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Sample records for treatment advice system

  1. ADVICE--Educational System for Teaching Database Courses

    Science.gov (United States)

    Cvetanovic, M.; Radivojevic, Z.; Blagojevic, V.; Bojovic, M.

    2011-01-01

    This paper presents a Web-based educational system, ADVICE, that helps students to bridge the gap between database management system (DBMS) theory and practice. The usage of ADVICE is presented through a set of laboratory exercises developed to teach students conceptual and logical modeling, SQL, formal query languages, and normalization. While…

  2. Attending physician and patient in radiotherapeutic treatment: practical advices

    International Nuclear Information System (INIS)

    2008-03-01

    This brochure is devoted to external radiotherapy and provides some pieces of practical advices for each stage of the patient's treatment: before, during and after radiotherapy. The monitoring and management of short-, medium- and long-term side-effects represent a major stake. Such side-effects and their treatments are presented in tables for each affected part of the body or affected organ. (J.S.)

  3. Advice under uncertainty in the marine system

    DEFF Research Database (Denmark)

    Dankel, Dorothy J.; Aps, Robert; Padda, Gurpreet

    2012-01-01

    lacking. Fisheries science that gives advice to policy-making is plagued by uncertainties; the stakes of the policies are high and value-laden and need therefore to be treated as an example of “post-normal science” (PNS). To achieve robust governance, understanding of the characteristics and implications...

  4. State-level prevalence of cigarette smoking and treatment advice, by disability status, United States, 2004.

    Science.gov (United States)

    Armour, Brian S; Campbell, Vincent A; Crews, John E; Malarcher, Ann; Maurice, Emmanuel; Richard, Roland A

    2007-10-01

    To our knowledge, no study has determined whether smoking prevalence is higher among people with disabilities than among people without disabilities across all U.S. states. Neither do we know whether people with disabilities and people without disabilities receive the same quality of advice about tobacco-cessation treatment from medical providers. We analyzed data from the 2004 Behavioral Risk Factor Surveillance System to estimate differences between people with and people without disabilities in smoking prevalence and the receipt of tobacco-cessation treatment advice from medical providers. We found that smoking prevalence for people with disabilities was approximately 50% higher than for people without disabilities. Smokers with disabilities were more likely than smokers without disabilities to have visited a medical provider at least once in the previous 12 months and to have received medical advice to quit. More than 40% of smokers with disabilities who were advised to quit, however, reported not being told about the types of tobacco-cessation treatment available. Ensuring that people with disabilities are included in state-based smoking cessation programs gives states an opportunity to eliminate health disparities and to improve the health and wellness of this group. Ways to reduce unmet preventive health care needs of people with disabilities include provider adoption of the Public Health Service's clinical practice guideline for treating tobacco use and dependence and the provision of smoking cessation services that include counseling and effective pharmaceutical treatment.

  5. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    NARCIS (Netherlands)

    Wendel, S.; Dellaert, B.G.C.; Ronteltap, A.; Trijp, van J.C.M.

    2013-01-01

    Background: Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine

  6. Consumers' intention to use health recommendation systems to receive personalized nutrition advice

    NARCIS (Netherlands)

    S. Wendel (Sonja); B.G.C. Dellaert (Benedict); A. Ronteltap (Amber); H.C.M. van Trijp (Hans)

    2013-01-01

    textabstractBackground: Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We

  7. Nutrition Advice and Recipes

    Science.gov (United States)

    ... Sign-Up Home Patient Information Nutrition Advice & Recipes Nutrition Advice & Recipes This is a very important section ... information on all aspects of daily life, including nutrition, medical treatments, pain management, and practical tips. For ...

  8. A nurse- and pharmacist-led treatment advice clinic for patients attending an HIV outpatient clinic.

    Science.gov (United States)

    Griffiths, C; Miles, K; Aldam, D; Cornforth, D; Minton, J; Edwards, S; Williams, I

    2007-05-01

    This paper is a report of a study to map care pathways, examine the approach of different treatment advisors and explore the acceptability of a nurse- and pharmacist-led treatment advice clinic in order to aid decision-making for the future development and evaluation of the clinic. High levels of adherence to antiretroviral drugs are a prerequisite for a successful and durable virological and immunological response to HIV. Treatment guidelines acknowledge that adherence is a process, not a single event, and that adherence support must be integrated into clinical follow-up for all patients receiving these drugs. Data were collected between September 2004 and January 2005 through 17 consultation observations and 10 patient interviews in a specialist treatment advice clinic located within a central London HIV outpatient clinic providing care for over 2200 patients, of whom more than 1300 are taking highly active antiretroviral therapy. The nurses and pharmacist had similar consultation approaches, although follow-up care varied in extent. Benefits of the clinic approach included permitting patients to observe real tablets, tailoring regimens to lifestyles and telephone follow-up. These factors, particularly telephone support, were perceived by patients to assist with adherence. The role of telephone support, perceived to assist with initial adherence, requires further investigation. Future work is also needed to explore the health economics of this approach and to determine the actual impact of the clinic on clinical and adherence outcomes.

  9. An Expert System for On-Site Instructional Advice.

    Science.gov (United States)

    Martindale, Elizabeth S.; Hofmeister, Alan M.

    1988-01-01

    Describes Written Language Consultant, an expert system designed to help teachers teach special education students how to write business letters. Three main components of the system are described, including entry of students' test scores; analysis of teachers' uses of classroom time and management techniques; and suggestions for improving test…

  10. Antibiotic use by farmers to control mastitis as influenced by health advice and dairy farming systems.

    Science.gov (United States)

    Poizat, A; Bonnet-Beaugrand, F; Rault, A; Fourichon, C; Bareille, N

    2017-10-01

    Mastitis is a bacterial disease common in dairy farms. Although knowledge about mastitis and its optimal technical management and treatment is now available, some dairy farmers still use antibiotics in inappropriate ways. Antibiotic use by farmers can be influenced by personal restraints and motivations, but it can be assumed that external drivers are also influential. The main purpose of this article is thus to analyse the choices of antibiotic and alternative medicine use for mastitis treatment and investigate the possible influence of two unexplored external drivers in dairy farms: (i) the health advice offered to farmers by farm advisors and veterinarians, (ii) the dairy farming system, as defined by combining the market valuation chosen for the milk, the level of intensification, and the perceived pressure related to investments. Research was based on 51 individual semi-structured interviews with farmers and their corresponding veterinarians and farm advisors. Based on verbatim, the use of antibiotics and alternative medicine by farmers for mastitis treatment, the vet-farmers interactions, and the dairy farming systems are described. The advisory relationships between farmers and farm advisors and between farmers and veterinarians influenced the implementation of selective dry cow therapy, but had very little effect on the use of alternative medicines by farmers, who were more willing to experiment alternative medicines than their advisors. The dairy farming system had very little influence on antibiotic use: some misuse of antibiotics was found whatever the farming system. Systematic dry cow therapy was also a widespread habit in all dairy farming systems except organic. The use of alternative medicine was common in all farming systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Factors influencing adherence to referral advice following pre-referral treatment with artesunate suppositories in children in rural Tanzania.

    Science.gov (United States)

    Simba, Daudi O; Warsame, Marian; Kimbute, Omari; Kakoko, Deodatus; Petzold, Max; Tomson, Goran; Premji, Zul; Gomes, Melba

    2009-07-01

    WHO recommends artemisinin suppository formulations as pre-referral treatment for children who are unable to take oral medication and cannot rapidly reach a facility for parenteral treatment. We investigated factors influencing caretakers' adherence to referral advice following pre-referral treatment of their children with rectal artesunate suppositories. The study was nested within an intervention study that involved pre-referral treatment of all children who came to a community dispenser for treatment because they were unable to take oral medications because of repeated vomiting, lethargy, convulsions or altered consciousness. All patients who did not comply with referral advice were stratified by actions taken post-referral: taking their children to a drug shop, a traditional healer, or not seeking further treatment, and added to a random selection of patients who complied with referral advice. Caretakers of the children were interviewed about their socio-economic status (SES), knowledge about malaria, referral advice given and actions they took following pre-referral treatment. Interview data for 587 caretakers were matched with symptoms of the children, the time of treatment, arrival at a health facility or other actions taken post-pre-referral treatment. The majority (93.5%) of caretakers reported being given referral advice by the community drug dispenser. The odds of adherence with this advice were three times greater for children with altered consciousness and/or convulsions than for children with other symptoms [odds ratio (OR) 3.47, 95% confidence interval (CI) 2.32-5.17, P < 0.001]. When questioned, caretakers who remembered when (OR 2.19, 95% CI 1.48-3.23, P < 0.001) and why (OR 1.77, 95% CI 1.07-2.95, P = 0.026) they were advised to proceed to health facility - were more likely to follow referral advice. Cost did not influence adherence except within a catchment area of facilities that charged for services. In these areas, costs deterred adherence by

  12. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    Science.gov (United States)

    2013-01-01

    Background Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. Methods 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. Results We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. Conclusions We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to

  13. Consumers' intention to use health recommendation systems to receive personalized nutrition advice.

    Science.gov (United States)

    Wendel, Sonja; Dellaert, Benedict G C; Ronteltap, Amber; van Trijp, Hans C M

    2013-04-04

    Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide personalized nutrition advice. We examine consumers' intention to use such a health recommendation system as a function of options related to the underlying system (e.g. the type of company that generates the advice) as well as intermediaries (e.g. general practitioner) that might assist in using the system. We further explore if the effect of both the system and intermediaries on intention to use a health recommendation system are mediated by consumers' perceived effort, privacy risk, usefulness and enjoyment. 204 respondents from a consumer panel in the Netherlands participated. The data were collected by means of a questionnaire. Each respondent evaluated three hypothetical health recommendation systems on validated multi-scale measures of effort, privacy risk, usefulness, enjoyment and intention to use the system. To test the hypothesized relationships we used regression analyses. We find evidence that the options related to the underlying system as well as the intermediaries involved influence consumers' intention to use such a health recommendation system and that these effects are mediated by perceptions of effort, privacy risk, usefulness and enjoyment. Also, we find that consumers value usefulness of a system more and enjoyment less when a general practitioner advices them to use a health recommendation system than if they use it out of their own curiosity. We developed and tested a model of consumers' intention to use a health recommendation system. We found that intermediaries play an important role in how consumers evaluate such a system over and above options of the underlying system that is used to generate the recommendation. Also, health-related information services seem to rely on endorsement by the medical sector

  14. Parental views on delivering preventive advice to children referred for treatment of dental caries under general anaesthesia: a qualitative investigation.

    Science.gov (United States)

    Aljafari, A K; Scambler, S; Gallagher, J E; Hosey, M T

    2014-06-01

    To: 1, Explore opinions of parents of children undergoing caries treatment under general anaesthesia (GA) regarding delivery of oral health advice; 2, Discover current oral health practices and beliefs; 3, Inform further research and action. Qualitative study using semi-structured interviews and thematic data analysis, sampling parents of children aged 3-10 years undergoing GA tooth extraction due to dental caries. Twenty nine parents were interviewed (mean age 38.9 years, range 28-50, sd 6.4). The mean age of their children was seven years (range 3-10, sd 2.1). All children required deciduous tooth extractions (5.1 teeth on average). Those that also required permanent tooth extractions had on average 2.1 permanent teeth extracted. Many parents knew the importance of oral hygiene and sugar limitation, describing it as 'general knowledge' and 'common sense'. However, few understood that fruit juice is potentially cariogenic. Parenting challenges seemed to restrict their ability to control the child's diet and establish oral hygiene. Many reported not previously receiving oral health advice and reported never having fluoride varnish applied. There were requests for more caries prevention information and advice via the internet, schools or video games. Parental oral health knowledge, parenting skills, and previous advice received seem to all be issues related to the oral health of those children. Providing advice, especially in respect to fruit juice cariogenicity and the benefits of fluoride application through a child-friendly website, including a video game, as well as the use of school programmes might be an acceptable approach.

  15. Improving energy decisions towards better scientific policy advice for a safe and secure future energy system

    CERN Document Server

    Droste-Franke, Bert; Kaiser, M; Schreurs, Miranda; Weber, Christoph; Ziesemer, Thomas

    2015-01-01

    Managing a successful transition of the current energy supply system to less carbon emitting options, ensuring a safe and secure supply during the whole process and in the long term, is one of the largest challenges of our time. Various approaches and first implementations show that it is not only technological issue, but also a matter of societal acceptance and acceptability, considering basic ethic values of the society. The main foci of the book are, thus, to develop an understanding about the specific challenges of the scientific policy advice in the area, to explore typical current approaches for the analysis of future energy systems and to develop criteria for the quality assessment and guidelines for the improvement of such studies. The book provides assistance to the interpretation of existing studies and guidelines for setting up and carrying out new analyses as well as for communicating and applying the results. Thereby, it aims to support the involved actors such as the respective scientific expert...

  16. Mobile Phone-Based Field Monitoring for Satsuma Mandarin and Its Application to Watering Advice System

    Science.gov (United States)

    Kamiya, Toshiyuki; Numano, Nagisa; Yagyu, Hiroyuki; Shimazu, Hideo

    This paper describes a mobile phone-based data logging system for monitoring the growing status of Satsuma mandarin, a type of citrus fruit, in the field. The system can provide various feedback to the farm producers with collected data, such as visualization of related data as a timeline chart or advice on the necessity of watering crops. It is important to collect information on environment conditions, plant status and product quality, to analyze it and to provide it as feedback to the farm producers to aid their operations. This paper proposes a novel framework of field monitoring and feedback for open-field farming. For field monitoring, it combines a low-cost plant status monitoring method using a simple apparatus and a Field Server for environment condition monitoring. Each field worker has a simple apparatus to measure fruit firmness and records data with a mobile phone. The logged data are stored in the database of the system on the server. The system analyzes stored data for each field and is able to show the necessity of watering to the user in five levels. The system is also able to show various stored data in timeline chart form. The user and coach can compare or analyze these data via a web interface. A test site was built at a Satsuma mandarin field at Kumano in Mie Prefecture, Japan using the framework, and farm workers monitor in the area used and evaluated the system.

  17. Professional advice

    DEFF Research Database (Denmark)

    Ottaviani, Marco; Sørensen, Peter Norman

    2006-01-01

    on the basis of the advice given and the realized state of the world. In equilibrium of this reputational cheap-talk game, no more than two messages are effectively reported. The model is extended to consider sequential communication by experts with conditionally independent signals. In the long run, learning...

  18. A Dietary Feedback System for the Delivery of Consistent Personalized Dietary Advice in the Web-Based Multicenter Food4Me Study.

    Science.gov (United States)

    Forster, Hannah; Walsh, Marianne C; O'Donovan, Clare B; Woolhead, Clara; McGirr, Caroline; Daly, E J; O'Riordan, Richard; Celis-Morales, Carlos; Fallaize, Rosalind; Macready, Anna L; Marsaux, Cyril F M; Navas-Carretero, Santiago; San-Cristobal, Rodrigo; Kolossa, Silvia; Hartwig, Kai; Mavrogianni, Christina; Tsirigoti, Lydia; Lambrinou, Christina P; Godlewska, Magdalena; Surwiłło, Agnieszka; Gjelstad, Ingrid Merethe Fange; Drevon, Christian A; Manios, Yannis; Traczyk, Iwona; Martinez, J Alfredo; Saris, Wim H M; Daniel, Hannelore; Lovegrove, Julie A; Mathers, John C; Gibney, Michael J; Gibney, Eileen R; Brennan, Lorraine

    2016-06-30

    Despite numerous healthy eating campaigns, the prevalence of diets high in saturated fatty acids, sugar, and salt and low in fiber, fruit, and vegetables remains high. With more people than ever accessing the Internet, Web-based dietary assessment instruments have the potential to promote healthier dietary behaviors via personalized dietary advice. The objectives of this study were to develop a dietary feedback system for the delivery of consistent personalized dietary advice in a multicenter study and to examine the impact of automating the advice system. The development of the dietary feedback system included 4 components: (1) designing a system for categorizing nutritional intakes; (2) creating a method for prioritizing 3 nutrient-related goals for subsequent targeted dietary advice; (3) constructing decision tree algorithms linking data on nutritional intake to feedback messages; and (4) developing personal feedback reports. The system was used manually by researchers to provide personalized nutrition advice based on dietary assessment to 369 participants during the Food4Me randomized controlled trial, with an automated version developed on completion of the study. Saturated fatty acid, salt, and dietary fiber were most frequently selected as nutrient-related goals across the 7 centers. Average agreement between the manual and automated systems, in selecting 3 nutrient-related goals for personalized dietary advice across the centers, was highest for nutrient-related goals 1 and 2 and lower for goal 3, averaging at 92%, 87%, and 63%, respectively. Complete agreement between the 2 systems for feedback advice message selection averaged at 87% across the centers. The dietary feedback system was used to deliver personalized dietary advice within a multi-country study. Overall, there was good agreement between the manual and automated feedback systems, giving promise to the use of automated systems for personalizing dietary advice. Clinicaltrials.gov NCT01530139

  19. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    1984-01-01

    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  20. 'How to stop a nosebleed': an assessment of the quality of epistaxis treatment advice on YouTube.

    Science.gov (United States)

    Haymes, A T; Harries, V

    2016-08-01

    Video hosting websites are increasingly being used to disseminate health education messages. This study aimed to assess the quality of advice contained within YouTube videos on the conservative management of epistaxis. YouTube.com was searched using the phrase 'how to stop a nosebleed'. The first 50 videos were screened. Objective advice scores and subjective production quality scores were attributed by independent raters. Forty-five videos were analysed. The mean advice score was 2.0 out of 8 and the mean production quality score was 1.6 out of 3. There were no correlations between a video's advice score and its search results rank (ρ = -0.28, p = 0.068), its view count (ρ = 0.20, p = 0.19) or its number of 'likes' (ρ = 0.21, p = 0.18). The quality of information on conservative epistaxis management within YouTube videos is extremely variable. A high search rank is no indication of video quality. Many videos proffer inappropriate and dangerous 'alternative' advice. We do not recommend YouTube as a source for patient information.

  1. Treatment of forefoot problems in older people: study protocol for a randomised clinical trial comparing podiatric treatment to standardised shoe advice

    Directory of Open Access Journals (Sweden)

    Peeraer Louis

    2011-03-01

    Full Text Available Abstract Background Foot problems in general and forefoot problems in particular can lead to a decrease in mobility and a higher risk of falling. Forefoot problems increase with age and are more common in women than in men. Around 20% of people over 65 suffer from non-traumatic foot problems and 60% of these problems are localised in the forefoot. Little is known about the best way to treat forefoot problems in older people. The aim of this study is to compare the effects of two common modes of treatment in the Netherlands: shoe advice and podiatric treatment. This paper describes the design of this study. Methods The study is designed as a pragmatic randomised clinical trial (RCT with 2 parallel intervention groups. People aged 50 years and over who have visited their general practitioner (GP with non traumatic pain in the forefoot in the preceding year and those who will visit their GP during the recruitment period with a similar complaint will be recruited for this study. Participants must be able to walk unaided for 7 metres and be able to fill in questionnaires. Exclusion criteria are: rheumatoid arthritis, neuropathy of the foot or pain caused by skin problems (e.g. warts, eczema. Inclusion and exclusion criteria will be assessed by a screening questionnaire and baseline assessment. Those consenting to participation will be randomly assigned to either a group receiving a standardised shoe advice leaflet (n = 100 or a group receiving podiatric treatment (n = 100. Primary outcomes will be the severity of forefoot pain (0-10 on a numerical rating scale and foot function (Foot Function 5-pts Index and Manchester Foot Pain and Disability Index. Treatment adherence, social participation and quality of life will be the secondary outcomes. All outcomes will be obtained through self-administered questionnaires at the start of the study and after 3, 6, 9 and 12 months. Data will be analysed according to the "intention-to-treat" principle using

  2. Specific treatment of problems of the spine (STOPS: design of a randomised controlled trial comparing specific physiotherapy versus advice for people with subacute low back disorders

    Directory of Open Access Journals (Sweden)

    Richards Matthew C

    2011-05-01

    Full Text Available Abstract Background Low back disorders are a common and costly cause of pain and activity limitation in adults. Few treatment options have demonstrated clinically meaningful benefits apart from advice which is recommended in all international guidelines. Clinical heterogeneity of participants in clinical trials is hypothesised as reducing the likelihood of demonstrating treatment effects, and sampling of more homogenous subgroups is recommended. We propose five subgroups that allow the delivery of specific physiotherapy treatment targeting the pathoanatomical, neurophysiological and psychosocial components of low back disorders. The aim of this article is to describe the methodology of a randomised controlled trial comparing specific physiotherapy treatment to advice for people classified into five subacute low back disorder subgroups. Methods/Design A multi-centre parallel group randomised controlled trial is proposed. A minimum of 250 participants with subacute (6 weeks to 6 months low back pain and/or referred leg pain will be classified into one of five subgroups and then randomly allocated to receive either physiotherapy advice (2 sessions over 10 weeks or specific physiotherapy treatment (10 sessions over 10 weeks tailored according to the subgroup of the participant. Outcomes will be assessed at 5 weeks, 10 weeks, 6 months and 12 months following randomisation. Primary outcomes will be activity limitation measured with a modified Oswestry Disability Index as well as leg and back pain intensity measured on separate 0-10 Numerical Rating Scales. Secondary outcomes will include a 7-point global rating of change scale, satisfaction with physiotherapy treatment, satisfaction with treatment results, the Sciatica Frequency and Bothersomeness Scale, quality of life (EuroQol-5D, interference with work, and psychosocial risk factors (Orebro Musculoskeletal Pain Questionnaire. Adverse events and co-interventions will also be measured. Data will be

  3. Consumers’ intention to use health recommendation systems to receive personalized nutrition advice

    NARCIS (Netherlands)

    S. Wendel (Sonja); B.G.C. Dellaert (Benedict); A. Ronteltap (Amber); H.C.M. van Trijp (Hans)

    2013-01-01

    markdownabstract__Abstract__ __Background:__ Sophisticated recommendation systems are used more and more in the health sector to assist consumers in healthy decision making. In this study we investigate consumers' evaluation of hypothetical health recommendation systems that provide

  4. An investigation into the efficacy of avatar-based systems for student advice

    Directory of Open Access Journals (Sweden)

    E. Currie

    2016-06-01

    Full Text Available Student support is an important function in all universities. Most students expect access to support 24/7, but support staff cannot be available at all times of day. This paper addresses this problem, describing the development of an avatar-based system to guide students through the materials provided by a university student employability service. Firstly, students and staff were surveyed to establish the demand for such a system. The system was then constructed. Finally, the system was evaluated by students and staff, which led to a clearer understanding of the optimal role for avatar-based systems and consequent improvements to the system’s functionality.

  5. Master thesis - Constructing an information system for advice on antibiotic therapy

    DEFF Research Database (Denmark)

    Gardi, Jonathan Eyal; Nielsen, Anders Møller

    used. The framework has been implemented in Java using client/server-architecture. The proposed framework consists of four components: a database, a decision support system, a client component handling interaction with the system, and a component handling the exchange of information between the clients......This report documents the development of a framework for medical information systems. The framework consists of connectivity between the users, the clinical database and the decision support system. This framework is designed to be independent of the information type and the decision support system......, the database and the decision support system. The method of communication between those three components is based CORBA and XML, thus providing portability and context free framework. Applying it to the TREAT project will validate the functionality and usability of the framework. The goal of TREAT project...

  6. ACADEMIC ADVICE FOR ONLINE TEACHING AND LEARNING SPANISH. EXPERIENCE THE EDUCATION SYSTEM VALLADOLID

    Directory of Open Access Journals (Sweden)

    Jesús Javier Vizcarra-Brito

    2016-07-01

    Full Text Available Distance education is a novel way to amass knowledge and raise levels of student learning. In this sense academic counseling online is a valuable method of teaching and distance learning. This article describes the scientific foundations, objectives, features and some of the main impacts of the program Online Guidance developed by the Valladolid education system, which is designed and implemented in various subjects are presented; in this case, the experience gained with the subject of Spanish at the elementary level is presented.

  7. Heatwave Early Warning Systems and Adaptation Advice to Reduce Human Health Consequences of Heatwaves

    Directory of Open Access Journals (Sweden)

    Bertil Forsberg

    2011-12-01

    Full Text Available Introduction: With climate change, there has been an increase in the frequency, intensity and duration of heatwave events. In response to the devastating mortality and morbidity of recent heatwave events, many countries have introduced heatwave early warning systems (HEWS. HEWS are designed to reduce the avoidable human health consequences of heatwaves through timely notification of prevention measures to vulnerable populations. Objective: To identify the key characteristics of HEWS in European countries to help inform modification of current, and development of, new systems and plans. Methods: We searched the internet to identify HEWS policy or government documents for 33 European countries and requested information from relevant organizations. We translated the HEWS documents and extracted details on the trigger indicators, thresholds for action, notification strategies, message intermediaries, communication and dissemination strategies, prevention strategies recommended and specified target audiences. Findings and Conclusions: Twelve European countries have HEWS. Although there are many similarities among the HEWS, there also are differences in key characteristics that could inform improvements in heatwave early warning plans.

  8. Psychosocial and demographic predictors of adherence and non-adherence to health advice accompanying air quality warning systems: a systematic review.

    Science.gov (United States)

    D'Antoni, Donatella; Smith, Louise; Auyeung, Vivian; Weinman, John

    2017-09-22

    Although evidence shows that poor air quality can harm human health, we have a limited understanding about the behavioural impact of air quality forecasts. Our aim was to understand to what extent air quality warning systems influence protective behaviours in the general public, and to identify the demographic and psychosocial factors associated with adherence and non-adherence to the health advice accompanying these warnings. In August 2016 literature was systematically reviewed to find studies assessing intended or actual adherence to health advice accompanying air quality warning systems, and encouraging people to reduce exposure to air pollution. Predictors of adherence to the health advice and/or self-reported reasons for adherence or non-adherence were also systematically reviewed. Studies were included only if they involved participants who were using or were aware of these warning systems. Studies investigating only protective behaviours due to subjective perception of bad air quality alone were excluded. The results were narratively synthesised and discussed within the COM-B theoretical framework. Twenty-one studies were included in the review: seventeen investigated actual adherence; three investigated intended adherence; one assessed both. Actual adherence to the advice to reduce or reschedule outdoor activities during poor air quality episodes ranged from 9.7% to 57% (Median = 31%), whereas adherence to a wider range of protective behaviours (e.g. avoiding busy roads, taking preventative medication) ranged from 17.7% to 98.1% (Median = 46%). Demographic factors did not consistently predict adherence. However, several psychosocial facilitators of adherence were identified. These include knowledge on where to check air quality indices, beliefs that one's symptoms were due to air pollution, perceived severity of air pollution, and receiving advice from health care professionals. Barriers to adherence included: lack of understanding of the indices

  9. Explaining customer experience of digital financial advice

    NARCIS (Netherlands)

    van Raaij, W.F.

    2017-01-01

    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have

  10. Is "treat your child normally" helpful advice for parents of survivors of treatment of hypoplastic left heart syndrome?

    Science.gov (United States)

    Rempel, Gwen R; Harrison, Margaret J; Williamson, Deanna L

    2009-04-01

    Developing technology affords children with complex congenitally malformed hearts a chance for survival. Parents gratefully pursue life-saving options on behalf of their children, despite the risks to the life of their child, and uncertainty about outcomes. Little is known about how mothers and fathers experience parenting a child whose new state as a survivor may include less than optimal developmental sequels. Our study involved multiple interactive interviews with 9 mothers and 7 fathers of infants and preschool children with hypoplastic left heart syndrome who had survived the Norwood surgical approach. Qualitative methodology included grounded theory methods of simultaneous collection and analysis of data, and we used open and selective coding of transcribed interviews. Parents used normalization in the context of uncertainty regarding the ongoing survival of their child. Parents described their underweight children as being on their own growth curve, and viewed their developmental progress, however delayed, as reason for celebration, as they had been prepared for their child to die. There is growing evidence that children with congenitally malformed hearts who require surgical intervention during the first year of life may experience developmental delay. The use of normalization by their parents may be effective in decreasing their worry regarding the uncertain future faced by their child, but may negatively affect the developmental progress of the child if they do not seek resources to assist development. Advice from paediatric specialists for parents to view their children as normal needs to be balanced with assistance for parents to access services to support optimal growth and development of their child.

  11. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Science.gov (United States)

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (pnutritional status changes was found. Response to chemotherapy was also similar between the groups. Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect. ClinicalTrials.gov NCT00459589.

  12. 78 FR 14590 - Advice Concerning Possible Modifications to the U.S. Generalized System of Preferences, 2012...

    Science.gov (United States)

    2013-03-06

    ... respect to the withdrawn articles and will not provide probable economic effect advice regarding them... Thailand; Rice flour (HTS subheading 1102.90.25) from Thailand; Food preparations not elsewhere specified or included, not canned or frozen (HTS subheading 2106.90.99) from Thailand; Porcelain or china (o...

  13. Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Isabelle Bourdel-Marchasson

    Full Text Available We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality.We conducted a multicentre, open-label interventional, stratified (centre, parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17-23.5. Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes.Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation age of 78.0 y (4·9, 51.2% male, mean MNA 20.2 (2.1. Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%, lymphoma (14.9%, lung (10.4%, and pancreas (17.0%. Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01. At the second visit, the energy target was achieved in 57 (40.4% patients and the protein target in 66 (46.8% with the intervention compared respectively to 13 (13.5% and 20 (20.8% in the controls. Death occurred during the first year in 143 patients (42.56%, without difference according to the intervention (p = 0.79. No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups.Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this lack of effect.ClinicalTrials.gov NCT

  14. Nutritional Advice in Older Patients at Risk of Malnutrition during Treatment for Chemotherapy: A Two-Year Randomized Controlled Trial

    Science.gov (United States)

    Bourdel-Marchasson, Isabelle; Blanc-Bisson, Christelle; Doussau, Adélaïde; Germain, Christine; Blanc, Jean-Frédéric; Dauba, Jérôme; Lahmar, Cyril; Terrebonne, Eric; Lecaille, Cédric; Ceccaldi, Joël; Cany, Laurent; Lavau-Denes, Sandrine; Houede, Nadine; Chomy, François; Durrieu, Jessica; Soubeyran, Pierre; Senesse, Pierre; Chene, Geneviève; Fonck, Mariane

    2014-01-01

    Objective We tested the effect of dietary advice dedicated to increase intake in older patients at risk for malnutrition during chemotherapy, versus usual care, on one-year mortality. Method We conducted a multicentre, open-label interventional, stratified (centre), parallel randomised controlled trial, with a 1∶1 ratio, with two-year follow-up. Patients were aged 70 years or older treated with chemotherapy for solid tumour and at risk of malnutrition (MNA, Mini Nutritional Assessment 17–23.5). Intervention consisted of diet counselling with the aim of achieving an energy intake of 30 kCal/kg body weight/d and 1.2 g protein/kg/d, by face-to-face discussion targeting the main nutritional symptoms, compared to usual care. Interviews were performed 6 times during the chemotherapy sessions for 3 to 6 months. The primary endpoint was 1-year mortality and secondary endpoints were 2-year mortality, toxicities and chemotherapy outcomes. Results Between April 2007 and March 2010 we randomised 341 patients and 336 were analysed: mean (standard deviation) age of 78.0 y (4·9), 51.2% male, mean MNA 20.2 (2.1). Distribution of cancer types was similar in the two groups; the most frequent were colon (22.4%), lymphoma (14.9%), lung (10.4%), and pancreas (17.0%). Both groups increased their dietary intake, but to a larger extent with intervention (p<0.01). At the second visit, the energy target was achieved in 57 (40.4%) patients and the protein target in 66 (46.8%) with the intervention compared respectively to 13 (13.5%) and 20 (20.8%) in the controls. Death occurred during the first year in 143 patients (42.56%), without difference according to the intervention (p = 0.79). No difference in nutritional status changes was found. Response to chemotherapy was also similar between the groups. Conclusion Early dietary counselling was efficient in increasing intake but had no beneficial effect on mortality or secondary outcomes. Cancer cachexia antianabolism may explain this

  15. Regulating household financial advice

    Directory of Open Access Journals (Sweden)

    Benjamin F. Cummings

    2012-08-01

    Full Text Available This paper reviews economic theory related to investment advice. This theory explains 1 why financial advisors need to be carefully regulated for the benefit of both the investment advice industry and for consumers, 2 why principles-based regulation (e.g., a fiduciary standard is more efficient than rules-based regulation, 3 why dual regulation of financial professionals providing investment or insurance advice is inefficient and inequitable policy, and 4 why the application of a universal and uniform fiduciary standard will be difficult to implement.

  16. Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and Canada.

    Science.gov (United States)

    Rio, A; Cawadias, E

    2007-02-01

    The management of amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) has shifted from an attitude of nihilism to treatments that prolong survival and offer hope. Nutrition is an integral component of ALS/MND care requiring coordination among acute and community multi-disciplinary teams (MDT). Evidence-based nutrition guidelines exist for this patient group but their use among dietitians is unknown. The aim of this study was to survey the knowledge, practice and guideline use of dietitians working in ALS/MND centres/clinics across England, Wales, Northern Ireland (EWNI) and Canada. Dietetic contact details were obtained from the Motor Neurone Disease Association (MNDA) and the ALS Society of Canada (ALSSC) websites. Telephone interviews were conducted with 23 dietitians using a standardized questionnaire. Multi-disciplinary team membership was high (78%). Only 22% dietitians had >4-years experience in ALS/MND care. Dietitians reported using body weight, percentage weight loss (PWL) and body mass index (BMI) to assess nutritional status. Equations used to estimate energy and protein requirements differed. Most frequent dietary advice was high calorie, texture modification and prescription nutritional supplements. Artificial nutrition and hydration (ANH) was discussed when patients developed dysphagia, energy intake was inadequate, weight loss of 10% or forced vital capacity (FVC) was reduced. A percutaneous endoscopic gastrostomy (PEG) service was available at all clinics/centres. Nutritional assessment techniques and dietary advice should be standardized. Dietetic collaboration at national and international level is recommended to reduce professional isolation. Training and support in ALS/MND nutrition should be made available as part of post-dietetic registration. Further dietetic research is required to stimulate nutritional care.

  17. Distributed Treatment Systems.

    Science.gov (United States)

    Zgonc, David; Plante, Luke

    2017-10-01

    This section presents a review of the literature published in 2016 on topics relating to distributed treatment systems. This review is divided into the following sections with multiple subsections under each: constituent removal; treatment technologies; and planning and treatment system management.

  18. ARISTOTLE (All Risk Integrated System TOward The hoListic Early-warning): a multi-hazard expert advice system for the EU disaster response

    Science.gov (United States)

    Michelini, A.; Wotawa, G.; Arnold-Arias, D.

    2017-12-01

    ARISTOTLE (http://aristotle.ingv.it/) is a Pilot Project funded by the DG ECHO (EU Humanitarian Aid and Civil Protection) that provides expert scientific advice on natural disasters around the world that may cause a country to seek international help to the EU's Emergency Response Coordination Centre (ERCC) and, consequently, to the Union Civil Protection Mechanism Participating States. The EU is committed to providing disaster response in a timely and efficient manner and to ensure European assistance meets the real needs in the population affected, whether in Europe or beyond. When a disaster strikes, every minute counts for saving lives and rapid, coordinated and pre-planned response is essential. The ARISTOTLE consortium includes 15 partner institutions (11 from EU Countries; 2 from non-EU countries and 2 European organizations) operating in the Meteorological and Geophysical domains. The project coordination is shared among INGV and ZAMG for the geophysical and meteorological communities, respectively. ARISTOTLE harnesses operational expertise from across Europe to form a multi-hazard perspective on natural disasters related to volcanoes, earthquake (and resulting tsunami), severe weather and flooding. Each Hazard Group brings together experts from the particular hazard domain to deliver a `collective analysis' which is then fed into the partnership multi-hazard discussions. Primary target of the pilot project has been the prototyping and the implementation of a scalable system (in terms of number of partners and hazards) capable of providing to ERCC the sought advice. To this end, the activities of the project have been focusing on the establishment of a "Multi-Hazard Operational Board" that is assigned the 24*7 operational duty regulated by a "Standard Operating Protocol" and the implementation of a dedicated IT platform to assembly the resulting reports. The project has reached the point where the routine and emergency advice services are being provided and

  19. Explaining customer experience of digital financial advice

    OpenAIRE

    van Raaij, W.F.

    2017-01-01

    The goal of this paper is to analyze the customer experience of digital-driven financial advice systems. It is the objective of this study to develop a cross-cultural model for validating customer experiences of digital financial advice. In doing so, both objective and subjective system aspects have been considered. It is found that experiential subjective system aspects are the most important. Surveys have been conducted in The United Kingdom and The Netherlands. In exploratory factor analys...

  20. Financial Advice: Who Pays

    Science.gov (United States)

    Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

    2011-01-01

    Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

  1. Portable treatment systems study

    Energy Technology Data Exchange (ETDEWEB)

    Sherick, M.J.; Schwinkendorf, W.E.; Bechtold, T.E.; Cole, L.T.

    1997-03-01

    In developing their Site Treatment Plans (STPs), many of the Department of Energy installations identified some form of portable treatment, to facilitate compliant disposition of select mixed low-level wastestreams. The Environmental Management Office of Science and Technology requested that a systems study be performed to better define the potential role of portable treatment with respect to mixed low-level waste, highlight obstacles to implementation, and identify opportunities for future research and development emphasis. The study was performed by first establishing a representative set of mixed waste, then formulating portable treatment system concepts to meet the required processing needs for these wastes. The portable systems that were conceptualized were evaluated and compared to a fixed centralized treatment alternative. The system evaluations include a life-cycle cost analysis and an assessment of regulatory, institutional, and technical issues associated with the potential use of portable systems. The results of this study show that when all costs are included, there are no significant cost differences between portable systems and fixed systems. However, it is also emphasized that many uncertainties exist that could impact the cost of implementing portable treatment systems. Portable treatment could be made more attractive through private sector implementation, although there is little economic incentive for a commercial vendor to develop small, specialized treatment capabilities with limited applicability. Alternatively, there may also be valid reasons why fixed units cannot be used for some problematic wastestreams. In any event, there are some site-specific problems that still need to be addressed, and there may be some opportunity for research and development to make a positive impact in these areas.

  2. Portable treatment systems study

    International Nuclear Information System (INIS)

    Sherick, M.J.; Schwinkendorf, W.E.; Bechtold, T.E.; Cole, L.T.

    1997-03-01

    In developing their Site Treatment Plans (STPs), many of the Department of Energy installations identified some form of portable treatment, to facilitate compliant disposition of select mixed low-level wastestreams. The Environmental Management Office of Science and Technology requested that a systems study be performed to better define the potential role of portable treatment with respect to mixed low-level waste, highlight obstacles to implementation, and identify opportunities for future research and development emphasis. The study was performed by first establishing a representative set of mixed waste, then formulating portable treatment system concepts to meet the required processing needs for these wastes. The portable systems that were conceptualized were evaluated and compared to a fixed centralized treatment alternative. The system evaluations include a life-cycle cost analysis and an assessment of regulatory, institutional, and technical issues associated with the potential use of portable systems. The results of this study show that when all costs are included, there are no significant cost differences between portable systems and fixed systems. However, it is also emphasized that many uncertainties exist that could impact the cost of implementing portable treatment systems. Portable treatment could be made more attractive through private sector implementation, although there is little economic incentive for a commercial vendor to develop small, specialized treatment capabilities with limited applicability. Alternatively, there may also be valid reasons why fixed units cannot be used for some problematic wastestreams. In any event, there are some site-specific problems that still need to be addressed, and there may be some opportunity for research and development to make a positive impact in these areas

  3. Safety advice sheets

    CERN Multimedia

    HSE Unit

    2013-01-01

    You never know when you might be faced with questions such as: when/how should I dispose of a gas canister? Where can I find an inspection report? How should I handle/store/dispose of a chemical substance…?   The SI section of the DGS/SEE Group is primarily responsible for safety inspections, evaluating the safety conditions of equipment items, premises and facilities. On top of this core task, it also regularly issues “Safety Advice Sheets” on various topics, designed to be of assistance to users but also to recall and reinforce safety rules and procedures. These clear and concise sheets, complete with illustrations, are easy to display in the appropriate areas. The following safety advice sheets have been issued so far: Other sheets will be published shortly. Suggestions are welcome and should be sent to the SI section of the DGS/SEE Group. Please send enquiries to general-safety-visits.service@cern.ch.

  4. MedMinify: An Advice-giving System for Simplifying the Schedules of Daily Home Medication Regimens Used to Treat Chronic Conditions.

    Science.gov (United States)

    Flynn, Allen J; Klasnja, Predrag; Friedman, Charles P

    2014-01-01

    For those with high blood pressure, diabetes, or high cholesterol, adherence to a home medication regimen is important for health. Reductions in the number of daily medication-taking events or daily pill burden improve adherence. A novel advice-giving computer application was developed using the SMART platform to generate advice on how to potentially simplify home medication regimens. MedMinify generated advice for 41.3% of 1,500 home medication regimens for adults age 60 years and older with chronic medical conditions. If the advice given by MedMinify were implemented, 320 regimen changes would have reduced daily medication-taking events while an additional 295 changes would have decreased the daily pill burden. The application identified four serious drug-drug interactions and so advised against taking two pairs of medications simultaneously. MedMinify can give advice to change home medication regimens that could result in simpler home medication-taking schedules.

  5. Caregivers' compliance with referral advice

    DEFF Research Database (Denmark)

    Lal, Sham; Ndyomugenyi, Richard; Paintain, Lucy

    2018-01-01

    BACKGROUND: Several malaria endemic countries have implemented community health worker (CHW) programmes to increase access to populations underserved by health care. There is considerable evidence on CHW adherence to case management guidelines, however, there is limited evidence on the compliance...... in the control arm were trained to treat malaria with ACTs based on fever symptoms. Caregivers' referral forms were linked with CHW treatment forms to determine whether caregivers complied with the referral advice. Factors associated with compliance were examined with logistic regression. RESULTS: CHW saw 18......,497 child visits in the moderate-to-high transmission setting and referred 15.2% (2815/18,497) of all visits; in the low-transmission setting, 35.0% (1135/3223) of all visits were referred. Compliance to referral was low, in both settings

  6. Implicit normativity in scientific advice

    DEFF Research Database (Denmark)

    Folker, Anna Paldam; Andersen, Hanne; Sandøe, Peter

    2008-01-01

    This paper focuses on implicit normative considerations underlying scientific advice-those normative questions, decisions, or issues that scientific advisers and the general public are not fully aware of but that nevertheless have implications for the character of the advice given. Using...... nutritional science as an example, we identify three such implicit normative issues. The first concerns the aim of scientific advice: whether it is about avoiding harm or promoting good. The second concerns the intended beneficiaries of the advice: whether advice should be framed to benefit the society...... as a whole or with special concern for the most vulnerable members of the population. The third consideration involves scientific advisers' attempts to balance the strengths of the scientific evidence with the expected consequences of scientific advice. We hope to promote more explicit discussion...

  7. Instructional Advice, Time Advice and Learning Questions in Computer Simulations

    Science.gov (United States)

    Rey, Gunter Daniel

    2010-01-01

    Undergraduate students (N = 97) used an introductory text and a computer simulation to learn fundamental concepts about statistical analyses (e.g., analysis of variance, regression analysis and General Linear Model). Each learner was randomly assigned to one cell of a 2 (with or without instructional advice) x 2 (with or without time advice) x 2…

  8. 76 FR 2415 - Advice Concerning Possible Modifications to the U.S. Generalized System of Preferences, 2010...

    Science.gov (United States)

    2011-01-13

    ... ). The media should contact Margaret O'Laughlin, Office of External Relations (202-205-1819 or margaret... articles provided for in the noted subheadings of the Harmonized Tariff System (HTS): Brazil for HTS...

  9. Behavior Modification of Studying Through Study Skills Advice and Self-Control Procedures

    Science.gov (United States)

    Richards, C. Steven

    1975-01-01

    Investigates the efficacy of two behavioral self-control procedures as additions to the typical treatment for college students' study behavior--study skills advice. Predicted self-monitoring would be an effective treatment addition to study skills advice and study skills advice would be superior to the control groups. Results supported…

  10. Actions and advice in coli

    DEFF Research Database (Denmark)

    Knoche, Hendrik; Jamadagni, HS; Rao, PR Sheshagiri

    2015-01-01

    To improve their agricultural output, farmers require timely and contextualized information and advice. Relevant information and advice provided by trusted peers represents a promising approach. We present the considerations for the design of coli, an agricultural information network on touch scr...

  11. Experts speak: advice from key informants to small, rural hospitals on implementing the electronic health record system.

    Science.gov (United States)

    Craven, Catherine K; Sievert, MaryEllen C; Hicks, Lanis L; Alexander, Gregory L; Hearne, Leonard B; Holmes, John H

    2013-01-01

    The US government has allocated $30 billion dollars to implement Electronic Health Records (EHRs) in hospitals and provider practices through a policy called Meaningful Use. Small, rural hospitals, particularly those designated as Critical Access Hospitals (CAHs), comprising nearly a quarter of US hospitals, had not implemented EHRs before. Little is known on implementation in this setting. We interviewed a spectrum of 31 experts in the domain. The interviews were then analyzed qualitatively to ascertain the expert recommendations. Nineteen themes emerged. The pool of experts included staff from CAHs that had recently implemented EHRs. We were able to compare their answers with those of other experts and make recommendations for stakeholders. CAH peer experts focused less on issues such as physician buy-in, communication, and the EHR team. None of them indicated concern or focus on clinical decision support systems, leadership, or governance. They were especially concerned with system selection, technology, preparatory work and a need to know more about workflow and optimization. These differences were explained by the size and nature of these small hospitals.

  12. Analysis and design of advice

    CERN Document Server

    Jureta, Ivan

    2011-01-01

    This innovative book offers a rigorous approach to the analysis and design of advice in real-world decision situations, in which the advisor must manage with variously imprecise, unclear, incomplete or conflicting qualitative information.

  13. Factors influencing compliance to tactical driver advice: an assessment using a think-aloud protocol

    NARCIS (Netherlands)

    Risto, Malte; Martens, Marieke Hendrikje

    2013-01-01

    Connected Cruise Control (CCC) is an in-car driver support systems that aims to improve throughput in dense motorway traffic by advising drivers how to drive. The system is currently under development within a HTAS project. It will integrate lane advice, headway advice and speed advice. CCC will not

  14. Treatment planning systems

    International Nuclear Information System (INIS)

    Fontenla, D.P.

    2008-01-01

    All aspects of treatment planning in radiotherapy are discussed in detail. Included are, among others, machine data and their acquisition, photon dose calculations and tests thereof, criteria of acceptability, sources of uncertainties, from 2D to 3D and from 3D to IMRT, dosimetric measurements for RTP validation, frequency of QA tests and suggested tolerances for TPS, time and staff requirements, model based segmentation, multi-dimensional radiotherapy (MD C RT), and biological IMRT process. (P.A.)

  15. Advice dilemmas: Managing advice against the competing public ...

    African Journals Online (AJOL)

    Key to resolving this issue is an acknowledgement that, whether as counsellor or health adviser, persuasion and influence are central features of the VCT interaction. Clear practice guidelines and tools are required to assist counsellors to distinguish between advice, suggestion or mere confirmation of an intended client ...

  16. Regulations and classification advice: transport safety

    International Nuclear Information System (INIS)

    Davies, M.; Owen, K.

    1990-01-01

    The packaging of radioactive material for transport must conform with the regulations of the International Atomic Energy Agency (IAEA). These regulations are extensive and complex and require specialist interpretation. Packaging must be designed to contain the material, to limit radiation to safe levels, and to maintain the material in a safe state under both normal and accident conditions. British Nuclear Fuels Ltd. (BNFL) developed the TRANAID expert system to provide automated expert advice on the subject. It is used at BNFL and by other users internationally. The system was produced to meet an internal BNFL emphasis on accurate consistent and reliable interpretation of the complex IAEA regulations; and to provide a commercial product which would meet an external need. TRANAID provides reliable and consistent advice on safe transport procedures which reduce the workload on scarce skilled personnel, and allows them to concentrate on their primary task of packaging design. TRANAID also avoids overclassifying radioactive shipments, which would lead to the use of more expensive packaging than strictly is required. The IAEA regulations are applied internationally, and so there is a large potential worldwide market. The indications from the initial response are that future sales and use are expected to more than cover the investment. Other non-quantifiable benefits include the provision of consistent advice within a uniform approach, the safe-guarding of knowledge of the IAEA regulations, training and improvement in the expertise of users, improved management control, and enhancement of the professional image of BNFL. (author)

  17. 3D treatment planning systems.

    Science.gov (United States)

    Saw, Cheng B; Li, Sicong

    2018-01-01

    Three-dimensional (3D) treatment planning systems have evolved and become crucial components of modern radiation therapy. The systems are computer-aided designing or planning softwares that speed up the treatment planning processes to arrive at the best dose plans for the patients undergoing radiation therapy. Furthermore, the systems provide new technology to solve problems that would not have been considered without the use of computers such as conformal radiation therapy (CRT), intensity-modulated radiation therapy (IMRT), and volumetric modulated arc therapy (VMAT). The 3D treatment planning systems vary amongst the vendors and also the dose delivery systems they are designed to support. As such these systems have different planning tools to generate the treatment plans and convert the treatment plans into executable instructions that can be implemented by the dose delivery systems. The rapid advancements in computer technology and accelerators have facilitated constant upgrades and the introduction of different and unique dose delivery systems than the traditional C-arm type medical linear accelerators. The focus of this special issue is to gather relevant 3D treatment planning systems for the radiation oncology community to keep abreast of technology advancement by assess the planning tools available as well as those unique "tricks or tips" used to support the different dose delivery systems. Copyright © 2018 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  18. Recursive Advice for Coordination

    DEFF Research Database (Denmark)

    Terepeta, Michal Tomasz; Nielson, Hanne Riis; Nielson, Flemming

    2012-01-01

    Aspect-oriented programming is a programming paradigm that is often praised for the ability to create modular software and separate cross-cutting concerns. Recently aspects have been also considered in the context of coordination languages, offering similar advantages. However, introducing aspects...... challenging. This is important since ensuring that a system does not contain errors is often equivalent to proving that some states are not reachable. In this paper we show how to solve these challenges by applying a successful technique from the area of software model checking, namely communicating pushdown...

  19. Unconditional lower bounds against advice

    NARCIS (Netherlands)

    Buhrman, H.; Fortnow, L.; Santhanam, R.

    2009-01-01

    We show several unconditional lower bounds for exponential time classes against polynomial time classes with advice, including: (1) For any constant c, NEXP not in P^{NP[n^c]} (2) For any constant c, MAEXP not in MA/n^c (3) BPEXP not in BPP/n^{o(1)}. It was previously unknown even whether NEXP in

  20. Integrated nonthermal treatment system study

    Energy Technology Data Exchange (ETDEWEB)

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J. [Morrison Knudsen Corp. (United States); Quapp, W.J. [Nuclear Metals (United States); Bechtold, T.; Brown, B.; Schwinkendorf, W. [Lockheed Martin Idaho Technologies Co., Idaho Falls, ID (United States); Swartz, G. [Swartz and Associates (United States)

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs.

  1. Integrated nonthermal treatment system study

    International Nuclear Information System (INIS)

    Biagi, C.; Bahar, D.; Teheranian, B.; Vetromile, J.; Quapp, W.J.; Bechtold, T.; Brown, B.; Schwinkendorf, W.; Swartz, G.

    1997-01-01

    This report presents the results of a study of nonthermal treatment technologies. The study consisted of a systematic assessment of five nonthermal treatment alternatives. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The alternatives considered were innovative nonthermal treatments for organic liquids and sludges, process residue, soil and debris. Vacuum desorption or various washing approaches are considered for treatment of soil, residue and debris. Organic destruction methods include mediated electrochemical oxidation, catalytic wet oxidation, and acid digestion. Other methods studied included stabilization technologies and mercury separation of treatment residues. This study is a companion to the integrated thermal treatment study which examined 19 alternatives for thermal treatment of MLLW waste. The quantities and physical and chemical compositions of the input waste are based on the inventory database developed by the US Department of Energy. The Integrated Nonthermal Treatment Systems (INTS) systems were evaluated using the same waste input (2,927 pounds per hour) as the Integrated Thermal Treatment Systems (ITTS). 48 refs., 68 figs., 37 tabs

  2. Advanced wastewater treatment system (SEADS)

    International Nuclear Information System (INIS)

    Dunn, J.

    2002-01-01

    'Full text:' This presentation will describe the nature, scope, and findings of a third-party evaluation of a wastewater treatment technology identified as the Advanced Wastewater Treatment System Inc.'s Superior Extended Aerobic Digester System (SEADS). SEADS is an advanced miniaturized wastewater treatment plant that can meet advanced wastewater treatment standards for effluent public reuse. SEADS goes beyond primary and secondary treatment operations to reduce nutrients such as nitrogen and phosphorus, which are typically found in excessive quantities in traditional wastewater treatment effluent. The objective of this evaluation will be to verify the performance and reliability of the SEADS to treat wastewater from a variety of sources, including domestic wastewater and commercial industrial wastewater. SEADS utilizes remote telemetry equipment to achieve added reliability and reduces monitoring costs as compared to many package wastewater treatment plants. The evaluation process will be overseen and coordinated by the Environmental Technology Evaluation Center (EvTEC), a program of the Civil Engineering Research Foundation (CERF), the research and technology transfer arm of the American Society of Civil Engineers (ASCE). EvTEC is a pilot program evaluating innovative environmental technologies under the US Environmental Protection Agency's (USEPA) Environmental Technology Verification (ETV) Program. Among other performance issues, the SEADS technology evaluation will address its ability to treat low flows-from remote individual and clustered housing applications, and individual commercial applications in lieu of a main station conventional wastewater treatment plant. The unneeded reliance on particular soil types for percolation and the improved effluent water quality over septic systems alone look to make these types of package treatment plants a viable option for rural communities, small farms, and other low-flow remote settings. Added benefits to be examined

  3. The Financial Coaching Advice Model: An Exploration into how it Satisfies Expectations of Quality Advice

    Directory of Open Access Journals (Sweden)

    Julie Knutsen

    2012-11-01

    Full Text Available For 20 years, the financial planning sector in Australia has been transitioning from a sales-orientated force to aprofession of qualified and skilled practitioners. Today, the potential for professional financial planning adviceto benefit Australians financially, economically and psychologically is recognised by government. Financially,these benefits include increased savings, less interest expense through faster debt reduction, higher investmentreturns and appropriate levels of insurance. Economically, a more financially literate society has the potentialfor less reliance on an already burdened social security system. Psychologically, the benefits include the peaceof mind that comes from an individual being confident in financial matters. However, despite this level ofrecognition and development, national surveys have reported that only a small percentage of the populationactually seek professional financial advice. The factors attributing to these low percentages included the gapsin financial literacy limiting an individual’s engagement in financial matters and consumer’s current mistrust ofthe financial advice business models that remain dominated by commission-driven product sales. Thesedeficiencies have led some financial planning firms to break from financial product sales as the primary advicemodel and focus on financial coaching. Exploratory interviews with the practitioners and clients of a selectedfinancial planning firm have generated insightful discussion into how a financial coaching advice model isachieving the financial, economic and psychological benefits recognised by government as the potentialoutcomes of professional financial advice. The aim of this paper is to present the findings from that discussionand demonstrate the opportunities embedded within a financial coaching advice model. It is argued that thisdiscussion offers a foundation for future research direction in an area currently under researched in

  4. Water Treatment Technology - Distribution Systems.

    Science.gov (United States)

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on distribution systems provides instructional materials for six competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: types of pipe for distribution systems, types…

  5. A quantitative analysis of the quality and content of the health advice in popular Australian magazines.

    Science.gov (United States)

    Wilson, Amanda; Smith, David; Peel, Roseanne; Robertson, Jane; Kypri, Kypros

    2017-06-01

    To examine how health advice is provided in popular magazines and the quality of that advice. A prospective quantitative analysis of the quality of health advice provided in Australian magazines between July and December 2011 was conducted. A rating instrument was adapted from the Media Doctor Australia rating tool used to assess quality of health news reporting. Criteria included: recommends seeing a doctor; advice based on reliable evidence; advice clear and easily applied; benefits presented meaningfully; potential harms mentioned; evidence of disease mongering; availability and cost of treatments; obvious advertising; vested interest, and anecdotal evidence. 163 health advice articles were rated showing a wide variation in the quality of advice presented between magazines. Magazines with 'health' in the title, rated most poorly with only 36% (26/73) of these articles presenting clear and meaningful advice and 52% (38/73) giving advice based on reliable evidence. Australian magazines, especially those with health in the title, generally presented poor quality, unreliable health advice. Teen magazine Dolly provided the highest quality advice. Consumers need to be aware of this when making health choices. © 2016 Public Health Association of Australia.

  6. Giving advice to agents with hidden goals

    CSIR Research Space (South Africa)

    Rosman, Benjamin S

    2014-05-01

    Full Text Available than it would have otherwise. Similarly, advice can be a boost to 1Benjamin Rosman is with the Institute of Perception, Action and Behaviour in the School of Informatics, University of Edinburgh, UK, and Mobile Intelligent Autonomous Systems (MIAS...), CSIR, South Africa benjros@gmail.com 2Subramanian Ramamoorthy is with the Institute of Perception, Action and Behaviour in the School of Informatics, University of Edinburgh, UK s.ramamoorthy@ed.ac.uk Fig. 1. The envisaged scene: an agent (the human...

  7. Financial Literacy, Confidence and Financial Advice Seeking

    NARCIS (Netherlands)

    Kramer, Marc M.

    2016-01-01

    We find that people with higher confidence in their own financial literacy are less likely to seek financial advice, but no relation between objective measures of literacy and advice seeking. The negative association between confidence and advice seeking is more pronounced among wealthy households.

  8. Discharge Against Medical Advice in the Pediatric Wards in Boo-ali Sina Hospital, Sari, Iran 2010.

    Science.gov (United States)

    Mohseni Saravi, Benyamin; Reza Zadeh, Esmaeil; Siamian, Hasan; Yahghoobian, Mahboobeh

    2013-12-01

    Since children neither comprehended nor contribute to the decision, discharge against medical advice is a challenge of health care systems in the world. Therefore, the current study was designed to determine the rate and causes of discharge against medical advice. This descriptive cross-sectional study was done by reviewing the medical records by census method. Data was analyzed using SPSS software and x(2) statistics was used to determine the relationship between variables. The value of P<0.05 was considered significant. Rate of discharged against medical advice was 108 (2.2%). Mean of age and length of stay were 2.8±4 (SD).3 years old and 3.7±5.4 (SD) days, respectively. Totally, 95 patients (88.7%) had health insurance and 65 (60.2%) patients lived in urban areas. History of psychiatric disease and addiction in 22 (20.6%) of the parents were negative. In addition, 100 (92.3%) patients admitted for medical treatment and the others for surgery. The relationship of the signatory with patients (72.3%) was father. Of 108 patients discharged against medical advice, 20 (12%) were readmitted. The relationship between the day of discharge and discharge against medical advice was significant (ρ =0/03). Rate of discharge against medical advice in Boo-ali hospital is the same as the other studies in the same range. The form which is used for this purpose did not have suitable data elements about description of consequence of such discharge, and it has not shown the real causes of discharge against medical advice.

  9. Nutritional Advice for Patients with Melasma in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Mahdis Mojtabaee

    2016-03-01

    Full Text Available Background Melasma (called Kalaf in Iranian traditional medicine is a common acquired hypermelanosis that affects sun-exposed areas of skin. Several factors including exposure to sunlight, pregnancy, and endocrine diseases increase the risk for Melasma. In traditional medicine, antecedent philosophers and physicians have tried to understand the nature and mechanisms of different systems of the human body for the diagnosis and management of Melasma; they have offered different solutions for it. This study is important since Melasma is a disease causing mental side effects in patients, due to darkness and opacity of the skin; therefore, the treatment of Melasma in terms of its psychological complications is of particular importance. In addition, texts of Iranian traditional medicine contain a wealth of nutritional advice for patients with Melasma. These texts have, until now, not yet been reviewed. The present study has considered the most important references of Iranian traditional medicine texts. Objectives The objective of this study was to extract and categorize the nutritional advice of Iranian traditional medicine texts for the treatment of Melasma. Results Dietary recommendations, not only for treatment but also for prevention of diseases and staying healthy, are very efficient. Conclusions Based on the traditional medicine texts, it is helpful to avoid Soda-producing food as well as to identify appropriate food in order to eliminate the accumulation of Soda or black bile from the blood. This study offers a set of analytical and clinical research on food, which in traditional medicine is called Soda-producing as well as Soda reducing.

  10. 77 FR 47880 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Canada and Mexico: Advice on the...

    Science.gov (United States)

    2012-08-10

    ....S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on Probable Economic... Partnership Free Trade Agreement Including Canada and Mexico: Advice on the Probable Economic Effect of... Mexico: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES...

  11. Watchful Waiting for Cases of Pediatric Otitis Media: Modeling Parental Response to Physician Advice.

    Science.gov (United States)

    MacGeorge, Erina L; Smith, Rachel A; Caldes, Emily P; Hackman, Nicole M

    2016-08-01

    Watchful waiting (WW) can reduce unnecessary antibiotic use in the treatment of pediatric otitis media (ear infection), but its utility is impaired by underutilization and noncompliance. Guided by advice response theory, the current study proposes advantage and capacity as factors that predict how caregivers evaluate and respond affectively to WW. Parents (N = 373) of at least 1 child age 5 years or younger completed questionnaires that assessed responses to hypothetical WW advice for their youngest child. Perceptions of advantage from WW and the capacity to monitor and manage symptoms predicted advice quality, physician trust, and future compliance both directly and indirectly through negative affect. The findings suggest the elaboration of advice response theory to include more aspects of advice content evaluation (e.g., advantage) and the influence of negative affect. The study also provides practical guidance for physicians seeking to improve caregiver reception of WW advice.

  12. 5 CFR 2635.107 - Ethics advice.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Ethics advice. 2635.107 Section 2635.107 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS STANDARDS OF ETHICAL CONDUCT FOR EMPLOYEES OF THE EXECUTIVE BRANCH General Provisions § 2635.107 Ethics advice. (a) As required by §§ 2638.201...

  13. Dietary Advice for Airline Travel.

    Science.gov (United States)

    Leggat; Nowak

    1997-03-01

    In addition to their regular meal service, most of the major domestic and international airlines offer special meals. It should be noted that regular meal services on international flights often give a choice of meals, even in economy class, and often include a salad and or fruit dish, which could be consumed by most people. More airlines also seem to be moving towards having at least one more culturally appropriate meal on the menu, particularly for relevant flight sectors. However, these meals may be inappropriate for some passengers, and there is a need for this special meals service. Meals services on airlines have improved greatly in recent years, particularly with the employment of consultant dietitians to the catering staff of airlines and advances in chef training. Special meal services are designed to cater to the most common variations of meals required by most passengers for medical, religious, or other reasons. The special requirements for these meals are described elsewhere.1 It is important to realize that the meals are designed and the ingredients interpreted by that airline, and may not necessarily reflect what the traveler might eat at home. So it is important to advise travelers not to have high expectations of this special meal service. This paper aims to provide some basic practical advice for selection of special diets for airline travelers.

  14. Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

    OpenAIRE

    Beto, Judith A.; Schury,Katherine; Bansal,Vinod

    2016-01-01

    Judith A Beto, Katherine A Schury, Vinod K Bansal Division of Nephrology and Hypertension, Loyola University Healthcare System, Loyola University of Chicago, Maywood, IL, USA Abstract: Chronic kidney disease (CKD) requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coor...

  15. Determinants of physical activity frequency and provider advice during pregnancy.

    Science.gov (United States)

    Santo, Eilann C; Forbes, Peter W; Oken, Emily; Belfort, Mandy B

    2017-09-05

    Our aims were to (1) describe the frequency of physical activity and prenatal healthcare provider advice about physical activity during pregnancy and (2) examine determinants and correlates of 3rd trimester physical activity and receipt of physical activity advice. We analyzed data from the 2008 Pregnancy Risk Assessment Monitoring System. We studied 2669 women from North Carolina and Colorado with data on physical activity frequency in the 3 months prior to pregnancy and during the 3rd trimester and 1584 women from Oklahoma with data on provider advice regarding physical activity during pregnancy. Respondents reported physical activity, defined as 30 min or more of exercise/physical activity (excluding vocationally related activity), in in these categories: pregnancy was strongly associated with low likelihood of ACOG guideline adherence in the 3rd trimester (aOR 0.10, 95% CU 0.04, 0.30 vs. 1-4 days/week). Underweight women were more likely to adhere to ACOG guidelines than normal weight women (aOR 2.27, 95% CI 1.36, 3.79). Overweight women were more likely to receive physical activity advice (aOR 2.9, 95% CI 1.3, 6.3 vs. normal weight), but obese women were not (aOR 0.65, 95% CI 0.4, 1.2). Few women meet ACOG guideline criteria for physical activity during pregnancy. Improving physical activity and weight status prior to pregnancy may improve activity levels during pregnancy. Nearly one third did not receive advice about physical activity during prenatal care. Obese women were no more likely to receive advice than their normal weight counterparts, indicating the need for targeted physical activity counseling in this population.

  16. Achieving Appropriate Gestational Weight Gain: The Role of Healthcare Provider Advice.

    Science.gov (United States)

    Deputy, Nicholas P; Sharma, Andrea J; Kim, Shin Y; Olson, Christine K

    2018-01-10

    The Institute of Medicine (IOM) revised gestational weight gain recommendations in 2009. We examined associations between healthcare provider advice about gestational weight gain and inadequate or excessive weight gain, stratified by prepregnancy body mass index category. We analyzed cross-sectional data from women delivering full-term (37-42 weeks of gestation), singleton infants from four states that participated in the 2010-2011 Pregnancy Risk Assessment Monitoring System (unweighted n = 7125). Women reported the weight gain range (start and end values) advised by their healthcare provider; advice was categorized as follows: starting below recommendations, starting and ending within recommendations (IOM consistent), ending above recommendations, not remembered, or not received. We examined associations between healthcare provider advice and inadequate or excessive, compared with appropriate, gestational weight gain using adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs). Overall, 26.3% of women reported receiving IOM-consistent healthcare provider advice; 26.0% received no advice. Compared with IOM-consistent advice, advice below recommendations was associated with higher likelihood of inadequate weight gain among underweight (aPR 2.22, CI 1.29-3.82) and normal weight women (aPR 1.57, CI 1.23-2.02); advice above recommendations was associated with higher likelihood of excessive weight gain among all but underweight women (aPR range 1.36, CI 1.08-1.72 to aPR 1.42, CI 1.19-1.71). Not remembering or not receiving advice was associated with both inadequate and excessive weight gain. Few women reported receiving IOM-consistent advice; not receiving IOM-consistent advice put women at-risk for weight gain outside recommendations. Strategies that raise awareness of IOM recommendations and address barriers to providing advice are needed.

  17. WASTE TREATMENT BUILDING SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    F. Habashi

    2000-06-22

    The Waste Treatment Building System provides the space, layout, structures, and embedded subsystems that support the processing of low-level liquid and solid radioactive waste generated within the Monitored Geologic Repository (MGR). The activities conducted in the Waste Treatment Building include sorting, volume reduction, and packaging of dry waste, and collecting, processing, solidification, and packaging of liquid waste. The Waste Treatment Building System is located on the surface within the protected area of the MGR. The Waste Treatment Building System helps maintain a suitable environment for the waste processing and protects the systems within the Waste Treatment Building (WTB) from most of the natural and induced environments. The WTB also confines contaminants and provides radiological protection to personnel. In addition to the waste processing operations, the Waste Treatment Building System provides space and layout for staging of packaged waste for shipment, industrial and radiological safety systems, control and monitoring of operations, safeguards and security systems, and fire protection, ventilation and utilities systems. The Waste Treatment Building System also provides the required space and layout for maintenance activities, tool storage, and administrative facilities. The Waste Treatment Building System integrates waste processing systems within its protective structure to support the throughput rates established for the MGR. The Waste Treatment Building System also provides shielding, layout, and other design features to help limit personnel radiation exposures to levels which are as low as is reasonably achievable (ALARA). The Waste Treatment Building System interfaces with the Site Generated Radiological Waste Handling System, and with other MGR systems that support the waste processing operations. The Waste Treatment Building System interfaces with the General Site Transportation System, Site Communications System, Site Water System, MGR

  18. WASTE TREATMENT BUILDING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    Habashi, F.

    2000-01-01

    The Waste Treatment Building System provides the space, layout, structures, and embedded subsystems that support the processing of low-level liquid and solid radioactive waste generated within the Monitored Geologic Repository (MGR). The activities conducted in the Waste Treatment Building include sorting, volume reduction, and packaging of dry waste, and collecting, processing, solidification, and packaging of liquid waste. The Waste Treatment Building System is located on the surface within the protected area of the MGR. The Waste Treatment Building System helps maintain a suitable environment for the waste processing and protects the systems within the Waste Treatment Building (WTB) from most of the natural and induced environments. The WTB also confines contaminants and provides radiological protection to personnel. In addition to the waste processing operations, the Waste Treatment Building System provides space and layout for staging of packaged waste for shipment, industrial and radiological safety systems, control and monitoring of operations, safeguards and security systems, and fire protection, ventilation and utilities systems. The Waste Treatment Building System also provides the required space and layout for maintenance activities, tool storage, and administrative facilities. The Waste Treatment Building System integrates waste processing systems within its protective structure to support the throughput rates established for the MGR. The Waste Treatment Building System also provides shielding, layout, and other design features to help limit personnel radiation exposures to levels which are as low as is reasonably achievable (ALARA). The Waste Treatment Building System interfaces with the Site Generated Radiological Waste Handling System, and with other MGR systems that support the waste processing operations. The Waste Treatment Building System interfaces with the General Site Transportation System, Site Communications System, Site Water System, MGR

  19. Sociality Mental Modes Modulate the Processing of Advice-Giving: An Event-Related Potentials Study

    Directory of Open Access Journals (Sweden)

    Jin Li

    2018-02-01

    Full Text Available People have different motivations to get along with others in different sociality mental modes (i.e., communal mode and market mode, which might affect social decision-making. The present study examined how these two types of sociality mental modes affect the processing of advice-giving using the event-related potentials (ERPs. After primed with the communal mode and market mode, participants were instructed to decide whether or not give an advice (profitable or damnous to a stranger without any feedback. The behavioral results showed that participants preferred to give the profitable advice to the stranger more slowly compared with the damnous advice, but this difference was only observed in the market mode condition. The ERP results indicated that participants demonstrated more negative N1 amplitude for the damnous advice compared with the profitable advice, and larger P300 was elicited in the market mode relative to both the communal mode and the control group. More importantly, participants in the market mode demonstrated larger P300 for the profitable advice than the damnous advice, whereas this difference was not observed at the communal mode and the control group. These findings are consistent with the dual-process system during decision-making and suggest that market mode may lead to deliberate calculation for costs and benefits when giving the profitable advice to others.

  20. The binding study advice in medical education: a 2-year experience.

    NARCIS (Netherlands)

    Eijsvogels, T.M.H.; Goorden, R.; Bosch, W.J.H.M. van den; Hopman, M.T.E.

    2015-01-01

    To improve the effectiveness of higher education, Dutch universities implemented the binding study advice at medical faculties. Accordingly, medicine students of Radboud University need to gain >/= 42 out of 60 European Credit Transfer System (ECTS) credits to obtain a positive binding study advice

  1. Advice on drug safety in pregnancy: are there differences between commonly used sources of information?

    Science.gov (United States)

    Frost Widnes, Sofia K; Schjøtt, Jan

    2008-01-01

    Safety regarding use in pregnancy is not established for many drugs. Inconsistencies between sources providing drug information can give rise to confusion with possible therapeutic consequences. Therefore, it is important to measure clinically important differences between drug information sources. The objective of this study was to compare two easily accessible Norwegian sources providing advice on drug safety in pregnancy - the product monographs in the Felleskatalog (FK), published by the pharmaceutical companies, and the five regional Drug Information Centres (DICs) in Norway - in addition to assessing the frequency of questions regarding drug safety in pregnancy made to the DICs according to the Anatomical Therapeutic Chemical (ATC) classification system. Advice on drug use in pregnancy provided by the DICs in 2003 and 2005 were compared with advice in the product monographs for the respective drugs in the FK. Comparison of advice was based on categorization to one of four categories: can be used, benefit-risk assessment, should not be used, or no available information. A total of 443 drug advice were categorized. Seven out of ten of drugs frequently enquired about, according to the ATC system, were drugs acting on the nervous system (group N). For 208 (47%) of the drugs, advice differed between the DICs and FK. Advice from the FK was significantly (p drugs that were newly introduced and those that had been on the market for a longer time, advice regarding use of drugs in the first trimester and advice regarding use of drugs in the second or third trimester, or between advice provided during 2003 and during 2005. The results of this study show considerable differences between two Norwegian sources providing advice on the use of drugs in pregnancy. Based on the knowledge that healthcare providers choose sources of information in a random manner, our results may be of clinical importance. We believe that the problem with heterogeneous drug information on this

  2. Development and feasibility of falls prevention advice.

    Science.gov (United States)

    van Harten-Krouwel, Diny; Schuurmans, Marieke; Emmelot-Vonk, Mariëlle; Pel-Littel, Ruth

    2011-10-01

    This study examined the feasibility of nursing falls prevention advice and factors influencing feasibility. The frequency and seriousness of falls in hospitalised patients are underestimated, and such falls should be preventable because of the presence of professionals. A best practice-based falls prevention advice was developed to decrease the incidence of secondary falls and the incidence of primary falls in the long term and to increase the knowledge of nurses about falls prevention and the seriousness of falls. A descriptive, explorative study. Feasibility of the advice for 30 patients was assessed 82 times (theoretically, three times per patient) by observation and by interviewing nurses, patients and their families. The falls prevention advice was used in 48% of the assessments. There was a difference in use between interventions. Interventions that required more knowledge, communication and extra activities were implemented the least. The absence of materials and knowledge about falls prevention were important determinants of the non-implementation of certain interventions. Before falls prevention advice is implemented, it is important to educate nurses about falls, communication skills and implementation of the advice. The falls prevention advice might help nurses to prevent falls and increase their knowledge about falls prevention. © 2011 Blackwell Publishing Ltd.

  3. Liquid waste treatment system. Final report

    International Nuclear Information System (INIS)

    Baker, M.N.; Houston, H.M.

    1999-01-01

    Pretreatment of high-level liquid radioactive waste (HLW) at the West Valley Demonstration Project (WVDP) involved three distinct processing operations: decontamination of liquid HLW in the Supernatant Treatment System (STS); volume reduction of decontaminated liquid in the Liquid Waste Treatment System (LWTS); and encapsulation of resulting concentrates into an approved cement waste form in the Cement Solidification System (CSS). Together, these systems and operations made up the Integrated Radwaste Treatment System (IRTS)

  4. MRSA Prevention Information and Advice for Athletes

    Science.gov (United States)

    ... and Team Healthcare Providers Prevention Information and Advice Posters for the Athletic Community General MRSA Information and ... site? Adobe PDF file Microsoft PowerPoint file Microsoft Word file Microsoft Excel file Audio/Video file Apple ...

  5. Integrated Thermal Treatment Systems study: US Department of Energy Internal Review Panel report

    International Nuclear Information System (INIS)

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy's (DOE) Office of Technology Development (OTD) commissioned two studies to uniformly evaluate nineteen thermal treatment technologies. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the advice and guidance of the DOE Office of Environmental Management's (EM's) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel, composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency (EPA), the California EPA, and private experts. The Panel met from November 15-18, 1994, to review and comment on the ITTS studies, to make recommendations on the most promising thermal treatment systems for DOE mixed low level wastes (MLLW), and to make recommendations on research and development necessary to prove the performance of the technologies on MLLW

  6. Pragmatic dietary advice for diabetes during Navratris

    Directory of Open Access Journals (Sweden)

    Lovely Gupta

    2017-01-01

    Full Text Available Navratri is one of the most common religious fasts observed among Hindus. A large number of people with diabetes follow Navratris fast irrespective of its health implications, often without proper education and medical advice. The quest for the scientific research on dietary advices for Hindu fasts including Navratris shows paucity of literature comparative to the dietary advices advocated during Ramadan. The eating and physical activity patterns during different fasts vary a lot depending up on social and cultural factors. Even eating pattern is not uniform among all persons following Navratris and is modified as per their region, local culture, and religious beliefs. Dietary advice during Navratris depends upon pattern of fasting, religious beliefs, and local sociocultural factors. In this review, efforts are made to provide pragmatic dietary advice for people with diabetes, modifications in the menus and cooking practices, and timings of the meals for successful blood glucose management during Navratris. This review will also help plan diet and physical activity advice for persons observing other fasts as well.

  7. Advice for acute low back pain: a comparison of what research supports and what guidelines recommend.

    Science.gov (United States)

    Stevens, Matthew L; Lin, Chung-Wei C; de Carvalho, Flavia A; Phan, Kevin; Koes, Bart; Maher, Chris G

    2017-10-01

    Advice is widely considered an effective treatment for acute low back pain (LBP); however, details on what and how to deliver this intervention is less clear. We assessed and compared clinical trials that test advice for acute LBP with practice guidelines for their completeness of reporting and concordance on the content, method of delivery, and treatment regimen of advice interventions. Systematic review. Advice randomized controlled trials were identified through a systematic search. Guidelines were taken from recent overviews of guidelines for LBP. Completeness of reporting was assessed using the Template for Intervention Description and Replication checklist. Thematic analysis was used to characterize advice interventions into topics across the aspects of content, method of delivery, and regimen. Concordance between clinical trials and guidelines was assessed by comparing the number of trials that found a statistically significant treatment effect for an intervention that included a specific advice topic with the number of guidelines recommending that topic. The median (interquartile range) completeness of reporting for clinical trials and guidelines was 8 (7-9) and 3 (2-4) out of nine items on the Template for Intervention Description and Replication checklist, respectively. Guideline recommendations were discordant with clinical trials for 50% of the advice topics identified. Completeness of reporting was less than ideal for randomized controlled trials and extremely poor for guidelines. The recommendations made in guidelines of advice for acute LBP were often not concordant with the results of clinical trials. Taken together, these findings mean that the potential clinical value of advice interventions for patients with acute LBP is probably not being realized. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Efficacy and safety of a fixed-dose combination of dutasteride and tamsulosin treatment (Duodart(®) ) compared with watchful waiting with initiation of tamsulosin therapy if symptoms do not improve, both provided with lifestyle advice, in the management of treatment-naïve men with moderately symptomatic benign prostatic hyperplasia: 2-year CONDUCT study results.

    Science.gov (United States)

    Roehrborn, Claus G; Oyarzabal Perez, Igor; Roos, Erik P M; Calomfirescu, Nicolae; Brotherton, Betsy; Wang, Fang; Palacios, Juan Manuel; Vasylyev, Averyan; Manyak, Michael J

    2015-09-01

    To investigate whether a fixed-dose combination (FDC) of 0.5 mg dutasteride and 0.4 mg tamsulosin is more effective than watchful waiting with protocol-defined initiation of tamsulosin therapy if symptoms did not improve (WW-All) in treatment-naïve men with moderately symptomatic benign prostatic hyperplasia (BPH) at risk of progression. This was a multicentre, randomised, open-label, parallel-group study (NCT01294592) in 742 men with an International Prostate Symptom Score (IPSS) of 8-19, prostate volume ≥30 mL and total serum PSA level of ≥1.5 ng/mL. Patients were randomised to FDC (369 patients) or WW-All (373) and followed for 24 months. All patients were given lifestyle advice. The primary endpoint was symptomatic improvement from baseline to 24 months, measured by the IPSS. Secondary outcomes included BPH clinical progression, impact on quality of life (QoL), and safety. The change in IPSS at 24 months was significantly greater for FDC than WW-All (-5.4 vs -3.6 points, P tamsulosin. FDC therapy with dutasteride and tamsulosin, plus lifestyle advice, resulted in rapid and sustained improvements in men with moderate BPH symptoms at risk of progression with significantly greater symptom and QoL improvements and a significantly reduced risk of BPH progression compared with WW plus initiation of tamsulosin as per protocol. © 2015 The Authors. BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  9. Advice on the accelerated market implementation of advanced biofuels

    International Nuclear Information System (INIS)

    2008-04-01

    The Platform for Sustainable Mobility aims to promote the accelerated market introduction of more sustainable motor fuels and vehicle technology. The Platform distinguishes four transition paths: hybridization of the fleet of cars; implementation of biofuels; hydrogen-fuelled driving (driving on natural gas and biogas); intelligent transport systems (ITS). This advice involves part of the transition path for the implementation of biofuels, i.e. accelerated market introduction of advances biofuels. [mk] [nl

  10. Support Systems for Treatment Integrity

    NARCIS (Netherlands)

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately

  11. Green Systems for Wastewater Treatment

    Science.gov (United States)

    Environmental Science and Technology, 1975

    1975-01-01

    Plants found in marshlands and wetlands in many parts of the world may play an increasing part in a very new, yet very old approach to treatment of water and wastewater--the application of biological methods. Biological water pollution control methods being utilized around the world are examined. (BT)

  12. Interferon-α treatment in systemic mastocytosis

    DEFF Research Database (Denmark)

    Bjerrum, Ole Weis

    2011-01-01

    classification need treatment. This review on interferon treatment in systemic mastocytosis documents an effect of this biological agent in some patients with mastocytosis. However, the place of interferon-a, as mono- or combination therapy, in the treatment algorithm may only be definitely established...

  13. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

    Science.gov (United States)

    Singh, Abhishek; Pallikadavath, Saseendran; Ram, Faujdar; Ogollah, Reuben

    2012-01-01

    Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India. The District Level Household Survey (2007-08) was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice. A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients, irrespective of

  14. Inequalities in advice provided by public health workers to women during antenatal sessions in rural India.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available Studies have widely documented the socioeconomic inequalities in maternal and child health related outcomes in developing countries including India. However, there is limited research on the inequalities in advice provided by public health workers on maternal and child health during antenatal visits. This paper investigates the inequalities in advice provided by public health workers to women during antenatal visits in rural India.The District Level Household Survey (2007-08 was used to compute rich-poor ratios and concentration indices. Binary logistic regressions were used to investigate inequalities in advice provided by public health workers. The dependent variables comprised the advice provided on seven essential components of maternal and child health care. A significant proportion of pregnant women who attended at least four ANC sessions were not advised on these components during their antenatal sessions. Only 51%-72% of the pregnant women were advised on at least one of the components. Moreover, socioeconomic inequalities in providing advice were significant and the provision of advice concentrated disproportionately among the rich. Inequalities were highest in the case of advice on family planning methods. Advice on breastfeeding was least unequal. Public health workers working in lower level health facilities were significantly less likely than their counterparts in the higher level health facilities to provide specific advice.A significant proportion of women were not advised on recommended components of maternal and child health in rural India. Moreover, there were enormous socioeconomic inequalities. The findings of this study raise questions about the capacity of the public health care system in providing equitable services in India. The Government of India must focus on training and capacity building of the public health workers in communication skills so that they can deliver appropriate and recommended advice to all clients

  15. Advice Complexity of the Online Search Problem

    DEFF Research Database (Denmark)

    Clemente, Jhoirene; Hromkovič, Juraj; Komm, Dennis

    2016-01-01

    the minimum amount of information needed in order to achieve a certain competitive ratio. We design an algorithm that reads $b$ bits of advice and achieves a competitive ratio of (M/m)^{1/(2^b+1)} where M and m are the maximum and minimum price in the input. We also give a matching lower bound. Furthermore......The online search problem is a fundamental problem in finance. The numerous direct applications include searching for optimal prices for commodity trading and trading foreign currencies. In this paper, we analyze the advice complexity of this problem. In particular, we are interested in identifying......, we compare the power of advice and randomization for this problem....

  16. The best advice I ever got.

    Science.gov (United States)

    Wademan, Daisy

    2005-01-01

    A young manager faces an impasse in his career. He goes to see his mentor at the company, who closes the office door, offers the young man a chair, recounts a few war stories, and serves up a few specific pointers about the problem at hand. Then, just as the young manager is getting up to leave, the elder executive adds one small kernel of avuncular wisdom--which the junior manager carries with him through the rest of his career. Such is the nature of business advice. Or is it? The six essays in this article suggest otherwise. Few of the leaders who tell their stories here got their best advice in stereotypical form, as an aphorism or a platitude. For Ogilvy & Mather chief Shelly Lazarus, profound insight came from a remark aimed at relieving the tension of the moment. For Novartis CEO Daniel Vasella, it was an apt comment, made on a snowy day, back when he was a medical resident. For publishing magnate Earl Graves and Starwood Hotels' Barry Sternlicht, advice they received about trust from early bosses took on ever deeper and more practical meaning as their careers progressed. For Goldman Sachs chairman Henry Paulson, Jr., it was as much his father's example as it was a specific piece of advice his father handed down to him. And fashion designer Liz Lange rejects the very notion that there's inherent wisdom in accepting other people's advice. As these stories demonstrate, people find wisdom when they least expect to, and they never really know what piece of advice will transcend the moment, profoundly affecting how they later make decisions, evaluate people, and examine--and reexamine--their own actions.

  17. 75 FR 65031 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable...

    Science.gov (United States)

    2010-10-21

    ... Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty...-2104-027, U.S.-Trans-Pacific Partnership Free Trade Agreement Including Malaysia: Advice on the Probable Economic Effect of Providing Duty-Free Treatment for Imports. DATES: November 10, 2010: Deadline...

  18. Radwaste treatment complex. DRAWMACS planned maintenance system

    International Nuclear Information System (INIS)

    Keel, A.J.

    1992-07-01

    This document describes the operation of the Planned Maintenance System for the Radwaste Treatment Complex. The Planned Maintenance System forms part of the Decommissioning and Radwaste Management Computer System (DRAWMACS). Further detailed information about the data structure of the system is contained in Database Design for the DRAWMACS Planned Maintenance System (AEA-D and R-0285, 2nd issue, 25th February 1992). Information for other components of DRAWMACS is contained in Basic User Guide for the Radwaste Treatment Plant Computer System (AEA-D and R-0019, July 1990). (author)

  19. Generating personalized advice for schizophrenia patients

    NARCIS (Netherlands)

    Emerencia, A.; van der Krieke, Lian; Sytema, S.; Petkov, N.; Aiello, M.

    The results of routine patient assessments in psychiatric healthcare in the Northern Netherlands are primarily used to support clinicians. We developed Wegweis, a web-based advice platform, to make this data accessible and understandable for patients. Objective: We show that a fully automated

  20. Mortgage risks, debt literacy and financial advice

    NARCIS (Netherlands)

    van Ooijen, Raun; van Rooij, Maarten C.J.

    2016-01-01

    A limited understanding of mortgage contracts and the risks involved may have contributed to the outbreak of the 2007–2008 financial crisis. We developed a special questionnaire relating mortgage loan decisions to financial knowledge and financial advice. Our results demonstrate that homeowners

  1. A New Paradigm in Mortgage Loan Advice

    DEFF Research Database (Denmark)

    Otterstedt, Margrét Sesselja; Rasmussen, Kourosh Marjani; Kulahci, Murat

    2013-01-01

    The Danish mortgage market has undergone considerable changes during the last 15 years. New and more complex variations of loan products have been introduced. Nevertheless, mortgage loan advice has remained, by large, unchanged. This paper addresses a study where a number of new refinancing rules...

  2. [Pharmaceutical advice concerning different pharmaceutical dosage forms].

    Science.gov (United States)

    Szakonyi, Gergely; Zelkó, Romána

    2010-01-01

    The present paper summarizes the commonly applied types of drug uptake and the pharmacists' advice concerning a certain dosage form. The manuscript also deals with the modified release dosage forms and their abbreviations in the name of the marketing authorized products.

  3. System and process for biomass treatment

    Science.gov (United States)

    Dunson, Jr., James B; Tucker, III, Melvin P; Elander, Richard T; Lyons, Robert C

    2013-08-20

    A system including an apparatus is presented for treatment of biomass that allows successful biomass treatment at a high solids dry weight of biomass in the biomass mixture. The design of the system provides extensive distribution of a reactant by spreading the reactant over the biomass as the reactant is introduced through an injection lance, while the biomass is rotated using baffles. The apparatus system to provide extensive assimilation of the reactant into biomass using baffles to lift and drop the biomass, as well as attrition media which fall onto the biomass, to enhance the treatment process.

  4. Systemic treatment of Krukenberg tumors

    Directory of Open Access Journals (Sweden)

    Kolak Agnieszka

    2017-12-01

    Full Text Available Of all ovarian tumors with distinct biological features, 10-25% are secondary ovarian tumors. Among the most common cancers that cause ovarian metastasis are breast cancer, colorectal cancer, endometrium, as well as gastric and lateral cancer. Krukenberg tumors remain asymptomatic until the tumor reaches a certain size, as in the case of primary ovarian cancer. Symptoms are non-specific: abdominal pain (42%, postmenopausal bleeding (18%, weight loss (6% and an increasing abdominal girth (15%. Diagnostic procedures should include physical examination, basic blood and biochemistry tests, radiographic imaging and endoscopy. There are currently no uniform guidelines to be followed in order to treat this cancer. However, the survival rate of selected subgroups of patients may be enhanced by means of cytoreductive surgery (performable among patients with good general health condition, where the metastases are limited only to the ovaries, where the primary tumor is derived from the colorectal cancer, and where there is the absence or minimal residual disease. It is still controversial to use adjuvant chemotherapy following the metastasectomy of Krukenberg tumors. Although this type of treatment seems to provide a survival benefit, there are currently no randomized prospective trials available so as to confirm or deny. Future research should, therefore, be focused on the potentially synergistic effect of surgery and perioperative administration of cytotoxic therapies targeted at high response rates. Studies on new molecularly targeted drugs can also be beneficial.

  5. Reinforcement learning agents providing advice in complex video games

    Science.gov (United States)

    Taylor, Matthew E.; Carboni, Nicholas; Fachantidis, Anestis; Vlahavas, Ioannis; Torrey, Lisa

    2014-01-01

    This article introduces a teacher-student framework for reinforcement learning, synthesising and extending material that appeared in conference proceedings [Torrey, L., & Taylor, M. E. (2013)]. Teaching on a budget: Agents advising agents in reinforcement learning. {Proceedings of the international conference on autonomous agents and multiagent systems}] and in a non-archival workshop paper [Carboni, N., &Taylor, M. E. (2013, May)]. Preliminary results for 1 vs. 1 tactics in StarCraft. {Proceedings of the adaptive and learning agents workshop (at AAMAS-13)}]. In this framework, a teacher agent instructs a student agent by suggesting actions the student should take as it learns. However, the teacher may only give such advice a limited number of times. We present several novel algorithms that teachers can use to budget their advice effectively, and we evaluate them in two complex video games: StarCraft and Pac-Man. Our results show that the same amount of advice, given at different moments, can have different effects on student learning, and that teachers can significantly affect student learning even when students use different learning methods and state representations.

  6. Endogenous System Microbes as Treatment Process ...

    Science.gov (United States)

    Monitoring the efficacy of treatment strategies to remove pathogens in decentralized systems remains a challenge. Evaluating log reduction targets by measuring pathogen levels is hampered by their sporadic and low occurrence rates. Fecal indicator bacteria are used in centralized systems to indicate the presence of fecal pathogens, but are ineffective decentralized treatment process indicators as they generally occur at levels too low to assess log reduction targets. System challenge testing by spiking with high loads of fecal indicator organisms, like MS2 coliphage, has limitations, especially for large systems. Microbes that are endogenous to the decentralized system, occur in high abundances and mimic removal rates of bacterial, viral and/or parasitic protozoan pathogens during treatment could serve as alternative treatment process indicators to verify log reduction targets. To identify abundant microbes in wastewater, the bacterial and viral communities were examined using deep sequencing. Building infrastructure-associated bacteria, like Zoogloea, were observed as dominant members of the bacterial community in graywater. In blackwater, bacteriophage of the order Caudovirales constituted the majority of contiguous sequences from the viral community. This study identifies candidate treatment process indicators in decentralized systems that could be used to verify log removal during treatment. The association of the presence of treatment process indic

  7. Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

    Directory of Open Access Journals (Sweden)

    Beto JA

    2016-02-01

    Full Text Available Judith A Beto, Katherine A Schury, Vinod K Bansal Division of Nephrology and Hypertension, Loyola University Healthcare System, Loyola University of Chicago, Maywood, IL, USA Abstract: Chronic kidney disease (CKD requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens, and involving the total patient food environment. Keywords: talking control, technology-enhanced learning, hemodialysis, nutrition education, education strategies

  8. Organic contaminants in onsite wastewater treatment systems

    Science.gov (United States)

    Conn, K.E.; Siegrist, R.L.; Barber, L.B.; Brown, G.K.

    2007-01-01

    Wastewater from thirty onsite wastewater treatment systems was sampled during a reconnaissance field study to quantify bulk parameters and the occurrence of organic wastewater contaminants including endocrine disrupting compounds in treatment systems representing a variety of wastewater sources and treatment processes and their receiving environments. Bulk parameters ranged in concentrations representative of the wide variety of wastewater sources (residential vs. non-residential). Organic contaminants such as sterols, surfactant metabolites, antimicrobial agents, stimulants, metal-chelating agents, and other consumer product chemicals, measured by gas chromatography/mass spectrometry were detected frequently in onsite system wastewater. Wastewater composition was unique between source type likely due to differences in source water and chemical usage. Removal efficiencies varied by engineered treatment type and physicochemical properties of the contaminant, resulting in discharge to the soil treatment unit at ecotoxicologically-relevant concentrations. Organic wastewater contaminants were detected less frequently and at lower concentrations in onsite system receiving environments. Understanding the occurrence and fate of organic wastewater contaminants in onsite wastewater treatment systems will aid in minimizing risk to ecological and human health.

  9. Advice letter on policy instruments renewable electricity

    International Nuclear Information System (INIS)

    2011-01-01

    In a letter of July 2010 the Energy Council made recommendations for a policy framework with more obligations and fewer subsidies. This included the Energy Council's advice to investigate whether the introduction of a supplier obligation could play a major role in the realisation of the CO2 emission target of the Netherlands and increase the share of renewable energy in line with European agreements. This advice letter deals with one aspect of the broader considerations: the share of renewable electricity and the kind of incentive framework that is needed to achieve the target concerned. In this letter we will examine the possibilities of the SDE+ support (financial incentive for renewable energy) scheme and the supplier obligation, the effects on the market and the consequences for achieving the target. This letter closes with conclusions and recommendations. [nl

  10. Treatment system operation, management, and finance

    Energy Technology Data Exchange (ETDEWEB)

    Truax, D.D. (Mississippi State Univ., Mississippi State (United States))

    1990-06-01

    This article deals with literature on operation, management, and financing of wastewater treatment plants. Some topics discussed are system hydraulics and flow monitoring, odor, reliability, equipment age, management philosophy, performance, reducing operating cost, planning and response to emergencies, preventative maintenance, inspection systems, mechanical vibrations, safety, privatization, municipal leasing, user and impact fees.

  11. Consumer's Negative emotions, Financial Decisions, Financial Advice

    OpenAIRE

    Konstantaki, Violetta

    2007-01-01

    Abstract The purpose of this study is to explore the consumers decision making process. In particular, this study attempts to examine consumers negative emotions, which elicit during a decision processing. Especially, the case of a financial decision will be examined. Moreover, consumers negative emotion will be investigated in relation with consumers coping behaviour. To be more specific, the option of seeking advice as a successful consumers coping behaviour will be explor...

  12. Financial Advice: An Improvement for Worse?

    OpenAIRE

    Karabulut, Yigitcan

    2010-01-01

    Using a unique administrative data set from a large German commercial bank, this paper aims to ascertain the role of financial advisors in individual portfolios. Following on the heels of the ongoing regulatory and political debate as to the merits of financial advice, we focus in this paper on three key issues. First, we examine whether collaboration with financial advisors attains to better performing portfolios. Second, we investigate whether the involvement of financial advisors mitigates...

  13. Communication of Science Advice to Government.

    Science.gov (United States)

    Hutchings, Jeffrey A; Stenseth, Nils Chr

    2016-01-01

    There are various ways to construct good processes for soliciting and understanding science. Our critique of advisory models finds that a well-supported chief science advisor (CSA) best ensures the provision of deliberative, informal, and emergency advice to government. Alternatively, bias, increasingly manifest as science-based advocacy, can hinder communication, diminish credibility, and distort scientific evidence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Maintaining clinical governance when giving telephone advice.

    Science.gov (United States)

    Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A

    2013-10-01

    Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

  15. Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

    Science.gov (United States)

    ... Avian Swine Variant Pandemic Other Protecting Against Influenza (Flu): Advice for Caregivers of Young Children Language: English ( ... from the flu. Advice on How to Prevent Flu for Caregivers of Young Children 1. Take Time ...

  16. No Effect of Writing Advice on Reading Comprehension

    DEFF Research Database (Denmark)

    Balling, Laura Winther

    2018-01-01

    This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences...

  17. Enhanced integrated nonthermal treatment system study

    International Nuclear Information System (INIS)

    Biagi, C.; Schwinkendorf, B.; Teheranian, B.

    1997-02-01

    The purpose of the Enhanced Nonthermal Treatment Systems (ENTS) study is to evaluate alternative configurations of one of the five systems evaluated in the Integrated Nonthermal Treatment Systems (INTS) study. Five alternative configurations are evaluated. Each is designed to enhance the final waste form performance by replacing grout with improved stabilization technologies, or to improve system performance by improving the destruction efficiency for organic contaminants. AU enhanced systems are alternative configurations of System NT-5, which has the following characteristics: Nonthermal System NT-5: (1) catalytic wet oxidation (CWO) to treat organic material including organic liquids, sludges, and soft (or combustible) debris, (2) thermal desorption of inorganic sludge and process residue, (3) washing of soil and inorganic debris with treatment by CWO of removed organic material, (4) metal decontamination by abrasive blasting, (5) stabilization of treated sludge, soil, debris, and untreated debris with entrained contamination in grout, and (6) stabilization of inorganic sludge, salts and secondary waste in polymer. System NT-5 was chosen because it was designed to treat combustible debris thereby minimizing the final waste form volume, and because it uses grout for primary stabilization. The enhanced nonthermal systems were studied to determine the cost and performance impact of replacing grout (a commonly used stabilization agent in the DOE complex) with improved waste stabilization methods such as vitrification and polymer

  18. Advances in HTGR Wastewater Treatment System Design

    International Nuclear Information System (INIS)

    Li Junfeng; Qiu Yu; Wang Jianlong; Jia Fei

    2014-01-01

    The source terms of radioactive wastewater from HTR-PM were introduced. Concentration process should be used to reduce volume. A radioactive wastewater treatment system was designed by using Disc tubular reverse osmosis (DTRO) membrane system. The pretreatment system was simplify by using a cartridge filter. A three-stage membrane system was built. The operated characters to treat low and intermediate radioactive waste water were studied. A concentration rates of 25-50 is reached. The decontamination factor of the membrane system can reach 30-100. (author)

  19. Stepwise Advice Negotiation in Writing Center Peer Tutoring

    Science.gov (United States)

    Park, Innhwa

    2014-01-01

    While the delivery and reception of advice is a practice integral to a wide range of settings, little attention has been given to the detailed practices of advice resistance and how it leads to advice negotiation. Based on 7 hours of videotaped tutoring interactions among 6 tutors and 11 tutees, this conversation analytic study examines the…

  20. 32 CFR 776.10 - Informal ethics advice.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Informal ethics advice. 776.10 Section 776.10... § 776.10 Informal ethics advice. (a) Advisors. Covered attorneys may seek informal ethics advice either... of Director, JA Division, HQMC; and (5) Head, Standards of Conduct/Government Ethics Branch...

  1. Content and Style of Advice in Iran and Canada

    Science.gov (United States)

    Tavakoli, Mahin

    2013-01-01

    The content and nature of nonprofessional advice in Iran, a hierarchical and collectivist culture, was compared to the same type of advice in Canada, an egalitarian and individualist culture. A researcher developed a questionnaire that consisted of 10 letters, each describing a writer's problem and asking for advice. The responses of participants…

  2. Acquisition and treatment systems for experimental data

    International Nuclear Information System (INIS)

    Bouard, E.

    1988-01-01

    The acquisition and treatment systems for experimental data has been conceived to give a response to experimental requirements in a research reactor such OSIRIS. Its objective is to acquire and treat the ensemble of informations coming from one or many experiences, to archive useful data for an ulterior treatment and to give at the experimentator a tool ensemble for a better track of his experience. Its main characteristics are given in this text [fr

  3. Linked analysis for definition of nurse advice line syndrome groups, and comparison to encounters.

    Science.gov (United States)

    Magruder, Steven F; Henry, J; Snyde, M

    2005-08-26

    Nurse advice call centers are a potentially important source of data for syndromic surveillance purposes. For this reason, researchers at Johns Hopkins University Applied Physics Laboratory and Kaiser Permanente of the Mid-Atlantic States (KPMAS) have been collaborating to develop methods to use this data within the ESSENCE II Syndromic Surveillance System in the National Capital Region. The objective of this report is to present a general method for finding syndrome groups in data sources that can be linked to physician encounters and to determine effective advice call syndrome groups for use with KPMAS advice data. Advice calls are linked to physician encounters and stratified by patient age. They are placed in groups according to a maximum positive predictive value criterion. The groups are evaluated by correlating the resulting syndrome time series against physician encounter data. Potentially useful advice syndrome groups are found for respiratory, lower gastrointestinal (GI), and total GI syndromes for each age stratum. The time series of the advice data for respiratory, lower GI, and upper GI syndromes accurately predict the physician encounter time series for the corresponding syndromes for each age stratum.

  4. On Advice Complexity of the k-server Problem under Sparse Metrics

    DEFF Research Database (Denmark)

    Gupta, S.; Kamali, S.; López-Ortiz, A.

    2013-01-01

    O (n(log μ +log logN)) bits of advice. Among other results, this gives a 3-competitive algorithm for planar graphs, provided with O (n log log N) bits of advice. On the other side, we show that an advice of size Ω (n) is required to obtain a 1-competitive algorithm for sequences of size n even......We consider the k-Server problem under the advice model of computation when the underlying metric space is sparse. On one side, we introduce Θ (1)-competitive algorithms for a wide range of sparse graphs, which require advice of (almost) linear size. Namely, we show that for graphs of size N...... and treewidth α, there is an online algorithm which receives O (n(log α +log log N))1 bits of advice and optimally serves a sequence of length n. With a different argument, we show that if a graph admits a system of μ collective tree (q, r)- spanners, then there is a (q + r)-competitive algorithm which receives...

  5. Sistem Advice Planing Online Dengan Framework Codeigniter Berbasis Web Bootstrap (Studi Kasus: Kabupaten Probolinggo

    Directory of Open Access Journals (Sweden)

    Moh Ainol Yaqin

    2018-05-01

    Full Text Available The information system in the form of Integrated Advice Planning by using CodeIgniter Framework and based on  Framework Bootstrap one of system which gives responsive form. The system is a service as one of solution for e-Government. Advice Planning service is the optimization of public services in the licensing sector and the optimization of agency management. The licensing service is in the form of design consultation and the location of the building in accordance with the Spatial and Regional Plan within a Local Government. Licensing process that must be fulfilled by prospective investors either individually or on behalf of the company and supporting infrastructure around the investment location. The services provided by the Information System have provided Advice Planning application submission online. The system is expected to provide convenience for the community in the region and create a friendly, the comfortable, the transparent and cheap of interaction between the government and the community.

  6. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    Psoriasis is a chronic inflammatory skin disease, which affects approximately 2.6% of the population in Northern Europe and Scandinavia. In order to achieve disease control, combinations of systemic treatments are sometimes needed for variable time periods. However, no evidence-based guidelines...... exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...

  7. System dynamics in complex psychiatric treatment organizations.

    Science.gov (United States)

    Rosenheck, R

    1988-05-01

    One of the major challenges facing contemporary psychiatry is the coordination of diverse services through organizational integration. With increasing frequency, psychiatric treatment takes place in complex treatment systems composed of multiple inpatient and outpatient programs. Particularly in public health care systems serving the chronically ill, contemporary practice demands a broad spectrum of programs, often geographically dispersed, that include crisis intervention teams, day treatment programs, substance abuse units, social rehabilitation programs and halfway houses (Bachrach 1983; Turner and TenHoor 1978). Individualized treatment planning often requires that a particular patient participate in two or more specialized programs either simultaneously or in a specified sequence. As a consequence of this specialization, treatment fragmentation has emerged as a significant clinical problem, and continuity of care has been highlighted as a valuable but elusive ingredient of optimal treatment. This paper will describe the dynamic interactions that result when several such programs are united under a common organizational roof. Using a large VA Psychiatry Service as an example, I will outline the hierarchical structure characteristic of such an organization, as well as the persistent pulls toward both integration and fragmentation that influence its operation.

  8. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  9. Treatment planning systems for high precision radiotherapy

    International Nuclear Information System (INIS)

    Deshpande, D.D.

    2008-01-01

    Computerized Treatment Planning System (TPS) play an important role in radiotherapy with the intent to maximize tumor control and minimize normal tissue complications. Treatment planning during earlier days was generally carried out through the manual summations of standard isodose charts on to patient body contours that were generated by direct tracing or lead wire representation, and relied heavily on the careful choices of beam weights and wedging. Since then there had been tremendous advances in field of Radiation Oncology in last few decades. The linear accelerators had evolved from MLC's to IGRT, the techniques like 3DCRT, IMRT has become almost routine affair. The simulation has seen transition from simple 2D film/fluoroscopy localization to CT Simulator with added development in PET, PET- CT and MR imaging. The Networking and advances in computer technology has made it possible to direct transfer of Images, contours to the treatment planning systems

  10. Systemic Treatments for Noninfectious Vitreous Inflammation

    Directory of Open Access Journals (Sweden)

    Angela Jiang

    2013-01-01

    Full Text Available Vitreous inflammation, or vitritis, may result from many causes, including both infectious and noninfectious, including rheumatologic and autoimmune processes. Vitritis is commonly vision threatening and has serious sequelae. Treatment is frequently challenging, but, today, there are multiple methods of systemic treatment for vitritis. These categories include corticosteroids, antimetabolites, alkylating agents, T-cell inhibitors/calcineurin inhibitors, and biologic agents. These treatment categories were reviewed last year, but, even over the course of just a year, many therapies have made progress, as we have learned more about their indications and efficacy. We discuss here discoveries made over the past year on both existing and new drugs, as well as reviewing mechanisms of action, clinical dosages, specific conditions that are treated, adverse effects, and usual course of treatment for each class of therapy.

  11. Grey water treatment systems: A review

    NARCIS (Netherlands)

    Abu-Ghunmi, L.N.A.H.; Zeeman, G.; Fayyad, M.; Lier, van J.B.

    2011-01-01

    This review aims to discern a treatment for grey water by examining grey water characteristics, reuse standards, technology performance and costs. The review reveals that the systems for treating grey water, whatever its quality, should consist of processes that are able to trap pollutants with a

  12. Advice on Writing a Scientific Paper

    Science.gov (United States)

    Sterken, C.

    2006-04-01

    What makes one author a good communicator and another a poor one? What turns out one manuscript a swift editorial task, and another an editorial nightmare? Based on direct experience from the manuscripts of the lectures and papers presented during this school, advice is given on what to do and on what to avoid when writing a scientific paper. Some feedback recommendation is also provided on how to prepare manuscripts, handle copyright and permissions to reproduce, how to anticipate plagiarism, how to deal with editors and referees, and how to avoid common errors. A few illustrations of English grammar and style for the foreign author are given.

  13. WITHDRAWN: Systemic treatments for metastatic cutaneous melanoma.

    Science.gov (United States)

    Crosby, Tom; Fish, Reg; Coles, Bernadette; Mason, Malcolm

    2018-02-07

    Systemic therapies for metastatic cutaneous melanoma, the most aggressive of all skin cancers, remain disappointing. Few lasting remissions are achieved and the therapeutic aim remains one of palliation.Many agents are used alone or in combination with varying degrees of toxicity and cost. It is unclear whether evidence exists to support these complex regimens over best supportive care / placebo. To review the benefits from the use of systemic therapies in metastatic cutaneous melanoma compared to best supportive care/placebo, and to establish whether a 'standard' therapy exists which is superior to other treatments. Randomised controlled trials were identified from the MEDLINE, EMBASE and CCTR/CENTRAL databases. References, conference proceedings, and Science Citation Index/Scisearch were also used to locate trials. Cancer registries and trialists were also contacted. Randomised controlled trials of adults with histologically proven metastatic cutaneous melanoma in which systemic anti-cancer therapy was compared with placebo or supportive care. Study selection was performed by two independent reviewers. Data extraction forms were used for studies which appeared to meet the selection criteria and, where appropriate, full text articles were retrieved and reviewed independently. No randomised controlled trials were found comparing a systemic therapy with placebo or best supportive care in metastatic cutaneous melanoma. There is no evidence from randomised controlled clinical trials to show superiority of systemic therapy over best supportive care / placebo in the treatment of malignant cutaneous melanoma.Given that patients with metastatic melanoma frequently receive systemic therapy, it is our pragmatic view that a future systematic review could compare any systemic treatment, or combination of treatments, to single agent dacarbazine.

  14. How do stroke survivors and their carers use practitioners' advice on secondary prevention medications? Qualitative study of an online forum.

    Science.gov (United States)

    Izuka, Nkeonye J; Alexander, Matthew A W; Balasooriya-Smeekens, Chantal; Mant, Jonathan; De Simoni, Anna

    2017-09-01

    Secondary prevention medications reduce risk of stroke recurrence, yet many people do not receive recommended treatment, nor take medications optimally. Exploring how patients report making use of practitioners' advice on secondary prevention medicines on an online forum and what feedback was received from other participants. Thematic analysis of the archive of Talkstroke (2004-2011), UK. Posts including any secondary prevention medication terms, General Practitioner (GP) and their replies were identified. Fifity participants talked about practitioners' advice on secondary prevention medications in 43 discussion threads. Patients consulted practitioners for reassurance and dealing with side effects. Practitioners' advice varied from altering to maintaining current treatment. Three main themes emerged from the use of practitioners' advice: patients following advice (reassured, happy when side effects made tolerable, or still retaining anxiety about treatment); patients not following advice (admitting adherence on-off or stopping medications as side effects still not tolerable); asking other participants for feedback on advice received. Practitioners' advice was disregarded mainly when related to dealing with statin side effects, after one or two consultations. Themes for feedback involved sharing experience, directing back to practitioners, or to external evidence. Side effects of secondary prevention medications and statins in particular, cause anxiety and resentment in some patients, and their concerns are not always addressed by practitioners. Practitioners could consider more proactive strategies to manage such side effects. Forum feedback was appropriate and supportive of the practitioners' advice received. Our findings from peer-to-peer online conversations confirm and widen previous research. © The Author 2017. Published by Oxford University Press.

  15. Supernatant treatment system design through testing

    International Nuclear Information System (INIS)

    Ploetz, D.K.; Leonard, I.M.

    1988-12-01

    The main purpose of the Supernatant Treatment System (STS) is to remove more than 99.9 percent of the radioactive cesium (Cs-137) from the high-level waste stored in tank 8D-2. Cesium removal is accomplished in the STS by processing the supernatant (liquid) portion of the high-level waste through three or four ion exchange columns filled with zeolite. After treatment in the STS, the decontaminated supernatant is processed as low-level waste and finally encapsulated in cement for eventual disposal. The Cs-137 removed from the waste and absorbed onto zeolite ion exchange material is temporarily stored in tank 8D-1 until it can be encapsulated in glass and disposed of as high-level waste. This report discusses construction and testing of the STS. Design of the STS was started in 1982 in parallel with the selection of the ion exchange material. The construction of this system was accomplished in five phase in parallel with completion of design to allow for faster completion of the project. The existing high-level waste storage tanks -- 8D-1, 8D-2, and 8D-3 -- required major renovations to permit transfer of the high-level waste from tank 8D-2 to tank 8D-1, to house the components that comprise the STS in tank 8D-1, and to store decontaminated wastes in tank 8D-3. Testing in the STS started before construction was complete and was accomplished by first testing components individually. Then the system was retested using simulated supernatant. Integrated testing of the whole Integrated Radwaste Treatment System (IRTS), which includes the STS, Liquid Waste Treatment System (LWTS), Cement Solidification System (CSS), and the Drum Cell, was also performed using simulated supernatant. Finally, slightly radioactive condensate water from tank 8D-1 was processed. After successfully completing this testing, the STS started operations with radioactive supernatant on May 23, 1988. 21 refs., 33 figs., 21 tabs

  16. Treatment Algorithms in Systemic Lupus Erythematosus.

    Science.gov (United States)

    Muangchan, Chayawee; van Vollenhoven, Ronald F; Bernatsky, Sasha R; Smith, C Douglas; Hudson, Marie; Inanç, Murat; Rothfield, Naomi F; Nash, Peter T; Furie, Richard A; Senécal, Jean-Luc; Chandran, Vinod; Burgos-Vargas, Ruben; Ramsey-Goldman, Rosalind; Pope, Janet E

    2015-09-01

    To establish agreement on systemic lupus erythematosus (SLE) treatment. SLE experts (n = 69) were e-mailed scenarios and indicated preferred treatments. Algorithms were constructed and agreement determined (≥50% respondents indicating ≥70% agreement). Initially, 54% (n = 37) responded suggesting treatment for scenarios; 13 experts rated agreement with scenarios. Fourteen of 16 scenarios had agreement as follows: discoid lupus: first-line therapy was topical agents and hydroxychloroquine and/or glucocorticoids then azathioprine and subsequently mycophenolate (mofetil); uncomplicated cutaneous vasculitis: initial treatment was glucocorticoids ± hydroxychloroquine ± methotrexate, followed by azathioprine or mycophenolate and then cyclophosphamide; arthritis: initial therapy was hydroxychloroquine and/or glucocorticoids, then methotrexate and subsequently rituximab; pericarditis: first-line therapy was nonsteroidal antiinflammatory drugs, then glucocorticoids with/without hydroxychloroquine, then azathioprine, mycophenolate, or methotrexate and finally belimumab or rituximab, and/or a pericardial window; interstitial lung disease/alveolitis: induction was glucocorticoids and mycophenolate or cyclophosphamide, then rituximab or intravenous gamma globulin (IVIG), and maintenance followed with azathioprine or mycophenolate; pulmonary hypertension: glucocorticoids and mycophenolate or cyclophosphamide and an endothelin receptor antagonist were initial therapies, subsequent treatments were phosphodiesterase-5 inhibitors and then prostanoids and rituximab; antiphospholipid antibody syndrome: standard anticoagulation with/without hydroxychloroquine, then a thrombin inhibitor for venous thrombosis, versus adding aspirin or platelet inhibition drugs for arterial events; mononeuritis multiplex and central nervous system vasculitis: first-line therapy was glucocorticoids and cyclophosphamide followed by maintenance with azathioprine or mycophenolate, and

  17. Let Me Give You a Piece of Advice: Empirical Papers about Advice Taking in Marketing

    NARCIS (Netherlands)

    S.C. Tzioti (Stefanie)

    2010-01-01

    textabstractUsing advice in decision making is widespread for all sorts of important personal and professional decisions. Yet, traditional research on individual decision making has failed to systematically study the impact that social interactions about a decision problem can have on the decision

  18. Leaving the Hospital Against Medical Advice Among People Who Use Illicit Drugs: A Systematic Review

    Science.gov (United States)

    Ti, Lianlian

    2015-01-01

    from psychiatric hospitals, drug treatment centers and emergency departments, and studies that discussed misuse of alcohol but not illicit drugs. Data collection and analysis. We created an electronic database that included study abstracts and relevant information matching the keywords and search criteria. We reviewed potentially eligible articles independently by scanning the titles, abstracts, and full texts of articles after removing duplicates. We identified studies for which eligibility was unclear and decided which studies to include after thoroughly reviewing and discussing them. Results. Of the 1649 studies that matched the search criteria, 17 met our inclusion criteria. Thirteen studies identified substance misuse as a significant predictor of leaving the hospital against medical advice. Three studies assessed the prevalence and predictors of leaving the hospital against medical advice among people who inject drugs and found that this phenomenon was commonly reported (prevalence range = 25%–30%). Factors positively associated with leaving the hospital against medical advice included recent injection drug use, Aboriginal ancestry, leaving on weekends and welfare check day. In-hospital methadone use, social support, older age, and admission to a community-based model of care were negatively associated with the outcome. Conclusions. To better understand risk factors associated with leaving the hospital against medical advice among PWUD, future research should consider the effect of individual, social, and structural characteristics on leaving the hospital against medical advice among PWUD. The development and evaluation of novel methods to address interventions to reduce the rate of leaving the hospital prematurely is necessary. PMID:26469651

  19. Treatment of pathological gambling - integrative systemic model.

    Science.gov (United States)

    Mladenović, Ivica; Lažetić, Goran; Lečić-Toševski, Dušica; Dimitrijević, Ivan

    2015-03-01

    Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of

  20. Improvements in patient treatment planning systems

    International Nuclear Information System (INIS)

    Wheeler, F.J.; Wessol, D.E.; Nigg, D.W.; Atkinson, C.A.; Babcock, R.; Evans, J.

    1995-01-01

    The Boron Neutron Capture Therapy, Radiation treatment planning environment (BNCT-Rtpe) software system is used to develop treatment planning information. In typical use BNCT-Rtpe consists of three main components: (1) Semi-automated geometric modeling of objects (brain, target, eyes, sinus) derived from MRI, CT, and other medical imaging modalities, (2) Dose computations for these geometric models with rtt-MC, the INEL Monte Carlo radiation transport computer code, and (3) Dose contouring overlaid on medical images as well as generation of other dose displays. We continue to develop a planning system based on three-dimensional image-based reconstructions using Bspline surfaces. Even though this software is in an experimental state, it has been applied for large animal research and for an isolated case of treatment for a human glioma. Radiation transport is based on Monte Carlo, however there will be implementations of faster methods (e.g. diffusion theory) in the future. The important thing for treatment planning is the output which must convey, to the radiologist, the deposition of dose to healthy and target tissue. Many edits are available such that one can obtain contours registered to medical image, dose/volume histograms and most information required for treatment planning and response assessment. Recent work has been to make the process more automatic and easier to use. The interface, now implemented for contouring and reconstruction, utilizes the Xwindowing system and the MOTIF graphical users interface for effective interaction with the planner. Much work still remains before the tool can be applied in a routine clinical setting

  1. 71: Three dimensional radiation treatment planning system

    International Nuclear Information System (INIS)

    Purdy, J.A.; Wong, J.W.; Harms, W.B.; Drzymala, R.E.; Emami, B.

    1987-01-01

    A prototype 3-dimensional (3-D) radiation treatment planning (RTP) system has been developed and is in use. The system features a real-time display device and an array processor for computer intensive computations. The dose distribution can be displayed as 2-D isodose distributions superimposed on 2-D gray scale images of the patient's anatomy for any arbitrary plane and as a display of isodose surfaces in 3-D. In addition, dose-volume histograms can be generated. 7 refs.; 2 figs

  2. Systemic antibiotics in the treatment of periodontitis.

    Science.gov (United States)

    Feres, Magda; Figueiredo, Luciene C; Soares, Geisla M Silva; Faveri, Marcelo

    2015-02-01

    Despite the fact that several clinical studies have shown additional benefits when certain systemic antibiotics are used as adjuncts to periodontal treatment, clear guidelines for the use of these agents in the clinical practice are not yet available. Basic questions concerning the use of systemic antibiotics to treat periodontitis remain unanswered, such as: which drug(s) should be used; which patients would most benefit from treatment; which are the most effective protocols (i.e. doses and durations); and in which phase of the mechanical therapy should the drug(s) be administered? Although not all of those questions have been directly addressed by controlled randomized clinical trials, recent concepts related to the ecology of periodontal diseases, as well as the major advances in laboratory and clinical research methods that have occurred in the past decade, have significantly broadened our knowledge in this field. This article endeavored to provide a 'state of the art' overview on the use of systemic antibiotics in the treatment of periodontitis, based on the most recent literature on the topic as well as on a compilation of data from studies conducted at the Center of Clinical Trials at Guarulhos University (São Paulo, Brazil) from 2002 to 2012. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Telemedical advice to long-distance passenger ferries

    DEFF Research Database (Denmark)

    Jensen, Olaf C; Bo Bøggild, Niels; Kristensen, Søren

    2005-01-01

    BACKGROUND: Radio medical (RM) advice for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyze the data from consultations with passenger ferries to identify areas for possible improvements. METHODS......: Data from the journals for 1 year from Radio Medical Denmark consultations with the medical officers on passenger ferries were analyzed retrospectively. RESULTS: Two hundred fourteen RM records, 73% pertaining to passengers and 27% for crew members, were analyzed. Passenger patients were generally...... complaints, and more than half of these involved severe or considerable pain. Only acetaminophen (paracetamol) and opioids were in the ferry medicine chest. At least 77 patients would have benefited from use of nonsteroidal anti-inflammatory drugs. CONCLUSIONS: The paramedical assistance and the medicine...

  4. Advice from working women with retired partners.

    Science.gov (United States)

    Cooley, Eileen L; Adorno, Gail

    2016-01-01

    in the 21st century, as more women are employed full-time and couples increasingly share egalitarian values, more women continue employment after their partners have voluntarily retired. However, we know very little about the experiences of this growing population of women. We asked working women with retired partners to share their advice for other women who may face this developmental transition. Open-ended responses from 97 women were analyzed to identify pertinent issues and themes. Four primary content areas were identified: time management, division of household labor, financial planning, and communication. Communication between partners was both a topic of concern as well as the solution suggested to resolve conflicts or differences that may arise when women live with a retired partner. It is expected that future changes in the workforce and improvements in the gender balance within relationships will continue to impact experiences for working women with retired partners.

  5. [Maintenance and monitoring of water treatment system].

    Science.gov (United States)

    Pontoriero, G; Pozzoni, P; Tentori, F; Scaravilli, P; Locatelli, F

    2005-01-01

    Water treatment systems must be submitted to maintenance, disinfections and monitoring periodically. The aim of this review is to analyze how these processes must complement each other in order to preserve the efficiency of the system and optimize the dialysis fluid quality. The correct working of the preparatory process (pre-treatment) and the final phase of depuration (reverse osmosis) of the system need a periodic preventive maintenance and the regular substitution of worn or exhausted components (i.e. the salt of softeners' brine tank, cartridge filters, activated carbon of carbon tanks) by a competent and trained staff. The membranes of reverse osmosis and the water distribution system, including dialysis machine connections, should be submitted to dis-infections at least monthly. For this purpose it is possible to use chemical and physical agents according to manufacturer' recommendations. Each dialysis unit should predispose a monitoring program designed to check the effectiveness of technical working, maintenance and disinfections and the achievement of chemical and microbiological standards taken as a reference. Generally, the correct composition of purified water is monitored by continuous measuring of conductivity, controlling bacteriological cultures and endotoxin levels (monthly) and checking water contaminants (every 6-12 months). During pre-treatment, water hardness (after softeners) and total chlorine (after chlorine tank) should be checked periodically. Recently the Italian Society of Nephrology has developed clinical guidelines for water and dialysis solutions aimed at suggesting rational procedures for production and monitoring of dialysis fluids. It is hopeful that the application of these guidelines will lead to a positive cultural change and to an improvement in dialysis fluid quality.

  6. TFA Systems: A Unique Group Treatment of Spouse Abusers.

    Science.gov (United States)

    Clow, Daniel R.; And Others

    1992-01-01

    Presents a group treatment model using Thought-Feeling-Action (TFA) Systems, an offense- and offender-specific group treatment for abusers. Describes use of TFA Systems in group of court-referred male spouse-abusers. Reviews evolution of TFA Systems, then focuses on TFA Systems treatment of spouse abusers. Notes that system can be adapted to other…

  7. Development of a laundry waste treatment system

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, M; Sugimoto, Y; Yusa, H; Ebara, K [Hitachi Ltd., Ibaraki (Japan). Hitachi Research Lab.; Takeshima, M [Hitachi Ltd., Ibaraki (Japan). Hitachi Works

    1977-12-01

    Fundamental and pilot plant experiments developed a laundry waste treatment system for nuclear power plants, consisting of a reverse osmosis unit for removal of radioactive materials and pre-concentration, and an evaporator for the final concentration. A sponge ball cleaning method was employed for the reverse osmosis unit and a heat-resistant antifoam reagent for the evaporator. The pilot plant test, using simulated wastes, showed a decontamination factor of above 10/sup 3/ and a volume reduction ratio of 10/sup -3/.

  8. Reducing travel delay by in-car advice on speed, headway and lane use based on downstream traffic flow conditions - a simulation study

    NARCIS (Netherlands)

    Schakel, W.J.; Klunder, G.; van Arem, B.; Harmsen, E.; Hagenzieker, M.P.

    2012-01-01

    A new advisory ADAS system is implemented in micro simulation to asses the effects on traffic flow as well as on safety. The system uses loop detector data from which situations may be recognized where advices are given to drivers in-car. Advice is given on speed, headway and lane use. Effectively

  9. Effects of yoga, strength training and advice on back pain: a randomized controlled trial.

    Science.gov (United States)

    Brämberg, Elisabeth Björk; Bergström, Gunnar; Jensen, Irene; Hagberg, Jan; Kwak, Lydia

    2017-03-29

    Among the working population, non-specific low-back pain and neck pain are one of the most common reasons for sickness absenteeism. The aim was to evaluate the effects of an early intervention of yoga - compared with strength training or evidence-based advice - on sickness absenteeism, sickness presenteeism, back and neck pain and disability among a working population. A randomized controlled trial was conducted on 159 participants with predominantly (90%) chronic back and neck pain. After screening, the participants were randomized to kundalini yoga, strength training or evidence-based advice. Primary outcome was sickness absenteeism. Secondary outcomes were sickness presenteeism, back and neck pain and disability. Self-reported questionnaires and SMS text messages were completed at baseline, 6 weeks, 6 and 12 months. The results did not indicate that kundalini yoga and strength training had any statistically significant effects on the primary outcome compared with evidence-based advice. An interaction effect was found between adherence to recommendations and sickness absenteeism, indicating larger significant effects among the adherers to kundalini yoga versus evidence-based advice: RR = 0.47 (CI 0.30; 0.74, p = 0.001), strength training versus evidence-based advice: RR = 0.60 (CI 0.38; 0.96, p = 0.032). Some significant differences were also found for the secondary outcomes to the advantage of kundalini yoga and strength training. Guided exercise in the forms of kundalini yoga or strength training does not reduce sickness absenteeism more than evidence-based advice alone. However, secondary analyses reveal that among those who pursue kundalini yoga or strength training at least two times a week, a significantly reduction in sickness absenteeism was found. Methods to increase adherence to treatment recommendations should be further developed and applied in exercise interventions. Clinicaltrials.gov NCT01653782, date of registration: June, 28

  10. Irradiation chamber for photoactivation patient treatment system

    International Nuclear Information System (INIS)

    Lee, K.H.; Troutner, V.H.; Goss, J.; King, M.J.

    1988-01-01

    A flat plate irradiation chamber is described for use in a patient treatment system for altering cells, including treating the cells with a photoactivatable agent and passing the cells and the agent through a field of photoactivating radiation whereby the agent is caused to be activated and to affect the cells. The agent and the cells are contained in the irradiation chamber during irradiation. The flat plate irradiation chamber comprises: a rigid top sheet matably joined with a rigid bottom sheet, forming therebetween a rigid serpentine pathway for conducting the cells through the field of radiation; and pump block means for holding tubing means in fluid communication with the serpentine pathway and adapted for engaging a peristaltic pump whereby rotation of the pump causes the cells to flow through the serpentine pathway, and wherein the chamber is removable from the system and disposable

  11. Pre-travel advice: an overview.

    Science.gov (United States)

    Sanford, Christopher

    2002-12-01

    The message of the pre-travel provider is necessarily paradoxic. First the provider lists a score of causes of illness and premature demise, and then states, "But it sounds like a great trip and I think you'll have fun." Pre-travel providers need to walk a fine line: they must encourage patients to be cautious but not paranoid, optimistic but realistic. This discussion is complicated further by the fact that risk reduction is not the only consideration; if it were, practitioners would advise patients to remain in the developed world and foray from their homes only to visit health clubs and the fruit-and-vegetable section of grocery stores. A tacit assumption in travel medicine is that some degree of acceptance of heightened risk is tolerated for the benefit of improved quality of life offered by travel abroad. The amount of risk that is reasonable to accept for a given benefit in quality of life yielded by travel cannot be quantified, however. Providers must render judgments on what is "reasonable" and what is not, and this complex decision is based on equal parts medical knowledge and intuition. At one extreme, mountaineers in Nepal have been found to have a 2.4% mortality rate per expedition [83,84]. The travel provider might make the reasonable decision to counsel these travelers to avoid that activity. These travelers most likely will ignore that advice, at which point the provider must endeavor to reduce risk to the extent possible. Other situations in which the provider should advise a change in itinerary or activities include counseling parents who plan to take an infant to high altitude or a pregnant woman who plans to scuba dive. If travelers remain cloistered in their hotel rooms, eating all meals from room service and watching CNN, then it could be suggested that they are overly risk-adverse and might consider foraying out of the hotel, despite the potential associated increased risks to health. Conversely, if travelers find themselves on motorcycles

  12. Integrated radwaste treatment system. Final report

    International Nuclear Information System (INIS)

    Baker, M.N.; Houston, H.M.

    1997-10-01

    In May 1988, the West Valley Demonstration Project (WVDP) began pretreating liquid high-level radioactive waste (HLW). This HLW was produced during spent nuclear fuel reprocessing operations that took place at the Western New York Nuclear Service Center from 1966 to 1972. Original reprocessing operations used plutonium/uranium extraction (PUREX) and thorium extraction (THOREX) processes to recover usable isotopes from spent nuclear fuel. The PUREX process produced a nitric acid-based waste stream, which was neutralized by adding sodium hydroxide to it. About two million liters of alkaline liquid HLW produced from PUREX neutralization were stored in an underground carbon steel tank identified as Tank 8D-2. The THOREX process, which was used to reprocess one core of mixed uranium-thorium fuel, resulted in about 31,000 liters of acidic waste. This acidic HLW was stored in an underground stainless steel tank identified as Tank 8D-4. Pretreatment of the HLW was carried out using the Integrated Radwaste Treatment System (IRTS), from May 1988 until May 1995. This system was designed to decontaminate the liquid HLW, remove salts from it, and encapsulate the resulting waste into a cement waste form that achieved US Nuclear Regulatory Commission (NRC) criteria for low-level waste (LLW) storage and disposal. A thorough discussion of IRTS operations, including all systems, subsystems, and components, is presented in US Department of Energy (DOE) Topical Report (DOE/NE/44139-68), Integrated Radwaste Treatment System Lessons Learned from 2 1/2 Years of Operation. This document also presents a detailed discussion of lessons learned during the first 2 1/2 years of IRTS operation. This report provides a general discussion of all phases of IRTS operation, and presents additional lessons learned during seven years of IRTS operation

  13. Biofeedback systems and adaptive control hemodialysis treatment

    Directory of Open Access Journals (Sweden)

    Azar Ahmad

    2008-01-01

    Full Text Available On-line monitoring devices to control functions such as volume, body temperature, and ultrafiltration, were considered more toys than real tools for routine clinical application. However, bio-feedback blood volume controlled hemodialysis (HD is now possible in routine dialysis, allowing the delivery of a more physiologically acceptable treatment. This system has proved to reduce the incidence of intra-HD hypotension episodes significantly. Ionic dialysance and the patient′s plasma conductivity can be calculated easily from on-line measurements at two different steps of dialysate conductivity. A bio-feedback system has been devised to calculate the patient′s plasma conductivity and modulate the conductivity of the dialysate continuously in order to achieve a desired end-dialysis patient plasma conductivity corresponding to a desired end-dialysis plasma sodium concentration. Another bio-feedback system can control the body tempe-rature by measuring it at the arterial and venous lines of the extra-corporeal circuit, and then modulating the dialysate temperature in order to stabilize the patients′ temperature at constant values that result in improved intra-HD cardiovascular stability. The module can also be used to quantify vascular access recirculation. Finally, the simultaneous computer control of ultrafiltration has proven the most effective means for automatic blood pressure stabilization during hemo-dialysis treatment. The application of fuzzy logic in the blood-pressure-guided biofeedback con-trol of ultrafiltration during hemodialysis is able to minimize HD-induced hypotension. In con-clusion, online monitoring and adaptive control of the patient during the dialysis session using the bio-feedback systems is expected to render the process of renal replacement therapy more physiological and less eventful.

  14. Multicenter, Randomized, Open-Label, Phase III Trial of Decitabine Versus Patient Choice, With Physician Advice, of Either Supportive Care or Low-Dose Cytarabine for the Treatment of Older Patients With Newly Diagnosed Acute Myeloid Leukemia

    Science.gov (United States)

    Kantarjian, Hagop M.; Thomas, Xavier G.; Dmoszynska, Anna; Wierzbowska, Agnieszka; Mazur, Grzegorz; Mayer, Jiri; Gau, Jyh-Pyng; Chou, Wen-Chien; Buckstein, Rena; Cermak, Jaroslav; Kuo, Ching-Yuan; Oriol, Albert; Ravandi, Farhad; Faderl, Stefan; Delaunay, Jacques; Lysák, Daniel; Minden, Mark; Arthur, Christopher

    2012-01-01

    Purpose This multicenter, randomized, open-label, phase III trial compared the efficacy and safety of decitabine with treatment choice (TC) in older patients with newly diagnosed acute myeloid leukemia (AML) and poor- or intermediate-risk cytogenetics. Patients and Methods Patients (N = 485) age ≥ 65 years were randomly assigned 1:1 to receive decitabine 20 mg/m2 per day as a 1-hour intravenous infusion for five consecutive days every 4 weeks or TC (supportive care or cytarabine 20 mg/m2 per day as a subcutaneous injection for 10 consecutive days every 4 weeks). The primary end point was overall survival (OS); the secondary end point was the complete remission (CR) rate plus the CR rate without platelet recovery (CRp). Adverse events (AEs) were recorded. Results The primary analysis with 396 deaths (81.6%) showed a nonsignificant increase in median OS with decitabine (7.7 months; 95% CI, 6.2 to 9.2) versus TC (5.0 months; 95% CI, 4.3 to 6.3; P = .108; hazard ratio [HR], 0.85; 95% CI, 0.69 to 1.04). An unplanned analysis with 446 deaths (92%) indicated the same median OS (HR, 0.82; 95% CI, 0.68 to 0.99; nominal P = .037). The CR rate plus CRp was 17.8% with decitabine versus 7.8% with TC (odds ratio, 2.5; 95% CI, 1.4 to 4.8; P = .001). AEs were similar for decitabine and cytarabine, although patients received a median of four cycles of decitabine versus two cycles of TC. The most common drug-related AEs with decitabine were thrombocytopenia (27%) and neutropenia (24%). Conclusion In older patients with AML, decitabine improved response rates compared with standard therapies without major differences in safety. An unplanned survival analysis showed a benefit for decitabine, which was not observed at the time of the primary analysis. PMID:22689805

  15. Micelles As Delivery System for Cancer Treatment.

    Science.gov (United States)

    Keskin, Dilek; Tezcaner, Aysen

    2017-01-01

    Micelles are nanoparticles formed by the self-assembly of amphiphilic block copolymers in certain solvents above concentrations called critical micelle concentration (CMC). Micelles are used in different fields like food, cosmetics, medicine, etc. These nanosized delivery systems are under spotlight in the recent years with new achievements in terms of their in vivo stability, ability to protect entrapped drug, release kinetics, ease of cellular penetration and thereby increased therapeutic efficacy. Drug loaded micelles can be prepared by dialysis, oil-in-water method, solid dispersion, freezing, spray drying, etc. The aim of this review is to give an overview of the research on micelles (in vitro, in vivo and clinical) as delivery system for cancer treatment. Passive targeting is one route for accumulation of nanosized micellar drug formulations. Many research groups from both academia and industry focus on developing new strategies for improving the therapeutic efficacy of micellar systems (active targeting to the tumor site, designing multidrug delivery systems for overcoming multidrug resistance or micelles formed by prodrug conjugates, etc). There is only one micellar drug formulation in South Korea that has reached clinical practice. However, there are many untargeted anticancer drug loaded micellar formulations in clinical trials, which have potential for use in clinics. Many more products are expected to be on the market in the near future. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. 29 CFR 1400.735-3 - Advice and counseling service.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Advice and counseling service. 1400.735-3 Section 1400.735-3 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE STANDARDS OF CONDUCT, RESPONSIBILITIES, AND DISCIPLINE General § 1400.735-3 Advice and counseling service...

  17. Emotions in advice taking: the roles of agency and valence

    NARCIS (Netherlands)

    de Hooge, I.E.; Verlegh, P.W.J.; Tzioti, S.C.

    2014-01-01

    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  18. Advice-giving in the English lingua franca classroom

    African Journals Online (AJOL)

    important pragmatic differences between the ways in which advice is given by native speakers and ... gender differences and that teacher modeling may have an effect on which available form of advice-giving a ... nation wishes to participate in global enterprises such as international finance, multi-national corporations, and ...

  19. The design, purpose, and effects of voting advice applications

    NARCIS (Netherlands)

    Rosema, Martin; Anderson, Joel; Walgrave, Stefaan

    2014-01-01

    In recent electoral politics, one of the most striking internet-related developments is the increasingly widespread use of Voting Advice Applications (VAAs). In this introduction to the symposium devoted to analysing the design, purpose, and effects of voting advice applications, we briefly discuss

  20. 19 CFR 111.39 - Advice to client.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Advice to client. 111.39 Section 111.39 Customs... CUSTOMS BROKERS Duties and Responsibilities of Customs Brokers § 111.39 Advice to client. (a) Withheld or false information. A broker must not withhold information relative to any customs business from a client...

  1. No Effect of Writing Advice on Reading Comprehension

    Science.gov (United States)

    Balling, Laura Winther

    2018-01-01

    This article considers text comprehension through the integrated perspectives of language processing research and practical writing advice as expressed in writing guides and language policies. Such guides for instance include advice to use active constructions instead of passives and sentences instead of nominalizations. These recommended and…

  2. 5 CFR 1304.4607 - Advice to former Government employees.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Advice to former Government employees. 1304.4607 Section 1304.4607 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES POST EMPLOYMENT CONFLICT OF INTEREST § 1304.4607 Advice to former Government employees. The Office...

  3. Advising in austerity reflections on challenging times for advice agencies

    CERN Document Server

    Kirwan, Samuel

    2016-01-01

    Advising in austerity provides a lively and thought-provoking account of the conditions, consequences and challenges of advice work in the UK. It examines how advisors negotiate the private troubles of those who come to Citizens Advice Bureaux (CAB) and construct ways forward.

  4. Emotions in Advice Taking: The Roles of Agency and Valence

    NARCIS (Netherlands)

    Hooge, de I.E.; Verlegh, P.W.J.; Tzioti, S.C.

    2014-01-01

    Recently, advice taking has received attention in decision-making research, and some studies suggest that emotions may play a role in this process. Yet a clear account of how emotions influence advice taking is lacking. The current research introduces a parsimonious explanation by suggesting that

  5. A self-help book is better than sleep hygiene advice for insomnia: a randomized controlled comparative study.

    Science.gov (United States)

    Bjorvatn, Bjørn; Fiske, Eldbjørg; Pallesen, Ståle

    2011-12-01

    The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  6. Program of medical advice in radioprotection of the Argentinean nuclear regulatory authority

    International Nuclear Information System (INIS)

    Perez, M.R.; Gisone, P.; Di Trano, J.L.; Dubher, D.; Michelin, S.

    1998-01-01

    The objective of this program is to have a system with the aim of guaranteing an appropriate medical response in the case of radiological or nuclear accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations

  7. 41 CFR 105-50.202-7 - Technical information and advice.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Technical information... Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION 50-PROVISION OF SPECIAL... Services Administration § 105-50.202-7 Technical information and advice. GSA will provide technical...

  8. Water Treatment Systems for Long Spaceflights

    Science.gov (United States)

    FLynn, Michael T.

    2012-01-01

    Space exploration will require new life support systems to support the crew on journeys lasting from a few days to several weeks, or longer. These systems should also be designed to reduce the mass required to keep humans alive in space. Water accounts for about 80 percent of the daily mass intake required to keep a person alive. As a result, recycling water offers a high return on investment for space life support. Water recycling can also increase mission safety by providing an emergency supply of drinking water, where another supply is exhausted or contaminated. These technologies also increase safety by providing a lightweight backup to stored supplies, and they allow astronauts to meet daily drinking water requirements by recycling the water contained in their own urine. They also convert urine into concentrated brine that is biologically stable and nonthreatening, and can be safely stored onboard. This approach eliminates the need to have a dedicated vent to dump urine overboard. These needs are met by a system that provides a contaminant treatment pouch, referred to as a urine cell or contaminant cell, that converts urine or another liquid containing contaminants into a fortified drink, engineered to meet human hydration, electrolyte, and caloric requirements, using a variant of forward osmosis (FO) to draw water from a urine container into the concentrated fortified drink as part of a recycling stage. An activated carbon pretreatment removes most organic molecules. Salinity of the initial liquid mix (urine plus other) is synergistically used to enhance the precipitation of organic molecules so that activated carbon can remove most of the organics. A functional osmotic bag is then used to remove inorganic contaminants. If a contaminant is processed for which the saline content is different than optimal for precipitating organic molecules, the saline content of the liquid should be adjusted toward the optimal value for that contaminant. A first urine

  9. K West integrated water treatment system subproject safety analysis document

    International Nuclear Information System (INIS)

    SEMMENS, L.S.

    1999-01-01

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System

  10. K West integrated water treatment system subproject safety analysis document

    Energy Technology Data Exchange (ETDEWEB)

    SEMMENS, L.S.

    1999-02-24

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

  11. Do not shoot the messenger: ICES advice for an ecosystem approach to fisheries management in the European Union

    DEFF Research Database (Denmark)

    Ballesteros, Marta; Chapela, Rosa; Monsalve, Maria Paulina Ramirez

    2017-01-01

    in the ICES’ capacity to produce and evaluate ecosystem knowledge, which is integrated into operational products. However, the results also indicate shortcomings related to content, process, resources and policies coherence. Our findings support the following conclusions: (i) ICES has taken a leading role...... in generating the EAFM framework in which management decisions could operate; (ii) advice suppliers and advice users agree on the capability of using existing knowledge to “do EAFM now”; (iii) some shortcomings can be addressed in-house, but other require concerted action in both the advisory system...... provide. First, we summarize the policy context shaping advisory demands and analyse the advice that is currently being provided. Second, we present the stakeholders’ advice needs for putting the EAFM into practice, elucidated through structured dialogues in 22 events. The results show advances...

  12. 78 FR 28623 - U.S.-Trans-Pacific Partnership Free Trade Agreement Including Japan: Advice on the Probable...

    Science.gov (United States)

    2013-05-15

    ... Probable Economic Effect of Providing Duty-Free Treatment for Imports after Malaysia joined the... Partnership Free Trade Agreement Including Japan: Advice on the Probable Economic Effect of Providing Duty... Economic Effect of Providing Duty-Free Treatment for Imports. DATES: May 28, 2013: Deadline for filing...

  13. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

    Science.gov (United States)

    Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

    2013-01-01

    Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

  14. INTEGRATED WATER TREATMENT SYSTEM PERFORMANCE EVALUATION

    International Nuclear Information System (INIS)

    Sexton, R.A.; Meeuwsen, W.E.

    2009-01-01

    This document describes the results of an evaluation of the current Integrated Water Treatment System (IWTS) operation against design performance and a determination of short term and long term actions recommended to sustain IWTS performance. The KW IWTS was designed to treat basin water and maintain basin clarity during fuel retrieval, washing, and packaging activities in the KW Basin. The original design was based on a mission that was limited to handling of KW Basin fuel. The use of the IWTS was extended by the decision to transfer KE fuel to KW to be cleaned and packaged using KW systems. The use was further extended for the packaging of two more Multi-Canister Overpacks (MCOs) containing legacy fuel and scrap. Planning is now in place to clean and package Knock Out Pot (KOP) Material in MCOs using these same systems. Some washing of KOP material in the Primary Cleaning Machine (PCM) is currently being done to remove material that is too small or too large to be included in the KOP Material stream. These plans will require that the IWTS remain operational through a campaign of as many as 30 additional MCOs, and has an estimated completion date in 2012. Recent operation of the IWTS during washing of canisters of KOP Material has been impacted by low pressure readings at the inlet of the P4 Booster Pump. The system provides a low pressure alarm at 10 psig, and low-low pressure interlock at 5 psig. The response to these low readings has been to lower total system flow to between 301 and 315 gpm. In addition, the IWTS operator has been required to operate the system in manual mode and make frequent adjustments to the P4 booster pump speed during PCM washes. The preferred mode of operation is to establish a setpoint of 317 gpm for the P4 pump speed and run IWTS in semi-automatic mode. Based on hydraulic modeling compared to field data presented in this report, the low P4 inlet pressure is attributed to restrictions in the 2-inch KOP inlet hose and in the KOP itself

  15. Dietary Advice on Prescription: A novel approach to dietary counseling

    Directory of Open Access Journals (Sweden)

    Gunnar Johansson

    2011-05-01

    Full Text Available This article describes a novel approach to giving dietary advice, which is called “Dietary Advice on Prescription” (DAP; Matordning på Recept [MoR] in Swedish. It is the same principle as prescription on medicine and “Physical Activity on Prescription” (PAP; Fysisk aktivitet på Recept [FaR] in Swedish. The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study.

  16. [Stop smoking advice for patients who smoke: feasible in the dental practice?

    OpenAIRE

    Maassen, I.T.H.M.; Jacobs, J.E.; Plasschaert, A.J.M.; Allard, R.H.; Schattenberg, G.T.B.M.R.; Hilberink, S.R.

    2008-01-01

    Smoking may cause periodontal diseases and raises the chance of getting oral cancer. The Dutch Guideline for the Treatment of Tobacco Addiction recommends that dental professionals explicitly advise all patients who smoke to stop smoking. In 12 dental practices a study was made of how the guidelines could be implemented. The strategy consisted of a patient protocol for minimal, one-time cessation advice or for more intensive supervision, a patient leaflet, centralized training for the dental ...

  17. Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors.

    Science.gov (United States)

    Dewa, Carolyn S; Trojanowski, Lucy; Tamminga, Sietske J; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S

    2016-01-01

    The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice would you give someone who has been newly diagnosed with head and neck cancer? (2) What advice would you give to employers of these people? Data were gathered through 10 individual semi-structured in-depth interviews with HNC clinic patients at a regional cancer center's head and neck clinic in Ontario, Canada. A constant comparative method of theme development was used. Codes identified in and derived from the data were discussed by research team members until consensus was reached. Codes with similar characteristics were grouped together and used to develop overarching themes. Work-related advice for peers focused on personal self-care and interactions within workplaces. Work-related advice to employers focused on demonstrating basic human values as well as the importance of communication. The study results suggest HNC clinic patients should be proactive with employers and help to set reasonable expectations and provide a realistic plan for work to be successfully completed. HNC clinic patients should develop communication skills to effectively disclose their cancer and treatment to employers. In this exploratory study, HNC clinic patients' advice was solution-focused underscoring the importance of self-care and pro-active communication and planning with employers. Employers were advised to demonstrate core human values throughout all phases of the work disability episode beginning at diagnosis.

  18. Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

    Science.gov (United States)

    Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

    2016-05-01

    Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

  19. The influential role of personal advice networks on general practitioners' performance: a social capital perspective.

    Science.gov (United States)

    Calciolari, Stefano; González-Ortiz, Laura G; Lega, Federico

    2017-08-08

    In several health systems of advanced countries, reforms have changed primary care in the last two decades. The literature has assessed the effects of a variety of interventions and individual factors on the behavior of general practitioners (GPs). However, there has been a lack of investigation concerning the influence of the resources embedded in the GPs' personal advice networks (i.e., social capital) on GPs' capacity to meet defined objectives. The present study has two goals: (a) to assess the GPs' personal advice networks according to the social capital framework and (b) to test the influence of such relationships on GPs' capacity to accomplish organizational goals. The data collection relied on administrative data provided by an Italian local health authority (LHA) and a survey administered to the GPs of the selected LHA. The GPs' personal advice networks were assessed through an ad-hoc instrument and interpreted as egocentric networks. Multivariate regression analyses assessed two different performance measures. Social capital may influence the GPs' capacity to meet targets, though the influence differs according to the objective considered. In particular, the higher the professional heterogeneity of a GP personal advice network, the lower her/his capacity is to meet targets of prescriptive appropriateness. Our findings might help to design more effective primary care reforms depending on the pursued goals. However, further research is needed.

  20. Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

    Science.gov (United States)

    Beaulieu, Richard; Humphreys, Janice

    2008-01-01

    Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

  1. Decisions and advice about infant feeding: findings from ...

    African Journals Online (AJOL)

    Decisions and advice about infant feeding: findings from sociological work in ... element were used to probe women's decision-making concerning infant feeding. ... Scant attention has been paid to the results of studies undertaken in other ...

  2. Antimalarial measures - type, sources of advice and compliance ...

    African Journals Online (AJOL)

    1994-06-01

    Jun 1, 1994 ... pharmacies as well as actual behaviour in this regard and sources of advice accessed ... pharmacies and 53 'care providers' (members of travel parties). Doctors ... TPS Drug Information Services, Johannesburg. L Baker, DIP.

  3. factors associated with discharge against medical advice among

    African Journals Online (AJOL)

    Hospital environmental factors have a significant relationship with discharge against medical advice. A similar study ..... contractors, and by reinforcing the infection control committee this will .... Sources: Field survey, 2015. The results in Table ...

  4. Factors Impacting On Patient Compliance with Medical Advice: Empirical Study

    Directory of Open Access Journals (Sweden)

    Krot Katarzyna

    2017-06-01

    Full Text Available The purpose of this paper to identify factors which have a bearing on compliance with medical advice in various age groups. The survey was conducted, using the CAWI method, on a representative sample of 1000 respondents who declared having used healthcare services in the previous six months. Control of competences is one of the strongest factors which is common for the oldest and youngest groups. Interestingly, trust in the integrity and honesty of doctors is significant for the youngest patients, i.e., the higher is the level of trust, the lower is the tendency to non-comply. Another type of trust is related to the benevolence of doctors and is significant to patients of the middle age group. Satisfaction is a significant predictor in the two oldest groups of patients. High levels of satisfaction seem to deter people from non-adherence to recommended treatment regimens. The results of the present study provide knowledge about the nature and diversity of factors behind patient compliance in various age groups.

  5. The Effect of Customer Empowerment on Adherence to Expert Advice

    OpenAIRE

    Camacho, Nuno; Jong, Martijn; Stremersch, Stefan

    2014-01-01

    textabstractCustomers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional empowerment and study whether empowerment leads customers to adhere more or less to expert advice. We empirically test our model using a unique dataset involving 11,735 respondents in 17 countries on four...

  6. GYNOTEL: telephone advice to gynaecological surgical patients after discharge.

    Science.gov (United States)

    Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J

    2010-12-01

    To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

  7. Evaluation of the decision support system for antimicrobial treatment, TREAT, in an acute medical ward of a university hospital

    DEFF Research Database (Denmark)

    Arboe, Bente; Laub, Rasmus Rude; Kronborg, Gitte

    2014-01-01

    OBJECTIVES: TREAT, a decision support system for antimicrobial therapy, was implemented in an acute medical ward. METHODS: Patients admitted on suspicion of infection were included in the study. The evaluation of TREAT was done both retrospectively and prospectively. Coverage of empirical...... antimicrobial treatments was compared to recommendations from TREAT and the optimal use of local guidelines. RESULTS: Five hundred and eleven patients were included, of whom 162 had a microbiologically documented infection. In the retrospective part of the study, TREAT, physician, and guideline antimicrobial.......247). The coverage of TREAT advice for the bacteraemia patients was non-inferior to the physicians (p=1.00). CONCLUSIONS: TREAT can potentially improve the ecological costs of empirical antimicrobial therapy for patients in acute medical wards, but provided lower coverage than local guidelines....

  8. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    DEFF Research Database (Denmark)

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  9. Dosimetry audit of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    Bulski, Wojciech; Chelminski, Krzysztof; Rostkowska, Joanna

    2015-01-01

    In radiotherapy Treatment Planning Systems (TPS) various calculation algorithms are used. The accuracy of dose calculations has to be verified. Numerous phantom types, detectors and measurement methodologies are proposed to verify the TPS calculations with dosimetric measurements. A heterogeneous slab phantom has been designed within a Coordinated Research Project (CRP) of the IAEA. The heterogeneous phantom was developed in the frame of the IAEA CRP. The phantom consists of frame slabs made with polystyrene and exchangeable inhomogeneity slabs equivalent to bone or lung tissue. Special inserts allow to position thermoluminescent dosimeters (TLD) capsules within the polystyrene slabs below the bone or lung equivalent slabs and also within the lung equivalent material. Additionally, there are inserts that allow to position films or ionisation chamber in the phantom. Ten Polish radiotherapy centres (of 30 in total) were audited during on-site visits. Six different TPSs and five calculation algorithms were examined in the presence of inhomogeneities. Generally, most of the results from TLD were within 5 % tolerance. Differences between doses calculated by TPSs and measured with TLD did not exceed 4 % for bone and polystyrene equivalent materials. Under the lung equivalent material, on the beam axis the differences were lower than 5 %, whereas inside the lung equivalent material, off the beam axis, in some cases they were of around 7 %. The TLD results were confirmed with the ionisation chamber measurements. The comparison results of the calculations and the measurements allow to detect limitations of TPS calculation algorithms. The audits performed with the use of heterogeneous phantom and TLD seem to be an effective tool for detecting the limitations in the TPS performance or beam configuration errors at audited radiotherapy departments. (authors)

  10. Dosimetry audit of radiotherapy treatment planning systems.

    Science.gov (United States)

    Bulski, Wojciech; Chełmiński, Krzysztof; Rostkowska, Joanna

    2015-07-01

    In radiotherapy Treatment Planning Systems (TPS) various calculation algorithms are used. The accuracy of dose calculations has to be verified. Numerous phantom types, detectors and measurement methodologies are proposed to verify the TPS calculations with dosimetric measurements. A heterogeneous slab phantom has been designed within a Coordinated Research Project (CRP) of the IAEA. The heterogeneous phantom was developed in the frame of the IAEA CRP. The phantom consists of frame slabs made with polystyrene and exchangeable inhomogeneity slabs equivalent to bone or lung tissue. Special inserts allow to position thermoluminescent dosimeters (TLD) capsules within the polystyrene slabs below the bone or lung equivalent slabs and also within the lung equivalent material. Additionally, there are inserts that allow to position films or ionisation chamber in the phantom. Ten Polish radiotherapy centres (of 30 in total) were audited during on-site visits. Six different TPSs and five calculation algorithms were examined in the presence of inhomogeneities. Generally, most of the results from TLD were within 5 % tolerance. Differences between doses calculated by TPSs and measured with TLD did not exceed 4 % for bone and polystyrene equivalent materials. Under the lung equivalent material, on the beam axis the differences were lower than 5 %, whereas inside the lung equivalent material, off the beam axis, in some cases they were of around 7 %. The TLD results were confirmed with the ionisation chamber measurements. The comparison results of the calculations and the measurements allow to detect limitations of TPS calculation algorithms. The audits performed with the use of heterogeneous phantom and TLD seem to be an effective tool for detecting the limitations in the TPS performance or beam configuration errors at audited radiotherapy departments. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Systemic treatments for metastatic cutaneous melanoma.

    Science.gov (United States)

    Pasquali, Sandro; Hadjinicolaou, Andreas V; Chiarion Sileni, Vanna; Rossi, Carlo Riccardo; Mocellin, Simone

    2018-02-06

    The prognosis of people with metastatic cutaneous melanoma, a skin cancer, is generally poor. Recently, new classes of drugs (e.g. immune checkpoint inhibitors and small-molecule targeted drugs) have significantly improved patient prognosis, which has drastically changed the landscape of melanoma therapeutic management. This is an update of a Cochrane Review published in 2000. To assess the beneficial and harmful effects of systemic treatments for metastatic cutaneous melanoma. We searched the following databases up to October 2017: the Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We also searched five trials registers and the ASCO database in February 2017, and checked the reference lists of included studies for further references to relevant randomised controlled trials (RCTs). We considered RCTs of systemic therapies for people with unresectable lymph node metastasis and distant metastatic cutaneous melanoma compared to any other treatment. We checked the reference lists of selected articles to identify further references to relevant trials. Two review authors extracted data, and a third review author independently verified extracted data. We implemented a network meta-analysis approach to make indirect comparisons and rank treatments according to their effectiveness (as measured by the impact on survival) and harm (as measured by occurrence of high-grade toxicity). The same two review authors independently assessed the risk of bias of eligible studies according to Cochrane standards and assessed evidence quality based on the GRADE criteria. We included 122 RCTs (28,561 participants). Of these, 83 RCTs, encompassing 21 different comparisons, were included in meta-analyses. Included participants were men and women with a mean age of 57.5 years who were recruited from hospital settings. Twenty-nine studies included people whose cancer had spread to their brains. Interventions were categorised into five groups: conventional

  12. Nephrogenic systemic fibrosis: clinical picture and treatment

    DEFF Research Database (Denmark)

    Marckmann, Peter; Skov, Lone

    2009-01-01

    , and the histology of deep skin biopsies. Symptomatic treatment with intensive physiotherapy and painkillers is important, but there is no known curative medical treatment. Spontaneous remission of NSF symptoms may occur with recovery of renal function after an episode of acute renal failure, or with kidney...

  13. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

    NARCIS (Netherlands)

    van Thiel, D.; van Raaij, W.F.

    2017-01-01

    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily

  14. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    Directory of Open Access Journals (Sweden)

    Hulshof Carel

    2005-08-01

    Full Text Available Abstract Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65% of all professional advice was not in line with the research literature. In 18 cases (24% professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17% than advice that had not mentioned the literature as a source (65% (difference 48%, 95% Confidence Interval from 27% to 69%. Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.

  15. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    Science.gov (United States)

    Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank

    2005-01-01

    Background Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature. Methods We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no. Results The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65%) of all professional advice was not in line with the research literature. In 18 cases (24%) professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17%) than advice that had not mentioned the literature as a source (65%) (difference 48%, 95% Confidence Interval from 27% to 69%). Conclusion Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice. PMID:16131405

  16. PhysioDirect: Supporting physiotherapists to deliver telephone assessment and advice services within the context of a randomised trial

    Science.gov (United States)

    Bishop, Annette; Gamlin, Jill; Hall, Jeanette; Hopper, Cherida; Foster, Nadine E.

    2013-01-01

    Physiotherapy-led telephone assessment and advice services for patients with musculoskeletal problems have been developed in many services in the UK, but high quality trial data on clinical and cost effectiveness has been lacking. In order to address this ‘The PhysioDirect trial’ (ISRCTN55666618), was a pragmatic randomised trial of a PhysioDirect telephone assessment and advice service. This paper describes the PhysioDirect system used in the trial and how physiotherapists were trained and supported to use the system and deliver the PhysioDirect service. The PhysioDirect system used in the trial was developed in Huntingdon and now serves a population of 350,000 people. When initiating or providing physiotherapy-led telephone assessment and advice services training and support for physiotherapists delivering care in this way is essential. An enhanced skill set is required for telephone assessment and advice particularly in listening and communication skills. In addition to an initial training programme, even experienced physiotherapists benefit from a period of skill consolidation to become proficient and confident in assessing patients and delivering care using the telephone. A computer-based system assists the delivery of a physiotherapy-led musculoskeletal assessment and advice service. Clinical Trials Registration Number (ISRCTN55666618). PMID:23219629

  17. Childhood Central Nervous System Atypical Teratoid/Rhabdoid Tumor Treatment

    Science.gov (United States)

    ... teratoid/rhabdoid tumor. There is no standard staging system for central nervous system atypical teratoid/rhabdoid tumor. The extent or spread ... different types of treatment for patients with central nervous system atypical teratoid/rhabdoid tumor. Different types of treatment ...

  18. Systemic treatment of breast cancer in pregnancy

    International Nuclear Information System (INIS)

    Szegheoova, O.

    2016-01-01

    Incidence of breast cancer in pregnancy is increasing due to trend of postponing child-bearing to later age. Breast cancer diagnosed during lactation has different biologic behaviour and worse prognosis than when diagnosed during pregnancy. Pregnancy does not constitute a negative prognostic factor per se for outcomes of breast cancer in pregnancy, therefore breast cancer should be treated while containing pregnancy. Pregnancy should not delay treatment. Therapy should follow standard procedures as closely as possible, though with different timing of treatment modalities. Experienced multidisciplinary team is crucial for achieving good treatment results and involvement of an informed patient in decision-making is a must. Properly managed treatment during pregnancy does not carry detrimental effect on development and well-being of children. (author)

  19. Communication of alcohol and smoking lifestyle advice to the gastroenterological patient.

    Science.gov (United States)

    Spence, Andrew D; Khasawneh, Mais; Allen, Patrick B; Addley, Jennifer

    2017-10-01

    Effective communication between healthcare staff and patients is central to development of the patient-professional relationship. Many barriers influence this communication, often resulting in patients' lack of understanding and retention of information, particularly affecting advice regarding lifestyle habits, such as alcohol consumption and smoking. Alcohol and smoking misuse are potentially modifiable risk factors known to adversely affect a variety of gastroenterological conditions and improvements in communication with patients regarding this is an important management component. This review discusses the clinical impact of these factors and how healthcare professionals can improve communication. We discuss how enhancing verbal communication skills through medical training leads to greater outcomes in patient satisfaction and adherence to treatment and advice. In addition, with the rapid digitalisation of society, platforms such as social media and smartphone applications may be considered as adjuncts to traditional forms of communication. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Compliance hotlines: practical advice for implementing a reporting mechanism.

    Science.gov (United States)

    Pastin, M J

    1999-01-01

    No element of a corporate compliance program in healthcare facilities generates more controversy than the hotline established for employees who wish to raise a concern. Healthcare organizations are adopting hotlines but with reluctance, mainly because of limited staff available to answer calls and because of limited support from upper management. Those that have committed to the hotline will tell you they can't imagine not having it. Running a good hotline means first answering such questions as whether it will be answered in-house, outsourced or handled through a combination of both means. The best organizations treat the hotline as a resource for employees, managers and physicians. If employees receive advice about policies over the hotline, however, it must be answered in-house. If multiple call answers are used, a secure file-sharing system, either paper or online, must be in use to track caller concerns. Most calls are routine, but one where the caller is reporting a serious infraction can save an organization millions of dollars by forestalling a false claim or allowing for voluntary resolution of a problem. If your company has run a hotline unsuccessfully and earned a poor reputation with employees, outsourcing may be the best option. A hotline that is not supported by management may prove to be an insurmountable problem for anyone who attempts to operate it. Your approach to hotline call intake will set the tone for your compliance program.

  1. Startup Report for Ground Water Extraction, Treatment, and Recharge System

    National Research Council Canada - National Science Library

    Lamb, Steve

    1997-01-01

    The document presents startup procedures, observations and measurements conducted during the startup of the Groundwater Extraction, Treatment and Recharge System, built for the 162nd Fighter Wing, Air...

  2. Operation technology of air treatment system in nuclear facilities

    CERN Document Server

    Chun, Y B; Hwong, Y H; Lee, H K; Min, D K; Park, K J; Uom, S H; Yang, S Y

    2001-01-01

    Effective operation techniques were reviewed on the air treatment system to protect the personnel in nuclear facilities from the contamination of radio-active particles and to keep the environment clear. Nuclear air treatment system consisted of the ventilation and filtering system was characterized by some test. Measurement of air velocity of blowing/exhaust fan in the ventilation system, leak tests of HEPA filters in the filtering, and measurement of pressure difference between the areas defined by radiation level were conducted. The results acquired form the measurements were reflected directly for the operation of air treatment. In the abnormal state of virus parts of devices composted of the system, the repairing method, maintenance and performance test were also employed in operating effectively the air treatment system. These measuring results and techniques can be available to the operation of air treatment system of PIEF as well as the other nuclear facilities in KAERI.

  3. Systemic combination treatment for psoriasis: a review

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone; Zachariae, Claus

    2010-01-01

    exist for the use of systemic combination therapy. Therefore, our aim was to review the current literature on systemic anti-psoriatic combination regimens. We searched PubMed and identified 98 papers describing 116 studies (23 randomized) reporting on the effect of various systemic combination...

  4. The travel advice as an inhibiting factor of tourist movement

    Directory of Open Access Journals (Sweden)

    Mylonopoulos Dimitrios

    2016-01-01

    Full Text Available Tourism is significantly affected by unpredictable and uncertain factors such as the occurrence of a terrorist attack, an epidemic outbreak or a natural disaster, etc. The impact of these phenomena on the tourist movement of the country or the place where the event occurred is aggravated by the way it is presented by the media both locally and internationally. The adverse climate gets worse by the issuance of travel advice that usually accompanies such phenomena and has the effect of limiting or even halting tourist flows. In order to identify and study the different types of travel advice that have been issued during international tourism crisis incidents, an internet search was carried out using keywords. Moreover, a study on the travel advice issued by major tourists' origin states, as the USA, Australia, Canada, Germany, the United Kingdom, etc. was carried out. Incidents (terrorist attacks, epidemics, natural disasters which had a great impact on tourism were then selected. In addition, the issuance of travel advice, their different issuing authorities, the classification level and the impact on the tourism of the country or the place in question were examined. An analysis of the reaction and the instructions of major international organizations (World Health Organization, World Tourism Organization concerning the management of such crises, directly or indirectly affecting tourism, were also analyzed. The study of the relevant websites, the international literature and the recorded incidents shows that the issuing of travel advice has negative effects on many sectors of tourism activity and is a bottleneck for tourism development. In fact, in many cases, travel advice is used by countries to exert pressure on other countries in order to achieve a desired result. Due to the enormous economic and social effects when issuing travel advice, the states proper management is necessary in order to minimize the negative consequences and avoid

  5. Volume definition system for treatment planning

    International Nuclear Information System (INIS)

    Alakuijala, Jyrki; Pekkarinen, Ari; Puurunen, Harri

    1997-01-01

    Purpose: Volume definition is a difficult and time consuming task in 3D treatment planning. We have studied a systems approach for constructing an efficient and reliable set of tools for volume definition. Our intent is to automate body outline, air cavities and bone volume definition and accelerate definition of other anatomical structures. An additional focus is on assisting in definition of CTV and PTV. The primary goals of this work are to cut down the time used in contouring and to improve the accuracy of volume definition. Methods: We used the following tool categories: manual, semi-automatic, automatic, structure management, target volume definition, and visualization tools. The manual tools include mouse contouring tools with contour editing possibilities and painting tools with a scaleable circular brush and an intelligent brush. The intelligent brush adapts its shape to CT value boundaries. The semi-automatic tools consist of edge point chaining, classical 3D region growing of single segment and competitive volume growing of multiple segments. We tuned the volume growing function to take into account both local and global region image values, local volume homogeneity, and distance. Heuristic seeding followed with competitive volume growing finds the body outline, couch and air automatically. The structure management tool stores ICD-O coded structures in a database. The codes have predefined volume growing parameters and thus are able to accommodate the volume growing dissimilarity function for different volume types. The target definition tools include elliptical 3D automargin for CTV to PTV transformation and target volume interpolation and extrapolation by distance transform. Both the CTV and the PTV can overlap with anatomical structures. Visualization tools show the volumes as contours or color wash overlaid on an image and displays voxel rendering or translucent triangle mesh rendering in 3D. Results: The competitive volume growing speeds up the

  6. Making medical treatments resilient to technological disruptions in telemedicine systems

    NARCIS (Netherlands)

    Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.

    Telemedicine depends on Information and Communication Technology (ICT) to support remote treatment of patients. This dependency requires the telemedicine system design to be resilient for ICT performance degradation or subsystem failures. Nevertheless, using telemedicine systems create a dependency

  7. Process modeling for the Integrated Nonthermal Treatment System (INTS) study

    Energy Technology Data Exchange (ETDEWEB)

    Brown, B.W.

    1997-04-01

    This report describes the process modeling done in support of the Integrated Nonthermal Treatment System (INTS) study. This study was performed to supplement the Integrated Thermal Treatment System (ITTS) study and comprises five conceptual treatment systems that treat DOE contract-handled mixed low-level wastes (MLLW) at temperatures of less than 350{degrees}F. ASPEN PLUS, a chemical process simulator, was used to model the systems. Nonthermal treatment systems were developed as part of the INTS study and include sufficient processing steps to treat the entire inventory of MLLW. The final result of the modeling is a process flowsheet with a detailed mass and energy balance. In contrast to the ITTS study, which modeled only the main treatment system, the INTS study modeled each of the various processing steps with ASPEN PLUS, release 9.1-1. Trace constituents, such as radionuclides and minor pollutant species, were not included in the calculations.

  8. Gender differences in medical advice and health behavior of obese African Americans with and without type 2 diabetes.

    Science.gov (United States)

    Vaccaro, Joan A; Huffman, Fatma G

    2012-09-01

    This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men with diabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.

  9. Automated system for review of radiotherapy treatment sheets

    International Nuclear Information System (INIS)

    Collado Chamorro, P.; Sanz Freire, C. J.; Vazquez Galinanes, A.; Diaz Pascual, V.; Gomez amez, J.; Martinez Sanchez, S.; Ossola Lentati, G. A.

    2011-01-01

    In many modern radiotherapy services begins to leaf treatment implemented in electronic form. In our department has developed an automated reporting system, that check the following parameters: treatment completed correctly, number of sessions and cumulative dose administered. Likewise treatments are verified in the allocated separate unit, and over-writing table parameters.

  10. Nutritional advice to breast cancer survivors.

    Science.gov (United States)

    Pasanisi, Patrizia; Villarini, Anna; Bruno, Eleonora; Raimondi, Milena; Gargano, Giuliana; Berrino, Franco

    2010-05-01

    Breast cancer (BC) survivors are constantly increasing, and research investment for the identification of modifiable factors associated with BC recurrences is increasing too. The Western lifestyle, characterized by low levels of physical activity and a diet rich in refined carbohydrates, animal fats, and protein, is associated with high prevalence of metabolic syndrome, insulin resistance, and high serum levels of sex hormones and growth factors. The present work summarizes the association between all these metabolic and hormonal factors with the risk of BC and BC recurrences. Since metabolic syndrome and endocrine imbalance may be favorably modified through comprehensive change in lifestyle, dietary changes should be recommended both for BC prevention and treatment.

  11. Board advice following publication of the 1990 Recommendations of ICRP

    International Nuclear Information System (INIS)

    1991-11-01

    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the Board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiological quantities recommended by ICRP. (author)

  12. Board advice following publication of the 1990 Recommendations of ICRP

    CERN Document Server

    United Kingdom. At. Energy Res. Establ. Nat. Radiolog. Protect. Board. Harwell

    1991-01-01

    The International Commission on Radiological Protection (ICRP) has published new Recommendations and the board has a statutory duty to advise Government and those with responsibilities for radiation protection on the acceptability to and the applicability in the UK of those Recommendations. The Board wishes to consult widely before finalising the advice which is proposed in this document. In general, the Board endorses the conceptual framework for radiological protection recommended by ICRP. In particular, the distinction between practices and intervention is useful and is consistent with the way in which the Board has presented its recent advice. A major new concept is that of a constraint. The Board believes that the introduction of constraints provides a powerful method for improving protection against ionising radiation. The advice in this consultative document is for maximum generic values of dose constraints for both workers and the public. Finally the Board proposes to endorse the use of the radiologic...

  13. Advice Complexity of the Online Induced Subgraph Problem

    DEFF Research Database (Denmark)

    Komm, Dennis; Královič, Rastislav; Královič, Richard

    2016-01-01

    of the input can influence the solution quality. We evaluate the information in a quantitative way by considering the best possible advice of given size that describes the unknown input. Using a result from Boyar et al. we give a tight trade-off relationship stating that, for inputs of length n, roughly n...... subgraph problem, preemption does not significantly help by giving a lower bound of Omega(n/(c^2\\log c)) on the bits of advice that are needed to obtain competitive ratio c, where c is any increasing function bounded from above by \\sqrt{n/\\log n}. We also give a linear lower bound for c close to 1....... these problems by investigating a generalized problem: for an arbitrary but fixed hereditary property, find some maximal induced subgraph having the property. We investigate this problem from the point of view of advice complexity, i.e. we ask how some additional information about the yet unrevealed parts...

  14. A comprehensive centralized control system for radiation waste treatment facility

    International Nuclear Information System (INIS)

    Kong Jinsong

    2014-01-01

    A comprehensive centralized control system is designed for the radiation waste treatment facility that lacking of coordinated operational mechanism for the radiation waste treatment. The centralized control and alarm linkage of various systems is implemented to ensure effectively the safety of nuclear facility and materials, improve the integral control ability through advanced informatization ways. (author)

  15. Integrated thermal treatment system sudy: Phase 2, Results

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr).

  16. Integrated thermal treatment system sudy: Phase 2, Results

    International Nuclear Information System (INIS)

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr)

  17. Reduction of treatment delivery variances with a computer-controlled treatment delivery system

    International Nuclear Information System (INIS)

    Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

    1997-01-01

    Purpose: To analyze treatment delivery variances for 3-D conformal therapy performed at various levels of treatment delivery automation, ranging from manual field setup to virtually complete computer-controlled treatment delivery using a computer-controlled conformal radiotherapy system. Materials and Methods: All external beam treatments performed in our department during six months of 1996 were analyzed to study treatment delivery variances versus treatment complexity. Treatments for 505 patients (40,641 individual treatment ports) on four treatment machines were studied. All treatment variances noted by treatment therapists or quality assurance reviews (39 in all) were analyzed. Machines 'M1' (CLinac (6(100))) and 'M2' (CLinac 1800) were operated in a standard manual setup mode, with no record and verify system (R/V). Machines 'M3' (CLinac 2100CD/MLC) and ''M4'' (MM50 racetrack microtron system with MLC) treated patients under the control of a computer-controlled conformal radiotherapy system (CCRS) which 1) downloads the treatment delivery plan from the planning system, 2) performs some (or all) of the machine set-up and treatment delivery for each field, 3) monitors treatment delivery, 4) records all treatment parameters, and 5) notes exceptions to the electronically-prescribed plan. Complete external computer control is not available on M3, so it uses as many CCRS features as possible, while M4 operates completely under CCRS control and performs semi-automated and automated multi-segment intensity modulated treatments. Analysis of treatment complexity was based on numbers of fields, individual segments (ports), non-axial and non-coplanar plans, multi-segment intensity modulation, and pseudo-isocentric treatments (and other plans with computer-controlled table motions). Treatment delivery time was obtained from the computerized scheduling system (for manual treatments) or from CCRS system logs. Treatment therapists rotate among the machines, so this analysis

  18. Patient characteristics associated with receipt of lifestyle behavior advice.

    Science.gov (United States)

    Corsino, Leonor; Svetkey, Laura P; Ayotte, Brian J; Bosworth, Hayden B

    2009-01-01

    Lifestyle behaviors such as reducing weight if overweight or obese, reducing salt intake, exercising, reducing alcohol intake, quitting smoking, and eating a healthy diet are related to the prevention and control of chronic diseases. However the amount of lifestyle advice provided by clinicians has been declining over the last decade. In 2002, a telephone survey was conducted to assess the quality of preventive care offered by health care providers. The study was a cross-sectional observational study of a randomly selected sample of 516 diverse individuals in Durham County, North Carolina. Information regarding age, sex, race, education, health conditions, and self-reported receipt of lifestyle advice was examined in the study. The odds of receiving advice to engage in preventive lifestyle behaviors were significantly higher for those with a pre-existing diagnosis of diabetes or hypertension and for participants reporting poor health status. For example, the odds of receiving advice to control or lose weight was 8.32 (95% CI, 2.65, 26.75) among individuals reporting a diagnosis of diabetes. Similarly, the odds of reporting "receiving advice to reduce salt intake" was 6.97 (95% CI, 3.74, 13.00) among subjects reporting a diagnosis of hypertension. The results are from a cross-sectional study of a sample of individuals in only one county. Additionally, the results are based on patient self-reported information, which could be subject to recall and social desirability bias. Patients with identified health problems were more likely than others to report being advised to adopt healthy lifestyle recommendations. Future research should examine methods to encourage health care providers to offer lifestyle advice to those without pre-existing illness.

  19. Belief revision and delusions: how do patients with schizophrenia take advice?

    Directory of Open Access Journals (Sweden)

    Mariia Kaliuzhna

    Full Text Available The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1 revise their beliefs, 2 take into account socially provided information to do so, 3 are not overconfident about their judgments, and 4 show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed.

  20. Belief revision and delusions: how do patients with schizophrenia take advice?

    Science.gov (United States)

    Kaliuzhna, Mariia; Chambon, Valérian; Franck, Nicolas; Testud, Bérangère; Van der Henst, Jean-Baptiste

    2012-01-01

    The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1) revise their beliefs, 2) take into account socially provided information to do so, 3) are not overconfident about their judgments, and 4) show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed.

  1. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture.

    Science.gov (United States)

    Armour, Michael; Dahlen, Hannah G; Smith, Caroline A

    2016-01-01

    Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM) acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of "more than needles" for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial.

  2. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture

    Directory of Open Access Journals (Sweden)

    Michael Armour

    2016-01-01

    Full Text Available Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of “more than needles” for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial.

  3. Enquiries to the United Kingdom National Travel Advice Line by healthcare professionals regarding immunocompromised travellers.

    Science.gov (United States)

    Allen, Joanna E; Patel, Dipti

    2016-03-01

    People who travel while immunocompromised are more at risk of serious travel-related infection. Their condition, medications or treatments can contraindicate, decrease the effectiveness of or increase the toxicity of vaccinations or malaria chemoprophylaxis. Therefore, immunocompromised travellers require careful assessment and specialized pre-travel advice. The aims of this study were to investigate enquiries by healthcare professionals (HCPs) to the UK National Travel Health Network and Centre (NaTHNaC) advice line regarding travellers with immunocompromise and to identify their most common concerns. Documentation for all calls taken by advisers at the London office during 2013 was reviewed. Of the 4910 enquiries to the London NaTHNaC advice line, 397 calls concerned immunocompromised travellers (8.1%). The majority of immunocompromised travellers were planning to visit Sub-Saharan Africa (53%) for the purpose of tourism (43%). Sixty-seven percent of enquiries concerned vaccine use, 11% were about malaria chemoprophylaxis, 20% were about both and 2% were for other reasons. Causes of immunocompromise included inflammatory or autoimmune conditions (43%), cancer (18%), splenic dysfunction (13%), immunosuppressive drugs (12%), human immunodeficiency virus (11%), primary immunodeficiency (1%), neutropenia (0.5%) and thymus abnormalities (0.5%). There were frequent enquires to the advice line by UK HCPs regarding immunocompromised travellers. The travellers in this study had a wide range of underlying medical conditions and varying levels of immunocompromise. These enquiries may reflect a lack of clarity in current national guidelines, difficulties in interpreting them or both. Establishing the reasons for these deficiencies as well as the reasons behind UK HCP concerns and lack of confidence requires further investigation. This research has highlighted potential knowledge gaps and will help inform future guidance and educational activities for UK HCPs advising

  4. Thromboembolic disease and air travel in pregnancy: a survey of advice given by obstetricians.

    Science.gov (United States)

    Voss, M; Cole, R; Moriarty, T; Pathak, Mamta; Iskaros, J; Rodeck, C

    2004-11-01

    The objective of this study was to document the awareness of risk and the nature of advice given by obstetricians to pregnant women who intend to travel by air and to compare the results with the advice given in an opinion paper of the Royal College of Obstetricians and Gynaecologists. The results were based on a self-completed questionnaire. All registered members of the Royal College of Obstetricians and Gynaecologists comprising 1349 individuals, obtained from a list provided by the RCOG, were invited to participate. An anonymous postal questionnaire was completed by the individuals before publication of the opinion paper of the RCOG. A total of 862 (62%) questionnaires returned, and 690 (51%) were available for analysis; 67% of obstetricians regard flying as being safe throughout pregnancy, 33% only in the 2nd and 3rd trimester. Nearly all obstetricians advised on simple prophylactic measures such as mobilisation, fluid intake and leg exercise. Fifty-three per cent would advise the use of prophylactic aspirin (75 mg), 49% the use of compression stockings; 4% recommended heparinisation; 44% believed this advice to be applicable only for the 2nd and 3rd trimester, while the RCOG emphasises that the risk of developing venous thromboembolism begins in the 1st trimester. Obstetricians as well as other health professionals need to be made aware that advice on air travel in pregnancy needs to start in the 1st trimester. Further research is needed to explore the relevance of the duration of flight when considering the application of thromboprophylactic measures as well as the value and choice of pharmacological treatment such as aspirin and heparin.

  5. Comorbidities and treatment of trichotillomania systemic approach

    Directory of Open Access Journals (Sweden)

    Maričić Mina

    2016-01-01

    Full Text Available Introduction: Trichotillomania is a type of traumatic alopecia and is defined as the irresistible urge to pull out the hair. It is classified as impulse control disorder. This chronic, recurrent disorder with dermatologic expression has specific symptomatology, affects daily activities and leads to social isolation. Goal: The aim of the study was to investigate mannerism between symptoms in population with trichotillomania and to determine connection with other habits and disorders as well as treatment differences and efficiency. Material and methods: This prospective research was conducted within 880 people with trichotillomania from all around the world in a period from November 5th to December 15th, 2016. The data were collected by using a standardized internet questionnaire. Results: Symptoms of trichotillomania usually start between 9 and 13 years. 48,5% respondents localize their disorder on one specific body region. The most involved are scalp, eyebrows and eyelashes. 56,5% of the patients pull their hairs everyday, 61,6% even in company. Oral habits are present in 20,9%. Trichotillomania is associated with dermatillomania in 42.0%, nail biting habit in 37.0%, alcohol (21.7% and drug abuse (12.3%, anxiety (60.6%, affective (55.3%, obsessive-compulsive (19.4% and sleep disorders (11.3%. The most effective treatment seem to be combination of psychotherapy, antipsychotic and antidepressant. Conclusion: Trichotillomania shows diverse psychiatric appearance in most cases, so there is not specific treatment for this condition. It is necessary to treat trichotillomania with their comorbidities, especially the ones with oral habits, who present potential surgical patients.

  6. Bounds on the power of proofs and advice in general physical theories.

    Science.gov (United States)

    Lee, Ciarán M; Hoban, Matty J

    2016-06-01

    Quantum theory presents us with the tools for computational and communication advantages over classical theory. One approach to uncovering the source of these advantages is to determine how computation and communication power vary as quantum theory is replaced by other operationally defined theories from a broad framework of such theories. Such investigations may reveal some of the key physical features required for powerful computation and communication. In this paper, we investigate how simple physical principles bound the power of two different computational paradigms which combine computation and communication in a non-trivial fashion: computation with advice and interactive proof systems. We show that the existence of non-trivial dynamics in a theory implies a bound on the power of computation with advice. Moreover, we provide an explicit example of a theory with no non-trivial dynamics in which the power of computation with advice is unbounded. Finally, we show that the power of simple interactive proof systems in theories where local measurements suffice for tomography is non-trivially bounded. This result provides a proof that [Formula: see text] is contained in [Formula: see text], which does not make use of any uniquely quantum structure-such as the fact that observables correspond to self-adjoint operators-and thus may be of independent interest.

  7. Evaluating Health Advice in a Web 2.0 Environment: The Impact of Multiple User-Generated Factors on HIV Advice Perceptions.

    Science.gov (United States)

    Walther, Joseph B; Jang, Jeong-Woo; Hanna Edwards, Ashley A

    2018-01-01

    Unlike traditional media, social media systems often present information of different types from different kinds of contributors within a single message pane, a juxtaposition of potential influences that challenges traditional health communication processing. One type of social media system, question-and-answer advice systems, provides peers' answers to health-related questions, which yet other peers read and rate. Responses may appear good or bad, responders may claim expertise, and others' aggregated evaluations of an answer's usefulness may affect readers' judgments. An experiment explored how answer feasibility, expertise claims, and user-generated ratings affected readers' assessments of advice about anonymous HIV testing. Results extend the heuristic-systematic model of persuasion (Chaiken, 1980) and warranting theory (Walther & Parks, 2002). Information that is generally associated with both systematic and heuristic processes influenced readers' evaluations. Moreover, content-level cues affected judgments about message sources unexpectedly. When conflicting cues were present, cues with greater warranting value (consensus user-generated ratings) had greater influence on outcomes than less warranted cues (self-promoted expertise). Findings present a challenge to health professionals' concerns about the reliability of online health information systems.

  8. Transfer of Knowledge on Agroforestry Management Practices: the Structure of Farmer Advice Networks

    Directory of Open Access Journals (Sweden)

    Marney E. Isaac

    2007-12-01

    Full Text Available Access to knowledge on farm management practices is essential for the maintenance of productive agroforestry systems. Farmers who lack the means to acquire farming knowledge from formal sources often rely on information within their informal social networks. However, little research has explored the explicit structure of farmer communication patterns. We examined advice network structures by using farmer attributes, i.e., kin relationships, community involvement, and imitation, to characterize structural positions and investigated the consequences of such structure on farming practices in cocoa agroforestry systems in Ghana, West Africa. Furthermore, we used a multicommunity approach; we constructed networks for four communities to increase replication and enhance the generality of our conclusions. A high density of advice ties occurred among a small group of farmers, indicating a core-periphery structure. Settler farmers composed 73% of core position members, suggesting that social proximity did not control the formation of informal advice structures. Because core farmers were highly participative in community activities, the promotion of community involvement may facilitate the movement of knowledge and social exchange to strengthen informal networks. Farmers in both core and peripheral structural positions indicated that they observed fellow farmers and subsequently adopted their practices. Of highly sought farmers, 84% used external information, predominately from government institutions, thus functioning as bridging links between formal and informal networks. Both external and farmer-derived sources of knowledge of agroforestry practices were transferred through informal advice networks, providing available information throughout the farming community, as well as a foundation for community-based adaptive management.

  9. The current situation of treatment systems for alcoholism in Korea.

    Science.gov (United States)

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon; Choi, Ihn-Geun

    2013-02-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

  10. Sense about Sex: Media, Sex Advice, Education and Learning

    Science.gov (United States)

    Attwood, Feona; Barker, Meg John; Boynton, Petra; Hancock, Justin

    2015-01-01

    The media are widely acknowledged as important in sex and relationship education, but they are usually associated with "bad" effects on young people in contrast to the "good" knowledge represented by more informational and educational formats. In this paper we look at sex advice giving in newspapers, magazines and television in…

  11. An Evaluation of an Occupational Health Advice Service

    Science.gov (United States)

    Shearn, P.; Ford, Norma J.; Murphy, R. G.

    2010-01-01

    Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

  12. Use and preference of advice on small children's food

    DEFF Research Database (Denmark)

    Nielsen, Annemette Ljungdalh; Krasnik, Allan; Vassard, Ditte

    2015-01-01

    The authors analyzed the influence of acculturation on parental attitudes to, and use of, different sources of health advice about young children's food in Denmark. Using combined ethnic position of the children's parents as a proxy for household acculturation, the authors conducted a postal survey...

  13. A Career Advice Helpline: A Case Study from South Africa

    Science.gov (United States)

    Flederman, Patricia

    2011-01-01

    This case study presents the new career guidance helpline managed by the South African Qualifications Authority in South Africa, a middle-income country. The National Qualifications Framework and Career Advice Helpline represent a national equity-driven initiative using technology to expand access. The model has drawn on contemporary international…

  14. 21 CFR 14.174 - Advice and recommendations in writing.

    Science.gov (United States)

    2010-04-01

    ... specific drug or a class of drugs are ordinarily in the form of a written report. The report may consist of the approved minutes of the meeting or a separate written report. The report responds to the specific... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Advice and recommendations in writing. 14.174...

  15. Advice for Writing a Thesis (Based on What Examiners Do)

    Science.gov (United States)

    Golding, Clinton

    2017-01-01

    In the article, "What examiners do: What thesis students should know", we identified 11 things that thesis examiners do as they read and judge a thesis. But, we left a gap in the research: knowing this, What should thesis students do to write for their examiners? In this article, I fill the gap. The advice for thesis students is: first,…

  16. Web accessibility practical advice for the library and information professional

    CERN Document Server

    Craven, Jenny

    2008-01-01

    Offers an introduction to web accessibility and usability for information professionals, offering advice on the concerns relevant to library and information organizations. This book can be used as a resource for developing staff training and awareness activities. It will also be of value to website managers involved in web design and development.

  17. Personalized nutrition advice : an everyday-life perspective

    NARCIS (Netherlands)

    Bouwman, L.I.

    2009-01-01

    This thesis presents societal preconditions for Personalized Nutrition Advice (PNA) that result from an everyday-life perspective on this innovative approach. Generally, PNA is regarded as promising, because it provides users with highly specific information on individual health risks and benefits

  18. Provision of RPA advice to users of minor radioactive sources

    International Nuclear Information System (INIS)

    French, A.P.; Anderson, A.G.

    1991-01-01

    The problems of providing cost effective Radiation Protection Supervisor (RPS) training and appropriate storage for minor radioactive sources are discussed. Threshold limits of radioactive holdings are proposed, above which an RPS should be formally trained and specialised source storage facilities provided. Proposals are made for the provision of practical radiation protection advice without need of a detailed hazard assessment. (author)

  19. 18 CFR 388.104 - Informal advice from Commission staff.

    Science.gov (United States)

    2010-04-01

    ... Commission staff. 388.104 Section 388.104 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... Commission staff. (a) The Commission staff provides informal advice and assistance to the general public and... expressed by the staff do not represent the official views of the Commission, but are designed to aid the...

  20. Discharge from hospital against medical advice among paediatric ...

    African Journals Online (AJOL)

    Twenty eight (87.5%) of the 32 children whose social class were available came from low social class. Conclusions: Discharge against medical advice is not infrequent in the study population. We recommend health education and free medical care for under-five children and comprehensive implementation of National ...

  1. The Effect of Customer Empowerment on Adherence to Expert Advice

    NARCIS (Netherlands)

    N.M.A. Camacho (Nuno); M.G. de Jong (Martijn); S. Stremersch (Stefan)

    2014-01-01

    textabstractCustomers often receive expert advice related to their health, finances, taxes or legal procedures, to name just a few. A noble stance taken by some is that experts should empower customers to make their own decisions. In this article, we distinguish informational from decisional

  2. Women and Heart Disease: Sharing Advice from the Heart

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring 2016 Table of Contents This ... inspired you to get involved in the American Heart Association's Go Red For Women movement and Red ...

  3. General physical health advice for people with serious mental illness.

    Science.gov (United States)

    Tosh, Graeme; Clifton, Andrew V; Xia, Jun; White, Margueritte M

    2014-03-28

    There is currently much focus on provision of general physical health advice to people with serious mental illness and there has been increasing pressure for services to take responsibility for providing this. To review the effects of general physical healthcare advice for people with serious mental illness. We searched the Cochrane Schizophrenia Group's Trials Register (last update search October 2012) which is based on regular searches of CINAHL, BIOSIS, AMED, EMBASE, PubMed, MEDLINE, PsycINFO and registries of Clinical Trials. There is no language, date, document type, or publication status limitations for inclusion of records in the register. All randomised clinical trials focusing on general physical health advice for people with serious mental illness.. We extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. We employed a fixed-effect model for analyses. We assessed risk of bias for included studies and created 'Summary of findings' tables using GRADE. Seven studies are now included in this review. For the comparison of physical healthcare advice versus standard care we identified six studies (total n = 964) of limited quality. For measures of quality of life one trial found no difference (n = 54, 1 RCT, MD Lehman scale 0.20, CI -0.47 to 0.87, very low quality of evidence) but another two did for the Quality of Life Medical Outcomes Scale - mental component (n = 487, 2 RCTs, MD 3.70, CI 1.76 to 5.64). There was no difference between groups for the outcome of death (n = 487, 2 RCTs, RR 0.98, CI 0.27 to 3.56, low quality of evidence). For service use two studies presented favourable results for health advice, uptake of ill-health prevention services was significantly greater in the advice group (n = 363, 1 RCT, MD 36.90, CI 33.07 to 40.73) and service use: one or more primary

  4. Acid mine water aeration and treatment system

    Science.gov (United States)

    Ackman, Terry E.; Place, John M.

    1987-01-01

    An in-line system is provided for treating acid mine drainage which basically comprises the combination of a jet pump (or pumps) and a static mixer. The jet pump entrains air into the acid waste water using a Venturi effect so as to provide aeration of the waste water while further aeration is provided by the helical vanes of the static mixer. A neutralizing agent is injected into the suction chamber of the jet pump and the static mixer is formed by plural sections offset by 90 degrees.

  5. Lessons learned and advice from Vietnam war nurses: a qualitative study.

    Science.gov (United States)

    Scannell-Desch, Elizabeth A

    2005-03-01

    The aim of this paper is to describe guidance for nurses today from the lessons learned by nurses who served in the Vietnam War. There is little research focusing on nurses' experiences in the Vietnam War. Lessons learned and subsequent advice from nurses who served in Vietnam may be helpful to those serving in current and future wars. A Husserlian phenomenological approach was taken, using interviews with a purposive sample of Registered Nurses who were female, and had served in the United States of America armed forces in Vietnam during the war. Seven theme clusters described the lesson learned and guidance offered by the Vietnam War nurses: advice about journaling, training, caring for yourself, use of support systems, talking about your experiences, understanding the mission, and lack of preparation for war. Much can be learned from the lessons learned and advice given by Vietnam War nurses. These lessons stress that nurses need to take a pro-active role in preparing themselves for deployment to a war zone, and that institutional training for war needs to be intensive and realistic. The environmental, cultural, technological, clinical and psychosocial demands of war nursing need to be comprehensively addressed before nurses deploy to a war.

  6. Sickness certification for common mental disorders and GP return-to-work advice.

    Science.gov (United States)

    Gabbay, Mark; Shiels, Chris; Hillage, Jim

    2016-09-01

    Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for 'stress'. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any 'may be fit' advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive 'may be fit' advice on their CMD fit notes.

  7. Integrating guideline development and implementation: analysis of guideline development manual instructions for generating implementation advice

    Directory of Open Access Journals (Sweden)

    Gagliardi Anna R

    2012-07-01

    Full Text Available Abstract Background Guidelines are important tools that inform healthcare delivery based on best available research evidence. Guideline use is in part based on quality of the guidelines, which includes advice for implementation and has been shown to vary. Others hypothesized this is due to limited instructions in guideline development manuals. The purpose of this study was to examine manual instructions for implementation advice. Methods We used a directed and summative content analysis approach based on an established framework of guideline implementability. Six manuals identified by another research group were examined to enumerate implementability domains and elements. Results Manuals were similar in content but lacked sufficient detail in particular domains. Most frequently this was Accomodation, which includes information that would help guideline users anticipate and/or overcome organizational and system level barriers. In more than one manual, information was also lacking for Communicability, information that would educate patients or facilitate their involvement in shared decision making, and Applicability, or clinical parameters to help clinicians tailor recommendations for individual patients. Discussion Most manuals that direct guideline development lack complete information about incorporating implementation advice. These findings can be used by those who developed the manuals to consider expanding their content in these domains. It can also be used by guideline developers as they plan the content and implementation of their guidelines so that the two are integrated. New approaches for guideline development and implementation may need to be developed. Use of guidelines might be improved if they included implementation advice, but this must be evaluated through ongoing research.

  8. 300 Area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    LUKE, S.N.

    1999-01-01

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999

  9. 300 Area waste acid treatment system closure plan

    Energy Technology Data Exchange (ETDEWEB)

    LUKE, S.N.

    1999-05-17

    The Hanford Facility Dangerous Waste Permit Application is considered to be a single application organized into a General Information Portion (document number DOERL-91-28) and a Unit-Specific Portion. The scope of the Unit-Specific Portion includes closure plan documentation submitted for individual, treatment, storage, and/or disposal units undergoing closure, such as the 300 Area Waste Acid Treatment System. Documentation contained in the General Information Portion is broader in nature and could be used by multiple treatment, storage, and/or disposal units (e.g., the glossary provided in the General Information Portion). Whenever appropriate, 300 Area Waste Acid Treatment System documentation makes cross-reference to the General Information Portion, rather than duplicating text. This 300 Area Waste Acid Treatment System Closure Plan (Revision 2) includes a Hanford Facility Dangerous Waste Permit Application, Part A, Form 3. Information provided in this closure plan is current as of April 1999.

  10. Performance assessment techniques for groundwater recovery and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, G.L. [Environmental Resources Management, Inc., Exton, PA (United States)

    1993-03-01

    Groundwater recovery and treatment (pump and treat systems) continue to be the most commonly selected remedial technology for groundwater restoration and protection programs at hazardous waste sites and RCRA facilities nationwide. Implementing a typical groundwater recovery and treatment system includes the initial assessment of groundwater quality, characterizing aquifer hydrodynamics, recovery system design, system installation, testing, permitting, and operation and maintenance. This paper focuses on methods used to assess the long-term efficiency of a pump and treat system. Regulatory agencies and industry alike are sensitive to the need for accurate assessment of the performance and success of groundwater recovery systems for contaminant plume abatement and aquifer restoration. Several assessment methods are available to measure the long-term performance of a groundwater recovery system. This paper presents six assessment techniques: degree of compliance with regulatory agency agreement (Consent Order of Record of Decision), hydraulic demonstration of system performance, contaminant mass recovery calculation, system design and performance comparison, statistical evaluation of groundwater quality and preferably, integration of the assessment methods. Applying specific recovery system assessment methods depends upon the type, amount, and quality of data available. Use of an integrated approach is encouraged to evaluate the success of a groundwater recovery and treatment system. The methods presented in this paper are for engineers and corporate management to use when discussing the effectiveness of groundwater remediation systems with their environmental consultant. In addition, an independent (third party) system evaluation is recommended to be sure that a recovery system operates efficiently and with minimum expense.

  11. Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature

    NARCIS (Netherlands)

    Schaafsma, Frederieke; Verbeek, Jos; Hulshof, Carel; van Dijk, Frank

    2005-01-01

    Background: Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based

  12. Targeted nanodrug delivery systems for the treatment of Tuberculosis

    CSIR Research Space (South Africa)

    Lemmer, Yolandy

    2010-06-01

    Full Text Available patient treatment compliance and drug resistance pose a great challenge to TB treatment programs worldwide. To improve the current inadequate therapeutic management of TB, a polymeric anti-TB nanodrug delivery system for anti-TB drugs was developed...

  13. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

    NARCIS (Netherlands)

    Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

    2013-01-01

    Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

  14. 300 Area waste acid treatment system closure plan. Revision 1

    International Nuclear Information System (INIS)

    1996-03-01

    This section provides a description of the Hanford Site, identifies the proposed method of 300 Area Waste Acid Treatment System (WATS) closure, and briefly summarizes the contents of each chapter of this plan

  15. Indigenous knowledge systems for the treatment of hypertension in ...

    African Journals Online (AJOL)

    Indigenous knowledge systems for the treatment of hypertension in Lusaka, Zambia: ... are said to access traditional medicine (TM) for their disease management. ... Healers & Practitioners Association of Zambia (THPAZ) operating from within ...

  16. Modeling Jambo wastewater treatment system to predict water re ...

    African Journals Online (AJOL)

    user

    C++ programme to implement Brown's model for determining water quality usage ... predicting the re-use options of the wastewater treatment system was a ... skins from rural slaughter slabs/butchers, slaughter .... City (Karnataka State, India).

  17. 300 Area waste acid treatment system closure plan. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This section provides a description of the Hanford Site, identifies the proposed method of 300 Area Waste Acid Treatment System (WATS) closure, and briefly summarizes the contents of each chapter of this plan.

  18. Zero insertion force socket for photoactivation patient treatment system

    International Nuclear Information System (INIS)

    Troutner, V.H.

    1988-01-01

    Automatic operating zero insertion force socket for use in a photoactivatable reagent treatment system wherein photoactivatable agents, in contact with patient blood cells, are irradiated extracorporeally and then returned to the patient

  19. On treatment of uncertainty in system planning

    International Nuclear Information System (INIS)

    Flage, R.; Aven, T.

    2009-01-01

    In system planning and operation considerable efforts and resources are spent to reduce uncertainties, as a part of project management, uncertainty management and safety management. The basic idea seems to be that uncertainties are purely negative and should be reduced. In this paper we challenge this way of thinking, using a common industry practice as an example. In accordance with this industry practice, three uncertainty interval categories are used: ±40% intervals for the feasibility phase, ±30% intervals for the concept development phase and ±20% intervals for the engineering phase. The problem is that such a regime could easily lead to a conservative management regime encouraging the use of existing methods and tools, as new activities and novel solutions and arrangements necessarily mean increased uncertainties. In the paper we suggest an alternative approach based on uncertainty and risk descriptions, but having no predefined uncertainty reduction structures. The approach makes use of risk assessments and economic optimisation tools such as the expected net present value, but acknowledges the need for broad risk management processes which extend beyond the analyses. Different concerns need to be balanced, including economic aspects, uncertainties and risk, and practicability

  20. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs.

  1. 2: Local area networks as a multiprocessor treatment planning system

    International Nuclear Information System (INIS)

    Neblett, D.L.; Hogan, S.E.

    1987-01-01

    The creation of a local area network (LAN) of interconnected computers provides an environment of multi computer processors that adds a new dimension to treatment planning. A LAN system provides the opportunity to have two or more computers working on the plan in parallel. With high speed interprocessor transfer, events such as the time consuming task of correcting several individual beams for contours and inhomogeneities can be performed simultaneously; thus, effectively creating a parallel multiprocessor treatment planning system

  2. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    International Nuclear Information System (INIS)

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs

  3. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  4. Review of the integrated thermal and nonthermal treatment system studies

    International Nuclear Information System (INIS)

    1996-08-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

  5. Phantom-based interactive simulation system for dental treatment training.

    Science.gov (United States)

    Sae-Kee, Bundit; Riener, Robert; Frey, Martin; Pröll, Thomas; Burgkart, Rainer

    2004-01-01

    In this paper, we propose a new interactive simulation system for dental treatment training. The system comprises a virtual reality environment and a force-torque measuring device to enhance the capabilities of a passive phantom of tooth anatomy in dental treatment training processes. The measuring device is connected to the phantom, and provides essential input data for generating the graphic animations of physical behaviors such as drilling and bleeding. The animation methods of those physical behaviors are also presented. This system is not only able to enhance interactivity and accessibility of the training system compared to conventional methods but it also provides possibilities of recording, evaluating, and verifying the training results.

  6. A transportable system for radioactivity contaminated water treatment

    International Nuclear Information System (INIS)

    2013-01-01

    Contaminated water treatment system called SARRY for retrieval and recovery of water in operation at the site of Fukushima Daiichi Nuclear Power Plant since August 2011 has been modified by compacting the system size to develop a mobile system SARRY-Aqua that can process Cs-contaminated water (one ton/hour) to the level of 10 Bq/kg. Installing the system in a small container with dimensions conforming to the international standards facilitates transportation by truck and enables the contaminated water treatment occurring in a variety of locations. (S. Ohno)

  7. Drug Treatment within the U.S. Federal Prison System: Are Treatment Needs Being Met?

    Science.gov (United States)

    van Wormer, Katherine; Persson, Lance Edwards

    2010-01-01

    A large percentage of inmates in the U.S. federal prison system have serious drug problems and are in need of treatment before they return to society. Accordingly, the Federal Bureau of Prisons has revamped substance abuse programming consistent with the latest research and expanded treatment services throughout its institutions. This article…

  8. Orthodontic treatment with skeletal anchorage system

    Directory of Open Access Journals (Sweden)

    Arya Brahmanta

    2011-06-01

    Full Text Available Background: Correction of class I malocclusion with bimaxillary dental protrusion and unilateral free end right upper ridge in adult patient is one of difficult biomechanical case in orthodontics. Due to this case that needs proper anchorage for upper incisor retraction with missing teeth in the right posterior segment. Purpose: The aim of this study to find an effective therapy for correction of bimaxillary protrusion with unilateral free and ridge. Case: A female patient, 36 year old complaining for the difficulty of lip closure due to severe bimaxillary protrusion with incompetence lip. Case management: Firstly correction of the maxillary and mandibular incisor proclination were done by extraction of the mandibular first premolar, the maxillary second premolar on left side and finally placement of miniplates implant in the zygomatic process on right side as an absolut anchorage. Conclusion: Skeletal anchorage system (SAS can be considered as an effective therapy for corection of bimaxillary protrusion with unilateral free end ridge.Latar belakang: Koreksi dari maloklusi klas I dari penderita dewasa yang disertai protrusi bimaksiler dengan kehilangan gigi posterior pada regio kanan atas merupakan salah satu kasus sulit untuk dikerjakan terutama berhubungan dengan biomekanik pergerakan giginya dalam perawatan ortodonti. Tujuan: Tujuan dari penulisan artikel ini adalah untuk menemukan terapi yang efektif untuk perbaikan protrusi bimaksiler dan kehilangan gigi posterior pada satu sisi. Kasus: Seorang penderita wanita usia 35 tahun datang dengan keluhan utama kesulitan untuk menutup mulut oleh karena gigi rahang atas dan rahang bawahnya maju dan bibirnya tidak kompeten. Tatalaksana kasus: Koreksi pada gigi insisivus rahang atas dan insisivus rahang bawah yang protrusi dilakukan dengan melakukan pencabutan terlebih dahulu pada gigi premolar pertama dirahang bawah sisi kanan dan sisi kiri serta pencabutan pada gigi premolar kedua di rahang atas sisi

  9. Rheumatology telephone advice line - experience of a Portuguese department.

    Science.gov (United States)

    Ferreira, R; Marques, A; Mendes, A; da Silva, J A

    2015-01-01

    Telephone helplines for patients are tool for information and advice. They can contribute to patient's satisfaction with care and to the effectiveness and safety of treatments. In order to achieve this, they need to be adequately adapted to the target populations, as to incorporate their abilities and expectations. a) Evaluate the adherence of patients to a telephone helpline managed by nurses in a Portuguese Rheumatology Department, b) Analyse the profile of users and their major needs, c) Analyse the management of calls by the nurses. The target population of this phone service are the patients treated at Day Care Hospital and Early Arthritis Clinic of our department. Nurses answered phone calls immediately between 8am and 4pm of working days. In the remaining hours messages were recorded on voice mail and answered as soon as possible. Details of the calls were registered in a dedicated sheet and patients were requested permission to use data to improve the service, with respect for their rights of confidentiality, anonymity and freedom of decision. In 18 months 173 calls were made by 79 patients, with a mean age of 47.9 years (sd=9.13). Considering the proportions of men and women in the target population, it was found that men called more frequently (M= 32.7% vs F= 20.4%, p=.016). The reasons for these calls can be divided into three categories: instrumental help, such as the request for results of complementary tests or rescheduling appointments (43.9% of calls); counselling on side effects or worsening of the disease/pain (31.2 %); counselling on therapy management (24.9%). Neither sex nor patient age were significantly related to these reasons for calling. Nurses resolved autonomously half (50.3%) of the calls and in 79.8% of the cases there was no need for patient referral to other health services. About a quarter of patients adhered to the telephone helpline.. Patients called to obtain support in the management of disease and therapy or to report side

  10. From data mining rules to medical logical modules and medical advices.

    Science.gov (United States)

    Gomoi, Valentin; Vida, Mihaela; Robu, Raul; Stoicu-Tivadar, Vasile; Bernad, Elena; Lupşe, Oana

    2013-01-01

    Using data mining in collaboration with Clinical Decision Support Systems adds new knowledge as support for medical diagnosis. The current work presents a tool which translates data mining rules supporting generation of medical advices to Arden Syntax formalism. The developed system was tested with data related to 2326 births that took place in 2010 at the Bega Obstetrics - Gynaecology Hospital, Timişoara. Based on processing these data, 14 medical rules regarding the Apgar score were generated and then translated in Arden Syntax language.

  11. Variability in the quality of overdose advice in Summary of Product Characteristics (SPC) documents: gut decontamination recommendations for CNS drugs.

    Science.gov (United States)

    Wall, Andrew J B; Bateman, D N; Waring, W S

    2009-01-01

    Deliberate self-poisoning is a major cause of morbidity and mortality. The Summary of Product Characteristics (SPC) document is a legal requirement for all drugs, and Section 4.9 addresses the features of toxicity and clinical advice on management of overdose. The quality and appropriateness of this advice have received comparatively little attention. Section 4.9 of the SPC was examined for all drugs in the central nervous system (CNS) category of the British National Formulary. Advice concerning gut decontamination was examined with respect to specific interventions: induced vomiting, oral activated charcoal, gastric lavage, and other interventions. Data were compared with standard reference sources for clinical management advice in poisoning. These were graded 'A' if no important differences existed, 'B' if differences were noted but not thought clinically important, and 'C' if differences were thought to be clinically significant. SPC documents were examined for 258 medications from 67 manufacturers. The overall agreement was 'A' in 23 (8.9%), 'B' in 28 (10.9%) and 'C' in 207 (80.2%). Discrepancies were due to inappropriate recommendation of induced emesis in 21.7% (95% confidence interval 17.1, 27.1), gastric lavage in 38.4% (32.7, 44.4), other gut decontamination in 5.8% (3.6, 9.4) and failure to recommend oral activated charcoal in 57.4% (51.1, 63.4). Gut decontamination advice in SPC documents with respect to CNS drugs was inadequate. Possible reasons for the observed discrepancies and ways of improving the consistency of advice are proposed.

  12. Impact of decontamination on LWR radioactive waste treatment systems

    International Nuclear Information System (INIS)

    Hoenes, G.R.; Perrigo, L.D.; Divine, J.R.; Faust, L.G.

    1979-01-01

    Only at N-Reactor is there a means to accommodate radwaste produced during decontamination. The Dresden system is expected to be ready to accommodate such solutions by the summer of 1979. Solidification of the processed decontamination waste may be a significant problem. There is doubt that the materials in current radwaste treatment systems can handle chemicals from a concentrated process. The total storage volume, for concentrated decontamination, is not sufficient in existing radwaste treatment systems. Greater attention should be placed on designing reactors and radwaste treatment systems for decontamination. A means of handling waste material resulting from leaks in the primary system during the decontamination must be developed. On-site storage of solidified decontamination wastes may be a viable option, but license amendments will be necessary

  13. Methods of Improving Water Treatment Systems for Individual Residential Houses

    Directory of Open Access Journals (Sweden)

    Pavlov Sergey

    2016-01-01

    Full Text Available One of hot topics for ecological management is sewage treatment today in places where there is no sewerage. The volume of country construction in territories, which are not connected to the public sewage system increasing nowadays. Therefore, problem of wastewater treatment take place. Currently, there are a lot of different designs of local waste treatment plants is offered to consumers. However, a large number of negative reviews indicate serious shortcomings in most of the local plants offered in the market. The purpose of this paper is the proposal of improvement of the most common local treatment plants in Russia.

  14. Personal Recommender System to advice Learning Tasks in Moodle

    NARCIS (Netherlands)

    Drachsler, Hendrik; Van den Berg, Bert

    2007-01-01

    License text: The tracking module is created as a Moodle module. Copyright for Moodle lies with Martin Dougiamas. Moodle is a free software, available under the GNU General Public License. Therefore, the scorecard module is also available under the GNU General Public License. Together with this

  15. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    Durrani, H.A.; Schmidt, L.J.; Erickson, T.A.; Sondreal, E.A.; Erjavec, J.; Steadman, E.N.; Fabrycky, W.J.; Wilson, J.S.; Musich, M.A.

    1996-07-01

    This report analyzes three systems engineering (SE) studies performed on integrated thermal treatment systems (ITTSs) and integrated nonthermal treatment systems (INTSs) for the remediation of mixed low-level waste (MLLW) stored throughout the US Department of Energy (DOE) weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center (EERC), Science Applications International Corporation (SAIC), the Waste Policy Institute (WPI), and Virginia Tech (VT). The three studies reviewed were as follows: Integrated Thermal Treatment System Study, Phase 1--issued July 1994; Integrated Thermal Treatment System Study, Phase 2--issued February 1996; and Integrated Nonthermal Treatment System Study--drafted March 1996. The purpose of this review was to (1) determine whether the assumptions taken in the studies might bias the resulting economic evaluations of both thermal and nonthermal systems, (2) identify the critical areas of the studies that would benefit from further investigation, and (3) develop a standard template that could be used in future studies to produce sound SE applications.

  16. Systemic treatment of advanced, persistent or recurrent cervical cancer

    International Nuclear Information System (INIS)

    Reckova, M.

    2015-01-01

    The cervical cancer is the third most common malignancy in women in the world. Despite advances in screening and treatment there are a relatively large number of patients who are diagnosed with advanced stage of disease, or who have inoperable recurrence. In this group of patients, the main aim of a treatment is palliative intent. The main cytotoxic agent is cisplatin, but the responses are also observed with other chemotherapy agents. Improved therapeutic results are observed with combined platinum-based chemotherapy regimens as compared to cisplatin monotherapy. Overall, however, the treatment results in advanced, persistent and recurrent cervical cancer are unfavorable and disease is considered to be relatively chemo resistant. The new treatment approaches are searched and a significant therapeutic benefit, as far as progression-free and overall survival, has been recently demonstrated when adding bevacizumab to systemic chemotherapy. The current article is a review of systemic treatment in advanced, persistent and recurrent metastatic carcinoma of the cervix. (author)

  17. Nutritional advice for prevention of acute pancreatitis: review of current opinion

    Directory of Open Access Journals (Sweden)

    Lowe ME

    2012-12-01

    Full Text Available Mark E Lowe, Wednesday A SevillaDivision of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USAAbstract: Pancreatitis is inflammation of the pancreas that can be acute and self-limiting or, in a small percentage of patients, recurrent. Patients with recurrent episodes of acute pancreatitis (RAP often progress to chronic pancreatitis. Pancreatitis in all forms causes significant economic and social burdens. Prevention of RAP may decrease those burdens and halt progression to chronic disease. Unfortunately, no therapy has proven effective at altering the course of RAP. While enteral nutritional therapy plays an important role in the treatment of acute pancreatitis during episodes, nutritional advice provided to patients in an attempt to prevent recurrent episodes has not proven effective in most cases. Discontinuing alcohol consumption and treating dyslipidemia with diet and medication can help patients with these issues. In patients whose pancreatitis is associated with celiac disease or eosinophilic gastroenteritis, a gluten-free diet and avoidance of food allergens can be effective in stopping RAP. Advice to take pancreatic enzyme replacement therapy, lose weight, control diabetes, decrease dietary sucrose, decrease dietary fat or avoid monosodium glutamate has little to no evidence of efficacy. Some studies suggest that an antioxidant cocktail may decrease the frequency of RAP and the intensity of chronic pain, but the evidence is weak. Nutritional therapy may have a role in the treatment of patients with RAP. At present, there are no clear guidelines for nutritional advice to give these patients. More studies are needed to identify nutritional interventions that will benefit patients with RAP.Keywords: pancreatitis, nutrition, pancreatic enzyme replacement therapy, antioxidants, herbal supplements

  18. A phenomenologic investigation of pediatric residents' experiences being parented and giving parenting advice.

    Science.gov (United States)

    Bax, A C; Shawler, P M; Blackmon, D L; DeGrace, E W; Wolraich, M L

    2016-09-01

    Factors surrounding pediatricians' parenting advice and training on parenting during residency have not been well studied. The primary purpose of this study was to examine pediatric residents' self-reported experiences giving parenting advice and explore the relationship between parenting advice given and types of parenting residents received as children. Thirteen OUHSC pediatric residents were individually interviewed to examine experiences being parented and giving parenting advice. Phenomenological methods were used to explicate themes and secondary analyses explored relationships of findings based upon Baumrind's parenting styles (authoritative, authoritarian, permissive). While childhood experiences were not specifically correlated to the parenting advice style of pediatric residents interviewed, virtually all reported relying upon childhood experiences to generate their advice. Those describing authoritative parents reported giving more authoritative advice while others reported more variable advice. Core interview themes related to residents' parenting advice included anxiety about not being a parent, varying advice based on families' needs, and emphasis of positive interactions and consistency. Themes related to how residents were parented included discipline being a learning process for their parents and recalling that their parents always had expectations, yet always loved them. Pediatric residents interviewed reported giving family centered parenting advice with elements of positive interactions and consistency, but interviews highlighted many areas of apprehension residents have around giving parenting advice. Our study suggests that pediatric residents may benefit from more general educational opportunities to develop the content of their parenting advice, including reflecting on any impact from their own upbringing.

  19. Monitoring Utilization of a Large Scale Addiction Treatment System: The Drug and Alcohol Treatment Information System (DATIs

    Directory of Open Access Journals (Sweden)

    Nooshin Khobzi Rotondi

    2012-01-01

    Full Text Available Client-based information systems can yield data to address issues of system accountability and planning, and contribute information related to changing patterns of substance use in treatment and, indirectly, general populations. The Drug and Alcohol Treatment Information System (DATIS monitors the number/types of clients treated in approximately 170 publicly-funded addiction treatment agencies in Ontario. The purpose of this study was to estimate the caseload of addiction treatment agencies, and describe important characteristics of clients, their patterns of service utilization and trends over-time from 2005 to 2010. In 2009–2010, 47,065 individuals were admitted to treatment. Since 2005–2006, there has been an increase in adolescents/youth in treatment, and a decrease in the male-female gender ratio. Alcohol problems predominated, but an increasing proportion of clients used cannabis and prescription opioids. DATIS is an evolving system and an integral component of Ontario's performance measurement system. Linkages with healthcare information systems will allow for longitudinal tracking of client health-related outcomes.

  20. Basic user guide for the radwaste treatment plant computer system

    International Nuclear Information System (INIS)

    Keel, A.

    1990-07-01

    This guide has been produced as an aid to using the Radwaste Treatment Plant computer system. It is designed to help new users to use the database menu system. Some of the forms can be used in ways different from those explained and more complex queries can be performed. (UK)

  1. PERAN COMMUNITY ADVICE SEBAGAI PEMODERASI DALAM KEPUTUSAN PEMBELIAN

    Directory of Open Access Journals (Sweden)

    Pristiana Widyastuti

    2018-03-01

    Full Text Available This study aims to analyze the influence of rational motives and emotional motives on purchasing decisions with community advice as a moderating variable. This study was conducted on biker as community adviser in Jakarta. The number of samples is 75 data, obtained from the questionaire filled by the respondents. Data analysis uses Structural Equation Modeling (SEM with Partial Least Square (PLS test equipment. The results of statistical tests revealed that the rational motives and emotional motives have positive effect on purchasing decisions, whereas community advice has no positive effect on purchasing decisions, it is not able to moderate the relationship among variables. Producer and distributors are important to maintain the quality and reliability of products that rationally influence consumers to buy. In addition, efforts to maintain the credibility of the brand are also important to emphasize the consumer’s pride.

  2. Getting started on your research: practical advice for medical educators.

    Science.gov (United States)

    Markert, Ronald J

    2010-10-01

    Guidance and mentorship benefit faculty who having little or no background conducting research in medical education. From his experience the author suggests three characteristics that distinguish medical educators who are especially productive in their scholarly activities: intrinsic rather than extrinsic motivation, collaboration with colleagues, and the personal qualities of patience and organization. He then expands on these characteristics by offering practical advice in the form of eight tips for faculty seeking to acquire or improve their medical education research skills.

  3. Do British travel agents provide adequate health advice for travellers?

    Science.gov (United States)

    Lawlor, D A; Burke, J; Bouskill, E; Conn, G; Edwards, P; Gillespie, D

    2000-01-01

    Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised. PMID:10954940

  4. Why Financial Advice Cannot Substitute for Financial Literacy?

    OpenAIRE

    M. Debbich

    2015-01-01

    This paper examines the ability of financial advice provided by sellers of financial services to substitute for financial literacy of customers. I set up a simple theoretical model in which an informed financial advisor communicates with a less informed customer of financial services. Given the existence of a conflict of interest from the advisor's perspective, the model predicts that only well financially sophisticated customers receive relevant information from the advisor. This fact tends ...

  5. Regulating Robo Advice across the Financial Services Industry

    OpenAIRE

    Baker, Tom; Dellaert, Benedict

    2017-01-01

    textabstractAutomated financial product advisors – “robo advisors” – are emerging across the financial services industry, helping consumers choose investments, banking products, and insurance policies. Robo advisors have the potential to lower the cost and increase the quality and transparency of financial advice for consumers. But they also pose significant new challenges for regulators who are accustomed to assessing human intermediaries. A well-designed robo advisor will be honest and comp...

  6. Millennials at Work: The Advice of Great Leaders

    Science.gov (United States)

    2015-04-01

    Millennials at Work The Advice of Great Leaders Carol Axten Axten has more than 30 years of experience in Defense Department engineering, program...management, and policy development. She has graduate degrees in business , engineering, international relations, and national security resource strategy...million members of the millennial generation will enter the workforce and by 2030 will make up 75 percent of all working professionals. As managers in the

  7. Pollution abatement with peat onsite wastewater treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, J L [University of Maine, Orano, ME (United States). Dept. of Civil Engineering

    1994-02-01

    The purpose of onsite wastewater treatment is to provide economical removal of dissolved nutrients, pathogens and other contaminates from septic tank effluent to avoid the pollution of groundwater or creation of other health hazards. The effective use of conventional soil adsorption systems is limited by a number of factors including site characteristics, soil type and condition, and the proximity of the system to surface waters or a source of potable water. On adverse sites, where the use of conventional subsurface soil adsorption systems does not provide acceptable levels of treatment, Sphagnum peat may be used as an economical method of onsite wastewater treatment. The peat system, when properly designed and constructed, is relatively simple to install, requires minimal energy and maintenance, and provides a high quality effluent without additional disinfection. 19 refs.

  8. POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    King, V.

    2000-01-01

    The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of the Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous

  9. Classification system for acute and chronic radiation treatment sequelae

    International Nuclear Information System (INIS)

    Seegenschmiedt, M.H.; Sauer, R.

    1993-01-01

    A classification system in German language is proposed for scoring of acute and chronic treatment sequelae after radiotherapy. It includes all important organs and organ systems. The proposed grading corresponds to the four-scale-system of the WHO and UICC. The system is also compatible to the RTOG and EORTC acute and late radiation morbidity scoring criteria. This facilitates the data transfer for retrospective and prospective analysis of monomodal and multimodal radiotherapy treatment regimes. We recommend to use this scoring system in all German speaking countries for multicentric prospective studies. It is possible, that organ-specific sophistications of the toxicity grading will be developed in the future. These additions should conform with (inter)national standards and apply the same four-scale grading of this classification system. (orig.) [de

  10. Nutrigenomics-based personalised nutritional advice: in search of a business model?

    NARCIS (Netherlands)

    Ronteltap, A.; Trijp, van J.C.M.; Berezowska, A.; Goossens, Jo

    2013-01-01

    Nutritional advice has mainly focused on population-level recommendations. Recent developments in nutrition, communication, and marketing sciences have enabled potential deviations from this dominant business model in the direction of personalisation of nutrition advice. Such personalisation efforts

  11. 75 FR 33824 - Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition...

    Science.gov (United States)

    2010-06-15

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 332-520] Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition of Certain Products to the Pharmaceutical Appendix..., Pharmaceutical Products and Chemical Intermediates, Fourth Review: Advice Concerning the Addition of Certain...

  12. Measured performance of four PWR liquid radioactive waste treatment systems

    International Nuclear Information System (INIS)

    McIsaac, C.V.; Mandler, J.W.; Stalker, A.C.

    1980-01-01

    This paper presents results of a study of the liquid radwaste treatment and boron recovery systems of four operating PWR power plants. The performance of a given system was determined from measurements of radionuclide inventories in samples drawn from demineralizers, evaporators, filters, and gaseous cleanup systems. The plants at which measurements were made are Fort Calhoun, Zion 1 and 2, Turkey Point 3 and 4, and Rancho Seco

  13. Mental health treatment teams and leadership: a systems model.

    Science.gov (United States)

    Yank, G R; Barber, J W; Spradlin, W W

    1994-10-01

    Mental health treatment teams are living systems at the group level and comprise key productive subsystems of organizations providing mental health care. Effective treatment teams, like effective organizations, are anticipatory systems that contain subsystems that model and predict future system and environmental conditions and enable responses that increase system viability. A systems analysis of treatment teams highlights their potential instability due to their tendencies to regress toward dysfunctional partial systems and their active maintenance in nonequilibrium steady states with their organizational and external environments. Team subsystems are analyzed from the viewpoints of system processes and also with regard to individuals and their roles. Boundary processes are central to effective team functioning, assure constancy of team membership, and regulate the team's interfaces with its parent agency and with the external environment. Various causes and forms of disturbed information processing within hierarchical organizations are examined, and their effects at the treatment team level are discussed. The conclusion of the discussion focuses on team leadership and how leadership expands upon the concept of the decider subsystem to include role and personal factors to the team's leaders, and functions that are anticipatory and integrative in nature. Effective leaders must set appropriate thresholds for feedback regulation processes, and balance several pairs of seemingly opposing forces, including homeostasis and development, role differentiation and role overlap, and personal accountability and empowerment of others.

  14. Process modeling for the Integrated Thermal Treatment System (ITTS) study

    Energy Technology Data Exchange (ETDEWEB)

    Liebelt, K.H.; Brown, B.W.; Quapp, W.J.

    1995-09-01

    This report describes the process modeling done in support of the integrated thermal treatment system (ITTS) study, Phases 1 and 2. ITTS consists of an integrated systems engineering approach for uniform comparison of widely varying thermal treatment technologies proposed for treatment of the contact-handled mixed low-level wastes (MLLW) currently stored in the U.S. Department of Energy complex. In the overall study, 19 systems were evaluated. Preconceptual designs were developed that included all of the various subsystems necessary for a complete installation, from waste receiving through to primary and secondary stabilization and disposal of the processed wastes. Each system included the necessary auxiliary treatment subsystems so that all of the waste categories in the complex were fully processed. The objective of the modeling task was to perform mass and energy balances of the major material components in each system. Modeling of trace materials, such as pollutants and radioactive isotopes, were beyond the present scope. The modeling of the main and secondary thermal treatment, air pollution control, and metal melting subsystems was done using the ASPEN PLUS process simulation code, Version 9.1-3. These results were combined with calculations for the remainder of the subsystems to achieve the final results, which included offgas volumes, and mass and volume waste reduction ratios.

  15. Process modeling for the Integrated Thermal Treatment System (ITTS) study

    International Nuclear Information System (INIS)

    Liebelt, K.H.; Brown, B.W.; Quapp, W.J.

    1995-09-01

    This report describes the process modeling done in support of the integrated thermal treatment system (ITTS) study, Phases 1 and 2. ITTS consists of an integrated systems engineering approach for uniform comparison of widely varying thermal treatment technologies proposed for treatment of the contact-handled mixed low-level wastes (MLLW) currently stored in the U.S. Department of Energy complex. In the overall study, 19 systems were evaluated. Preconceptual designs were developed that included all of the various subsystems necessary for a complete installation, from waste receiving through to primary and secondary stabilization and disposal of the processed wastes. Each system included the necessary auxiliary treatment subsystems so that all of the waste categories in the complex were fully processed. The objective of the modeling task was to perform mass and energy balances of the major material components in each system. Modeling of trace materials, such as pollutants and radioactive isotopes, were beyond the present scope. The modeling of the main and secondary thermal treatment, air pollution control, and metal melting subsystems was done using the ASPEN PLUS process simulation code, Version 9.1-3. These results were combined with calculations for the remainder of the subsystems to achieve the final results, which included offgas volumes, and mass and volume waste reduction ratios

  16. Municipal wastewater treatment in Mexico: current status and opportunities for employing ecological treatment systems.

    Science.gov (United States)

    Zurita, Florentina; Roy, Eric D; White, John R

    2012-06-01

    The aim of this paper is to evaluate the current status of municipal wastewater (MWW) treatment in Mexico, as well as to assess opportunities for using ecological treatment systems, such as constructed wetlands. In 2008, Mexico had 2101 MWW treatment plants that treated only 84 m3/s of wastewater (208 m3/s ofMWW were collected in sewer systems). Unfortunately, most treatment plants operate below capacity owing to a lack of maintenance and paucity of properly trained personnel. The main types of treatment systems applied in Mexico are activated sludge and waste stabilization ponds, which treat 44.3% and 18% of the MWW collected, respectively. As in many other developing nations around the world, there is a great need in Mexico for low-cost, low-maintenance wastewater treatment systems that are both economically and environmentally sustainable. In 2005, 24.3 million Mexicans lived in villages of less than 2500 inhabitants and 14.1 million lived in towns with 2500-15,000 inhabitants. An opportunity exists to extend the use of ecological treatment systems to these low population density areas and considerably increase the percentage of MWW that is treated in Mexico. Small-scale and medium-size constructed wetlands have been built successfully in some states, primarily during the past five years. Several barriers need to be overcome to increase the adoption and utilization of ecological wastewater technology in Mexico, including: a lack of knowledge about this technology, scarce technical information in Spanish, and the government's concentration on constructing MWW treatment plants solely in urban areas.

  17. Implementation of three dimensional treatment planning system for external radiotherapy

    International Nuclear Information System (INIS)

    Major, Tibor; Kurup, P.G.G.; Stumpf, Janos

    1997-01-01

    A three dimensional (3D) treatment planning system was installed at Apollo Cancer Hospital, Chennai, India in 1995. This paper gives a short description of the system including hardware components, calculation algorithm, measured data requirements and specific three dimensional features. The concept and the structure of the system are shortly described. The first impressions along with critical opinions and the experiences are gained during the data acquisition are mentioned. Some improvements in the user interface are suggested. It is emphasized that although a 3D system offers more detailed and accurate dose distributions compared to a 2D system, it also introduces a greatly increased workload for the planning staff. (author)

  18. Integrated thermal treatment systems study. Internal review panel report

    International Nuclear Information System (INIS)

    Cudahy, J.; Escarda, T.; Gimpel, R.

    1995-04-01

    The U.S. Department of Energy (DOE) Office of Technology Development (OTD) commissioned two studies to evaluate nineteen thermal treatment technologies for treatment of DOE mixed low-level waste. These studies were called the Integrated Thermal Treatment System (ITTS) Phase I and Phase II. With the help of the DOE Office of Environmental Management (EM) Mixed Waste Focus Group, OTD formed an ITTS Internal Review Panel to review and comment on the ITTS studies. This Panel was composed of scientists and engineers from throughout the DOE complex, the U.S. Environmental Protection Agency, the California EPA, and private experts. The Panel met from November 15-18, 1994 to review the ITTS studies and to make recommendations on the most promising thermal treatment systems for DOE mixed low-level wastes and on research and development necessary to prove the performance of the technologies. This report describes the findings and presents the recommendations of the Panel

  19. Rituximab treatment in primary angiitis of the central nervous system.

    Science.gov (United States)

    Patel, Shreeya; Ross, Laura; Oon, Shereen; Nikpour, Mandana

    2018-06-01

    Primary angiitis of the central nervous system (PACNS) is a rare autoimmune vasculitis affecting the brain and spinal cord. Treatment with biological agents has revolutionised the treatment of many rheumatic conditions but there is scant literature regarding the use of biological agents in PACNS. We present three cases of PACNS treated with rituximab, including two cases of relapsed disease, and a literature review suggesting a role for rituximab in this condition. © 2018 Royal Australasian College of Physicians.

  20. Targeting the robo-advice customer: the development of a psychographic segmentation model for financial advice robots

    OpenAIRE

    van Thiel, D.; van Raaij, W.F.

    2017-01-01

    The purpose of this study is to develop the world’s first psychographic market segmentation model that supports personalization, customer education, customer activation, and customer engagement strategies with financial advice robots. As traditional segmentation models in consumer finance primarily focus on externally observed demographics or economic criteria such as profession, age, income, or wealth, post-hoc psychographic segmentation further supports personalization in the digital adviso...

  1. The sun burns: New advice of the Dutch National Health Council on ultraviolet radiation

    International Nuclear Information System (INIS)

    Passchier, W.F.

    1994-01-01

    The aim of the advice of the Dutch National Health Council is to outline the consequences of the depleted ozone layer, and as a result the increased ultraviolet (UV) radiation, on the public health and the environment. In particular, attention is paid to the effect of UV radiation on the immune system, the increased occurrence of carcinomas, melanomas and other forms of skin cancer, the impact on the development of eye defects, and the impact on different levels of ecosystems. A brief overview is given of preventive measures. 5 figs., 1 ref

  2. 77 FR 48169 - The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1...

    Science.gov (United States)

    2012-08-13

    ... Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 1; The Information Technology Agreement: Advice and Information on the Proposed Expansion: Part 2 AGENCY: United States... Technology Agreement: Advice and Information on the Proposed Expansion: Part 1, and investigation No. 332-536...

  3. The present day relevance of Paul's advice to the family in the ...

    African Journals Online (AJOL)

    Many people and organizations have made several efforts to improve and enhance the survival of the family. An example is the advice of Saint Paul, the Apostle to the Christian family in Ephesians 5:22-25 and 6:1-9. This paper examines this advice and its relevance to the society today. Key Words: Paul, Apostle; Advice; ...

  4. The pattern of clinical advice sought by general practitioners from a medical consultant in clinical biochemistry.

    Science.gov (United States)

    Bhatnagar, D

    1997-01-01

    Clinical biochemistry departments can be a valuable source of clinical advice for further investigations and the need for referral to specialist clinics. This paper outlines the pattern of clinical advice sought by general practitioners in a district hospital setting, and addresses some of the issues regarding seeking such advice and the implications for continuing medical education and training. PMID:9196966

  5. Integrated thermal treatment system study: Phase 1 results. Volume 1

    International Nuclear Information System (INIS)

    Feizollahi, F.; Quapp, W.J.; Hempill, H.G.; Groffie, F.J.

    1994-07-01

    An integrated systems engineering approach is used for uniform comparison of widely varying thermal treatment technologies proposed for management of contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. Ten different systems encompassing several incineration design options are studied. All subsystems, including facilities, equipment, and methods needed for integration of each of the ten systems are identified. Typical subsystems needed for complete treatment of MLLW are incoming waste receiving and preparation (characterization, sorting, sizing, and separation), thermal treatment, air pollution control, primary and secondary stabilization, metal decontamination, metal melting, mercury recovery, lead recovery, and special waste and aqueous waste treatment. The evaluation is performed by developing a preconceptual design package and planning life-cycle cost (PLCC) estimates for each system. As part of the preconceptual design process, functional and operational requirements, flow sheets and mass balances, and conceptual equipment layouts are developed for each system. The PLCC components estimated are technology development, production facility construction, pre-operation, operation and maintenance, and decontamination and decommissioning. Preconceptual design data and other technology information gathered during the study are examined and areas requiring further development, testing, and evaluation are identified and recommended. Using a qualitative method, each of the ten systems are ranked

  6. The sewer collection system, the first treatment step

    International Nuclear Information System (INIS)

    Rustia, B.M.; Dickerson, J.R.

    2002-01-01

    'Full text:' The Civil Engineering Research Foundation's (CERF) Environmental Technology Evaluation Center (EvTEC) conducted an evaluation of a microbial treatment additive that converts the entire sewer collection system into an efficient high-speed treatment step. The technology claims to reduce total suspended solids (TSS) by > 60% and carbonaceous biological oxygen demand (CBOD), simultaneously by > 30% before it reaches the treatment plant. The technology uses pump station wet wells as the network nodes to add the microbial treatment to the waste water collection system This process uses the natural retention time in the sewer coupled with the addition of an extremely concentrated mixture of select, symbiotic, facultative microbes, which degrade the waste en route to the treatment plant. These bacteria do not produce odorous compounds and they replace the sulfur-reducing-bacteria (SRB) in the biomass on the walls of the force mains and on the wet perimeter of the gravity sewer piping by 'competitive exclusion.' This microbial substitution is achieved by the high quantity of organisms injected into the collection system. This reduces the sulfides in the wastewater thereby reducing the odor, along with greatly reducing the corrosion elements, which attack the piping in a sewer collection system. The objective of EvTEC evaluation was to verify the performance and reliability of such a microbial additive to treat wastewater and reduce plant 'sludges,' or biosolids. Among other performance issues, the evaluation addressed the technology's ability to treat domestic wastewater flows over an extended time period (i.e., greater than 3 months, 6 months, 12 months..., etc.) and to see if the benefits are improved during particular times of year. The benefits to using the additive include reducing the biosolids produced at the treatment plant and increasing the treatment plant's efficiency and capacity. This in turn helped reduce operating costs without requiring a large

  7. Review of the integrated thermal and nonthermal treatment system studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering.

  8. Review of the integrated thermal and nonthermal treatment system studies

    International Nuclear Information System (INIS)

    1996-01-01

    This report contains a review and evaluation of three systems analysis studies performed by LITCO on integrated thermal treatment systems and integrated nonthermal treatment systems for the remediation of mixed low-level waste stored throughout the US Department of Energy weapons complex. The review was performed by an independent team of nine researchers from the Energy and Environmental Research Center, Science Applications International Corporation, the Waste Policy Institute, and Virginia Tech. The purpose of this review was to (1) determine whether the assumptions of the studies were adequate to produce an unbiased review of both thermal and nonthermal systems, (2) to identify the critical areas of the studies that would benefit from further investigation, and (3) to develop a standard template that could be used in future studies to assure a sound application of systems engineering

  9. Treatment systems for liquid wastes generated in chemical analysis laboratories

    International Nuclear Information System (INIS)

    Linda Berrio; Oscar Beltran; Edison Agudelo; Santiago Cardona

    2012-01-01

    Nowadays, handling of liquid wastes from chemical analysis laboratories is posing problems to different public and private organizations because of its requirements of an integrated management. This article reviews various treatment technologies and its removal efficiencies in order to establish criteria for selecting the system and the appropriate variables to achieve research objectives as well as environmental sustainability. Review begins with a description of the problem and continues with the study of treatments for laboratory wastes. These technologies are segregated into physicochemical and biological treatments that comprise a variety of processes, some of which are considered in this review.

  10. Carrier-Based Drug Delivery System for Treatment of Acne

    Science.gov (United States)

    Vyas, Amber; Kumar Sonker, Avinesh

    2014-01-01

    Approximately 95% of the population suffers at some point in their lifetime from acne vulgaris. Acne is a multifactorial disease of the pilosebaceous unit. This inflammatory skin disorder is most common in adolescents but also affects neonates, prepubescent children, and adults. Topical conventional systems are associated with various side effects. Novel drug delivery systems have been used to reduce the side effect of drugs commonly used in the topical treatment of acne. Topical treatment of acne with active pharmaceutical ingredients (API) makes direct contact with the target site before entering the systemic circulation which reduces the systemic side effect of the parenteral or oral administration of drug. The objective of the present review is to discuss the conventional delivery systems available for acne, their drawbacks, and limitations. The advantages, disadvantages, and outcome of using various carrier-based delivery systems like liposomes, niosomes, solid lipid nanoparticles, and so forth, are explained. This paper emphasizes approaches to overcome the drawbacks and limitations associated with the conventional system and the advances and application that are poised to further enhance the efficacy of topical acne formulations, offering the possibility of simplified dosing regimen that may improve treatment outcomes using novel delivery system. PMID:24688376

  11. Operational availability improvement through online monitoring and advice for emergency diesel generator

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beom; Kim, Han Gon; Kim, Byong Sup [Korea Electric Power Research Institute, Taejon (Korea, Republic of); Golay, M; Kang, C W; Sui, Y [Massachusetts Institute of Technology, Massachusetts (United States)

    1999-12-31

    This research broadens the prime concern of nuclear power plant operations from safe performance to both economic and safe performance. First, emergency diesel generator is identified as one of main contributors for the lost plant availability through the review of plant forced outage records. The framework of an integrated architecture of performing modern on-line condition for operational availability improvement is configured in this work. For the development of the comprehensive sensor networks for complex target systems, and integrated methodology incorporating a structural hierarchy, a functional hierarchy, and a fault-symptom matrix is formulated. The second part of our research is development of intelligent diagnosis and maintenance advisory system, which employs Bayesian Belief Networks (BBNs) as a high level reasoning tool for incorporating inherent uncertainty for use in probabilistic inference. Our prototype diagnosis algorithms are represented explicitly through topological symbols and links between them in a causal direction. As new evidence from sensor network developed is entered into the model especially, our advisory system provides operational advice concerning both availability and safety, so that the operator is able to determine the likely failure modes, diagnose the system state, locate root causes, and take the most advantageous action. Thereby, this advice improves operational availability. 6 refs., 7 figs., 1 tab. (Author)

  12. Operational availability improvement through online monitoring and advice for emergency diesel generator

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Beom; Kim, Han Gon; Kim, Byong Sup [Korea Electric Power Research Institute, Taejon (Korea, Republic of); Golay, M.; Kang, C. W.; Sui, Y. [Massachusetts Institute of Technology, Massachusetts (United States)

    1998-12-31

    This research broadens the prime concern of nuclear power plant operations from safe performance to both economic and safe performance. First, emergency diesel generator is identified as one of main contributors for the lost plant availability through the review of plant forced outage records. The framework of an integrated architecture of performing modern on-line condition for operational availability improvement is configured in this work. For the development of the comprehensive sensor networks for complex target systems, and integrated methodology incorporating a structural hierarchy, a functional hierarchy, and a fault-symptom matrix is formulated. The second part of our research is development of intelligent diagnosis and maintenance advisory system, which employs Bayesian Belief Networks (BBNs) as a high level reasoning tool for incorporating inherent uncertainty for use in probabilistic inference. Our prototype diagnosis algorithms are represented explicitly through topological symbols and links between them in a causal direction. As new evidence from sensor network developed is entered into the model especially, our advisory system provides operational advice concerning both availability and safety, so that the operator is able to determine the likely failure modes, diagnose the system state, locate root causes, and take the most advantageous action. Thereby, this advice improves operational availability. 6 refs., 7 figs., 1 tab. (Author)

  13. Discharge against medical advice at a tertiary center in southeastern Nigeria: sociodemographic and clinical dimensions

    Directory of Open Access Journals (Sweden)

    Boniface Eze

    2010-09-01

    Full Text Available Boniface Eze1, Kenneth Agu2, Jones Nwosu31Department of Ophthalmology, 2Department of Surgery, 3Department of Otorhinolaryngology, University of Nigeria Teaching Hospital (UNTH, Ituku-Ozalla, Enugu, Enugu State, Nigeria Objective: To assess the sociodemographic and clinical characteristics of patients discharged against medical advice (DAMA at the University of Nigeria Teaching Hospital (UNTH, Enugu, Nigeria.Methods: The UNTH’s admission and discharge records between 1997 and 2006 were examined. Patients DAMA were identified; relevant sociodemographic and clinical data were extracted from their recalled clinical charts. Data were analyzed to generate rates, percentages, and proportions, and a level of P < 0.05 (one degree of freedom was considered statistically significant.Results: Of the 64,856 admissions (45.2% male, 54.8% female, 113 (0.002%; males: 54%, females: 46% were discharged against medical advice. DAMA rate was highest in Surgery (0.4%, and lowest in Obstetrics and Gynecology (0.1% and Pediatrics (0.1%. Infections (32.7%, trauma (29.2%, and cancer (16.8% were the leading diagnoses in patients DAMA. Financial constraints (37.2%, unsatisfactory response to treatment (17.7%, and dissatisfaction with hospital environment (15.0% were the main reasons for patients choosing to discharge themselves. DAMA was associated with a short admission period (P < 0.05, patients having high levels of formal education (P < 0.05, and those who had not been previously hospitalized (P < 0.05; but not with age (P = 0.398, gender (P = 0.489, or employment (P = 0.091.Conclusion: Comparatively, the rate of DAMA at UNTH is low. The causes of DAMA are preventable; for example, strengthening of the national health insurance scheme, enhancement of doctor-patient communication, and improvement of hospital environment would further reduce DAMA rate. Keywords: discharge against medical advice, tertiary center, sociodemographic characteristics, clinical

  14. Integrated Risk Framework for Onsite Wastewater Treatment Systems

    Science.gov (United States)

    Carroll, Steven; Goonetilleke, Ashantha; Thomas, Evan; Hargreaves, Megan; Frost, Ray; Dawes, Les

    2006-08-01

    Onsite wastewater treatment systems (OWTS) are becoming increasingly important for the treatment and dispersal of effluent in new urbanised developments that are not serviced by centralised wastewater collection and treatment systems. However, the current standards and guidelines adopted by many local authorities for assessing suitable site and soil conditions for OWTS are increasingly coming under scrutiny due to the public health and environmental impacts caused by poorly performing systems, in particular septic tank-soil adsorption systems. In order to achieve sustainable onsite wastewater treatment with minimal impacts on the environment and public health, more appropriate means of assessment are required. This paper highlights an integrated risk based approach for assessing the inherent hazards associated with OWTS in order to manage and mitigate the environmental and public health risks inherent with onsite wastewater treatment. In developing a sound and cohesive integrated risk framework for OWTS, several key issues must be recognised. These include the inclusion of relevant stakeholders throughout framework development, the integration of scientific knowledge, data and analysis with risk assessment and management ideals, and identification of the appropriate performance goals for successful management and mitigation of associated risks. These issues were addressed in the development of the risk framework to provide a generic approach to assessing risk from OWTS. The utilisation of the developed risk framework for achieving more appropriate assessment and management techniques for OWTS is presented in a case study for the Gold Coast region, Queensland State, Australia.

  15. Performance of slow rate systems for treatment of domestic wastewater.

    Science.gov (United States)

    Tzanakakis, V E; Paranychianakis, N V; Angelakis, A N

    2007-01-01

    The performance of slow rate (SR) systems in terms of treatment efficiency, environmental and health risks, and land sustainability was investigated over a three-year period in a rural community close to Iraklio, Greece. Four plant species (Acacia cyanophylla, Eucalyptus camandulensis, Populus nigra and Arundo donax) were used in order to investigate the role of vegetation in the treatment of wastewater and in biomass production. Wastewater effluent was pre-treated in a septic tank before its application to land. Applied hydraulic loading rates were based on crop water requirements which were determined separately for each plant species. The evaluation of treatment performance was accomplished by measuring COD, TKN, NH3-N, NO3-N, total and reactive P, TC and FC in soil solution samples taken at different depths (15, 30 and 60 cm). SR systems showed great potential for COD, TKN and NH4-N removal which reached 89, 90 and 94%, respectively at a depth of 15 cm. An outstanding removal was also observed for TC and FC which reached 99.99%. The concentration of both P and NO3-N in soil solution increased with the passage of time, but it was lower in winter. Despite the differences in the application rates among the SR systems planted with different plant species, the treatment efficiency was not affected. Moreover, increasing the soil depth from 15 to 60 cm had no effect on the treatment efficiency of the SR systems.

  16. Sustainable Optimization for Wastewater Treatment System Using PSF-HS

    Directory of Open Access Journals (Sweden)

    Zong Woo Geem

    2016-03-01

    Full Text Available The sustainability in a river with respect to water quality is critical because it is highly related with environmental pollution, economic expenditure, and public health. This study proposes a sustainability problem of wastewater treatment system for river ecosystem conservation which helps the healthy survival of the aquatic biota and human beings. This study optimizes the design of a wastewater treatment system using the parameter-setting-free harmony search algorithm, which does not require the existing tedious value-setting process for algorithm parameters. The real-scale system has three different options of wastewater treatment, such as filtration, nitrification, and diverted irrigation (fertilization, as well as two existing treatment processes (settling and biological oxidation. The objective of this system design is to minimize life cycle costs, including initial construction costs of those treatment options, while satisfying minimal dissolved oxygen requirements in the river, maximal nitrate-nitrogen concentration in groundwater, and a minimal nitrogen requirement for crop farming. Results show that the proposed technique could successfully find solutions without requiring a tedious setting process.

  17. A framework for the organization and delivery of systemic treatment.

    Science.gov (United States)

    Vandenberg, T; Coakley, N; Nayler, J; Degrasse, C; Green, E; Mackay, J A; McLennan, C; Smith, A; Wilcock, L; Trudeau, M E

    2009-01-01

    Increasing systemic treatment and shortages of oncology professionals in Canada require innovative approaches to the safe and effective delivery of intravenous (IV) cancer treatment. We conducted a systematic review of the clinical and scientific literature, and an environmental scan of models in Canada, the United Kingdom, Australia, and New Zealand. We then developed a framework for the organization and delivery of IV systemic treatment. The systematic review covered the medline, embase, cinahl, and HealthStar databases. The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine. The Systemic Treatment Working Group reviewed the evidence and developed a draft framework using evidence-based analysis, existing recommendations from various jurisdictions, and expert opinion based on experience and consensus. The draft was assessed by Ontario stakeholders and reviewed and approved by Cancer Care Ontario. The poor quantity and quality of the evidence necessitated a consensus-derived model. That model comprises four levels of care determined by a regional systemic treatment program and three integrated structures (integrated cancer programs, affiliate institutions, and satellite institutions), each with a defined scope of practice and a specific organizational framework. New models of care are urgently required beyond large centres, particularly in geographically remote or rural areas. Despite limited applicable evidence, the development and successful implementation of this framework is intended to create sustainable, accessible, quality care and to measurably improve patient outcomes.

  18. Pre-travel advice seeking from GPs by travellers with chronic illness seen at a travel clinic.

    Science.gov (United States)

    Gagneux-Brunon, Amandine; Andrillat, Carole; Fouilloux, Pascale; Daoud, Fatiha; Defontaine, Christiane; Charles, Rodolphe; Lucht, Frédéric; Botelho-Nevers, Elisabeth

    2016-03-01

    Travellers are ageing and frequently report chronic illness. Pre-travel health advice is crucial, particularly in this subgroup, and general practitioners (GPs) are first in line for treatment adjustment before departure. Our aim is to evaluate pre-travel health advice seeking from GPs by travellers with chronic illness seen at a travel clinic. A cross-sectional observational survey using a questionnaire was conducted between August 2013 and July 2014 in travellers attending the travel medicine clinic of a tertiary university hospital in France. During the study, 2019 travellers were included. Mean age was 39.4 years (±18.8). Three hundred and ninety-one (19.4%) travellers reported a history of a chronic illness. Arterial hypertension and diabetes mellitus were the most frequently reported illnesses, affecting, respectively, 168 (8.3%) travellers and 102 (5.1%). Hajj pilgrims were more likely to report a history of chronic illness than other travellers. Only 810 (40.1%) travellers sought pre-travel advice from their GP. Six hundred and fifty-two (40.1%) healthy travellers and 158 (40.5%) travellers reporting chronic illness sought pre-travel advice from their GP (P = 0.96). Travellers with a history of chronic illness do not seek pre-travel health advice from their GP more frequently than healthy travellers. Travel health specialists are generally not the best practitioners to manage the care of underlying medical conditions presenting risks during travel. However, GPs offer continuity and disease management expertise to improve the specificity of pre-travel planning. Thus, ongoing collaboration between the traveller, GP and travel health specialist is likely to yield the best outcomes. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: journals.permissions@oup.com.

  19. Ultrasonic treatment for microbiological control of water systems

    International Nuclear Information System (INIS)

    Broekman, S.; Pohlmann, O.; Beardwooden, E. S.; Cordemans de Meulenaer, E.

    2010-01-01

    A combination treatment of shear, micro-bubbles, and high-frequency low-power ultrasound introduced via side-stream treatment of industrial water systems has shown excellent results in controlling bacteria and algae; Through the physical, high-stress environment created by ultrasonic waves, sessile and planktonic biological populations, some of which may undergo programmed cell death (PCD), can be controlled. Additionally, the instability and reduction of biofilm have been observed in systems treated by ultrasound and may be attributed to starvation-stress and lack of available cross-linking cations in the biofilm. (authors)

  20. Ultrasonic treatment for microbiological control of water systems

    Energy Technology Data Exchange (ETDEWEB)

    Broekman, S.; Pohlmann, O.; Beardwooden, E. S.; Cordemans de Meulenaer, E. [Ashland Hercules Water Technologies, Krefeld (Germany)

    2010-08-15

    A combination treatment of shear, micro-bubbles, and high-frequency low-power ultrasound introduced via side-stream treatment of industrial water systems has shown excellent results in controlling bacteria and algae; Through the physical, high-stress environment created by ultrasonic waves, sessile and planktonic biological populations, some of which may undergo programmed cell death (PCD), can be controlled. Additionally, the instability and reduction of biofilm have been observed in systems treated by ultrasound and may be attributed to starvation-stress and lack of available cross-linking cations in the biofilm. (authors)

  1. Low-level radioactive waste treatment systems in northern Europe

    International Nuclear Information System (INIS)

    Sjoeblom, R.

    1987-08-01

    In the United States, the use of low-level waste (LLW) treatment systems by low level waste generators can be expected to expand with increasing costs for disposal and continuing uncertainty over the availability of disposal space. This development increases the need for performance information and operational data and has prompted the US Department of Energy to commission several compilations of LLW systems experience. The present paper summarizes some of the know-how from Northern Europe where the incentive for LLW treatment and volume reduction is very high since deposition space has not been available for many years. 65 refs., 10 figs., 4 tabs

  2. Stochastic responses of tumor–immune system with periodic treatment

    International Nuclear Information System (INIS)

    Li Dong-Xi; Li Ying

    2017-01-01

    We investigate the stochastic responses of a tumor–immune system competition model with environmental noise and periodic treatment. Firstly, a mathematical model describing the interaction between tumor cells and immune system under external fluctuations and periodic treatment is established based on the stochastic differential equation. Then, sufficient conditions for extinction and persistence of the tumor cells are derived by constructing Lyapunov functions and Ito’s formula. Finally, numerical simulations are introduced to illustrate and verify the results. The results of this work provide the theoretical basis for designing more effective and precise therapeutic strategies to eliminate cancer cells, especially for combining the immunotherapy and the traditional tools. (paper)

  3. Developing the public health role of a front line clinical service: integrating stop smoking advice into routine podiatry services.

    Science.gov (United States)

    Gray, Jackie; Eden, Gary; Williams, Maria

    2007-06-01

    Although smoking is a major public health problem, many clinicians do not routinely provide evidence-based health improvement advice to smokers to help them to quit. Plan, Do, Study, Act (PDSA) cycle methodology was used to design and implement a service development so that health improvement advice for smokers featured in all podiatry consultations provided by a Primary Care Trust in North East England. IT systems were developed to record the number and proportion of patients for whom smoking status was assessed, and the number and proportion of smokers who were given advice to quit and referred for specialist support. A questionnaire to staff explored their perceptions of the development on their clinics and consultations. During a 6-month period, smoking status was recorded for all 8831 (100%) patients attending podiatry clinics; 83% of smokers were given brief advice to quit; 7% of smokers were given help to access specialist stop smoking support services. Improvements were introduced within existing budgets and did not prolong clinics. It is straightforward and inexpensive to develop clinical services so that public health guidance is routinely implemented. More widespread implementation of similar service developments could lead to national improvements in public health.

  4. Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Systemic Treatment.

    Science.gov (United States)

    Kim, Jung Eun; Kim, Hyun Jeong; Lew, Bark-Lynn; Lee, Kyung Ho; Hong, Seung Phil; Jang, Yong Hyun; Park, Kui Young; Seo, Seong Jun; Bae, Jung Min; Choi, Eung Ho; Suhr, Ki Beom; Lee, Seung Chul; Ko, Hyun Chang; Park, Young Lip; Son, Sang Wook; Seo, Young Jun; Lee, Yang Won; Cho, Sang Hyun; Park, Chun Wook; Roh, Joo Young

    2015-10-01

    Since the treatment guidelines for atopic dermatitis (AD) were issued by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been further advances in the systemic treatment of AD. We aimed to establish updated evidence- and experience-based systemic treatment guidelines for Korean AD. We compiled a database of references from relevant systematic reviews and guidelines regarding the systemic management of AD, including antihistamines, antimicrobials, systemic immunomodulators, allergen-specific immunotherapy, phototherapy, adjunctive treatment, and complementary and alternative medicines. Evidence for each statement was graded and classified based on the strength of the recommendation. Thirty-nine council members of KADA participated in the three rounds of votes and expert consensus recommendations were established. The use of antihistamines is recommended to relieve pruritus and to prevent exacerbation due to scratching in AD patients. Infection should be controlled as needed and long-term medication should be avoided. For moderate to severe AD patients, concomitant active treatments with systemic immunomodulators are indicated. Cyclosporine is the first choice among systemic immunomodulators and others should be considered as second-line alternatives. Allergen-specific immunotherapy could be effective in AD patients with aeroallergen hypersensitivity. Phototherapy can be useful for moderate to severe AD patients and narrow-band ultraviolet B is the most effective option. Complementary and alternative medicines cannot be recommended for treating AD. We expect these recommendations to be a reference guide for physicians and AD patients in choosing the appropriate treatment to improve quality of life and decrease unnecessary social medical costs.

  5. STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

    Directory of Open Access Journals (Sweden)

    M. Majlesi Nasr, A. R. Yazdanbakhsh

    2008-07-01

    Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

  6. Systemic multimodal approach to speech therapy treatment in autistic children.

    Science.gov (United States)

    Tamas, Daniela; Marković, Slavica; Milankov, Vesela

    2013-01-01

    Conditions in which speech therapy treatment is applied in autistic children are often not in accordance with characteristics of opinions and learning of people with autism. A systemic multimodal approach means motivating autistic people to develop their language speech skill through the procedure which allows reliving of their personal experience according to the contents that are presented in the their natural social environment. This research was aimed at evaluating the efficiency of speech treatment based on the systemic multimodal approach to the work with autistic children. The study sample consisted of 34 children, aged from 8 to 16 years, diagnosed to have different autistic disorders, whose results showed a moderate and severe clinical picture of autism on the Childhood Autism Rating Scale. The applied instruments for the evaluation of ability were the Childhood Autism Rating Scale and Ganzberg II test. The study subjects were divided into two groups according to the type of treatment: children who were covered by the continuing treatment and systemic multimodal approach in the treatment, and children who were covered by classical speech treatment. It is shown that the systemic multimodal approach in teaching autistic children affects the stimulation of communication, socialization, self-service and work as well as that the progress achieved in these areas of functioning was retainable after long time, too. By applying the systemic multimodal approach when dealing with autistic children and by comparing their achievements on tests applied before, during and after the application of this mode, it has been concluded that certain improvement has been achieved in the functionality within the diagnosed category. The results point to a possible direction in the creation of new methods, plans and programs in dealing with autistic children based on empirical and interactive learning.

  7. Safety in wastewater treatment: the pure oxygen system

    International Nuclear Information System (INIS)

    Giagnoni, L.

    1998-01-01

    Though the active sludge process represent, nowadays, the main reference system referring to installations for wastewater treatments, nevertheless systems that exploit the pure oxygen properties constitute an alternative method to the traditional cycle. The following essay is divided into two parts: the first one deals with the fundamental concepts related to the active sludge process and to the alternative system proposed, mentioned before, and includes a short account of the functional characteristics and a brief comparison with traditional methods; the second part represents the head corpus of the work and deals with the problems related to the safety with particular reference to the risk of an explosion meanwhile the process. Moreover, it's drawn attention to the fundamental role of security systems that, nowadays, get frequently used in such kind of installations. On this subject, furthermore, it's pointed out the great importance of the whole preliminary treatments in the planning phase, with particular reference to the processes used for stripping [it

  8. A computer aided treatment event recognition system in radiation therapy

    International Nuclear Information System (INIS)

    Xia, Junyi; Mart, Christopher; Bayouth, John

    2014-01-01

    Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when

  9. A computer aided treatment event recognition system in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Xia, Junyi, E-mail: junyi-xia@uiowa.edu; Mart, Christopher [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Bayouth, John [Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Human Oncology, University of Wisconsin - Madison, 600 Highland Avenue, K4/B55, Madison, Wisconsin 53792-0600 (United States)

    2014-01-15

    Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when

  10. Integration of energy and environmental systems in wastewater treatment plants

    Energy Technology Data Exchange (ETDEWEB)

    Long, Suzanna [Department of Engineering Management and Systems Engineering, 600 W, 14th Street, 215 EMGT Building, Rolla, MO-65401, 573-341-7621 (United States); Cudney, Elizabeth [Department of Engineering Management and Systems Engineering, 600 W, 14th Street, 217 EMGT Building, Rolla, MO-65401, 573-341-7931 (United States)

    2012-07-01

    Most wastewater treatment facilities were built when energy costs were not a concern; however, increasing energy demand, changing climatic conditions, and constrained energy supplies have resulted in the need to apply more energy-conscious choices in the maintenance or upgrade of existing wastewater treatment facilities. This research develops an integrated energy and environmental management systems model that creates a holistic view of both approaches and maps linkages capable of meeting high-performing energy management while meeting environmental standards. The model has been validated through a case study on the Rolla, Missouri Southeast Wastewater Treatment Plant. Results from plant performance data provide guidance to improve operational techniques. The significant factors contributing to both energy and environmental systems are identified and balanced against considerations of cost.

  11. Textile wastewater treatment: aerobic granular sludge vs activated sludge systems.

    Science.gov (United States)

    Lotito, Adriana Maria; De Sanctis, Marco; Di Iaconi, Claudio; Bergna, Giovanni

    2014-05-01

    Textile effluents are characterised by high content of recalcitrant compounds and are often discharged (together with municipal wastewater to increase their treatability) into centralized wastewater treatment plants with a complex treatment scheme. This paper reports the results achieved adopting a granular sludge system (sequencing batch biofilter granular reactor - SBBGR) to treat mixed municipal-textile wastewater. Thanks to high average removals in SBBGR (82.1% chemical oxygen demand, 94.7% total suspended solids, 87.5% total Kjeldahl nitrogen, 77.1% surfactants), the Italian limits for discharge into a water receiver can be complied with the biological stage alone. The comparison with the performance of the centralized plant treating the same wastewater has showed that SBBGR system is able to produce an effluent of comparable quality with a simpler treatment scheme, a much lower hydraulic residence time (11 h against 30 h) and a lower sludge production. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. A Decision Fusion Framework for Treatment Recommendation Systems.

    Science.gov (United States)

    Mei, Jing; Liu, Haifeng; Li, Xiang; Xie, Guotong; Yu, Yiqin

    2015-01-01

    Treatment recommendation is a nontrivial task--it requires not only domain knowledge from evidence-based medicine, but also data insights from descriptive, predictive and prescriptive analysis. A single treatment recommendation system is usually trained or modeled with a limited (size or quality) source. This paper proposes a decision fusion framework, combining both knowledge-driven and data-driven decision engines for treatment recommendation. End users (e.g. using the clinician workstation or mobile apps) could have a comprehensive view of various engines' opinions, as well as the final decision after fusion. For implementation, we leverage several well-known fusion algorithms, such as decision templates and meta classifiers (of logistic and SVM, etc.). Using an outcome-driven evaluation metric, we compare the fusion engine with base engines, and our experimental results show that decision fusion is a promising way towards a more valuable treatment recommendation.

  13. Following celebrities’ medical advice: meta-narrative analysis

    Science.gov (United States)

    Tan, Charlie

    2013-01-01

    Objective To synthesise what is known about how celebrities influence people’s decisions on health. Design Meta-narrative analysis of economics, marketing, psychology, and sociology literatures. Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-). Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context. Results Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital. Conclusions The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.

  14. Validation Aspects of Water Treatment Systems for Pharmaceutical ...

    African Journals Online (AJOL)

    The goal of conducting validation is to demonstrate that a process, when operated within established limits, produces a product of consistent and specified quality with a high degree of assurance. Validation of water treatment systems is necessary to obtain water with all desired quality attributes. This also provides a ...

  15. Immune system as a vital partner in cancer treatment

    Czech Academy of Sciences Publication Activity Database

    Říhová, Blanka; Etrych, Tomáš; Šírová, Milada; Šubr, Vladimír; Ulbrich, Karel

    2015-01-01

    Roč. 8, Supplement 1 (2015), s. 37 ISSN 1875-2292. [7th International Conference on Tumor Microenvironment. 11.10.2015-15.10.2015, Tel Aviv] Institutional support: RVO:61388971 ; RVO:61389013 Keywords : Immune system * cancer treatment * nanomedicines Subject RIV: EC - Immunology OBOR OECD: Immunology

  16. Treatment outcome in early diffuse cutaneous systemic sclerosis

    DEFF Research Database (Denmark)

    Herrick, Ariane L; Pan, Xiaoyan; Peytrignet, Sébastien

    2017-01-01

    OBJECTIVES: The rarity of early diffuse cutaneous systemic sclerosis (dcSSc) makes randomised controlled trials very difficult. We aimed to use an observational approach to compare effectiveness of currently used treatment approaches. METHODS: This was a prospective, observational cohort study...

  17. Constructed Wetland Treatment Systems For Water Quality Improvement

    International Nuclear Information System (INIS)

    Nelson, E.

    2010-01-01

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m 3 per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m 3 of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m 3 per day, and be able to handle 9,690 m 3 of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during the first season of

  18. CONSTRUCTED WETLAND TREATMENT SYSTEMS FOR WATER QUALITY IMPROVEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, E.

    2010-07-19

    The Savannah River National Laboratory implemented a constructed wetland treatment system (CWTS) in 2000 to treat industrial discharge and stormwater from the Laboratory area. The industrial discharge volume is 3,030 m{sup 3} per day with elevated toxicity and metals (copper, zinc and mercury). The CWTS was identified as the best treatment option based on performance, capital and continuing cost, and schedule. A key factor for this natural system approach was the long-term binding capacity of heavy metals (especially copper, lead, and zinc) in the organic matter and sediments. The design required that the wetland treat the average daily discharge volume and be able to handle 83,280 m{sup 3} of stormwater runoff in a 24 hour period. The design allowed all water flow within the system to be driven entirely by gravity. The CWTS for A-01 outfall is composed of eight one-acre wetland cells connected in pairs and planted with giant bulrush to provide continuous organic matter input to the system. The retention basin was designed to hold stormwater flow and to allow controlled discharge to the wetland. The system became operational in October of 2000 and is the first wetland treatment system permitted by South Carolina DHEC for removal of metals. Because of the exceptional performance of the A-01 CWTS, the same strategy was used to improve water quality of the H-02 outfall that receives discharge and stormwater from the Tritium Area of SRS. The primary contaminants in this outfall were also copper and zinc. The design for this second system required that the wetland treat the average discharge volume of 415 m{sup 3} per day, and be able to handle 9,690 m{sup 3} of stormwater runoff in a 24 hour period. This allowed the building of a system much smaller than the A-01 CWTS. The system became operational in July 2007. Metal removal has been excellent since water flow through the treatment systems began, and performance improved with the maturation of the vegetation during

  19. Health professionals' advice for breastfeeding problems: not good enough!

    Science.gov (United States)

    Amir, Lisa H; Ingram, Jennifer

    2008-09-11

    Jane Scott and colleagues have recently published a paper in the International Breastfeeding Journal showing that health professionals are still giving harmful advice to women with mastitis. We see the management of mastitis as an illustration of health professionals' management of wider breastfeeding issues. If health professionals don't know how to manage this common problem, how can they be expected to manage less common conditions such as a breast abscess or nipple/breast candidiasis? There is an urgent need for more clinical research into breastfeeding problems and to improve the education of health professionals to enable them to promote breastfeeding and support breastfeeding women.

  20. Policy Advice to Alberta’s New Premier

    Directory of Open Access Journals (Sweden)

    Jack M. Mintz

    2014-09-01

    Full Text Available On September 6th, 2014, members of the Progressive Conservative Party of Alberta elected Jim Prentice as leader of their party, and Premier of Alberta. The School of Public Policy assembled its key thinkers in economic, taxation, energy and natural resource policy to provide unsolicited but important advice to Premier Prentice on some areas of policy that matter most to Alberta, and that will demand the Premier’s attention as he takes office. These are opinion pieces, are not peer reviewed, and reflect the views of their authors alone.

  1. More about software requirements thorny issues and practical advice

    CERN Document Server

    Wiegers, Karl E

    2006-01-01

    No matter how much instruction you've had on managing software requirements, there's no substitute for experience. Too often, lessons about requirements engineering processes lack the no-nonsense guidance that supports real-world solutions. Complementing the best practices presented in his book, Software Requirements, Second Edition, requirements engineering authority Karl Wiegers tackles even more of the real issues head-on in this book. With straightforward, professional advice and practical solutions based on actual project experiences, this book answers many of the tough questions rais

  2. Health professionals' advice for breastfeeding problems: Not good enough!

    Directory of Open Access Journals (Sweden)

    Amir Lisa H

    2008-09-01

    Full Text Available Abstract Jane Scott and colleagues have recently published a paper in the International Breastfeeding Journal showing that health professionals are still giving harmful advice to women with mastitis. We see the management of mastitis as an illustration of health professionals' management of wider breastfeeding issues. If health professionals don't know how to manage this common problem, how can they be expected to manage less common conditions such as a breast abscess or nipple/breast candidiasis? There is an urgent need for more clinical research into breastfeeding problems and to improve the education of health professionals to enable them to promote breastfeeding and support breastfeeding women.

  3. Hazardous Waste Treatment Facility and skid-mounted treatment systems at Los Alamos

    International Nuclear Information System (INIS)

    Lussiez, G.W.; Zygmunt, S.J.

    1994-01-01

    To centralize treatment, storage, and areas for hazardous wastes, Los Alamos National Laboratory has designed a 1115 m2 hazardous waste treatment facility. The facility will house a treatment room for each of four kinds of wastes: nonradioactive characteristic wastes, nonradioactive listed wastes, radioactive characteristic wastes, and radioactive listed wastes. The facility will be used for repacking labpacks; bulking small organic waste volumes; processing scintillation vials; treating reactives such as lithium hydride and pyrophoric uranium; treating contaminated solids such as barium sand; treating plating wastes and other solutions with heavy metals and oxidizing organics: Separate treatment rooms will allow workers to avoid mixing waste types and prevent cross-contamination. The ventilation air from the treatment areas may contain hazardous or radioactive dust. Gas may also leak from process equipment. The gas treatment process includes separating solids and gases and neutralization or adsorption of the hazardous gases. The ventilation air from each room will first be filtered before being scrubbed in a common gas caustic scrubber on an outside pad. There are two levels of exhaust in each treatment room, one for heavy gases and another for light gases. Several features help mitigate or eliminate hazards due to spills and releases: each treatment room is sealed and under slight negative pressure; each room has its own HEPA filtration; to avoid mixing of incompatible wastes and reagents, portable individual spill-containment trays are used for skids, to limit the danger of spills, the waste is directly transferred from outside storage to the treatment room; to mitigate the consequences of a gas release in the room, mobile hoods are connected to the exhaust-air treatment system; the floor, walls, ceilings, fixtures, ducts, and piping are made of acid-resistant material or are coated

  4. From single-species advice to mixed-species management: taking the next step

    DEFF Research Database (Denmark)

    Vinther, Morten; Reeves, S.A.; Patterson, K.R.

    2004-01-01

    Fishery management advice has traditionally been given on a stock-by-stock basis. Recent problems in implementing this advice, particularly for the demersal fisheries of the North Sea, have highlighted the limitations of the approach. In the long term, it would be desirable to give advice...... that accounts for mixed-fishery effects, but in the short term there is a need for approaches to resolve the conflicting management advice for different species within the same fishery, and to generate catch or effort advice that accounts for the mixed-species nature of the fishery. This paper documents...... a recent approach used to address these problems. The approach takes the single-species advice for each species in the fishery as a starting point, then attempts to resolve it into consistent catch or effort advice using fleet-disaggregated catch forecasts in combination with explicitly stated management...

  5. Parenting an overweight or obese teen; issues and advice from parents

    Science.gov (United States)

    Boutelle, Kerri N.; Feldman, Shira; Neumark-Sztainer, Dianne

    2013-01-01

    Objective This qualitative study addresses: 1) What challenges do parents of overweight adolescents face? 2) What advice do parents of overweight adolescents have for other parents? Design One-on-one interviews were conducted with 27 parents of overweight or previously overweight adolescents Setting Medical clinic at the University of Minnesota Participants 27 parents of adolescents (12-19 years) who were either currently or previously overweight recruited from the community Main Outcome Measures. Qualitative interviews related to parenting overweight adolescents Analysis Content analysis was used to identify themes regarding parental experiences. Results Issues most frequently mentioned: 1) uncertainty regarding effective communication with adolescent about weight-related topics, 2) inability to control adolescent’s decisions around healthy eating and activity behaviors, 3) concern for adolescent’s well-being, 4) parental feeling of responsibility/guilt. Parental advice most often provided included: 1) setting up healthy home environment, 2) parental role modeling of healthy behaviors, and 3) providing support/encouragement for positive efforts. Conclusions Topics for potential intervention development include communication and motivation of adolescents regarding weight-related topics, appropriate autonomy, and addressing negative emotions concerning the adolescent’s weight status. Targeting these topics could potentially improve acceptability and outcomes for treatments. PMID:22770833

  6. A record and verify system for radiotherapy treatment

    International Nuclear Information System (INIS)

    Koens, M.L.; Vroome, H. de

    1984-01-01

    The Record and Verify system developed for the radiotherapy department of the Leiden University Hospital is described. The system has been in use since 1980 and will now be installed in at least four of the Dutch University Hospitals. The system provides the radiographer with a powerful tool for checking the set-up of the linear accelerator preceeding the irradiation of a field. After the irradiation of a field the machine settings are registered in the computer system together with the newly calculated cumulative dose. These registrations are used by the system to produce a daily report which provides the management of the department with insight into the established differences between treatment and treatment planning. Buying a record and verify system from the manufacturer of the linear accelerator is not an optimal solution especially for a department with more than one accelerator from different manufacturers. Integration in a Hospital Information System (HIS) has important advantages over the development of a dedicated departmental system. (author)

  7. Development of laundry drainage treatment system with ceramic ultra filter

    International Nuclear Information System (INIS)

    Kanda, Masanori; Kurahasi, Takafumi

    1995-01-01

    A compact laundry drainage treatment system (UF system hereafter) with a ceramic ultra filter membrane (UF membrane hereafter) has been developed to reduce radioactivity in laundry drainage from nuclear power plants. The UF membrane is made of sintered fine ceramic. The UF membrane has 0.01 μm fine pores, resulting in a durable, heat-resistant, and corrosion-resistant porous ceramic filter medium. A cross-flow system, laundry drainage is filtrated while it flows across the UF membrane, is used as the filtration method. This method creates less caking when compared to other methods. The UF membrane is back washed at regular intervals with permeated water to minimize caking of the filter. The UF membrane and cross-flow system provides long stable filtration. The ceramic UF membrane is strong enough to concentrate suspended solids in laundry drainage up to a weight concentration of 10%. The final concentrated laundry drainage can be treated in an incinerator. The performance of the UF system was checked using radioactive laundry drainage. The decontamination factor of the UF system was 25 or more. The laundry drainage treatment capacity and concentration ratio of the UF system, as well as the service life of the UF membrane were also checked by examination using simulated non-radioactive laundry drainage. Even though laundry drainage was concentrated 1000 times, the UF system showed good permeated water quality and permeated water flux. (author)

  8. Process waste treatment system upgrades: Clarifier startup at the nonradiological wastewater treatment plant

    International Nuclear Information System (INIS)

    Lucero, A.J.; McTaggart, D.R.; Van Essen, D.C.; Kent, T.E.; West, G.D.; Taylor, P.A.

    1998-07-01

    The Waste Management Operations Division at Oak Ridge National Laboratory recently modified the design of a reactor/clarifier at the Nonradiological Wastewater Treatment Plant, which is now referred to as the Process Waste Treatment Complex--Building 3608, to replace the sludge-blanket softener/clarifier at the Process Waste Treatment Plant, now referred to as the Process Waste Treatment Complex-Building 3544 (PWTC-3544). This work was conducted because periodic hydraulic overloads caused poor water-softening performance in the PWTC-3544 softener, which was detrimental to the performance and operating costs of downstream ion-exchange operations. Over a 2-month time frame, the modified reactor/clarifier was tested with nonradiological wastewater and then with radioactive wastewater to optimize softening performance. Based on performance to date, the new system has operated more effectively than the former one, with reduced employee radiological exposure, less downtime, lower costs, and improved effluent quality

  9. Design of safeguards information treatment system at the facility level

    Energy Technology Data Exchange (ETDEWEB)

    Song, Dae Yong; Lee, Byung Doo; Kwack, Eun Ho; Choi, Young Myong

    2001-05-01

    We are developing Safeguards Information Treatment System at the facility level(SITS) to manage synthetically safeguards information and to implement efficiently the obligations under the Korea-IAEA Safeguards Agreement, bilateral agreements with other countries and domestic law. In this report, we described the contents of the detailed design of SITS such as database, I/O layout and program. In the present, we are implementing the SITS based on the contents of the design of SITS, and then we plan to provide the system for the facilities after we finish implementing and testing the system.

  10. Effluent treatment options for nuclear thermal propulsion system ground tests

    International Nuclear Information System (INIS)

    Shipers, L.R.; Brockmann, J.E.

    1992-01-01

    A variety of approaches for handling effluent from nuclear thermal propulsion system ground tests in an environmentally acceptable manner are discussed. The functional requirements of effluent treatment are defined and concept options are presented within the framework of these requirements. System concepts differ primarily in the choice of fission-product retention and waste handling concepts. The concept options considered range from closed cycle (venting the exhaust to a closed volume or recirculating the hydrogen in a closed loop) to open cycle (real time processing and venting of the effluent). This paper reviews the strengths and weaknesses of different methods to handle effluent from nuclear thermal propulsion system ground tests

  11. Design of safeguards information treatment system at the facility level

    International Nuclear Information System (INIS)

    Song, Dae Yong; Lee, Byung Doo; Kwack, Eun Ho; Choi, Young Myong

    2001-05-01

    We are developing Safeguards Information Treatment System at the facility level(SITS) to manage synthetically safeguards information and to implement efficiently the obligations under the Korea-IAEA Safeguards Agreement, bilateral agreements with other countries and domestic law. In this report, we described the contents of the detailed design of SITS such as database, I/O layout and program. In the present, we are implementing the SITS based on the contents of the design of SITS, and then we plan to provide the system for the facilities after we finish implementing and testing the system

  12. A vision fusion treatment system based on ATtiny26L

    Science.gov (United States)

    Zhang, Xiaoqing; Zhang, Chunxi; Wang, Jiqiang

    2006-11-01

    Vision fusion treatment is an important and effective project to strabismus children. The vision fusion treatment system based on the principle for eyeballs to follow the moving visual survey pole is put forward first. In this system the original position of visual survey pole is about 35 centimeters far from patient's face before its moving to the middle position between the two eyeballs. The eyeballs of patient will follow the movement of the visual survey pole. When they can't follow, one or two eyeballs will turn to other position other than the visual survey pole. This displacement is recorded every time. A popular single chip microcomputer ATtiny26L is used in this system, which has a PWM output signal to control visual survey pole to move with continuously variable speed. The movement of visual survey pole accords to the modulating law of eyeballs to follow visual survey pole.

  13. In Situ Modular Waste Retrieval and Treatment System

    International Nuclear Information System (INIS)

    Walker, M.S.

    1996-10-01

    As part of the Comprehensive Environmental Response, Compensation, and Liability Act process from remediation of Waste Area Grouping (WAG 6) at ORNL, a public meeting was held for the Proposed Plan. It was recognized that contaminant releases from WAG 6 posed minimal potential risk to the public and the environment. The US DOE in conjunction with the US EPA and the TDEC agreed to defer remedial action at WAG 6 until higher risk release sites were first remediated. This report presents the results of a conceptual design for an In Situ Modular Retrieval and Treatment System able to excavate, shred, and process buried waste on site, with minimum disturbance and distribution of dust and debris. the system would bring appropriate levels of treatment to the waste then encapsulate and leave it in place. The system would be applicable to areas in which waste was disposed in long trenches

  14. A research-oriented treatment planning program system

    International Nuclear Information System (INIS)

    Kalet, I.J.; Jacky, J.P.

    1982-01-01

    The function of a treatment planning program is to graphically simulate radiation dose distributions from proposed radiation therapy treatments. While many such programs are available which provide this much-needed service, none addresses the question of how to intercompare calculation and display techniques. This paper describes a program system designed for support of research efforts, particularly development and testing of new calculation algorithms. The system emphasizes a modular flexible structure, enabling programs to be developed somewhat as interchangeable parts. Thus multiple variants of a calculation algorithm can be compared without undue software overhead or additional data management. Unusual features of the system include extensive use of command procedures, logical names and a structured language (PASCAL). These features are described along with other implementation details. Obstacles, limitations and future applications are also discussed. (Auth.)

  15. INTEC CPP-603 Basin Water Treatment System Closure: Process Design

    Energy Technology Data Exchange (ETDEWEB)

    Kimmitt, Raymond Rodney; Faultersack, Wendell Gale; Foster, Jonathan Kay; Berry, Stephen Michael

    2002-09-01

    This document describes the engineering activities that have been completed in support of the closure plan for the Idaho Nuclear Technology and Engineering Center (INTEC) CPP-603 Basin Water Treatment System. This effort includes detailed assessments of methods and equipment for performing work in four areas: 1. A cold (nonradioactive) mockup system for testing equipment and procedures for vessel cleanout and vessel demolition. 2. Cleanout of process vessels to meet standards identified in the closure plan. 3. Dismantlement and removal of vessels, should it not be possible to clean them to required standards in the closure plan. 4. Cleanout or removal of pipelines and pumps associated with the CPP-603 basin water treatment system. Cleanout standards for the pipes will be the same as those used for the process vessels.

  16. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    International Nuclear Information System (INIS)

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy's (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled open-quotes Integrated Thermal Treatment System Study - Phase 1 Resultsclose quotes (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was open-quotes to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.close quotes The study also open-quotes identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.close quotes This study evaluated ten primary thermal treatment technologies, organized into complete open-quotes cradle-to-graveclose quotes systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews

  17. The treatment implementation advisor: a component of the GypsES project

    Science.gov (United States)

    Michael C. Saunders; Michael A. Foster

    1991-01-01

    The treatment implementation advisor is one of the knowledge based advisory modules of GypsES, a knowledge system environment for decision support in gypsy moth management. Its function is to provide detailed advice on intervention tactics for gypsy moth: e.g. aerial and ground application of insecticides and microbials, inundative or augmentative releases of...

  18. Modelling of treatment couch top with prowess panther treatment planning system for external beam radiotherapy

    International Nuclear Information System (INIS)

    Owusu-Agyapong, Linus

    2016-07-01

    The aim of this work is to evaluate the attenuation effects of a treatment couch and to alternatively model the couch top material with a Prowess Panther treatment planning system which does not support couch top modelling. The Hounsfield Unit classification of the couch structure was determined using a PMMA phantom by comparing ion chamber measurements with the dose forecasted by the treatment planning system (TPS). The transmission factor (TF) of the couch top was determined and was used as a TF for a treatment accessory that represented the treatment couch in the TPS. A treatment plan was done for various angles with and without the interference of the couch top and a simulated treatment was done using the PMMA phantom. Ion chamber measurement were made and compared with dose predicted by the TPS to evaluate the accuracy of the couch top modelling in the treatment planning system TPS. These investigations were done for various field sizes. The ideal set of HU for the couch was established to be -674. The measured TF was 0.956042 and the TPS calculated Transmission factor was 0.951456. The percentage difference between the measured and calculated TFs was 0.48% and this agrees perfectly with the IAEA recommended tolerance of 2%. Relative attenuation measurements were as high as 54.16% and as low as 0.63% for the beams that exited the couch before interacting with the phantom. In comparing couch modelling by couch simulation and couch TF insert, it was observed that the normalized doses were the same for 5×5 square field but deviated approximately 1% for the other field sizes. The highest deviation was observed at 10×10 square field. This study demonstrates that the couch simulation method of couch modelling is the best method that can be used to account for the effect of the treatment couch top on intersecting posterior beam fields. Thus, the attenuation effects of the treatment couch was effectively evaluated and the couch top material accurately modelled in

  19. A review of virus removal in wastewater treatment pond systems.

    Science.gov (United States)

    Verbyla, Matthew E; Mihelcic, James R

    2015-03-15

    Wastewater treatment ponds (lagoons) are one of the most common types of technologies used for wastewater management worldwide, especially in small cities and towns. They are particularly well-suited for systems where the effluent is reused for irrigation. However, the efficiency of virus removal in wastewater treatment pond systems is not very well understood. The main objective of this paper is to critically review the major findings related to virus removal in wastewater treatment pond systems and to statistically analyze results reported in the literature from field studies on virus removal in these systems. A comprehensive analysis of virus removal reported in the literature from 71 different wastewater treatment pond systems reveals only a weak to moderate correlation of virus removal with theoretical hydraulic retention time. On average, one log10 reduction of viruses was achieved for every 14.5-20.9 days of retention, but the 95th percentile value of the data analyzed was 54 days. The mechanisms responsible for virus removal in wastewater treatment ponds were also reviewed. One recent finding is that sedimentation may not be a significant virus removal mechanism in some wastewater ponds. Recent research has also revealed that direct and indirect sunlight-mediated mechanisms are not only dependent on pond water chemistry and optics, but also on the characteristics of the virus and its genome. MS2 coliphage is considered to be the best surrogate for studying sunlight disinfection in ponds. The interaction of viruses with particles, with other microorganisms, and with macroinvertebrates in wastewater treatment ponds has not been extensively studied. It is also unclear whether virus internalization by higher trophic-level organisms has a protective or a detrimental effect on virus viability and transport in pond systems. Similarly, the impact of virus-particle associations on sunlight disinfection in ponds is not well understood. Future research should focus on

  20. The place of the clock in pediatric advice: rationales, cultural themes, and impediments to breastfeeding.

    Science.gov (United States)

    Millard, A V

    1990-01-01

    This analysis treats the U.S. medical literature as evidence concerning the formal system of knowledge in allopathic medicine. An examination of pediatric advice on breastfeeding reveals the logic of medical reasoning, the use of scientific rationales, and the intrusion of specific cultural themes. The corpus of data includes works of 18 authors published in 36 volumes from 1897 to 1987, 27 volumes being editions of two major pediatric textbooks. All sources advocate breastfeeding but the detailed advice on how to carry out the process actually tends to undermine it. Moreover, the clock has provided the main frame of reference, creating regimentation reminiscent of factory work, segmenting breastfeeding into a series of steps, and emphasizing efficiency in time and motion. Feeding schedules were advocated in former decades as a matter of discipline for the infant, but nowadays they are viewed as biologically innate to normal infants and to breast milk production. The literature manifests responses over the century to behavioral, biochemical and physiological studies; however, except possibly for one textbook, no thorough rethinking has occurred. Sources of the 1980s continue to focus on the tempo of feeding as a major concern. Cultural themes besides the factory model of breastfeeding include the extension of professional advice to family matters, the subordination of lay women to professional expertise, mistrust of women's bodily signals including the let-down reflex in determining the timing of feedings, mistrust of signals from infants as well, and a professional ideal of flexible advice coupled with rigid limits concerning schedules. The literature interweaves the cultural themes with rationales based on physiological studies in support of specific regimens in breastfeeding, and the relegation of control in breastfeeding to medical experts denies the validity of mutual bodily and emotional responses within the mother-infant dyad. Pediatric authorities thus

  1. New electrochemical and photochemical systems for water and wastewater treatment

    International Nuclear Information System (INIS)

    Sarria, Victor M; Parra, Sandra; Rincon, Angela G; Torres, Ricardo A; Pulgarin, Cesar

    2005-01-01

    With the increasing pressure on a more effective use of water resources, the development of appropriate water treatment technologies become more and more important. Photochemical and electrochemical oxidation processes have been proposed in recent years as an attractive alternative for the treatment of contaminated water containing anthropogenic substances hardly biodegradable as well as to purify and disinfect drinking waters. The aim of this paper is to present some of our last results demonstrating that electrochemical, photochemical, and the coupling of these processes with biological systems are very promising alternatives for the improvement of the water quality

  2. Delivering effective science communication: advice from a professional science communicator.

    Science.gov (United States)

    Illingworth, Sam

    2017-10-01

    Science communication is becoming ever more prevalent, with more and more scientists expected to not only communicate their research to a wider public, but to do so in an innovative and engaging manner. Given the other commitments that researchers and academics are required to fulfil as part of their workload models, it is unfair to be expect them to also instantly produce effective science communication events and activities. However, by thinking carefully about what it is that needs to be communicated, and why this is being done, it is possible to develop high-quality activities that are of benefit to both the audience and the communicator(s). In this paper, I present some practical advice for developing, delivering and evaluating effective science communication initiatives, based on over a decade of experience as being a professional science communicator. I provide advice regarding event logistics, suggestions on how to successfully market and advertise your science communication initiatives, and recommendations for establishing effective branding and legacy. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Unrealistic optimism in advice taking: A computational account.

    Science.gov (United States)

    Leong, Yuan Chang; Zaki, Jamil

    2018-02-01

    Expert advisors often make surprisingly inaccurate predictions about the future, yet people heed their suggestions nonetheless. Here we provide a novel, computational account of this unrealistic optimism in advice taking. Across 3 studies, participants observed as advisors predicted the performance of a stock. Advisors varied in their accuracy, performing reliably above, at, or below chance. Despite repeated feedback, participants exhibited inflated perceptions of advisors' accuracy, and reliably "bet" on advisors' predictions more than their performance warranted. Participants' decisions tightly tracked a computational model that makes 2 assumptions: (a) people hold optimistic initial expectations about advisors, and (b) people preferentially incorporate information that adheres to their expectations when learning about advisors. Consistent with model predictions, explicitly manipulating participants' initial expectations altered their optimism bias and subsequent advice-taking. With well-calibrated initial expectations, participants no longer exhibited an optimism bias. We then explored crowdsourced ratings as a strategy to curb unrealistic optimism in advisors. Star ratings for each advisor were collected from an initial group of participants, which were then shown to a second group of participants. Instead of calibrating expectations, these ratings propagated and exaggerated the unrealistic optimism. Our results provide a computational account of the cognitive processes underlying inflated perceptions of expertise, and explore the boundary conditions under which they occur. We discuss the adaptive value of this optimism bias, and how our account can be extended to explain unrealistic optimism in other domains. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  4. In Vivo Diode Dosimetry for Imrt Treatments Generated by Pinnacle Treatment Planning System

    International Nuclear Information System (INIS)

    Alaei, Parham; Higgins, Patrick D.; Gerbi, Bruce J.

    2009-01-01

    Dose verification using diodes has been proposed and used for intensity modulated radiation therapy (IMRT) treatments. We have previously evaluated diode response for IMRT deliveries planned with the Eclipse/Helios treatment planning system. The Pinnacle treatment planning system generates plans that are delivered in a different fashion than Eclipse. Whereas the Eclipse-generated segments are delivered in organized progression from one side of each field to the other, Pinnacle-generated segments are delivered in a much more randomized fashion to different areas within the field. This makes diode measurements at a point more challenging because the diode may be exposed fully or partially to multiple small segments during one single field's treatment as opposed to being exposed to very few segments scanning across the diode during an Eclipse-generated delivery. We have evaluated in vivo dosimetry for Pinnacle-generated IMRT plans and characterized the response of the diode to various size segments on phantom. We present results of patient measurements on approximately 300 fields, which show that 76% of measurements agree to within 10% of the treatment-plan generated calculated doses. Of the other 24%, about 11% are within 15% of the calculated dose. Comparison of these with phantom measurements indicates that many of the discrepancies are due to diode positioning on patients and increased diode response at short source-to-surface distances (SSDs), with the remainder attributable to other factors such as segment size and partial irradiation of the diode

  5. Development of Nuclear Control and Management Information Treatment System

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, J. G.; Lee, B. D.; So, D. S. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2007-07-01

    To implement obligations under the Non-Proliferation Treaty (NPT) and the bilateral agreements more effectively, we proposed a computerized system named the Nuclear Control and Management Information Treatment System (NCAMITS) as a part of the Nuclear Transparency Enhancement Project at the Korea Atomic Energy Research Institute (KAERI). The database system is designed not only to undertake the facility-level accounting for and control of nuclear material at KAERI, but also to meet the requirements of the State (National) System of Accounting and Control (SSAC). Since the NCAMITS will provide services for the facility operators as well as the safeguard information managers at KAERI, the development of the system is supposed to accommodate the end-user's convenience and the manager's sophisticated specifications as well.

  6. Decision making in treatment strategy of AVMs. Treatment board system at Tohoku University

    International Nuclear Information System (INIS)

    Jokura, Hidefumi; Yoshimoto, Takashi

    1999-01-01

    Treatment of some large, deep-seated arteriovenous malformations is still a challenge to neurosurgeons. The recent development of non-invasive imaging modalities has increased the chance of finding asymptomatic AVM's, for which evaluation for treatment is more complicated than in symptomatic cases. Currently there are 3 major treatment options for AVM: microsurgical removal, radiosurgery, and intravascular embolization. It is not easy to choose the best single modality or combination of modalities for individual patients, who have different types of onset, neurological deficits, size and location, and social background. After the installation of the Gamma Knife in November 1991, we established an 'AVM Treatment Board.' It comprises vascular neurosurgeons, endovascular neurosurgeons, and radio-neurosurgeons, and meetings are held twice a month. Every AVM case referred to us is presented to the board, and treatment strategy is selected after a discussion among experts who know the advantages and drawbacks of each treatment modality. We describe this board system in detail and emphasize the importance of gathering expertise in decision making. (author)

  7. The stochastic system approach for estimating dynamic treatments effect.

    Science.gov (United States)

    Commenges, Daniel; Gégout-Petit, Anne

    2015-10-01

    The problem of assessing the effect of a treatment on a marker in observational studies raises the difficulty that attribution of the treatment may depend on the observed marker values. As an example, we focus on the analysis of the effect of a HAART on CD4 counts, where attribution of the treatment may depend on the observed marker values. This problem has been treated using marginal structural models relying on the counterfactual/potential response formalism. Another approach to causality is based on dynamical models, and causal influence has been formalized in the framework of the Doob-Meyer decomposition of stochastic processes. Causal inference however needs assumptions that we detail in this paper and we call this approach to causality the "stochastic system" approach. First we treat this problem in discrete time, then in continuous time. This approach allows incorporating biological knowledge naturally. When working in continuous time, the mechanistic approach involves distinguishing the model for the system and the model for the observations. Indeed, biological systems live in continuous time, and mechanisms can be expressed in the form of a system of differential equations, while observations are taken at discrete times. Inference in mechanistic models is challenging, particularly from a numerical point of view, but these models can yield much richer and reliable results.

  8. Greenhouse gas emissions from on-site wastewater treatment systems

    Science.gov (United States)

    Somlai-Haase, Celia; Knappe, Jan; Gill, Laurence

    2016-04-01

    Nearly one third of the Irish population relies on decentralized domestic wastewater treatment systems which involve the discharge of effluent into the soil via a percolation area (drain field). In such systems, wastewater from single households is initially treated on-site either by a septic tank and an additional packaged secondary treatment unit, in which the influent organic matter is converted into carbon dioxide (CO2) and methane (CH4) by microbial mediated processes. The effluent from the tanks is released into the soil for further treatment in the unsaturated zone where additional CO2 and CH4 are emitted to the atmosphere as well as nitrous oxide (N2O) from the partial denitrification of nitrate. Hence, considering the large number of on-site systems in Ireland and internationally, these are potential significant sources of greenhouse gas (GHG) emissions, and yet have received almost no direct field measurement. Here we present the first attempt to quantify and qualify the production and emissions of GHGs from a septic tank system serving a single house in the County Westmeath, Ireland. We have sampled the water for dissolved CO2, CH4 and N2O and measured the gas flux from the water surface in the septic tank. We have also carried out long-term flux measurements of CO2 from the drain field, using an automated soil gas flux system (LI-8100A, Li-Cor®) covering a whole year semi-continuously. This has enabled the CO2 emissions from the unsaturated zone to be correlated against different meteorological parameters over an annual cycle. In addition, we have integrated an ultraportable GHG analyser (UGGA, Los Gatos Research Inc.) into the automated soil gas flux system to measure CH4 flux. Further, manual sampling has also provided a better understanding of N2O emissions from the septic tank system.

  9. Design of a new flotation system for industrial waters treatment

    International Nuclear Information System (INIS)

    Forero, J E; Diaz, J; Blandon V R

    1999-01-01

    The air flotation is a process of physical separation for the industrial wastewater treatment that removes oils and suspended solids. Although methods different from flotation have been used in petroleum industry, their application is subjected to numerous operational and economic limitations. In this work some comparisons of these flotation techniques are discussed and, a new system for the treatment of residual waters by flotation is the developed. This system is the result of several years of research both in laboratory and in pilot plants. The new design uses characteristics from other techniques, it is based on a modification of a system of induced air flotation as to operate like a system of dissolved air flotation, which improves its performance at lower costs and reduces operational problems associated with equipment maintenance. The developed system has several characteristics that improve its operation, including the use of nozzles for gas injection and dispersion in the liquid phase. As opposed to conventional systems, there is no need to use motorized bubble generating equipment for each flotation cell, diminishing therefore power requirements

  10. Treatment Planning Systems for BNCT Requirements and Peculiarities

    CERN Document Server

    Daquino, G G

    2003-01-01

    The main requirements and peculiarities expected from the BNCT-oriented treatment planning system (TPS) are summarized in this paper. The TPS is a software, which can be integrated or composed by several auxiliary programs. It plays important roles inside the whole treatment planning of the patient's organ in BNCT. However, the main goal is the simulation of the irradiation, in order to obtain the optimal configuration, in terms of neutron spectrum, patient positioning and dose distribution in the tumour and healthy tissues. The presence of neutrons increases the level of complexity, because much more nuclear reactions need to be monitored and properly calculated during the simulation of the patient's treatment. To this purposes several 3D geometry reconstruction techniques, generally based on the CT scanning data, are implemented and Monte Carlo codes are normally used. The TPSs are expected to show also the results (basically doses and fluences) in a proper format, such as isocurves (or isosurfaces) along t...

  11. Optimal design of regional wastewater pipelines and treatment plant systems.

    Science.gov (United States)

    Brand, Noam; Ostfeld, Avi

    2011-01-01

    This manuscript describes the application of a genetic algorithm model for the optimal design of regional wastewater systems comprised of transmission gravitational and pumping sewer pipelines, decentralized treatment plants, and end users of reclaimed wastewater. The algorithm seeks the diameter size of the designed pipelines and their flow distribution simultaneously, the number of treatment plants and their size and location, the pump power, and the required excavation work. The model capabilities are demonstrated through a simplified example application using base runs and sensitivity analyses. Scaling of the proposed methodology to real life wastewater collection and treatment plants design problems needs further testing and developments. The model is coded in MATLAB using the GATOOL toolbox and is available from the authors.

  12. Advice taking from humans and machines: an fMRI and effective connectivity study

    Directory of Open Access Journals (Sweden)

    Kimberly Goodyear

    2016-11-01

    Full Text Available With new technological advances, advice can come from different sources such as machines or humans, but how individuals respond to such advice and the neural correlates involved need to be better understood. We combined functional MRI and multivariate Granger causality analysis with an X-ray luggage-screening task to investigate the neural basis and corresponding effective connectivity involved with advice utilization from agents framed as experts. Participants were asked to accept or reject good or bad advice from a human or machine agent with low reliability (high false alarm rate. We showed that unreliable advice decreased performance overall and participants interacting with the human agent had a greater depreciation of advice utilization during bad advice compared to the machine agent. These differences in advice utilization can be perceivably due to reevaluation of expectations arising from association of dispositional credibility for each agent. We demonstrated that differences in advice utilization engaged brain regions that may be associated with evaluation of personal characteristics and traits (precuneus, posterior cingulate cortex, temporoparietal junction and interoception (posterior insula. We found that the right posterior insula and left precuneus were the drivers of the advice utilization network that were reciprocally connected to each other and also projected to all other regions. Our behavioral and neuroimaging results have significant implications for society because of progressions in technology and increased interactions with machines.

  13. Integrated constructed wetland systems: design, operation, and performance of low-cost decentralized wastewater treatment systems.

    Science.gov (United States)

    Behrends, L L; Bailey, E; Jansen, P; Houke, L; Smith, S

    2007-01-01

    Several different types of constructed wetland systems are being used as decentralized treatment systems including surface-flow, subsurface-flow, vertical-flow, and hybrid systems. Archetypical wetland systems have design strengths and weaknesses, and therefore it should be possible to design combined (integrated) systems to optimize a number of important treatment processes. This study provides comparative efficacy data for two integrated wetland treatment systems (IWTS) designed to enhance treatment of medium strength wastewater generated from a pilot-scale intensive fish farm. Results from the twenty eight months study included consistently high removal of COD (84% +) and ammonia nitrogen (93%) in both systems. Initially, phosphorus removal was also high (>90%) in both systems, but removal efficacy declined significantly over time. Nitrate removal was significantly better in the system that provided sequential aerobic and anoxic environments. Short hydraulic retention times coupled with sustained removal of COD and ammonia indicate that the ReCip components could be a least-cost wastewater treatment technology in the decentralized market sector.

  14. Safety evaluation of BWR off-gas treatment systems

    International Nuclear Information System (INIS)

    Schultz, R.J.; Schmitt, R.C.

    1975-01-01

    Some of the results of a safety evaluation performed on current generic types of BWR off-gas treatment systems including cooled and ambient temperature adsorber beds and cryogenics are presented. The evaluation covered the four generic types of off-gas systems and the systems of five major vendors. This study was part of original work performed under AEC contract for the Directorate of Regulatory Standards. The analysis techniques employed for the safety evaluation of these systems include: Fault Tree Analysis; FMECA (Failure Mode Effects and Criticality Analysis); general system comparisons, contaminant, system control, and design adequacy evaluations; and resultant Off-Site Dose Calculations. The salient areas presented are some of the potential problem areas, the approach that industry has taken to mitigate or design against potential upset conditions, and areas where possible deficiencies still exist. Potential problem areas discussed include hydrogen detonation, hydrogen release to equipment areas, operator/automatic control interface, and needed engineering evaluation to insure safe system operation. Of the systems reviewed, most were in the category of advanced or improved over that commonly in use today, and a conclusion from the study was that these systems offer excellent potential for noble gas control for BWR power plants where more stringent controls may be specified -- now or in the future. (U.S.)

  15. MINERVA - a multi-modal radiation treatment planning system

    Energy Technology Data Exchange (ETDEWEB)

    Wemple, C.A. E-mail: cew@enel.gov; Wessol, D.E.; Nigg, D.W.; Cogliati, J.J.; Milvich, M.L.; Frederickson, C.; Perkins, M.; Harkin, G.J

    2004-11-01

    Researchers at the Idaho National Engineering and Environmental Laboratory and Montana State University have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system. This system can be used for planning and analyzing several radiotherapy modalities, either singly or combined, using common modality independent image and geometry construction and dose reporting and guiding. It employs an integrated, lightweight plugin architecture to accommodate multi-modal treatment planning using standard interface components. The MINERVA design also facilitates the future integration of improved planning technologies. The code is being developed with the Java Virtual Machine for interoperability. A full computation path has been established for molecular targeted radiotherapy treatment planning, with the associated transport plugin developed by researchers at the Lawrence Livermore National Laboratory. Development of the neutron transport plugin module is proceeding rapidly, with completion expected later this year. Future development efforts will include development of deformable registration methods, improved segmentation methods for patient model definition, and three-dimensional visualization of the patient images, geometry, and dose data. Transport and source plugins will be created for additional treatment modalities, including brachytherapy, external beam proton radiotherapy, and the EGSnrc/BEAMnrc codes for external beam photon and electron radiotherapy.

  16. Strategies for the reduction of Legionella in biological treatment systems.

    Science.gov (United States)

    Nogueira, R; Utecht, K-U; Exner, M; Verstraete, W; Rosenwinkel, K-H

    A community-wide outbreak of Legionnaire's disease occurred in Warstein, Germany, in August 2013. The epidemic strain, Legionella pneumophila Serogruppe 1, was isolated from an industrial wastewater stream entering the municipal wastewater treatment plant (WWTP) in Wartein, the WWTP itself, the river Wäster and air/water samples from an industrial cooling system 3 km downstream of the WWTP. The present study investigated the effect of physical-chemical disinfection methods on the reduction of the concentration of Legionella in the biological treatment and in the treated effluent entering the river Wäster. Additionally, to gain insight into the factors that promote the growth of Legionella in biological systems, growth experiments were made with different substrates and temperatures. The dosage rates of silver micro-particles, hydrogen peroxide, chlorine dioxide and ozone and pH stress to the activated sludge were not able to decrease the number of culturable Legionella spp. in the effluent. Nevertheless, the UV treatment of secondary treated effluent reduced Legionella spp. on average by 1.6-3.4 log units. Laboratory-scale experiments and full-scale measurements suggested that the aerobic treatment of warm wastewater (30-35 °C) rich in organic nitrogen (protein) is a possible source of Legionella infection.

  17. [Newly Designed Water Treatment Systems for Hospital Effluent].

    Science.gov (United States)

    Azuma, Takashi

    2018-01-01

     Pharmaceuticals are indispensable to contemporary life. Recently, the emerging problem of pharmaceutical-based pollution of river environments, including drinking water sources and lakes, has begun to receive significant attention worldwide. Because pharmaceuticals are designed to perform specific physiological functions in targeted regions of the human body, there is increasing concern regarding their toxic effects, even at low concentrations, on aquatic ecosystems and human health, via residues in drinking water. Pharmaceuticals are consistently employed in hospitals to treat disease; and Japan, one of the most advanced countries in medical treatment, ranks second worldwide in the quantity of pharmaceuticals employed. Therefore, the development of technologies that minimize or lessen the related environmental risks for clinical effluent is an important task as well as that for sewage treatment plants (STPs). However, there has been limited research on clinical effluent, and much remains to be elucidated. In light of this, we are investigating the occurrence of pharmaceuticals, and the development of water treatment systems for clinical effluent. This review discusses the current research on clinical effluent and the development of advanced water treatment systems targeted at hospital effluent, and explores strategies for future environmental risk assessment and risk management.

  18. Advanced treatment and reuse system developed for oilfield process water

    Energy Technology Data Exchange (ETDEWEB)

    Conroy, Kevin

    2011-01-15

    An innovative plant to treat oilfield produced wastewater is being constructed in Trinidad and Tobago following recent regulations and industrial water supply challenges. The 4,100m3/day treatment system, developed by Golder Associates, will produce water for industrial reuse and effluent that meets new regulations. The treatment stages include: oil-water separation by gravity, equalization with a two-day capacity basin, dissolved air flotation, cooling, biotreatment/settling with immobilized cell bioreactors (ICB) technology, prefiltration/reverse osmosis and effluent storage/transfer. This advanced system will provide several important benefits including the elimination of inland discharge of minimally-treated water and the reduction of environmental and public health concerns. In addition, it will provide a new source of industrial water, resulting in a decrease in demand for fresh water. The success of this plant could lead to additional facilities in other oil field locations, expanding economic and environmental benefits of water reuse.

  19. Model-based aviation advice on distal volcanic ash clouds by assimilating aircraft in situ measurements

    Directory of Open Access Journals (Sweden)

    G. Fu

    2016-07-01

    Full Text Available The forecast accuracy of distal volcanic ash clouds is important for providing valid aviation advice during volcanic ash eruption. However, because the distal part of volcanic ash plume is far from the volcano, the influence of eruption information on this part becomes rather indirect and uncertain, resulting in inaccurate volcanic ash forecasts in these distal areas. In our approach, we use real-life aircraft in situ observations, measured in the northwestern part of Germany during the 2010 Eyjafjallajökull eruption, in an ensemble-based data assimilation system combined with a volcanic ash transport model to investigate the potential improvement on the forecast accuracy with regard to the distal volcanic ash plume. We show that the error of the analyzed volcanic ash state can be significantly reduced through assimilating real-life in situ measurements. After a continuous assimilation, it is shown that the aviation advice for Germany, the Netherlands and Luxembourg can be significantly improved. We suggest that with suitable aircrafts measuring once per day across the distal volcanic ash plume, the description and prediction of volcanic ash clouds in these areas can be greatly improved.

  20. Simulation of gamma irradiation system for a ballast water treatment

    International Nuclear Information System (INIS)

    Faez, T. P.; Sarkar, S.

    2006-01-01

    Invasion by different kinds of ballast the water microorganisms is one of the most important marine environment problems around the world therefore preventing the invasion of these unwanted and harmful stowaways is one of the main strategies of responsible agencies. Some of these methods such as ocean exchange, heating, filtration, hydro cyclones, UV irradiation and chemical treatment, have various problems such as technical deficiency, high costs, lack of safety and environmental side effects. Materials and Methods: A novel system of treatment by Gamma irradiation is designed to irradiate the blast water uniformly and effectively. To determine the dose distribution as a function of distance from the irradiation source, the MCNP code was used. The systems used for source implant in this simulation were Paterson-Parker, Paris and Network systems. In each system, Sivert-integral and inverse square law were used in MATLAB program to determine the dose distribution. Results: Results of initial laboratory tests on offshore water samples of Siri Island indicated that the appropriate dose for deactivation of organisms of water samples is approximately one kGy. It has been demonstrated that the dose can be provided by twenty five 100,000 Ci line sources of ' 60 Co in a triangle implant arranged in a 1*1*1 m3 cubic shape water pipe. In order to increase efficiency and radiation safety, water passed from two other coaxial and bigger cubes, after passing from the first cube. A one meter thick wall of concrete around the cubes was adequate to shield the system completely. Conclusion: The main advantages of this system such as high efficiency, safety, reliability, minimum environmental adverse effects, proves that this novel method not only can be used for ballast water treatment, but is also effective for drinking water purification

  1. Systemic treatment of seborrheic dermatitis with retinol palmitate

    OpenAIRE

    O. V. Kalinina; V. I. Albanova; T. A. Belousova; V. I. Nozdrin

    2014-01-01

    The goal of the study. Evaluating of the effectiveness of treatment of men with a diagnosis «Seborrheic dermatitis of the scalp» by the system using of retinol palmitate. Material and methods. 36 patients every day for 2 months received overnight per os 200000 ME of retinol palmitate, and in the comparison group (39 people) antiseborrheic shampoos have been used. The dynamics of severity of skin oiliness, pruritis, erythema, peeling, infiltration, excoriations has been evaluated in points. Be...

  2. Current status of quality assurance of treatment planning systems

    International Nuclear Information System (INIS)

    Mijnheer, B.J.

    1997-01-01

    A review is given of the current status of quality assurance of treatment planning systems. At this moment only one comprehensive report is available. In order to review national activities a questionnaire has been distributed amongst national societies of medical physicists. From the 23 responding countries, 8 indicated that only limited efforts are underway, 8 answered that a working group is evaluating their specific national requirements while in 5 countries a document is drafted. The highlights of these reports have been summarized. (author)

  3. TREATMENT SYSTEM FOR WASTEWATER AT VILLA CLARA WATER MANAGEMENT COMPANY

    Directory of Open Access Journals (Sweden)

    Floramis Pérez Martín

    2016-04-01

    Full Text Available The aim of this paper is to assess the current operating and safety conditions of biological treatment systems for wastewater in the centers of swinish and poultry breeding at Villa Clara Water Management Company, with the purpose of setting a group of organizational, technical and human measures that contributes to prevent contamination and minimize biological risks. In this way it can be guaranteed the protection to the workers, the facilities, community and the environment, to have a sure occupational atmosphere in the organization. As a result of the evaluation the factors that affect the operation of the biodigestion system and the security of the process are defined.

  4. Candidal Arthritis After Complete Treatment of Systemic Candidiasis

    Directory of Open Access Journals (Sweden)

    Wen-Bin Hsieh

    2005-04-01

    Full Text Available Over the last few decades, the incidence of invasive candidal infections in neonatal intensive care units has increased dramatically. Various complications, such as arthritis, endocarditis, meningitis, and endophthalmitis, have been reviewed. We present the case of a premature infant with systemic candidemia. Arthritis was discovered 6 months after completion of amphotericin B therapy, and was successfully treated with oral fluconazole for 6 weeks. We conclude that long-term follow-up is particularly important in patients with treated candidemia. To prevent complications, prolonged treatment with high-dose amphotericin B is suggested for systemic fungal infection, and oral fluconazole is an effective alternative for candidal arthritis.

  5. System for supporting conception in the field of surface treatments

    International Nuclear Information System (INIS)

    Evrard, J.M.; Gras, M.

    1989-01-01

    The application of the techniques issued from artificial intelligence for assisting the development of a computer technical memory on a representative subject, which is the surface treatments and coating in tribology, is illustrated. The development of the system is composed of several steps: data acquisition and formatting representation, data validation and software. Particular attention is given to the dialogue between the user and the system. The study shows that the development of the following points are indispensable: the possibility of following the user's reasoning and coming back to previous steps or exploring several parallel ways [fr

  6. Extracellular enzyme activity in a willow sewage treatment system.

    Science.gov (United States)

    Brzezinska, Maria Swiontek; Lalke-Porczyk, Elżbieta; Kalwasińska, Agnieszka

    2012-12-01

    This paper presents the results of studies on the activity of extra-cellular enzymes in soil-willow vegetation filter soil which is used in the post-treatment of household sewage in an onsite wastewater treatment system located in central Poland. Wastewater is discharged from the detached house by gravity into the onsite wastewater treatment system. It flows through a connecting pipe into a single-chamber septic tank and is directed by the connecting pipe to a control well to be further channelled in the soil-willow filter by means of a subsurface leaching system. Soil samples for the studies were collected from two depths of 5 cm and 1 m from three plots: close to the wastewater inflow, at mid-length of the plot and close to its terminal part. Soil samples were collected from May to October 2009. The activity of the extra-cellular enzymes was assayed by the fluorometric method using 4-methylumbelliferyl and 7-amido-4-methylcoumarin substrate. The ranking of potential activity of the assayed enzymes was the same at 5 cm and 1 m soil depths, i.e. esterase > phosphmomoesterase > leucine-aminopeptidase > β-glucosidase > α-glucosidase. The highest values of enzymatic activity were recorded in the surface layer of the soil at the wastewater inflow and decreased with increasing distance from that point.

  7. Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

    Science.gov (United States)

    Hassanein, Mohamed; Belhadj, Mohamed; Abdallah, Khalifa; Bhattacharya, Arpan D.; Singh, Awadhesh K.; Tayeb, Khaled; Al-Arouj, Monira; Elghweiry, Awad; Iraqi, Hinde; Nazeer, Mohamed; Jamoussi, Henda; Mnif, Mouna; Al-Madani, Abdulrazzaq; Al-Ali, Hossam; Ligthelm, Robert

    2014-01-01

    The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin. PMID:25364673

  8. Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

    Directory of Open Access Journals (Sweden)

    Mohamed Hassanein

    2014-01-01

    Full Text Available The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2-3 months pre-Ramadan. Although, American diabetes association (ADA recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin.

  9. Treatment of trace organic compounds in common onsite wastewater systems

    Science.gov (United States)

    Robert Siegrist,; Conn, Kathleen E.

    2015-01-01

    Onsite wastewater systems (OWS) have historically been relied on to treat conventional pollutants and pathogens in a fashion similar to that expected from centralized wastewater systems. However, based on the occurrence of, and potential effects from, contaminants of emerging concern in wastewaters, OWS as well as centralized systems need to account for these compounds in system design and use. One group of contaminants involves organic compounds such as those associated with consumer product chemicals and pharmaceuticals, which are collectively referred to as trace organic compounds (TOrCs) due to their very low levels (e.g., ng/L to ug/L) relative to other pollutants. The question being confronted today is how best to account for TOrCs in onsite system design and use while also achieving other goals such as system simplicity, limited operation and maintenance requirements, low cost, and sustainability. In contrast to conventional pollutants such as nutrients and pathogens which have specific and achievable treatment goals, there are currently no enforceable treatment standards for TOrCs, which often have non-traditional toxicological endpoints (i.e. endocrine disruption). As highlighted in this paper, there are a large number of TOrCs that can be present in OWS and they have different properties, can be present at different frequencies of occurrence and concentrations, and have different susceptibilities to treatment in OWS. In general, based on the studies summarized in this paper, TOrCs normally should not require additional considerations beyond those for conventional pollutants and pathogens (e.g., nitrogen or bacteria and virus) during design and use of OWS. That said, there are situations where TOrCs could be a serious concern warranting special consideration in system design and use. In this paper, the frequency of occurrence of TOrCs and the range of concentrations encountered are highlighted. An evolving approach is outlined that could help assess the

  10. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment.

    Science.gov (United States)

    Fuangrod, Todsaporn; Woodruff, Henry C; van Uytven, Eric; McCurdy, Boyd M C; Kuncic, Zdenka; O'Connor, Daryl J; Greer, Peter B

    2013-09-01

    To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient. The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance. The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s). A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy.

  11. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment

    Energy Technology Data Exchange (ETDEWEB)

    Fuangrod, Todsaporn [Faculty of Engineering and Built Environment, School of Electrical Engineering and Computer Science, the University of Newcastle, NSW 2308 (Australia); Woodruff, Henry C.; O’Connor, Daryl J. [Faculty of Science and IT, School of Mathematical and Physical Sciences, the University of Newcastle, NSW 2308 (Australia); Uytven, Eric van; McCurdy, Boyd M. C. [Division of Medical Physics, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, Manitoba R3E 0V9 (Canada); Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Department of Radiology, University of Manitoba, Winnipeg, Manitoba R3T 2N2 (Canada); Kuncic, Zdenka [School of Physics, University of Sydney, Sydney, NSW 2006 (Australia); Greer, Peter B. [Faculty of Science and IT, School of Mathematical and Physical Sciences, the University of Newcastle, NSW 2308, Australia and Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Locked Bag 7, Hunter region Mail Centre, Newcastle, NSW 2310 (Australia)

    2013-09-15

    Purpose: To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient.Methods: The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance.Results: The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s).Conclusions: A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy.

  12. A system for EPID-based real-time treatment delivery verification during dynamic IMRT treatment

    International Nuclear Information System (INIS)

    Fuangrod, Todsaporn; Woodruff, Henry C.; O’Connor, Daryl J.; Uytven, Eric van; McCurdy, Boyd M. C.; Kuncic, Zdenka; Greer, Peter B.

    2013-01-01

    Purpose: To design and develop a real-time electronic portal imaging device (EPID)-based delivery verification system for dynamic intensity modulated radiation therapy (IMRT) which enables detection of gross treatment delivery errors before delivery of substantial radiation to the patient.Methods: The system utilizes a comprehensive physics-based model to generate a series of predicted transit EPID image frames as a reference dataset and compares these to measured EPID frames acquired during treatment. The two datasets are using MLC aperture comparison and cumulative signal checking techniques. The system operation in real-time was simulated offline using previously acquired images for 19 IMRT patient deliveries with both frame-by-frame comparison and cumulative frame comparison. Simulated error case studies were used to demonstrate the system sensitivity and performance.Results: The accuracy of the synchronization method was shown to agree within two control points which corresponds to approximately ∼1% of the total MU to be delivered for dynamic IMRT. The system achieved mean real-time gamma results for frame-by-frame analysis of 86.6% and 89.0% for 3%, 3 mm and 4%, 4 mm criteria, respectively, and 97.9% and 98.6% for cumulative gamma analysis. The system can detect a 10% MU error using 3%, 3 mm criteria within approximately 10 s. The EPID-based real-time delivery verification system successfully detected simulated gross errors introduced into patient plan deliveries in near real-time (within 0.1 s).Conclusions: A real-time radiation delivery verification system for dynamic IMRT has been demonstrated that is designed to prevent major mistreatments in modern radiation therapy

  13. Parents’ professional sources of advice regarding child discipline and their use of corporal punishment

    Science.gov (United States)

    Taylor, Catherine A.; Moeller, William; Hamvas, Lauren; Rice, Janet C.

    2014-01-01

    Parents (n=500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents that sought advice from religious leaders (vs. pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported they were more likely to follow the advice of pediatricians than any other professional; however, Black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents. PMID:23185082

  14. Parents' professional sources of advice regarding child discipline and their use of corporal punishment.

    Science.gov (United States)

    Taylor, Catherine A; Moeller, William; Hamvas, Lauren; Rice, Janet C

    2013-02-01

    Parents (n = 500) were surveyed about which professional groups they were most likely to seek and follow advice from regarding child discipline as well as their use of corporal punishment (CP). Nearly half of the parents reported that they were most likely to seek child discipline advice from pediatricians (48%), followed by religious leaders (21%) and mental health professionals (18%). Parents who sought advice from religious leaders (vs pediatricians) had nearly 4 times the odds of reporting use of CP. Parents reported that they were more likely to follow the advice of pediatricians than any other professional; however, black parents were as likely to follow the advice of religious leaders as that of pediatricians. Pediatricians play a central role in advising parents about child discipline. Efforts to engage pediatricians in providing violence prevention counseling should continue. Increased efforts are needed to engage other professionals, especially religious leaders, in providing such advice to parents.

  15. TPMG Northern California appointments and advice call center.

    Science.gov (United States)

    Conolly, Patricia; Levine, Leslie; Amaral, Debra J; Fireman, Bruce H; Driscoll, Tom

    2005-08-01

    Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the "front office" for primary care services across approximately 89% of Northern California. The AACC provides primary care phone service for approximately 3 million Kaiser Foundation Health Plan members in Northern California and responds to approximately 1 million calls per month across the three AACC sites. A database records each caller's identity as well as the day, time, and duration of each call; reason for calling; services provided to callers as a result of calls; and clinical outcomes of calls. We here summarize this information for the period 2000 through 2003.

  16. Sport participation and Ramadan observance: Advice for the athlete

    Directory of Open Access Journals (Sweden)

    Roy J. Shephard

    2015-07-01

    Full Text Available Introduction: A growing number of Muslim athletes now engage in international competition. This raises the question of the advice they should be given if a major event occurs during the month of Ramadan. Methods: A narrative review has been based upon books and extensive reviews completed by the author and other investigators. Results: Practical considerations hamper assessment of the effects of Ramadan upon physical performance, but there seem small decreases in muscular strength and both anaerobic and aerobic capacity.  Nevertheless, athletes who wish to observe Ramadan can reduce such effects by prior adjustment of diet and training plans, minimizing sleep loss, and careful management of fluid and food intake during the period of intermittent fasting. Conclusion: Competitors in most events can observe Ramadan with a small loss of athletic performance. However, intermittent fasting can endanger health for individuals with type I diabetes mellitus, and for participants in ultra-endurance events (particularly under hot conditions.

  17. Onsite defluoridation system for drinking water treatment using calcium carbonate.

    Science.gov (United States)

    Wong, Elaine Y; Stenstrom, Michael K

    2018-06-15

    Fluoride in drinking water has several effects on teeth and bones. At concentrations of 1-1.5 mg/L, fluoride can strengthen enamel, improving dental health, but at concentrations above 1.5 to 4 mg/L can cause dental fluorosis. At concentrations of 4-10 mg/L, skeletal fluorosis can occur. There are many areas of the world that have excessive fluoride in drinking water, such as China, India, Sri Lanka, and the Rift Valley countries in Africa. Treatment solutions are needed, especially in poor areas where drinking water treatment plants are not available. On-site or individual treatment alternatives can be attractive if constructed from common materials and if simple enough to be constructed and maintained by users. Advanced on-site methods, such as under sink reserve osmosis units, can remove fluoride but are too expensive for developing areas. This paper investigates calcium carbonate as a cost effective sorbent for an onsite defluoridation drinking water system. Batch and column experiments were performed to characterize F - removal properties. Fluoride sorption was described by a Freundlich isotherm model, and it was found that the equilibrium time was approximately 3 h. Calcium carbonate was found to have comparable F - removal abilities as the commercial ion exchange resins and possessed higher removal effectiveness compared to calcium containing eggshells and seashells. It was also found that the anion Cl- did not compete with F - at typical drinking water concentrations, having little impact on the effectiveness of the treatment system. A fluoride removal system is proposed that can be used at home and can be maintained by users. Through this work, we can be a step closer to bringing safe drinking water to those that do not have access to it. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients.

    Science.gov (United States)

    Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn

    2014-06-01

    Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P periodontal disease index; r = 0.56, P periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C-reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  19. The Process of Parents' Decision-Making to Discharge Their Child against Medical Advice (DAMA: A grounded theory study

    Directory of Open Access Journals (Sweden)

    Nikbakht Nasrabadi Alireza

    2016-05-01

    Full Text Available Discharge against medical advice (DAMA refers to the phenomenon that patient or the patient’s surrogate decides to leave the hospital before the attending physician confirms the patient is discharged. Children are much more vulnerable to such discharges. This process occurs with different mechanisms that identifying them can be helpful in reducing this phenomenon. We aimed to explore the process of parents' decision-making to discharge their child against medical advice. In-depth, semi-structured interviews were conducted with 10 fathers, 10 mothers, 6 nurses and 3 physician assistants and the data were collected to the point of saturation. Grounded theory methodology was adopted for data collection and analysis. The results of qualitative analysis in the field of the parents' decisionmaking on the DAMA revealed 4 main themes: "lack of family-centered care", "disruption of the parenting process", "distrust to the medical team and center" and "psychological strategy of shirk responsibility for child care and treatment ". By providing family-centered care, adopting measures to empowering the families, developing the trust of parents to the health care team and developing a discharge plan from the beginning of children hospitalization with the cooperation of health care team and parents and considering all factors such as child's special health condition and parent's health related perceptions and beliefs, children will not be discharged against medical advice and will experience better outcomes.

  20. Clinical treatment planning optimization by Powell's method for gamma unit treatment system

    International Nuclear Information System (INIS)

    Yan Yulong; Shu Huazhong; Bao Xudong; Luo Limin; Bai Yi

    1997-01-01

    Purpose: This article presents a new optimization method for stereotactic radiosurgery treatment planning for gamma unit treatment system. Methods and Materials: The gamma unit has been utilized in stereotactic radiosurgery for about 30 years, but the usual procedure for a physician-physicist team to design a treatment plan is a trial-and-error approach. Isodose curves are viewed on two-dimensional computed tomography (CT) or magnetic resonance (MR) image planes, which is not only time consuming but also seldom achieves the optimal treatment plan, especially when the isocenter weights are regarded. We developed a treatment-planning system on a computer workstation in which Powell's optimization method is realized. The optimization process starts with the initial parameters (the number of iso centers as well as corresponding 3D iso centers' coordinates, collimator sizes, and weight factors) roughly determined by the physician-physicist team. The objective function can be changed to consider protection of sensitive tissues. Results: We use the plan parameters given by a well-trained physician-physicist team, or ones that the author give roughly as the initial parameters for the optimization procedure. Dosimetric results of optimization show a better high dose-volume conformation to the target volume compared to the doctor's plan. Conclusion: This method converges quickly and is not sensitive to the initial parameters. It achieves an excellent conformation of the estimated isodose curves with the contours of the target volume. If the initial parameters are varied, there will be a little difference in parameters' configuration, but the dosimetric results proved almost to be the same

  1. Dynamics of Nutrients Transport in Onsite Wastewater Treatment Systems

    Science.gov (United States)

    Toor, G.; De, M.

    2013-05-01

    Domestic wastewater is abundant in nutrients¬ that originate from various activities in the households. In developed countries, wastewater is largely managed by (1) centralized treatment where wastewater from large population is collected, treated, and discharged and (2) onsite treatment where wastewater is collected from an individual house, treated, and dispersed onsite; this system is commonly known as septic system or onsite wastewater treatment system (OWTS) and consist of a septic tank (collects wastewater) and drain-field (disperses wastewater in soil). In areas with porous sandy soils, the transport of nutrients from drain-field to shallow groundwater is accelerated. To overcome this limitation, elevated disposal fields (commonly called mounds) on top of the natural soil are constructed to provide unsaturated conditions for wastewater treatment. Our objective was to study the dynamics of nitrogen (N) and phosphorus (P) transport in the vadose zone and groundwater in traditional and advanced OWTS. Soil water samples were collected from the vadose zone by using suction cup lysimeters and groundwater samples were collected by using piezometers. Collected samples (wastewater, soil-water, groundwater) were analyzed for various water quality parameters. The pH (4.39-4.78) and EC (0.28-0.34 dS/m) of groundwater was much lower than both wastewater and soil-water. In contrast to >50 mg/L of ammonium-N in wastewater, concentrations in all lysimeters (0.02-0.81 mg/L) and piezometers (0.01-0.82 mg/L) were 99% disappeared (primarily nitrified) in the vadose zone (20 mg/L in the vadose zones of traditional systems (drip dispersal and gravel trench). Concentrations of chloride showed a distinct pattern of nitrate-N breakthrough in vadose zone and groundwater; the groundwater nitrate-N was elevated upto 19.2 mg/L after wastewater delivery in tradional systems. Total P in the wastewater was ~10 mg/L, but low in all lysimeters (0.046-1.72 mg/L) and piezometers (0.01-0.78 mg

  2. Diagnostic medical exposures: advice on exposure to ionising radiation during pregnancy

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The NRPB offers advice on exposure to ionizing radiation during pregnancy, based on data published since 1985. In providing this advice the Board has considered risks to the developing embryo and fetus of death, malformation, mental impairment, cancer (solid tumours and leukaemias) and genetic damage from irradiation after the first missed menstrual period. The possible risks from irradiation of the early (up to 3-4 weeks) conceptus and from gonodal irradiation of patients is also covered in the present advice. (Author)

  3. Monte Carlo systems used for treatment planning and dose verification

    Energy Technology Data Exchange (ETDEWEB)

    Brualla, Lorenzo [Universitaetsklinikum Essen, NCTeam, Strahlenklinik, Essen (Germany); Rodriguez, Miguel [Centro Medico Paitilla, Balboa (Panama); Lallena, Antonio M. [Universidad de Granada, Departamento de Fisica Atomica, Molecular y Nuclear, Granada (Spain)

    2017-04-15

    General-purpose radiation transport Monte Carlo codes have been used for estimation of the absorbed dose distribution in external photon and electron beam radiotherapy patients since several decades. Results obtained with these codes are usually more accurate than those provided by treatment planning systems based on non-stochastic methods. Traditionally, absorbed dose computations based on general-purpose Monte Carlo codes have been used only for research, owing to the difficulties associated with setting up a simulation and the long computation time required. To take advantage of radiation transport Monte Carlo codes applied to routine clinical practice, researchers and private companies have developed treatment planning and dose verification systems that are partly or fully based on fast Monte Carlo algorithms. This review presents a comprehensive list of the currently existing Monte Carlo systems that can be used to calculate or verify an external photon and electron beam radiotherapy treatment plan. Particular attention is given to those systems that are distributed, either freely or commercially, and that do not require programming tasks from the end user. These systems are compared in terms of features and the simulation time required to compute a set of benchmark calculations. (orig.) [German] Seit mehreren Jahrzehnten werden allgemein anwendbare Monte-Carlo-Codes zur Simulation des Strahlungstransports benutzt, um die Verteilung der absorbierten Dosis in der perkutanen Strahlentherapie mit Photonen und Elektronen zu evaluieren. Die damit erzielten Ergebnisse sind meist akkurater als solche, die mit nichtstochastischen Methoden herkoemmlicher Bestrahlungsplanungssysteme erzielt werden koennen. Wegen des damit verbundenen Arbeitsaufwands und der langen Dauer der Berechnungen wurden Monte-Carlo-Simulationen von Dosisverteilungen in der konventionellen Strahlentherapie in der Vergangenheit im Wesentlichen in der Forschung eingesetzt. Im Bemuehen, Monte

  4. Software Design for Interactive Graphic Radiation Treatment Simulation Systems*

    Science.gov (United States)

    Kalet, Ira J.; Sweeney, Christine; Jacky, Jonathan

    1990-01-01

    We examine issues in the design of interactive computer graphic simulation programs for radiation treatment planning (RTP), as well as expert system programs that automate parts of the RTP process, in light of ten years of experience at designing, building and using such programs. An experiment in object-oriented design using standard Pascal shows that while some advantage is gained from the design, it is still difficult to achieve modularity and to integrate expert system components. A new design based on the Common LISP Object System (CLOS) is described. This series of designs for RTP software shows that this application benefits in specific ways from object-oriented design methods and appropriate languages and tools.

  5. Bacterial communities in full-scale wastewater treatment systems.

    Science.gov (United States)

    Cydzik-Kwiatkowska, Agnieszka; Zielińska, Magdalena

    2016-04-01

    Bacterial metabolism determines the effectiveness of biological treatment of wastewater. Therefore, it is important to define the relations between the species structure and the performance of full-scale installations. Although there is much laboratory data on microbial consortia, our understanding of dependencies between the microbial structure and operational parameters of full-scale wastewater treatment plants (WWTP) is limited. This mini-review presents the types of microbial consortia in WWTP. Information is given on extracellular polymeric substances production as factor that is key for formation of spatial structures of microorganisms. Additionally, we discuss data on microbial groups including nitrifiers, denitrifiers, Anammox bacteria, and phosphate- and glycogen-accumulating bacteria in full-scale aerobic systems that was obtained with the use of molecular techniques, including high-throughput sequencing, to shed light on dependencies between the microbial ecology of biomass and the overall efficiency and functional stability of wastewater treatment systems. Sludge bulking in WWTPs is addressed, as well as the microbial composition of consortia involved in antibiotic and micropollutant removal.

  6. The endocannabinoid system: a new pharmacological target for obesity treatment?

    Science.gov (United States)

    Hu, Jia; Zhu, Chao; Huang, Mao

    2009-06-01

    Being a great threaten for human health, obesity has become a pandemic chronic disease. There have been several therapeutic treatments for this social health issue, including diet and exercise therapy, medication and surgery, among which the diet is still the most common way. However, none of these therapeutic measures available is ideal, making it necessary to find an effective medical treatment. The endocannabinoid system, which is well known for its contributions in certain mental processes such as relaxation, amelioration of pain and anxiety, and sedation initiation, has been recently reported to play an essential role in regulating appetite and metabolism to maintain energy balance, leading to the belief that endocannabinoid system is closely related to obesity. This new discovery deepens our understanding of obesity, and provides us with a new direction for clinical obesity treatment. Rimonabant is an antagonist for CB1, and has entered the market in some countries. However, although effective as an anti-obesity drug, rimonabant also causes obviously adverse side-effects, thus is being doubted and denied for medical usage.

  7. Systemic treatment of seborrheic dermatitis with retinol palmitate

    Directory of Open Access Journals (Sweden)

    O. V. Kalinina

    2014-01-01

    Full Text Available The goal of the study. Evaluating of the effectiveness of treatment of men with a diagnosis «Seborrheic dermatitis of the scalp» by the system using of retinol palmitate. Material and methods. 36 patients every day for 2 months received overnight per os 200000 ME of retinol palmitate, and in the comparison group (39 people antiseborrheic shampoos have been used. The dynamics of severity of skin oiliness, pruritis, erythema, peeling, infiltration, excoriations has been evaluated in points. Before and after the treatment a histological and morphometric study of biopsy material from the affected areas has been carried.The terms of relapses have been set. Results. Retinol palmitate treatment efficiency - 91.7%, antiseborrheic shampoos - 84.6%. Along with the regression of symptoms of the disease in both groups after retinol palmitate treatment significantly declined oiliness of skin; the sizes of sebaceous glands acini and the presence of differentiated sebocytes, the squares of lymphocytic-macrophage clusters in the dermis, the number of keratinocytes with vacuolated cytoplasm have been reduced. Relapses of the disease during a year occured more rare - in 21 patients out of 32 (in the comparison group- in 25 out of 31 and at a later date (in the first 3 months in 2 patients out of 32, in comparison group in 10 out of 31. Identified effects were due to the action of retinol palmitate on the morphogenesis of the sebaceous glands.

  8. Cost of Tuberculosis Treatment: Evidence from Iran's Health System.

    Science.gov (United States)

    Bay, Vahid; Tabarsi, Payam; Rezapour, Aziz; Marzban, Sima; Zarei, Ehsan

    2017-10-01

    This study aimed to estimate the cost of smear-positive drug-susceptible pulmonary tuberculosis (TB) treatment of the patients in the Azadshahr district, Golestan Province, Iran. In this retrospective study, all new smear positive pulmonary TB patients who had been registered at the district's health network between April, 2013 and December, 2015 and had successfully completed their treatment were entered into the study (45 patients). Treatment costs were estimated from the provider's perspective using an activity-based costing (ABC) method. The cost of treating a new smear-positive pulmonary TB patient was US dollar (USD) 1,409.00 (Iranian Rial, 39,438,260), which can be divided into direct and indirect costs (USD 1,226.00 [87%] and USD 183.00 [13%], respectively). The highest cost (58.1%) was related to care and management of TB patients (including 46.1% human resources costs and 12% directly-observed treatment, short course implementation) and then respectively related to hospitalization (12.1%), supportive activity centers (11.4%), transportation (6.5%), medicines (5.3%), and laboratory tests and radiography (3.2%). Using disease-specific cost studies can help the healthcare system management to have correct insight into the financial burden created by the disease. This can subsequently be used in prioritization, planning, operational budgeting, economic evaluation of programs, interventions, and ultimately in disease management.

  9. Radioactive waste treatment system for Tsuruga Nuclear Power Station

    International Nuclear Information System (INIS)

    Taniguchi, Takashi; Takeshima, Masaki; Saito, Toru; Kikkawa, Ryozo

    1978-01-01

    The augmentation of the radioactive waste treatment system in the Tsuruga Nuclear Power Station was planned in 1973, and this enlarged facility was completed in June, 1977. The object of this augmentation is to increase the storage capacity for wastes and to enlarge the treating capacity utilizing the newly installed facility. The operating experience in the facility having been already constructed was fed back for the engineering of this new facility. This new facility contains the newly developed vacuum forced circulation type concentrator, the exclusive storage pool for solid wastes, etc. At the design stage of this new system, the pilot plant test of slurry transportation and the corrosion test of long hours were carried out as the research and developmental works for the confirmation of correct design condition. The measures for augmenting this radioactive waste treatment system are the installation of a long time storage tank with the capacity of 350 m 3 , the sit bunker facility and the drum storage as the storage facility, and the vacuum forced circulation type concentrator with the circulating flow rate more than 200 times as much as the treating flow rate and vacuum level of 0.255 ata. The augmented system is shown with the flow sheet of whole waste disposal system. The flow sheet of the concentrator is separately shown, and the relating research and developmental works, for example, the test of the cause of corrosion, the surface finishing test, the material test, the blockage test for heat transfer tubes and the inhibiter test, are explained with the test results. The ion exchange resin is transported by air and water as the slurry state, and the long distance transport of about 250 m is required in this new system. As clogging has to be avoided in this transportation, the experimental work was conducted to obtain the flow characteristics of slurry, and the test result is outlined. (Nakai, Y.)

  10. Microbial Diversity in Soil Treatment Systems for Wastewater

    Science.gov (United States)

    Van Cuyk, S.; Spear, J.; Siegrist, R.; Pace, N.

    2002-05-01

    There is an increasing awareness and concern over land based wastewater system performance with respect to the removal of bacteria and virus. The goal of this work is to describe and identify the organismal composition of the microbiota in the applied wastewater effluent, the rich biomat that develops at the infiltrative surface, and in the soil percolate in order to aid in the understanding of bacterial and virus purification in soil treatment systems. The traditional reliance on pure culture techniques to describe microbiota is circumvented by the employment of a molecular approach. Microbial community characterization is underway based on cloning and sequencing of 16S rRNA genes for phylogenetic analyses, to determine the nature and quantity of microbiota that constitute these ecosystems. Knowledge of the organisms naturally present can influence the design and treatment capacity of these widely used land based systems. Laboratory, intermediate and field scale systems are currently under study. Since human pathogens are known to exist in sewage effluents, their removal in wastewater infiltration systems and within the underlying soil are in need of a more fundamental understanding. The relationship between design parameters and environmental conditions, including a microbial characterization, is essential for the prevention of contamination in groundwater sources. Preliminary results indicate the presence of uncultured organisms and phylogenetic kinds that had not been detected in these systems using other methods. Acinetobacter johnsonii and Acrobacter cryaerophilus were the two dominant species found in septic tank effluent, comprising 20% and 11% of the library respectively. In soil samples collected from the infiltrative surface of a column dosed with STE, there was no dominant bacterial species present. Percolate samples collected from the outflow of the column showed that a tuber borchii symbiont, a common soil microorganism, dominated the bacterial

  11. Central nervous system side effects associated with zolpidem treatment.

    Science.gov (United States)

    Toner, L C; Tsambiras, B M; Catalano, G; Catalano, M C; Cooper, D S

    2000-01-01

    Zolpidem is one of the newer medications developed for the treatment of insomnia. It is an imidazopyridine agent that is an alternative to the typical sedative-hypnotic agents. Zolpidem use is gaining favor because of its efficacy and its side effect profile, which is milder and less problematic than that of the benzodiazepines and barbiturates used to treat insomnia. Still, side effects are not uncommon with zolpidem use. We report a series of cases in which the patients developed delirium, nightmares and hallucinations during treatment with zolpidem. We will review its pharmacology, discuss previous reports of central nervous system side effects, examine the impact of drug interactions with concurrent use of antidepressants, examine gender differences in susceptibility to side effects, and explore the significance of protein binding in producing side effects.

  12. Tendencies the treatment of the central nervous system (CNS) tumors

    International Nuclear Information System (INIS)

    Alert Silva, Jose; Jimenez Medina, Jose

    2004-01-01

    It is known that the treatment of the central nervous system (CNS) tumors is based on the use of surgery and radiotherapy (RT) and that chemotherapy (QMT) is used even more, as well as the other drugs. A bibliographic review was made to update the knowledge on the current trends and perspectives of RT applied to CNS tumors. The following were found among them: a) combinations of RT and CMT; b) radiosensitizers incorporated to the radiant treatment; c) angiogenesis inhibitors associated with RT; d) the scale-up or increase of the RT doses thanks to the development of new technologies, such as 3 D conformal radiotherapy, intensity- modulated radiotherapy, surgery and others. Another field of research is that of the changes in the rhythm or fractioning of the RT: hyperfractionated, accelerated, combinations of both, etc., which will allow mainly to increase the dosage scale-up

  13. Do health systems delay the treatment of poor children?

    DEFF Research Database (Denmark)

    Samuelsen, Helle; Tersbøl, Britt Pinkowski; Mbuyita, Selemani Said

    2013-01-01

    Child mortality remains one of the major public-health problems in Tanzania. Delays in receiving and accessing adequate care contribute to these high rates. The literature on public health often focuses on the role of mothers in delaying treatment, suggesting that they contact the health system too...... late and that they prefer to treat their children at home, a perspective often echoed by health workers. Using the three-delay methodology, this study focus on the third phase of the model, exploring the delays experienced in receiving adequate care when mothers with a sick child contact a health......-care facility. The overall objective is to analyse specific structural factors embedded in everyday practices at health facilities in a district in Tanzania which cause delays in the treatment of poor children and to discuss possible changes to institutions and social technologies....

  14. Comparison of DVH data from multiple radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    Ebert, M A; Kearvell, R; Hooton, B; Spry, N A; Bydder, S A; Joseph, D J; Haworth, A; Hug, B

    2010-01-01

    This study examined the variation of dose-volume histogram (DVH) data sourced from multiple radiotherapy treatment planning systems (TPSs). Treatment plan exports were obtained from 33 Australian and New Zealand centres during a dosimetry study. Plan information, including DVH data, was exported from the TPS at each centre and reviewed in a digital review system (SWAN). The review system was then used to produce an independent calculation of DVH information for each delineated structure. The relationships between DVHs extracted from each TPS and independently calculated were examined, particularly in terms of the influence of CT scan slice and pixel widths, the resolution of dose calculation grids and the TPS manufacturer. Calculation of total volume and DVH data was consistent between SWAN and each TPS, with the small discrepancies found tending to increase with decreasing structure size. This was significantly influenced by the TPS model used to derive the data. For target structures covered with relatively uniform dose distributions, there was a significant difference between the minimum dose in each TPS-exported DVH and that calculated independently. (note)

  15. Effect of systemic insulin treatment on diabetic wound healing.

    Science.gov (United States)

    Vatankhah, Nasibeh; Jahangiri, Younes; Landry, Gregory J; Moneta, Gregory L; Azarbal, Amir F

    2017-04-01

    This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation. Median age was 60.0 years (range: 31.1-90.1 years) and 58 cases (68.2%) were males. Twenty-four cases reached a complete healing (healing rate: 22.4%). The median follow-up period in subjects with classified as having chronic wounds was 6.0 months (range: 0.7-21.8 months). Insulin treatment was a part of diabetes management in 52 (61.2%) cases. Insulin therapy significantly increased the wound healing rate (30.3% [20/66 ulcers] vs. 9.8% [4/41 ulcers]) (p = 0.013). In multivariate random-effect logistic regression model, adjusting for age, gender, smoking status, type of diabetes, hypertension, chronic kidney disease, peripheral arterial disease, oral hypoglycemic use, wound infection, involved side, presence of Charcot's deformity, gangrene, osteomyelitis on x-ray, and serum hemoglobin A1C levels, insulin treatment was associated with a higher chance of complete healing (beta ± SE: 15.2 ± 6.1, p = 0.013). Systemic insulin treatment can improve wound healing in diabetic ulcers after adjusting for multiple confounding covariates. © 2017 by the Wound Healing Society.

  16. Integrated thermal treatment system study. Phase 2. Addendum system A8

    International Nuclear Information System (INIS)

    Biagi, C.; Teheranian, B.; Quapp, W.J.; Schwinkendorf, W.E.

    1996-05-01

    This is an addendum to the Integrated Treatment System Study - Phase 2 Results report. This addendum describes the technology and the operation of System A-8, Rotary Kiln, Air Combustion Gas, Dry-Wet APC, and Grout Stabilization. A process flow diagram, functional allocation diagrams, and plan views and perspective views for this system are attached. Detailed cost information for this subsystem is reported in Appendix A of this addendum

  17. Development of safeguards information treatment system at the facility level

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Doo; Song, Dae Yong; So, Dong Sup; Kwack, Eun Ho [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2000-04-01

    Safeguards Information Treatment System(SITS) at the facility level is required to implement efficiently the obligations under the Korea-IAEA Safeguards Agreement, bilateral agreements with other countries and domestic law. In this report, the requirements and major functions of SITS were considered, and the error checking methods and the relationships of safeguards information were reviewed. SITS will be developed to cover the different accounting procedures and methods applied at the various facilities under IAEA safeguards. Also, the resolved result of the Y2K problem in the existing nuclear material accounting program was described. 3 tabs. (Author)

  18. The proposed combustion standards and DOE thermal treatment systems

    International Nuclear Information System (INIS)

    McFee, J.; Hinman, M.B.; Eaton, D.; NcNeel, K.

    1997-01-01

    Under the provisions of the Clean Air Act (CAA) concerning emission of hazardous air pollutants (HAPs), the Environmental Protection Agency (EPA) published the proposed Revised Standards for Hazardous Waste Combustors on April 19, 1996 (EPA, 1996). These standards would apply to the existing Department of Energy (DOE) radioactive and mixed waste incinerators, and may be applied to several developing alternatives to incineration. The DOE has reviewed the basis for these regulations and prepared extensive comments to present concerns about the bases and implications of the standards. DOE is now discussing compliance options with the EPA for regulation of radioactive and mixed waste thermal treatment systems

  19. Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

    2013-01-01

    Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

  20. Quality aspects of ex vivo root canal treatments done by undergraduate dental students using four different endodontic treatment systems.

    Science.gov (United States)

    Jungnickel, Luise; Kruse, Casper; Vaeth, Michael; Kirkevang, Lise-Lotte

    2018-04-01

    To evaluate factors associated with treatment quality of ex vivo root canal treatments performed by undergraduate dental students using different endodontic treatment systems. Four students performed root canal treatment on 80 extracted human teeth using four endodontic treatment systems in designated treatment order following a Latin square design. Lateral seal and length of root canal fillings was radiographically assessed; for lateral seal, a graded visual scale was used. Treatment time was measured separately for access preparation, biomechanical root canal preparation, obturation and for the total procedure. Mishaps were registered. An ANOVA mirroring the Latin square design was performed. Use of machine-driven nickel-titanium systems resulted in overall better quality scores for lateral seal than use of the manual stainless-steel system. Among systems with machine-driven files, scores did not significantly differ. Use of machine-driven instruments resulted in shorter treatment time than manual instrumentation. Machine-driven systems with few files achieved shorter treatment times. With increasing number of treatments, root canal-filling quality increased, treatment time decreased; a learning curve was plotted. No root canal shaping file separated. The use of endodontic treatment systems with machine-driven files led to higher quality lateral seal compared to the manual system. The three contemporary machine-driven systems delivered comparable results regarding quality of root canal fillings; they were safe to use and provided a more efficient workflow than the manual technique. Increasing experience had a positive impact on the quality of root canal fillings while treatment time decreased.

  1. Hospitals as a 'risk environment': an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs.

    Science.gov (United States)

    McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

    2014-03-01

    People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the 'risk environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm

  2. System and method for treatment of a medium

    Science.gov (United States)

    Singh, Surinder Prabhjot; Acharya, Harish Radhakrishna; Perry, Robert James; McDermott, John Brian

    2017-05-23

    A system and method for treatment of a medium is disclosed. The system includes a plurality of separator zones and a plurality of heat transfer zones. Each of the separator zone and the heat transfer zone among the plurality of separator zones and heat transfer zones respectively, are disposed alternatively in a flow duct. Further, each separator zone includes an injector device for injecting a sorbent into the corresponding separator zone. Within the corresponding separator zone, the injected sorbent is reacted with a gaseous medium flowing in the flow duct, so as to generate a reacted gaseous medium and a reacted sorbent. Further, each heat transfer zone exchanges heat between the reacted gaseous medium fed from the corresponding separator zone and a heat transfer medium.

  3. Topical vs. systemic treatments for acute otitis media.

    Science.gov (United States)

    Thornton, Kathy; Parrish, Francie; Swords, Christine

    2011-01-01

    Acute otitis media (AOM) is a common condition in children that is often treated with systemic antibiotic therapy; however, research suggests that non-complicated AOM will resolve spontaneously using only eardrops. To determine best practice for the use of systematic antibiotics compared to topical treatment of AOM, a systematic review of evidence was conducted. Cochrane, Medline, CINAHL, and other databases were searched. Inclusion criteria were studies published from 1995-2010 that included children with AOM and were randomized controlled trials (RCTs). Five systematic reviews and five RCTs were included in the review. Current evidence recommends using topical and other alternative approaches for treating non-complicated AOM in children 2 years of age or older; however, many practitioners are not currently following these recommendations for various reasons. Additional research to address these reasons may help determine how to improve practitioner adherence to best practice evidence and guidelines to help reduce the unnecessary use of systemic antibiotics.

  4. Family medicine physicians' advice about use of nonconventional modalities for menopausal symptom management.

    Science.gov (United States)

    Grant, Kathryn; Burg, Mary Ann; Fraser, Kathryn; Gui, Serena; Kosch, Shae Graham; Nierenberg, Barry; Oyama, Oliver; Pomm, Heidi; Sibille, Kimberly; Spruill, Timothy; Swartz, Virginia

    2007-05-01

    This study explores the beliefs and practices of family medicine physicians regarding the use of nonconventional modalities for menopausal symptom management. Anonymous self-administered questionnaires were distributed to faculty and residents from eight participating family medicine residency programs around Florida, with an overall response rate of 66% (212 respondents). The survey explored what physicians report about patterns of patient inquiries and their responses to patients' inquiries about nonconventional modalities for specific menopausal symptoms and what physicians' report on their advice to patients about using specific herbs and supplements for menopausal symptom relief. Behavioral approaches were encouraged more than herbal therapies, acupuncture, and body therapies for the treatment of most of the menopausal symptoms. However, the most frequent response category was No advice. Resident physicians were significantly more likely than faculty to encourage acupuncture. Faculty physicians were more likely than residents to recommend particular herbal remedies. The majority of the respondents believed there was not sufficient evidence for recommending any of the herbs and supplements listed. These data reveal some important trends about how family medicine physicians respond to nontraditional approaches for menopausal symptom management. Because family medicine physicians typically receive some training in behavioral and psychotherapeutic approaches and there is some evidence for the effectiveness of behavioral strategies in menopausal symptom management, it is not surprising that they are more likely to endorse these approaches. Most family medicine physicians, however, have little or no training in the other nonconventional modalities, and our data show that these modalities received lower levels of endorsement, suggesting that physicians are not clear on their advantages or disadvantages.

  5. Water treatment in the EBR-II steam system

    International Nuclear Information System (INIS)

    Klein, M.A.; Hurst, H.

    1975-01-01

    Boiler-water treatment in the EBR-II steam system consists of demineralizing makeup water and using hydrazine to remove traces of oxygen and morpholine to adjust pH to 8.8-9.2. This treatment is called a ''zero-solids'' method, because the chemical agents and reaction products are either volatile or form water and do not contribute solids to the boiler water. A continuous blowdown is cooled, filtered, and deionized to remove impurities and maintain high purity of the water. If a cooling-water leak occurs, phosphate is added to control scaling, and the ''zero-solids'' eatment is suspended until the leak is repaired. Water streams are sampled at six points to control water purity. Examination of the steam drum and an evaporator show the metal surfaces to be in excellent condition with minimal corrosion. The EBR-II steam-generating plant has accumulated over 85,000 hours of in-service operation and has operated successfully for over ten years with the ''zero-solids'' treatment. (auth)

  6. Periodontal disease, periodontal treatment and systemic nitric oxide in dogs.

    Science.gov (United States)

    Nemec, A; Verstraete, F J M; Jerin, A; Šentjurc, M; Kass, P H; Petelin, M; Pavlica, Z

    2013-06-01

    Thirty-two client-owned dogs treated for periodontal disease were divided in group 1 if no periodontitis, group 2 if ≤25%, and group 3 if >25% of the teeth present were affected with periodontitis. Blood was tested before and 2 weeks after periodontal therapy for nitrosyl hemoglobin (HbNO), plasma nitrite/nitrate (NOx) and 3-nitrotyrosine (NT) levels. No HbNO was detected in any of the animals tested. There was no significant difference in the NOx plasma levels within each group or across the groups before and after the treatment, but a noticeable increase in NOx plasma levels was observed in group 3 after the treatment. Plasma NT was detected in only one third of the animals. NO levels varied greatly across individual dogs. The data are suggestive of an overall increase in systemic NO response 2 weeks after periodontal treatment in dogs with advanced periodontal disease, but the response is greatly individually-dependent. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Ionic interactions in biological and physical systems: a variational treatment.

    Science.gov (United States)

    Eisenberg, Bob

    2013-01-01

    Chemistry is about chemical reactions. Chemistry is about electrons changing their configurations as atoms and molecules react. Chemistry has for more than a century studied reactions as if they occurred in ideal conditions of infinitely dilute solutions. But most reactions occur in salt solutions that are not ideal. In those solutions everything (charged) interacts with everything else (charged) through the electric field, which is short and long range extending to the boundaries of the system. Mathematics has recently been developed to deal with interacting systems of this sort. The variational theory of complex fluids has spawned the theory of liquid crystals (or vice versa). In my view, ionic solutions should be viewed as complex fluids, particularly in the biological and engineering context. In both biology and electrochemistry ionic solutions are mixtures highly concentrated (to approximately 10 M) where they are most important, near electrodes, nucleic ids, proteins, active sites of enzymes, and ionic channels. Ca2+ is always involved in biological solutions because the concentration (really free energy per mole) of Ca2+ in a particular location is the signal that controls many biological functions. Such interacting systems are not simple fluids, and it is no wonder that analysis of interactions, such as the Hofmeister series, rooted in that tradition has not succeeded as one would hope. Here, we present a variational treatment of ard spheres in a frictional dielectric with the hope that such a treatment of an lectrolyte as a complex fluid will be productive. The theory automatically extends to spatially nonuniform boundary conditions and the nonequilibrium systems and flows they produce. The theory is unavoidably self-consistent since differential equations are derived (not assumed) from models of (Helmholtz free) nergy and dissipation of the electrolyte. The origin of the Hofmeister series is (in my view) an inverse problem that becomes well posed when

  8. Innovation and Patchwork Partnerships: Advice Services in Austere Times

    Directory of Open Access Journals (Sweden)

    Alice Forbess

    2017-12-01

    Full Text Available In the UK’s austerity regime, government spending has been slashed, while audit regimes tie up officers of charitable organisations in bureaucracy rather than leaving them free to attend to the substance of their jobs. These funding-cuts-masquerading-as-market-based-restructuring have drastically affected the provision of advice to welfare dependents. But advisers, and the organisations they work for, piece together new patchworks of funds, devise new forms of face-to-face advice, and rework the boundaries of the law. Local authority funds are invested to yield returns from centrally-funded sources. People are helped to honour their tax commitments while challenging debts incurred from the incorrect award and reclaim of benefits, and to pay their council tax and rent. For advisers, austerity is more a matter of seeking new resource flows, inventing novel interventions, and creating new spaces where justice may be sought and found, than of passively accepting funding cuts. En el Reino Unido, las políticas de recortes de fondos maquilladas como restructuraciones basadas en el mercado han afectado drásticamente la provisión a los dependientes de la asistencia social. Pero los asesores y las organizaciones para las que trabajan forman nuevos tejidos de fondos financieros, ingenian nuevas formas de ayudar en persona y reconfiguran los límites de la ley. Los fondos financieros de los gobiernos locales se invierten para obtener réditos de fuentes de financiación centralizada. Se ayuda a la gente a cumplir con sus obligaciones fiscales y, al mismo tiempo, a recortar las deudas generadas por una incorrecta concesión y reclamación de prestaciones, y a pagar sus tasas municipales y sus alquileres. Para los asesores, la austeridad es una cuestión de buscar nuevos flujos de recursos, idear nuevas formas de intervención y crear nuevos espacios en los que la justicia pueda ser buscada y hallada. DOWNLOAD THIS PAPER FROM SSRN: http

  9. [Pre-travel advice and patient education of Hungarian travellers].

    Science.gov (United States)

    Lengyel, Ingrid; Felkai, Péter

    2018-03-01

    According to international surveys, over half of the travellers face some kind of health issue when travelling. The overwhelming majority of travel-related illnesses can be prevented with pre-travel medical consultations, but the syllabus and content of the consultation have to match the travel habits and culture of the given society. This publication explores the specificities and travel habits of Hungarian travellers. One hundred participants of a travel exhibition completed a survey about their international travel. As the survey was not representative, the data could only be processed through simple statistical methods. However, since the exhibition was presumably attended by those wishing to travel, the conclusions drawn from the results are worth publishing, since no similar survey in Hungary has been published before. Based on the suitable classification of age groups in travel medicine, 11% of the participants were adolescents / young adults (aged 15-24), 81% adults (25-59) and 8% elderly (60-74). Twenty-eight percent of the participants travel multiple times a year, 40% yearly and 32% of them less frequently; 16% of the adults, 8% of the adolescents and 4% of the elderly age group travel multiple times a year. The travel destinations of Hungarian travellers have remained practically unchanged since a study was conducted 13 years ago: the vast majority (95%) travelled within Europe, 2% to the United States, and 11% of them elsewhere. Since Hungarians do not travel to endemic areas, only 5% consulted their general practitioners (GPs) prior to travelling, and 29% did when they had to be vaccinated. Forty-two percent of those wishing to travel never consult their GPs, even though 29% of them are aware of some chronic illness. Instead, 51% gather their health information from the internet and only 6% from their doctors. By the contradiction between the poor health status of the majority of Hungarian travellers and the negligence of seeking pre-travel advice

  10. Just ask Siri? A pilot study comparing smartphone digital assistants and laptop Google searches for smoking cessation advice.

    Science.gov (United States)

    Boyd, Matt; Wilson, Nick

    2018-01-01

    To compare voice-activated internet searches by smartphone (two digital assistants) with laptop ones for information and advice related to smoking cessation. Responses to 80 questions on a range of topics related to smoking cessation (including the FAQ from a NHS website), compared for quality. Smartphone and internet searches as performed in New Zealand. Ranked responses to the questions. Google laptop internet searches came first (or first equal) for best quality smoking cessation advice for 83% (66/80) of the responses. Voiced questions to Google Assistant ("OK Google") came first/first equal 76% of the time vs Siri (Apple) at 28%. Google and Google Assistant were statistically significantly better than Siri searches (odds ratio 12.4 and 8.5 respectively, pGoogle internet searches and Google Assistant were found to be significantly superior to the Siri digital assistant for smoking cessation information. While expert content was returned over half the time, there is still substantial room for improvement in how these software systems deliver smoking cessation advice.

  11. Environmentally safe system for treatment of bio corrosion of ETICS

    Directory of Open Access Journals (Sweden)

    Minarovičová Katarína

    2018-01-01

    Full Text Available Effects of microorganisms on building facades are responsible for aesthetic, bio-geophysical and biogeochemical deterioration. The process of cleaning of contaminated facades involves the removal and eradication of micro flora on the surface of insulation using chemical products, killing cells and eliminating all living mass, including organic ingredients. The removal of bio corrosion coating from ETICS structure by means of chemical and preservative substances (biocides is currently the only effective and most used technology. Uncontrolled leaching of the used biocides is unacceptable. Meantime, new technology for environmentally safe maintenance of ETICS is needed. Scientists have been working on replacement the biocides currently used in facades treatment with eco-friendly biocides that have no negative effects on the environment or human beings. While the eco- treatment will be available, safe dewatering of chemicals being leached from the surface of the facade could be provided by e.g. special drain systems adjusted to the building type, use and age. The paper gives an overview of the problem in context of Slovakia and examples of leaching systems designed for new and renovated buildings.

  12. Phosphorus in soil treatment systems: accumulation and mobility.

    Science.gov (United States)

    Eveborn, David; Gustafsson, Jon Petter; Elmefors, Elin; Yu, Lin; Eriksson, Ann-Kristin; Ljung, Emelie; Renman, Gunno

    2014-11-01

    Septic tanks with subsequent soil treatment systems (STS) are a common treatment technique for domestic wastewater in rural areas. Phosphorus (P) leakage from such systems may pose a risk to water quality (especially if they are located relatively close to surface waters). In this study, six STS in Sweden (11-28 years old) were examined. Samples taken from the unsaturated subsoil beneath the distribution pipes were investigated by means of batch and column experiments, and accumulated phosphorus were characterized through X-ray absorption near edge structure (XANES) analysis. At all sites the wastewater had clearly influenced the soil. This was observed through decreased pH, increased amounts of oxalate extractable metals and at some sites altered P sorption properties. The amount of accumulated P in the STS were found to be between 0.32 and 0.87 kg m(-3), which in most cases was just a fraction of the estimated P load (<30%). Column studies revealed that high P concentrations (up to 6 mg L(-1)) were leached from the material when deionized water was applied. However, the response to deionized water varied between the sites. As evidenced by XANES analysis, aluminium phosphates or P adsorbed to aluminium (hydr)oxides, as well as organically bound P, were important sinks for P. Generally soils with a high content of oxalate-extractable Al were also less vulnerable to P leakage. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Potential applications of plasma science techniques for water treatment systems

    International Nuclear Information System (INIS)

    Pavlik, D.

    1994-01-01

    The historical evolution of water treatment techniques and their impact on man and his environment are presented. Ancient man recognized the relationship between good water and good health. However, it was not until the late 1800's that man's own contribution to the pollution of water via biological and chemical contamination of the water stream was recognized as having adverse affects on water quality. Since that time virtually every nation has adopted laws and regulations to ensure that safe sources of unpolluted water are available to its citizens. In the United States, water quality is governed by the Clean Water Act of 1972 administered at the federal level by the Environmental Protection Agency (EPA). Further, each state has established its equivalent agency which administers its own laws and regulations. Different biological and chemical biohazards present in the water system are discussed. Biological contaminants include various types of viruses, bacteria, fungii, molds, yeasts, algae, amoebas, and parasites. Chemical contaminates include elemental heavy metals and other organic and inorganic compounds which interfere with normal biological functions. Conventional water treatments for both consumption and sewage effluent commonly employ four different principals: mechanical filtration, quiescent gravity settling, biological oxidation, and chemical treatment. Although these techniques have greatly reduced the incidence of water-borne disease recent studies suggest that more effective means of eliminating biohazards are needed. Regulatory requirements for more aggressive treatment and elimination of residual contaminants present a significant opportunity for the application of various forms of electromagnetic radiation techniques. A comparison between conventional techniques and more advanced methods using various forms of electromagnetic radiation is discussed

  14. The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

    Science.gov (United States)

    Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

    2016-03-28

    In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for

  15. SNF sludge treatment system preliminary project execution plan

    International Nuclear Information System (INIS)

    Flament, T.A.

    1998-01-01

    The Fluor Daniel Hanford, Inc. (FDH) Project Director for the Spent Nuclear Fuel (SNF) Project has requested Numatec Hanford Company (NHC) to define how Hanford would manage a new subproject to provide a process system to receive and chemically treat radioactive sludge currently stored in the 100 K Area fuel retention basins. The subproject, named the Sludge Treatment System (STS) Subproject, provides and operates facilities and equipment to chemically process K Basin sludge to meet Tank Waste Remediation System (TWRS) requirements. This document sets forth the NHC management approach for the STS Subproject and will comply with the requirements of the SNF Project Management Plan (HNF-SD-SNFPMP-011). This version of this document is intended to apply to the initial phase of the subproject and to evolve through subsequent revision to include all design, fabrication, and construction conducted on the project and the necessary management and engineering functions within the scope of the subproject. As Project Manager, NHC will perform those activities necessary to complete the STS Subproject within approved cost and schedule baselines and turn over to FDH facilities, systems, and documentation necessary for operation of the STS

  16. Centrifugal Filtration System for Severe Accident Source Term Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Shu Chang; Yim, Man Sung [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    The objective of this paper is to present the conceptual design of a filtration system that can be used to process airborne severe accident source term. Reactor containment may lose its structural integrity due to over-pressurization during a severe accident. This can lead to uncontrolled radioactive releases to the environment. For preventing the dispersion of these uncontrolled radioactive releases to the environment, several ways to capture or mitigate these radioactive source term releases are under investigation at KAIST. Such technologies are based on concepts like a vortex-like air curtain, a chemical spray, and a suction arm. Treatment of the radioactive material captured by these systems would be required, before releasing to environment. For current filtration systems in the nuclear industry, IAEA lists sand, multi-venturi scrubber, high efficiency particulate arresting (HEPA), charcoal and combinations of the above in NS-G-1-10, 4.143. Most if not all of the requirements of the scenario for applying this technology near the containment of an NPP site and the environmental constraints were analyzed for use in the design of the centrifuge filtration system.

  17. Nutrient fate in aquacultural systems for waste treatment

    Energy Technology Data Exchange (ETDEWEB)

    Dontje, J.H.; Clanton, C.J.

    1999-08-01

    Twelve small, recirculating aquacultural systems were operated for livestock waste treatment to determine nutrient fate. Each system consisted of a 730-L fish tank coupled in a recirculating loop with three sand beds (serving as biofilters) in parallel. Fish (Tilapia species) were grown in the tanks while cattails, reed canary grass, and tomatoes were grown in separate sand beds. Swine waste was added to the fish tanks every other day at average rates of 50, 72, 95, and 118 kg-COD/ha/day of fish tank surface (three replications of each loading rate). Water from the fish tanks was filtered through the sand beds three times per day with 20% of the tank volume passing through the sand each day. The systems were operated in a greenhouse for eight months (21 July to 8 March). Aboveground plant matter was harvested at eight-week intervals. The fish were removed after four months and the tanks were restocked with fingerlings. Initial and final nitrogen (N), phosphorus (P), and potassium (K) contents of the system components, as well as that of the harvested plants and fish, were determined. Nutrient balance calculations revealed that 30 to 68% of added N was lost from the systems, probably via denitrification. Nutrient removal by plants was 6 to 18% for N, 8 to 21% for P, and 25 to 71% for K, with tomatoes (foliage and fruit) accounting for the majority of the removal. Plant growth was limited by growing conditions (particularly day length), not be nutrient availability. Fish growth was limited by temperature; thus nutrient extraction by the fish was minimal. Under the conditions of this experiment, the system required supplemental aeration.

  18. The role of financial literacy and advice in fi nancial decision making ...

    African Journals Online (AJOL)

    A growing body of research is focused on determining to what extent fi nancial advice can act as a substitute for low levels of fi nancial literacy. To date, studies have found confl icting results. This study used data from a national survey of South Africans to determine whether advice could substitute for low levels of fi nancial ...

  19. The visual advice centre Eindhoven, an experiment in Dutch low vision care

    NARCIS (Netherlands)

    Neve, J.J.; Jorritsma, F.F.; Kinds, G.F.; Kooijman, A.C.; Looijestijn, P.L.; Welling, J.A.; Wildt, van der G.J.

    1994-01-01

    The Visual Advice Centre Eindhoven (VAC-E) provides the partially sighted with advice and prescriptions for low vision aids and illumination on the basis of an examination of their individual needs and their residual visual abilities. In the Dutch context of low vision care the V AC-E can be

  20. Empowering Girls through Sport? Sports Advice Books for Young Female Readers

    Science.gov (United States)

    Heinecken, Dawn

    2016-01-01

    Advice books by female athletes are among the top selling sports books for young readers in the US. Though they have received little attention to date, sports advice books are important to examine because of how they function as a form of conduct manual instructing girls in specific understandings of female identity. Implying that girls face…

  1. Smoking cessation advice in consultations with health problems not related to smoking?

    DEFF Research Database (Denmark)

    Guassora, Ann Dorrit Kristiane; Baarts, Charlotte

    2010-01-01

    and was primarily discussed if it posed a particular risk to a particular patient. Smoking cessation advice also occurred in conversations addressing the patient ’ s well-being. If occurring without any other readable frame, smoking cessation advice was apt to be perceived by patients as part of a public campaign...

  2. 21 CFR 312.41 - Comment and advice on an IND.

    Science.gov (United States)

    2010-04-01

    .... Examples of such advice may include advice on the adequacy of technical data to support an investigational plan, on the design of a clinical trial, and on whether proposed investigations are likely to produce the data and information that is needed to meet requirements for a marketing application. (c) Unless...

  3. Treatment of poly- and perfluoroalkyl substances in U.S. full-scale water treatment systems.

    Science.gov (United States)

    Appleman, Timothy D; Higgins, Christopher P; Quiñones, Oscar; Vanderford, Brett J; Kolstad, Chad; Zeigler-Holady, Janie C; Dickenson, Eric R V

    2014-03-15

    The near ubiquitous presence of poly- and perfluoroalkyl substances (PFASs) in humans has raised concerns about potential human health effects from these chemicals, some of which are both extremely persistent and bioaccumulative. Because some of these chemicals are highly water soluble, one major pathway for human exposure is the consumption of contaminated drinking water. This study measured concentrations of PFASs in 18 raw drinking water sources and 2 treated wastewater effluents and evaluated 15 full-scale treatment systems for the attenuation of PFASs in water treatment utilities throughout the U.S. A liquid-chromatography tandem mass-spectrometry method was used to enable measurement of a suite of 23 PFASs, including perfluorocarboxylic acids (PFCAs) and perfluorosulfonic acids (PFSAs). Despite the differences in reporting levels, the PFASs that were detected in >70% of the source water samples (n = 39) included PFSAs, perfluorobutane sulfonic acid (74%), perfluorohexane sulfonic acid (79%), and perfluorooctane sulfonic acid (84%), and PFCAs, perfluoropentanoic acid (74%), perfluorohexanoic acid (79%), perfluoroheptanoic acid (74%), and perfluorooctanoic acid (74%). More importantly, water treatment techniques such as ferric or alum coagulation, granular/micro-/ultra- filtration, aeration, oxidation (i.e., permanganate, ultraviolet/hydrogen peroxide), and disinfection (i.e., ozonation, chlorine dioxide, chlorination, and chloramination) were mostly ineffective in removing PFASs. However, anion exchange and granular activated carbon treatment preferably removed longer-chain PFASs and the PFSAs compared to the PFCAs, and reverse osmosis demonstrated significant removal for all the PFASs, including the smallest PFAS, perfluorobutanoic acid. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Advice concerning the early diagnosis of bronchial carcinoma

    International Nuclear Information System (INIS)

    1982-01-01

    Bronchial carcinoma is in the Netherlands for men the most frequent type of cancer; the incidence in women is rising. In the Netherlands nowadays, per year about 7100 persons die of this disease which therefore constitutes an important public health problem. The request of advice asks - among other things - whether in the future the periodical X-ray examination of the thorax for the detection of tuberculosis of persons over 40 years can be continued for presymptomatic cases of bronchial carcinoma. The available relevant literature does not yet give indications that periodical mass radiography has any influence on the morbidity and mortality of the disease. On the other hand, literature describing clinical experience shows that the prognosis of patients with bronchial carcinoma, detected in an early presymptomatic stage, is essentially better than in the case of patients with symptomatic disease. A critical analysis of the literature does not furnish epidemiological arguments to recommend periodical mass radiography for bronchial carcinoma. However, because lungcancer forms an extremely important public health problem and because the scarcity of randomized; controlled studies in this field, the committee advises - from a scientific point of view - to perform such a study in one or preferably two regions in the Netherlands. A number of conditions are mentioned which such a study at least should meet. (Auth.)

  5. Top-selling childbirth advice books: a discourse analysis.

    Science.gov (United States)

    Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

    2009-12-01

    Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

  6. Inspiration from role models and advice for moving forward.

    Science.gov (United States)

    Newman, Michelle G; McGinn, Lata K

    2012-12-01

    This Behavior Therapy series on overcoming the glass ceiling followed from a highly attended panel at ABCT on the same topic. The current paper summarizes the common themes across the various papers in this series with respect to obstacles prominent women have faced, and how we can learn from their stories to help inform the future. These themes include the importance of role models, messages from a supportive environment, difficulties balancing careers with children, coordinating careers with family, importance of taking charge of one's career, moving forward despite negative internal and external messages, and questions about whether things have changed substantially. In addition, this paper contains a summary of the helpful advice from accomplished women in academia for navigating the academic waters. It is our aspiration that going forward this series will stimulate other conversations as well as increase thought, behavior, solidarity, and awareness about this topic so that we can continue to work toward a future when things will continue to improve for women. Copyright © 2012. Published by Elsevier Ltd.

  7. Refugees' advice to physicians: how to ask about mental health.

    Science.gov (United States)

    Shannon, Patricia J

    2014-08-01

    About 45.2 million people were displaced from their homes in 2012 due to persecution, political conflict, generalized violence and human rights violations. Refugees who endure violence are at increased risk of developing chronic psychiatric disorders such as posttraumatic stress disorder and major depression. The primary care visit may be the first opportunity to detect the devastating psychological effects of trauma. Physicians and refugees have identified communication barriers that inhibit discussions about mental health. In this study, refugees offer advice to physicians about how to assess the mental health effects of trauma. Ethnocultural methodology informed 13 focus groups with 111 refugees from Burma, Bhutan, Somali and Ethiopia. Refugees responded to questions concerning how physicians should ask about mental health in acceptable ways. Focus groups were recorded, transcribed and analyzed using thematic categorization informed by Spradley's Developmental Research Sequence. Refugees recommended that physicians should take the time to make refugees comfortable, initiate direct conversations about mental health, inquire about the historical context of symptoms and provide psychoeducation about mental health and healing. Physicians may require specialized training to learn how to initiate conversations about mental health and provide direct education and appropriate mental health referrals in a brief medical appointment. To assist with making appropriate referrals, physicians may also benefit from education about evidence-based practices for treating symptoms of refugee trauma. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Endocrine system on chip for a diabetes treatment model.

    Science.gov (United States)

    Nguyen, Dao Thi Thuy; van Noort, Danny; Jeong, In-Kyung; Park, Sungsu

    2017-02-21

    The endocrine system is a collection of glands producing hormones which, among others, regulates metabolism, growth and development. One important group of endocrine diseases is diabetes, which is caused by a deficiency or diminished effectiveness of endogenous insulin. By using a microfluidic perfused 3D cell-culture chip, we developed an 'endocrine system on chip' to potentially be able to screen drugs for the treatment of diabetes by measuring insulin release over time. Insulin-secreting β-cells are located in the pancreas, while L-cells, located in the small intestines, stimulate insulin secretion. Thus, we constructed a co-culture of intestinal-pancreatic cells to measure the effect of glucose on the production of glucagon-like peptide-1 (GLP-1) from the L-cell line (GLUTag) and insulin from the pancreatic β-cell line (INS-1). After three days of culture, both cell lines formed aggregates, exhibited 3D cell morphology, and showed good viability (>95%). We separately measured the dynamic profile of GLP-1 and insulin release at glucose concentrations of 0.5 and 20 mM, as well as the combined effect of GLP-1 on insulin production at these glucose concentrations. In response to glucose stimuli, GLUTag and INS-1 cells produced higher amounts of GLP-1 and insulin, respectively, compared to a static 2D cell culture. INS-1 combined with GLUTag cells exhibited an even higher insulin production in response to glucose stimulation. At higher glucose concentrations, the diabetes model on chip showed faster saturation of the insulin level. Our results suggest that the endocrine system developed in this study is a useful tool for observing dynamical changes in endocrine hormones (GLP-1 and insulin) in a glucose-dependent environment. Moreover, it can potentially be used to screen GLP-1 analogues and natural insulin and GLP-1 stimulants for diabetes treatment.

  9. Schizophrenia and the immune system: pathophysiology, prevention, and treatment.

    Science.gov (United States)

    Richard, Michelle D; Brahm, Nancy C

    2012-05-01

    Published evidence on established and theoretical connections between immune system dysfunction and schizophrenia is reviewed, with a discussion of developments in the search for immunologically-targeted treatments. A growing body of evidence indicates that immunologic influences may play an important role in the etiology and course of schizophrenia. A literature search identified more than 100 articles pertaining to suspected immunologic influences on schizophrenia published over the past 15 years. Schizophrenia researchers have explored a wide range of potential immune system-related causal or contributory factors, including neurobiological and neuroanatomical disorders, genetic abnormalities, and environmental influences such as maternal perinatal infection. Efforts to establish an immunologic basis for schizophrenia and identify reliable immune markers continue to be hindered by sampling challenges and methodological problems. In aggregate, the available evidence indicates that at least some cases of schizophrenia have an immunologic component, suggesting that immune-focused prevention strategies (e.g., counseling of pregnant women to avoid immune stressors) and close monitoring of at-risk children are appropriate. While antipsychotics remain the standard treatments for schizophrenia, a variety of drugs with immunologic effects have been investigated as adjunctive therapies, with variable and sometimes conflicting results; these include the cyclooxygenase-2 inhibitor celecoxib, immune-modulating agents (e.g., azathioprine and various anticytokine agents such as atlizumab, anakinra, and tumor necrosis factor-α blockers), and an investigational anti-interferon-γ agent. The published evidence indicates that immune system dysfunction related to genetic, environmental, and neurobiological influences may play a role in the etiology of schizophrenia in a subset of patients.

  10. For the sake of whom: conversation analysis of advice giving in offender counseling.

    Science.gov (United States)

    Jing-ying, Guo

    2013-08-01

    Regarded as beneficial and preferable to the clients, advice delivery has been an integral part of counseling; however, there are controversies over the suitability of giving advice in counseling services, including counseling conducted in the context of prisons. Based on conversation analysis, this article tries to explore when and how police counselors in two Chinese prisons give advice and how inmate clients respond to and seek advice in offender counseling. It is found that advice delivery, supposed to be for the inmate clients' sake, only serves a phatic function in the context of prisons in which security is a priority, and transforming inmates into law-abiding citizen is the overall goal of prison rehabilitation and correction. Hence, offender counselors, intending to alleviate depression and anxiety in inmate clients, are caught in a dilemma.

  11. Adult Central Nervous System Tumors Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Adult central nervous system tumor treatment may include surgery, radiosurgery, radiation therapy, chemotherapy, surveillance, and targeted therapy. Treatment depends on the tumor type. Learn more about brain and spinal tumor treatment in this expert-reviewed summary.

  12. Nitrogen transformations in a waterhyacinth-based water treatment system

    International Nuclear Information System (INIS)

    Moorhead, K.K.; Reddy, K.R.; Graetz, D.A.

    1988-01-01

    Fate of added 15 NH 4 -N and 15 NO 3 -N in waterhyacinth [Eichhornia crassipes (Mart.) Solms]-based water treatment system was evaluated under controlled conditions. Labeled 15 NH 4 -N uptake by waterhyacinth exceeded 15 NO 3 -N uptake. Total 15 N recovery by waterhyacinth ranged from 57 to 72% for added 15 NO 3 -N and 70 to 89% for added 15 NH 4 -N. Both sediment and detritus were potential sources of N for waterhyacinths. Waterhyacinths cultured in sewage effluent removed 55% of the added 15 NH 4 -N and 14% of the added 15 NO 3 -N, respectively. Three to 44% of the added 15 NH 4 -N was lost through nitrification in the water column and subsequent denitrification in the underlying sediments, whereas 24 to 86% of the added 15 NO 3 -N was lost through denitrification. In a system without plants, 13 to 89% of the added 15 NH 4 -N and 48 to 96% of the added 15 NO 3 -N were lost from the system through a combination of nitrification/denitrification and NH 3 volatilization

  13. Oral immune therapy: targeting the systemic immune system via the gut immune system for the treatment of inflammatory bowel disease.

    Science.gov (United States)

    Ilan, Yaron

    2016-01-01

    Inflammatory bowel diseases (IBD) are associated with an altered systemic immune response leading to inflammation-mediated damage to the gut and other organs. Oral immune therapy is a method of systemic immune modulation via alteration of the gut immune system. It uses the inherit ability of the innate system of the gut to redirect the systemic innate and adaptive immune responses. Oral immune therapy is an attractive clinical approach to treat autoimmune and inflammatory disorders. It can induce immune modulation without immune suppression, has minimal toxicity and is easily administered. Targeting the systemic immune system via the gut immune system can serve as an attractive novel therapeutic method for IBD. This review summarizes the current data and discusses several examples of oral immune therapeutic methods for using the gut immune system to generate signals to reset systemic immunity as a treatment for IBD.

  14. Advice about infant feeding for allergy prevention: A confusing picture for Australian consumers?

    Science.gov (United States)

    Netting, Merryn J; Allen, Katrina J

    2017-09-01

    Early feeding plays an important role in programming the immune system, particularly the risk of food allergy. There are many infant feeding guides published for consumers available in Australia, with most based on the National Health and Medical Research Council (NHMRC) 2012 Infant Feeding Guidelines for Health Workers and the Australasian Society of Clinical Immunology and Allergy (ASCIA) Infant Feeding Advice for allergy prevention. We sought to compare allergy-specific content of infant feeding educational material written for parents with these two documents. Australian websites of children's hospitals, early child health organisations and consumer groups providing information about diet during pregnancy, breastfeeding and early infancy were compared with NHMRC and ASCIA guidelines. Twenty-five sets of infant feeding information were identified. Food allergy was discussed in 18 resources. Recommended length of exclusive breastfeeding and timing of commencing solid foods was consistently around 6 months, with some variation in wording. Advice regarding to include and not delay introduction of common allergens into babies' diets was generally consistent with NHMRC and ASCIA recommendations, however the audit identified some resources that still recommended delayed introduction of common allergens. As consumers have access to a plethora of health information it is imperative that information about infant feeding from health-care authorities is simple, evidence-based and consistent to avoid confusion. Use of consensus wording related to infant feeding guidelines to prevent allergies will provide clear messages related to the timing of introduction to solid foods and inclusion of allergens in the early diet. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  15. Treatment planning systems dosimetry auditing project in Portugal.

    Science.gov (United States)

    Lopes, M C; Cavaco, A; Jacob, K; Madureira, L; Germano, S; Faustino, S; Lencart, J; Trindade, M; Vale, J; Batel, V; Sousa, M; Bernardo, A; Brás, S; Macedo, S; Pimparel, D; Ponte, F; Diaz, E; Martins, A; Pinheiro, A; Marques, F; Batista, C; Silva, L; Rodrigues, M; Carita, L; Gershkevitsh, E; Izewska, J

    2014-02-01

    The Medical Physics Division of the Portuguese Physics Society (DFM_SPF) in collaboration with the IAEA, carried out a national auditing project in radiotherapy, between September 2011 and April 2012. The objective of this audit was to ensure the optimal usage of treatment planning systems. The national results are presented in this paper. The audit methodology simulated all steps of external beam radiotherapy workflow, from image acquisition to treatment planning and dose delivery. A thorax CIRS phantom lend by IAEA was used in 8 planning test-cases for photon beams corresponding to 15 measuring points (33 point dose results, including individual fields in multi-field test cases and 5 sum results) in different phantom materials covering a set of typical clinical delivery techniques in 3D Conformal Radiotherapy. All 24 radiotherapy centers in Portugal have participated. 50 photon beams with energies 4-18 MV have been audited using 25 linear accelerators and 32 calculation algorithms. In general a very good consistency was observed for the same type of algorithm in all centres and for each beam quality. The overall results confirmed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy is generally acceptable with no major causes for concern. This project contributed to the strengthening of the cooperation between the centres and professionals, paving the way to further national collaborations. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Ecological System Influences in the Treatment of Pediatric Chronic Pain

    Directory of Open Access Journals (Sweden)

    Deirdre E Logan

    2012-01-01

    Full Text Available Family, school and the peer network each shape the chronic pain experience of the individual child, and each of these contexts also represents a domain of functioning often impaired by chronic pain. The goal of the present article is to summarize what is known about these bidirectional influences between children with pain and the social systems that surround them. Case reports that illustrate these complex, transactional forces and their ultimate impact on the child’s pain-related functioning are included. A case involving siblings participating in an intensive interdisciplinary program for functional restoration and pain rehabilitation highlights how parents change through this treatment approach and how this change is vital to the child’s outcomes. Another case involving a child undergoing intensive interdisciplinary treatment illustrates how school avoidance can be treated in the context of pain rehabilitation, resulting in successful return to the regular school environment. Finally, an acceptance and commitment therapy-focused group intervention for children with sickle cell disease and their parents demonstrates the benefits of peer contact as an element of the therapeutic intervention.

  17. The 300 area waste acid treatment system closure plan

    International Nuclear Information System (INIS)

    Luke, S.N.

    1996-01-01

    The 300 Area Waste Acid Treatment System (WATS) is located within operable units 300-FF-2 (source) and 300-FF-5 (groundwater), as designated in the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) . Operable units 300-FF-2 and 300-FF-5 are scheduled to be remediated using the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) Remedial Investigation/Feasibility Study (RI/FS) process. Thus, any remediation of the 300 Area WATS with respect to contaminants not produced by those facilities and soils and groundwater will be deferred to the CERCLA RI/FS process. Final closure activities will be completed in 3 phases and certified in accordance with the 300 Area WATS closure plan by the Washington State Department of Ecology (Ecology) and the U.S. Environmental Protection Agency (EPA). It is anticipated that the 300 Area WATS closure would take 2 years to complete

  18. Engineering report for the central mercury treatment system

    International Nuclear Information System (INIS)

    1995-03-01

    Mercury (Hg) was used at the Oak Ridge Y-12 Plant between 1950 and 1963. This contamination legacy has prompted a series of remedial measures. Since the mid-1980s, a series of engineered projects, maintenance activities, and general improvement in work practices has resulted in a decreasing trend of Hg concentration in East Fork Poplar Creek (EFPC). Some of the Hg in the soils surrounding past Hg- use buildings enters the building sumps which are discharged to EFPC. Overall goal is to reduce the Hg contamination of EFPC to no more than 5 g/day. This project will create the Central Mercy Treatment System to reduce the Hg contribution to EFPC by installing carbon adsorption units to treat the effluent from buildings 9201-4, 9201-5, and 9204-4. Use of carbon adsorption will be the long-term strategy for reduction of Hg in plant effluent

  19. System and method for treatment of a flue gas

    Science.gov (United States)

    Spiry, Irina Pavlovna; Wood, Benjamin Rue; Singh, Surinder Prabhjot; Perry, Robert James; McDermott, John Brian

    2017-09-19

    A method for treatment of a flue gas involves feeding the flue gas and a lean solvent to an absorber. The method further involves reacting the flue gas with the lean solvent within the absorber to generate a clean flue gas and a rich solvent. The method also involves feeding the clean flue gas from the absorber and water from a source, to a wash tower to separate a stripped portion of the lean solvent from the clean flue gas to generate a washed clean flue gas and a mixture of the water and the stripped portion of the lean solvent. The method further involves treating at least a portion of the mixture of the water and the stripped portion of the lean solvent via a separation system to separate the water from the stripped portion of the lean solvent.

  20. Extruder system and method for treatment of a gaseous medium

    Energy Technology Data Exchange (ETDEWEB)

    Silvi, Norberto; Perry, Robert James; Singh, Surinder Prabhjot; Balch, Gary Stephen; Westendorf, Tiffany Elizabeth Pinard

    2016-04-05

    A system for treatment of a gaseous medium, comprises an extruder having a barrel. The extruder further comprises a first inlet port, a second inlet port, and a plurality of outlet ports coupled to the barrel. The first inlet port is configured for feeding a lean sorbent, the second inlet port is configured for feeding a gaseous medium, and the plurality of outlet ports are configured for releasing a plurality of components removed from the gaseous medium. Further, the extruder comprises a plurality of helical elements coupled to a plurality of kneading elements, mounted on a shaft, and disposed within the barrel. The barrel and the plurality of helical and kneading elements together form an absorption unit and a desorption unit. The first and second inlet ports are formed in the absorption unit and the plurality of outlet ports are formed in the absorption and desorption units.

  1. What advice are oncologists and surgeons in the United Kingdom giving to breast cancer patients about physical activity?

    Directory of Open Access Journals (Sweden)

    Daley Amanda J

    2008-09-01

    Full Text Available Abstract Evidence has shown that physical activity may attenuate the negative physical, psychological and functional effects of treatment in women diagnosed with breast cancer. Physical activity levels also decline substantially during and after completion of treatment for cancer, highlighting the importance of strategies to promote participation in regular physical activity in this population. Oncologists and surgeons may serve as an influential source of motivation to be physically activity in cancer patients, by conveying the importance of a healthy lifestyle. The primary purpose of the present study was to investigate whether oncologists and surgeons routinely discuss physical activity with their breast cancer patients and to investigate the nature of any information/advice provided during consultations. A secondary aim was to examine whether physically active oncologists and surgeons were more likely to provide advice about physical activity to patients, than inactive oncologists and surgeons. A brief postal questionnaire was sent to 710 consultant breast cancer oncologists and surgeons throughout the UK and 102 responded (response rate = 14.4%. Of responders, most (55.9% did not routinely discuss physical activity with their patients. Amongst oncologists/surgeons (clinicians who did offer advice, most focussed on discussing the benefits of physical activity for physical and functional health gains and for facilitating weight control and maintenance. A number of clinicians indicated they advised patients that physical activity may decrease risk of recurrence and improve survival, despite the lack of evidence from RCTs to support this suggestion. There was no significant association between the physical activity status of oncologists/surgeons and the likelihood that they discussed physical activity with patients. Educational strategies aimed at encouraging clinicians to promote physical activity in consultations need to be targeted widely

  2. Specification and acceptance testing of radiotherapy treatment planning systems

    International Nuclear Information System (INIS)

    2007-04-01

    Quality assurance (QA) in the radiation therapy treatment planning process is essential to ensure accurate dose delivery to the patient and to minimize the possibility of accidental exposure. The computerized radiotherapy treatment planning systems (RTPSs) are now widely available in industrialized and developing countries and it is of special importance to support hospitals in Member States in developing procedures for acceptance testing, commissioning and QA of their RTPSs. Responding to these needs, a group of experts developed an IAEA publication with such recommendations, which was published in 2004 as IAEA Technical Reports Series No. 430. This report provides a general framework and describes a large number of tests and procedures that should be considered by the users of new RTPSs. However, small hospitals with limited resources or large hospitals with high patient load and limited staff are not always able to perform complete characterization, validation and software testing of algorithms used in RTPSs. Therefore, the IAEA proposed more specific guidelines that provide a step-by-step recommendation for users at hospitals or cancer centres how to implement acceptance and commissioning procedures for newly purchased RTPSs. The current publication was developed in the framework of the Coordinated Research Project on Development of Procedures for Quality Assurance for Dosimetry Calculations in Radiotherapy and uses the International Electrotechnical Commission (IEC) standard IEC 62083, Requirements for the Safety of Radiotherapy Treatment Planning Systems as its basis. The report addresses the procedures for specification and acceptance testing of RTPSs to be used by both manufacturers and users at the hospitals. Recommendations are provided for specific tests to be performed at the manufacturing facility known as type tests, and for acceptance tests to be performed at the hospital known as site tests. The purpose of acceptance testing is to demonstrate to the

  3. Evaluation of a commercial biologically based IMRT treatment planning system

    International Nuclear Information System (INIS)

    Semenenko, Vladimir A.; Reitz, Bodo; Day, Ellen; Qi, X. Sharon; Miften, Moyed; Li, X. Allen

    2008-01-01

    A new inverse treatment planning system (TPS) for external beam radiation therapy with high energy photons is commercially available that utilizes both dose-volume-based cost functions and a selection of cost functions which are based on biological models. The purpose of this work is to evaluate quality of intensity-modulated radiation therapy (IMRT) plans resulting from the use of biological cost functions in comparison to plans designed using a traditional TPS employing dose-volume-based optimization. Treatment planning was performed independently at two institutions. For six cancer patients, including head and neck (one case from each institution), prostate, brain, liver, and rectal cases, segmental multileaf collimator IMRT plans were designed using biological cost functions and compared with clinically used dose-based plans for the same patients. Dose-volume histograms and dosimetric indices, such as minimum, maximum, and mean dose, were extracted and compared between the two types of treatment plans. Comparisons of the generalized equivalent uniform dose (EUD), a previously proposed plan quality index (fEUD), target conformity and heterogeneity indices, and the number of segments and monitor units were also performed. The most prominent feature of the biologically based plans was better sparing of organs at risk (OARs). When all plans from both institutions were combined, the biologically based plans resulted in smaller EUD values for 26 out of 33 OARs by an average of 5.6 Gy (range 0.24 to 15 Gy). Owing to more efficient beam segmentation and leaf sequencing tools implemented in the biologically based TPS compared to the dose-based TPS, an estimated treatment delivery time was shorter in most (five out of six) cases with some plans showing up to 50% reduction. The biologically based plans were generally characterized by a smaller conformity index, but greater heterogeneity index compared to the dose-based plans. Overall, compared to plans based on dose

  4. Pretravel health advice among international travelers visiting Cuzco, Peru.

    Science.gov (United States)

    Cabada, Miguel M; Maldonado, Fernando; Quispe, Wanda; Serrano, Edson; Mozo, Karen; Gonzales, Elsa; Seas, Carlos; Verdonck, Kristien; Echevarria, Juan I; Gotuzzo, Eduardo

    2005-01-01

    Cuzco, a Peruvian city of historical interest located 3,326 m above sea level, is a frequent destination for tourists. We conducted a descriptive study to assess the extent and sources of pretravel health advice received by international travelers before their arrival to Cuzco. Data were collected as part of a health survey among travelers. Between August and November 2002, travelers between 15 and 65 years old were invited to fill out a questionnaire in the departing area of Cuzco's international airport. A total of 5,988 travelers participated. The mean age was 35.4 years (SD 11.4 yr); 50.6% were female and 50.8% were single. Tourism was the reason for traveling in 90.2% of the participants, and 89.3% of them were traveling with companions. Pretravel health information was received by 93.6%. The median number of information sources was two, with books (41.5%), travel medicine clinics (38.8%), the Internet (23.3%), and general practitioners (22.7%) as the main sources. Most frequently received recommendations were about safe food and water consumption (85%), use of insect repellents (66.0%), sunburn protection (64.4%), and condom use (22%). Only 16.5% took medication to prevent altitude sickness, and 14.2% took medication to prevent traveler's diarrhea. Variables independently associated with receiving pretravel health information from a health care professional were female gender, country of residence other than the United States, length of stay in Cuzco > 7 days, length of stay in other Peruvian cities > 7 days, tourism as the main reason for visiting Cuzco, traveling with companions, and consulting of more than one source of information. Most travelers arriving to Cuzco had received pretravel health information, and the majority obtained it from more than one source. Recommendations addressed for specific health risks, such as altitude sickness prophylaxis, were received by few travelers.

  5. System Life Cycle Evaluation(SM) (SLiCE): harmonizing water treatment systems with implementers' needs.

    Science.gov (United States)

    Goodman, Joseph; Caravati, Kevin; Foote, Andrew; Nelson, Molly; Woods, Emily

    2013-06-01

    One of the methods proposed to improve access to clean drinking water is the mobile packaged water treatment system (MPWTS). The lack of published system performance comparisons combined with the diversity of technology available and intended operating conditions make it difficult for stakeholders to choose the system best suited for their application. MPWTS are often deployed in emergency situations, making selection of the appropriate system crucial to avoiding wasted resources and loss of life. Measurable critical-to-quality characteristics (CTQs) and a system selection tool for MPWTS were developed by utilizing relevant literature, including field studies, and implementing and comparing seven different MPWTS. The proposed System Life Cycle Evaluation (SLiCE) method uses these CTQs to evaluate the diversity in system performance and harmonize relevant performance with stakeholder preference via a selection tool. Agencies and field workers can use SLiCE results to inform and drive decision-making. The evaluation and selection tool also serves as a catalyst for communicating system performance, common design flaws, and stakeholder needs to system manufacturers. The SLiCE framework can be adopted into other emerging system technologies to communicate system performance over the life cycle of use.

  6. Early outbreak detection by linking health advice line calls to water distribution areas retrospectively demonstrated in a large waterborne outbreak of cryptosporidiosis in Sweden

    Directory of Open Access Journals (Sweden)

    Pär Bjelkmar

    2017-04-01

    Full Text Available Abstract Background In the winter and spring of 2011 a large outbreak of cryptosporidiosis occurred in Skellefteå municipality, Sweden. This study summarizes the outbreak investigation in terms of outbreak size, duration, clinical characteristics, possible source(s and the potential for earlier detection using calls to a health advice line. Methods The investigation included two epidemiological questionnaires and microbial analysis of samples from patients, water and other environmental sources. In addition, a retrospective study based on phone calls to a health advice line was performed by comparing patterns of phone calls between different water distribution areas. Results Our analyses showed that approximately 18,500 individuals were affected by a waterborne outbreak of cryptosporidiosis in Skellefteå in 2011. This makes it the second largest outbreak of cryptosporidiosis in Europe to date. Cryptosporidium hominis oocysts of subtype IbA10G2 were found in patient and sewage samples, but not in raw water or in drinking water, and the initial contamination source could not be determined. The outbreak went unnoticed to authorities for several months. The analysis of the calls to the health advice line provides strong indications early in the outbreak that it was linked to a particular water treatment plant. Conclusions We conclude that an earlier detection of the outbreak by linking calls to a health advice line to water distribution areas could have limited the outbreak substantially.

  7. Teledermatologist expert skin advice: A unique model of care for managing skin disorders and adverse drug reactions in hepatitis C patients.

    Science.gov (United States)

    Charlston, Samuel; Siller, Gregory

    2018-03-23

    To conduct an audit of teledermatologist expert skin advice, a store and forward tele-dermatological service, to determine its effectiveness and user satisfaction in managing cutaneous adverse drug reactions in patients with hepatitis C, and to demonstrate a unique collaborative model of care for patients receiving specialised drug therapy. A retrospective analysis of data on teledermatologist expert skin advice referrals from January 2014 to December 2015 was performed. The primary outcomes assessed included number of referrals, referral locations, diagnoses, response times, quality of clinical information provided and user satisfaction ratings. Altogether 43 consultations from 29 referring sites were received from Australian metropolitan and rural settings. Of the patients, 43 were diagnosed with an adverse drug reaction related to the use of either telaprevir or simeprevir. The average time taken for the dermatologist to reply electronically with a final diagnosis and management plan was 1 h 57 min. As many as 26% of referrals required additional photos to establish a diagnosis due to poor-quality images or insufficient detail. Altogether 18 clinicians completed the customer satisfaction survey, all of whom rated teledermatologist expert skin advice nine or above on a scale of one to 10. Teledermatologist expert skin advice was regarded by clinicians as a valuable patient care service. The platform is a novel modality that supports patients undergoing specialised treatments at risk of cutaneous adverse drug reaction. © 2018 The Australasian College of Dermatologists.

  8. Systemic vs. Topical Therapy for the Treatment of Vulvovaginal Candidiasis

    Directory of Open Access Journals (Sweden)

    Sebastian Faro

    1994-01-01

    Full Text Available It is estimated that 75% of all women will experience at least 1 episode of vulvovaginal candidiasis (VVC during their lifetimes. Most patients with acute VVC can be treated with short-term regimens that optimize compliance. Since current topical and oral antifungals have shown comparably high efficacy rates, other issues should be considered in determining the most appropriate therapy. It is possible that the use of short-duration narrow-spectrum agents may increase selection of more resistant organisms which will result in an increase of recurrent VVC (RVVC. Women who are known or suspected to be pregnant and women of childbearing age who are not using a reliable means of contraception should receive topical therapy, as should those who are breast-feeding or receiving drugs that can interact with an oral azole and those who have previously experienced adverse effects during azole therapy. Because of the potential risks associated with systemic treatment, topical therapy with a broad-spectrum agent should be the method of choice for VVC, whereas systemic therapy should be reserved for either RVVC or cases where the benefits outweigh any possible adverse reactions.

  9. SOS switch system (SSS) in the radiation treatment room

    International Nuclear Information System (INIS)

    Komiyama, Takafumi; Motoyama, Tsuyoshi; Nakamura, Koji; Onishi, Hiroshi; Araya, Masayuki; Sano, Naoki

    2009-01-01

    We applied patient's self-breath hold irradiation system to a device to declare the patient's intentions (SOS switch system: SSS) in the radiation room and examined a utility for problem recognition and improvement of risk management during radiation therapy by induction of SSS. Between May 2005 and October 2006, we used SSS with 65 patients. The study involved 32 men and 33 women with a median age of 65 (range, 26-88) years. The reason for using SSS was as a shell in 57, a history of laryngectomy in 2, a cough in 6, convulsions in 1, and anxiety in 3. The treatment with SSS was performed 1,120 times. The hand switch was pushed 11 times. The reasons the switch was pushed were for nausea, aspiration, pain, and cough one time each. For the others, the reasons were unclear, and it was thought due to the clouding of consciousness from brain metastases. No problems were observed with the use of SSS. SSS was a useful device for improvement of risk management during the radiation therapy. (author)

  10. A virtual linear accelerator for verification of treatment planning systems

    International Nuclear Information System (INIS)

    Wieslander, Elinore

    2000-01-01

    A virtual linear accelerator is implemented into a commercial pencil-beam-based treatment planning system (TPS) with the purpose of investigating the possibility of verifying the system using a Monte Carlo method. The characterization set for the TPS includes depth doses, profiles and output factors, which is generated by Monte Carlo simulations. The advantage of this method over conventional measurements is that variations in accelerator output are eliminated and more complicated geometries can be used to study the performance of a TPS. The difference between Monte Carlo simulated and TPS calculated profiles and depth doses in the characterization geometry is less than ±2% except for the build-up region. This is of the same order as previously reported results based on measurements. In an inhomogeneous, mediastinum-like case, the deviations between TPS and simulations are small in the unit-density regions. In low-density regions, the TPS overestimates the dose, and the overestimation increases with increasing energy from 3.5% for 6 MV to 9.5% for 18 MV. This result points out the widely known fact that the pencil beam concept does not handle changes in lateral electron transport, nor changes in scatter due to lateral inhomogeneities. It is concluded that verification of a pencil-beam-based TPS with a Monte Carlo based virtual accelerator is possible, which facilitates the verification procedure. (author)

  11. Weight Management Advice for Clients with Overweight or Obesity: Allied Health Professional Survey

    Directory of Open Access Journals (Sweden)

    Suzanne J. Snodgrass

    2016-11-01

    Full Text Available The prevalence of obesity is increasing. The potential for allied health professionals to intervene through the provision of lifestyle advice is unknown. This study aimed to determine the knowledge, attitudes and practices of health professionals in the provision of dietary and physical activity advice for clients with overweight or obesity. Dietitians, exercise physiologists, nurses, occupational therapists, physiotherapists and psychologists (n = 296 working in New South Wales were surveyed using paper-based and online methods. The majority of health professionals (71% believed that providing weight management advice was within their scope of practice; 81% provided physical activity advice but only 57% provided dietary advice. Other than dietitians, few had received training in client weight management during their professional qualification (14% or continuing education (16%. Providing dietary advice was associated with: believing it was within their scope of practice (OR 3.9, 95% CI 1.9–7.9, p < 0.01, training during their entry-level qualification (OR 7.2, 3.2–16.4, p < 0.01 and having departmental guidelines (OR 4.7, 2.1–10.9, p < 0.01. Most health professionals are willing to provide lifestyle advice to clients with overweight or obesity but few have received required training. Developing guidelines and training for in client weight management may potentially impact on rising obesity levels.

  12. Advice for salt, sugar and fat intake habits among adults: a national-based study

    Directory of Open Access Journals (Sweden)

    Suele Manjourany Silva

    2013-12-01

    Full Text Available INTRODUCTION : A healthy diet is recognized as an important strategy for promoting health as an essential part of non-pharmacological therapy of various health problems. OBJECTIVE : To analyze the reported advice for the intake of salt, sugar and fat for the Brazilian adults living in urban areas. METHODOLOGY : National-based cross-sectional study with 12,402 adults interviewed in 100 Brazilian cities. RESULTS : The most prevalent advice was to low fat intake (38%, followed by the advice to low salt and sugar intake (36% and sugar (29%. The percentage of receiving different advice was similar and more common among women, older people, those with a partner, higher economic class, former smokers, active and in person with physician diagnoses of hypertension, diabetes and overweight. People with white skin color received more advice to eat healthy food, except for the orientation to low salt intake. CONCLUSION : The results show a low prevalence of advice, which configures a missed opportunity to prevent health problems. Although dietary counseling should not be understood only as the transmission of advice regarding some nutrients, it is important to develop actions in order to qualify services and health professionals, allowing the population to have access to qualified information about the benefits of having healthy lifestyles.

  13. Family planning advice and postpartum contraceptive use among low-income women in Mexico.

    Science.gov (United States)

    Barber, Sarah L

    2007-03-01

    In Mexico, family planning advice has been incorporated into the clinical guidelines for prenatal care. However, the relationship between women's receipt of family planning advice during prenatal care and subsequent contraceptive use has not been evaluated. Data were collected in 2003 and 2004 in 17 Mexican states from 2,238 urban low-income women postpartum. Participating women reported on prenatal services received and contraceptive use. Logistic and multinomial logistic regression models evaluated whether receiving family planning advice during prenatal care predicted current contraceptive use, after quality of care in the community, service utilization, delivery characteristics, household socioeconomic characteristics, and maternal and infant characteristics were controlled for. Overall, 47% of women used a modern contraceptive method. Women who received family planning advice during prenatal care were more likely to use a contraceptive than were those who did not receive such advice (odds ratio, 2.2). Women who received family planning advice had a higher probability of using condoms (relative risk ratio, 2.3) and IUDs (5.2), and of undergoing sterilization (1.4), than of using no method. Integrating family planning advice into prenatal care may be an important strategy for reaching women when their demand for contraception is high.

  14. Treatment of erectile dysfunction with sildenafil citrate (Viagra) in parkinsonism due to Parkinson's disease or multiple system atrophy with observations on orthostatic hypotension

    Science.gov (United States)

    Hussain, I; Brady, C; Swinn, M; Mathias, C; Fowler, C

    2001-01-01

    multiple system atrophy reported a good erectile response and were reluctant to discontinue the medication.
CONCLUSIONS—Sidenafil citrate (50 mg) is efficacious in the treatment of erectile dysfunction in parkinsonism due to Parkinson's disease or multiple system atrophy; however, it may unmask or exacerbate hypotension in multiple system atrophy. As Parkinson's disease may be diagnostically difficult to distinguish from multiple system atrophy, especially in the early stages, we recommend measurement of lying and standing blood pressure before prescribing sildenafil to men with parkinsonism. Furthermore, such patients should be made aware of seeking medical advice if they develop symptoms on treatment suggestive of orthostatic hypotension.

 PMID:11511713

  15. Hydroponic system for the treatment of anaerobic liquid.

    Science.gov (United States)

    Krishnasamy, K; Nair, J; Bäuml, B

    2012-01-01

    The effluent from anaerobic digestion process has high concentrations of nutrients, particularly nitrogen, essential for plant growth but is not suitable for direct disposal or application due to high chemical oxygen demand (COD), low dissolved oxygen (DO), odour issues and is potentially phytotoxic. This research explored the optimum conditions of anaerobic effluent for application and dilutions of the effluent required to obtain better plant growth. A small-scale hydroponic system was constructed in a glasshouse to test different concentrations of anaerobic effluent against a commercial hydroponic medium as the control for the growth of silverbeet. It was found that the survival of silverbeet was negatively affected at 50% concentration due to low DO and NH(4) toxicity. The concentration of 20% anaerobic liquid was found to be the most efficient with highest foliage yield and plant growth. The hydroponic system with 20% concentrated effluent had better utilisation of nutrients for plant growth and a COD reduction of 95% was achieved during the 50-day growth period. This preliminary evaluation revealed that the growth and development of silverbeet was significantly lower in anaerobic effluent compared with a commercial hydroponic plant growth solution. The nutrient quality of anaerobic effluent could be highly variable with the process and the waste material used and dilution may depend on the nutrient content of the effluent. It is recommended that, a pre-treatment of the effluent to increase DO and reduce ammonium content is required before plant application, and simple dilution by itself is not suitable for optimum plant growth in a hydroponic system.

  16. An evaluation of oxygen systems for treatment of childhood pneumonia

    Directory of Open Access Journals (Sweden)

    Rudan Igor

    2011-04-01

    Full Text Available Abstract Background Oxygen therapy is recommended for all of the 1.5 – 2.7 million young children who consult health services with hypoxemic pneumonia each year, and the many more with other serious conditions. However, oxygen supplies are intermittent throughout the developing world. Although oxygen is well established as a treatment for hypoxemic pneumonia, quantitative evidence for its effect is lacking. This review aims to assess the utility of oxygen systems as a method for reducing childhood mortality from pneumonia. Methods Aiming to improve priority setting methods, The Child Health and Nutrition Research Initiative (CHNRI has developed a common framework to score competing interventions into child health. That framework involves the assessment of 12 different criteria upon which interventions can be compared. This report follows the proposed framework, using a semi-systematic literature review and the results of a structured exercise gathering opinion from experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies, to assess and score each criterion as their “collective optimism” towards each, on a scale from 0 to 100%. Results A rough estimate from an analysis of the literature suggests that global strengthening of oxygen systems could save lives of up to 122,000 children from pneumonia annually. Following 12 CHNRI criteria, the experts expressed very high levels of optimism (over 80% for answerability, low development cost and low product cost; high levels of optimism (60-80% for low implementation cost, likelihood of efficacy, deliverability, acceptance to end users and health workers; and moderate levels of optimism (40-60% for impact on equity, affordability and sustainability. The median estimate of potential effectiveness of oxygen systems to reduce the overall childhood pneumonia mortality was ~20% (interquartile range: 10-35%, min

  17. Utilisation of Business Advice in Small Innovative Firms: the Role of Trust and Tacit Knowledge

    Directory of Open Access Journals (Sweden)

    Katarzyna Łobacz

    2016-06-01

    Full Text Available Objective: The aim of this paper is to expand the understanding of the influence of trust relationship, as well as tacit knowledge on the process of business advice utilisation in small innovative firms. Research Design & Methods: The  analysis  is  based  on  empirical  research  conducted with the use of the explorative approach. The multiple case study methodology was used. Findings: Trust relationships as well as tacit knowledge were identified as factors essential to the process of utilisation of business advice in small innovative firms. It was recognised that the significance of both factors is related not only to the process of advice, but also as a purpose of activities happening prior to advice. They are referred to as the initial phase. Implications & Recommendations: The  findings  provide  implications  for  further  research of the structure of the process of business advice utilisation. It is related to the inclusion of the “initial phase”, as well as to the  necessity to include both factors in further research. The paper also provides implicationsrelated to the measurement of business advice output, and recommendations on the construction of public policy instruments. Contribution & Value Added: The originality of this work lies in using the process perspective and qualitative methodology in the field of the utilisation of business advice. It extends our understanding of the processes of business advice with regard to trust, as well as the use of tacit knowledge. The original contribution is to add the “initial phase” to the description of the business advice process.

  18. Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

    Science.gov (United States)

    Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

    2011-01-01

    Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

  19. [Treatment of systemic lupus erythematosus: myths, certainties and doubts].

    Science.gov (United States)

    Ruiz-Irastorza, Guillermo; Danza, Alvaro; Khamashta, Munther

    2013-12-21

    Systemic lupus erythematosus (SLE) is a complex disease with different clinical forms of presentation, including a wide range of severity and organic involvement. Such circumstance, along with the fact of the uncommon nature of the disease and the absence of clinically representative response criteria, make it difficult to design controlled clinical trials in SLE patients. As a result, observational studies have a special relevance, being a source of valuable information of SLE prognosis and outcome as well as of the efficacy and adverse effects of the different therapies. Herein we update some of the main treatments used in SLE. Steroids may have more risks than benefits if used at high doses. New mechanisms of action have been described, supporting the use of lower doses, possibly with the same efficacy and less adverse effects. Intravenous pulses of cyclophosphamide still have a role in the treatment of proliferative lupus nephritis and other serious SLE manifestations. Mycophenolate mofetil has shown its efficacy both as induction and maintenance therapy of selected cases of lupus nephritis. Biological therapies have emerged as new promising options. Although clinical trials have not confirmed a clear superiority of rituximab in SLE, observational studies have shown good response rates in severe SLE manifestations or refractory forms. Belimumab has recently been added to the therapeutic armamentarium of SLE; although its place in clinical practice is not well-defined, it may be recommended in active patients with no response or good tolerance to standard therapies. Hydroxichloroquine improves survival, decreases the risk of thrombosis and flares and is safe in pregnancy, and should be considered the baseline therapy in most SLE patients. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  20. ENDOVASCULAR TREATMENT FOR DISORDERS OF THE VENOUS SYSTEM

    Directory of Open Access Journals (Sweden)

    A. G. Osiev

    2015-01-01

    Full Text Available The annual rate of deep vein thrombosis in general population is from 5 to 9 cases per 10 000, whereas for venous thromboembolism (deep vein thrombosis and pulmonary embolism taken together amounts to 14 cases per 10 000. To improve longterm results of therapy for thrombosis of deep veins of the lower extremities, it is important to restore venous function and outflow. Anticoagulant therapy with low weight or non-fractionated heparin preparations remains the most widely used method of management. However, total or partial thrombosis resolution under anticoagulant treatment is achieved only in 4 and 14% of cases, respectively. Thrombolysis allows for early resorption of the thrombus by means of a minimally invasive procedure with lower risk of complication. After the venous flow is restored, the aim of treatment is to prevent damage to the venous valves, venous hypertension and repeated thrombosis with development of the post-thrombotic syndrome. Compared to anticoagulation, systemic thrombolysis has the benefit of more rapid clot resorption and less damage to the venous valve. One of its serious limitations is a high bleeding risk related to higher doses of the drug administered through a peripheral vein catheter. Therefore, selective intra-clot administration of thombolytics (direct catheter thrombolysis has been suggested as an alternative. For more effective therapy with the use of lower doses of thrombolytics, the so called pharmaco-mechanical thrombectomy has been developed. Venous stenosis hindering the venous outflow is frequently seen after direct catheter or pharmaco-mechanical thrombolysis. Angioplasty with stent placement is recommended in the cases with residual venous abnormality after successful thrombolysis and thrombectomy. 

  1. Evaluation of on-site wastewater treatment systems

    International Nuclear Information System (INIS)

    Dunn, J.

    2002-01-01

    'Full text:' This presentation will describe the nature, scope, and findings of a program designed to conduct a third-party group evaluation of wastewater denitrification technologies appropriate for low-flow systems, partially funded by a grant from the Pennsylvania Department of Environmental Protection (PADEP). The objective of this program is to verify the performance of products that provide nutrient reduction in wastewater from a variety of sources, including domestic wastewater, agricultural runoff, or other waste streams. The evaluation process will be overseen and coordinated by the Environmental Technology Evaluation Center (EvTEC), a program of the Civil Engineering Research Foundation (CERF), the research and technology transfer arm of the American Society of Civil Engineers (ASCE). EvTEC is a pilot program evaluating innovative environmental technologies under the US Environmental Protection Agency's (USEPA) Environmental Technology Verification (ETV) Program. Among other performance issues, the potential energy savings of using nutrient reducing technologies scaled to treat low flows - larger than an individual septic tank but smaller than that of a conventional wastewater treatment plant - will be assessed. The energy savings realized by reduced construction and equipment transport costs alone could make low-flow nutrient reduction technologies viable options for rural communities, small farms, and other low-flow settings. The evaluation is being funded in part by PADEP, which is sponsoring this evaluation due to its interest in developing low-cost wastewater treatment technologies for Pennsylvania's rural communities. However, the evaluation is national in scope, and participants will come from all areas of the country. The presentation will include a description of the process for establishing the testing protocol, testing results from various nutrient reducing technologies, and obstacles encountered and lessons learned during the process. (author)

  2. Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system

    Directory of Open Access Journals (Sweden)

    Han Ruolan

    2008-04-01

    Full Text Available Abstract Background Cancer treatment with a variety of chemotherapeutic agents often is associated with delayed adverse neurological consequences. Despite their clinical importance, almost nothing is known about the basis for such effects. It is not even known whether the occurrence of delayed adverse effects requires exposure to multiple chemotherapeutic agents, the presence of both chemotherapeutic agents and the body's own response to cancer, prolonged damage to the blood-brain barrier, inflammation or other such changes. Nor are there any animal models that could enable the study of this important problem. Results We found that clinically relevant concentrations of 5-fluorouracil (5-FU; a widely used chemotherapeutic agent were toxic for both central nervous system (CNS progenitor cells and non-dividing oligodendrocytes in vitro and in vivo. Short-term systemic administration of 5-FU caused both acute CNS damage and a syndrome of progressively worsening delayed damage to myelinated tracts of the CNS associated with altered transcriptional regulation in oligodendrocytes and extensive myelin pathology. Functional analysis also provided the first demonstration of delayed effects of chemotherapy on the latency of impulse conduction in the auditory system, offering the possibility of non-invasive analysis of myelin damage associated with cancer treatment. Conclusions Our studies demonstrate that systemic treatment with a single chemotherapeutic agent, 5-FU, is sufficient to cause a syndrome of delayed CNS damage and provide the first animal model of delayed damage to white-matter tracts of individuals treated with systemic chemotherapy. Unlike that caused by local irradiation, the degeneration caused by 5-FU treatment did not correlate with either chronic inflammation or extensive vascular damage and appears to represent a new class of delayed degenerative damage in the CNS.

  3. Whole systems thinking for sustainable water treatment design

    Science.gov (United States)

    Huggins, Mitchell Tyler

    Microbial fuel cell (MFC) technology could provide a low cost alternative to conventional aerated wastewater treatment, however there has been little comparison between MFC and aeration treatment using real wastewater substrate. This study attempts to directly compare the wastewater treatment efficiency and energy consumption and generation among three reactor systems, a traditional aeration process, a simple submerged MFC configuration, and a control reactor acting similar as natural lagoons. Results showed that all three systems were able to remove >90% of COD, but the aeration used shorter time (8 days) then the MFC (10 days) and control reactor (25 days). Compared to aeration, the MFC showed lower removal efficiency in high COD concentration but much higher efficiency when the COD is low. Only the aeration system showed complete nitrification during the operation, reflected by completed ammonia removal and nitrate accumulation. Suspended solid measurements showed that MFC reduced sludge production by 52-82% as compared to aeration, and it also saved 100% of aeration energy. Furthermore, though not designed for high power generation, the MFC reactor showed a 0.3 Wh/g COD/L or 24 Wh/m3 (wastewater treated) net energy gain in electricity generation. These results demonstrate that MFC technology could be integrated into wastewater infrastructure to meet effluent quality and save operational cost. The high cost and life-cycle impact of electrode materials is one major barrier to the large scale application of microbial fuel cells (MFC). We also demonstrate that biomass-derived black carbon (biochar), could be a more cost effective and sustainable alternative to granular activated carbon (GAC) and graphite granule (GG) electrodes. In a comparison study, two biochar materials made from lodgepole pine sawdust pellets (BCp) and lodgepole pine woodchips (BCc), gassified at a highest heat temperature (HHT) of 1000°C under a heating rate of 16°C/min, showed a

  4. Neural network models for biological waste-gas treatment systems.

    Science.gov (United States)

    Rene, Eldon R; Estefanía López, M; Veiga, María C; Kennes, Christian

    2011-12-15

    This paper outlines the procedure for developing artificial neural network (ANN) based models for three bioreactor configurations used for waste-gas treatment. The three bioreactor configurations chosen for this modelling work were: biofilter (BF), continuous stirred tank bioreactor (CSTB) and monolith bioreactor (MB). Using styrene as the model pollutant, this paper also serves as a general database of information pertaining to the bioreactor operation and important factors affecting gas-phase styrene removal in these biological systems. Biological waste-gas treatment systems are considered to be both advantageous and economically effective in treating a stream of polluted air containing low to moderate concentrations of the target contaminant, over a rather wide range of gas-flow rates. The bioreactors were inoculated with the fungus Sporothrix variecibatus, and their performances were evaluated at different empty bed residence times (EBRT), and at different inlet styrene concentrations (C(i)). The experimental data from these bioreactors were modelled to predict the bioreactors performance in terms of their removal efficiency (RE, %), by adequate training and testing of a three-layered back propagation neural network (input layer-hidden layer-output layer). Two models (BIOF1 and BIOF2) were developed for the BF with different combinations of easily measurable BF parameters as the inputs, that is concentration (gm(-3)), unit flow (h(-1)) and pressure drop (cm of H(2)O). The model developed for the CSTB used two inputs (concentration and unit flow), while the model for the MB had three inputs (concentration, G/L (gas/liquid) ratio, and pressure drop). Sensitivity analysis in the form of absolute average sensitivity (AAS) was performed for all the developed ANN models to ascertain the importance of the different input parameters, and to assess their direct effect on the bioreactors performance. The performance of the models was estimated by the regression

  5. Modulation of the immune system for the treatment of glaucoma.

    Science.gov (United States)

    Bell, Katharina; Und Hohenstein-Blaul, Nadine von Thun; Teister, Julia; Grus, Franz H

    2017-07-19

    At present intraocular pressure (IOP) lowering therapies are the only approach to treat glaucoma. Neuroprotective strategies to protect the retinal ganglion cells (RGC) from apoptosis are lacking to date. Results from clinical studies revealed altered immunoreactivities against retinal and optic nerve antigens in sera and aqueous humor of glaucoma patients and point toward an autoimmune involvement in glaucomatous neurodegeneration and RGC death. IgG accumulations along with plasma cells were found localised in human glaucomatous retinae in a pro-inflammatory environment possibly maintained by microglia. Animal studies show that antibodies (e.g. anti- heat shock protein 60 and anti-myelin basic protein) elevated in glaucoma patients provoke autoaggressive RGC loss and are associated with IgG depositions and increased microglial cells. We demonstrate that intermittent IOP elevation in a rat model is sufficient to provoke glaucoma-like neurodegeneration and elicits correlating changes of IgG autoantibody reactivities. On the other hand, antibodies (e.g. anti-glial fibrillary acidic protein and anti-gamma-Synuclein) found decreased in glaucoma patients hold neuroprotective potential on immortalised neuroretinal cells and RGC in an adolescent porcine retina organ culture. We believe that our work not only demonstrates an autoimmune component in glaucoma, but also opens up new options for glaucoma diagnostics and treatment. Nevertheless the immune system also consists of other cells involved not only in the adaptive, but also innate immune system. Studies addressing changes in T lymphocytes, macrophages but also local immune responses in the retina have been performed and also hold promising results. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. MODIFIED REVERSE OSMOSIS SYSTEM FOR TREATMENT OF PRODUCED WATERS

    Energy Technology Data Exchange (ETDEWEB)

    T.M. Whitworth; Liangxiong Li

    2002-09-15

    This report describes work performed during the first year of the project ''Modified Reverse Osmosis System for Treatment of Produced Waters.'' This research project has two objectives. The first objective is to test the use of clay membranes in the treatment of produced waters by reverse osmosis. The second objective is to test the ability of a system patented by the New Mexico Tech Research Foundation to remove salts from reverse osmosis waste streams as a solid. We performed 12 experiments using clay membranes in cross-flow experimental cells. We found that, due to dispersion in the porous frit used adjacent to the membrane, the concentration polarization layer seems to be completely (or nearly completely) destroyed at low flow rates. This observation suggests that clay membranes used with porous frit material many reach optimum rejection rates at lower pumping rates than required for use with synthetic membranes. The solute rejection efficiency decreases with increasing solution concentration. For the membranes and experiments reported here, the rejection efficiency ranged from 71% with 0.01 M NaCl solution down to 12% with 2.3 M NaCl solution. More compacted clay membranes will have higher rejection capabilities. The clay membranes used in our experiments were relatively thick (approximately 0.5 mm). The active layer of most synthetic membranes is only 0.04 {micro}m (0.00004 mm), approximately 1250 times thinner than the clay membranes used in these experiments. Yet clay membranes as thin as 12 {micro}m have been constructed (Fritz and Eady, 1985). Since Darcy's law states that the flow through a material of constant permeability is inversely proportional to it's the material's thickness, then, based on these experimental observations, a very thin clay membrane would be expected to have much higher flow rates than the ones used in these experiments. Future experiments will focus on testing very thin clay membranes. The

  7. Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

    Science.gov (United States)

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

  8. Classification System for Individualized Treatment of Adult Buried Penis Syndrome.

    Science.gov (United States)

    Tausch, Timothy J; Tachibana, Isamu; Siegel, Jordan A; Hoxworth, Ronald; Scott, Jeremy M; Morey, Allen F

    2016-09-01

    The authors present their experience with reconstructive strategies for men with various manifestations of adult buried penis syndrome, and propose a comprehensive anatomical classification system and treatment algorithm based on pathologic changes in the penile skin and involvement of neighboring abdominal and/or scrotal components. The authors reviewed all patients who underwent reconstruction of adult buried penis syndrome at their referral center between 2007 and 2015. Patients were stratified by location and severity of involved anatomical components. Procedures performed, demographics, comorbidities, and clinical outcomes were reviewed. Fifty-six patients underwent reconstruction of buried penis at the authors' center from 2007 to 2015. All procedures began with a ventral penile release. If the uncovered penile skin was determined to be viable, a phalloplasty was performed by anchoring penoscrotal skin to the proximal shaft, and the ventral shaft skin defect was closed with scrotal flaps. In more complex patients with circumferential nonviable penile skin, the penile skin was completely excised and replaced with a split-thickness skin graft. Complex patients with severe abdominal lipodystrophy required adjacent tissue transfer. For cases of genital lymphedema, the procedure involved complete excision of the lymphedematous tissue, and primary closure with or without a split-thickness skin graft, also often involving the scrotum. The authors' overall success rate was 88 percent (49 of 56), defined as resolution of symptoms without the need for additional procedures. Successful correction of adult buried penis often necessitates an interdisciplinary, multimodal approach. Therapeutic, IV.

  9. Dosimetry audit simulation of treatment planning system in multicenters radiotherapy

    Science.gov (United States)

    Kasmuri, S.; Pawiro, S. A.

    2017-07-01

    Treatment Planning System (TPS) is an important modality that determines radiotherapy outcome. TPS requires input data obtained through commissioning and the potentially error occurred. Error in this stage may result in the systematic error. The aim of this study to verify the TPS dosimetry to know deviation range between calculated and measurement dose. This study used CIRS phantom 002LFC representing the human thorax and simulated all external beam radiotherapy stages. The phantom was scanned using CT Scanner and planned 8 test cases that were similar to those in clinical practice situation were made, tested in four radiotherapy centers. Dose measurement using 0.6 cc ionization chamber. The results of this study showed that generally, deviation of all test cases in four centers was within agreement criteria with average deviation about -0.17±1.59 %, -1.64±1.92 %, 0.34±1.34 % and 0.13±1.81 %. The conclusion of this study was all TPS involved in this study showed good performance. The superposition algorithm showed rather poor performance than either analytic anisotropic algorithm (AAA) and convolution algorithm with average deviation about -1.64±1.92 %, -0.17±1.59 % and -0.27±1.51 % respectively.

  10. Breaking emulsions in Navy bilge collection and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Little, R.C.; Patterson, R.L.

    1978-05-01

    A new bilge waste collection and treatment system, which serves as the collector, transporter, and gravity separator for ship's bilge waste, was used as a medium for the application of chemical demulsification techniques to emulsified oily wastes that are reluctant to separate into the constituent phases. Laboratory tests on 27 demulsifying agents showed that three cation active quaternary ammonium salts were acceptable. They were effective in breaking 5% oil-in-sea-water emulsions over a 20 hr period at 4/sup 0/-45/sup 0/C. The demuslifier concentration required to break the emulsions generally ranged from 1-2% at 4/sup 0/C to 0.1-0.2% at 45/sup 0/C. At 4/sup 0/C, the oil concentration in the separated water was in the 100-500 ppm range; at 45/sup 0/C, no more than 55 ppm was observed with most oil level readings of the order of 25 ppm or less. The demulsifiers were useful in breaking emulsions of Navy distillate oil, used motor oil, turbine oil, and bilge wastes containing unknown oil mixtures. A field demonstration supported the laboratory tests.

  11. Evaluation of advanced wastewater treatment systems for water reuse in the era of advanced wastewater treatment

    Science.gov (United States)

    Kon, Hisao; Watanabe, Masahiro

    This study focuses on effluent COD concentration from wastewater treatment in regards to the reduction of pathogenic bacteria and trace substances in public waters. The main types of secondary wastewater treatment were conventional activated sludge processes. Recently, however, advance wastewater treatment processes have been developed aimed at the removal of nitrogen and phosphorus, and the effluent quality of these processes was analyzed in this study. Treatment processes for water reclamation that make effluent to meet the target water quality for reuse purposes were selected and also optimum design parameters for these processes were proposed. It was found that the treatment cost to water reclamation was greatly affected by the effluent COD of the secondary treatment. It is important to maintain low COD concentration in the secondary treated effluent. Therefore, it is considered that adequate cost benefits would be obtained by achieving target COD quality through shifting from a conventional activated sludge process to an advanced treatment process.

  12. Destination image and crime in Mexico: An analysis of foreign government travel advice

    Directory of Open Access Journals (Sweden)

    J. Carlos Monterrubio

    2013-01-01

    Full Text Available Destination image has been recognised as an influential component of travel decision processes. Although organic sources of information play an important role in shaping destination image, researchers have often ignored the types of sources and the information they deliver. In particular, official websites where government travel advice is given, especially in relation to crime, have been widely excluded from scholarly research. This paper analyses the relationship between crime-related travel advice given by foreign governments and Mexico’s destination image. Qualitative content analysis of official websites from the US, Canada, the UK and Spain reveals that the travel advice given relates largely to the violence and insecurity that Mexico is currently experiencing. “No advisory in effect”, “Exercise caution” and “Defer non-essential travel” are messages commonly found in the governments’ travel advice about Mexico.

  13. ETV REPORT AND VERIFICATION STATEMENT - KASELCO POSI-FLO ELECTROCOAGULATION TREATMENT SYSTEM

    Science.gov (United States)

    The Kaselco Electrocoagulation Treatment System (Kaselco system) in combination with an ion exchange polishing system was tested, under actual production conditions, processing metal finishing wastewater at Gull Industries in Houston, Texas. The verification test evaluated the a...

  14. A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease.

    Science.gov (United States)

    Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

    2015-01-01

    Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Metformin and dietary advice to improve insulin sensitivity and promote gestational restriction of weight among pregnant women who are overweight or obese: the GRoW Randomised Trial.

    Science.gov (United States)

    Dodd, Jodie M; Grivell, Rosalie M; Deussen, Andrea R; Dekker, Gustaaf; Louise, Jennie; Hague, William

    2016-11-21

    Obesity is a significant global health problem, with approximately 50% of women entering pregnancy having a body mass index greater than or equal to 25 kg/m 2 . Obesity during pregnancy is associated with a well-recognised increased risk of adverse health outcomes both for the woman and her infant. Currently available data from large scale randomised trials and systematic reviews highlight only modest effects of antenatal dietary and lifestyle interventions in limiting gestational weight gain, with little impact on clinically relevant pregnancy outcomes. Further information evaluating alternative strategies is required. The aims of this randomised controlled trial are to assess whether the use of metformin as an adjunct therapy to dietary and lifestyle advice for overweight and obese women during pregnancy is effective in improving maternal, fetal and infant health outcomes. Design: Multicentre randomised, controlled trial. Women with a singleton, live gestation between 10 +0 -20 +0 weeks who are obese or overweight (defined as body mass index greater than or equal to 25 kg/m 2 ), at the first antenatal visit. Trial Entry & Randomisation: Eligible, consenting women will be randomised between 10 +0 and 20 +0 weeks gestation using an online computer randomisation system, and randomisation schedule prepared by non-clinical research staff with balanced variable blocks. Stratification will be according to maternal BMI at trial entry, parity, and centre where planned to give birth. Treatment Schedules: Women randomised to the Metformin Group will receive a supply of 500 mg oral metformin tablets. Women randomised to the Placebo Group will receive a supply of identical appearing and tasting placebo tablets. Women will be instructed to commence taking one tablet daily for a period of one week, increasing to a maximum of two tablets twice daily over four weeks and then continuing until birth. Women, clinicians, researchers and outcome assessors will be blinded to the

  16. The role of cystovaginoscopy and hygienic advice in girls referred for symptoms of vulvovaginitis.

    Science.gov (United States)

    Ram, Ashok Daya; Hurst, Katherine Victoria; Steinbrecher, Henrik

    2012-05-01

    Vulvovaginitis is a common presenting symptom referred to a paediatric urology clinic. Some of these patients undergo diagnostic cystovaginoscopy to determine whether there is any underlying anatomical cause for the persistent infection. However, in the majority of the patients, no underlying abnormality is found and they are given hygienic advice and prescribed bio yoghurt postoperatively. This study examines the outcome in these patients after hygienic advice is given: determining whether cystovaginoscopy was really necessary and whether it changed the management of vulvovaginitis.

  17. Ebinformatics: Ebola fuzzy informatics systems on the diagnosis, prediction and recommendation of appropriate treatments for Ebola virus disease (EVD

    Directory of Open Access Journals (Sweden)

    Olugbenga Oluwagbemi

    Full Text Available Ebola Virus Disease (EVD also known as the Ebola hemorrhagic fever is a very deadly infectious disease to humankind. Therefore, a safer and complementary method of diagnosis is to employ the use of an expert system in order to initiate a platform for pre-clinical treatments, thus acting as a precursor to comprehensive medical diagnosis and treatments. This work presents a design and implementation of informatics software and a knowledge-based expert system for the diagnosis, and provision of recommendations on the appropriate type of recommended treatment to the Ebola Virus Disease (EVD.In this research an Ebola fuzzy informatics system was developed for the purpose of diagnosing and providing useful recommendations to the management of the EVD in West Africa and other affected regions of the world. It also acts as a supplementary resource in providing medical advice to individuals in Ebola – ravaged countries. This aim was achieved through the following objectives: (i gathering of facts through the conduct of a comprehensive continental survey to determine the knowledge and perception level of the public about factors responsible for the transmission of the Ebola Virus Disease (ii develop an informatics software based on information collated from health institutions on basic diagnosis of the Ebola Virus Disease-related symptoms (iii adopting and marrying the knowledge of fuzzy logic and expert systems in developing the informatics software. Necessary requirements were collated from the review of existing expert systems, consultation of journals and articles, and internet sources. Online survey was conducted to determine the level at which individuals are aware of the factors responsible for the transmission of the Ebola Virus Disease (EVD. The expert system developed, was designed to use fuzzy logic as its inference mechanism along with a set of rules. A knowledge base was created to help provide diagnosis on the Ebola Virus Disease (EVD

  18. Radioisotope measurement system

    International Nuclear Information System (INIS)

    Villanueva Ruibal, Jose

    2007-01-01

    A radioisotope measurement system installed at L.M.R. (Ezeiza Atomic Center of CNEA) allows the measurement of nuclear activity from a wide range of radioisotopes. It permits to characterize a broad range of radioisotopes at several activity levels. The measurement hardware as well as the driving software have been developed and constructed at the Dept. of Instrumentation and Control. The work outlines the system's conformation and its operating concept, describes design characteristics, construction and the error treatment, comments assay results and supplies use advices. Measuring tests carried out employing different radionuclides confirmed the system performing satisfactorily and with friendly operation. (author) [es

  19. Life cycle assessment comparing the treatment of surplus activated sludge in a sludge treatment reed bed system with mechanical treatment on centrifuge

    DEFF Research Database (Denmark)

    Larsen, Julie Dam; Hoeve, Marieke ten; Nielsen, Steen

    2018-01-01

    or the centrifuge and terminated by land application of the final sludge product. The environmental impacts caused by the sludge treatment reed bed system strategy were comparable to or lower than those caused by the mechanical sludge treatment method. The impacts on climate change were the same for all...

  20. Knowledge-based treatment planning and its potential role in the transition between treatment planning systems.

    Science.gov (United States)

    Masi, Kathryn; Archer, Paul; Jackson, William; Sun, Yilun; Schipper, Matthew; Hamstra, Daniel; Matuszak, Martha

    2017-11-22

    Commissioning a new treatment planning system (TPS) involves many time-consuming tasks. We investigated the role that knowledge-based planning (KBP) can play in aiding a clinic's transition to a new TPS. Sixty clinically treated prostate/prostate bed intensity-modulated radiation therapy (IMRT) plans were exported from an in-house TPS and were used to create a KBP model in a newly implemented commercial application. To determine the benefit that KBP may have in a TPS transition, the model was tested on 2 groups of patients. Group 1 consisted of the first 10 prostate/prostate bed patients treated in the commercial TPS after the transition from the in-house TPS. Group 2 consisted of 10 patients planned in the commercial TPS after 8 months of clinical use. The KBP-generated plan was compared with the clinically used plan in terms of plan quality (ability to meet planning objectives and overall dose metrics) and planning efficiency (time required to generate clinically acceptable plans). The KBP-generated plans provided a significantly improved target coverage (p = 0.01) compared with the clinically used plans for Group 1, but yielded plans of comparable target coverage to the clinically used plans for Group 2. For the organs at risk, the KBP-generated plans produced lower doses, on average, for every normal-tissue objective except for the maximum dose to 0.1 cc of rectum. The time needed for the KBP-generated plans ranged from 6 to 15 minutes compared to 30 to 150 and 15 to 60 minutes for manual planning in Groups 1 and 2, respectively. KBP is a promising tool to aid in the transition to a new TPS. Our study indicates that high-quality treatment plans could have been generated in the newly implemented TPS more efficiently compared with not using KBP. Even after 8 months of the clinical use, KBP still showed an increase in plan quality and planning efficiency compared with manual planning. Copyright © 2017 American Association of Medical Dosimetrists. Published