WorldWideScience

Sample records for unit review kc

  1. Overcoming KC-10 Formal Training Unit Pilot Production Challenges

    Science.gov (United States)

    2013-06-14

    Additionally, KC-10s were used to support multiple Operation PHOENIX SCORPION contingencies beginning in November 1997 and through 1998 as well. KC-10s...and ACIQ syllabi recommend for training purposes. As part of determining sources of delay, qualitative data will be used to explain what is...bare hands in that arena, because we can’t teach you to learn how to use a spear. If we do, you might cut your finger while you’re learning." And

  2. Nwoko, KC

    African Journals Online (AJOL)

    Nwoko, KC. Vol 10, No 1 (2014) - Articles Forward to the Past: Strikes and Striking as Dialogue by other means in Nigeria's Democratic Process Abstract. ISSN: 1597-3778. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

  3. Ofokansi, KC

    African Journals Online (AJOL)

    Ofokansi, KC. Vol 7, No 3 (2010) - Articles Ibuprofen-loaded microspheres based on a co-polymer of Eudragit® RS 100 and RL 100: Formulation, swelling and drug release properties. Abstract · Vol 8, No 3 (2011) - Articles Stability studies and degradation kinetics of some commercially available metronidazole suspensions ...

  4. Ofokansi, KC

    African Journals Online (AJOL)

    Ofokansi, KC. Vol 5, No 1 (2006) - Articles The use of liquid self-emulsifying drug delivery systems based on peanut oil/tween 80 in the delivery of griseofulvin. Abstract · Vol 8, No 1 (2010) - Articles A Novel Self-Nanoemulsifying Drug Delivery System Based on a Homolipid from Capra Hircus for the Delivery of Indomethacin

  5. KC-135 Operations Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The KC-135 Low-G Flight Research aircraft (a predecessor of the Boeing 707) is used to fly parabolas to create 20-25 seconds of weightlessness so that the astronauts...

  6. KC-46A Tanker Modernization (KC-46A)

    Science.gov (United States)

    2015-12-01

    Program Startup Workshop with the assistance from Defense Acquisition University at Wright-Patterson Air Force Base, Ohio. July 8 - 10, 2013: The KC-46A...Selected Acquisition Report (SAR) RCS: DD-A&T(Q&A)823-387 KC-46A Tanker Modernization (KC-46A) As of FY 2017 President’s Budget Defense Acquisition ...Deliveries and Expenditures 48 Operating and Support Cost 49 Common Acronyms and Abbreviations for MDAP Programs Acq O&M - Acquisition

  7. RA Construction KC, LLC Information Sheet

    Science.gov (United States)

    RA Construction KC, LLC (the Company) is located in Gladstone, Missouri. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Kansas City, Missouri.

  8. Senator Jake Garn on the KC-135

    Science.gov (United States)

    1985-01-01

    Senator Jake Garn appears to be springing from a trampoline in this scene, taken during a brief period of weightlessness provided by a parabola flown by the KC-135. Jeff Bingham, an aide to the senator, floats freely nearby (25616); Sen. Garn and Jeff Bingham prepare to ease from a partially anchored position to a totally free flying mode during a brief weightless session (25617); Sen. Garn gets an initial 'feel' of weightlessness as his feet float freely while he anchors himself with his hands. Seated nearby is his aide Bingham (25618); Sen. Garn (background) shares some of the ceiling space of the KC-135 with Bingham (25619); Sen. Garn (foreground) takes a seat behind the KC-135's crew in the forward cabin. Roger Zweig and Joseph S. Algranti, pilot and co-pilot, are partially visible in the background (25620).

  9. Environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' effort to manage its environment including air, water nature, and biodiversity to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 40 figs., 21 tabs.

  10. The Marginal Value of the CRAF DC-10-10 Compared to the KC-10A

    National Research Council Canada - National Science Library

    1981-01-01

    ...) DC-lO-lO aircraft was provided for HQ USAF review. In light of the modification costs, AF/SA was tasked to examine the marginal value between the proposal and the procurement of additional Air Force KC-1OA tankers...

  11. Pulmonary function in microgravity: KC-135 experience

    Science.gov (United States)

    Guy, Harold J.; Prisk, G. K.

    1991-01-01

    We have commenced a KC-135 program that parallels and proceeds our Spacelab (SLS-1) pulmonary function experiment. Our first task was to elucidate the affect of normal gravitation on the shape of the maximum expiratory flow volume (MEFV) curve. Nine normal subjects performed multiple MEFV maneuvers at 0-G, 1-G, and approximately 1.7-G. The MEFV curves for each subject were filtered, aligned at RV, and ensemble-averaged to produce an average MEFV curve for each state, allowing differences to be studied. Most subjects showed a decrease in the FVC at 0-G, which we attribute to an increased intrathoracic blood volume. In most of these subjects, the mean lung volume associated with a given flow was lower at 0-G, over about the upper half of the vital capacity. This is similar to the change previously reported during heat out immersion and is consistent with the known affect of engorgement of the lung with blood, on elastic recoil. There were also consistent but highly individual changes in the position and magnitude of detailed features of the curve, the individual patterns being similar to those previously reported on transition from the erect to the supine position. This supports the idea that the location and motion of choke points which determine the detailed individual configuration of MEFV curves, can be significantly influenced by gravitational forces, presumably via the effects of change in longitudinal tension on local airway pressure-diameter behavior and wave speed. We have developed a flight mass spectrometer and have commenced a study of single breath gradients in gas exchange, inert gas washouts, and rebreathing cardiac outputs and lung volumes at 0-G, 1-G, and 1.7-G. Comparison of our results with those from SLS-1 should identify the opportunities and limitations of the KC-135 as an accessible microgravity resource.

  12. Risk Management of an Aging KC-130 Fleet

    National Research Council Canada - National Science Library

    Hoffman, Paul

    1999-01-01

    .... For the aging USMC KC-130 F/R fleet, a damage-tolerant approach ensured that safety would be maintained but it presented a problem in forecasting readiness, aircraft remaining in the inventory...

  13. Air Force KC-X Aerial Refueling Tanker Aircraft Program

    National Research Council Canada - National Science Library

    2007-01-01

    Why You Should Read This Report. This report discusses efforts by Air Force acquisition officials to develop an acquisition strategy to ensure that the Air Force maintains competition throughout the life-cycle of the Air Force KC-X...

  14. Testing Microgravity Flight Hardware Concepts on the NASA KC-135

    Science.gov (United States)

    Motil, Susan M.; Harrivel, Angela R.; Zimmerli, Gregory A.

    2001-01-01

    This paper provides an overview of utilizing the NASA KC-135 Reduced Gravity Aircraft for the Foam Optics and Mechanics (FOAM) microgravity flight project. The FOAM science requirements are summarized, and the KC-135 test-rig used to test hardware concepts designed to meet the requirements are described. Preliminary results regarding foam dispensing, foam/surface slip tests, and dynamic light scattering data are discussed in support of the flight hardware development for the FOAM experiment.

  15. Psychogeriatric inpatient unit design: a literature review.

    Science.gov (United States)

    Dobrohotoff, John T; Llewellyn-Jones, Robert H

    2011-03-01

    In many parts of the world the provision of psychogeriatric inpatient units (PGUs) remains limited. More units will be required over coming decades given rapid population aging. Medline (1950-2010), psycINFO (1806-2009), EMBASE (1980-2009) and CINAHL (1982-2009) were searched for papers about PGU design. Selected non-peer reviewed literature such as government reports and unpublished academic dissertations were also reviewed. Data were also obtained from the literature related to general adult psychiatry inpatient units where there was limited information from studies of units designed for older people. Over 200 papers were reviewed and 130 were included. There are few good quality studies to guide the design of acute PGUs and much of the existing literature is based on opinion and anecdote or, at best, based on observational studies. Randomized controlled studies comparing different designs and assessing outcomes are virtually non-existent. Several studies have identified violence and trauma resulting from hospitalization as significant problems with current acute PGU care. Despite its limitations the available literature provides useful guidance on how PGU design can optimize patient and staff safety and improve clinical outcomes. There are significant problems with current acute PGUs, and patient mix on existing units is an important issue. Future research should examine patient and staff perceptions of different PGU ward environments, the relationship between ward design and clinical outcomes, the effects of segregating patients with challenging behaviors in dementia and the benefits or otherwise of gender segregation.

  16. 28 CFR 541.49 - Review of control unit placement.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Review of control unit placement. 541.49... INMATE DISCIPLINE AND SPECIAL HOUSING UNITS Control Unit Programs § 541.49 Review of control unit placement. (a) Unit staff shall evaluate informally and daily an inmate's adjustment within the control unit...

  17. OECD environmental performance reviews: United States

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-01-15

    This book presents OECD assessments and recommendations regarding the United States' efforts to manage its environment including air, water, nature, and biodiversity; to do this in a sustainable manner; and to do this in co-operation with its global neighbours. In particular, it assesses progress made since 1996, when OECD's previous review on the US was done. 47 figs., 20 tabs.

  18. United States electric industry : restructuring in review

    International Nuclear Information System (INIS)

    Slocum Hollis, S.

    2004-01-01

    This paper provides a detailed review of the United States electric power industry. The aim of the review was to clarify and better define current industry procedures and practices in light of significant and recent restructuring. In addition, recent bankruptcies and the power blackout in 2003 have raised concerns over industry practices. Issues concerning Independent System Operators (ISO) and regional transmission organizations were evaluated, with reference to an evolution and implementation of Regional Transmission Organization (RTO) policy, including a cost-benefit analysis. A background of RTO formations was provided with reference to consolidation, selection process and transfer of assets. Standard market design, network access and pricing issues were reviewed, as well as market and reliability concerns. Issues concerning affiliate treatment, shortages and the effect of sale of securities were presented. Various approaches to congestion management were examined, with examples from California and New England. Market monitoring issues, investigations and hearings were also examined, with examples and orders, including details of refunds. Measures to improve reliability were reviewed, including: management systems, benefit margins, requirements, assurance agreements and reserve markets. Issues concerning information access were presented, including: Open Access Same-time Information System (OASIS) requirements; tagging; standard business practices and protocols; and quarterly report practices and protocols. Interconnection policies were reviewed with reference to applicability, service options and pricing. The issue of variations was examined, with case examples concerning cost allocation, contract rights and treatment of specific costs. Jurisdiction issues concerning corporate realignments and power exchanges were presented, as well as specific services and state-federal relations. Issues concerning mergers and merger policy were also discussed, with reference

  19. United States of America: health system review.

    Science.gov (United States)

    Rice, Thomas; Rosenau, Pauline; Unruh, Lynn Y; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2013-01-01

    This analysis of the United States health system reviews the developments in organization and governance, health financing, health-care provision, health reforms and health system performance. The US health system has both considerable strengths and notable weaknesses. It has a large and well-trained health workforce, a wide range of high-quality medical specialists as well as secondary and tertiary institutions, a robust health sector research program and, for selected services, among the best medical outcomes in the world. But it also suffers from incomplete coverage of its citizenry, health expenditure levels per person far exceeding all other countries, poor measures on many objective and subjective measures of quality and outcomes, an unequal distribution of resources and outcomes across the country and among different population groups, and lagging efforts to introduce health information technology. It is difficult to determine the extent to which deficiencies are health-system related, though it seems that at least some of the problems are a result of poor access to care. Because of the adoption of the Affordable Care Act in 2010, the United States is facing a period of enormous potential change. Improving coverage is a central aim, envisaged through subsidies for the uninsured to purchase private insurance, expanded eligibility for Medicaid (in some states) and greater protection for insured persons. Furthermore, primary care and public health receive increased funding, and quality and expenditures are addressed through a range of measures. Whether the ACA will indeed be effective in addressing the challenges identified above can only be determined over time. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

  20. 78 FR 77118 - KC Small Hydro, LLC; Notice of Amended Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2013-12-20

    ..., Motions To Intervene, and Competing Applications On May 28, 2013, KC Scoby Hydro, LLC, filed an... 28, 2013, application and sent an acceptance letter to KC Scoby Hydro, LLC. Subsequently, On October 28, 2013, KC Scoby Hydro, LLC, amended its preliminary permit application to change its name to KC...

  1. Comprehensive stroke units: a review of comparative evidence and experience.

    Science.gov (United States)

    Chan, Daniel K Y; Cordato, Dennis; O'Rourke, Fintan; Chan, Daniel L; Pollack, Michael; Middleton, Sandy; Levi, Chris

    2013-06-01

    Stroke unit care offers significant benefits in survival and dependency when compared to general medical ward. Most stroke units are either acute or rehabilitation, but comprehensive (combined acute and rehabilitation) model (comprehensive stroke unit) is less common. To examine different levels of evidence of comprehensive stroke unit compared to other organized inpatient stroke care and share local experience of comprehensive stroke units. Cochrane Library and Medline (1980 to December 2010) review of English language articles comparing stroke units to alternative forms of stroke care delivery, different types of stroke unit models, and differences in processes of care within different stroke unit models. Different levels of comparative evidence of comprehensive stroke units to other models of stroke units are collected. There are no randomized controlled trials directly comparing comprehensive stroke units to other stroke unit models (either acute or rehabilitation). Comprehensive stroke units are associated with reduced length of stay and greatest reduction in combined death and dependency in a meta-analysis study when compared to other stroke unit models. Comprehensive stroke units also have better length of stay and functional outcome when compared to acute or rehabilitation stroke unit models in a cross-sectional study, and better length of stay in a 'before-and-after' comparative study. Components of stroke unit care that improve outcome are multifactorial and most probably include early mobilization. A comprehensive stroke unit model has been successfully implemented in metropolitan and rural hospital settings. Comprehensive stroke units are associated with reductions in length of stay and combined death and dependency and improved functional outcomes compared to other stroke unit models. A comprehensive stroke unit model is worth considering as the preferred model of stroke unit care in the planning and delivery of metropolitan and rural stroke services

  2. United Nations Environment Programme. Annual Review 1981.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    This edition of the United Nations Environment Programme (UNEP) annual report is structured in three parts. Part 1 focuses on three contemporary problems (ground water, toxic chemicals and human food chains and environmental economics) and attempts to solve them. Also included is a modified extract of "The Annual State of the Environment…

  3. 78 FR 71601 - KC Small Hydro LLC; Advanced Hydropower, Inc.; Notice of Preliminary Permit Application Accepted...

    Science.gov (United States)

    2013-11-29

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project Nos. 14521-001, 14561-000] KC Small Hydro LLC; Advanced Hydropower, Inc.; Notice of Preliminary Permit Application Accepted for Filing and Soliciting Comments, Motions To Intervene, and Competing Applications On May 13, 2013, KC Scoby...

  4. Country programme review. United Republic of Tanzania

    International Nuclear Information System (INIS)

    Cuaron, A.; Hance, R.; Yurtsever, Y.; Maudarbocus, V.

    1992-01-01

    This document provides a review of past and present IAEA Technical Co-operation Activities in Tanzania and gives descriptions of the current status of nuclear applications in food and agriculture, human health, water resources and industrial applications/nuclear instrumentation

  5. Assessing RN-to-RN peer review on clinical units.

    Science.gov (United States)

    Pfeiffer, Judith A; Wickline, Mary A; Deetz, Jill; Berry, Elise S

    2012-04-01

    The primary purpose of this study was to measure informal registered nurse (RN)-to-RN peer review (defined as collegial communication about the quality of nursing care) at the work-unit level. Survey design with cluster sampling of 28 hospital or ambulatory care units (n = 541 respondents). Results were compared with existing patient safety and satisfaction data. A chi-squared test was used to compare responses against nurse characteristics. Nurses agreed that RN-to-RN peer review takes place on their units, but no correlation with patient safety and satisfaction data was found. Misunderstandings about the meaning of peer review were evident. Open-ended comments revealed barriers to peer review: fear of retribution, language barriers and lack of professionalism. Nurses need clarification of peer review. Issues with common language in a professional environment need to be addressed and nurses can learn collaboration from each other's cultures. Managers should support RN-to-RN peer review on clinical units. Methods used here may be useful to assess current departmental nurse peer review. © 2011 Blackwell Publishing Ltd.

  6. File list: InP.CeL.05.AllAg.Kc167 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.CeL.05.AllAg.Kc167 dm3 Input control Cell line Kc167 SRX749056,SRX365698,SRX511...SRX1056719,SRX495296 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.CeL.05.AllAg.Kc167.bed ...

  7. 78 FR 54643 - KC Scoby Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and Soliciting...

    Science.gov (United States)

    2013-09-05

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14526-000] KC Scoby Hydro... Intervene, and Competing Applications On May 28, 2013, KC Scoby Hydro, LLC, filed an application for a... Contact: Kelly Sackheim, KC Scoby Hydro, LLC, 5096 Cocoa Palm Way, Fair Oaks, CA 95628; phone: (301) 401...

  8. Transformation of carbon tetrachloride by Pseudomonas sp. strain KC under denitrification conditions

    International Nuclear Information System (INIS)

    Criddle, C.S.; DeWitt, J.T.; Grbic-Galic, D.; McCarty, P.L.

    1990-01-01

    A denitrifying Pseudomonas sp. (strain KC) capable of transforming carbon tetrachloride (CT) was isolated from groundwater aquifer solids. Major products of the transformation of 14 C-labeled CT by Pseudomonas strain KC under denitrification conditions were 14 CO 2 and an unidentified water-soluble fraction. Little or no chloroform was produced. Addition of dissolved trace metals, notably, ferrous iron and cobalt, to the growth medium appeared to enhance growth of Pseudomonas strain KC while inhibiting transformation of CT. It is hypothesized that transformation of CT by this organism is associated with the mechanism of trace-metal scavenging

  9. United Kingdom (England): Health system review.

    Science.gov (United States)

    Boyle, Seán

    2011-01-01

    The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the population has improved over the last few decades. However, inequalities in health across socioeconomic groups have been increasing since the 1970s. The main diseases affecting the population are circulatory diseases, cancer, diseases of the respiratory system and diseases of the digestive system. Risk factors such as the steadily rising levels of alcohol consumption, the sharp increases in adult and child obesity and prevailing smoking levels are among the most pressing public health concerns, particularly as they reflect the growing health inequalities among different socioeconomic groups. Health services in England are largely free at the point of use. The NHS provides preventive medicine, primary care and hospital services to all those ordinarily resident. Over 12% of the population is covered by voluntary health insurance schemes, known in the United Kingdom as private medical insurance (PMI), which mainly provides access to acute elective care in the private sector. Responsibility for publicly funded health care rests with the Secretary of State for Health, supported by the Department of Health. The Department operates at a regional level through 10 strategic health authorities (SHAs), which are responsible for ensuring the quality and performance of local health services within their geographic area. Responsibility for commissioning health services at the local level lies with 151 primary care

  10. Hotline Allegations Involving Contracts for Programmed Depot Maintenance of KC-135 Aircraft

    National Research Council Canada - National Science Library

    1998-01-01

    Introduction. We performed the audit in response to 15 allegations made to the Defense Hotline involving two contracts on the Programmed Depot Maintenance of the KC-135 Aircraft, which Oklahoma City Air logistics...

  11. Kansas City Transportation and Local-Scale Air Quality Study (KC-TRAQS) Fact Sheet

    Science.gov (United States)

    In fall 2017, the U.S. Environmental Protection Agency (EPA) launched the Kansas City Transportation Local-Scale Air Quality Study (KC-TRAQS) to learn more about local community air quality in three neighborhoods in Kansas City, KS.

  12. Air Force Air Refueling: The KC-X Aircraft Acquisition Program

    National Research Council Canada - National Science Library

    Bolkcom, Christopher; Knight, William

    2008-01-01

    .... The program is expected to cost approximately $35 billion. Both Boeing and a consortium consisting of Northrop Grumman and European Aeronautic Defence and Space Company (EADS) competed for KC-X...

  13. Employing organizational modeling and simulation of the KC-135 depot's flight controls repair cell

    OpenAIRE

    Paskin, Matthew A.; Trevino, Alice W.; Ferrer, Geraldo; Dillard, John T.

    2008-01-01

    Today’s environment of increased operations tempo is stressing the KC- 135 Stratotanker fleet. With an 80-year life span expectancy, effectively maintaining these aircraft is challenging. This research modeled the KC- 135 programmed depot maintenance (PDM) flight controls repair cell to identify improvement opportunities within the repair process. Computational organizational modeling (COM) incorporates the human element along with organizational design theory. By employing ...

  14. Experimental Investigation on Tool Wear Behavior and Cutting Temperature during Dry Machining of Carbon Steel SAE 1030 Using KC810 and KC910 Coated Inserts

    Directory of Open Access Journals (Sweden)

    Y. Tamerabet

    2018-03-01

    Full Text Available The removal of cutting fluids and lubrication in dry machining operations requires a good knowledge and full control of all the mechanisms that lead to tool damage. In order to optimize dry machining operations, it is necessary to clearly identify the wear patterns, determine the contact conditions and define the relationship between the contact parameters and the operating conditions. The idea is to choose optimal cutting conditions which lead to the best contact conditions limiting the triggering or aggravation of wear phenomena. The purpose of this paper is to determine the impact multilayer coatings and cutting parameters on tool wear and temperature at the tool-chip interface for two types of coated carbides (KC810 and KC910 Commercialized inserts during dry turning operation of carbon steel SAE 1030, in order to determine the ideal parameters and guarantee the best performances of the cutting tools. Cutting temperature, Crater and Flank wear have been systematically recorded in order to determine their influence on tool life time. To ensure the optimum choice of machining conditions; the TAGUCHI method associated to multi-factorial method were applied to plan the experiments. It has been noted that cutting speed was the most influential factor on temperature and wear evolution. We noted also that the KC810 insert was more suitable for machining of SAE 1030 Carbon Steel; where The best life time was registered (T=228 min. The KC810 inserts offer 30 min of additional machining time for the same work conditions.

  15. Pharmacist-led medication review in an acute admissions unit

    DEFF Research Database (Denmark)

    Hansen, Trine Graabæk; Bonnerup, Dorthe Krogsgaard; Kjeldsen, Lene Juel

    2015-01-01

    of principles and methodologies, and the practical procedure is seldom described in detail, which makes reproducing study findings difficult. The objective of this paper is to provide a detailed description of a procedure developed and used for pharmacist-led medication review in acute admissions units......) collection of information about the patient's medical treatment, (3) patient interview, (4) critical examination of the patient's medications and (5) recommendations for the hospital physician.Conclusions We have provided a detailed description of a procedure for pharmacist-led medication review. We do so...

  16. Survey of regulatory agency review of generating unit performance

    International Nuclear Information System (INIS)

    Roach, E.M. Jr.; Tarletz, D.B.

    1985-01-01

    Regulatory agencies across the country are being called upon increasingly to monitor the management of electric utilities. Such activity, which once was relatively rare, is now common. Most frequently this oversight centers around the operating performance of generating units, both nuclear and fossil. There are, perhaps, several reasons for this increased interest in the efficient operation of generating units: increased fuel costs and fuel cost differentials, increased lead times and costs for construction of new generating units, and increased dependence on existing units because of construction programs being revised to meet decreased load growth. The monitoring of generating units has taken the form of after the fact evaluation of performance on a case-by-case basis and the implementation of productivity incentive programs. Performance standards are used in these contexts both to measure the adequacy of unit performance and to implement incentives in the form of rewards or penalties. The standard used may be a subjective test of prudent performance or some numerical index of plant performance, e.g., equivalent availability, capacity factor or heat rate. Some of the activity by regulators is reviewed in applying subjective and numerical standards and the considerations involved in applying such standards are discussed

  17. Vogtle Unit 1 readiness review: Assessment of Georgia Power Company readiness review pilot program

    International Nuclear Information System (INIS)

    Lewis, G.

    1987-09-01

    Georgia Power Company (GPC) performed a readiness review at Vogtle Unit 1 as a pilot program. The pilot program was a new and innovative approach for the systematic and disciplined review, with senior management involvement, of GPC's implementation of design, construction, and operational readiness processes. The program's principal objective was to increase the level of assurance that quality programs at Vogtle Unit 1 have been accomplished in accordance with regulatory requirements. This report assesses the effectiveness of the GPC's readiness review pilot program (RRPP) at Vogtle Unit 1. It includes (1) an overview of what was experienced during the program's implementation, (2) an assessment of how well program objectives were met, and (3) lessons learned on the future use of the readiness review concept. Overall, GPC and the NRC staff believe that the RRPP at Vogtle Unit 1 was a success and that the program provided significant added assurance that Vogtle Unit 1 licensing commitments and NRC regulations have been adequately implemented. Although altering the NRC licensing review process for the few plants still in the construction pipeline may not be appropriate, licensees may benefit significantly by performing readiness reviews on their own initiative as GPC did for Vogtle. (7 refs.)

  18. Factors Affecting The Customer Saving in KC Singkawang Bank Syariah Mandiri

    Directory of Open Access Journals (Sweden)

    Maulina Fera

    2017-10-01

    Full Text Available This study aims to determine how much influence the product factor, quality of services provided, offered profit sharing ratio and religiosity factor customers to save customers' interest in Bank Syariah Mandiri (BSM KC Singkawang. The research location is in Singkawang, where people Singkawang has a multi-ethnic city that consists of three (3 the largest ethnic Chinese, Malay and Dayak. This underlying this research. The method used is an associative method, the data collection technique of distributing questionnaires to the respondents to explore related information about the factors that affect customers save on BSM KC Singkawang. This research resulted in the coefficient of determination (R2 of 0443 which means that the variable products, services, revenue sharing and religiosity can explain the customer's decision in BSM KC Singkawang saving of 44.3%. While the remaining 55.7% is influenced by other factors not included in this research model.

  19. Fas-deficient mice have impaired alveolar neutrophil recruitment and decreased expression of anti-KC autoantibody:KC complexes in a model of acute lung injury

    Directory of Open Access Journals (Sweden)

    Gil Sucheol

    2012-10-01

    Full Text Available Abstract Background Exposure to mechanical ventilation enhances lung injury in response to various stimuli, such as bacterial endotoxin (LPS. The Fas/FasL system is a receptor ligand system that has dual pro-apoptotic and pro-inflammatory functions and has been implicated in the pathogenesis of lung injury. In this study we test the hypothesis that a functioning Fas/FasL system is required for the development of lung injury in mechanically ventilated mice. Methods C57BL/6 (B6 and Fas-deficient lpr mice were exposed to either intra-tracheal PBS followed by spontaneous breathing or intra-tracheal LPS followed by four hours mechanical ventilation with tidal volumes of 10 mL/kg, respiratory rate of 150 breaths per minute, inspired oxygen 0.21 and positive end expiratory pressure (PEEP of 3 cm of water. Results Compared with the B6 mice, the lpr mice showed attenuation of the neutrophilic response as measured by decreased numbers of BAL neutrophils and lung myeloperoxidase activity. Interestingly, the B6 and lpr mice had similar concentrations of pro-inflammatory cytokines, including CXCL1 (KC, and similar measurements of permeability and apoptosis. However, the B6 mice showed greater deposition of anti-KC:KC immune complexes in the lungs, as compared with the lpr mice. Conclusions We conclude that a functioning Fas/FasL system is required for full neutrophilic response to LPS in mechanically ventilated mice.

  20. Occupational Therapy in the Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Weinreich, Mark; Herman, Jennifer; Dickason, Stephanie; Mayo, Helen

    2017-07-01

    This paper is a synthesis of the available literature on occupational therapy interventions performed in the adult intensive care unit (ICU). The databases of Ovid MEDLINE, Embase, the Cochrane Library, ClinicalTrials.gov and CINAHL databases were systematically searched from inception through August 2016 for studies of adults who received occupational therapy interventions in the ICU. Of 1,938 citations reviewed, 10 studies met inclusion criteria. Only one study explicitly discussed occupational therapy interventions performed and only one study specifically tested the efficacy of occupational therapy. Future research is needed to clarify the specific interventions and role of occupational therapy in the ICU and the efficacy of these interventions.

  1. Spiritual Care in the Intensive Care Unit: A Narrative Review.

    Science.gov (United States)

    Ho, Jim Q; Nguyen, Christopher D; Lopes, Richard; Ezeji-Okoye, Stephen C; Kuschner, Ware G

    2018-05-01

    Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.

  2. Energy policies of IEA countries: the United Kingdom 2006 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The United Kingdom is facing a critical moment in its energy policy: North Sea oil and gas production is declining, dependence on imported energy is increasing, while rising energy prices and climate change considerations pose further challenges. The second thematic review of the UK addresses these challenges, focusing on energy investment, energy efficiency, and the return of nuclear power to the political agenda. Almost all coal-fired and nuclear power capacity in the United Kingdom will be retired within the next 15 years. The review encourages the government to maintain its trust in the market mechanism for the delivery of required investment and security of supply. However, it also identifies the need for the government to play a more active role in setting the framework. On the demand side, the IEA considers the government's 'Energy Efficiency Commitment' (EEC) an impressive success. The EEC was introduced in 2002 and is an energy-saving programme under which suppliers must achieve efficiency targets in households. Challenges, such as the requirement that 50 per cent of savings come from low-income households, remain, and the review invites the government to investigate ways in which fuel poverty could be reduced without distorting the EEC. The review also assesses the government's shifting direction on nuclear energy and backs this new path. It argues that the development of a positive investment framework in planning and licensing - without direct intervention in investment decisions favouring nuclear - will allow investors to judge the viability of new plants. 3 apps.

  3. Burnout in the intensive care unit professionals: A systematic review.

    Science.gov (United States)

    Chuang, Chien-Huai; Tseng, Pei-Chi; Lin, Chun-Yu; Lin, Kuan-Han; Chen, Yen-Yuan

    2016-12-01

    Burnout has been described as a prolonged response to chronic emotional and interpersonal stress on the job that is often the result of a period of expending excessive effort at work while having too little recovery time. Healthcare workers who work in a stressful medical environment, especially in an intensive care unit (ICU), may be particularly susceptible to burnout. In healthcare workers, burnout may affect their well-being and the quality of professional care they provide and can, therefore, be detrimental to patient safety. The objectives of this study were: to determine the prevalence of burnout in the ICU setting; and to identify factors associated with burnout in ICU professionals. The original articles for observational studies were retrieved from PubMed, MEDLINE, and Web of Science in June 2016 using the following MeSH terms: "burnout" and "intensive care unit". Articles that were published in English between January 1996 and June 2016 were eligible for inclusion. Two reviewers evaluated the abstracts identified using our search criteria prior to full text review. To be included in the final analysis, studies were required to have employed an observational study design and examined the associations between any risk factors and burnout in the ICU setting. Overall, 203 full text articles were identified in the electronic databases after the exclusion of duplicate articles. After the initial review, 25 studies fulfilled the inclusion criteria. The prevalence of burnout in ICU professionals in the included studies ranged from 6% to 47%. The following factors were reported to be associated with burnout: age, sex, marital status, personality traits, work experience in an ICU, work environment, workload and shift work, ethical issues, and end-of-life decision-making. The impact of the identified factors on burnout remains poorly understood. Nevertheless, this review presents important information, suggesting that ICU professionals may suffer from a high level

  4. IAEA Completes Nuclear Security Review Mission in United States

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: A team of nuclear security experts led by the International Atomic Energy Agency (IAEA) today completed a mission to review nuclear security practices of civil nuclear facilities licensed by the United States Nuclear Regulatory Commission (NRC). Conducted at the U.S. Government's request, the two-week International Physical Protection Advisory Service (IPPAS) mission reviewed the United States' nuclear security-related legislative and regulatory framework. As part of this work, the IPPAS team, led by John O'Dacre of Canada and comprising nine experts from eight IAEA Member States, met with NRC officials and reviewed the physical protection systems at the Center for Neutron Research (NCNR) at the National Institute of Standards and Technology. The IPPAS team concluded that nuclear security within the U.S. civil nuclear sector is robust and sustainable and has been significantly enhanced in recent years. The team identified a number of good practices in the nation's nuclear security regime and at the NCNR. The IPPAS team also made a recommendation and some suggestions for the continuing improvement of nuclear security overall. The mission in the United States was the 60th IPPAS mission organized by the IAEA. 'Independent international peer reviews such as IAEA IPPAS missions are increasingly being recognized for their value as a key component for exchanges of views and advice on nuclear security measures', said Khammar Mrabit, Director of the IAEA Office of Nuclear Security. 'The good practices identified during this mission will contribute to the continuous improvements of nuclear security in other Member States'. The IPPAS team provided a draft report to the NRC and will submit a final report soon. Because it contains security-related information about a specific nuclear site, IPPAS reports are not made public. 'The IPPAS programme gives us a chance to learn from the experience and perspective of our international partners', said NRC Chairman Allison M

  5. 76 FR 71960 - KC Hydro LLC of New Hampshire; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14247-000] KC Hydro LLC of..., Motions To Intervene, and Competing Applications On August 8, 2011, KC Hydro LLC of New Hampshire filed an... spillway elevation of 130 feet mean sea level (msl); (3) connecting new electrical [[Page 71961...

  6. 76 FR 71961 - KC Hydro LLC of New Hampshire; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14246-000] KC Hydro LLC of..., Motions To Intervene, and Competing Applications On August 8, 2011, KC Hydro LLC of New Hampshire filed an... at the spillway crest elevation; (3) a newly constructed powerhouse; (4) new electrical generating...

  7. Energy policies of IEA countries: United States - 2007 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-02-15

    The United States is the largest economy and energy user in the world. Significant developments have taken place in its energy policy since the last IEA review in 2002. Most important is the Energy Policy Act 2005 - a comprehensive energy legislation which has set new directions, including opening the way for a nuclear renaissance. Two closely connected challenges shape all debates on the nation's energy policy path: how to increase security by reducing the dependence on imported supplies; and how to address growing emissions of greenhouse gases. The United States national strategy is to find solutions largely through technology. It is a world leader in R&D and is driving development of carbon capture and storage and second-generation biofuels. But thus far, no federal government policy is in place to establish as a target an absolute reduction of CO2 emissions. The resulting uncertainty risks holding back investments into new technologies and may delay projects that are urgently required. The transport sector will be a key to a sustainable success. In the short to medium term, reduced fuel demand through higher vehicle efficiency will increase security and reduce CO2 emissions. Yet the policy for the revision of CAFE (the corporate average fuel economy) standards will leave consumers with vehicles that fall short of the technological possibilities. This review takes an in-depth look at these issues and provides recommendations on how the United States can do more to answer the challenges of both improving its security of energy supply and lowering its emissions intensity, demonstrating the significant improvements that can already be realised through existing technologies.

  8. Energy policies of IEA countries: United States - 2007 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-02-15

    The United States is the largest economy and energy user in the world. Significant developments have taken place in its energy policy since the last IEA review in 2002. Most important is the Energy Policy Act 2005 - a comprehensive energy legislation which has set new directions, including opening the way for a nuclear renaissance. Two closely connected challenges shape all debates on the nation's energy policy path: how to increase security by reducing the dependence on imported supplies; and how to address growing emissions of greenhouse gases. The United States national strategy is to find solutions largely through technology. It is a world leader in R&D and is driving development of carbon capture and storage and second-generation biofuels. But thus far, no federal government policy is in place to establish as a target an absolute reduction of CO2 emissions. The resulting uncertainty risks holding back investments into new technologies and may delay projects that are urgently required. The transport sector will be a key to a sustainable success. In the short to medium term, reduced fuel demand through higher vehicle efficiency will increase security and reduce CO2 emissions. Yet the policy for the revision of CAFE (the corporate average fuel economy) standards will leave consumers with vehicles that fall short of the technological possibilities. This review takes an in-depth look at these issues and provides recommendations on how the United States can do more to answer the challenges of both improving its security of energy supply and lowering its emissions intensity, demonstrating the significant improvements that can already be realised through existing technologies.

  9. Final Work Plan for a Remedial Action Plan in Support of the Risk-Based Approach to Remediation at KC-135 Crash Site

    National Research Council Canada - National Science Library

    1994-01-01

    ... receptor exposure to fuel-hydrocarbon- contaminated environmental media at the KC-135 Crash Site. The second goal is to implement any necessary and appropriate remedial technologies at the KC-135 Crash Site...

  10. Isolation and analysis of a multifunctional triterpene synthase KcMS promoter region from mangrove plant kandelia candel

    Science.gov (United States)

    Basyuni, M.; Wati, R.; Sulistiyono, N.; Sumardi; Oku, H.; Baba, S.; Sagami, H.

    2018-03-01

    Molecular cloning of Kandelia candel KcMS gene has previously been cloned and encoded a multifunctional triterpene synthase. In this study, the KcMS gene promoter was cloned through Genome walking, sequenced, and analyzed. A 1,358 bp genomic DNA fragment of KcMS promoter was obtained. PLACE and PlantCARE analysis of the KcMS promoter revealed that there was some regulatory elements in response to environmental signals and involved in the regulation of gene expression. Results showed that four kinds of elements are regulated by hormone binding, namely 2 MeJA-responsiveness elements (CGTCA-motif and TGACG-motif), the ABRE (TACGTG) involved in abscisic acid responsiveness, gibberellin-related GARE-motif (AAACAGA), and the TGA-element (AACGAC) as an auxin-responsive element. Several elements in the KcMS have been shown in other plants to be responsive to abiotic stress. These motifs were MBS (CAACTG), TC-rich repeats, and eight light responsive elements. The KcMS promoter was also involved in the activation of defense genes in plants such as HSE (AAAAAATTC) and four circadian control elements (CAANNNNATC). The presence of multipotential regulatory motifs suggested that KcMS may be involved in regulation of plant tolerance to several types of stresses.

  11. Polarizability of KC60: Evidence for Potassium Skating on the C60 Surface

    Science.gov (United States)

    Rayane, D.; Antoine, R.; Dugourd, Ph.; Benichou, E.; Allouche, A. R.; Aubert-Frécon, M.; Broyer, M.

    2000-02-01

    We present the first measurement of the polarizability and the permanent dipole moment of isolated KC60 molecules by molecular beam deflection technique. We have obtained a value of 2506+/-250 Å3 for the polarizability at room temperature. The addition of a potassium atom enhances by more than a factor of 20 the polarizability of a pure C60 molecule. This very high polarizability and the lack of observed permanent dipole show that the apparent polarizability of KC60 is induced by the free skating of the potassium atom on the C60 surface, resulting in a statistical orientation of the dipole. The results are interpreted with a simple model similar to the Langevin theory for paramagnetic systems.

  12. Establishment and characterization of a new epithelial cell line, KC-1, from koala (Phascolarctos cinereus) conjunctiva.

    Science.gov (United States)

    Girjes, Adeeb A; Lee, Kristen E; Carrick, Frank N

    2003-01-01

    A novel, untransformed koala cell line (KC-1) was established by culturing koala conjunctival tissue in growth medium, which has permitted the study of the cell biology of this unique system. After the establishment of the KC-1 cell line, the cells were characterized by light microscopy, doubling time, and Western blot analysis. Light microscopy revealed that the cells have an epithelial morphology. Doubling times were significantly different (P koala cell line was adapted to grow continuously in Dulbecco modified Eagle medium containing 10% FCS for at least 30 passages. This unique cell line is an ideal tool for further investigation on koala cell biology and cytogenetics and for exploration of the pathophysiological mechanism of eye infections caused by different pathogens in koalas.

  13. SPECIAL REPORT - The KC EMPOWER Project: Designing More Accessible STEM Learning Activities

    OpenAIRE

    Bob Hirshon; Laureen Summers; Babette Moeller; Wendy Martin

    2016-01-01

    The overall purpose of the Kinetic City (KC) Empower project was to examine how informal science activities can be made accessible for students with disabilities. The premise of this project was that all students, including those with disabilities, are interested in and capable of engaging in science learning experiences, if these experiences are accessible to them. Drawing on resources from Kinetic City, a large collection of science experiments, games, and projects developed by the American...

  14. Page 1 Heterogeneous doping effects in KC-AlO composites 213 of ...

    Indian Academy of Sciences (India)

    Heterogeneous doping effects in KC-AlO composites 213 of Al-O in KCl at 500°C for three different sizes of Al-O particles (0-05, 0-3 and. 1-0 um). The figure shows that as the concentration of Al Os increases, the conductivity increases slowly initially, then rather rapidly before it peaks at a 45mol%. Al2O. Moreover, as the ...

  15. 78 FR 18325 - Intent To Prepare an Environmental Impact Statement (EIS) for the Formal Training Unit (FTU) and...

    Science.gov (United States)

    2013-03-26

    ... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC... Statement (EIS) for the Formal Training Unit (FTU) and Main Operating Base 1 (MOB 1) for the Beddown of KC...-46A tanker aircraft, associated infrastructure and manpower of the FTU and MOB 1 at existing active...

  16. Volatile Removal Assembly Flight Experiment and KC-135 Packed Bed Experiment: Results and Lessons Learned

    Science.gov (United States)

    Holder, Donald W.; Parker, David

    2000-01-01

    The Volatile Removal Assembly (VRA) is a high temperature catalytic oxidation process that will be used as the final treatment for recycled water aboard the International Space Station (ISS). The multiphase nature of the process had raised concerns as to the performance of the VRA in a microgravity environment. To address these concerns, two experiments were designed. The VRA Flight Experiment (VRAFE) was designed to test a full size VRA under controlled conditions in microgravity aboard the SPACEHAB module and in a 1 -g environment and compare the performance results. The second experiment relied on visualization of two-phase flow through small column packed beds and was designed to fly aboard NASA's microgravity test bed plane (KC-135). The objective of the KC-135 experiment was to understand the two-phase fluid flow distribution in a packed bed in microgravity. On Space Transportation System (STS) flight 96 (May 1999), the VRA FE was successfully operated and in June 1999 the KC-135 packed bed testing was completed. This paper provides an overview of the experiments and a summary of the results and findings.

  17. PI3KC2{alpha}, a class II PI3K, is required for dynamin-independent internalization pathways

    DEFF Research Database (Denmark)

    Krag, Claudia; Malmberg, Emily Kim; Salcini, Anna Elisabetta

    2010-01-01

    as fluid-phase endocytosis. Our data suggest a general role for PI3KC2a in regulating physiologically relevant dynamin-independent internalization pathways by recruiting early endosome antigen 1 (EEA1) to vesicular compartments, a step required for the intracellular trafficking of vesicles generated...... screen using a cell line expressing a diphtheria toxin receptor (DTR, officially known as HBEGF) anchored to GPI (DTR-GPI), which internalizes diphtheria toxin (DT, officially known as DTX) in a dynamin-independent manner, identified PI3KC2a, a class II phosphoinositide 3-kinase (PI3K), as a specific...... regulator of dynamin-independent DT internalization. We found that the internalization of several proteins that enter the cell through dynamin-independent pathways led to a relocalization of PI3KC2a to cargo-positive vesicles. Furthermore, downregulation of PI3KC2a impaired internalization of CD59 as well...

  18. Thermal stability of the F centre in KC1 between 80 and 300 K; Estabilidad termica del centro F' en KC1 entre 80 y 300 K

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Codovila, C

    1974-07-01

    After shining an F spark light of high intensity upon a coloured sample of KC1, the annealing of the induced F1 band and the decay of the induced luminescence are observed. This luminescence is produced by the electrons returning to the anion vacancies through the F* state. From the annealing characteristics of the F1 band between 80 and 300 K, we conclude that at least six thermally activated processes ase involved. The luminescence decay curves also show evidence of six the thermally activated processes which correlate quite wall in magnitude with those from the F1 band anneal. We conclude that the luminescence and annealing of the F1 band are aspects of the same process, and some explanations are suggested involving the interaction of F1 centres and electron traps. (Author) 41 refs.

  19. SPECIAL REPORT - The KC EMPOWER Project: Designing More Accessible STEM Learning Activities

    Directory of Open Access Journals (Sweden)

    Bob Hirshon

    2016-01-01

    Full Text Available The overall purpose of the Kinetic City (KC Empower project was to examine how informal science activities can be made accessible for students with disabilities. The premise of this project was that all students, including those with disabilities, are interested in and capable of engaging in science learning experiences, if these experiences are accessible to them. Drawing on resources from Kinetic City, a large collection of science experiments, games, and projects developed by the American Association for the Advancement of Science (AAAS, the project researched and adapted five afterschool science activities guided by universal design for learning principles.

  20. Quarrelsome Committees in U.S. Defense Acquisition: The KC-X Case

    Science.gov (United States)

    2014-04-30

    Chair: Jeff Ronka, Managing Partner, Renaissance Strategic Advisors Quarrelsome Committees in U.S. Defense Acquisition: The KC-X Case Raymond...aircraft; “ Italian Air Force,” n.d.; “Japan Air Self-Defense Force,” n.d.). Since the A330 can carry (and offload) more fuel (Fulghum, 2010), it would be...Retrieved from http://www.latimes.com Italian Air Force. (n.d.). In Wikipedia. Retrieved from http://en.wikipedia.org/wiki/Italian_Air_Force (last

  1. A review of United States yellow cake precipitation practice

    International Nuclear Information System (INIS)

    Litz, J.E.; Coleman, R.B.

    1980-01-01

    The various process flowsheets used to produce concentrated uranium solutions are reviewed. The choices of flowsheets are affected by ore alkalinity, uranium mineralization, and the impurities solubilized during leaching. The techniques used to precipitate yellow cake from concentrated uranium solutions are reviewed. Consideration is given to precipitation chemistry, reagent requirements, and process equipment and costs for precipitation, dewatering, drying and calcining. (author)

  2. Inactivation of the Class II PI3K-C2β Potentiates Insulin Signaling and Sensitivity

    Directory of Open Access Journals (Sweden)

    Samira Alliouachene

    2015-12-01

    Full Text Available In contrast to the class I phosphoinositide 3-kinases (PI3Ks, the organismal roles of the kinase activity of the class II PI3Ks are less clear. Here, we report that class II PI3K-C2β kinase-dead mice are viable and healthy but display an unanticipated enhanced insulin sensitivity and glucose tolerance, as well as protection against high-fat-diet-induced liver steatosis. Despite having a broad tissue distribution, systemic PI3K-C2β inhibition selectively enhances insulin signaling only in metabolic tissues. In a primary hepatocyte model, basal PI3P lipid levels are reduced by 60% upon PI3K-C2β inhibition. This results in an expansion of the very early APPL1-positive endosomal compartment and altered insulin receptor trafficking, correlating with an amplification of insulin-induced, class I PI3K-dependent Akt signaling, without impacting MAPK activity. These data reveal PI3K-C2β as a critical regulator of endosomal trafficking, specifically in insulin signaling, and identify PI3K-C2β as a potential drug target for insulin sensitization.

  3. Institutional Review Boards: Perspectives from the United States

    Directory of Open Access Journals (Sweden)

    Alvita Nathaniel, Ph.D., FNP-BC, FAANP

    2010-12-01

    Full Text Available In the U.S., all research must be approved by an Institutional Review Board (IRB that evaluates research protocols for the purpose of protecting human subjects. This paper includes a brief history of the development of public policy that guides institutional review boards in the U.S. and commentary on the responsibilities of a grounded theory researcher interested in applying for approval for a research study.An institutional review board (IRB is a formally constituted committee that approves and monitors biomedical and behavioural research with the purpose of protecting the rights and welfare of research participants. An IRB performs scientific, ethical, and regulatory oversight functions. In the U.S., it is common for grounded theorists to experience frustration with the IRB protocol submission process. Facets of the application process may seem rigid, redundant, and non-applicable. Review board members may not seem to understand or appreciate qualitative methods and delays are common. In addition, a conglomeration of disparate policies and procedures coupled with a variety of types of review boards creates a system that defies description. Nevertheless, a researcher who understands public policy and the responsibilities of institutional review boards can learn to develop research applications that are quickly approved.

  4. Determinação do coeficiente cultural (Kc do feijoeiro (Phaseolus vulgaris L., em Campos dos Goytacazes, RJ Determination of the crop coefficient (Kc for common bean (Phaseolus vulgaris L. in Campos dos Goytacazes, RJ

    Directory of Open Access Journals (Sweden)

    José C. Mendonça

    2007-10-01

    Full Text Available A evapotranspiração de uma cultura é uma das principais informações exigidas para o manejo de irrigação e para fins de planejamento do uso da água. Dentre as abordagens disponíveis para a estimativa do consumo de água pelas plantas, destaca-se o uso de coeficientes de cultura (Kc associados a estimativas da evapotranspiração de referência (ETo. Buscou-se determinar, aqui, os valores de Kc para as diferentes fases fenológicas do feijoeiro comum (Phaseolus vulgaris L., cultivar em lançamento UENF-47, através da utilização de um lisímetro de pesagem e compará-los com os valores propostos pela FAO 56. Concluiu-se que as equações de ajustamento propostas por Allen et al. (1998 se mostraram eficientes para a correção e ajustamento dos coeficientes culturais obtidos neste experimento e que os coeficientes culturais das fases 3 (Kc méd e 4 (Kc fim sugeridos também por Allen et al. (1998 se ajustaram bem ��s condições de cultivo do feijoeiro cultivado no período de outono/inverno, em Campos dos Goytacazes, RJ.The evapotranspiration of a crop is one of the main information required for proper irrigation management and to develop an efficient water usage plan. Among the methods to estimate the amount of water that is consumed by plants, the use of crop coefficients (Kc, associated with estimates of the reference evapotranspiration (ETo, stands as one of the most promising. This work aimed to deterime the values of Kc for different phenological phases of common bean plants (Phaseolus vulgaris L. of the cultivar UENF-47. Determination of Kc values was performed using a weighing lisimeter and results were compared with values obtained through the FAO 56 standard. Results showed that the adjustment equations proposed by Allen et al. (1998 were adequate for fitting the values of Kc obtained in this experiment. It has been shown that the crop coefficients for phenological phases 3 and 4 proposed by Allen et al. (1998 are adequate

  5. A Review of Technical Communication Programs Outside the United States.

    Science.gov (United States)

    Alred, Gerald J.

    2001-01-01

    Examines technical communication programs outside the United States and comments on such features as their location in the university structure, links with public relations, the inclusion of internships or practicums, the balance of theory and practice, and typical course offerings. Lists a dozen major programs in seven countries. Concludes that…

  6. Initial approach to hypertension in the hemodynamics unit: review article

    Directory of Open Access Journals (Sweden)

    Gustavo Teixeira Fulton Schimit

    2013-06-01

    Full Text Available Correct identification and early management of hypertensive disorders should be a part of the therapeutic repertoire of every professional working in hemodynamics units. Based on recent publications, this study aims to propose a practical approach to the identification and early management of these disorders in this type of service.

  7. An Analytical Review of the United States National Interests in Korea

    National Research Council Canada - National Science Library

    Swope, Frederick

    2004-01-01

    ... and interests for continued security on the peninsula and in the region. It will address these new growing tensions and review the United States National interests and policy differences with South Korea...

  8. Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

    Science.gov (United States)

    2017-04-01

    This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

  9. A review of the disposal of miscellaneous radioactive wastes in the United Kingdom

    International Nuclear Information System (INIS)

    Hookway, B.

    1980-01-01

    Current practices in the United Kingdom for waste disposal from ''minor users'' of radioactive materials are reviewed. The regulation of the disposal of solid, liquid and airborne wastes is discussed. (H.K.)

  10. Isolation and characterization of deleterious Pseudomonas aeruginosa KC1 from rhizospheric soils and its interaction with weed seedlings

    Directory of Open Access Journals (Sweden)

    Vijaya Lakshmi

    2015-04-01

    Full Text Available The bacterial isolate KC1 was screened from the rhizosphere of castor plants (Ricinus communis indigenous to agricultural fields of Bihar. The isolate was Gram negative, non-spore forming, and exhibited fluorescence under UV light. Its molecular characterization is based on the sequencing of 16S rDNA (1450 bp and alignment at GeneBank (NCBI, MaryLand. The strain has been validated as Pseudomonas aeruginosa (HM195190. The bacterium grew at 4–42 °C, with a temperature optima of 30 °C. The strain KC1 was found to produce cyanide (4.78 nmol l−1 over a period of 36 h. Data revealed enhanced cyanogenesis (6.98 nmol l−1, when glycine was provided in the King’s B medium. Seed bacterization exhibited reduction in root length, shoot length of weed seedlings (Amaranthus spinosus, Portulaca oleracea, which was significant (p < 0.05 in both laboratory and glasshouse experiments. Biomass was significantly reduced (p < 0.05 for the weed seedlings in glasshouse experiments. However, KC1 inoculated crop seedlings (Triticum aestivum were found to be less inhibitory as compared to weed seedlings. The observations are significant to establish, that the secondary metabolites producing KC1 rhizobacterium, P. aeruginosa KC1 could be exploited as a weed biocontrol agent. The innate potential of KC1 could be further formulated and utilized in field applications for agricultural sustainability.

  11. Review of noise in neonatal intensive care units - regional analysis

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez Abril, A [National Technological University, Regional Bioengineering Institute, Mendoza (Argentina); Terron, A; Boschi, C [National Technological University, Regional Bioengineering Institute, Mendoza (Argentina); Gomez, M [National Technological University, La Rioja (Argentina)

    2007-11-15

    This work is about the problem of noise in neonatal incubators and in the environment in the neonatal intensive care units. Its main objective is to analyse the impact of noise in hospitals of Mendoza and La Rioja. Methodology: The measures were taken in different moments in front of higher or lower severity level in the working environment. It is shown that noise produces severe damages and changes in the behaviour and the psychological status of the new born babies. Results: The noise recorded inside the incubators and the neonatal intensive care units together have many components but the noise of motors, opening and closing of access gates have been considered the most important ones. Values above 60 db and and up to 120 db in some cases were recorded, so the need to train the health staff in order to manage the new born babies, the equipment and the instruments associated with them very carefully is revealed.

  12. Review of noise in neonatal intensive care units - regional analysis

    International Nuclear Information System (INIS)

    Alvarez Abril, A; Terron, A; Boschi, C; Gomez, M

    2007-01-01

    This work is about the problem of noise in neonatal incubators and in the environment in the neonatal intensive care units. Its main objective is to analyse the impact of noise in hospitals of Mendoza and La Rioja. Methodology: The measures were taken in different moments in front of higher or lower severity level in the working environment. It is shown that noise produces severe damages and changes in the behaviour and the psychological status of the new born babies. Results: The noise recorded inside the incubators and the neonatal intensive care units together have many components but the noise of motors, opening and closing of access gates have been considered the most important ones. Values above 60 db and and up to 120 db in some cases were recorded, so the need to train the health staff in order to manage the new born babies, the equipment and the instruments associated with them very carefully is revealed

  13. Critical review of the current radiation protection quantities and units

    International Nuclear Information System (INIS)

    Sabol, J.

    1998-01-01

    Examples exist in dosimetry and radiation protection where primary attention was focused on the unit rather than the corresponding quantity. Another difficulty arises from the fact that quantities in this field cannot be considered as pure physical quantities, they are rather biophysical quantities. There are too many quantities (e. g. 17 quantities based on the dose equivalent), with differences in numerical values of 'similar' quantities, not always satisfactory approximations of virtually unmeasurable quantities by measurable quantities, inconsistency in definitions and interpretations of quantities of some international expert bodies, and problems of weighting and conversion factors. (M.D.)

  14. Test results of smart aircraft fastener for KC-135 structural integrity

    Science.gov (United States)

    Schoess, Jeffrey N.; Seifert, Greg

    1998-07-01

    Hidden and inaccessible corrosion in aircraft structures is the number one logistics problem for the US Air Force, with an estimated maintenance cost in excess of $LR 1.0B per year in 1990-equivalent dollars. The Smart Aircraft Fastener Evaluation (SAFE) system was developed to provide early warning detection of corrosion-related symptoms in hidden locations of aircraft structures. The SAFE system incorporates an in situ measurement approach that measures and autonomously records several environmental conditions within a Hi-Lok aircraft fastener that could cause corrosion. The SAFE system integrates a miniature electrochemical microsensor array and a time-of-wetness sensor with an ultra low power 8-bit microcontroller and 4- Mbyte solid-state FLASH archival memory to measure evidence of active corrosion. A summary of the technical approach and a detailed analysis of the KC-135 lap joint test coupon results are presented.

  15. Estimation Of The Spatial Distribution Of Crop Coefficient (Kc) From Landsat Satellite Imagery

    International Nuclear Information System (INIS)

    Abou EI-Magd, I.H.

    2009-01-01

    Single crop coefficient factor (K c ) is an essential component for crop water allocation for efficient irrigation scheduling and irrigation water management. Kc is basically defined as the ratio of actual evapotranspiration and grass/alfalfa reference evapotranspiration and always measured by lysimeter in localized area in the field, which then generalized on the whole irrigated land. The lack of precise information about the crop coefficient particularly in our country together with both small sized fields and heterogeneity of agricultural crops calls for developing a new methodology for computing a real time crop coefficient from remotely sensed data. This paper discusses the methodology developed for obtaining a real time single crop coefficient from Landsat Satellite ETM + 7 imageries. The methodology was applied and optimized on one irrigation field with two different dates and crop cover in the northern Delta of Egypt

  16. KC-A Kinectic computer code for investigation of parametric plasma instabilities

    International Nuclear Information System (INIS)

    Olshansky, V.

    1995-07-01

    In the frame of a joint research program of the Institute of Plasma Physics of the NationaI Science Center 'Kharkov Institute of Physics and Technology' (Kh IPT), Ukraine, and the plasma physics group of the Austrian Research Center Seibersdorf (FZS) a kinetic computer code with the acronym KC for investigation of paramarametric plasma instabilities has been implemented at the computer facilities of FZS as a starting point for further research in this field. This code based on a macroparticle technique is appropriate for studying the evolution of instabilities in a turbulent plasma including saturation. The results can be of interest for heating of tokamaks of the next generation, i.g. ITER. The present report describes the underlying physical models and numerical methods as well as the code structure and how to use the code as a reference of forthcoming joint papers. (author)

  17. Thermal stability of the F centre in KC1 between 80 and 300 K

    International Nuclear Information System (INIS)

    Garcia Codovila, C.

    1974-01-01

    After shining an F spark light of high intensity upon a coloured sample of KC1, the annealing of the induced F1 band and the decay of the induced luminescence are observed. This luminescence is produced by the electrons returning to the anion vacancies through the F* state. From the annealing characteristics of the F1 band between 80 and 300 K, we conclude that at least six thermally activated processes ase involved. The luminescence decay curves also show evidence of six the thermally activated processes which correlate quite wall in magnitude with those from the F1 band anneal. We conclude that the luminescence and annealing of the F1 band are aspects of the same process, and some explanations are suggested involving the interaction of F1 centres and electron traps. (Author) 41 refs

  18. United Kingdom Atomic Energy Authority Annual Review 1996-1997

    International Nuclear Information System (INIS)

    1997-01-01

    The UKAEA's current main task is to manage and ultimately dismantle those nuclear facilities developed during its days as an R and D organisation leading the development of nuclear energy in the UK. This is carried out in conjunction with other responsibilities. The organisation's key tasks are thus to: eliminate the nuclear liabilities left from earlier R and D; exploit the property assets on the organisation's sites; exploit remaining useful and operational nuclear facilities at Dounreay, Harwell and Windscale; explore the fusion energy option through participation in the European Union's experimental programme at the Joint European Torus (JET). The success achieved within each of these areas during 1996/97 is reviewed. (UK)

  19. A review of the United Kingdom fast reactor programme

    International Nuclear Information System (INIS)

    Bramman, J.I.; Hickey, H.B.; Adam, E.R.; Allan, C.G.; Gregory, C.V.

    1991-01-01

    At the PFR the gross electrical generation for the calendar year 1990 was 23,937 MWd with a load factor of 26.2%. These figures are only about half of the corresponding figures for 1989, mainly as a consequence of an outage extending from 24 April to 23 November, when a leak in the Reheater 1 vessel was being repaired. The plant was unavailable for operation on 264 days. However, prior to the April shut-down, the station had operated with high load factors (up to 85.0%). One reprocessing campaign was undertaken during the year under review. (author). 1 tab

  20. General review of diagnostic systems in EDF PWR units

    International Nuclear Information System (INIS)

    Chevalier, R.; Brasseur, S.; Ricard, B.

    1998-01-01

    Since the beginning of the French nuclear program, Electricite de France (EDF) has looked for ways to improve the availability and safety of its nuclear units. Therefore, monitoring systems on turbogenerators, reactor coolant pumps, primary circuits and core internal structures were designed by the Research and Development Division and implemented with technologies available during the 1970's. However, mainly because of difficulties for data interpretation by plant personnel, EDF subsequently decided to design and develop different tools to help plant operators to process a diagnosis: - a new generation of the Monitoring and Diagnostic System called PSAD, - expert systems for diagnosis on reactor coolant pumps (RCP) 'DIAPO' and turbogenerator units (TG) 'DIVA', - diagnostic guides written for most equipment pending the installation of new monitoring and diagnosis systems. The first version of PSAD, installed in five units, performs on-line monitoring of the turbogenerator shaft line, steam inlet valves, the reactor coolant pumps and the generator stator. The second version not yet implemented, will include Loose Part Detection (LPD) and Core Internal Structure Monitoring (CISM). The level of diagnosis achieved by PSAD depends on the component monitored. The TG and RCP monitoring functions of PSAD compute high level diagnosis descriptors such as natural frequencies and long term trends but do not elaborate a diagnosis automatically. However, a diagnostic assistance window is available on-line, whenever a warning message is displayed, whether for immediate or later action. The window presents a diagnostic approach whose purpose is to find the causes of the symptoms observed. This diagnosis approach is automated in the DIVA and DIAPO expert systems. Numerous potential faults can be identified for both systems thanks to a hierarchy of abnormal situations. The user interactively answers questions when information is needed to progress in the diagnosis. The resulting

  1. Review of the uranium miner experience in the United States

    International Nuclear Information System (INIS)

    Hilberg, A.W.

    1973-01-01

    Mining of uranium ores on a very small scale began in the United States in 1898. In 1948 mining of uranium ores increased significantly as a result of the increasing demands of the atomic energy program, particularly, the weapons program. It was well-known that radioactivity was associated with uranium ore and potential health hazards had been identified as early as 1921. It was then suggested that the large number of lung cancers found in the Schneeberg miners could possibly be caused by ionizing radiation. Radiation exposure to the lungs of uranium ore miners comes about because of varying concentrations of radon decay products in the mine atmosphere. Measurements of the amount of radioactivity in mine atmospheres began in the United States in 1950 and between 1951 and through 1968, approximately 43,000 measurements were made in about 2,500 uranium mines. Periodic medical surveys were made starting in 1950, but it was not until 1954, that a concerted effort was made to examine all miners. At this time an epidemiological study was begun by the U.S. Public Health Service to determine the effects of uranium mining with particular emphasis on the problem of lung cancer induction. The study of the miners, the results of which have been published, revealed a distinct and somewhat dramatic increase in lung cancer. This increase has been ascribed to the radiation exposure to radon-daughters. Because of the presence of a number of other potential occupational carcinogens in the dust of underground mines, there has been some question as to whether radon and radon-daughters constitute the principal cause of increased lung cancer risk among these miners

  2. CXC-chemokines KC and macrophage inflammatory protein-2 (MIP-2) synergistically induce leukocyte recruitment to the central nervous system in rats

    NARCIS (Netherlands)

    Zwijnenburg, Petra J. G.; Polfliet, Machteld M. J.; Florquin, Sandrine; van den Berg, Timo K.; Dijkstra, Christine D.; van Deventer, Sander J. H.; Roord, John J.; van der Poll, Tom; van Furth, A. Marceline

    2003-01-01

    Intracisternal injection of the CXC-chemokines KC or macrophage inflammatory protein (MIP)-2 induced a pleocytosis in the cerebrospinal fluid (CSF) of rats in a dose dependent way. MIP-2 was much more potent than KC. The concurrent injection of both chemokines revealed a profound synergistic effect

  3. 77 FR 50682 - KC Scoby Hydro, LLC; Notice of Preliminary Permit Application Accepted for Filing and Soliciting...

    Science.gov (United States)

    2012-08-22

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 14423-000] KC Scoby Hydro... concrete gravity dam with a 183-foot-long spillway; (2) an existing impoundment having a surface area of 22 acres and a storage capacity of 52 acre-feet at an elevation of 1,080 feet mean sea level (msl); (3) a...

  4. A review of the United Kingdom fast reactor programme

    International Nuclear Information System (INIS)

    Bramman, J.I.; Hickey, H.B.; Wheeler, R.C.; Gregory, C.V.

    1989-01-01

    The total electricity generating capacity in the UK is approximately 54 GW. Total electricity generation in 1988 was 288 TW hours, of which just over 20% was nuclear. In Scotland the percentage of electricity generated by nuclear stations was 49% of the total, and will exceed 60% in 1989. The privatization of the Electricity Supply Industry (ESI) in the UK (mentioned in last year's report) is proceeding on schedule. Considerable efforts are being made to ensure that the maximum benefits will be obtained from operating the PFR during the next five years. The main thrust of the UKAEA's programme continues to be towards the requirements of the EFR. Reload 16 included the biennial maintenance and statutory inspection period. It was extended from its original 60 days by the need to carry out modifications aimed at improving the reliability of the protection systems designed to safeguard the components of the secondary circuit, including the IHXs, in the event of a sodium-water reaction in a steam generator unit, and by the need to inspect and repair the vessels of the steam generator units. Good progress was made with the fuel development programme. The leading experimental cluster of PE16-clad 6.6 mm diameter pins is continuing irradiation above 21% burnup and 150 dpa (NRT). The lead subassembly with 5.8 mm pins clad in PE16 has exceeded 17.6% burnup, 130 dpa (NRT). The leading subassembly with pins of the same type to have undergone complete PIE contained fuel at 16% burnup and PE16 clad at 116 dpa; these pins were found to be in very good condition. Radial blanket subassemblies have exceeded 2% burnup without failure. In 1988/89 there was one reprocessing campaign in the PFR Reprocessing Plant lasting from November 1988 to February 1989. Feed material included irradiated fuel from 12 subassemblies irradiated in the PFR, some unirradiated subassemblies and loose pins and residues; in all containing 1.3t of Heavy Metal (HM) containing 242 kg plutonium. The cumulative

  5. Dry coolers and air-condensing units (Review)

    Science.gov (United States)

    Milman, O. O.; Anan'ev, P. A.

    2016-03-01

    The analysis of factors affecting the growth of shortage of freshwater is performed. The state and dynamics of the global market of dry coolers used at electric power plants are investigated. Substantial increase in number and maximum capacity of air-cooled condensers, which have been put into operation in the world in recent years, are noted. The key reasons facilitating the choice of developers of the dry coolers, in particular the independence of the location of thermal power plant from water sources, are enumerated. The main steam turbine heat removal schemes using air cooling are considered, their comparison of thermal efficiency is assessed, and the change of three important parameters, such as surface area of heat transfer, condensate pump flow, and pressure losses in the steam exhaust system, are estimated. It is shown that the most effective is the scheme of direct steam condensation in the heat-exchange tubes, but other schemes also have certain advantages. The air-cooling efficiency may be enhanced much more by using an air-cooling hybrid system: a combination of dry and wet cooling. The basic applied constructive solutions are shown: the arrangement of heat-exchange modules and the types of fans. The optimal mounting design of a fully shopassembled cooling system for heat-exchange modules is represented. Different types of heat-exchange tubes ribbing that take into account the operational features of cooling systems are shown. Heat transfer coefficients of the plants from different manufacturers are compared, and the main reasons for its decline are named. When using evaporative air cooling, it is possible to improve the efficiency of air-cooling units. The factors affecting the faultless performance of dry coolers (DC) and air-condensing units (ACU) and the ways of their elimination are described. A high velocity wind forcing reduces the efficiency of cooling systems and creates preconditions for the development of wind-driven devices. It is noted that

  6. Annual review and summary financial statement [United Kingdom

    International Nuclear Information System (INIS)

    1992-01-01

    National Power owns and operates 35 power stations in England and Wales with a total generating capacity of 26,623 MW, of which 20,460 is coal-fired and the rest oil-fired. 89% of coal supplies have been domestic. Till now Port facilities have been constructed to increase the import of cheaper, lower sulphur content coal with the future objective of taking up to half of supplies from this source. A programme of construction of combined cycle gas turbine (CCGT) stations is underway, with two already being built, planning consent for a third having been obtained and applications submitted for a further two. Supplies of North Sea gas at economic prices have been secured for the next five years. Applications to burn the competitively priced fuel orimulsion at two stations are still being evaluated. Apart from the move to low sulphur coal and the low emission CCGT stations, other major initiatives are being taken to protect the environment in the course of power generation. These include : the installation of flue gas desulphurisation equipment at the largest power station, Drax; investment in special burners to reduce nitrogen oxide emissions; installing of equipment to reduce dust emissions at the largest stations; promotion of energy efficiency encouraging the development of wind power and the conversion of domestic waste into electricity. A summary financial statement is appended to the review showing a pre-tax profit of Pound 514 M for 1991/92, an increase of 18% on 1990/91. (Author)

  7. Experience of the United States in Hosting and Supporting IAEA Peer Review Missions

    International Nuclear Information System (INIS)

    Mamish, N.

    2016-01-01

    The International Atomic Energy Agency (IAEA) provides a number of peer review services to its Member States. The United States has strongly supported these peer reviews since their inception. In 2010, the United States hosted an Integrated Regulatory Review Service (IRRS) mission, with a follow-up mission completed in 2014. The missions provided valuable recommendations and suggestions, identified a number of best practices, and acknowledged the prompt and effective actions taken by the NRC following the Fukushima Daiichi accident. Through hosting an International Physical Protection Advisory Service (IPPAS) mission in 2013, the United States benefited both from the insights provided by the team, as well as the U.S. Government’s gap analyses and preparatory efforts in advance of the mission. The United States strongly supports the IAEA’s Operational Safety Review Team (OSART) program, inviting a peer review mission to a U.S. nuclear power plant every 3 years. Although OSART is an operational, not regulatory, peer review, the NRC provides funding for the mission and gives inspection credit to operators that host them. The United States also contributes significant technical expertise to IAEA peer review missions hosted by other Member States. With the IRRS and IPPAS reaching their 10th and 20th anniversaries respectively, these programs have improved as they have matured. However, it remains critical for Member States to continue to support these programs, and provide feedback to the IAEA Secretariat on their effectiveness and areas where IAEA might enhance them. Doing so will ensure peer reviews remain an effective tool for strengthening nuclear safety and security worldwide. (author)

  8. Microgravity Impact Experiments: The Prime Campaign on the NASA KC-135

    Science.gov (United States)

    Colwell, Joshua E.; Sture, Stein; Lemos, Andreas R.

    2002-11-01

    Low velocity collisions (v less than 100 m/s) occur in a number of astrophysical contexts, including planetary rings, protoplanetary disks, the Kuiper belt of comets, and in secondary cratering events on asteroids and planetary satellites. In most of these situations the surface gravity of the target is less than a few per cent of 1 g. Asteroids and planetary satellites are observed to have a regolith consisting of loose, unconsolidated material. Planetary ring particles likely are also coated with dust based on observations of dust within ring systems. The formation of planetesimals in protoplanetary disks begins with the accretion of dust particles. The response of the surface dust layer to collisions in the near absence of gravity is necessary for understanding the evolution of these systems. The Collisions Into Dust Experiment (COLLIDE) performs six impact experiments into simulated regolith in microgravity conditions on the space shuttle. The parameter space to be explored is quite large, including effects such as impactor mass and velocity, impact angle, target porosity, size distribution, and particle shape. We have developed an experiment, the Physics of Regolith Impacts in Microgravity Experiment (PRIME), that is analogous to COLLIDE that is optimized for flight on the NASA KC-135 reduced gravity aircraft. The KC-135 environment provides the advantage of more rapid turnover between experiments, allowing a broader range of parameters to be studied quickly, and more room for the experiment so that more impact experiments can be performed each flight. The acceleration environment of the KC-135 is not as stable and minimal as on the space shuttle, and this requires impact velocities to be higher than the minimum achievable with COLLIDE. The experiment consists of an evacuated PRIME Impact Chamber (PIC) with an aluminum base plate and acrylic sides and top. A target tray, launcher, and mirror mount to the base plate. The launcher may be positioned to allow for

  9. Systematic review of qualitative studies exploring parental experiences in the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Al Maghaireh, Dua'a Fayiz; Abdullah, Khatijah Lim; Chan, Chong Mei; Piaw, Chua Yan; Al Kawafha, Mariam Mofleh

    2016-10-01

    To determine the feasibility and utility of a thematic analysis approach to synthesising qualitative evidence about parental experiences in the neonatal intensive care unit. Admission of infants to the neonatal intensive care unit is usually an unexpected event for parents who can cause them to experience psychosocial difficulties. A qualitative systematic review is the best method for exploring these parents' experiences regarding this type of admission. Systematic review. Qualitative studies in peer-reviewed journals aimed at understanding parental experiences regarding infant neonatal intensive care unit admission were identified in six electronic databases. Three reviewers selected relevant articles and assessed the quality of the methodological studies using the Critical Appraisal Skills Programme. A thematic analysis approach was used to identify the most common themes in the studies describing parental experiences in the neonatal intensive care unit. A total of eighty articles were identified; nine studies were included in this review. Four studies used semistructured interviews, three used interviews, one used self-reporting and one used both focus group and interview methodologies. Common themes across parents' experiences were the stress of hospitalisation, alteration in parenting roles and the impact of infant hospitalisation on psychological health. Having an infant hospitalised in the neonatal intensive care unit is a stressful experience for parents. This experience is the result of exposure to different stressors related to the infant's condition, an alteration in parenting roles or the neonatal intensive care unit environment and staffing. These parents suffered negative psychological effects, experienced an interrupted development of a healthy parent-infant attachment and/or felt parental role alteration. The study's findings are crucial for neonatal intensive care unit nurses to develop intervention strategies and programmes that help parents to

  10. Safety review on unit testing of safety system software of nuclear power plant

    International Nuclear Information System (INIS)

    Liu Le; Zhang Qi

    2013-01-01

    Software unit testing has an important place in the testing of safety system software of nuclear power plants, and in the wider scope of the verification and validation. It is a comprehensive, systematic process, and its documentation shall meet the related requirements. When reviewing software unit testing, attention should be paid to the coverage of software safety requirements, the coverage of software internal structure, and the independence of the work. (authors)

  11. A review of the neural and behavioral consequences for unitizing emotional and neutral information

    Directory of Open Access Journals (Sweden)

    Brendan eMurray

    2013-05-01

    Full Text Available A special type of association, called a unitization, is formed when pieces of information are encoded as a single representation in memory (e.g., shirt and blue are encoded as a blue shirt; Graf & Schacter, 1989 and typically are later reactivated in memory as a single unit, allowing access to the features of multiple related stimuli at once (Bader et al., 2010; Diana et al., 2011. This review examines the neural processes supporting memory for unitizations and how the emotional content of the material may influence unitization. Although associative binding is typically reliant on hippocampal processes and supported by recollection, the first part of this review will present evidence to suggest that when two items are unitized into a single representation, memory for those bound items may be accomplished on the basis of familiarity and without reliance on the hippocampus. The second part of this review discusses how emotion may affect the processes that give rise to unitizations. Emotional information typically receives a mnemonic benefit over neutral information, but the literature is mixed on whether the presence of emotional information impedes or enhances the associative binding of neutral information (reviewed by Mather, 2007. It has been suggested that the way the emotional and neutral details are related together may be critical to whether the neutral details are enhanced or impeded (Mather, 2007; Mather & Sutherland, 2011. We focus on whether emotional arousal aides or inhibits the creation of a unitized representation, presenting preliminary data and future directions to test empirically the effects of forming and retrieving emotional and neutral unitizations.

  12. A review of the United Kingdom fast reactor program - March 1983

    International Nuclear Information System (INIS)

    Smith, R.D.

    1983-01-01

    A review of the United Kingdom Fast Reactor Programme was given in March 1983. Operational experience with the Prototype Fast Reactor (PFR) is briefly summarized. The design concept of the Commercial Demonstration Fast Reactor (CDFR), including design codes, engineering components, materials and fuels development, chemical engineering/sodium technology, safety and reactor performance, is reviewed. The problems of PFR and CDFR fuel reprocessing are also discussed

  13. Clinical peer review in the United States: history, legal development and subsequent abuse.

    Science.gov (United States)

    Vyas, Dinesh; Hozain, Ahmed E

    2014-06-07

    The Joint Commission on Accreditation requires hospitals to conduct peer review to retain accreditation. Despite the intended purpose of improving quality medical care, the peer review process has suffered several setbacks throughout its tenure. In the 1980s, abuse of peer review for personal economic interest led to a highly publicized multimillion-dollar verdict by the United States Supreme Court against the perpetrating physicians and hospital. The verdict led to decreased physician participation for fear of possible litigation. Believing that peer review was critical to quality medical care, Congress subsequently enacted the Health Care Quality Improvement Act (HCQIA) granting comprehensive legal immunity for peer reviewers to increase participation. While serving its intended goal, HCQIA has also granted peer reviewers significant immunity likely emboldening abuses resulting in Sham Peer Reviews. While legal reform of HCQIA is necessary to reduce sham peer reviews, further measures including the need for standardization of the peer review process alongside external organizational monitoring are critical to improving peer review and reducing the prevalence of sham peer reviews.

  14. Revised tuning of Ocean Drilling Program Site 964 and KC01B (Mediterranean) and implications for the delta 0-18, tephra, calcareous nannofossil, and geomagnetic reversal chronologies of the past 1.1 Myr

    NARCIS (Netherlands)

    Lourens, L.J.

    2004-01-01

    High-resolution color reflectance records of KC01 and KC01B (Calabrian Ridge, Ionian Sea) are presented and compared with a modified spliced high-resolution color reflectance record of Ocean Drilling Program (ODP) Site 964. This comparison revealed that KC01B is characterized by intensive

  15. Comparison of Flight Measured, Predicted and Wind Tunnel Measured Winglet Characteristics on a KC-135 Aircraft

    Science.gov (United States)

    Dodson, R. O., Jr.

    1982-01-01

    One of the objectives of the KC-135 Winglet Flight Research and Demonstration Program was to obtain experimental flight test data to verify the theoretical and wind tunnel winglet aerodynamic performance prediction methods. Good agreement between analytic, wind tunnel and flight test performance was obtained when the known differences between the tests and analyses were accounted for. The flight test measured fuel mileage improvements for a 0.78 Mach number was 3.1 percent at 8 x 10(5) pounds W/delta and 5.5 percent at 1.05 x 10(6) pounds W/delta. Correcting the flight measured data for surface pressure differences between wind tunnel and flight resulted in a fuel mileage improvement of 4.4 percent at 8 x 10(5) pounds W/delta and 7.2 percent at 1.05 x 10(6) pounds W/delta. The performance improvement obtained was within the wind tunnel test data obtained from two different wind tunnel models. The buffet boundary data obtained for the baseline configuration was in good agreement with previous established data. Buffet data for the 15 deg cant/-4 deg incidence configuration showed a slight improvement, while the 15 deg cant/-2 deg incidence and 0 deg cant/-4 deg incidence data showed a slight deterioration.

  16. Galaxies and their Masks A Conference in Honour of K.C. Freeman, FRS

    CERN Document Server

    Block, David L; Puerari, Ivânio

    2010-01-01

    Various kinds of masks obscure our view of our galaxy, the Milky Way, as well as of other galaxies. Masks of interstellar dust affect our measurements within galaxies, on scales ranging from individual supernovae to the galaxies themselves. The “mass mask” (our inability to image mass rather than light) gives astronomers a very incomplete picture of the size and structure of galaxies themselves, because we cannot image the dark matter which provides most of the galactic mass. Another mass is the “dynamical mask”: as galaxies form, much dynamical information is lost in the birthing process. A new thrust in research is to retrieve such information by means of chemical tagging. About 50 astronomers flew into Namibia in April 2010, to celebrate the 70th birthday of Professor K.C. Freeman, Fellow of the Royal Society. At age 70, Freeman, a father of dark matter in galaxies, continues to be one of planet’s most highly cited astronomers. The current volume affords readers a unique perspective on galaxies b...

  17. Dolichol related intermediates involved in N-linked gloycoprotein synthesis in Drosophila Kc cells

    International Nuclear Information System (INIS)

    Sagami, H.; Chap, R.; Rivero, M.; Lennarz, W.J.

    1986-01-01

    The purpose of this investigation is to study the regulation of the biosynthesis of dolichyl phosphate (Dol-P) in embryonic cells. Using embryonic Drosophila Kc cells which are known to lack the squalene-cholesterol branch of polyisoprenoid biosynthetic pathway, the authors labeled the cells in suspension culture for 4 hrs with [5- 3 H]mevalonic acid. After harvesting the cells, the incorporated radioactive lipids were extracted with CHCl 3 /CH 3 OH (2/1). Analysis of the extract by a combination of several methods consisting of ion exchange chromatography on DEAE-cellulose, gel filtration on Fractogel TSK-HW 40, and silica gel thin layer chromatography revealed that the extract contained coenzyme Q, farnesol, dolichol (Dol), Dol-P, and dolichol-linked sugar (Dol-P-Sugar). In a pulse-chase experiment the metabolism of these intermediates was measured for various times up to 30 hrs. The amount of radioactivity in Dol slightly increased with the chase time, while that in Dol-P decreased. The amount of radioactive Dol-P-Sugar remained unchanged. These results suggest that the de novo end product in dolichol biosynthesis is Dol-P and that the level of Dol-P can be controlled by varying the rate of de novo biosynthesis and by dephosphorylation. The authors are now investigating the effect of ecdysone, the molting hormone, on the level of these intermediates and on incorporation of sugars into glycoproteins

  18. Waterpipe Smoking among College Students in the United States: A Review of the Literature

    Science.gov (United States)

    Grekin, Emily R.; Ayna, Dinah

    2012-01-01

    Objective: To review the literature on college student waterpipe use with a focus on undergraduates in the United States. Participants: Undergraduate students. Methods: Studies were accessed using the databases PubMed, MEDLINE, PsycINFO, and Academic Search Premier. Searches included combinations of the following keywords: "waterpipe," "hookah,"…

  19. Evaluation of Adult Literacy Education in the United States: A Review of Methodological Issues

    Science.gov (United States)

    Shi, Yan; Tsang, Mun C.

    2008-01-01

    This is a critical review of methodological issues in the evaluation of adult literacy education programs in the United States. It addresses the key research questions: What are the appropriate methods for evaluating these programs under given circumstances. It identifies 15 evaluation studies that are representative of a range of adult literacy…

  20. Engine Tune-up Service. Unit 6: Emission Control Systems. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 6, Emission Control Systems, available separately as CE 031 220. Focus of the exercises and pretests is inspecting, testing, and servicing emission control systems. Pretests and performance checklists are provided for each of the…

  1. Mentoring and New Teacher Induction in the United States: A Review and Analysis of Current Practices

    Science.gov (United States)

    Bullough, Robert V., Jr.

    2012-01-01

    In this article, current practices were reviewed in mentoring and induction across three large states--New York, Texas, and California--and one small state, Utah. Patterns and trends are described in the United States, program results and evolving views of mentoring are discussed, gaps in the research literature are identified, and the future of…

  2. Engine Tune-Up Service. Unit 3: Primary Circuit. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the exercises and pretests is testing the primary ignition circuit. Pretests and performance checklists are provided for each of the eight performance objectives…

  3. Engine Tune-up Service. Unit 2: Charging System. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Richardson, Roger L.; Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 2, Charging System, available separately as CE 031 208. Focus of the exercises and pretests is testing the charging system. Pretests and performance checklists are provided for each of the three performance objectives contained in…

  4. Engine Tune-up Service. Unit 4: Secondary Circuit. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 4, Secondary Circuit, available separately as CE 031 214. Focus of the exercises and pretests is testing and servicing the secondary ignition circuit. Pretests and performance checklists are provided for each of the seven…

  5. Second periodic safety review of Angra Nuclear Power Station, unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Martins, Carlos F.O.; Crepaldi, Roberto; Freire, Enio M., E-mail: ottoncf@tecnatom.com.br, E-mail: emfreire46@gmail.com, E-mail: robcrepaldi@hotmail.com [Tecnatom do Brasil Engenharia e Servicos Ltda, Rio de Janeiro, RJ (Brazil); Campello, Sergio A., E-mail: sacampe@eletronuclear.gov.br [Eletrobras Termonuclear S.A. (ELETRONUCLEAR), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    This paper describes the second Periodic Safety Review (PSR2-A1) of Angra Nuclear Power Station, Unit 1, prepared by Eletrobras Eletronuclear S.A. and Tecnatom do Brasil Engenharia e Servicos Ltda., during Jul.2013-Aug.2014, covering the period of 2004-2013. The site, in Angra dos Reis-RJ, Brazil, comprises: Unit 1, (640 MWe, Westinghouse PWR, operating), Unit 2 (1300 MWe, KWU/Areva, operating) and Unit 3 (1405 MWe, KWU/Areva, construction). The PSR2-A1 attends the Standards 1.26-Safety in Operation of Nuclear Power Plants, Brazilian Nuclear Regulatory Commission (CNEN), and IAEA.SSG.25-Periodic Safety Review of Nuclear Power Plants. Within 18 months after each 10 years operation, the operating organization shall perform a plant safety review, to investigate the evolution consequences of safety code and standards, regarding: Plant design; structure, systems and components behavior; equipment qualification; plant ageing management; deterministic and probabilistic safety analysis; risk analysis; safety performance; operating experience; organization and administration; procedures; human factors; emergency planning; radiation protection and environmental radiological impacts. The Review included 6 Areas and 14 Safety Parameters, covered by 33 Evaluations.After document evaluations and discussions with plant staff, it was generated one General and 33 Specific Guide Procedures, 33 Specific and one Final Report, including: Description, Strengths, Deficiencies, Areas for Improvement and Conclusions. An Action Plan was prepared by Electronuclear for the recommendations. It was concluded that the Unit was operated within safety standards and will attend its designed operational lifetime, including possible life extensions. The Final Report was submitted to CNEN, as one requisite for renewal of the Unit Permanent Operation License. (author)

  6. Second periodic safety review of Angra Nuclear Power Station, unit 1

    International Nuclear Information System (INIS)

    Martins, Carlos F.O.; Crepaldi, Roberto; Freire, Enio M.; Campello, Sergio A.

    2015-01-01

    This paper describes the second Periodic Safety Review (PSR2-A1) of Angra Nuclear Power Station, Unit 1, prepared by Eletrobras Eletronuclear S.A. and Tecnatom do Brasil Engenharia e Servicos Ltda., during Jul.2013-Aug.2014, covering the period of 2004-2013. The site, in Angra dos Reis-RJ, Brazil, comprises: Unit 1, (640 MWe, Westinghouse PWR, operating), Unit 2 (1300 MWe, KWU/Areva, operating) and Unit 3 (1405 MWe, KWU/Areva, construction). The PSR2-A1 attends the Standards 1.26-Safety in Operation of Nuclear Power Plants, Brazilian Nuclear Regulatory Commission (CNEN), and IAEA.SSG.25-Periodic Safety Review of Nuclear Power Plants. Within 18 months after each 10 years operation, the operating organization shall perform a plant safety review, to investigate the evolution consequences of safety code and standards, regarding: Plant design; structure, systems and components behavior; equipment qualification; plant ageing management; deterministic and probabilistic safety analysis; risk analysis; safety performance; operating experience; organization and administration; procedures; human factors; emergency planning; radiation protection and environmental radiological impacts. The Review included 6 Areas and 14 Safety Parameters, covered by 33 Evaluations.After document evaluations and discussions with plant staff, it was generated one General and 33 Specific Guide Procedures, 33 Specific and one Final Report, including: Description, Strengths, Deficiencies, Areas for Improvement and Conclusions. An Action Plan was prepared by Electronuclear for the recommendations. It was concluded that the Unit was operated within safety standards and will attend its designed operational lifetime, including possible life extensions. The Final Report was submitted to CNEN, as one requisite for renewal of the Unit Permanent Operation License. (author)

  7. Incident reviews in UK maternity units: a systematic appraisal of the quality of local guidelines.

    Science.gov (United States)

    Shah, Anjali; Mohamed-Ahmed, Olaa; Peirsegaele, Philippe; McClymont, Charlotte; Knight, Marian

    2015-03-14

    Maternity care is recognised as a particularly high-risk speciality that is subject to investigation and inquiry, and improvements in risk management have been recommended. However, the quality of guidelines for local reviews of maternity incidents is unknown. The aim of the study is to appraise the quality of local guidance on conducting reviews of severe maternity incidents in the National Health Service. Guidelines for incident reviews were requested from all 211 consultant-led maternity units in the UK during 2012. The Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) was used to evaluate the quality of guidelines. The methods used for reviewing an incident, the people involved in the review and the methods for disseminating the outcomes of the reviews were also examined. Guidelines covering 148 (70%) of all NHS maternity units in the UK were received for evaluation. Most guidelines (55%) received were of good or high quality. The median score on 'scope and purpose' (86%), concerned with the aims and target population of the guideline, was higher than for other domains. Median scores were: 'stakeholder involvement' (representation of users' views) 56%, 'rigour of development' (process used to develop guideline) 34%, 'clarity of presentation' 78%, 'applicability' (organisational and cost implications of applying guideline) 56% and 'editorial independence' 0%. Most guidelines (81%) recommended a range of health professionals review serious maternity incidents using root cause analysis. Findings were most often disseminated at meetings, in reports and in newsletters. Many guidelines (69%) stated lessons learnt from incidents would be audited. Overall, local guidance for the review of maternity incidents was mostly of good or high quality. Stakeholder participation in guideline development could be widened, and editorial independence more clearly stated. It was unclear in over a quarter of guidelines whether changes in practice in response

  8. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review.

    Science.gov (United States)

    Gasperino, James

    2011-10-01

    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  9. A UKAEA review of gas-cooled reactors in the United Kingdom

    International Nuclear Information System (INIS)

    Heath, E.C.; Knowles, A.N.

    1983-01-01

    The commercial use of nuclear power for electrical generation commenced in the UK in the 1950s with the Calder Hall reactors. Based on this concept, eighteen commercial reactor units, with two further units outside the UK, were constructed and have been in operation for periods ranging from 10 to 19 years. The paper reviews this experience mainly from the aspects of safety and the achieved costs, which compare favourably with current figures for fossil fired generation. The further development of the gas-cooled system in the UK commenced with the construction of the Windscale AGR, which came into operation in 1962. This led to the ordering of 14 large commercial AGR units, 4 of which have been in service since 1976, 6 are at an advanced stage of construction and 4 are at an early stage of construction. The paper reviews the main safety features of the AGR and considers the costs, taking achieved costs for the units which are in service and a combination of historical costs and projected costs for the units under construction. Again a clear advantage over fossil fuelled stations is shown. The paper also includes a preliminary account of the use of the prototype AGR at Windscale for the series of experiments concerning plateout, over-temperature in the fuel and simulated fault transients in the core which were carried out earlier in 1981. (author)

  10. Determination of actual crop evapotranspiration (ETc) and dual crop coefficients (Kc) for cotton, wheat and maize in Fergana Valley: integration of the FAO-56 approach and BUDGET

    Science.gov (United States)

    Kenjabaev, Shavkat; Dernedde, Yvonne; Frede, Hans-Georg; Stulina, Galina

    2014-05-01

    Determination of the actual crop evapotranspiration (ETc) during the growing period is important for accurate irrigation scheduling in arid and semi-arid regions. Development of a crop coefficient (Kc) can enhance ETc estimations in relation to specific crop phenological development. This research was conducted to determine daily and growth-stage-specific Kc and ETc values for cotton (Gossypium hirsutum L.), winter wheat (Triticum aestivum L.) and maize (Zea mays L.) for silage at fields in Fergana Valley (Uzbekistan). The soil water balance model - Budget with integration of the dual crop procedure of the FAO-56 was used to estimate the ETc and separate it into evaporation (Ec) and transpiration (Tc) components. An empirical equation was developed to determine the daily Kc values based on the estimated Ec and Tc. The ETc, Kc determination and comparison to existing FAO Kc values were performed based on 10, 5 and 6 study cases for cotton, wheat and maize, respectively. Mean seasonal amounts of crop water consumption in terms of ETc were 560±50, 509±27 and 243±39 mm for cotton, wheat and maize, respectively. The growth-stage-specific Kc for cotton, wheat and maize was 0.15, 0.27 and 0.11 at initial; 1.15, 1.03 and 0.56 at mid; and 0.45, 0.89 and 0.53 at late season stages. These values correspond to those reported by the FAO-56. Development of site specific Kc helps tremendously in irrigation management and furthermore provides precise water applications in the region. The developed simple approach to estimate daily Kc for the three main crops grown in the Fergana region was a first attempt to meet this issue. Keywords: Actual crop evapotranspiration, evaporation and transpiration, crop coefficient, model BUDGET, Fergana Valley.

  11. 75 FR 61352 - Airworthiness Directives; McDonnell Douglas Corporation Model DC-10-30, DC-10-30F, DC-10-30F (KC...

    Science.gov (United States)

    2010-10-05

    ... Airworthiness Directives; McDonnell Douglas Corporation Model DC- 10-30, DC-10-30F, DC-10-30F (KC-10A and KDC-10...-13 McDonnell Douglas Corporation: Amendment 39-16448; Docket No. FAA-2010-0553; Directorate.... Applicability (c) This AD applies to McDonnell Douglas Corporation Model DC- 10-30, DC-10-30F, DC-10-30F (KC-10A...

  12. Exploding Head Syndrome in the Epilepsy Monitoring Unit: Case Report and Literature Review.

    Science.gov (United States)

    Gillis, Kara; Ng, Marcus C

    2017-01-01

    Diagnosis of paroxysmal events in epilepsy patients is often made through video-telemetry electroencephalography in the epilepsy monitoring unit. This case report describes the first-ever diagnosis of exploding head syndrome in a patient with longstanding epilepsy and novel nocturnal events. In this report, we describe the presentation of exploding head syndrome and its prevalence and risk factors. In addition, the prevalence of newly diagnosed sleep disorders through video-telemetry electroencephalography in the epilepsy monitoring unit is briefly reviewed. This report also illustrates the novel use of clobazam for the treatment of exploding head syndrome.

  13. Pregnant Adolescents Admitted to an Inpatient Child and Adolescent Psychiatric Unit: An Eight-Year Review.

    Science.gov (United States)

    Fletcher, Teresa M; Markley, Laura A; Nelson, Dana; Crane, Stephen S; Fitzgibbon, James J

    2015-12-01

    To assess patient outcomes and describe demographic data of pregnant adolescents admitted to an inpatient child and adolescent psychiatric unit, as well as to determine if it is safe to continue to admit pregnant adolescents to such a unit. A descriptive retrospective chart review conducted at a free-standing pediatric hospital in northeast Ohio of all pregnant adolescents aged 13 to 17 years admitted to the inpatient child and adolescent psychiatric unit from July 2005 to April 2013. Data collection included details on demographic, pregnancy status, and psychiatric diagnoses. Eighteen pregnant adolescents were admitted to the psychiatric unit during the time frame. Sixteen of those were in the first trimester of pregnancy. Pregnancy was found to be a contributing factor to the adolescent's suicidal ideation and admission in 11 of the cases. Admission to an inpatient psychiatric facility did not lead to adverse effects in pregnancy. Pregnant adolescents did not have negative pregnancy outcomes related to admission to an inpatient psychiatric unit. Results of this study suggest that it is safe to continue to admit uncomplicated pregnant adolescents in their first trimester to an inpatient child and adolescent psychiatric unit for an acute stay. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. Mexican immigrants in the United States. A review of the literature on integration, segregation and discrimination

    Directory of Open Access Journals (Sweden)

    Judith Pérez-Soria

    2017-09-01

    Full Text Available

    This article reviews the literature on integration, segregation and discrimination against Mexican immigrants in the United States. It is an assessment of the different theoretical approaches and empirical research results published from the first decades of the twentieth century until present days. Our review suggests that the assimilation model is the dominant theoretical approach, while empirical findings in the field reveal the permanence of patterns of occupational and residential segregation among Mexican-born population and their offspring. Results reported by studies on discrimination vary broadly, as a result of the different methodological perspectives adopted in each study. We conclude with a note encouraging the use of new approaches and complementary methodologies in the study about segregation and discrimination against Mexican immigrants in the United States.

  15. Will you give birth in pain? Integrative review of obstetric violence in Brazilian public units

    OpenAIRE

    Martins, Aline de Carvalho; Barros, Geiza Martins

    2016-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: The study aimed at providing further visibility to discussions about obstetric violence suffered by Brazilian women in public health institutions. CONTENTS: This was an integrative review of the last decade, where 100 articles were evaluated to identify how Obstetric Violence is in Brazilian public health units. CONCLUSION: Identified obstetric violences were: institutional violence, moral violence, physical violence, sexual violence, psychological and v...

  16. Clinical review: Moral assumptions and the process of organ donation in the intensive care unit

    OpenAIRE

    Streat, Stephen

    2004-01-01

    The objective of the present article is to review moral assumptions underlying organ donation in the intensive care unit. Data sources used include personal experience, and a Medline search and a non-Medline search of relevant English-language literature. The study selection included articles concerning organ donation. All data were extracted and analysed by the author. In terms of data synthesis, a rational, utilitarian moral perspective dominates, and has captured and circumscribed, the lan...

  17. Soil-transmitted Helminthiasis in the United States: a systematic review--1940-2010.

    Science.gov (United States)

    Starr, Michelle C; Montgomery, Susan P

    2011-10-01

    The epidemiology of soil-transmitted helminth infections (hookworm, Trichuris trichiura, Ascaris lumbricoides, and Strongyloides stercoralis) in the United States is poorly understood. To gain understanding of the status of disease, a systematic review was performed to assess the prevalence of soil-transmitted helminth infections in the United States. Of all studies reviewed, 14 were designated as high-quality. High-quality studies were published from 1942 to 1982 and showed that infection was prevalent throughout the southern United States and Appalachia as recently as 1982, finding that hookworm (19.6%), T. trichiura (55.2%), A. lumbricoides (49.4%), and S. stercoralis (3.8%) affected significant percentages of the population. However, because the most recent high-quality studies were published over 25 years ago, the literature does not provide sufficient data to assess current endemic transmission. Because the status of disease remains unclear, there is a need for additional studies to determine if soil-transmitted helminths remain endemic in the United States.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Moran Lazaryan

    2016-08-01

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

  20. A Systematic Review of the Liaison Nurse Role on Patient's Outcomes after Intensive Care Unit Discharge.

    Science.gov (United States)

    Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas

    2014-10-01

    This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient's outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitive keywords such as liaison nurse, intensive care unit, and patient outcomes in the following databases: Science direct, PubMed, Scopus, Ovid, Oxford, Wiley, Scholar, and Mosby. Then, the articles which had the inclusion criteria after quality control were selected for a systematic review. From 662 retrieved articles, six articles were analyzed in a case study and four articles showed a statistically significant effect of the liaison nurse on the patient's outcomes such as reducing delays in patient discharge, effective discharge planning, improvement in survival for patients at the risk for readmission. Liaison nurses have a positive role on the outcomes of patients who are discharged from the ICU and more research should be done to examine the exact function of liaison nurses and other factors that influence outcomes in patients discharged from ICU.

  1. Review of laparoscopic training in pediatric surgery in the United Kingdom.

    Science.gov (United States)

    Stormer, Emma J; Sabharwal, Atul J

    2009-04-01

    To review the exposure pediatric surgery trainees have to laparoscopic surgery in the United Kingdom (UK). A confidential postal questionnaire was sent to all trainees working at registrar level in centers responsible for pediatric surgical training in the UK. Questions assessed the number of consultants with an interest in laparoscopic surgery, types of cases performed laparoscopically, and trainees' role in laparoscopic appendicectomy (LA). Questionnaires were sent to 112 trainees with a 55% response rate (62 replies). At least one response was received from each unit. Based on responses, 49 to 67 consultants in 21 training centers have an interest in laparoscopic surgery (0%-100% of consultants per unit). LA was offered in 20 out of 21 training centers. There was no significant difference in the proportion of appendicectomies performed laparoscopically by junior (years 1-3) and senior (years 4-6) trainees. A significantly higher proportion of junior trainees had not performed any LAs (P = 0.02). Seventy-three percent of trainees were the principal operator. For trainees who were principal operators, the cameraperson was a consultant in 52% and a junior trainee in 17%. The time of day affected the likelihood of a procedure being carried out laparoscopically in 43 (81%) responses. The majority of trainees' exposure to laparoscopic surgery could be viewed as suboptimal; however, the exposure gained varies significantly between different units throughout the UK. In an age moving in favor of minimal access surgery, all units must be in a position to offer pediatric laparoscopic surgical training.

  2. KC-46A Formal Training Unit (FTU) and First Main Operating Base (MOB 1) Beddown EIS. Volume 1

    Science.gov (United States)

    2014-03-01

    discharged into the sanitary sewer system. Most of the sanitary sewer system at Altus AFB is over 45 years old and constructed of vitrified clay ...drained (USDA 2002a, 2003). The textures of the Tillman-Hollister soils range from clay loam to clay , with the Hollister subsurface soils being more clayey...range from sandy to sandy loam to sandy clay loam, with the Nobscot soils having a more sandy nature, especially in the surface soils (Altus AFB 2009a

  3. Final KC-46A Formal Training Unit (FTU) and First Main Operating Base (MOB 1) Beddown EIS

    Science.gov (United States)

    2014-03-01

    years old and constructed of vitrified clay pipe or concrete. Of the sanitary sewer lines field surveyed in 2004 and 2007, approximately 85 percent...Hollister soils are very deep and well-drained (USDA 2002a, 2003). The textures of the Tillman-Hollister soils range from clay loam to clay , with...The textures of the Miles-Nobscot soils range from sandy to sandy loam to sandy clay loam, with the Nobscot soils having a more sandy nature

  4. Developing nursing research in the United Arab Emirates: a narrative review.

    Science.gov (United States)

    McCreaddie, M; Kuzemski, D; Griffiths, J; Sojka, E M; Fielding, M; Al Yateem, N; Williams, J J

    2018-03-01

    This article identified, critically analysed and synthesized the literature on international nursing and midwifery research capacity building and standards. The United Arab Emirates is heavily dependent up on expatriate nurses. Only 4% of nurses working within the country are Emirati. The nation is therefore committed to developing nurses and nursing as a profession. The United Arab Emirates' Nursing and Midwifery Council was formed in 2009 and initially focused on regulation, education and specialization. This review was undertaken to inform the work of the Council's newly established Scientific Research Sub-Committee. A rapid narrative review was conducted using the Cumulative Index of Nursing and Allied Health Literature database, key words, Boolean operators, parameters and a journal-specific search. An inclusion/exclusion criterion was identified. The search provided 332 articles with 45 included in the final review. The literature on nursing research 'standards' and 'capacity building' is diverse and inconsistent across continents and in approaches. Nursing research has evolved to varying degrees across the globe. Nevertheless, irrespective of the locale, there are similar problems encountered in growing research, for example nursing faculty shortage, lack of collaborative research, funding. There are also specific challenges in the Middle East and North Africa region. The review was constrained by time and access. There are specific challenges for the United Arab Emirates. However, the country is well placed to learn from the experiences of colleagues elsewhere. Time and commitment is required to build the solid foundations necessary to ensure robust, sustained growth. Identifying research capacity as both a process and outcome at the outset may also assist. Further, it may be prudent to consider initiating a Gulf Coast Countries' collaborative approach to building research capacity to harness scare resources and create a larger critical mass. © 2017

  5. International review of Kursk unit 1 in-depth safety analysis report

    International Nuclear Information System (INIS)

    Chouha, M.; Bolshov, L.; Butcher, P.; Janke, R.; Parsons, T.; Weber, J.P.

    2004-01-01

    The paper presents the objectives, organisation, main findings and conclusions of the international review of the Kursk unit 1 safety analysis report (K1IRSR). The K1IRSR was administered by RISKAUDIT IRSN/GRS international and carried out by international experts from 7 western countries plus the Russian Federation, under the supervision of the safety review group (SRG) of the European bank for reconstruction and development (EBRD). The project was financed by the nuclear safety account (NSA) administered by the EBRD. The Russian experts worked under a contract with IBRAE financed by Rosenergoatom. The main conclusions were that the SAR followed a correct approach, broadly in line with Russian and international guidance documents, but needed improvement in structure and content. It established that the safety level of the unit has been increased significantly by the modernisation programme. The important deviations of the unit from current Russian regulations and the IAEA safety issues for RBMK are either fully resolved or are being addressed to the extent possible by compensatory measures to further reduce the risk. The K1IRSR experts have made a number of recommendations for improvement of the K1SAR. The authors agreed to take the recommendations into account in future revision of the K1SAR. (orig.)

  6. Acculturation and Postpartum Depressive Symptoms among Hispanic Women in the United States: Systematic Review.

    Science.gov (United States)

    Alhasanat, Dalia; Giurgescu, Carmen

    The purpose of this review was to evaluate studies that examined the relationship between acculturation and postpartum depression (PPD) among immigrant and/or refugee women in the United States. A systematic, computer-assisted search of quantitative, English-language, peer-reviewed, published research articles was conducted in the Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Maternity and Infant Care databases using the keyword terms of "postpartum depression" and "perinatal depression" in combination with "acculturation." Studies were included if they were conducted in the United States. Seven studies met inclusion criteria. Three studies used longitudinal designs and four used cross-sectional designs. All were conducted with Hispanic women. Only one study used a diagnostic tool to measure PPD; the remaining studies used screening tools to measure postpartum depressive symptoms. Most studies used country of birth, country of residence, and language preferences to measure acculturation. Five studies reported acculturation was positively related to risk of postpartum depressive symptoms, and two studies reported no relationship. Higher levels of acculturation were related to higher risk of postpartum depressive symptoms in Hispanic women living in the United States. Nurses should have an understanding of stressors of immigrant women to guide their assessment and screening for postpartum depressive symptoms and make appropriate referrals. More research is needed to confirm the relationship between acculturation and PPD among immigrant women from different cultural backgrounds.

  7. Ethnographic research into nursing in acute adult mental health units: a review.

    Science.gov (United States)

    Cleary, Michelle; Hunt, Glenn E; Horsfall, Jan; Deacon, Maureen

    2011-01-01

    Acute inpatient mental health units are busy and sometimes chaotic settings, with high bed occupancy rates. These settings include acutely unwell patients, busy staff, and a milieu characterised by unpredictable interactions and events. This paper is a report of a literature review conducted to identify, analyse, and synthesize ethnographic research in adult acute inpatient mental health units. Several electronic databases were searched using relevant keywords to identify studies published from 1990-present. Additional searches were conducted using reference lists. Ethnographic studies published in English were included if they investigated acute inpatient care in adult settings. Papers were excluded if the unit under study was not exclusively for patients in the acute phase of their mental illness, or where the original study was not fully ethnographic. Ten research studies meeting our criteria were found (21 papers). Findings were grouped into the following overarching categories: (1) Micro-skills; (2) Collectivity; (3) Pragmatism; and (4) Reframing of nursing activities. The results of this ethnographic review reveal the complexity, patient-orientation, and productivity of some nursing interventions that may not have been observed or understood without the use of this research method. Additional quality research should focus on redefining clinical priorities and philosophies to ensure everyday care is aligned constructively with the expectations of stakeholders and is consistent with policy and the realities of the organisational setting. We have more to learn from each other with regard to the effective nursing care of inpatients who are acutely disturbed.

  8. Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Haddad, Linda; El-Shahawy, Omar; Ghadban, Roula; Barnett, Tracey E; Johnson, Emily

    2015-05-29

    Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

  9. Waterpipe Smoking and Regulation in the United States: A Comprehensive Review of the Literature

    Directory of Open Access Journals (Sweden)

    Linda Haddad

    2015-05-01

    Full Text Available Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

  10. Human Factors Evaluation of Procedures for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the results of human factors assessment on the plant operating procedures as part of Periodic Safety Review(PSR) of Yonggwang Nuclear Power Plant Unit no. 1, 2. The suitability of item and appropriateness of format and structure in the key operating procedures of nuclear power plants were investigated by the review of plant operating experiences and procedure documents, field survey, and experimental assessment on some part of procedures. A checklist was used to perform this assessment and record the review results. The reviewed procedures include EOP(Emergency Operating Procedures), GOP(General Operating Procedures), AOP(Abnormal Operating Procedures), and management procedures of some technical departments. As results of the assessments, any significant problem challenging the safety was not found on the human factors in the operating procedures. However, several small items to be changed and improved were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on the operating procedure.

  11. Protective effect of the silkworm protein 30Kc6 on human vascular endothelial cells damaged by oxidized low density lipoprotein (Ox-LDL.

    Directory of Open Access Journals (Sweden)

    Wei Yu

    Full Text Available Although the 30K family proteins are important anti-apoptotic molecules in silkworm hemolymph, the underlying mechanism remains to be investigated. This is especially the case in human vascular endothelial cells (HUVECs. In this study, a 30K protein, 30Kc6, was successfully expressed and purified using the Bac-to-Bac baculovirus expression system in silkworm cells. Furthermore, the 30Kc6 expressed in Escherichia coli was used to generate a polyclonal antibody. Western blot analysis revealed that the antibody could react specifically with the purified 30Kc6 expressed in silkworm cells. The In vitro cell apoptosis model of HUVEC that was induced by oxidized low density lipoprotein (Ox-LDL and in vivo atherosclerosis rabbit model were constructed and were employed to analyze the protective effects of the silkworm protein 30Kc6 on these models. The results demonstrated that the silkworm protein 30Kc6 significantly enhanced the cell viability in HUVEC cells treated with Ox-LDL, decreased the degree of DNA fragmentation and markedly reduced the level of 8-isoprostane. This could be indicative of the silkworm protein 30Kc6 antagonizing the Ox-LDL-induced cell apoptosis by inhibiting the intracellular reactive oxygen species (ROS generation. Furthermore, Ox-LDL activated the cell mitogen activated protein kinases (MAPK, especially JNK and p38. As demonstrated with Western analysis, 30Kc6 inhibited Ox-LDL-induced cell apoptosis in HUVEC cells by preventing the MAPK signaling pathways. In vivo data have demonstrated that oral feeding of the silkworm protein 30Kc6 dramatically improved the conditions of the atherosclerotic rabbits by decreasing serum levels of total triglyceride (TG, high density lipoprotein cholesterol (HDL-C, low density lipoprotein cholesterol (LDL-C and total cholesterol (TC. Furthermore, 30Kc6 alleviated the extent of lesions in aorta and liver in the atherosclerotic rabbits. These data are not only helpful in understanding the anti

  12. Cooperative Fish and Wildlife Research Units Program—2017 year in review postcard

    Science.gov (United States)

    Organ, John F.; Thompson, John D.; Dennerline, Donald E.; Childs, Dawn E.

    2018-02-08

    This postcard provides details about the Cooperative Fish and Wildlife Research Units Program—2017 Year in Review, U.S. Geological Survey Circular 1438, now available at https://doi.org/10.3133/cir1438. In this report, you will find details about the Cooperative Fish and Wildlife Research Units (CRU) Program relating to its background, fish and wildlife science, students, staffing, vacancies, research funding, outreach and training, science themes, accolades, and professional services. You will see snapshots of CRU projects with information on how results have been or are being applied by cooperators. This is the essence of what we do: science that matters.Throughout the year, keep up with CRU research projects at http://www.coopunits.org.

  13. Notes on critical care-review of seminal management and leadership papers in the United Kingdom.

    Science.gov (United States)

    Coombs, Maureen

    2009-06-01

    Review of recent critical care provision reveals substantial changes in clinical unit operating, and policy drivers influencing international critical care delivery. Practitioners who have worked in healthcare environments over this time, will have witnessed substantial shifts in healthcare policy, changes in professional body guidance and greater service evaluation have impacted on critical care management and leadership. This paper offers a personal perspective on seminal management and leadership papers published in the critical care literature over the past decade. Presenting a range of national and international work that utilise diverse approaches, ten key papers are highlighted that have impacted in the United Kingdom setting. Through this, the influence of the modernisation agenda, the increasing significance of outcome studies, and the need for flexible, interdependent practice emerges. A key message to surface from this paper is the need for all in critical care to engage with, and understand the wider implications of management and leadership change for critical care delivery.

  14. The United States spent fuel acceptance policy - A year in review

    International Nuclear Information System (INIS)

    Huizenga, David G.

    1997-01-01

    Through the combined efforts of the United States and many other nations participating in the Reduced Enrichment for Research and Test Reactors (RERTR) program, much progress has been made toward reducing the amount of highly enriched uranium (HEU) in international commerce. A little more than a year ago, the U.S. Department of Energy adopted a new 1 0-year policy to accept research reactor spent nuclear fuel into the United States from other nations. The policy supports U.S. nuclear weapons nonproliferation objectives and demonstrates the continued commitment of the U.S. to the RERTR program. This paper is a review of the past year's activities and addresses the progress made since the policy was implemented

  15. Historical review of efforts to reduce noise-induced hearing loss in the United States.

    Science.gov (United States)

    Kerr, Madeleine J; Neitzel, Richard L; Hong, OiSaeng; Sataloff, Robert T

    2017-06-01

    Noise-induced hearing loss is a centuries-old problem that is still prevalent in the United States and worldwide. To describe highlights in the development of hearing loss prevention in the U.S. from World War II to the present. Literature review. Approaches to occupational noise-induced hearing loss prevention in the United States over the past seven decades are described using a hierarchy of controls framework and an interdisciplinary perspective. Historical timelines and developmental milestones related to occupational noise-induced hearing loss prevention are summarized as a life course. Lessons are drawn for other countries in their hearing conservation efforts. Future developments building on the hearing loss prevention work of the past 70 years can prevent the problem of occupational NIHL in the 21st century. Am. J. Ind. Med. 60:569-577, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. Glycolytic pathway (GP), kreb's cycle (KC), and hexose monophosphate shunt (HMS) activity in myocardial subcellular fractions exposed to cannabinoids

    International Nuclear Information System (INIS)

    Watson, A.T.; Manno, B.R.; King, J.W.; Fowler, M.R.; Dempsey, C.A.; Manno, J.E.

    1986-01-01

    Delta-9-tetrahydrocannabinol (Δ 9 -THC), the primary psychoactive component of marihuana, and its active metabolite 11-hydroxy-Δ 9 -tetrahydrocannabinol (11-OH-Δ 9 -THC) have been reported to produce a direct cardiac depressant effect. Studies in isolated perfused rat hearts have indicated a decreased force of contraction (inotropic response) when Δ 9 -THC or 11-OH-Δ 9 -THC was administered in microgram amounts. The mechanism and site of action have not been explained or correlated with associated metabolic pathways. The purpose of this study was to investigate the effects of cannabinoids on major myocardial energy producing pathways, GP and KC, and a non-energy producing pathway, HMS. Cardiac ventricular tissue from male Sprague-Dawley rats (250-300 g) was excised and homogenized for subcellular fractionation. KC, GP and HMS activity was assayed in the appropriate fractions by measuring 14 CO 2 generation from 14 C-2-pyruvate, 14 C-6-glucose and 14 C-1-glucose respectively. Duplicate assays (n=8) were performed on tissue exposed to saline (control), empty liposomes (vehicle) and four doses each of Δ 9 -THC and 11-OH-Δ 9 -THC. Changes in metabolic activity and decreases in cardiac contractile performance may be associated

  17. Pengaruh Kualitas Layanan Internet Banking terhadap Kepuasan Nasabah pada PT Bank Negara Indonesia Persero Tbk KC Madiun

    Directory of Open Access Journals (Sweden)

    Febri Nur Endah Safitri

    2018-01-01

    Full Text Available This research has purpose to know the quality of internet banking service in PT BNI Persero Tbk KC Madin, to know customer satisfaction at PT BNI Persero Tbk KC Madiun. In this study the population consists of 512 customers with a sample of 225 clients taken with Incidental sampling technique. Technique of taking data taken by questionnaire, observation and documentation. The analysis was processed with SPSS version 20.0 using simple linear regression with hypothesis test, determination test and t test. The result of the research shows that the result of Simple Linear Regression Test is Y = 12,646 + 0,635 X, constant equal to 12,646 meaning if variable of Quality of Internet Banking Service is fixed then Customer Satisfaction amount is 0,635 so there is influence between Quality of Internet Banking Service to Customer Satisfaction. The result of Coefficient of Determination Adjust (R2 is known 0,377 means 37,7% Quality of Internet Banking Service influenced by Customer Satisfaction, while the rest 62,3% Quality of Internet Banking Service influenced by other variable not examined in this research. The result of t test is t_hitung value is 11,697 while t_tabel is 1,651. This means that the value of 〖t〗 _count> t_table (11,697> 1,651. so it can be concluded that Ho is rejected and Ha accepted.

  18. Marketing dietary supplements in the United States: A review of the requirements for new dietary ingredients

    International Nuclear Information System (INIS)

    Noonan, Chris; Patrick Noonan, W.

    2006-01-01

    Since the passage of the Dietary Supplement Health and Education Act in 1994, the marketplace for dietary supplements has experienced dramatic growth. New products have redefined the entire marketplace, and new ingredients are introduced to consumers at lightning speed. As part of this act, laws were passed to ensure the safety of new dietary ingredients introduced into the United States marketplace. But more than 11 years later, these laws are frequently misunderstood, and more frequently ignored. This article reviews the regulatory landscape of new dietary ingredients and defines the issues manufacturers must contend with to legally market dietary supplements with new dietary ingredients in the U.S

  19. Data integrity review of Three Mile Island Unit 2. Hydrogen burn data. Volume 3

    International Nuclear Information System (INIS)

    Jacoby, J.K.; Nelson, R.A.; Nalezny, C.L.; Averill, R.H.

    1983-09-01

    About 10 hours after the March 28, 1979 loss-of-coolant accident began at Three Mile Island Unit 2 (TMI-2), a hydrogen burn occurred inside the Reactor Building. This report reviews and presents data from 16 channels of resistance temperature detectors (RTDs), 2 steam generator pressure transmitters, 16 Reactor Building pressure switches, 2 channels of Reactor Building pressure measurements, and measurements of Reactor Building hydrogen, oxygen, and nitrogen concentrations with regard to their usefulness for determining the extent of the burn and the resulting pressure and temperature excursions inside the building

  20. Review of the Shearon Harris Unit 1 auxiliary feedwater system reliability analysis

    International Nuclear Information System (INIS)

    Fresco, A.; Youngblood, R.; Papazoglou, I.A.

    1986-02-01

    This report presents the results of a review of the Auxiliary Feedwater System Reliability Analysis for the Shearon Harris Nuclear Power Plant (SHNPP) Unit 1. The objective of this report is to estimate the probability that the Auxiliary Feedwater System will fail to perform its mission for each of three different initiators: (1) loss of main feedwater with offsite power available, (2) loss of offsite power, (3) loss of all ac power except vital instrumentation and control 125-V dc/120-V ac power. The scope, methodology, and failure data are prescribed by NUREG-0611 for other Westinghouse plants

  1. Review of the research proposal for the steam generator retired from Kori unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Joung Soo; Han, Joung Ho; Kim, Hong Pyo; Lim, Yun Soo; Lee, Deok Hyun; Hwang, Seong Sik; Hur, Do Haeng [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-03-01

    The tubes of the steam generator retired form Kori unit 1 have many different kinds of failures, such as denting pitting, wastage, ODSCC, PWSCC.Korea Electric Power Research Institute (KEPRI) submitted a research proposal for the steam generator to the Korea Institute S and T Evaluation and Planning (KSITEP). The KISTEP requested Korea Atomic Energy Research Institute to review the proposal by organizing a committee which should be composed of the specialists of the related domestic research institutes. Opinions of the committee on the objectives, research fields, economic benefit and validity in the research proposal were reviewed and suggested optimal research fields to be fulfilled successfully for the retired steam generator. Also, the rolls for the participants in the research works were allocated, which is critical in order to do the project effectively. 6 figs., 5 tabs. (Author)

  2. A Review of Underground Coal Gasification Research and Development in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Camp, D. W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-06-26

    An intense and productive period of research and development on underground coal gasification (UCG) took place in the United States from the mid-1970’s through the late 1980’s. It began with the translation and review of Soviet literature and ended with the Rocky Mountain 1 field test. This demonstrated the feasibility of newly-developed technologies that form the basis of many UCG projects around the world today. This period began with little domestic understanding of UCG and ended with an accurate observation-based conceptual model and a corresponding predictive multi-physics mathematical model of the process. The many accomplishments of this period form the main content of this report. This report also covers recent U.S. activities and accomplishments during the period 2004-2015, and touches briefly on the Bureau of Mines efforts between 1948 and 1963. Most of the activities were funded by the United States Department of Energy and its predecessors. While private/commercially-funded activities are reviewed here, the emphasis is on government-funded work. It has a much greater extent of publicly available reports and papers, and they generally contain much greater technical detail. Field tests were the marquis activities around which an integrated multi-faceted program was built. These are described in detail in Section 4. Highlights from modeling efforts are briefly covered, as the program was integrated and well-rounded, with field results informing models and vice-versa. The primary goal of this report is to review what has been learned about UCG from the U.S. experience in aggregate. This includes observations, conclusions, lessons-learned, phenomena understood, and technology developed. The latter sections of this report review these things.

  3. A Review and Analysis of the History of Special Education and Disability Advocacy in the United States

    Science.gov (United States)

    Spaulding, Lucinda S.; Pratt, Sharon M.

    2015-01-01

    Most reviews of the history of special education in the United States survey reforms from the 1960s to the1970s, thus inferring the field is fairly young and progress is quite recent. However, this recent era of reform is not unprecedented. The history of disability advocacy and the development of special education in the United States began a…

  4. Engine Tune-Up Service. Unit 1: Battery and Cranking System. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Goodson-Roberts, Ludy; And Others

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 1, Battery and Cranking System. Focus of the exercises and pretests is testing the battery and cranking system. Pretests and performance checklists are provided for each of the four performance objectives contained in the unit.…

  5. Predictors of cervical cancer screening adherence in the United States: a systematic review.

    Science.gov (United States)

    Limmer, Karen; LoBiondo-Wood, Geri; Dains, Joyce

    2014-01-01

    Cervical cancer incidence rates have decreased dramatically since the implementation of the Papanicolaou (Pap) smear. Nevertheless, the American Cancer Society (ACS) estimates for 2013 predicted more than 12,000 new cases of cervical cancer in the United States. Given that some subpopulations in the United States are at a higher risk for cervical cancer than others, efforts to increase screening adherence are warranted. Many studies have explored the demographics of underscreened women, but no systematic reviews of screening demographics in adult US women were identified in the past 10 years, after release of the 2002 ACS cervical cancer screening guidelines. Knowledge of adherence to these guidelines becomes important as new guidelines were developed and released in 2012. The purpose of this systematic review of relevant studies was to identify factors that predict the use of cervical cancer screening in US women. Variables found to be significantly associated with adherence to screening included education, financial status, acculturation, psychosocial issues, and marital status. Using this information, nurse practitioners and other providers can target specific at-risk populations to increase screening by educating women about the need for cervical cancer screening and ensuring access to methods for prevention and early detection of the disease.

  6. Final Environmental Impact Statement Second Main Operating Base KC-46A Beddown at Alternative Air National Guard Installations

    Science.gov (United States)

    2014-06-01

    175 Parrott Ave Portsmouth, NH 03801 Moon Township Public Library 1700 Beaver Grade Rd Moon Township, PA 15108 Robert Morris University...Robert Morris University Library 6001 University Blvd Moon Township, PA 15108 Metropolitan Library South High Branch 3540 S. High Street...mailto:Teresa.D.Spagna@usace.army.mill Sent: Tuesday , October 01, 201311:29 AM To: ANGRC/NGB/A7A NEPA COMMENTS Subject: review of United States Air Force

  7. Window Spacers and Edge Seals in Insulating Glass Units: A State-of-the-Art Review and Future Perspectives

    Energy Technology Data Exchange (ETDEWEB)

    SINTEF Building and Infrastructure; Norwegian University of Science and Technology (NTNU); Bergh, Sofie Van Den; Hart, Robert; Jelle, Bjrn Petter; Gustavsen, Arild

    2013-01-31

    Insulating glass (IG) units typically consist of multiple glass panes that are sealed and held together structurally along their perimeters. This report describes a study of edge seals in IG units. First, we summarize the components, requirements, and desired properties of edge construction in IG units, based on a survey of the available literature. Second, we review commercially available window edge seals and describe their properties, to provide an easily accessible reference for research and commercial purposes. Finally, based on the literature survey and review of current commercial edge seal systems, we identify research opportunities for future edge seal improvements and solutions.

  8. Effectiveness of Pressure Ulcer Prevention Strategies for Adult Patients in Intensive Care Units: A Systematic Review.

    Science.gov (United States)

    Tayyib, Nahla; Coyer, Fiona

    2016-12-01

    Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention. The aim was to synthesize the best available evidence regarding the effectiveness of single strategies designed to reduce the incidence and prevalence of HAPUs development in ICUs. The search strategy was designed to retrieve studies published in English across CINAHL, Medline, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Mednar between 2000 and 2015. All adult ICU participants were aged 18 years or over. This review included randomized controlled trials, quasi-experimental and comparative studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. The review included 25 studies, and the meta-analysis revealed a statistically significant effect of a silicon foam dressing strategy in reducing HAPUs incidence (effect size = 4.62; 95% CI: 0.05-0.29; p prevention of HAPUs development in the ICU was limited, which precludes strong conclusions. The review provides an evidence-based guide to future priorities for clinical practice. In particular, a silicone foam dressing has positive impact in reducing sacrum and heel HAPUs incidence in the ICU. © 2016 Sigma Theta Tau International.

  9. Thermal stability of the F centre in KC1 between 80 and 300 K; Estabilidad termica del centro F' en KC1 entre 80 y 300 K

    Energy Technology Data Exchange (ETDEWEB)

    Garcia Codovila, C.

    1974-07-01

    After shining an F spark light of high intensity upon a coloured sample of KC1, the annealing of the induced F1 band and the decay of the induced luminescence are observed. This luminescence is produced by the electrons returning to the anion vacancies through the F* state. From the annealing characteristics of the F1 band between 80 and 300 K, we conclude that at least six thermally activated processes ase involved. The luminescence decay curves also show evidence of six the thermally activated processes which correlate quite wall in magnitude with those from the F1 band anneal. We conclude that the luminescence and annealing of the F1 band are aspects of the same process, and some explanations are suggested involving the interaction of F1 centres and electron traps. (Author) 41 refs.

  10. Obesity and Nursing Home Care in the United States: A Systematic Review.

    Science.gov (United States)

    Harris, John Alexander; Castle, Nicholas George

    2017-12-14

    Obesity is increasing among people residing in nursing homes, and resident obesity substantially affects services needed, equipment and facilities provided, and morbidity in this setting. The purpose of this article is to describe the scope and depth of evidence regarding the impact of obesity among nursing home residents in the United States. A systematic literature review was performed in PubMed, EMBASE, CINAHL, and Web of Science databases as well as additional hand-searched documents. Included articles were published from 1997 to March 2017. The characteristics and content of the included articles were systematically reviewed and reported. Twenty-eight studies met inclusion criteria for review. The median study size was 636 residents (interquartile range 40-11,248); 18 (64%) studies were retrospective and 10 (36%) were prospective in nature. Ten (36%) studies examined medical and functional morbidity, 10 (36%) examined health system effects, and 5 (18%) examined the risk of admission to nursing homes. Most studies found that obesity poses serious issues to resident health and the provision of health care, as well as broad health system and nursing challenges in the provision of high-quality nursing home care and services. Although obesity affects about one in four nursing home residents in the United States, relatively limited evidence exists on the complex challenges of obesity for their residents and their care. A continued focus on resident quality of life, health system improvement, and nursing best practices for properly caring for individuals with obesity is needed. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Racial and ethnic disparity in food allergy in the United States: a systematic review.

    Science.gov (United States)

    Greenhawt, Matthew; Weiss, Christopher; Conte, Marisa L; Doucet, Marlie; Engler, Amy; Camargo, Carlos A

    2013-01-01

    The prevalence of food allergy is rising among US children. Little is known about racial/ethnic disparities in food allergy. We performed a systematic literature review to understand racial/ethnic disparities in food allergy in the United States. We searched PubMed/MEDLINE, Embase, and Scopus for original data about racial/ethnic disparities in the diagnosis, prevalence, treatment, or clinical course of food allergy or sensitization, with a particular focus on black (African American) race. Articles were analyzed by study methodology, racial/ethnic composition, food allergy definition, outcomes, summary statistic used, and covariate adjustment. Twenty of 645 identified articles met inclusion criteria. The studies used multiple differing criteria to define food allergy, including self-report, sensitization assessed by serum food-specific IgE to selected foods without corroborating history, discharge codes, clinic chart review, and event-reporting databases. None used oral food challenge. In 12 studies, black persons (primarily children) had significantly increased adjusted odds of food sensitization or significantly higher proportion or odds of food allergy by self-report, discharge codes, or clinic-based chart review than white children. Major differences in study methodology and reporting precluded calculation of a pooled estimate of effect. Sparse and methodologically limited data exist about racial/ethnic disparity in food allergy in the United States. Available data lack a common definition for food allergy and use indirect measures of allergy, not food challenge. Although data suggest an increased risk of food sensitization, self-reported allergy, or clinic-based diagnosis of food allergy among black children, no definitive racial/ethnic disparity could be found among currently available studies. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Draft audit report, human factors engineering control room design review: Saint Lucie Nuclear Power Plant, Unit No. 2

    International Nuclear Information System (INIS)

    Peterson, L.R.; Lappa, D.A.; Moore, J.W.

    1981-01-01

    A human factors engineering preliminary design review of the Saint Lucie Unit 2 control room was performed at the site on August 3 through August 7, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The review team included human factors consultants from BioTechnology, Inc., Falls Church, Virginia, and from Lawrence Livermore National Laboratory (University of California), Livermore, California

  13. Imaging of non-small cell lung cancers with a monoclonal antibody, KC-4G3, which recognizes a human milk fat globule antigen

    International Nuclear Information System (INIS)

    Dienhart, D.G.; Schmelter, R.F.; Lear, J.L.; Miller, G.J.; Glenn, S.D.; Bloedow, D.C.; Kasliwal, R.; Moran, P.; Seligman, P.; Murphy, J.R.

    1990-01-01

    To determine the role of lung cancer tumor imaging with monoclonal antibodies directed against high molecular weight human milk fat globule antigens, we administered i.v. 111In-KC-4G3 to 24 patients with advanced non-small cell lung cancer. One mg of 111In-KC-4G3 was mixed with 0, 9, 49, 99, or 499 mg of unlabeled KC-4G3 and infused i.v. over 1 to 5 h. The mean 111In-KC-4G3 radiochemical purity was greater than 97% and the resultant immunoreactivity averaged 62%. Successful imaging of cancer sites was accomplished in 92% of 24 patients, and 57% of 91 total lesions were visualized. Successful localization of tumor sites related to size (P less than 0.001), with 81% of lesions greater than 3.0 cm in diameter, 50% of lesions 1.5 to 3 cm, and 6% of lesions less than 1.5 cm successfully imaging, and to location (P less than 0.05), with 69% of pulmonary lesions, 80% of soft tissue lesions, and only 32% of bone metastases being visualized. Nonspecific reticulo-endothelial uptake of radioactivity was a major problem. Approximately 35% of 111In was chelated to serum transferrin by 24 and 48 h after infusion. The mean t 1/2 beta for plasma radioisotope and immunoreactive KC-4G3 was 29 and 27 h, respectively. There was no correlation between total infused antibody dose and imaging success or between total dose and effect on 111In and KC-4G3 kinetics. Circulating free KC-4 antigen was measurable in all but one patient before study. Tumor biopsy following infusion could demonstrate antibody presence but not saturable antigen binding. We conclude that (a) 111In-KC-4G3 demonstrates successful tumor localization in non-small cell lung cancers bearing generally high expression of its antigen and (b) further investigations to diminish nonspecific radioactivity for imaging and utilization of high dose radiolabeled antibody for therapeutic intent are warranted

  14. 21st Century Parent-Child Sex Communication in the United States: A Process Review.

    Science.gov (United States)

    Flores, Dalmacio; Barroso, Julie

    Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

  15. Safety Experts Complete IAEA Nuclear Regulatory Review of the United States

    International Nuclear Information System (INIS)

    2010-01-01

    Full text: An international team of senior nuclear safety experts today completed a two-week International Atomic Energy Agency (IAEA) review of the governmental and regulatory framework for nuclear safety in the United States. The team identified good practices within the U.S. system and offered suggestions for ways the U.S. Nuclear Regulatory Commission (NRC) could improve. The IAEA has conveyed the team's main conclusions to the NRC, and a final report will be submitted to the NRC in about two months. At the request of the United States, the IAEA assembled a team of 19 international experts to conduct an Integrated Regulatory Review Service (IRRS) mission. This mission was a peer review based on the IAEA Safety Standards. It was not an inspection, nor an audit. The experts came from 14 different countries: Canada, China, the Czech Republic, Finland, France, Italy, Japan, Mexico, the Republic of Korea, Slovenia, Spain, Sweden, Switzerland, and the United Kingdom. Team leader Jukka Laaksonen of Finland said: ''We found a comprehensive, consistent, and mature regulatory system run by the NRC, which has a strong drive for continuous improvement.' The scope of the mission included the U.S. regulatory framework and the regulation of the nuclear plant operation. The mission was conducted from 18 to 29 October, mainly at NRC headquarters outside of Washington, D.C. To study U.S. regulatory activities, the mission conducted a series of interviews and discussions with NRC staff and other organizations to help assess the effectiveness of the regulatory system. In addition, the team observed regulatory activities at two operating nuclear power reactors and an emergency preparedness exercise. The IAEA's IRRS coordinator Gustavo Caruso said, ''This mission represents a milestone for the IRRS program because the U.S. regulatory system is the largest in the world and many nations look to it. The IRRS is a useful tool that allows host nations to gain guidance from experienced

  16. Peer review of the Three Mile Island Unit 2 Vessel Investigation Project metallurgical examinations

    Energy Technology Data Exchange (ETDEWEB)

    Bohl, R.W.; Gaydos, R.G.; Vander Voort, G.F.; Diercks, D.R. [Argonne National Lab., IL (United States)

    1994-07-01

    Fifteen samples recovered from the lower head of the Three Mile Island (TMI) Unit 2 nuclear reactor pressure vessel were subjected to detailed metallurgical examinations by the Idaho National Engineering Laboratory (INEL), with supporting work carried out by Argonne National Laboratory (ANL) and several of the European participants. These examinations determined that a portion of the lower head, a so-called elliptical ``hot spot`` measuring {approx}0.8 {times} 1 m, reached temperatures as high as 1100{degrees}C during the accident and cooled from these temperatures at {approx}10--100{degrees}C/min. The remainder of the lower head was found to have remained below the ferrite-toaustenite transformation temperature of 727{degrees}C during the accident. Because of the significance of these results and their importance to the overall analysis of the TMI accident, a panel of three outside peer reviewers, Dr. Robert W. Bohl, Mr. Richard G. Gaydos, and Mr. George F. Vander Voort, was formed to conduct an independent review of the metallurgical analyses. After a thorough review of the previous analyses and examination of photo-micrographs and actual lower head specimens, the panel determined that the conclusions resulting from the INEL study were fundamentally correct. In particular, the panel reaffirmed that four lower head samples attained temperatures as high as 1100{degrees}C, and perhaps as high as 1150--1200{degrees}C in one case, during the accident. They concluded that these samples subsequently cooled at a rate of {approx}50--125{degrees}C/min in the temperature range of 600--400{degrees}C, in good agreement with the original analysis. The reviewers also agreed that the remainder of the lower head samples had not exceeded the ferrite-to-austenite transformation temperature during the accident and suggested several refinements and alternative procedures that could have been employed in the original analysis.

  17. Peer review of the Three Mile Island Unit 2 Vessel Investigation Project metallurgical examinations

    International Nuclear Information System (INIS)

    Bohl, R.W.; Gaydos, R.G.; Vander Voort, G.F.; Diercks, D.R.

    1994-07-01

    Fifteen samples recovered from the lower head of the Three Mile Island (TMI) Unit 2 nuclear reactor pressure vessel were subjected to detailed metallurgical examinations by the Idaho National Engineering Laboratory (INEL), with supporting work carried out by Argonne National Laboratory (ANL) and several of the European participants. These examinations determined that a portion of the lower head, a so-called elliptical ''hot spot'' measuring ∼0.8 x 1 m, reached temperatures as high as 1100 degrees C during the accident and cooled from these temperatures at ∼10--100 degrees C/min. The remainder of the lower head was found to have remained below the ferrite-toaustenite transformation temperature of 727 degrees C during the accident. Because of the significance of these results and their importance to the overall analysis of the TMI accident, a panel of three outside peer reviewers, Dr. Robert W. Bohl, Mr. Richard G. Gaydos, and Mr. George F. Vander Voort, was formed to conduct an independent review of the metallurgical analyses. After a thorough review of the previous analyses and examination of photo-micrographs and actual lower head specimens, the panel determined that the conclusions resulting from the INEL study were fundamentally correct. In particular, the panel reaffirmed that four lower head samples attained temperatures as high as 1100 degrees C, and perhaps as high as 1150--1200 degrees C in one case, during the accident. They concluded that these samples subsequently cooled at a rate of ∼50--125 degrees C/min in the temperature range of 600--400 degrees C, in good agreement with the original analysis. The reviewers also agreed that the remainder of the lower head samples had not exceeded the ferrite-to-austenite transformation temperature during the accident and suggested several refinements and alternative procedures that could have been employed in the original analysis

  18. Analysis of KC-46 Live-Fire Risk Mitigation Program Testing

    Science.gov (United States)

    2012-03-01

    the use of real hardware such as electrohydraulic actuators , electrical units, and converter regulators (Andrus, 2010). The only feasible method for...worked with the MQ-9 as a test engineer and analyst for the programs IOT &E, RQ-4 as lead engineer and program lead for the block 3 and the block 4

  19. 78 FR 57377 - KC Pittsfield LLC; Notice of Preliminary Permit Application Accepted for Filing and Soliciting...

    Science.gov (United States)

    2013-09-18

    ... as a penstock; (3) a new powerhouse containing a single Pelton type turbine generator rated at 1,300... bulb-type turbine generator rated at 800 kilowatts, located at the terminus of the Bear River canal... Powerhouse development would consist of using PG&E's existing Unit 2 impulse turbine in the Alta Powerhouse...

  20. A Review of Communications Protocol for Intelligent Remote Terminal Unit Development

    Directory of Open Access Journals (Sweden)

    Mohd Ruddin Ab. Ghani

    2013-11-01

    Full Text Available This paper reviewed all the possible interfacing communication protocols for remote terminal unit (RTU. Supervisory Control and Data Acquisition (SCADA system is a central station that can communicate with other network using the protocol. Fundamentally, the architectures of all networks are based on the seven layers of open system interconnection (OSI and International Standard Organization (ISO. The objective of designing the protocols is to check the status of all the input and output field devices and send the report according to that status. The corresponding protocol and communication parameters between the connecting devices will be included in designing a complex SCADA system. The available protocols to develop the communication of RTU are Modbus/ASCII, distributed network protocol (DNP3, controller area network (CAN, International Electro-technical Commission (IEC 60870, transmission control protocol/internet protocol (TCP/IP.

  1. Review of nuclear liability compensation systems applicable to reactors outside the United States

    International Nuclear Information System (INIS)

    McIntosh, C.

    1985-01-01

    The review, which summarizes the Paris Convention and the Brussels Supplementary Convention, as well as the laws of Canada, France, Federal Republic of Germany, Japan, Spain, Sweden, Switzerland, and the United Kingdom, notes that the Price-Anderson program has a number of common points with the laws of Western Europe. The points of similarly are the goal of ensuring simple and equitable compensation for victims without burdening the nuclear industry with an uneconomic load. Price-Anderson differs in the higher amounts fixed for nuclear operators' liability, although the limits are now closer together. The purpose of the comparisons is to help those concerned with US programs of third-party liability and indemnification with a broader perspective

  2. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States.

    Science.gov (United States)

    Oladapo, Abiola O; Rascati, Karen L

    2012-08-01

    To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM

  3. A Survey Study of Institutional Review Board Thought Processes in the United States and South Korea

    Directory of Open Access Journals (Sweden)

    Si-Kyung Jung

    2012-09-01

    Full Text Available Introduction: In the last several decades, South Korea has rapidly adopted Western customs and practices. Yet, cultural differences between South Korea and the United States exist. The purpose ofthis study was to identify and characterize potential cultural differences in the Korean and US institutional review board (IRB approach to certain topics.Methods: A qualitative analysis of a 9-item survey, describing 4 research study case scenarios, sent to IRB members from the United States and South Korea. The case scenarios involved the followingissues: (1 the need for consent for retrospective chart review when research subjects receive their care after the study is conceived; (2 child assent; (3 individual versus population benefit; and (4 exception from informed consent in emergency resuscitation research. The free-text responses were analyzed and abstracted for recurrent themes.Results: Twenty-three of the 45 survey recipients completed the survey, for an overall response rate of 51%. The themes that emerged were as follows: (1 the importance of parental authority among Korean participants versus the importance of child autonomy and child assent among US participants; (2 the recognition of the rights of a proxy or surrogate who can represent an individual’s values by all participants; and (3 the importance of the community, expressed by the Korean respondents, versus individualism, expressed by US respondents.Conclusion: Whereas US participants appear to emphasize the importance of the individual and the autonomy of a child, the Korean respondents stressed the importance of parental authority andbenefiting the community, above and beyond that of the individual person. However, there was substantial overlap in the themes expressed by respondents from both countries.

  4. A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States.

    Science.gov (United States)

    Livorsi, Daniel J; Chorazy, Margaret L; Schweizer, Marin L; Balkenende, Erin C; Blevins, Amy E; Nair, Rajeshwari; Samore, Matthew H; Nelson, Richard E; Khader, Karim; Perencevich, Eli N

    2018-01-01

    Carbapenem-resistant Enterobacteriaceae (CRE) pose an urgent public health threat in the United States. An important step in planning and monitoring a national response to CRE is understanding its epidemiology and associated outcomes. We conducted a systematic literature review of studies that investigated incidence and outcomes of CRE infection in the US. We performed searches in MEDLINE via Ovid, CDSR, DARE, CENTRAL, NHS EED, Scopus, and Web of Science for articles published from 1/1/2000 to 2/1/2016 about the incidence and outcomes of CRE at US sites. Five studies evaluated incidence, but many used differing definitions for cases. Across the entire US population, the reported incidence of CRE was 0.3-2.93 infections per 100,000 person-years. Infection rates were highest in long-term acute-care (LTAC) hospitals. There was insufficient data to assess trends in infection rates over time. Four studies evaluated outcomes. Mortality was higher in CRE patients in some but not all studies. While the incidence of CRE infections in the United States remains low on a national level, the incidence is highest in LTACs. Studies assessing outcomes in CRE-infected patients are limited in number, small in size, and have reached conflicting results. Future research should measure a variety of clinical outcomes and adequately adjust for confounders to better assess the full burden of CRE.

  5. Biodiversity of Aspergillus section Flavi in the United States: a review.

    Science.gov (United States)

    Horn, Bruce W

    2007-10-01

    Fungi belonging to Aspergillus section Flavi are of great economic importance in the United States due to their ability to produce toxic and carcinogenic aflatoxins in agricultural commodities. Development of control strategies against A. flavus and A. parasiticus, the major aflatoxin-producing species, is dependent upon a basic understanding of their diversity in agricultural ecosystems. This review summarizes our current knowledge of species and population diversity in the United States in relation to morphology, mycotoxin production and genetic characters. The high genetic diversity in populations of aflatoxigenic fungi is a reflection of their versatile habits in nature, which include saprotrophic colonization of plant debris in soil and parasitism of seeds and grain. Genetic variation within populations may originate from a cryptic sexual state. The advent of intensive monoculture agriculture not only increases population size but also may introduce positive selective pressure for aflatoxin production due to its link with pathogenicity in crops. Important goals in population research are to determine how section Flavi diversity in agricultural ecosystems is changing and to measure the direction of this evolution.

  6. Moral distress within neonatal and paediatric intensive care units: a systematic review.

    Science.gov (United States)

    Prentice, Trisha; Janvier, Annie; Gillam, Lynn; Davis, Peter G

    2016-08-01

    To review the literature on moral distress experienced by nursing and medical professionals within neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs). Pubmed, EBSCO (Academic Search Complete, CINAHL and Medline) and Scopus were searched using the terms neonat*, infant*, pediatric*, prematur* or preterm AND (moral distress OR moral responsibility OR moral dilemma OR conscience OR ethical confrontation) AND intensive care. 13 studies on moral distress published between January 1985 and March 2015 met our inclusion criteria. Fewer than half of those studies (6) were multidisciplinary, with a predominance of nursing staff responses across all studies. The most common themes identified were overly 'burdensome' and disproportionate use of technology perceived not to be in a patient's best interest, and powerlessness to act. Concepts of moral distress are expressed differently within nursing and medical literature. In nursing literature, nurses are often portrayed as victims, with physicians seen as the perpetrators instigating 'aggressive care'. Within medical literature moral distress is described in terms of dilemmas or ethical confrontations. Moral distress affects the care of patients in the NICU and PICU. Empirical data on multidisciplinary populations remain sparse, with inconsistent definitions and predominantly small sample sizes limiting generalisability of studies. Longitudinal data reflecting the views of all stakeholders, including parents, are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    Science.gov (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  8. A Review of the Structural Characteristics of Family Meals with Children in the United States12

    Science.gov (United States)

    McCullough, Mary Beth; Robson, Shannon M; Stark, Lori J

    2016-01-01

    Family meals are associated with a range of positive outcomes among children and adolescents. There is inconsistency, however, in the way in which studies have defined and measured family meals. Therefore, a systematic review of the literature was conducted to determine how studies describe family meals with the use of structural characteristics. The current review focused on studies in the United States that included children ages 2–18 y. A total of 33 studies were identified that characterized family meals with the use of ≥1 of the following structural features: frequency or mean number of family meals per week, length of family meal, people present at meal, and where meals occurred. No study characterized family meals by using all 4 family meal features, whereas most studies (81%) characterized family meals by using frequency or mean number of meals per week. Findings not only provide an initial understanding of the structural features used to define family meals but also point to the importance of developing a more comprehensive, sensitive assessment that can accurately capture the complex and multidimensional nature of family meals. PMID:27422500

  9. Quality of Sleep Among Intensive Care Unit Patients: A Literature Review.

    Science.gov (United States)

    Bani Younis, Mohammad; Hayajneh, Ferial A

    Investigating sleep disturbances among intensive care unit (ICU) patients and its serious consequences is considered a crucial issue for nurses. The need of sleep increases during hospitalization time to preserve energy for the healing process. Previous studies have demonstrated that sleep disturbance is one of the most common complaints of patients in the ICUs, with a prevalence of more than 50%. Although the total sleep time might be normal, the patients' sleep is fragmented and light in the intensive care settings. The main purpose of this review is to generate a clear view of what is known about sleep disturbances among ICU patients as well as to identify the gap in knowledge regarding this issue. This was done by describing, summarizing, clarifying, and evaluating well-selected previous studies about this topic. In addition, this concise review has focused on the prevalence of sleep disturbances in the ICU, factors contributing to poor quality of sleep among ICU patients, and the physiological effects of poor sleep on the patients' prognosis.

  10. Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review.

    Science.gov (United States)

    Koornneef, Erik; Robben, Paul; Blair, Iain

    2017-09-20

    The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent and success of these reforms has not recently been comprehensively reviewed. In this paper we review the progress and outcomes of health systems reform in the UAE. We searched relevant databases and other sources to identify published and unpublished studies and other data available between 01 January 2002 and 31 March 2016. Eligible studies were appraised and data were descriptively and narratively synthesized. Seventeen studies were included covering the following themes: the UAE health system, population health, the burden of disease, healthcare financing, healthcare workforce and the impact of reforms. Few, if any, studies prospectively set out to define and measure outcomes. A central part of the reforms has been the introduction of mandatory private health insurance, the development of the private sector and the separation of planning and regulatory responsibilities from provider functions. The review confirmed the commitment of the UAE to build a world class health system but amongst researchers and commentators opinion is divided on whether the reforms have been successful although patient satisfaction with services appears high and there are some positive indications including increasing coverage of hospital accreditation. The UAE has a rapidly growing population with a unique age and sex distribution, there have been notable successes in improving child and maternal mortality and extending life expectancy but there are high levels of chronic diseases. The relevance of the reforms for public health and their impact on the determinants of chronic diseases have been questioned. From the existing research literature it is not possible to conclude whether UAE health system reforms are

  11. Predictors of maternal vaccination in the United States: An integrative review of the literature.

    Science.gov (United States)

    Myers, Kristen L

    2016-07-25

    The purpose of this literature review was to identify, analyze, and synthesize existing research related to patient, provider, and health system predictors of maternal vaccination in the United States, strategies used to increase maternal vaccination rates, and major theoretical frameworks used to guide maternal vaccination research. A search for evidence was conducted in CINAHL, PubMed, PsychINFO, Cochrane Systematic Reviews, and Google Scholar. Twenty-two articles were identified as best evidence for inclusion in this review: five randomized control trials, one cluster randomized trial, one mixed methods study, 12 observational studies, and three qualitative studies. Patient-focused predictors of maternal vaccination included provider recommendation; knowledge, attitudes, and beliefs; cues to action; and race and ethnicity. Provider-focused predictors included knowledge, attitudes, and beliefs; and multi-component intervention packages. Health system predictors included standing order protocols and practice site logistics. The major theoretical frameworks that emerged were the Health Belief Model, Theory of Reasoned Action/Theory of Planned Behavior, and Message Framing/Prospect Theory. Provider recommendation was the single most important predictor of vaccine acceptance among pregnant women. An abundance of theoretically-supported, patient-focused research was found in the literature. A minimal number of U.S.-based, provider-focused research was found and none of these used a theoretical framework. Minimal research examining health system barriers to maternal vaccination was found. Additional research into the logistical barriers to maternal vaccination programs within obstetrical practice locations in other geographical locations within the U.S. is warranted. Future provider- and health system-focused research needs to be grounded in theory. The field of implementation science may offer the theoretical guidance necessary to better understand problems in

  12. Quality of care provided in two Scottish rural community maternity units: a retrospective case review.

    Science.gov (United States)

    Denham, Sara; Humphrey, Tracy; Taylor, Ruth

    2017-06-21

    Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model. The research aim was to explore the safety and effectiveness of the maternity services provided at two rural Community Maternity Units in Scotland, both 40 miles by main road access from a tertiary obstetric unit. Following appropriate NHS and University ethical approval, an anonymous retrospective review of consecutive maternity records for all women who accessed care at the CMUs over a 12 month period (June 2011 to May 2012) was undertaken in 2013 -14. Data was extracted using variables chosen to provide a description of the socio-demographics of the cohort and the process and outcomes of the care provided. Data were analysed using descriptive statistics. Regarding effectiveness, the correct care pathway was allocated to 97.5% of women, early access to antenatal care achieved by 95.7% of women, 94.8% of women at one CMU received continuity of carer and 78.6% of those clinically eligible accessed care in labour. 11.9% were appropriately transferred to obstetrician-led care antenatally and 16.9% were transferred in labour. All women received one-to one care in labour and 67.1% of babies born at the CMUs were breastfed at birth. Regarding safety, severe morbidity for women was rare, perineal trauma of 3rd degree tear occurred for 0.3% of women and 1.0% experienced an episiotomy. Severe post partum haemorrhage occurred for 0.3% of women. Babies admitted to the Neonatal unit were discharged within 48 hrs. These findings support the recommendations of professional

  13. Social policy devolution: a historical review of Canada, the United kingdom, and the United States (1834-1999).

    Science.gov (United States)

    Dunlop, Judith M

    2009-01-01

    This paper explores the recurring themes of devolution and social policy across time and nation in Canada, the United Kingdom, and the United States. Devolution is defined as the transfer of responsibility from national governments to state and local levels. Using a historical framework, the central/local tensions that characterize devolution and social policy in these countries are noted from 1834 to the late 1990s. This chronology shows that despite their geographical, ideological, and cultural differences, all of these countries have shifted responsibility for social provision back and forth between central and local governments in similar ways throughout the three eras delineated in this analysis. Clearly, devolution characterizes the current social policy climate in these three countries and across many Western democracies. Recent trends in the environment such as privatization, mandatory collaboration, community capacity building, and service integration are identified, and process questions are presented as a guide for practitioners who seek to explore the current devolution reality.

  14. Clinical characteristics of keratoconus patients in Malaysia: a review from a cornea specialist centre

    OpenAIRE

    Mohd-Ali, Bariah; Abdu, Mustafa; Yaw, Choong Yean; Mohidin, Norhani

    2012-01-01

    Purpose: To evaluate the demographic profile, refraction, visual acuity (VA), corneal curvature (K) and severity of keratoconus (KC) patients from a cornea specialist centre in Malaysia. This may improve the management of KC patients in this country. Methods: Records of 13,000 patients were reviewed. The patients were categorized into 4 age groups: (Gp 1: 42 years). Refraction and VA were determined using subjective refraction and Snellen chart. Corneal curvature was measured using Orbscan...

  15. A Review Of The United States Government’s Status Quo North Korean Foreign Policy Approach And Reasons For Change

    Science.gov (United States)

    2016-02-16

    AIR WAR COLLEGE AIR UNIVERSITY A REVIEW OF THE UNITED STATES GOVERNMENT’S STATUS QUO NORTH KOREAN FOREIGN POLICY APPROACH AND REASONS FOR...administration DPRK policy review . Initially the Obama administration also sought negotiations through Six-party offering official US aid. In his... movies and sports, as well as being educated in Switzerland. Mr. Kim invited Dennis Rodman to visit his country, who has made several trips.44 Former

  16. Best practice in nurse-led chemotherapy review: a position statement from the United Kingdom Oncology Nursing Society

    OpenAIRE

    Lennan, E; Vidall, C; Roe, H; Jones, P; Smith, J; Farrell, C

    2012-01-01

    This position statement has been formulated by nurses from the United Kingdom Oncology Nursing Society (UKONS) to provide guidance on the provision of nurse-led chemotherapy review clinics for adult patients. For the purposes of this statement, a nurse-led chemotherapy clinic is defined as one that conducts formal review (in a consultation room) before the decision to proceed and prescribe the next cycle of chemotherapy. This statement does not address the toxicity checks that take place imme...

  17. Smoking Initiation Among Young Adults in the United States and Canada, 1998-2010: A Systematic Review

    OpenAIRE

    Freedman, Kit S.; Nelson, Nanette M.; Feldman, Laura L.

    2011-01-01

    Introduction Young adults have the highest smoking rate of any age group in the United States and Canada, and recent data indicate that they often initiate smoking as young adults. The objective of this study was to systematically review peer-reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults. Methods We searched 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) ...

  18. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  19. A qualitative systematic review of factors influencing parents’ vaccination decision-making in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Alice S. Forster

    2016-12-01

    Full Text Available Background: High uptake of vaccinations is crucial for disease prevention. Although overall uptake of childhood immunisations is high in the United Kingdom (UK, pockets of lower uptake remain. Novel systematic methods have not been employed when reviewing the qualitative literature examining parents’ vaccination decisions. Aims: We aimed to conduct a qualitative systematic review of studies in the UK to understand factors influencing parental decisions to vaccinate a child. Methods: On 12/2/14 we searched PsycINFO, MEDLINE, CINAHL plus, Embase, Social Policy and Practice and Web of Science for studies using qualitative methods and reporting reasons why parents in the UK had or had not immunised their child. Participant quotes and authors’ interpretations of qualitative data were extracted from the results of articles. Thematic synthesis was used to develop higher-order themes (conducted in 2015. Results: 34 papers were included. Two types of decision-making had been adopted: non-deliberative and deliberative. With non-deliberative decisions parents felt they had no choice, were happy to comply and/or relied on social norms. Deliberative decisions involved weighing up the risks and benefits, considering others’ advice/experiences and social judgement. Emotions affected deliberative decision-making. Trust in information and vaccine stakeholders was integral to all decision-making. Practical issues affected those who intended to vaccinate. Conclusions: Parents adopted two different approaches to decision-making about childhood vaccinations. By understanding more about the mechanisms underpinning parents’ vaccination behaviour, in collaboration with vaccine stakeholders, we can better design interventions to enhance informed uptake. Keywords: Thematic synthesis, Vaccination, Parents, Patient Acceptance of Health Care

  20. Mental Health Service Use Among Immigrants in the United States: A Systematic Review

    Science.gov (United States)

    Derr, Amelia Seraphia

    2016-01-01

    Objective Immigrants face stressors unique to the experience of migration that may exacerbate or cause mental health problems but access care at rates far below the general population, leaving them at risk of untreated mental health conditions. This review synthesizes current findings on mental health service utilization among immigrants to inform future research efforts addressing disparities in access to care. Methods A systematic literature search of seven databases yielded 62 articles that met inclusion criteria: peer-reviewed reports of empirical studies based in the United States with an explicit focus on immigrant mental health service use. Each article was evaluated, and information was extracted by using a structured abstracting form. Results Studies have shown that immigrants from Asia, Latin America, and Africa use mental health services at lower rates than nonimmigrants, despite an equal or greater need. Lower usage has been found to be more pronounced among men, the uninsured, and the undocumented. Structural barriers to service use reported included lack of insurance, high cost, and language barriers. Studies have shown that social support is particularly important for immigrants and that those who seek help for mental health concerns tend to turn first to family, friends, or religious leaders. Conclusions Important areas for future research on disparities in mental health service use among immigrants include expanding research and analytic design to emphasize understudied groups and the heterogeneity of immigrant experiences over time, studying interventions that foster collaboration between formal and informal service sectors, and examining the role of social support in problem recognition and treatment initiation. PMID:26695493

  1. Changing the Translational Research Landscape: A Review of the Impacts of Biomedical Research Units in England.

    Science.gov (United States)

    Marjanovic, Sonja; Soper, Bryony; Ismail, Sharif; Reding, Anais; Ling, Tom

    2012-01-01

    This article describes a review of the Biomedical Research Units (BRU) scheme, undertaken for the Department of Health. This review was a perceptions audit of senior executives involved in the scheme, and explored what impact they felt the scheme is having on the translational research landscape. More specifically, we investigated whether and how institutional relationships between NHS and academic partners, industry and other health research system players are changing because of the scheme; how the scheme is helping build critical mass in specific priority disease areas; and the effects of any changes on efforts to deliver the broader goals set out in Best Research for Best Health. The views presented are those of study informants only. The information obtained through our interviews suggests that the BRU scheme is significantly helping shape the health research system to pursue translational research and innovation, with the clear goal of realising patient benefit. The BRUs are already contributing to observable changes in institutional relationships between the NHS and academic partners: trusts and medical schools are collaborating more closely than in the past, have signed up to the same vision of translational research from bench to bedside, and are managing and governing targeted research resources more professionally and transparently than in the past. There is also a stronger emphasis on engaging industry and more strategic thinking about strengthening regional and national collaboration with other hospital trusts, PCTs, research organisations, networks and development agencies. The scheme is also transforming capacity building in the health research system. This includes (i) developing and modernising facilities and equipment for translation; (ii) building a critical mass of human resources through recruitment and training, as well as improving retention of existing expertise; and (iii) helping ensure a steady flow of funds needed to sustain research

  2. Early rehabilitation in the intensive care unit: an integrative literature review.

    Science.gov (United States)

    Sosnowski, Kellie; Lin, Frances; Mitchell, Marion L; White, Hayden

    2015-11-01

    The aim of this review is to appraise current research which examines the impact of early rehabilitation practices on functional outcomes and quality of life in adult intensive care unit (ICU) survivors. A systematic literature search was undertaken; retrieved data was evaluated against a recognised evaluation tool; research findings were analysed and categorised into themes; and a synthesis of conclusions from each theme was presented as an integrated summation of the topic. Electronic databases of PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Medline and Google Scholar were searched using key search terms 'ICU acquired weakness', 'early rehabilitation' 'early mobility' and 'functional outcomes' combined with 'intensive care' and 'critical illness'. Additional literature was sourced from reference lists of relevant original publications. Five major themes related to the review objectives emerged from the analysis. These themes included: critically ill patients do not always receive physical therapy as a standard of care; ICU culture and resources determine early rehabilitation success; successful respiratory and physical rehabilitation interventions are tailored according to individual patient impairment; early exercise in the ICU prevents the neuromuscular complications of critical illness and improves functional status; early exercise in the ICU is effective, safe and feasible. A limited body of research supports early rehabilitation interventions to optimise the short term outcomes and long term quality of life for ICU survivors. Critical care nurses are in an excellent position to drive change within their departments ensuring that early rehabilitation practices are adopted and implemented. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

  3. A Systematic Review of the Liaison Nurse Role on Patient’s Outcomes after Intensive Care Unit Discharge

    OpenAIRE

    Tabanejad, Zeinab; Pazokian, Marzieh; Ebadi, Abbas

    2014-01-01

    Background: This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient’s outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. Methods: A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitiv...

  4. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    International Nuclear Information System (INIS)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang

    2006-01-01

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area

  5. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area.

  6. Disturbance and climate change in United States/Mexico borderland plant communities: a state-of-the-knowledge review

    Science.gov (United States)

    Guy R. McPherson; Jake F. Weltzin

    2000-01-01

    This review evaluates the effects and importance of disturbance and climate change on plant community dynamics in the United States/Mexico borderlands region. Our primary focus is on knowledge of physiognomic-level change in grasslands and woodlands of southeastern Arizona and southwestern New Mexico. Changes in vegetation physiognomy have broad implications for...

  7. Engine Tune-Up Service. Unit 5: Fuel and Carburetion Systems. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Goodson, Ludy

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 5, Fuel and Carburetion Systems, available separately as CE 031 217. Focus of the exercises and pretests is inspecting and servicing the fuel and carburetion systems. Pretests and performance checklists are provided for each of the…

  8. Review of potential host rocks for radioactive waste disposal in the southeastern United States. Executive summary

    International Nuclear Information System (INIS)

    Bledsoe, H.W. Jr.; Marine, I.W.

    1980-10-01

    The geology of the southeastern United States was studied to recommend areas that should be considered for field exploration in order to select a site for a radioactive waste repository. The region studied included the Piedmont Province, the Triassic Basins, and the Atlantic Coastal Plain in Maryland, Virginia, North Carolina, South Carolina, and Georgia. This study was entirely a review of literature and existing knowledge from a geotechnical point of view and was performed by subcontractors whose individual reports are listed in the bibliography. No field work was involved. The entire study was geotechnical in nature, and no consideration was given to socioeconomic or demographic factors. These factors need to be addressed in a separate study. For all areas, field study is needed before any area is further considered. A total of 29 areas are recommended for further consideration in the Piedmont Province subregion: one area in Maryland, 8 areas in Virginia, 4 areas in North Carolina, 6 areas in South Carolina, and 10 areas in Georgia. Of the 14 exposed and 5 buried or hypothesized basins identified in the Triassic basin subregion, 6 are recommended for further study: one basin in Virginia, 3 basins in North Carolina, and 2 basins in South Carolina. Four potential candidate areas are identified within the Atlantic Coastal Plain subregion: one in Maryland, one in North Carolina, and 2 in Georgia

  9. A review of the relationships between drought and forest fire in the United States

    Science.gov (United States)

    Littell, Jeremy; Peterson, David L.; Riley, Karin L.; Yongquiang Liu,; Luce, Charles H.

    2016-01-01

    The historical and pre-settlement relationships between drought and wildfire are well documented in North America, with forest fire occurrence and area clearly increasing in response to drought. There is also evidence that drought interacts with other controls (forest productivity, topography, fire weather, management activities) to affect fire intensity, severity, extent, and frequency. Fire regime characteristics arise across many individual fires at a variety of spatial and temporal scales, so both weather and climate—including short- and long-term droughts—are important and influence several, but not all, aspects of fire regimes. We review relationships between drought and fire regimes in United States forests, fire-related drought metrics and expected changes in fire risk, and implications for fire management under climate change. Collectively, this points to a conceptual model of fire on real landscapes: fire regimes, and how they change through time, are products of fuels and how other factors affect their availability (abundance, arrangement, continuity) and flammability (moisture, chemical composition). Climate, management, and land use all affect availability, flammability, and probability of ignition differently in different parts of North America. From a fire ecology perspective, the concept of drought varies with scale, application, scientific or management objective, and ecosystem.

  10. Immigration, Work, and Health: A Literature Review of Immigration Between Mexico and the United States

    Science.gov (United States)

    Flynn, Michael A.; Carreón, Tania; Eggerth, Donald E.; Johnson, Antoinette I.

    2015-01-01

    Understanding the influence someone’s job or career has on their health goes beyond the physical, emotional and social hazards, risks and conditions that they face at work. One’s job or career also exerts a significant influence over other aspects of life that contribute or detract from their health and that of their family. Work is the major incentive for Latin American migration to the United States. Latino immigrants experience increasingly poorer outcomes for physical health and chronic diseases the longer they remain in the U.S. The strong link between work and immigration suggests that, for many Latin Americans, immigration can be understood as a career path which puts them, and their family members, in situations that can change their physical, emotional, and social health as a condition of their employment. Given the large number of Latin Americans who emigrate for work, it is essential that the unique physical, mental and social impacts of emigration are accounted for when working with clients impacted by emigration at the individual, family and community level as well as those social workers practicing at the system level. This paper is a literature review that explores the impact that emigrating for work has on the health of those that emigrate and their family members that stay behind. PMID:28260831

  11. A review of the relationships between drought and forest fire in the United States.

    Science.gov (United States)

    Littell, Jeremy S; Peterson, David L; Riley, Karin L; Liu, Yongquiang; Luce, Charles H

    2016-07-01

    The historical and presettlement relationships between drought and wildfire are well documented in North America, with forest fire occurrence and area clearly increasing in response to drought. There is also evidence that drought interacts with other controls (forest productivity, topography, fire weather, management activities) to affect fire intensity, severity, extent, and frequency. Fire regime characteristics arise across many individual fires at a variety of spatial and temporal scales, so both weather and climate - including short- and long-term droughts - are important and influence several, but not all, aspects of fire regimes. We review relationships between drought and fire regimes in United States forests, fire-related drought metrics and expected changes in fire risk, and implications for fire management under climate change. Collectively, this points to a conceptual model of fire on real landscapes: fire regimes, and how they change through time, are products of fuels and how other factors affect their availability (abundance, arrangement, continuity) and flammability (moisture, chemical composition). Climate, management, and land use all affect availability, flammability, and probability of ignition differently in different parts of North America. From a fire ecology perspective, the concept of drought varies with scale, application, scientific or management objective, and ecosystem. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  12. Peer review of the Barselina Level 1 probabilistic safety assessment of the Ignalina Nuclear Power Plant, Unit 2

    International Nuclear Information System (INIS)

    McKay, S.L.; Coles, G.A.

    1995-01-01

    The Barselina Project is a Swedish-funded, cooperative effort among Lithuania, Russia and Sweden to transfer Western probabilistic safety assessment (PSA) methodology to the designers/operators of Ignalina Nuclear Power Plant (INPP). The overall goal is to use the PSA as a tool for assessing plant operational safety. The INPP is a two-unit, Former Soviet Union-designed nuclear facility located in Lithuania. The results of this PSA will ultimately be used to identify plant-specific improvements in system design and the conduct of facility operations, allowing improved operational safety. Pacific Northwest Laboratory (PNL) was asked to perform an independent expert peer review of the Barselina PSA. This report documents the findings of this review. This review, financed with nuclear safety assistance funds through the US Agency for International Development (USAID) and the US Department of Energy (DOE), satisfies Task II of the PNL peer review of the Barselina project. The objective is to provide an independent, in-proce ss examination of the Barselina Level 1 PSA of Ignalina Nuclear Power Plant, Unit 2. The review consisted of an investigation of the project documentation, interviews, and extensive discussions with the PSA staff during critical stages of the project. PNL assessed the readability, completeness, consistency, validity, and applicability of the PSA. The major aspects explored were its purpose, major assumptions, analysis/modeling, results, and interpretation. It was not within the scope of this review to perform plant walkdowns or to review material other than the PSA documentation

  13. Alpha-2 agonists for sedation of mechanically ventilated adults in intensive care units: a systematic review.

    Science.gov (United States)

    Cruickshank, Moira; Henderson, Lorna; MacLennan, Graeme; Fraser, Cynthia; Campbell, Marion; Blackwood, Bronagh; Gordon, Anthony; Brazzelli, Miriam

    2016-03-01

    Care of critically ill patients in intensive care units (ICUs) often requires potentially invasive or uncomfortable procedures, such as mechanical ventilation (MV). Sedation can alleviate pain and discomfort, provide protection from stressful or harmful events, prevent anxiety and promote sleep. Various sedative agents are available for use in ICUs. In the UK, the most commonly used sedatives are propofol (Diprivan(®), AstraZeneca), benzodiazepines [e.g. midazolam (Hypnovel(®), Roche) and lorazepam (Ativan(®), Pfizer)] and alpha-2 adrenergic receptor agonists [e.g. dexmedetomidine (Dexdor(®), Orion Corporation) and clonidine (Catapres(®), Boehringer Ingelheim)]. Sedative agents vary in onset/duration of effects and in their side effects. The pattern of sedation of alpha-2 agonists is quite different from that of other sedatives in that patients can be aroused readily and their cognitive performance on psychometric tests is usually preserved. Moreover, respiratory depression is less frequent after alpha-2 agonists than after other sedative agents. To conduct a systematic review to evaluate the comparative effects of alpha-2 agonists (dexmedetomidine and clonidine) and propofol or benzodiazepines (midazolam and lorazepam) in mechanically ventilated adults admitted to ICUs. We searched major electronic databases (e.g. MEDLINE without revisions, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE and Cochrane Central Register of Controlled Trials) from 1999 to 2014. Evidence was considered from randomised controlled trials (RCTs) comparing dexmedetomidine with clonidine or dexmedetomidine or clonidine with propofol or benzodiazepines such as midazolam, lorazepam and diazepam (Diazemuls(®), Actavis UK Limited). Primary outcomes included mortality, duration of MV, length of ICU stay and adverse events. One reviewer extracted data and assessed the risk of bias of included trials. A second reviewer cross-checked all the data extracted. Random-effects meta

  14. Voluntary peer review as innovative tool for quality improvement in the intensive care unit--a retrospective descriptive cohort study in German intensive care units.

    Science.gov (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs - representing over 300 patient beds - had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators.

  15. Voluntary peer review as innovative tool for quality improvement in the intensive care unit – a retrospective descriptive cohort study in German intensive care units

    Science.gov (United States)

    Kumpf, Oliver; Bloos, Frank; Bause, Hanswerner; Brinkmann, Alexander; Deja, Maria; Marx, Gernot; Kaltwasser, Arnold; Dubb, Rolf; Muhl, Elke; Greim, Clemens-A.; Weiler, Norbert; Chop, Ines; Jonitz, Günther; Schaefer, Henning; Felsenstein, Matthias; Liebeskind, Ursula; Leffmann, Carsten; Jungbluth, Annemarie; Waydhas, Christian; Pronovost, Peter; Spies, Claudia; Braun, Jan-Peter

    2014-01-01

    Introduction: Quality improvement and safety in intensive care are rapidly evolving topics. However, there is no gold standard for assessing quality improvement in intensive care medicine yet. In 2007 a pilot project in German intensive care units (ICUs) started using voluntary peer reviews as an innovative tool for quality assessment and improvement. We describe the method of voluntary peer review and assessed its feasibility by evaluating anonymized peer review reports and analysed the thematic clusters highlighted in these reports. Methods: Retrospective data analysis from 22 anonymous reports of peer reviews. All ICUs – representing over 300 patient beds – had undergone voluntary peer review. Data were retrieved from reports of peers of the review teams and representatives of visited ICUs. Data were analysed with regard to number of topics addressed and results of assessment questionnaires. Reports of strengths, weaknesses, opportunities and threats (SWOT reports) of these ICUs are presented. Results: External assessment of structure, process and outcome indicators revealed high percentages of adherence to predefined quality goals. In the SWOT reports 11 main thematic clusters were identified representative for common ICUs. 58.1% of mentioned topics covered personnel issues, team and communication issues as well as organisation and treatment standards. The most mentioned weaknesses were observed in the issues documentation/reporting, hygiene and ethics. We identified several unique patterns regarding quality in the ICU of which long-term personnel problems und lack of good reporting methods were most interesting Conclusion: Voluntary peer review could be established as a feasible and valuable tool for quality improvement. Peer reports addressed common areas of interest in intensive care medicine in more detail compared to other methods like measurement of quality indicators. PMID:25587245

  16. Profile of IL-2, IL-4, IL-10, IFN- ? , TNF- ? and KC-like cytokines in pregnant bitches

    Directory of Open Access Journals (Sweden)

    M.A.R. Feliciano

    2014-08-01

    Full Text Available The aim of this study was to determine the profile of IL-2, IL-4, IL-10, IFN-γ, and TNF-α cytokines and KC-like cells (natural killer in pregnant bitches, unpublished values for the species. A total of 27 females of the Shi Tzu, Pug, English Bulldog and French breeds, weighing 4-20kg and aged 4-6 years were used. Blood samples were collected from bitches during the anestrous and on the 2nd, 5th, 6th, 7th and 8th week of pregnancy. Serum levels of cytokines were measured by panel MILLIPLEX MAP (CCYTO-90K, MILLIPORE, Billerica, Massachusetts, USA validated for dogs. Twenty four females showed physiological pregnancy and three bitches showed pathological pregnancy. There was no difference between cytokine values during anestrous and gestational weeks of bitches (P>0.05. However, it was possible to verify the physiological behavior of serum levels during modulation of immune response in the gestational process of animals. In animals with gestational disorders, abnormal values for IL-2, IL-4 and INF-y were noted. It was concluded that serum levels of cytokines evaluated in pregnant bitches can help the better understanding of physiological and pathological gestational processes and correlated immunology in this species.

  17. State review United States of America. Risks and risk assessment according to the law of the United States of America

    International Nuclear Information System (INIS)

    Feldmann, F.J.

    1980-01-01

    In the chapter 'Risk Assessment in Atomic Energy Law of the United States' of this report you find among other things the Atomic Energy Act, the approval conditions, General Design Criteria for Nuclear Power Plants, the defense-in-depth concept, probabilistic safety studies, probabilistic probability assessments in the case of external influences onto nuclear power plants, quantitative analyses of the consequences of conceivable accidents, reduction of radiation exposure, the National Environmental Policy Act, the environmental compatibility declaration, the so-called residual risk under the environmental aspect, the classification of the accidents into 9 types, new developments concerning accident analysis, effects of the nuclear fuel cycle on environment, indicial decisions. The chapter about 'Risk Assessment in Civil Law, Criminal Law and Law on Protection of the Environment', deals among other things with the Law on nuisance, the Clean Air Act, the Federal Environmental Pesticide Control Act. In 'Problems of the Cost-Efficiency-Analysis' the significance and purpose of this analysis, the availability of data and information, the monetary quantification of risks and costs, alternatives and the danger of misuse are illustrated. (HSCH) [de

  18. Adherence: a review of education, research, practice, and policy in the United States

    Directory of Open Access Journals (Sweden)

    Brown TA

    2010-03-01

    Full Text Available Objective: To describe the education, research, practice, and policy related to pharmacist interventions to improve medication adherence in community settings in the United States.Methods: Authors used MEDLINE and International Pharmaceutical Abstracts (since 1990 to identify community and ambulatory pharmacy intervention studies which aimed to improve medication adherence. The authors also searched the primary literature using Ovid to identify studies related to the pharmacy teaching of medication adherence. The bibliographies of relevant studies were reviewed in order to identify additional literature. We searched the tables of content of three US pharmacy education journals and reviewed the American Association of Colleges of Pharmacy website for materials on teaching adherence principles. Policies related to medication adherence were identified based on what was commonly known to the authors from professional experience, attendance at professional meetings, and pharmacy journals.Results: Research and Practice: 29 studies were identified: 18 randomized controlled trials; 3 prospective cohort studies; 2 retrospective cohort studies; 5 case-controlled studies; and one other study. There was considerable variability in types of interventions and use of adherence measures. Many of the interventions were completed by pharmacists with advanced clinical backgrounds and not typical of pharmacists in community settings. The positive intervention effects had either decreased or not been sustained after interventions were removed. Although not formally assessed, in general, the average community pharmacy did not routinely assess and/or intervene on medication adherence. Education: National pharmacy education groups support the need for pharmacists to learn and use adherence-related skills. Educational efforts involving adherence have focused on students’ awareness of adherence barriers and communication skills needed to engage patients in behavioral

  19. A Review of Mine Rescue Ensembles for Underground Coal Mining in the United States.

    Science.gov (United States)

    Kilinc, F Selcen; Monaghan, William D; Powell, Jeffrey B

    The mining industry is among the top ten industries nationwide with high occupational injury and fatality rates, and mine rescue response may be considered one of the most hazardous activities in mining operations. In the aftermath of an underground mine fire, explosion or water inundation, specially equipped and trained teams have been sent underground to fight fires, rescue entrapped miners, test atmospheric conditions, investigate the causes of the disaster, or recover the dead. Special personal protective ensembles are used by the team members to improve the protection of rescuers against the hazards of mine rescue and recovery. Personal protective ensembles used by mine rescue teams consist of helmet, cap lamp, hood, gloves, protective clothing, boots, kneepads, facemask, breathing apparatus, belt, and suspenders. While improved technology such as wireless warning and communication systems, lifeline pulleys, and lighted vests have been developed for mine rescuers over the last 100 years, recent research in this area of personal protective ensembles has been minimal due to the trending of reduced exposure of rescue workers. In recent years, the exposure of mine rescue teams to hazardous situations has been changing. However, it is vital that members of the teams have the capability and proper protection to immediately respond to a wide range of hazardous situations. Currently, there are no minimum requirements, best practice documents, or nationally recognized consensus standards for protective clothing used by mine rescue teams in the United States (U.S.). The following review provides a summary of potential issues that can be addressed by rescue teams and industry to improve potential exposures to rescue team members should a disaster situation occur. However, the continued trending in the mining industry toward non-exposure to potential hazards for rescue workers should continue to be the primary goal. To assist in continuing this trend, the mining industry

  20. Cardiovascular Risk Factor Management Performance in Canada and the United States: A Systematic Review.

    Science.gov (United States)

    Alabousi, Mostafa; Abdullah, Peri; Alter, David A; Booth, Gillian L; Hogg, William; Ko, Dennis T; Manuel, Douglas G; Farkouh, Michael E; Tu, Jack V; Udell, Jacob A

    2017-03-01

    Comparative cardiovascular risk factor care across North America is unknown. We aimed to determine current performance in Canada and the United States (US). A systematic review was conducted of Medline and EMBASE (to June 1, 2014). Eligible studies reported on screening, awareness, treatment, or control rates for hypertension, dyslipidemia, diabetes, and smoking. Categorical performance 'ratings' on the basis of the most successful US health plans were used to classify rates as suboptimal ( 90%). A total of 127 studies reporting on 10,510,324 individuals across North America were included. Hypertension awareness (84.3%) and treatment (82.0%) rates in Canada and the US (82.7% and 75.6%, respectively) were above target, whereas control in both nations was below target (68.1% vs 51.8%, respectively). Canadian awareness, treatment, and control rates for dyslipidemia (42.7%, 40.9%, and 41.5%, respectively) were suboptimal, and American indicators were generally below target (61.5%, 43.0%, and 63.6%, respectively). Canada and the US showed diabetes awareness (88.2% vs 86.8%) and treatment rates (82.3% vs 82.5%) above target. However, glucose control was suboptimal in Canada (35.3%), and below target in the US (58.8%). There was a modest decline in absolute smoking prevalence rates in Canada from 1999 to 2013 (25.2% to 14.6%). Screening for tobacco use (72.2%) and counselling rates (73.8%) in the US were above target. Substantial variation exists in cardiovascular risk factor care across North America. Standardized reporting, dissemination of practice guidelines, and setting explicit goal-directed targets for performance might facilitate improvement. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  1. Nuclear waste transportation package testing: A review of selected programs in the United States and abroad

    International Nuclear Information System (INIS)

    Snedeker, D.F.

    1990-12-01

    This report provides an overview of some recent nuclear waste transportation package development programs. This information is intended to aid the State of Nevada in its review of US Department of Energy (DOE) nuclear waste transportation programs. This report addresses cask testing programs in the United Kingdom and selected 1/4 and full scale testing in the US. Facilities that can provide cask testing services, both in the US and to a limited extent abroad, are identified. The costs for different type test programs are identified as a means to estimate costs for future test programs. Not addressed is the public impact such testing might have in providing an increased sense of safety or confidence. The British test program was apparently quite successful in demonstrating safety to the public at the time. There is no US test effort that is similar in scope for direct comparison. Also addressed are lessons learned from testing programs and areas that may merit possible future integrated examination. Areas that may require further examination are both technical and institutional. This report provides information which, when combined with other sources of information will enable the State of Nevada to assess the following areas: feasibility of full scale testing; costs of full scale tests; potential benefits of testing; limits that full scale testing impose; and disadvantages of emphasis on testing vs analytical solutions. This assessment will then allow the state to comment on DOE Office of Civilian Radioactive Waste Management (OCRWM) plans for the development and licensing of new shipping cask designs. These plans currently expect contractors to perform engineering testing for materials development, quarter scale model testing to validate analytical assessments and full scale prototype testing of operational features. DOE currently plans no full scale or extra-regulatory destructive testing to aid in cask licensing. 1 tab

  2. Cost of diabetic foot in France, Spain, Italy, Germany and United Kingdom: A systematic review.

    Science.gov (United States)

    Tchero, Huidi; Kangambega, Pauline; Lin, Lucien; Mukisi-Mukaza, Martin; Brunet-Houdard, Solenne; Briatte, Christine; Retali, Gerald Reparate; Rusch, Emmanuel

    2018-04-01

    Cost estimates for diabetic foot are available for developed countries based on cost data for different years. This study aimed to provide a comparison of the cost of diabetic foot in E5 (France, Spain, Italy, Germany, and the United Kingdom) and its characteristics across different conditions. PubMed, Central and Embase databases were searched in February 2017 for English language publications. Bibliographies of relevant papers were also searched manually. Reviews and research papers from E5 regions reporting on cost of diabetic foot were included. Reported cost was converted to equivalent 2016 $ for comparison purposes. All the costs presented are mean cost per patient per year in 2016 $. Nine studies were included in the analysis. The total cost of amputation ranged from $ 15,046 in 2001 to $ 38,621 in 2005. The direct cost of amputation ranged from $ 13,842 in 2001 to $ 83,728 during 2005-2009. Indirect cost of amputation was more uniform, ranging from between $ 1,043 to $ 1,442. The direct cost of gangrene ranged from $ 3,352 in 2003 to $ 8,818 in Germany. Although, for the same year, 2003, the cost for Spain was almost double that for Germany. The total cost of an uninfected ulcer was $ 6,174 in 2002, but increased to $ 14,441 in 2005; for an infected ulcer the cost increased from $ 2,637 to $ 2,957. The different countries showed variations in the components used to calculate the cost of diabetic foot. The E5 incurs a heavy cost from diabetic foot and its complications. There is an unmet need for the identification of cost-cutting strategies, as diabetic foot costs more than major cardiac diseases. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Review of Technical Studies in the United States in Support of Burnup Credit Regulatory Guidance

    International Nuclear Information System (INIS)

    Wagner, John C.; Parks, Cecil V.; Mueller, Don; Gauld, Ian C.

    2010-01-01

    Taking credit for the reduction in reactivity associated with fuel depletion can enable more cost-effective, higher-density storage, transport, disposal, and reprocessing of spent nuclear fuel (SNF) while maintaining sufficient subcritical margin to establish an adequate safety basis. Consequently, there continues to be considerable interest in the United States (U.S.), as well as internationally, in the increased use of burnup credit in SNF operations, particularly related to storage, transport, and disposal of commercial SNF. This interest has motivated numerous technical studies related to the application of burnup credit, both domestically and internationally, as well as the design of SNF storage, transport and disposal systems that rely on burnup credit for maintaining subcriticality. Responding to industry requests and needs, the U.S. Nuclear Regulatory Commission (NRC) initiated a burnup credit research program in 1999, with support from the Oak Ridge National Laboratory (ORNL), to develop regulatory guidance and the supporting technical bases for allowing and expanding the use of burnup credit in pressurized-water reactor SNF storage and transport applications. Although this NRC research program has not been continuous since its inception, considerable progress has been achieved in many key areas in terms of increased understanding of relevant phenomena and issues, availability of relevant information and data, and subsequently updated regulatory guidance for expanded use of burnup credit. This paper reviews technical studies performed by ORNL for the U.S. NRC burnup credit research program. Examples of topics include reactivity effects associated with reactor operating characteristics, fuel assembly characteristics, burnable absorbers, control rods, spatial burnup distributions, cooling time, and assembly misloading; methods and data for validation of isotopic composition predictions; methods and data for validation of criticality calculations; and

  4. Entrepreneurial nurses and midwives in the United Kingdom: an integrative review.

    Science.gov (United States)

    Drennan, Vari; Davis, Kathy; Goodman, Claire; Humphrey, Charlotte; Locke, Rachel; Mark, Annabelle; Murray, Susan F; Traynor, Michael

    2007-12-01

    This paper is a report of an integrative literature review to investigate: (a) the extent of entrepreneurial activity by nurses, midwives and health visitors in the United Kingdom and (b) the factors that influenced these activities. Internationally, social and commercial entrepreneurial activity is regarded as important for economic growth and social cohesion. Seventeen bibliographic databases were searched using single and combined search terms: 'entrepreneur$', 'business', 'private practice', 'self-employ$', 'intrapreneur$''social enterprise$''mutuals', 'collectives', 'co-op' and 'social capital' which were related to a second layer of terms 'Nurs$', 'Midwi$', 'Visit$'. 'Entrepreneur$' Private Midwi$, Independent Midwi$, and 'nursing workforce'. In addition, hand searches of non-indexed journals and grey literature searches were completed. The following inclusion criteria were: (a) describing nurses, midwife and/or health visitor entrepreneurship (b) undertaken in the UK, and (c) reported between January 1996 and December 2005. Of 154 items included only three were empirical studies; the remainder were narrative accounts. While quality of these accounts cannot be verified, they provide as complete an account as possible in this under-researched area. The numbers of nurses, midwives and health visitors acting entrepreneurially were very small and mirror international evidence. A categorization of entrepreneurial activity was inductively constructed by employment status and product offered. 'Push' and 'pull' influencing factors varied between types of entrepreneurial activity. Empirical investigation into the extent to which nurses and midwives respond to calls for greater entrepreneurialism should take account of the complex interplay of contextual factors (e.g. healthcare legislation), professional and managerial experience and demographic factors.

  5. Pharmacogenomics and pharmacogenetics for the intensive care unit: a narrative review.

    Science.gov (United States)

    MacKenzie, Meghan; Hall, Richard

    2017-01-01

    Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. We selected relevant literature to illustrate the important concepts contained within. Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach. Genetic variability in response to drugs may occur as a result of alterations of drug-metabolizing (cytochrome P [CYP]) enzymes, receptors, and transport proteins leading to enhancement or delay in the therapeutic response. Of relevance to the ICU, genetic variation in CYP-450 isoenzymes results in altered effects of midazolam, fentanyl, morphine, codeine, phenytoin, clopidogrel, warfarin, carvedilol, metoprolol, HMG-CoA reductase inhibitors, calcineurin inhibitors, non-steroidal anti-inflammatory agents, proton pump inhibitors, and ondansetron. Changes in cholinesterase enzyme function may affect the disposition of succinylcholine, benzylisoquinoline muscle relaxants, remifentanil, and hydralazine. Genetic variation in transport proteins leads to differences in the response to opioids and clopidogrel. Polymorphisms in drug receptors result in altered effects of β-blockers, catecholamines, antipsychotic agents, and opioids. Genetic variation also contributes to the diversity and incidence of diseases and conditions such as sepsis, malignant hyperthermia, drug-induced hypersensitivity reactions, cardiac channelopathies, thromboembolic disease, and congestive heart failure. Application of pharmacogenetics and pharmacogenomics has seen improvements in drug therapy. Ongoing study and incorporation of these concepts into clinical decision making in the ICU has the potential to affect patient outcomes.

  6. KC-46 Tanker Modernization: Delivery of First Fully Capable Aircraft Has Been Delayed over One Year and Additional Delays Are Possible

    Science.gov (United States)

    2017-03-01

    will then allow Boeing to complete remaining developmental flight tests and meet other key milestones . Program officials do not consider the WARP...a break in production while it completes developmental and operational testing. The program expects to begin delivering these aircraft in 2018 and...there have been no requirements changes and there have been fewer engineering changes than expected . Total Acquisition Cost Estimate for the KC-46

  7. Uncovering the decision-making work of transferring dying patients home from critical care units: An integrative review.

    Science.gov (United States)

    Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

    2017-12-01

    To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.

  8. Pengaruh Diameter Partikel Terhadap Konsentrasi L-Dopa, Kc Dan De Pada Ekstraksi L-Dopa Dari Biji Kara Benguk (Mucuna Pruriens Dc.

    Directory of Open Access Journals (Sweden)

    Eni Budiyati

    2013-10-01

    Full Text Available Mucuna pruriens (biji kara benguk merupakan tanaman penghasil bahan obat-obatan karena mengandung senyawa L-Dopa. Senyawa tersebut dapat digunakan untuk pengobatan penyakit gangguan syaraf, anti bisa ular, meningkatkan bobot dan kekuatan otot, vitalitas seksual pria, zat anti-aging dan obat cacing pada manusia. Penelitian ini bertujuan untuk mengekstraksi L- Dopa dari biji kara benguk dengan menggunakan pelarut air. Di samping itu, penelitian ini juga mengevaluasi pengaruh dari diameter partikel terhadap konsentrasi L- dopa hasil ekstraksi, koefisien transfer massa (kC, dan difusivitas efektif (De. Tahapan yang digunakan pada penelitian ini adalah, persiapan bahan baku, proses ekstraksi, dan analisis L-Dopa. Proses ekstraksi dilakukan dalam tangki yang dilengkapi dengan thermometer. Analisis L-Dopa dilakukan dengan dengan High Performance Liquid Chromatography (HPLC. Hasil penelitian menunjukkan bahwa semakin kecil diameter partikel maka konsentrasi L-Dopa terekstrak semakin besar. Konsentrasi tertinggi diperoleh pada diameter partikel 0,5 mm yaitu 1739,56 ppm. Nilai difusivitas efektif (De untuk variabel diameter partikel (0,5; 0,675; 2,18; dan 2,5 mm hampir sama yaitu 2,99.10–5 sampai 3,07.10–5 cm2/menit. Sedangkan nilai koefisien transfer massa (kC berbanding terbalik dengan diameter partikel. Nilai kC berkisar antara 2,83.10-2 sampai 3,98.10-2 g/cm2.menit. 

  9. A systematic review of instruments for assessing parent satisfaction with family-centred care in neonatal intensive care units.

    Science.gov (United States)

    Dall'Oglio, Immacolata; Mascolo, Rachele; Gawronski, Orsola; Tiozzo, Emanuela; Portanova, Anna; Ragni, Angela; Alvaro, Rosaria; Rocco, Gennaro; Latour, Jos M

    2018-03-01

    This systematic review synthesised and described instruments measuring parent satisfaction with the increasing standard practice of family-centred care (FCC) in neonatal intensive care units. We evaluated 11 studies published from January 2006 to March 2016: two studies validated a parent satisfaction questionnaire, and nine developed or modified previous questionnaires to use as outcome measures in their local settings. Most instruments were not tested on reliability and validity. Only two validated instruments included all six of the FCC principles and could assess parent satisfaction with FCC in neonatal intensive care units and be considered as outcome indicators for further research. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  10. The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review

    OpenAIRE

    Mol, Margo; Kompanje, Erwin; Benoit, Dominique; Bakker, Jan; Nijkamp, Marjan; Seedat, Soraya

    2015-01-01

    textabstractBackground: Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health. Purpose: The purpose of this review is to evaluate the literature related...

  11. Risks of serious complications and death from smallpox vaccination: A systematic review of the United States experience, 1963–1968

    OpenAIRE

    Aragón, Tomás J; Ulrich, Skylar; Fernyak, Susan; Rutherford, George W

    2003-01-01

    Abstract Background The United States (US) has re-instituted smallpox vaccinations to prepare for an intentional release of the smallpox virus into the civilian population. In an outbreak, people of all ages will be vaccinated. To prepare for the impact of large-scale ring and mass vaccinations, we conducted a systematic review of the complication and mortality risks of smallpox vaccination. We summarized these risks for post-vaccinial encephalitis, vaccinia necrosum (progressive vaccinia), e...

  12. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health

    OpenAIRE

    Gutierrez, Kristie S.; LePrevost, Catherine E.

    2016-01-01

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are ...

  13. Severe imported malaria in an intensive care unit: a review of 59 cases

    Directory of Open Access Journals (Sweden)

    Santos Lurdes C

    2012-03-01

    Full Text Available Abstract Background In view of the close relationship of Portugal with African countries, particularly former Portuguese colonies, the diagnosis of malaria is not a rare thing. When a traveller returns ill from endemic areas, malaria should be the number one suspect. World Health Organization treatment guidelines recommend that adults with severe malaria should be admitted to an intensive care unit (ICU. Methods Severe cases of malaria in patients admitted to an ICU were reviewed retrospectively (1990-2011 and identification of variables associated with in-ICU mortality performed. Malaria prediction score (MPS, malaria score for adults (MSA, simplified acute physiology score (SAPSII and a score based on WHO's malaria severe criteria were applied. Statistical analysis was performed using StataV12. Results Fifty nine patients were included in the study, all but three were adults; 47 (79,6% were male; parasitaemia on admission, quantified in 48/59 (81.3% patients, was equal or greater than 2% in 47 of them (97.9%; the most common complications were thrombocytopaenia in 54 (91.5% patients, associated with disseminated intravascular coagulation (DIC in seven (11.8%, renal failure in 31 (52.5% patients, 18 of which (30.5% oliguric, shock in 29 (49.1% patients, liver dysfunction in 27 (45.7% patients, acidaemia in 23 (38.9% patients, cerebral dysfunction in 22 (37.2% patients, 11 of whom with unrousable coma, pulmonary oedema/ARDS in 22 (37.2% patients, hypoglycaemia in 18 (30.5% patients; 29 (49.1% patients presented five or more dysfunctions. The case fatality rate was 15.2%. Comparing the four scores, the SAPS II and the WHO score were the most sensitive to death prediction. In the univariate analysis, death was associated with the SAPS II score, cerebral malaria, acute renal and respiratory failure, DIC, spontaneous bleeding, acidosis and hypoglycaemia. Age, partial immunity to malaria, delay in malaria diagnosis and the level of parasitaemia were

  14. Occurrence of human pharmaceuticals in water resources of the United States: A review

    Science.gov (United States)

    Focazio, M.J.; Kolpin, D.W.; Furlong, E.T.

    2004-01-01

    The widespread environmental presence of some pharmaceuticals and other organic wastewater compounds has been documented globally (e.g. Buser et al. 1998; Ternes 1998; Stumpf et al.1999; Heberer et al. 2001; Kümmerer 2001; Ternes et al. 2001; Scheytt et al. 2001; Golet et al. 2002; Kolpin et al. 2002; Boyd et al. 2003; Metcalf et al. 2003). Recently, there have been several literature reviews and summary studies of the occurrence, fate, transport, and treatment of targeted human pharmaceuticals in wastewater effluent and associated environmental waters across the globe (e.g. Daughton and Ternes 1999; Sedlak et al. 2000; Suter and Giger 2000; Daughton and Jones-Lepp 2001; Jones et al. 2001; Heberer 2002; and Drewes et al. 2002). The occurrence of pharmaceutical compounds in water resources is explained by their ubiquitous use, excretion of large percentages of the mass consumed, and incomplete removal during wastewater treatment (Stumpf et al.1999). The recent increase in detection of trace concentrations (typically less than a part per billion) of pharmaceuticals in water resources across the globe reflects improvements in laboratory analytical methods (Sedlak et al. 2000) and the associated increases in field surveys. The detection of pharmaceutical compounds in large rivers in Europe and in the North Sea (Buser et al. 1998; Ternes 1998; Stumpf et al. 1999) highlighted the fact that highly soluble, trace organic compounds, such as pharmaceuticals, may escape removal in wastewater treatment, and the mixing and concentration of wastewaters through conventional wastewater treatment processes could provide a means of delivering these chemicals to environmental waters in a manner that would contaminate water resources on a large scale at trace levels (Richardson and Bowron 1985). In the United States, some of the first detections of a limited number of pharmaceutically active compounds or their transformation products were found in waters associated with landfill

  15. Pain: A content review of undergraduate pre-registration nurse education in the United Kingdom.

    Science.gov (United States)

    Mackintosh-Franklin, Carolyn

    2017-01-01

    Pain is a global health issue with poor assessment and management of pain associated with serious disability and detrimental socio economic consequences. Pain is also a closely associated symptom of the three major causes of death in the developed world; Coronary Heart Disease, Stroke and Cancer. There is a significant body of work which indicates that current nursing practice has failed to address pain as a priority, resulting in poor practice and unnecessary patient suffering. Additionally nurse education appears to lack focus or emphasis on the importance of pain assessment and its management. A three step online search process was carried out across 71 Higher Education Institutes (HEIs) in the United Kingdom (UK) which deliver approved undergraduate nurse education programmes. Step one to find detailed programme documentation, step 2 to find reference to pain in the detailed documents and step 3 to find reference to pain in nursing curricula across all UK HEI websites, using Google and each HEIs site specific search tool. The word pain featured minimally in programme documents with 9 (13%) documents making reference to it, this includes 3 occurrences which were not relevant to the programme content. The word pain also featured minimally in the content of programmes/modules on the website search, with no references at all to pain in undergraduate pre-registration nursing programmes. Those references found during the website search were for continuing professional development (CPD) or Masters level programmes. In spite of the global importance of pain as a major health issue both in its own right, and as a significant symptom of leading causes of death and illness, pain appears to be a neglected area within the undergraduate nursing curriculum. Evidence suggests that improving nurse education in this area can have positive impacts on clinical practice, however without educational input the current levels of poor practice are unlikely to improve and unnecessary

  16. Cooperative Fish and Wildlife Research Units Program—2016 year in review

    Science.gov (United States)

    Organ, John F.; Thompson, John D.; Dennerline, Donald E.; Childs, Dawn E.

    2017-02-22

    SummaryThe Cooperative Fish and Wildlife Research Units (CRU) Program had a productive year in 2016. Despite vacancies in our scientist ranks exceeding 20 percent, our research, training, and teaching portfolio was full and we graduated 93 students and published 398 manuscripts primarily focused on addressing the real conservation challenges of our cooperators. As I’ve stated before, our mission is our legacy: meeting the actionable science needs of our cooperators, providing them technical guidance and assistance in interpreting and applying new advances in science, and developing the future workforce through graduate education and mentoring. Our scientists and the manner in which they approach our mission continue to inspire me. The most rewarding part of my job is meeting and engaging with the students they recruit—the conservation professionals of the future. I cannot help but feel uplifted after discussions with and presentations by these young men and women. Personally, I owe my place in the profession today to the mentoring I received as a CRU student, and today’s CRU scientists have raised the bar. It gives me hope for the future of conservation, and added motivation to see our vacancies filled so that we can expand our portfolio.The National Cooperators’ Coalition has been active and is strategically working to build support on our behalf. Sincere thanks to the American Fisheries Society, the Association of Fish and Wildlife Agencies, the Boone and Crockett Club, the National Association of University Fish and Wildlife Programs, the Wildlife Management Institute, and The Wildlife Society for their efforts and those of their affiliated members.We co-sponsored a workshop at the 2016 North American Wildlife and Natural Resources Conference along with the American Fisheries Society, the Association of Fish and Wildlife Agencies, the Wildlife Management Institute, and The Wildlife Society, titled “Barriers and Bridges in Reconnecting Natural Resources

  17. Bench-to-bedside review: leadership and conflict management in the intensive care unit.

    Science.gov (United States)

    Strack van Schijndel, Rob J M; Burchardi, Hilmar

    2007-01-01

    In the management of critical care units, leadership and conflict management are vital areas for the successful performance of the unit. In this article a practical approach to define competencies for leadership and principles and practices of conflict management are offered. This article is, by lack of relevant intensive care unit (ICU) literature, not evidence based, but it is the result of personal experience and a study of literature on leadership as well on conflicts and negotiations in non-medical areas. From this, information was selected that was recognisable to the authors and, thus, also seems to be useful knowledge for medical doctors in the ICU environment.

  18. A Unit on "Fahrenheit 451" That Uses Cooperative Learning (Resources and Reviews).

    Science.gov (United States)

    Ebbers, Frances A.

    1991-01-01

    Provides a curriculum unit using the novel "Fahrenheit 451" to provide student-centered activities based on solid pedagogical methodology. Emphasizes value-centered analysis of the novel, comparison of alternative arguments, and integration of cooperative learning activities. (PRA)

  19. A Review Of The History Of Gender Equality In The United States Of America

    OpenAIRE

    Wedad Andrada Quffa

    2016-01-01

    Gender inequality is one of the important challenges in all modern societies, the United States of America being no exception, despite the progress and significant advances that have been made in the past century. There still is a significant gender gap in many areas - most notable being the pay gap, social norms and practices, education, political participation and social institutions. The present article aims to analyse the legal framework and social framework that has evolved in the United...

  20. Organisation and experience of the regulatory review in the United Kingdom

    International Nuclear Information System (INIS)

    Gausden, R.; Woods, P.B.

    1979-01-01

    Regulatory requirements and stages of the review in the UK are outlined. The organisation, management and working procedures of the Inspectorate are described and the effort and timescale which have been found necessary for a satisfactory safety review is discussed. A number of problem areas in the review situation have been identified from experience and these are discussed and possible solutions proposed. They include the importance of early review of generic aspects of systems which are being considered for licensing, the place of safety principles and of detailed engineering assessment in the review process, the independence of the regulatory group's activities in its study of major technical issues and the use which should be made of outside expertise. (auth.)

  1. Cooperative Fish and Wildlife Research Units Program—2017 year in review

    Science.gov (United States)

    Organ, John F.; Thompson, John D.; Dennerline, Donald E.; Childs, Dawn E.

    2018-02-08

    The Cooperative Fish and Wildlife Research Units Program was involved in a number of notable events during 2017, many concerning our personnel. Dr. Barry Grand left his position as Leader of the Alabama Cooperative Fish and Wildlife Research Unit to become the Cooperative Units Program Supervisor for the South, replacing Dr. Kevin Whalen who took over as Supervisor for the West. We welcomed Dr. Sarah Converse who left the Patuxent Wildlife Research Center to become Leader of the Washington Cooperative Fish and Wildlife Research Unit. Dr. Amanda Rosenberger joined the Tennessee Cooperative Fishery Research Unit as Assistant Leader, transferring from the Missouri Cooperative Unit. Dr. Scott Carleton left his position as Assistant Unit Leader in New Mexico to become Chief of the Region 2 Migratory Bird Program of the U.S. Fish and Wildlife Service.We said farewell to many colleagues who retired. Their departure is bittersweet as we wish them health, happiness, and wellness in retirement. We will miss their companionship and the extraordinary contributions they have made to the Cooperative Fish and Wildlife Research Units Program and conservation.The Cooperative Fish and Wildlife Research Units Program has a record high number of vacant scientist positions due to a combination of retirements and base funding short-falls. These issues are affecting our ability to meet cooperator needs. Yet, we remain highly productive. For example, this year we released a report (https://doi.org/10.3133/cir1427) containing abstracts of nearly 600 of our research projects, covering thematic areas ranging from advanced technologies to wildlife diseases. We provided highly competent, trained scientists and natural resource managers for our cooperators’ workforce. We delivered technical training and guidance to professional practitioners. We provided critical information to cooperators for decisions on species status assessments and management of species of greatest conservation need

  2. Prospective gas turbine and combined-cycle units for power engineering (a Review)

    Science.gov (United States)

    Ol'khovskii, G. G.

    2013-02-01

    The modern state of technology for making gas turbines around the world and heat-recovery combined-cycle units constructed on their basis are considered. The progress achieved in this field by Siemens, Mitsubishi, General Electric, and Alstom is analyzed, and the objectives these companies set forth for themselves for the near and more distant future are discussed. The 375-MW gas turbine unit with an efficiency of 40% produced by Siemens, which is presently the largest one, is subjected to a detailed analysis. The main specific features of this turbine are that the gas turbine unit's hot-path components have purely air cooling, due to which the installation has enhanced maneuverability. The single-shaft combined-cycle plant constructed on the basis of this turbine has a capacity of 570 MW and efficiency higher than 60%. Programs adopted by different companies for development of new-generation gas turbine units firing synthesis gas and fitted with low-emission combustion chambers and new cooling systems are considered. Concepts of rotor blades for new gas turbine units with improved thermal barrier coatings and composite blades different parts of which are made of materials selected in accordance with the conditions of their operation are discussed.

  3. A systematic review evaluating the role of nurses and processes for delivering early mobility interventions in the intensive care unit.

    Science.gov (United States)

    Krupp, Anna; Steege, Linsey; King, Barbara

    2018-04-19

    To investigate processes for delivering early mobility interventions in adult intensive care unit patients used in research and quality improvement studies and the role of nurses in early mobility interventions. A systematic review was conducted. Electronic databases PubMED, CINAHL, PEDro, and Cochrane were searched for studies published from 2000 to June 2017 that implemented an early mobility intervention in adult intensive care units. Included studies involved progression to ambulation as a component of the intervention, included the role of the nurse in preparing for or delivering the intervention, and reported at least one patient or organisational outcome measure. The System Engineering Initiative for Patient Safety (SEIPS) model, a framework for understanding structure, processes, and healthcare outcomes, was used to evaluate studies. 25 studies were included in the final review. Studies consisted of randomised control trials, prospective, retrospective, or mixed designs. A range of processes to support the delivery of early mobility were found. These processes include forming interdisciplinary teams, increasing mobility staff, mobility protocols, interdisciplinary education, champions, communication, and feedback. Variation exists in the process of delivering early mobility in the intensive care unit. In particular, further rigorous studies are needed to better understand the role of nurses in implementing early mobility to maintain a patient's functional status. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. A review of the United Kingdom fast reactor programme: March 1987

    International Nuclear Information System (INIS)

    Bramman, J.I.; Wheeler, R.C.

    1987-03-01

    The UK fast reactor programme is reviewed under the following headings: Progress with PFR; Reprocessing; Commercial Design Studies: Structural Integrity; Engineering and Components; Materials; Sodium Chemistry; Core and Fuel; Safety; Plant Performance Studies. (U.K.)

  5. Book Review: The Modern School Movement: Anarchism and Education in the United States, by Paul Avrich.

    Science.gov (United States)

    Goodenow, Ronald K.

    1981-01-01

    Reviews the Modern School Movement, a history of the modern school movement that examines the Modern School Association, the Modern School at Shelton, New Jersey, its literary and educational journal, and the role of anarchism and radicalism in education. (APM)

  6. Three-dimensional ultrasound. Early personal experience with a dedicated unit and literature review

    International Nuclear Information System (INIS)

    Cesarani, F.; Isolato, G.; Capello, S.; Bianchi, S.D.

    1999-01-01

    The authors report our preliminary clinical experience with three-dimensional ultrasound (3D US) in abdominal and small parts imaging, comparing the yield of 3D versus 2D US and the through a literature review [it

  7. Review on evolvement of systems of ionizing radiation quantities and units

    International Nuclear Information System (INIS)

    Zheng Junzheng; Zeng Zhi

    2009-01-01

    To scientifically and practically measure the ionizing radiation in unison is an indispensable prerequisite and foundation for the extensive uses of nuclear science and technology, development of radiological protection and safety standards, as well as prevention and treatment of ionizing radiation hazards. Concerning about the quantities and units of ionizing radiation as well as their corresponding measurement and application methods, relevant international organizations and all countries in the world generally adopt the systems proposed by the International Commission on Radiation Units and Measurements (ICRU) which is a well recognized and authoritative academic organization.In the paper,the major evolutions of the systems for ionizing radiation quantities and units in the past decades are summarized. (authors)

  8. Report of the IPERS (International Peer Review Service) pre-review workshop for the Zaporozhye, Unit 5 nuclear power plant probabilistic safety assessment in Vienna, Austria 12 to 16 June 1995

    International Nuclear Information System (INIS)

    1995-01-01

    This report presents the results of the IAEA international peer review services pre-review workshop held in Vienna, 12 to 16 June 1995, which reviewed the status of the present version of the Probabilistic Safety Assessment (PSA) for the Zaporozhye, Unit 5, nuclear power plant. 3 refs, 1 fig., 1 tab

  9. Older people’s forums in the United Kingdom:Civic engagement and activism reviewed

    OpenAIRE

    Manthorpe, Jill; Harris, Jessica; Mauger, Sam

    2016-01-01

    PurposeThis paper reviews the literature on UK older people’s forums. Forums seek to influence statutory responses to ageing, and enable older people to speak up on matters important to them. The review examined three facets of forums: their membership, structures and effectiveness.MethodsMethods included searching databases, internet and specialist libraries for materials relating to older people’s forums. Key points were extracted and source material described but not subject to quality app...

  10. Understanding How Organized Youth Sport May Be Harming Individual Players within the Family Unit: A Literature Review

    Directory of Open Access Journals (Sweden)

    Corliss N. Bean

    2014-10-01

    Full Text Available Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little thus far has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of studies on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest, SPORTDiscus and Health, History, Management databases (EBSCOhost, Science, Social Science, Arts and Humanities on Web of Science (ISI, SCOPUS and Scirus (Elsevier. Results show the darker side of organized sport for actors within the family unit. A model is proposed to explain under which circumstances sport leads to positive versus negative outcomes, ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health.

  11. The quality of work life of registered nurses in Canada and the United States: a comprehensive literature review.

    Science.gov (United States)

    Nowrouzi, Behdin; Giddens, Emilia; Gohar, Basem; Schoenenberger, Sandrine; Bautista, Mary Christine; Casole, Jennifer

    2016-10-01

    Workplace environment is related to the physical and psychological well-being, and quality of work life (QWL) for nurses. The aim of this paper was to perform a comprehensive literature review on nurses' quality of work life to identify a comprehensive set of QWL predictors for nurses employed in the United States and Canada. Using publications from 2004-2014, contributing factors to American and Canadian nurses' QWL were analyzed. The review was structured using the Work Disability Prevention Framework. Sixty-six articles were selected for analysis. Literature indicated that changes are required within the workplace and across the health care system to improve nurses' QWL. Areas for improvement to nurses' quality of work life included treatment of new nursing graduates, opportunities for continuing education, promotion of positive collegial relationships, stress-reduction programs, and increased financial compensation. This review's findings support the importance of QWL as an indicator of nurses' broader work-related experiences. A shift in health care systems across Canada and the United States is warranted where health care delivery and services are improved in conjunction with the health of the nurses working in the system.

  12. Climate Justice in Rural Southeastern United States: A Review of Climate Change Impacts and Effects on Human Health.

    Science.gov (United States)

    Gutierrez, Kristie S; LePrevost, Catherine E

    2016-02-03

    Climate justice is a local, national, and global movement to protect at-risk populations who are disproportionately affected by climate change. The social context for this review is the Southeastern region of the United States, which is particularly susceptible to climate change because of the geography of the area and the vulnerabilities of the inhabiting populations. Negative human health effects on variable and vulnerable populations within the Southeast region due to changing climate are concerning, as health threats are not expected to produce parallel effects among all individuals. Vulnerable communities, such as communities of color, indigenous people, the geographically isolated, and those who are socioeconomically disadvantaged and already experiencing poor environmental quality, are least able to respond and adapt to climate change. Focusing on vulnerable populations in the Southeastern United States, this review is a synthesis of the recent (2010 to 2015) literature-base on the health effects connected to climate change. This review also addresses local and regional mitigation and adaptation strategies for citizens and leaders to combat direct and indirect human health effects related to a changing climate.

  13. Understanding How Organized Youth Sport May Be Harming Individual Players within the Family Unit: A Literature Review

    Science.gov (United States)

    Bean, Corliss N.; Fortier, Michelle; Post, Courtney; Chima, Karam

    2014-01-01

    Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little thus far has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of studies on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. A model is proposed to explain under which circumstances sport leads to positive versus negative outcomes, ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health. PMID:25275889

  14. Analysis of the Air Force Logistics Enterprise. Evaluation of Global Repair Network Options for Supporting the F-16 and KC-135

    Science.gov (United States)

    2009-01-01

    Redford, NGB/A4R, Col Dave Whipple , ANG Advisor to AF/A4M, Col Tom Murgatroyd, ANG Advisor to AMC/ A4, and Col Chuck Melton, ANG Advisor to ACC/A4...necessary to support home-station operations. For more details on this calcula- tion procedure , see Appendix E. Based on our extension of these AMC KC-135... procedure discussed in this appendix. RAND’s source for UMD manpower authorizations data is the end-of-month MPES data extract, which we obtain from

  15. A Review Of The History Of Gender Equality In The United States Of America

    Directory of Open Access Journals (Sweden)

    Wedad Andrada Quffa

    2016-12-01

    Full Text Available Gender inequality is one of the important challenges in all modern societies, the United States of America being no exception, despite the progress and significant advances that have been made in the past century. There still is a significant gender gap in many areas - most notable being the pay gap, social norms and practices, education, political participation and social institutions. The present article aims to analyse the legal framework and social framework that has evolved in the United States of America in order to diminish or completely abolish gender inequality and discrimination. After the 1920 ratification of the Nineteenth Amendment to the Constitution of the United States of America, which empowered women with political rights, there was a proposed amendment to the Constitution to guarantee equal rights for women, first introduced in Congress in 1923, passed by both houses in 1972, but which failed ratification - only 35 out of the 38 states needed ratified the amendment before the deadline - 1979, which later was extended to 1982. The United States has since taken some steps in reducing the gender gap and stopping gender discrimination

  16. "Index for Inclusion": A Framework for School Review in the United Arab Emirates

    Science.gov (United States)

    Alborno, Nadera Emran; Gaad, Eman

    2014-01-01

    This study uses the "Index for Inclusion", developed by Booth and Ainscow, as a framework for investigating inclusive provision in the United Arab Emirates (UAE), introduced through the "School for All" initiative. The study, by Nadera Emran Alborno of the American University in Dubai and Eman Gaad of the British University in…

  17. Human Health Impacts of Forest Fires in the Southern United States: A Literature Review

    Science.gov (United States)

    Cynthia T. Fowler

    2003-01-01

    Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners federal, state, andprivate forests is to crap ecosystem management plans that simultaneously optimize forest health and human health. Fire-a major forest management issue in the United States-complicates these goals. Wildfires are natural phenomena with...

  18. Progress and outcomes of health systems reform in the United Arab Emirates: A systematic review

    NARCIS (Netherlands)

    E.J. Koornneef (Erik J.); P.B.M. Robben (Paul); Blair, I. (Iain)

    2017-01-01

    textabstractBackground: The United Arab Emirates (UAE) government aspires to build a world class health system to improve the quality of healthcare and the health outcomes for its population. To achieve this it has implemented extensive health system reforms in the past 10 years. The nature, extent

  19. Review of the desalinated water market in France for small units

    International Nuclear Information System (INIS)

    Dutheil, F.; Malissen, M.

    1969-01-01

    On the initiative of and in close collaboration with the Commissariat a l'Energie Atomique, the Societe pour la Conversion et le Developpement Industriel (SODIC) has carried out a very general study of the coastal regions of France in which the short, medium and long-term prospects of the demand for water, and the cost of the necessary supplies, could possibly make desalination units of 3 000 to 10 000 m3/day competitive. So far this general enquiry, which went into detail on some particular aspects, has not revealed any very clear possibilities in this respect, except in the case of the small islands, and of units of much lower capacity, as well as that of large units on the coast, which would benefit from the size effect. However the probable difference between the cost of desalinated water and the high selling price already applying in a small number of coastal regions is relatively small. It might therefore be worthwhile and relatively inexpensive to install an experimental desalination unit in the near future. (author) [fr

  20. Technical cooperation on nuclear security between the United States and China : review of the past and opportunities for the future.

    Energy Technology Data Exchange (ETDEWEB)

    Pregenzer, Arian Leigh

    2011-12-01

    The United States and China are committed to cooperation to address the challenges of the next century. Technical cooperation, building on a long tradition of technical exchange between the two countries, can play an important role. This paper focuses on technical cooperation between the United States and China in the areas of nonproliferation, arms control and other nuclear security topics. It reviews cooperation during the 1990s on nonproliferation and arms control under the U.S.-China Arms Control Exchange, discusses examples of ongoing activities under the Peaceful Uses of Technology Agreement to enhance security of nuclear and radiological material, and suggests opportunities for expanding technical cooperation between the defense nuclear laboratories of both countries to address a broader range of nuclear security topics.

  1. The occurrence of adverse events potentially attributable to nursing care in medical units: cross sectional record review.

    Science.gov (United States)

    D'Amour, Danielle; Dubois, Carl-Ardy; Tchouaket, Eric; Clarke, Sean; Blais, Régis

    2014-06-01

    Ensuring the safety of hospitalized patients remains a major challenge for healthcare systems, and nursing services are at the center of hospital care. Yet our knowledge about safety of nursing care is quite limited. In fact, most earlier studies examined one, or at most two, indicators, thus presenting an incomplete picture of safety at an institutional or broader level. Furthermore, methodologies have differed from one study to another, making benchmarking difficult. The aim of this study was to describe the frequencies of six adverse events widely considered in the literature to be nursing-sensitive outcomes and to estimate the degree to which these events could be attributed to nursing care. Cross-sectional review of charts of 2699 patients hospitalized on 22 medical units in 11 hospitals in Quebec, Canada. The events included: pressure sores, falls, medication administration errors, pneumonias, urinary infections, and inappropriate use of restraints. Experienced nurse reviewers abstracted patients' charts based on a grid developed for the study. Patient-level risk for at least one of these six adverse events was 15.3%, ranging from 9% to 28% across units. Of the 412 patients who experienced an event, 30% experienced two or more, for a total of 568 events. The risk of experiencing an adverse event with consequences was 6.2%, with a unit-level range from 3.2% to 13.5%. Abstractors concluded that 76.8% of the events were attributable to nursing care. While the measurement approach adopted here has limitations stemming from reliance on review of documentation, it provided a practical means of assessing several nursing-sensitive adverse events simultaneously. Given that patient safety issues are so complex, tracking their prevalence and impact is important, as is finding means of evaluating progress in reducing them. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  2. Thermal treatment of solid residues from WtE units: A review

    Energy Technology Data Exchange (ETDEWEB)

    Lindberg, Daniel, E-mail: daniel.lindberg@abo.fi; Molin, Camilla, E-mail: camilla.molin@abo.fi; Hupa, Mikko, E-mail: mikko.hupa@abo.fi

    2015-03-15

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field.

  3. Thermal treatment of solid residues from WtE units: A review

    International Nuclear Information System (INIS)

    Lindberg, Daniel; Molin, Camilla; Hupa, Mikko

    2015-01-01

    Highlights: • We review the thermal treatment methods for ashes and residues from WtE plants. • We review the results from extensive laboratory work on vitrification, melting and vaporization of ash. • We analyze the results from the extensive patent literature on thermal treatment. • We review industrial concepts for thermal treatment of ash. - Abstract: Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field

  4. Federally Chartered Corporation: Review of the Financial Statement Audit Reports for the Jewish War Veterans of the United States of America, Incorporated for Fiscal Years 1999 and 1998

    National Research Council Canada - National Science Library

    Steinhoff, Jeffrey

    2000-01-01

    As requested, we reviewed the audit reports covering the financial statements of the Jewish War Veterans of the United States of America, Incorporated, a federally chartered corporation, for the years...

  5. Federally Chartered Corporation: Review of the Financial Statement Audit Report for the Navy Club of the United States of America for Fiscal Year 1998

    National Research Council Canada - National Science Library

    2000-01-01

    As requested, the General Accounting Office (GAO) reviewed the audit report covering the financial statements of the Navy Club of the United States of America, a federally chartered corporation, for the fiscal year ended July 31, 1998...

  6. Human factors review of CFMS displays for Ulchin Nuclear Power Unit 3 and 4

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Baek, Seung Min; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Oh, In Suk; Lee, Joon Whan; Jung, Kwang Tae; Cha, Hye Young [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1996-11-01

    This report describes the human factors review of CFMS displays for Ulchin 3 and 4 by the following four subjects; At first, by reviewing issues regarding the design process of present CFMS, human factors engineering program plan (HFEPP) and human factors verification and validation plan Were proposed to accomplish the completeness of design word; Secondly, researches and developments were integrated into the review results at the point of suitability of CFMS design concept and basic function; For the third, availability and suitability were assessed according to human factors evaluation criteria on the CFMS display design, and overall effectiveness was also evaluated in parts; For the fourth, recommendations were made to human factors problems in accordance with their importance and an implementation plan was suggested for the resolution of problems. 54 refs., 34 tabs., 42 figs. (author)

  7. A comparative review between the updated models of Brazilian, United Kingdom and American eye banks and lamellar transplants

    Directory of Open Access Journals (Sweden)

    Gustavo Victor

    2014-12-01

    Full Text Available The corneal transplantation (CT is the most commonly performed type of transplant in the world and the Eye Banks are organizations whose capture, evaluate, preserve, store and distribute ocular tissues. With the evolution of surgical techniques and equipment for CT, the BOs had to evolve to keep up with these requirements. This evolution goes from tissues capture techniques, donating money and clarification to the patient (e.g. internet-based, use of current equipment for more adequate tissues supply for the most current surgical techniques, integration of BOs of certain country and real-time management of stocks of ocular tissues, and adequacy of laws that manage the entire process. This review aims to make a comparative review between the updated models of Brazilian, United Kingdon and American Eye Banks. Like, check what the trend towards lamellar transplants in these three countries.

  8. An approach for Periodic Safety Review (PSR) of units 5 and 6 of Kozloduy NPP

    International Nuclear Information System (INIS)

    Kichev, Emil

    2014-01-01

    Periodic Safety Reviews (PSR) is complementary to the routine and special safety reviews and does not replaced them. It determines the level of compliance with current safety requirements and covers all safety aspects of NPP operation and all equipment (SSCs) on site. Three levels of importance are defined for the documents in PSR (towards higher conservatism): Bulgarian documents; IAEA documents; Documents of manufactures and suppliers of the equipment (SSCs). The scope and activities consists of four stages and includes 14 safety factors (SF). Cooperation with external companies and organizations in areas with proved experience is used.

  9. A literature review of methods of analysis of organic analytes in radioactive wastes with an emphasis on sources from the United Kingdom

    International Nuclear Information System (INIS)

    Clauss, S.A.; Bean, R.M.

    1993-09-01

    This report, compiled by Pacific Northwest Laboratory (PNL), examines literature originating through the United Kingdom (UK) nuclear industry relating to the analyses of organic constituents of radioactive waste. Additionally, secondary references from the UK and other counties, including the United States, have been reviewed. The purpose of this literature review was to find analytical methods that would apply to the mixed-waste matrices found at Hanford

  10. Quality Assurance Peer Review Chart Rounds in 2011: A Survey of Academic Institutions in the United States

    International Nuclear Information System (INIS)

    Lawrence, Yaacov Richard; Whiton, Michal A.; Symon, Zvi; Wuthrick, Evan J.; Doyle, Laura; Harrison, Amy S.; Dicker, Adam P.

    2012-01-01

    Purpose: In light of concerns regarding the quality of radiation treatment delivery, we surveyed the practice of quality assurance peer review chart rounds at American academic institutions. Methods and Materials: An anonymous web-based survey was sent to the chief resident of each institution across the United States. Results: The response rate was 80% (57/71). The median amount of time spent per patient was 2.7 minutes (range, 0.6–14.4). The mean attendance by senior physicians and residents was 73% and 93%, respectively. A physicist was consistently present at peer review rounds in 66% of departments. There was a close association between attendance by senior physicians and departmental organization: in departments with protected time policies, good attendance was 81% vs. 31% without protected time (p = 0.001), and in departments that documented attendance, attending presence was 69% vs. 29% in departments without documentation (p 75% of institutions, whereas dosimetric details (beams, wedges), isodose coverage, intensity-modulated radiation therapy constraints, and dose–volume histograms were always peer reviewed in 63%, 59%, 42%, and 50% of cases, respectively. Chart rounds led to both minor (defined as a small multileaf collimator change/repeated port film) and major (change to dose prescription or replan with dosimetry) treatment changes. Whereas at the majority of institutions changes were rare (<10% of cases), 39% and 11% of institutions reported that minor and major changes, respectively, were made to more than 10% of cases. Conclusion: The implementation of peer review chart rounds seems inconsistent across American academic institutions. Brachytherapy and radiosurgical procedures are rarely reviewed. Attendance by senior physicians is variable, but it improves when scheduling clashes are avoided. The potential effect of a more thorough quality assurance peer review on patient outcomes is not known.

  11. Effectiveness of culturally tailored diabetes interventions for Asian immigrants to the United States: a systematic review.

    Science.gov (United States)

    Joo, Jee Young

    2014-01-01

    The purpose of this systematic review is to evaluate the effectiveness of tailoring community-based diabetes intervention to Asian immigrant cultures. The Cochrane processes and Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations guided this systematic review. PubMed, the Cumulative Index to Nursing and Allied Health Literature, Ovid, and PsycINFO were searched for analyses and syntheses of primary research published since 2000 that described interventions tailored for the cultures of Asian immigrants with diabetes. This search yielded a total of 9 articles published from 2005 to 2013. The Amsterdam-Maastricht Consensus List for Quality Assessment was used to assess the quality of the studies. Retrieved studies' populations were foreign-born adults >50 years of age with type 2 diabetes. The review revealed that culturally tailored diabetes programs are effective at improving patients' objectively measured clinical outcomes, in particular A1C levels, and psychobehavioral outcomes. Patients were also highly satisfied with bilingual health care providers and bilingual educational programs. There is strong evidence of the effectiveness of tailoring diabetes interventions to Asian immigrant populations' cultures. Further studies, including longitudinal studies and studies with rigorous research designs that subclassify Asian immigrants, are needed to encourage the implementation of culturally tailored diabetes intervention for this ethnic minority. © 2014 The Author(s).

  12. Stress ulcer prophylaxis in adult intensive care unit patients - a protocol for a systematic review

    DEFF Research Database (Denmark)

    Barbateskovic, M; Marker, S; Jakobsen, J C

    2018-01-01

    by consensus. We will perform conventional meta-analyses using Review Manager, and STATA 15, and we will assess the risk of random errors using Trial Sequential Analysis. Also, we will assess and report the overall quality of evidence for all outcomes according to GRADE. DISCUSSION: The evidence...

  13. Post-wildfire seeding in forests of the western United States: An evidence-based review

    Science.gov (United States)

    Donna Peppin; Peter Z. Fule; Carolyn Hull Sieg; Jan L. Beyers; Molly E. Hunter

    2010-01-01

    Broadcast seeding is one of the most widely used post-wildfire emergency response treatments intended to reduce soil erosion, increase vegetative ground cover, and minimize establishment and spread of non-native plant species. We conducted an evidence-based review to examine the effectiveness and effects of post-wildfire seeding treatments on soil stabilization, non-...

  14. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  15. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities

    International Nuclear Information System (INIS)

    Moyers, M. F.; Ibbott, G. S.; Grant, R. L.; Summers, P. A.; Followill, D. S.

    2014-01-01

    Purpose: Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Methods: Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Results: Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 N D,w based method gave results approximately 3% higher than both the ICRU 59 N X and ICRU 78 (TRS-398) N D,w based methods. Conclusions: Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 N X based and ICRU 78 (TRS-398) N D,w based methods but use of the ICRU 59 N D,w based method should not be allowed simultaneously with the other two until the difference is resolved

  16. Pengembangan Model Persediaan Continuous Review dengan All-Unit Discount dan Faktor Kadaluwarsa

    Directory of Open Access Journals (Sweden)

    Cherish Rikardo

    2017-06-01

    Full Text Available Paper ini membahas suatu model matematika untuk suatu sistem persediaan dengan mempertimbangkan adanya all-unit discount dan faktor kadaluwarsa. Permintaan barang bersifat deterministik yang merupakan fungsi dari waktu dan bergantung pada jumlah persediaan yang ada (inventory dependent demand, laju kadaluwarsa barang juga bergantung pada waktu dan tidak ada lead time. Model yang dibahas merupakan pengembangan dari Nagare dan Dutta [9] dengan menambah faktor all-unit discount dan laju kadaluwarsa yang bergantung pada waktu. Dari model yang dikembangkan akan ditentukan kuantitas pemesanan (economic order quantity dan waktu antar pemesanan yang optimum yang meminimumkan total biaya persediaan tahunan. Algoritma penentuan solusi optimum dari model yang dikembangkan dan contoh numerik sebagai ilustrasi dari permasalahan persediaan ini diberikan. Analisis sensitivitas model dengan melihat pengaruh laju kadaluwarsa dan laju permintaan terhadap kuantitas dan waktu antar pemesanan yang optimal juga diberikan. Dari hasil analisis sensitivitas diperoleh bahwa semakin besar laju kadaluwarsa, maka waktu antar pemesanan menjadi semakin singkat dan kuantitas pemesanan menjadi semakin sedikit.  Hal yang sama terjadi jika laju permintaan barang semakin besar.   Kata kunci:  Persediaan, kadaluwarsa, all-unit discount.

  17. Book review: Biology and management of invasive quagga and zebra mussels in the western United States

    Science.gov (United States)

    Benson, Amy J.

    2017-01-01

    Water is a precious and limited commodity in the western United States and its conveyance is extremely important. Therefore, it is critical to do as much as possible to prevent the spread of two species of dreissenid mussels, both non-native and highly invasive aquatic species already well-established in the eastern half of the United States. This book addresses the occurrences of the two dreissenid mussels in the West, the quagga mussel and the zebra mussel, that are both known to negatively impact water delivery systems and natural ecosystems. It is edited by two researchers whom have extensive experience working with the mussels in the West and is composed of 34 chapters, or articles, written by a variety of experts.Book information: Biology and Management of Invasive Quagga and Zebra Mussels in the Western United States. Edited by Wai Hing Wong and Shawn L. Gerstenberger. Boca Raton (Florida): CRC Press (Taylor & Francis Group). $149.95. xx + 545 p.; ill.; index. ISBN: 978-1-4665-9561-3. [Compact Disc included.] 2015.

  18. Water-Chemistry and Its Utility Systems in CCP Power Units (Review)

    Science.gov (United States)

    Larin, B. M.

    2018-01-01

    Damageability of heat transfer surfaces of waste heat recovery steam generators (HRSG) of combined- cycle plants (CCP) can be reduced due to an increase in the quality of make-up and feed water, the use of phosphate-alkaline or amino compound water chemistry (WC), and improved chemical quality control of the heat carrier and make-up water preparation techniques. Temporary quality standards for the heat medium developed by the All-Russia Thermal Engineering institute (VTI) for CCP power units are presented in comparison with the IAPWS standards; preferences for the choice of a WC type for some power units commissioned in Russia in the first decade of this century are shown; and operational data on the quality of feed, boiler water, and steam for two large CCP-450 and CCP-425 power units are given. The state and prospects for the development of chemical-technological monitoring systems and CCP water treatment plants are noted. Estimability of some CCP diagnostic parameters by measuring specific electric conductivity and pH is shown. An extensive bibliography on this topic is given.

  19. Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities.

    Science.gov (United States)

    Mandathara, Preeji S; Stapleton, Fiona J; Willcox, Mark D P

    2017-05-01

    To describe the past 20 years' contemporary management modalities for keratoconus (KC) and their outcomes and failures and to propose recommendations in reporting their outcomes. A systematic review of the literature on KC management options for the last 20 years was performed. Original articles that reported the outcome of any form of KC management other than full-thickness or lamellar corneal graft were reviewed to collect information on their outcomes and complications and the level of scientific evidence of the study. A total of 1,147 articles retrieved and of those, 241 satisfied the inclusion criteria, and 41.1% of them were prospective case series. The higher level of evidence studies, that is, randomized controlled trials (RCTs), were limited to only one intervention, that is, corneal collagen cross-linking (CXL). However, the quality of most RCTs was limited because of performance and detection bias. Contact lenses (CLs) remain the mainstream of KC management and were associated with reversible and non-sight-threatening complications. Surgical options such as intracorneal segment implantation and phakic intraocular lens are considered in the visual rehabilitation of CL intolerants, and CXL is the only available option to stop or delay the disease progression. Generally, these surgical procedures are associated with transient inflammatory events and permanent sequelae. The published studies on KC management options varied significantly with respect to the study population, age of participants, severity of KC, clinical outcome measurements, and follow-up period. High-quality longer follow-up RCTs are required to evaluate the long-term effects of KC interventions.

  20. A systematic review and meta-analysis of 3-unit fixed dental prostheses : Are the results of 2 abutment implants comparable to the results of 2 abutment teeth?

    NARCIS (Netherlands)

    Pol, C. W. P.; Raghoebar, G. M.; Kerdijk, W.; Boven, G. C.; Cune, M. S.; Meijer, H. J. A.

    The purpose of the systematic review and meta-analysis was to compare the performance of 3-unit bridges on teeth with 3-unit bridges on implants, evaluating survival of the bridges, survival of the teeth or implants, condition of the hard and soft tissues surrounding the supports, complications and

  1. Glycolytic pathway (GP), kreb's cycle (KC), and hexose monophosphate shunt (HMS) activity in myocardial subcellular fractions exposed to cannabinoids

    Energy Technology Data Exchange (ETDEWEB)

    Watson, A.T.; Manno, B.R.; King, J.W.; Fowler, M.R.; Dempsey, C.A.; Manno, J.E.

    1986-03-05

    Delta-9-tetrahydrocannabinol (..delta../sup 9/-THC), the primary psychoactive component of marihuana, and its active metabolite 11-hydroxy-..delta../sup 9/-tetrahydrocannabinol (11-OH-..delta../sup 9/-THC) have been reported to produce a direct cardiac depressant effect. Studies in isolated perfused rat hearts have indicated a decreased force of contraction (inotropic response) when ..delta../sup 9/-THC or 11-OH-..delta../sup 9/-THC was administered in microgram amounts. The mechanism and site of action have not been explained or correlated with associated metabolic pathways. The purpose of this study was to investigate the effects of cannabinoids on major myocardial energy producing pathways, GP and KC, and a non-energy producing pathway, HMS. Cardiac ventricular tissue from male Sprague-Dawley rats (250-300 g) was excised and homogenized for subcellular fractionation. KC, GP and HMS activity was assayed in the appropriate fractions by measuring /sup 14/CO/sub 2/ generation from /sup 14/C-2-pyruvate, /sup 14/C-6-glucose and /sup 14/C-1-glucose respectively. Duplicate assays (n=8) were performed on tissue exposed to saline (control), empty liposomes (vehicle) and four doses each of ..delta../sup 9/-THC and 11-OH-..delta../sup 9/-THC. Changes in metabolic activity and decreases in cardiac contractile performance may be associated.

  2. Effects of disorder on the intrinsically hole-doped iron-based superconductor KC a2F e4A s4F2 by cobalt substitution

    Science.gov (United States)

    Ishida, Junichi; Iimura, Soshi; Hosono, Hideo

    2017-11-01

    In this paper, the effects of cobalt substitution on the transport and electronic properties of the recently discovered iron-based superconductor KC a2F e4A s4F2 , with Tc=33 K , are reported. This material is an unusual superconductor showing intrinsic hole conduction (0.25 holes /F e2 + ). Upon doping of Co, the Tc of KC a2(Fe1-xC ox) 4A s4F2 gradually decreased, and bulk superconductivity disappeared when x ≥0.25 . Conversion of the primary carrier from p type to n type upon Co-doping was clearly confirmed by Hall measurements, and our results are consistent with the change in the calculated Fermi surface. Nevertheless, neither spin density wave (SDW) nor an orthorhombic phase, which are commonly observed for nondoped iron-based superconductors, was observed in the nondoped or electron-doped samples. The electron count in the 3 d orbitals and structural parameters were compared with those of other iron-based superconductors to show that the physical properties can be primarily ascribed to the effects of disorder.

  3. A systematic review of the unit costs of allied health and community services used by older people in Australia

    Directory of Open Access Journals (Sweden)

    Farag Inez

    2013-02-01

    Full Text Available Abstract Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. Method A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. Results The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Conclusions Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.

  4. Urban-rural differences in childhood and adolescent obesity in the United States: a systematic review and meta-analysis.

    Science.gov (United States)

    Johnson, James Allen; Johnson, Asal Mohamadi

    2015-06-01

    A systematic literature review and subsequent meta-analysis were performed to investigate differences in childhood obesity between urban and rural areas in the United States. A search of published studies comparing childhood obesity in urban and rural settings was undertaken by probing PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for articles that met predetermined inclusion criteria. A subsequent meta-analysis was conducted to determine the combined effect size and significance of differences in childhood obesity between urban and rural areas. Ten studies were identified for systematic review, five of which contributed to the meta-analysis. All but one study suggested that residence in rural areas was associated with higher prevalence or increased odds of childhood obesity, compared to children living in urban areas. A meta-analysis of 74,168 pooled participants ages 2-19 found that rural children have 26% greater odds of obesity, compared to urban children (odds ratio=1.26; 95% confidence interval, 1.21-1.32). Obesity rates are higher among rural children than urban children in the United States. To ensure successful targeted interventions and effective resource allocation, practitioners and policy makers alike should be cognizant of this disparity in childhood obesity.

  5. Public Stigma of Mental Illness in the United States: A Systematic Literature Review

    OpenAIRE

    Parcesepe, Angela M.; Cabassa, Leopoldo J.

    2013-01-01

    Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public’s stigma toward mental disorders, (2) summarize stigma findings focused on the public’s stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental...

  6. A review of start-up operations on the first units of the 1300 MWe generation

    International Nuclear Information System (INIS)

    Meclot, B.; Lemagny Boc Lonlaygue, C.; Lavogiez, M.

    1986-01-01

    This paper describes and offers comments on the different phases of start-up on power stations of the P4 series. Then, one reviews incidents which occurred in the course of these start-up phases and, having highlighted the lessons to be learnt from the commissioning of these power stations, goes on to make a comparative study of 1300 and 900 MWe availability in the initial year of operation [fr

  7. Review of short-lived radionuclide activities in the United States

    International Nuclear Information System (INIS)

    Sodd, V.J.

    1985-01-01

    A review is given of the accelerator-produced short-lived radionuclides which are used in radiopharmaceuticals available commercially in the US and of the accelerator facilities devoted primarily to their production. Reactions for the efficient production of 67 Ga, 81 Rb → /sup 81m/Kr, 111 In, 201 Tl, and 123 I are given. Methods for the production of higher purity 123 I are suggested

  8. Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review.

    Science.gov (United States)

    Carruthers, Helen; Astin, Felicity; Munro, Wendy

    2017-10-01

    To assess the effectiveness of Augmentative and Alternative Communication (AAC) strategies to enable people who are temporarily voiceless due to medical intervention, to communicate. A systematic review informed by a protocol published on an international register. Ten databases were searched from January 2004 to January 2017. Included studies assessed the effect of using AAC strategies on patient related outcomes and barriers to their use. All included studies were quality appraised. Due to the heterogeneity of interventions and outcome measures findings were narratively reviewed. Twelve studies met the inclusion criteria and were included in the review reporting outcomes from 1981 patient and 454 health professional participants. The quality of included studies were moderate to weak. AAC communication strategies increased the number of communication interactions, improved patient satisfaction with communication and reduced communication difficulties. Barriers to usage were device characteristics, the clinical condition of the patient, lack of timeliness in communication and staff constraints. There is preliminary, but inconsistent evidence that AAC strategies are effective in improving patient satisfaction with communication and reducing difficulties in communication. A lack of comparable studies precluded the identification of the most effective AAC strategy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. On hitting children: a review of corporal punishment in the United States.

    Science.gov (United States)

    Knox, Michele

    2010-01-01

    Research has clearly demonstrated associations between corporal punishment of children and maladaptive behavior patterns such as aggression and delinquency. Hitting children is an act of violence and a clear violation of children's human rights. In this article, the position of the United States on corporal punishment of children is discussed. Professional and international progress on ending corporal punishment is explained, and the relationship between corporal punishment and child abuse is discussed. An appeal is made for prevention efforts such as parent education and removal of social sanctions for hitting children that may hold significant promise for preventing child maltreatment.

  10. Periodical safety review of units 1 and 2 of PAKS NPP. Examples from summary report

    International Nuclear Information System (INIS)

    Hammar, K.

    1998-01-01

    On the basis of American practice of qualification and relevant IAEA recommendations detailed guidelines of the qualification procedure were developed and executed on the Units 1 and 2 of the Paks NPP. Periodic safety supervision will be performed by evaluation of the following reports to be submitted by NPP: real technical conditions of the facility; existing practice and proposals for equipment qualification; evaluation of the existing safety reports estimating their validity up to the plant lifetime; ageing and ageing management; procedures of operation, maintenance, supervision; organisation and administration; safety impact of human factor, training, education, qualification of personnel

  11. A systematic review of factors influencing human papillomavirus vaccination among immigrant parents in the United States.

    Science.gov (United States)

    Kim, Kyounghae; LeClaire, Anna-Rae

    2017-11-21

    To critically appraise factors influencing human papillomavirus (HPV) vaccination among immigrant parents in the United States, a comprehensive search of electronic databases and reference lists was conducted. The findings from 22 articles were ordered based on a socioecological model. About 30% of children initiated and 14% completed a three-dose series. Correlates of HPV vaccine initiation rates included lack of information, concerns about vaccine safety and promiscuity, providers' recommendations, school mandates, financial issues, immigration laws, and living in disadvantaged neighborhoods. Upstream initiatives embracing cultural descriptors could facilitate HPV vaccination, reducing HPV-related disparities in cancer among immigrants in the US.

  12. Kikuchi-Fujimoto Disease in the United States: Three Case Reports and Review of the Literature

    OpenAIRE

    Darcie M Deaver; Mojdeh Naghashpour; Lubomir Sokol

    2013-01-01

    Kikuchi-Fujimoto Disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting disease that manifests primarily as cervical lymphadenopathy but may include low-grade fever, headache, and fatigue.  There is a higher incidence of KFD in women aged 20-35 years and in Asian populations.  A PubMed search revealed 590 articles that described KFD.  Of these, 22 cases have been fully described in the United States.  Ten of the 22 (45%) patients were male and 12 (55%) ...

  13. Epidemiology of burns undergoing hospitalization to the National Burns Unit in the Sultanate of Oman: a 25-year review.

    Science.gov (United States)

    Al-Shaqsi, Sultan; Al-Kashmiri, Ammar; Al-Bulushi, Taimoor

    2013-12-01

    The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011. This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011. During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this "silent and costly epidemic." Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Implementing health promotion in schools: protocol for a realist systematic review of research and experience in the United Kingdom (UK

    Directory of Open Access Journals (Sweden)

    Pearson Mark

    2012-10-01

    Full Text Available Abstract Background School-based interventions and campaigns are used to promote health and address a wide variety of public health problems. Schools are considered to be key sites for the implementation of health promotion programmes for their potential to reach the whole population in particular age-groups and instil healthy patterns of behavior early in life. However, evidence for the effectiveness of school-based health promotion interventions is highly variable. Systematic reviews of the evidence of school-based interventions tend to be highly problem- or intervention- specific, thereby missing potential generic insights into implementation and effectiveness of such programmes across problems. Methods/design A realist systematic review will be undertaken to explain how, why and in what circumstances schools can provide feasible settings for effective health promotion programmes in the United Kingdom (UK. The review will be conducted in two phases. Phase 1 will identify programme theories about implementation (ideas about what enables or inhibits effective health promotion to be delivered in a school setting. Phase 2 will test the programme theories so that they can be challenged, endorsed and/or refined. A Review Advisory Group of education and health professionals will be convened to help identify and choose potential programme theories, provide a ‘reality check’ on the clarity and explanatory strength of the mechanisms to be tested, and help shape the presentation of findings to be usable by practitioners and decision-makers. Review findings will be disseminated through liaison with decision-makers, and voluntary and professional groups in the fields of education and health.

  15. Ketamine for Analgosedation in the Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Patanwala, Asad E; Martin, Jennifer R; Erstad, Brian L

    2017-07-01

    To evaluate the evidence for the use of intravenous ketamine for analgosedation in the intensive care unit. MEDLINE and EMBASE were queried from inception until July 2015. Search terms used included ketamine, intensive care, and critical care. The search retrieved 584 articles to be screened for inclusion. The intent was to include randomized controlled studies using sustained intravenous infusions (>24 hours) of ketamine in the critically ill patients. One trial evaluated opioid consumption as an outcome in postoperative critically ill patients who were randomized to ketamine or saline infusions. The mean cumulative morphine consumption at 48 hours was significantly lower in the ketamine group (58 ± 35 mg) compared to the morphine-only group (80 ± 37 mg; P ketamine in terms of cerebral hemodynamics in patients with traumatic brain injury, improved gastrointestinal motility, and decreased vasopressor requirements. The observational study and case reports suggest that ketamine is safe and effective and may have a role in patients who are refractory to other therapies. Ketamine use may decrease analgesic consumption in the intensive care unit. Additional trials are needed to further delineate the role of ketamine for analgosedation.

  16. [Communication, information, and roles of parents in the pediatric intensive care unit: A review article].

    Science.gov (United States)

    Béranger, A; Pierron, C; de Saint Blanquat, L; Jean, S; Chappuy, H

    2017-03-01

    Pediatric intensive care units (PICUs), whose accessibility to parents raises controversy, often operate under their own rules. Patients are under critical and unstable conditions, often in a life-threatening situation. In this context, the communication with the parents and their participation in the unit may be difficult. Information is a legal, deontological, and moral duty for caregivers, confirmed by the parents' needs. But the ability to enforce them is a challenge, and there is a gap between the theory and the reality. The communication between the parents and the physicians starts at the admission of the child with a family conference. According to the Société de réanimation de langue française (SRLF), the effectiveness of the communication is based on three criteria: the patients' comprehension, their satisfaction and their anxiety and depression. It has been shown that comprehension depends on multiple factors, related on the parents, the physicians, and the medical condition of the child. Regarding the parents' participation in the organization of the service, the parents' presence is becoming an important factor. In the PICU, the parents' status has evolved. They become a member of the care team, as a partner. The best interest of the child is always discussed with the parents, as the person knowing the best their child. This partnership gives them a responsibility, which is complementary to the physician's one, but does not substitute it. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Infectious diseases of afghan immigrants in the united states: review of published reports

    International Nuclear Information System (INIS)

    Pilsczek, F.H.

    2011-01-01

    Infectious diseases of immigrants may differ from patients born and resident in the same country, especially if immigrants from Africa or Asia live in Europe or North America. Because the available information is limited published reports of infections of Afghan immigrants in the United States and other countries were analysed. Four reports from the US and 15 reports from other countries were identified [7, (46.7%) Pakistan, 5 (33.3%) Iran, 1 (6.7%) United Kingdom, 1 (6.7%) Germany, 1 (6.7%) Israel)]. Reports from the US were case reports or case series of infections with gastro-intestinal parasites and Mycobacterium tuberculosis (1, 25%), Echinococcus species (2, 50%), and Plasmodium vivax (1, 25%). Reports from other countries were case reports, case series, or surveys and investigated infections with Echinococcus species (2, 13%), Hepatitis B virus (HBV) (1, 6.7%), M. tuberculosis (6, 40%), P. falciparum (1, 6.7%), Leishmania tropica (3, 20%), Fasciola hepatica (1, 6.7%), and M. leprae (1, 6.7%). The reports suggest that Echinococcus species and L. tropica infections can be encountered in Afghan immigrants in the US, and the frequency of a positive PPD (purified protein derivative) response or HBsAg test was increased. An infectious diseases database specific for the country of residence readily available to clinicians treating Afghan patients outside of Afghanistan may be useful. (author)

  18. Determinants of preventable readmissions in the United States: a systematic review

    Directory of Open Access Journals (Sweden)

    Slawson Kevin M

    2010-11-01

    Full Text Available Abstract Background Hospital readmissions are a leading topic of healthcare policy and practice reform because they are common, costly, and potentially avoidable events. Hospitals face the prospect of reduced or eliminated reimbursement for an increasing number of preventable readmissions under nationwide cost savings and quality improvement efforts. To meet the current changes and future expectations, organizations are looking for potential strategies to reduce readmissions. We undertook a systematic review of the literature to determine what factors are associated with preventable readmissions. Methods We conducted a review of the English language medicine, health, and health services research literature (2000 to 2009 for research studies dealing with unplanned, avoidable, preventable, or early readmissions. Each of these modifying terms was included in keyword searches of readmissions or rehospitalizations in Medline, ISI, CINAHL, The Cochrane Library, ProQuest Health Management, and PAIS International. Results were limited to US adult populations. Results The review included 37 studies with significant variation in index conditions, readmitting conditions, timeframe, and terminology. Studies of cardiovascular-related readmissions were most common, followed by all cause readmissions, other surgical procedures, and other specific-conditions. Patient-level indicators of general ill health or complexity were the commonly identified risk factors. While more than one study demonstrated preventable readmissions vary by hospital, identification of many specific organizational level characteristics was lacking. Conclusions The current literature on preventable readmissions in the US contains evidence from a variety of patient populations, geographical locations, healthcare settings, study designs, clinical and theoretical perspectives, and conditions. However, definitional variations, clear gaps, and methodological challenges limit translation of

  19. Public stigma of mental illness in the United States: a systematic literature review.

    Science.gov (United States)

    Parcesepe, Angela M; Cabassa, Leopoldo J

    2013-09-01

    Public stigma is a pervasive barrier that prevents many individuals in the U.S. from engaging in mental health care. This systematic literature review aims to: (1) evaluate methods used to study the public's stigma toward mental disorders, (2) summarize stigma findings focused on the public's stigmatizing beliefs and actions and attitudes toward mental health treatment for children and adults with mental illness, and (3) draw recommendations for reducing stigma towards individuals with mental disorders and advance research in this area. Public stigma of mental illness in the U.S. was widespread. Findings can inform interventions to reduce the public's stigma of mental illness.

  20. Length of stay of general psychiatric inpatients in the United States: systematic review.

    LENUS (Irish Health Repository)

    Tulloch, Alex D

    2011-05-01

    Psychiatric length of stay (LOS) has reduced but is still longer than for physical disorders. Inpatient costs are 16% of total mental health spending. Regression analyses of the determinants of LOS for US adult psychiatric inpatients were systematically reviewed. Most studies predated recent LOS reductions. Psychosis, female gender and larger hospital size were associated with longer LOS, while discharge against medical advice, prospective payment, being married, being detained and either younger or middle age were associated with shorter LOS. Associations appeared consistent, especially where sample size was above 3,000. Updated studies should be adequately powered and include the variables above.

  1. "Bed Side" Human Milk Analysis in the Neonatal Intensive Care Unit: A Systematic Review.

    Science.gov (United States)

    Fusch, Gerhard; Kwan, Celia; Kotrri, Gynter; Fusch, Christoph

    2017-03-01

    Human milk analyzers can measure macronutrient content in native breast milk to tailor adequate supplementation with fortifiers. This article reviews all studies using milk analyzers, including (i) evaluation of devices, (ii) the impact of different conditions on the macronutrient analysis of human milk, and (iii) clinical trials to improve growth. Results lack consistency, potentially due to systematic errors in the validation of the device, or pre-analytical sample preparation errors like homogenization. It is crucial to introduce good laboratory and clinical practice when using these devices; otherwise a non-validated clinical usage can severely affect growth outcomes of infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. United States high-altitude test experiences. A review emphasizing the impact on the environment

    International Nuclear Information System (INIS)

    Hoerlin, H.

    1976-06-01

    The US high-altitude nuclear explosions of the 1955-1962 period are listed chronologically; dates, locations, and yields are given. The major physical phases of the interactions of the weapon outputs with the atmosphere are described, such as the formation of fireballs at the low high-altitudes and the partition of energies and their distribution over very large spaces at the higher high-altitudes. The effects of these explosions on the normal activities of populations and the protective measures taken are documented. Many scientific observations, together with their significance and values, are reviewed. 109 refs

  3. Assessing Parenting Capacity in Psychiatric Mother and Baby Units: A case report and review of literature.

    Science.gov (United States)

    Hammond, Julie; Lipsedge, Maurice

    2015-09-01

    This review aimed to improve infant risk assessments in the context of maternal mental illness by identifying key predictors of poor parenting outcomes. Inadequate parenting as a result of severe and persistent mental illness is a common reason for courts terminating parental rights. However, the current practice of parenting capacity assessments in the setting of perinatal psychiatry is fraught with risks and uncertainty. A well-recognised flaw in the assessment process is the lack of valid and reliable tools that have been specifically validated for assessing parenting capacity in mothers with a history of mental illness and the potential risk of harm to their infant. To date, there is only one instrument available. A systematic search of Medline, PsycInfo and Embase via the Ovid interface was conducted between September and December 2014. Citation snowball sampling was also used to identify further relevant studies. An additional search was performed in Google to access grey literature. A total of 38 citations were identified, of which 8 publications focusing on the populations of England, France and Belgium met the eligibility criteria of this review. Evidence from existing research suggests that poor parenting outcomes in maternal psychiatric illness are strongly associated with correlates of socio-economic inequalities. However, evidence regarding the long-term implications of such factors is weak as only one follow up study and no longitudinal studies were identified in this review. Our review suggests that the use of standardised empirically validated risk assessment tools would benefit the current practice of parenting assessments by improving the process by which collected information is analysed. This would enhance the accuracy of decision-making, and improve the safeguarding of the infant. Further research is needed on medium to long-term parenting outcomes, particularly regarding its relations to: the type of maternal psychiatric disorder; the quality

  4. Exploring Communication Challenges Between Nurses and Mechanically Ventilated Patients in the Intensive Care Unit: A Structured Review.

    Science.gov (United States)

    Dithole, Kefalotse; Sibanda, Sambulelwe; Moleki, Mary M; Thupayagale-Tshweneagae, Gloria

    2016-06-01

    Mechanical ventilation is a necessary procedure for patients with a range of illnesses and conditions. Mechanical ventilation affects voice production, leaving patients unable to communicate their needs with nurses and family. The communication difficulty causes distress, frustration, and anger if not attended to. This structured review sought to identify communication challenges which exist between nurses and mechanically ventilated patients in intensive care units (ICU) and hence explore possible solutions to improve these communication challenges. A electronic search of MEDLINE, CINAHL, and PsycINFO was conducted to identify relevant literature on nurse-patient communication challenges in the ICU published between January 2005 and December 2014. Studies meeting the inclusion criteria were retrieved in full, reviewed, and study quality assessed. Six studies were identified for inclusion in the review. Analysis identified five core influences on communication in the ICU: patient's consciousness level, nature of nurse-patient interactions, communication methods, staff skills and perceptions, and the intensive care physical environment. An evidence-based and multifactorial communication intervention encompassing staff skills development and training, development of relevant patient materials or devices and collaborations with relevant health professionals like speech and language therapists has the potential to improve nurse-patient communication in the ICU and hence improve patient outcomes. © 2016 Sigma Theta Tau International.

  5. Realist review of policy intervention studies aimed at reducing exposures to environmental hazards in the United States

    Directory of Open Access Journals (Sweden)

    Dorie E. Apollonio

    2016-08-01

    Full Text Available Abstract Background Exposure to pollution is a significant risk to human health. However few studies have attempted to identify the types of policy interventions that can reduce the health risks of pollution exposure in the United States. The study objective was to conduct a realist review of policy interventions conducted or aimed at reducing chemical exposures in humans or the environment where exposure was measured. Methods A systematic literature search identified published articles that assessed policy interventions using exposure data. Two coders independently extracted data from the studies, assessing methods, context, details of interventions, outcomes, and risks of bias. Data were analyzed iteratively and manually to identify the most effective and transferrable types of interventions. The reasons for variability in the success of different interventions were explored. Results The review found that regulatory interventions that eliminate point sources of pollution appeared to reduce exposure to environmental hazards. Regular monitoring to provide environmental and human exposure data helped assess compliance with the regulatory standards. Educational and economic interventions were less successful. Conclusions Although some types of regulatory interventions appear to reduce exposures, our findings are limited by the nature of existing interventions, the weaknesses of the study designs used in the literature, and the lack of details on implementation. Information on contextual factors that influence implementation would assist with future reviews and could help identify effective interventions.

  6. Understanding HIV-Related Stigma Among Women in the Southern United States: A Literature Review.

    Science.gov (United States)

    Darlington, Caroline K; Hutson, Sadie P

    2017-01-01

    Societal stigmatization of HIV/AIDS due to assumptions about transmission and associated behaviors plays a substantial role in the psychosocial well-being of people living with this chronic illness, particularly for women in traditionally conservative geographic regions. Known for social conservatism, the Southern United States (US) holds the highest incidence rate of HIV infection in the US. A systematic search of four databases was used to identify 27 relevant scientific articles pertaining to HIV-related stigma among women living with HIV/AIDS in the Southern US. These studies revealed a rudimentary understanding of stigma sources, effects, and stigma-reduction interventions in this population. Due to the cultural specificity of stigma, further differentiation of stigma in discrete sectors of the South as well as a dialogue about the moral implications of stigma is necessary to lay the groundwork for patient-centered interventions to mitigate the destructive effects of stigma experienced by women in this region.

  7. A Review of the United Kingdom Fast Reactor Programme, March 1987

    International Nuclear Information System (INIS)

    Bramman, J.I.; Wheeler, R.C.

    1987-01-01

    Nuclear power produced about 20% of the electricity supply in the United Kingdom in 1986, mostly from gas-cooled reactors, i.e. the 10 AGRs currently in operation and the 26 older MAGNOX reactors. Plans to increase the nuclear component of generating capacity by building the first PWR in the UK, Sizewell 'B', were strongly endorsed in the report by Sir Frank Layfield published on 26 January 1987. This resulted from the Public Inquiry into building Sizewell 'B', which was held between 11 January 1983 and 7 March 1985, the longest Public Inquiry ever held in the UK. The government gave the go-ahead for the building of Sizewell 'B' on 12 March 1987

  8. Medication prescribing advice and drug utilization: a review from the United Kingdom.

    Science.gov (United States)

    Law, J; Thompson, A

    1996-01-01

    General Medical Practitioners (GPs) in the United Kingdom are usually the first point of contact with the National Health Service (NHS) for patients. They provide the majority of ambulatory care for their practice population and act as 'gatekeepers' for referral onwards to other services. This article investigates the influence of the purchasing authority prescribing advisors (PAs), including pharmacists and GPs on the prescribing habits in Salford, England, an inner city area in the North of England, close to the city of Manchester. The PAs became known as the prescribing CIA, and used the strategy of Control, progressing to Influence and Autonomy, to develop a mature partnership between the GPs, PAs and other health care professionals. Information collated from prescribing (PACT) data, by the Prescription Pricing Authority, was used to make comparisons between different practices within an area. Savings made by making rational changes in prescribing, were used to enhance practice development for the benefit of patient care.

  9. Kikuchi-Fujimoto Disease in the United States: Three Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Darcie M Deaver

    2013-12-01

    Full Text Available Kikuchi-Fujimoto Disease (KFD, also known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting disease that manifests primarily as cervical lymphadenopathy but may include low-grade fever, headache, and fatigue.  There is a higher incidence of KFD in women aged 20-35 years and in Asian populations.  A PubMed search revealed 590 articles that described KFD.  Of these, 22 cases have been fully described in the United States.  Ten of the 22 (45% patients were male and 12 (55% were female, with 20% Caucasian, 20% Asian American, and the remaining 60% of other ethnic backgrounds.  In this study, we describe an additional 3 cases of KFD and discuss the diagnosis, pathology, and management of KFD.

  10. Review of tokamak power reactor and blanket designs in the United States

    International Nuclear Information System (INIS)

    Baker, C.; Brooks, J.; Ehst, D.; Gohar, Y.; Smith, D.; Sze, D.

    1986-01-01

    The last major conceptual design study of a tokamak power reactor in the United States was STARFIRE which was carried out in 1979-1980. Since that time US studies have concentrated on engineering test reactors, demonstration reactors, parametric systems studies, scoping studies, and studies of selected critical issues such as pulsed vs. steady-state operation and blanket requirements. During this period, there have been many advancements in tokamak physics and reactor technology, and there has also been a recognition that it is desirable to improve the tokamak concept as a commercial power reactor candidate. During 1984-1985 several organizations participated in the Tokamak Power Systems Study (TPSS) with the objective of developing ideas for improving the tokamak as a power reactor. Also, the US completed a comprehensive Blanket Comparison and Selection Study which formed the basis for further studies on improved blankets for fusion reactors

  11. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review

    Science.gov (United States)

    Walton, AnnMarie Lee; Rogers, Bonnie

    2017-01-01

    Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation. PMID:28534859

  12. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review.

    Science.gov (United States)

    Walton, AnnMarie Lee; Rogers, Bonnie

    2017-05-19

    Nursing assistants (NAs) make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious), or exposure to hazardous drugs (chemical), literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed). More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.

  13. Workplace Hazards Faced by Nursing Assistants in the United States: A Focused Literature Review

    Directory of Open Access Journals (Sweden)

    AnnMarie Lee Walton

    2017-05-01

    Full Text Available Nursing assistants (NAs make up a large share of the healthcare provider workforce and their numbers are expected to grow. NAs are predominantly women who earn a low wage and report financial, work, and family demands. Working as a NA is hazardous; this manuscript specifically examines the biological/infectious, chemical, enviromechanical, physical and psychosocial hazards that appear in the literature to date. A focused search strategy was used to review literature about hazards that fell into each of the five aforementioned domains. While some hazards that were documented were clear, such as exposure to influenza because of close contact with patients (biological/infectious, or exposure to hazardous drugs (chemical, literature was limited. The majority of the literature we reviewed fell into the domain of psychosocial hazards and centered on stress from workplace organization issues (such as mandatory overtime, lack of managerial support, and feeling rushed. More research is needed to understand which hazards NAs identify as most concerning and tailored interventions are needed for risk mitigation.

  14. Barriers to delirium assessment in the intensive care unit: A literature review.

    Science.gov (United States)

    Rowley-Conwy, Gabby

    2018-02-01

    Delirium is a common syndrome that has both short and long-term negative outcomes for critically ill patients. Many studies over several years have found a knowledge gap and lack of evidence-based practice from critical care personnel, but there has been little exploration of the reasons for this. To identify the perceived barriers to delirium assessment and management among critical care nurses. A literature review of published studies to examine barriers to effective delirium assessment using a comprehensive search strategy. Five relevant studies identified for review. Few studies have investigated barriers to delirium assessment and management, but several themes reoccur throughout the literature. The perceived time consuming nature of the assessment tools is cited by many, as is the lack of medical prioritisation of results. Lack of education on delirium appears to be a significant factor and reinforces some of the stated misconceptions. Many barriers exist to prevent effective assessment and management of delirium, but several of these are due to a lack of understanding or unfamiliarity with the condition and the assessment tools as well as lack of medical prioritisation of the results. Further research is needed on this topic. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Thermal treatment of solid residues from WtE units: a review.

    Science.gov (United States)

    Lindberg, Daniel; Molin, Camilla; Hupa, Mikko

    2015-03-01

    Thermal treatment methods of bottom ash, fly ash and various types of APC (air pollution control) residues from waste-to-energy plants can be used to obtain environmentally stable material. The thermal treatment processes are meant to reduce the leachability of harmful residue constituents, destroy toxic organic compounds, reduce residue volume, and produce material suitable for utilization. Fly ash and APC residues often have high levels of soluble salts, particularly chlorides, metals such as cadmium, lead, copper and zinc, and trace levels of organic pollutants such as dioxins and furans. Different thermal treatment methods can be used to either decompose or stabilize harmful elements and compounds in the ash, or separate them from the ash to get a material that can be safely stored or used as products or raw materials. In the present paper, thermal treatment methods, such as sintering, vitrification, and melting have been reviewed. In addition to a review of the scientific literature, a survey has been made of the extensive patent literature in the field. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Facets of career satisfaction for women physicians in the United States: a systematic review.

    Science.gov (United States)

    Rizvi, Rabab; Raymer, Lindsay; Kunik, Mark; Fisher, Joslyn

    2012-01-01

    Women make up a growing proportion of the physician workforce, and their career satisfaction may affect their health. The authors hypothesized that many facets adversely affecting career satisfaction in women physicians were extrinsic, therefore, preventable or modifiable. The authors conducted a systematic review of the literature in English published through February 2010 to examine facets of career satisfaction of U.S. women physicians. The authors used the women physician AND job satisfaction OR career satisfaction Medical Subject Headings (MeSH) terms, and reviewed bibliographies of key articles to ensure inclusion of relevant studies. The authors used the "Strengthening the Reporting of Observation Studies in Epidemiology" quality tool. Of an initial 1,000 studies, only 30 met the inclusion criteria. Facets reported most frequently to influence career satisfaction for women physicians were income/prestige, practice characteristics, and personal/family characteristics. Overall, career satisfaction for women and men physicians was 73.4% (range = 56.4% to 90%) and 73.2% (range = 59% to 90%), respectively. When compared with men, women physicians were more concerned with perceived lack of time for relationships with patients, colleagues, and family; less satisfied with mentoring relationships and support from all sources; and less satisfied with career-advancement opportunities, recognition, and salary. Career satisfaction can affect health, as well as health and safety of patients. Many factors adversely affecting career satisfaction for women physicians are extrinsic and, therefore, modifiable.

  17. Risk factors for domestic minor sex trafficking in the United States: a literature review.

    Science.gov (United States)

    Choi, Kristen R

    2015-01-01

    Domestic minor sex trafficking (DMST) is an important social and public health problem, but it has received little attention from healthcare professionals in research, practice, and policy. Prevention and early victim identification efforts for this population are severely limited or entirely absent. The aim of this study was to integrate evidence on risk factors for DMST and critically appraise the quality and quantity of nursing literature on DMST. This literature review was reported using PRISMA criteria. Three databases (CINAHL, PsychInfo, and PubMed) were searched using various terms for (a) human trafficking, (b) risk factors, and (c) children. Demographic factors were not important predictors of DMST. Childhood maltreatment trauma and running away from home were the most important risk factors for trafficking victimization. There was little nursing literature on the topic of DMST. Nurses and other healthcare professionals must engage in confronting DMST by improving early identification of victims and conducting high-quality research to inform practice.

  18. A Critical Review of the Marketing Claims of Infant Formula Products in the United States.

    Science.gov (United States)

    Belamarich, Peter F; Bochner, Risa E; Racine, Andrew D

    2016-05-01

    A highly competitive infant formula market has resulted in direct-to-consumer marketing intended to promote the sale of modified formulas that claim to ameliorate common infant feeding problems. The claims associated with these marketing campaigns are not evaluated with reference to clinical evidence by the Food and Drug Administration. We aimed to describe the language of claims made on formula labels and compare it with the evidence in systematic reviews. Of the 22 product labels we identified, 13 product labels included claims about colic and gastrointestinal symptoms. There is insufficient evidence to support the claims that removing or reducing lactose, using hydrolyzed or soy protein or adding pre-/probiotics to formula benefits infants with fussiness, gas, or colic yet claims like "soy for fussiness and gas" encourage parents who perceive their infants to be fussy to purchase modified formula. Increased regulation of infant formula claims is warranted. © The Author(s) 2015.

  19. Rhodotorula fungemia of an intensive care unit patient and review of published cases.

    Science.gov (United States)

    Spiliopoulou, Anastasia; Anastassiou, Evangelos D; Christofidou, Myrto

    2012-10-01

    Rhodotorula species are commensal yeasts that have emerged as a cause of life-threatening fungemia in severely immunocompromised patients. A case of Rhodotorula mucilaginosa fungemia in a 48-year-old woman that had undergone consecutive abdominal surgeries due to ovarian cancer and bowel necrosis while she was receiving fluconazole prophylaxis is presented. Several risk factors were identified such as presence of central venous catheters, solid organ neoplasm, abdominal surgery and administration of antibiotics. Identification was performed using commercial systems. The yeast was resistant to fluconazole, posaconazole and voriconazole and to echinocandins, whereas MIC to amphotericin B was 1.5 mg/L. Furthermore, published cases of Rhodotorula spp fungemia during the last decade are reviewed. In conclusion, Rhodotorula spp must be considered a potential pathogen in patients with immunosupression and central venous catheters. Correct identification is mandatory for appropriate management, as Rhodotorula spp are resistant to antifungal agents, such as fluconazole and echinocandins.

  20. Smokeless tobacco use in the United States military: a systematic review.

    Science.gov (United States)

    Bergman, Hannah E; Hunt, Yvonne M; Augustson, Erik

    2012-05-01

    Smokeless tobacco (ST) use represents an important target for intervention in the U.S. military population because it impairs "military readiness" and harms the health of the military. This paper aims to provide a systematic review of ST studies conducted in the U.S. military population in order to assess the content of existing ST research in this population, provide estimates of prevalence and clinically relevant use patterns, and discuss how these findings might be used to guide future ST research among this population. We reviewed articles published through December 2010 using PubMed and PsycINFO databases, Google Scholar, and any relevant articles' reference lists. Inclusion criteria included focus on a U.S. military sample, English language, measured tobacco use, and ST prevalence was reported or could be calculated. To the extent possible, each article was coded for demographics, socioeconomic status, prevalence, amount, frequency, and length of use, and quit intentions/attempts. Thirty-nine articles met criteria for inclusion. Less than half focused primarily on ST use among military personnel. The remaining studies measured ST use in the context of other behaviors. Findings related to clinically relevant behaviors included a need for more cohort and intervention studies, a better understanding of ST use in combination with cigarettes (i.e., concurrent use), and identifying risk factors for ST initiation and use. ST use is prevalent among military personnel, as is concurrent use of cigarettes and ST. We provide a number of recommendations to guide future research in this important, yet understudied, area.

  1. Pathology of Haemonchus contortus in New World camelids in the southeastern United States: a retrospective review.

    Science.gov (United States)

    Edwards, Erin E; Garner, Bridget C; Williamson, Lisa H; Storey, Bob E; Sakamoto, Kaori

    2016-03-01

    Most small ruminant farms in tropical climates are plagued by Haemonchus contortus, a hematophagous, abomasal parasite. Heavy burdens of this parasite can cause anemia, hypoproteinemia, weight loss, and mortality in susceptible animals. Haemonchus contortus is becoming a major health concern in New World camelids as well, namely llamas (Llama glama) and alpacas (Vicugna pacos), yet little research has been conducted regarding its prevalence or pathology in these species. Herein, we present a retrospective review of llamas and alpacas that were admitted to The University of Georgia Veterinary Teaching Hospital and Athens Diagnostic Laboratory between the years 2002 and 2013. Antemortem fecal egg count (FEC) estimates performed on 30 alpacas were negatively correlated with hematocrit, hemoglobin, and red blood cell count. Total protein was not significantly correlated with FEC. On postmortem examination, 55 of 198 camelids, including 2 from the aforementioned antemortem review, were infected with H. contortus, with llamas (42.6%) having a significantly higher infection rate than alpacas (22.2%). In 15.7% of the total cases, the parasite was the major cause of death. Common gross lesions included peritoneal, thoracic, and pericardial effusions, visceral pallor, subcutaneous edema, and serous atrophy of fat. Histologic lesions included centrilobular hepatic necrosis, hepatic atrophy, lymphoplasmacytic inflammation of the mucosa of the third gastric compartment (C3), extramedullary hematopoiesis in both the liver and spleen, and the presence of nematodes in C3. Our study emphasizes the importance of H. contortus diagnosis and herd monitoring in New World camelids, particularly llamas. © 2016 The Author(s).

  2. [Non-pharmacological treatment of dementia in geriatric psychiatry care units : Scoping review].

    Science.gov (United States)

    Göhner, Anne; Hüll, Michael; Voigt-Radloff, Sebastian

    2018-02-01

    The number of persons suffering from dementia will continuously increase in the coming years; therefore, evidence-based interventions are needed in geriatric psychiatric care. When evidence is poor scoping reviews may help to identify knowledge gaps and needs for research. To present an overview of clinical trials on non-pharmacological treatment for elderly with dementia in hospitals, wards and nursing homes, specializing in gerontopsychiatric care. A systematic search was carried out by one of the authors for clinical trials (randomized controlled, controlled and single group pre-post design, English and German, 1998-2014) in PsycINFO, PubMED, PSYNDEX and the Cochrane Library as well as a manual search in two relevant German peer-reviewed journals. Two authors included studies according to a priori defined inclusion criteria. One author extracted data after consulting the second author in cases of ambiguity. The risk of bias of the studies was not assessed. A total of 77 studies were identified, 29 studies on restructured treatment pathways or settings, 14 trials on environmental changes and 34 studies on therapeutic single or group interventions. Both the methodological quality of the studies and the evidence for the efficacy of non-pharmacological treatment were limited. There are clear indications for an advantage of specialized environments and treatment settings for the elderly with dementia in hospitals, wards and nursing homes. There are consistent indications for positive effects of psychosocial activation alone or in combination with cognitive or physical activation, partly with high-quality study designs. This is consistent with the German S3 guidelines for dementia. For single interventions, such as electroconvulsive therapy or horticultural activities, the level of evidence remains limited.

  3. Bench-to-bedside review: Dealing with increased intensive care unit staff turnover: a leadership challenge

    Science.gov (United States)

    Laporta, Denny P; Burns, Judy; Doig, Chip J

    2005-01-01

    Critical care leaders frequently must face challenging situations requiring specific leadership and management skills for which they are, not uncommonly, poorly prepared. Such a fictitious scenario was discussed at a Canadian interdisciplinary critical care leadership meeting, whereby increasing intensive care unit (ICU) staff turnover had led to problems with staff recruitment. Participants discussed and proposed solutions to the scenario in a structured format. The results of the discussion are presented. In situations such as this, the ICU leader should first define the core problem, its complexity, its duration and its potential for reversibility. These factors often reside within workload and staff support issues. Some examples of core problems discussed that are frequently associated with poor retention and recruitment are a lack of a positive team culture, a lack of a favorable ICU image, a lack of good working relationships between staff and disciplines, and a lack of specific supportive resources. Several tools or individuals (typically outside the ICU environment) are available to help determine the core problem. Once the core problem is identified, specific solutions can be developed. Such solutions often require originality and flexibility, and must be planned, with specific short-term, medium-term and long-term goals. The ICU leader will need to develop an implementation strategy for these solutions, in which partners who can assist are identified from within the ICU and from outside the ICU. It is important that the leader communicates to all stakeholders frequently as the process moves forward. PMID:16277732

  4. Review of the 2012 Epizootic Hemorrhagic Disease Outbreak in Domestic Ruminants in the United States.

    Directory of Open Access Journals (Sweden)

    G Stevens

    Full Text Available An unusually large number of cases of Epizootic hemorrhagic disease (EHD were observed in United States cattle and white-tailed deer in the summer and fall of 2012. USDA APHIS Veterinary Services area offices were asked to report on foreign animal disease investigations and state diagnostic laboratory submissions which resulted in a diagnosis of EHD based on positive PCR results. EHD was reported in the following species: cattle (129 herds, captive white-tailed deer (65 herds, bison (8 herds, yak (6 herds, elk (1 herd, and sheep (1 flock. A majority of the cases in cattle and bison were found in Nebraska, South Dakota, and Iowa. The majority of cases in captive white-tailed deer were found in Ohio, Iowa, Michigan, and Missouri. The most common clinical sign observed in the cattle and bison herds was oral lesions. The major observation in captive white-tailed deer herds was death. Average within-herd morbidity was 7% in cattle and bison herds, and 46% in captive white-tailed deer herds. The average within-herd mortality in captive white-tailed deer herds was 42%.

  5. Privacy of genetic information: a review of the laws in the United States.

    Science.gov (United States)

    Fuller, B; Ip, M

    2001-01-01

    This paper examines the privacy of genetic information and the laws in the United States designed to protect genetic privacy. While all 50 states have laws protecting the privacy of health information, there are many states that have additional laws that carve out additional protections specifically for genetic information. The majority of the individual states have enacted legislation to protect individuals from discrimination on the basis of genetic information, and most of this legislation also has provisions to protect the privacy of genetic information. On the Federal level, there has been no antidiscrimination or genetic privacy legislation. Secretary Donna Shalala of the Department of Health and Human Services has issued proposed regulations to protect the privacy of individually identifiable health information. These regulations encompass individually identifiable health information and do not make specific provisions for genetic information. The variety of laws regarding genetic privacy, some found in statutes to protect health information and some found in statutes to prevent genetic discrimination, presents challenges to those charged with administering and executing these laws.

  6. A review of gasoline retailing Canada vs United States: Update, 1980-1990

    International Nuclear Information System (INIS)

    1992-10-01

    A comparison is presented of the economies of scale achieved by the gasoline retailing sector in Canada and the United States over the period 1980-1990. Gasoline demand increased steadily in the USA and by 1990 was 10% higher than in 1980, while in Canada the fluctuating demand has led to a 12% decline for the same period. Number of automobiles increased 23% in Canada compared to 19% in the USA, while number of retail outlets fell by 5,000 in Canada and 47,000 in the USA. The average distance travelled by automobile increased 11% and 7%, respectively for Canada and the USA, however Canadians drove 7% further than Americans. In 1990, automobiles used ca 200 litres less fuel per year in Canada than the USA. Average sales per outlet increased by 56% in the USA and 10% in Canada. While most of the price difference between American and Canadian gasoline is attributable to taxes, the larger size of American refineries, transportation costs, product slate and product demand affects prices. 6 figs

  7. Drug utilization review of cephalosporins in a secondary care hospital in United Arab Emirates.

    Science.gov (United States)

    Abou-Shaaban, Mohammad; Ali, Areeg Anwer; Rao, Padma G M; Majid, Asif

    2016-12-01

    Background Cephalosporins are one of the most commonly used antibiotics in United Arab Emirates (UAE). Few studies have been carried out to evaluate the antibiotic utilization pattern in UAE in spite of the obvious increase in cephalosporins resistance during the past decade. Objective To assess the prescriptions pattern of cephalosporins among physicians at a secondary care hospital in Ras Al Khaimah, UAE. Method This observational prospective study was carried out during October 2013 to April 2014. The data of in patients were documented in the predesigned patient profile form and was analyzed for patient's, drug's and drug's therapy related parameters. Results The 3rd generation cephalosporins constituted 83.6 % of the prescriptions, with ceftriaxone being the most commonly used one (81.1 %). They were mainly prescribed for the treatment of the lower respiratory tract infections (60.2 %). Seven (3.5 %) different ADRs linked to cephalosporin use were observed ranging from oral thrush to clostridium difficile infection. A total of 1039 antimicrobial and nonantimicrobial medications were prescribed concomitantly with cephalosporins. Conclusion The 3rd generation cephalosporins were commonly prescribed by parenteral route. Thus, there is a strong need for rationalizing their use to preserve their efficacy and prevent the development of resistance in the region.

  8. Becoming a father in Neonatal Intensive Care Unit: an integrative review

    Directory of Open Access Journals (Sweden)

    Bruna de Souza Lima Marski

    2015-07-01

    Full Text Available ematurity and low birth weight are prevalent cases of children hospitalized in Neonatal Intensive Care Units (NICU in Brazil. The hospitalization of a child shortly after birth requires early separation from parents with ramifications for the development of maternity and paternity. This study has the objective to know the national and international scientific productions, published between 2007 and June 2012, addressing the aspects of becoming a father of a premature and/or low birth weight infant admitted in NICUs and to identify core promoters to the development of paternity in this situation. The results express lack of professional support to the father of the child born premature and/or with low birth weight hospitalized in NICUs, especially for disregarding the relationships with professionals. Such aspects were explored by the following thematic groups: Needs and contempt; Proximity; Transformation and every day life; Fathers and the NICU’s staff; and Paternity after hospital discharge. Relationships with professionals gain prominence as a hub for promoting fatherhood in this context with a view to comprehensive health care of children.

  9. Cervical Cancer Screening Among Arab Women in the United States: An Integrative Review.

    Science.gov (United States)

    Abboud, Sarah; De Penning, Emily; Brawner, Bridgette M; Menon, Usha; Glanz, Karen; Sommers, Marilyn S

    2017-01-01

    Arab American women are an ethnic minority and immigrant population in the United States with unique and nuanced sociocultural factors that influence preventive health behaviors. The aims of this article are to evaluate and synthesize the existing evidence on cervical cancer screening behaviors, as well as determine factors that influence these behaviors, among Arab American women.
. Extensive literature searches were performed using PubMed, CINAHL®, Scopus, Embase, and Cochrane databases; articles published through October 2015 were sought. 
. Of 17 articles, 14 explicitly identified Arab and/or Muslim women and cervical cancer screening in either the title or the abstract; the remaining three focused on cancer attitudes and behaviors in Arab Americans in general but measured cervical cancer screening. Eleven articles reported different aspects of one intervention. Because of methodologic heterogeneity, the current authors synthesized results narratively.
. Key factors influencing cervical cancer screening were identified as the following. Cervical cancer screening rates among Arab American women are comparable to other ethnic minorities and lower than non-Hispanic White women. Findings are inconsistent regarding factors influencing cervical cancer screening behaviors in this underrepresented group. 
. Significant need exists for more research to better understand cervical cancer prevention behaviors in this group to inform culturally relevant interventions. Healthcare providers play a crucial role in increasing cervical cancer screening awareness and recommendations for Arab American women.

  10. Assessment of the mechanical properties of the muscle-tendon unit by supersonic shear wave imaging elastography: a review

    Directory of Open Access Journals (Sweden)

    Kelly Mônica Marinho e Lima

    2018-01-01

    Full Text Available This review aimed to describe the state of the art in muscle-tendon unit (MTU assessment by supersonic shear wave imaging (SSI elastography in states of muscle contraction and stretching, during aging, and in response to injury and therapeutic interventions. A consensus exists that MTU elasticity increases during passive stretching or contraction, and decreases after static stretching, electrostimulation, massage, and dry needling. There is currently no agreement regarding changes in the MTU due to aging and injury. Currently, the application of SSI for the purpose of diagnosis, rehabilitation, and physical training remains limited by a number of issues, including the lack of normative value ranges, the lack of consensus regarding the appropriate terminology, and an inadequate understanding of the main technical limitations of this novel technology.

  11. Review and evaluation of the Millstone Unit 3 probabilistic safety study. Containment failure modes, radiological source - terms and offsite consequences

    International Nuclear Information System (INIS)

    Khatib-Rahbar, M.; Pratt, W.; Ludewig, H.

    1985-09-01

    A technical review and evaluation of the Millstone Unit 3 probabilistic safety study has been performed. It was determined that; (1) long-term damage indices (latent fatalities, person-rem, etc.) are dominated by late failure of the containment, (2) short-term damage indices (early fatalities, etc.) are dominated by bypass sequences for internally initiated events, while severe seismic sequences can also contribute significantly to early damage indices. These overall estimates of severe accident risk are extremely low compared with other societal sources of risk. Furthermore, the risks for Millstone-3 are comparable to risks from other nuclear plants at high population sites. Seismically induced accidents dominate the severe accident risks at Millstone-3. Potential mitigative features were shown not to be cost-effective for internal events. Value-impact analysis for seismic events showed that a manually actuated containment spray system might be cost-effective

  12. Computer science teacher professional development in the United States: a review of studies published between 2004 and 2014

    Science.gov (United States)

    Menekse, Muhsin

    2015-10-01

    While there has been a remarkable interest to make computer science a core K-12 academic subject in the United States, there is a shortage of K-12 computer science teachers to successfully implement computer sciences courses in schools. In order to enhance computer science teacher capacity, training programs have been offered through teacher professional development. In this study, the main goal was to systematically review the studies regarding computer science professional development to understand the scope, context, and effectiveness of these programs in the past decade (2004-2014). Based on 21 journal articles and conference proceedings, this study explored: (1) Type of professional development organization and source of funding, (2) professional development structure and participants, (3) goal of professional development and type of evaluation used, (4) specific computer science concepts and training tools used, (5) and their effectiveness to improve teacher practice and student learning.

  13. The Use of Technology for STD Partner Services in the United States: A Structured Review.

    Science.gov (United States)

    Kachur, Rachel; Hall, Wendasha; Coor, Alexandra; Kinsey, Jennine; Collins, Dayne; Strona, F V

    2018-05-01

    Since the late 1990s, health departments and STD programs throughout the U.S. have used technologies, such as the internet and mobile phones, to provide services to persons with a sexually transmitted infection, including HIV, and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. We conducted a structured literature review of all U.S. studies that examined the use of technology to notify persons exposed to an STD (syphilis, chlamydia, gonorrhea), including HIV, by health care professionals in the U.S. from 2000 to 2017. Outcome measures, including the number of the number of partners notified, screened or tested; and new positives identified, were captured and cost savings were calculated, when data were available. Seven studies were identified. Methods used for partner services differed across studies, although email was the primary mode in 6 (83%) of the 7 studies. Only 2 of the 7 studies compared use of technology for partner services to traditional partner services. Between 10% and 97% of partners were successfully notified of their exposure through the use of technology and between 34% and 81% were screened or tested. Five studies reported on new infections identified, which ranged from 3-19. Use of technology for partner serves saved programs between $22,795 and $45,362 in direct and indirect medical costs. Use of technology for partner services increased the number of partners notified, screened or tested, and new infections found. Importantly, the use of technology allowed programs to reach partners who otherwise would not have been notified of their exposure to an STD or HIV. Improved response times and time to treatment were also seen as was re-engagement into care for previous HIV positive patients. Data and outcome measures across the studies were not standardized, making it

  14. A systematic review of suicide prevention interventions targeting indigenous peoples in Australia, United States, Canada and New Zealand.

    Science.gov (United States)

    Clifford, Anton C; Doran, Christopher M; Tsey, Komla

    2013-05-13

    Indigenous peoples of Australia, Canada, United States and New Zealand experience disproportionately high rates of suicide. As such, the methodological quality of evaluations of suicide prevention interventions targeting these Indigenous populations should be rigorously examined, in order to determine the extent to which they are effective for reducing rates of Indigenous suicide and suicidal behaviours. This systematic review aims to: 1) identify published evaluations of suicide prevention interventions targeting Indigenous peoples in Australia, Canada, United States and New Zealand; 2) critique their methodological quality; and 3) describe their main characteristics. A systematic search of 17 electronic databases and 13 websites for the period 1981-2012 (inclusive) was undertaken. The reference lists of reviews of suicide prevention interventions were hand-searched for additional relevant studies not identified by the electronic and web search. The methodological quality of evaluations of suicide prevention interventions was assessed using a standardised assessment tool. Nine evaluations of suicide prevention interventions were identified: five targeting Native Americans; three targeting Aboriginal Australians; and one First Nation Canadians. The main intervention strategies employed included: Community Prevention, Gatekeeper Training, and Education. Only three of the nine evaluations measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. The methodological quality of evaluations was variable. Particular problems included weak study designs, reliance on self-report measures, highly variable consent and follow-up rates, and the absence of economic or cost analyses. There is an urgent need for an increase in the number of evaluations of preventive interventions targeting reductions in Indigenous suicide using methodologically rigorous study designs across geographically and culturally diverse Indigenous

  15. Impact of the design of neonatal intensive care units on neonates, staff, and families: a systematic literature review.

    Science.gov (United States)

    Shahheidari, Marzieh; Homer, Caroline

    2012-01-01

    Newborn intensive care is for critically ill newborns requiring constant and continuous care and supervision. The survival rates of critically ill infants and hospitalization in neonatal intensive care units (NICUs) have improved over the past 2 decades because of technological advances in neonatology. The design of NICUs may also have implications for the health of babies, parents, and staff. It is important therefore to articulate the design features of NICU that are associated with improved outcomes. The aim of this study was to explore the main features of the NICU design and to determine the advantages and limitations of the designs in terms of outcomes for babies, parents, and staff, predominately nurses. A systematic review of English-language, peer-reviewed articles was conducted for a period of 10 years, up to January 2011. Four online library databases and a number of relevant professional Web sites were searched using key words. There were 2 main designs of NICUs: open bay and single-family room. The open-bay environment develops communication and interaction with medical staff and nurses and has the ability to monitor multiple infants simultaneously. The single-family rooms were deemed superior for patient care and parent satisfaction. Key factors associated with improved outcomes included increased privacy, increased parental involvement in patient care, assistance with infection control, noise control, improved sleep, decreased length of hospital stay, and reduced rehospitalization. The design of NICUs has implications for babies, parents, and staff. An understanding of the positive design features needs to be considered by health service planners, managers, and those who design such specialized units.

  16. Smoking initiation among young adults in the United States and Canada, 1998-2010: a systematic review.

    Science.gov (United States)

    Freedman, Kit S; Nelson, Nanette M; Feldman, Laura L

    2012-01-01

    Young adults have the highest smoking rate of any age group in the United States and Canada, and recent data indicate that they often initiate smoking as young adults. The objective of this study was to systematically review peer-reviewed articles on cigarette smoking initiation and effective prevention efforts among young adults. We searched 5 databases for research articles published in English between 1998 and 2010 on smoking initiation among young adults (aged 18-25) living in the United States or Canada. We extracted the following data from each study selected: the measure of initiation used, age range of initiation, age range of study population, data source, target population, sampling method, and sample size. We summarized the primary findings of each study according to 3 research questions and categories of data (eg, sociodemographic) that emerged during the data extraction process. Of 1,072 identified studies, we found 27 articles that met our search criteria, but several included a larger age range of initiation (eg, 18-30, 18-36) than we initially intended to include. Disparities in young adult smoking initiation existed according to sex, race, and educational attainment. The use of alcohol and illegal drugs was associated with smoking initiation. The risk of smoking initiation among young adults increased under the following circumstances: exposure to smoking, boredom or stress while serving in the military, attending tobacco-sponsored social events while in college, and exposure to social norms and perceptions that encourage smoking. Effective prevention efforts include exposure to counter-marketing, denormalization campaigns, taxation, and the presence of smoke-free policies. Much remains to be learned about young adult smoking initiation, particularly among young adults in the straight-to-work population. Dissimilar measures of smoking initiation limit our knowledge about smoking initiation among young adults. We recommend developing a standardized

  17. The scope and impact of mobile health clinics in the United States: a literature review.

    Science.gov (United States)

    Yu, Stephanie W Y; Hill, Caterina; Ricks, Mariesa L; Bennet, Jennifer; Oriol, Nancy E

    2017-10-05

    As the U.S. healthcare system transforms its care delivery model to increase healthcare accessibility and improve health outcomes, it is undergoing changes in the context of ever-increasing chronic disease burdens and healthcare costs. Many illnesses disproportionately affect certain populations, due to disparities in healthcare access and social determinants of health. These disparities represent a key area to target in order to better our nation's overall health and decrease healthcare expenditures. It is thus imperative for policymakers and health professionals to develop innovative interventions that sustainably manage chronic diseases, promote preventative health, and improve outcomes among communities disenfranchised from traditional healthcare as well as among the general population. This article examines the available literature on Mobile Health Clinics (MHCs) and the role that they currently play in the U.S. healthcare system. Based on a search in the PubMed database and data from the online collaborative research network of mobile clinics MobileHealthMap.org , the authors evaluated 51 articles with evidence on the strengths and weaknesses of the mobile health sector in the United States. Current literature supports that MHCs are successful in reaching vulnerable populations, by delivering services directly at the curbside in communities of need and flexibly adapting their services based on the changing needs of the target community. As a link between clinical and community settings, MHCs address both medical and social determinants of health, tackling health issues on a community-wide level. Furthermore, evidence suggest that MHCs produce significant cost savings and represent a cost-effective care delivery model that improves health outcomes in underserved groups. Even though MHCs can fulfill many goals and mandates in alignment with our national priorities and have the potential to help combat some of the largest healthcare challenges of this era, there

  18. Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review.

    Science.gov (United States)

    Hindi, Ali M K; Schafheutle, Ellen I; Jacobs, Sally

    2018-04-01

    The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited. To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services. Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings. UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016. Data were extracted into a grid and subjected to narrative synthesis following thematic analysis. From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi-structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes "public cognizance" and "attitudes towards services" each with 4 subthemes. Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists' clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness. © 2017 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  19. Direct medical cost of overweight and obesity in the United States: a quantitative systematic review

    Science.gov (United States)

    Tsai, Adam Gilden; Williamson, David F.; Glick, Henry A.

    2010-01-01

    Objectives To estimate per-person and aggregate direct medical costs of overweight and obesity and to examine the effect of study design factors. Methods PubMed (1968–2009), EconLit (1969–2009), and Business Source Premier (1995–2009) were searched for original studies. Results were standardized to compute the incremental cost per overweight person and per obese person, and to compute the national aggregate cost. Results A total of 33 U.S. studies met review criteria. Among the 4 highest quality studies, the 2008 per-person direct medical cost of overweight was $266 and of obesity was $1723. The aggregate national cost of overweight and obesity combined was $113.9 billion. Study design factors that affected cost estimate included: use of national samples versus more selected populations; age groups examined; inclusion of all medical costs versus obesity-related costs only; and BMI cutoffs for defining overweight and obesity. Conclusions Depending on the source of total national health care expenditures used, the direct medical cost of overweight and obesity combined is approximately 5.0% to 10% of U.S. health care spending. Future studies should include nationally representative samples, evaluate adults of all ages, report all medical costs, and use standard BMI cutoffs. PMID:20059703

  20. Health facility environment as humanization strategy care in the pediatric unit: systematic review

    Directory of Open Access Journals (Sweden)

    Juliane Portella Ribeiro

    2014-06-01

    Full Text Available Objective: To identify and analyze the production of knowledge about the strategies that health care institutions have implemented to humanize care of hospitalized children. Method: This is a systematic review conducted in the Virtual Health Library - Nursing and SciELO, using the seven steps proposed by the Cochrane Handbook. Results: 15 studies were selected, and strategies that involved relationship exchanges were used between the health professional, the hospitalized child and their families, which may be mediated by leisure activities, music and by reading fairy tales. We also include the use of the architecture itself as a way of providing welfare to the child and his/her family, as well as facilitating the development of the work process of health professionals. Conclusion: Investments in research and publications about the topic are necessary, so that, the National Humanization Policy does not disappear and that the identified strategies in this study do not configure as isolated and disjointed actions of health policy.

  1. Incorporation of a rotavirus vaccine into the national immunisation schedule in the United Kingdom: a review.

    Science.gov (United States)

    Nakagomi, Osamu; Iturriza-Gomara, Miren; Nakagomi, Toyoko; Cunliffe, Nigel A

    2013-11-01

    Rotavirus, the commonest cause of severe acute gastroenteritis in infants and young children worldwide, imposes a large health and economic burden on the British society, accounting for an estimated 14,300 hospitalisations and 133,000 general practitioner consultations each year among children aged rotavirus vaccine, Rotarix (GlaxoSmithKline Biologicals, Belgium), was introduced into the UK childhood immunisation programme in 2013. This article provides a review of the product profile of the Rotarix vaccine for use in the national immunisation programme in the UK from an expert perspective. This single G1P[8] strain-based human rotavirus vaccine has demonstrated high efficacy in preventing severe rotavirus gastroenteritis in the first 3 years of life in middle- and high-income countries. In countries that have adopted rotavirus vaccine in childhood immunisation programmes, indirect benefits (herd protection) have been observed among older, unvaccinated children and adults. When the first dose is administered between 6 and 14 weeks of age and the last dose by 24 weeks of age, Rotarix carries a small risk of intussusception within the week of vaccination. However, this small risk may at most result in a negligible population attributable risk at the end of the first year of life. Overall, the rotavirus immunisation programme is expected to provide substantial health benefits to the UK population.

  2. Microbiological safety of mayonnaise, salad dressings, and sauces produced in the United States: a review.

    Science.gov (United States)

    Smittle, R B

    2000-08-01

    The literature on the death and survival of foodborne pathogens in commercial mayonnaise, dressing, and sauces was reviewed and statistically analyzed with emphasis on Salmonella, Escherichia coli O157:H7, and Listeria monocytogenes. The absence of reports of foodborne illness associated directly with the consumption of commercially prepared acidic dressings and sauces is evidence of their safety. Salmonella, E. coli O157:H7, E. coli, L. monocytogenes, Staphylococcus aureus, and Yersinia enterocolitica die when inoculated into mayonnaise and dressings. Historically, mayonnaise and dressings have been exempt from the acidified food regulations and have justly deserved this status due primarily to the toxic effect of acetic and to a lesser extent lactic and citric acids. These organic acids are inimical to pathogenic bacteria and are effective natural preservatives with acetic being the most effective in killing pathogenic bacteria at the pH values encountered in these products. Statistical analysis on data reported in the literature shows that the most important and significant factor in destroying pathogenic bacteria is pH as adjusted with acetic acid followed by the concentration of acetic acid in the water phase. The reported highest manufacturing target pH for dressings and sauces is 4.4, which is below the 4.75 pKa of acetic acid and below the reported inhibitory pH of 4.5 for foodborne pathogens in the presence of acetic acid. The overall conclusion is that these products are very safe. They should remain exempt from the acidified food regulations providing adequate research has been done to validate their safety, and the predominant acid is acetic and reasonable manufacturing precautions are taken.

  3. Systematic review of the incidence of sudden cardiac death in the United States.

    Science.gov (United States)

    Kong, Melissa H; Fonarow, Gregg C; Peterson, Eric D; Curtis, Anne B; Hernandez, Adrian F; Sanders, Gillian D; Thomas, Kevin L; Hayes, David L; Al-Khatib, Sana M

    2011-02-15

    The need for consistent and current data describing the true incidence of sudden cardiac arrest (SCA) and/or sudden cardiac death (SCD) was highlighted during the most recent Sudden Cardiac Arrest Thought Leadership Alliance's (SCATLA) Think Tank meeting of national experts with broad representation of key stakeholders, including thought leaders and representatives from the American College of Cardiology, American Heart Association, and the Heart Rhythm Society. As such, to evaluate the true magnitude of this public health problem, we performed a systematic literature search in MEDLINE using the MeSH headings, "death, sudden" OR the terms "sudden cardiac death" OR "sudden cardiac arrest" OR "cardiac arrest" OR "cardiac death" OR "sudden death" OR "arrhythmic death." Study selection criteria included peer-reviewed publications of primary data used to estimate SCD incidence in the U.S. We used Web of Science's Cited Reference Search to evaluate the impact of each primary estimate on the medical literature by determining the number of times each "primary source" has been cited. The estimated U.S. annual incidence of SCD varied widely from 180,000 to >450,000 among 6 included studies. These different estimates were in part due to different data sources (with data age ranging from 1980 to 2007), definitions of SCD, case ascertainment criteria, methods of estimation/extrapolation, and sources of case ascertainment. The true incidence of SCA and/or SCD in the U.S. remains unclear, with a wide range in the available estimates that are badly dated. As reliable estimates of SCD incidence are important for improving risk stratification and prevention, future efforts are clearly needed to establish uniform definitions of SCA and SCD and then to prospectively and precisely capture cases of SCA and SCD in the overall U.S. population. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. Liquid metal fires. A review of work status in the United Kingdom

    International Nuclear Information System (INIS)

    Newman, R.N.; Hargreaves, K.

    1983-01-01

    Liquid metal coolants (Na and NaK) are used for the transfer of heat in LMFBR circuits. Their high chemical reactivity and the high circuit operating temperatures mean that any leakage of coolant to the atmosphere can result in spontaneous combustion. Additionally spilled coolant may contact and react with structural materials such as concrete. These sodium fires and reactions with concrete are exothermic, and the fires in particular are characterised by significant evolution of heat and release of combustion product aerosols in high concentrations. A major sodium fire places special demands on the integrity of reactor secondary containment structures and may require special measures to control the release of chemically toxic (and possibly radioactive) aerosols to the environment. Precautions must also be taken to minimise damage to equipment, especially safety-related items. Work under way in laboratories in a number of countries is aimed at resolving these issues. These studies comprise investigations of the combustion mechanisms of sodium in both liquid and vapour states, and of the reactions of sodium with structural materials at high temperature. Extensive studies are also under way on the chemical and physical nature and on the behaviour of airborne reaction products released from fires. Data from these studies are used as an input to codes developed to model conditions resulting from sodium fires and thus to provide a basis for the design of containment structures and air clean-up equipment requirements. A knowledge of liquid metal combustion mechanisms is also a necessary adjunct to the development of fire prevention and fire-fighting systems. In the UK fire studies are conducted by CEGB (Berkeley Laboratories), NNC and the UKAEA, and this paper reviews the status of work carried out

  5. Do United States’ Teachers Know and Adhere to the National Guidelines on Asthma Management in the Classroom? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yudilyn Jaramillo

    2015-01-01

    Full Text Available Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms “asthma management,” “teacher(s,” “school teacher,” and “public school.” The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US. From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

  6. Review of registration requirements for new part-time doctors in New Zealand, Australia, the United Kingdom, Ireland and Canada.

    Science.gov (United States)

    Leitch, Sharon; Dovey, Susan M

    2010-12-01

    By the time medical students graduate many wish to work part-time while accommodating other lifestyle interests. To review flexibility of medical registration requirements for provisional registrants in New Zealand, Australia, the United Kingdom, Ireland and Canada. Internet-based review of registration bodies of each country, and each state or province in Australia and Canada, supplemented by emails and phone calls seeking clarification of missing or obscure information. Data from 20 regions were examined. Many similarities were found between study countries in their approaches to the registration of new doctors, although there are some regional differences. Most regions (65%) have a provisional registration period of one year. Extending this period was possible in 91% of regions. Part-time options were possible in 75% of regions. All regions required trainees to work in approved practice settings. Only the UK provided comprehensive documentation of their requirements in an accessible format and clearly explaining the options for part-time work. Australia appeared to be more flexible than other countries with respect to part- and full-time work requirements. All countries need to examine their registration requirements to introduce more flexibility wherever possible, as a strategy for addressing workforce shortages.

  7. Review: Regional groundwater flow modeling in heavily irrigated basins of selected states in the western United States

    Science.gov (United States)

    Rossman, Nathan R.; Zlotnik, Vitaly A.

    2013-09-01

    Water resources in agriculture-dominated basins of the arid western United States are stressed due to long-term impacts from pumping. A review of 88 regional groundwater-flow modeling applications from seven intensively irrigated western states (Arizona, California, Colorado, Idaho, Kansas, Nebraska and Texas) was conducted to provide hydrogeologists, modelers, water managers, and decision makers insight about past modeling studies that will aid future model development. Groundwater models were classified into three types: resource evaluation models (39 %), which quantify water budgets and act as preliminary models intended to be updated later, or constitute re-calibrations of older models; management/planning models (55 %), used to explore and identify management plans based on the response of the groundwater system to water-development or climate scenarios, sometimes under water-use constraints; and water rights models (7 %), used to make water administration decisions based on model output and to quantify water shortages incurred by water users or climate changes. Results for 27 model characteristics are summarized by state and model type, and important comparisons and contrasts are highlighted. Consideration of modeling uncertainty and the management focus toward sustainability, adaptive management and resilience are discussed, and future modeling recommendations, in light of the reviewed models and other published works, are presented.

  8. Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses.

    Science.gov (United States)

    Zahnd, Whitney E; McLafferty, Sara L

    2017-11-01

    There is increasing call for the utilization of multilevel modeling to explore the relationship between place-based contextual effects and cancer outcomes in the United States. To gain a better understanding of how contextual factors are being considered, we performed a systematic review. We reviewed studies published between January 1, 2002 and December 31, 2016 and assessed the following attributes: (1) contextual considerations such as geographic scale and contextual factors used; (2) methods used to quantify contextual factors; and (3) cancer type and outcomes. We searched PubMed, Scopus, and Web of Science and initially identified 1060 studies. One hundred twenty-two studies remained after exclusions. Most studies utilized a two-level structure; census tracts were the most commonly used geographic scale. Socioeconomic factors, health care access, racial/ethnic factors, and rural-urban status were the most common contextual factors addressed in multilevel models. Breast and colorectal cancers were the most common cancer types, and screening and staging were the most common outcomes assessed in these studies. Opportunities for future research include deriving contextual factors using more rigorous approaches, considering cross-classified structures and cross-level interactions, and using multilevel modeling to explore understudied cancers and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Review of infrastructures and preparedness systems in France, Germany and United Kingdom for potential releases of radioactivity into the environment

    International Nuclear Information System (INIS)

    Fiedler, I.; Voigt, G.; Lochard, J.; Croueail, P.; Nisbet, A.; Mercer, J.; Green, N.; Wilkins, B.

    2004-01-01

    For the European SAGE-Project a review of the existing infrastructures and preparedness systems in France, Germany and United Kingdom concerning radiation protection with regard to a long term contamination after a nuclear accident was made. This review clearly shows that the infrastructure in all three countries regulates the situation during and shortly after a nuclear incident but not in case that a radioactive contamination will last for long time. For that situation it is necessary to install local information centres in the affected area with sufficient trained staff. To improve the confidence of the population in possible measures implemented by the authorities a copious and understandable information and education must be provided. Especially doctors, teachers, kindergarten teachers and mothers have to get the possibility to be educated in a reasonable way how to deal with a short, middle and long term contamination. The concerned population must be able to control the own radiological situation by measuring their environment and their food and by reducing food contamination by appropriate reasonable measures. (orig.)

  10. Review of infrastructures and preparedness systems in France, Germany and United Kingdom for potential releases of radioactivity into the environment

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, I.; Voigt, G. [International Atomic Energy Agency, Vienna (Austria); Lochard, J.; Croueail, P. [Centre d' Etudes sur l' Evaluation de la Protection dans le Domaine Nucleaire, Paris (France); Nisbet, A.; Mercer, J.; Green, N.; Wilkins, B. [National Radiological Protection Board, Chilton (United Kingdom)

    2004-07-01

    For the European SAGE-Project a review of the existing infrastructures and preparedness systems in France, Germany and United Kingdom concerning radiation protection with regard to a long term contamination after a nuclear accident was made. This review clearly shows that the infrastructure in all three countries regulates the situation during and shortly after a nuclear incident but not in case that a radioactive contamination will last for long time. For that situation it is necessary to install local information centres in the affected area with sufficient trained staff. To improve the confidence of the population in possible measures implemented by the authorities a copious and understandable information and education must be provided. Especially doctors, teachers, kindergarten teachers and mothers have to get the possibility to be educated in a reasonable way how to deal with a short, middle and long term contamination. The concerned population must be able to control the own radiological situation by measuring their environment and their food and by reducing food contamination by appropriate reasonable measures. (orig.)

  11. A Cross-National Review of Evidence-Based Psychosocial Treatments for Children and Adolescents with Autistic Spectrum Disorders in the United Kingdom, Ireland, and United States

    Science.gov (United States)

    Robinson, Lee; Bond, Caroline

    2017-01-01

    The most thoroughly researched topic in relation to autistic spectrum disorders (ASDs) is the evaluation of interventions. Educational psychology in the United Kingdom and Ireland is the most closely allied profession to school psychology in the United States. In considering what is published by and for the profession, it is important to include…

  12. Review of operational experience with the gas-cooled Magnox reactors of the United Kingdom Central Electricity Generating Board

    International Nuclear Information System (INIS)

    Cave, L.; Clarke, A.W.

    1984-01-01

    The paper provides a review, which is mainly of a statistical nature, of 260 reactor years of operating experience which the (United Kingdom) Central Electricity Generating Board (CEGB) has obtained with its gas-cooled, graphite moderated Magnox reactors. The main emphasis in the review is on safety rather than on availability. Data are provided on the overall incidence and frequencies of faults and it is shown that the plant items which are predominantly responsible for recorded faults are the gas circulators and the turbo-alternators. Analysis of the reactor trip experience shows that the incidence of events which necessitate an automatic shutdown of the reactor has been about one per reactor year and that of other events leading to a reactor trip has not been much higher (1.4 per reactor year). As would be expected from the length of the operating experience, some relatively rare events have occurred (expected frequency 10 -2 per reactor year, or less) but on each occasion the reactor shutdown system and decay heat removal systems functioned satisfactorily. No overheating of, or damage to, the fuel occurred as a result of these rare events or of other, more frequent, faults. Analysis of the trend of failure rates has shown an improvement with time in nearly all safety-related items and external inspection of the primary coolant circuits has shown no significant deterioration with time. However, some derating of the reactors has been necessary to reduce the effects of oxidation of mild steel in CO 2 , in order to obtain optimum service lives. In spite of major differences between the systems, a comparison of the failure rates of analogous systems and plant items in PWRs and the Magnox reactors show a considerable similarity. Overall, the review of CEGB's operational experience with its Magnos reactors has shown that the frequencies of faults in systems and plant items has been satisfyingly low. (author)

  13. Quality of care assessment in geriatric evaluation and management units: construction of a chart review tool for a tracer condition

    Directory of Open Access Journals (Sweden)

    Latour Judith

    2009-07-01

    Full Text Available Abstract Background The number of elderly people requiring hospital care is growing, so, quality and assessment of care for elders are emerging and complex areas of research. Very few validated and reliable instruments exist for the assessment of quality of acute care in this field. This study's objective was to create such a tool for Geriatric Evaluation and Management Units (GEMUs. Methods The methodology involved a reliability and feasibility study of a retrospective chart review on 934 older inpatients admitted in 49 GEMUs during the year 2002–2003 for fall-related trauma as a tracer condition. Pertinent indicators for a chart abstraction tool, the Geriatric Care Tool (GCT, were developed and validated according to five dimensions: access to care, comprehensiveness, continuity of care, patient-centred care and appropriateness. Consensus methods were used to develop the content. Participants were experts representing eight main health care professions involved in GEMUs from 19 different sites. Items associated with high quality of care at each step of the multidisciplinary management of patients admitted due to falls were identified. The GCT was tested for intra- and inter-rater reliability using 30 medical charts reviewed by each of three independent and blinded trained nurses. Kappa and agreement measures between pairs of chart reviewers were computed on an item-by-item basis. Results Three quarters of 169 items identifying the process of care, from the case history to discharge planning, demonstrated good agreement (kappa greater than 0.40 and agreement over 70%. Indicators for the appropriateness of care showed less reliability. Conclusion Content validity and reliability results, as well as the feasibility of the process, suggest that the chart abstraction tool can gather standardized and pertinent clinical information for further evaluating quality of care in GEMU using admission due to falls as a tracer condition. However, the GCT

  14. A review of the United Kingdom fast reactor programme: March 1985

    International Nuclear Information System (INIS)

    Bramman, J.I.; John, C.T.; Wheeler, R.C.

    1986-01-01

    applicable methodologies, although this latter objective remains an ultimate goal. Other activities in the field of fast breeder reactors are also reviewed in this report

  15. 76 FR 71959 - KC Hydro LLC of New Hampshire; Notice of Preliminary Permit Application Accepted for Filing and...

    Science.gov (United States)

    2011-11-21

    ... shaft Kaplan turbine-generating unit with a total installed capacity of 0.84 MW; (5) a new 135-foot-long... outlet works; (4) a minimum flow turbine generator and a new 2,000-square-foot powerhouse containing one or two submersible or tubular-type turbine generators with a total installed capacity of 0.36 MW; (5...

  16. The effectiveness of music on pain among preterm infants in the neonatal intensive care unit: a systematic review.

    Science.gov (United States)

    Pölkki, Tarja; Korhonen, Anne

    The objective of this review is to synthesize the best available evidence related to the effectiveness of music as pain relieving method among preterm infants during painful procedures in the neonatal intensive care unit.Review questions are: Among preterm infants in the neonatal intensive care unit, is music effective in reducing BACKGROUND: Preterm infants (i.e. babies born at or before 37 gestational weeks) compose a patient group of the most vulnerable to pain. Infants treated in a neonatal intensive care unit (NICU) are exposed to a variety of painful procedures (e.g. heel prick, iv cannula insertion, endotracheal suctioning) and to environmental stress (e.g. noise, light). Simons et al., for example, described an average 14 +/- 4 painful procedures during the first 2 weeks of life within a period of 24 hours among 151 neonates. Many studies have shown that repeated and sustained pain can have direct and long-term consequences on the neurological and behavior-oriented development of the neonates during the rapid development phase of the central nervous system. Pain can cause detectable physiological, behavioral and hormonal changes and contribute to the altered development of the pain system during later childhood and adolescence. Instead, live music such as singing is excellent type of music when it is steady, constant, quiet, soothing and directed to the infants. Graven emphasizes that recorded sound should not replace human voice exposure in the NICU; therefore, health care providers should provide ample opportunity for the infant to hear parent's voices live, such as singing or humming, in interactions between the parent and the infant at the bedside.The AmericanAcademy of Pediatrics Committee on Environmental Health has recommended safe levels of sound, and these recommendations have been updated by an expert team of practitioners. Recommendations specify that continuous sound should not exceed an hourly equivalent sound level of 50 A-weighted decibels (d

  17. Amplification of the uvrA gene product of Escherichia coli to 7% of cellular protein by linkage to the p/sub L/ promoter of pKC30

    International Nuclear Information System (INIS)

    Yoakum, G.H.; Yeung, A.T.; Mattes, W.B.; Grossman, L.

    1982-01-01

    Researchers have constructed a hybrid pKC30-uvrA plasmid (pGHY5003) in which transcription of the uvrA gene can be induced under p/sub L/ control to amplify the uvrA gene product to 7% of cellular protein. To construct pGHY5003, researchers developed a genetic selection using the basal level of expression (30 0 C) from p/sub L/ in thermosensitive cI857 lysogens to isolate appropriately tailored repair genes inserted at the Hpa I site of pKC30 from recombinant DNA mixtures with a variety of products. In addition, a post-uv-irradiation radiolabeling method was adapted to screen inserts for temperature-inducible polypeptide synthesis directed by transcription under p/sub L/ control rapidly. This should prove generally useful for isolating genes inserted at the Hpa I site of plasmid pKC30 with the following characteristics: (1) genetically functional hybrid plasmids selected from a large population of exonucleolytically tailored fragments ligated into Hpa I of pKC30 and (2) production of high-level amplification for the gene product of interest by screening for post-uv-irradiation temperature inducibility of polypeptides synthesized from hybrid plasmids. The level of amplification obtained for the uvrA gene product from pGHY5003 is approximately 10,000-fold higher than estimates of the level of uvrA protein in logarithmic phase Escherichia coli

  18. Ecohydrological consequences of non-native riparian vegetation in the southwestern United States: A review from an ecophysiological perspective

    Science.gov (United States)

    Hultine, K. R.; Bush, S. E.

    2011-07-01

    Protecting water resources for expanding human enterprise while conserving valued natural habitat is among the greatest challenges of the 21st century. Global change processes such as climate change and intensive land use pose significant threats to water resources, particularly in arid regions where potential evapotranspiration far exceeds annual rainfall. Potentially compounding these shortages is the progressive expansion of non-native plant species in riparian areas along streams, canals and rivers in geographically arid regions. This paper sets out to identify when and where non-native riparian plant species are likely to have the highest potential impact on hydrologic fluxes of arid and semiarid river systems. We develop an ecophysiological framework that focuses on two main criteria: (1) examination of the physiological traits that promote non-native species establishment and persistence across environmental gradients, and (2) assessment of where and to what extent hydrologic fluxes are potentially altered by the establishment of introduced species at varying scales from individual plants, to small river reaches, to entire river basins. We highlight three non-native plant species that currently dominate southwestern United States riparian forests. These include tamarisk (Tamarix spp.), Russian olive (Eleagnus angustifolia), and Russian knapweed (Acroptilon repens). As with other recent reviews, we suspect that in many cases the removal of these, and other non-native species will have little or no impact on either streamflow volume or groundwater levels. However, we identify potential exceptions where the expansion of non-native plant species could have significant impact on ecohydrologic processes associated with southwestern United States river systems. Future research needs are outlined that will ultimately assist land managers and policy makers with restoration and conservation priorities to preserve water resources and valued riparian habitat given

  19. Host regulation of lysogenic decision in bacteriophage lambda: transmembrane modulation of FtsH (HflB), the cII degrading protease, by HflKC (HflA).

    Science.gov (United States)

    Kihara, A; Akiyama, Y; Ito, K

    1997-05-27

    The cII gene product of bacteriophage lambda is unstable and required for the establishment of lysogenization. Its intracellular amount is important for the decision between lytic growth and lysogenization. Two genetic loci of Escherichia coli are crucial for these commitments of infecting lambda genome. One of them, hflA encodes the HflKC membrane protein complex, which has been believed to be a protease degrading the cII protein. However, both its absence and overproduction stabilized cII in vivo and the proposed serine protease-like sequence motif in HflC was dispensable for the lysogenization control. Moreover, the HflKC protein was found to reside on the periplasmic side of the plasma membrane. In contrast, the other host gene, ftsH (hflB) encoding an integral membrane ATPase/protease, is positively required for degradation of cII, since loss of its function stabilized cII and its overexpression accelerated the cII degradation. In vitro, purified FtsH catalyzed ATP-dependent proteolysis of cII and HflKC antagonized the FtsH action. These results, together with our previous finding that FtsH and HflKC form a complex, suggest that FtsH is the cII degrading protease and HflKC is a modulator of the FtsH function. We propose that this transmembrane modulation differentiates the FtsH actions to different substrate proteins such as the membrane-bound SecY protein and the cytosolic cII protein. This study necessitates a revision of the prevailing view about the host control over lambda lysogenic decision.

  20. The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review.

    Science.gov (United States)

    van Mol, Margo M C; Kompanje, Erwin J O; Benoit, Dominique D; Bakker, Jan; Nijkamp, Marjan D

    2015-01-01

    Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health. The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue and the available preventive strategies. A systematic literature review was conducted, using Embase, Medline OvidSP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar for articles published between 1992 and June, 2014. Studies reporting the prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals were included, as well as related intervention studies. Forty of the 1623 identified publications, which included 14,770 respondents, met the selection criteria. Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The reported prevalence of burnout in the ICU varied from 0% to 70.1%. A wide range of intervention strategies emerged from the recent literature search, such as different intensivist work schedules, educational programs on coping with emotional distress, improving communication skills, and relaxation methods. The true prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals remains open for discussion. A thorough exploration of emotional distress in relation to communication skills, ethical rounds, and mindfulness might provide an appropriate starting point for the development of further preventive

  1. An integrative review of supports, facilitators and barriers to patient-centred nursing in the intensive care unit.

    Science.gov (United States)

    Jakimowicz, Samantha; Perry, Lin; Lewis, Joanne

    2017-12-01

    To systematically review the literature describing factors perceived by nurses as impacting the provision of patient-centred nursing in the intensive care unit. Patient-centred nursing in critical care differs from other healthcare areas, and the aggressive curative environment of the ICU has potential to compromise some of its elements. Understanding critical care, nurses' perceptions of promoting and deterrent factors may inform development of strategies to support effective patient-centred nursing and job satisfaction in this workforce. An integrative literature review. Whittemore and Knafl's method was used with "best-fit" framework synthesis. CINAHL, PsycINFO, Medline and EMBASE were searched for 2000-2016 literature using search terms drawn from the ICU patient-centred framework. In total, 3,079 papers were identified, with 23 retained after applying eligibility criteria. Five themes were identified: Nurse identity; Organisation; Communication; Relationships; and Ideology of ICU. Almost every theme and related categories referred to factors acting as barriers to patient-centred nursing in the ICU; only four referred to supports/facilitators. Findings showed that provision of patient-centred nursing may be compromised by some factors of the critical care environment, and illustrate the challenges and complexity of providing effective patient-centred nursing in this environment. Findings should be applied to address barriers and to enhance facilitators of effective patient-centred nursing in critical care. The emotional and physical demands of critical care nursing are major considerations; supporting these nurses to fulfil their challenging role may empower them in their professional quality of life and provide a basis for workforce retention as well as delivery of effective patient-centred nursing. Measures to enhance patient-centred nursing could promote critical care nurses' job satisfaction and workforce retention, and be applied more broadly and

  2. ALARA review of the maintenance and repair jobs of repetitive high radiation dose at Kori Unit 3 and 4

    International Nuclear Information System (INIS)

    Cho, Y.H.; Moon, J.H.; Kang, C.S.; Lee, J.S.; Lee, D.H.

    2003-01-01

    The policy of maintaining occupational radiation dose (ORD) as low as reasonably achievable (ALARA) requires the effective reduction of ORD in the phases of design as well as operation of nuclear power plants. It has been identified that a predominant portion of ORD arises during maintenance and repair operations at nuclear power plants. The cost-effective reduction of ORD cannot be achieved without a comprehensive analysis of accumulated ORD data of existing nuclear power plants. To identify the jobs of repetitive high ORD, the ORD data of Kori Units 3 and 4 over 10-year period from 1986 to 1995 were compiled into the PC-based ORD database program. As the radiation job classification structure, 26 main jobs are considered, most of which are further subdivided into detailed jobs. According to the order of the collective dose values for 26 main jobs, 10 jobs of high collective dose are identified. As an ALARA review, then, top 10 jobs of high collective dose are statistically analyzed with regard to 1) dose rate, 2) crew number and 3) job frequency that are the factors determining the collective dose for the radiation job of interest. Through the ALARA review, main reasons causing to high collective dose values are identified as follows. The high collective dose of RCP maintenance job is mainly due to the large crew number and the high job frequency. The characteristics of refueling job are similar to those of RCP maintenance job. However, the high collective doses of SG-related jobs such as S/G nozzle dam job, S/G man-way job and S/G tube maintenance job are mainly due to high radiation dose rate. (author)

  3. The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Margo M C van Mol

    Full Text Available Working in the stressful environment of the Intensive Care Unit (ICU is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or a brain and skill drain if the healthcare professionals leave their jobs prematurely in order to preserve their own health.The purpose of this review is to evaluate the literature related to emotional distress among healthcare professionals in the ICU, with an emphasis on the prevalence of burnout and compassion fatigue and the available preventive strategies.A systematic literature review was conducted, using Embase, Medline OvidSP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar for articles published between 1992 and June, 2014. Studies reporting the prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals were included, as well as related intervention studies.Forty of the 1623 identified publications, which included 14,770 respondents, met the selection criteria. Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The reported prevalence of burnout in the ICU varied from 0% to 70.1%. A wide range of intervention strategies emerged from the recent literature search, such as different intensivist work schedules, educational programs on coping with emotional distress, improving communication skills, and relaxation methods.The true prevalence of burnout, compassion fatigue, secondary traumatic stress and vicarious trauma in ICU healthcare professionals remains open for discussion. A thorough exploration of emotional distress in relation to communication skills, ethical rounds, and mindfulness might provide an appropriate starting point for the development of

  4. Forest products research and development organizations in a worldwide setting: A review of structure, governance, and measures of performance of organizations outside the United States

    Science.gov (United States)

    Paul V. Ellefson; Michael A. Kilgore; Kenneth E. Skog; Christopher D. Risbrudt

    2007-01-01

    Located in 23 countries, 40 forest-products research and development organizations outside the United States were reviewed in 2004 and 2005. The intent was to obtain a better understanding of how such organizations are structured and administered and their performance judged. Investing over $600 million annually, the 40 organizations employed 7,000 to 7,500 scientists...

  5. Book Review: McCoy, Alfred, Policing America’s Empire: The United States, the Philippines, and the Rise of the Surveillance State

    Directory of Open Access Journals (Sweden)

    Salvador Santino F. Regilme, Jr

    2010-01-01

    Full Text Available Book Review of the Monograph: McCoy, Alfred (2009, Policing America’s Empire: The United States, the Philippines, and the Rise of the Surveillance State, Madison, Wisconsin: The University of Wisconsin Press ISBN 978-0-299-23414-0, 659 pages

  6. Credible Leadership-In the Eyes of the Follower: A Historical Review of Leadership Theory throughout the Twentieth Century in the United States

    Science.gov (United States)

    Hoffman, Sharon C.

    2008-01-01

    The purpose of this historical review was to trace the credible leadership construct of trustworthiness, integrity, honesty, and consistency in leadership theory development during the last 100 years in the United States. Theory focus, key U.S. pivotal events, and follower importance influenced the construct's occurrence in leadership theory. …

  7. Assimilation into the literary mainstream? The classification of ethnic minority authors in newspaper reviews in the United States, the Netherlands and Germany

    NARCIS (Netherlands)

    P.P.L. Berkers (Pauwke); M.S.S.E. Janssen (Susanne); M.N.M. Verboord (Marc)

    2014-01-01

    textabstractThis article addresses to what extent literary critics in the United States, the Netherlands and Germany have drawn ethnic boundaries in their reviews of ethnic minority writers between 1983 and 2009 and to what extent these boundaries have changed in the course of ethnic minority

  8. Scales for evaluating self-perceived anxiety levels in patients admitted to intensive care units: a review.

    Science.gov (United States)

    Perpiñá-Galvañ, Juana; Richart-Martínez, Miguel

    2009-11-01

    To review studies of anxiety in critically ill patients admitted to an intensive care unit to describe the level of anxiety and synthesize the psychometric properties of the instruments used to measure anxiety. The CUIDEN, IME, ISOC, CINAHL, MEDLINE, and PSYCINFO databases for 1995 to 2005 were searched. The search focused on 3 concepts: anxiety, intensive care, and mechanical ventilation for the English-language databases and ansiedad, cuidados intensivos, and ventilación mecánica for the Spanish-language databases. Information was extracted from 18 selected articles on the level of anxiety experienced by patients and the psychometric properties of the instruments used to measure anxiety. Moderate levels of anxiety were reported. Levels were higher in women than in men, and higher in patients undergoing positive pressure ventilation regardless of sex. Most multi-item instruments had high coefficients of internal consistency. The reliability of instruments with only a single item was not demonstrated, even though the instruments had moderate-to-high correlations with other measurements. Midlength scales, such the anxiety subscale of the Brief Symptom Inventory or the shortened state version of the State-Trait Anxiety Inventory are best for measuring anxiety in critical care patients.

  9. The proximal hamstring muscle–tendon–bone unit: A review of the normal anatomy, biomechanics, and pathophysiology

    International Nuclear Information System (INIS)

    Beltran, Luis; Ghazikhanian, Varand; Padron, Mario; Beltran, Javier

    2012-01-01

    Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle–tendon–bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation.

  10. Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review.

    Science.gov (United States)

    Al-Shaar, Laila; Vercammen, Kelsey; Lu, Chang; Richardson, Scott; Tamez, Martha; Mattei, Josiemer

    2017-01-01

    As energy drink consumption continues to grow worldwide and within the United States, it is important to critically examine the nutritional content and effects on population health of these beverages. This mini-review summarizes the current scientific evidence on health consequences from energy drink consumption, presents relevant public health challenges, and proposes recommendations to mitigate these issues. Emerging evidence has linked energy drink consumption with a number of negative health consequences such as risk-seeking behaviors, poor mental health, adverse cardiovascular effects, and metabolic, renal, or dental conditions. Despite the consistency in evidence, most studies are of cross-sectional design or focus almost exclusively on the effect of caffeine and sugar, failing to address potentially harmful effects of other ingredients. The negative health effects associated with energy drinks (ED) are compounded by a lack of regulatory oversight and aggressive marketing by the industry toward adolescents. Moreover, the rising trend of mixing ED with alcohol presents a new challenge that researchers and public health practitioners must address further. To curb this growing public health issue, policy makers should consider creating a separate regulatory category for ED, setting an evidence-based upper limit on caffeine, restricting sales of ED, and regulating existing ED marketing strategies, especially among children and adolescents.

  11. Health Effects and Public Health Concerns of Energy Drink Consumption in the United States: A Mini-Review

    Directory of Open Access Journals (Sweden)

    Laila Al-Shaar

    2017-08-01

    Full Text Available As energy drink consumption continues to grow worldwide and within the United States, it is important to critically examine the nutritional content and effects on population health of these beverages. This mini-review summarizes the current scientific evidence on health consequences from energy drink consumption, presents relevant public health challenges, and proposes recommendations to mitigate these issues. Emerging evidence has linked energy drink consumption with a number of negative health consequences such as risk-seeking behaviors, poor mental health, adverse cardiovascular effects, and metabolic, renal, or dental conditions. Despite the consistency in evidence, most studies are of cross-sectional design or focus almost exclusively on the effect of caffeine and sugar, failing to address potentially harmful effects of other ingredients. The negative health effects associated with energy drinks (ED are compounded by a lack of regulatory oversight and aggressive marketing by the industry toward adolescents. Moreover, the rising trend of mixing ED with alcohol presents a new challenge that researchers and public health practitioners must address further. To curb this growing public health issue, policy makers should consider creating a separate regulatory category for ED, setting an evidence-based upper limit on caffeine, restricting sales of ED, and regulating existing ED marketing strategies, especially among children and adolescents.

  12. Prevention of ventilator-associated pneumonia in the intensive care unit: A review of the clinically relevant recent advancements

    Directory of Open Access Journals (Sweden)

    Holly Keyt

    2014-01-01

    Full Text Available Ventilator-associated pneumonia (VAP is one of the most commonly encountered hospital-acquired infections in intensive care units and is associated with significant morbidity and high costs of care. The pathophysiology, epidemiology, treatment and prevention of VAP have been extensively studied for decades, but a clear prevention strategy has not yet emerged. In this article we will review recent literature pertaining to evidence-based VAP-prevention strategies that have resulted in clinically relevant outcomes. A multidisciplinary strategy for prevention of VAP is recommended. Those interventions that have been shown to have a clinical impact include the following: (i Non-invasive positive pressure ventilation for able patients, especially in immunocompromised patients, with acute exacerbation of chronic obstructive pulmonary disease or pulmonary oedema, (ii Sedation and weaning protocols for those patients who do require mechanical ventilation, (iii Mechanical ventilation protocols including head of bed elevation above 30 degrees and oral care, and (iv Removal of subglottic secretions. Other interventions, such as selective digestive tract decontamination, selective oropharyngeal decontamination and antimicrobial-coated endotracheal tubes, have been tested in different studies. However, the evidence for the efficacy of these measures to reduce VAP rates is not strong enough to recommend their use in clinical practice. In numerous studies, the implementation of VAP prevention bundles to clinical practice was associated with a significant reduction in VAP rates. Future research that considers clinical outcomes as primary endpoints will hopefully result in more detailed prevention strategies.

  13. Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review

    International Nuclear Information System (INIS)

    Mitra, Debanjali; Kaye, James A; Piecoro, Lance T; Brown, Jennifer; Reith, Kelly; Mughal, Tariq I; Sarlis, Nicholas J

    2013-01-01

    Myelofibrosis (MF) is a clonal hematopoietic malignancy characterized by constitutional and localized symptoms, progressive splenomegaly, bone marrow fibrosis, and cytopenias. Although MF is well studied, few studies exist regarding its symptomatic burden in routine clinical practice. This study aimed to characterize symptoms and other clinical features of MF among patients in the United States. We conducted a retrospective medical record review of adult patients with an MF diagnosis between 1 January 2005 and 31 March 2010, stratified by the presence of palpable splenomegaly. Eligible patients had 12 months or more of follow-up after diagnosis (or after detection of splenomegaly, if present) unless death occurred. Demographic and clinical characteristics, MF-related symptoms, and treatments were reported by treating physicians. We report on 180 MF patients: 102 with splenomegaly, 78 without. Median age was 66 years, 63% were male, and 82% had intermediate-2 or high-risk MF (International Prognostic Scoring System). Fatigue was reported by ∼85% of patients; weight loss, night sweats, and fever (any grade) were each reported by 50% or more of patients. Generalized abdominal pain, left subcostal pain, and early satiety occurred more frequently among patients with splenomegaly. Multiple symptoms were reported by 95% of patients. Common comorbidities were hypertension, diabetes, and chronic pulmonary disease. Symptoms are common in MF patients, regardless of the presence of palpable splenomegaly. Careful assessment of symptom burden is an important aspect of the clinical evaluation of patients with MF

  14. The proximal hamstring muscle–tendon–bone unit: A review of the normal anatomy, biomechanics, and pathophysiology

    Energy Technology Data Exchange (ETDEWEB)

    Beltran, Luis, E-mail: luisbeltran@mac.com [Department of Radiology, Hospital for Joint Diseases, NYU, New York, NY (United States); Ghazikhanian, Varand, E-mail: varandg@aol.com [Department of Radiology, Maimonides Medical Center, Brooklyn, NY (United States); Padron, Mario, E-mail: mario.padron@cemtro.es [Clinica CEMTRO, Avenida del Ventisquero de la Condesa 42, 28035 Madrid (Spain); Beltran, Javier, E-mail: Jbeltran46@msn.com [Department of Radiology, Maimonides Medical Center, Brooklyn, NY (United States)

    2012-12-15

    Proximal hamstring injuries occur during eccentric contraction with the hip and the knee on extension; hence they are relatively frequent lesions in specific sports such as water skiing and hurdle jumping. Additionally, the trend toward increasing activity and fitness training in the general population has resulted in similar injuries. Myotendinous strains are more frequent than avulsion injuries. Discrimination between the two types of lesions is relevant for patient management, since the former is treated conservatively and the latter surgically. MRI and Ultrasonography are both well suited techniques for the diagnosis and evaluation of hamstring tendon injuries. Each one has its advantages and disadvantages. The purpose of this article is to provide a comprehensive review of the anatomy and biomechanics of the proximal hamstring muscle–tendon–bone unit and the varied imaging appearances of hamstring injury, which is vital for optimizing patient care. This will enable the musculoskeletal radiologist to contribute accurate and useful information in the treatment of athletes at all levels of participation.

  15. Review of the desalinated water market in France for small units; Apercu sur le marche de l'eau dessalee en France pour de petites unites

    Energy Technology Data Exchange (ETDEWEB)

    Dutheil, F; Malissen, M [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1969-07-01

    On the initiative of and in close collaboration with the Commissariat a l'Energie Atomique, the Societe pour la Conversion et le Developpement Industriel (SODIC) has carried out a very general study of the coastal regions of France in which the short, medium and long-term prospects of the demand for water, and the cost of the necessary supplies, could possibly make desalination units of 3 000 to 10 000 m3/day competitive. So far this general enquiry, which went into detail on some particular aspects, has not revealed any very clear possibilities in this respect, except in the case of the small islands, and of units of much lower capacity, as well as that of large units on the coast, which would benefit from the size effect. However the probable difference between the cost of desalinated water and the high selling price already applying in a small number of coastal regions is relatively small. It might therefore be worthwhile and relatively inexpensive to install an experimental desalination unit in the near future. (author) [French] A l'initiative du Commissariat a l'Energie Atomique et en etroite liaison avec lui, la Societe pour la Conversion et le Developpement Industriel (SODIC) a effectue une etude tres generale des zones cotieres francaises dans lesquelles les perspectives de la demande d'eau a court, moyen et long terme et le cout des approvisionnements necessaires, pourraient eventuellement faire apparaitre comme competitives des unites de dessalement de 3 a 10 000 m{sup 3}/jour. Jusqu'ici, cette enquete generale, d'ailleurs approfondie sur quelques points particuliers, n'a pas fait apparaitre de possibilites tres nettes a cet egard. Le cas des petites iles, et pour des unites de bien plus faible capacite, demeure reserve ainsi que, sur les zones cotieres, celui de grandes unites qui beneficieraient de l'effet de taille. Toutefois, l'ecart probable entre le cout de l'eau dessalee et le prix de vente eleve deja observe dans un petit nombre de zones cotieres

  16. Utilizing Physiological Principles of Motor Unit Recruitment to Reduce Fatigability of Electrically-Evoked Contractions: A Narrative Review.

    Science.gov (United States)

    Barss, Trevor S; Ainsley, Emily N; Claveria-Gonzalez, Francisca C; Luu, M John; Miller, Dylan J; Wiest, Matheus J; Collins, David F

    2018-04-01

    Neuromuscular electrical stimulation (NMES) is used to produce contractions to restore movement and reduce secondary complications for individuals experiencing motor impairment. NMES is conventionally delivered through a single pair of electrodes over a muscle belly or nerve trunk using short pulse durations and frequencies between 20 and 40Hz (conventional NMES). Unfortunately, the benefits and widespread use of conventional NMES are limited by contraction fatigability, which is in large part because of the nonphysiological way that contractions are generated. This review provides a summary of approaches designed to reduce fatigability during NMES, by using physiological principles that help minimize fatigability of voluntary contractions. First, relevant principles of the recruitment and discharge of motor units (MUs) inherent to voluntary contractions and conventional NMES are introduced, and the main mechanisms of fatigability for each contraction type are briefly discussed. A variety of NMES approaches are then described that were designed to reduce fatigability by generating contractions that more closely mimic voluntary contractions. These approaches include altering stimulation parameters, to recruit MUs in their physiological order, and stimulating through multiple electrodes, to reduce MU discharge rates. Although each approach has unique advantages and disadvantages, approaches that minimize MU discharge rates hold the most promise for imminent translation into rehabilitation practice. The way that NMES is currently delivered limits its utility as a rehabilitative tool. Reducing fatigability by delivering NMES in ways that better mimic voluntary contractions holds promise for optimizing the benefits and widespread use of NMES-based programs. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Disease burden of intensive care unit-acquired pneumonia in China: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Yaowen; Yao, Zhiyuan; Zhan, Siyan; Yang, Zhirong; Wei, Dong; Zhang, Jing; Li, Jingyi; Kyaw, Moe H

    2014-12-01

    Intensive care unit (ICU)-acquired pneumonia and ventilator-associated pneumonia (VAP) are associated with poor clinical and economic outcomes. Data regarding ICU-acquired pneumonia and VAP are not readily available from developing countries, including China. The objective of this meta-analysis was to evaluate the incidence, mortality rate, length of stay, and pathogens associated with ICU-acquired pneumonia in China. A meta-analysis and systematic review of 334 publications published between January 2007 and May 2012 and retrieved from the Chinese BioMedical database, China National Knowledge Infrastructure, VIP Chinese Science and Technique Journals database, Wanfang database, and PubMed was conducted. The incidences of ICU-acquired pneumonia and VAP were 16.2% (95% confidence interval (CI) 12.8-20.4%) and 33.7% (95% CI 31.4-36.1%), respectively; mortality rates were 37.4% (95% CI 24.6-52.2%) and 34.5% (95% CI 29.2-40.1%), respectively. The durations of stay in the ICU and hospital were 12.4 (95% CI 9.6-15.3) and 17.7 (95% CI 15.6-19.7) days and 18.0 (95% CI 16.5-19.6) and 30.5 (95% CI 26.4-34.7) days for ICU-acquired pneumonia and VAP, respectively. Pseudomonas aeruginosa (19.9%) and Acinetobacter baumannii (13.9%) were the most frequently isolated pathogens, followed by Klebsiella pneumoniae (11.9%) and Staphylococcus aureus (10.4%); 82.9% of S. aureus isolates were reported to be methicillin-resistant. ICU-acquired pneumonia/VAP remains a major cause of morbidity and mortality in patients in the ICU in China. Data on organisms causing disease in this population could help guide appropriate prevention strategies and treatment. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Risks of serious complications and death from smallpox vaccination: A systematic review of the United States experience, 1963–1968

    Directory of Open Access Journals (Sweden)

    Aragón Tomás J

    2003-08-01

    Full Text Available Abstract Background The United States (US has re-instituted smallpox vaccinations to prepare for an intentional release of the smallpox virus into the civilian population. In an outbreak, people of all ages will be vaccinated. To prepare for the impact of large-scale ring and mass vaccinations, we conducted a systematic review of the complication and mortality risks of smallpox vaccination. We summarized these risks for post-vaccinial encephalitis, vaccinia necrosum (progressive vaccinia, eczema vaccinatum, generalized vaccinia, and accidental infection (inadvertant autoinoculation. Methods Using a MEDLINE search strategy, we identified 348 articles, of which seven studies met our inclusion criteria (the number of primary vaccinations and re-vaccinations were reported, sufficient data were provided to calculate complication or case-fatality risks, and comparable case definitions were used. For each complication, we estimated of the complication, death, and case-fatality risks. Results The life-threatening complications of post-vaccinial encephalitis and vaccinia necrosum were at least 3 and 1 per million primary vaccinations, respectively. Twenty-nine percent of vaccinees with post-vaccinial encephalitis died and 15% with vaccinia necrosum died. There were no deaths among vaccinees that developed eczema vaccinatum; however, 2.3% of non-vaccinated contacts with eczema vaccinatum died. Among re-vaccinees, the risk of post-vaccinial encephalitis was reduced 26-fold, the risk of generalized vaccinia was reduced 29-fold, and the risk of eczema vaccinatum was reduced 12-fold. However, the risk reductions of accidental infection and vaccinia necrosum were modest (3.8 and 1.5 fold respectively.

  19. Millstone 3 risk evaluation report. An overall review and evaluation of the Millstone Unit 3 probabilistic safety study

    International Nuclear Information System (INIS)

    Kelly, G.; Barrett, R.; Buslik, A.

    1986-06-01

    In 1981, the US Nuclear Regulatory Commission (NRC) requested Northeast Utilities to perform a design-specific probabilistic safety study (PSS) for Millstone Nuclear Power Station, Unit No. 3 (Millstone 3). In 1983, Northeast Utilities submitted the Millstone 3 Probabilistic Safety Study for review by the NRC staff. The NRC staff prepared the Millstone 3 Risk Evaluation Report, which discusses the findings regarding the PSS. The PSS estimates that the mean annual core damage frequency due to internal and external events is 5 x 10 -5 and 2 x 10 -5 , respectively. The NRC staff's Risk Evaluation Report estimates that the mean annual core damage frequency is about 2 x 10 -4 for internal events and lies between 1 x 10 -5 and 2 x 10 -4 for external events. The NRC staff estimates that station blackout dominates internal and external event core damage frequencies. The staff recommends that Northeast Utilities perform an engineering analysis on upgrading the diesel generator lube oil cooler anchorage system and on adding a manually operated, AC-independent containment spray system. The staff also recommends that Northeast Utilities prepare two emergency procedures (loss of room cooling and relay chatter due to an earthquake) to help reduce uncertainties. (Subsequent to the completion of this document, Northeast Utilities and the NRC staff have continued a dialogue regarding station blackout from events other than earthquakes. Both Northeast Utilities and the staff have performed additional evaluations, which have drawn their results closer together. Final requirements, if any, for the prevention or mitigation of station blackout from events other than earthquakes have not yet been determined.) 26 refs., 16 tabs

  20. Transient Diabetes Insipidus After Discontinuation of Vasopressin in Neurological Intensive Care Unit Patients: Case Series and Literature Review.

    Science.gov (United States)

    Bohl, Michael A; Forseth, James; Nakaji, Peter

    2017-01-01

    Arginine vasopressin (AVP) is a common second-line or third-line vasopressor used in critically ill neurosurgical patients. Neurosurgical indications include hyperdynamic therapy for vasospasm, maintenance of cerebral perfusion pressure in patients with intracranial hypertension, and prevention of hypotension in patients with sepsis. A series of 6 neurosurgical patients receiving AVP infusions developed severe but transient diabetes insipidus (tDI) after cessation of AVP. To our knowledge, no previous reports of this phenomenon in neurosurgical patients have been published. We reviewed the clinical histories, intensive care unit treatment, medication administration records, and laboratory values of these patients, and we found recurrent elevated serum sodium and urine output and decreased urine specific gravity after discontinuation of AVP. Resolution of tDI occurred upon resumption of AVP or administration of desmopressin. Elevated serum sodium levels were often severe, resulting in worsened clinical outcomes. When AVP was resumed, tDI typically recurred if AVP was again tapered and discontinued. Routine administration of desmopressin was useful in controlling sodium levels until the tDI resolved. Recognition of this phenomenon has caused us to change our clinical management of neurosurgical patients receiving AVP. We hypothesize that tDI is caused by downregulation of the V2 receptor mass in the renal distal convoluted tubule and collecting duct cells. When AVP is discontinued, patients develop nephrogenic tDI secondary to decreased V2 receptor binding, which explains why desmopressin is effective in correcting tDI. Future research includes a large prospective study to determine risk factors for tDI, its incidence, and its pathophysiology. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Prevalence and Clinical Outcomes of Clostridium difficile Infection in the Intensive Care Unit: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Karanika, Styliani; Paudel, Suresh; Zervou, Fainareti N; Grigoras, Christos; Zacharioudakis, Ioannis M; Mylonakis, Eleftherios

    2016-01-01

    Background.  Intensive care unit (ICU) patients are at higher risk for Clostridium difficile infection (CDI). We performed a systematic review and meta-analysis of published studies from 1983 to 2015 using the PubMed, EMBASE, and Google Scholar databases to study the prevalence and outcomes of CDI in this patient population. Among the 9146 articles retrieved from the studies, 22 articles, which included a total of 80 835 ICU patients, were included in our final analysis. Results.  The prevalence of CDI among ICU patients was 2% (95% confidence interval [CI], 1%-2%), and among diarrheic ICU patients the prevalence was 11% (95% CI, 6%-17%). Among CDI patients, 25% (95% CI, 5%-51%) were diagnosed with pseudomembranous colitis, and the estimated length of ICU stay before CDI acquisition was 10.74 days (95% CI, 5%-51%). The overall hospital mortality among ICU patients with CDI was 32% (95% CI, 26%-39%), compared with 24% (95% CI, 14%-36%) among those without CDI presenting a statistically significant difference in mortality risk (P = .030). It is worth noting that the length of ICU and hospital stay among CDI patients was significantly longer, compared with non-CDI patients (standardized mean of difference [SMD] = 0.49, 95% CI, .39%-.6%, P = .00 and SMD = 1.15, 95% CI, .44%-1.91%, P = .003, respectively). It is noteworthy that the morbidity score at ICU admission (Acute Physiology and Chronic Health Evaluation II [APACHE II]) was not statistically different between the 2 groups (P = .911), implying that the differences in outcomes can be attributed to CDI. Conclusions.  The ICU setting is associated with higher prevalence of CDI. In this setting, CDI is associated with increased hospital mortality and prolonged ICU and overall hospital stay. These findings highlight the need for additional prevention and treatment studies in this setting.

  2. The cytoskeleton of Drosophila-derived Schneider line-1 and Kc23 cells undergoes significant changes during long-term culture

    Science.gov (United States)

    Schatten, H.; Hedrick, J.; Chakrabarti, A.

    1998-01-01

    Insect cell cultures derived from Drosophila melanogaster are increasingly being used as an alternative system to mammalian cell cultures, as they are amenable to genetic manipulation. Although Drosophila cells are an excellent tool for the study of genes and expression of proteins, culture conditions have to be considered in the interpretation of biochemical results. Our studies indicate that significant differences occur in cytoskeletal structure during the long-term culture of the Drosophila-derived cell lines Schneider Line-1 (S1) and Kc23. Scanning, transmission-electron, and immunofluorescence microscopy studies reveal that microfilaments, microtubules, and centrosomes become increasingly different during the culture of these cells from 24 h to 7-14 days. Significant cytoskeletal changes are observed at the cell surface where actin polymerizes into microfilaments, during the elongation of long microvilli. Additionally, long protrusions develop from the cell surface; these protrusions are microtubule-based and establish contact with neighboring cells. In contrast, the microtubule network in the interior of the cells becomes disrupted after four days of culture, resulting in altered transport of mitochondria. Microtubules and centrosomes are also affected in a small percent of cells during cell division, indicating an instability of centrosomes. Thus, the cytoskeletal network of microfilaments, microtubules, and centrosomes is affected in Drosophila cells during long-term culture. This implies that gene regulation and post-translational modifications are probably different under different culture conditions.

  3. Synthesis of the (N2)3- radical from Y2+ and its protonolysis reactivity to form (N2H2)2- via the Y[N(SiMe3)2]3/KC8 reduction system.

    Science.gov (United States)

    Fang, Ming; Lee, David S; Ziller, Joseph W; Doedens, Robert J; Bates, Jefferson E; Furche, Filipp; Evans, William J

    2011-03-23

    Examination of the Y[N(SiMe(3))(2)](3)/KC(8) reduction system that allowed isolation of the (N(2))(3-) radical has led to the first evidence of Y(2+) in solution. The deep-blue solutions obtained from Y[N(SiMe(3))(2)](3) and KC(8) in THF at -35 °C under argon have EPR spectra containing a doublet at g(iso) = 1.976 with a 110 G hyperfine coupling constant. The solutions react with N(2) to generate (N(2))(2-) and (N(2))(3-) complexes {[(Me(3)Si)(2)N](2)(THF)Y}(2)(μ-η(2):η(2)-N(2)) (1) and {[(Me(3)Si)(2)N](2)(THF)Y}(2)(μ-η(2):η(2)-N(2))[K(THF)(6)] (2), respectively, and demonstrate that the Y[N(SiMe(3))(2)](3)/KC(8) reaction can proceed through an Y(2+) intermediate. The reactivity of (N(2))(3-) radical with proton sources was probed for the first time for comparison with the (N(2))(2-) and (N(2))(4-) chemistry. Complex 2 reacts with [Et(3)NH][BPh(4)] to form {[(Me(3)Si)(2)N](2)(THF)Y}(2)(μ-N(2)H(2)), the first lanthanide (N(2)H(2))(2-) complex derived from dinitrogen, as well as 1 as a byproduct, consistent with radical disproportionation reactivity.

  4. Safety of Patient Mobilization and Rehabilitation in the Intensive Care Unit. Systematic Review with Meta-Analysis.

    Science.gov (United States)

    Nydahl, Peter; Sricharoenchai, Thiti; Chandra, Saurabh; Kundt, Firuzan Sari; Huang, Minxuan; Fischill, Magdalena; Needham, Dale M

    2017-05-01

    Early mobilization and rehabilitation of patients in intensive care units (ICUs) may improve physical function, and reduce the duration of delirium, mechanical ventilation, and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes, and desaturation. Systematic literature review, including searches of five databases. Eligible studies evaluated patients who received mobilization-related interventions in the ICU. Exclusion criteria included: (1) case series with fewer than 10 patients; (2) majority of patients under 18 years of age; and (3) data not reported to permit calculation of incidence of safety events. Number of patients, mobilization/rehabilitation sessions, potential safety events, and events with negative consequences (e.g., requiring intervention or additional therapy). Heterogeneity was assessed by I 2 statistics, and bias assessed by the Newcastle-Ottawa Scale and Cochrane risk of bias assessment. The literature search identified 20,660 titles. There were 48 eligible publications evaluating 7,546 patients, with 583 potential safety events occurring in 22,351 mobilization/rehabilitation sessions. There was a total of 583 (2.6%) potential safety events with heterogeneity in the definitions for these events. For the safety event types that could be meta-analyzed, pooled incidences per 1,000 mobilization/rehabilitation sessions (95% confidence interval), were: hemodynamic changes, 3.8 (1.3-11.4), and desaturation, 1.9 (0.9-4.3). A total of 24 studies of 3,404 patients reported on any consequences of potential safety events (e.g., needing to increase dose of vasopressor due to mobility-related hypotension), with a frequency of 0.6% in 14,398 mobilization

  5. Prevalence of Financial Fraud and Scams Among Older Adults in the United States: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Burnes, David; Henderson, Charles R; Sheppard, Christine; Zhao, Rebecca; Pillemer, Karl; Lachs, Mark S

    2017-08-01

    The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers. A valid estimate of elder financial fraud-scam prevalence is necessary as a foundation for research and prevention efforts. To estimate the prevalence of elder financial fraud-scam victimization in the United States based on a systematic review and meta-analysis. Multiple investigators independently screened titles and abstracts and reviewed relevant full-text records from PubMed, Medline, PsycINFO, Criminal Justice Abstracts, Social Work Abstracts, and AgeLine databases. To maximize the validity and generalizability of prevalence estimation, we restricted eligibility to general population-based studies (English speaking, 1990 onward) using state- or national-level probability sampling and collecting data directly from older adults. Information on elder financial fraud-scam prevalence and study-level characteristics was extracted independently by 2 investigators. Meta-analysis of elder financial fraud-scam prevalence used generalized mixed models with individual studies as levels of a random classification factor. We included 12 studies involving a total of 41 711 individuals in the meta-analysis. Overall pooled elder financial fraud-scam prevalence (up to 5-year period) across studies was 5.6% (95% confidence interval [CI] = 4.0%, 7.8%), with a 1-year period prevalence of 5.4% (95% CI = 3.2%, 7.6%). Studies using a series of questions describing specific fraud-scam events to measure victimization found a significantly higher prevalence (7.1%; 95% CI = 4.8%, 9.4%) than studies

  6. Parents' experiences of transition when their infants are discharged from the Neonatal Intensive Care Unit: a systematic review protocol.

    Science.gov (United States)

    Aagaard, Hanne; Uhrenfeldt, Lisbeth; Spliid, Mette; Fegran, Liv

    2015-10-01

    The objective of this review is to identify, appraise and synthesize the best available studies exploring parents' experiences of transition when their infants are discharged from the Neonatal Intensive Care Unit (NICU).The review questions are: Giving birth to a premature or sick infant is a stressful event for parents. The parents' presence and participation in the care of the infant is fundamental to reduce this stress and to provide optimal care for both the premature or sick infant and family. A full term pregnancy is estimated to last between 37 and 40 weeks. Preterm infants born before 28 week (5.1%) are defined as extremely preterm, while those who are born between 28 to 31 weeks (10.3%) are defined as very preterm. The majority of the preterm (84.1%) are born between 32 to 37 week and may have significant medical problems requiring prolonged hospitalization.The prevalence of preterm birth is increasing worldwide. More than one in ten babies are born preterm annually. This is equal to 15 million preterm infants born globally and the second largest direct cause of deaths in children below five. The highest rates of preterm birth are in Sub-Saharan Africa and South Asia (more than 60%) and the lowest rates are in Northern Africa, Western Asia, Latin America and the Caribbean. The preterm birth rates in the developing countries vary widely and follow a different pattern than in high income countries.The preterm birth rate has increased between 1990 and 2010 with an average of 0.8% annually in almost all countries. Morbidity among critically ill newborn and preterm infants vary widely from no late effects to severe complications, such as visual or hearing impairment, chronic lung disease, growth failure in infancy and specific learning impairments, dyslexia and reduced academic achievement. Full term infants may also experience significant health problems requiring neonatal intensive care. The most common reasons for a full term infant to be admitted to a NICU

  7. A review from the regulatory position of the control of occupational exposure associated with the first 20 years of the United Kingdom commercial nuclear power programme

    International Nuclear Information System (INIS)

    Emmerson, B.W.

    1980-01-01

    The control of occupational exposure received at commercial nuclear generating plants in the United Kingdom has been subject to regulatory requirements embodied in site licence conditions since 1959, and at commercial fuel production and reprocessing plants since 1971. The paper indicates the main radiological control objectives which have applied, reviews the statutory measures introduced for their achievement and indicates some of the administrative arrangements made by site operators in order to comply. The principal sources of occupational exposure associated with each stage of the fuel cycle are identified and exposure data since licensed operations commenced are reviewed. The effectiveness of the United Kingdom site licensing procedure in ensuring adequate radiological control procedures, including the minimisation of occupational exposure, is examined in relation to the relevant ICRP recommendations and against the background of the first 20 years of commercial nuclear power production. The impact on these procedures of more recently introduced legislation relating to health and safety at all places of employment in the United Kingdom is discussed. The paper considers the changes in current regulatory procedures that may result from the introduction of ICRP-26 and the recommendations of ICRP Committee 2, and concludes with a review of the more important problems facing the licensee and the Nuclear Inspectorate with regard to the implementation of future radiological control procedures. (H.K.)

  8. Prepublication Review of Government Employee Speech: A Case Study of the Department of Defense and United States Air Force Security/Policy Review Programs.

    Science.gov (United States)

    Warden, Michael L.

    Since 1957 the Department of Defense has subjected all forms of speech of U.S. military personnel meant for publication to prepublication review based on security and policy criteria. The historical development of the Defense Department's prepublication review program and its specific implementation by the U.S. Air Force lead to questions of First…

  9. Light in Rural Schools, polyclinics and police detachment : inventory of 210 rural units, energetic and socio economics review

    International Nuclear Information System (INIS)

    Santiago Silva, T.

    1994-01-01

    With the aim to the future solar installations system in the rural area it has been done a report about 210 rural units placed in: Rivera, Tacuarembo, Salto, Paysandu, Florida, Flores, Lavalleja, Durazno, Cerro largo y Rio Negro departments

  10. Aircraft wake vortices : a state-of-the-art review of the United States R&D program

    Science.gov (United States)

    1977-02-28

    The report summarizes the current state-of-the-art understanding : of the aircraft wake vortex phenomenon and the results of the United : States program to minimize the restrictions caused by aircraft wake : vortices in the terminal environment. The ...

  11. KC-135 Crew System Criteria.

    Science.gov (United States)

    1981-03-01

    isav overlhead cu e!t cc n s o 1 e o f adequate F7 ’e Cs r -.r ra isplays Present xmon leF o or-t ion of, tne pi lot ’: ’centor b)oom operator ’:,- i...c z L ;~i’)n 1 -T r A ofCV Arevy dat :or ontr- o a;- t C oiycitne conter 15 f tn crw member to aa acca - +3 1: i I.~ .. ~~r~c wi-z --nic LTIA’ i-iz

  12. Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis.

    Science.gov (United States)

    Daneman, Nick; Sarwar, Syed; Fowler, Robert A; Cuthbertson, Brian H

    2013-04-01

    Many meta-analyses have shown reductions in infection rates and mortality associated with the use of selective digestive decontamination (SDD) or selective oropharyngeal decontamination (SOD) in intensive care units (ICUs). These interventions have not been widely implemented because of concerns that their use could lead to the development of antimicrobial resistance in pathogens. We aimed to assess the effect of SDD and SOD on antimicrobial resistance rates in patients in ICUs. We did a systematic review of the effect of SDD and SOD on the rates of colonisation or infection with antimicrobial-resistant pathogens in patients who were critically ill. We searched for studies using Medline, Embase, and Cochrane databases, with no limits by language, date of publication, study design, or study quality. We included all studies of selective decontamination that involved prophylactic application of topical non-absorbable antimicrobials to the stomach or oropharynx of patients in ICUs, with or without additional systemic antimicrobials. We excluded studies of interventions that used only antiseptic or biocide agents such as chlorhexidine, unless antimicrobials were also included in the regimen. We used the Mantel-Haenszel model with random effects to calculate pooled odds ratios. We analysed 64 unique studies of SDD and SOD in ICUs, of which 47 were randomised controlled trials and 35 included data for the detection of antimicrobial resistance. When comparing data for patients in intervention groups (those who received SDD or SOD) versus data for those in control groups (who received no intervention), we identified no difference in the prevalence of colonisation or infection with Gram-positive antimicrobial-resistant pathogens of interest, including meticillin-resistant Staphylococcus aureus (odds ratio 1·46, 95% CI 0·90-2·37) and vancomycin-resistant enterococci (0·63, 0·39-1·02). Among Gram-negative bacilli, we detected no difference in aminoglycoside-resistance (0

  13. A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States.

    Science.gov (United States)

    Clifford, Anton; Shakeshaft, Anthony

    2017-07-01

    Indigenous peoples of Australia, New Zealand, Canada and the United States experience a disproportionately high burden of harms from substance misuse. Research is therefore required to improve our understanding of substance use in Indigenous populations and provide evidence on strategies effective for reducing harmful use. A search of 13 electronic databases for peer-reviewed articles published between 1993 and 2014 focusing on substance use and Indigenous peoples of Australia, New Zealand, Canada and the United States. Relevant abstracts were classified as data or non-data based research. Data-based studies were further classified as measurement, descriptive or intervention and their trends examined by country and drug type. Intervention studies were classified by type and their evaluation designs classified using the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. There was a statistically significant increase from 1993 to 2014 in the percentage of total publications that were data-based (P Indigenous drug and alcohol field are required. The dominance of descriptive research in the Indigenous drug and alcohol field is less than optimal for generating evidence to inform Indigenous drug and alcohol policy and programs. [Clifford A, Shakeshaft A. A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States. Drug Alcohol Rev 2017;36:509-522]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  14. External Peer Review Report on the United States Special Operations Command Office of Inspector General Audit Division

    Science.gov (United States)

    2016-08-15

    and procedures to provide it with reasonable assurance of conforming to Government Auditing Standards. The elements of quality control are...organization with reasonable assurance of performing and reporting in conformity with applicable professional standards in all material respects. Audit ...USSOCOM OIG’s audit organization did not perform any nonaudit services during the period of our review so we did not review any nonaudit services

  15. The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review

    NARCIS (Netherlands)

    M.M.C. van Mol (Margo); E.J.O. Kompanje (Erwin); D.D. Benoit (Dominique); J. Bakker (Jan); M.D. Nijkamp (Marjan); S. Seedat (Soraya)

    2015-01-01

    textabstractBackground: Working in the stressful environment of the Intensive Care Unit (ICU) is an emotionally charged challenge that might affect the emotional stability of medical staff. The quality of care for ICU patients and their relatives might be threatened through long-term absenteeism or

  16. Computer Science Teacher Professional Development in the United States: A Review of Studies Published between 2004 and 2014

    Science.gov (United States)

    Menekse, Muhsin

    2015-01-01

    While there has been a remarkable interest to make computer science a core K-12 academic subject in the United States, there is a shortage of K-12 computer science teachers to successfully implement computer sciences courses in schools. In order to enhance computer science teacher capacity, training programs have been offered through teacher…

  17. A Review of Special Education Services Delivery in the United States and Nigeria: Implications for Inclusive Education

    Science.gov (United States)

    Michael, Eskay; Onu, Victoria; Janeth, Igbo

    2012-01-01

    Both Nigeria and the United States represent developing and developed countries respectively, and special education policy between these two countries are different. Both countries have contributed to help learners with exceptionalities in their policies. These policies help in the formulation and implementation of special education programmes for…

  18. A Review of Children's Rights Literature since the Adoption of the United Nations Convention on the Rights of the Child

    Science.gov (United States)

    Reynaert, Didier; Bouverne-de-Bie, Maria; Vandevelde, Stijn

    2009-01-01

    Children's rights have become a significant field of study during the past decades, largely due to the adoption of the United Nations Convention on the Rights of the Child (UNCRC) in 1989. Today, scholarly work on children's rights is almost inconceivable without considering the Convention as the bearer of the children's rights debate. The goal of…

  19. Prepare, Do, Review: A Model Used to Reduce the Negative Feelings towards Laboratory Classes in an Introductory Chemistry Undergraduate Unit

    Science.gov (United States)

    Spagnoli, Dino; Wong, Lawrence; Maisey, Shannan; Clemons, Tristan D.

    2017-01-01

    Student feelings towards the laboratory component of an introductory chemistry unit were evaluated in an action research study, over a three-year period at the University of Western Australia. In 2013 we found that the percentage of students with negative feelings towards the laboratory increased over the duration of a semester. In 2014 we…

  20. Frequency and characteristics of battered child syndrome in patients on a paediatric burns unit: A clinical case review

    Directory of Open Access Journals (Sweden)

    M. Gil-Vargas

    2017-07-01

    Conclusions: Having knowledge of and being able to identify battered child syndrome may prevent fatal injuries. It is important to equip healthcare staff on first-contact care units with the knowledge to establish a presumptive diagnosis of child/adolescent abuse. Only through proper investigation of social events may just solutions be sought and implemented.

  1. A Comparative Review of Music Education in Mainland China and the United States: From Nationalism to Multiculturalism

    Science.gov (United States)

    Ho, Wai-Chung

    2016-01-01

    This paper attempts to compare interactions between social changes and the integration of nationalism and multiculturalism in the context of music education by focusing on the ways in which the governmental politics of mainland China and the United States have managed nationalism and diversity in school music education. This paper also explores…

  2. Assistance at mealtimes in hospital settings and rehabilitation units for older adults from the perspective of patients, families and healthcare professionals: a mixed methods systematic review protocol.

    Science.gov (United States)

    Edwards, Deborah; Carrier, Judith; Hopkinson, Jane

    2015-11-01

    The review question is: assistance at mealtimes for older adults in hospital settings and rehabilitation units: what goes on, what works and what do patients, families and healthcare professionals think about it?The specific objectives are:This mixed methods review seeks to develop an aggregated synthesis of quantitative and qualitative data on assistance at mealtimes for older adults in hospital settings and rehabilitation units in order to derive conclusions and recommendations useful for clinical practice and policy decision making. Worldwide, it is estimated that between 20% and 50% of all adult patients admitted to hospital wards are malnourished. Reported prevalence occurs, depending on the specific patient group of interest, type of healthcare setting, disease state and criteria used to assess malnutrition. For older adults in hospital (over 65 years) the prevalence of malnutrition has been reported as being as high as 60% and can continue to deteriorate during the hospital stay. This is an area of concern as it is associated with prolonged hospital stays and increased morbidity (pressure ulcers, infections and falls) and mortality, especially for those with chronic conditions.Malnutrition in adults in developed countries is frequently associated with disease and may occur because of reduced dietary intake, malabsorption, increased nutrient losses or altered metabolic demands, with reduced dietary intake being considered the single most important aetiological factor. For the hospitalized older adult patient with pre-existing malnutrition, further nutritional problems are often encountered due to a reduced dietary intake. Poor food intake for older patients in hospital may be due to the effects of acute illness, poor appetite, nausea or vomiting, "nil by mouth" orders, medication side effects, catering limitations, swallowing and/or oral problems, difficulty with vision and opening containers, the placement of food out of the patients' reach, limited access

  3. Review

    African Journals Online (AJOL)

    abp

    2014-01-15

    Jan 15, 2014 ... However, there are no known drug therapies to improve recovery after stroke. ... psychological, social and cognitive functions [1-4]. The established ..... the Rehabilitation Unit of Prince Sultan Military Medical City of. Riyadh ...

  4. Safety assessment of Olkiluoto NPP units 1 and 2. Decision of the Radiation and Nuclear Safety Authority regarding the periodic safety review of the Olkiluoto NPP

    International Nuclear Information System (INIS)

    2010-02-01

    In this safety assessment the Radiation and Nuclear Safety Authority (STUK) has evaluated the safety of the Olkiluoto Nuclear Power Plant units 1 and 2 in connection with the periodic safety review. This safety assessment provides a summary of the reviews, inspections and continuous oversight carried out by STUK. The issues addressed in the assessment and the related evaluation criteria are set forth in the nuclear energy and radiation safety legislation and the regulations issued thereunder. The provisions of the Nuclear Energy Act concerning the safe use of nuclear energy, security and emergency preparedness arrangements, and waste management are specified in more detail in the Government Decrees and Regulatory Guides issued by STUK. Based on the assessment, STUK consideres that the Olkiluoto Nuclear Power Plant units 1 and 2 meet the set safety requirements for operational nuclear power plants, the emergency preparedness arrangements are sufficient and the necessary control to prevent the proliferation of nuclear weapons has been appropriately arranged. The physical protection of the Olkiluoto nuclear power plant is not yet completely in compliance with the requirements of Government Decree 734/2008, which came into force in December 2008. Further requirements concerning this issue based also on the principle of continuous improvement were included in the decision relating to the periodic safety review. The safety of the Olkiluoto nuclear power plant was assessed in compliance with the Government Decree on the Safety of Nuclear Power Plants (733/2008), which came into force in 2008. The decree notes that existing nuclear power plants need not meet all the requirements set out for new plants. Most of the design bases pertaining to the Olkiluoto 1 and 2 nuclear power plant units were set in the 1970s. Substantial modernisations have been carried out at the Olkiluoto 1 and 2 nuclear power plant units since their commissioning to improve safety. This is in line with

  5. Reviews

    Science.gov (United States)

    2002-11-01

    CD-ROM REVIEW (551) Essential Physics BOOK REVIEWS (551) Collins Advanced Science: Physics, 2nd edition Quarks, Leptons and the Big Bang, 2nd edition Do Brilliantly: A2 Physics IGCSE Physics Geophysics in the UK Synoptic Skills in Advanced Physics Flash! The hunt for the biggest explosions in the universe Materials Maths for Advanced Physics

  6. A Systematic Review on Confidentiality, Disclosure, and Stigma in the United States: Lessons for HIV Care in Pregnancy From Reproductive Genetics.

    Science.gov (United States)

    Wilkinson, Barbara; Arora, Kavita Shah

    2015-01-01

    The fields of HIV care in pregnancy and reproductive genetics have always been 'exceptional' in that patients are highly concerned about the potential for stigma and the corresponding need for privacy and confidentiality. However, the two fields have diverged in how they have addressed these concerns. The systematic review analyzed 61 manuscripts for similarities and differences between the fields of HIV care in pregnancy and reproductive genetics in the United States, with respect to privacy, confidentiality, disclosure, and stigma. The systematic review revealed that the field of HIV care in pregnancy has insufficiently addressed patient concerns about privacy, confidentiality, and stigma compared to the field of reproductive genetics. Failure to adequately protect confidentiality of HIV-positive patients, and failure to reduce stigma associated with HIV testing and treatment are deficiencies in the delivery of care to HIV-positive pregnant woman and barriers to reducing vertical transmission of HIV. Improvements in care and policy should mirror the field of reproductive genetics.

  7. Using Simulation for Clinical Practice Hours in Nurse Practitioner Education in The United States: A Systematic Review.

    Science.gov (United States)

    Rutherford-Hemming, Tonya; Nye, Carla; Coram, Cathy

    2016-02-01

    The National Organization for Nurse Practitioner Faculty (NONPF) does not allow simulation to be used in lieu of traditional clinical hours. The NONPF cites a lack of empirical evidence related to learning outcomes with simulation as rationale for its stance. The purpose of this systematic review was to search, extract, appraise, and synthesize research related to the use of simulation in Nurse Practitioner (NP) education in order to answer the two following questions: 1) What research related to simulation in NP education has emerged in the literature between 2010 and April 2015?, and 2) Of the research studies that have emerged, what level of Kirkpatrick's Training Evaluation Model (1994) is evaluated? This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was completed in PubMed and CINAHL using a combination of medical subject headings, or Mesh terms, as well as keywords to retrieve non-indexed citations. The inclusion criteria for this review were broad in order to disseminate information on future research needed. The review considered studies related to NP education that included any form of simulation intervention, e.g. role-playing and standardized patients. The review considered studies that described original research, but no other design restrictions were imposed. The review was limited to studies published in the English language. The database search strategy yielded 198 citations. These results were narrowed down to 15 studies based on identified inclusion criteria. There is a lack of empirical evidence in the literature to support using simulation in lieu of direct patient care clinical hours in NP education. The evidence in this systematic review affirms NONPF's statement. Five years after the inception of NONPF's position statement, research to support learning outcomes with simulation in nurse practitioner education remains lacking. There is a need to produce rigorous

  8. Posttraumatic stress disorder in children and their parents following admission to the pediatric intensive care unit: a review.

    Science.gov (United States)

    Nelson, Lara P; Gold, Jeffrey I

    2012-05-01

    To evaluate posttraumatic stress disorder in children who have been admitted to the pediatric intensive care unit and their families. Studies were identified through PubMed, MEDLINE, and Ovid. All descriptive, observational, and controlled studies with a focus on posttraumatic stress disorder and the pediatric intensive care unit were included. Posttraumatic stress disorder rates in children following admission to the pediatric intensive care unit were between 5% and 28%, while rates of posttraumatic stress disorder symptoms were significantly higher, 35% to 62%. There have been inconsistencies noted across risk factors. Objective and subjective measurements of disease severity were intermittently positively associated with development of posttraumatic stress disorder. There was a positive relationship identified between the child's symptoms of posttraumatic stress disorder and their parents' symptoms.The biological mechanisms associated with the development of posttraumatic stress disorder in children admitted to the pediatric intensive care unit have yet to be explored. Studies in children following burn or other unintentional injury demonstrate potential relationships between adrenergic hormone levels and a diagnosis of posttraumatic stress disorder. Likewise genetic studies suggest the importance of the adrenergic system in this pathway.The rates of posttraumatic stress disorder in parents following their child's admission to the pediatric intensive care unit ranged between 10.5% and 21%, with symptom rates approaching 84%. It has been suggested that mothers are at increased risk for the development of posttraumatic stress disorder compared to fathers. Objective and subjective measures of disease severity yielded mixed findings with regard to the development of posttraumatic stress disorder. Protective parental factors may include education or the opportunity to discuss the parents' feelings during the admission. Following admission to the pediatric intensive

  9. Eliminating Health Disparities through Action on the Social Determinants of Health: A Systematic Review of Home Visiting in the United States, 2005-2015.

    Science.gov (United States)

    Abbott, Laurie S; Elliott, Lynn T

    2017-01-01

    The purpose of this systematic literature review was to synthesize the results of transdisciplinary interventions designed with a home visit component in experimental and quasi-experimental studies having representative samples of racial and ethnic minorities. The design of this systematic review was adapted to include both experimental and quasi-experimental quantitative studies. The predetermined inclusion criteria were studies (a) having an experimental or quasi-experimental quantitative design, (b) having a home visit as a research component, (c) including a prevention research intervention strategy targeting health and/or safety issues, (d) conducted in the United States, (e) having representation (at least 30% in the total sample size) of one or more racial/ethnic minority, (f) available in full text, and (g) published in a peer-reviewed journal between January, 2005 and December, 2015. Thirty-nine articles were included in the review. There were 20 primary prevention, 5 secondary prevention, and 14 tertiary prevention intervention studies. Community and home visitation interventions by nurses can provide an effective means for mitigating social determinants of health by empowering people at risk for health disparities to avoid injury, maintain health, and prevent and manage existing disease. © 2016 Wiley Periodicals, Inc.

  10. Social determinants and maternal exposure to intimate partner violence of obstetric patients with severe maternal morbidity in the intensive care unit: a systematic review protocol.

    Science.gov (United States)

    Ayala Quintanilla, Beatriz Paulina; Taft, Angela; McDonald, Susan; Pollock, Wendy; Roque Henriquez, Joel Christian

    2016-11-28

    Maternal mortality is a potentially preventable public health issue. Maternal morbidity is increasingly of interest to aid the reduction of maternal mortality. Obstetric patients admitted to the intensive care unit (ICU) are an important part of the global burden of maternal morbidity. Social determinants influence health outcomes of pregnant women. Additionally, intimate partner violence has a great negative impact on women's health and pregnancy outcome. However, little is known about the contextual and social aspects of obstetric patients treated in the ICU. This study aimed to conduct a systematic review of the social determinants and exposure to intimate partner violence of obstetric patients admitted to an ICU. A systematic search will be conducted in MEDLINE, CINAHL, ProQuest, LILACS and SciELO from 2000 to 2016. Studies published in English and Spanish will be identified in relation to data reporting on social determinants of health and/or exposure to intimate partner violence of obstetric women, treated in the ICU during pregnancy, childbirth or within 42 days of the end of pregnancy. Two reviewers will independently screen for study eligibility and data extraction. Risk of bias and assessment of the quality of the included studies will be performed by using the Critical Appraisal Skills Programme (CASP) checklist. Data will be analysed and summarised using a narrative description of the available evidence across studies. This systematic review protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Since this systematic review will be based on published studies, ethical approval is not required. Findings will be presented at La Trobe University, in Conferences and Congresses, and published in a peer-reviewed journal. CRD42016037492. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Review of selected contributions of the conference 'Integrated quality management systems in completion of units 3 and 4 Mochovce'

    International Nuclear Information System (INIS)

    2009-04-01

    There were 14 contributions presented of the conference focused on the integrated quality management systems in completion EMO34. Contributions were focused both on theoretical problems from the project management area and on the applications in practice in management systems implementation in accordance with the standards: STN EN ISO 9001:2000, STN EN ISO 14 001:2005, and OHSAS 18 001:1999 at the completion of the Nuclear Power Plant Mochovce of units 3 and 4

  12. Cyberbullying Prevalence among United States Middle and High School Aged Adolescents: A Systematic Review and Quality Assessment

    Science.gov (United States)

    Selkie, Ellen M.; Fales, Jessica L.; Moreno, Megan A.

    2015-01-01

    Background Cyberbullying has established links to physical and mental health problems including depression, suicidality, substance use, and somatic symptoms. Quality reporting of cyberbullying prevalence is essential to guide evidence-based policy and prevention priorities. The purpose of this systematic review was to investigate study quality and reported prevalence among cyberbullying research studies conducted in populations of US adolescents of middle and high school age. Methods Searches of peer-reviewed literature published through June 2015 for “cyberbullying” and related terms were conducted using PubMed, PsycINFO, CINAHL Plus, and Web of Science. Included manuscripts reported cyberbullying prevalence in general populations of U.S. adolescents between the ages of 10 and 19. Using a review tool based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, reviewers independently scored study quality on study methods, results reporting, and reported prevalence. Results Search results yielded 1,447 manuscripts; 81 manuscripts representing 58 unique studies were identified as meeting inclusion criteria. Quality scores ranged between 12 and 37 total points out of a possible 42 points (M = 26.7, SD = 4.6). Prevalence rates of cyberbullying ranged as follows: perpetration, 1% to 41%; victimization, 3% to 72%; and overlapping perpetration and victimization, 2.3% to 16.7%. Conclusions Literature on cyberbullying in US middle and high school aged students is robust in quantity but inconsistent in quality and reported prevalence. Consistent definitions and evidence-based measurement tools are needed. PMID:26576821

  13. State property tax programs promoting sustainable forests in the United States: A review of program structure and administration

    Science.gov (United States)

    Michael Kilgore; Paul Ellefson; Travis Funk; Gregory E. Frey

    2018-01-01

    Financial incentives offered by state property tax programs are a means of promoting goods and services from private forestland. Identified by a 50-state review in 2014–2015, these incentives often require adherence to several conditions including valid ownership and use of forestland, correct size of parcel and suitable forest...

  14. Systematic review of the primary research on minority ethnic groups and end-of-life care from the United Kingdom

    NARCIS (Netherlands)

    Evans, N.; Meñaca, A.; Andrew, E.V.W.; Koffman, J.; Harding, R.; Higginson, I.J.; Pool, R.; Gysels, M.

    2012-01-01

    Context Patients from minority ethnic groups experience lower rates of referrals to end-of-life (EoL) care services, higher levels of dissatisfaction with services, and perceive some services as culturally inappropriate. Objectives To systematically review original studies of minority ethnic groups

  15. Systematic Review of the Primary Research on Minority Ethnic Groups and End-of-Life Care From the United Kingdom

    NARCIS (Netherlands)

    Evans, N.C.; Menaca, A.; Andrew, E.V.; Koffman, J.; Harding, R.; Higginson, I.J.; Pool, R.; Gysels, M.

    2012-01-01

    Context: Patients from minority ethnic groups experience lower rates of referrals to end-of-life (EoL) care services, higher levels of dissatisfaction with services, and perceive some services as culturally inappropriate. Objectives: To systematically review original studies of minority ethnic

  16. The Management of Pemphigus Vulgaris in a Burn Intensive Care Unit: A Case Report and Treatment Review

    Science.gov (United States)

    2014-10-01

    achieving com- plete remission. J Am Acad Dermatol 2011;64:490–4. 10. Martin LK, Werth VP, Villaneuva EV, Murrell DF. A system- atic review of randomized...Cavacini LA, Posner MR. Treatment of pemphigus vulgaris with rituximab and intra- venous immune globulin. N Engl J Med 2006;355:1772–9. 29. Joly P

  17. The Peer Reviewed Literature on Undergraduate Education for Public Health in the United States, 2004-2014

    Directory of Open Access Journals (Sweden)

    Connie J Evashwick

    2014-11-01

    Full Text Available The education of undergraduate college students in the field of public health has burgeoned over the past decade. Professional literature in peer-reviewed journals is one indicator of the status of a field of study and its related body of knowledge. It is also a mechanism for sharing information among professionals about challenges, issues, experiences and best practices.The purpose of the literature review conducted here was to describe the status of the peer reviewed literature over the past decade pertaining to the education of undergraduates about the field of public health in the U.S.A literature search was conducted of three data bases: PubMed, Scopus and ERIC. Inclusion criteria were publication date from January 1, 2004 through July 31, 2014; written in the English language; pertaining to undergraduate education in the U.S.; and a focus on public health as the primary discipline. Public health was searched as an overarching discipline; articles focused on sub-disciplines or other health professions disciplines were excluded.The search resulted in 158 articles. Each of the authors reviewed the abstracts for all articles and read full articles when necessary. The result was 23 articles that were then considered in depth. The articles were categorized according to their primary theme: curriculum, courses, learning objectives (N=14; evaluation of teaching method (N=3; case study (N=3; career path and advising (N=2; accreditation (N=1. Year of publication and journal were also examined.The results of the literature search lead to several observations about how the peer reviewed literature has been used to date and how it could be used to advance the emerging field of undergraduate education for public health.

  18. Cross-cultural adaptation of the US consumer form of the short Primary Care Assessment Tool (PCAT): the Korean consumer form of the short PCAT (KC PCAT) and the Korean standard form of the short PCAT (KS PCAT).

    Science.gov (United States)

    Jeon, Ki-Yeob

    2011-01-01

    It is well known that countries with well-structured primary care have better health outcomes, better health equity and reduced healthcare costs. This study aimed to culturally modify and validate the US consumer form of the short Primary Care Assessment Tool (PCAT) in primary care in the Republic of Korea (hereafter referred to as Korea). The Korean consumer form of the short PCAT (KC PCAT) was cross-culturally modified from the original version using a standardised transcultural adaptation method. A pre-test version of the KC PCAT was formulated by replacement of four items and modification of a further four items from the 37 items of the original consumer form of the short PCAT at face value evaluation meetings. Pilot testing was done with a convenience sample of 15 responders at two different sites. Test-retest showed high reliability. To validate the KC PCAT, 606 clients participated in a survey carried out in Korea between February and May 2006. Internal consistency reliability, test-retest reliability and factor analysis were conducted in order to test validity. Psychometric testing was carried out on 37 items of the KC PCAT to make the KS PCAT which has 30 items and has seven principal domains: first contact utilisation, first contact accessibility, ongoing accountable care (ongoing care and coordinated rapport care), integrated care (patient-centred care with integration between primary and specialty care or between different specialties), comprehensive care, community-oriented care and culturally-oriented care. Component factors of the verified KS PCAT explained 58.28% of the total variance in the total item scores of primary care. The verified KS PCAT has been characterised by the seven classic domains of primary care with minor modifications. This may provide clues concerning differences in expectations for primary care in the Korean population as compared with that of the US. The KS PCAT is a reliable and valid tool for the evaluation of the quality of

  19. Reviews.

    Science.gov (United States)

    Journal of Chemical Education, 1987

    1987-01-01

    Provides a review of both the Apple and IBM versions of ENZPACK, a software package which is designed to assist in the teaching of enzyme kinetics in courses where this topic is treated in some depth. (TW)

  20. Review

    Indian Academy of Sciences (India)

    2012-03-29

    Mar 29, 2012 ... The present review documents an overview of speciation mediated through behavioural ...... The Drosophila model (New York: Oxford University Press) .... second part of his big species book written from 1856–1858. (New ...

  1. Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States.

    Science.gov (United States)

    Sun, Shawn X; Liu, Gordon G; Christensen, Dale B; Fu, Alex Z

    2007-10-01

    To review the literature addressing the economic outcomes of nonadherence in the treatment of schizophrenia, and to utilize the review results to provide an update on the economic impact of hospitalizations among schizophrenia patients related to antipsychotic nonadherence. A structured search of EMBASE, Ovid MEDLINE, PubMed and PsycINFO for years 1995-2007 was conducted to identify published English-language articles addressing the economic impact of antipsychotic nonadherence in schizophrenia. The following key words were used in the search: compliance, noncompliance, adherence, nonadherence, relapse, economic, cost, and schizophrenia. A bibliographic search of retrieved articles was performed to identify additional studies. For a study to be included, the date of publication had to be from 1/1/1995 to 6/1/2007, and the impact of nonadherence had to be measured in terms of direct healthcare costs or inpatient days. Subsequently, an estimate of incremental hospitalization costs related to antipsychotic non adherence was extrapolated at the US national level based on the reviewed studies (nonadherence rate and hospitalization rate) and the National Inpatient Sample of Healthcare Cost and Utilization Project (average daily hospitalization costs). Seven studies were identified and reviewed based on the study design, measurement of medication nonadherence, study setting, and cost outcome results. Despite the varied adherence measures across studies, all articles reviewed showed that antipsychotic nonadherence was related to an increase in hospitalization rate, hospital days or hospital costs. We also estimated that the national rehospitalization costs related to antipsychotic nonadherence was $1479 million, ranging from $1392 million to $1826 million in the US in 2005. The estimate of rehospitalization costs was restricted to schizophrenia patients from the Medicaid program. Additionally, the studies we reviewed did not capture the newer antipsychotic drugs

  2. Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

    Directory of Open Access Journals (Sweden)

    Reams R Renee

    2009-02-01

    Full Text Available Abstract Background African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade. Results Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks. Conclusion The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.

  3. Epidemiological and economic burden of Alzheimer's disease: a systematic literature review of data across Europe and the United States of America.

    Science.gov (United States)

    Takizawa, Claire; Thompson, Paula L; van Walsem, Anneloes; Faure, Céline; Maier, William C

    2015-01-01

    Alzheimer's disease (AD) weighs heavily on health expenditure and is strongly associated with increasing age. Due to population aging, increasing global prevalence of AD will pose huge challenges to public health and elderly care systems in all countries across the world. This study aimed to better understand the burden of AD from a healthcare perspective. A systematic literature review of journal articles published between January 2002 and December 2012 was performed for studies conducted in France, Germany, Italy, The Netherlands, Spain, the United Kingdom (UK), and the United States of America (USA), using Medline, Embase, and the NHS Economic Evaluation Database. 3,288 references were initially retrieved, and 39 epidemiological and 66 economic publications were selected for data extraction. AD incidence rates greatly varied between countries; however, prevalence was more consistent across all included countries, ranging between 3-7%. Overall, medical costs were lower in France compared to other included countries and increased with AD severity, e.g., direct medical costs per year for mild AD ranged from 5,476 int$ in France to 27,380 int$ in Spain. Limitations, such as heterogeneous methodology and missing data, prevented the comparison of results across studies between countries or the conclusion of any trend over time. This review corroborates previous understanding that AD burden is high for both society and healthcare providers. Limitations regarding study heterogeneity restricted conclusions; further research is required. Stakeholders could benefit from new healthcare strategies addressing both epidemiological and economic aspects of AD.

  4. The use of performance improvement methods to enhance emergency department patient satisfaction in the United States: a critical review of the literature and suggestions for future research.

    Science.gov (United States)

    Boudreaux, Edwin D; Cruz, Brian L; Baumann, Brigitte M

    2006-07-01

    The authors reviewed the evidence on performance improvement methods for increasing emergency department (ED) patient satisfaction to provide evidence-based suggestions for clinical practice. Data sources consisted of searches through MEDLINE, CINAHL, PSYCHINFO, Cochrane Library, and Emergency Medicine Abstracts and a manual search of references. Articles were included if they reported a performance improvement intervention targeting patient satisfaction in the ED setting. Articles on studies not conducted in the United States or that failed to provide enough details to allow critical evaluation of the study were excluded. Two authors used structured evaluation criteria to independently review each retained study. Nineteen articles met all selection criteria. Three studies found varying levels of support for multicomponent interventions, predominantly focused on implementation of clinical practice guidelines for specific presenting complaints and process redesign. Sixteen studies evaluated single-component interventions, with the following having at least one supportive study: using alternating patient assignment to provider teams rather than "zone"-based assignment, enhancing provider communication and customer service skills, incorporating information delivery interventions (e.g., pamphlets, video) that target patient expectations, using preformatted charts, and establishing ED-based observation units for specific conditions such as asthma and chest pain. There is modest evidence supporting a range of performance improvement interventions for improving ED patient satisfaction. Further work is needed before specific, evidence-based recommendations can be made regarding which process changes are most effective. Recommendations are made for improving the quality of performance improvement efforts in the ED setting.

  5. An Integrative Review of Empirical Research on Perceptions and Behaviors Related to Prescribed Burning and Wildfire in the United States

    Science.gov (United States)

    Dupéy, Lauren Nicole; Smith, Jordan W.

    2018-06-01

    Social science research from a variety of disciplines has generated a collective understanding of how individuals prepare for, and respond to, the risks associated with prescribed burning and wildfire. We provide a systematic compilation, review, and quantification of dominant trends in this literature by collecting all empirical research conducted within the U.S. that has addressed perceptions and behaviors surrounding various aspects of prescribed burning and wildfire. We reviewed and quantified this literature using four thematic categories covering: (1) the theory and methods that have been used in previous research; (2) the psychosocial aspects of prescribed burning and wildfire that have been studied; (3) the biophysical characteristics of the fires which have been studied; and (4) the types of fire and management approaches that have been examined. Our integrative review builds on previous literature reviews on the subject by offering new insight on the dominant trends, underutilized approaches, and under-studied topics within each thematic category. For example, we found that a select set of theories (e.g., Protection Motivation Theory, Attribution Theory, etc.) and approaches (e.g., mixed-methods) have only been used sparingly in previous research, even though these theories and approaches can produce insightful results that can readily be implemented by fire-management professionals and decision makers. By identifying trends and gaps in the literature across the thematic categories, we were able to answer four questions that address how future research can make the greatest contribution to our understanding of perceptions and behaviors related to prescribed burning and wildfire.

  6. Bench-to-bedside review: Treating acid–base abnormalities in the intensive care unit – the role of buffers

    Science.gov (United States)

    Gehlbach, Brian K; Schmidt, Gregory A

    2004-01-01

    The recognition and management of acid–base disorders is a commonplace activity for intensivists. Despite the frequency with which non-bicarbonate-losing forms of metabolic acidosis such as lactic acidosis occurs in critically ill patients, treatment is controversial. This article describes the properties of several buffering agents and reviews the evidence for their clinical efficacy. The evidence supporting and refuting attempts to correct arterial pH through the administration of currently available buffers is presented. PMID:15312208

  7. Bench-to-bedside review: treating acid-base abnormalities in the intensive care unit - the role of buffers.

    Science.gov (United States)

    Gehlbach, Brian K; Schmidt, Gregory A

    2004-08-01

    The recognition and management of acid-base disorders is a commonplace activity for intensivists. Despite the frequency with which non-bicarbonate-losing forms of metabolic acidosis such as lactic acidosis occurs in critically ill patients, treatment is controversial. This article describes the properties of several buffering agents and reviews the evidence for their clinical efficacy. The evidence supporting and refuting attempts to correct arterial pH through the administration of currently available buffers is presented.

  8. An Integrative Review of Empirical Research on Perceptions and Behaviors Related to Prescribed Burning and Wildfire in the United States.

    Science.gov (United States)

    Dupéy, Lauren Nicole; Smith, Jordan W

    2018-06-01

    Social science research from a variety of disciplines has generated a collective understanding of how individuals prepare for, and respond to, the risks associated with prescribed burning and wildfire. We provide a systematic compilation, review, and quantification of dominant trends in this literature by collecting all empirical research conducted within the U.S. that has addressed perceptions and behaviors surrounding various aspects of prescribed burning and wildfire. We reviewed and quantified this literature using four thematic categories covering: (1) the theory and methods that have been used in previous research; (2) the psychosocial aspects of prescribed burning and wildfire that have been studied; (3) the biophysical characteristics of the fires which have been studied; and (4) the types of fire and management approaches that have been examined. Our integrative review builds on previous literature reviews on the subject by offering new insight on the dominant trends, underutilized approaches, and under-studied topics within each thematic category. For example, we found that a select set of theories (e.g., Protection Motivation Theory, Attribution Theory, etc.) and approaches (e.g., mixed-methods) have only been used sparingly in previous research, even though these theories and approaches can produce insightful results that can readily be implemented by fire-management professionals and decision makers. By identifying trends and gaps in the literature across the thematic categories, we were able to answer four questions that address how future research can make the greatest contribution to our understanding of perceptions and behaviors related to prescribed burning and wildfire.

  9. Pulmonary interstitial emphysema presenting in a woman on the intensive care unit: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jovaisa Tomas

    2011-06-01

    Full Text Available Abstract Introduction Pulmonary interstitial emphysema is a life-threatening form of ventilator-induced lung injury. We present one of the few reported adult cases of pulmonary interstitial emphysema in a woman with respiratory failure admitted to our intensive care unit. Case presentation An 87-year-old Caucasian woman with a diagnosis of community-acquired pneumonia was admitted to our intensive care unit requiring invasive ventilation. The combination of a poor oxygenation index and bilateral alveolar/interstitial infiltrates on a chest radiograph fulfilled the criteria for adult respiratory distress syndrome; the cause was thought to be a combination of the direct pneumonic pulmonary injury and extrapulmonary severe sepsis. By day seven, the fraction of inspired oxygen, peak airway and positive end expiratory pressures weaned sufficiently to allow an uncomplicated percutaneous tracheostomy. On day 10, problems with ventilation necessitated recruitment maneuvers with a Mapleson C circuit, after which dramatic surgical emphysema was noted. An upper airway bronchoscopy showed no obvious tracheal wall injury, and computed tomography of her chest showed extensive surgical emphysema, perivascular emphysema and peribronchial emphysema, which were consistent with a diagnosis of pulmonary interstitial emphysema. Over the following days, despite protective ventilatory strategies and intercostal tube thoracostomy, lung compliance along with oxygenation deteriorated and our patient died on day 14. Conclusion The development of pulmonary interstitial emphysema is a rare but real risk when caring for patients with worsening lung compliance on the intensive care unit. Improved awareness of the condition, early protective ventilation strategies and timely treatment of any of the lethal complications will hopefully result in improved survival from the condition in adults.

  10. SI units in radiology

    Energy Technology Data Exchange (ETDEWEB)

    Iyer, P S [Bhabha Atomic Research Centre, Bombay (India). Div. of Radiation Protection

    1978-11-01

    The proposal of the International Commission on Radiation Units and Measurements that the special units of radiation and radioactivity-roentgen, rad, rem and curie-be replaced by the International System (SI) of Units has been accepted by international bodies. This paper reviews the resons for introducing the new units and their features. The relation between the special units and the corresponding SI units is discussed with examples. In spite of anticipated difficulties, the commission recommends a smooth and efficient changeover to the SI units in ten years.

  11. Review of nuclear regulatory activities associated with safety culture and the management of safety in the United Kingdom

    International Nuclear Information System (INIS)

    Woodhouse, P.A.

    1995-01-01

    This paper describes some of the key regulatory activities which have taken place in the United Kingdom in recent years in the areas of safety culture and management of safety. It explains how the UK's nuclear licensing regime, regulated and enforced by the Nuclear Installations Inspectorate, (NII), provides the framework for a viable safety management system and identifies a management of safety model which a NII Task Force has developed. It finally identifies further work which is being undertaken by the NII. (author). 4 refs, 2 figs

  12. Structural review of the Palisades Nuclear Power Plant Unit 1 containment structure under combined loads for the Systematic Evaluation Program

    International Nuclear Information System (INIS)

    Liaw, C.Y.; Debeling, A.; Tsai, N.C.

    1981-12-01

    A structural reassessment of the containment structure of the Palisades Nuclear Power Plant Unit 1 was performed for the Nuclear Regulatory Commission as part of the Systematic Evaluation Program. Conclusions about the ability of the containment structure to withstand the Abnormal/Extreme Environment are presented. The reassessment focused mainly on the overall structural integrity of the containment building for the Abnormal/Extreme Environment. In this case, the Abnormal Environmental condition is caused by the worst case of either a Loss-of-Coolant Accident or a main steam line break. The Extreme Environmental condition is the Safe Shutdown Earthquake

  13. Clarification of Institutional Controls at the Rocky Flats Site Central Operable Unit and Implementation of the Soil Disturbance Review Plan - 13053

    Energy Technology Data Exchange (ETDEWEB)

    DiSalvo, Rick [Stoller LMS Team, 11025 Dover St, Suite 1000, Westminster, CO 80021 (United States); Surovchak, Scott [U.S. Department of Energy, Office of Legacy Management, 11025 Dover St, Suite 1000, Westminster, CO 80021 (United States); Spreng, Carl [Colorado Department of Public Health and Environment, 4300 Cherry Creek Dr. S, Denver, CO 80246-1530 (United States); Moritz, Vera [U.S. Environmental Protection Agency, Region 8, 1595 Wynkoop St., Denver, CO 80202-1129 (United States)

    2013-07-01

    Cleanup and closure of DOE's Rocky Flats Site in Colorado, which was placed on the CERCLA National Priority List in 1989, was accomplished under CERCLA, RCRA, and the Colorado Hazardous Waste Act (CHWA). The physical cleanup work was completed in late 2005 and all buildings and other structures that composed the Rocky Flats industrial complex were removed from the surface, but remnants remain in the subsurface. Other remaining features include two landfills closed in place with covers, four groundwater treatment systems, and surface water and groundwater monitoring systems. Under the 2006 Corrective Action Decision/Record of Decision for Rocky Flats Plant (US DOE) Peripheral Operable Unit and the Central Operable Unit (CAD/ROD), the response actions selected for the Central Operable Unit (OU) are institutional controls (ICs), physical controls, and continued monitoring and maintenance. The objectives of these ICs were to prevent unacceptable exposure to remaining subsurface contamination and to prevent contaminants from mobilizing to surface water and to prevent interfering with the proper functioning of the engineered components of the remedy. An amendment in 2011 of the 2006 CAD/ROD clarified the ICs to prevent misinterpretation that would prohibit work to manage and maintain the Central OU property. The 2011 amendment incorporated a protocol for a Soil Disturbance Review Plan for work subject to ICs that requires approval from the State and public notification by DOE prior to conducting approved soil-disturbing work. (authors)

  14. Reviews

    NARCIS (Netherlands)

    NN,

    1997-01-01

    BRUENIG, E.F. 1996. Conservation and management of tropical rainforests. An integrated approach to sustainability. 352 pp., illus. CAB International, Wallingford, Oxon 0X10 8DE, United Kingdom. ISBN 0-85198-994-2. Hardcover. Price: US$ 99, £ 55. This is the? ultimate masterpiece of Eberhardt

  15. Nosocomial bloodstream infection in a neonatal intensive care unit of a medical center: a three-year review.

    Science.gov (United States)

    Tseng, Ya-Chun; Chiu, Yu-Chiao; Wang, Jen-Hsien; Lin, Hsiao-Chuan; Lin, Hung-Chih; Su, Bai-Horng; Chiu, Hsiu-Hui

    2002-09-01

    Bloodstream infections are the most frequent nosocomial infections in neonatal intensive care units. This retrospective study surveyed the epidemiologic characteristics of nosocomial bloodstream infections which occurred in the neonatal intensive care unit from January 1, 1997 to December 31, 1999. The overall infection patient rate was 5.5% in the 3-year period, and the overall infection patient-day rate was 4.4 per 1000 patient-days. Low birth weight was a risk factor for bloodstream infections. The rate of infection for neonates with birth weight below 1000 g ranged from 36.6% to 45.8% (1997: 36.6%; 1998: 45.8% and 1999: 38.9%). The most common pathogens causing nosocomial bloodstream infection were: Staphylococcus aureus (18.5%) (with 92% oxacillin-resistant), Acinectobacter baumannii (16.3%), Klebsiella pneumoniae (11.9%), Escherichia coli (9.6%), and Pseudomonas aeruginosa (8.1%). The mortality due to nosocomial bloodstream infection was highest among gram-negative bacteria, especially with P. aeruginosa (45.5%). Therefore, surveillance of nosocomial bloodstream infection and successful strategies to decrease nosocomial bloodstream infection, such as infection control and optimal antibiotic use, are warranted.

  16. Sandstone uranium deposits in the United States: a review of the history, distribution, genesis, mining areas, and outlook

    International Nuclear Information System (INIS)

    Crawley, R.A.

    1983-03-01

    Sandstone uranium deposits account for about 94 percent of uranium reserves in the United States. Most sandstone uranium districts had been found by the mid-1950s in response to incentives promulgated by the US Atomic Energy Commission. Principal uranium resource regions in the United States are the Colorado Plateau, Wyoming Basins, and Texas Coastal Plain. Statistical data published annually by the US Department of Energy show trends of uranium exploration and production, estimates of resources, and distributions and characteristics of reserves. At present, US exploration and production are curtailed because of uranium oversupply, a trend that will continue for the next few years. Although the outlook is more optimistic over the longer term, it is clouded by possible competition from foreign low-cost, nonsandstone uranium. Roll-type and peneconcordant are the two principal types of sandstone uranium deposits. Roll deposits are formed at geochemical fronts where oxidizing uranium-bearing groundwater penetrates reduced sandstone. Uranium is precipitated by reduction at the front. Under mildly reducing conditions, uranium may remain in solution until it is locally precipitated by reduction, chelation, or complexing to form peneconcordant deposits. Proposed precipitating agents include carbonaceous matter, humate, pyrite, and hydrogen sulfide. The uranium is thought to have been derived from leaching of tuffaceous or arkosic sediments, or of granitic rocks

  17. Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review [Formula: see text].

    Science.gov (United States)

    Lew, Charles Chin Han; Yandell, Rosalie; Fraser, Robert J L; Chua, Ai Ping; Chong, Mary Foong Fong; Miller, Michelle

    2017-07-01

    Malnutrition is associated with poor clinical outcomes among hospitalized patients. However, studies linking malnutrition with poor clinical outcomes in the intensive care unit (ICU) often have conflicting findings due in part to the inappropriate diagnosis of malnutrition. We primarily aimed to determine whether malnutrition diagnosed by validated nutrition assessment tools such as the Subjective Global Assessment (SGA) or Mini Nutritional Assessment (MNA) is independently associated with poorer clinical outcomes in the ICU and if the use of nutrition screening tools demonstrate a similar association. PubMed, CINAHL, Scopus, and Cochrane Library were systematically searched for eligible studies. Search terms included were synonyms of malnutrition, nutritional status, screening, assessment, and intensive care unit. Eligible studies were case-control or cohort studies that recruited adults in the ICU; conducted the SGA, MNA, or used nutrition screening tools before or within 48 hours of ICU admission; and reported the prevalence of malnutrition and relevant clinical outcomes including mortality, length of stay (LOS), and incidence of infection (IOI). Twenty of 1168 studies were eligible. The prevalence of malnutrition ranged from 38% to 78%. Malnutrition diagnosed by nutrition assessments was independently associated with increased ICU LOS, ICU readmission, IOI, and the risk of hospital mortality. The SGA clearly had better predictive validity than the MNA. The association between malnutrition risk determined by nutrition screening was less consistent. Malnutrition is independently associated with poorer clinical outcomes in the ICU. Compared with nutrition assessment tools, the predictive validity of nutrition screening tools were less consistent.

  18. Evaluating approved medications to treat allergic rhinitis in the United States: an evidence-based review of efficacy for nasal symptoms by class.

    Science.gov (United States)

    Benninger, Michael; Farrar, Judith R; Blaiss, Michael; Chipps, Bradley; Ferguson, Berrylin; Krouse, John; Marple, Bradley; Storms, William; Kaliner, Michael

    2010-01-01

    To evaluate how well the medications currently approved in the United States for allergic rhinitis (AR) treat nasal symptoms when examined according to Food and Drug Administration-indicated uses and dosages. MEDLINE (1966 onward), EMBASE (1974 onward), and the Cochrane Library (2007) were systematically searched according to the following criteria defined at a roundtable meeting of the authors: randomized controlled trial, at least a 2-week duration, and approved indication and dosage in the United States. Data from studies that met the inclusion criteria were extracted into evidence tables, which were reviewed twice by the full panel of authors. Individual panel members also were asked to comment on abstracts, articles, and summary tables based on their known expertise. The entire faculty approved the selection of studies included in this review. Fifty-four randomized, placebo-controlled studies involving more than 14,000 adults and 1,580 children with AR met the criteria for review: 38 studies of seasonal allergic rhinitis (SAR; n = 11,980 adults and 946 children) and 12 studies of perennial allergic rhinitis (PAR; n = 3,800 adults and 366 children). The median percentage changes from baseline for total nasal symptom score for SAR were as follows: nasal antihistamines, -22.2%; oral antihistamines, -23.5%; intranasal steroids (INSs), -40.7%; and placebo, -15.0%. For PAR, the changes were as follows: oral antihistamines, -51.4%; INSs, -37.3%; and placebo, -24.8%. Data for mediator antagonists were limited. The data, although limited, confirm that INSs produce the greatest improvements in nasal symptoms in patients with SAR. In addition, INSs are effective for PAR, but the data were of variable quality, and oral antihistamines may be equally effective for some patients. The reporting of published data should be standardized to permit better comparisons in future studies.

  19. Emissions of volatile organic compounds in the United Kingdom: a review of emission factors by species and process. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Marlowe, I.T.; Richardson, S.J.; Dowsett, R.; Passant, N.R.; Coleman, P.; Loader, A.; Giddings, T.; Warde-Jones, S.; Richardson, J.L.; Lethlean, J.; McAlister, R.

    1992-01-01

    The objective was to prepare a comprehensive review of UK VOC emissions by species and process. The purpose was to: check that no major sources have been omitted; test the relative size ranking of sources; improve the estimate of the size of each sector; sub-divide each sector so that emissions could be related to abatement options; and add speciated data. Best emission estimates are provided for the following: solvent use, oil industry, chemical industry, stationary combustion, food industry, iron and steel, waste disposal and agriculture. 9 refs., 20 tabs.

  20. A Historical Review of R. J. Reynolds’ Strategies for Marketing Tobacco to Hispanics in the United States

    Science.gov (United States)

    Parascandola, Mark

    2013-01-01

    Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds’ marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February–July 2011 and April–August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities. PMID:23488493

  1. A historical review of R.J. Reynolds' strategies for marketing tobacco to Hispanics in the United States.

    Science.gov (United States)

    Iglesias-Rios, Lisbeth; Parascandola, Mark

    2013-05-01

    Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.

  2. Reviews on Rzewski’s Leftist Political Piano Variations: ‘The People United Will Never Be Defeated’

    Directory of Open Access Journals (Sweden)

    Deng Liang

    2017-02-01

    Full Text Available ‘The People United Will Never Be Defeated (1975 is an one-hour epic modern piano variations, is one with an exquisite structure as well as a humanistic content. As a political context, this could be a legendary piece as well, in its creation in Chile just before Pinochet's military regime and the music's subsequent meaning for so many leftist political enthusiasts. In his approach the author highlighted the role of music, i.e. the role of cultural power in crating consciousness and attracting masses of people to political causes inspiring them to fight for better future. In addition, the author opened a number of questions on performance of contemporary music on the basis of Rzewski’s own DVD recording, the analyzing of which revealed an interesting phenomenon because when Rzewski played his own music, his playing differentiated from his own score.

  3. Review and Status of Wind Integration and Transmission in the United States. Key Issues and Lessons Learned

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, M. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Kirby, B. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Acker, T. [Northern Arizona Univ., Flagstaff, AZ (United States); Ahlstrom, M. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Frew, B. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Goggin, M. [American Wind Energy Association, Washington, DC (United States); Lasher, W. [Electric Reliability Council of Texas, Austin, TX (United States); Marquis, M. [National Oceanic and Atmospheric Adminstration, Washington, DC (United States); Osborn, D. [Midcontinent Independent System Operator, Carmel, IN (United States)

    2015-03-01

    The objective in electric power system operation is to use generation and transmission resources within organizational constraints and operational rules and regulations to reliably and costeffectively balance load and generation. To meet this objective, system operational practices have been created to accommodate the innate variability and uncertainty that comes from a variety of sources, such as uncertainty of demand forecasts, whether a specific generating unit will be available when called upon, the variability of demand from many different types of customers, and others. As more wind power is connected to the power system, operating experiences acquired during the past several years have generally confirmed the findings of wind integration studies: wind energy increases the level of variability and uncertainty that a system operator must manage.

  4. Assessments in Australian stroke rehabilitation units: a systematic review of the post-stroke validity of the most frequently used.

    Science.gov (United States)

    Kitsos, Gemma; Harris, Dawn; Pollack, Michael; Hubbard, Isobel J

    2011-01-01

    In Australia, stroke is the leading cause of adult disability. For most stroke survivors, the recovery process is challenging, and in the first few weeks their recovery is supported with stroke rehabilitation services. Stroke clinicians are expected to apply an evidence-based approach to stroke rehabilitation and, in turn, use standardised and validated assessments to monitor stroke recovery. In 2008, the National Stroke Foundation conducted the first national audit of Australia's post acute stroke rehabilitation services and findings identified a vast array of assessments being used by clinicians. This study undertook a sub-analysis of the audit's assessment tools data with the aim of making clinically relevant recommendations concerning the validity of the most frequently selected assessments. Data reduction ranked the most frequently selected assessments across a series of sub-categories. A serial systematic review of relevant literature using Medline and the Cumulative Index to Nursing and Allied Health Literature identified post-stroke validity ranking. The study found that standardised and non-standardised assessments are currently in use in stroke rehabilitation. It recommends further research in the sub-categories of strength, visual acuity, dysphagia, continence and nutrition and found strengths in the sub-categories of balance and mobility, upper limb function and mood. This is the first study to map national usage of post-stroke assessments and review that usage against the evidence. It generates new knowledge concerning what assessments we currently use post stroke, what we should be using and makes some practical post stroke clinical recommendations.

  5. Review

    DEFF Research Database (Denmark)

    Van Den Hazel, H B; Kielland-Brandt, Morten; Winther, Jakob R.

    1996-01-01

    The yeast vacuole, which is equivalent to the lysosome of higher eukaryotes, is one of the best characterized degradative organelles. This review describes the biosynthesis and function of yeast vacuolar proteases. Most of these enzymes are delivered to the vacuole via the early compartments...

  6. Reviews

    NARCIS (Netherlands)

    Adema, Frits

    1995-01-01

    This is the second volume of a revision of Tabernaemontana (Apocynaceae). The volume covers the New World species (44) and the genus Stemmadenia (10 species). This part of the revision of Tabernaemontana comes up to the high standards set in the first volume [see the review by Leenhouts, Blumea 38

  7. Reviews.

    Science.gov (United States)

    Science Teacher, 1989

    1989-01-01

    Reviews a software planetarium package called "Sky Travel." Includes two audiovisuals: "Conquest of Space" and "Windows on Science: Earth Science"; and four books: "Small Energy Sources: Choices that Work,""Stonehenge Complete,""Uneasy Careers and Intimate Lives: Women in Science…

  8. REVIEW

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... narrowing the gap between recommended treatment protocols in ... for pregnant women is complicated by the need to take into account the health and safety of both the ... meta-analysis as at July 2011 (which reviews the APR and other ... 0.82 - 3.18) and relative risk of birth defects in EFV-containing ART.

  9. Review

    Indian Academy of Sciences (India)

    Review. J. Astrophys. Astr., Vol. 36, No. 4, December 2015, pp. 623–634 ..... 4000 K ≤ T ≤ 10000 K. The processes (1b) are characterized in this paper via ..... Mihajlov, A. A., Sreckovic, V. A., Ignjatovic, L. M., Klyucharev, A. N. 2012, J. Cluster.

  10. Review

    NARCIS (Netherlands)

    Kalkman, C.; Adema, F.

    1998-01-01

    This book intends (according to the preface) to afford at once a review, a general outline of what has been accomplished, and a set of signposts for the future. It attempts to do so in three sections on Origin and Diversification of Primitive Land Plants (4 papers), Origin and Diversification of

  11. Review

    NARCIS (Netherlands)

    Wilde, de W.J.J.O.

    1994-01-01

    This review marks the appearance of Volume II, after the publication of Volume I, Pteridophytes and Gymnosperms, in 1990; several more volumes are expected in the future before completion of the Vascular plants as a whole. The present volume contains 73 families out of some 250-500 families which

  12. Malaysia's Human Rights Performance: Assessment of its First Session of Universal Periodic Review in the United Nations Human Rights Council

    Directory of Open Access Journals (Sweden)

    Ying Hooi Khoo

    2014-05-01

    Full Text Available Since its inception, the Universal Periodic Review (UPR has been subjected to a substantial amount of criticism. The mechanism began functioning in 2008, however there have been little made known about the roles and functions of the UPR. This article explicitly examines the first UPR process of Malaysia in 2009, in order to illustrate how the mechanism operates in practice by highlighting the engagement of Malaysia government with the stakeholders, the follow-up process and the main issues concerned. This article argues that in spite of the excellent diplomacy skills that portrayed by the Malaysian government in the UPR session, the human rights situation in the country has not been improved much. This paper seeks to determine how effective the UPR has been at encouraging human rights reforms nationally by analyzing and assessing the implementation actions of Malaysian government in response to their accepted UPR recommendations.

  13. A Brief Review of Intimate Partner Violence in the United States: Nature, Correlates, and Proposed Preventative Measures

    Directory of Open Access Journals (Sweden)

    Pamela C. Regan

    2015-12-01

    Full Text Available Aggression and violence are themes which characterize a significant proportion of many close romantic relationships. Both women and men may find themselves caught in a web of intimate terror – controlled, manipulated, and hurt by a coercive and violent partner. In this brief review article, we summarize existing literature on the form of intimate partner violence known as coercive controlling violence (CCV, domestic abuse, or intimate terrorism. We begin by discussing the nature and consequences of CCV relationships. Personal or individual (e.g., biological sex, age, immigrant status, socioeconomic status, attitudes and beliefs, mental health and psychopathology, relational or interpersonal (e.g., relationship type, relationship satisfaction, and environmental (e.g., economic strain, social isolation risk factors associated with the occurrence of domestic abuse are identified. Finally, potential preventative measures at the individual, interpersonal, and sociocultural level that may serve to reduce the likelihood of this pernicious interpersonal phenomenon are considered.

  14. Systematic review of the primary research on minority ethnic groups and end-of-life care from the United Kingdom.

    Science.gov (United States)

    Evans, Natalie; Meñaca, Arantza; Andrew, Erin V W; Koffman, Jonathan; Harding, Richard; Higginson, Irene J; Pool, Robert; Gysels, Marjolein

    2012-02-01

    Patients from minority ethnic groups experience lower rates of referrals to end-of-life (EoL) care services, higher levels of dissatisfaction with services, and perceive some services as culturally inappropriate. To systematically review original studies of minority ethnic groups and EoL care in the U.K. and appraise their quality. Searches were carried out in 13 electronic databases, eight journals, reference lists, and the gray literature. Studies of minority ethnic groups and EoL care in the U.K. were included. Studies were graded for quality and key themes were identified. Forty-five studies met inclusion criteria. Study quality was good on average. Identified key themes included age structure; inequality by disease group; referrals; caregivers; place of care and death; awareness of services and communication; and cultural competency. Strategies described for the reduction of inequities were partial and reactive. The format of 10 studies prevented quality grading; these were, however, reviewed as they provided unique insights. Variations in terminology and sampling frames complicated comparison across studies. The results highlight the multiple and related factors that contribute to low service use and substandard quality of services experienced by minority ethnic groups, and the need for authors to clarify what they mean by "culturally competent" EoL care. The synthesis of diverse and disparate studies underpins a number of key recommendations for health care professionals and policymakers. Tackling these epidemiological, demographic, institutional, social, and cultural factors will require a systematic and organization-wide approach rather than the current piecemeal and reactive interventions. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  15. Independent Review of Elemental Phosphorus Remediation at the Eastern Michaud Flats FMC Operable Unit near Pocatello, Idaho

    Energy Technology Data Exchange (ETDEWEB)

    Martino, L. E. [Argonne National Lab. (ANL), Argonne, IL (United States); Jerden, J. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Kimmell, T. A. [Argonne National Lab. (ANL), Argonne, IL (United States); Quinn, J. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-01-01

    If, despite risks to workers and these potential impacts, stakeholders decide that P4 wastes need to be excavated and treated, the Review Team determined that a number of the ETTs examined warrant further consideration for the treatment of P4 waste that has been characterized (for example, P4 waste present in the historical ponds). Nevertheless, concerns about the health and safety of site investigation workers using then-available investigation approaches prevented the collection of subsurface samples containing P4 from large areas of the site (e.g., the railroad swale, the vadose zone beneath the Furnace Building, and the abandoned railcars), As a result, the contaminant CSM in those particular areas was not refined enough to allow the Review Team to draw conclusions about using some of the ETTs to treat P4 waste in those areas. The readiness of an ETT for implementation varies depending on many factors, including stakeholder input, permitting, and remedial action construction requirements. Technologies that could be ready for use in the near term (within 1 year) include the following: mechanical excavation, containment technologies, off-site incineration, and drying and mechanical mixing under a tent structure. Technologies that could be ready for use in the mid-term (1 to 2 years) include cutter suction dredging, thermal-hydraulic dredging, and underground pipeline cleaning technologies. Technologies requiring a longer lead time (2 to 5 years) include on-site incineration, a land disposal restriction waste treatment system, an Albright & Wilson batch mud still, post-treatment on-site disposal, and post-treatment off-site disposal.

  16. Systematic thematic review of e-health research in the Gulf Cooperation Council (Arabian Gulf): Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates.

    Science.gov (United States)

    Weber, Alan S; Turjoman, Rebal; Shaheen, Yanal; Al Sayyed, Farah; Hwang, Mu Ji; Malick, Faryal

    2017-05-01

    Introduction The Gulf Cooperation Council (GCC or 'Arabian Gulf'), comprising Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates, is a political organization sharing a common history and culture. All GCC nations have made substantial investments in telecommunications and electronic health infrastructure since 2000. Methods We conducted a literature search in English and Arabic on peer-reviewed e-health research up to December 2014 originating in the GCC. The objective was to retrieve all research on e-health in the GCC and to categorize and analyse it qualitatively to reveal the current state of e-health research and development in the region. Inclusion criteria included peer-reviewed articles, books, book chapters, conference papers and graduate theses written on e-health in the GCC. Blogs, health websites and non-peer-reviewed literature were excluded. Results Three hundred and six articles were retrieved, categorized and analysed qualitatively to reveal the state of e-health research in the GCC. Both country-specific and GCC-wide major themes were identified using NVivo 10.0 qualitative software and summarized. The most common type of study was an overview (35.0%), with common study designs of case studies (26.8%) and descriptive articles (46.4%). Significant themes were: prospective national benefits from e-health, implementation and satisfaction with electronic health records, online technologies in medical education, innovative systems (case studies), and information security and personal health information. Discussion This is the first comprehensive analytical literature review of e-health in the GCC. Important research gaps were identified: few cost-benefit analyses, controlled interventional studies, or research targeting gender and religious issues were retrieved.

  17. Review of potential host rocks for radioactive waste disposal in the southeast United States-Southern Piedmont subregion

    International Nuclear Information System (INIS)

    1980-10-01

    A literature study was conducted on the geology of the Southern Piedmont province in the states of Maryland, Virginia, North Carolina, South Carolina, and Georgia. The purpose was to identify geologic areas potentially suitable for containment of a repository for the long-term isolation of solidified radioactive waste. The crystalline rocks of the Southern Piedmont province range in age from Precambrian to Paleozoic, and are predominantly slates, phyllites, argillites, schists, metavolcanics, gneisses, gabbros, and granites. These rock units were classified as either favorable, potentially favorable, or unfavorable as potential study areas based on an evaluation of the geologic, hydrologic, and geotechnical characteristics. No socio-economic factors were considered. Rocks subjected to multiple periods of deformation and metamorphism, or described as highly fractured, or of limited areal extent were generally ranked as unfavorable. Potentially favorable rocks are primarily the high-grade metamorphic gneisses and granites. Sixteen areas were classified as being favorable for additional study. These areas are primarily large igneous granite plutons as follows: the Petersburg granite in Virginia; the Rolesville-Castallia, Churchland, and Landis plutons in North Carolina; the Liberty Hill, Winnsboro, and Ogden plutons in South Carolina; and the Siloam, Elberton, and six unnamed granite plutons in Georgia

  18. The United Kingdom Acid Waters Monitoring Network: a review of the first 15 years and introduction to the special issue

    International Nuclear Information System (INIS)

    Monteith, D.T.; Evans, C.D.

    2005-01-01

    The United Kingdom Acid Waters Monitoring Network (AWMN) was established in 1988 to determine the ecological impact of acidic emissions control policy on acid-sensitive lakes and streams. AWMN data have been used to explore a range of causal linkages necessary to connect changes in emissions to chemical and, ultimately, biological recovery. Regional scale reductions in sulphur (S) deposition have been found to have had an immediate influence on surface water chemistry, including increases in acid neutralising capacity, pH and alkalinity and declines in aluminium toxicity. These in turn can be linked to changes in the aquatic biota which are consistent with 'recovery' responses. A continuation of the current programme is essential in order to better understand apparent non-linearity between nitrogen (N) in deposition and runoff, the substantial rise in organic acid concentrations, and the likely impacts of forecast climate change and other potential constraints on further biological improvement. - After 15 years of the UK Acid Waters Monitoring Network, we can now draw clear conclusions regarding the impact of emission reductions on acidified UK fresh waters

  19. Review of potential host rocks for radioactive wasste disposal in the southeast United States: Triassic basin subregion

    International Nuclear Information System (INIS)

    1980-10-01

    Based on an evaluation of existing information, areas were identified within the Triassic basins of the southeastern United States with geologic properties considered favorable for containment of radioactive waste. The study region included both exposed and buried Triassic basins from Maryland to Georgia. These basins are long, narrow northeast-trending troughs filled with continental deposits derived from Paleozoic and Precambrian metamorphic and igneous rocks bordering the basins. The rocks are predominantly red in color and consist mainly of fanglomerates, conglomerates, arkosic sandstones, siltstones, claystones, shales, and argillites. The investigation identified 14 exposed and 5 buried basins within the study region. Candidate areas for further investigation were identified which meet the broad general criteria for tectonic stability, slow ground water movement, and long flow paths to the biosphere. These include: the Danville Triassic Basin in Virginia; the Dan River, Durham, and Wadesboro Triassic Basins in North Carolina; and the buried Florence and Dunbarton Triassic Basins in South Carolina. Other rock types in the southeast may prove more or less suitable as host rocks for a repository, but the available data suggest that the argillaceous Triassic rocks offer sufficient promise to be considered for additional study

  20. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker

    1998-12-01

    Full Text Available There were two copy-editing blunders in Clive Betts's review, in ALT-J 5 (3, of Shirley Fletcher's Designing Competence-Based Training, one in paragraph 2 line 1, the other in paragraph 3 line 8. The errors (the result of the Editor, Gabriel Jacobs, trying to perform a final proof of the journal at lightning speed in order to meet the printing deadline, and not of any mistake on the part of either Philip Barker or the University of Wales Press hardly affected meaning, but the fact that they appeared in a review of a book on competence makes the embarrassment all the more telling. The Editor apologizes, and thanks eagle-eyed readers. He has decided to read the book in the hope that such errors will not recur.

  1. Reviews

    Directory of Open Access Journals (Sweden)

    Wilma D'Ambrosio

    2013-12-01

    Full Text Available In the wake of the great interest raised by Maurizio Gabrieli’s review of the book Musical Networks. Parallel Distributed Perception and Performance (various authors; edited by Niall Griffith and Peter M. Todd, MA: MIT Press, Cambridge, 1999 which appeared in our last issue of Analitica, the present review section no longer follows the format used up to now but offers a survey of texts dedicated to the relationship between music analysis and technology. This decision was also made as a result of the request for more information on the subject by many of our readers. In coming issues we plan to extend this bibliography and comment on at least some of the most interesting texts published in recent years, among which we would immediately like to draw attention to the important work by Baroni, Dalmonte and Jacoboni published in 1999 (Le regole della musica. Indagine sui meccanismi della comunicazione, Torino, I Manuali EDT/SIdM, 1999.

  2. [Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

    Science.gov (United States)

    Servel, A-C; Rideau Batista Novais, A

    2016-09-01

    The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Seismic safety review mission for the follow-up of the seismic upgrading of Kozloduy NPP (Units 1-4). Sofia, Bulgaria, 16-20 November 1992

    International Nuclear Information System (INIS)

    David, M.; Shibata, H.; Stevenson, J.D.; Godoy, A.; Gurpinar, A.

    1992-11-01

    A Seismic Safety Review Mission for the follow-up of the design and implementation of the seismic upgrading of Kozloduy NPP was performed in Sofia from 16-20 November 1992. This mission continued the second task of the follow-up activities of the design and implementation of the seismic upgrading (Phases 1 and 2), which is being carried out in Units 1 and 2 of the NPP. Thus the objectives of the mission was to assist the Bulgarian authorities in the technical evaluation of the design tasks defined for Phases 1 and 2 item HB of WANO 6 Month Programme, as follows: anchorage upgrades of low seismic capacity components; list of seismic safety related systems and components; detailed walkdown to assess seismic capacity of components and define priorities for the upgrading; determination of seismic structural capacity of pump house, diesel generator building and turbine building and design of required upgrades; liquefaction potential evaluation. Tabs

  4. A historical review of managed honey bee populations in Europe and the United States and the factors that may affect them.

    Science.gov (United States)

    Vanengelsdorp, Dennis; Meixner, Marina Doris

    2010-01-01

    Honey bees are a highly valued resource around the world. They are prized for their honey and wax production and depended upon for pollination of many important crops. While globally honey bee populations have been increasing, the rate of increase is not keeping pace with demand. Further, honey bee populations have not been increasing in all parts of the world, and have declined in many nations in Europe and in North America. Managed honey bee populations are influenced by many factors including diseases, parasites, pesticides, the environment, and socio-economic factors. These factors can act alone or in combination with each other. This review highlights the present day value of honey bees, followed by a detailed description of some of the historical and present day factors that influence honey bee populations, with particular emphasis on colony populations in Europe and the United States. Copyright 2009 Elsevier Inc. All rights reserved.

  5. Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis

    Science.gov (United States)

    2012-01-01

    Background Despite warfarin's marked efficacy, not all eligible patients receive it for stroke prevention in AF. The aim of this meta-analysis was to evaluate the association between prescriber and/or patient characteristics and subsequent prescription of warfarin for stroke prevention in patients with atrial fibrillation (AF). Methods Observational studies conducted in the US using multivariate analysis to determine the relationship between characteristics and the odds of receiving warfarin for stroke prevention were identified in MEDLINE, EMBASE and a manual review of references. Effect estimates of prescriber and/or patient characteristics from individual studies were pooled to calculate odds ratios (ORs) with 95% confidence intervals. Results Twenty-eight studies reporting results of 33 unique multivariate analyses were identified. Warfarin use across studies ranged from 9.1%-79.8% (median = 49.1%). There was a moderately-strong correlation between warfarin use and year of study (r = 0.60, p = 0.002). Upon meta-analysis, characteristics associated with a statistically significant increase in the odds of warfarin use included history of cerebrovascular accident (OR = 1.59), heart failure (OR = 1.36), and male gender (OR = 1.12). Those associated with a significant reduction in the odds of warfarin use included alcohol/drug abuse (OR = 0.62), perceived barriers to compliance (OR = 0.87), contraindication(s) to warfarin (OR = 0.81), dementia (OR = 0.32), falls (OR = 0.60), gastrointestinal hemorrhage (OR = 0.47), intracranial hemorrhage (OR = 0.39), hepatic (OR = 0.59), and renal impairment (OR = 0.69). While age per 10-year increase (OR = 0.78) and advancing age as a dichotomized variable (cut-off varied by study) (OR = 0.57) were associated with significant reductions in warfarin use; qualitative review of results of studies evaluating age as a categorical variable did not confirm this relationship. Conclusions Warfarin use has increased somewhat over time. The

  6. Traditional and Complementary Medicine Use Among Indigenous Cancer Patients in Australia, Canada, New Zealand, and the United States: A Systematic Review.

    Science.gov (United States)

    Gall, Alana; Leske, Stuart; Adams, Jon; Matthews, Veronica; Anderson, Kate; Lawler, Sheleigh; Garvey, Gail

    2018-05-01

    Cancer 'patients' are increasingly using traditional indigenous and complementary medicines (T&CM) alongside conventional medical treatments to both cure and cope with their cancer diagnoses. To date T&CM use among Indigenous cancer patients from Australia, Canada, New Zealand, and the United States has not been systematically reviewed. We systematically searched bibliographic databases to identify original research published between January 2000 and October 2017 regarding T&CM use by Indigenous cancer patients in Australia, Canada, New Zealand, and the United States. Data from records meeting eligibility criteria were extracted and appraised for quality by 2 independent reviewers. Twenty-one journal articles from 18 studies across all 4 countries met our inclusion criteria. T&CM use ranged from 19% to 57.7% (differing across countries). T&CM was mostly used concurrently with conventional cancer treatments to meet their spiritual, emotional, social, and cultural needs; however, bush, traditional, and herbal medicines were used in a minority of cases as an alternative. Our findings highlight the importance of T&CM use to Indigenous cancer patients across these 4 countries; we identified multiple perceived spiritual, emotional and cultural benefits to its use. The patient's perception of their health professional's attitudes toward T&CM in some cases hindered or encouraged the patient's disclosure. Additional research is required to further explore the use and disclosure of T&CM among Indigenous cancer patients to help inform and ensure effective, safe, coordinated care for Indigenous cancer patients that relies on shared open decision making and communication across patients, communities, and providers.

  7. Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Rich, Nicole E; Oji, Stefany; Mufti, Arjmand R; Browning, Jeffrey D; Parikh, Neehar D; Odewole, Mobolaji; Mayo, Helen; Singal, Amit G

    2018-02-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States, affecting 75-100 million Americans. However, the disease burden may not be equally distributed among races or ethnicities. We conducted a systematic review and meta-analysis to characterize racial and ethnic disparities in NAFLD prevalence, severity, and prognosis. We searched MEDLINE, EMBASE, and Cochrane databases through August 2016 for studies that reported NAFLD prevalence in population-based or high-risk cohorts, NAFLD severity including presence of nonalcoholic steatohepatitis (NASH) and significant fibrosis, and NAFLD prognosis including development of cirrhosis complications and mortality. Pooled relative risks, according to race and ethnicity, were calculated for each outcome using the DerSimonian and Laird method for a random-effects model. We identified 34 studies comprising 368,569 unique patients that characterized disparities in NAFLD prevalence, severity, or prognosis. NAFLD prevalence was highest in Hispanics, intermediate in Whites, and lowest in Blacks, although differences between groups were smaller in high-risk cohorts (range 47.6%-55.5%) than population-based cohorts (range, 13.0%-22.9%). Among patients with NAFLD, risk of NASH was higher in Hispanics (relative risk, 1.09; 95% CI, 0.98-1.21) and lower in Blacks (relative risk, 0.72; 95% CI, 0.60-0.87) than Whites. However, the proportion of patients with significant fibrosis did not significantly differ among racial or ethnic groups. Data were limited and discordant on racial or ethnic disparities in outcomes of patients with NAFLD. In a systematic review and meta-analysis, we found significant racial and ethnic disparities in NAFLD prevalence and severity in the United States, with the highest burden in Hispanics and lowest burden in Blacks. However, data are discordant on racial or ethnic differences in outcomes of patients with NAFLD. Copyright © 2018 AGA Institute. Published by

  8. Educational Contributions Of The Nurse In The Prevention Of Sepsis In The Unit Of Intensive Therapy: Integrative Review

    Directory of Open Access Journals (Sweden)

    Alana Morais Venancio

    2017-02-01

    Full Text Available Sepsis is defined as a syndrome of inflammatory response, motivated by an aggressive agent, associated with systemic infection, the early approach of the infectious agent, both in the direction of diagnosis and in the control of infectious focus, are fundamental for the good evolution of the patient. This pathology has been considered a global health problem, affecting a large number of people and causing high rates of morbidity and mortality. OBJECTIVE: The study aimed to investigate how nurses contribute in an educational way in the prevention of complications caused by sepsis in an intensive care unit. METHOD: The research was carried out through an electronic search of scientific papers published in the databases LILACS, SCIELO and PUBMED, portal of the virtual library in health. Other materials were located in scientific journals available on university websites and articles related to the subject. The initial evaluation of the material occurred through the reading of the abstracts, in order to select those that met the objectives of the study, with this, 37 articles were selected. In carrying out the research it was possible to verify that the recognition of sepsis by nursing professionals is mainly identified through the changes in the signs and symptoms that are observed through the provision of care to these critical patients. RESULTS: It has been shown that even with all the advances in the production of knowledge about the pathophysiology and the treatment of sepsis, it is still possible to find several difficulties for the proper handling in the diagnosis and in the ideal treatment for each particular case. CONCLUSION: The professional nurse should always be updating and seeking new knowledge for a fast, safe and effective action, in conjunction with the entire health team to promote quality and resolutive care for the patient, especially those affected by sepsis.

  9. Convulsive status epilepticus in a quaternary hospital paediatric intensive care unit (PICU) in South Africa: An 8 year review.

    Science.gov (United States)

    Reddy, Yavini; Balakrishna, Yusentha; Mubaiwa, Lawrence

    2017-10-01

    Convulsive status epilepticus (CSE) is associated with a high morbidity and mortality. This study aimed to describe the clinical profile, aetiology, neuroimaging and EEG findings as well as outcome of children with CSE in Sub-Saharan Africa. This was a retrospective analysis of electronic records of children with CSE admitted to the Paediatric Intensive Care Unit (PICU) over an 8-year period from January 2007 to December 2014. Seventy six patients were admitted to the PICU with CSE and 55(72%) had refractory status epilepticus. The median age at presentation was 15 months (IQR 6-37 months). The main aetiologies were meningoencephalitis and gastroenteritis in 33(43%) and 19(25%) patients respectively. The most frequently used antiepileptic drugs for CSE in PICU consisted of infusions of midazolam (96%) and thiopentone (22%). Neuroimaging findings were abnormal in 53(75%) patients with hypoxic changes in 17 patients. On multivariable regression, the predictors of poor outcome included the use of more than 3 antiepileptic drugs in PICU(RR-1.41(1.12-1.78), p=0.003), duration of mechanical ventilation for more than 3days (RR 1.98(1.22-3.20), p=0.005) and abnormal neuroimaging findings (RR 3.21(1.53-6.72), p=0.002). The mortality rate was 24%(n=18). Persistent seizures or a new neurological deficit occurred in 58%(n=44). The main cause of mortality was CSE related diffuse cortical and brainstem injury. Predominant neurological sequelae were cerebral palsy and persistent epilepsy. The high burden of infection related CSE is associated with high morbidity and mortality rates in contrast to the rates in developed countries. This highlights the need for early recognition and treatment of underlying conditions. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  10. The obstetric performance of United Kingdom asylum seekers from Somalia: a case-control study and literature review.

    Science.gov (United States)

    Yoong, W; Kolhe, S; Karoshi, Mahantesh; Ullah, M; Nauta, M

    2005-01-01

    Little published research exists regarding obstetric performance of immigrant women in the United Kingdom. The aim of this study was to evaluate the obstetric performance and fetal outcomes of Somalian women who received prenatal care and requested to deliver at a teaching hospital in North London. This is a case-control study in which consecutive Somalian women were identified as index cases and the subsequent British-born Caucasian women listed in the delivery book served as controls. 69 index and 69 control cases were analyzed. Fifty-five percent of the Somalian women spoke little or no English. Half (50%) had undergone circumcision, the majority being type I WHO classification of female genital circumcision, which did not require significant surgical intervention prior to labor; 13% had cesarean sections, 13% instrumental vaginal deliveries, and 74% had vaginal deliveries. The Somalian women had higher parity (2.35 vs. 1.18) and were more likely to be grand multiparous (9/69 vs. 1/69) compared to controls. Epidural use was less frequent in Somalian women, but otherwise there were no significant differences between the two groups with regard to maternal age, rates of induction of labor, cesarean sections, duration of labor, premature deliveries, instrumental deliveries, and birth weights. The demographic characteristics of the Somalian female population appear to exert minimal effect on obstetric and fetal outcomes. This may be due to the increased vigilance exercised by health professionals as well as to the fact that recent arrivals are from more urban and westernized areas in Somalia.

  11. Seniors centre-based health intervention programmes in the United States and South Korea: A systematic review.

    Science.gov (United States)

    Song, Misoon; Seo, Kyoungsan; Choi, Suyoung; Choi, Jeongshil; Ko, Hana; Lee, Soo Jin

    2017-10-01

    Despite the great need for health interventions among seniors centre participants, this matter has received little attention. This systematic review aimed to identify what types of health interventions are effective and feasible for seniors centre participants. MEDLINE, Ovid, CINAHL, Google Scholar, EMBASE, and RISS were searched. We searched for health intervention studies conducted in seniors centres published in English and Korean between 1990 and 2014. Of 907 screened articles, 22 studies of all types of experimental designs were selected. Selected studies were grouped by intervention domain: health promotion (n = 8), safety (n = 5), chronic disease management (n = 6), and comprehensive wellness (n = 3). Overall, 59.1% of the interventions were provided by nurses. The health interventions resulted in positive effects on seniors centre participants' knowledge, health behaviours, clinical indices, and hospitalization rates. Few studies reported on feasibility outcomes such as satisfaction and cost-effectiveness. Considering the impact and ease of access to older people at seniors centres, health interventions and services within seniors centres should be strengthened. There is potential for nursing to spearhead seniors centre health intervention programmes to enhance active ageing for participants. © 2017 John Wiley & Sons Australia, Ltd.

  12. Review of potential host rocks for radioactive waste disposal in the southeast United States: Southeastern Coastal Plain Subregion

    International Nuclear Information System (INIS)

    1980-10-01

    A literature review was made of the geological characteristics of the Southeastern Coastal Plain physiograhic province in the states of Maryland, Virginia, North Carolina, South Carolina, and Georgia. The purpose of this study was to identify candidate exploration areas for the possible location of a mined repository for the storage of radioactive waste in the argillaceous sedimentary rocks of the Coastal Plain. Candidate areas were selected on the basis of geological characteristics, available subsurface data, and generally accepted requirements for waste isolation developed by previous studies. Factors considered in the evaluation include the stratigraphy and lithology, geologic history, structure, seismicity, hydrogeology, and natural resources of the candidate area. Unlike other potential regions, the Southeastern Coastal Plain is not composed of competent rock, but consists primarily of unconsolidated and water-saturated sediments overlying a basement of crystalline and metavolcanic rocks. Thus, construction of both shafts and tunnels to depths of approx. 1000 meters may encounter difficulties. Socio-economic and construction considerations have not been addressed in the evaluation. Based on the applied criteria, four areas were selected as being most favorable for future field investigation. These include one in Maryland, one in North Carolina, and two in Georgia

  13. Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P

    2012-07-01

    Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

  14. A Review of Power Distribution Test Feeders in the United States and the Need for Synthetic Representative Networks

    Directory of Open Access Journals (Sweden)

    Fernando E. Postigo Marcos

    2017-11-01

    Full Text Available Under the increasing penetration of distributed energy resources and new smart network technologies, distribution utilities face new challenges and opportunities to ensure reliable operations, manage service quality, and reduce operational and investment costs. Simultaneously, the research community is developing algorithms for advanced controls and distribution automation that can help to address some of these challenges. However, there is a shortage of realistic test systems that are publically available for development, testing, and evaluation of such new algorithms. Concerns around revealing critical infrastructure details and customer privacy have severely limited the number of actual networks published and that are available for testing. In recent decades, several distribution test feeders and US-featured representative networks have been published, but the scale, complexity, and control data vary widely. This paper presents a first-of-a-kind structured literature review of published distribution test networks with a special emphasis on classifying their main characteristics and identifying the types of studies for which they have been used. This both aids researchers in choosing suitable test networks for their needs and highlights the opportunities and directions for further test system development. In particular, we highlight the need for building large-scale synthetic networks to overcome the identified drawbacks of current distribution test feeders.

  15. Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

    Science.gov (United States)

    Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

    2016-01-01

    eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

  16. Characteristics of efficacy evidence supporting approval of supplemental indications for prescription drugs in United States, 2005-14: systematic review.

    Science.gov (United States)

    Wang, Bo; Kesselheim, Aaron S

    2015-09-23

    To characterize the types of comparators and endpoints used in efficacy trials for approvals of supplemental indications, compared with the data supporting these drugs' originally approved indications. Systematic review. Publicly accessible data on supplemental indications approved by the US Food and Drug Administration from 2005 to 2014. Types of comparators (active, placebo, historical, none) and endpoints (clinical outcomes, clinical scales, surrogate) in the efficacy trials for these drugs' supplemental and original indication approvals. The cohort included 295 supplemental indications. Thirty per cent (41/136) of supplemental approvals for new indications were supported by efficacy trials with active comparators, compared with 51% (47/93) of modified use approvals and 11% (7/65) of approvals expanding the patient population (Pindications, 30% (28/93) of modified indication approvals, and 22% (14/65) of expanded population approvals (P=0.29). Orphan drugs had supplemental approvals for 40 non-orphan indications, which were supported by similar proportions of trials using active comparators (28% (11/40) for non-orphan supplemental indications versus 24% (10/42) for original orphan indications; P=0.70) and clinical outcome endpoints (25% (10/40) versus 31% (13/42); P=0.55). Wide variations were seen in the evidence supporting approval of supplemental indications, with the fewest active comparators and clinical outcome endpoints used in trials leading to supplemental approvals that expanded the patient population. © Wang et al 2015.

  17. Assessment of microbiological air quality in hemato-oncology units and its relationship with the occurrence of invasive fungal infections: an integrative review

    Directory of Open Access Journals (Sweden)

    Mayra Goncalves Menegueti

    2013-07-01

    Full Text Available Worldwide aging of the human population has promoted an increase in the incidence of neoplasia, including hematological cancers, which render patients particularly vulnerable to invasive fungal infections. For this reason, air filtration in hemato-oncology units has been recommended. However, scarce literature has assessed the impact of microbiological air quality on the occurrence of fungal infections in this population. We performed an integrative review of studies in the MEDLINE database that were published between January 1980 and October 2012, using the following combinations of keywords: air × quality × HEPA, air × quality × hematology, and airborne fungal infections. The search yielded only 13 articles, suggesting that high-efficiency filtering of the ambient air in hemato-oncology units can prevent the incidence of invasive fungal infections. However, no randomized clinical trial was found to confirm this suggestion. Currently, there is no consensus about the maximum allowable count of fungi in the air, which complicates filtration monitoring, including filter maintenance and replacement, and needs to be addressed in future studies.

  18. Impact of Community Health Workers on Use of Healthcare Services in the United States: A Systematic Review.

    Science.gov (United States)

    Jack, Helen E; Arabadjis, Sophia D; Sun, Lucy; Sullivan, Erin E; Phillips, Russell S

    2017-03-01

    As the US transitions to value-based healthcare, physicians and payers are incentivized to change healthcare delivery to improve quality of care while controlling costs. By assisting with the management of common chronic conditions, community health workers (CHWs) may improve healthcare quality, but physicians and payers who are making choices about care delivery also need to understand their effects on healthcare spending. We searched PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PsycINFO, Embase, and Web of Science from the inception of each database to 22 June 2015. We included US-based studies that evaluated a CHW intervention for patients with at least one chronic health condition and reported cost or healthcare utilization outcomes. We evaluated studies using tools specific to study design. Our search yielded 2,941 studies after removing duplicates. Thirty-four met inclusion and methodological criteria. Sixteen studies (47%) were randomized controlled trials (RCTs). RCTs typically had less positive outcomes than other study designs. Of the 16 RCTs, 12 reported utilization outcomes, of which 5 showed a significant reduction in one or more of ED visits, hospitalizations and/or urgent care visits. Significant reductions reported in ED visits ranged from 23%-51% and in hospitalizations ranged from 21%-50%, and the one significant reduction in urgent care visits was recorded at 60% (p < 0.05 for all). Our results suggest that CHW interventions have variable effects, but some may reduce costs and preventable utilization. These findings suggest that it is possible to achieve reductions in care utilization and cost savings by integrating CHWs into chronic care management. However, variations in cost and utilization outcomes suggest that CHWs alone do not make an intervention successful. The paucity of rigorous studies and heterogeneity of study designs limited conclusions about factors associated with reduced

  19. A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions.

    Science.gov (United States)

    Higgins-Biddle, John C; Babor, Thomas F

    2018-05-03

    The US Preventive Services Task Force recommends that clinicians screen all adults for alcohol misuse and provide brief counseling to those engaged in risky or hazardous drinking. The World Health Organization's (WHO's) Alcohol Use Disorders Identification Test (AUDIT) is the most widely tested instrument for screening in primary health care. This paper describes the structural and functional features of the AUDIT and methodological problems with the validation of the alcohol consumption questions (AUDIT-C). The content, scoring, and rationale for a new version of the AUDIT (called the USAUDIT), adapted to US standard drink size and hazardous drinking guidelines, is presented. Narrative review focusing on the consumption elements of the AUDIT. Four studies of the AUDIT-C are reviewed and evaluated. The AUDIT has been used extensively in many countries without making the changes in the first three consumption questions recommended in the AUDIT User's Manual. As a consequence, the original WHO version is not compatible with US guidelines and AUDIT scores are not comparable with those obtained in countries that have different drink sizes, consumption units, and safe drinking limits. Clinical and Scientific Significance. The USAUDIT has adapted the WHO AUDIT to a 14 g standard drink, and US low-risk drinking guidelines. These changes provide greater accuracy in measuring alcohol consumption than the AUDIT-C.

  20. Reviews

    Science.gov (United States)

    2008-09-01

    WE RECOMMEND Mini Hotplate A constant temperature source is a very useful thing to have Mondo Magnets Book full of magnetism experiments, both classic and new The Physics of Star Trek A book that is not just for fans of the TV series The Trouble with Physics This book explains how string theory has sidetracked physicists Tubular Spring Balance Cheap alternative to the classic newton meter is a winner From Atoms to Patterns The book of the exhibition shows physics' role in fashion Water Heater Heater and calorimeter unit is simple and effective WORTH A LOOK Building Materials Sample Pack A good idea that is not well delivered Double-glazing Kit Another cheap and straightforward idea from SEP Cosmological Enigmas This book gives a personal edge to deep-space physics HANDLE WITH CARE Spring Balance Classically designed newton meter is poorly produced WEB WATCH Gary Williams searches for physics at its most extreme

  1. Reviews

    Science.gov (United States)

    2008-07-01

    WE RECOMMEND Geyser Tube A simple plastic tube makes a great difference to an old trick Field Trip to the Moon This DVD postulates what the next Moon mission will be like Plutonium: A History of the World's Most Dangerous Element A fascinating account of the people and the science behind atomic bombs Solar Energy Modules A series of units ideal for use with 7-14-year-olds Photocopiable Practical Science New teaching resource is clear, straightforward and flexible Joseph Rotblat: Visionary for Peace Biography that is thorough, well-told and worth the telling WORTH A LOOK Applied Biophysics: A Molecular Approach for Physical Scientists This book explains why physics is essential to biology William's Words in Science Classroom dictionary of scientific terms can be hit and miss HANDLE WITH CARE Zero Time Space This story of quantum mechanics loses its thread in translation WEB WATCH A whizz around the pole-related science tools that are available

  2. Systematic Review of Brain Metastases in Patients With Non-Small-Cell Lung Cancer in the United States, European Union, and Japan.

    Science.gov (United States)

    Fenske, D Christian; Price, Gregory L; Hess, Lisa M; John, William J; Kim, Edward S

    2017-11-01

    Brain metastases (BRM) occur frequently in non-small-cell lung cancer (NSCLC) and present a substantial unmet medical need. Previous literature on global BRM prevalence, treatment patterns, costs, and outcomes typically has described a subset of these factors. The primary objective of this systematic literature review was to summarize BRM-related epidemiology, treatment patterns, costs, and survival of patients with NSCLC in the United States, European Union, and Japan. The study was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. Literature searches were conducted in PubMed, Ovid MedLine, and Embase to identify studies published between 2003 and 2014. Peer-reviewed, English language, and human observational studies of patients with NSCLC and BRM were identified. Demographic characteristics, treatment patterns, histology subtype, costs, and survival data were extracted into Microsoft Excel and descriptively analyzed using SAS version 9.2 (SAS Institute, Inc). Of 8257 studies, 243 were eligible. Data from 46,422 patients with NSCLC and 27,907 patients with BRM were summarized. Radiation therapy was used by 70.7% (n = 19,736) of the total BRM population, followed by systemic therapy (8.9%, n = 2497), and surgery (6.1%, n = 1690). Reported median survival was 9.78 months ranging from 2.5 to 38 months. Radiation therapy had the best outcome at 10.0 months with 41.6% (n = 101) of the studies reporting the use of stereotactic radiosurgery. Highly variable median survival and treatment patterns were reported between countries. Costs and histology subtype data were not reported for most countries, highlighting the need for additional research to describe the economic burden of BRM and improve the diagnosis, prognosis, and prescription of effective therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Diagnostic performance of major depression disorder case-finding instruments used among mothers of young children in the United States: A systematic review.

    Science.gov (United States)

    Owora, Arthur H; Carabin, Hélène; Reese, Jessica; Garwe, Tabitha

    2016-09-01

    Growing recognition of the interrelated negative outcomes associated with major depression disorder (MDD) among mothers and their children has led to renewed public health interest in the early identification and treatment of maternal MDD. Healthcare providers, however, remain unsure of the validity of existing case-finding instruments. We conducted a systematic review to identify the most valid maternal MDD case-finding instrument used in the United States. We identified articles reporting the sensitivity and specificity of MDD case-finding instruments based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by systematically searching through three electronic bibliographic databases, PubMed, PsycINFO, and EMBASE, from 1994 to 2014. Study eligibility and quality were evaluated using the Standards for the Reporting of Diagnostic Accuracy studies and Quality Assessment of Diagnostic Accuracy Studies guidelines respectively. Overall, we retrieved 996 unduplicated articles and selected 74 for full-text review. Of these, 14 articles examining 21 different instruments were included in the systematic review. The 10 item Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale had the most stable (lowest variation) and highest diagnostic performance during the antepartum and postpartum periods (sensitivity range: 0.63-0.94 and 0.67-0.95; specificity range: 0.83-0.98 and 0.68-0.97 respectively). Greater variation in diagnostic performance was observed among studies with higher MDD prevalence. Factors that explain greater variation in instrument diagnostic performance in study populations with higher MDD prevalence were not examined. Findings suggest that the diagnostic performance of maternal MDD case-finding instruments is peripartum period-specific. Published by Elsevier B.V.

  4. Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States.

    Science.gov (United States)

    Olds, Jessica; Reilly, Rachel; Yerrell, Paul; Stajic, Janet; Micklem, Jasmine; Morey, Kim; Brown, Alex

    International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to

  5. Review of the geochemistry and metallogeny of approximately 1.4 Ga granitoid intrusions of the conterminous United States

    Science.gov (United States)

    du Bray, Edward A.; Holm-Denoma, Christopher S.; Lund, Karen; Premo, Wayne R.

    2018-03-27

    The conterminous United States hosts numerous volumetrically significant and geographically dispersed granitoid intrusions that range in age from 1.50 to 1.32 billion years before present (Ga). Although previously referred to as A-type granites, most are better described as ferroan granites. These granitoid intrusions are distributed in the northern and central Rocky Mountains, the Southwest, the northern midcontinent, and a swath largely buried beneath Phanerozoic cover across the Great Plains and into the southern midcontinent. These intrusions, with ages that are bimodally distributed between about 1.455–1.405 Ga and 1.405–1.320 Ga, are dispersed nonsystematically with respect to age across their spatial extents. Globally, although A-type or ferroan granites are genetically associated with rare-metal deposits, most U.S. 1.4 Ga granitoid intrusions do not contain significant deposits. Exceptions are the light rare-earth element deposit at Mountain Pass, California, and the iron oxide-apatite and iron oxide-copper-gold deposits in southeast Missouri.Most of the U.S. 1.4 Ga granitoid intrusions are composed of hornblende ± biotite or biotite ± muscovite monzogranite, commonly with prominent alkali feldspar megacrysts; however, modal compositions vary widely. These intrusions include six of the eight commonly identified subtypes of ferroan granite: alkali-calcic and calc-alkalic peraluminous subtypes; alkalic, alkali-calcic, and calc-alkalic metaluminous subtypes; and the alkalic peralkaline subtype. The U.S. 1.4 Ga granitoid intrusions also include variants of these subtypes that have weakly magnesian compositions. Extreme large-ion lithophile element enrichments typical of ferroan granites elsewhere are absent among these intrusions. Chondrite-normalized rare-earth element patterns for these intrusions have modest negative slopes and moderately developed negative europium anomalies. Their radiogenic isotopic compositions are consistent with mixing involving

  6. Sono-leather technology with ultrasound: a boon for unit operations in leather processing - review of our research work at Central Leather Research Institute (CLRI), India.

    Science.gov (United States)

    Sivakumar, Venkatasubramanian; Swaminathan, Gopalaraman; Rao, Paruchuri Gangadhar; Ramasami, Thirumalachari

    2009-01-01

    Ultrasound is a sound wave with a frequency above the human audible range of 16 Hz to 16 kHz. In recent years, numerous unit operations involving physical as well as chemical processes are reported to have been enhanced by ultrasonic irradiation. There have been benefits such as improvement in process efficiency, process time reduction, performing the processes under milder conditions and avoiding the use of some toxic chemicals to achieve cleaner processing. These could be a better way of augmentation for the processes as an advanced technique. The important point here is that ultrasonic irradiation is physical method activation rather than using chemical entities. Detailed studies have been made in the unit operations related to leather such as diffusion rate enhancement through porous leather matrix, cleaning, degreasing, tanning, dyeing, fatliquoring, oil-water emulsification process and solid-liquid tannin extraction from vegetable tanning materials as well as in precipitation reaction in wastewater treatment. The fundamental mechanism involved in these processes is ultrasonic cavitation in liquid media. In addition to this there also exist some process specific mechanisms for the enhancement of the processes. For instance, possible real-time reversible pore-size changes during ultrasound propagation through skin/leather matrix could be a reason for diffusion rate enhancement in leather processing as reported for the first time. Exhaustive scientific research work has been carried out in this area by our group working in Chemical Engineering Division of CLRI and most of these benefits have been proven with publications in valued peer-reviewed international journals. The overall results indicate that about 2-5-fold increase in the process efficiency due to ultrasound under the given process conditions for various unit operations with additional benefits. Scale-up studies are underway for converting these concepts in to a real viable larger scale operation. In

  7. Archives of Voivodship Committee of Polish United Workers’ Party in Biała Podlaska

    Directory of Open Access Journals (Sweden)

    Dariusz Magier

    2010-12-01

    Full Text Available Documentation generated by the communist party after World War II constituted the part of Polish archival heritage. However, Party’s archives were not supervised by nationalarchival network. At the beginning they were storehouses of acts, and since 1955 they had been taken over by propaganda sections of voivodship committees of PZPR (Polish United Workers’ Party and later transformed into the archives of voivodship committees of the Party. The task to preserve documentation generated by the structures of the communist party in Poland was subsequently supervised by: Party HistoryInstitute at KC PZPR (Central Committee of Polish United Workers’ Party, Archives of KC PZPR, and since 1971 Central Archives of KC PZPR. Together with the archives of voivodship committees the net with its own regulations, staff and archival methodology was created. This article gives a detailed description of the activity of the organizational unit,that is the archives of the voivodship committee of the communist party. One of the smallest committees existing in Poland, a provincial Voivodship Committee of PZPR in Biała Podlaska, which operated from 1975 to 1990, serves as an example. The article discusses the reporting structure, handing-over, analysis and preservation of acts, means of recording, premises, system of training and control as well as characterizes the role of a supervisor of the Party’s voidovdship committee Archives played in the archives and chancery.

  8. High-resolution paleoclimatology of the Santa Barbara Basin during the Medieval Climate Anomaly and early Little Ice Age based on diatom and silicoflagellate assemblages in Kasten core SPR0901-02KC

    Science.gov (United States)

    Barron, John A.; Bukry, David B.; Hendy, Ingrid L.

    2015-01-01

    Diatom and silicoflagellate assemblages documented in a high-resolution time series spanning 800 to 1600 AD in varved sediment recovered in Kasten core SPR0901-02KC (34°16.845’ N, 120°02.332’ W, water depth 588 m) from the Santa Barbara Basin (SBB) reveal that SBB surface water conditions during the Medieval Climate Anomaly (MCA) and the early part of the Little Ice Age (LIA) were not extreme by modern standards, mostly falling within one standard deviation of mean conditions during the pre anthropogenic interval of 1748 to 1900. No clear differences between the character of MCA and the early LIA conditions are apparent. During intervals of extreme droughts identified by terrigenous proxy scanning XRF analyses, diatom and silicoflagellate proxies for coastal upwelling typically exceed one standard deviation above mean values for 1748-1900, supporting the hypothesis that droughts in southern California are associated with cooler (or La Niña-like) sea surface temperatures (SSTs). Increased percentages of diatoms transported downslope generally coincide with intervals of increased siliciclastic flux to the SBB identified by scanning XRF analyses. Diatom assemblages suggest only two intervals of the MCA (at ~897 to 922 and ~1151 to 1167) when proxy SSTs exceeded one standard deviation above mean values for 1748 to 1900. Conversely, silicoflagellates imply extreme warm water events only at ~830 to 860 (early MCA) and ~1360 to 1370 (early LIA) that are not supported by the diatom data. Silicoflagellates appear to be more suitable for characterizing average climate during the 5 to 11 year-long sample intervals studied in the SPR0901-02KC core than diatoms, probably because diatom relative abundances may be dominated by seasonal blooms of a particular year.

  9. Treatment of diabetic mice with undenatured whey protein accelerates the wound healing process by enhancing the expression of MIP-1α, MIP-2, KC, CX3CL1 and TGF-β in wounded tissue

    Directory of Open Access Journals (Sweden)

    Badr Gamal

    2012-06-01

    Full Text Available Abstract Background Continuous diabetes-associated complications are a major source of immune system exhaustion and an increased incidence of infection. Diabetes can cause poor circulation in the feet, increasing the likelihood of ulcers forming when the skin is damaged and slowing the healing of the ulcers. Whey proteins (WPs enhance immunity during childhood and have a protective effect on some immune disorders. Therefore, in this study, we investigated the effects of camel WP on the healing and closure of diabetic wounds in a streptozotocin (STZ-induced type I diabetic mouse model. Results Diabetic mice exhibited delayed wound closure characterized by a significant decrease in an anti-inflammatory cytokine (namely, IL-10 and a prolonged elevation of the levels of inflammatory cytokines (TNF-α, IL-1β and IL-6 in wound tissue. Moreover, aberrant expression of chemokines that regulate wound healing (MIP-1α, MIP-2, KC and CX3CL1 and growth factors (TGF-β were observed in the wound tissue of diabetic mice compared with control nondiabetic mice. Interestingly, compared with untreated diabetic mice, supplementation with WP significantly accelerated the closure of diabetic wounds by limiting inflammatory stimuli via the restoration of normal IL-10, TNF-α, IL-1β and IL-6 levels. Most importantly, the supplementation of diabetic mice with WP significantly modulated the expression of MIP-1α, MIP-2, KC, CX3CL1 and TGF-β in wound tissue compared with untreated diabetic mice. Conclusion Our data demonstrate the benefits of WP supplementation for improving the healing and closure of diabetic wounds and restoring the immune response in diabetic mice.

  10. A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

    Directory of Open Access Journals (Sweden)

    Wendy Pons

    Full Text Available Reports of outbreaks in Canada and the United States (U.S. indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs. Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks.The objectives of this study were to: 1 identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2 summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3 identify terminology used to describe SDWSs in outbreak reports.Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis.From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7% and lack of water treatment (20.2% were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (p<0.001. There was large variation in terminology used to describe SDWSs, and a large number of variables were not reported, including water source and whether water treatment was used (missing in 31% and 66% of reports, respectively.More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

  11. A Systematic Review of Waterborne Disease Outbreaks Associated with Small Non-Community Drinking Water Systems in Canada and the United States.

    Science.gov (United States)

    Pons, Wendy; Young, Ian; Truong, Jenifer; Jones-Bitton, Andria; McEwen, Scott; Pintar, Katarina; Papadopoulos, Andrew

    2015-01-01

    Reports of outbreaks in Canada and the United States (U.S.) indicate that approximately 50% of all waterborne diseases occur in small non-community drinking water systems (SDWSs). Summarizing these investigations to identify the factors and conditions contributing to outbreaks is needed in order to help prevent future outbreaks. The objectives of this study were to: 1) identify published reports of waterborne disease outbreaks involving SDWSs in Canada and the U.S. since 1970; 2) summarize reported factors contributing to outbreaks, including water system characteristics and events surrounding the outbreaks; and 3) identify terminology used to describe SDWSs in outbreak reports. Three electronic databases and grey literature sources were searched for outbreak reports involving SDWSs throughout Canada and the U.S. from 1970 to 2014. Two reviewers independently screened and extracted data related to water system characteristics and outbreak events. The data were analyzed descriptively with 'outbreak' as the unit of analysis. From a total of 1,995 citations, we identified 50 relevant articles reporting 293 unique outbreaks. Failure of an existing water treatment system (22.7%) and lack of water treatment (20.2%) were the leading causes of waterborne outbreaks in SDWSs. A seasonal trend was observed with 51% of outbreaks occurring in summer months (pwater source and whether water treatment was used (missing in 31% and 66% of reports, respectively). More consistent reporting and descriptions of SDWSs in future outbreak reports are needed to understand the epidemiology of these outbreaks and to inform the development of targeted interventions for SDWSs. Additional monitoring of water systems that are used on a seasonal or infrequent basis would be worthwhile to inform future protection efforts.

  12. How does intimate partner violence affect condom and oral contraceptive Use in the United States?: A systematic review of the literature.

    Science.gov (United States)

    Bergmann, Julie N; Stockman, Jamila K

    2015-06-01

    Intimate partner violence (IPV) is estimated to affect 25% of adult women in the United States alone. IPV directly impacts women's ability to use contraception, resulting in many of unintended pregnancies and STIs. This review examines the relationship between IPV and condom and oral contraceptive use within the United States at two levels: the female victim's perspective on barriers to condom and oral contraceptive use, in conjunction with experiencing IPV (Aim 1) and the male perpetrator's perspective regarding condom and oral contraceptive use (Aim 2). We systematically reviewed and synthesized all publications meeting the study criteria published since 1997. We aimed to categorize the results by emerging themes related to each study aim. We identified 42 studies that met our inclusion criteria. We found 37 studies that addressed Aim 1. Within this we identified three themes: violence resulting in reduced condom or oral contraceptive use (n=15); condom or oral contraceptive use negotiation (n=15); which we further categorized as IPV due to condom or oral contraceptive request, perceived violence (or fear) of IPV resulting in decreased condom or oral contraceptive use, and sexual relationship power imbalances decreasing the ability to use condoms or oral contraceptives; and reproductive coercion (n=7). We found 5 studies that addressed Aim 2. Most studies were cross-sectional, limiting the ability to determine causality between IPV and condom or oral contraceptive use; however, most studies did find a positive relationship between IPV and decreased condom or oral contraceptive use. Quantitative, qualitative, and mixed methods research has demonstrated the linkages between female IPV victimization/male IPV perpetration and condom or oral contraceptive use. However, additional qualitative and longitudinal research is needed to improve the understanding of dynamics in relationships with IPV and determine causality between IPV, intermediate variables (e

  13. Effectiveness of structured multidisciplinary rounding in acute care units on length of stay and satisfaction of patients and staff: a quantitative systematic review.

    Science.gov (United States)

    Mercedes, Angela; Fairman, Precillia; Hogan, Lisa; Thomas, Rexi; Slyer, Jason T

    2016-07-01

    Consistent, concise and timely communication between a multidisciplinary team of healthcare providers, patients and families is necessary for the delivery of quality care. Structured multidisciplinary rounding (MDR) using a structured communication tool may positively impact length of stay (LOS) and satisfaction of patients and staff by improving communication, coordination and collaboration among the healthcare team. To evaluate the effectiveness of structured MDR using a structured communication tool in acute care units on LOS and satisfaction of patients and staff. Adult patients admitted to acute care units and healthcare providers who provide direct care for adult patients hospitalized in in-patient acute care units. The implementation of structured MDR utilizing a structured communication tool to enhance and/or guide communication. Quasi-experimental studies and descriptive studies. Length of stay, patient satisfaction and staff satisfaction. The comprehensive search strategy aimed to find relevant published and unpublished quantitative English language studies from the inception of each database searched through June 30, 2015. Databases searched include Cumulative Index to Nursing and Allied Health Literature, PubMed, Excerpta Medica Database, Health Source, Cochrane Central Register of Controlled Trials and Scopus. A search of gray literature was also performed. All reviewers independently evaluated the included studies for methodological quality using critical appraisal tools from the Joanna Briggs Institute (JBI). Data related to the methods, participants, interventions and findings were extracted using a standardized data extraction tool from the JBI. Due to clinical and methodological heterogeneity in the interventions and outcome measures of the included studies, statistical meta-analysis was not possible. Results are presented in narrative form. Eight studies were included, three quasi-experimental studies and five descriptive studies of quality

  14. What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition

    Science.gov (United States)

    Baker, Phillip; Hawkes, Corinna; Wingrove, Kate; Parkhurst, Justin; Thow, Anne Marie; Walls, Helen

    2018-01-01

    Introduction Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016–2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic ‘commitment-building’ actions. Method We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis and framework modification. Results 75 studies were included. We identified 18 factors that drive commitment, organised into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and, capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilisation, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence were commitment drivers. Low-income and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination and capacities and resources. In upper-middle-income and high-income country studies, private sector interference frequently undermined commitment. Conclusion Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a core set of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive

  15. What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition.

    Science.gov (United States)

    Baker, Phillip; Hawkes, Corinna; Wingrove, Kate; Demaio, Alessandro Rhyl; Parkhurst, Justin; Thow, Anne Marie; Walls, Helen

    2018-01-01

    Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature, we ask: what factors generate, sustain and constrain political commitment for nutrition, how and under what circumstances? Our aim is to inform strategic 'commitment-building' actions. We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis and framework modification. 75 studies were included. We identified 18 factors that drive commitment, organised into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and, capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilisation, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence were commitment drivers. Low-income and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination and capacities and resources. In upper-middle-income and high-income country studies, private sector interference frequently undermined commitment. Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a core set of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly led nutrition actor

  16. Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: a rapid review of population surveys.

    Science.gov (United States)

    McIntyre, Cecily; Harris, Meredith G; Baxter, Amanda J; Leske, Stuart; Diminic, Sandra; Gone, Joseph P; Hunter, Ernest; Whiteford, Harvey

    2017-08-04

    Indigenous people in Australia, Canada, New Zealand and the United States of America experience disproportionately poor mental health compared to their non-Indigenous counterparts. To optimally allocate resources, health planners require information about the services Indigenous people use for mental health, their unmet treatment needs and the barriers to care. We reviewed population surveys of Indigenous people to determine whether the information needed to guide service development is being collected. We sought national- or state-level epidemiological surveys of Indigenous populations conducted in each of the four selected countries since 1990 that asked about service use for mental health. Surveys were identified from literature reviews and web searches. We developed a framework for categorising the content of each survey. Using this framework, we compared the service use content of the surveys of Indigenous people to each other and to general population mental health surveys. We focused on identifying gaps in information coverage and topics that may require Indigenous-specific questions or response options. Nine surveys met our inclusion criteria. More than half of these included questions about health professionals consulted, barriers to care, perceived need for care, medications taken, number, duration, location and payment of health professional visits or use of support services or self-management. Less than half included questions about interventions received, hospital admissions or treatment dropout. Indigenous-specific content was most common in questions regarding use of support services or self-management, types of health professionals consulted, barriers to care and interventions received. Epidemiological surveys measuring service use for mental health among Indigenous populations have been less comprehensive and less standardised than surveys of the general population, despite having assessed similar content. To better understand the gaps in mental

  17. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    Science.gov (United States)

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95

  18. The Role of Online Social Support in Supporting and Educating Parents of Young Children With Special Health Care Needs in the United States: A Scoping Review

    Science.gov (United States)

    Staten, Lisa K; Rodgers, Rylin Christine; Denne, Scott C

    2016-01-01

    Background When parents of young children with special health care needs (CSHCN) receive their child’s diagnosis, they encounter information they may not understand, emotions they may not know how to cope with, and questions about their child’s immediate and long-term future that frequently lack answers. The challenge of health care providers is how to prepare parents for caring for their CSHCN, for coping with any resulting challenges, and for accessing the systems and services that can assist them. Objective The purpose of this work was to review evidence of the information and support needs of parents of young CSHCN and to determine whether online social support can serve as an avenue for learning and empowerment for these parents. Methods A scoping review identified the challenges, coping mechanisms, and support needs among parents of CSHCN, and the reach and effectiveness of digital technologies with these families and health care providers. We also conducted interviews with professionals serving parents of CSHCN. Results The literature review and interviews suggested that parents best learn the information they need, and cope with the emotional challenges of raising a CSHCN, with support from other parents of CSHCN, and that young parents in recent years have most often been finding this parent-to-parent support through digital media, particularly social media, consistent with the theory of online social support. Evidence also shows that social media, particularly Facebook, is used by nearly all women aged 18-29 years across racial and socioeconomic lines in the United States. Conclusions Parents of young CSHCN experience significant stress but gain understanding, receive support, and develop the ability to care for and be advocates for their child through parent-to-parent emotional and informational social support. Online social support is most effective with young adults of childbearing age, with social media and apps being the most useful within the

  19. The Role of Online Social Support in Supporting and Educating Parents of Young Children With Special Health Care Needs in the United States: A Scoping Review.

    Science.gov (United States)

    DeHoff, Beth A; Staten, Lisa K; Rodgers, Rylin Christine; Denne, Scott C

    2016-12-22

    When parents of young children with special health care needs (CSHCN) receive their child's diagnosis, they encounter information they may not understand, emotions they may not know how to cope with, and questions about their child's immediate and long-term future that frequently lack answers. The challenge of health care providers is how to prepare parents for caring for their CSHCN, for coping with any resulting challenges, and for accessing the systems and services that can assist them. The purpose of this work was to review evidence of the information and support needs of parents of young CSHCN and to determine whether online social support can serve as an avenue for learning and empowerment for these parents. A scoping review identified the challenges, coping mechanisms, and support needs among parents of CSHCN, and the reach and effectiveness of digital technologies with these families and health care providers. We also conducted interviews with professionals serving parents of CSHCN. The literature review and interviews suggested that parents best learn the information they need, and cope with the emotional challenges of raising a CSHCN, with support from other parents of CSHCN, and that young parents in recent years have most often been finding this parent-to-parent support through digital media, particularly social media, consistent with the theory of online social support. Evidence also shows that social media, particularly Facebook, is used by nearly all women aged 18-29 years across racial and socioeconomic lines in the United States. Parents of young CSHCN experience significant stress but gain understanding, receive support, and develop the ability to care for and be advocates for their child through parent-to-parent emotional and informational social support. Online social support is most effective with young adults of childbearing age, with social media and apps being the most useful within the theoretical framework of social support. This opens new

  20. Systematic evaluation program review of NRC safety topic VII-2 associated with the electrical, instrumentation and control portions of the ESF system control logic and design for the Dresden Station, Unit II nuclear power plant

    International Nuclear Information System (INIS)

    St Leger-Barter, G.

    1980-11-01

    This report documents the technical evaluation and review of NRC Safety Topic VII-2, associated with the electrical, instrumentation, and control portions of the ESF system control logic and design for the Dresden Station Unit II nuclear power plant, using current licensing criteria

  1. Mental health services for black and minority ethnic elders in the United Kingdom: a systematic review of innovative practice with service provision and policy implications.

    Science.gov (United States)

    Bhattacharyya, Sarmishtha; Benbow, Susan Mary

    2013-03-01

    The proportion of older people from black and minority ethnic (BME) groups in the United Kingdom (UK) is increasing steadily as the population ages. The numbers with dementia, depression, and other mental health problems are predicted to increase. Government policy documents have highlighted gaps in services for BME elders and/or the need to develop culturally appropriate services, in order to prevent people from BME communities from becoming socially excluded and finding services hard to access. This paper reviews published examples of innovative services and key learning points from them. A search was carried out on Pubmed, Medline, and Google Scholar for service developments aimed at BME elders in the UK. Sixteen relevant papers and reports were identified and were analysed to identify learning points and implications for clinical practice and policy. Commissioning issues included were forward planning for continuing funding and mainstreaming versus specialist services. Provider management issues included were employing staff from the communities of interest, partnership, and removing language barriers. Provider service issues included were education for service provider staff on the needs of BME elders, making available information in relevant languages, building on carers' and users' experiences, and addressing the needs of both groups. A model for structuring understanding of the underutilisation of services by BME elders is suggested. The main emphasis in future should be to ensure that learning is shared, disseminated, and applied to the benefit of all communities across the whole of the UK and elsewhere. Person-centred care is beneficial to all service users.

  2. Prevention and control of rabies in an age of global travel: a review of travel- and trade-associated rabies events--United States, 1986-2012.

    Science.gov (United States)

    Lankau, E W; Cohen, N J; Jentes, E S; Adams, L E; Bell, T R; Blanton, J D; Buttke, D; Galland, G G; Maxted, A M; Tack, D M; Waterman, S H; Rupprecht, C E; Marano, N

    2014-08-01

    Rabies prevention and control efforts have been successful in reducing or eliminating virus circulation regionally through vaccination of specific reservoir populations. A notable example of this success is the elimination of canine rabies virus variant from the United States and many other countries. However, increased international travel and trade can pose risks for rapid, long-distance movements of ill or infected persons or animals. Such travel and trade can result in human exposures to rabies virus during travel or transit and could contribute to the re-introduction of canine rabies variant or transmission of other viral variants among animal host populations. We present a review of travel- and trade-associated rabies events that highlight international public health obligations and collaborative opportunities for rabies prevention and control in an age of global travel. Rabies is a fatal disease that warrants proactive coordination among international public health and travel industry partners (such as travel agents, tour companies and airlines) to protect human lives and to prevent the movement of viral variants among host populations. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  3. Effect of study design and setting on tuberculosis clustering estimates using Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR): a systematic review.

    Science.gov (United States)

    Mears, Jessica; Abubakar, Ibrahim; Cohen, Theodore; McHugh, Timothy D; Sonnenberg, Pam

    2015-01-21

    To systematically review the evidence for the impact of study design and setting on the interpretation of tuberculosis (TB) transmission using clustering derived from Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) strain typing. MEDLINE, EMBASE, CINHAL, Web of Science and Scopus were searched for articles published before 21st October 2014. Studies in humans that reported the proportion of clustering of TB isolates by MIRU-VNTR were included in the analysis. Univariable meta-regression analyses were conducted to assess the influence of study design and setting on the proportion of clustering. The search identified 27 eligible articles reporting clustering between 0% and 63%. The number of MIRU-VNTR loci typed, requiring consent to type patient isolates (as a proxy for sampling fraction), the TB incidence and the maximum cluster size explained 14%, 14%, 27% and 48% of between-study variation, respectively, and had a significant association with the proportion of clustering. Although MIRU-VNTR typing is being adopted worldwide there is a paucity of data on how study design and setting may influence estimates of clustering. We have highlighted study design variables for consideration in the design and interpretation of future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. A Review of Applicability and Effectiveness of Low Impact Development/Green Infrastructure Practices in Arid/Semi-Arid United States

    Directory of Open Access Journals (Sweden)

    Yan Jiang

    2015-06-01

    Full Text Available Urbanized areas of the southwestern/western United States are among the fastest growing in the nation and face multiple water resource challenges. Low impact development (LID/green infrastructure (GI practices are increasingly popular technologies for managing stormwater; however, LID is often not as common in the southwest/west due to the lack of regulatory and/or economic drivers. There is also a lack of performance evaluation of these practices, particularly at the field scale. This study focused on investigating the hydrologic and pollutant removal performance of field-scale LID/GI systems in arid/semi-arid climates. Nine typical practices were reviewed: rainwater harvest system, detention pond, retention pond, bioretention, media filter, porous pavement, vegetated swale/buffer/strip, green roof, and infiltration trench, as well as integrated LIDs. We evaluate these practices by a cost-effectiveness analysis and also recommend best practices for the arid/semi-arid area. The analysis provides data support and insights for future implementation of LID/GI in the southwest/west.

  5. Neoplasia in 125 donkeys (Equus asinus): literature review and a survey of five veterinary schools in the United States and Canada.

    Science.gov (United States)

    Davis, Corrine R; Valentine, Beth A; Gordon, Emma; McDonough, Sean P; Schaffer, Paula A; Allen, Andrew L; Pesavento, Patricia

    2016-11-01

    A diagnosis of neoplasia was noted in 125 of 357 donkeys (35%) in our review of medical records from 5 veterinary schools in the United States and Canada. Equine sarcoid was the most common tumor in our study, accounting for 72% of all tumors and 82% of cutaneous tumors. Soft-tissue sarcomas were the second most common skin tumors. All other types of neoplasia were rare. Important differences in the occurrence of neoplasia in donkeys compared to horses included the rarity or absence of squamous cell carcinoma in any organ system and gray horse melanoma. Lymphosarcoma, the most common malignant tumor in horses, appears to be very rare in donkeys. We report several tumors in donkeys including melanocytoma, peripheral nerve sheath tumor, and gastrointestinal stromal tumor. Our data demonstrate commonalities as well as differences in neoplastic diseases of donkeys and horses. Understanding differences in carcinogenesis among these 2 closely related species can inform researchers pursuing pathogenic mechanisms of equine disease and inform veterinary diagnosticians regarding tumor prevalence. © 2016 The Author(s).

  6. Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review.

    Science.gov (United States)

    Risher, Kathryn A; Kapoor, Sunaina; Daramola, Alice Moji; Paz-Bailey, Gabriela; Skarbinski, Jacek; Doyle, Kate; Shearer, Kate; Dowdy, David; Rosenberg, Eli; Sullivan, Patrick; Shah, Maunank

    2017-07-01

    In the United States (US), there are high levels of disengagement along the HIV care continuum. We sought to characterize the heterogeneity in research studies and interventions to improve care engagement among people living with diagnosed HIV infection. We performed a systematic literature search for interventions to improve HIV linkage to care, retention in care, reengagement in care and adherence to antiretroviral therapy (ART) in the US published from 2007-mid 2015. Study designs and outcomes were allowed to vary in included studies. We grouped interventions into categories, target populations, and whether results were significantly improved. We identified 152 studies, 7 (5%) linkage studies, 33 (22%) retention studies, 4 (3%) reengagement studies, and 117 (77%) adherence studies. 'Linkage' studies utilized 11 different outcome definitions, while 'retention' studies utilized 39, with very little consistency in effect measurements. The majority (59%) of studies reported significantly improved outcomes, but this proportion and corresponding effect sizes varied substantially across study categories. This review highlights a paucity of assessments of linkage and reengagement interventions; limited generalizability of results; and substantial heterogeneity in intervention types, outcome definitions, and effect measures. In order to make strides against the HIV epidemic in the US, care continuum research must be improved and benchmarked against an integrated, comprehensive framework.

  7. Federally Chartered Corporation: Review of the Financial Statement Audit Report for the Navy Club of the United States of America for Fiscal Year 1998

    National Research Council Canada - National Science Library

    2000-01-01

    .... The main purpose of the corporation is to further, encourage, promote, and maintain comradeship among those persons who are or have been in active service of the United States Navy, the United States...

  8. Yield of community-based tuberculosis targeted testing and treatment in foreign-born populations in the United States: A systematic review.

    Directory of Open Access Journals (Sweden)

    Mohsen Malekinejad

    Full Text Available To synthesize outputs and outcomes of community-based tuberculosis targeted testing and treatment (TTT programs in foreign-born populations (FBP in the United States (US.We systematically searched five bibliographic databases and other key resources. Two reviewers independently applied eligibility criteria to screen citations and extracted data from included studies. We excluded studies that contained 90%. We used random-effects meta-analytic models to calculate pooled proportions and 95% confidence intervals (CI for community-based TTT cascade steps (e.g., recruited, tested and treated, and used them to create two hypothetical cascades for 100 individuals.Fifteen studies conducted in 10 US states met inclusion criteria. Studies were heterogeneous in recruitment strategies and mostly recruited participants born in Latin America. Of 100 hypothetical participants (predominantly FBP reached by community-based TTT, 40.4 (95% CI 28.6 to 50.1 would have valid test results, 15.7 (95% CI 9.9 to 21.8 would test positive, and 3.6 (95% CI 1.4 to 6.0 would complete LTBI treatment. Likewise, of 100 hypothetical participants (majority FBP reached, 77.9 (95% CI 54.0 to 92.1 would have valid test results, 26.5 (95% CI 18.0 to 33.5 would test positive, and 5.4 (95% CI 2.1 to 9.0 would complete LTBI treatment. Of those with valid test results, pooled proportions of LTBI test positive for predominantly FBP and majority FBP were 38.9% (95% CI 28.6 to 49.8 and 34.3% (95% CI 29.3 to 39.5, respectively.We observed high attrition throughout the care cascade in FBP participating in LTBI community-based TTT studies. Few studies included cascade steps prior to LTBI diagnosis, limiting our review findings. Moreover, Asia-born populations in the US are substantially underrepresented in the FBP community-based TTT literature.

  9. Reviewing the effects of an educational program about sepsis care on knowledge, attitude, and practice of nurses in intensive care units.

    Science.gov (United States)

    Yousefi, Hojatollah; Nahidian, Malihe; Sabouhi, Fakhri

    2012-02-01

    The most common complication of hospitalization in intensive care units (ICUs) is infections caused by health care. Although sepsis results in a small percentage of infections, it has a high mortality rate. Intensive care nurses play a critical role in the prevention, early detection, and beginning of therapeutic interventions in patients with sepsis. This study aimed to review the effects of an educational program on knowledge, attitude, and practice of ICU nurses in Shariati Hospital, Isfahan, Iran. This was a quasi-experimental study on 64 nurses with at least one year of experience in ICU. The subjects were randomly selected and divided into test and control groups. Scores of knowledge, attitude, and practice of the participants were reviewed through a researcher-made questionnaire before and immediately and three weeks after a one-day workshop. Compared to baseline, there were significant increases in mean scores of knowledge, attitude, and practice in the test group immediately and three weeks after the education. Mean scores of knowledge in the test group before and immediately and 3 weeks after the intervention were 64.5, 84.9 and 85.2, respectively. The corresponding values for attitude were 73, 79.7, and 83.3. Mean scores of practice were 81.8, 90.5, and 91.3 before and immediately and 3 weeks after the intervention, respectively. In the control group, mean scores of knowledge before and immediately and 3 weeks after the educational course (which they did not attend) was 63.7, 63.9, and 63.5, respectively. Mean scores of attitude were respectively 72.8, 73.3, and 73.2 at the mentioned intervals. The corresponding values for practice were 82.1, 82.9, and 82.7. Training significantly improved levels of knowledge, attitude, and practice of ICU nurses in sepsis care. Therefore, compiling and organizing seminars and continuous basic educational workshops for sepsis care are recommended for health caregivers.

  10. Evaluation of the marginal fit of single-unit, complete-coverage ceramic restorations fabricated after digital and conventional impressions: A systematic review and meta-analysis.

    Science.gov (United States)

    Tsirogiannis, Panagiotis; Reissmann, Daniel R; Heydecke, Guido

    2016-09-01

    In existing published reports, some studies indicate the superiority of digital impression systems in terms of the marginal accuracy of ceramic restorations, whereas others show that the conventional method provides restorations with better marginal fit than fully digital fabrication. Which impression method provides the lowest mean values for marginal adaptation is inconclusive. The findings from those studies cannot be easily generalized, and in vivo studies that could provide valid and meaningful information are limited in the existing publications. The purpose of this study was to systematically review existing reports and evaluate the marginal fit of ceramic single-tooth restorations after either digital or conventional impression methods by combining the available evidence in a meta-analysis. The search strategy for this systematic review of the publications was based on a Population, Intervention, Comparison, and Outcome (PICO) framework. For the statistical analysis, the mean marginal fit values of each study were extracted and categorized according to the impression method to calculate the mean value, together with the 95% confidence intervals (CI) of each category, and to evaluate the impact of each impression method on the marginal adaptation by comparing digital and conventional techniques separately for in vitro and in vivo studies. Twelve studies were included in the meta-analysis from the 63 identified records after database searching. For the in vitro studies, where ceramic restorations were fabricated after conventional impressions, the mean value of the marginal fit was 58.9 μm (95% CI: 41.1-76.7 μm), whereas after digital impressions, it was 63.3 μm (95% CI: 50.5-76.0 μm). In the in vivo studies, the mean marginal discrepancy of the restorations after digital impressions was 56.1 μm (95% CI: 46.3-65.8 μm), whereas after conventional impressions, it was 79.2 μm (95% CI: 59.6-98.9 μm) No significant difference was observed regarding

  11. Review report: safety and reliability issues on digital instrumentation and control systems in nuclear power plants and United States Nuclear Regulatory Commission`s dispositions

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Norio; Suzudo, Tomoaki [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    1998-09-01

    Recently, digital instrumentation and control (I and C) systems have been applied to nuclear power plants (NPPs) in various countries. Introduction of digital I and C systems, however, raises special issues on design, implementation, safety and licensing. Since FY 1997, the Japan Atomic Energy Research Institute (JAERI) has been carrying out a project, Study on Reliability of Digital I and C Systems, which includes extensive reviews of design approaches, technical standards, regulatory processes, especially, in the United States. This report summarizes the results from the study of National Research Council (NRC) and the U.S. Nuclear Regulatory Commission`s (USNRC`s) responses to the recommendations made by the NRC`s study. That study identified six technical key issues (system aspects of digital I and C technology, software quality assurance, common-mode software failure potential, safety and reliability assessment methods, human factors and man-machine interface, dedication of commercial off-the-shelf hardware and software) and two strategic key issues (case-by-case licensing process, adequacy of technical infrastructure) that arise from the introduction of digital I and C technology and then, made recommendations to the USNRC for coping with digital I and C applications. The USNRC responded to each recommendation and showed their own dispositions in which the USNRC agreed with most of the recommendations. In Japan, it is expected that introduction of digital I and C technology is inevitable in NPPs because the vendors are gradually discontinuing support and stocking of analog components. To cope with such situations, there is a need to develop and update the standards and guidelines applicable to digital I and C technology. The key issues and the USNRC`s dispositions provided in this report is believed to be useful for developing and updating them. (J.P.N.)

  12. Review report: safety and reliability issues on digital instrumentation and control systems in nuclear power plants and United States Nuclear Regulatory Commission's dispositions

    International Nuclear Information System (INIS)

    Watanabe, Norio; Suzudo, Tomoaki

    1998-09-01

    Recently, digital instrumentation and control (I and C) systems have been applied to nuclear power plants (NPPs) in various countries. Introduction of digital I and C systems, however, raises special issues on design, implementation, safety and licensing. Since FY 1997, the Japan Atomic Energy Research Institute (JAERI) has been carrying out a project, Study on Reliability of Digital I and C Systems, which includes extensive reviews of design approaches, technical standards, regulatory processes, especially, in the United States. This report summarizes the results from the study of National Research Council (NRC) and the U.S. Nuclear Regulatory Commission's (USNRC's) responses to the recommendations made by the NRC's study. That study identified six technical key issues (system aspects of digital I and C technology, software quality assurance, common-mode software failure potential, safety and reliability assessment methods, human factors and man-machine interface, dedication of commercial off-the-shelf hardware and software) and two strategic key issues (case-by-case licensing process, adequacy of technical infrastructure) that arise from the introduction of digital I and C technology and then, made recommendations to the USNRC for coping with digital I and C applications. The USNRC responded to each recommendation and showed their own dispositions in which the USNRC agreed with most of the recommendations. In Japan, it is expected that introduction of digital I and C technology is inevitable in NPPs because the vendors are gradually discontinuing support and stocking of analog components. To cope with such situations, there is a need to develop and update the standards and guidelines applicable to digital I and C technology. The key issues and the USNRC's dispositions provided in this report is believed to be useful for developing and updating them. (J.P.N.)

  13. Interface unit

    NARCIS (Netherlands)

    Keyson, D.V.; Freudenthal, A.; De Hoogh, M.P.A.; Dekoven, E.A.M.

    2001-01-01

    The invention relates to an interface unit comprising at least a display unit for communication with a user, which is designed for being coupled with a control unit for at least one or more parameters in a living or working environment, such as the temperature setting in a house, which control unit

  14. Development of innovative teaching materials: clinical pharmacology problem-solving (CPPS) units: comparison with patient-oriented problem-solving units and problem-based learning--a 10-year review.

    Science.gov (United States)

    Lathers, Claire M; Smith, Cedric M

    2002-05-01

    The First Teaching Clinic in Clinical Pharmacology, sponsored by the American College of Clinical Pharmacology in September 1992, was designed for the preparation and development of new clinical pharmacology problem-solving (CPPS) units. CPPS units are case histories that illustrate pertinent principles in clinical pharmacology. Each unit consists of the following sections: introduction, learning objectives, pretest, four clinical pharmacology scenarios, posttest, answers to pre- and posttest questions, and selected references. The clinical pharmacology content of the CPPS units place greater emphasis on clinical information, drug selection, and risk/benefit analyses, and thus they complement the basic pharmacology presented in the patient-oriented problem-solving (POPS) units. In general, the CPPS units are intended for use by students more advanced in clinical pharmacology than first- and second-year medical students. The CPPS unit "Clinical Pharmacology of Antiepileptic Drug Use: Clinical Pearls about the Perils of Patty" was developed for use by third- and fourth-year medical students doing rotations in neurology or clinical pharmacology; advanced pharmacy students; residents in neurology, pediatrics, internal medicine, and family practice; fellows in clinical pharmacology, and those taking the board examination in clinical pharmacology. The CPPS unit titled "Geriatric Clinical Psychopharmacology" was written for third- and fourth-year medical students; residents in psychiatry, family practice, and internal medicine;fellows in clinical pharmacology; and those studying for boards in clinical pharmacology. The CPPS unit "Anisocoria and Glaucoma" was written for more advanced students of clinical pharmacology. The CPPS unit titled "Antiepileptic Drugs" was intended for second-year medical students. The second teaching clinic was held in November 1993 and focused on the development and editing of the CPPS units and their evaluations by faculty and students from

  15. A comparison of the lattice discrete particle method to the finite-element method and the K&C material model for simulating the static and dynamic response of concrete.

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Jovanca J.; Bishop, Joseph E.

    2013-11-01

    This report summarizes the work performed by the graduate student Jovanca Smith during a summer internship in the summer of 2012 with the aid of mentor Joe Bishop. The projects were a two-part endeavor that focused on the use of the numerical model called the Lattice Discrete Particle Model (LDPM). The LDPM is a discrete meso-scale model currently used at Northwestern University and the ERDC to model the heterogeneous quasi-brittle material, concrete. In the first part of the project, LDPM was compared to the Karagozian and Case Concrete Model (K&C) used in Presto, an explicit dynamics finite-element code, developed at Sandia National Laboratories. In order to make this comparison, a series of quasi-static numerical experiments were performed, namely unconfined uniaxial compression tests on four varied cube specimen sizes, three-point bending notched experiments on three proportional specimen sizes, and six triaxial compression tests on a cylindrical specimen. The second part of this project focused on the application of LDPM to simulate projectile perforation on an ultra high performance concrete called CORTUF. This application illustrates the strengths of LDPM over traditional continuum models.

  16. Memorandum About the Science and Ethics Review of USDA Protocol for Laboratory Evaluation of Bite Protection from Repellent-treated Clothing for the United States Military

    Science.gov (United States)

    This review assesses the scientific aspects of the proposed research for a special efficacy study to assess etofenprox-treated U.S. Military uniforms in terms of the recommendations of the EPA and of the EPA Human Studies Review Board.

  17. Report of an experts' mission to review the modernization programme of the Kozloduy NPP units 5 and 6 Kozloduy, Bulgaria 26 June - 1 July 1995

    International Nuclear Information System (INIS)

    1995-01-01

    The purpose of the IAEA Safety Review Mission was to review the safety aspects of the Kozloduy 5/6 modernization programme, and to advise on the completeness and adequacy of the safety improvements proposed. The IAEA draft report ''Ranking of Safety Issues for WWER-1000 Model 320 NPPs'', WWER-SC-104, 1995-05-29 (referred to as the Issue Book in the subsequent text) was the basis for the experts' review. The IAEA NUSS standards and guides, and internationally accepted safety concepts and practices and national standards, complemented by the Russian safety rules in force, were used in the preparation of the issue book. The scope of the review covered the plant design and operational safety aspects as proposed in the modernization programme. The upgrading measures, which are only related to the improvement of plant availability, were not included in the review

  18. Public Review Draft: A Method for Assessing Carbon Stocks, Carbon Sequestration, and Greenhouse-Gas Fluxes in Ecosystems of the United States Under Present Conditions and Future Scenarios

    Science.gov (United States)

    Bergamaschi, Brian A.; Bernknopf, Richard; Clow, David; Dye, Dennis; Faulkner, Stephen; Forney, William; Gleason, Robert; Hawbaker, Todd; Liu, Jinxun; Liu, Shu-Guang; Prisley, Stephen; Reed, Bradley; Reeves, Matthew; Rollins, Matthew; Sleeter, Benjamin; Sohl, Terry; Stackpoole, Sarah; Stehman, Stephen; Striegl, Robert G.; Wein, Anne; Zhu, Zhi-Liang; Zhu, Zhi-Liang

    2010-01-01

    The Energy Independence and Security Act of 2007 (EISA), Section 712, authorizes the U.S. Department of the Interior to develop a methodology and conduct an assessment of the Nation's ecosystems focusing on carbon stocks, carbon sequestration, and emissions of three greenhouse gases (GHGs): carbon dioxide, methane, and nitrous oxide. The major requirements include (1) an assessment of all ecosystems (terrestrial systems, such as forests, croplands, wetlands, shrub and grasslands; and aquatic ecosystems, such as rivers, lakes, and estuaries), (2) an estimation of annual potential capacities of ecosystems to increase carbon sequestration and reduce net GHG emissions in the context of mitigation strategies (including management and restoration activities), and (3) an evaluation of the effects of controlling processes, such as climate change, land use and land cover, and wildlfires. The purpose of this draft methodology for public review is to propose a technical plan to conduct the assessment. Within the methodology, the concepts of ecosystems, carbon pools, and GHG fluxes used for the assessment follow conventional definitions in use by major national and international assessment or inventory efforts. In order to estimate current ecosystem carbon stocks and GHG fluxes and to understand the potential capacity and effects of mitigation strategies, the method will use two time periods for the assessment: 2001 through 2010, which establishes a current ecosystem GHG baseline and will be used to validate the models; and 2011 through 2050, which will be used to assess future potential conditions based on a set of projected scenarios. The scenario framework is constructed using storylines of the Intergovernmental Panel on Climate Change (IPCC) Special Report Emission Scenarios (SRES), along with initial reference land-use and land-cover (LULC) and land-management scenarios. An additional three LULC and land-management mitigation scenarios will be constructed for each

  19. Characterization of the antifungal activity of Lactobacillus harbinensis K.V9.3.1Np and Lactobacillus rhamnosus K.C8.3.1I in yogurt.

    Science.gov (United States)

    Delavenne, Emilie; Cliquet, Sophie; Trunet, Clément; Barbier, Georges; Mounier, Jérôme; Le Blay, Gwenaëlle

    2015-02-01

    Few antifungal protective cultures adapted to fermented dairy products are commercially available because of the numerous constraints linked to their market implementation. Consumer's demand for naturally preserved food products is growing and the utilization of lactic acid bacteria is a promising way to achieve this goal. In this study, using a 2(5-1) factorial fractional design, we first evaluated the effects of fermentation time, of initial sucrose concentration and of the initial contamination amount of a spoilage yeast, on antifungal activities of single and mixed cultures of Lactobacillus rhamnosus K.C8.3.1I and Lactobacillus harbinensis K.V9.3.1Np in yogurt. L. harbinensis K.V9.3.1Np, the most relevant strain with regard to antifungal activity was then studied to determine its minimal inhibitory inoculation rate, its antifungal stability during storage and its impact on yogurt organoleptic properties. We showed that L. harbinensis K.V9.3.1Np maintained a stable antifungal activity over time, which was not affected by initial sucrose, nor by a reduction of the fermentation time. This inhibitory activity was an all-or-nothing phenomenon. Once L. harbinensis K.V9.3.1Np reached a population of ∼ 2.5 × 10(6) cfu/g of yogurt at the time of contamination, total inhibition of the yeast was achieved. We also showed that an inoculation rate of 5 × 10(6) cfu/ml in milk had no detrimental effect on yogurt organoleptic properties. In conclusion, L. harbinensis K.V9.3.1Np is a promising antifungal bioprotective strain for yogurt preservation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Phytate degradation by Leuconostoc mesenteroides KC51 ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-07-06

    Jul 6, 2009 ... The mixture was stirred on a vortex mixer and then filtered with 0.45. µm syringe filter; the absorbance of the filtrate was read at 500 nm. Concentration of phytate was shown mean values and standard deviation (n=3). RESULTS AND DISCUSSION. To evaluate the phytate breakdown activity of lactic acid.