readmission to the ED were also significantly different (17.5 days vs. 62.4 days, p = 0.008). The available data suggest that patients are more likely to receive appropriate doses of antimicrobials, and in a more timely fashion, whenever the EPh is present. Areas for future investigation include whether the presence of EPhs at the bedside has the potential to impact areas of patient care, including readmission rates, drug costs, and medication errors.

Predicting Appropriate Admission of Bronchiolitis Patients in the Emergency Department: Rationale and Methods.

Science.gov (United States)

Luo, Gang; Stone, Bryan L; Johnson, Michael D; Nkoy, Flory L

2016-03-07

In young children, bronchiolitis is the most common illness resulting in hospitalization. For children less than age 2, bronchiolitis incurs an annual total inpatient cost of $1.73 billion. Each year in the United States, 287,000 emergency department (ED) visits occur because of bronchiolitis, with a hospital admission rate of 32%-40%. Due to a lack of evidence and objective criteria for managing bronchiolitis, ED disposition decisions (hospital admission or discharge to home) are often made subjectively, resulting in significant practice variation. Studies reviewing admission need suggest that up to 29% of admissions from the ED are unnecessary. About 6% of ED discharges for bronchiolitis result in ED returns with admission. These inappropriate dispositions waste limited health care resources, increase patient and parental distress, expose patients to iatrogenic risks, and worsen outcomes. Existing clinical guidelines for bronchiolitis offer limited improvement in patient outcomes. Methodological shortcomings include that the guidelines provide no specific thresholds for ED decisions to admit or to discharge, have an insufficient level of detail, and do not account for differences in patient and illness characteristics including co-morbidities. Predictive models are frequently used to complement clinical guidelines, reduce practice variation, and improve clinicians' decision making. Used in real time, predictive models can present objective criteria supported by historical data for an individualized disease management plan and guide admission decisions. However, existing predictive models for ED patients with bronchiolitis have limitations, including low accuracy and the assumption that the actual ED disposition decision was appropriate. To date, no operational definition of appropriate admission exists. No model has been built based on appropriate admissions, which include both actual admissions that were necessary and actual ED discharges that were unsafe. The

High-Level Football and Appropriations to Universities: Are Sports-Crazed Representatives Responsive to NCAA Divisional Affiliation?

Science.gov (United States)

Jones, Willis A.

2015-01-01

Does fielding a Football Bowl Subdivision (FBS) program help an institution of higher education obtain aid in the form of state appropriations? Two published studies have found some evidence of a positive correlation between having an FBS-level football program and the amount of appropriations received by public universities. This study looked to…

Shapes of the $^{192,190}$Pb ground states from beta decay studies using the total absorption technique

CERN Document Server

Estevez Aguado, M.E.; Agramunt, J.; Rubio, B.; Tain, J.L.; Jordan, D.; Fraile, L.M.; Gelletly, W.; Frank, A.; Csatlos, M.; Csige, L.; Dombradi, Zs.; Krasznahorkay, A.; Nacher, E.; Sarriguren, P.; Borge, M.J.G.; Briz, J.A.; Tengblad, O.; Molina, F.; Moreno, O.; Kowalska, M.; Fedosseev, V.N.; Marsh, B.A.; Fedorov, D.V.; Molkanov, P.L.; Andreyev, A.N.; Seliverstov, M.D.; Burkard, K.; Huller, W.

2015-01-01

The beta decay of $^{192,190}$Pb has been studied using the total absorption technique at the ISOLDE(CERN) facility. The beta-decay strength deduced from the measurements, combined with QRPA theoretical calculations, allow us to infer that the ground states of the $^{192,190}$Pb isotopes are spherical. These results represent the first application of the shape determination method using the total absorption technique for heavy nuclei and in a region where there is considerable interest in nuclear shapes and shape effects.

Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

Science.gov (United States)

Jones, D. B.; da Costa, R. F.; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

2016-04-01

We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20-250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron-furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

Energy Technology Data Exchange (ETDEWEB)

Jones, D. B. [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Costa, R. F. da [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Departamento de Física, Universidade Federal do Espírito Santo, 29075-910, Vitória, Espírito Santo (Brazil); Varella, M. T. do N. [Instituto de Física, Universidade de São Paulo, CP 66318, 05315-970 São Paulo (Brazil); Bettega, M. H. F. [Departamento de Física, Universidade Federal do Paraná, CP 19044, 81531-990 Curitiba, Paraná (Brazil); Lima, M. A. P. [Instituto de Física “Gleb Wataghin,” Universidade Estadual de Campinas, Campinas, 13083-859 São Paulo (Brazil); Blanco, F. [Departamento de Física Atómica, Molecular y Nuclear, Universidad Complutense de Madrid, Madrid E-28040 (Spain); García, G. [Instituto de Física Fundamental, CSIC, Serrano 113-bis, 28006 Madrid (Spain); Brunger, M. J., E-mail: Michael.Brunger@flinders.edu.au [School of Chemical and Physical Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia 5001 (Australia); Institute of Mathematical Sciences, University of Malaya, 50603 Kuala Lumpur (Malaysia)

2016-04-14

We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

Integral elastic, electronic-state, ionization, and total cross sections for electron scattering with furfural

International Nuclear Information System (INIS)

Jones, D. B.; Costa, R. F. da; Varella, M. T. do N.; Bettega, M. H. F.; Lima, M. A. P.; Blanco, F.; García, G.; Brunger, M. J.

2016-01-01

We report absolute experimental integral cross sections (ICSs) for electron impact excitation of bands of electronic-states in furfural, for incident electron energies in the range 20–250 eV. Wherever possible, those results are compared to corresponding excitation cross sections in the structurally similar species furan, as previously reported by da Costa et al. [Phys. Rev. A 85, 062706 (2012)] and Regeta and Allan [Phys. Rev. A 91, 012707 (2015)]. Generally, very good agreement is found. In addition, ICSs calculated with our independent atom model (IAM) with screening corrected additivity rule (SCAR) formalism, extended to account for interference (I) terms that arise due to the multi-centre nature of the scattering problem, are also reported. The sum of those ICSs gives the IAM-SCAR+I total cross section for electron–furfural scattering. Where possible, those calculated IAM-SCAR+I ICS results are compared against corresponding results from the present measurements with an acceptable level of accord being obtained. Similarly, but only for the band I and band II excited electronic states, we also present results from our Schwinger multichannel method with pseudopotentials calculations. Those results are found to be in good qualitative accord with the present experimental ICSs. Finally, with a view to assembling a complete cross section data base for furfural, some binary-encounter-Bethe-level total ionization cross sections for this collision system are presented.

Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

Science.gov (United States)

Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

2012-01-01

To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

Libertarianism and Original Appropriation

OpenAIRE

Dominiak, Łukasz

2017-01-01

The article is devoted to the problem of the structure of libertarian theory of justice. It tries to present a map of the main concepts and principles of this theory and to investigate its possible justifications. It explains such fundamental concepts as original appropriation, homesteading, labour theory of property or first possession theory of original appropriation. The article shows merits and drawbacks of alternative libertarian principles of justice in first acquisition and proposes a ...

76 FR 34270 - Federal-State Extended Benefits Program-Methodology for Calculating “on” or “off” Total...

Science.gov (United States)

2011-06-13

... requirement. The Department plans to promulgate regulations about this methodology in the near future. In the...--Methodology for Calculating ``on'' or ``off'' Total Unemployment Rate Indicators for Purposes of Determining..., Labor. ACTION: Notice. SUMMARY: UIPL 16-11 informs states of the methodology used to calculate the ``on...

Pediatric Biopharmaceutical Classification System: Using Age-Appropriate Initial Gastric Volume.

Science.gov (United States)

Shawahna, Ramzi

2016-05-01

Development of optimized pediatric formulations for oral administration can be challenging, time consuming, and financially intensive process. Since its inception, the biopharmaceutical classification system (BCS) has facilitated the development of oral drug formulations destined for adults. At least theoretically, the BCS principles are applied also to pediatrics. A comprehensive age-appropriate BCS has not been fully developed. The objective of this work was to provisionally classify oral drugs listed on the latest World Health Organization's Essential Medicines List for Children into an age-appropriate BCS. A total of 38 orally administered drugs were included in this classification. Dose numbers were calculated using age-appropriate initial gastric volume for neonates, 6-month-old infants, and children aging 1 year through adulthood. Using age-appropriate initial gastric volume and British National Formulary age-specific dosing recommendations in the calculation of dose numbers, the solubility classes shifted from low to high in pediatric subpopulations of 12 years and older for amoxicillin, 5 years, 12 years and older for cephalexin, 9 years and older for chloramphenicol, 3-4 years, 9-11 and 15 years and older for diazepam, 18 years and older (adult) for doxycycline and erythromycin, 8 years and older for phenobarbital, 10 years and older for prednisolone, and 15 years and older for trimethoprim. Pediatric biopharmaceutics are not fully understood where several knowledge gaps have been recently emphasized. The current biowaiver criteria are not suitable for safe application in all pediatric populations.

Appropriate Technology as Indian Technology.

Science.gov (United States)

Barry, Tom

1979-01-01

Describes the mounting enthusiasm of Indian communities for appropriate technology as an inexpensive means of providing much needed energy and job opportunities. Describes the development of several appropriate technology projects, and the goals and activities of groups involved in utilizing low scale solar technology for economic development on…

Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States.

Science.gov (United States)

Le, Margaret; Flores, David; May, Danica; Gourley, Eric; Nangia, Ajay K

2016-05-01

The evaluation and management of male hypogonadism should be based on symptoms and on serum testosterone levels. Diagnostically this relies on accurate testing and reference values. Our objective was to define the distribution of reference values and assays for free and total testosterone by clinical laboratories in the United States. Upper and lower reference values, assay methodology and source of published reference ranges were obtained from laboratories across the country. A standardized survey was reviewed with laboratory staff via telephone. Descriptive statistics were used to tabulate results. We surveyed a total of 120 laboratories in 47 states. Total testosterone was measured in house at 73% of laboratories. At the remaining laboratories studies were sent to larger centralized reference facilities. The mean ± SD lower reference value of total testosterone was 231 ± 46 ng/dl (range 160 to 300) and the mean upper limit was 850 ± 141 ng/dl (range 726 to 1,130). Only 9% of laboratories where in-house total testosterone testing was performed created a reference range unique to their region. Others validated the instrument recommended reference values in a small number of internal test samples. For free testosterone 82% of laboratories sent testing to larger centralized reference laboratories where equilibrium dialysis and/or liquid chromatography with mass spectrometry was done. The remaining laboratories used published algorithms to calculate serum free testosterone. Reference ranges for testosterone assays vary significantly among laboratories. The ranges are predominantly defined by limited population studies of men with unknown medical and reproductive histories. These poorly defined and variable reference values, especially the lower limit, affect how clinicians determine treatment. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Is BMD testing appropriate for all menopausal women?

Science.gov (United States)

Kleerekoper, Michael; Nelson, Dorothy A

2005-01-01

The United States Preventive Services Task Force has provided an evidence-based guideline indicating that bone mineral density (BMD) testing is appropriate for all women aged 65 or older. This does not preclude BMD testing in younger postmenopausal women but places the onus on the treating physician to justify the procedure to the patient and often the patient's insurance carrier. There are very few circumstances in which BMD testing is appropriate for healthy premenopausal women, but BMD testing in younger postmenopausal women is often appropriate: when there is a family history of osteoporosis with fracture, a personal history of fracture as an adult, and a medical, surgical or therapeutic history that might be associated with accelerated bone loss or increased risk of fracture. Medical conditions include intestinal diseases associated with malabsorption, such as non-tropical sprue, or primary hyperparathyroidism. Women who have neurologic conditions that increase the risk of falling should also be tested. There are data to suggest that patients with hemoglobinopathy are at increased risk for osteoporosis. Surgical conditions include the increasingly performed surgery for obesity and other surgery resulting in bowel resection (e.g., for inflammatory bowel disease). The major medication-related concern is corticosteroid therapy, but chronic or over-treatment with thyroxine, and chronic heparin therapy, should also be considered risk factors for osteoporosis. When performing a BMD test for the first time, it is essential to remember that 50% of women at menopause will have a negative T-score, but this does not imply that the patient has indeed lost any bone from her peak bone mass.

An analysis of state legislation on community trails.

Science.gov (United States)

Eyler, Amy; Lankford, Tina; Chriqui, Jamie; Evenson, Kelly R; Kruger, Judy; Tompkins, Nancy; Voorhees, Carolyn; Zieff, Susan; Aytur, Semra; Brownson, Ross

2010-03-01

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements. State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance. Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance. There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

Appropriation of Information Systems

DEFF Research Database (Denmark)

Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

2008-01-01

This paper explores the use of cognitive mapping for eliciting users' sensemaking during information system (IS) appropriation. Despite the potential usefulness of sensemaking, few studies in IS research use it as a theoretical lens to address IS appropriation. A possible reason for this may...... be that sensemaking does not easily lend itself to be used in practice. We introduce cognitive mapping as a way to elicit users' sensemaking and illustrate its value by reporting on findings from an empirical study of the introduction of an Electronic Patient Record (EPR) system. The contribution of the paper...

Total photoionization cross-sections of excited electronic states by the algebraic diagrammatic construction-Stieltjes-Lanczos method.

Science.gov (United States)

Ruberti, M; Yun, R; Gokhberg, K; Kopelke, S; Cederbaum, L S; Tarantelli, F; Averbukh, V

2014-05-14

Here, we extend the L2 ab initio method for molecular photoionization cross-sections introduced in Gokhberg et al. [J. Chem. Phys. 130, 064104 (2009)] and benchmarked in Ruberti et al. [J. Chem. Phys. 139, 144107 (2013)] to the calculation of total photoionization cross-sections of molecules in electronically excited states. The method is based on the ab initio description of molecular electronic states within the many-electron Green's function approach, known as algebraic diagrammatic construction (ADC), and on the application of Stieltjes-Chebyshev moment theory to Lanczos pseudospectra of the ADC electronic Hamiltonian. The intermediate state representation of the dipole operator in the ADC basis is used to compute the transition moments between the excited states of the molecule. We compare the results obtained using different levels of the many-body theory, i.e., ADC(1), ADC(2), and ADC(2)x for the first two excited states of CO, N2, and H2O both at the ground state and the excited state equilibrium or saddle point geometries. We find that the single excitation ADC(1) method is not adequate even at the qualitative level and that the inclusion of double electronic excitations for description of excited state photoionization is essential. Moreover, we show that the use of the extended ADC(2)x method leads to a substantial systematic difference from the strictly second-order ADC(2). Our calculations demonstrate that a theoretical modelling of photoionization of excited states requires an intrinsically double excitation theory with respect to the ground state and cannot be achieved by the standard single excitation methods with the ground state as a reference.

Rovibrational bound states of SO2 isotopologues. I: Total angular momentum J = 0-10

Science.gov (United States)

Kumar, Praveen; Ellis, Joseph; Poirier, Bill

2015-04-01

Isotopic variation of the rovibrational bound states of SO2 for the four stable sulfur isotopes 32-34,36S is investigated in comprehensive detail. In a two-part series, we compute the low-lying energy levels for all values of total angular momentum in the range J = 0-20. All rovibrational levels are computed, to an extremely high level of numerical convergence. The calculations have been carried out using the ScalIT suite of parallel codes. The present study (Paper I) examines the J = 0-10 rovibrational levels, providing unambiguous symmetry and rovibrational label assignments for each computed state. The calculated vibrational energy levels exhibit very good agreement with previously reported experimental and theoretical data. Rovibrational energy levels, calculated without any Coriolis approximations, are reported here for the first time. Among other potential ramifications, this data will facilitate understanding of the origin of mass-independent fractionation of sulfur isotopes in the Archean rock record-of great relevance for understanding the "oxygen revolution".

Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method

Directory of Open Access Journals (Sweden)

Hossein Yousefi Manesh

2013-01-01

Full Text Available MRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM criteria. Methods This study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated. Results Of 300 cases of lumbar spine MRI prescriptions, approximately 167 (56% were considered inappropriate, 72 (24% were uncertain, and 61 (20% were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions. Conclusion In conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA and Clinical Practice Guidelines (CPGs. As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.

The emergency department: An appropriate referral rate for radiography

International Nuclear Information System (INIS)

Richards, P.J.; Tins, B.; Cherian, R.; Rae, F.; Dharmarajah, R.; Phair, I.C.; McCall, I.

2002-01-01

AIM: To evaluate the hypothesis that where there is good clinical practice in an emergency department (ED), there is a low uptake of plain radiography. MATERIALS AND METHODS: Emergency notes and radiography records were reviewed over one week in January 1999, to determine the rate of radiography of first time attenders at the North Staffordshire NHS Trust. The clinical appropriateness of the imaging was assessed by pairs of radiology specialist registrars and casualty physicians. They judged the appropriateness of the imaging by the 1998 Royal College of Radiologists (RCR) guidelines and/or their clinical judgement, by consensus. Where there was no consensus or the data appeared incomplete, the radiology and ED consultant reviewed the notes. RESULTS: A total of 1615 notes were found out of 1643 (98%). Of these, 147 (9%) return attenders were excluded and 32 patients left without being seen. The number of first time attenders was 1436 (87%), of whom 637 (44%) were radiographed; 95% of these radiography examinations were appropriate and 5% were inappropriate. Of the first time attenders who were not radiographed the decision was appropriate in 95% of cases, and inappropriate for 5%, i.e. 5% of those who had no radiography, should have been X-rayed. There were no disagreements between RCR guidelines and the clinical judgements, but in 16% there were no suitable RCR guidelines. Junior doctors were not always able to find the relevant RCR guideline (relevant clinical guideline found in 73% of cases) in the guideline book, compared to the consultants (relevant clinical guideline found in 84% of cases). CONCLUSION: The application of the RCR guidelines is taken as representing good clinical practice in determining when to refer a patient for radiography. Based on this assumption, a referral rate for radiography of 44% of first time attenders was found to be appropriate. This referral rate can be taken as a benchmark. A benchmark is necessary in order to allow departments

ACR Appropriateness Criteria® Tinnitus.

Science.gov (United States)

Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

2017-11-01

Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Operational resource theory of total quantum coherence

Science.gov (United States)

Yang, Si-ren; Yu, Chang-shui

2018-01-01

Quantum coherence is an essential feature of quantum mechanics and is an important physical resource in quantum information. Recently, the resource theory of quantum coherence has been established parallel with that of entanglement. In the resource theory, a resource can be well defined if given three ingredients: the free states, the resource, the (restricted) free operations. In this paper, we study the resource theory of coherence in a different light, that is, we consider the total coherence defined by the basis-free coherence maximized among all potential basis. We define the distillable total coherence and the total coherence cost and in both the asymptotic regime and the single-copy regime show the reversible transformation between a state with certain total coherence and the state with the unit reference total coherence. Extensively, we demonstrate that the total coherence can also be completely converted to the total correlation with the equal amount by the free operations. We also provide the alternative understanding of the total coherence, respectively, based on the entanglement and the total correlation in a different way.

Impact of appropriate empirical antibiotic treatment on recurrence and mortality in patients with bacteraemia

DEFF Research Database (Denmark)

Gradel, Kim O.; Jensen, Ulrich S; Schønheyder, Henrik C.

2017-01-01

of bacteraemia patients. Methods: A cohort study including all patients hospitalized with incident bacteraemia during 2007-2008 in the Copenhagen City and County areas and the North Denmark Region. EAT was defined as the antibiotic treatment given at the 1st notification of a positive blood culture...... models. Results: In 6483 eligible patients, 712 (11%) had a recurrent episode. A total of 3778 (58%) patients received appropriate EAT, 1290 (20%) received inappropriate EAT, while EAT status was unrecorded for 1415 (22%) patients. The 2-30 day mortality was 15.1%, 17.4% and 19.2% in patients receiving...... appropriate EAT, inappropriate EAT, and unknown EAT, respectively. Among patients alive on day 30, the 31-365 day mortality was 22.3% in patients given appropriate EAT compared to 30.7% in those given inappropriate EAT. Inappropriate EAT was independently associated with recurrence (HR 1.25; 95% CI = 1...

Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009.

Science.gov (United States)

Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

2014-10-01

We examined neonatal mortality in relation to birth settings and birth attendants in the United States from 2006 through 2009. Data from the Centers for Disease Control and Prevention-linked birth and infant death dataset in the United States from 2006 through 2009 were used to assess early and total neonatal mortality for singleton, vertex, and term births without congenital malformations delivered by midwives and physicians in the hospital and midwives and others out of the hospital. Deliveries by hospital midwives served as the reference. Midwife home births had a significantly higher total neonatal mortality risk than deliveries by hospital midwives (1.26 per 1000 births; relative risk [RR], 3.87 vs 0.32 per 1000; P home births of 41 weeks or longer (1.84 per 1000; RR, 6.76 vs 0.27 per 1000; P home births of women with a first birth (2.19 per 1000; RR, 6.74 vs 0.33 per 1000; P home births, neonatal mortality for first births was twice that of subsequent births (2.19 vs 0.96 per 1000; P home births compared with midwife hospital births was 9.32 per 10,000 births, and the excess early neonatal mortality was 7.89 per 10,000 births. Our study shows a significantly increased total and early neonatal mortality for home births and even higher risks for women of 41 weeks or longer and women having a first birth. These significantly increased risks of neonatal mortality in home births must be disclosed by all obstetric practitioners to all pregnant women who express an interest in such births. Copyright © 2014 Elsevier Inc. All rights reserved.

French government to trim direct stake in Total

International Nuclear Information System (INIS)

Anon.

1992-01-01

This paper reports that the French government has decided to slash its direct stake in partly state owned oil company Total to 5% from 31.7%, a surprise move expected to raise 10 billion francs ($1.8 billion). At the same time, other state owned entities will be asked to boost their combined 2.2% stake in Total to 10%, leaving the government with a net 15% interest in Total vs. the current 34%. Initially, state owned insurance companies Groupe des Assurances Nationales and Assurances Generale de France will be asked to hike their stakes in Total, but others could be asked to join if needed to meet the 10% target. The government the its phase-down of participation in Total, established in 1924 to manage French interests in Iraq Petroleum Co., was prompted by the evolution of the oil context, which differs greatly from what had prompted a significant stake of the state in Total's capital

17 CFR 256.215 - Appropriated retained earnings.

Science.gov (United States)

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Appropriated retained earnings... UTILITY HOLDING COMPANY ACT OF 1935 Liabilities and Other Credit Accounts § 256.215 Appropriated retained earnings. This account shall include the amount of retained earnings which has been appropriated or set...

Total Petroleum Hydrocarbons (TPH): ToxFAQs

Science.gov (United States)

... a state: This map displays locations where Total Petroleum Hydrocarbons (TPH) is known to be present. On ... I get more information? ToxFAQs TM for Total Petroleum Hydrocarbons (TPH) ( Hidrocarburos Totales de Petróleo (TPH) ) August ...

Minimizing total costs of forest roads with computer-aided design ...

Indian Academy of Sciences (India)

imum total road costs, while conforming to design specifications, environmental ..... quality, and enhancing fish and wildlife habitat, an appropriate design ..... Soil, Water and Timber Management: Forest Engineering Solutions in Response to.

Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia

Science.gov (United States)

Kabbara, Wissam K; Ramadan, Wijdan H; Rahbany, Peggy; Al-Natour, Souhaila

2015-01-01

Background Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged. Objective The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia) in diabetic and nondiabetic patients. Methods A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin) were identified. Patients were mainly recruited from internal medicine floors and intensive care units. Results The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%), followed by levofloxacin (42.4%) and moxifloxacin (7.6%). Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%), followed by ciprofloxacin (39.0%) and moxifloxacin (33.3%). In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was more common with moxifloxacin (11.1%) and levofloxacin (6.0%). Conclusion The major clinical interventions for the future will adjust the dose and duration of therapy with commonly prescribed fluoroquinolones. The incidence of hypoglycemia was less common than hyperglycemia. PMID:25960658

7 CFR 457.9 - Appropriation contingency.

Science.gov (United States)

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Appropriation contingency. 457.9 Section 457.9 Agriculture Regulations of the Department of Agriculture (Continued) FEDERAL CROP INSURANCE CORPORATION, DEPARTMENT OF AGRICULTURE COMMON CROP INSURANCE REGULATIONS § 457.9 Appropriation contingency...

Rovibrational bound states of SO2 isotopologues. II: Total angular momentum J = 11-20

Science.gov (United States)

Kumar, Praveen; Poirier, Bill

2015-11-01

In a two-part series, the rovibrational bound states of SO2 are investigated in comprehensive detail, for all four stable sulfur isotopes 32-34,36S. All low-lying rovibrational energy levels-both permutation-symmetry-allowed and not allowed-are computed, for all values of total angular momentum in the range J = 0-20. The calculations have carried out using the ScalIT suite of parallel codes. The present study (Paper II) examines the J = 11-20 rovibrational levels, providing symmetry and rovibrational labels for every computed state, relying on a new lambda-doublet splitting technique to make completely unambiguous assignments. Isotope shifts are analyzed, as is the validity of ;J-shifting; as a predictor of rotational fine structure. Among other ramifications, this work will facilitate understanding of mass-independent fractionation of sulfur isotopes (S-MIF) observed in the Archean rock record-particularly as this may have arisen from self shielding. S-MIF, in turn is highly relevant in the broader context of understanding the ;oxygen revolution;.

Youth as Design Partners: Age-Appropriate Websites for Middle and High School Students

Science.gov (United States)

Chow, Anthony S.; Smith, Kathelene McCarty; Sun, Katherine

2012-01-01

This study explored the impact of using best practices identified in previous studies in designing age-appropriate websites for middle and high school youth. Utilizing a mixed-method approach, 31 middle and 22 high school youth took part in six focus groups across four states. Participants were introduced to a website specifically designed for…

Study on risk indicator for appropriate plant maintenance considering aging effect

International Nuclear Information System (INIS)

Mano, Akihiro; Yamaguchi, Akira; Takata, Takashi

2014-01-01

Since, nuclear power plants run for a long term and plant component may deteriorate due to aging, plant safety must be maintained through maintenance activities of components. The maintenance will become more important as the number of aged plant increases. In the planning of maintenance, one must select appropriate components and interval. In general, Fussell-Vesely importance (FV) and Risk Achievement Worth (RAW) are used as a risk indicator for the maintenance. A priority order of each component can be evaluated using those risk indicators at a certain condition. However, the influence of aging (time history) on the order cannot be estimated directly. In the paper, a change of conditional core damage probability (ΔCCDP) and a change of conditional containment failure probability (ΔCCFP) are proposed as additional indicators in which the aging effect is evaluated directly so as to determine the priority order. A simplified level one probabilistic risk assessment (PRA) has been carried out in order to investigate the change of the risk indicators by considering the change of a component failure probability due to aging. In the analyses, three conditions are assumed; base (original) state, aging state and further aging state without maintenance activities. It is demonstrated that the proposed indicator (ΔCCDP and ΔCCFP) reveals the aging effect of each component, while the change of the FV and RAW represent unrealistic behavior through the states. As a result, it is found that the ΔCCDP and ΔCCFP are superior to the others in terms of the ability to evaluate components appropriately in deteriorated (aging) states and take account of differences of deterioration behavior. It is also found that the priority order of the multiple-components maintenance at the same time can also be evaluated using the ΔCCDP and ΔCCFP. Additionally, a risk informed decision making based on the risk acceptance criteria can be discussed for the maintenance procedure using the

An Empirical State Error Covariance Matrix for Batch State Estimation

Science.gov (United States)

Frisbee, Joseph H., Jr.

2011-01-01

State estimation techniques serve effectively to provide mean state estimates. However, the state error covariance matrices provided as part of these techniques suffer from some degree of lack of confidence in their ability to adequately describe the uncertainty in the estimated states. A specific problem with the traditional form of state error covariance matrices is that they represent only a mapping of the assumed observation error characteristics into the state space. Any errors that arise from other sources (environment modeling, precision, etc.) are not directly represented in a traditional, theoretical state error covariance matrix. Consider that an actual observation contains only measurement error and that an estimated observation contains all other errors, known and unknown. It then follows that a measurement residual (the difference between expected and observed measurements) contains all errors for that measurement. Therefore, a direct and appropriate inclusion of the actual measurement residuals in the state error covariance matrix will result in an empirical state error covariance matrix. This empirical state error covariance matrix will fully account for the error in the state estimate. By way of a literal reinterpretation of the equations involved in the weighted least squares estimation algorithm, it is possible to arrive at an appropriate, and formally correct, empirical state error covariance matrix. The first specific step of the method is to use the average form of the weighted measurement residual variance performance index rather than its usual total weighted residual form. Next it is helpful to interpret the solution to the normal equations as the average of a collection of sample vectors drawn from a hypothetical parent population. From here, using a standard statistical analysis approach, it directly follows as to how to determine the standard empirical state error covariance matrix. This matrix will contain the total uncertainty in the

Designing appropriate blended courses: a students' perspective.

Science.gov (United States)

Tsai, Chia-Wen

2010-10-01

The computing education in Taiwan's vocational schools usually focuses on how to help students enhance their professional skills and pass certified examinations. In addition, due to national education policy and universities' regulations, pure online courses are not permitted in Taiwan. In order to design appropriate blended learning (BL) courses, the author explored the effects of web-mediated self-regulated learning (SRL) with variations in online class frequency on enhancing students' computing skills and their perspective of the blended courses. A total of 172 students, divided into four groups, participated in the experiment. The results showed that students in the SRL and BL group with five online classes had the highest scores for using a database management system (DBMS), and the highest pass rate on certified examinations. Students in this group also expressed their positive perspective on the arrangement of their blended course with the intervention of web-mediated SRL.

Application of Total Quality Management (TQM) Requirements in Risk Management in Construction Projects in Iraq

OpenAIRE

Entisar K. Al-Geelawee; Anfal Nadhel Mohammed

2016-01-01

Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be a...

Appropriate use of diagnostic imaging

Energy Technology Data Exchange (ETDEWEB)

Palmer, P.E.S.; Cockshott, W.P.

1984-11-16

This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

The moral appropriateness of shame

Directory of Open Access Journals (Sweden)

M. Ally

2005-07-01

Full Text Available In this article I explore the much neglected moral emotion of shame and consider the senses in which it may be regarded as morally appropriate. I argue that there is a connection between coming to terms with shame for those who feel ashamed, and judgments concerning its moral appropriateness. The elucidation of normative connections between shame, self-respect and autonomy implies the need to accept certain aspects of shame as regrettable yet, sometimes, as valuable.

Stakeout electronic total station construction layout boring of the experience and precision

International Nuclear Information System (INIS)

Xu Zhiqiang

2012-01-01

Electronic total station can simultaneously measure angle and distance, together with the appropriate calculation methods and operating skills, able to efficiently complete the survey work, this paper based on practical experience, theoretical analysis, based on total station introduced in setting out a few boring in the skills and the measurement of total station in the construction layout for accuracy. (authors)

77 FR 7600 - Notice of Segregation of Public Lands in the State of Arizona for the Restoration Design Energy...

Science.gov (United States)

2012-02-13

...] Notice of Segregation of Public Lands in the State of Arizona for the Restoration Design Energy Project... Arizona from all forms of appropriation under the public land laws, including the mining law, but... the Restoration Design Energy Project (RDEP). The public lands contained in this segregation total...

Development of an economical model to determine an appropriate feed-in tariff for grid-connected solar PV electricity in all states of Australia

International Nuclear Information System (INIS)

Zahedi, A.

2009-01-01

Australia is a country with a vast amount of natural resources including sun and wind. Australia lies between latitude of 10-45 S and longitude of 112-152 E, with a daily solar exposure of between less than 3 MJ/(m 2 day) in winter and more than 30 MJ/(m 2 day) in summer. Global solar radiation in Australia varies between minimum of 3285 MJ/(m 2 year) in Hobart to 8760 MJ/(m 2 year) in Northern Territory. As a result of this wide range of radiation level there will be a big difference between costs of solar PV electricity in different locations. A study we have recently conducted on the solar PV electricity price in all states of Australia. For this purpose we have developed an economical model and a computer simulation to determine the accurate unit price of grid-connected roof-top solar photovoltaic (PV) electricity in A$/kWh for all state of Australia. The benefit of this computer simulation is that we can accurately determine the most appropriate feed-in tariff of grid-connected solar PV energy system. The main objective of this paper is to present the results of this study. A further objective of this paper is to present the details of the unit price of solar PV electricity in the state of Victoria in each month and then to compare with electricity price from conventional power systems, which is currently applied to this state. The state Victoria is located south of Australia and in terms of sun radiation is second lowest compared with the other Australian states. The computer simulation developed for this study makes it possible to determine the cost of grid-connected solar PV electricity at any location in any country based on availability of average daily solar exposure of each month as well as economical factors of the country. (author)

[Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital].

Science.gov (United States)

López-Picazo Ferrer, J J; Tomás García, N; Cubillana Herrero, J D; Gómez Company, J A; de Dios Cánovas García, J

2014-01-01

To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level («A» to «D») increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. There were 22.4±6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. AEP is useful to assess the admission appropriateness and may be included in the «Emergencies» process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Ghost-Story Telling: Keeping It Appropriate.

Science.gov (United States)

Weintraub, Jeff

1996-01-01

Guidelines for telling ghost stories at camp involve considering children's fears at different ages, telling age appropriate stories, determining appropriate times for telling ghost stories, and minimizing fear when a child becomes frightened by a ghost story. Includes tips on the selection, preparation, and presentation of ghost stories. (LP)

32 CFR 3.5 - Appropriate use.

Science.gov (United States)

2010-07-01

... CONTRACTS, GRANTS, OR COOPERATIVE AGREEMENTS FOR PROTOTYPE PROJECTS § 3.5 Appropriate use. In accordance... 32 National Defense 1 2010-07-01 2010-07-01 false Appropriate use. 3.5 Section 3.5 National... is participating to a significant extent in the prototype project; or (b) No nontraditional Defense...

The difficulties encountered in conversion from classic pancreaticoduodenectomy to total laparoscopic pancreaticoduodenectomy

Directory of Open Access Journals (Sweden)

Muharrem Battal

2016-01-01

Full Text Available Background: Recently, total laparoscopic pancreatectomy has been performed at many centres as an alternative to open surgery. In this study, we aimed to present the difficulties that we have encountered in converting from classic open pancreaticoduodenectomy to total laparoscopic pancreatectomy. Materials and Methods: Between December 2012 and January 2014, we had 100 open pancreaticoduodenectomies. Subsequently, we tried to perform total laparoscopic pancreaticoduodenectomy (TLPD in 22 patients. In 17 of these 22 patients, we carried out the total laparoscopic procedure. We analysed the difficulties that we encountered converting to TLPD in three parts: Preoperative, operative and postoperative. Preoperative difficulties involved patient selection, preparation of operative instruments, and planning the operation. Operative difficulties involved the position of the trocars, dissection, and reconstruction problems. The postoperative difficulty involved follow-up of the patient. Results: According to our experiences, the most important problem is the proper selection of patients. Contrary to our previous thoughts, older patients who were in better condition were comparatively more appropriate candidates than younger patients. This is because the younger patients have generally soft pancreatic texture, which complicates the reconstruction. The main operative problems are trocar positions and maintaining the appropriate position of the camera, which requires continuous changes in its angles during the operation. However, postoperative follow-up is not very different from the classic procedure. Conclusion: TLPD is a suitable procedure under appropriate conditions.

26 CFR 1.801-5 - Total reserves.

Science.gov (United States)

2010-04-01

... TAXES Life Insurance Companies § 1.801-5 Total reserves. (a) Total reserves defined. For purposes of... its highest aggregate reserve by taking State A's requirement of 10 against its life insurance business and adding it to State B's requirement of 7 against its annuity business. (b) Reserves required by...

Anomalies from aerial spectrometric and total count radiometric surveys in the southeastern United States

International Nuclear Information System (INIS)

Lee, C.H.; Lawton, D.E.

1978-01-01

Aerial radiometric reconnaissance surveys are conducted because of their cost, time, and manpower savings compared to surface studies. Two types of aerial surveys are being flown in the southeastern United States: total count gamma-ray surveys for the Coastal Plains Regional Commission and the US Geological Survey, and differential gamma-ray spectrometric surveys for the US Department of Energy. Anomalous radioactivity detected during aerial surveys is related to higher concentrations of naturally occurring uranium, or to cultural activities, natural causes, or mapping errors which simulate real uranium anomalies. Each anomaly should be ground checked; however, several types of anomalies may be eliminated by evaluation of the aerial data in the office if field time is limited

Development and appropriation of an integration policy for sport

DEFF Research Database (Denmark)

Agergaard, Sine

2011-01-01

the history and culture of the society in which it is created. Second, policy is seen as discourses that are articulated by specific institutions, and third, the anthropological perspective focuses on the ways in which policy is a applied and interpreted in practice. The first part of this article therefore...... explores Danish immigration history and the development of an integration policy that currently focuses on adaptation of the cultural values and norms of immigrants. The second part of this article looks at current state funds that aim to promote this kind of adaptation through sports. It becomes clear......-Danish ethnic background) appropriate these political assumptions....

Appropriate Interventions on the Problems Encountered on Effective Teaching Practices in a State University External Campus in the Philippines

Directory of Open Access Journals (Sweden)

Nilo L. Masbaño

2015-12-01

Full Text Available Descriptive studies on the perception of teachers regarding effective teaching practices, problems encountered and appropriate interventions have generally supported the beliefs that the problems of education did not lie only outside the school but inside the school itself. Yet such studies neglect the primary reason through which students learn, the effective teaching practices. The current study explores the link on the perception of teachers regarding effective teaching practices, problems encountered and appropriate interventions. Data were obtained using the questionnaire that were collected from 80 respondents whom faculty members of WVSU-JC. Mean and rank were used as statistical tools. A high level of agreement among teachers on the propositions regarding effective teaching was hypothesized. However, they preferred some teaching practices to the other. Teachers' perception on effective teaching practices were, showing of mastery on the subject matter, updating of knowledge about the subject matter, utilizing an appropriate strategies and methods and observing an ethical and moral principles in teaching. Generally, the top problems perceived by teachers that hinder their effective teaching includes inadequacy of laboratory facilities and equipment, insufficient library references and classrooms which are not conducive for teaching-learning process. However, it varies according to the classification as to different categories of variables. The appropriate interventions were the upgrading of laboratory facilities and equipment, the purchasing of additional books, the giving of trainings to the teachers on the recent development on the subject that they are teaching, providing more hands on activities for students, enhancing the teaching strategies and methods, and strengthening the commitment among teachers.

Chinese National Strategy of Total War

National Research Council Canada - National Science Library

Good, Michael J

2008-01-01

... concept of total warfare. This research seeks to determine if China is currently engaged in a total war with the United States across nontraditional forms of conflict including economic, political, information, financial...

Medicaid Financial Management Data – National Totals

Data.gov (United States)

U.S. Department of Health & Human Services — This dataset reports summary state-by-state total expenditures by program for the Medicaid Program, Medicaid Administration and CHIP programs. These state...

Exploring voices, exploring appropriate education. A practitioners’ discourse'

NARCIS (Netherlands)

Grol, C.E.J.

2012-01-01

My thesis describes an exploratory process into a practitioners’ discourse on appropriate education. Chapter one: Appropriate Education is about the Dutch educational policy called Passend onderwijs. The chapter positions the appropriate education in national and international educational and

State administration and financing of family planning services.

Science.gov (United States)

Weinberg, D

1972-04-01

A 1971 survey by the Center for Family Planning Program Development consisted of a questionnaire mailed to health and welfare directors in 50 states and 5 federal jurisdictions concerning their family planning policies and administrative practices. 52 agencies responded; Guam, Mississippi, and Louisiana did not. The major funding for state health agencies was allocated by HEW and by maternal and child health (MCH) formula grants under Title 5 of the Social Security Act. 11 states made additional expenditures of $1.7 million for a variety of purposes. 21 states required local welfare departments to purchase services under the Medicaid program established by Title 19 of the Social Security Act. Administration was assigned to specific organizations within the state health agencies. 31 states reported a total of 128 full-time professional personnel, with 90 assigned at state headquarters level. In general, on a state-by-state basis, the full-time staff does not correspond to the size of the appropriations. Survey findings were useful measures of resource commitments to family planning services by state health and welfare agencies and provided data on future levels of resource requirements.

Total cross section of highly excited strings

International Nuclear Information System (INIS)

Lizzi, F.; Senda, I.

1990-01-01

The unpolarized total cross section for the joining of two highly excited strings is calculated. The calculation is performed by taking the average overall states in the given excitation levels of the initial strings. We find that the total cross section grows with the energy and momentum of the initial states. (author). 8 refs, 1 fig

The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: Evidence from the National Health and Nutrition Examination Survey.

Science.gov (United States)

Lipton, Brandy J; Decker, Sandra L

2016-02-01

Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. Copyright © 2015 Elsevier Ltd. All rights reserved.

Total and single differential cross sections for the electron impact ionization of the ground state of helium

International Nuclear Information System (INIS)

Singh, T.S.C.; Choudhury, K.B.; Singh, M.B.; Deb, N.C.; Mukherjee, S.C.; Mazumdar, P.S.

1997-01-01

Total cross sections (TCS) and single differential cross sections (SDCS) have been computed for the single ionization of the ground state of helium by electron impact in a distorted wave formalism which takes into account the effects of the initial and final channel distortions. The present TCS and SDCS results are in fair agreement with the measured values and other theoretical predictions for the incident electron energy E i > 150 eV. (orig.)

Total Logistic Plant Solutions

Directory of Open Access Journals (Sweden)

Dusan Dorcak

2016-02-01

Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

Influences on Tobacco Control Funding Decisions: Explaining State Variation in Appropriations

Science.gov (United States)

2003-01-01

18 and older) in all states was 23.3%, far short of the national goal of reducing adult smoking prevalence to 15% (CDC, 2002; Mendez & Warner, 2000...Multiple levels, multiple agendas. Quorum Books: Westport CT, 1995. Mendez D, Warner K. Smoking prevalence in 2010: Why the healthy people goal is...1998. Siegel M, Carol J, Jordan J, Hobart R, Schoenmarklin S, DuMelle F, Fisher P. Preemption in tobacco control: Review of an emerging public health

Renormalization of total sets of states into generalized bases with a resolution of the identity

International Nuclear Information System (INIS)

Vourdas, A

2017-01-01

A total set of states for which we have no resolution of the identity (a ‘pre-basis’), is considered in a finite dimensional Hilbert space. A dressing formalism renormalizes them into density matrices which resolve the identity, and makes them a ‘generalized basis’, which is practically useful. The dresssing mechanism is inspired by Shapley’s methodology in cooperative game theory, and it uses Möbius transforms. There is non-independence and redundancy in these generalized bases, which is quantified with a Shannon type of entropy. Due to this redundancy, calculations based on generalized bases are sensitive to physical changes and robust in the presence of noise. For example, the representation of an arbitrary vector in such generalized bases, is robust when noise is inserted in the coefficients. Also in a physical system with a ground state which changes abruptly at some value of the coupling constant, the proposed methodology detects such changes, even when noise is added to the parameters in the Hamiltonian of the system. (paper)

The effect of ICD programming on inappropriate and appropriate ICD Therapies in ischemic and nonischemic cardiomyopathy: the MADIT-RIT trial.

Science.gov (United States)

Sedláček, Kamil; Ruwald, Anne-Christine; Kutyifa, Valentina; McNitt, Scott; Thomsen, Poul Erik Bloch; Klein, Helmut; Stockburger, Martin; Wichterle, Dan; Merkely, Bela; DE LA Concha, Joaquin Fernandez; Swissa, Moshe; Zareba, Wojciech; Moss, Arthur J; Kautzner, Josef; Ruwald, Martin H

2015-04-01

The MADIT-RIT trial demonstrated reduction of inappropriate and appropriate ICD therapies and mortality by high-rate cut-off and 60-second-delayed VT therapy ICD programming in patients with a primary prophylactic ICD indication. The aim of this analysis was to study effects of MADIT-RIT ICD programming in patients with ischemic and nonischemic cardiomyopathy. First and total occurrences of both inappropriate and appropriate ICD therapies were analyzed by multivariate Cox models in 791 (53%) patients with ischemic and 707 (47%) patients with nonischemic cardiomyopathy. Patients with ischemic and nonischemic cardiomyopathy had similar incidence of first inappropriate (9% and 11%, P = 0.21) and first appropriate ICD therapy (11.6% and 14.1%, P = 0.15). Patients with ischemic cardiomyopathy had higher mortality rate (6.1% vs. 3.3%, P = 0.01). MADIT-RIT high-rate cut-off (arm B) and delayed VT therapy ICD programming (arm C) compared with conventional (arm A) ICD programming were associated with a significant risk reduction of first inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy (HR range 0.11-0.34, P programming and delayed VT therapy ICD programming in both ischemic and nonischemic cardiomyopathy patients. High-rate cut-off and delayed VT therapy ICD programming are associated with significant reduction in first and total inappropriate and appropriate ICD therapy in patients with ischemic and nonischemic cardiomyopathy. © 2014 Wiley Periodicals, Inc.

45 CFR 84.33 - Free appropriate public education.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Free appropriate public education. 84.33 Section..., Elementary, and Secondary Education § 84.33 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate...

45 CFR 605.33 - Free appropriate public education.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Free appropriate public education. 605.33 Section... Preschool, Elementary, and Secondary Education § 605.33 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program shall provide a free appropriate...

Public Opinion Regarding Whether Speaking With Patients About Firearms Is Appropriate: Results of a National Survey.

Science.gov (United States)

Betz, Marian E; Azrael, Deborah; Barber, Catherine; Miller, Matthew

2016-10-18

Health care providers have been encouraged to discuss firearms with patients; whether patients view these discussions as appropriate is unclear. To estimate, in a national sample, the perceived appropriateness of provider discussions about firearms. Probability-based online survey conducted in April 2015. Analyses used survey weights to generate nationally representative estimates. U.S. adults. 3914 English-speaking adults (55% participation rate). Participants were asked, "In general, would you think it is never, sometimes, usually, or always appropriate for physicians and other health professionals to talk to their patients about firearms?" A majority (66% [95% CI, 63% to 69%]) of participants said that it is at least sometimes appropriate for providers to talk to patients about firearms. Specifically, 23% (CI, 20% to 25%) said that provider discussions about firearms were always appropriate, 14% (CI, 11% to 16%) said that they were usually appropriate, and 30% (CI, 27% to 33%) thought they were sometimes appropriate; 34% (CI, 31% to 37%) felt that such discussions were never appropriate. Views varied by firearm ownership: 54% (CI, 52% to 57%) of gun owners said that provider discussions are at least sometimes appropriate, compared with 67% (CI, 62% to 71%) of nonowners living with an owner and 70% (CI, 66% to 74%) of nonowners not living with an owner. Firearm owners who were more likely to think that firearm discussions are at least sometimes appropriate included those with children at home (62% [CI, 57% to 67%]), those who thought that having a gun at home increases suicide risk (75% [CI, 67% to 83%), and those who thought that provider discussions of seat belts are at least sometimes appropriate (73% [CI, 70% to 75%]). The provider discussion question did not specify clinical context. Two thirds of non-firearm owners and over one half of firearm owners in the United States believe that health care provider discussions about firearms are at least sometimes

Special Appropriation Act Projects

Science.gov (United States)

EPA is sometimes directed to provide funding to a specific entity for study, purpose, or activity.This information will be of interest to a community or other entity that has been identified in one of EPA's appropriations acts to receive such funding.

Estimating the contribution of strong daily export events to total pollutant export from the United States in summer

Science.gov (United States)

Fang, Yuanyuan; Fiore, Arlene M.; Horowitz, Larry W.; Gnanadesikan, Anand; Levy, Hiram; Hu, Yongtao; Russell, Armistead G.

2009-12-01

While the export of pollutants from the United States exhibits notable variability from day to day and is often considered to be "episodic," the contribution of strong daily export events to total export has not been quantified. We use carbon monoxide (CO) as a tracer of anthropogenic pollutants in the Model of OZone And Related Tracers (MOZART) to estimate this contribution. We first identify the major export pathway from the United States to be through the northeast boundary (24-48°N along 67.5°W and 80-67.5°W along 48°N), and then analyze 15 summers of daily CO export fluxes through this boundary. These daily CO export fluxes have a nearly Gaussian distribution with a mean of 1100 Gg CO day-1 and a standard deviation of 490 Gg CO day-1. To focus on the synoptic variability, we define a "synoptic background" export flux equal to the 15 day moving average export flux and classify strong export days according to their fluxes relative to this background. As expected from Gaussian statistics, 16% of summer days are "strong export days," classified as those days when the CO export flux exceeds the synoptic background by one standard deviation or more. Strong export days contributes 25% to the total export, a value determined by the relative standard deviation of the CO flux distribution. Regressing the anomalies of the CO export flux through the northeast U.S. boundary relative to the synoptic background on the daily anomalies in the surface pressure field (also relative to a 15 day running mean) suggests that strong daily export fluxes are correlated with passages of midlatitude cyclones over the Gulf of Saint Lawrence. The associated cyclonic circulation and Warm Conveyor Belts (WCBs) that lift surface pollutants over the northeastern United States have been shown previously to be associated with long-range transport events. Comparison with observations from the 2004 INTEX-NA field campaign confirms that our model captures the observed enhancements in CO outflow

A Comparison of Concentrations of Sodium and Related Nutrients (Potassium, Total Dietary Fiber, Total and Saturated Fat, and Total Sugar) in Private-Label and National Brands of Popular, Sodium-Contributing, Commercially Packaged Foods in the United States.

Science.gov (United States)

Ahuja, Jaspreet K C; Pehrsson, Pamela R; Cogswell, Mary

2017-05-01

Private-label brands account for about one in four foods sold in US supermarkets. They provide value to consumers due to their low cost. We know of no US studies comparing the nutrition content of private-label products with corresponding national brand products. The objective was to compare concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) in popular sodium-contributing, commercially packaged foods by brand type (national or private-label brand). During 2010 to 2014, the Nutrient Data Laboratory of the US Department of Agriculture obtained 1,706 samples of private-label and national brand products from up to 12 locations nationwide and chemically analyzed 937 composites for sodium and related nutrients. The samples came from 61 sodium-contributing, commercially packaged food products for which both private-label and national brands were among the top 75% to 80% of brands for US unit sales. In this post hoc comparative analysis, the authors assigned a variable brand type (national or private label) to each composite and determined mean nutrient contents by brand type overall and by food product and type. The authors tested for significant differences (Pfoods sampled, differences between brand types were not statistically significant for any of the nutrients studied. However, differences in both directions exist for a few individual food products and food categories. Concentrations of sodium and related nutrients (potassium, total dietary fiber, total and saturated fat, and total sugar) do not differ systematically between private-label and national brands, suggesting that brand type is not a consideration for nutritional quality of foods in the United States. The study data provide public health officials with baseline nutrient content by brand type to help focus US sodium-reduction efforts. Published by Elsevier Inc.

The appropriateness of a proton pump inhibitor prescription.

LENUS (Irish Health Repository)

Moran, N

2014-11-01

Proton pump inhibitors (PPIs) are one of the most commonly prescribed groups of drug in Ireland, at great expense to the Irish healthcare executive. This study aims to evaluate the appropriateness of PPI prescriptions on admission and discharge in a tertiary referral hospital. All non-elective admissions in the Emergency Department in one week were included in the study. 102 patients in total were included, with 36 (35.4%) treated with a PPI on admission. Of these, only 3 (8.3%) had a clear indication noted as per current NICE guidelines. 18 new in-hospital PPI prescriptions were documented. 11 (61%) of which were present on discharge prescriptions. Continuing PPI prescription on discharge into the community may be inappropriate, costly and potentially harmful. Brief interventions aimed at reducing inappropriate PPI prescriptions have been shown to be effective at reducing the cost and potential harm of unnecessary treatment.

Chautauqua notebook: appropriate technology on radio

Energy Technology Data Exchange (ETDEWEB)

Renz, B.

1981-01-01

Experiences in establishing and maintaining a regional call-in information-exchange radio show (Chautauqua) on energy conservation, appropriate technology, renewable energy sources, and self-reliance are discussed. Information is presented on: appropriate technology; the Chautauquaa concept; topics discussed; research performed; guests; interviewing tips; types of listeners; program features; where to find help; promotion and publicity; the technical and engineering aspects; the budget and funding; and station policies. (MCW)

[Appropriateness admissions to the Department of Internal Medicine of the Hospital de Santa Luzia (Elvas) evaluated by the AEP (Appropriateness Evaluation Protocol)].

Science.gov (United States)

Cordero, A; Aguila, J; Massalana, A; Escoto, V; Lopes, L; Susano, R

2004-01-01

The authors analyse the appropriateness admissions to the Internal Medicine ward of the Hospital de Santa Luzia (Elvas). A retrospective study was performed during 6 months of 2001, using the Appropriateness Evaluation Protocol (AEP). Non-appropriateness admissions were found in 19% (CI95%: 16-22), and this group of patients had less mean age (63 + 16 vs 69 + 16; p <0.01), and less mean days of admission (7.1 + 6 vs 9.3 + 7; p <0.01) than group with appropriateness admissions. Appropriateness admissions were mainly found in patients admitted from the emergency room (86% vs 49%; p <0.001). Most of patients with non-appropriate admissions were admitted to undergo diagnostic tests (44%; CI95%: 35-53), or to be referred to other medical centres for specialized study and/or treatment (12%; CI95%: 6-18).

The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic.

Science.gov (United States)

Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N; Wright, John; Katz, Jeffrey N

2012-02-01

Total knee replacement utilization in the United States more than doubled from 1999 to 2008. Although the reasons for this increase have not been examined rigorously, some have attributed the increase to population growth and the obesity epidemic. Our goal was to investigate whether the rapid increase in total knee replacement use over the past decade can be sufficiently attributed to changes in these two factors. We used data from the Nationwide Inpatient Sample to estimate changes in total knee replacement utilization rates from 1999 to 2008, stratified by age (eighteen to forty-four years, forty-five to sixty-four years, and sixty-five years or older). We obtained data on obesity prevalence and U.S. population growth from federal sources. We compared the rate of change in total knee replacement utilization with the rates of population growth and change in obesity prevalence from 1999 to 2008. In 2008, 615,050 total knee replacements were performed in the United States adult population, 134% more than in 1999. During the same time period, the overall population size increased by 11%. While the population of forty-five to sixty-four-year-olds grew by 29%, the number of total knee replacements in this age group more than tripled. The number of obese and non-obese individuals in the United States increased by 23% and 4%, respectively. Assuming unchanged indications for total knee replacement among obese and non-obese individuals with knee osteoarthritis over the last decade, these changes fail to account for the 134% growth in total knee replacement use. Population growth and obesity cannot fully explain the rapid expansion of total knee replacements in the last decade, suggesting that other factors must also be involved. The disproportionate increase in total knee replacements among younger patients may be a result of a growing number of knee injuries and expanding indications for the procedure.

Academic appropriation and Impact Indicators

Directory of Open Access Journals (Sweden)

Wilson López López

2012-06-01

Full Text Available The role of appropriation of scientific knowledge and the indicators designed to measure its impact is being hotly debated in Iberoamerica right now. I will separate what I call academic appropriation of knowledge from what many authors have called social appropriation of knowledge. The former isrelated to knowledge communication and transference practices in scientific communities, and the latter has to do with the multiple ways in which knowledge goes to society. This editorial will address academic appropriation.Academic appropriations are found in many levels: the first is that performed by colleagues (peers who use this knowledge, and citations are the indicators of usage. This is a sensitive indicator, and thus vulnerable to citation dynamics in academic communities. For example, communities with low levels of knowledge use are generally endogamic and have low international collaboration.They are also characterised by not easily modifying their citation habits. In this sense, a part of these citations generally make themselves invisible, this is, they do not acknowledge neither their own efforts, not those made by local peer groups (regional, and are negatively paradoxical, even when proclaimed in an anti-mainstream science discourse. At the same time, they downplay their own production or the regional production, and ground their work on the production that they claim to go beyond.On the other hand, research groups with an important output can improve or decrease the visibility of other groups and journals, since the amount of work ends up concentrating citations in particular works or journals, which affects themeasures derived from citation-expressed impacts. In this sense, and as a response with additional elements for assessing academic production, it is suggested that: 1. The quartile of the journal be used, since it gives a more accurate idea of its dynamics and shows the journal in relation to other journals with its variability

APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

Directory of Open Access Journals (Sweden)

Cornelia DUMITRU

2015-07-01

Full Text Available The ownership, either public or private, is an expression for appropriating goods. Consequently, the appropriation takes the form of private (i.e. private property and common forms (i.e. public property. The common law property defines appropriation as „a deliberate act of acquisition of something, often without the permission of the owner”, but the intellectual property rights do not protect goods. Particularly in this case „the object” of appropriation does not represent a „res nullius” simply because the intellectual property right arises from the act of creation, therefore the appropriation of somebody else’s creation becomes equivalent with stealing (plagiarism. Consequently, if we are to admit that the authors have a right of ownership over them, then ownership in intellectual property law has (it must have other manifestations than those known and accepted in the common law of property.

Principles of Antibiotic Prophylaxis in Total Joint Arthroplasty: Current Concepts.

Science.gov (United States)

Bosco, Joseph A; Bookman, Jared; Slover, James; Edusei, Emmanuel; Levine, Brett

2015-08-01

Infection is a rare, serious complication following total joint arthroplasty and constitutes a considerable emotional and financial burden for patients, surgeons, and healthcare systems. Prevention of surgical site and periprosthetic joint infections is crucial. This requires knowledge of the microorganisms that commonly cause these infections, including Staphylococcus species. Selection of the appropriate antibiotic regimen to treat infection remains controversial, but cefazolin and cefuroxime are the most commonly recommended antibiotics for prophylaxis. Appropriate timing of administration before surgery, with redosing performed as needed, can help to ensure optimal antibiotic concentration during surgery. Given the increasing evidence that S aureus colonization is a risk factor for periprosthetic joint infection, an exploration of the potential benefits of preoperative S aureus carrier screening and decolonization protocols is warranted. The use of antibiotic-loaded bone cement in primary total joint arthroplasty and antibiotic powder at wound closure are other controversial topics that require additional research. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

The costume of Shangri-La: thoughts on white privilege, cultural appropriation, and anti-asian racism.

Science.gov (United States)

Kleisath, C Michelle

2014-01-01

This piece poses cultural appropriation as an undertheorized aspect of white privilege in White Privilege Studies. By way of narrative exploration, it asserts that a paucity of scholarship on Orientalism and anti-Asian racism has created a gap in White Privilege Studies that curbs its radical transformative potential. It argues for the value of a structural and historically focused lens for understanding the issue of cultural appropriation, and extends questions of culture and race relations beyond the borders of the United States. It also explores the complex ways that interracial and transnational relationships can influence white racial identity, and illustrates the disruptive potential that queer interracial relationships can offer to dominant historical patterns of white behavior.

Slurry dispersion state as a parameter to control internal structure of alumina green compact

Energy Technology Data Exchange (ETDEWEB)

Saito, M.; Shui, A.; Tanaka, S.; Uchida, N.; Uematsu, K. [Nagaoka Univ. of Technology, Niigata (Japan)

2002-07-01

The dispersion state of slurry must be controlled to produce granules with appropriated properties for pressing. In this study dispersion state of alumina slurry is changed to form granules with different morphology, deformation property and packing density, and the influence on the internal structure of green compact are presented. Novel methods applying liquid immersion technique coupled with different type of microscopy were used to characterize the internal structures of green compacts. Two types of granules were obtained: dimpled, hard and dense granule, and spherical, soft and loose granule. The respective internal structures of green compacts were totally different. (orig.)

Partnership in an application of RBCA: Case study for quantitative assessment of total petroleum hydrocarbons

International Nuclear Information System (INIS)

Srinivasan, K.; Shepherd, D.

1995-01-01

Risk-Based Corrective Action (RBCA) was successfully applied at a site contaminated with weathered Total Petroleum Hydrocarbons (TPH) from a past release of Diesel Fuel No. 2. In partnership with the state regulatory agency, an approach was developed to assess the toxicity of TPH by the evaluation of its individual classes/constituents. Historically, assessments of petroleum product releases have focused solely on TPH as an analytical parameter and not its individual fractions and/or constituents which represent the actual toxicity of the released product. Soil and groundwater TPH data by Modified California Method 8015 (GC/MS) were reviewed. Based on analytical standards, typical Diesel Fuel No. 2 carbon ranges/fractions were identified. In addition, site-specific carbon-chain lengths were identified based on the aforementioned standard. In consultation with state regulators and according to state draft RBCA guidance, site-specific polycyclic aromatic hydrocarbons (PAHs) and three TPH carbon-range fractions were identified as constituents of concern. In order to quantify the three TPH fractions, appropriate toxicological surrogates were identified. Site-specific exposures to potential human and ecological receptors were evaluated in close consultation with the state regulators. Limited contaminant fate and transport analysis was conducted. Subsequently, complete exposure pathways were quantified

[Evaluation of the appropriateness of hospital admissions using the iso-gravity classification systems APR-DRG and Disease Staging and the Italian version of Appropriateness Evaluation Protocol (AEP)].

Science.gov (United States)

D'Andrea, G; Capalbo, G; Volpe, M; Marchetti, M; Vicentini, F; Capelli, G; Cambieri, A; Cicchetti, A; Ricciardi, G; Catananti, C

2006-01-01

Our main purpose was to evaluate the organizational appropriateness of admissions made in a university hospital, by comparing two iso-gravity classification systems, APR-DRG and Disease Staging, with the Italian version of AEP (PRUO). Our analysis focused on admissions made in 2001, related to specific Diagnosis Related Groups (DRGs), which, according an Italian Law, would be considered at high risk of inappropriateness, if treated as ordinary admissions. The results obtained by using the 2 classification systems did not show statistically significant differences with respect to the total number of admissions. On the other hand, some DRGs showed statistically significant differences due to different algorithms of attribution of the severity levels used by the two systems. For almost all of the DRGs studied, the AEP-based analysis of a sample of medical records showed an higher number of inappropriate admissions in comparison with the number expected by iso-gravity classification methods. The difference is possibly due to the percentage limits of tolerability fixed by the Law for each DRG. Therefore, the authors suggest an integrated use of the two methods to evaluate organizational appropriateness of hospital admissions.

Mapping the Coastline Limits of the Mexican State Sinaloa Using GPS

Science.gov (United States)

Vazquez, G. E.

2007-12-01

This research work presents the delimitation of the coastline limits of Sinaloa (one of the richest states of northwestern Mexico). In order to achieve this big task, it was required to use GPS (Global Positioning System) together with leveling spirit measurements. Based on the appropriate selection of the cited measurement techniques, the objective was to map the Sinaloa's state coastline to have the cartography of approximate 1600 km of littoral. The GPS measurements were performed and referred with respect to a GPS network located across the state. This GPS network consists of at least one first-order-site at each of the sixteen counties that constitute the state, and three to four second-order-sites of the ten counties of the state surrounded by sea. The leveling spirit measurements were referred to local benchmarks pre-established by the Mexican agency SEMARNAT (SEcretaría Del Medio Ambiente y Recursos NATurales). Within the main specifications of the GPS measurements and equipment, we used geodetic-dual-frequency GPS receivers in kinematic mode for both base stations (first and second order sites of the GPS state network) and rover stations (points forming the state littoral) with 5-sec log-rate interval and 10 deg cut-off angle. The GPS data processing was performed using the commercial software Trimble Geomatics Office (TGO) with Double Differences (DD) in post-processing mode. To this point, the field measurements had been totally covered including the cartography (scale 1:1000) and this includes the specifications and appropriate labeling according to the Mexican norm NOM-146-SEMARNAT-2005.

Analysis of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach.

Science.gov (United States)

Keyvanara, Mahmoud; Sohrabi, Mozaffar Cheshmeh; Zare, Firoozeh; Hassnazadeh, Akbar; Malekahmadi, Parisa

2014-01-01

Numerous researches conducted on about the quality of perception of media messages shows that the people are not passive receivers but they have the ability of understanding, interpreting and accepting or rejecting messages. In order to make clear the relationship of information and communication technologies with social changes and to gain a broader vision from this scope, sociological theories about information and communication technologies' usage, especially appropriation approach can be very useful. So, keeping in mind the important role of Databases in the qualitative expansion of education, research, diagnosis, remedy and medical services presentation, this research was carried out with the aim of status determination of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach in 2012. This is an applicative research of an analytical-descriptive type, which was carried out by measurement approach. The statistical society of this research was composed of the academic staffs of the Iranian Universities of Medical Sciences in 2012 and finally 390 academic staffs were selected according to the Cochran's formula were selected. The research tool are searcher's made questionnaire, which was composed of nine separate parts. Its validity was accepted by the specialists and its reliability was calculated and found to be 0.961 by Cronbakh's alpha. Database appropriation score in the academic staffs of Iranian Universities of Medical Sciences with 65.020% was in a good status and data bases dis appropriation score with 71.484 was in a high status. According to the findings of this research, Librarians and politicians in this scope-with determination of the academic staff's positive and negative points in usage and appropriation would be capable of accurately diagnozing and analyzing the chances and challenges of the academic staffs members in using databases and would also be capable of

Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia

Directory of Open Access Journals (Sweden)

Kabbara WK

2015-04-01

Full Text Available Wissam K Kabbara,1 Wijdan H Ramadan,1 Peggy Rahbany,2 Souhaila Al-Natour3 1Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon; 2Children’s National Medical Center, Washington, DC, USA; 3Medex Pharmaceutical Company, Beirut, Lebanon Background: Fluoroquinolones are among the most widely prescribed antibiotics. However, concerns about increasing resistant microorganisms and the risk of dysglycemia associated with the use of these agents have emerged.Objective: The primary objective of the study was to evaluate the appropriate use of commonly prescribed fluoroquinolones, including appropriate indication, dose, dose adjustment in renal impairment, and duration of treatment. The secondary objective was to investigate the dysglycemic effect of fluoroquinolone use (hypoglycemia and/or hyperglycemia in diabetic and nondiabetic patients.Methods: A prospective observational study at a teaching hospital in Lebanon was conducted over a 6-month period. A total of 118 patients receiving broad-spectrum fluoroquinolones (levofloxacin, ciprofloxacin, and moxifloxacin were identified. Patients were mainly recruited from internal medicine floors and intensive care units.Results: The final percentage for the appropriate indication, dose, and duration of fluoroquinolone therapy was 93.2%, 74.6%, and 57.6%, respectively. A total of 57.1% of the patients did not receive the appropriate dose adjustment according to their level of renal impairment. In addition, dysglycemia occurred in both diabetic and nondiabetic patients. Dysglycemia was more frequently encountered with ciprofloxacin (50.0%, followed by levofloxacin (42.4% and moxifloxacin (7.6%. Hyperglycemia was more common than hypoglycemia in all groups. The highest incidence of hyperglycemia occurred with levofloxacin (70.0%, followed by ciprofloxacin (39.0% and moxifloxacin (33.3%. In contrast, hypoglycemia did not occur in the ciprofloxacin group, but it was

ACR Appropriateness Criteria® Colorectal Cancer Screening.

Science.gov (United States)

Moreno, Courtney; Kim, David H; Bartel, Twyla B; Cash, Brooks D; Chang, Kevin J; Feig, Barry W; Fowler, Kathryn J; Garcia, Evelyn M; Kambadakone, Avinash R; Lambert, Drew L; Levy, Angela D; Marin, Daniele; Peterson, Christine M; Scheirey, Christopher D; Smith, Martin P; Weinstein, Stefanie; Carucci, Laura R

2018-05-01

This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Can a quantum state over time resemble a quantum state at a single time?

Science.gov (United States)

Horsman, Dominic; Heunen, Chris; Pusey, Matthew F; Barrett, Jonathan; Spekkens, Robert W

2017-09-01

The standard formalism of quantum theory treats space and time in fundamentally different ways. In particular, a composite system at a given time is represented by a joint state, but the formalism does not prescribe a joint state for a composite of systems at different times. If there were a way of defining such a joint state, this would potentially permit a more even-handed treatment of space and time, and would strengthen the existing analogy between quantum states and classical probability distributions. Under the assumption that the joint state over time is an operator on the tensor product of single-time Hilbert spaces, we analyse various proposals for such a joint state, including one due to Leifer and Spekkens, one due to Fitzsimons, Jones and Vedral, and another based on discrete Wigner functions. Finding various problems with each, we identify five criteria for a quantum joint state over time to satisfy if it is to play a role similar to the standard joint state for a composite system: that it is a Hermitian operator on the tensor product of the single-time Hilbert spaces; that it represents probabilistic mixing appropriately; that it has the appropriate classical limit; that it has the appropriate single-time marginals; that composing over multiple time steps is associative. We show that no construction satisfies all these requirements. If Hermiticity is dropped, then there is an essentially unique construction that satisfies the remaining four criteria.

Evaluation of total aboveground biomass and total merchantable biomass in Missouri

Science.gov (United States)

Michael E. Goerndt; David R. Larsen; Charles D. Keating

2014-01-01

In recent years, the state of Missouri has been converting to biomass weight rather than volume as the standard measurement of wood for buying and selling sawtimber. Therefore, there is a need to identify accurate and precise methods of estimating whole tree biomass and merchantable biomass of harvested trees as well as total standing biomass of live timber for...

Narrative self-appropriation: embodiment, alienness, and personal responsibility in the context of borderline personality disorder.

Science.gov (United States)

Køster, Allan

2017-12-01

It is often emphasised that persons diagnosed with borderline personality disorder (BPD) show difficulties in understanding their own psychological states. In this article, I argue that from a phenomenological perspective, BPD can be understood as an existential modality in which the embodied self is profoundly saturated by an alienness regarding the person's own affects and responses. However, the balance of familiarity and alienness is not static, but can be cultivated through, e.g., psychotherapy. Following this line of thought, I present the idea that narrativising experiences can play an important role in processes of appropriating such embodied self-alienness. Importantly, the notion of narrative used is that of a scalar conception of narrativity as a variable quality of experience that comes in degrees. From this perspective, narrative appropriation is a process of gradually attributing the quality of narrativity to experiences, thereby familiarising the moods, affects, and responses that otherwise govern 'from behind'. Finally, I propose that the idea of a narrative appropriation of embodied self-alienness is also relevant to the much-debated question of personal responsibility in BPD, particularly as this question plays out in psychotherapeutic contexts where a narrative self-appropriation may facilitate an increase in sense of autonomy and reduce emotions of guilt and shame.

Positron collisions with acetylene calculated using the R-matrix with pseudo-states method

Science.gov (United States)

Zhang, Rui; Galiatsatos, Pavlos G.; Tennyson, Jonathan

2011-10-01

Eigenphase sums, total cross sections and differential cross sections are calculated for low-energy collisions of positrons with C2H2. The calculations demonstrate that the use of appropriate pseudo-state expansions very significantly improves the representation of this process giving both realistic eigenphases and cross sections. Differential cross sections are strongly forward peaked in agreement with the measurements. These calculations are computationally very demanding; even with improved procedures for matrix diagonalization, fully converged calculations are too expensive with current computer resources. Nonetheless, the calculations show clear evidence for the formation of a virtual state but no indication that acetylene actually binds a positron at its equilibrium geometry.

Positron collisions with acetylene calculated using the R-matrix with pseudo-states method

Energy Technology Data Exchange (ETDEWEB)

Zhang Rui; Galiatsatos, Pavlos G; Tennyson, Jonathan, E-mail: j.tennyson@ucl.ac.uk [Department of Physics and Astronomy, University College London, Gower St., London WC1E 6BT (United Kingdom)

2011-10-14

Eigenphase sums, total cross sections and differential cross sections are calculated for low-energy collisions of positrons with C{sub 2}H{sub 2}. The calculations demonstrate that the use of appropriate pseudo-state expansions very significantly improves the representation of this process giving both realistic eigenphases and cross sections. Differential cross sections are strongly forward peaked in agreement with the measurements. These calculations are computationally very demanding; even with improved procedures for matrix diagonalization, fully converged calculations are too expensive with current computer resources. Nonetheless, the calculations show clear evidence for the formation of a virtual state but no indication that acetylene actually binds a positron at its equilibrium geometry.

Appropriateness of upper-GI endoscopy: an Italian survey on behalf of the Italian Society of Digestive Endoscopy.

Science.gov (United States)

Hassan, Cesare; Bersani, Gianluca; Buri, Luigi; Zullo, Angelo; Anti, Marcello; Bianco, Maria Antonia; Di Giulio, Emilio; Ficano, Leonardo; Morini, Sergio; Di Matteo, Giovanni; Loriga, Piero; Pietropaolo, Vincenzo; Cipolletta, Livio; Costamagna, Guido

2007-05-01

Open-access endoscopy allows physicians to directly schedule endoscopic procedures for their patients without prior consultation. An evaluation of both appropriateness and diagnostic yield of endoscopic procedures is critical when assessing the costs and benefits of endoscopy in an open-access setting. The aim of this Italian multicenter study was to assess the appropriate use of upper endoscopy (EGD) in an open-access system and to establish the yield of diagnostic information relevant to patient care. Cross-sectional, prospective, multicenter study. A total of 6270 patients referred to 44 Italian centers for open-access EGD during 1 month were prospectively enrolled. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines were used to assess the relation between the appropriate use of EGD and the presence of relevant endoscopic findings. The rate for "generally not indicated" EGDs was 22.9%: 29.4% for primary care physicians and 12.9% for specialists (P 20, 99% CI 3 to >100; P < .01). Open-access EGD is an useful procedure for clinical practice. Because most of the relevant findings were detected during examinations performed for appropriate indications, the use of ASGE guidelines emerges as crucial to the cost-effectiveness of an open-access system.

From Adaptation to Appropriation: Framing the World Through News Translation

Directory of Open Access Journals (Sweden)

Valdeón Roberto A.

2014-02-01

Full Text Available Terminological issues are problematic in the analysis of translation processes in news production. In the 1980s, Stetting coined the term “transediting”, which has been widely used in the translation studies literature, but “translation” itself becomes contentious in communication studies, a discipline closely related to news translation research. Only a few communication scholars have specifically dealt with the linguistic and cultural transformations of source texts, but they tend to regard translation as word-for-word transfer, unusual news production. More productive for the study of news translation seems to be the application of the concept of framing, widely used in communication studies. Framing considers the linguistic and paralinguistic elements of news texts in the promotion of certain organizing ideas that the target audience can identify with. In news translation, this entails the adaptation of a text for the target readership, a process can lead to appropriation of source material. Two examples are mentioned to illustrate this point: the appropriation of the US Department of State cables by the Wikileak organisation, and the pro-Romanian slogans produced by the Gandul newspaper as a response to Britain’s anti-immigration campaigns. The final section relates news adaptation to adaptation of other text types, such as literary and historical works.

How Building Principals Made Sense of Free and Appropriate Public Education in the Least Restrictive Environment

Science.gov (United States)

Sumbera, Meagan J.; Pazey, Barbara L.; Lashley, Carl

2014-01-01

Confusion among school leaders regarding how to interpret and implement special education legislation, and specific federal and state policies and mandates such as a free and appropriate public education (FAPE), in the least restrictive environment (LRE) at the school-site level has existed since the 1970s and continues to exist. This…

18 CFR 367.4360 - Account 436, Appropriations of retained earnings.

Science.gov (United States)

2010-04-01

..., Appropriations of retained earnings. 367.4360 Section 367.4360 Conservation of Power and Water Resources FEDERAL... NATURAL GAS ACT Retained Earnings Accounts § 367.4360 Account 436, Appropriations of retained earnings. This account must include appropriations of retained earnings as follows: (a) Appropriations required...

43 CFR 20.506 - Appropriations, legislation and lobbying.

Science.gov (United States)

2010-10-01

... money appropriated by any enactment of Congress to pay for any personal service, advertisement, telegram... appropriations which they deem necessary for the efficient conduct of the public business (18 U.S.C. 1913). (b...

Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011-12.

Science.gov (United States)

Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

2017-01-01

District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

Vibrational enhancement of total breakup cross sections

International Nuclear Information System (INIS)

Haftel, M.I.; Lim, T.K.

1984-01-01

This paper considers the role of multi-two-body bound states, namely vibrational excitations, on total three-body breakup cross-sections. Total cross-sections are usually easy to measure, and they play a fundamental role in chemical kinetics. (orig.)

7 CFR 15b.22 - Free appropriate public education.

Science.gov (United States)

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Free appropriate public education. 15b.22 Section 15b... Extension Education § 15b.22 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program or activity shall provide a free appropriate public...

Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

Directory of Open Access Journals (Sweden)

Francesco Napolitano

Full Text Available BACKGROUND: The appropriate use of antibiotics prophylaxis in the prevention and reduction in the incidence of surgical site infection is widespread. This study evaluates the appropriateness of the prescription of antibiotics prophylaxis prior to surgery amongst hospitalized patients in the geographic area of Avellino, Caserta, and Naples (Italy and the factors associated with a poor adherence. METHODS: A sample of 382 patients admitted to 23 surgical wards and undergoing surgery in five hospitals were randomly selected. RESULTS: Perioperative antibiotic prophylaxis was appropriate in 18.1% of cases. The multivariate logistic regression analysis showed that patients with hypoalbuminemia, with a clinical infection, with a wound clean were more likely to receive an appropriate antibiotic prophylaxis. Compared with patients with an American Society of Anesthesiologists (ASA score ≥4, those with a score of 2 were correlated with a 64% reduction in the odds of having an appropriate prophylaxis. The appropriateness of the timing of prophylactic antibiotic administration was observed in 53.4% of the procedures. Multivariate logistic regression model showed that such appropriateness was more frequent in older patients, in those admitted in general surgery wards, in those not having been underwent an endoscopic surgery, in those with a higher length of surgery, and in patients with ASA score 1 when a score ≥4 was chosen as the reference category. The most common antibiotics used inappropriately were ceftazidime, sultamicillin, levofloxacin, and teicoplanin. CONCLUSIONS: Educational interventions are needed to improve perioperative appropriate antibiotic prophylaxis.

Choosing Appropriate Business Models

OpenAIRE

UNCTAD; World Bank

2018-01-01

This note provides guidance on considerations in the selection of an appropriate business model through which to conduct an agricultural investment. Agricultural investments have a wide range of impacts, positive and negative. The choice of business model is one, but by no means the only, determining factor of the financial success of the investment, as well as its socioeconomic and enviro...

A Gaussian quadrature method for total energy analysis in electronic state calculations

Science.gov (United States)

Fukushima, Kimichika

This article reports studies by Fukushima and coworkers since 1980 concerning their highly accurate numerical integral method using Gaussian quadratures to evaluate the total energy in electronic state calculations. Gauss-Legendre and Gauss-Laguerre quadratures were used for integrals in the finite and infinite regions, respectively. Our previous article showed that, for diatomic molecules such as CO and FeO, elliptic coordinates efficiently achieved high numerical integral accuracy even with a numerical basis set including transition metal atomic orbitals. This article will generalize straightforward details for multiatomic systems with direct integrals in each decomposed elliptic coordinate determined from the nuclear positions of picked-up atom pairs. Sample calculations were performed for the molecules O3 and H2O. This article will also try to present, in another coordinate, a numerical integral by partially using the Becke's decomposition published in 1988, but without the Becke's fuzzy cell generated by the polynomials of internuclear distance between the pair atoms. Instead, simple nuclear weights comprising exponential functions around nuclei are used. The one-center integral is performed with a Gaussian quadrature pack in a spherical coordinate, included in the author's original program in around 1980. As for this decomposition into one-center integrals, sample calculations are carried out for Li2.

Quantum jointly assisted cloning of an unknown three-dimensional equatorial state

Science.gov (United States)

Ma, Peng-Cheng; Chen, Gui-Bin; Li, Xiao-Wei; Zhan, You-Bang

2018-02-01

We present two schemes for perfectly cloning an unknown single-qutrit equatorial state with assistance from two and N state preparers, respectively. In the first scheme, the sender wishes to teleport an unknown single-qutrit equatorial state from two state preparers to a remote receiver, and then to create a perfect copy of the unknown state at her location. The scheme consists of two stages. The first stage of the scheme requires the usual teleportation. In the second stage, to help the sender realize the quantum cloning, two state preparers perform single-qutrit projective measurements on their own qutrits from the sender, then the sender can acquire a perfect copy of the unknown state. It is shown that, only if the two state preparers collaborate with each other, the sender can create a copy of the unknown state by means of some appropriate unitary operations. In the second scheme, we generalized the jointly assisted cloning in the first scheme to the case of N state prepares. In the present schemes, the total probability of success for assisted cloning of a perfect copy of the unknown state can reach 1.

Resonance structure of 32S+n from measurements of neutron total and capture cross sections

International Nuclear Information System (INIS)

Halperin, J.; Johnson, C.H.; Winters, R.R.; Macklin, R.L.

1980-01-01

Neutron total and capture cross sections of 32 S have been measured up to 1100 keV neutron energy [E/sub exc/( 33 S) =9700 keV]. Spin and parity assignments have been made for 28 of the 64 resonances found in this region. Values of total radiation widths, reduced neutron widths, level spacings, and neutron strength functions have been evaluated for s/sub 1/2/, p/sub 1/2/, p/sub 3/2/, and d/sub 5/2/ levels. Single particle contributions using the valency model account for a significant portion of the total radiation width only for the p/sub 1/2/-wave resonances. A significant number of resonances can be identified with reported levels excited in 32 S(d,p) and 29 Si(α,n) reactions. A calculation of the Maxwellian average cross section appropriate to stellar interiors indicates an average capture cross section at 30 keV, sigma-bar approx. = 4.2(2) mb, a result that is relatively insensitive to the assumed stellar temperature. Direct (potential) capture and the s-wave resonance capture contributions to the thermal capture cross section do not fully account for the reported thermal cross section (530 +- 40 mb) and a bound state is invoked to account for the discrepancy

Thermalization of squeezed states

International Nuclear Information System (INIS)

Solomon, Allan I

2005-01-01

Starting with a thermal squeezed state defined as a conventional thermal state based on an appropriate Hamiltonian, we show how an important physical property, the signal-to-noise ratio, is degraded, and propose a simple model of thermalization (Kraus thermalization)

NIF total neutron yield diagnostic

International Nuclear Information System (INIS)

Cooper, Gary W.; Ruiz, Carlos L.

2001-01-01

We have designed a total neutron yield diagnostic for the National Ignition Facility (NIF) which is based on the activation of In and Cu samples. The particular approach that we have chosen is one in which we calibrate the entire counting system and which we call the ''F factor'' method. In this method, In and/or Cu samples are exposed to known sources of DD and DT neutrons. The activated samples are then counted with an appropriate system: a high purity Ge detector for In and a NaI coincidence system for Cu. We can then calculate a calibration factor, which relates measured activity to total neutron yield. The advantage of this approach is that specific knowledge of such quantities as cross sections and detector efficiencies is not needed. Unless the actual scattering environment of the NIF can be mocked up in the calibration experiment, the F factor will have to be modified using the results of a numerical simulation of the NIF scattering environment. In this article, the calibration factor methodology will be discussed and experimental results for the calibration factors will be presented. Total NIF neutron yields of 10 9 --10 19 can be measured with this method assuming a 50 cm stand-off distance can be employed for the lower yields

Appropriate roads for rural access

CSIR Research Space (South Africa)

Paige-Green, P

2006-03-01

Full Text Available be reduced, the result remains environmentally unsustainable. Low cost but appropriate techniques for upgrading these roads cost-effectively to sealed standards have been implemented in many countries recently. These techniques optimize the use of local...

Appropriate strategies.

Science.gov (United States)

Halty, M

1979-01-01

Technology strategies are concerned with the production, distribution, and consumption of technology. Observation of less developed countries (LDCs) and international organizations shows that little attention is given to the development of a technology strategy. LDCs need to formulate a strategy of self-reliant technological development for the next decade. They should no longer be content to stand in a technologically dependent relationship to the developed countries. Such strategies must balance the ratio between investment in indigenous technologies and expenditure for foreign technology. The strategies change according to the level of industrialization achieved. The following considerations come into development of technology strategies: 1) determination of an appropriate balance among the accumulation, consumption, and distribution of technology; 2) the amount and level of government support; and 3) the balance between depth and breadth of technology to be encouraged.

Water and the human culture of appropriation: the Vaal River up to 1956

Directory of Open Access Journals (Sweden)

Johann W.N. Tempelhoff

2006-04-01

Full Text Available There is discernable evidence of the human presence having historically appropriated the 1300 kilometer long Vaal River of South Africa as it extends itself from the Drakensberg Plateau into the arid Karoo region. This hard-working tributary of the Orange River, which was instrumental as a supply of water to the Witwatersrand, in the era of the region’s gold mines, has been used by humans in a variety of ways. First it was used as a route of communications, then as a borderline demarcating the territorial spaces of states and colonies. Later it was used for purposes of economic development. In the study the objective is to point towards the manner in which humans have influenced the river and its hinterland, particularly from the nineteenth century, up to the 1950s. The process of appropriation, it is argued, has had a different effect when humans laid claim to the river and its environment for social, economic and political purposes.

Reliability evaluation of linear multi-state consecutively-connected systems constrained by m consecutive and n total gaps

International Nuclear Information System (INIS)

Yu, Huan; Yang, Jun; Peng, Rui; Zhao, Yu

2016-01-01

This paper extends the linear multi-state consecutively-connected system (LMCCS) to the case of LMCCS-MN, where MN denotes the dual constraints of m consecutive gaps and n total gaps. All the nodes are distributed along a line and form a sequence. The distances between the adjacent nodes are usually non-uniform. The nodes except the last one can contain statistically independent multi-state connection elements (MCEs). Each MCE can provide a connection between the node at which it is located and the next nodes along the sequence. The LMCCS-MN fails if it meets either of the two constraints. The universal generating function technique is adopted to evaluate the system reliability. The optimal allocations of LMCCS-MN with two different types of failures are solved by genetic algorithm. Finally, two examples are given for the demonstration of the proposed model. - Highlights: • A new model of multi-state consecutively-connected system (LMCCS-MN) is proposed. • The non-uniform distributed nodes are involved in the proposed LMCCS-MN model. • An algorithm for system reliability evaluation is provided by the UGF method. • The computational complexity of the proposed algorithm is discussed in detail. • Optimal element allocation problem is formulated and solved.

Primary to comprehensive stroke center transfers: Appropriateness, not futility.

Science.gov (United States)

Goyal, Mayank; Menon, Bijoy K; Wilson, Alexis T; Almekhlafi, Mohammed A; McTaggart, Ryan; Jayaraman, Mahesh; Demchuk, Andrew M; Hill, Michael D

2018-01-01

Background and purpose Ischemic stroke patients must be transferred to comprehensive stroke centers for endovascular treatment, but this transfer can be interpreted post hoc as "futile" if patients do not ultimately undergo the procedure or have a poor outcome. We posit that transfer decisions must instead be evaluated in terms of appropriateness at the time of decision-making. Methods We propose a classification schema for Appropriateness of Transfer for Endovascular Thrombectomy based on patient, logistic, and center characteristics. Results The classification outline characteristics of patients that are 1. Appropriate for transfer for endovascular treatment; 2. Inappropriate for transfer; and 3. Appropriate for transfer for higher level of care. Conclusions Appropriate transfer decisions for endovascular treatment are significant for patient outcomes. A more nuanced understanding of transfer decision-making and a classification for such transfers can help minimize inappropriate transfers in acute stroke.

Total quality management in American industry.

Science.gov (United States)

Widtfeldt, A K; Widtfeldt, J R

1992-07-01

The definition of total quality management is conformance to customer requirements and specifications, fitness for use, buyer satisfaction, and value at an affordable price. The three individuals who have developed the total quality management concepts in the United States are W.E. Deming, J.M. Juran, and Philip Crosby. The universal principles of total quality management are (a) a customer focus, (b) management commitment, (c) training, (d) process capability and control, and (e) measurement through quality improvement tools. Results from the National Demonstration Project on Quality Improvement in Health Care showed the principles of total quality management could be applied to healthcare.

Appropriate customization of radiation therapy for stage II and III rectal cancer: Executive summary of an ASTRO Clinical Practice Statement using the RAND/UCLA Appropriateness Method.

Science.gov (United States)

Goodman, Karyn A; Patton, Caroline E; Fisher, George A; Hoffe, Sarah E; Haddock, Michael G; Parikh, Parag J; Kim, John; Baxter, Nancy N; Czito, Brian G; Hong, Theodore S; Herman, Joseph M; Crane, Christopher H; Hoffman, Karen E

2016-01-01

To summarize results of a Clinical Practice Statement on radiation therapy for stage II-III rectal cancer, which addressed appropriate customization of (neo)adjuvant radiation therapy and use of non-surgical therapy for patients who are inoperable or refuse abdominoperineal resection. The RAND/University of California, Los Angeles, Appropriateness Method was applied to combine current evidence with multidisciplinary expert opinion. A systematic literature review was conducted and used by the expert panel to rate appropriateness of radiation therapy options for different clinical scenarios. Treatments were categorized by median rating as Appropriate, May Be Appropriate, or Rarely Appropriate. In the neoadjuvant setting, chemoradiation was rated Appropriate and the ratings indicated short-course radiation therapy, chemotherapy alone, and no neoadjuvant therapy are potential options in selected patients. However, neoadjuvant endorectal brachytherapy was rated Rarely Appropriate. For adjuvant therapy, chemoradiation (plus ≥4 months of chemotherapy) was rated Appropriate and chemotherapy alone May Be Appropriate for most scenarios. For medically inoperable patients, definitive external beam radiation therapy and chemotherapy alone were rated May Be Appropriate, whereas endorectal brachytherapy and chemoradiation plus endorectal brachytherapy were possible approaches for some scenarios. The last option, definitive chemoradiation, was rated Appropriate to May Be Appropriate based on performance status. Finally, for patients with low-lying tumors refusing abdominoperineal resection, definitive chemoradiation alone, chemoradiation plus endorectal brachytherapy, and chemoradiation plus external beam radiation therapy were all rated Appropriate. This Clinical Practice Statement demonstrated the central role of radiation therapy in stage II-III rectal cancer management and evaluated ways to better individualize its use in the neoadjuvant, adjuvant, and definitive settings

A combined method to estimate the appropriate age value of closed uraniun-lead system

International Nuclear Information System (INIS)

Malakhov, S.S.

1982-01-01

A new method is proposed for obtaining the appropriate age values of closed uranium-lead systems taking into account total indeependent information delivered as a result of spectral and isotope-lead analyses. A simple mathematical apparatus which permits to perform a geochronological interpretation of samples using miniature computers is considered and suggested. A simple estimation formula for determining the age of uranium-lead systems under the assumption of model development of isotope ratios of ordinary lead is derived and tested basing on the facts

Authorizing appropriations to the Nuclear Regulatory Commission. Hearing before the Subcommittee on Energy Research and Development of the Committee on Energy and Natural Resources, United States Senate, Ninety-Eighth Congress, Second Session on S. 2846 (Section 201), July 31, 1984

International Nuclear Information System (INIS)

Anon.

1984-01-01

A hearing on S. 2846, which would amend the Nuclear Waste Policy Act of 1982 to authorize appropriations, reduces funding from $466.8 million in fiscal year 1984 to $460 million in fiscal year 1985. It also authorizes allocations. Responses to the bill noted its effect on state and federal relations and limitations on the scope of state participation. Testimony focused on the subject of States rights to reject a nuclear waste depository and other adverse effects. DOE and the nuclear industry oppose the legislation. Spokesmen for Texas felt that States rights would not suffer, but that the legislation would not be of help

Appropriate use of medical imaging in two Spanish public hospitals: a cross-sectional analysis.

Science.gov (United States)

Vilar-Palop, Jorge; Hernandez-Aguado, Ildefonso; Pastor-Valero, María; Vilar, José; González-Alvarez, Isabel; Lumbreras, Blanca

2018-03-16

To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Cross-sectional retrospective study. Two Spanish public tertiary hospitals. 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient's clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on sociodemographic and clinical characteristics such as sex, age, referral physician and medical imaging test

38 CFR 18.433 - Free appropriate public education.

Science.gov (United States)

2010-07-01

... education. 18.433 Section 18.433 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS..., Secondary, and Adult Education § 18.433 Free appropriate public education. (a) General. A recipient that operates a public elementary or secondary education program shall provide a free appropriate public...

Solid state video cameras

CERN Document Server

Cristol, Y

2013-01-01

Solid State Video Cameras reviews the state of the art in the field of solid-state television cameras as compiled from patent literature. Organized into 10 chapters, the book begins with the basic array types of solid-state imagers and appropriate read-out circuits and methods. Documents relating to improvement of picture quality, such as spurious signal suppression, uniformity correction, or resolution enhancement, are also cited. The last part considerssolid-state color cameras.

Defense Authorization and Appropriations Bills: FY1970-FY2017

Science.gov (United States)

2017-01-18

textbooks on legislative procedure. Tracking DOD authorization or appropriation bills can be confusing and time-consuming. This has been particularly...by the President through the White House Office of Management and Budget) to the defense authorizing and appropriations committees. Then, for...maintain operations . 3 This might be considered a “line of credit” against the enactment of the relevant appropriations for the new fiscal year

16 CFR 614.1 - Appropriate proof of identity.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Appropriate proof of identity. 614.1 Section... IDENTITY § 614.1 Appropriate proof of identity. (a) Consumer reporting agencies shall develop and implement reasonable requirements for what information consumers shall provide to constitute proof of identity for...

Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

LENUS (Irish Health Repository)

Baker, Joseph F

2012-12-01

Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +\\/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.

ACR appropriateness criteria jaundice.

Science.gov (United States)

Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

2013-06-01

A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Exploring health providers’ and community perceptions and experiences with malaria tests in South-East Nigeria: a critical step towards appropriate treatment

Directory of Open Access Journals (Sweden)

Ezeoke Ogochukwu P

2012-11-01

Full Text Available Abstract Background The adoption of ACT as the first line treatment for uncomplicated malaria in Nigeria has concentrated attention on the role of testing in appropriate malaria treatment. There are calls at both national and global level for malaria treatment to be based on test result, but it is still unclear how testing can be incorporated into treatment-seeking and practices of health providers. This study explored community members and health providers’ perceptions and experiences with malaria tests in south east Nigeria. Methods The study was conducted in urban and rural areas of Enugu state in south-eastern Nigeria. A total of 18 focus group discussions with 179 community members including sub-groups of primary caregivers, adult men and adult women aged 15 years and above. Twenty- six (26 In-depth interviews were held with public and private health providers involved in prescribing medicines at public and private health facilities in the study area. Results Both providers and community members were familiar with malaria tests and identified malaria tests as an important step to distinguish malaria from other illnesses with similar symptoms and as a means of delivering appropriate treatment. However, the logic of test-directed treatment was undermined by cost of test and a lack of testing facilities but above all concerns over the reliability of negative test results, with community members and providers observing inconsistencies between results and symptoms, and providers attributing inaccurate results to incompetencies of technicians. Recognition of malaria symptoms was deemed most important in determining the use of antimalarial drugs rather than the result of a malaria test. Conclusion The results highlight important areas of intervention to promote appropriate malaria treatment. If tests are to play a role in patient management, demand and supply side interventions are needed to change people’s attitude towards malaria test

Colostrum and milk pasteurization improve health status and decrease mortality in neonatal calves receiving appropriate colostrum ingestion.

Science.gov (United States)

Armengol, Ramon; Fraile, Lorenzo

2016-06-01

The objective of the study was to evaluate if on-farm heat treatment of colostrum and bulk tank milk can improve calf health status and morbidity and mortality rates during the first 21d of life in neonatal Holstein calves receiving appropriate colostrum ingestion. A total of 587 calves were randomly assigned to 2 groups of males and females over 18mo. The nonpasteurized group (n=287, 143 males and 144 females) was fed frozen (-20°C) colostrum (6-8L during the first 12h of life) that was previously reheated up to 40°C. They were also fed refrigerated (4°C) raw milk from the bulk tank that was also reheated up to 40°C (1.8L every 12h). The pasteurized group (n=300, 150 males and 150 females) was also fed colostrum and milk, but both were pasteurized before freezing. Blood samples were drawn from all calves to obtain serum at 2 to 5d of life. Serum total protein (g/dL) was determined using a commercially available refractometer. Colostrum and milk underwent routine bacteriological analysis to determine total plate counts (cfu/mL) and total coliform counts (cfu/mL). All the calves underwent clinical examination every 24h during the first 21d of life. Every day, calves were clinically diagnosed either as being healthy or suffering from respiratory disease, neonatal calf diarrhea, or suffering other diseases. On-farm heat treatment for colostrum and milk reduced total plate counts and total coliform counts between 1 and 2 log10. Pasteurization of colostrum and milk significantly decreased the morbidity and mortality (5.2 and 2.8%) in comparison with calves receiving nonpasteurized colostrum and milk (15.0 and 6.5%), respectively, during the first 21d of life, even in animals receiving appropriate colostrum ingestion. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: Predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy.

Science.gov (United States)

Candan, Ozkan; Gecmen, Cetin; Bayam, Emrah; Guner, Ahmet; Celik, Mehmet; Doğan, Cem

2017-06-01

In this study, we investigated whether mechanical dispersion which reflects electrical abnormality and other echocardiographic and clinic parameters predict appropriate ICD shock in patients undergone ICD implantation for hypertrophic cardiomyopathy. Sixty-three patients who received ICD implantation for primary or secondary prevention were included in the study. Patients' clinical, electrocardiographic, 2D classic, and speckle tracking echocardiographic data were collected. Mechanical dispersion was defined as the standard deviation of time to peak negative strain in 18 left ventricular segments. Appropriate ICD therapy was defined as cardioversion or defibrillation due to ventricular tachycardia or fibrillation. Patients were divided into two groups as occurrence or the absence of appropriate ICD therapy. A total of 17 (26.9%) patients were observed to have an appropriate ICD therapy during follow-up periods. In patients who performed appropriate ICD therapy, a larger left atrial volume index, higher sudden cardiac death (SCD)-Risk Score, longer mechanical dispersion, and decreased global longitudinal peak strain (GLPS) were observed. In multivariate logistic regression analysis, including (GLPS, mechanical dispersion, LAVi, and SCD-Risk Score) was used to determine independent predictors of occurrence of appropriate ICD therapy during the follow-up. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be independent predictors of occurrence of appropriate ICD therapy. Mechanical dispersion, GLPS, and SCD-Risk Score were found to be predictive for appropriate ICD therapy in patients receiving ICD implantation. Readily measurable mechanical dispersion and GLPS could be helpful to distinguish patients at high risk who could optimally benefit from ICD therapy. © 2017, Wiley Periodicals, Inc.

Appropriate Use of FDG-PET for the Management of Cancer Patients

International Nuclear Information System (INIS)

2010-01-01

The use of PET (positron emission tomography) has become the standard quality of care for optimal management of patients with cancer. The availability of the hybrid PET/CT (positron emission tomography/computed tomography) scanner has further improved the utility of PET scanning and provides additional benefits both to patients and to the health system. This publication addresses the important issue of appropriateness of the application of PET/CT procedures in different clinical scenarios for many cancers. It is a resource for specialists in nuclear medicine and oncology, and aims to make reliable information widely available to those Member States where PET programmes are still in their planning phase or where the use of PET scanning is limited.

Technological transfer. 1. Appropriateness for developing countries

Energy Technology Data Exchange (ETDEWEB)

Berrie, T W

1978-12-01

Capital-intensive projects dominate the technology transferred to developing countries in spite of the need to serve a pool of unskilled labor and small capital reserves. Recent doubts about the appropriateness of large industrialization projects have questioned the social and economic benefits of this approach and led to an emphasis on innovative planning for the benefit of the urban and rural poor. This shift assumed that direct attacks on the roots of poverty will be more effective than the trickle-down approach, but development planners now see that technologies can be planned that are not limited to single groups. Official policies, often working against the adoption of appropriate technologies, must consider local needs and local resources. Farm equipment, for example, must minimize the need for skilled labor and maintenance. Planners for appropriate urban technology should emphasize local capability, but should also risk occasional failure in the effort to improve the efficiency of labor.

Indication criteria for total hip or knee arthroplasty in osteoarthritis: a state-of-the-science overview.

Science.gov (United States)

Gademan, Maaike G J; Hofstede, Stefanie N; Vliet Vlieland, Thea P M; Nelissen, Rob G H H; Marang-van de Mheen, Perla J

2016-11-09

This systematic review gives an overview of guidelines and original publications as well as the evidence on which the currently proposed indication criteria are based. Until now such a state-of-the-science overview was lacking. Websites of orthopaedic and arthritis organizations (English/Dutch language) were independently searched by two authors for THA/TKA guidelines for OA. Furthermore, a systematic search strategy in several databases through August 2014 was performed. Quality of the guidelines was assessed with the AGREE II instrument, which consists of 6 domains (maximum summed score of 6 indicating high quality). Also, the level of evidence of all included studies was assessed. We found 6 guidelines and 18 papers, out of 3065 references. The quality of the guidelines summed across 6 domains ranged from 0.46 to 4.78. In total, 12 THA, 10 TKA and 2 THA/TKA indication sets were found. Four studies stated that no evidence-based indication criteria are available. Indication criteria concerning THA/TKA consisted of the following domains: pain (in respectively 11 and 10 sets), function (12 and 7 sets), radiological changes (10 and 9 sets), failed conservative therapy (8 and 4 sets) and other indications (6 and 7 sets). Specific cut-off values or ranges were often not stated and the level of evidence was low. The indication criteria for THA/TKA are based on limited evidence. Empirical research is needed, especially regarding domain specific cut-off values or ranges at which the best postoperative outcomes are achieved for patients, taking into account the limited lifespan of a prosthesis.

Role of QA in total quality management environment

International Nuclear Information System (INIS)

McCarthy, J.B.; Ayres, R.A.

1992-01-01

A successful company in today's highly competitive business environment must emphasize quality in all activities at all times. For most companies, this requires a major cultural change to establish appropriate operating attitudes and priorities. A total quality environment is required where quality becomes a way of life, and this process must be carefully managed. It will not be accomplished in a few short months with a simple management pronouncement. Instead, it evolves over a period of years through continuous incremental improvement. This evolution towards total quality requires a dramatic change in the quality assurance (QA) function of most companies. Traditionally, quality was automatically equated to QA and its attendant procedures and personnel. Now, quality is becoming a global concept, and QA can play a significant role in the process. The QA profession must, however, recognize and accept a new role as consultant, coach, and partner in today's total quality game. The days of the hard-line enforcer of procedural requirements are gone

Are Nursing Students Appropriate Partners for the Interdisciplinary Training of Surgery Residents?

Science.gov (United States)

Stefanidis, Dimitrios; Ingram, Katherine M; Williams, Kristy H; Bencken, Crystal L; Swiderski, Dawn

2015-01-01

Interdisciplinary team training in a simulation center recreates clinical team interactions and holds promise in improving teamwork of clinicians by breaking down educational silos. The objective of our study was to assess the appropriateness of interdisciplinary training with general surgery residents and nursing students. Over 2 consecutive academic years (2012-2013 and 2013-2014), general surgery residents participated in interdisciplinary team-training simulation-based sessions with senior nursing students. Scenario objectives included demonstration of appropriate teamwork and communication, and clinical decision making; sessions incorporated interdisciplinary debriefing of the scenarios. Participants were asked to assess their team-training experience and the appropriateness of their team-training partner. Responses were compared. A total of 16 team-training sessions were conducted during the study period. Overall, 12 surgery residents (67%) and 44 nursing students (63%) who had participated in at least 1 session responded to the survey. Although both residents and nursing students indicated that the knowledge and team skills acquired during these sessions were useful to them in clinical practice (73% vs 86%, respectively; p = not significant), residents rated their educational value lower (3.3 vs 4.3 on a 5-point scale, respectively; p training partners whereas 100% residents preferred practicing nurses and 0% with nursing students owing to their limited clinical experience. Interdisciplinary team training and debriefing of surgery residents with nursing students is feasible and highly valued by nursing students. Nevertheless, our experience indicates that residents do not prefer nursing students as team-training partners owing to their limited clinical experience and would rather train with experienced nurses. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Physician Contacts and Their Influence on the Appropriateness of Pain Medication in Nursing Home Residents: A Cross-Sectional Study.

Science.gov (United States)

Flaig, Tanja Maria; Budnick, Andrea; Kuhnert, Ronny; Kreutz, Reinhold; Dräger, Dagmar

2016-09-01

This study assessed the frequency of physician contacts for individual nursing home residents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs. Observational cross-sectional study conducted between March 2009 and April 2010. Forty nursing homes in Berlin and Brandenburg, Germany. A total of 560 NHRs. The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model. The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056). Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Report of the State Auditor. State Colleges in Colorado. Financial, State-Funded Student Financial Assistance Programs, and NCAA Audits. Fiscal Year Ended June 30, 1995.

Science.gov (United States)

Barba, J. David

The results of a Colorado State audit of the consolidated financial statements are reported, along with the statements of appropriations, expenditures, transfers and reversions for state-funded Student Financial Assistance Programs for the four State Colleges in Colorado for the year ended June 30, 1995. Specific recommendations are given for each…

Workspace appropriation and attachment

Directory of Open Access Journals (Sweden)

M. PAVALACHE-ILIE

2016-11-01

Full Text Available This literature synthesis presents a short history of the evolution of the concepts of space appropriation and place attachment, highlighting the difficulty of their operationalisation from a cultural point of view. The next subject brought into discussion is the relation between the affective dimension of the connection between a person and the work place and the behaviours which are prone to insure the proper functioning of organizations, such as the organizational civism and the organizational commitment.

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

Science.gov (United States)

McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

2014-04-01

Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A

Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

Science.gov (United States)

Kumar, Rajesh; Dogra, Vishal; Rani, Khushbu; Sahu, Kanti

2017-01-01

Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53%) of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR illiteracy with splits at 23% to determine TFR illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run. PMID:29416999

Choosing the Right Words: The Development of Guidelines for the Selection of the "Appropriate" Crisis-Response Strategies.

Science.gov (United States)

Coombs, W. Timothy

1995-01-01

States that although crisis management has evolved rapidly in the past decade, the symbolic aspect of crisis management has been ignored. Indicates little research has been done to examine the effects of crisis-response strategies to see how they shape public opinion. Presents a list of guidelines for appropriate use of a given strategy (based on…

Military Construction: FY2017 Appropriations

Science.gov (United States)

2016-10-04

Appropriations Act (H.R. 4974, S. 2806, H.R. 2577, H.R. 5325) Committee Markup (H.R. 4974, S. 2806) House Report H.R. 4974 House Passage H.R...List (UPL), has had the UPL extracted to indicate the budget authority not requested by the President:  Active Components (Army, Navy and Marine

Rotating quantum states

International Nuclear Information System (INIS)

Ambruş, Victor E.; Winstanley, Elizabeth

2014-01-01

We revisit the definition of rotating thermal states for scalar and fermion fields in unbounded Minkowski space–time. For scalar fields such states are ill-defined everywhere, but for fermion fields an appropriate definition of the vacuum gives thermal states regular inside the speed-of-light surface. For a massless fermion field, we derive analytic expressions for the thermal expectation values of the fermion current and stress–energy tensor. These expressions may provide qualitative insights into the behaviour of thermal rotating states on more complex space–time geometries

33 CFR 337.2 - State requirements.

Science.gov (United States)

2010-07-01

.... However, if a state agency attempts to impose conditions or controls which, in the district engineers... “Management Strategy for Disposal of Dredged Material: Contaminant Testing and Controls” or its appropriate updated version as a guide for developing the appropriate tests to be conducted. If the agency insists on...

APpropriAteness of percutaneous Coronary interventions in patients with ischaemic HEart disease in Italy: the APACHE pilot study

Science.gov (United States)

Marino, Marcello; Crimi, Gabriele; Maiorana, Florinda; Rizzotti, Diego; Lettieri, Corrado; Bettari, Luca; Zuccari, Marco; Sganzerla, Paolo; Tresoldi, Simone; Adamo, Marianna; Ghiringhelli, Sergio; Sponzilli, Carlo; Pasquetto, Giampaolo; Pavei, Andrea; Pedon, Luigi; Bassan, Luciano; Bollati, Mario; Camisasca, Paola; Trabattoni, Daniela; Brancati, Marta; Poli, Arnaldo; Panciroli, Claudio; Lettino, Maddalena; Tarelli, Giuseppe; Tarantini, Giuseppe; De Luca, Leonardo; Varbella, Ferdinando; Musumeci, Giuseppe; De Servi, Stefano

2017-01-01

Objectives To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. Design Retrospective, pilot study. Setting 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. Participants 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics. Primary and secondary outcome measures Proportion of patients who received appropriate PCI using validated appropriate use scores (ie, AUS≥7). Also, in patients with stable CAD, we examined adherence to the following European Society of Cardiology recommendations: (A) per cent of patients with complex coronary anatomy treated after heart team discussion; (B) per cent of fractional flow reserve-guided PCI for borderline stenoses in patients without documented ischaemia; (C) per cent of patients receiving guideline-directed medical therapy at the time of PCI as well as use of provocative test of ischaemia according to pretest probability (PTP) of CAD. Results Of the 401 mappable PCIs (91%), 38.7% (95% CI 33.9 to 43.6) were classified as appropriate, 47.6% (95% CI 42.7 to 52.6) as uncertain and 13.7% (95% CI 10.5% to 17.5%) as inappropriate. Median PTP in patients with stable CAD without known coronary anatomy was 69% (78% intermediate PTP, 22% high PTP). Ischaemia testing use was similar (p=0.71) in patients with intermediate (n=140, 63%) and with high PTP (n=40, 66%). In patients with stable CAD (n=352) guideline adherence to the three recommendations explored was: (A) 11%; (B) 25%; (C) 23%. AUS was higher in patients evaluated by the heart team as compared with patients who were not (7 (6.8) vs 5 (4.7); p=0.001). Conclusions Use of heart team approaches and adherence to guideline recommendations on coronary revascularisation in a real-world setting

Highlights of TOMS Version 9 Total Ozone Algorithm

Science.gov (United States)

Bhartia, Pawan; Haffner, David

2012-01-01

The fundamental basis of TOMS total ozone algorithm was developed some 45 years ago by Dave and Mateer. It was designed to estimate total ozone from satellite measurements of the backscattered UV radiances at few discrete wavelengths in the Huggins ozone absorption band (310-340 nm). Over the years, as the need for higher accuracy in measuring total ozone from space has increased, several improvements to the basic algorithms have been made. They include: better correction for the effects of aerosols and clouds, an improved method to account for the variation in shape of ozone profiles with season, latitude, and total ozone, and a multi-wavelength correction for remaining profile shape errors. These improvements have made it possible to retrieve total ozone with just 3 spectral channels of moderate spectral resolution (approx. 1 nm) with accuracy comparable to state-of-the-art spectral fitting algorithms like DOAS that require high spectral resolution measurements at large number of wavelengths. One of the deficiencies of the TOMS algorithm has been that it doesn't provide an error estimate. This is a particular problem in high latitudes when the profile shape errors become significant and vary with latitude, season, total ozone, and instrument viewing geometry. The primary objective of the TOMS V9 algorithm is to account for these effects in estimating the error bars. This is done by a straightforward implementation of the Rodgers optimum estimation method using a priori ozone profiles and their error covariances matrices constructed using Aura MLS and ozonesonde data. The algorithm produces a vertical ozone profile that contains 1-2.5 pieces of information (degrees of freedom of signal) depending upon solar zenith angle (SZA). The profile is integrated to obtain the total column. We provide information that shows the altitude range in which the profile is best determined by the measurements. One can use this information in data assimilation and analysis. A side

Total Diet Study. Mg and Mn content estimation of a Market Basket of Sao Paulo state (Brazil) by Instrumental Neutron Activation

International Nuclear Information System (INIS)

Roseane Pagliaro Avegliano; Vera Akiko Maihara

2014-01-01

Total Diet Studies (TDS) have been carried out to estimate dietary intakes of the essential and toxic elements for a large-scale population over a specific period of time. In this study, the TDS was based on the evaluation of food representing a Market Basket (MB), which reflected the dietary habits of the Sao Paulo State population, corresponding to 72 % of the average food consumption for the state of Sao Paulo. In the present Total Diet Study, magnesium and manganese concentrations were determined in 30 of the most consumed food groups of a MB of Sao Paulo State, Brazil. Instrumental Neutron Activation Analysis (INAA) has been successfully used on a regularly basis in several areas of nutrition and foodstuffs. Element concentrations were determined by INAA in freeze-dried samples and ranged in mg kg -1 . Mg 41.4 (fats)-5287 (coffee) and Mn 0.12 (prime grade beef)-32.9 (coffee). The average daily Mg and Mn intake was calculated by multiplying the concentration of each element in each table-ready food group by the respective weight (g day -1 ) of the food group in the MB and adding the products from all food groups. The results of daily dietary intakes in this study were: Mg 174.8 and Mn 1.34 mg day -1 . Theses values were lower than the adequate intake (AI) proposed by the Food and Nutrition Board of the Institute of Medicine (USA National Academy) for adults. The low levels of Mg and Mn intakes presented in this TDS are probably due to the fact that MB of this study represented only 72 % of the weight of the most consumed household foods of Sao Paulo State. (author)

Relations between the technological standards and technological appropriation

Directory of Open Access Journals (Sweden)

Carlos Alberto PRADO GUERRERO

2010-06-01

Full Text Available The objective of this study is to analyze the educational practices of using Blackboard in blended learning environments with students of higher education to understand the relationship between technological appropriation and standards of educational technology. To achieve that goal, the following research question was raised: ¿To what extent are the standards of education technology with the appropriation of technology in blended learning environments in higher educa­tion related? The contextual framework of this work includes the following topics: the institution, teaching, teachers and students. The design methodology that was used is of a correlation type. Correlations were carried out to determine the frequency and level in the technological standards as well as the appropriation of technology. In the comparison of the results obtained by the students, the teachers and the platform; we found that students in the school study showed a high degree of technology ownership and this was the same for the performance shown on the technological standards. It was established that teachers play a key role in developing the techno­logical appropriation of students and performance in technology standards.

Convergence of the Policies for Promoting Total Quality Management in the Public Administrations of Balkan States – European Union Member States

Directory of Open Access Journals (Sweden)

Ani MATEI

2011-03-01

Full Text Available In the past three decades, total quality management (TQM has been appreciated as “fundamental modality in view to improve the activity in the public and private sectors” (Boyne and Walker, 2002, p. 1. For the time being, in public administrations, we witness an extension of the policies for promoting TQM, although the experiences have not always been positive.The European Administrative Space (EAS incorporates TQM, in different manners at national level, taking into consideration its recognised impact on the efficiency of public administration, one of EAS fundamental principles (Zurga, 2008, pp. 39-49. In the context of analysing EAS evolution, the administrative convergence will also comprise the convergence of TQM policies. In fact, the field literature (Hackman, Wageman, 1995 reveals, in the context of national TQM policy-making, the concepts of ”Convergent validity” and ”Discriminant validity”, reflecting ”the degree to which the version of TQM promulgated by the founders and observed in organizational practice share a common set of assumptions and prescriptions” (Hackman, Wageman, 1995, pp. 318-319.By a comparative analysis on TQM policies in the national public administrations of Balkan states, EU Member States: Greece, Cyprus, Slovenia, Bulgaria and Romania, the current paper aims to reveal the level of their convergence as well as the theoretical consistency of the conceptual and practical framework for TQM assertion.The comparative analysis will be based on a comprehensive vision on TQM, provided by Dean and Bowen (1994, Boyne and Walker (2002, namely its approach should be characterised on own principles, practices and techniques, grouped on customer focus, continuous improvement and team work (Boyne and Walker, 2002, pp. 4-5.The tradition on promoting TQM in public administration in the above-mentioned states is relatively recent: since 1990s – Cyprus, since 1995 – Greece and Slovenia, since 2000 – Bulgaria and

Appropriate flow forecasting for reservoir operation

NARCIS (Netherlands)

Dong, Xiaohua

2005-01-01

The aim of the study presented in this thesis is to develop and apply a methodology to determine the appropriate model application by including the water management objective explicitly, and to demonstrate its benefits.

ACR Appropriateness Criteria® Suspected Pulmonary Hypertension.

Science.gov (United States)

Sirajuddin, Arlene; Donnelly, Edwin F; Crabtree, Traves P; Henry, Travis S; Iannettoni, Mark D; Johnson, Geoffrey B; Kazerooni, Ella A; Maldonado, Fabien; Olsen, Kathryn M; Wu, Carol C; Mohammed, Tan-Lucien; Kanne, Jeffrey P

2017-05-01

Pulmonary hypertension may be idiopathic or related to a large variety of diseases. Various imaging examinations that may be helpful in diagnosing and determining the etiology of pulmonary hypertension are discussed. Imaging examinations that may aid in the diagnosis of pulmonary hypertension include chest radiography, ultrasound echocardiography, ventilation/perfusion scans, CT, MRI, right heart catheterization, pulmonary angiography, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Total robotic pancreaticoduodenectomy: a systematic review of the literature.

Science.gov (United States)

Kornaropoulos, Michail; Moris, Demetrios; Beal, Eliza W; Makris, Marinos C; Mitrousias, Apostolos; Petrou, Athanasios; Felekouras, Evangelos; Michalinos, Adamantios; Vailas, Michail; Schizas, Dimitrios; Papalampros, Alexandros

2017-11-01

Pancreaticoduodenectomy (PD) is a complex operation with high perioperative morbidity and mortality, even in the highest volume centers. Since the development of the robotic platform, the number of reports on robotic-assisted pancreatic surgery has been on the rise. This article reviews the current state of completely robotic PD. A systematic literature search was performed including studies published between January 2000 and July 2016 reporting PDs in which all procedural steps (dissection, resection and reconstruction) were performed robotically. Thirteen studies met the inclusion criteria, including a total of 738 patients. Data regarding perioperative outcomes such as operative time, blood loss, mortality, morbidity, conversion and oncologic outcomes were analyzed. No major differences were observed in mortality, morbidity and oncologic parameters, between robotic and non-robotic approaches. However, operative time was longer in robotic PD, whereas the estimated blood loss was lower. The conversion rate to laparotomy was 6.5-7.8%. Robotic PD is feasible and safe in high-volume institutions, where surgeons are experienced and medical staff are appropriately trained. Randomized controlled trials are required to further investigate outcomes of robotic PD. Additionally, cost analysis and data on long-term oncologic outcomes are needed to evaluate cost-effectiveness of the robotic approach in comparison with the open technique.

Probabilistic teleportation via multi-parameter measurements and partially entangled states

Science.gov (United States)

Wei, Jiahua; Shi, Lei; Han, Chen; Xu, Zhiyan; Zhu, Yu; Wang, Gang; Wu, Hao

2018-04-01

In this paper, a novel scheme for probabilistic teleportation is presented with multi-parameter measurements via a non-maximally entangled state. This is in contrast to the fact that the measurement kinds for quantum teleportation are usually particular in most previous schemes. The detail implementation producers for our proposal are given by using of appropriate local unitary operations. Moreover, the total success probability and classical information of this proposal are calculated. It is demonstrated that the success probability and classical cost would be changed with the multi-measurement parameters and the entanglement factor of quantum channel. Our scheme could enlarge the research range of probabilistic teleportation.

Estimation of Total Body Fat from Potassium-40 Content

International Nuclear Information System (INIS)

Taha Mohamed Taha Ahmed, T.M.T.

2010-01-01

This paper concerns on estimation of total body fat from potassium 40 content using total body counting technique. The work performed using fast scan whole body counter. Calibration of that system for K-40 was carried out under assumption that uniformity distribution of radioactivity of potassium was distributed in 10 polyethylene bottles phantom. Different body sizes were represented by 2, 4, 6, 8 and 10 polyethylene bottles; each bottle has a volume of 0.04 m3. The counting efficiency for each body size was determined. Lean body weight (LBW) was calculated for ten males and ten females using appropriate mathematical equation. Total Body Potassium, TBK for the same selected group was measured using whole body counter. A mathematical relationship between lean body weight and potassium content was deduced .Fat contents for some individuals were calculated and weight/height ratio was indicated for fatness.

Total Evidence, Uncertainty and A Priori Beliefs

NARCIS (Netherlands)

Bewersdorf, Benjamin; Felline, Laura; Ledda, Antonio; Paoli, Francesco; Rossanese, Emanuele

2016-01-01

Defining the rational belief state of an agent in terms of her initial or a priori belief state as well as her total evidence can help to address a number of important philosophical problems. In this paper, I discuss how this strategy can be applied to cases in which evidence is uncertain. I argue

Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

OpenAIRE

Rajesh Kumar; Vishal Dogra; Khushbu Rani; Kanti Sahu

2017-01-01

Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12) was analysed using STATA and R software packages. Multiple linear regression models...

Female married illiteracy as the most important continual determinant of total fertility rate among districts of Empowered Action Group States of India: Evidence from Annual Health Survey 2011–12

Directory of Open Access Journals (Sweden)

Rajesh Kumar

2017-01-01

Full Text Available Background: District level determinants of total fertility rate in Empowered Action Group states of India can help in ongoing population stabilization programs in India. Objective: Present study intends to assess the role of district level determinants in predicting total fertility rate among districts of the Empowered Action Group states of India. Material and Methods: Data from Annual Health Survey (2011-12 was analysed using STATA and R software packages. Multiple linear regression models were built and evaluated using Akaike Information Criterion. For further understanding, recursive partitioning was used to prepare a regression tree. Results: Female married illiteracy positively associated with total fertility rate and explained more than half (53% of variance. Under multiple linear regression model, married illiteracy, infant mortality rate, Ante natal care registration, household size, median age of live birth and sex ratio explained 70% of total variance in total fertility rate. In regression tree, female married illiteracy was the root node and splits at 42% determined TFR = 2.7. The next left side branch was again married illiteracy with splits at 23% to determine TFR = 2.1. Conclusion: We conclude that female married illiteracy is one of the most important determinants explaining total fertility rate among the districts of an Empowered Action Group states. Focus on female literacy is required to stabilize the population growth in long run.

Characterizing the hydration state of L-threonine in solution using terahertz time-domain attenuated total reflection spectroscopy

Science.gov (United States)

Huang, Huachuan; Liu, Qiao; Zhu, Liguo; Li, Zeren

2018-01-01

The hydration of biomolecules is closely related to the dynamic process of their functional expression, therefore, characterizing hydration phenomena is a subject of keen interest. However, direct measurements on the global hydration state of biomolecules couldn't have been acquired using traditional techniques such as thermodynamics, ultrasound, microwave spectroscopy or viscosity, etc. In order to realize global hydration characterization of amino acid such as L-threonine, terahertz time-domain attenuated total reflectance spectroscopy (THz-TDS-ATR) was adopted in this paper. By measuring the complex permittivity of L-threonine solutions with various concentrations in the THz region, the hydration state and its concentration dependence were obtained, indicating that the number of hydrous water decreased with the increase of concentration. The hydration number was evaluated to be 17.8 when the molar concentration of L-threonine was 0.34 mol/L, and dropped to 13.2 when the molar concentration increased to 0.84 mol/L, when global hydration was taken into account. According to the proposed direct measurements, it is believed that the THz-TDS-ATR technique is a powerful tool for studying the picosecond molecular dynamics of amino acid solutions.

ACR Appropriateness Criteria®  Resectable Rectal Cancer

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Jones William E

2012-09-01

Full Text Available Abstract The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+ benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The use of IMRT requires knowledge of the patterns of spreads and anatomy. Clinical trials demonstrate high variability in target delineation without specific guidance demonstrating the need for peer review and the use of a consensus atlas. Concomitant with radiation, fluorouracil based chemotherapy remains the standard, and although toxicity is decreased with continuous infusion fluorouracil, oral capecitabine is non-inferior to the continuous infusion regimen. Additional chemotherapeutic agents, including oxaliplatin, continue to be investigated, however currently should only be utilized on clinical trials as increased toxicity and no definitive benefit has been demonstrated in clinical trials. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to

Application of TACT registered to the evaluation of total joint arthroplasty

International Nuclear Information System (INIS)

Fahey, Frederic H.; Webber, Richard L.; Chew, Felix S.-K.; Dickerson, Bryon A.

2003-01-01

Three-dimensional imaging may be valuable in the evaluation of total joint arthroplasty. The partial-volume effect and streak artifacts from the metallic components of these devices limit the applicability of computed tomography (CT) to this application. Tuned-aperture computed tomography registered (TACT registered ) is a tomographic approach that has been successfully used in other medical applications. In TACT, the acquisition geometry is inferred from the localization of fiducial markers in a series of projection images. The flexibility and robustness of TACT, as well as the fact that through an appropriate choice of reconstruction algorithms it can suppress streak artifacts, potentially makes it an appropriate approach for evaluating total joint arthroplasty. A simple computer-simulated model of a total knee replacement (TKR) was generated and used to evaluate the accuracy and artifacts associated with three-dimensional (3-D) renderings produced using TACT. A knee specimen from a cadaver that had received a TKR was used to investigate further the potential of TACT for this application. In both tests, TACT provided high-quality 3-D representations of the object. Both simple back-projection and minimum pixel back-projection were used to reconstruct the data. Minimum pixel back-projection provided high-contrast images that appeared to be relatively free of tomosynthetic artifacts. In summary, the potential of TACT in the evaluation of total joint arthroplasty was demonstrated. Future investigations will study TACT's ability to quantify the spatial relationship between the metallic components of these devices as well as TACT's ability to identify bony changes of diagnostic consequence

22 CFR 710.13 - Appropriate action.

Science.gov (United States)

2010-04-01

... communication to, OPIC on any matter or business for a period not to exceed five years, which may be... communication. (b) Taking other appropriate disciplinary action. [45 FR 5685, Jan. 24, 1980; 49 FR 18295, Apr...

An Evaluation of Industry Relationships Among Contributors to AAOS Clinical Practice Guidelines and Appropriate Use Criteria.

Science.gov (United States)

Checketts, Jake X; Cook, Courtney; Vassar, Matt

2018-01-17

A long-standing relationship between orthopaedic surgeons and industry has made financial conflicts of interest a concerning issue. Research supports that financial conflicts of interest can influence both medical research and clinical practice. Financial conflicts of interest may also influence clinical practice guideline recommendations and their corresponding appropriate use criteria. Because of the influential nature of these guidelines, it is imperative that care be taken to minimize bias during guideline development. We retrieved clinical practice guidelines and their corresponding appropriate use criteria from the American Academy of Orthopaedic Surgery that were published or revised between 2013 and 2016. We extracted industry payments received by physicians using the Centers for Medicare & Medicaid Services Open Payments database. We then evaluated the value and types of these payments. We also used these data to determine whether disclosure statements were accurate and whether guideline development was in adherence with the Institute of Medicine's (IOM's) standards. Of the 106 physicians that were evaluated, 85 (80%) received at least 1 industry payment, 56 (53%) accepted >$1,000, and 35 (33%) accepted >$10,000. Financial payments amounted to a mean of $93,512 per physician. Total reimbursement for the 85 clinical practice guideline and appropriate use criteria contributors was $9,912,309. We found that disclosure statements disagreed with the Open Payments data and that the IOM standards were not completely enforced. Clinical practice guideline and appropriate use criteria contributors received substantial payments from industry, many disclosure statements were inaccurate, and the IOM standards were not completely met. Clinical practice guidelines and appropriate use criteria are critical for practicing evidence-based medicine. If financial conflicts of interest are present during their development, it is possible that patient care may be compromised.

An appropriate level for reactor regulatory research

International Nuclear Information System (INIS)

Budnitz, R.J.; Kouts, H.J.C.

1986-01-01

In this brief paper the appropriate role for NRC's research program is set down, based on the experience of the last decade; and the broad outlines of an appropriate research program for the next decade are discussed. The two authors bring to this topic direct personal experience: they are two of only three former directors of NRC's research program in its history (the other was the last Saul Levine). The discussion considers only reactor safety research, although NRC's research program covers several other areas as well. Safeguards, environmental and health studies, waste management, and transportation are not covered

Appropriateness of mechanistic and non-mechanistic models for the application of ultrafiltration to mixed waste

International Nuclear Information System (INIS)

Foust, Henry; Ghosehajra, Malay

2007-01-01

This study asks two questions: (1) How appropriate is the use of a basic filtration equation to the application of ultrafiltration of mixed waste, and (2) How appropriate are non-parametric models for permeate rates (volumes)? To answer these questions, mechanistic and non-mechanistic approaches are developed for permeate rates and volumes associated with an ultrafiltration/mixed waste system in dia-filtration mode. The mechanistic approach is based on a filtration equation which states that t/V vs. V is a linear relationship. The coefficients associated with this linear regression are composed of physical/chemical parameters of the system and based the mass balance equation associated with the membrane and associated developing cake layer. For several sets of data, a high correlation is shown that supports the assertion that t/V vs. V is a linear relationship. It is also shown that non-mechanistic approaches, i.e., the use of regression models to are not appropriate. One models considered is Q(p) = a*ln(Cb)+b. Regression models are inappropriate because the scale-up from a bench scale (pilot scale) study to full-scale for permeate rates (volumes) is not simply the ratio of the two membrane surface areas. (authors)

Assessment of inpatient multimodal cardiac imaging appropriateness at large academic medical centers.

Science.gov (United States)

Remfry, Andrew; Abrams, Howard; Dudzinski, David M; Weiner, Rory B; Bhatia, R Sacha

2015-11-14

Responding to concerns regarding the growth of cardiac testing, the American College of Cardiology Foundation (ACCF) published Appropriate Use Criteria (AUC) for various cardiac imaging modalities. Single modality cardiac imaging appropriateness has been reported but there have been no studies assessing the appropriateness of multiple imaging modalities in an inpatient environment. A retrospective study of the appropriateness of cardiac tests ordered by the inpatient General Internal Medicine (GIM) and Cardiology services at three Canadian academic hospitals was conducted over two one-month periods. Cardiac tests characterized were transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), single-photon emission tomography myocardial perfusion imaging (SPECT), and diagnostic cardiac catheterization. Overall, 553 tests were assessed, of which 99.8% were classifiable by AUC. 91% of all studies were categorized as appropriate, 4% may be appropriate and 5% were rarely appropriate. There were high rates of appropriate use of all modalities by GIM and Cardiology throughout. Significantly more appropriate diagnostic catheterizations were ordered by Cardiology than GIM (93% vs. 82%, p = imaging modalities in this multi-centered study on Cardiology and GIM inpatients in the acute care setting. The rate of appropriate ordering was high across all imaging modalities. We recommend further work towards improving appropriate utilization of cardiac imaging resources focus on the out-patient setting.

State laws and the provision of family planning and abortion services in 1985.

Science.gov (United States)

Sollom, T; Donovan, P

1985-01-01

65 laws relating to fertility were enacted by the 49 state legislatures that held sessions in 1985. This was the largest enacted since 1973, and the 2nd largest total since. Some of the 1985 abortion laws are designed to protect abortion rights. Several states in the US took action to severely punish the perpetrators of violence against abortion clinics. Lesislation dealing with the delivery of family planning services was subjected to public funding restrictions in 1985. Attempts have been made recently on the federal level to prevent Title X recipients from being provided with information on abortion in their pregnancy counseling sessions. These actions are similar to some of the state laws attempting to reach the same end. Many states included funds for family planning in general appropriations bills. Differences among legislators regarding the right of minors to consent to reproductive health care have led to 2 patterns of response: 1) affirmation of the right of minors to receive family planning services on their own consent; or 2) laws mandating parental involvement in a minor's abortion decision. The most troubling aspect of the fertility related legislation endated in 1985 is the effort by a number of legislatures to attach restrictions on abortion counseling and referral to family planning appropriations bills. In 1985, state laws were enacted to regulate the disposal of fetal remains, to prohibit the use of fetal remains for commercial purposes and to impose criminal sanctions for causing the miscarriage of a fetus during a felony.

State-to-state dynamics of molecular energy transfer

Energy Technology Data Exchange (ETDEWEB)

Gentry, W.R.; Giese, C.F. [Univ. of Minnesota, Minneapolis (United States)

1993-12-01

The goal of this research program is to elucidate the elementary dynamical mechanisms of vibrational and rotational energy transfer between molecules, at a quantum-state resolved level of detail. Molecular beam techniques are used to isolate individual molecular collisions, and to control the kinetic energy of collision. Lasers are used both to prepare specific quantum states prior to collision by stimulated-emission pumping (SEP), and to measure the distribution of quantum states in the collision products by laser-induced fluorescence (LIF). The results are interpreted in terms of dynamical models, which may be cast in a classical, semiclassical or quantum mechanical framework, as appropriate.

Current state of total artificial heart therapy and introduction of the most important total artificial heart systems.

Science.gov (United States)

Spiliopoulos, Sotirios; Hergesell, Vera; Wasler, Andrae; Dapunt, Otto

2018-06-14

Due to the declining instances of organ donation, total artificial heart (TAH) therapy is of increasing importance for the management of end-stage biventricular heart failure. We introduce the currently most important established and novel TAH systems (SynCardia, CARMAT, ReinHeart, BiVACOR), report clinical outcomes and discuss technical requirements for the successful implementation of TAH therapy as an alternative to cardiac transplantation.

Visual Approach and Design: The Appropriate Characteristics of Instructional Photos as a Tool to Support Elementary Setting in Kuwait

Science.gov (United States)

Buhamad, Ali

2016-01-01

This study provided a guide for appropriate characteristics of Instructional Photo to be used by teachers, trainers, coaches, instructors, and anyone else who desires to deliver knowledge and present content with visual meaning to elementary students in the state of Kuwait as a teaching style that supports teachers, facilitates clarification, and…

Total neutron cross section of lead

International Nuclear Information System (INIS)

Kanda, K.; Aizawa, O.

1976-01-01

The total thermal-neutron cross section of natural lead under various physical conditions was measured by the transmission method. It became clear that the total cross section at room temperature previously reported is lower than the present data. The total cross section at 400, 500, and 600 0 C, above the melting point of lead, 327 0 C, was also measured, and the changes in the cross section as a function of temperature were examined, especially near and below the melting point. The data obtained for the randomly oriented polycrystalline state at room temperature were in reasonable agreement with the theoretical values calculated by the THRUSH and UNCLE-TOM codes

Formal and informal appropriation mechanisms: the role of openness and innovativeness

NARCIS (Netherlands)

Zobel, Ann-Kristin; Lokshin, Boris; Hagedoorn, John

2016-01-01

This paper analyses how firms’ degree of openness and innovativeness influence their use of formal and informal appropriation mechanisms. Patents, trademarks, copyrights, and design rights are formal appropriation mechanisms. Secrecy, lead-time, and complexity are examples of informal appropriation

18 CFR 367.2150 - Account 215, Appropriated retained earnings.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Account 215, Appropriated retained earnings. 367.2150 Section 367.2150 Conservation of Power and Water Resources FEDERAL... retained earnings. This account must include the amount of retained earnings that has been appropriated or...

Pediatric pancreas transplantation, including total pancreatectomy with islet autotransplantation.

Science.gov (United States)

Bondoc, Alexander J; Abu-El-Haija, Maisam; Nathan, Jaimie D

2017-08-01

Unlike other solid-organ transplants, whole pancreas transplantation in children is relatively rare, and it occurs more frequently in the context of multivisceral or composite organ transplantation. Because children only infrequently suffer severe sequelae of type 1 diabetes mellitus, pancreas transplantation is rarely indicated in the pediatric population. More commonly, pediatric pancreas transplant occurs in the setting of incapacitating acute recurrent or chronic pancreatitis, specifically islet autotransplantation after total pancreatectomy. In this clinical scenario, total pancreatectomy removes the nidus of chronic pain and debilitation, while autologous islet transplantation aims to preserve endocrine function. The published experiences with pediatric total pancreatectomy with islet autotransplantation (TPIAT) in children has demonstrated excellent outcomes including liberation from chronic opioid use, as well as improved mental and physical quality of life with good glycemic control. Given the complexity of the operation, risk of postoperative complication, and long-term physiologic changes, appropriate patient selection and comprehensive multidisciplinary care teams are critical to ensuring optimal outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Application of Total Quality Management (TQM Requirements in Risk Management in Construction Projects in Iraq

Directory of Open Access Journals (Sweden)

Entisar K. Al-Geelawee

2016-06-01

Full Text Available Total quality management considers one of the modern scientific entrances which practiced by productivity service organizations alike to provide appropriate quality required outputs according to the needs and desires of customers manage , enable the organization seeking to continue and grow in light of the increasing competition from the satisfy and provide the appropriate total quality management requirements whenever led to face risks that they may have in a manner in which they can be addressed and find ways to avoid them in the future when repeated. The research has consist of two main parts firstly have included a review of the most important concepts of total quality management in addition to the concept of risk analysis and management in construction projects and how to apply the concept of total quality management in the risk analysis and management. Second part included the practical part of the research, which was open and closed questionnaire for experts in the construction industry to obtain required informations for the application of total quality management requirements in risk management in construction projects in Iraq. One of the main findings of the research is that top management support has a high impact on risk management in addition to continuous improvement, training and education, while the participation of all employees in the organization and constant stimulation and focusing on the customer as one of the total quality management requirements had a moderate impact on risk management.

Entanglement between total intensity and polarization for pairs of coherent states

Science.gov (United States)

Sanchidrián-Vaca, Carlos; Luis, Alfredo

2018-04-01

We examine entanglement between number and polarization, or number and relative phase, in pair coherent states and two-mode squeezed vacuum via linear entropy and covariance criteria. We consider the embedding of the two-mode Hilbert space in a larger space to get a well-defined factorization of the number-phase variables. This can be regarded as a kind of protoentanglement that can be extracted and converted into real particle entanglement via feasible experimental procedures. In particular this reveals interesting entanglement properties of pairs of coherent states.

Developing an Enterprise Systems Appropriation Model in the Public Sector: A Case Study of Implementing Payroll System Replacement (PAYSERV) at the New York State Office of the State Comptroller

Science.gov (United States)

Kamya, Moses M.

2009-01-01

This dissertation examines an enterprise system appropriation process applying structuration theory and adaptive structuration theory (AST). The key research questions are: (1) what structures emerge from the implementation of enterprise information technology (EIT); (2) how do enterprise technologies and existing organization structures influence…

Is the DLQI appropriate for medical decision-making in psoriasis patients?

Science.gov (United States)

Poór, Adrienn Katalin; Brodszky, Valentin; Péntek, Márta; Gulácsi, László; Ruzsa, Gábor; Hidvégi, Bernadett; Holló, Péter; Kárpáti, Sarolta; Sárdy, Miklós; Rencz, Fanni

2018-01-01

Dermatology Life Quality Index (DLQI) is the most commonly applied measure of health-related quality of life (HRQoL) in psoriasis patients. It is among defining criteria of moderate-to-severe psoriasis and present in treatment guidelines. Our objective was to estimate preference-based HRQoL values (i.e., utilities) for hypothetical health states described by the 10 items of the DLQI in psoriasis patients. Moreover, we compare results to findings of a similar study previously conducted among the general public. A cross-sectional survey was carried out among 238 psoriasis patients. Seven hypothetical DLQI-defined health states with total scores of 6, 11, and 16 (3-3 and 1 states, respectively) were evaluated by time trade-off method. The difference in DLQI scores between hypothetical health states was set at 5 points, as it exceeds the minimal clinically important difference (MCID). Utility scores were found to be homogenous across the seven hypothetical health states (range of means for the 6-point states 0.85-0.91, range of means for the 11-point states 0.83-0.85, and mean of 0.84 for the 16-point state). Overall, mean utilities assessed by psoriasis patients were higher for all seven states compared with the general public (mean difference 0.16-0.28; p definition of moderate-to-severe disease and reconsideration of the DLQI in clinical assessment of psoriasis patients are suggested.

Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

Science.gov (United States)

Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

2010-06-01

Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

COMPARATIVE EVALUTION OF CEPHALOSPORIN-C PRODUCTION IN SOLID STATE FERMENTATION AND SUBMERGED LIQUID CULTURE

Directory of Open Access Journals (Sweden)

Mahdi Rezazarandi

2012-08-01

Full Text Available The advantages of solid state fermentation (SSF utilization in producing enzymes & secondary metabolites have been shown, whereas, submerged liquid fermentation (SLF condition has the major usage in industrial production of antibiotics. As an antibiotic of B-lactams group, cephalosporin-C (CPC is indicated due to its wide effect and broad convention in treatment of infectious diseases. Regarding industrial production of CPC regularly done in SLF condition, we compared CPC production sum in SLF and SSF conditions. In this analysis, A. chrysogenum was employed, which was inoculated to SLF and SSF, while internal fermenter conditions were totally under control. After extraction of CPC, productions in two states of SLF and SSF were compared using the cylinder plate method. According to Antibiotic assay and production amount comparison, results expressed a ratio of development of production in SSF conditions to SLF conditions. Regarding previous studies on a solid state fermenter and its advantages, in this study, convenience of SSF conditions compared to SLF conditions was experimented. Also mentioning that maintaining the condition of solid state fermenter is more comfortable and practical than liquid state fermenter, using a solid based fermenter to produce antibiotics, especially CPC, can be appropriate. Considering appropriate control conditions of SSF to produce secondary metabolites, decrease in expenses, and increase of production, taking advantage of it in order to increase production parallel to modern methods, such as genetically manipulating CPC producing microorganisms are recommended to pharmacological industries. Also, to make this method applicable, further studies in industrial criterion seem necessary.

Validation of a Culturally Appropriate Social Capital Framework to Explore Health Conditions in Canadian First Nations Communities

Directory of Open Access Journals (Sweden)

Brenda Elias

2011-05-01

Full Text Available An earlier study of our research group formulated a conceptual framework of social capital for First Nation communities and developed a culturally appropriate instrument for its measurement. We tested this instrument further with the Manitoba (Canada First Nations Regional Health Survey, 2003. Using data from this survey, we investigated the bonding dimension of the social capital conceptual framework, with a total sample of 2,765 First Nations individuals living in 24 Manitoba First Nations communities. Twenty seven Likert-scale survey questions measured aspects of bonding social capital, socially-invested resources, ethos,and networks. Validation analyses included an evaluation of internal consistency, factor analyses to explore how well the items clustered together into the components of the social capital framework, and the ability of the items to discriminate across the communities represented in the sample. Cronbach’s Alpha was computed on the 27 scale items, producing an Alpha of 0.84 indicating high internal consistency. The factor analyses produced five distinct factors with a total explained variance of 54.3%. Lastly, a one-way analysis of variancerun by community produced highly significant F-ratios between the groups on all twenty-seven bonding items. The culturally-sensitive items included in the social capital framework were found to be an appropriate tool to measure bonding aspects among Manitoba First Nations communities. Research and policy implications are discussed.

Identity appropriateness and the structure of the theory of planned behaviour.

Science.gov (United States)

Case, Philippa; Sparks, Paul; Pavey, Louisa

2016-03-01

In contrast to the cost-benefit, utility-based approach to decision-making implicit in models such as the theory of planned behaviour (TPB), the logic of appropriateness (March, 1994. A Primer on Decision Making: How decisions happen. New York, NY: The Free Press) describes decision-making in terms of heuristic decision rules that involve matching identities to situations. This research is the first to apply the logic of appropriateness in conjunction with the theoretical structure of the TPB and assessed whether a measure of identity appropriateness might independently predict adults' intentions to engage in binge drinking. In Study 1, participants (N = 197) completed questionnaires assessing attitudes, subjective norm, perceived behavioural control, past behaviour, and identity appropriateness in relation to binge drinking. Path analysis revealed an independent predictive effect of identity appropriateness on intentions in addition to an indirect effect via attitudes. In Study 2 (N = 179), a prospective measure of behaviour was included in a similar study: Identity appropriateness again predicted intentions independently of the extended TPB predictors. It was again also found to be a strong predictor of attitudes. We suggest that the notion of identity appropriateness may assist in explaining the capacity of measures of self-identity to predict people's behavioural intentions. © 2015 The British Psychological Society.

Critical Care Admissions following Total Laryngectomy: Is It Time to Change Our Practice?

Science.gov (United States)

Walijee, Hussein; Morgan, Alexandria; Gibson, Bethan; Berry, Sandeep; Jaffery, Ali

2016-01-01

Critical Care Unit (CCU) beds are a limited resource and in increasing demand. Studies have shown that complex head and neck patients can be safely managed on a ward setting given the appropriate staffing and support. This retrospective case series aims to quantify the CCU care received by patients following total laryngectomy (TL) at a District General Hospital (DGH) and compare patient outcomes in an attempt to inform current practice. Data relating to TL were collected over a 5-year period from 1st January 2010 to 31st December 2015. A total of 22 patients were included. All patients were admitted to CCU postoperatively for an average length of stay of 25.5 hours. 95% of these patients were admitted to CCU for the purpose of close monitoring only, not requiring any active treatment prior to discharge to the ward. 73% of total complications were encountered after the first 24 hours postoperatively at which point patients had been stepped down to ward care. Avoiding the use of CCU beds and instead providing the appropriate level of care on the ward would result in a potential cost saving of approximately £8,000 with no influence on patient morbidity and mortality.

Intakes and sources of total and added sugars among 4 to 13-year-old children in China, Mexico and the United States.

Science.gov (United States)

Afeiche, M C; Koyratty, B N S; Wang, D; Jacquier, E F; Lê, K-A

2018-04-01

Intakes of dietary sugars is a global concern, and many national and international organizations have set targets to limit consumption. However, it is unclear to what extent intakes of total and added sugars vary between geographies. The aim of this study was to assess the differences in intakes of total and added sugars in 4 to 13-year-old children in China, Mexico and the United States. The secondary aim was to identify main sources of total and added sugars in the diets of these children. Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National Health and Nutrition Survey, and 2009-2012 US National Health and Nutrition Examination Surveys. Total and added sugar intakes were calculated using the US Food Patterns Equivalents Database. Mean intakes of total and added sugars were 26 and 9 g d -1 among Chinese children, 92 and 55 g d -1 among Mexican children, and 124 and 76 g d -1 among US children, respectively. The top food sources of total sugars were fruits among Chinese children, and sugar-sweetened beverages and milk-based beverages among Mexican and US children. These data highlight the heterogeneity of food patterns worldwide and the need for adapted country-specific public health recommendations on sugars. © 2017 The Authors. Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

State Radiation Protection Supervision and Control

International Nuclear Information System (INIS)

2003-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented

State Radiation Protection Supervision and Control

CERN Document Server

2002-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 2002 is presented.

Rovibrational bound states of SO{sub 2} isotopologues. I: Total angular momentum J = 0–10

Energy Technology Data Exchange (ETDEWEB)

Kumar, Praveen, E-mail: Praveen.Kumar@ttu.edu; Ellis, Joseph; Poirier, Bill, E-mail: Bill.Poirier@ttu.edu

2015-04-01

Highlights: • We report calculation of the exact rovibrational energy levels of SO{sub 2} for J = 0–10. • We report sulfur isotope shifts of the SO{sub 2} isotopologues rovibrational frequencies. • Coriolis coupling is treated exactly. • All rovibrational levels are computed to a high level of numerical convergence. • All of the rovibrational data exhibit near-perfect mass-dependent fractionation. - Abstract: Isotopic variation of the rovibrational bound states of SO{sub 2} for the four stable sulfur isotopes {sup 32–34,36}S is investigated in comprehensive detail. In a two-part series, we compute the low-lying energy levels for all values of total angular momentum in the range J = 0–20. All rovibrational levels are computed, to an extremely high level of numerical convergence. The calculations have been carried out using the ScalIT suite of parallel codes. The present study (Paper I) examines the J = 0–10 rovibrational levels, providing unambiguous symmetry and rovibrational label assignments for each computed state. The calculated vibrational energy levels exhibit very good agreement with previously reported experimental and theoretical data. Rovibrational energy levels, calculated without any Coriolis approximations, are reported here for the first time. Among other potential ramifications, this data will facilitate understanding of the origin of mass-independent fractionation of sulfur isotopes in the Archean rock record—of great relevance for understanding the “oxygen revolution”.

ACR Appropriateness Criteria® Ovarian Cancer Screening.

Science.gov (United States)

Pandharipande, Pari V; Lowry, Kathryn P; Reinhold, Caroline; Atri, Mostafa; Benson, Carol B; Bhosale, Priyadarshani R; Green, Edward D; Kang, Stella K; Lakhman, Yulia; Maturen, Katherine E; Nicola, Refky; Salazar, Gloria M; Shipp, Thomas D; Simpson, Lynn; Sussman, Betsy L; Uyeda, Jennifer; Wall, Darci J; Whitcomb, Bradford; Zelop, Carolyn M; Glanc, Phyllis

2017-11-01

There has been much interest in the identification of a successful ovarian cancer screening test, in particular, one that can detect ovarian cancer at an early stage and improve survival. We reviewed the currently available data from randomized and observational trials that examine the role of imaging for ovarian cancer screening in average-risk and high-risk women. We found insufficient evidence to recommend ovarian cancer screening, when considering the imaging modality (pelvic ultrasound) and population (average-risk postmenopausal women) for which there is the greatest available published evidence; randomized controlled trials have not demonstrated a mortality benefit in this setting. Screening high-risk women using pelvic ultrasound may be appropriate in some clinical situations; however, related data are limited because large, randomized trials have not been performed in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Coherent states approach to Penning trap

International Nuclear Information System (INIS)

Fernandez, David J; Velazquez, Mercedes

2009-01-01

By using a matrix technique, which allows us to identify directly the ladder operators, the Penning trap coherent states are derived as eigenstates of the appropriate annihilation operators. These states are compared with those obtained through the displacement operator. The associated wavefunctions and mean values for some relevant operators in these states are also evaluated. It turns out that the Penning trap coherent states minimize the Heisenberg uncertainty relation

Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

African Journals Online (AJOL)

Appropriateness of Referrals for Upper Gastrointestinal Endoscopy. ... Accra between January and December, 2008 were interviewed and evaluated for this study. ... Presentations with bleeding and suspicion of malignancy showed statistical ...

ACR Appropriateness Criteria® Routine Chest Radiography.

Science.gov (United States)

McComb, Barbara L; Chung, Jonathan H; Crabtree, Traves D; Heitkamp, Darel E; Iannettoni, Mark D; Jokerst, Clinton; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Mohammed, Tan-Lucien H; Ravenel, James G

2016-03-01

Chest radiographs are sometimes taken before surgeries and interventional procedures on hospital admissions and outpatients. This manuscript summarizes the American College of Radiology review of the literature and recommendations on routinely performed chest radiographies in these settings. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

SUSTAINABLE URBAN LANDSCAPE: AN APPROACH FOR ASSESSING AND APPROPRIATING INDICATORS

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Ahmed Mohamed Amin

2012-07-01

Full Text Available The impact of development on its context is considered a key issue that governs the discussion and understanding of sustainability. For the reason, that ethics of sustainability are based on developing with no or less negative impacts on the contextual environment despite its urban scale whether limited or extended. This describes types of development that increase the good impacts on the tangible and intangible aspects of the built environment. Thus, achieving sustainability is no more a choice but it is a must especially, in an environment suffering from a lot of threats and stresses that affect all aspects of life; socially, economically, environmentally and also affect the beauty and aesthetics of urban fabrics. Assessing sustainability, the applied indicators and ways of assessment are allimportant concerns for urban sustainability discourses. Especially in such sensitive interacting domains as landscape, that links nature with the built environment. Approaching these concerns has a great deal when enhancing our environment aiming at better urban life containers. This paper aims at investigating the issue of sustainable urban landscape assessment through discussing the hue of indicators, their ways of classification, the criteria of selection and stating the variety of methods in which they can be assessed. Finally, it appropriates an approach for stating and assessing urban landscape sustainability indicators, which evaluates their both qualitative and quantitative value upon performance scale.

Solid State Sensor for Simultaneous Measurement of Total Alkalinity and pH of Seawater.

Science.gov (United States)

Briggs, Ellen M; Sandoval, Sergio; Erten, Ahmet; Takeshita, Yuichiro; Kummel, Andrew C; Martz, Todd R

2017-09-22

A novel design is demonstrated for a solid state, reagent-less sensor capable of rapid and simultaneous measurement of pH and Total Alkalinity (A T ) using ion sensitive field effect transistor (ISFET) technology to provide a simplified means of characterization of the aqueous carbon dioxide system through measurement of two "master variables": pH and A T . ISFET-based pH sensors that achieve 0.001 precision are widely used in various oceanographic applications. A modified ISFET is demonstrated to perform a nanoliter-scale acid-base titration of A T in under 40 s. This method of measuring A T , a Coulometric Diffusion Titration, involves electrolytic generation of titrant, H + , through the electrolysis of water on the surface of the chip via a microfabricated electrode eliminating the requirement of external reagents. Characterization has been performed in seawater as well as titrating individual components (i.e., OH - , HCO 3 - , CO 3 2- , B(OH) 4 - , PO 4 3- ) of seawater A T . The seawater measurements are consistent with the design in reaching the benchmark goal of 0.5% precision in A T over the range of seawater A T of ∼2200-2500 μmol kg -1 which demonstrates great potential for autonomous sensing.

Intakes and sources of total and added sugars among 4 to 13‐year‐old children in China, Mexico and the United States

Science.gov (United States)

Afeiche, M. C.; Koyratty, B. N. S.; Wang, D.; Jacquier, E. F.

2017-01-01

Summary Background Intakes of dietary sugars is a global concern, and many national and international organizations have set targets to limit consumption. However, it is unclear to what extent intakes of total and added sugars vary between geographies. Objectives The aim of this study was to assess the differences in intakes of total and added sugars in 4 to 13‐year‐old children in China, Mexico and the United States. The secondary aim was to identify main sources of total and added sugars in the diets of these children. Methods Secondary data analysis was conducted using the 2011 China Health and Nutrition Survey, 2012 Mexican National Health and Nutrition Survey, and 2009–2012 US National Health and Nutrition Examination Surveys. Total and added sugar intakes were calculated using the US Food Patterns Equivalents Database. Results Mean intakes of total and added sugars were 26 and 9 g d−1 among Chinese children, 92 and 55 g d−1 among Mexican children, and 124 and 76 g d−1 among US children, respectively. The top food sources of total sugars were fruits among Chinese children, and sugar‐sweetened beverages and milk‐based beverages among Mexican and US children. Conclusions These data highlight the heterogeneity of food patterns worldwide and the need for adapted country‐specific public health recommendations on sugars. PMID:28960843

Trainee Knowledge of Imaging Appropriateness and Safety: Results of a Series of Surveys From a Large Academic Medical Center.

Science.gov (United States)

Hollingsworth, Thaddeus D; Duszak, Richard; Vijayasarathi, Arvind; Gelbard, Rondi B; Mullins, Mark E

2017-10-31

In order to provide high quality care to their patients and utilize imaging most judiciously, physician trainees should possess a working knowledge of appropriate use, radiation dose, and safety. Prior work has suggested knowledge gaps in similar areas. We aimed to evaluate the knowledge of imaging appropriateness, radiation dose, and MRI and contrast safety of physician trainees across a variety of specialties. Between May 2016 and January 2017, three online surveys were distributed to all interns, residents, and fellows in ACGME accredited training programs at a large academic institution over two academic years. Response rates to three surveys ranged from 17.2% (218 of 1266) for MRI and contrast material safety, 19.1% (242 of 1266) for imaging appropriateness, to19.9% (246 of 1238) for radiation dose. Overall 72% (509 of 706) of survey respondents reported regularly ordering diagnostic imaging examinations, but fewer than half (47.8%; 470 of 984) could correctly estimate radiation dose across four commonly performed imaging studies. Only one third (34%; 167 of 488) of trainees chose appropriate imaging in scenarios involving pregnant patients. Trainee post-graduate year was not significantly correlated with overall radiation safety scores, and no significant difference was found between radiation safety or appropriate imaging scores of those who participated in a medical school radiology elective vs. those who did not. A total of 84% (57 of 68) of radiology trainees and 43% (269 of 630) of non-radiology trainees considered their knowledge adequate but that correlated only weakly correlated to actual knowledge scores (pimaging safety exist among many trainees. In order to enhance the value of imaging at the population level, further work is needed to assess the most appropriate method and stage of training to address these knowledge gaps. Copyright © 2017 Elsevier Inc. All rights reserved.

ACR Appropriateness Criteria on Resectable Rectal Cancer

International Nuclear Information System (INIS)

Suh, W. Warren; Blackstock, A. William; Herman, Joseph; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

2008-01-01

The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007

Imaging Total Stations - Modular and Integrated Concepts

Science.gov (United States)

Hauth, Stefan; Schlüter, Martin

2010-05-01

Keywords: 3D-Metrology, Engineering Geodesy, Digital Image Processing Initialized in 2009, the Institute for Spatial Information and Surveying Technology i3mainz, Mainz University of Applied Sciences, forces research towards modular concepts for imaging total stations. On the one hand, this research is driven by the successful setup of high precision imaging motor theodolites in the near past, on the other hand it is pushed by the actual introduction of integrated imaging total stations to the positioning market by the manufacturers Topcon and Trimble. Modular concepts for imaging total stations are manufacturer independent to a large extent and consist of a particular combination of accessory hardware, software and algorithmic procedures. The hardware part consists mainly of an interchangeable eyepiece adapter offering opportunities for digital imaging and motorized focus control. An easy assembly and disassembly in the field is possible allowing the user to switch between the classical and the imaging use of a robotic total station. The software part primarily has to ensure hardware control, but several level of algorithmic support might be added and have to be distinguished. Algorithmic procedures allow to reach several levels of calibration concerning the geometry of the external digital camera and the total station. We deliver insight in our recent developments and quality characteristics. Both the modular and the integrated approach seem to have its individual strengths and weaknesses. Therefore we expect that both approaches might point at different target applications. Our aim is a better understanding of appropriate applications for robotic imaging total stations. First results are presented. Stefan Hauth, Martin Schlüter i3mainz - Institut für Raumbezogene Informations- und Messtechnik FH Mainz University of Applied Sciences Lucy-Hillebrand-Straße 2, 55128 Mainz, Germany

Korean guidelines for the appropriate use of cardiac CT

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Kim, Young Jin [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul(Korea, Republic of); Yong, Hwan Seok [Dept. of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul(Korea, Republic of); Kim, Sung Mok [Dept. of Radiology, amsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jung A [Dept. of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2015-04-15

The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.

An Empirical State Error Covariance Matrix Orbit Determination Example

Science.gov (United States)

Frisbee, Joseph H., Jr.

2015-01-01

State estimation techniques serve effectively to provide mean state estimates. However, the state error covariance matrices provided as part of these techniques suffer from some degree of lack of confidence in their ability to adequately describe the uncertainty in the estimated states. A specific problem with the traditional form of state error covariance matrices is that they represent only a mapping of the assumed observation error characteristics into the state space. Any errors that arise from other sources (environment modeling, precision, etc.) are not directly represented in a traditional, theoretical state error covariance matrix. First, consider that an actual observation contains only measurement error and that an estimated observation contains all other errors, known and unknown. Then it follows that a measurement residual (the difference between expected and observed measurements) contains all errors for that measurement. Therefore, a direct and appropriate inclusion of the actual measurement residuals in the state error covariance matrix of the estimate will result in an empirical state error covariance matrix. This empirical state error covariance matrix will fully include all of the errors in the state estimate. The empirical error covariance matrix is determined from a literal reinterpretation of the equations involved in the weighted least squares estimation algorithm. It is a formally correct, empirical state error covariance matrix obtained through use of the average form of the weighted measurement residual variance performance index rather than the usual total weighted residual form. Based on its formulation, this matrix will contain the total uncertainty in the state estimate, regardless as to the source of the uncertainty and whether the source is anticipated or not. It is expected that the empirical error covariance matrix will give a better, statistical representation of the state error in poorly modeled systems or when sensor performance

Emerging quasi-0D states at vanishing total entropy of the 1D hard sphere system: A coarse-grained similarity to the car parking problem

Science.gov (United States)

Frusawa, Hiroshi

2014-05-01

A coarse-grained system of one-dimensional (1D) hard spheres (HSs) is created using the Delaunay tessellation, which enables one to define the quasi-0D state. It is found from comparing the quasi-0D and 1D free energy densities that a frozen state due to the emergence of quasi-0D HSs is thermodynamically more favorable than fluidity with a large-scale heterogeneity above crossover volume fraction of ϕc=e/(1+e)=0.731⋯ , at which the total entropy of the 1D state vanishes. The Delaunay-based lattice mapping further provides a similarity between the dense HS system above ϕc and the jamming limit in the car parking problem.

Emerging quasi-0D states at vanishing total entropy of the 1D hard sphere system: A coarse-grained similarity to the car parking problem

International Nuclear Information System (INIS)

Frusawa, Hiroshi

2014-01-01

A coarse-grained system of one-dimensional (1D) hard spheres (HSs) is created using the Delaunay tessellation, which enables one to define the quasi-0D state. It is found from comparing the quasi-0D and 1D free energy densities that a frozen state due to the emergence of quasi-0D HSs is thermodynamically more favorable than fluidity with a large-scale heterogeneity above crossover volume fraction of ϕ c =e/(1+e)=0.731⋯ , at which the total entropy of the 1D state vanishes. The Delaunay-based lattice mapping further provides a similarity between the dense HS system above ϕ c and the jamming limit in the car parking problem.

ACR Appropriateness Criteria® Multiple Gestations.

Science.gov (United States)

Glanc, Phyllis; Nyberg, David A; Khati, Nadia J; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara Lynn; Poder, Liina; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M

2017-11-01

Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model. Screening for congenital heart disease is warranted in monochorionic twins because they have an increased rate of congenital cardiac anomalies. In addition, monochorionic twins have a higher risk of developing cardiac abnormalities in later gestation related to right ventricular outflow obstruction, in particular the subgroups with twin-twin transfusion syndrome or selective intrauterine growth restriction. Monochorionic twins have unique complications including twin-to-twin transfusion syndrome, twin embolization syndrome, and acardius, or twin-reversed arterial perfusion sequence. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or

Quo usque tandem! An interpretation of “genocide” that deprives the Convention of its appropriate effects

Directory of Open Access Journals (Sweden)

Favio Farinella

2016-12-01

Full Text Available In its recent judgment on the case “Application of the Convention for the Prevention and Punishment of the Crime of Genocide”, the International Court of Justice missed a historic opportunity to extend the margin of appreciation regarding the protection of individuals and Humanity. The ICJ consolidates a strict and restricted interpretation of the crime of genocide, contrary to the principles of International Human Rights Law and the precedents of the courts specialized in International Humanitarian Law and International Criminal Law. The opinion of the majority the defense of State sovereignty is placed above the humanitarian obligations of the State and gross violations of human rights. In Cançado Trindade’s words, the reason of State (raison d'Etat prevailed over reasons of Humanity. This paper is intended to demonstrate that the interpretation of the crime of genocide by the ICJ deprives the thematic Convention of its appropriate effects which must be aimed at the protection of the human being. 

Qualità totale e mobilità totale Total Quality and Total Mobility

Directory of Open Access Journals (Sweden)

Giuseppe Trieste

2010-05-01

Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

Total integrated dose testing of solid-state scientific CD4011, CD4013, and CD4060 devices by irradiation with CO-60 gamma rays

Science.gov (United States)

Dantas, A. R. V.; Gauthier, M. K.; Coss, J. R.

1985-01-01

The total integrated dose response of three CMOS devices manufactured by Solid State Scientific has been measured using CO-60 gamma rays. Key parameter measurements were made and compared for each device type. The data show that the CD4011, CD4013, and CD4060 produced by this manufacturers should not be used in any environments where radiation levels might exceed 1,000 rad(Si).

Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.

Science.gov (United States)

Kendall, Elizabeth; Barnett, Leda

2015-01-01

To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.

A phylogenetic approach to total evaporative water loss in mammals.

Science.gov (United States)

Van Sant, Matthew J; Oufiero, Christopher E; Muñoz-Garcia, Agustí; Hammond, Kimberly A; Williams, Joseph B

2012-01-01

Maintaining appropriate water balance is a constant challenge for terrestrial mammals, and this problem can be exacerbated in desiccating environments. It has been proposed that natural selection has provided desert-dwelling mammals physiological mechanisms to reduce rates of total evaporative water loss. In this study, we evaluated the relationship between total evaporative water loss and body mass in mammals by using a recent phylogenetic hypothesis. We compared total evaporative water loss in 80 species of arid-zone mammals to that in 56 species that inhabit mesic regions, ranging in size from 4 g to 3,500 kg, to test the hypothesis that mammals from arid environments have lower rates of total evaporative water loss than mammals from mesic environments once phylogeny is taken into account. We found that arid species had lower rates of total evaporative water loss than mesic species when using a dichotomous variable to describe habitat (arid or mesic). We also found that total evaporative water loss was negatively correlated with the average maximum and minimum environmental temperature as well as the maximum vapor pressure deficit of the environment. Annual precipitation and the variable Q (a measure of habitat aridity) were positively correlated with total evaporative water loss. These results support the hypothesis that desert-dwelling mammals have lower rates of total evaporative water loss than mesic species after controlling for body mass and evolutionary relatedness regardless of whether categorical or continuous variables are used to describe habitat.

Hypnosis control based on the minimum concentration of anesthetic drug for maintaining appropriate hypnosis.

Science.gov (United States)

Furutani, Eiko; Nishigaki, Yuki; Kanda, Chiaki; Takeda, Toshihiro; Shirakami, Gotaro

2013-01-01

This paper proposes a novel hypnosis control method using Auditory Evoked Potential Index (aepEX) as a hypnosis index. In order to avoid side effects of an anesthetic drug, it is desirable to reduce the amount of an anesthetic drug during surgery. For this purpose many studies of hypnosis control systems have been done. Most of them use Bispectral Index (BIS), another hypnosis index, but it has problems of dependence on anesthetic drugs and nonsmooth change near some particular values. On the other hand, aepEX has an ability of clear distinction between patient consciousness and unconsciousness and independence of anesthetic drugs. The control method proposed in this paper consists of two elements: estimating the minimum effect-site concentration for maintaining appropriate hypnosis and adjusting infusion rate of an anesthetic drug, propofol, using model predictive control. The minimum effect-site concentration is estimated utilizing the property of aepEX pharmacodynamics. The infusion rate of propofol is adjusted so that effect-site concentration of propofol may be kept near and always above the minimum effect-site concentration. Simulation results of hypnosis control using the proposed method show that the minimum concentration can be estimated appropriately and that the proposed control method can maintain hypnosis adequately and reduce the total infusion amount of propofol.

RAND-like appropriateness methodology consensus for primary open-angle glaucoma in Latin America.

Science.gov (United States)

Lerner, S Fabian; Singh, Kuldev; Susanna, Remo; Wilson, M Roy; Lee, Brian L; Maul, Eugenio

2012-09-01

To report the results of a Latin American consensus panel regarding the diagnosis and management of primary open-angle glaucoma and to compare these results with those from a similar panel in the United States. A RAND-like (Research and Development) appropriateness methodology was used to assess glaucoma practice in Latin America. The 148 polling statements created for the RAND- like analysis in the United States and 10 additional statements specific to glaucoma care in Latin America were presented to a panel of Latin American glaucoma experts. Panelists were polled in private using the RAND- like methodology before and after the panel meeting. Consensus agreement or disagreement among Latin American experts was reached for 51.3% of statements before the meeting and increased to 66.5% in the private, anonymous meeting after polling (79.0% agreement, 21.0% disagreement). Although there was a high degree of concordance (111 of 148 statements; 75%) between the results of this Latin American panel and the United States panel, there were some notable exceptions relating to diagnostic and therapeutic decision making. This RAND-like consensus methodology provides a perspective of how Latin American glaucoma practitioners view many aspects of glaucoma and compares these results with those obtained using a similar methodology from practitioners in the United States. These findings may be helpful to ophthalmologists providing glaucoma care in Latin America and in other regions of the world. Copyright © 2012 Elsevier Inc. All rights reserved.

Appropriate Technology and Journal Writing: Structured Dialogues that Enhance Learning

Science.gov (United States)

Longhurst, James; Sandage, Scott A.

2004-01-01

Of the many available options, instructors should choose "appropriate technology" that meets pedagogical goals with minimum disruption. Student journal assignments follow many teaching "best practices" but consume time and energy; we recommend e-mail as the most appropriate choice for journal assignments. E-mail encourages fast and personalized…

Determination of Lung-to-Blood Absorption Rates for Lead and Bismuth which are Appropriate for Radon Progeny

International Nuclear Information System (INIS)

Marsh, J.W.; Birchall, A.

1999-01-01

The ICRP Publication 66 Human Respiratory Tract Model (HRTM) treats clearance as a competitive process between absorption into blood and particle transport to the gastrointestinal tract and lymphatics. The ICRP recommends default absorption rates for lead and bismuth in ICRP Publication 71 but states that the values are not appropriate for short-lived radon progeny. This paper describes an evaluation of published data from volunteer experiments to estimate the absorption half-times of lead and bismuth that are appropriate for short-lived radon progeny. The absorption half-time for lead was determined to be 10±2 h, based on 212 Pb lung and blood retention data from several studies. The absorption half-time for bismuth was estimated to be about 13 h, based on 212 Bi urinary excretion data from one experiment and the ICRP biokinetic model for bismuth as a decay product of lead. (author)

Generalized coherent states related to the associated Bessel functions and Morse potential

International Nuclear Information System (INIS)

Mojaveri, B; Amiri Faseghandis, S

2014-01-01

Using the associated Bessel functions, a shape-invariant Lie algebra spanned by ladder operators plus the identity operator, is realized. The Hilbert space of the associated Bessel functions, representing the Lie algebra, are established and two kinds of generalized coherent states as an appropriate superposition of these functions are constructed. By implying appropriate similarity transformation on the constructed coherent states, the generalized coherent states for the Morse potential are obtained. By considering some statistical characteristics, it is revealed that the constructed coherent states indeed possess nonclassical features, such as squeezing and sub-Poissonian statistics. (paper)

Microscopic model of quasiparticle wave packets in superfluids, superconductors, and paired Hall states.

Science.gov (United States)

Parameswaran, S A; Kivelson, S A; Shankar, R; Sondhi, S L; Spivak, B Z

2012-12-07

We study the structure of Bogoliubov quasiparticles, bogolons, the fermionic excitations of paired superfluids that arise from fermion (BCS) pairing, including neutral superfluids, superconductors, and paired quantum Hall states. The naive construction of a stationary quasiparticle in which the deformation of the pair field is neglected leads to a contradiction: it carries a net electrical current even though it does not move. However, treating the pair field self-consistently resolves this problem: in a neutral superfluid, a dipolar current pattern is associated with the quasiparticle for which the total current vanishes. When Maxwell electrodynamics is included, as appropriate to a superconductor, this pattern is confined over a penetration depth. For paired quantum Hall states of composite fermions, the Maxwell term is replaced by a Chern-Simons term, which leads to a dipolar charge distribution and consequently to a dipolar current pattern.

The total artificial heart.

Science.gov (United States)

Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

2015-12-01

The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

Pragmatic awareness of Suggestions: From (Im)Polite Mannerism to Attitudinal Appropriateness

OpenAIRE

Hamid Allami; Nasim Boustani

2017-01-01

The present research seeks to determine: (a) Iranian EFL learners’ application of suggestion semantic formulae ;(b) their attitude of appropriateness in terms of confidence in the employment of appropriate supportive moves; (c), their (im)polite mannerism with respect to the selected strategies; and (d) the relationship between attitude of appropriateness and mannerism of (im)politeness. An Oxford Quick placement Test (OQPT) was administered among 60 Iranian EFL learners to check their langua...

Multicultural Leadership, Sustainable Total School Environment

Science.gov (United States)

Yeung, See-Wai Alison; Lee, Yeung; Yue, K. W. Ryan

2006-01-01

Banks (2002) stated that to implement multicultural education successfully, we must think of the school as a social system. Therefore, if educational equity and excellence are to be provided to all students, a systemic Total School Environment [Banks (2001) "Cultural diversity and education: Foundations curriculum and teaching, 4th ed." Allyn and…

State Supervision and Control of Radiation Protection

CERN Document Server

2001-01-01

Radiation Protection Centre is carrying state supervision and control of radiation protection. The main objective of state supervision and control of radiation protection is assessing how licensees comply with requirements of the appropriate legislation and enforcement. Summary of inspections conducted in 1999-2001 is presented.

Annotating State of Mind in Meeting Data

NARCIS (Netherlands)

Heylen, Dirk K.J.; Reidsma, Dennis; Ordelman, Roeland J.F.; Devillers, L.; Martin, J-C.; Cowie, R.; Batliner, A.

We discuss the annotation procedure for mental state and emotion that is under development for the AMI (Augmented Multiparty Interaction) corpus. The categories that were found to be most appropriate relate not only to emotions but also to (meta-)cognitive states and interpersonal variables. The

Radioimmunological determination of total thyroxine in the serum

Energy Technology Data Exchange (ETDEWEB)

Premachandra, Bhartur

1975-09-04

A radioimmunological method to determine total thyroxine in a serum sample is described. The method is as follows: trichloracetic acid and sodium hydroxide are mixed with the sample; radioactive thyroxine is added to the mixture, which is left to reach equilibrium then placed in contact with a resin sponge consisting of a polyurethane foam with intercommunicating cells containing a strongly basic anion exchange resin; the mixture and the resin sponge are incubated, the initial radioactivity of the mixture and resin sponge combination is measured with an appropriate detection system, then the resin sponge is removed from the mixture, washed and its residual radioactivity measured.

Radioimmunological determination of total thyroxine in the serum

International Nuclear Information System (INIS)

Premachandra, Bhartur.

1975-01-01

A radioimmunological method to determine total thyroxine in a serum sample is described. The method is as follows: trichloracetic acid and sodium hydroxide are mixed with the sample; radioactive thyroxine is added to the mixture, which is left to reach equilibrium then placed in contact with a resin sponge consisting of a polyurethane foam with intercommunicating cells containing a strongly basic anion exchange resin; the mixture and the resin sponge are incubated, the initial radioactivity of the mixture and resin sponge combination is measured with an appropriate detection system, then the resin sponge is removed from the mixture, washed and its residual radioactivity measured [fr

Total Quality Management in the United States Army Corps of Engineers

Science.gov (United States)

1993-05-01

Office. Telephone interview with author, 20 November 1992. Ishikawa , Kaoru (1985). What is Total Quality Control? The Japanese Way. Prentice-Hall, Inc...Organizations ..... 55 Table 13. Ishikawa PDCA Cycle .......................................................... 68 Table 14. TQM Training M atrix...Standards 1008 ( Ishikawa 1985). The Japanese were aware of both the American and British work with standards. The standards were studied by

Teleportation of an unknown bipartite state via non-maximally entangled two-particle state

Institute of Scientific and Technical Information of China (English)

Cao Hai-Jing; Guo Yan-Qing; Song He-Shan

2006-01-01

In this paper a new scheme for teleporting an unknown entangled state of two particles is proposed. To weaken the requirement for the quantum channel, without loss of generality, two communicators only share a non-maximally entangled two-particle state. Teleportation can be probabilistically realized if sender performs Bell-state measurements and Hadamard transformation and receiver introduces two auxiliary particles, operates G-not operation, single-qubit measurements and appropriate unitary transformations. The probability of successful teleportation is determined by the smaller one among the coefficients' absolute values of the quantum channel.

Pragmatic awareness of Suggestions: From (ImPolite Mannerism to Attitudinal Appropriateness

Directory of Open Access Journals (Sweden)

Hamid Allami

2017-09-01

Full Text Available The present research seeks to determine: (a Iranian EFL learners’ application of suggestion semantic formulae ;(b their attitude of appropriateness in terms of confidence in the employment of appropriate supportive moves; (c, their (impolite mannerism with respect to the selected strategies; and (d the relationship between attitude of appropriateness and mannerism of (impoliteness. An Oxford Quick placement Test (OQPT was administered among 60 Iranian EFL learners to check their language proficiency level and to satisfy the assumption of homogeneity among the learners. These participants along with 10 American native speakers then underwent a suggestion DCT. The questionnaire included questions addressing interlocutors’ with higher, lower or equal power status and intimate or strange social distance. The DCT also involved attitudinal appropriateness scale and (impoliteness mannerism likert scale to examine the learners’ degree of confidence and mannerism. Besides similarities and differences in the application of suggestion semantic formulae between the Iranian learners and American speakers, the results revealed variations in the two groups’ performances for appropriateness and (impoliteness. The results also indicated a positive relationship between the attitude and mannerism scales.

Developing spatial inequalities in carbon appropriation: a sociological analysis of changing local emissions across the United States.

Science.gov (United States)

Elliott, James R; Clement, Matthew Thomas

2015-05-01

This study examines an overlooked dynamic in sociological research on greenhouse gas emissions: how local areas appropriate the global carbon cycle for use and exchange purposes as they develop. Drawing on theories of place and space, we hypothesize that development differentially drives and spatially decouples use- and exchange-oriented emissions at the local level. To test our hypotheses, we integrate longitudinal, county-level data on residential and industrial emissions from the Vulcan Project with demographic, economic and environmental data from the U.S. Census Bureau and National Land Change Database. Results from spatial regression models with two-way fixed-effects indicate that alongside innovations and efficiencies capable of reducing environmentally harmful effects of development comes a spatial disarticulation between carbon-intensive production and consumption within as well as across societies. Implications for existing theory, methods and policy are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

A Systematic Review and Meta-Analysis of the Clinical Appropriateness of Blood Transfusion in China.

Science.gov (United States)

Zhu, Changtai; Gao, Yulu; Li, Zhiqiang; Li, Qinyun; Gao, Zongshuai; Liao, Yanqiu; Deng, Zhifeng

2015-12-01

The issue of the clinical appropriateness of blood transfusion has become a focus of transfusion medicine worldwide. In China, irrational uses of blood have often been reported in recent years. However, to date there lacks a systematic review of the rational uses of blood. This study aimed to determine the clinical appropriateness of blood transfusion in China. We searched PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database, WanFang Database, and Chinese BioMedical Literature Database, and the retrieval cut-off date was June 31, 2015. SPSS 17.0 and MetaAnalyst 3.13 were employed as the statistics tools in this review. A pooled rate of clinical inappropriateness of transfusion was analyzed by DerSimonian-Laird method. In this study, a total of 39 observational studies were included, which related to 75,132 cases of blood transfusion. According to the meta-analysis results, the overall incidence of clinical inappropriateness of transfusion in China was estimated to be 37.3% (95% confidence interval [CI] [32.1, 42.8]). The subgroup analyses revealed that the pooled rates of clinical inappropriateness of transfusion of plasma, red blood cells (RBCs), cryoprecipitate, and platelets were 56.3% (95% CI [45.8, 66.2]), 30.9% (95% CI [27.1, 35.0]), 25.2% (95% CI [13.2, 42.7]), and 14.1% (95% CI [8.8, 21.9]), respectively. However, the pooled incidence of inappropriateness of transfusion in operative departments was 47.5% (95% CI [36.8, 58.3]), which was significantly higher than that in nonoperative departments, 25.8% (95% CI [18.7, 34.4], P  0.05). In conclusion, China has suffered from a disadvantage in the clinical appropriateness of blood transfusion, especially in plasma and RBC use. In future, comprehensive measures should be implemented in order to improve the clinical appropriateness of blood transfusion.

The Changing Role of State Appropriations for Higher Education: An Econometric Analysis from 1985-2008

Science.gov (United States)

Mushrush, Christopher E.

2013-01-01

Traditionally, public funding of higher education has been viewed as cyclical, where support falls during times of economic downturn and then recovers as the economy improves. This view, however, is being challenged as budgetary shortfalls are becoming more common for states, even in times of economic growth, due to structural constraints. Using…

Development of a total reflection X-ray fluorescence spectrometer for ...

Indian Academy of Sciences (India)

Unknown

design and use of a peltier cooled solid state detector for energy dispersive detection. Alignment and ... X-ray beam at a glancing angle less than the critical angle at which total ... materials is < 1 so that external total reflection takes place at an ...

A general method for computing the total solar radiation force on complex spacecraft structures

Science.gov (United States)

Chan, F. K.

1981-01-01

The method circumvents many of the existing difficulties in computational logic presently encountered in the direct analytical or numerical evaluation of the appropriate surface integral. It may be applied to complex spacecraft structures for computing the total force arising from either specular or diffuse reflection or even from non-Lambertian reflection and re-radiation.

Total nitrogen and total phosphorus removal from brackish aquaculture wastewater using effective microorganism

Science.gov (United States)

Mohamad, K. A.; Mohd, S. Y.; Sarah, R. S.; Mohd, H. Z.; Rasyidah, A.

2017-09-01

Aquaculture is one of dominant food based industry in the world with 8.3% annual growth rate and its development had led to adverse effect on the environment. High nutrient production in form of nitrogenous compound and phosphorus contributed to environmental deterioration such as eutrophication and toxicity to the industry. Usage of Effective Microorganism (EM), one of the biological approaches to remove Total Nitrogen (TN) and Total Phosphorus (TP) in aquaculture pond was proposed. Samples were obtained from the Sea Bass intensive brackish aquaculture wastewater (AW) from fish farm at Juru, Penang and the parameters used to measure the removal of nitrogenous compounds include, pH, EM dosage, shaking, contact time and optimum variable conditions. From the study, for effective contact time, day 6 is the optimum contact time for both TN and TP with 99.74% and 62.78% removal respectively while in terms of optimum pH, the highest TN removal was at pH 7 with 66.89 %. The optimum dosage of EM is 1.5 ml with ratio 1:166 for 81.5 % TN removal was also found appropriate during the experiment. At varied optimum conditions of EM, the removal efficiency of TN and TP were 81.53% and 38.94% respectively while the removal mechanism of TN was highly dependent on the decomposition rate of specific bacteria such as Nitrobacter bacteria, Yeast and Bacillus Subtilis sp. The study has established the efficacy of EM's ability to treat excessive nutrient of TN and TP from AW.

Correlation between Soil Organic Matter, Total Organic Matter and ...

African Journals Online (AJOL)

A total of four sites distributed in different soils of Kelantan State, Malaysia was identified for the study. Soils were collected by depth interval of 0-10cm, 10-20cm and 20-30cm. The correlation of soil organic matter (SOM) content, total organic carbon (TOC) content, water content and soils texture for industrial area at ...

Appropriate administrative structures in harnessing water resources ...

African Journals Online (AJOL)

Appropriate administrative structures in harnessing water resources for sustainable growth in Nigeria. Lekan Oyebande. Abstract. No Abstract. Journal of Mining and Geology Vol. 42(1) 2006: 21-30. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

Using Appropriate Strategies to Improve Students' Comprehension ...

African Journals Online (AJOL)

Using Appropriate Strategies to Improve Students' Comprehension of Chemistry Texts: A Guide for Chemistry Teachers. ... African Research Review ... Unfortunately, contemporary research insight into science reading is lacking and science educators tend to focus on methods of teaching specific subject matter and ...

Nationally Appropriate Mitigation Action: Understanding NAMA Cycle

DEFF Research Database (Denmark)

Sharma, Sudhir; Desgain, Denis DR

There is no internationally defined or agreed Nationally Appropriate Mitigation Action(NAMA) cycle, as was the case, for example, with the Clean Development Mechanisms (CDM) project cycle. However, there are some common steps that NAMA identification, formulation, and implementation will all go...

Catalog of CERCLA applicable or relevant and appropriate requirements (ARARs) - fact sheets

Energy Technology Data Exchange (ETDEWEB)

1990-07-01

Section 121(d) of the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA), requires attainment of federal and state applicable or relevant and appropriate requirements (ARARs). Subpart E, Section 300.400(g) {open_quotes}Identification of applicable or relevant and appropriate requirements{close_quotes} of the National Oil and Hazardous Substances Pollution Contingency Plan (NCP)(55 FR 8666, March 8, 1990) describes the process for attaining ARARs. The purpose of this catalog is to provide DOE Program Offices and Field Organizations with all of the {open_quotes}Quick Reference Fact Sheets{close_quotes} on attaining ARARS. These fact sheets provide overviews of ARARs for CERCLA cleanup actions pertinent to DOE environmental restoration activities. All of the fact sheets in this catalog were prepared by the Environmental Protection Agency`s Office of Solid Waste and Emergency Response. Fact sheets 1-7 discuss land disposal restrictions (LDRs) and their applicability. LDRs may pertain to a number of CERCLA response actions at DOE facilities. Fact Sheets 8-13 are based on the CERCLA Compliance with Other Laws Manual: Parts I and II and provide an overview of many other CERCLA ARARs. Overview of ARARs-Focus on ARAR Waivers (fact sheet 11), provides a good introduction to ARARS. The last two fact sheets, 14 and 15, are periodic reports that describe additional fact sheets and clarify issues.

Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

Science.gov (United States)

2017-02-27

eight divisions that are further divided into 38 districts.2 This report provides an overview of the Corps water resource activities , including...rules associated with authorization and appropriation earmarks, individual Members often brought attention to similar activities for congressional...Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities Nicole T. Carter Specialist in Natural Resources Policy

Total reflection X-ray fluorescence analysis

International Nuclear Information System (INIS)

Michaelis, W.; Prange, A.

1987-01-01

In the past few years, total reflection X-ray flourescence analysis (TXRF) has found an increasing number of assignments and applications. Experience of trace element analysis using TXRF and examples of applications are already widespread. Therefore, users of TXRF had the opportunity of an intensive exchange of their experience at the 1st workshop on total reflection X-ray fluorescence analysis which took place on May 27th and 28th 1986 at the GKSS Research Centre at Geesthacht. In a series of lectures and discussions dealing with the analytical principle itself, sample preparation techniques and applications as well as comuter programs for spectrum evaluation, the present state of development and the range of applications were outlined. 3 studies out of a total of 14 were included separately in the INIS and ENERGY databases. With 61 figs., 12 tabs [de

Appropriate Separator Sizing: A Modified Stewart and Arnold Method

Directory of Open Access Journals (Sweden)

F. Boukadi

2012-01-01

Full Text Available Oil and gas separators were one of the first pieces of production equipment to be used in the petroleum industry. The different stages of separation are completed using the following three principles: gravity, centrifugal force, and impingement. The sizes of the oil droplets, in the production water, are based mainly on the choke valve pressure drop. The choke valve pressure drop creates a shearing effect; this reduces the ability of the droplets to combine. One of the goals of oil separation is to reduce the shearing effect of the choke. Separators are conventionally designed based on initial flow rates; as a result, the separator is no longer able to accommodate totality of produced fluids. Changing fluid flow rates as well as emulsion viscosity effect separator design. The reduction in vessel performance results in recorded measurements that do not match actual production levels inducing doubt into any history matching process and distorting reservoir management programs. In this paper, the new model takes into account flow rates and emulsion viscosity. The generated vessel length, vessel diameter, and slenderness ratio monographs are used to select appropriate separator size based on required retention time. Model results are compared to API 12J standards.

Soft-tissue tension total knee arthroplasty.

Science.gov (United States)

Asano, Hiroshi; Hoshino, Akiho; Wilton, Tim J

2004-08-01

It is far from clear how best to define the proper strength of soft-tissue tensioning in total knee arthroplasty (TKA). We attached a torque driver to the Monogram balancer/tensor device and measured soft-tissue tension in full extension and 90 degrees flexion during TKA. In our surgical procedure, when we felt proper soft-tissue tension was being applied, the mean distraction force was noted to be 126N in extension and 121N in flexion. There was no significant correlation between soft-tissue tension and the postoperative flexion angle finally achieved. To the best of our knowledge, this is the first study to assess the actual distraction forces in relation to soft-tissue tension in TKA. Further study may reveal the most appropriate forces to achieve proper soft-tissue tension in the wide variety of circumstances presenting at knee arthroplasty.

Ascertaining the international state of the art of PSA methodology

International Nuclear Information System (INIS)

Linden, J. von

1998-01-01

Plant-specific PSAs, to be performed within the framework of the Periodic Safety Review of German Nuclear Power Plants require further development of the methodology. For that purpose foreign PSA-guidelines and PSA-reviewes as well as relevant literature are examined and appropriate insights are adopted within task A.2 of project SR 2096. The main goal of these activities is to achieve a comparison of the state of the art of PSA-methodologies applied abroad and in Germany. The German state of the art refers to the extent as is documented in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) which has to be used for the Periodic Safety Review of German Nuclear Power Plants. The structure for the evaluation is based on the working steps of a PSA. In total, according to the objectives of the Periodic Safety Review the German approach for plant-specific PSAs based on the German PSA Guide is conform to the state of the art abroad. Identified deviations in some details are evaluated reflecting the view of GRS. Particular aspects resulting from the evaluation should be considered for further development of the German PSA Guide. (orig.) [de

The trivector approach for minimally invasive total knee arthroplasty: a technical note.

Science.gov (United States)

Benazzo, Francesco; Rossi, Stefano Marco Paolo

2012-09-01

One of the main criticisms of minimally invasive approaches in total knee arthroplasty has been their poor adaptability in cases of major deformity or stiffness of the knee joint. When they are used in such cases, excessive soft-tissue tension is needed to provide appropriate joint exposure. Here, we describe the "mini trivector approach," which has become our standard approach for total knee replacement because it permits us to enlarge the indication for minimally or less invasive total knee replacement to many knees where quad sparing, a subvastus approach, or a mini quad or mini midvastus snip may not be sufficient to achieve correct exposure. It consists of a limited double snip of the VMO and the quadriceps tendon that reduces tension on the extensor mechanism and allows easier verticalization of the patella as well as good joint exposure.

Desktop Publishing Choices: Making an Appropriate Decision.

Science.gov (United States)

Crawford, Walt

1991-01-01

Discusses various choices available for desktop publishing systems. Four categories of software are described, including advanced word processing, graphics software, low-end desktop publishing, and mainstream desktop publishing; appropriate hardware is considered; and selection guidelines are offered, including current and future publishing needs,…

Selective conservatism in the management of thoracic trauma remains appropriate in the 21st century.

Science.gov (United States)

Kong, V Y; Oosthuizen, G V; Clarke, D L

2015-04-01

Selective conservatism for thoracic trauma is well established but the emergence of new technologies may cause management strategies to continue to evolve. A retrospective study was conducted on thoracic trauma patients managed in a single institution in South Africa over a 4-year period to determine the appropriateness of our current policy of selective conservatism. A total of 1,239 patients were included in the study; 112 required an emergency thoracotomy, 125 were admitted for observation and 1,002 required a tube thoracostomy (TT). Ninety-one per cent of the patients were male and the median age was 24 years. Seventy-five per cent of the cases were penetrating trauma and the remaining were blunt trauma. The indications for TT were pneumothorax (PTX) (n=382, 38%), haemothorax (HTX) (n=300, 30%) and haemopneumothorax (HPTX) (n=320, 32%). A total of 13% (127/1,002) of all chest x-rays (CXR) following tube removal demonstrated residual pathologies that precluded immediate discharge: 32 (8%) in Group A (PTX), 44 (15%) in Group B (HTX) and 51 (16%) in Group C (HPTX). All 32 patients in Group A were simply observed and did not require further intervention. In Group B, 17 patients required repeat TTs and 27 required video assisted thoracoscopic surgery (VATS) for clearance of residual HTX. Twenty-nine patients in Group C required repeat TTs and twenty-two required VATS. The vast majority of patients with thoracic trauma can be managed conservatively with TT alone. Residual pathology appeared to be lowest in patients with a PTX, which seldom requires treatment, while only a minority of patients required repeat TTs or VATS for a retained HTX. Selective conservatism is still appropriate in the current era in a developing world setting.

Selective conservatism in the management of thoracic trauma remains appropriate in the 21st century

Science.gov (United States)

Oosthuizen, GV; Clarke, DL

2015-01-01

Introduction Selective conservatism for thoracic trauma is well established but the emergence of new technologies may cause management strategies to continue to evolve. Methods A retrospective study was conducted on thoracic trauma patients managed in a single institution in South Africa over a 4-year period to determine the appropriateness of our current policy of selective conservatism. Results A total of 1,239 patients were included in the study; 112 required an emergency thoracotomy, 125 were admitted for observation and 1,002 required a tube thoracostomy (TT). Ninety-one per cent of the patients were male and the median age was 24 years. Seventy-five per cent of the cases were penetrating trauma and the remaining were blunt trauma. The indications for TT were pneumothorax (PTX) (n=382, 38%), haemothorax (HTX) (n=300, 30%) and haemopneumothorax (HPTX) (n=320, 32%). A total of 13% (127/1,002) of all chest x-rays (CXR) following tube removal demonstrated residual pathologies that precluded immediate discharge: 32 (8%) in Group A (PTX), 44 (15%) in Group B (HTX) and 51 (16%) in Group C (HPTX). All 32 patients in Group A were simply observed and did not require further intervention. In Group B, 17 patients required repeat TTs and 27 required video assisted thoracoscopic surgery (VATS) for clearance of residual HTX. Twenty-nine patients in Group C required repeat TTs and twenty-two required VATS. Conclusions The vast majority of patients with thoracic trauma can be managed conservatively with TT alone. Residual pathology appeared to be lowest in patients with a PTX, which seldom requires treatment, while only a minority of patients required repeat TTs or VATS for a retained HTX. Selective conservatism is still appropriate in the current era in a developing world setting. PMID:26263809

Variable-angle total internal reflection fluorescence microscopy of intact cells of Arabidopsis thaliana

Directory of Open Access Journals (Sweden)

Kim Myung K

2011-09-01

Full Text Available Abstract Background Total internal reflection fluorescence microscopy (TIRFM is a powerful tool for observing fluorescently labeled molecules on the plasma membrane surface of animal cells. However, the utility of TIRFM in plant cell studies has been limited by the fact that plants have cell walls, thick peripheral layers surrounding the plasma membrane. Recently, a new technique known as variable-angle epifluorescence microscopy (VAEM was developed to circumvent this problem. However, the lack of a detailed analysis of the optical principles underlying VAEM has limited its applications in plant-cell biology. Results Here, we present theoretical and experimental evidence supporting the use of variable-angle TIRFM in observations of intact plant cells. We show that when total internal reflection occurs at the cell wall/cytosol interface with an appropriate angle of incidence, an evanescent wave field of constant depth is produced inside the cytosol. Results of experimental TIRFM observations of the dynamic behaviors of phototropin 1 (a membrane receptor protein and clathrin light chain (a vesicle coat protein support our theoretical analysis. Conclusions These findings demonstrate that variable-angle TIRFM is appropriate for quantitative live imaging of cells in intact tissues of Arabidopsis thaliana.

APPROPRIATE ALLOCATION OF CONTINGENCY USING RISK ANALYSIS METHODOLOGY

Directory of Open Access Journals (Sweden)

Andi Andi

2004-01-01

Full Text Available Many cost overruns in the world of construction are attributable to either unforeseen events or foreseen events for which uncertainty was not appropriately accommodated. It is argued that a significant improvement to project management performance may result from greater attention to the process of analyzing project risks. The objective of this paper is to propose a risk analysis methodology for appropriate allocation of contingency in project cost estimation. In the first step, project risks will be identified. Influence diagramming technique is employed to identify and to show how the risks affect the project cost elements and also the relationships among the risks themselves. The second step is to assess the project costs with regards to the risks under consideration. Using a linguistic approach, the degree of uncertainty of identified project risks is assessed and quantified. The problem of dependency between risks is taken into consideration during this analysis. For the final step, as the main purpose of this paper, a method for allocating appropriate contingency is presented. Two types of contingencies, i.e. project contingency and management reserve are proposed to accommodate the risks. An illustrative example is presented at the end to show the application of the methodology.

Appropriate selection for omalizumab treatment in patients with severe asthma?

DEFF Research Database (Denmark)

Nygaard, Leo; Henriksen, Daniel Pilsgaard; Madsen, Hanne

2017-01-01

Background: Omalizumab improves asthma control in patients with uncontrolled severe allergic asthma; however, appropriate patient selection is crucial. Information in this field is sparse. Objective: We aimed to estimate whether potential omalizumab candidates were appropriately selected according...... to guidelines, and the clinical effect of omalizumab treatment over time. Design: We performed a retrospective observational study on adult patients with asthma treated with omalizumab during 2006-2015 at the Department of Respiratory Medicine at Odense University Hospital (OUH), Denmark. Data were obtained...... from the Electronic Patient Journal of OUH and Odense Pharmaco-Epidemiological Database. Guideline criteria for omalizumab treatment were used to evaluate the appropriateness of omalizumab candidate selection, and the Asthma Control Test (ACT) to assess the clinical effects of omalizumab at weeks 16...

The myth of the state, or the state's religious legitimation

Directory of Open Access Journals (Sweden)

Carl-Martin Edsman

1972-01-01

Full Text Available The myth of the state is used for legitimating certain actions. For example, the ideologist of National Socialism, A. Rosenberg, used the term myth for the belief or conception of life which was to sustain the new state. The Third Reich's myth was the superiority and glory of the Aryan' race. In addition, Hitler compared the requisite official ideology or philosophy to a religion. It must be intolerant like a religion; it demanded total submission, organization and devotion to struggle. Even Hitler's comrade in arms, Mussolini, used similar language, although the substance was partially different. Thus in a speech at Naples in 1922, Mussolini said: "We have created our myth. The myth is a faith, it is passion. It is not necessary that it shall be a reality. It is a reality by the fact that it is a goad, a hope, a faith, that it is courage. Our myth is the nation, our myth is the greatness of the nation ! In the Third World, besides native traditions, there are ideas taken from the Christian or secularized West. The first type of appropriation may have taken place long ago or in our own time. Within Islam, an offshoot from Judaism and Christianity, the theocratic consciousness is highly evident. The holder of political power is the instrument of God and shall therefore be obeyed. The ruler, on the other hand, shall consult his subjects, and the believers shall do the same among themselves and assist each other in word and deed.

The current state of bearing surfaces in total hip replacement.

Science.gov (United States)

Rajpura, A; Kendoff, D; Board, T N

2014-02-01

We reviewed the literature on the currently available choices of bearing surface in total hip replacement (THR). We present a detailed description of the properties of articulating surfaces review the understanding of the advantages and disadvantages of existing bearing couples. Recent technological developments in the field of polyethylene and ceramics have altered the risk of fracture and the rate of wear, although the use of metal-on-metal bearings has largely fallen out of favour, owing to concerns about reactions to metal debris. As expected, all bearing surface combinations have advantages and disadvantages. A patient-based approach is recommended, balancing the risks of different options against an individual's functional demands.

Collaboration, campaigns and champions for appropriate imaging: feedback from the Zagreb workshop.

Science.gov (United States)

Remedios, D; Brkljacic, B; Ebdon-Jackson, S; Hierath, M; Sinitsyn, V; Vassileva, J

2018-04-01

Leading radiologists and representatives from national radiation protection regulatory authorities and health ministries from 19 countries of the European region worked together with five experts at the workshop on justification and appropriate use of imaging in Zagreb, Croatia, from 26 to 28 October 2017 jointly organised by the IAEA and the European Society of Radiology. The workshop served as a forum to exchange information on challenges and solutions for improving justification and the appropriate use of diagnostic imaging. Common barriers to improving the use of imaging referral guidelines were discussed and the need for increased collaboration identified. Examples of good practices were presented, including use of Clinical Decision Support (CDS) systems to facilitate rapid and good justification decisions. The workshop identified some of the needs of European countries for achieving more appropriate imaging proposing wider use of collaboration, campaigns and champions. • Drivers for appropriate imaging in Europe are similar to those elsewhere globally. • Implementing imaging referral guidelines is the main barrier to more appropriate imaging. • Clinical Decision Support systems (CDS) facilitates good referral practice and justification decisions. • Collaboration, campaigns and champions may improve awareness, appropriateness and audit.

Permutationally invariant state reconstruction

DEFF Research Database (Denmark)

Moroder, Tobias; Hyllus, Philipp; Tóth, Géza

2012-01-01

Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large-scale opti...... optimization, which has clear advantages regarding speed, control and accuracy in comparison to commonly employed numerical routines. First prototype implementations easily allow reconstruction of a state of 20 qubits in a few minutes on a standard computer.......-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum...

State Arts Agencies 1965-2003. Whose Interests to Serve?

National Research Council Canada - National Science Library

Lowell, Julia

2004-01-01

... (referred to as state arts agencies, or SAAs). In fiscal year (FY) 2003, a record 43 of 56 SAAs reported year-over-year declines in the general fund appropriations budgeted to them by their state legislatures...

Is length an appropriate estimator to characterize pulmonary alveolar capillaries? A critical evaluation in the human lung

DEFF Research Database (Denmark)

Mühlfeld, Christian; Weibel, Ewald R.; Hahn, Ute

2010-01-01

Stereological estimations of total capillary length have been used to characterize changes in the alveolar capillary network (ACN) during developmental processes or pathophysiological conditions. Here, we analyzed whether length estimations are appropriate to describe the 3D nature of the ACN. Semi...... resulted in a mean of 2,746 km (SD: 722 km). Because of the geometry of the ACN both approaches carry an unpredictable bias. The bias incurred by the design-based approach is proportional to the ratio between radius and length of the capillary segments in the ACN, the number of branching points...... and the winding of the capillaries. The model-based approach is biased because of the real noncylindrical shape of capillaries and the network structure. In conclusion, the estimation of the total length of capillaries in the ACN cannot be recommended as the geometry of the ACN does not fulfill the requirements...

Choosing Appropriate Theories for Understanding Hospital Reporting of Adverse Drug Events, a Theoretical Domains Framework Approach.

Science.gov (United States)

Shalviri, Gloria; Yazdizadeh, Bahareh; Mirbaha, Fariba; Gholami, Kheirollah; Majdzadeh, Reza

2018-01-01

Adverse drug events (ADEs) may cause serious injuries including death. Spontaneous reporting of ADEs plays a great role in detection and prevention of them; however, underreporting always exists. Although several interventions have been utilized to solve this problem, they are mainly based on experience and the rationale for choosing them has no theoretical base. The vast variety of behavioural theories makes it difficult to choose appropriate theory. Theoretical domains framework (TDF) is suggested as a solution. The objective of this study was to select the best theory for evaluating ADE reporting in hospitals based on TDF. We carried out three focus group discussions with hospital pharmacists and nurses, based on TDF questions. The analysis was performed through five steps including coding discussions transcript, extracting beliefs, selecting relevant domains, matching related constructs to the extracted beliefs, and determining the appropriate theories in each domain. The theory with the highest number of matched domains and constructs was selected as the theory of choice. A total of six domains were identified relevant to ADE reporting, including "Knowledge", "Skills", "Beliefs about consequences", "Motivation and goals", "Environmental context and resources" and "Social influences". We found theory of planned behavior as the comprehensive theory to study factors influencing ADE reporting in hospitals, since it was relevant theory in five out of six relevant domains and the common theory in 55 out of 75 identified beliefs. In conclusion, we suggest theory of planned behavior for further studies on designing appropriate interventions to increase ADE reporting in hospitals.

Mobile phone appropriation in the favelas of Rio de Janeiro, Brazil

DEFF Research Database (Denmark)

de Souza e Silva, Adriana Araujo; Sutko, Daniel; Salis, Fernando

2011-01-01

This qualitative case study describes the social appropriation of mobile phones among low-income communities in Rio de Janeiro (Brazil) by asking how favela (slum) residents appropriate cell phones. Findings highlight the difficulty these populations encounter in acquiring and using cell phones due...

Developing theoretically based and culturally appropriate interventions to promote hepatitis B testing in 4 Asian American populations, 2006-2011.

Science.gov (United States)

Maxwell, Annette E; Bastani, Roshan; Glenn, Beth A; Taylor, Victoria M; Nguyen, Tung T; Stewart, Susan L; Burke, Nancy J; Chen, Moon S

2014-05-01

Hepatitis B infection is 5 to 12 times more common among Asian Americans than in the general US population and is the leading cause of liver disease and liver cancer among Asians. The purpose of this article is to describe the step-by-step approach that we followed in community-based participatory research projects in 4 Asian American groups, conducted from 2006 through 2011 in California and Washington state to develop theoretically based and culturally appropriate interventions to promote hepatitis B testing. We provide examples to illustrate how intervention messages addressing identical theoretical constructs of the Health Behavior Framework were modified to be culturally appropriate for each community. Intervention approaches included mass media in the Vietnamese community, small-group educational sessions at churches in the Korean community, and home visits by lay health workers in the Hmong and Cambodian communities. Use of the Health Behavior Framework allowed a systematic approach to intervention development across populations, resulting in 4 different culturally appropriate interventions that addressed the same set of theoretical constructs. The development of theory-based health promotion interventions for different populations will advance our understanding of which constructs are critical to modify specific health behaviors.

Sensitive radioimmunoassay of total thyroxine (T4) in horses using a simple extraction method.

Science.gov (United States)

Tangyuenyong, Siriwan; Nambo, Yasuo; Nagaoka, Kentaro; Tanaka, Tomomi; Watanabe, Gen

2017-07-28

Most thyroid hormone determinations in animals are based on immunoassays adapted from those used to test human samples, which may not reflect the actual values of thyroid hormone in horses because of the presence of binding proteins. The aims of the present study were i) to establish a novel radioimmunoassay (RIA) using a more simple and convenient method to separate binding proteins for the measurement of total thyroxine (T4) in horses and ii) to validate the assay by comparing total T4 concentrations in yearling horses raised in different climates. Blood samples were collected from trained yearlings in Hokkaido (temperate climate) and Miyazaki (subtropical climate) in Japan and from adult horses in estrus and diestrus. T4 was extracted from both serum and plasma using modified acid ethanol cryo-precipitation and sodium acetate ethanol methods. Circulating total T4 concentrations were determined by RIA. T4 concentration by sodium acetate ethanol was appropriately detectable rather than sodium salicylate method and was the same as for acid ethanol method. Furthermore, this sodium acetate ethanol method required fewer extraction steps than the other methods. Circulating T4 concentrations in yearlings were 225.98 ± 20.89 ng/ml, which was higher than the previous reference values. With respect to climate, T4 levels in Hokkaido yearlings tended to be higher than those in Miyazaki yearlings throughout the study period. These results indicated that this RIA protocol using a modified sodium acetate ethanol separation technique might be an appropriate tool for specific measurement of total T4 in horses.

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information.

Science.gov (United States)

Nitzke, Susan; Freeland-Graves, Jeanne

2007-07-01

It is the position of the American Dietetic Association that the total diet or overall pattern of food eaten is the most important focus of a healthful eating style. All foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity. The American Dietetic Association strives to communicate healthful eating messages to the public that emphasize a balance of foods, rather than any one food or meal. Public policies that support the total diet approach include the Dietary Guidelines for Americans, MyPyramid, the DASH Diet (Dietary Approaches to Stop Hypertension), Dietary Reference Intakes, and nutrition labeling. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthful eating behaviors. Alternative approaches may be necessary in some health conditions. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, lifestyle, time challenges, economics, environment, attitudes and beliefs, social/cultural influences, media, food technology, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, food and nutrition professionals should utilize appropriate behavioral theory and evidence-based strategies. A focus on moderation and proportionality in the context of a healthful lifestyle, rather than specific nutrients or foods, can help reduce consumer confusion. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes.

Explicit appropriate basis function method for numerical solution of stiff systems

International Nuclear Information System (INIS)

Chen, Wenzhen; Xiao, Hongguang; Li, Haofeng; Chen, Ling

2015-01-01

Highlights: • An explicit numerical method called the appropriate basis function method is presented. • The method differs from the power series method for obtaining approximate numerical solutions. • Two cases show the method is fit for linear and nonlinear stiff systems. • The method is very simple and effective for most of differential equation systems. - Abstract: In this paper, an explicit numerical method, called the appropriate basis function method, is presented. The explicit appropriate basis function method differs from the power series method because it employs an appropriate basis function such as the exponential function, or periodic function, other than a polynomial, to obtain approximate numerical solutions. The method is successful and effective for the numerical solution of the first order ordinary differential equations. Two examples are presented to show the ability of the method for dealing with linear and nonlinear systems of differential equations

Evaluating total carrying capacity of tourism using impact indicators

Directory of Open Access Journals (Sweden)

R. Sharma

2016-03-01

Full Text Available The carrying capacity is well identified tool to manage problems due to uncontrolled tourism for any destination. This report highlights the carrying capacity estimation of Kerwa tourism area, Bhopal, India. The methodology used in this report is a new two-tier mechanism of impact analysis using index numbers derived from a survey of 123 stakeholders. From this the individual component impact analysis and the total carrying capacity of the area is computed in order to state the insight of the total carrying capacity left for the tourism activities in Kerwa tourism area. It is calculated from, the results so obtained, that the Kerwa catchment area falls in “very low impact category” and hence in a healthy state of the artwork in terms of total carrying capacity. The study conveys the current need in the destination management and tourism development as a road map for the destination managers for implementing sustainable tourism.

16 CFR 801.11 - Annual net sales and total assets.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Annual net sales and total assets. 801.11 Section 801.11 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND... person; and (2) The total assets of a person shall be as stated on the last regularly prepared balance...

ACR Appropriateness Criteria® Nonvariceal Upper Gastrointestinal Bleeding.

Science.gov (United States)

Singh-Bhinder, Nimarta; Kim, David H; Holly, Brian P; Johnson, Pamela T; Hanley, Michael; Carucci, Laura R; Cash, Brooks D; Chandra, Ankur; Gage, Kenneth L; Lambert, Drew L; Levy, Angela D; Oliva, Isabel B; Peterson, Christine M; Strax, Richard; Rybicki, Frank J; Dill, Karin E

2017-05-01

Upper gastrointestinal bleeding (UGIB) remains a significant cause of morbidity and mortality with mortality rates as high as 14%. This document addresses the indications for imaging UGIB that is nonvariceal and unrelated to portal hypertension. The four variants are derived with respect to upper endoscopy. For the first three, it is presumed that upper endoscopy has been performed, with three potential initial outcomes: endoscopy reveals arterial bleeding source, endoscopy confirms UGIB without a clear source, and negative endoscopy. The fourth variant, "postsurgical and traumatic causes of UGIB; endoscopy contraindicated" is considered separately because upper endoscopy is not performed. When endoscopy identifies the presence and location of bleeding but bleeding cannot be controlled endoscopically, catheter-based arteriography with treatment is an appropriate next study. CT angiography (CTA) is comparable with angiography as a diagnostic next step. If endoscopy demonstrates a bleed but the endoscopist cannot identify the bleeding source, angiography or CTA can be typically performed and both are considered appropriate. In the event of an obscure UGIB, angiography and CTA have been shown to be equivalent in identifying the bleeding source; CT enterography may be an alternative to CTA to find an intermittent bleeding source. In the postoperative or traumatic setting when endoscopy is contraindicated, primary angiography, CTA, and CT with intravenous contrast are considered appropriate. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to

Mind-Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind-Related Comments Independently Predict Infant-Mother Attachment in a Socially Diverse Sample

Science.gov (United States)

Meins, Elizabeth; Fernyhough, Charles; de Rosnay, Marc; Arnott, Bronia; Leekam, Susan R.; Turner, Michelle

2012-01-01

In a socially diverse sample of 206 infant-mother pairs, we investigated predictors of infants' attachment security at 15 months, with a particular emphasis on mothers' tendency to comment appropriately or in a non-attuned manner on their 8-month-olds' internal states (so-called mind-mindedness). Multinomial logistic regression analyses showed…

ACR Appropriateness Criteria® Breast Cancer Screening.

Science.gov (United States)

Mainiero, Martha B; Moy, Linda; Baron, Paul; Didwania, Aarati D; diFlorio, Roberta M; Green, Edward D; Heller, Samantha L; Holbrook, Anna I; Lee, Su-Ju; Lewin, Alana A; Lourenco, Ana P; Nance, Kara J; Niell, Bethany L; Slanetz, Priscilla J; Stuckey, Ashley R; Vincoff, Nina S; Weinstein, Susan P; Yepes, Monica M; Newell, Mary S

2017-11-01

Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State.

Science.gov (United States)

Ahmed, Selena; Byker Shanks, Carmen

2017-08-17

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores ( p vegetable TP scores ( p vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health.

Appropriation and educational uses of cell phones by students and university teachers

Directory of Open Access Journals (Sweden)

Javier Organista Sandoval

2013-12-01

Full Text Available Abstract This article presents a study on appropriation and educational uses of cell phones. For the research, a random sample of 954 students and 246 teachers was selected, representing respectively 12% and 24% of the total population in two facilities of UABC in Ensenada, Mexico. Our survey showed that 97% of teachers or students have some kind of cell phone or smartphone. However, we observed that one of every four interactions with the mobile device had a concrete educational purpose. We also found that in general the educational use of the cell phone is mainly aimed to establish communication between the students and to access information via Internet. However, in spite of its limitations, our results show that the cell phone is a technological tool with great pedagogical potential. We suggest that institutional policies are necessary in order to tap that the cell phone potential to adequately support the teaching-learning process.

[Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

Science.gov (United States)

Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Asymmetric Penning trap coherent states

International Nuclear Information System (INIS)

Contreras-Astorga, Alonso; Fernandez, David J.

2010-01-01

By using a matrix technique, which allows to identify directly the ladder operators, the coherent states of the asymmetric Penning trap are derived as eigenstates of the appropriate annihilation operators. They are compared with those obtained through the displacement operator method.

Exploration of Serum 25-Hydroxy Vitamin D in Total Joint Arthroplasty within a Subtropical Climate

Directory of Open Access Journals (Sweden)

Brandon Naylor

2017-10-01

Conclusion: The majority (53.8% of an otherwise classically low risk patient population present with vitamin D insufficiency or deficiency prior to undergoing elective total joint arthroplasty, with elderly non-white patients in the winter months at the highest risk. Appropriate vitamin D management is associated with favorable influences on both skeletal and non-skeletal outcomes. Potential complications of total joint arthroplasty (TJA, including periprosthetic joint infection and aseptic loosening, can possibly be decreased with proper identification and treatment, which can be elucidated by future high quality studies.

Extreme events in total ozone over Arosa – Part 1: Application of extreme value theory

Directory of Open Access Journals (Sweden)

H. E. Rieder

2010-10-01

Full Text Available In this study ideas from extreme value theory are for the first time applied in the field of stratospheric ozone research, because statistical analysis showed that previously used concepts assuming a Gaussian distribution (e.g. fixed deviations from mean values of total ozone data do not adequately address the structure of the extremes. We show that statistical extreme value methods are appropriate to identify ozone extremes and to describe the tails of the Arosa (Switzerland total ozone time series. In order to accommodate the seasonal cycle in total ozone, a daily moving threshold was determined and used, with tools from extreme value theory, to analyse the frequency of days with extreme low (termed ELOs and high (termed EHOs total ozone at Arosa. The analysis shows that the Generalized Pareto Distribution (GPD provides an appropriate model for the frequency distribution of total ozone above or below a mathematically well-defined threshold, thus providing a statistical description of ELOs and EHOs. The results show an increase in ELOs and a decrease in EHOs during the last decades. The fitted model represents the tails of the total ozone data set with high accuracy over the entire range (including absolute monthly minima and maxima, and enables a precise computation of the frequency distribution of ozone mini-holes (using constant thresholds. Analyzing the tails instead of a small fraction of days below constant thresholds provides deeper insight into the time series properties. Fingerprints of dynamical (e.g. ENSO, NAO and chemical features (e.g. strong polar vortex ozone loss, and major volcanic eruptions, can be identified in the observed frequency of extreme events throughout the time series. Overall the new approach to analysis of extremes provides more information on time series properties and variability than previous approaches that use only monthly averages and/or mini-holes and mini-highs.

Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

Science.gov (United States)

Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

2010-01-01

Purpose: Entrepreneurship can refer to business start-up, but now sometimes has wider connotations. This paper aims to explore what entrepreneurship means for the promoters of entrepreneurship education and what might be appropriate for the students who consume it. Design/methodology/approach: The paper assesses the work of NICENT (The Northern…

Audit incorporating avoidability and appropriate intervention can ...

African Journals Online (AJOL)

Audit incorporating avoidability and appropriate intervention can significantly decrease perinatal mortality. H. R. G. Ward, G. R. Howarth, O. J. N. Jennings,. R. C. Pattinson .... 6 months) and seven interns. The study was .... maternity care notes study: a randomized control trial to assess the effects of giving expectant mothers ...

Solid-state lithium battery

Science.gov (United States)

Ihlefeld, Jon; Clem, Paul G; Edney, Cynthia; Ingersoll, David; Nagasubramanian, Ganesan; Fenton, Kyle Ross

2014-11-04

The present invention is directed to a higher power, thin film lithium-ion electrolyte on a metallic substrate, enabling mass-produced solid-state lithium batteries. High-temperature thermodynamic equilibrium processing enables co-firing of oxides and base metals, providing a means to integrate the crystalline, lithium-stable, fast lithium-ion conductor lanthanum lithium tantalate (La.sub.1/3-xLi.sub.3xTaO.sub.3) directly with a thin metal foil current collector appropriate for a lithium-free solid-state battery.

Financial Status of Air Force Expired Year Appropriations

National Research Council Canada - National Science Library

1994-01-01

... Procurement appropriations. In our report on that audit, we found that the Air Force experienced deficits and accounting problems relating to funding upward cost adjustments to obligations when such costs were charged...

Age-Appropriate Immunization (AAI) as an Intractable Issue ...

African Journals Online (AJOL)

Dinesh Kumar

) approved. 30 cluster ... As FI measures coverage for services, but age appropriate ..... providers need to be effectively oriented towards importance of ... planning and management interventions for improving age- ... BMC Health Serv Res.

Preservice and Inservice Teachers' Perceptions of Appropriateness of Teacher Self-Disclosure

Science.gov (United States)

Zhang, Shaoan; Shi, Qingmin; Tonelson, Stephen; Robinson, Jack

2009-01-01

This study investigated preservice and inservice teachers' perceptions of appropriateness of teacher self-disclosure. A sample of 180 preservice teachers and 135 preK-12 teachers participated in the study. Results showed statistically significant differences between the groups of teachers in their perceptions of appropriateness of teacher…

Interior, Environment, and Related Agencies: FY2007 Appropriations

National Research Council Canada - National Science Library

Vincent, Carol H; Bearden, David M; Corn, M. L; Gorte, Ross W; Humphries, Marc; Sheikh, Pervaze A; Whiteman, David L; Boren, Susan; Walke, Roger; Bea, Keith

2007-01-01

... of Health and Human Services. It also includes funding for arts and cultural agencies; the Environmental Protection Agency, which was recently transferred to the appropriations subcommittees that deal with Interior and Related Agencies...

Appropriate tools and methods for tropical microepidemiology: a ...

African Journals Online (AJOL)

Appropriate tools and methods for tropical microepidemiology: a case-study of malaria clustering in Ethiopia. Tedros A Ghebreyesus, Peter Byass, Karen H Witten, Asfaw Getachew, Mitiku Haile, Mekonnen Yohannes, Steven W Lindsay ...

Coordinating Council. Ninth Meeting: Total Quality Management

Science.gov (United States)

1992-01-01

This report summarizes the 9th meeting of the STI Coordinating Council. The council listened to the speakers' understanding of Total Quality Management (TQM) principles and heard stories of successful applications of these principles. Definitions of quality stated were focused on customer satisfaction. Reports presented by the speakers are also included.

Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

Science.gov (United States)

Silvério Marques, Sara; Goldfarb, Eva S.; Deardorff, Julianna; Constantine, Norman A.

2017-01-01

Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field.…

Diligence in determining the appropriate form of stationarity

Directory of Open Access Journals (Sweden)

André Heymans

2014-11-01

Full Text Available Orientation: One of the most vexing problems of modelling time series data is determining the appropriate form of stationarity, as it can have a significant influence on the model’s explanatory properties, which makes interpreting the results problematic. Research purpose: This article challenged the assumption that most financial time series are first differenced stationary. The common difference first, ask questions later approach was revisited by taking a more systematic approach when analysing the statistical properties of financial time series data. Motivation for the study: Since Nelson and Plosser’s (1982 argued that many macroeconomic time series are difference stationary, many econometricians simply differenced data in order to achieve stationarity. However, the inherent properties of time series data have changed over the past 30 years. This necessitates a proper evaluation of the properties of data before deciding on the appropriate course of action, in order to avoid over-differencing which causes variables to lose their explanatory ability that leads to spurious results. Research approach, design and method: This article introduced a rigorous process that enables econometricians to determine the most appropriate form of stationarity, which is led by the underlying statistical properties of several financial and economic variables. Main findings: The results highlighted the importance of consulting the d parameter to makea more informed decision, rather than only assuming that the data are I(1. Evidence also suggested that the appropriate form of stationarity can vary, but emphasises the importance to consider a series to be fractionally differenced. Practical/managerial implications: Only when data are correctly classified and transformed accordingly will the data be neither under- nor over-differenced, thus enhancing the validity of the results generated by statistical models. Contribution/value-add: By utilising this rigorous

Beyond Brazilian Coalition Presidentialism: the Appropriation of the Legislative Agenda

Directory of Open Access Journals (Sweden)

Rafael Silveira e Silva

2014-12-01

Full Text Available Even though they possess several power resources, Brazilian Presidents also elaborate their legislative proposals based upon bills already being processed in Congress through a phenomenon called Appropriation of the legislative agenda. In this paper I examine the conditions under which this phenomenon occurs by means of a typology and a qualitative comparative analysis (QCA. I conclude that Appropriation provides the President with the expansion of the formal support base by controlling the agenda of allied and opposition parties as well as obtaining the "paternity" of several policies already in motion in Congress, thus enabling a public association of the President's actions and his or her party with the possibility of social benefits. Be it in the pursuit of promising agendas or for the maintenance of their own dominance, Appropriation shows that Brazilian Presidents must go beyond coalition presidentialism.

Two schemes of perfect teleportation one-particle state by a three-particle general W state

Institute of Scientific and Technical Information of China (English)

无

2008-01-01

In teleportation, it can be seen that the probability of success is determined by Alice's measurement and quantum channel. If the Alice's measurement is appropriate, the teleportation can be successfully realized with the maximal probability. In accordance with transformation operator, two schemes are proposed for teleportation of an unknown one-particle state via a general W state, through which the successful probability and the fidelity of both schemes reach 1. Furthermore, two optimal matches of orthogonal complete measurement bases are given for teleporting an unknown one-particle state.

Use of total cross sections for obtaining the anisotropic interaction potential in atom--diatom system

International Nuclear Information System (INIS)

Eccles, J.; Secrest, D.

1977-01-01

A study is made of the ''conservation of the total cross section'' and the ''equivalence of the total cross section'' rules for scattering from H 2 . It is shown that these rules are a better approximation than the random phase approximation would indicate. Cross section formulas are given for scattering atoms from m/sub j/ state selected molecules and it is shown that total cross sections for state selected molecules depend on the anisotropic part of the interaction potential, while the spin-averaged total cross section often depends only on the spherically symmetric part of the interaction potential. The total spin-averaged cross section is thus independent of the initial rotation state of the molecule and depends only on the relative collision energy. It is further demonstrated that isotopic substitution, which shifts the center of mass changing the symmetric part of the interaction potential, has too small an effect on the total cross section to be useful as a means of determining the anisotropy of the potential

Implementing Total Quality Management in a University Setting.

Science.gov (United States)

Coate, L. Edwin

1991-01-01

Oregon State University implemented Total Quality Management in nine phases: exploration; establishing a pilot study team; defining customer needs; adopting the breakthrough planning process; performing breakthrough planning in divisions; forming daily management teams; initiating cross-functional pilot projects; implementing cross-functional…

Economic analysis model for total energy and economic systems

International Nuclear Information System (INIS)

Shoji, Katsuhiko; Yasukawa, Shigeru; Sato, Osamu

1980-09-01

This report describes framing an economic analysis model developed as a tool of total energy systems. To prospect and analyze future energy systems, it is important to analyze the relation between energy system and economic structure. We prepared an economic analysis model which was suited for this purpose. Our model marks that we can analyze in more detail energy related matters than other economic ones, and can forecast long-term economic progress rather than short-term economic fluctuation. From view point of economics, our model is longterm multi-sectoral economic analysis model of open Leontief type. Our model gave us appropriate results for fitting test and forecasting estimation. (author)

HANPP Collection: Global Patterns in Human Appropriation of Net Primary Productivity (HANPP)

Data.gov (United States)

National Aeronautics and Space Administration — The Global Patterns in Human Appropriation of Net Primary Productivity (HANPP) portion of the HANPP Collection represents a digital map of human appropriation of net...

Teleportation of an arbitrary three-particle state

Institute of Scientific and Technical Information of China (English)

陈立冰

2002-01-01

We propose two schemes for teleporting an arbitrary three-particle state. In the first scheme, a two-particle state and a three-particle entangled state (both non-maximally entangled states) are used as quantum channels, while in the second scheme, three non-maximally entangled particle pairs are employed as quantum channels. We show that teleportation can be successfully realized with certain probability if a receiver adopts some appropriate unitary transformations. Their success probabilities and the classical communication costs are different.

Validity and reliability of a tool for determining appropriateness of days of stay: an observational study in the orthopedic intensive rehabilitation facilities in Italy.

Directory of Open Access Journals (Sweden)

Aida Bianco

Full Text Available OBJECTIVES: To test the validity and reliability of a tool specifically developed for the evaluation of appropriateness in rehabilitation facilities and to assess the prevalence of appropriateness of the days of stay. METHODS: The tool underwent a process of cross-cultural translation, content validity, and test-retest validity. Two hospital-based rehabilitation wards providing intensive rehabilitation care located in the Region of Calabria, Southern Italy, were randomly selected. A review of medical records on a random sample of patients aged 18 or more was performed. RESULTS: The process of validation resulted in modifying some of the criteria used for the evaluation of appropriateness. Test-retest reliability showed that the agreement and the k statistic for the assessment of the appropriateness of days of stay were 93.4% and 0.82, respectively. A total of 371 patient days was reviewed, and 22.9% of the days of stay in the sample were judged to be inappropriate. The most frequently selected appropriateness criterion was the evaluation of patients by rehabilitation professionals for at least 3 hours on the index day (40.8%; moreover, the most frequent primary reason accounting for the inappropriate days of stay was social and/or family environment issues (34.1%. CONCLUSIONS: The findings showed that the tool used is reliable and have adequate validity to measure the extent of appropriateness of days of stay in rehabilitation facilities and that the prevalence of inappropriateness is contained in the investigated settings. Further research is needed to expand appropriateness evaluation to other rehabilitation settings, and to investigate more thoroughly internal and external causes of inappropriate use of rehabilitation services.

A qualitative study of psychological, social and behavioral barriers to appropriate food portion size control.

Science.gov (United States)

Spence, Michelle; Livingstone, M Barbara E; Hollywood, Lynsey E; Gibney, Eileen R; O'Brien, Sinéad A; Pourshahidi, L Kirsty; Dean, Moira

2013-08-01

Given the worldwide prevalence of overweight and obesity, there is a clear need for meaningful practical healthy eating advice - not only in relation to food choice, but also on appropriate food portion sizes. As the majority of portion size research to date has been overwhelmingly quantitative in design, there is a clear need to qualitatively explore consumers' views in order to fully understand how food portion size decisions are made. Using qualitative methodology this present study aimed to explore consumers' views about factors influencing their portion size selection and consumption and to identify barriers to appropriate portion size control. Ten focus groups with four to nine participants in each were formed with a total of 66 persons (aged 19-64 years) living on the island of Ireland. The semi-structured discussions elicited participants' perceptions of suggested serving size guidance and explored the influence of personal, social and environmental factors on their food portion size consumption. Audiotapes of the discussions were professionally transcribed verbatim, loaded into NVivo 9, and analysed using an inductive thematic analysis procedure. The rich descriptive data derived from participants highlight that unhealthy portion size behaviors emanate from various psychological, social and behavioral factors. These bypass reflective and deliberative control, and converge to constitute significant barriers to healthy portion size control. Seven significant barriers to healthy portion size control were apparent: (1) lack of clarity and irrelevance of suggested serving size guidance; (2) guiltless eating; (3) lack of self-control over food cues; (4) distracted eating; (5) social pressures; (6) emotional eating rewards; and (7) quantification habits ingrained from childhood. Portion size control strategies should empower consumers to overcome these effects so that the consumption of appropriate food portion sizes becomes automatic and habitual.

The taxation of the petroleum products in the appropriation bill for 2001 and the correcting appropriation bill for 2000

International Nuclear Information System (INIS)

2000-01-01

This document provides information on the petroleum products taxation in the framework of the appropriation bills. The following aspects are presented : the utilization of fuels more respectful of the environment, the taxation lightening measures, measures in favor of the transportation sector, the juridical references and elements for the economic situation. (A.L.B.)

Appropriate technology for rural India - solar decontamination of water for emergency settings and small communities.

Science.gov (United States)

Kang, Gagandeep; Roy, Sheela; Balraj, Vinohar

2006-09-01

A commercial solar water heating system was evaluated for its effectiveness in decontaminating drinking water with a view to use in emergency situations. A total of 18 seeding experiments carried out over 6 months with 10(5) to 10(7)Escherichia coli/ml showed that the solar heater produced 125 l of bacteriologically safe water in 4 h when the ambient temperature was above 30 degrees C, with a holding time of at least 2 h. The solar water heating system is inexpensive, easy to transport and set up and could provide safer drinking water for 50 people a day. It would be effective in the decrease and prevention of waterborne disease in emergency situations, and is appropriate for use in small communities.

ED pharmacist monitoring of provider antibiotic selection aids appropriate treatment for outpatient UTI.

Science.gov (United States)

Lingenfelter, Erin; Drapkin, Zachary; Fritz, Kelly; Youngquist, Scott; Madsen, Troy; Fix, Megan

2016-08-01

We sought to determine whether an emergency department (ED) pharmacist could aid in the monitoring and correction of inappropriate empiric antibiotic selection for urinary tract infections in an outpatient ED population. Urine cultures with greater than 100 000 CFU/mL bacteria from the University of Utah Emergency Department over 1 year (October 2011-Sept 2012) were identified using our electronic medical record system. Per ED protocol, an ED pharmacist reviews all cultures and performs a chart review of patient symptoms, diagnosis, and discharge antibiotics to determine whether the treatment was appropriate. A retrospective review of this process was performed to identify how often inappropriate treatment was recognized and intervened on by an ED pharmacist. Of the 180 cultures included, a total of 42 (23%) of empiric discharge treatments were considered inappropriate and required intervention. In 35 (83%) of 42 patients, the ED pharmacist was able to contact the patient and make appropriate changes; the remaining 7 patients were unable to be contacted, and no change could be made in their treatment. A chart review of all urine cultures with greater than 100 000 CFU/mL performed by an ED pharmacist helped identify inappropriate treatment in 23% of patients discharged to home with the diagnosis of urinary tract infection. Of these patients who had received inappropriate treatment, an ED pharmacist was able to intervene in 83% of cases. These data highlight the role of ED pharmacists in improving patient care after discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

Pharmacy-Driven Dexmedetomidine Stewardship and Appropriate Use Guidelines in a Community Hospital Setting.

Science.gov (United States)

Schickli, M Alexandra; Eberwein, Kip A; Short, Marintha R; Ratliff, Patrick D

2017-01-01

Dexmedetomidine is a widely utilized agent in the intensive care unit (ICU) because it does not suppress respiratory drive and may be associated with less delirium than midazolam or propofol. Cost of dexmedetomidine therapy and debate as to the proper duration of use has brought its use to the forefront of discussion. To validate the efficacy and cost savings associated with pharmacy-driven dexmedetomidine appropriate use guidelines and stewardship in mechanically ventilated patients. This was a retrospective cohort study of adult patients who received dexmedetomidine for ICU sedation while on mechanical ventilation at a 433-bed not-for-profit community hospital. Included patients were divided into pre-enactment (PRE) and postenactment (POST) of dexmedetomidine guideline groups. A total of 100 patients (50 PRE and 50 POST) were included in the analysis. A significant difference in duration of mechanical ventilation (11.1 vs 6.2 days, P = 0.006) and incidence of reintubation (36% vs 18% of patients, P = 0.043) was seen in the POST group. Aggregate use of dexmedetomidine 200-µg vials (37.1 vs 18.4 vials, P = 0.010) and infusion days (5.4 vs 2.5 days, P = 0.006) were significantly lower in the POST group. Dexmedetomidine acquisition cost savings were calculated at $374 456.15 in the POST group. There was no difference between the PRE and POST groups with regard to ICU length of stay, expected mortality, and observed mortality. Pharmacy-driven dexmedetomidine appropriate use guidelines decreased the use of dexmedetomidine and increased cost savings at a community hospital without adversely affecting clinical outcomes.

Position of the academy of nutrition and dietetics: total diet approach to healthy eating.

Science.gov (United States)

Freeland-Graves, Jeanne H; Nitzke, Susan

2013-02-01

It is the position of the Academy of Nutrition and Dietetics that the total diet or overall pattern of food eaten is the most important focus of healthy eating. All foods can fit within this pattern if consumed in moderation with appropriate portion size and combined with physical activity. The Academy strives to communicate healthy eating messages that emphasize a balance of food and beverages within energy needs, rather than any one food or meal. Public policies and dietary patterns that support the total diet approach include the 2010 Dietary Guidelines for Americans, DASH (Dietary Approaches to Stop Hypertension) Diet, MyPlate, Let's Move, Nutrition Facts labels, Healthy People 2020, and the Dietary Reference Intakes. In contrast to the total diet approach, classification of specific foods as good or bad is overly simplistic and can foster unhealthy eating behaviors. Alternative approaches are necessary in some situations. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, time and convenience, environment, abundance of foods, economics, media/marketing, perceived product safety, culture, and attitudes/beliefs. To increase the effectiveness of nutrition education in promoting sensible food choices, skilled food and nutrition practitioners utilize appropriate behavioral theory and evidence-based strategies. Focusing on variety, moderation, and proportionality in the context of a healthy lifestyle, rather than targeting specific nutrients or foods, can help reduce consumer confusion and prevent unnecessary reliance on supplements. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Lead exposure in radiator repair workers: a survey of Washington State radiator repair shops and review of occupational lead exposure registry data.

Science.gov (United States)

Whittaker, Stephen G

2003-07-01

Radiator repair workers in Washington State have the greatest number of very elevated (> or =60 microg/dL) blood lead levels of any other worker population. The goals of this study were to determine the number of radiator repair workers potentially exposed to lead; estimate the extent of blood lead data underreporting to the Occupational Lead Exposure Registry; describe current safety and health practices in radiator repair shops; and determine appropriate intervention strategies to reduce exposure and increase employer and worker awareness. Lead exposure in Washington State's radiator repair workers was assessed by reviewing Registry data and conducting a statewide survey of radiator repair businesses. This study revealed that a total of 226 workers in Washington State (including owner-operators and all employees) conduct repair activities that could potentially result in excessive exposures to lead. Approximately 26% of radiator repair workers with elevated blood lead levels (> or =25 microg/dL) were determined to report to Washington State's Registry. This study also revealed a lack of awareness of lead's health effects, appropriate industrial hygiene controls, and the requirements of the Lead Standard. Survey respondents requested information on a variety of workplace health and safety issues and waste management; 80% requested a confidential, free-of-charge consultation. Combining data derived from an occupational health surveillance system and a statewide mail survey proved effective at characterizing lead exposures and directing public health intervention in Washington State.

Schistosomiasis in the Amazon region: is the current diagnostic strategy still appropriate?

OpenAIRE

Sousa, Sergei Rodrigo Magalhães de; Carvalho, Alessandra de Queiroz; Cardoso, Joyce Favacho Nogueira; Coelho, Paulo Marcos Zech; Geiger, Stefan Michael; Enk, Martin Johannes

2017-01-01

Abstract INTRODUCTION: This study analyzed the performance of the Kato Katz technique in detecting intestinal schistosomiasis in the State of Pará. METHODS: Of three stool samples provided by each of 380 participants, a total of 16 Kato Katz slides were examined to define the reference value (RV) of positives for comparisons. RESULTS: The RV revealed 37 (9.7%) infected participants in contrast to 10 (2.6%) according to a single slide. CONCLUSIONS: This significant underestimation of t...

The revised geometric measure of entanglement for isotropic state

International Nuclear Information System (INIS)

Cao Ya

2011-01-01

Based on the revised geometric measure of entanglement (RGME), we obtain the analytical expression of isotropic state and generalize to n-particle and d-dimension mixed state case. Meantime, we obtain the relation about isotropic state E-tilde sin 2 (ρ) ≤ E re (ρ). The results indicate RGME is an appropriate measure of entanglement. (authors)

Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)

2014-11-15

Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

Study on the most appropriate time for romurtide administration (Nopia) in radiotherapy patients

International Nuclear Information System (INIS)

Yokouchi, Junichi; Hirabayashi, Shoji; Kanesaka, Naoto; Baba, Seiko; Amino, Masayuki; Abe, Kimihiko

1997-01-01

The most appropriate time for administration was studied based on examination of the total number of leukocytes, differential white blood count, and the number of platelets in 30 cases in which 200 μg Romurtide (Nopia) was injected subcutaneously on the day of radiotherapy, 5 times a week, for 2 weeks, totally 10 times because leukopenia was caused during treatment with radiotherapy. It was recognized that the number of leukocytes, mainly neutrophils, increased from 1 week after starting administration of Romurtide to after the completion of administration (2 weeks after administration), except 1 week after completion of administration. The increasing effect in the number of platelets was not recognized, and it had decreased from at the completion of administration to 1 week after the completion of administration of Romurtide. The rate of completion of radiotherapy was 100% without any serious adverse events, but there were 4 cases in which fever was observed. Therefore, it is not very favorable to administer Romurtide immediately after radiation, taking account of the treatment period of radiotherapy. It is also considered that it would be necessary to start radiation after sufficient recovery of the number of leukocytes or increase in their number by using G-CSF preparation in cases in which the leukocyte count has fallen since starting radiation due to the influence of the preceding chemotherapy. (author)

Counterterrorism and cybersecurity total information awareness

CERN Document Server

Lee, Newton

2013-01-01

Provides a broad survey of the United States' counterterrorism history, the use of artificial intelligence in data mining, social media and privacy, cyber attacks and prevention, and longstanding issues of war and peace Closely examines how Total Information Awareness, a governmental data mining project focused on scanning public and private data, plays an integral role in cybersecurity Analyzes recent cyberattacks across the globe orchestrated by 'hacktivist' groups, such as Anonymous

Dynamic effect of total solid content, low substrate/inoculum ratio and particle size on solid-state anaerobic digestion.

Science.gov (United States)

Motte, J-C; Escudié, R; Bernet, N; Delgenes, J-P; Steyer, J-P; Dumas, C

2013-09-01

Among all the process parameters of solid-state anaerobic digestion (SS-AD), total solid content (TS), inoculation (S/X ratio) and size of the organic solid particles can be optimized to improve methane yield and process stability. To evaluate the effects of each parameter and their interactions on methane production, a three level Box-Behnken experimental design was implemented in SS-AD batch tests degrading wheat straw by adjusting: TS content from 15% to 25%, S/X ratio (in volatile solids) between 28 and 47 and particle size with a mean diameter ranging from 0.1 to 1.4mm. A dynamic analysis of the methane production indicates that the S/X ratio has only an effect during the start-up phase of the SS-AD. During the growing phase, TS content becomes the main parameter governing the methane production and its strong interaction with the particle size suggests the important role of water compartmentation on SS-AD. Copyright © 2013 Elsevier Ltd. All rights reserved.

Total Atheism: Making 'Mental Revolution' in South India

NARCIS (Netherlands)

Binder, S.

2017-01-01

The dissertation titled “Total Atheism: Making ‘mental revolution’ in South India” is an anthropological study of an organised atheist movement in the two South Indian states of Andhra Pradesh and Telangana. This movement consists of groups and individuals who self-identify as atheists,

Total L-shell X-ray production cross sections by 400-700 keV proton impact for elements with 34≤Z≤53

International Nuclear Information System (INIS)

Miranda, J.; Ledesma, R.; Lucio, O.G. de

2001-01-01

Total L-shell X-ray production cross sections induced by protons with energies between 400 and 700 keV were measured for elements with atomic number Z between 34 and 53. The ECPSSR theory describes appropriately the results. This model modifies the plane wave born approximation by considering projectile energy loss (E), Coulomb deflection of the incoming ion (C), polarization and change in electron binding energies through a perturbed stationary states method (PSS) and relativistic values of target electron mass (R). A comparison is given with previously published data for proton energies below 1 MeV and 26 ≤ Z ≤ 53, based on a scaling obtained from a reduced velocity parameter ξ L R . The results show that the scaling for these atomic numbers and energy ranges is adequate and a semi-empirical expression to calculate those cross sections is proposed

Two-channel totally asymmetric simple exclusion processes

International Nuclear Information System (INIS)

Pronina, Ekaterina; Kolomeisky, Anatoly B

2004-01-01

Totally asymmetric simple exclusion processes, consisting of two coupled parallel lattice chains with particles interacting with hard-core exclusion and moving along the channels and between them, are considered. In the limit of strong coupling between the channels, the particle currents, density profiles and a phase diagram are calculated exactly by mapping the system into an effective one-channel totally asymmetric exclusion model. For intermediate couplings, a simple approximate theory, that describes the particle dynamics in vertical clusters of two corresponding parallel sites exactly and neglects the correlations between different vertical clusters, is developed. It is found that, similarly to the case of one-channel totally asymmetric simple exclusion processes, there are three stationary state phases, although the phase boundaries and stationary properties strongly depend on inter-channel coupling. Extensive computer Monte Carlo simulations fully support the theoretical predictions

Infliximab for Crohn's disease in the Swiss IBD Cohort Study: clinical management and appropriateness.

Science.gov (United States)

Juillerat, Pascal; Pittet, Valérie; Vader, John-Paul; Burnand, Bernard; Gonvers, Jean-Jacques; de Saussure, Philippe; Mottet, Christian; Seibold, Frank; Rogler, Gerhard; Sagmeister, Markus; Felley, Christian; Michetti, Pierre; Froehlich, Florian

2010-11-01

Antitumor necrosis factor a agents have significantly improved the management of Crohn's disease (CD), but not all patients benefit from this therapy. We used data from the Swiss Inflammatory Bowel Disease Cohort Study and predefined appropriateness criteria to examine the appropriateness of use of infliximab (IFX) in CD patients. EPACT II (European Panel on the Appropriateness of CD Therapy, 2007; www.epact.ch) appropriateness criteria have been developed using a formal explicit panel process combining evidence from the published literature and expert opinion. Questionnaires relating to EPACT II criteria were used at enrollment and follow-up of all Swiss Inflammatory Bowel Disease Cohort Study patients. A step-by-step analysis of all possible indications for IFX therapy in a given patient allowed identification of the most appropriate indication and final classification in a single appropriateness category (appropriate, uncertain, inappropriate). Eight hundred and twenty-one CD patients were prospectively enrolled between November 2006 and March 2009. IFX was administered to 146 patients (18%) at enrollment and was most frequently used for complex fistulizing disease and for the maintenance of remission induced by biological therapy. IFX therapy was considered appropriate in 44%, uncertain in 44%, and inappropriate in 10% of patients. In this cohort, 9 out of 10 indications for IFX therapy were clinically generally acceptable (appropriate or uncertain) according to EPACT II criteria. Uncertain indications resulted mainly from the current more liberal use of IFX in clinical practice as compared with the EPACT II criteria.

7 CFR 1948.82 - Plan and State Investment Strategy approval procedure.

Science.gov (United States)

2010-01-01

... the State Investment Strategy for Energy Impacted Areas. (c) Appropriate growth management and/or... 7 Agriculture 13 2010-01-01 2009-01-01 true Plan and State Investment Strategy approval procedure... Impacted Area Development Assistance Program § 1948.82 Plan and State Investment Strategy approval...

77 FR 5614 - Department of State FY11 Service Contract Inventory

Science.gov (United States)

2012-02-03

... DEPARTMENT OF STATE [Public Notice 7785] Department of State FY11 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory.../ . Section 743 of Division C of the FY 2010 Consolidated Appropriations Act, Public Law 111-117, requires...

Guideline for appropriate use of cardiac CT in heart disease

International Nuclear Information System (INIS)

Kim, Young Jin; Hong, Yoo Jin; Yong, Hwan Seok; Kim, Sung Mok; Kim, Jeong A; Yang, Dong Hyun

2014-01-01

Heart disease is one of the leading causes of deaths in Korea, along with malignant neoplasms and cerebrovascular diseases. The proper diagnosis and management for patients with suspected heart diseases should be warranted for the public health care. Advances in CT technology have allowed detailed images of the heart to be obtained, which enable evaluations not only of the coronary arteries but also of other cardiac structures. Currently, the latest multi-detector CT machines are widespread around Korea. The appropriate use of cardiac CT may lead to improvements of the physicians' medical performances and to reduce medical costs which eventually contribute to promotions of public health. However, until now, there has been no guidelines regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist the clinicians and other health professionals when using cardiac CT for diagnosis and treatments of heart diseases.

The Yerkes-Dodson law and appropriate stimuli for conditioned taste aversion in Lymnaea.

Science.gov (United States)

Ito, Etsuro; Yamagishi, Miki; Takigami, Satoshi; Sakakibara, Manabu; Fujito, Yutaka; Lukowiak, Ken

2015-02-01

The pond snail Lymnaea stagnalis can learn conditioned taste aversion and then consolidate it into long-term memory (LTM). A high-voltage electric shock was used as the unconditioned stimulus, where we have previously used KCl. We varied the strength of both the conditioned and unconditioned stimuli to determine whether the so-called Yerkes-Dodson law prevailed. This is an empirical relationship between the state of arousal and LTM formation, showing that there is an optimal level of arousal leading to memory formation. However, too little or too much arousal results in poorer LTM. We found here that the most appropriate stimuli to use in taste aversion training in Lymnaea were a 10 mmol l(-1) sucrose solution as the conditioned stimulus and a 3 s electric shock as the unconditioned stimulus. © 2015. Published by The Company of Biologists Ltd.

Increase of content and bioactivity of total phenolic compounds from spent coffee grounds through solid state fermentation by Bacillus clausii.

Science.gov (United States)

Rochín-Medina, Jesús J; Ramírez, Karina; Rangel-Peraza, Jesús G; Bustos-Terrones, Yaneth A

2018-03-01

Spent coffee grounds are waste material generated during coffee beverage preparation. This by-product disposal causes a negative environmental impact, in addition to the loss of a rich source of nutrients and bioactive compounds. A rotating central composition design was used to determine the optimal conditions for the bioactivity of phenolic compounds obtained after the solid state fermentation of spent coffee grounds by Bacillus clausii . To achieve this, temperature and fermentation time were varied according to the experimental design and the total phenolic and flavonoid content, antioxidant activity and antimicrobial activity were determined. Surface response methodology showed that optimum bioprocessing conditions were a temperature of 37 °C and a fermentation time of 39 h. Under these conditions, total phenolic and flavonoid contents increased by 36 and 13%, respectively, in fermented extracts as compared to non-fermented. In addition, the antioxidant activity was increased by 15% and higher antimicrobial activity was observed against Gram positive and negative bacteria. These data demonstrated that bioprocessing optimization of spent coffee grounds using the surface response methodology was an important tool to improve phenolic extraction, which could be used as an antioxidant and antimicrobial agents incorporated into different types of food products.

Total Mini-Mental State Examination score and regional cerebral blood flow using Z score imaging and automated ROI analysis software in subjects with memory impairment

International Nuclear Information System (INIS)

Ikeda, Eiji; Shiozaki, Kazumasa; Takahashi, Nobukazu; Togo, Takashi; Odawara, Toshinari; Oka, Takashi; Inoue, Tomio; Hirayasu, Yoshio

2008-01-01

The Mini-Mental State Examination (MMSE) is considered a useful supplementary method to diagnose dementia and evaluate the severity of cognitive disturbance. However, the region of the cerebrum that correlates with the MMSE score is not clear. Recently, a new method was developed to analyze regional cerebral blood flow (rCBF) using a Z score imaging system (eZIS). This system shows changes of rCBF when compared with a normal database. In addition, a three-dimensional stereotaxic region of interest (ROI) template (3DSRT), fully automated ROI analysis software was developed. The objective of this study was to investigate the correlation between rCBF changes and total MMSE score using these new methods. The association between total MMSE score and rCBF changes was investigated in 24 patients (mean age±standard deviation (SD) 71.5±9.2 years; 6 men and 18 women) with memory impairment using eZIS and 3DSRT. Step-wise multiple regression analysis was used for multivariate analysis, with the total MMSE score as the dependent variable and rCBF change in 24 areas as the independent variable. Total MMSE score was significantly correlated only with the reduction of left hippocampal perfusion but not with right (P<0.01). Total MMSE score is an important indicator of left hippocampal function. (author)

Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

DEFF Research Database (Denmark)

Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian

2012-01-01

building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful...

Appropriate assessment of English language competency for South ...

African Journals Online (AJOL)

Appropriate assessment of English language competency for South African teachers-in-training. ... albeit having regard to learner attitudes and purposes. The paper concludes that using the new communicative methods of language testing with foundation phase teachers-in-training may improve classroom practice.

Herbal dietary supplements and knowledge of appropriate use ...

African Journals Online (AJOL)

%) and Aloe vera (32.2%). Fifty eight (71.6%) out of the 81 respondents on prescription drugs were using it alongside HDS. Respondents with poor, fair and good knowledge of appropriate use of HDS were 69.1%, 27.3% and 3.6% respectively.

Evaluation of appropriate technologies for grey water treatments and reuses.

Science.gov (United States)

Li, Fangyue; Wichmann, Knut; Otterpohl, Ralf

2009-01-01

As water is becoming a rare resource, the onsite reuse and recycling of grey water is practiced in many countries as a sustainable solution to reduce the overall urban water demand. However, the lack of appropriate water quality standards or guidelines has hampered the appropriate grey water reuses. Based on literature review, a non-potable urban grey water treatment and reuse scheme is proposed and the treatment alternatives for grey water reuse are evaluated according to the grey water characteristics, the proposed standards and economical feasibility.

ACR Appropriateness Criteria® rib fractures.

Science.gov (United States)

Henry, Travis S; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Parker, J Anthony; Ravenel, James G; Restrepo, Carlos Santiago; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D; Mohammed, Tan-Lucien H

2014-11-01

Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Live Streaming of the Moon's Shadow from the Edge of Space across the United States during the August 2017 Total Solar Eclipse

Science.gov (United States)

Guzik, T. G.

2017-12-01

On August 21, 2017 approximately 55 teams across the path of totality of the eclipse across America will use sounding balloon platforms to transmit, in real-time from an altitude of 90,000 feet, HD video of the moon's shadow as it crosses the U.S. from Oregon to South Carolina. This unprecedented activity was originally organized by the Montana Space Grant Consortium in order to 1) use the rare total eclipse event to captivate the imagination of students and encourage the development of new ballooning teams across the United States, 2) provide an inexpensive high bandwidth data telemetry system for real-time video streaming, and 3) establish the basic infrastructure at multiple institutions enabling advanced "new generation" student ballooning projects following the eclipse event. A ballooning leadership group consisting of Space Grant Consortia in Montana, Colorado, Louisiana, and Minnesota was established to support further development and testing of the systems, as well as to assist in training the ballooning teams. This presentation will describe the high bandwidth telemetry system used for the never before attempted live streaming of HD video from the edge of space, the results of this highly collaborative science campaign stretching from coast-to-coast, potential uses of the data telemetry system for other student science projects, and lessons learned that can be applied to the 2024 total solar eclipse.

ACR Appropriateness Criteria Assessment of Fetal Well-Being.

Science.gov (United States)

Simpson, Lynn; Khati, Nadia J; Deshmukh, Sandeep P; Dudiak, Kika M; Harisinghani, Mukesh G; Henrichsen, Tara L; Meyer, Benjamin J; Nyberg, David A; Poder, Liina; Shipp, Thomas D; Zelop, Carolyn M; Glanc, Phyllis

2016-12-01

Although there is limited evidence that antepartum testing decreases the risk for fetal death in low-risk pregnancies, women with high-risk factors for stillbirth should undergo antenatal fetal surveillance. The strongest evidence supporting antepartum testing pertains to pregnancies complicated by intrauterine fetal growth restriction secondary to uteroplacental insufficiency. The main ultrasound-based modalities to determine fetal health are the biophysical profile, modified biophysical profile, and duplex Doppler velocimetry. In patients at risk for cardiovascular compromise, fetal echocardiography may also be indicated to ensure fetal well-being. Although no single antenatal test has been shown to be superior, all have high negative predictive values. Weekly or twice-weekly fetal testing has become the standard practice in high-risk pregnancies. The timing for the initiation of assessments of fetal well-being should be tailored on the basis of the risk for stillbirth and the likelihood of survival with intervention. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (the RAND/UCLA Appropriateness Method and the Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Cost and appropriateness of treating asthma with fixed-combination drugs in local health care units in Italy

Directory of Open Access Journals (Sweden)

Ruggeri I

2012-12-01

Full Text Available Isabella Ruggeri,1 Donatello Bragato,2 Giorgio L Colombo,3,4 Emanuela Valla,3 Sergio Di Matteo41Servizio Governo Area Farmaceutica, Azienda Sanitaria Locale, Milano, Binasco, 2Data Solution Provider, Milan, 3University of Pavia, Department of Drug Sciences, School of Pharmacy, 4Studi Analisi Valutazioni Economiche, MilanBackground: Bronchial asthma is a chronic airways disease and is considered to be one of the major health problems in the Western world. During the last decade, a significant increase in the use of β2-agonists in combination with inhaled corticosteroids has been observed. The aim of this study was to assess the appropriateness of expenditure on these agents in an asthmatic population treated in a real practice setting.Methods: This study used data for a resident population of 635,906 citizens in the integrated patient database (Banca Dati Assistito of a local health care unit (Milano 2 Azienda Sanitaria Locale in the Lombardy region over 3 years (2007–2009. The sample included 3787–4808 patients selected from all citizens aged ≥ 18 years entitled to social security benefits, having a prescription for a corticosteroid + β2-agonist combination, and an ATC code corresponding to R03AK, divided into three groups, ie, pressurized (spray drugs, inhaled powders, and extrafine formulations. Patients with chronic obstructive lung disease were excluded. Indicators of appropriateness were 1–3 packs per year (underdosed, inappropriate, 4–12 packs per year (presumably appropriate, and ≥13 packs per year (overtreatment, inappropriate.Results: The corticosteroid + β2-agonist combination per treated asthmatic patient increased from 37% in 2007 to 45% in 2009 for the total of prescribed antiasthma drugs, and 28%–32% of patients used the drugs in an appropriate manner (4–12 packs per years. The cost of inappropriately used packs increased combination drug expenditure by about 40%, leading to inefficient use of health care

76 FR 9399 - Department of State FY10 Service Contract Inventory

Science.gov (United States)

2011-02-17

... DEPARTMENT OF STATE [Public Notice 7321] Department of State FY10 Service Contract Inventory... Contract Inventory. SUMMARY: The Department of State has publically released its Service Contract Inventory for FY10. Section 743 of Division C of the FY 2010 Consolidated Appropriations Act, Public Law 111-117...

49 CFR 22.15 - Delinquency on Federal, State, or Municipality Debt.

Science.gov (United States)

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Delinquency on Federal, State, or Municipality... PROGRAM (STLP) Policies Applying to STLP Loans § 22.15 Delinquency on Federal, State, or Municipality Debt... appropriate Federal and State databases. (b) If any delinquencies are determined during the application...

Vitamin D metabolites in captivity? Should we measure free or total 25(OH)D to assess vitamin D status?

Science.gov (United States)

Bikle, Daniel; Bouillon, Roger; Thadhani, Ravi; Schoenmakers, Inez

2017-10-01

There is general consensus that serum 25(OH)D is the best biochemical marker for nutritional vitamin D status. Whether free 25(OH)D would be a better marker than total 25(OH)D is so far unclear. Free 25(OH)D can either be calculated based on the measurement of the serum concentrations of total 25(OH)D, vitamin D-binding protein (DBP), albumin, and the affinity between 25(OH)D and its binding proteins in physiological situations. Free 25(OH)D can also be measured directly by equilibrium dialysis, ultrafitration or immunoassays. During the vitamin D workshop held in Boston in March 2016, a debate was organized about the measurements and clinical value of free 25(OH)D, and this debate is summarized in the present manuscript. Overall there is consensus that most cells apart from the renal tubular cells are exposed to free rather than to total 25(OH)D. Therefore free 25(OH)D may be highly relevant for the local production and action of 1,25(OH) 2 D. During the debate it became clear that there is a need for standardization of measurements of serum DBP and of direct measurements of free 25(OH)D. There seems to be very limited genetic or racial differences in DBP concentrations or (probably) in the affinity of DBP for its major ligands. Therefore, free 25(OH)D is strongly correlated to total 25(OH)D in most normal populations. Appropriate studies are needed to define the clinical implications of free rather than total 25(OH)D in normal subjects and in disease states. Special attention is needed for such studies in cases of abnormal DBP concentrations or when one could expect changes in its affinity for its ligands. Copyright © 2017. Published by Elsevier Ltd.

Water Quality Assessment and Total Maximum Daily Loads Information (ATTAINS)

Data.gov (United States)

U.S. Environmental Protection Agency — The Water Quality Assessment TMDL Tracking And Implementation System (ATTAINS) stores and tracks state water quality assessment decisions, Total Maximum Daily Loads...

TOTAL KNEE REPLACEMENT IN PATIENTS WITH BELOW-KNEE AMPUTATION

Science.gov (United States)

Karam, Matthew D; Willey, Michael; Shurr, Donald G

2010-01-01

Total knee replacement (TKR) is reserved for patients with severe and disabling arthritis that is non-responsive to conservative measures. Based on existing data, total knee replacement is a safe and cost-effective treatment for alleviating pain and improving physical function in patients who do not respond to conservative therapy. Despite the large variation in health status of patients and types of prosthesis implanted, total knee replacement has proven to be a relatively low risk and successful operation. Each year in the United States surgeons perform approximately 300,000 TKR.1 Likewise, lower extremity amputation is commonly performed in the United States with an annual incidence of 110,000 per year.2 Nearly 70% of all lower extremity amputations are performed as the result of chronic vascular disease, followed by trauma (22%), congenital etiology and tumor (4% each).3 Approximately 50% of all lower extremity amputations are performed secondary to complications from Diabetes Mellitus. Norvell et al. demonstrated that patients who have previously undergone transtibial amputation and ambulate with a prosthesis are more likely to develop degenerative joint disease in the con-tralateral extremity than the ipsilateral extremity.4 Further, radiographic changes consistent with osteoporosis have been demonstrated in up to 88% of limbs that have undergone transtibial amputation.8 To our knowledge, there have been only three reported cases of total knee replacement in patients with ipsilateral transtibial amputation.5,7 The purpose of the present study is to review the existing data on total knee replacement in patients who have undergone transtibial amputation. Further we present a patient with a transtibial amputation who underwent contralateral total knee replacement. PMID:21045987

Counselling as a psychological approach to fostering appropriate ...

African Journals Online (AJOL)

The focus of this paper is on counselling as a psychological approach to fostering appropriate learning behaviour in Nigerian secondary school students. The paper drew attention to the confrontation, mentoring, behavioural, appraisal, and standards blending models to appeal to the consciences of students with ...

Multiparticle states in deformed special relativity

International Nuclear Information System (INIS)

Hossenfelder, S.

2007-01-01

We investigate the properties of multiparticle states in deformed special relativity (DSR). Starting from the Lagrangian formalism with an energy dependent metric, the conserved Noether current can be derived which is additive in the usual way. The integrated Noether current had previously been discarded as a conserved quantity, because it was correctly realized that it does no longer obey the DSR transformations. We identify the reason for this mismatch in the fact that DSR depends only on the extensive quantity of total four momentum instead of the energy-momentum densities as would be appropriate for a field theory. We argue that the reason for the failure of DSR to reproduce the standard transformation behavior in the well established limits is due to the missing sensitivity to the volume inside which energy is accumulated. We show that the soccer-ball problem is absent if one formulates DSR instead for the field densities. As a consequence, estimates for predicted effects have to be corrected by many orders of magnitude. Further, we derive that the modified quantum field theory implies a locality bound

Adoption, adaptation, and abandonment: Appropriation of science education professional development learning

Science.gov (United States)

Longhurst, Max L.

Understanding factors that impact teacher utilization of learning from professional development is critical in order maximize the educational and financial investment in teacher professional learning. This study used a multicase mixed quantitative and qualitative methodology to investigate the factors that influence teacher adoption, adaption, or abandonment of learning from science teacher professional development. The theoretical framework of activity theory was identified as a useful way to investigate the phenomenon of teacher appropriation of pedagogical practices from professional development. This framework has the capacity to account for a multitude of elements in the context of a learning experience. In this study educational appropriation is understood through a continuum of how an educator acquires and implements both practical and conceptual aspects of learning from professional development within localized context. The variability associated with instructional changes made from professional development drives this inquiry to search for better understandings of the appropriation of pedagogical practices. Purposeful sampling was used to identify two participants from a group of eighth-grade science teachers engaged in professional development designed to investigate how cyber-enabled technologies might enhance instruction and learning in integrated science classrooms. The data from this investigation add to the literature of appropriation of instructional practices by connecting eight factors that influence conceptual and practical tools with the development of ownership of pedagogical practices in the appropriation hierarchy. Recommendations are shared with professional development developers, providers, and participants in anticipation that future science teaching experiences might be informed by findings from this study.

Providing Appropriate Technology for Emerging Markets: Case Study on China’s Solar Thermal Industry

Directory of Open Access Journals (Sweden)

Jianghua Zhou

2017-01-01

Full Text Available Building on a case study of five Chinese solar thermal companies and one association, our study aims to understand how the innovator’s choices regarding the use of technology and organizational practices for new product development enable companies to design and diffuse appropriate technology in emerging markets. The study uncovers two critical factors that enhance the appropriateness of technology: redefining the identity of technology and building a local supply system. Our analysis shows that synergic innovation in both architecture and component leads to the appropriate functionalities desired by emerging markets. Moreover, modular design and the building of a local supply system enhance the process appropriateness of technology. Our study provides an empirical basis for advocating going beyond minor adaptations of existing products to creating appropriate technology for emerging markets, and extends our understandings of the upstream process of designing appropriate technology. Moreover, the emphasis on the local supply system reflects a holistic framework for shaping and delivering appropriate technology, expanding the existing research focus on the perspective of the technology itself. Our research also has managerial implications that may help firms tap into emerging markets.

How does sagittal imbalance affect the appropriateness of surgical indications and selection of procedure in the treatment of degenerative scoliosis? Findings from the RAND/UCLA Appropriate Use Criteria study.

Science.gov (United States)

Daubs, Michael D; Brara, Harsimran S; Raaen, Laura B; Chen, Peggy Guey-Chi; Anderson, Ashaunta T; Asch, Steven M; Nuckols, Teryl K

2018-05-01

Degenerative lumbar scoliosis (DLS) is often associated with sagittal imbalance, which may affect patients' health outcomes before and after surgery. The appropriateness of surgery and preferred operative approaches has not been examined in detail for patients with DLS and sagittal imbalance. The goals of this article were to describe what is currently known about the relationship between sagittal imbalance and health outcomes among patients with DLS and to determine how indications for surgery in patients with DLS differ when sagittal imbalance is present. This study included a literature review and an expert panel using the RAND/University of California at Los Angeles (UCLA) Appropriateness Method. To develop appropriate use criteria for DLS, researchers at the RAND Corporation recently employed the RAND/UCLA Appropriateness Method, which involves a systematic review of the literature and multidisciplinary expert panel process. Experts reviewed a synopsis of published literature and rated the appropriateness of five common operative approaches for 260 different clinical scenarios. In the present work, we updated the literature review and compared panelists' ratings in scenarios where imbalance was present versus absent. This work was funded by the Collaborative Spine Research Foundation, a group of surgical specialty societies and device manufacturers. On the basis of 13 eligible studies that examined sagittal imbalance and outcomes in patients with DLS, imbalance was associated with worse functional status in the absence of surgery and worse symptoms and complications postoperatively. Panelists' ratings demonstrated a consistent pattern across the diverse clinical scenarios. In general, when imbalance was present, surgery was more likely to be appropriate or necessary, including in some situations where surgery would otherwise be inappropriate. For patients with moderate to severe symptoms and imbalance, a deformity correction procedure was usually appropriate

High resolution neutron total and capture cross-sections in separated isotopes of copper (6365Cu)

International Nuclear Information System (INIS)

Pandey, M.S.

1975-01-01

High resolution neutron total and capture cross section measurements have been performed on separated isotopes of copper ( 63 65 Cu). Measurements for capture cross section were made from about 1 keV to a few hundreds of keV. The total cross section measurements were made in the energy interval of approximately 10 keV to 150 keV. The resulting capture data have been analyzed by a generalized least square peak fitting computer code in the energy interval of 2.5 keV to 50 keV. Photon strengths are determined using the data up to approximately 250 keV. The resulting total cross section data have been analyzed by area-analysis on the transmission values and by R-matrix multilevel code on cross section values. Average s- and p-wave level spacing and s- and p-wave strength function values are determined. From the resonance parameters thus obtained, by the analysis, statistical distribution is studied for s- and p-wave level spacings and reduced neutron widths. A comparison has been made for adjacent level spacings with the theoretical predictions of level repulsion (of same J/sup π/) by Wigner considering levels with various spin states separately for s-wave resonances where confident spin assignment has been possible. Reduced neutron widths are compared with the Porter-Thomas distribution. Optical model formulated by Feshbach, Porter and Weiskopf describes the neutron-nucleus interaction. A comparison has been made between experimentally determined values of the s- and p-wave strength functions and that obtainable from optical model calculations, thereby determining the appropriate optical model parameters. The experimental arrangement, pertinent theoretical discussion, and the processes of data reduction and the analyses along with the comparison of the previously reported results with the present work are presented in detail

Appropriateness of using a symbol to identify dementia and/or delirium.

Science.gov (United States)

Hines, Sonia; Abbey, Jenny; Wilson, Jacinda; Sacre, Sandy

2010-09-01

The main objective of this systematic review was to evaluate any published and unpublished evidence regarding the appropriateness of developing a symbol for dementia and/or delirium, which could be used in a variety of settings to indicate that a person has dementia and/or delirium. Using the methods of the Joanna Briggs Institute, we conducted a systematic search of a wide range of databases, Internet resources and unpublished literature. Papers meeting the inclusion criteria were critically appraised by two independent reviewers. Data were extracted, using the standardised tool from the Joanna Briggs Institute, from those papers considered to be of sufficient quality. Because of significant methodological heterogeneity, no meta-analysis was possible and results are presented narratively instead. From a total of 37 retrieved papers, 18 were found to be of sufficient relevance and quality to be included in the review. There was general consensus among the literature that a symbol for dementia is appropriate in the acute care setting. It was also clear from the research that an abstract symbol, as opposed to one that explicitly attempts to depict dementia, was most acceptable to staff, people with dementia and their carers. Both staff and health consumers seem to have largely positive perceptions and attitudes towards the use of a symbol for dementia. Families and carers of people with dementia are frequently concerned about their loved one wandering away and becoming lost and unable to identify themselves, and these concerns seem to outweigh any reservations they hold about the use of a symbol or some other identifier. In healthcare settings the use of symbols to indicate special needs seems well established and widely accepted. However, regarding the use of a symbol for dementia in the broader community, there remain concerns about issues such as stigmatisation and the potential for victimisation of this vulnerable population and so further research is indicated

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

Science.gov (United States)

2011-01-01

Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days). Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients) and 33% (other patients, from the time of referral). Most inappropriate days in acute care were due to delays in processes/scheduling (45%) or being more appropriate for rehabilitation or lower level of care (30%). On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively). From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

Directory of Open Access Journals (Sweden)

Bashford Guy

2011-10-01

Full Text Available Abstract Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days. Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients and 33% (other patients, from the time of referral. Most inappropriate days in acute care were due to delays in processes/scheduling (45% or being more appropriate for rehabilitation or lower level of care (30%. On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively. From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of

Asymptotics of Rydberg states for the hydrogen atom

International Nuclear Information System (INIS)

Thomas, L.E.

1997-01-01

The asymptotics of Rydberg states, i.e., highly excited bound states of the hydrogen atom Hamiltonian, and various expectations involving these states are investigated. We show that suitable linear combinations of these states, appropriately rescaled and regarded as functions either in momentum space or configuration space, are highly concentrated on classical momentum space or configuration space Kepler orbits respectively, for large quantum numbers. Expectations of momentum space or configuration space functions with respect to these states are related to time-averages of these functions over Kepler orbits. (orig.)

34 CFR 104.33 - Free appropriate public education.

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Free appropriate public education. 104.33 Section 104.33 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING...

Calibration of whole-body counters for transuranic radionuclides by using total-body donations to the United States Transuranium Registry

International Nuclear Information System (INIS)

Palmer, H.E.; Heid, K.R.; Breitenstein, B.D.; Durbin, P.W.; McInroy, J.F.

1985-01-01

One of the many benefits of the whole-body donation programme of the United States Transuranium Registry is the calibration of whole-body counters by measuring a donated body containing radioactivity before radiochemical analysis of the body occurs. These measurements have provided the best existing calibration factors for measuring 241 Am and 239 Pu in the skeleton of living people. In one case where the body contained an easily measurable quantity of 241 Am, the 241 Am content was found to be the same for identical bones on the right and left sides of the body. The bones from the right side of the body and every other vertebrae were radiochemically analysed and the bones from the left side were reserved. These latter have a known quantity of naturally distributed 241 Am based on the analysis of bones from the right side. These reserved bones are being incorporated into tissue equivalent body parts for future calibrations and interlaboratory comparisons. The measurements on the total body and the reserved bones have already been very useful in determining the contribution of skeletal activity to that of lung measurements and determining a calibration factor for measuring 239 Pu deposited in the skeleton. In the future it is planned to periodically make in vivo measurements on those people participating in the total-body donation programme so that calibration factors can be obtained for lung and liver content after subsequent analysis of these tissues. (author)

[Appropriate use of benzodiazepines zolpidem and zopiclone in diseases attended in primary care].

Science.gov (United States)

Granados Menéndez, M Isabel; Salinero Fort, Miguel Angel; Palomo Ancillo, Marta; Aliaga Gutiérrez, Laura; García Escalonilla, Carmen; Ortega Orcos, Rebeca

2006-01-01

To estimate the proportion of benzodiazepine prescriptions that comply with the guidelines for appropriate prescription. To identify the variables associated with appropriate prescription. Observational, cross-sectional study. Monóvar Health Centre in Area IV, Madrid, Spain. Random sample of 270 active benzodiazepine prescriptions in adult patients from the prescriptions record of the OMI-AP V. 5.0 computer system. The chosen dimensions for appropriate prescription were: a) correct diagnostic indication; b) absence of benzodiazepines with long half-life in the elderly; c) existence of support or monitoring visits; d) overall appropriateness or coexistence of correct diagnostic indications and monitoring visits. Independent variables were recorded in relation to patient, person prescribing and prescription. Diagnostic indication, 75.6%; absence of benzodiazepines with long half-life in the elderly, 79.8%; existence of support visits, 63.3%; overall appropriateness, 53%. Main diagnoses: pure anxiety, 29%; anxiety related to other illness, 18.6%; insomnia, 14.8%; cardiovascular illness, 14.8%; alcohol and drug abuse, 4.5%; osteo-muscular illness, 4.4%; schizophrenia, 4.4%. Most prescribed substances: lorazepam, 27.8%; bromazepam, 23.7%. Average life of prescriptions: 18.58 months. Origins: health centre, 68.5%; out-patient psychiatry, 10%; hospital, 10%. The variable that is most closely associated with overall appropriateness, fitted with the rest of the variables, is out-patient psychiatry prescription (OR, 6.67; 95% CI, 1.92-23.18). The mean duration of the prescriptions infringes all standards. The overall appropriateness or correct coexistence of adequate diagnostic indication with follow-up visits is associated with out-patient Psychiatry prescription.

Case studies in nanny state name-calling: what can we learn?

Science.gov (United States)

Magnusson, R S

2015-08-01

The 'nanny state' has become a popular metaphor in debates about public health regulation. It fulfils a particular role in that debate: to caution government against taking action. This paper presents case studies of nanny state criticisms, using them to identify a series of contextual features that may assist in better understanding, evaluating and where appropriate, resisting the rhetorical force of nanny state criticisms. The case studies presented include Rush Limbaugh's reactions to Michelle Obama's efforts to encourage American food companies to market healthier food to children; Christopher Hitchens' critique of New York City Mayor Michael Bloomberg's public health policies; and the reaction of neoliberal think tanks to Australia's plain tobacco packaging legislation. These case studies do not provide a basis for making generalisations about the practice of 'nanny state name-calling'. Nor do they preclude debate about the appropriate limits of government action. However, in appropriate cases they may assist policy-makers and public health advocates to contest the framing of public health interventions as unwarranted incursions into the private lives of individuals. One important lesson from these case studies is that the principal concern of nanny state critics is not loss of freedom as such, but the role of the state. The nanny state critique is ultimately a call for the state to be agnostic about the health of citizens, allowing market forces to dominate. Although the nanny state critique is not new, it is a significant challenge to government efforts to address lifestyle-influenced risk factors for non-communicable diseases, including tobacco use, harmful use of alcohol, and unhealthy diet. Copyright © 2015 The Author. Published by Elsevier Ltd.. All rights reserved.

National trends and in hospital outcomes for total hip arthroplasty in avascular necrosis in the United States.

Science.gov (United States)

Mayers, William; Schwartz, Brian; Schwartz, Aaron; Moretti, Vincent; Goldstein, Wayne; Shah, Ritesh

2016-09-01

While a majority of total hip arthroplasty (THA) is performed for osteoarthritis (OA), a significant portion is performed in the setting of avascular necrosis (AVN). The purpose of this study is to evaluate recent trends, patient demographics, and in hospital outcomes for primary THA in the setting of AVN in the United States. The National Hospital Discharge Survey database was searched for patients admitted to US hospitals after a primary THA for the years 2001-2010. Patients were then separated into two groups by ICD-9 diagnosis codes for OA and AVN. The rates of THA for AVN (r = 0.65) and THA for OA (r = 0.82) both demonstrated a positive correlation with time. The mean patient age of the AVN group was significantly lower (56.9 vs 65.9 years, p < 0.01). Men accounted for 51.9 % of the AVN group and 43.0 % of the OA group (p < 0.01). The AVN group had a significantly higher percentage of African Americans (11.2 % vs 5.4 %, p < 0.01) when compared to the OA group. The AVN group had a higher rate of myocardial infarction (0.3 % vs 0.07 %, p = 0.0163) and a higher average number of medical co-morbidities (5.16 vs 4.77, p < 0.01). Patients undergoing THA for AVN were more likely to be younger, male, African American, have more medical co-morbidities, and more likely to have a myocardial infarction than those with OA. While the number of primary THAs performed for AVN in the United States has increased over the past ten years, the rate of primary THA for OA increased at a much more rapid rate.

Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit.

Science.gov (United States)

Lazaryan, Moran; Abu-Kishk, Ibrahim; Rosenfeld-Yehoshua, Noa; Berkovitch, Sofia; Toledano, Michal; Reshef, Iris; Kanari, Tal; Ziv-Baran, Tomer; Berkovitch, Matitiahu

2016-01-01

One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available. To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU). A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded. The review time for one medical record was 8.9 (95% CI, 6.9-10.9) min. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11) min. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8) and 12 (9-15) min, respectively, for patients with psychiatric-neurologic disorders compared to those without (p = 0.032). Usually, a daily workload of 240 min was needed for the pharmacist accompanying the round in contrast to 108 min per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9%, and made no comment on 36.9% of the recommendations. Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

Do Social Factors Predict Appropriate Treatment of Child Diarrheal Disease in Peru?

Science.gov (United States)

Volpicelli, Kathryn; Buttenheim, Alison M

2016-11-01

Objectives Diarrheal disease is a significant cause of morbidity among children in Peru. Oral rehydration therapy (ORT) is a cost-effective evidence-based approach to treat diarrhea in young children, yet many Peruvian children in poorer households do not receive this life-saving treatment. This study investigates the social determinants of care-seeking behavior and utilization of appropriate home treatment for diarrheal episodes. Methods We used the nationally-representative 2008 Peru Demographic and Health Survey to: (1) describe the burden of non-bloody diarrheal disease among children <5 years old; and (2) identify socioeconomic correlates of care-seeking behavior and utilization/appropriateness of treatment among mothers of children with recent non-bloody diarrheal episodes (N = 1365). For the former, we reported descriptive statistics; for the latter, we utilized logistic regression to generate odds ratios. Results 2-week period prevalence of diarrheal disease was almost twice as high among poor (17 %) compared with wealthier (10 %) children, higher among children aged 12-23 months old (22 %), and higher among children from households that do not have an improved source of drinking water (16 %) compared with those that have an improved source (12 %). Interestingly, rural residence was a significant predictor of seeking care for diarrhea. Furthermore, although widely available, few mothers (15 %) used appropriate treatment for a recent diarrheal episode. Water source, mother's education, and wealth were significant predictors of appropriate home treatment. Conclusions Mothers in rural areas-typically with less access to care-were more likely to seek care for diarrheal disease in their children, even when adjusting for other variables. However, this increase in care seeking behavior did not extend to appropriate home treatment. Innovative behavior change strategies to reduce barriers to access and appropriate home treatment for diarrheal disease are

Appropriating Public Private Partnership in Senior High School Program: A Socio-Cultural Approach to Policy Making

Directory of Open Access Journals (Sweden)

Peter G. Romerosa

2018-05-01

Full Text Available The implementation of the Senior High School program in the Philippines illuminates the State’s response to the changing landscape of the global market economy. Its salient features focus on the additional two year-senior high school program which highlights the development of middle level skills for national development and global competitiveness. In order to concretize the implementation of the program, the State entered into collaboration with the private schools which is commonly known as Public Private Partnership (PPP. In this collaboration, the government provides the guidelines and financing while the private educational institutions provide the academic service. Framed from a socio-cultural approach to policy making in education, this study aimed to unpack a particular implementation of PPP of a private institution in an urban area, examine the institutional policies that were created in response to PPP, and interrogate the impacts of these policies on micro social processes. Using interviews and focus group discussions for methodology, the researcher drew narratives and insights from on-the-ground actors. Further, the investigation looked into how authorized policy actors (school administrators and nonauthorized policy actors (teachers, parents, and students are appropriating policies within the operational framework of the PPP in the implementation of the senior high school program. The results demonstrated that multi- layered appropriation and exercise of the agency were explicitly and implicitly deployed in diverse social spaces by actors as a pragmatic and creative response to the new educational arrangement. The paper provides a lens to further develop under-standing on how policy appropriation and production from the local context can inform institutional approaches in facilitating relevant student experience within the realm of PPP in education.

Applicable or relevant and appropriate requirements (ARARs) for remedial actions at the Paducah Gaseous Diffusion Plant: A compendium of environmental laws and guidance

International Nuclear Information System (INIS)

Etnier, E.L.; Eaton, L.A.

1992-03-01

Section 121 of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of 1980 specifies that remedial actions for cleanup of hazardous substances found at sites placed on the National Priorities List (NPL) by the US Environmental Protection Agency (EPA) must comply with applicable or relevant and appropriate requirements (ARARs) or standards under federal and state environmental laws. To date, the US Department of Energy (DOE) Paducah Gaseous Diffusion Plant (PGDP) has not been on the NPL. Although DOE and EPA have entered into an Administrative Consent Order (ACO), the prime regulatory authority for cleanup at PGDP will be the Resource Conservation and Recovery Act (RCRA). This report supplies a preliminary list of available federal and state ARARs that might be considered for remedial response at PGDP in the event that the plant becomes included on the NPL or the ACO is modified to include CERCLA cleanup. A description of the terms ''applicable'' and ''relevant and appropriate'' is provided, as well as definitions of chemical-, location-, and action-specific ARARS. ARARs promulgated by the federal government and by the state of Kentucky are listed in tables. In addition, the major provisions of RCRA, the Safe Drinking Water Act, the Clean Water Act, the Clean Air Act, and other acts, as they apply to hazardous and radioactive waste cleanup, are discussed

Total quality management of cobalt-60 sources

International Nuclear Information System (INIS)

Malkoske, G.R.

1999-01-01

Total Quality Management of Cobalt-60 sources by a supplier requires a life cycle approach to source management. This covers various aspects, including design, manufacturing, installation, field inspection, source surveillance and return of cobalt-60 sources at the end of their useful life. The Total Quality Management approach demonstrates a strong industry commitment to the beneficial use of gamma technology for industrial irradiation applications in both developed nations and in those nations who are developing their infrastructure and techniques for the beneficial use of this technology. MDS Nordion continues to demonstrate its support and commitment to the industry by developing and implementing state-of-the-art standards for the safe use of cobalt-60 sources

Internal States and Behavioral Decision-Making: Toward an Integration of Emotion and Cognition.

Science.gov (United States)

Kennedy, Ann; Asahina, Kenta; Hoopfer, Eric; Inagaki, Hidehiko; Jung, Yonil; Lee, Hyosang; Remedios, Ryan; Anderson, David J

2014-01-01

Social interactions, such as an aggressive encounter between two conspecific males or a mating encounter between a male and a female, typically progress from an initial appetitive or motivational phase, to a final consummatory phase. This progression involves both changes in the intensity of the animals' internal state of arousal or motivation and sequential changes in their behavior. How are these internal states, and their escalating intensity, encoded in the brain? Does this escalation drive the progression from the appetitive/motivational to the consummatory phase of a social interaction and, if so, how are appropriate behaviors chosen during this progression? Recent work on social behaviors in flies and mice suggests possible ways in which changes in internal state intensity during a social encounter may be encoded and coupled to appropriate behavioral decisions at appropriate phases of the interaction. These studies may have relevance to understanding how emotion states influence cognitive behavioral decisions at higher levels of brain function. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.

HANPP Collection: Human Appropriation of Net Primary Productivity (HANPP) by Country and Product

Data.gov (United States)

National Aeronautics and Space Administration — The Global Patterns in Human Appropriation of Net Primary Productivity (HANPP) portion of the HANPP Collection represents a digital map of human appropriation of net...

ACR Appropriateness Criteria® First Trimester Vaginal Bleeding.

Science.gov (United States)

Brown, Douglas L; Packard, Ann; Maturen, Katherine E; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara L; Meyer, Benjamin J; Poder, Liina; Sadowski, Elizabeth A; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M; Glanc, Phyllis

2018-05-01

Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention. Less common causes of first trimester vaginal bleeding include gestational trophoblastic disease and arteriovenous malformations. Pulsed methods of Doppler US should generally be avoided in the first trimester when there is a normal, or a potentially normal, IUP. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as retained products of conception or arteriovenous malformations are suspected. MRI may occasionally be helpful as a problem-solving tool. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

40 CFR 131.20 - State review and revision of water quality standards.

Science.gov (United States)

2010-07-01

... (CONTINUED) WATER PROGRAMS WATER QUALITY STANDARDS Procedures for Review and Revision of Water Quality Standards § 131.20 State review and revision of water quality standards. (a) State review. The State shall... reviewing applicable water quality standards and, as appropriate, modifying and adopting standards. Any...

Total and EDF invest

International Nuclear Information System (INIS)

Signoret, St.

2008-01-01

So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

Computed tomography measurements of the acetabulum in adult dysplastic hips: Which level is appropriate

Energy Technology Data Exchange (ETDEWEB)

Anda, S.; Kvistad, K.A. (Dept. of Radiology, Trondheim Univ. (Norway)); Terjesen, T. (Dept. of Orthopedic Surgery, Trondheim Univ. (Norway))

1991-05-01

A study has been performed to evaluate whether one or several levels are needed with comuted tomography (CT) study to provide sufficient information regarding anteversion and acetabular support to the femoral head. A total of 23 hips in 14 adults with uni- or bilateral congenital hip dysplasia (center-edge angle less than 20deg) were assessed by obtaining 5-mm contiguous CT slices and performing acetabular measurements at four levels. Both anterior and posterior acetabular supports as quantified by the anterior and posterior acetabular sector angles were significantly lower than normal at all levels. The sector angles increased in the proximal cuts, whereas the acetabular anteversin increased caudally. Because no important additional information was gained by measuring at different levels, we conclude that CT study at one level is sufficient for acetabular measurements and suggest that the slice through the center of the femoral head is the most appropriate one. (orig.).

Groundwater Monitoring and Tritium-Tracking Plan for the 200 Area State-Approved Land Disposal Site

Energy Technology Data Exchange (ETDEWEB)

DB Barnett

2000-08-31

The 200 Area State-Approved Land Disposal Site (SALDS) is a drainfield which receives treated wastewater, occasionally containing tritium from treatment of Hanford Site liquid wastes at the 200 Area Effluent Treatment Facility (ETF). Since operation of the SALDS began in December 1995, discharges of tritium have totaled {approx}304 Ci, only half of what was originally predicted for tritium quantity through 1999. Total discharge volumes ({approx}2.7E+8 L) have been commensurate with predicted volumes to date. This document reports the results of all tritium analyses in groundwater as determined from the SALDS tritium-tracking network since the first SALDS wells were installed in 1992 through July 1999, and provides interpretation of these results as they relate to SALDS operation and its effect on groundwater. Hydrologic and geochemical information are synthesized to derive a conceptual model, which is in turn used to arrive at an appropriate approach to continued groundwater monitoring at the facility.

Determining the appropriate code in a South African business ...

African Journals Online (AJOL)

Determining the appropriate code in a South African business environment. ... Southern African Linguistics and Applied Language Studies ... would be perceived to enhance the quality of the interaction between client and service provider.

Teaching Young Adults with Disabilities to Respond Appropriately to Lures from Strangers

Science.gov (United States)

Fisher, Marisa H.; Burke, Meghan M.; Griffin, Megan M.

2013-01-01

We taught 5 adults with mild intellectual disabilities to respond appropriately to lures from strangers. Skills were taught in the classroom first and then in situ. Before training, participants did not walk away from confederate strangers who tried to lure them away. Participants demonstrated appropriate responses during classroom and in situ…

Evaluation of HIV Surveillance System in Rivers State, Nigeria ...

African Journals Online (AJOL)

Background: Rivers State has been reported to have the highest HIV prevalence of all the thirty-six states in Nigeria. HIV surveillance system generates information for timely and appropriate public health action. Evaluation of the surveillance system is vital in ensuring that the purpose of the surveillance system is being met.

Analytical approaches used in stream benthic macroinvertebrate biomonitoring programs of State agencies in the United States

Science.gov (United States)

Carter, James L.; Resh, Vincent H.

2013-01-01

Biomonitoring programs based on benthic macroinvertebrates are well-established worldwide. Their value, however, depends on the appropriateness of the analytical techniques used. All United States State, benthic macroinvertebrate biomonitoring programs were surveyed regarding the purposes of their programs, quality-assurance and quality-control procedures used, habitat and water-chemistry data collected, treatment of macroinvertebrate data prior to analysis, statistical methods used, and data-storage considerations. State regulatory mandates (59 percent of programs), biotic index development (17 percent), and Federal requirements (15 percent) were the most frequently reported purposes of State programs, with the specific tasks of satisfying the requirements for 305b/303d reports (89 percent), establishment and monitoring of total maximum daily loads, and developing biocriteria being the purposes most often mentioned. Most states establish reference sites (81 percent), but classify them using State-specific methods. The most often used technique for determining the appropriateness of a reference site was Best Professional Judgment (86 percent of these states). Macroinvertebrate samples are almost always collected by using a D-frame net, and duplicate samples are collected from approximately 10 percent of sites for quality assurance and quality control purposes. Most programs have macroinvertebrate samples processed by contractors (53 percent) and have identifications confirmed by a second taxonomist (85 percent). All States collect habitat data, with most using the Rapid Bioassessment Protocol visual-assessment approach, which requires ~1 h/site. Dissolved oxygen, pH, and conductivity are measured in more than 90 percent of programs. Wide variation exists in which taxa are excluded from analyses and the level of taxonomic resolution used. Species traits, such as functional feeding groups, are commonly used (96 percent), as are tolerance values for organic pollution

Textual appropriation in engineering master's theses: a preliminary study.

Science.gov (United States)

Eckel, Edward J

2011-09-01

In the thesis literature review, an engineering graduate student is expected to place original research in the context of previous work by other researchers. However, for some students, particularly those for whom English is a second language, the literature review may be a mixture of original writing and verbatim source text appropriated without quotations. Such problematic use of source material leaves students vulnerable to an accusation of plagiarism, which carries severe consequences. Is such textual appropriation common in engineering master's writing? Furthermore, what, if anything, can be concluded when two texts have been found to have textual material in common? Do existing definitions of plagiarism provide a sufficient framework for determining if an instance of copying is transgressive or not? In a preliminary attempt to answer these questions, text strings from a random sample of 100 engineering master's theses from the ProQuest Dissertations and Theses database were searched for appropriated verbatim source text using the Google search engine. The results suggest that textual borrowing may indeed be a common feature of the master's engineering literature review, raising questions about the ability of graduate students to synthesize the literature. The study also illustrates the difficulties of making a determination of plagiarism based on simple textual similarity. A context-specific approach is recommended when dealing with any instance of apparent copying.

Request of laboratory liver tests in primary care in Spain: potential savings if appropriateness indicator targets were achieved.

Science.gov (United States)

Salinas, Maria; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

2015-10-01

Liver laboratory tests are used to screen for liver disease, suggest the underlying cause, estimate the severity, assess prognosis, and monitor the efficacy of therapy. The aim of this study was to compare the liver laboratory tests requesting patterns by GPs in Spain, according to geographic and hospital characteristics, to investigate the degree of requesting appropriateness. One hundred and forty-one clinical laboratories were invited to participate from diverse regions across Spain. They filed out the number of laboratory liver tests requested by GPs for the year 2012. Two types of appropriateness indicators were calculated: every test request per 1000 inhabitants or ratios of related tests requests. The indicator results obtained were compared between the different hospitals, according to their setting, location, and management. The savings generated, if each area would have achieved indicator targets, were calculated. We recruited 76 laboratories covering a population of 17,679,195 inhabitants. GPs requested 20,916,780 laboratory liver tests in the year 2012. No differences were obtained according to their setting. Lactate dehydrogenase and direct bilirubin per 1000 inhabitants were significantly higher in institutions with private management. Largest differences were observed between communities. Nine, 31, 0, and 13 laboratories, respectively, achieved the aspartate aminotransferase, lactate dehydrogenase, γ-glutamyl transpeptidase, and total bilirubin-related alanine aminotransferase indicator targets. Reaching ratios would have resulted in savings of €1,028,468. There was a high variability in the request of liver tests. This emphasizes the need to implement interventions to improve appropriate use of liver tests.

5 CFR 532.217 - Appropriated fund survey jobs.

Science.gov (United States)

2010-01-01

... Laundry Worker 1 Food Service Worker 2 Cook 8 (e) A lead agency must obtain prior approval of OPM to add a... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Appropriated fund survey jobs. 532.217 Section 532.217 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS...

FTA Training Programs: Searching for Appropriate Teaching Styles.

Science.gov (United States)

Byrd, Patricia; Constantinides, Janet C.

1988-01-01

In addition to acquiring communicative competence, teaching assistants who speak English as a second language must learn human relations skills, and how to teach content through appropriate teaching methods and skills that will help them bridge the cultural and language differences they experience in U.S. institutions of higher education. (CB)

A case study of culturally appropriate conservation education

Science.gov (United States)

David N. Bengston; Michele Schermann

2016-01-01

Create culturally appropriate conservation education materials for Hmong Americans, including new refugees and elders with little proficiency in English, as well as the broader, multigenerational Hmong community. This case study discusses an organizational response from the USDA Forest Service, in partnership with others, to better serve the Hmong American community....

Total body calcium by neutron activation analysis. Reference data for children

International Nuclear Information System (INIS)

Ellis, K.J.; Shypailo, R.J.

2001-01-01

There is a paucity of data on the chemical composition of the human body during growth. Total body calcium (TBCa) has been reported for only one male child, aged 41/2 yr. TBCa values for 25 children and 27 young women using in vivo neutron activation analysis have been obtained. TBCa results were lower than those reported for the one male cadaver, as well as the estimates derived for the 'Reference Man' model. It was concluded that the reference values for TBCa may need to be adjusted to appropriately describe skeletal mineralization of contemporary children. (author)

Appropriation System: water rights in the western United States; water pollution problems peculiar to the uranium industry

International Nuclear Information System (INIS)

Worcester, T.E.

1976-01-01

The legal framework surrounding water rights acquisition and usage in the western United States and the steps which should be taken in analyzing potential sources of water are dealt with. Some of the applicable water pollution control laws and regulations are discussed briefly

Effect of training and structured medication review on medication appropriateness in nursing home residents and on cooperation between health care professionals: the InTherAKT study protocol.

Science.gov (United States)

Mahlknecht, Angelika; Nestler, Nadja; Bauer, Ulrike; Schüßler, Nadine; Schuler, Jochen; Scharer, Sebastian; Becker, Ralf; Waltering, Isabel; Hempel, Georg; Schwalbe, Oliver; Flamm, Maria; Osterbrink, Jürgen

2017-01-18

Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes. The trial is designed as single-arm study. It involves 300 nursing home residents aged ≥ 65 years and the members of the different professional groups practising in nursing home care (15-20 general practitioners, nurses, pharmacists). The intervention consists of interprofessional education on safe medication use in geriatric patients, and a systematic interprofessional therapy check (recording, reviewing and adapting the medication of the participating residents by means of a specific online platform). The intervention period is divided into two phases; total project period is 3 years. Primary outcome measure is the change in medication appropriateness according to the Medication Appropriateness Index. Secondary outcomes are cognitive performance, occurrence of delirium, agitation, tendency of falls, total number of drugs, number of potentially dangerous drug-drug interactions and appropriateness of recorded analgesic therapy regimens according to the Medication Appropriateness Index. Data are collected at t 0 (before the start of the intervention), t 1 (after the first intervention period) and t 2 (after the second intervention period). Cooperation and communication between the professional groups are investigated twice by qualitative interviews. The project aims to establish a structured system for monitoring of drug therapy in nursing home residents

Selecting Appropriate Spatial Scale for Mapping Plastic-Mulched Farmland with Satellite Remote Sensing Imagery

Directory of Open Access Journals (Sweden)

Hasituya

2017-03-01

Full Text Available In recent years, the area of plastic-mulched farmland (PMF has undergone rapid growth and raised remarkable environmental problems. Therefore, mapping the PMF plays a crucial role in agricultural production, environmental protection and resource management. However, appropriate data selection criteria are currently lacking. Thus, this study was carried out in two main plastic-mulching practice regions, Jizhou and Guyuan, to look for an appropriate spatial scale for mapping PMF with remote sensing. The average local variance (ALV function was used to obtain the appropriate spatial scale for mapping PMF based on the GaoFen-1 (GF-1 satellite imagery. Afterwards, in order to validate the effectiveness of the selected method and to interpret the relationship between the appropriate spatial scale derived from the ALV and the spatial scale with the highest classification accuracy, we classified the imagery with varying spatial resolution by the Support Vector Machine (SVM algorithm using the spectral features, textural features and the combined spectral and textural features respectively. The results indicated that the appropriate spatial scales from the ALV lie between 8 m and 20 m for mapping the PMF both in Jizhou and Guyuan. However, there is a proportional relation: the spatial scale with the highest classification accuracy is at the 1/2 location of the appropriate spatial scale generated from the ALV in Jizhou and at the 2/3 location of the appropriate spatial scale generated from the ALV in Guyuan. Therefore, the ALV method for quantitatively selecting the appropriate spatial scale for mapping PMF with remote sensing imagery has theoretical and practical significance.

Symmetric discrete coherent states for n-qubits

International Nuclear Information System (INIS)

Muñoz, C; Klimov, A B; Sánchez-Soto, L L

2012-01-01

We put forward a method of constructing discrete coherent states for n qubits. After establishing appropriate displacement operators, the coherent states appear as displaced versions of a fiducial vector that is fixed by imposing a number of natural symmetry requirements on its Q-function. Using these coherent states, we establish a partial order in the discrete phase space, which allows us to picture some n-qubit states as apparent distributions. We also analyze correlations in terms of sums of squared Q-functions. This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘Coherent states: mathematical and physical aspects’. (paper)

Total dissociation cross section of halo nuclei

Energy Technology Data Exchange (ETDEWEB)

Formanek, J. [Karlova Univ., Prague (Czech Republic). Fakulta Matematicko-Fyzikalni; Lombard, R.J. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire

1996-10-01

Calculations of the total dissociation cross section is performed in the impact parameter representation. The case of {sup 11}Be and {sup 11}Li loosing one and two neutron(s), respectively, by collision on a {sup 12}C target, which remains in its ground state are discussed. The results are found to depend essentially on the rms radius of the halo wave function. (author). 12 refs.

Unusual way of loosened total hip arthroplasty treatment with an Austin Moore endoprosthesis

OpenAIRE

M Erceg; K Becic

2014-01-01

A 65-year-old female patient with aseptic loosening of total cemented hip endoprosthesis and pathologic fracture of the femur at the level of the stem of endoprosthesis was presented. As no appropriate endoprosthesis was available due to the war in Croatia and war priority, the problem was managed by femur osteosynthesis and implantation of a partial Austin Moore hip endoprosthesis. The endoprosthesis is still functioning well (for 20 years).To the best of the author′s knowledge, nobody has e...

State Emergency Department Opioid Guidelines: Current Status.

Science.gov (United States)

Broida, Robert I; Gronowski, Tanner; Kalnow, Andrew F; Little, Andrew G; Lloyd, Christopher M

2017-04-01

The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP. We found that 17 states had emergency department-specific guidelines. We further organized the guidelines into four categories: limiting prescriptions for opioids with 67 total recommendations; preventing/diverting abuse with 56 total recommendations; addiction-related guidelines with 29 total recommendations; and a community resources section with 24 total recommendations. Our results showed that current state guidelines focus on providers limiting opioid pain prescriptions and vetting patients for possible abuse/diversion. This study highlights the 17 states that have addressed opioid prescribing guidelines and categorizes their efforts to date. It is hoped that this study will provide the basis for similar efforts in other states.

Selection of appropriate conditioning matrices for the safe disposal of radioactive waste

International Nuclear Information System (INIS)

Vance, E.R.

2002-01-01

The selection of appropriate solid conditioning matrices or wasteforms for the safe disposal of radioactive waste is dictated by many factors. The overriding issue is that the matrix incorporating the radionuclides, together with a set of engineered barriers in a near-surface or deep geological repository, should prevent significant groundwater transport of radionuclides to the biosphere. For high-level waste (HLW) from nuclear fuel reprocessing, the favored matrices are glasses, ceramics and glass-ceramics. Borosilicate glasses are presently being used in some countries, but there are strong scientific arguments why ceramics based on assemblages of natural minerals are advantageous for HLW. Much research has been carried out in the last 40 years around the world, and different matrices are more suitable than others for a given waste composition. However a major stumbling block for HLW immobilisation is the mall number of approved geological repositories for such matrices. The most appropriate matrices for Intermediate and low-level wastes are contentious and the selection criteria are not very well defined. The candidate matrices for these latter wastes are cements, bitumen, geopolymers, glasses, glass-ceramics and ceramics. After discussing the pros and cons of various candidate matrices for given kinds of radioactive wastes, the SYNROC research program at ANSTO will be briefly surveyed. Some of the potential applications of this work using a variety of SYNROC derivatives will be given. Finally the basic research program at ANSTO on radioactive waste immobilisation will be summarised. This comprises mainly work on solid state chemistry to understand ionic valences and co-ordinations for the chemical design of wasteforms, aqueous durability to study the pH and temperature dependence of solid-water reactions, radiation damage effects on structure and solid-water reactions. (Author)

Identification of appropriate tools of information and communication ...

African Journals Online (AJOL)

Access to sufficient and desirable food is one of the principles of any developing and healthy society. One of the important means for attainment of food security is information and communication technologies (ICT). The purpose of the research was to identify appropriate tools of ICT in improving food security of Iran's rural ...

Correlations in Werner States

International Nuclear Information System (INIS)

Luo Shunlong; Li Nan

2008-01-01

Werner states are paradigmatic examples of quantum states and play an innovative role in quantum information theory. In investigating the correlating capability of Werner states, we find the curious phenomenon that quantum correlations, as quantified by the entanglement of formation, may exceed the total correlations, as measured by the quantum mutual information. Consequently, though the entanglement of formation is so widely used in quantifying entanglement, it cannot be interpreted as a consistent measure of quantum correlations per se if we accept the folklore that total correlations are measured (or rather upper bounded) by the quantum mutual information.

Financing Community Colleges: A Longitudinal Study of 11 States

Science.gov (United States)

Kenton, Carol Piper; Huba, Mary E.; Schuh, John H.; Shelley II, Mack C.

2005-01-01

This study examined the financing patterns of 212 community colleges in 11 midwestern states during the decade of the 1990s using the Integrated Postsecondary Education Data System (IPEDS). Support from state appropriations declined between 1990 and 2000, and reliance on tuition and fees increased between 1990 and 1995, although both trends were…

Selecting the most appropriate inferential statistical test for your quantitative research study.

Science.gov (United States)

Bettany-Saltikov, Josette; Whittaker, Victoria Jane

2014-06-01

To discuss the issues and processes relating to the selection of the most appropriate statistical test. A review of the basic research concepts together with a number of clinical scenarios is used to illustrate this. Quantitative nursing research generally features the use of empirical data which necessitates the selection of both descriptive and statistical tests. Different types of research questions can be answered by different types of research designs, which in turn need to be matched to a specific statistical test(s). Discursive paper. This paper discusses the issues relating to the selection of the most appropriate statistical test and makes some recommendations as to how these might be dealt with. When conducting empirical quantitative studies, a number of key issues need to be considered. Considerations for selecting the most appropriate statistical tests are discussed and flow charts provided to facilitate this process. When nursing clinicians and researchers conduct quantitative research studies, it is crucial that the most appropriate statistical test is selected to enable valid conclusions to be made. © 2013 John Wiley & Sons Ltd.

Is the Appropriateness of Emotions Culture-Dependent? The Relevance of Social Meaning

Directory of Open Access Journals (Sweden)

Welpinghus Anna

2018-02-01

Full Text Available This paper contributes to the question to what extent the socio-cultural context is relevant for the appropriateness of emotions, while appropriateness of an emotion means that the emotion entails a correct, or adequate, evaluation of its object. In a first step, two adequacy conditions for theories of emotions are developed: the first condition ensures that the socio-cultural context is not neglected: theories must allow for the fact that appropriateness often depends on the social meaning of the emotion’s particular object. The second condition rules out implausible forms of cultural determinism. In a second step, an account that meets both conditions is presented: the Acceptance within Social Context account.

Patient gender affects the referral and recommendation for total joint arthroplasty.

Science.gov (United States)

Borkhoff, Cornelia M; Hawker, Gillian A; Wright, James G

2011-07-01

Rates of use of total joint arthroplasty among appropriate and willing candidates are lower in women than in men. A number of factors may explain this gender disparity, including patients' preferences for surgery, gender bias influencing physicians' clinical decision-making, and the patient-physician interaction. We propose a framework of how patient gender affects the patient and physician decision-making process of referral and recommendation for total joint arthroplasty and consider potential interventions to close the gender gap in total joint arthroplasty utilization. The process involved in the referral and recommendation for total joint arthroplasty involves eight discrete steps. A systematic review is used to describe the influence of patient gender and related clinical and nonclinical factors at each step. WHERE ARE WE NOW?: Patient gender plays an important role in the process of referral and recommendation for total joint arthroplasty. Female gender primarily affects Steps 3 through 8, suggesting barriers unique to women exist in the patient-physician interaction. WHERE DO WE NEED TO GO?: Developing and evaluating interventions that improve the quality of the patient-physician interaction should be the focus of future research. HOW DO WE GET THERE?: Potential interventions include using decision support tools that facilitate shared decision-making between patients and their physicians and promoting cultural competency and shared decision-making skills programs as a core component of medical education. Increasing physicians' acceptance and awareness of the unconscious biases that may be influencing their clinical decision-making may require additional skills programs.

Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1 year postoperatively

DEFF Research Database (Denmark)

Paulsen, Aksel; Roos, Ewa M.; Pedersen, Alma Becic

2014-01-01

-55% improvement from mean baseline PRO score and PASSs corresponded to absolute follow-up scores of 57-91% of the maximum score in THA patients 1 year after surgery. Interpretation - This study improves the interpretability of PRO scores. The different estimation approaches presented may serve as a guide......Background and purpose - The increased use of patient-reported outcomes (PROs) in orthopedics requires data on estimated minimal clinically important improvements (MCIIs) and patient-acceptable symptom states (PASSs). We wanted to find cut-points corresponding to minimal clinically important PRO...... change score and the acceptable postoperative PRO score, by estimating MCII and PASS 1 year after total hip arthroplasty (THA) for the Hip Dysfunction and Osteoarthritis Outcome Score (HOOS) and the EQ-5D. Patients and methods - THA patients from 16 different departments received 2 PROs and additional...

'Parity effect' based generation of Schrodinger cat like states in high-Q microcavity

International Nuclear Information System (INIS)

Napoli, A.; Messina, A.

1999-01-01

It has been very recently shown that the dynamics of a two-level atom coupled to a bimodal degenerate cavity field by two-photon processes, is characterized by an interesting nonclassical dynamical behavior christened ''parity effect''. This effect consists in the fact that if the cavity field is prepared leaving one mode in its vacuum state and exciting the other one in a generic linear combination of even number states only, or odd number states only, then there exists an appropriate intensity-dependent interval of time after which the bimodal cavity exhibits macroscopically different parity-dependent quantum features. We show that this nonclassical effect is at the origin of the possibility of generating Schrodinger cat like states of the bimodal field appropriately selecting its initial conditions

Solar stove as a mechanism of appropriate energy by the low-income population in Sergipe, Brazil; Fogao solar como mecanismo de apropriacao de energia pela populacao de baixa renda em Sergipe

Energy Technology Data Exchange (ETDEWEB)

Brazil, Osiris Ashton Vital; Silva, Maria Susana [Sergipe Parque Tecnologico (SERGIPETEC), Aracaju, SE (Brazil); Araujo, Paulo Mario Machado de; Doria, Mary Barreto; Claudia Andrade, Leao Ana [Instituto de Tecnologia e Pesquisa (LEM/ITP), Aracaju, Sergipe (Brazil). Lab. de Energia e Materiais; Teixeira, Olivio [Universidade Federal do Sergipe (UFS), Aracaju, SE (Brazil)

2008-07-01

This work presents the experience from the realization of social workshops technology of construction and use of the solar stove box type in Sergipe State. The workshops were realized in 2007 and in the beginning from 2008 like mechanisms to appropriate the low income family to the use of the solar energy. The workshops accompanying enables to analyze the dynamic and propose betterments in the construction process of the innovation. The incentive to the solar stove use is justified by the fact of low income population frequently use logs like energetic for cook. The reached results in the workshops made possible the discussion of the mechanism from appropriation of the solar stove by the population in the government State action optic. (author)

Total disintegration of three-nucleon nuclei in charged-pion photo-production

International Nuclear Information System (INIS)

Dzhibuti, R.I.; Kezerashvili, R.Y.

1984-01-01

The total disintegration of three-nucleon nuclei in charged-pion photo-production is studied within the framework of the microscopic approach based on the method of hyperspherical functions. The initial and final nuclear states are described using the same NN potentials. The differential and total cross sections are calculated using various NN potentials. It is shown that the cross sections are sensitive to the form of the NN interaction and to the final-state interaction of the three nucleons. It is found that the cross section for π - meson production is systematically larger than the cross section for π + meson production. The importance of an experimental investigation of these reactions is shown

Ethics under uncertainty: the morality and appropriateness of utilitarianism when outcomes are uncertain.

Science.gov (United States)

Kortenkamp, Katherine V; Moore, Colleen F

2014-01-01

Real-life moral dilemmas inevitably involve uncertainty, yet research has not considered how uncertainty affects utilitarian moral judgments. In addition, even though moral dilemma researchers regularly ask respondents, "What is appropriate?" but interpret it to mean, "What is moral?," little research has examined whether a difference exists between asking these 2 types of questions. In this study, 140 college students read moral dilemmas that contained certain or uncertain consequences and then responded as to whether it was appropriate and whether it was moral to kill 1 to save many (a utilitarian choice). Ratings of the appropriateness and morality of the utilitarian choice were lower under uncertainty than certainty. A follow-up experiment found that these results could not be explained entirely by a change in the expected values of the outcomes or a desire to avoid the worst-case scenario. In addition, the utilitarian choice to kill 1 to save many was rated as more appropriate than moral. The results imply that moral decision making may depend critically on whether uncertainties in outcomes are admitted and whether people are asked about appropriateness or morality.

On the Total Variation Distance of Semi-Markov Chains

DEFF Research Database (Denmark)

Bacci, Giorgio; Bacci, Giovanni; Larsen, Kim Guldstrand

2015-01-01

Semi-Markov chains (SMCs) are continuous-time probabilistic transition systems where the residence time on states is governed by generic distributions on the positive real line. This paper shows the tight relation between the total variation distance on SMCs and their model checking problem over...

42 CFR 403.308 - State systems under demonstration projects-mandatory approval.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false State systems under demonstration projects..., DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Recognition of State... approval of a State system are met under § 403.304 (b)(1)-(10) and § 403.304(c), and, if appropriate § 403...

Sensory quality and appropriateness of raw and boiled Jerusalem artichoke tubers (Helianthus tuberosus L.).

Science.gov (United States)

Bach, Vibe; Kidmose, Ulla; Thybo, Anette K; Edelenbos, Merete

2013-03-30

The aim of the present study was to investigate the sensory attributes, dry matter and sugar content of five varieties of Jerusalem artichoke tubers and their relation to the appropriateness of the tubers for raw and boiled preparation. Sensory evaluation of raw and boiled Jerusalem artichoke tubers was performed by a trained sensory panel and a semi-trained consumer panel of 49 participants, who also evaluated the appropriateness of the tubers for raw and boiled preparation. The appropriateness of raw Jerusalem artichoke tubers was related to Jerusalem artichoke flavour, green nut flavour, sweetness and colour intensity, whereas the appropriateness of boiled tubers was related to celeriac aroma, sweet aroma, sweetness and colour intensity. In both preparations the variety Dwarf stood out from the others by being the least appropriate tuber. A few sensory attributes can be used as predictors of the appropriateness of Jerusalem artichoke tubers for raw and boiled consumption. Knowledge on the quality of raw and boiled Jerusalem artichoke tubers can be used to inform consumers on the right choice of raw material and thereby increase the consumption of the vegetable. © 2012 Society of Chemical Industry.

Comparison between Total Parenteral Nutrition Vs. Partial Parenteral Nutrition on Serum Lipids Among Chronic Ventilator Dependent Patients; A Multi Center Study.

Science.gov (United States)

Radpay, Rojan; Poor Zamany Nejat Kermany, Mahtab; Radpay, Badiozaman

2016-01-01

Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method. 97 patients were enrolled and divided into two groups based on the inclusion criteria. Serum protein, serum albumin, serum transferrin, and total lymphocyte count were measured on days 7 and 14. We did not find any statistically significant differences in clinical status or laboratory values between the two groups but there were significant improvements in measured lab values between days 7 and 14 (pnutritional status in each groups. This study shows that both TPN and PPN can be used safely in chronic ICU patients to provide nutritional support and prevent catabolic state among chronic critically ill patients. We need to develop precise selection criteria in order to choose the patients who would benefit the most from TPN and PPN. In addition, appropriate laboratory markers are needed to monitor the metabolic requirements of the patients and assess their progress.

[Potential of cooperative learning in project development : Relevance of cooperative participation procedure for the further development of generation-appropriate accomodation in structurally weak rural areas].

Science.gov (United States)

Kaufmann, Gerd; Frankenberg, Olga; Sommer, Ralf-Rüdiger; Jost, Annemarie

2017-04-01

A joint initiative of existing senior care organizations, the municipality of Meyenburg and the state of Brandenburg was further developed by affiliation of an institute of the Brandenburg University of Technology Cottbus-Senftenberg (ABV) in cooperation with members of the architecture and social work departments in 2014. A cooperative process between different players was central to create an appropriate structure of services for this region. Cooperative projects are necessary to establish new forms of generation-appropriate living and care concepts in rural areas. Cooperative learning methods are needed to develop new forms of generation-appropriate living and care concepts in rural areas, which take the diversity of elderly people, the rural context, intergenerational residential arrangements and affordable accommodation that meets the requirements of the social security system into account. Furthermore, the project had to reflect the recent developments of the German care insurance. The article describes the participatory methods, the coordination process and the resulting concept.

Total, Added, and Free Sugars: Are Restrictive Guidelines Science-Based or Achievable?

OpenAIRE

Jennifer Erickson; Joanne Slavin

2015-01-01

Sugar consumption, especially added sugars, is under attack. Various government and health authorities have suggested new sugar recommendations and guidelines as low as 5% of total calories from free sugars. Definitions for total sugars, free sugars, and added sugars are not standardized, nor are there accepted nutrient databases for this information. Our objective was to measure total sugars and added sugars in sample meal plans created by the United States Department of Agriculture (USDA) a...

Appropriateness of using a symbol to identify dementia and/or delirium: a systematic review.

Science.gov (United States)

Hines, Sonia; Abbey, Jenny; Wilson, Jacinda; Sacre, Sandy

2009-01-01

condition or functional impairment. Any references to symbols, identifiers or alerts being used to indicate a particular type of service were also considered. Retrieved papers were critically appraised by two reviewers, using tools developed by the Joanna Briggs Institute. Due to the type and clinical heterogeneity of papers retrieved, meta-analysis was not possible, and a narrative summary was developed instead. The systematic review revealed that several different symbols and identifiers are in current use, in various parts of the world, to represent a range of medical and functional conditions, including dementia, delirium, falls risk, diabetes, and vision impairment. According to the papers reviewed, the most commonly used colour of symbols representing dementia was blue. There was general consensus amongst the literature that a symbol for dementia is appropriate in the acute care setting. It was also clear from the research that an abstract symbol, as opposed to one which explicitly attempts to depict dementia, was most acceptable to staff, people with dementia and their carers. There appeared to be some support for the use of a body worn symbol (on a bracelet) for people with dementia who may go missing from their home, aged care facility or day centre. Future research should concentrate on the appropriateness of a dementia symbol for commonly used services such as public transport and banking, and the acceptability of large scale marketing campaigns if a dementia symbol were to be introduced at a state or national level. In addition, further research is recommended into the acceptability of such a symbol across a wide range of different cultural and linguistic groups.

Predictors of Total Mortality and Echocardiographic Response for Cardiac Resynchronization Therapy: A Cohort Study

Directory of Open Access Journals (Sweden)

Guilherme Ferreira Gazzoni

2017-11-01

Full Text Available Abstract Background: Clinical studies demonstrate that up to 40% of patients do not respond to cardiac resynchronization therapy (CRT, thus, appropriate patient selection is critical to the success of CRT in heart failure. Objective: Evaluation of mortality predictors and response to CRT in the Brazilian scenario. Methods: Retrospective cohort study including patients submitted to CRT in a tertiary hospital in southern Brazil from 2008 to 2014. Survival was assessed through a database of the State Department of Health (RS. Predictors of echocardiographic response were evaluated using Poisson regression. Survival analysis was performed by Cox regression and Kaplan Meyer curves. A two-tailed p value less than 0.05 was considered statistically significant. Results: A total of 170 patients with an average follow-up of 1011 ± 632 days were included. The total mortality was 30%. The independent predictors of mortality were age (hazard ratio [HR] of 1.05, p = 0.027, previous acute myocardial infarction (AMI (HR of 2.17, p = 0.049 and chronic obstructive pulmonary disease (COPD (HR of 3.13, p = 0.015. The percentage of biventricular stimulation at 6 months was identified as protective factor of mortality ([HR] 0.97, p = 0.048. The independent predictors associated with the echocardiographic response were absence of mitral insufficiency, presence of left bundle branch block and percentage of biventricular stimulation. Conclusion: Mortality in patients submitted to CRT in a tertiary hospital was independently associated with age, presence of COPD and previous AMI. The percentage of biventricular pacing evaluated 6 months after resynchronizer implantation was independently associated with improved survival and echocardiographic response.

Appropriateness of the study of iron deficiency anemia prior to referral for small bowel evaluation at a tertiary center.

Science.gov (United States)

Rodrigues, Jaime Pereira; Pinho, Rolando; Silva, Joana; Ponte, Ana; Sousa, Mafalda; Silva, João Carlos; Carvalho, João

2017-06-28

To evaluate the adequacy of the study of iron deficiency anemia (IDA) in real life practice prior to referral to a gastroenterology department for small bowel evaluation. All consecutive patients referred to a gastroenterology department for small bowel investigation due to iron deficiency anemia, between January 2013 and December 2015 were included. Both patients referred from general practitioners or directly from different hospital departments were selected. Relevant clinical information regarding prior anemia workup was retrospectively collected from medical records. An appropriate pre-referral study was considered the execution of esophagogastroduodenoscopy (EGD) with Helicobacter pylori ( H. pylori ) investigation, colonoscopy with quality standards (recent, total and with adequate preparation) and celiac disease (CD) screening (through serologic testing and/or histopathological investigation). A total of 77 patients (58.4% female, mean age 67.1 ± 16.7 years) were included. Most (53.2%) patients were referred from general practitioners, 41.6% from other hospital specialties and 5.2% directly from the emergency department. The mean pre-referral hemoglobin concentration was 8.8 ± 2.0 g/dL and the majority of anemias had microcytic (71.4%) and hypochromic (72.7%) characteristics. 77.9% of patients presented with an incomplete pre-referral study: EGD in 97.4%, with H. pylori investigation in 58.3%, colonoscopy with quality criteria in 63.6%, and CD screening in 24.7%. Patients with an appropriate study at the time of referral were younger (48.7 ± 17.7 vs 72.3 ± 12.3 years, P < 0.001). Small bowel evaluation was ultimately undertaken in 72.7% of patients, with a more frequent evaluation in patients with a quality colonoscopy at referral (78.6% vs 23.8%); P < 0.001 (OR = 11.7, 95%CI: 3.6-38.6). The most common diagnosis regarded as the likely cause of IDA was small bowel angioectasia (18.2%) but additional causes were also found in the upper and lower

The Determinants of State Spending on Higher Education: How Capital Project Funding Differs from General Fund Appropriations

Science.gov (United States)

Ness, Erik C.; Tandberg, David A.

2013-01-01

Our fixed-effects panel data analysis of state spending on higher education fills a near void of studies examining capital expenditures on higher education. In our study, we found that political characteristics (e.g., interest group activity, organizational structure, and formal powers) largely account for differences between general fund and…

The effect of product–context appropriateness on emotion associations in evoked eating occasions

NARCIS (Netherlands)

Piqueras Fiszman, B.; Jaeger, S.R.

2015-01-01

The aim of this research was to investigate the impact that perceived product–context appropriateness exerts on elicited emotion associations. The experimental approach consisted in creating eating occasions (as a multi-component entity) varying in appropriateness, which consumers were instructed to

Questioning Appropriation: Agency and Complicity in a Transnational Feminist Location Politics

Directory of Open Access Journals (Sweden)

Joe Parker

2012-12-01

Full Text Available In feminist circles agency is often opposed to complicity and associated with resistance to sexism and patriarchy, yet such binary oppositions make the political stakes of their presumed boundaries difficult to interrogate. By bringing location politics into dialogue with agency theory, boundaries of same/Other and location categories may move from a naturalized ground for political work to the contested center of a politics of resistance. I follow a Foucauldian interpretation of agency to reconsider the ethico-politics of established divisions of self and Other both individually and in terms of social movements. By following Gayatri Spivak, Meyda Yeğenoğlu, and Chandra Mohanty's transnational feminist politics, I argue for the refusal of totalizing binaries and for careful attention to unavoidable complicities. This makes possible practices of agency that can critique the political and ethical limits and effects of its epistemology and take as its central project the intervention into appropriations of the Others into modern notions of the "real." The resulting reconstitution of self-Other relations in their work opens up important new avenues for building social movements that acknowledge difference within the subject or the movement rather than deny and expel their Others.

Total process surveillance: (TOPS)

International Nuclear Information System (INIS)

Millar, J.H.P.

1992-01-01

A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

State Teacher Evaluation and Teacher Education

Science.gov (United States)

Marchant, Gregory J.; David, Kristine A.; Rodgers, Deborah; German, Rachel L.

2015-01-01

Current accountability trends suggest an increasing role in state mandates regarding teacher evaluation. With various evaluation models and components serving as the basis for quality teaching, teacher education programs need to recognize the role teacher evaluation plays and incorporate aspects where appropriate. This article makes that case and…

Pharmacist Remote Review of Medication Prescriptions for Appropriateness in Pediatric Intensive Care Unit

Directory of Open Access Journals (Sweden)

Moran Lazaryan

2016-08-01

Full Text Available Background: One aspect of ordering and prescribing medication is the requirement for a trained professional to review medication orders or prescriptions for appropriateness. In practice, this review process is usually performed by a clinical pharmacist. However, in many medical centers there is a shortage of staff and a pharmacist is not always available.Objective: To determine whether remote review of medication orders by a pharmacist is a plausible method in a pediatric intensive care unit (PICU. Methods: A pharmacist from the pharmacy department reviewed medication orders of patients admitted to our PICU over a 7-month period for appropriateness. A special form for medical orders was filled in and sent to the physician in the PICU, who replied informing whether the recommendation had been accepted. The time spent by the pharmacist for this activity was recorded.Results: The review time for one medical record was 8.9 (95% CI, 6.9-10.9 minutes. Every additional drug prescribed increased the total review time by 0.8 (95% CI, 0.45-1.11 minutes. The pharmacist filled in 186 forms on 117 admissions for 109 children. The median review time was 15 (12.8-18.8 and 12 (9-15 minutes, respectively, for patients with psychiatric-neurologic disorders compared to those without (p=0.032. Usually, a daily workload of 240 minutes was needed for the pharmacist accompanying the round in contrast to 108 minutes per day needed to review all the medical records in 95% of the cases. The physician accepted 51.2%, rejected 11.9% and made no comment on 36.9% of the recommendations. Conclusion: Hospitals facing budget shortages can carry out focused remote reviews of prescriptions by the pharmacist.

Rational use of medicine in dentistry: do dentists prescribe antibiotics in appropriate indications?

Science.gov (United States)

Koyuncuoglu, Cenker Z; Aydin, Mehtap; Kirmizi, N Ipek; Aydin, Volkan; Aksoy, Mesil; Isli, Fatma; Akici, Ahmet

2017-08-01

There are concerns regarding appropriate use of antibiotics in dentistry practice. Data on dental antibiotic prescribing patterns by dentists is relatively limited. This nationwide study aimed to examine dentists' antibiotic prescriptions in a diagnosis-based manner in Turkey. This retrospective study on utilization of systemic antibiotics for dental problems was based on the national health data of the dentists obtained from Prescription Information System between January 2013 and August 2015. Only those prescriptions containing single diagnosis and at least one systemic antibiotic were included in the study. Antibiotic prescribing was compared by diagnoses and expertise of dentists. A total of 9,293,410 antibiotics were detected in 9,214,956 prescriptions that contained "single diagnosis and at least one antibiotic." The number of antibiotics per prescription was 1.01. "Periapical abscess without sinus" (28.1%), "dental examination" (20.7%), and "dental caries" (16.2%) were the three most common indications in which antibiotics were prescribed by dentists. While only 3.4% of antibiotics were prescribed upon the single and appropriate "cellulitis and abscess of mouth" diagnosis, the remaining 96.6% was prescribed for irrational/uncertain indications. Consistent in all diagnoses, "amoxicillin + enzyme inhibitor" (58.6%) was the mainly prescribed antibiotic. Analysis of the most preferred "amoxicillin + enzyme inhibitor" prescriptions by expertise of dentists showed significantly much higher prescription rates among Group A specialists and Group B specialists (67.0 and 67.8%, respectively) than those in unidentified dental practitioners (58.2%, p < 0.0001). This study showed that dentists prescribed antibiotics in an arbitrary and mostly unnecessary manner. In general, their antibiotic choices for examined diagnoses could be regarded as irrational. These results indicate the urgent need for improvement of rational antibiotic prescribing habits of dentists.

Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department.

Science.gov (United States)

Miller, Joseph B; Arter, Andrew; Wilson, Suprat S; Janke, Alexander T; Brody, Aaron; Reed, Brian P; Levy, Phillip D

2017-08-01

While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18-89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4%) were considered inappropriately treated. Overall, labetalol (61%) was the most commonly used medication, followed by enalaprilat (18%), hydralazine (18%), and metoprolol (3%). There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2%) patients in the inappropriate treatment cohort and in two (1%) patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant resources could perhaps be saved through education of

Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department

Directory of Open Access Journals (Sweden)

Joseph B. Miller

2017-07-01

Full Text Available Introduction: While moderate to severely elevated blood pressure (BP is present in nearly half of all emergency department (ED patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. Methods: We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18–89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. Results: We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4% were considered inappropriately treated. Overall, labetalol (61% was the most commonly used medication, followed by enalaprilat (18%, hydralazine (18%, and metoprolol (3%. There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2% patients in the inappropriate treatment cohort and in two (1% patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. Conclusion: More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant

75 FR 76731 - Request for Comment for Report on In-State Broadcast Programming

Science.gov (United States)

2010-12-09

... Report on In-State Broadcast Programming AGENCY: Federal Communications Commission. ACTION: Notice... to submit a report on in- state broadcast programming to the appropriate Congressional committees no.... REPORT ON IN-STATE BROADCAST PROGRAMMING. Not later than 18 months after the date of the enactment of...

An Analysis of Total Lightning Flash Rates Over Florida

Science.gov (United States)

Mazzetti, Thomas O.; Fuelberg, Henry E.

2017-12-01

Although Florida is known as the "Sunshine State", it also contains the greatest lightning flash densities in the United States. Flash density has received considerable attention in the literature, but lightning flash rate has received much less attention. We use data from the Earth Networks Total Lightning Network (ENTLN) to produce a 5 year (2010-2014) set of statistics regarding total flash rates over Florida and adjacent regions. Instead of tracking individual storms, we superimpose a 0.2° × 0.2° grid over the study region and count both cloud-to-ground (CG) and in-cloud (IC) flashes over 5 min intervals. Results show that the distribution of total flash rates is highly skewed toward small values, whereas the greatest rate is 185 flashes min-1. Greatest average annual flash rates ( 3 flashes min-1) are located near Orlando. The southernmost peninsula, North Florida, and the Florida Panhandle exhibit smaller average annual flash rates ( 1.5 flashes min-1). Large flash rates > 100 flashes min-1 can occur during any season, at any time during the 24 h period, and at any location within the domain. However, they are most likely during the afternoon and early evening in East Central Florida during the spring and summer months.

Total lymphoid irradiation in rhesus monkeys

International Nuclear Information System (INIS)

Vriesendorp, H.M.; Maat, B.; Hogeweg, B.

Total lymphoid irradiation (TLI) consists of three contiguous fields, a mantle, an inverted Y and a spleen field. TLI induces a state of immunosuppression in patients with Hodgkin disease or in small rodents. Infusion of allogeneic bone marrow cells into mice after TLI led to the development split haemopoietic chimerism and indefinite survival of skin grafts from the bone marrow donor. A protocol for TLI was developed for rhesus monkeys to attempt to verify these interesting observations in a pre-clinical animal model. (Auth.)

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

Science.gov (United States)

2014-01-01

Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

Science.gov (United States)

Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

2014-01-28

It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a

A Nationwide Survey About Palliative Sedation Involving Japanese Palliative Care Specialists: Intentions and Key Factors Used to Determine Sedation as Proportionally Appropriate.

Science.gov (United States)

Hamano, Jun; Morita, Tatsuya; Ikenaga, Masayuki; Abo, Hirofumi; Kizawa, Yoshiyuki; Tunetou, Satoru

2018-03-01

Although there has long been debate about physicians' intentions and what physicians consider to be proportionally appropriate when performing palliative sedation, few large studies have been performed. To identify physicians' intentions when starting continuous deep sedation and to clarify what factors determine whether physicians regard sedation as proportionally appropriate in relation to expected survival, the patients' wishes, and refractoriness. A nationwide questionnaire survey of Japanese palliative care specialists was performed from August to December 2016. We defined continuous deep sedation as the continuous use of sedatives to relieve intolerable and refractory symptoms with the loss of consciousness until death. Of the 695 palliative care specialists enrolled, 440 were analyzed (response rate, 69%). A total of 95% and 87% of the physicians reported that they explicitly intended to perform symptom palliation and decrease consciousness levels, respectively. Moreover, 38% answered that they explicitly intended to maintain unconsciousness until death, and 11% reported that they intended to shorten survival to some extent. The respondents considered that continuous deep sedation is more appropriate when the predicted survival is shorter, the patients' wishes are consistent and clear, and confidence in the refractoriness of symptoms is higher. Japanese palliative care specialists explicitly intend to control symptoms and reduce the level of consciousness when performing continuous deep sedation, but there are differences in their intentions with regard to maintaining unconsciousness until death. Predicted survival, patients' wishes, and confidence in refractoriness are associated with physicians' judgment that sedation is proportionally appropriate. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A d-person Differential Game with State Space Constraints

International Nuclear Information System (INIS)

Ramasubramanian, S.

2007-01-01

We consider a network of d companies (insurance companies, for example) operating under a treaty to diversify risk. Internal and external borrowing are allowed to avert ruin of any member of the network. The amount borrowed to prevent ruin is viewed upon as control. Repayment of these loans entails a control cost in addition to the usual costs. Each company tries to minimize its repayment liability. This leads to a d -person differential game with state space constraints. If the companies are also in possible competition a Nash equilibrium is sought. Otherwise a utopian equilibrium is more appropriate. The corresponding systems of HJB equations and boundary conditions are derived. In the case of Nash equilibrium, the Hamiltonian can be discontinuous; there are d interlinked control problems with state constraints; each value function is a constrained viscosity solution to the appropriate discontinuous HJB equation. Uniqueness does not hold in general in this case. In the case of utopian equilibrium, each value function turns out to be the unique constrained viscosity solution to the appropriate HJB equation. Connection with Skorokhod problem is briefly discussed

The economics of violence in natural states

NARCIS (Netherlands)

van Besouw, B.; Ansink, Erik; van Bavel, B.

2016-01-01

Violence is key to understanding human interaction and societal development. The natural state of societal organization is that a subset of the population, capable of mustering organized large-scale violence, forms an elite coalition that restrains both violence and coercive appropriation. We

Preoperative Optimization of Total Joint Arthroplasty Surgical Risk: Obesity.

Science.gov (United States)

Fournier, Matthew N; Hallock, Justin; Mihalko, William M

2016-08-01

Obesity is a problem that is increasing in prevalence in the United States and in other countries, and it is a common comorbidity in patients seeking total joint arthroplasty for degenerative musculoskeletal diseases. Obesity, as well as commonly associated comorbidities such as diabetes mellitus, cardiovascular disease, and those contributing to the diagnosis of metabolic syndrome, have been shown to have detrimental effects on total joint arthroplasty outcomes. Although there are effective surgical and nonsurgical interventions which can result in weight loss in these patients, concomitant benefit on arthroplasty outcomes is not clear. Preoperative optimization of surgical risk in obese total joint arthroplasty patients is an important point of intervention to improve arthroplasty outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Tourism package preferences of West Virginia state park visitors

Science.gov (United States)

William Gravley; John Dengler; Roy Ramthun; Chad Pierskalla

2009-01-01

This study was a preliminary examination of the activity and spending behavior of visitors to Pipestem State Park in West Virginia. This state park is being used as a case study area to determine whether a new fish stocking program accompanied by appropriate marketing activities can increase park visitation by anglers and other sports-oriented people. The research was...

40 CFR 745.325 - Lead-based paint activities: State and Tribal program requirements.

Science.gov (United States)

2010-07-01

... appropriate infrastructure or government capacity to effectively carry out a State or Tribal program. (b... documents the results of the inspection. (v) Records are retained by the certified inspector or the firm. (2... elimination of all identified hazards. (vi) The certified risk assessor or the firm retains the appropriate...

Bound states in string nets

Science.gov (United States)

Schulz, Marc Daniel; Dusuel, Sébastien; Vidal, Julien

2016-11-01

We discuss the emergence of bound states in the low-energy spectrum of the string-net Hamiltonian in the presence of a string tension. In the ladder geometry, we show that a single bound state arises either for a finite tension or in the zero-tension limit depending on the theory considered. In the latter case, we perturbatively compute the binding energy as a function of the total quantum dimension. We also address this issue in the honeycomb lattice where the number of bound states in the topological phase depends on the total quantum dimension. Finally, the internal structure of these bound states is analyzed in the zero-tension limit.

Applicable or relevant and appropriate requirements (ARARs) for remedial actions at the Portsmouth Gaseous Diffusion Plant: A compendium of environmental laws and guidance

International Nuclear Information System (INIS)

Houlberg, L.M.; Eaton, L.A.; Martin, J.A.; McDonald, E.P.; Etnier, E.L.

1992-02-01

Section 121 of the Comprehensive Environmental Response, Compensation, and Liability Act of 1990 (CERCLA) specifies that remedial actions for cleanup of hazardous substances must comply with applicable or relevant and appropriate requirements (ARARs) or standards under federal and state environmental laws. Although the US Department of Energy (DOE) Portsmouth Gaseous Diffusion Plant (PORTS) has not at this time been proposed for inclusion on the US Environmental Protection Agency National Priorities List, under Sect. I of an administrative consent order signed by DOE and the US Environmental Protection Agency on September 29, 1989, effective October 4, 1989, any necessary response actions at PORTS stipulated in the administrative consent order must be performed in a manner consistent with the Resource Conservation and Recovery Act of 1976 and CERCLA. Section 121 of CERCLA calls for the preparation of a draft listing of all ARARs. This report supplies a preliminary list of available federal and state ARARs that might be considered for remedial response at PORTS. A description of the terms ''applicable'' and ''relevant and appropriate'' is provided, as well as definitions of chemical-, location-, and action-specific ARARs. ARARs promulgated by the federal government and by the state of Ohio are listed in tables. In addition, the major provisions of the Resource Conservation and Recovery Act, Safe Drinking Water Act, Clean Water Act, and other acts, as they apply to hazardous waste cleanup, are discussed

Finite-State Methodology in Natural Language Processing

Directory of Open Access Journals (Sweden)

Michal Korzycki

2001-01-01

Full Text Available Recent mathematical and algorithmic results in the field of finite-state technology, as well the increase in computing power, have constructed the base for a new approach in natural language processing. However the task of creating an appropriate model that would describe the phenomena of the natural language is still to be achieved. ln this paper I'm presenting some notions related to the finite-state modelling of syntax and morphology.

Challenges in Selecting an Appropriate Heat Stress Index to Protect Workers in Hot and Humid Underground Mines

Directory of Open Access Journals (Sweden)

Pedram Roghanchi

2018-03-01

Full Text Available Background: A detailed evaluation of the underground mine climate requires extensive measurements to be performed coupled to climatic modeling work. This can be labor-intensive and time-consuming, and consequently impractical for daily work comfort assessments. Therefore, a simple indicator like a heat stress index is needed to enable a quick, valid, and acceptable evaluation of underground climatic conditions on a regular basis. This can be explained by the unending quest to develop a “universal index,” which has led to the proliferation of many proposed heat stress indices. Methods: The aim of this research study is to discuss the challenges in identifying and selecting an appropriate heat stress index for thermal planning and management purposes in underground mines. A method is proposed coupled to a defined strategy for selecting and recommending heat stress indices to be used in underground metal mines in the United States and worldwide based on a thermal comfort model. Results: The performance of current heat stress indices used in underground mines varies based on the climatic conditions and the level of activities. Therefore, carefully selecting or establishing an appropriate heat stress index is of paramount importance to ensure the safety, health, and increasing productivity of the underground workers. Conclusion: This method presents an important tool to assess and select the most appropriate index for certain climatic conditions to protect the underground workers from heat-related illnesses. Although complex, the method presents results that are easy to interpret and understand than any of the currently available evaluation methods. Keywords: climatic conditions, heat stress index, thermal comfort, underground mining

Fourier-based reconstruction via alternating direction total variation minimization in linear scan CT

International Nuclear Information System (INIS)

Cai, Ailong; Wang, Linyuan; Yan, Bin; Zhang, Hanming; Li, Lei; Xi, Xiaoqi; Li, Jianxin

2015-01-01

In this study, we consider a novel form of computed tomography (CT), that is, linear scan CT (LCT), which applies a straight line trajectory. Furthermore, an iterative algorithm is proposed for pseudo-polar Fourier reconstruction through total variation minimization (PPF-TVM). Considering that the sampled Fourier data are distributed in pseudo-polar coordinates, the reconstruction model minimizes the TV of the image subject to the constraint that the estimated 2D Fourier data for the image are consistent with the 1D Fourier transform of the projection data. PPF-TVM employs the alternating direction method (ADM) to develop a robust and efficient iteration scheme, which ensures stable convergence provided that appropriate parameter values are given. In the ADM scheme, PPF-TVM applies the pseudo-polar fast Fourier transform and its adjoint to iterate back and forth between the image and frequency domains. Thus, there is no interpolation in the Fourier domain, which makes the algorithm both fast and accurate. PPF-TVM is particularly useful for limited angle reconstruction in LCT and it appears to be robust against artifacts. The PPF-TVM algorithm was tested with the FORBILD head phantom and real data in comparisons with state-of-the-art algorithms. Simulation studies and real data verification suggest that PPF-TVM can reconstruct higher accuracy images with lower time consumption

Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

Directory of Open Access Journals (Sweden)

Hanna T

2014-03-01

Full Text Available Objective: To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods: Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG by three expert researchers. Results: In seven of nine scenarios (78%, the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency in the majority of scenarios. Due to this, only 47% (76/162 of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162 of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusion: Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

Using scenarios to test the appropriateness of pharmacist prescribing in asthma management.

Science.gov (United States)

Hanna, Tamer; Bajorek, Beata; Lemay, Kate; Armour, Carol L

2014-01-01

To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists' confidence, and appropriateness, in the context of asthma management. Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.

Using scenarios to test the appropriateness of pharmacist prescribing in asthma management

Science.gov (United States)

Hanna, Tamer; Bajorek, Beata; LeMay, Kate; Armour, Carol L.

Objective To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. Results In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusions Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way. PMID:24644524

Selection criteria for oxidation method in total organic carbon measurement.

Science.gov (United States)

Yoon, GeunSeok; Park, Sang-Min; Yang, Heuiwon; Tsang, Daniel C W; Alessi, Daniel S; Baek, Kitae

2018-05-01

During the measurement of total organic carbon (TOC), dissolved organic carbon is converted into CO 2 by using high temperature combustion (HTC) or wet chemical oxidation (WCO). However, the criteria for selecting the oxidation methods are not clear. In this study, the chemical structures of organic material were considered as a key factor to select the oxidation method used. Most non-degradable organic compounds showed a similar oxidation efficiency in both methods, including natural organic compounds, dyes, and pharmaceuticals, and thus both methods are appropriate to measure TOC in waters containing these compounds. However, only a fraction of the carbon in the halogenated compounds (perfluorooctanoic acid and trifluoroacetic acid) were oxidized using WCO, resulting in measured TOC values that are considerably lower than those determined by HTC. This result is likely due to the electronegativity of halogen elements which inhibits the approach of electron-rich sulfate radicals in the WCO, and the higher bond strength of carbon-halogen pairs as compared to carbon-hydrogen bonds, which results in a lower degree of oxidation of the compounds. Our results indicate that WCO could be used to oxidize most organic compounds, but may not be appropriate to quantify TOC in organic carbon pools that contain certain halogenated compounds. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigation and Determination of Corn Combine Harvester Losses to Introduce Appropriate Methods to Reduce Losses

Directory of Open Access Journals (Sweden)

M.R Mostofi Sarkari

2011-03-01

Full Text Available Corn harvesting involves some losses. These losses result in decreased benefits. It is almost impossible to lower losses to zero percent but it can be controlled in an acceptable level. As a result of this research, appropriate methods are introduced to decrease losses and reduce waste. In this project, losses in different part of combine were measured and evaluated according to the available standard method (ASAE S396.2 & S343.3. Harvesting losses include preharvest and during harvest losses comprising ear loss and kernal loss in the header, cylinder and cleaning losses. This project was conducted on farmers’ lands in Gazvin province. Some assessments related to yield factors were evaluated in different parts of farm with specified area, e.g. Plant height, ear number, stem diameter, ear diameter, cob diameter, row/ear and seed/row. All losses evaluated in three treatments which they were: seed moisture content (w.b. in three levels of 19%, 23% and 27%, ground speed in three levels of 0.8, 1.2 and 1.6 ms-1 and cylinder speed of 400, 600 and 800 rpm. The split plot experimental design based on the randomised complete block design (RCBD was used to evaluate treatments. Measured losses compared with standard values to introduce the proper methods to decrease losses and proper adjustments. The results show that appropriate seed moisture content, cylinder and ground speed were 23%, 400 rpm and 1.2 ms-1, respectively. They had minimum total loss which WAS 1.55%, 2.65% and 2.34%, respectivily. The results also show that there was an ear loss in preharvest loss (because of bad weather condition that was 0.95-5.42%, also kernal loss on the header and cylinder loss which all related to improper adjustment of combine but total loss was in an acceptable level and standard. It was variable from 1.55% to 4.02%. Other parameters such as using inexperienced driver, improper combine adjustment, and also nonuniformity of field and ear moisture content in

Total protein

Science.gov (United States)

... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

Scheme for generating the singlet state of three atoms trapped in distant cavities coupled by optical fibers

Energy Technology Data Exchange (ETDEWEB)

Wang, Dong-Yang [Department of Physics, College of Science, Yanbian University, Yanji, Jilin 133002 (China); Wen, Jing-Ji [College of Foundation Science, Harbin University of Commerce, Harbin, Heilongjiang 150028 (China); Bai, Cheng-Hua; Hu, Shi; Cui, Wen-Xue [Department of Physics, College of Science, Yanbian University, Yanji, Jilin 133002 (China); Wang, Hong-Fu, E-mail: hfwang@ybu.edu.cn [Department of Physics, College of Science, Yanbian University, Yanji, Jilin 133002 (China); Zhu, Ai-Dong [Department of Physics, College of Science, Yanbian University, Yanji, Jilin 133002 (China); Zhang, Shou, E-mail: szhang@ybu.edu.cn [Department of Physics, College of Science, Yanbian University, Yanji, Jilin 133002 (China)

2015-09-15

An effective scheme is proposed to generate the singlet state with three four-level atoms trapped in three distant cavities connected with each other by three optical fibers, respectively. After a series of appropriate atom–cavity interactions, which can be arbitrarily controlled via the selective pairing of Raman transitions and corresponding optical switches, a three-atom singlet state can be successfully generated. The influence of atomic spontaneous decay, photon leakage of cavities and optical fibers on the fidelity of the state is numerically simulated showing that the three-atom singlet state can be generated with high fidelity by choosing the experimental parameters appropriately.

ACR appropriateness criteria blunt chest trauma.

Science.gov (United States)

Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

2014-04-01

Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Method for Determining Appropriate Clustering Criteria of Location-Sensing Data

Directory of Open Access Journals (Sweden)

Youngmin Lee

2016-08-01

Full Text Available Large quantities of location-sensing data are generated from location-based social network services. These data are provided as point properties with location coordinates acquired from a global positioning system or Wi-Fi signal. To show the point data on multi-scale map services, the data should be represented by clusters following a grid-based clustering method, in which an appropriate grid size should be determined. Currently, there are no criteria for determining the proper grid size, and the modifiable areal unit problem has been formulated for the purpose of addressing this issue. The method proposed in this paper is applies a hexagonal grid to geotagged Twitter point data, considering the grid size in terms of both quantity and quality to minimize the limitations associated with the modifiable areal unit problem. Quantitatively, we reduced the original Twitter point data by an appropriate amount using Töpfer’s radical law. Qualitatively, we maintained the original distribution characteristics using Moran’s I. Finally, we determined the appropriate sizes of clusters from zoom levels 9–13 by analyzing the distribution of data on the graphs. Based on the visualized clustering results, we confirm that the original distribution pattern is effectively maintained using the proposed method.

Total Radiosynthesis: Thinking outside “the box”

OpenAIRE

Liang, Steven H.; Vasdev, Neil

2015-01-01

The logic of total synthesis transformed a stagnant state of medicinal and synthetic organic chemistry when there was a paucity of methods and reagents to synthesize drug molecules and/or natural products. Molecular imaging by positron emission tomography (PET) is now experiencing a renaissance in the way radiopharmaceuticals for molecular imaging are synthesized, however, a paradigm shift is desperately needed in the discovery pipeline to accelerate in vivo imaging studies. A significant cha...

The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

International Nuclear Information System (INIS)

Gerbaud, Laurent; Manhes, Geraud; Debourse, Juliette; Gouby, Gerald; Glanddier, Phyllis-Yvonne; Vader, John-Paul; Boyer, Louis; Deteix, Patrice

2008-01-01

Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis (≥70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http

Multiple scroll wave chimera states

Science.gov (United States)

Maistrenko, Volodymyr; Sudakov, Oleksandr; Osiv, Oleksiy; Maistrenko, Yuri

2017-06-01

We report the appearance of three-dimensional (3D) multiheaded chimera states that display cascades of self-organized spatiotemporal patterns of coexisting coherence and incoherence. We demonstrate that the number of incoherent chimera domains can grow additively under appropriate variations of the system parameters generating thereby head-adding cascades of the scroll wave chimeras. The phenomenon is derived for the Kuramoto model of N 3 identical phase oscillators placed in the unit 3D cube with periodic boundary conditions, parameters being the coupling radius r and phase lag α. To obtain the multiheaded chimeras, we perform the so-called `cloning procedure' as follows: choose a sample single-headed 3D chimera state, make appropriate scale transformation, and put some number of copies of them into the unit cube. After that, start numerical simulations with slightly perturbed initial conditions and continue them for a sufficiently long time to confirm or reject the state existence and stability. In this way it is found, that multiple scroll wave chimeras including those with incoherent rolls, Hopf links and trefoil knots admit this sort of multiheaded regeneration. On the other hand, multiple 3D chimeras without spiral rotations, like coherent and incoherent balls, tubes, crosses, and layers appear to be unstable and are destroyed rather fast even for arbitrarily small initial perturbations.

Human Nutrition Research Conducted at State Agricultural Experiment Stations and 1890/Tuskegee Agricultural Research Programs.

Science.gov (United States)

Driskell, Judy A.; Myers, John R.

1989-01-01

Cooperative State Research Service-administered and state-appropriated State Agriculture Experiment Station funds for human nutrition research increased about two-fold from FY70-FY86, while the percentage of budget expended for this research decreased. (JOW)

Oral Tranexamic Acid Reduces Transfusions in Total Knee Arthroplasty.

Science.gov (United States)

Perreault, Roger E; Fournier, Christine A; Mattingly, David A; Junghans, Richard P; Talmo, Carl T

2017-10-01

Tranexamic acid (TXA) reduces intraoperative blood loss and transfusions in patients undergoing total knee arthroplasty. Although numerous studies demonstrate the efficacy of intravenous and topical TXA in these patients, few demonstrate the effectiveness and appropriate dosing recommendations of oral formulations. A retrospective cohort study was performed to evaluate differences in transfusion requirements in patients undergoing primary unilateral total knee arthroplasty with either no TXA (n = 866), a single-dose of oral TXA (n = 157), or both preoperative and postoperative oral TXA (n = 1049). Secondary outcomes included postoperative hemoglobin drop, total units transfused, length of stay, drain output, and cell salvage volume. Transfusion rates decreased from 15.4% in the no-oral tranexamic acid (OTA) group to 9.6% in the single-dose OTA group (P < .001) and 7% in the 2-dose group (P < .001), with no difference in transfusion rates between the single- and 2-dose groups (P = .390). In addition, postoperative hemoglobin drop was reduced from 4.2 g/dL in the no-OTA group to 3.5 g/dL in the single-dose group (P < .01) and to 3.4 g/dL in the 2-dose group (P < .01), without a difference between the single- and 2-dose groups (P = .233). OTA reduces transfusions, with greater ease of administration and improved cost-effectiveness relative to other forms of delivery. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends in metformin utilisation and dose appropriateness in Australia.

Science.gov (United States)

Moon, J; Kumar, S S; Graham, G G; Baysari, M T; Williams, K M; Chen, W; Viardot, A; Greenfield, J R; Day, R O

2016-12-01

The study aimed to (1) determine the trends in the utilisation of metformin in Australia, (2) determine the appropriateness of metformin dosing in an Australian teaching hospital and (3) gather the opinions of prescribers on the relationship between metformin dose and renal function. National prescription data between 1990 and 2012 were accessed. A retrospective audit (2008-2012) of metformin doses and patient renal function (20 % random sample of all in-patients prescribed metformin) was conducted at St Vincent's Hospital (SVH), Sydney. Prescribers of metformin were interviewed (semi-structured; consultants at SVH) or surveyed (Australian endocrinologists) to gather their understanding of metformin dosing in relation to renal function. Metformin utilisation increased fivefold nationally between 1995 and 2012. Metformin tended to be under-dosed in SVH patients with normal renal function (83.5 %) and over-dosed in patients with impaired renal function (estimated glomerular filtration rate (eGFR) metformin doses needed to be reduced in renal impairment. Most endocrinologists (61 %) were comfortable prescribing metformin down to eGFRs around 30 mL/min. The use of metformin increased greatly over the period of the study. Metformin is prescribed frequently for patients with eGFR values below the minimal level approved in the product label (60 mL/min). While prescribers expressed their understanding of the need to reduce metformin doses in patients with renal impairment, we found that metformin doses were higher than appropriate in patients with impaired renal function. Metformin may be used safely when renal function is poor provided dosage is appropriately reduced.

Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

Data.gov (United States)

Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

State and local safety program

Energy Technology Data Exchange (ETDEWEB)

Carlyle Thompson, G D [Utah State Division of Health, Salt Lake City, UT (United States)

1969-07-01

This paper will give emphasis to the need for an increasing role of the states, along with the Federal agencies, in the Plowshare Program in order to assure state and local confidence with respect to the safety of their residents as the Federal government seeks new methods to benefit society. First will be stressed the age-old principle of control at the source. Other factors to be discussed are monitoring; standards and their use; control action; public relations; predictions and the need to have certain advance knowledge of tests - even if security clearance is necessary for appropriate state representatives; the state and local government responsibility to their citizens; the isolation of national decision making from state and local concern and responsibility; cost assessments and their responsibility; and research as it relates to the ecological system as well a the direct short- or long-term effects of radioactivity on man. (author)

State and local safety program

International Nuclear Information System (INIS)

Carlyle Thompson, G.D.

1969-01-01

This paper will give emphasis to the need for an increasing role of the states, along with the Federal agencies, in the Plowshare Program in order to assure state and local confidence with respect to the safety of their residents as the Federal government seeks new methods to benefit society. First will be stressed the age-old principle of control at the source. Other factors to be discussed are monitoring; standards and their use; control action; public relations; predictions and the need to have certain advance knowledge of tests - even if security clearance is necessary for appropriate state representatives; the state and local government responsibility to their citizens; the isolation of national decision making from state and local concern and responsibility; cost assessments and their responsibility; and research as it relates to the ecological system as well a the direct short- or long-term effects of radioactivity on man. (author)

Interventions to provide culturally-appropriate maternity care services: factors affecting implementation.

Science.gov (United States)

Jones, Eleri; Lattof, Samantha R; Coast, Ernestina

2017-08-31

The World Health Organization recently made a recommendation supporting 'culturally-appropriate' maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women's use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders' perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Women's and other stakeholders' perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups' access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their

Appropriating Geometric Series as a Cultural Tool: A Study of Student Collaborative Learning

Science.gov (United States)

Carlsen, Martin

2010-01-01

The aim of this article is to illustrate how students, through collaborative small-group problem solving, appropriate the concept of geometric series. Student appropriation of cultural tools is dependent on five sociocultural aspects: involvement in joint activity, shared focus of attention, shared meanings for utterances, transforming actions and…