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Sample records for utilization review dur

  1. 42 CFR 456.716 - DUR Board.

    Science.gov (United States)

    2010-10-01

    ... most effectively lead to improvement in the quality of drug therapy. The DUR board recommendations must... review, evaluation, and intervention. (4) Medical quality assurance. (b) Board composition. At least one... predetermined standards that pharmacies not using approved software must use in conducting prospective DUR. (2...

  2. The effect of the introduction of a nationwide DUR system where local DUR systems are operating--The Korean experience.

    Science.gov (United States)

    Yang, Ju-Hyun; Kim, Mira; Park, Young-Taek; Lee, Eui-Kyung; Jung, Chai Young; Kim, Sukil

    2015-11-01

    Outpatient clinics in Korea usually have local DUR (drug utilisation review) systems, which are integrated with EMRs or health insurance claims submission systems. Whenever, the government announces a list of drug contraindications, each local DUR system loads the list and applies it in practice. In December 2010, a nationwide DUR system was introduced. This study is to investigate the impact of the nationwide DUR system on prescribing practices where local DUR systems are already operating. Between January 2009 and December 2012 the monthly number of drugs per prescription was retrieved from the health insurance claims data warehouse at the Health Insurance Review and Assessment (HIRA). The monthly proportions of 3 DDI (drug-drug interaction) pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications from January 2007 to December 2012, at the outpatient clinic level, were also retrieved. An interrupted time series analysis was used for controlling government announcements of drug contraindications. There was no difference in the number of drugs per prescription before and after the introduction of the nationwide DUR system. Most proportions of the 3 DDI pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications, were significantly reduced following the government announcement of drug contraindications in the short term and/or long term. The number of drugs per prescription was not related to the nationwide DUR introduction in places where local DUR systems are operating. The introduction of duplicate guidelines, in locations where the guidelines were already well followed, is considered to be the main reason for this. Furthermore, the Doctor's ignorance of alerts, and their continued substitution of regulated drugs, for non-regulated drugs, likely played a role in nullifying the effectiveness of the nationwide DUR system. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  4. Impact of doctors' resistance on success of drug utilization review system.

    Science.gov (United States)

    Choi, Jong Soo; Yun, Seong Hyeon; Kim, Dongsoo; Park, Seung Woo

    2014-04-01

    The drug utilization review (DUR) system, which checks any conflict event of medications, contributes to improve patient safety. One of the important barriers in its adoption is doctors' resistance. This study aimed to analyze the impacts of doctors' resistance on the success of the DUR system. This study adopted an augmented the DeLone and McLean Information System (D&M IS) Success Model (2003), which used doctors' resistance as a socio-technological measure. This study framework is the same as that of the D&M IS Success Model in that it is based on qualities, such as system, information, and services. The major difference is that this study excluded the variable 'use' because it was not statistically significant for mandatory systems. A survey of doctors who used computers to enter prescriptions was conducted at a Korean tertiary hospital in February 2012. This study is very meaningful in that it is the first study to explore the success factors of the DUR system associated with doctors' resistance. Doctors' resistance to the DUR system was not statistically associated with user usefulness, whereas it affected user satisfaction. The results indicate that doctors still complain of discomfort in using the DUR system in the outpatient clinical setting, even though they admit that it contributes to patient safety. To mitigate doctors' resistance and raise user satisfaction, more opinions from doctors regarding the DUR system have to be considered and have to be reflected in the system.

  5. Effect of drug utilization reviews on the quality of in-hospital prescribing: a quasi-experimental study

    Directory of Open Access Journals (Sweden)

    Chabot Isabelle

    2006-03-01

    Full Text Available Abstract Background Drug utilization review (DUR programs are being conducted in Canadian hospitals with the aim of improving the appropriateness of prescriptions. However, there is little evidence of their effectiveness. The objective of this study was to assess the impact of both a retrospective and a concurrent DUR programs on the quality of in-hospital prescribing. Methods We conducted an interrupted time series quasi-experimental study. Using explicit criteria for quality of prescribing, the natural history of cisapride prescription was established retrospectively in three university-affiliated hospitals. A retrospective DUR was implemented in one of the hospitals, a concurrent DUR in another, whereas the third hospital served as a control. An archivist abstracted records of all patients who were prescribed cisapride during the observation period. The effect of DURs relative to the control hospital was determined by comparing estimated regression coefficients from the time series models and by testing the statistical significance using a 2-tailed Student's t test. Results The concurrent DUR program significantly improved the appropriateness of prescriptions for the indication for use whereas the retrospective DUR brought about no significant effect on the quality of prescribing. Conclusion Results suggest a retrospective DUR approach may not be sufficient to improve the quality of prescribing. However, a concurrent DUR strategy, with direct feedback to prescribers seems effective and should be tested in other settings with other drugs.

  6. Drug utilisation review (DUR) of the third generation cephalosporins. Focus on ceftriaxone, ceftazidime and cefotaxime.

    Science.gov (United States)

    Adu, A; Armour, C L

    1995-09-01

    Six parenteral third generation cephalosporins have been introduced into clinical use in the past 10 years. The 3 most frequently available agents are cefotaxime, ceftriaxone and ceftazidime. These 3 third generation cephalosporins are characterised by a broad spectrum of activity and increased stability to beta-lactamases compared with the first and second generation cephalosporins. However, there are growing numbers of reports of resistance to these agents with increasing use. The major differences in the properties of the 3 agents are the long half-life of ceftriaxone and its dual route of elimination. Ceftazidime is best restricted to Pseudomonas aeruginosa infections where other agents are contraindicated or ineffective. Cefotaxime and ceftriaxone can be used in nosocomial Gram-negative infections where P. aeruginosa can be ruled out. The types and incidences of adverse drug reactions are not different for the 3 agents. A number of drug utilisation review (DUR) studies of these agents in the hospital setting have reported a considerable incidence of inappropriate use and substantial avoidable costs. There are methodological problems with most of the DUR studies, especially the criteria and the methods of cost estimation. The use of pharmacoeconomic methodology could ensure more realistic cost estimation; however, outcome data are, in most cases, not available.

  7. The novel Candida albicans transporter Dur31 Is a multi-stage pathogenicity factor.

    Directory of Open Access Journals (Sweden)

    François L Mayer

    Full Text Available Candida albicans is the most frequent cause of oral fungal infections. However, the exact pathogenicity mechanisms that this fungus employs are largely unknown and many of the genes expressed during oral infection are uncharacterized. In this study we sought to functionally characterize 12 previously unknown function genes associated with oral candidiasis. We generated homozygous knockout mutants for all 12 genes and analyzed their interaction with human oral epithelium in vitro. Eleven mutants caused significantly less epithelial damage and, of these, deletion of orf19.6656 (DUR31 elicited the strongest reduction in pathogenicity. Interestingly, DUR31 was not only involved in oral epithelial damage, but in multiple stages of candidiasis, including surviving attack by human neutrophils, endothelial damage and virulence in vivo. In silico analysis indicated that DUR31 encodes a sodium/substrate symporter with 13 transmembrane domains and no human homologue. We provide evidence that Dur31 transports histatin 5. This is one of the very first examples of microbial driven import of this highly cytotoxic antimicrobial peptide. Also, in contrast to wild type C. albicans, dur31Δ/Δ was unable to actively increase local environmental pH, suggesting that Dur31 lies in the extracellular alkalinization hyphal auto-induction pathway; and, indeed, DUR31 was required for morphogenesis. In agreement with this observation, dur31Δ/Δ was unable to assimilate the polyamine spermidine.

  8. The Novel Candida albicans Transporter Dur31 Is a Multi-Stage Pathogenicity Factor

    Science.gov (United States)

    Mayer, François L.; Wilson, Duncan; Jacobsen, Ilse D.; Miramón, Pedro; Große, Katharina; Hube, Bernhard

    2012-01-01

    Candida albicans is the most frequent cause of oral fungal infections. However, the exact pathogenicity mechanisms that this fungus employs are largely unknown and many of the genes expressed during oral infection are uncharacterized. In this study we sought to functionally characterize 12 previously unknown function genes associated with oral candidiasis. We generated homozygous knockout mutants for all 12 genes and analyzed their interaction with human oral epithelium in vitro. Eleven mutants caused significantly less epithelial damage and, of these, deletion of orf19.6656 (DUR31) elicited the strongest reduction in pathogenicity. Interestingly, DUR31 was not only involved in oral epithelial damage, but in multiple stages of candidiasis, including surviving attack by human neutrophils, endothelial damage and virulence in vivo. In silico analysis indicated that DUR31 encodes a sodium/substrate symporter with 13 transmembrane domains and no human homologue. We provide evidence that Dur31 transports histatin 5. This is one of the very first examples of microbial driven import of this highly cytotoxic antimicrobial peptide. Also, in contrast to wild type C. albicans, dur31Δ/Δ was unable to actively increase local environmental pH, suggesting that Dur31 lies in the extracellular alkalinization hyphal auto-induction pathway; and, indeed, DUR31 was required for morphogenesis. In agreement with this observation, dur31Δ/Δ was unable to assimilate the polyamine spermidine. PMID:22438810

  9. Stenhammer, Wilhelm. sinfonien Nr. 1 F-Dur und Nr. 2 g-Moll op. 34, Excelsior! op. 13, Serenade F-Dur op. 31. Sinfonieorchester Göteborg, Neeme Järvi / Andreas K. W. Meyer

    Index Scriptorium Estoniae

    Meyer, Andreas K. W.

    1995-01-01

    Uuest heliplaadist "Stenhammer, Wilhelm. sinfonien Nr. 1 F-Dur und Nr. 2 g-Moll op. 34, Excelsior! op. 13, Serenade F-Dur op. 31. Sinfonieorchester Göteborg, Neeme Järvi". DG 2 CD 445857-2 (WD: 138'37")

  10. Urea retranslocation from senescing Arabidopsis leaves is promoted by DUR3-mediated urea retrieval from leaf apoplast

    Science.gov (United States)

    Bohner, Anne; Kojima, Soichi; Hajirezaei, Mohammad; Melzer, Michael; von Wirén, Nicolaus

    2015-01-01

    In plants, urea derives either from root uptake or protein degradation. Although large quantities of urea are released during senescence, urea is mainly seen as a short-lived nitrogen (N) catabolite serving urease-mediated hydrolysis to ammonium. Here, we investigated the roles of DUR3 and of urea in N remobilization. During natural leaf senescence urea concentrations and DUR3 transcript levels showed a parallel increase with senescence markers like ORE1 in a plant age- and leaf age-dependent manner. Deletion of DUR3 decreased urea accumulation in leaves, whereas the fraction of urea lost to the leaf apoplast was enhanced. Under natural and N deficiency-induced senescence DUR3 promoter activity was highest in the vasculature, but was also found in surrounding bundle sheath and mesophyll cells. An analysis of petiole exudates from wild-type leaves revealed that N from urea accounted for >13% of amino acid N. Urea export from senescent leaves further increased in ureG-2 deletion mutants lacking urease activity. In the dur3 ureG double insertion line the absence of DUR3 reduced urea export from leaf petioles. These results indicate that urea can serve as an early metabolic marker for leaf senescence, and that DUR3-mediated urea retrieval contributes to the retranslocation of N from urea during leaf senescence. PMID:25440717

  11. R.H. Moreno-Durán: fantasía y verdad. Valoración múltiple

    OpenAIRE

    Giraldo, Luz Mary; Espinosa, Germán; García Ponce, Juan; Restrepo Forero, Gabriel Adolfo; Jaramillo Zuluaga, Jaime Eduardo; Palacios Rozo, Marco Antonio; Gutiérrez Girardot, Rafael; Raymond L., Williams; Balza, José; Torres Duque, Óscar; Fajardo, Diógenes; Carandell, José María; Cohen, Marcelo; Olaciregui, Julio; Goloboff, Gerardo Mario

    2005-01-01

    Pocos escritores colombianos han explorado diversos géneros literarios con resultados satisfactorios; Moreno-Durán destaca en el panorama artístico de Colombia al cosechar logros en una amplia producción creativa que incluye novelas, cuentos, ensayos y en los últimos tiempos el teatro. / Contenido. Preliminares; Capítulo 1 - R.H. Moreno-Durán: a fondo; Capítulo 2 - R.H. Moreno-Durán: en breve; Anexos.

  12. Constituents from Bupleurum montanum (Coss. & Dur. (Apiaceae

    Directory of Open Access Journals (Sweden)

    M. Benahmed

    2014-12-01

    Full Text Available A chemical investigation of the aerial parts of Bupleurum montanum (Coss. & Dur. (Apiaceae afforded five compounds, quercitin 1, tamarexetin 2, isorhamnetin-3-rutinoside 3, kaempferol-3-O-β-rutinoside 4, and 3,4-dihydroxybenzoic acid (Protocatechuic acid 5. The structural elucidation was performed mainly by MS, 1D and 2D NMR spectrum data.

  13. Beethoven, Ludwig van: Violinkonzert D-Dur op. 61

    Index Scriptorium Estoniae

    1997-01-01

    Uuest heliplaadist "Beethoven, Ludwig van: Violinkonzert D-Dur op. 61 (Kadenz: Alfred Schnittke). Romanzen für Violine und Orchester op. 40 und 50. Estonian National Symphony Orchestra, Arvo Volmer". Globe GLO 5155, distribution Talis (CD:153F). 1996. TT:1h 01'56"

  14. Reflexiones sobre la actualidad del relativismo cultural: respuesta a Nicolás Sánchez Durá

    OpenAIRE

    Jacorzynski, Witold

    2013-01-01

    Este ensayo propone entablar una discusión con las tesis contenidas en el artículo de Nicolás Sánchez Durá, "Actualidad del relativismo cultural". En primer lugar, se analizan el etnocentrismo y el relativismo como dos respuestas éticas distintas al fenómeno de la diversidad cultural. En segundo lugar, se desarrollan la formulación del relativismo y el concepto de cultura propuestos por Sánchez Durá para analizarlos a la luz de la epistemología elaborada por el Wittgenstein tardío. En tercer ...

  15. Kalinnikov: Sinfonie Nr.2 A-Dur, Ouvertüre Zar Boris / Hanspeter Krellmann

    Index Scriptorium Estoniae

    Krellmann, Hanspeter

    1990-01-01

    Uuest heliplaadist "Kalinnikov: Sinfonie Nr.2 A-Dur, Ouvertüre Zar Boris, Die Zeder und die Palme. Scottish National Orchestra, Neeme Järvi" (AD: 1989) Chandos / Koch Records CD 8805 (WD: 59'40") DDD

  16. Mahler: Sinfonie Nr. 8 Es-Dur (Sinfonie der Tausend) / Norbert Rüdell

    Index Scriptorium Estoniae

    Rüdell, Norbert

    1995-01-01

    Uuest heliplaadist "Mahler: Sinfonie Nr. 8 Es-Dur (Sinfonie der Tausend). Estonian Boys' Choir, Brunnsbo Children's Choir, Gothenburg Opera Chorus, Royal Stockholm Philharmonic Choir, Gothenburg Symphony Chorus, Gothenburg Opera Chorus, Gothenburg Symphony Orchestra, Neeme Järvi. BIS/Disco-Center CD 700 (WD:72'18")

  17. Distribution des durées de séjour par Diagnosis Related Group

    OpenAIRE

    Eggli, Yves; Koehn, Véronique; Paccaud, Fred; Moyard M. (Collab.),

    1988-01-01

    Ce cahier fournit les principales informations concernant les durées de séjour et le nombre de sorties observées dans 33 hôpitaux suisses pour l'années 1984. La description des clientèles hospitalières est fondée sur les "Diagnosis Related Groups" (DRG), qui forment une classification de 472 groupes de patients hospitalisés. [Auteurs, p. 1

  18. Light exposure enhances urea absorption in the fluted giant clam, Tridacna squamosa, and up-regulates the protein abundance of a light-dependent urea active transporter, DUR3-like, in its ctenidium.

    Science.gov (United States)

    Chan, Christabel Y L; Hiong, Kum C; Boo, Mel V; Choo, Celine Y L; Wong, Wai P; Chew, Shit F; Ip, Yuen K

    2018-04-19

    Giant clams live in nutrient-poor reef waters of the Indo-Pacific and rely on symbiotic dinoflagellates ( Symbiodinium spp., also known as zooxanthellae) for nutrients. As the symbionts are nitrogen deficient, the host clam has to absorb exogenous nitrogen and supply it to them. This study aimed to demonstrate light-enhanced urea absorption in the fluted giant clam, Tridacna squamosa , and to clone and characterize the urea active transporter DUR3-like from its ctenidium (gill). The results indicate that T. squamosa absorbs exogenous urea, and the rate of urea uptake in the light was significantly higher than that in darkness. The DUR3-like coding sequence obtained from its ctenidium comprised 2346 bp, encoding a protein of 782 amino acids and 87.0 kDa. DUR3-like was expressed strongly in the ctenidium, outer mantle and kidney. Twelve hours of exposure to light had no significant effect on the transcript level of ctenidial DUR3-like However, between 3 and 12 h of light exposure, DUR3-like protein abundance increased progressively in the ctenidium, and became significantly greater than that in the control at 12 h. DUR3-like had an apical localization in the epithelia of the ctenidial filaments and tertiary water channels. Taken together, these results indicate that DUR3-like might participate in light-enhanced urea absorption in the ctenidium of T. squamosa When made available to the symbiotic zooxanthellae that are known to possess urease, the absorbed urea can be metabolized to NH 3 and CO 2 to support amino acid synthesis and photosynthesis, respectively, during insolation. © 2018. Published by The Company of Biologists Ltd.

  19. Medical miracles and the longue durée.

    Science.gov (United States)

    Duffin, Jacalyn

    2005-01-01

    The hematologist-historian author became interested in the nature 'medical miracles', following a request to write a report on a set of bone marrows that was sent to the Vatican as a possible miracle cure in a cause for canonization. She questioned the prevalence of medical miracles, their structure, and relationship to other 'official' miracles that are recognized by the Church. Evidence was drawn from a variety of sources: oral testimony of pilgrims at feast day celebrations, ex voto paintings, and 160 miracle files in 67 canonization records of the Vatican Archives. Some changes can be detected through time, but the results also testify to remarkable longue durée in the healing experience: the patterns of suffering and despair, the gestures of pleading, the presence of beds and dreams, the astonishment of the caregivers, and above all the simultaneous recourse to medicine and religion both.

  20. Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

    Directory of Open Access Journals (Sweden)

    Angalakuditi M

    2011-06-01

    Full Text Available Mallik Angalakuditi1, Joseph Gomes21Georgia State University, Atlanta, GA, USA; 2Baxter Health Care, Deerfield, IL, USAObjectives: To evaluate the impact of retrospective drug utilization review (RDUR, pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention.Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group.Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505 were involved in a repeated intervention vs 18.2% (428 in controls (P < 0.001, which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%, and for controls it was drug–drug interactions (1796, 25.4%. The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls (P = 0.01.Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.Keywords: pharmacy management, spillover effect, RDUR, DUR

  1. Schmidt. Sinfonie Nr. 1 E-Dur; Strauss. Vier sinfonische Zwischenspiele aus Intermezzo. Detroit Symphony Orchestra, Neeme Järvi / Helge Grünewald

    Index Scriptorium Estoniae

    Grünewald, Helge

    1996-01-01

    Uuest heliplaadist "Schmidt. Sinfonie Nr. 1 E-Dur; Strauss. Vier sinfonische Zwischenspiele aus Intermezzo. Detroit Symphony Orchestra, Neeme Järvi. Chandos/Koch CD 9357 (WD: 68'20") DDD (WD:114'36")

  2. 42 CFR 456.702 - Definitions.

    Science.gov (United States)

    2010-10-01

    ... ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System..., experienced by a patient, due to a course of drug therapy. Appropriate and medically necessary means drug...

  3. Nurses' ethical conflicts in performance of utilization reviews.

    Science.gov (United States)

    Bell, Sue Ellen

    2003-09-01

    This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed.

  4. Integrated concurrent utilization quality review, Part one.

    Science.gov (United States)

    Caterinicchio, R P

    1987-01-01

    This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

  5. 42 CFR 456.705 - Prospective drug review.

    Science.gov (United States)

    2010-10-01

    ... recipient or the recipient's caregiver. The State must provide pharmacies with detailed information as to what they must do to comply with prospective DUR requirements, including guidelines on counseling... prescription is filled or delivered to the recipient or the recipient's caregiver. The review must include...

  6. Roussel. Sinfonien Nr. 3 g-Moll op. 42 und Nr. 4 A-Dur op. 5, Neeme Järvi / Christoph Schlüren

    Index Scriptorium Estoniae

    Schlüren, Christoph

    1995-01-01

    Uuest heliplaadist "Roussel. Sinfonien Nr. 3 g-Moll op. 42 und Nr. 4 A-Dur op. 53, Bacchus et Ariane op. 43 (Zweite Orchestersuite). Sinfonietta für Streichorchester d-Moll op. 52. Detroit Symphony Orchester, N. Järvi". Chandos/Koch CD 7007(WD: 70'10") DDD

  7. Review of inter-utility trade in electricity

    International Nuclear Information System (INIS)

    1994-01-01

    In 1992, Canada's National Energy Board released two discussion papers on inter-utility trade. Responses to the papers were received from utilities, government agencies, and other interested parties with regard to questions concerning measures that could be taken to enhance interprovincial trade in electricity and to enable buyers and sellers of electricity to obtain commercial access to available transmission capacity through intermediate provinces for wheeling purposes. The Board's review had estimated long-term net benefits from enhanced inter-utility cooperation at $23-32.5 billion by the year 2000 from such types of transactions as seasonal diversity exchanges and long-term firm sales. Seven types of options to achieve enhanced inter-utility trade were identified. Most of the respondent utilities and provinces that have direct access to external markets tended to prefer the status quo, opposing mandated solutions but supporting (or at least not opposing) federal monitoring of progress on enhanced inter-utility cooperation. Provinces and utilities without direct access to external markets tended to support (as a last resort) mandated solutions to disputes concerning electricity trade. Since the Board review, important events in the North American electricity supply industry have occurred; these are described, focusing on the US Energy Policy Act that gives powers to order transmission access. The formation by US utilities of regional transmission groups (RTGs) with federal encouragement is discussed, along with the implications for Canadian utilities that may want to become members of particular RTGs. The advantages and drawbacks of selecting the various options for enhancing inter-utility trade are then summarized. 1 tab

  8. Chemical composition and antioxidant activity of essential oils of Deverra scoparia Coss. & Dur. (Apiaceae)

    International Nuclear Information System (INIS)

    Hammoudi, R.; Dehak, K.; Hadj Mahammed, M.; Didi Ouldelhadj, M.

    2015-01-01

    This study aimed to determine the chemical composition and to evaluate the antioxidant activity of the essential oils of the aerial part of the plant Deverra scoparia Coss. &Dur. The extraction of essential oils was carried out by hydrodistillation. The composition of essential oils was analyzed by gas chromatography coupled with mass spectrometry (GC and GC/MS). 22 constituents were identified, representing 84.63% of the essential oil. The major compounds are: α-bornyl acetate (31.99%) andα-pinene (12.05%). The study of the antioxidant power of these oils was performed by the method of DPPH and ABTS. The results showed that antioxidant activity of the Deverra scoparia essential oil wasmore effective than the two references tested,ascorbic acidand Trolox (author)

  9. Drug Utilization Review of parenteral opioid analgesics in cardiovascular surgery department of Shahid Modarres Hospital, Tehran

    Directory of Open Access Journals (Sweden)

    Vatanpour H, Soltani M,

    2016-08-01

    Full Text Available Persistent pain continues to be a common problem among patients undergoing cardiac operations and the need for controlling such pain is believed to be as a prime necessity in terms of the patient’s well being, health care costs and avoiding negative consequences provoked by the pain itself. Regarding to the newly established guidelines, opioid analgesic agents are considered as the mainstay of moderate to severe acute pain. Nonetheless, the underutilization of opioids for pain relief is still a persisting huge challenge. This survey, applying as a concurrent Drug Utilization Review using ATC/DDD system provided and recommended by the DUR group of the World Health Organization, conducted on 108 inpatients who received opioid drugs by parenteral route during 9 months from February to November 2013 at the post-ICU ward of Shahid Modarres Cardiovascular Hospital, affiliated to Shahid Beheshti University of Medical Science, in Tehran. Our findings revealed that morphine was the most commonly prescribed parenteral opioid in the hospitalized patients and pethidine usage was in the lowest level for the geriatric patients, resulting in satisfaction with the analgesic procedure among most of the cases in our study. Both of the mentioned drugs were prescribed by intramuscular route, regarding PRN way of injecting as well. Comparative results of our study with the literature revealed relatively moderate and roughly rational consumption of morphine (10.282 DDD/100bed-days and pethidine (0.013 DDD/100bed-days. Applying multivariate conditional regression modeling on the question of determining independent predictors for opioid usage, disclosed a direct correlation between the patient’s weight and daily dose of parenteral opioid consumption.

  10. Forms of Religious Glocalization: Orthodox Christianity in the Longue Durée

    Directory of Open Access Journals (Sweden)

    Victor Roudometof

    2014-10-01

    Full Text Available This article advocates a “glocal turn” in the religion–globalization problematic. It proposes a model of multiple glocalizations in order to analyze the historically constituted relationship between world religions and local cultures. First, the conceptual evolution from globalization to glocalization is discussed with special reference to the study of the religion. Second, the necessity for adopting the perspective of the longue durée with regard to the study of Eastern Orthodox Christianity is explained. Third, an outline of four forms of religious glocalization is proposed. Each of these forms is presented both analytically as well as through examples from the history of Eastern Christianity (from the 8th to the 21st century. It is argued that this approach offers a model for analyzing the relation between religion, culture and society that does not succumb to the Western bias inherent in the conventional narrative of western modernization and secularization.

  11. PEMIKIRAN GUS DUR TENTANG PENDIDIKAN KARAKTER DAN KEARIFAN LOKAL

    Directory of Open Access Journals (Sweden)

    LukLuk Nur Mufidah

    2015-08-01

    Full Text Available Abstract: Education which emphasized on cognition domain should be changed by balancing it with skills (psychomotor and attitudes (affective. It is intended that education is able to produce savvy generations who have high moral standards. To that end, KH Abdurrahman Wahid -or better known as Gus Dur- had a concept of character building in education by promoting morality in education. Character building in education is the education which is based on local wisdom. Local wisdom is social norms and values contained in tradition and customs as well as in Islamic teachings that govern how a balance should be established between carrying capacity of the natural environment, lifestyle, and the needs of human beings. In the language of Gus Dur, local wisdom was called the indigenization of Islam in which the teachings of Islam and local traditions were used as a moral basis in the real life of people. Because the cultivation of moral values could be done through education, the local wisdom should be the basic concept of education process. Customs become an integral part in daily life, while religion becomes a way of life to conform to the guidance of Allah. Local wisdom formed from local traditions and locality of religious teachings was able to provide life lessons that were useful for the development process of maturity through the educational process.           الملخص: إن التربية المفضّلة الجانب المعرفي – كما يقع الآن -  لابد من تركها، ويكون البديل هو الموازنة بين الجانب المعرفي والجانب النفسحركي والمهني. والهدف من هذا تخريج الطلاب أو الأجيال الأذكياء المتأدّبين المتخلّقين. وفي هذا كان لكياهي الحاج عبد الرحمن وحيد المعروف بغوسدور فكرة عن التربية الخلقية وهي التربية التي

  12. Personal utility in genomic testing: a systematic literature review.

    Science.gov (United States)

    Kohler, Jennefer N; Turbitt, Erin; Biesecker, Barbara B

    2017-06-01

    Researchers and clinicians refer to outcomes of genomic testing that extend beyond clinical utility as 'personal utility'. No systematic delineation of personal utility exists, making it challenging to appreciate its scope. Identifying empirical elements of personal utility reported in the literature offers an inventory that can be subsequently ranked for its relative value by those who have undergone genomic testing. A systematic review was conducted of the peer-reviewed literature reporting non-health-related outcomes of genomic testing from 1 January 2003 to 5 August 2016. Inclusion criteria specified English language, date of publication, and presence of empirical evidence. Identified outcomes were iteratively coded into unique domains. The search returned 551 abstracts from which 31 studies met the inclusion criteria. Study populations and type of genomic testing varied. Coding resulted in 15 distinct elements of personal utility, organized into three domains related to personal outcomes: affective, cognitive, and behavioral; and one domain related to social outcomes. The domains of personal utility may inform pre-test counseling by helping patients anticipate potential value of test results beyond clinical utility. Identified elements may also inform investigations into the prevalence and importance of personal utility to future test users.

  13. Acceptable risk of contact allergy in the general population assessed by CE-DUR--a method to detect and categorize contact allergy epidemics based on patient data

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Menné, Torkil; Schnuch, Axel

    2009-01-01

    of persons eligible for patch testing each year based on patch test sales data. A reverse CE-DUR was performed to make delineations between the 10-year prevalence of contact allergy in the general population and the corresponding theoretical prevalences of contact allergy observed among patients...

  14. 42 CFR 482.30 - Condition of participation: Utilization review.

    Science.gov (United States)

    2010-10-01

    ... circumstances: (1) A Utilization and Quality Control Quality Improvement Organization (QIO) has assumed binding... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Basic Hospital Functions § 482.30 Condition of participation: Utilization review. The hospital must have in...

  15. A Systematic Review and Meta-analysis of Childhood Health Utilities.

    Science.gov (United States)

    Kwon, Joseph; Kim, Sung Wook; Ungar, Wendy J; Tsiplova, Kate; Madan, Jason; Petrou, Stavros

    2018-04-01

    A common feature of most reviews or catalogues of health utilities has been their focus on adult health states or derivation of values from adult populations. More generally, utility measurement in or on behalf of children has been constrained by several methodological concerns. The objective of this study was to conduct the first comprehensive systematic review and meta-analysis of primary utility data for childhood conditions and descriptors, and to determine the effects of methodological factors on childhood utilities. The review followed PRISMA guidelines. PubMed, Embase, Web of Science, PsycINFO, EconLit, CINAHL and Cochrane Library were searched for primary studies reporting health utilities for childhood conditions or descriptors using direct or indirect valuation methods. The Paediatric Economic Database Evaluation (PEDE) Porject was also searched for cost-utility analyses with primary utility values. Mean or median utilities for each of the main samples were catalogued, and weighted averages of utilities for each health condition were estimated, by valuation method. Mixed-effects meta-regression using hierarchical linear modeling was conducted for the most common valuation methods to estimate the utility decrement for each health condition category relative to general childhood population health, as well as the independent effects of methodological factors. The literature searches resulted in 272 eligible studies. These yielded 3,414 utilities when all sub-groups were considered, covering all ICD-10 chapters relevant to childhood health, 19 valuation methods, 12 respondent types, 8 modes of administration, and data from 36 countries. A total of 1,191 utility values were obtained when only main study samples were considered, and these were catalogued by health condition or descriptor, and methodological characteristics. 1,073 mean utilities for main samples were used for fixed-effects meta-analysis by health condition and valuation method. Mixed

  16. Nuevos hallazgos documentales y biográficos sobre Alonso Xuárez maestro de Sebastián Durón

    Directory of Open Access Journals (Sweden)

    de la Fuente Charfolé, José Luis

    2012-12-01

    Full Text Available Alonso Xuárez was no minor composer in the musical field of his time. The quality and effectiveness of his compositions makes them deserving of a leading place in Spanish and European music of the 17th century. In spite of this almost nothing is known about this composer prior to his being appointed to teach in the chapel of Cuenca cathedral. Virtually all the currently available data is of a secondary and collateral nature and arises from research into his disciple the organist Sebastián Durón, the renowned opera composer and teacher at the Capilla Real of Charles II.

    Alonso Xuárez no fue un compositor menor dentro del panorama musical de su tiempo. La calidad y eficacia de su música merece estar en primera línea de la música española y europea del siglo XVII. Sin embargo, el desconocimiento de este músico es casi completo con anterioridad a su nombramiento en el magisterio de capilla de la catedral de Cuenca. Prácticamente todos los datos expuestos hasta el momento han sido restos secundarios y colaterales desprendidos de otras investigaciones realizadas sobre la figura de su discípulo, el reputado compositor de teatro lírico y maestro de la Capilla Real de Carlos II, el organista Sebastián Durón.

  17. Individual determinants of research utilization by nurses: a systematic review update

    Directory of Open Access Journals (Sweden)

    Wallin Lars

    2011-01-01

    Full Text Available Abstract Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39 or kinds of research utilization (n = 6 using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional

  18. Individual determinants of research utilization by nurses: a systematic review update

    Science.gov (United States)

    2011-01-01

    Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only

  19. Review of utility staff training and certification

    International Nuclear Information System (INIS)

    1999-04-01

    The Advisory Committee on Nuclear Safety (ACNS) has reviewed the nuclear utility training programs in Canada and the Atomic Energy Control Board (AECB) certification program, to determine their effectiveness in meeting current and future needs. It has also looked briefly at the practices in other countries and in the aviation industry in Canada, by way of comparison. While a quantitative measure of effectiveness was beyond the scope of this review, on a purely qualitative basis the ACNS concludes that the current training and certification regime produces qualified operators, but not necessarily in the most effective way. The report makes five recommendations. The thrust of these recommendations is towards a more effective and streamlined training and certification regime based on strict adherence to the Systematic Approach to Training (SAT) methodology combined with independent verification through a peer review and accreditation process. The Committee believes that training and qualification of nuclear power plant operating staff is the complete responsibility of the utilities and that the role of the AECB is to audit the process to ensure that the utilities discharge their responsibility appropriately. In other words, the AECB should deal with operator training and certification in the same way that it deals with other aspects of nuclear power plant operation that are important to health, safety, security and the environment - by inspections and audits. The Committee believes that the proposed regulatory requirement for recertification of certain nuclear power plant operating staff, which would come into effect when the new Regulations are promulgated, is not consistent with the government's thrust and with how the AECB regulates other aspects of nuclear power plant operations. (author)

  20. Inter-utility trade review

    International Nuclear Information System (INIS)

    Vaahedi, E.; Poirier, R.; Necsulescu, C.; Warnes, E.M.

    1991-01-01

    The National Energy Board (NEB) was requested by the Minister of Energy, Mines and Resources to identify possible measures to improve cooperation among Canadian electrical utilities and to enhance access for Canadian buyers and sellers of electricity to available transmission capacity through intervening systems for wheeling purposes. To identify measures for enhancing transmission access, two projects were initiated: a study of technical issues associated with wheeling, and quantification of potential wheeling benefits. The first project examined the technical and economic problems associated with wheeling, while the second used computer simulation to quantify benefits of wheeling. The projects are described together with a historical review of wheeling in Canada. The following conclusions where reached: there seems to be enough wheeling benefits (a 6-10% increase in benefits) to justify its promotion; wheeling should be performed on a voluntary basis; the wheeling utility should make the final decisions regarding the ability of the system to wheel power and the need for system improvements; pricing should be flexible, reflecting the conditions of the service; the buy/sell type of arrangement which disregards the transmission path may be the preferred wheeling arrangement; and if negotiation fails to resolve conflicts over pricing, arbitration is suggested as an effective means for resolving disputes. 6 refs., 6 figs

  1. A retrospective review of snake bite victims admitted in a tertiary ...

    African Journals Online (AJOL)

    stay, need for elective ventilation, details of investigations and outcome were reviewed. The data were ... les résultats de l'examen local à l'emplacement de morsure, durée du séjour hospitalier, nécessité de ventilation élective, détails des ..... walk bare footed, and use protective boots,[5,6,11,53] to use a torch while walking ...

  2. Review of inter-utility trade in electricity: Analyses of submissions

    International Nuclear Information System (INIS)

    1994-04-01

    In November 1992, Canada's National Energy Board released two discussion papers describing its review of inter-utility trade in electricity. The review was undertaken to report on measures that could be taken to enhance interprovincial trade in electricity by encouraging greater cooperation among utilities in systems planning and development, and by enabling buyers and sellers of electricity to obtain commercial access to available transmission capacity through intermediate provinces for wheeling purposes. Interested parties were invited to comment on the papers and 42 responses were received from Canadian utilities, provincial governments, regulatory agencies, and others. These responses are summarized and analyzed, providing an indication of how future policy initiatives on electricity trade might be received. Most submitters agreed that there is a need to enable commercial access to available transmission capacity through intermediate provinces for wheeling purposes. Of the seven options described in the discussion papers that would enable buyers and sellers of electricity to gain commercial access to transmission grids, the status quo was preferred by those utilities and provinces that have direct access to export markets by virtue of their geographic location. Those utilities and provinces that do not have such direct access tend to support, as a last resort, mandated solutions to disputes concerning electricity trade. 78 figs

  3. Medical Utilization of Kiosks in the Delivery of Patient Education: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Roxanne Nagurka

    2014-07-01

    Full Text Available Background: The utilization of kiosks has previously been shown to be effective for collecting information, delivering educational modules, and providing access to health information. We discuss a review of current literature for the utilization of kiosks for the delivery of patient education. Methods: The criteria for inclusion in this literature review were: (1 study dis-cusses the utilization of kiosks for patient health education; (2 study discusses the use of touch screens for patient health information; (3 published in English. Our review includes searches via MEDLINE databases and Google Scholar for the years 1996-2014. Results: Overall, 167 articles were screened for final eligibility, and after discarding duplicates and non-eligible studies with abstract. Full-text review of 28 articles was included in the final analysis. Conclusion: The review of available literature demonstrates the effectiveness of touch screen kiosks to educate patients and to improve healthcare, both at a performance and cost advantage over other modes of patient education.

  4. Medical utilization of kiosks in the delivery of patient education: a systematic review.

    Science.gov (United States)

    Yvonne Chan, Yu-Feng; Nagurka, Roxanne; Bentley, Suzanne; Ordonez, Edgardo; Sproule, William

    2014-01-01

    The utilization of kiosks has previously been shown to be effective for collecting information, delivering educational modules, and providing access to health information. We discuss a review of current literature for the utilization of kiosks for the delivery of patient education. The criteria for inclusion in this literature review were: (1) study discusses the utilization of kiosks for patient health education; (2) study discusses the use of touch screens for patient health information; (3) published in English. Our review includes searches via MEDLINE databases and Google Scholar for the years 1996-2014. Overall, 167 articles were screened for final eligibility, and after discarding duplicates and non-eligible studies with abstract. Full-text review of 28 articles was included in the final analysis. The review of available literature demonstrates the effectiveness of touch screen kiosks to educate patients and to improve healthcare, both at a performance and cost advantage over other modes of patient education.

  5. Chiropractic and CAM utilization: a descriptive review.

    Science.gov (United States)

    Lawrence, Dana J; Meeker, William C

    2007-01-22

    To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  6. [Systematic review of health-related utilities in Spain: the case of mental health].

    Science.gov (United States)

    García-Pérez, Lidia; Aguiar-Ibáñez, Raquel; Pinilla-Domínguez, Pilar; Arvelo-Martín, Alejandro; Linertová, Renata; Rivero-Santana, Amado

    2014-01-01

    Currently, there is no registry of utility values for the Spanish population that could potentially be used in economic evaluations. Consequently, a systematic review of utilities or preferences for health states in the Spanish population was conducted. The results related to mental health are reported. A systematic review of the literature was conducted. The main databases searched were MEDLINE, CRD, Embase, PsycINFO, CINAHL, and Cochrane. The search strategy combined terms related to utilities and Spain. The inclusion criteria comprised the resident population in Spain, whether affected by any disease or not; the reported utilities had to be evaluated through a tool validated in Spain (i.e., EQ-5D, HUI, SF-6D) and/or following accepted techniques (e.g., time trade-off, standard gamble, or the visual analog scale). A narrative synthesis of articles was undertaken and the results related to mental health summarized. A total of 103 articles were finally included, from which 742 utility values were extracted. Sixty-nine utility values related to mental health and behavioral disorders were extracted from 12 studies. The most widely used tool was the E5-QD questionnaire. Most of the excluded articles evaluated quality of life but did not provide an estimation of utilities. This review adds value to research on utilities in Spain by gathering values to be included in economic evaluations, as well as by identifying research gaps in this field. The utility values related to mental health identified in this study are similar to those reported in international publications. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. The dynamics of utilization review: a case study of 44 Massachusetts hospitals.

    Science.gov (United States)

    Gertman, P M; Egdahl, R E

    1978-10-01

    Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.

  8. Coordinación de las protecciones de la subestación de distribución en el sistema Durán norte

    OpenAIRE

    Tinoco Tinoco, Misael Patricio; Sanchez Yela, Darwin Horacio

    2016-01-01

    El presente trabajo desarrolla el estudio de la coordinación de protecciones aplicados a la subestación de distribución “DURÁN NORTE”, ubicada en el cantón Durán en la parte norte de la cuidad del mismo nombre. Partiendo primero desde la descripción de las instalaciones, para conocer los elementos que la componen; posteriormente, se realiza un estudio de flujo de carga en condiciones de máxima y mínima carga y un estudio de cortocircuito de la subestación aplicados a la barra de 69kV y 13.8kV...

  9. A review of health utilities across conditions common in paediatric and adult populations

    Directory of Open Access Journals (Sweden)

    Hopkins Robert B

    2010-01-01

    Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

  10. Review of US utility demand-side bidding programs

    International Nuclear Information System (INIS)

    Goldman, C.A.; Kito, M.S.

    1995-01-01

    In this study, we review utility experiences with demand-side management (DSM) bidding programs. Since 1987, about 35 US utilities have signed long-term contracts with developers of DSM resources (ie energy service companies and customers) to provide a quantity of demand and energy savings at specified prices. Total resource costs range between 5.4 and 8 cents/kWh for DSM bidding programs where complete information on program costs is available. Almost all DSM bidding programs have been cost-effective compared with the utility's own supply-side alternatives, although there is substantial disagreement regarding the value of these programs compared with the utility's own DSM programs. In most bidding programs, payments to bidders account for between 70 and 90% of total program costs. Variation in winning bid prices is influenced primarily by DSM bid ceiling prices, differences in the mix of measures and markets targeted by developers, and the degree of performance risk borne by the DSM developer. Bids targeting residential customers averaged 6.2 cents/kWh compared with about 5.0 cents/kWh for commercial/industrial bids. We also compared the costs of acquiring lighting savings in DSM bidding contracts with a sample of 20 utility sponsored commercial/industrial lighting programs. We found that, on average total resource costs were slightly higher in bidding programs (6.1 vs 5.6 cents/kWh), although ratepayers bear significantly less performance risk in bidding programs compared with traditional utility-sponsored DSM programs. (author)

  11. Review of utility values for economic modeling in type 2 diabetes.

    Science.gov (United States)

    Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

    2014-06-01

    Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  12. Chiropractic and CAM Utilization: A Descriptive Review

    Directory of Open Access Journals (Sweden)

    Meeker William C

    2007-01-01

    Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  13. Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

    Science.gov (United States)

    Parrino, Thomas A

    2005-02-01

    To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

  14. Energy minimization strategies and renewable energy utilization for desalination: a review.

    Science.gov (United States)

    Subramani, Arun; Badruzzaman, Mohammad; Oppenheimer, Joan; Jacangelo, Joseph G

    2011-02-01

    Energy is a significant cost in the economics of desalinating waters, but water scarcity is driving the rapid expansion in global installed capacity of desalination facilities. Conventional fossil fuels have been utilized as their main energy source, but recent concerns over greenhouse gas (GHG) emissions have promoted global development and implementation of energy minimization strategies and cleaner energy supplies. In this paper, a comprehensive review of energy minimization strategies for membrane-based desalination processes and utilization of lower GHG emission renewable energy resources is presented. The review covers the utilization of energy efficient design, high efficiency pumping, energy recovery devices, advanced membrane materials (nanocomposite, nanotube, and biomimetic), innovative technologies (forward osmosis, ion concentration polarization, and capacitive deionization), and renewable energy resources (solar, wind, and geothermal). Utilization of energy efficient design combined with high efficiency pumping and energy recovery devices have proven effective in full-scale applications. Integration of advanced membrane materials and innovative technologies for desalination show promise but lack long-term operational data. Implementation of renewable energy resources depends upon geography-specific abundance, a feasible means of handling renewable energy power intermittency, and solving technological and economic scale-up and permitting issues. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Utility of proteomics in obstetric disorders: a review

    Directory of Open Access Journals (Sweden)

    Hernández-Núñez J

    2015-04-01

    Full Text Available Jónathan Hernández-Núñez,1 Magel Valdés-Yong21Department of Obstetrics and Gynecology, Hospital Alberto Fernández-Valdés, Santa Cruz del Norte, Mayabeque, 2Department of Obstetrics and Gynecology, Hospital Luis Díaz Soto, Habana del Este, La Habana, CubaAbstract: The study of proteomics could explain many aspects of obstetric disorders. We undertook this review with the aim of assessing the utility of proteomics in the specialty of obstetrics. We searched the electronic databases of MEDLINE, EBSCOhost, BVS Bireme, and SciELO, using various search terms with the assistance of a librarian. We considered cohort studies, case-control studies, case series, and systematic review articles published until October 2014 in the English or Spanish language, and evaluated their quality and the internal validity of the evidence provided. Two reviewers extracted the data independently, then both researchers simultaneously revised the data later, to arrive at a consensus. The search retrieved 1,158 papers, of which 965 were excluded for being duplicates, not relevant, or unrelated studies. A further 86 papers were excluded for being guidelines, protocols, or case reports, along with another 64 that did not contain relevant information, leaving 43 studies for inclusion. Many of these studies showed the utility of proteomic techniques for prediction, pathophysiology, diagnosis, management, monitoring, and prognosis of pre-eclampsia, perinatal infection, premature rupture of membranes, preterm birth, intrauterine growth restriction, and ectopic pregnancy. Proteomic techniques have enormous clinical significance and constitute an invaluable weapon in the management of obstetric disorders that increase maternal and perinatal morbidity and mortality.Keywords: proteomic techniques, obstetrics, diagnosis, prediction

  16. Systematic review of health state utility values for acute myeloid leukemia

    OpenAIRE

    Forsythe, Anna; Brandt, Patricia S; Dolph, Mike; Patel, Sachin; Rabe, Adrian Paul J; Tremblay, Gabriel

    2018-01-01

    Anna Forsythe,1 Patricia S Brandt,2 Mike Dolph,1 Sachin Patel,3 Adrian Paul J Rabe,1 Gabriel Tremblay1 1Purple Squirrel Economics, New York, NY, 2Novartis Pharmaceuticals, East Hanover, NJ, USA; 3Novartis Pharmaceuticals UK Limited, Frimley, Camberley, Surrey, UK Background: Cost-utility analyses for acute myeloid leukemia (AML) require health state utility values (HSUVs) in order to calculate quality-adjusted life-years (QALYs) for each health state. Aim: This study reviewed AML-related HSU...

  17. Impact of comorbidity and healthcare utilization on colorectal cancer stage at diagnosis: literature review

    Science.gov (United States)

    Corkum, Mark; Urquhart, Robin; Burge, Fred; Porter, Geoffrey; Johnston, Grace

    2013-01-01

    Purpose Individuals diagnosed with cancer close to death have low access to enrollment in palliative care programs. The purpose of this literature review was to assess the usefulness of pre-diagnostic comorbidity and healthcare utilization as indicators of late-stage colorectal cancer (CRC) diagnosis, to help with early identification of individuals who may benefit from palliative care. Methods A literature search was conducted in relevant databases using title/abstract terms which included “cancer,” “stage,” “diagnosis,” “determinants,” “predictors,” and “associated.” Included studies examined whether comorbidity and/or healthcare utilization had an impact on the stage at which CRC was diagnosed. A standardized data abstraction form was used to assess the eligibility of each study. Thirteen articles were included in the literature review. These studies were assessed and synthesized using qualitative methodology. Results We found much heterogeneity among study variables. The findings of this literature review point to the presence of comorbidity and non-emergent healthcare utilization as having no association with late-stage diagnosis. Conversely, emergency room presentation (ERP) was associated with late-stage diagnosis. Conclusions The results of this literature review did not find strong evidence to suggest that comorbidity and healthcare utilization are potential indicators of late-stage diagnosis. However, ERP may be useful as a flag for consideration of prompt referral to palliative care. Additional research is required to identify potential indicators of late-stage diagnosis that may be available in administrative databases, particularly in the area of healthcare utilization. PMID:22101505

  18. Migrants' utilization of somatic healthcare services in Europe - a systematic review

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Nielsen, Signe Smith; Krasnik, Allan

    2010-01-01

    on the abstracts. Additional searches were conducted via the references of the selected articles. The final number of studies included was 21. Results: The results suggested a diverging picture regarding utilization of somatic healthcare services by migrants compared to non-migrants in Europe. Overall, migrants......Background: Utilization of services is an important aspect of migrants' access to healthcare. The aim was to review the European literature on utilization of somatic healthcare services related to screening, general practitioner, specialist, emergency room and hospital by adult first......-generation migrants. Our study question was: ‘Are there differences in migrants' utilization of somatic healthcare services compared to non-migrants?' Methods: Publications were identified by a systematic search of PUBMED and EMBASE. Appropriateness of the studies was judged independently by two researchers based...

  19. A review of neem biopesticide utilization and challenges in Central ...

    African Journals Online (AJOL)

    The status of neem biopesticide research, utilization and challenges in the central part of northern Nigeria was reviewed. In the sampled areas such as the Federal Capital Territory (FCT), Abuja and Niger State, the highest category of neem users (17.19%) were the rural farmers. Majority of the neem users obtained their ...

  20. Inter-utility trade review

    International Nuclear Information System (INIS)

    Warnes, E.M.; Vaahedi, E.

    1991-01-01

    The National Energy Board was requested by the Minister of Energy, Mines and Resources to identify possible measures to improve cooperation among Canadian electrical utilities and to enhance access for buyers and sellers of electricity to available transmission capacity through intervening systems for wheeling purposes. To identify measures to improve cooperation, a questionnaire was sent to electric utilities and other interested parties on the present extent and future possibilities for inter-utility cooperation. The questionnaire and its results are presented. It was found that there already exists a significant amount of inter-utility cooperation in Canada. Such cooperation generally involves interchanges of economy energy, non-economic capacity and energy, coordinated operation, resource sharing, maintenance scheduling, emergency supports, etc. There is a very limited degree of integrated generation expansion planning. Typically, these agreements are carried out under interconnection agreements negotiated on a bi-lateral basis. The highest current degree of cooperation exists under the auspices of the Alberta interconnected power system pool. Wheeling is limited and generally restricted to cases where the sender and receiver are the same entity or where power is wheeled to a utility purchasing it from the wheeler's system. 2 figs., 3 tabs

  1. “recolección, manejo y transformación de la pollinaza en abono orgánico en el cantón durán”

    OpenAIRE

    Benites Zari, Fátima Mariana; Lozano Salcedo, Laura Alejandra; Torres Nazareno, María Antonieta

    2013-01-01

    El presente proyecto consiste en realizar un estudio de factibilidad de manejo de residuos avícolas (pollinaza) a fin de proyectar la creación de un centro de recolección, manejo y transformación en abono orgánico compost para el sector agrícola del cantón de Durán en el año 2014, debido a la gran cantidad de basura que se genera en el cantón, y la falta de gestión eficiente en la zona. La población objetivo de nuestro proyecto son las empresas e industrias del sector agrícola en ...

  2. 10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Schedule of fees for production and utilization facilities, review of standard referenced design approvals, special projects, inspections and import and export... AMENDED Schedule of Fees § 170.21 Schedule of fees for production and utilization facilities, review of...

  3. Energy and water quality management systems for water utility's operations: a review.

    Science.gov (United States)

    Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

    2015-04-15

    Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. NRC review of Electric Power Research Institute's Advanced Light Reactor Utility Requirements Document - Program summary, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 1 of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Program Summary,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER provides a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  5. Juice blends--a way of utilization of under-utilized fruits, vegetables, and spices: a review.

    Science.gov (United States)

    Bhardwaj, Raju Lal; Pandey, Shruti

    2011-07-01

    The post-harvest shelf life of maximum of fruits and vegetables is very limited due to their perishable nature. In India more then 20-25 percent of fruits and vegetables are spoiled before utilization. Despite being the world's second largest producer of fruits and vegetables, in India only 1.5 percent of the total fruits and vegetables produced are processed. Maximum amounts of fruit and vegetable juices turn bitter after extraction due to conversion of chemical compounds. In spite of being under utilized, the utilization of highly nutritive fruits and vegetables is very limited due to high acidity, astringency, bitterness, and some other factors. While improving flavor, palatability, and nutritive and medicinal value of various fruit juices such as aonla, mango, papaya, pineapple, citrus, ber, pear, apple, watermelon, and vegetables including bottle gourd, carrot, beet root, bitter gourd, medicinal plants like aloe vera and spices can also be used for juice blending. All these natural products are valued very highly for their refreshing juice, nutritional value, pleasant flavor, and medicinal properties. Fruits and vegetables are also a rich source of sugars, vitamins, and minerals. However, some fruits and vegetables have an off flavor and bitterness although they are an excellent source of vitamins, enzymes, and minerals. Therefore, blending of two or more fruit and vegetable juices with spices extract for the preparation of nutritive ready-to-serve (RTS), beverages is thought to be a convenient and economic alternative for utilization of these fruits and vegetables. Moreover, one could think of a new product development through blending in the form of a natural health drink, which may also serve as an appetizer. The present review focuses on the blending of fruits, under-utilized fruits, vegetables, medicinal plants, and spices in appropriate proportions for the preparation of natural fruit and vegetable based nutritive beverages.

  6. Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Vest, Joshua R.; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B.

    2016-01-01

    Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. PMID:26614882

  7. Evaluation of conformity of a first prescription of lipid-based formulation of amphotericin B in a university-teaching pediatric hospital.

    Science.gov (United States)

    Agogué, Claire; Bussières, Jean-François; Dehaut, Catherine; Lebel, Denis; Brochet, Marie-Sophie

    2006-04-01

    Invasive fungal infections are an important cause of morbidity and mortality in immunodeficient children. Amphotericin B is an important therapeutic agent for the treatment of invasive fungal infections but is associated with significant toxicities and high acquisition costs. The purpose of this study was to evaluate physician adherence to a local guideline for the use of lipid-based amphotericin B. The study was approved through Pharmacology & Therapeutics (P&T) committee activities. A retrospective drug utilization review (DUR) was conducted. All orders written between January 1, 2003, and December 31, 2004, were reviewed. Demographic and descriptive clinical data were collected as well as variables related to the drug order process. Conformity rates were calculated for the primary objective criteria (authorized prescribers - infectious disease members; recommended drug of choice-Abelcet; accepted indications; and presence of underlying conditions). A total of 109 orders for 70 patients were reviewed by a single research assistant for a 2-year period. Global conformity rate for all four criteria was calculated at 7.3%. Non-conformity was mostly associated with the absence of underlying conditions (e.g., prerenal insufficiency or presence of nephrotoxicity due to amphotericin B desoxycholate) in 84.5% of the cases. Infusionrelated adverse drug reactions partly explained a switch to a non-formulary lipid-based amphotericin B product. External factors (newly published results since the adoption of the guideline and continuous marketing practices) and internal factors (availability of non-formulary process, inefficient DUR process) could have contributed to non-adherence to a local guideline. This study shows low adherence to P&T committee drug guidelines on lipid-based amphotericin B. Continuous and efficient DUR processes should be in place to monitor drug guideline adherence.

  8. Socioeconomic disparities in home health care service access and utilization: a scoping review.

    Science.gov (United States)

    Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie

    2012-10-01

    Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage

  9. Mediamania? Contemporary German Poetry in the Age of New Information Technologies: Thomas Kling and Durs Grünbein

    Directory of Open Access Journals (Sweden)

    Erk Grimm

    1997-01-01

    Full Text Available The essay examines the preoccupation with information technologies as a dominant theme of German poetry in the 1980s and 1990s. Outlining the historical shift from a critique of mass media to the ironic affirmation of hi-tech media, the investigation seeks an understanding of its driving forces. The analysis of Enzensberger's polemical essays on the culture industry shows the parallels and the difference in attitude between him and younger poets of the 1980s. A concise account of their publications illuminates the development of an aesthetically demanding poetry that kept aloof from the mass media. In their rejection of a common quotidian or sentimental tone, poets such as Thomas Kling and Durs Grunbein created new idioms and challenging forms while concentrating on hi-tech media as an epochal phenomenon. The sober reflection and technical terminology originate in a materialistic attitude, driven by the desire to regain the power of sophisticated aesthetic expression and to compensate for the loss of experience caused by the simulation of the past.The essay closes with a critical interpretation of the "mediamania" of the 1990s by giving heed to the fashionable remixing of poetic idioms that leaves the false impression of a new school of media poets.

  10. Impact of an Advanced Imaging Utilization Review Program on Downstream Health Care Utilization and Costs for Low Back Pain.

    Science.gov (United States)

    Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

    2018-06-01

    Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. Interrupted time series. In total, 76,119 Washington State workers' compensation claimants with LBP between 2006 and 2014. Proportion of workers receiving imaging per month (MRI, computed tomography, radiographs) and lumbosacral injections and surgery; mean total health care costs per worker; mean duration of disability per worker. Measures were aggregated monthly and attributed to injury month. After accounting for secular trends, decreases in early MRI [level change: -5.27 (95% confidence interval, -4.22 to -6.31); trend change: -0.06 (-0.01 to -0.12)], any MRI [-4.34 (-3.01 to -5.67); -0.10 (-0.04 to -0.17)], and injection [trend change: -0.12 (-0.06 to -0.18)] utilization were associated with the policy. Radiograph utilization increased in parallel [level change: 2.46 (1.24-3.67)]. In addition, the policy resulted in significant decreasing changes in mean costs per claim, mean disability duration, and proportion of workers who received disability benefits. The policy had no effect on computed tomography or surgery utilization. The UR policy had discernable effects on health care utilization, costs, and disability. Integrating evidence-based guidelines with UR can improve quality of care and patient outcomes, while reducing use of low-value health services.

  11. Decision 13-2009 in the matter of a review by the NWT Public Utilities Board regarding customer complaints of high consumption on power bills from Northland Utilities Limited

    International Nuclear Information System (INIS)

    Acorn, J.

    2009-01-01

    In February 2009, in response to customer complaints, the Northwest Territories Public Utilities Board requested that Northland Utilities conduct a review of at least the last 3 billing cycles to detect and explain unusually high power bills. Northland responded that the complaints were based primarily on price, not usage, and that the findings can be attributed to rate adjustments as well as colder weather. However, the Board decided to examine certain aspects of Northland's response in detail and initiated an inquiry under section 52 of the Public Utilities Act. The Board determined that Northland Utilities' process for investigating customer complaints was too informal and without any clear structure, resulting in confusion for some customers. The Board directed the utility to develop a document for dealing with customer concerns that clearly outlines the rights and responsibilities of both the utility and the customers. The Board also directed Northland Utilities to reduce the $500 threshold for a company-initiated review of an account to $400. This document addressed issues regarding estimated versus actual meter readings; the number of days in a billing cycle; the prominence of consumption and overall cost on a bill; bill calculators; customer consumption monitoring; pre-paid meters; and meter accuracy. Specific customer complaints were included along with a summary of Board directives.

  12. Social relationships and physician utilization among older adults-A systematic review.

    Directory of Open Access Journals (Sweden)

    Daniel Bremer

    Full Text Available In older age health needs and demand for health services utilization increase. Individual's social relationships can play a decisive role regarding the utilization of outpatient health care services. This systematic review examines the associations of structural and functional dimensions of social relationships with outpatient health services use of older adults.The databases PubMed, CINAHL, SocINDEX, PsycINFO, International Bibliography of the Social Sciences (IBSS, Sociological Abstracts, and Applied Social Sciences Index and Abstracts (ASSIA were searched in February 2016. The methodological and reporting quality of the articles was assessed and the results were synthesized descriptively and systematically.Out of 1.392 hits, 36 articles (35 studies were included in the systematic review. The methodological and reporting quality of the included articles was reasonable. Various structural and functional characteristics of social relationships were associated with the use (yes/no and the frequency of using outpatient care among older adults. The majority of the associations between structural dimensions of social relationships and the use of physicians were positive and moderate in strength. The associations between functional dimensions of social relationships and the probability of using physician services were inconsistent and varied in strength. For the most part, social relationship variables assigned to the structural dimension were positively and weakly to moderately associated with the frequency of physician visits. Functional aspects of social relationships also tended to have positive associations with the frequency of physician utilization. The associations were weak to moderate in strength.Measuring social relationships and their influence on health services use is a challenging methodological endeavor indicated by the inconclusive results. The results suggest that the outpatient care utilization behavior of older individuals being

  13. Social relationships and physician utilization among older adults-A systematic review.

    Science.gov (United States)

    Bremer, Daniel; Inhestern, Laura; von dem Knesebeck, Olaf

    2017-01-01

    In older age health needs and demand for health services utilization increase. Individual's social relationships can play a decisive role regarding the utilization of outpatient health care services. This systematic review examines the associations of structural and functional dimensions of social relationships with outpatient health services use of older adults. The databases PubMed, CINAHL, SocINDEX, PsycINFO, International Bibliography of the Social Sciences (IBSS), Sociological Abstracts, and Applied Social Sciences Index and Abstracts (ASSIA) were searched in February 2016. The methodological and reporting quality of the articles was assessed and the results were synthesized descriptively and systematically. Out of 1.392 hits, 36 articles (35 studies) were included in the systematic review. The methodological and reporting quality of the included articles was reasonable. Various structural and functional characteristics of social relationships were associated with the use (yes/no) and the frequency of using outpatient care among older adults. The majority of the associations between structural dimensions of social relationships and the use of physicians were positive and moderate in strength. The associations between functional dimensions of social relationships and the probability of using physician services were inconsistent and varied in strength. For the most part, social relationship variables assigned to the structural dimension were positively and weakly to moderately associated with the frequency of physician visits. Functional aspects of social relationships also tended to have positive associations with the frequency of physician utilization. The associations were weak to moderate in strength. Measuring social relationships and their influence on health services use is a challenging methodological endeavor indicated by the inconclusive results. The results suggest that the outpatient care utilization behavior of older individuals being structurally

  14. Social relationships and physician utilization among older adults—A systematic review

    Science.gov (United States)

    Inhestern, Laura; von dem Knesebeck, Olaf

    2017-01-01

    Background In older age health needs and demand for health services utilization increase. Individual’s social relationships can play a decisive role regarding the utilization of outpatient health care services. This systematic review examines the associations of structural and functional dimensions of social relationships with outpatient health services use of older adults. Methods The databases PubMed, CINAHL, SocINDEX, PsycINFO, International Bibliography of the Social Sciences (IBSS), Sociological Abstracts, and Applied Social Sciences Index and Abstracts (ASSIA) were searched in February 2016. The methodological and reporting quality of the articles was assessed and the results were synthesized descriptively and systematically. Results Out of 1.392 hits, 36 articles (35 studies) were included in the systematic review. The methodological and reporting quality of the included articles was reasonable. Various structural and functional characteristics of social relationships were associated with the use (yes/no) and the frequency of using outpatient care among older adults. The majority of the associations between structural dimensions of social relationships and the use of physicians were positive and moderate in strength. The associations between functional dimensions of social relationships and the probability of using physician services were inconsistent and varied in strength. For the most part, social relationship variables assigned to the structural dimension were positively and weakly to moderately associated with the frequency of physician visits. Functional aspects of social relationships also tended to have positive associations with the frequency of physician utilization. The associations were weak to moderate in strength. Conclusions Measuring social relationships and their influence on health services use is a challenging methodological endeavor indicated by the inconclusive results. The results suggest that the outpatient care utilization behavior

  15. Willingness to Pay for Renewable Electricity: A Review of Utility Market Research

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B. C.

    1999-09-09

    As competition in the electric utility industry has become more widespread and federal legislation deregulating the utility industry more likely, utilities have become more concerned about actions they can take to help ensure the loyalty of their customers. National polls have, for 20 years, found majority preferences for renewable energy over other energy sources. This issue brief compiles and analyzes recent market research conducted by utility companies on customer interest in and willingness to pay for renewable electricity. Findings in the areas examined in this review are: Customers are favorable toward renewable sources of electricity, although they know little about them; Solar and wind are the most favored sources of electricity generation; Majorities of 52% to nearly 100% of residential customers said they were willing to pay at least a modest amount more per month on their electric bills for green power; their responses follow a predictable curve showing that percentages willing to pay more decline as cost increases. The residential market for green pricing is approximately 2% near program rollout at a $5/month price increment, and should increase slowly but steadily over time; Customers may view with favor, and be more willing to purchase electricity from, utilities that provide green power.

  16. Vers une prévision de la durée de vie des polymères géosynthétiques : Principes de base, Etat de l'art

    OpenAIRE

    BARTOLOMEO, P

    2003-01-01

    Cette étude bibliographique dresse un bilan des connaissances sur la durabillité des matériaux géosynthétiques à base de polymères. Les causes et les mécanismes qui affectent plus particulièrement les polyéthylènes, polypropylènes, polyesters et PVC sont abordés en détail. L'accent est d'abord mis sur la nécessité d'identifier des critères de durée de vie pertinents, et les difficultés que l'on rencontre quand on cherche des extrapolations entre les essais accélérés et les conditions naturell...

  17. Prospective utility of therapeutic ultrasound in dentistry-Review with recent comprehensive update

    Directory of Open Access Journals (Sweden)

    Shalu Rai

    2012-01-01

    Full Text Available Background: The utility of ultrasound (US for therapeutic purposes is still in its infancy. Therapeutic US (TUS has been used widely in medical field for urological application, surgical intervention, bone healing, and osteointegration in cancer and healing of full thickness excised skin lesions, and within dentistry as a prediagnostic, diagnostic and therapeutic purpose. The purpose of the paper is to review and determine the efficacy of US as one of the treatment modalities for its role in maxillofacial region to reduce pain and promote soft tissue healing. Materials and Methods: A Medline search included of the international literature published between 1976 and 2011 and was restricted to English language articles, published work of past researchers including in vitro and in vivo studies, recent additions of textbooks on surgical and therapeutic applications of US and, current articles in conference papers and reports accessed from the internet using Google search engine on therapeutic ultrasound. Results: Very few article regarding effect of therapeutic of US for its use of insonation for treatment of patient with pain and soft tissue injury are available. This review article mainly emphasizes the therapeutic utility of US in dentistry for its effectiveness to decrease joint stiffness, reduce pain and muscle spasms and improve muscle mobility. In vivo studies have shown very little clinical effects. Conclusions: Further research is warranted in this clinically important area to make the development of noninvasive, multifunctional ultrasound devices for repair, regeneration and other therapeutic utility a success.

  18. Análisis funcional de la vivienda de interés social: El Recreo, cantón Durán 2017

    Directory of Open Access Journals (Sweden)

    MSc. Silvia Alcívar Macías

    2018-01-01

    Full Text Available El estudio de la vivienda de interés social en el Ecuador, y caso concreto en la ciudadela de El Recreo, cantón Durán, de la Provincia del Guayas Ecuador, pretende conocer los estándares de funcionabilidad y confort para las familias de bajo poder adquisitivo. El levantamiento de información fue realizado en el periodo comprendido entre los meses de octubre a diciembre del 2016, se aplicó técnica de encuesta muestreo en cinco estratos correspondientes a las 5 etapas que conforman la ciudadela El Recreo, constituyéndose entonces en un tipo de muestreo simple disperso, donde se entrevistó a 300 familias para medir el grado de confort y funcionabilidad de las viviendas. Posteriormente a la tabulación de los datos obtenidos se procedió al diseño de gráficos estadísticos, que permitieron realizar un análisis descriptivo y dinámico para diagnosticar la situación funcional y de confort de las viviendas

  19. Plastic solid waste utilization technologies: A Review

    Science.gov (United States)

    Awasthi, Arun Kumar; Shivashankar, Murugesh; Majumder, Suman

    2017-11-01

    Plastics are used in more number of applications in worldwide and it becomes essential part of our daily life. In Indian cities and villages people use the plastics in buying vegetable as a carry bag, drinking water bottle, use of plastic furniture in home, plastics objects uses in kitchen, plastic drums in packing and storage of the different chemicals for industrial use, use plastic utensils in home and many more uses. After usage of plastics it will become part of waste garbage and create pollution due to presence of toxic chemicals and it will be spread diseases and give birth to uncontrolled issues in social society. In current scenario consumption of plastic waste increasing day by day and it is very difficult to manage the plastic waste. There are limited methodologies available for reutilization of plastic waste again. Such examples are recycling, landfill, incineration, gasification and hydrogenation. In this paper we will review the existing methodologies of utilization of plastic waste in current scenario

  20. Review of Recommender Systems Algorithms Utilized in Social Networks based e-Learning Systems & Neutrosophic System

    Directory of Open Access Journals (Sweden)

    A. A. Salama

    2015-03-01

    Full Text Available In this paper, we present a review of different recommender system algorithms that are utilized in social networks based e-Learning systems. Future research will include our proposed our e-Learning system that utilizes Recommender System and Social Network. Since the world is full of indeterminacy, the neutrosophics found their place into contemporary research. The fundamental concepts of neutrosophic set, introduced by Smarandache in [21, 22, 23] and Salama et al. in [24-66].The purpose of this paper is to utilize a neutrosophic set to analyze social networks data conducted through learning activities.

  1. Clinical Utility of SPECT Neuroimaging in the Diagnosis and Treatment of Traumatic Brain Injury: A Systematic Review

    OpenAIRE

    Raji, Cyrus A.; Tarzwell, Robert; Pavel, Dan; Schneider, Howard; Uszler, Michael; Thornton, John; van Lierop, Muriel; Cohen, Phil; Amen, Daniel G.; Henderson, Theodore

    2014-01-01

    PURPOSE: This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). METHODS: After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild,...

  2. Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review.

    Science.gov (United States)

    Gardner, Preston; Flis, Diana; Chaiyasate, Kongkrit

    2017-01-01

    Morel-Lavallée lesions are irregularly occurring and often overlooked results of traumatic injuries, resulting in potential long-term encapsulation of fluid between soft-tissue layers. The objective in this review was to discuss the delayed presentation of a Morel-Lavallée lesion and operative utility of liposuction in the patient's treatment and review literature with particular focus on diagnosis and therapeutic interventions. The reviewed case demonstrates the presentation and successful therapy of a young female presenting with a MLL and contour deformity.

  3. Utilization of byproducts and waste materials from meat, poultry and fish processing industries: a review.

    Science.gov (United States)

    Jayathilakan, K; Sultana, Khudsia; Radhakrishna, K; Bawa, A S

    2012-06-01

    India is bestowed with vast livestock wealth and it is growing at the rate of 6% per annum. The contribution of livestock industry including poultry and fish is increasing substantially in GDP of country which accounts for >40% of total agricultural sector and >12% of GDP. This contribution would have been much greater had the animal by-products been also efficiently utilized. Efficient utilization of by-products has direct impact on the economy and environmental pollution of the country. Non-utilization or under utilization of by-products not only lead to loss of potential revenues but also lead to the added and increasing cost of disposal of these products. Non-utilization of animal by-products in a proper way may create major aesthetic and catastrophic health problems. Besides pollution and hazard aspects, in many cases meat, poultry and fish processing wastes have a potential for recycling raw materials or for conversion into useful products of higher value. Traditions, culture and religion are often important when a meat by-product is being utilized for food. Regulatory requirements are also important because many countries restrict the use of meat by-products for reasons of food safety and quality. By-products such as blood, liver, lung, kidney, brains, spleen and tripe has good nutritive value. Medicinal and pharmaceutical uses of by-product are also highlighted in this review. Waste products from the poultry processing and egg production industries must be efficiently dealt with as the growth of these industries depends largely on waste management. Treated fish waste has found many applications among with which the most important are animal feed, biodiesel/biogas, dietectic products (chitosan), natural pigments (after extraction) and cosmetics (collagen). Available information pertaining to the utilization of by-products and waste materials from meat, poultry and fish and their processing industries has been reviewed here.

  4. NRC review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Evolutionary plant designs, Chapter 1, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 2 (Parts 1 and 2) of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Evolutionary Plant Designs,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER gives the results of the staff's review of Volume II of the Requirements Document for evolutionary plant designs, which consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant (approximately 1300 megawatts-electric)

  5. The utility of repeat enzyme immunoassay testing for the diagnosis of Clostridium difficile infection: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    P S Garimella

    2012-01-01

    Full Text Available Over the last 20 years, the prevalence of healthcare-associated Clostridium difficile (C. diff disease has increased. While multiple tests are available for the diagnosis of C. diff infection, enzyme immunoassay (EIA testing for toxin is the most used. Repeat EIA testing, although of limited utility, is common in medical practice. To assess the utility of repeat EIA testing to diagnose C. diff infections. Systematic literature review. Eligible studies performed >1 EIA test for C. diff toxin and were published in English. Electronic searches of MEDLINE and EMBASE were performed and bibliographies of review articles and conference abstracts were hand searched. Of 805 citations identified, 32 were reviewed in detail and nine were included in the final review. All studies except one were retrospective chart reviews. Seven studies had data on number of participants (32,526, and the overall reporting of test setting and patient characteristics was poor. The prevalence of C. diff infection ranged from 9.1% to 18.5%. The yield of the first EIA test ranged from 8.4% to 16.6%, dropping to 1.5-4.7% with a second test. The utility of repeat testing was evident in outbreak settings, where the yield of repeat testing was 5%. Repeat C. diff testing for hospitalized patients has low clinical utility and may be considered in outbreak settings or when the pre-test probability of disease is high. Future studies should aim to identify patients with a likelihood of disease and determine the utility of repeat testing compared with empiric treatment.

  6. Consumer sleep tracking devices: a review of mechanisms, validity and utility.

    Science.gov (United States)

    Kolla, Bhanu Prakash; Mansukhani, Subir; Mansukhani, Meghna P

    2016-05-01

    Consumer sleep tracking devices such as fitness trackers and smartphone apps have become increasingly popular. These devices claim to measure the sleep duration of their users and in some cases purport to measure sleep quality and awaken users from light sleep, potentially improving overall sleep. Most of these devices appear to utilize data generated from in-built accelerometers to determine sleep parameters but the exact mechanisms and algorithms are proprietary. The growing literature comparing these devices against polysomnography/actigraphy shows that they tend to underestimate sleep disruptions and overestimate total sleep times and sleep efficiency in normal subjects. In this review, we evaluate the current literature comparing the accuracy of consumer sleep tracking devices against more conventional methods used to measure sleep duration and quality. We discuss the current technology that these devices utilize as well as summarize the value of these devices in clinical evaluations and their potential limitations.

  7. The impact of transitional care programs on health services utilization in community-dwelling older adults: a systematic review.

    Science.gov (United States)

    Weeks, Lori E; Macdonald, Marilyn; Martin-Misener, Ruth; Helwig, Melissa; Bishop, Andrea; Iduye, Damilola F; Moody, Elaine

    2018-02-01

    The objective was to identify and synthesize the best available evidence on the impact of transitional care programs on various forms of health services utilization in community-dwelling older adults. There is growing evidence that transitional care programs can help address important challenges facing health care systems and our increasing older adult population in many countries by reducing unnecessary health service utilization. There is a need for a systematic review of the research evaluating the impact of transitional care programs on hospital and other health service usage. The review included studies on community-dwelling adults age 60 and over with at least one medical diagnosis, and which evaluated the outcomes of transitional care programs on health system utilization of older adults. The outcomes for this review were hospital usage including admissions and readmissions, emergency department usage, primary care/physician usage, nursing home usage, and home health care usage. The review considered experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, and case-control studies. A three-step search was utilized to find published and unpublished studies conducted in any country but reported in English. Six electronic databases were searched from inception of the database to May, 2016. A search for unpublished studies was also conducted. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Quantitative data were extracted from included studies independently by the two reviewers using the standardized Joanna Briggs Institute data extraction tools. Due to the methodological heterogeneity of the included studies, a comprehensive meta-analysis for all outcomes was not possible

  8. NRC review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Evolutionary plant designs, Chapters 2--13, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 2 (Parts 1 and 2) of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Evolutionary Plant Designs,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER gives the results of the staff's review of Volume II of the Requirements Document for evolutionary plant designs, which consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant (approximately 1300 megawatts-electric)

  9. Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

    Science.gov (United States)

    Yoshizawa, R S

    2013-01-01

    Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Music Therapy with Children: A Review of Clinical Utility and Application to Special Populations.

    Science.gov (United States)

    Yeaw, John David Andrew

    This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…

  11. Influencers of generic drug utilization: A systematic review.

    Science.gov (United States)

    Howard, Jennifer N; Harris, Ilene; Frank, Gavriella; Kiptanui, Zippora; Qian, Jingjing; Hansen, Richard

    2017-08-04

    With an increase in prescription drug spending and rising drug costs there is a need to encourage the use of generic prescription drugs. However, maximizing generic drug use is not possible without the public's positive perception and meeting their informational needs about generic drugs. Thus, improving the public's confidence in, and knowledge of generic drugs on the market is critical. The objective of this systematic review is to examine and evaluate the studies focusing on the nature and extent of key factors influencing generic drug use in the United States in order to help guide policy, education and practice interventions. Using multiple search engines and key word screening criteria, empirical studies published in English between January 1, 2005 and December 31, 2015 were identified. A qualitative synthesis of the evidence identified domains of key factors that influenced generic drug use across studies. Over 3000 citations met the key word screening criteria; 67 of these met inclusion criteria for the systematic review. Seven domains of factors that influence generic drug utilization were identified: 1) patient-related factors, 2) formulary management or cost containment, 3) healthcare policies, 4) promotional activities, 5) educational initiatives, 6) technology, and 7) physician-related factors. Patients, physicians, pharmacists, formulary managers, and policymakers play an important role in generic drug use. Understanding the factors influencing generic drug use can help guide future policy, education, and practice interventions to increase generic drug use. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. et de blé dur (Triticum durum

    African Journals Online (AJOL)

    SARAH

    31 mai 2017 ... Study of the genetic diversity of some varieties of bread wheat (Triticum aestivum L.) and durum wheat. (Triticum durum Desf.) ...... Crop adaptation to climate change,1e éd. Oxford, Wiley-Blackwell, 595 p. Zeven AC,1998. Landraces: a review of definitions and classifications. Euphytica 104(2) : 127-139.

  13. Federal policies to promote the widespread utilization of photovoltaic systems. Supplement: review and critique

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.L.

    1980-04-15

    This document is intended as a supplement to the two-volume report entitled Federal Policies to Promote the Widespread Utilization of Photovoltaic Systems that was submitted to Congress by the Department of Energy in February and April of 1980. This supplement contains review comments prepared by knowledgeable experts who reviewed early drafts of the Congressional report. Responses to the review comments by the Jet Propulsion Laboratory, preparer of the Congressional report, are also included in this supplement. The Congressional report, mandated in the Solar Photovoltaic Energy Research, Development, and Demonstration Act of 1978 (P.L. 95-590), discusses various issues related to promoting the deployment of photovoltaic systems through the Federal Photovoltaic Program. Various program strategies and funding levels are examined.

  14. Utilizing Social Media Data for Pharmacovigilance: A Review

    Science.gov (United States)

    Sarker, Abeed; Ginn, Rachel; Nikfarjam, Azadeh; O’Connor, Karen; Smith, Karen; Jayaraman, Swetha; Upadhaya, Tejaswi; Gonzalez, Graciela

    2015-01-01

    Objective Automatic monitoring of Adverse Drug Reactions (ADRs), defined as adverse patient outcomes caused by medications, is a challenging research problem that is currently receiving significant attention from the medical informatics community. In recent years, user-posted data on social media, primarily due to its sheer volume, has become a useful resource for ADR monitoring. Research using social media data has progressed using various data sources and techniques, making it difficult to compare distinct systems and their performances. In this paper, we perform a methodical review to characterize the different approaches to ADR detection/extraction from social media, and their applicability to pharmacovigilance. In addition, we present a potential systematic pathway to ADR monitoring from social media. Methods We identified studies, describing approaches for ADR detection from social media from the Medline, Embase, Scopus and Web of Science databases, and the Google Scholar search engine. Studies that met our inclusion criteria were those that attempted to utilize ADR information posted by users on any publicly available social media platform. We categorized the studies into various dimensions such as primary ADR detection approach, size of data, source(s), availability, evaluation criteria, and so on. Results Twenty-two studies met our inclusion criteria, with fifteen (68.2%) published within the last two years. The survey revealed a clear trend towards the usage of annotated data with eleven of the fifteen (73.3%) studies published in the last two years relying on expert annotations. However, publicly available annotated data is still scarce, and we found only six (27.3%) studies that made the annotations used publicly available, making system performance comparisons difficult. In terms of algorithms, supervised classification techniques to detect posts containing ADR mentions, and lexicon-based approaches for extraction of ADR mentions from texts have been

  15. Action de Paenibacillus polymyxa SGK2 sur quelques champignons de la fusariose du blé dur (Triticum durum en Algérie

    Directory of Open Access Journals (Sweden)

    Lamia Lounaci

    2014-05-01

    Full Text Available Les tests ont porté sur l’action de P. polymyxa SGK2 à l’égard de F. graminearum, F. culmorum, F. verticillioides et M. nivale agents de la fusariose du blé dur en Algérie. La technique de confrontation directe en boîtes de Petri met en évidence une action inhibitrice caractérisée par un ralentissement de la croissance mycélienne. Après 7 jours d’incubation, un arrêt à distance des colonies du pathogène est observé. Nous étions également attachés à rechercher le (ou les moyen utilisé par P. polymyxa SGK2 pour inhiber la croissance des mycètes tests. Cette capacité naturelle agit par la synthèse d'une (ou des substance constitutive inhibitrice de la croissance des quatre champignons sur le milieu King B, d'une (ou des substance inductible inhibitrice de la croissance du F. culmorum et F. graminearum sur le même milieu, et d'une (ou des substance volatile inhibitrice de la croissance des quatre mycètes sur les milieux King B et PDA.

  16. Active pipe-embedded structures in buildings for utilizing low-grade energy sources: A review

    International Nuclear Information System (INIS)

    Xu, Xinhua; Wang, Jinbo; Wang, Shengwei; Xiao, Fu

    2010-01-01

    Low-grade energy sources such as geothermal energy, favorable ambient air and industrial waste heat etc. exist widely. Sufficient utilization of these low-grade energy sources may reduce our daily dependence on high-grade energy sources such as electricity resulting in reduced emission of green house gas for environmental conservation. Active pipe-embedded structure as floor/ceiling usually with water as the medium to carry heat or coolth may utilize these low-grade energy sources for providing space air-conditioning. Compact arrangement of pipes in the structure may significantly enlarge heat transfer surface between the slab mass and water in the pipe allowing substantial heat flows even for relatively small temperature differences. Application of the heat or coolth storage capacity of this structure for preheating or pre-cooling is also one among the advantages of this structure for shifting load and exploiting the nighttime cheap electricity tariff in some regions. This paper presents the technology of the active pipe-embedded structure for utilizing widely existing low-grade energy sources following by a comprehensive review on the heat transfer calculation models of this structure and its practical applications in real building systems for space air-conditioning. This review shows that more works on the active structure, especially simple and transient models for dynamic and accurate performance prediction and easy integration with existing building energy simulation packages, are worthwhile for further promoting the practical application wherever the low-grade energy sources are favorable. (author)

  17. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

    Science.gov (United States)

    de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

    2015-02-01

    A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

  18. Utilization of construction and agricultural waste in Malaysia for development of Green Concrete: A Review

    Science.gov (United States)

    Tambichik, M. A.; Mohamad, N.; Samad, A. A. A.; Bosro, M. Z. M.; Iman, M. A.

    2018-04-01

    Green Concrete (GC) is defined as a concrete that utilize a waste material for at least one of its component. The production of GC has been increasing due to the drawback of conventional concrete that create many environmental problems. In Malaysia, the amount of waste generates from agricultural and construction industries were increasing every year. Hence, one of the solutions to reduce the impact of conventional concrete and limited landfill spaces due to excessive waste is by utilizing it in concrete. This paper reviews the possible use of construction waste (Recycle Concrete Aggregate) and agricultural waste (Palm Oil Fuel Ash, Rice Husk Ash and Palm Oil Fibre) as partial replacement for the basic material in a concrete to produce an innovative Green Concrete. The optimum replacement level for each type of waste was also been review. Green Concrete also has the potential to reduce environmental pollution and solve the depletion of natural sources. The result from this review shows that the addition of agricultural waste or construction waste in concrete indicate positive and satisfactory strength when compared to normal concrete. Finally, a mass production of Green Concrete can fulfil the Construction Industry Transformation Plan (CITP) 2016-2020 made by CIDB that emphasizes on a construction system which is environmentally sustainable.

  19. The Hermeneutical Horizon and the Ethnohistoric Value in the Philological Annotation of the «Libro de los ritos» (1579 Written by friar Diego Durán (OP

    Directory of Open Access Journals (Sweden)

    Paloma Vargas Montes

    2016-05-01

    Full Text Available The following discussion offers a panorama of the hermeneutical horizon from which the philological annotation apparatus of the Libro de los ritos critical edition was created. The book, written by the Dominican friar Diego Durán in 1579, describes the religious life of the Nahua people with emphasis in the Mexicas or Aztecs of the postclassical period. Also, this work offers some considerations about the ethnohistorical value of the Libro de los ritos and explains how this idea was used as a hypothesis to create the philological annotation apparatus of the critical edition. The value of the analysis of this experience is the contribution that it offers to the discussion between philologists about the proper methodology that must be used for the critical annotation of the Indian chronicles, documents that conserve the memory of the Native American people.

  20. Sentiment Analysis in the Sales Review of Indonesian Marketplace by Utilizing Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Anang Anggono Lutfi

    2018-04-01

    Full Text Available The online store is changing people’s shopping behavior. Despite the fact, the potential customer’s distrust in the quality of products and service is one of the online store’s weaknesses. A review is provided by the online stores to overcome this weakness. Customers often write a review using languages that are not well structured. Sentiment analysis is used to extract the polarity of the unstructured texts. This research attempted to do a sentiment analysis in the sales review. Sentiment analysis in sales reviews can be used as a tool to evaluate the sales. This research intends to conduct a sentiment analysis in the sales review of Indonesian marketplace by utilizing Support Vector Machine and Naive Bayes. The reviews of the data are gathered from one of Indonesian marketplace, Bukalapak. The data are classified into positive or negative class. TF-IDF is used to feature extraction. The experiment shows that Support Vector Machine with linear kernel provides higher accuracy than Naive Bayes. Support Vector Machine shows the highest accuracy average. The generated accuracy is 93.65%. This approach of sentiment analysis in sales review can be used as the base of intelligent sales evaluation for online stores in the future.

  1. A systematic literature review of health state utility values in head and neck cancer.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2017-09-02

    Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered

  2. Lessons Learned: A review of utility experience with conservation and load management programs for commercial and industrial customers

    Energy Technology Data Exchange (ETDEWEB)

    Nadel, S.

    1990-10-01

    This report examines utility experience with conservation and load management (C LM) programs of commercial and industrial (C I) customers in order to summarize the lessons learned from program experiences to date and what these teach us about how to operate successful programs in the future. This analysis was motivated by a desire to learn about programs which achieve high participation rates and high electricity savings while remaining cost effective. Also, we wanted to review the very latest experiences with innovative program approaches -- approaches that might prove useful to utilities as they scale up their C LM activities. Specific objectives of this phase of the study are threefold: (1) To disseminate information on utility C LM experience to a nationwide audience. (2) To review current New York State utility programs and make suggestions on how these programs can be improved. (3) To collect data for the final phase of the American Council for an Energy-Efficient Economy/New York State Energy Research and Development Authority project, which will examine the savings that are achievable if C LM programs are pushed to the limit'' of current knowledge on how to structure and run cost-effective C LM programs. 19 tabs.

  3. Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature.

    Directory of Open Access Journals (Sweden)

    Dominic Thorrington

    Full Text Available The objective of this review was to evaluate the use of all direct and indirect methods used to estimate health utilities in both children and adolescents. Utilities measured pre- and post-intervention are combined with the time over which health states are experienced to calculate quality-adjusted life years (QALYs. Cost-utility analyses (CUAs estimate the cost-effectiveness of health technologies based on their costs and benefits using QALYs as a measure of benefit. The accurate measurement of QALYs is dependent on using appropriate methods to elicit health utilities.We sought studies that measured health utilities directly from patients or their proxies. We did not exclude those studies that also included adults in the analysis, but excluded those studies focused only on adults.We evaluated 90 studies from a total of 1,780 selected from the databases. 47 (52% studies were CUAs incorporated into randomised clinical trials; 23 (26% were health-state utility assessments; 8 (9% validated methods and 12 (13% compared existing or new methods. 22 unique direct or indirect calculation methods were used a total of 137 times. Direct calculation through standard gamble, time trade-off and visual analogue scale was used 32 times. The EuroQol EQ-5D was the most frequently-used single method, selected for 41 studies. 15 of the methods used were generic methods and the remaining 7 were disease-specific. 48 of the 90 studies (53% used some form of proxy, with 26 (29% using proxies exclusively to estimate health utilities.Several child- and adolescent-specific methods are still being developed and validated, leaving many studies using methods that have not been designed or validated for use in children or adolescents. Several studies failed to justify using proxy respondents rather than administering the methods directly to the patients. Only two studies examined missing responses to the methods administered with respect to the patients' ages.

  4. CERN : Nouveaux records lors d'une période d'exploitation au PS/SPS ; Un nouveau rôle pour les ISR ; Deuxième région d'intersection pour le système pp du SPS ; Détermination de la durée de vie du charme ; Calcul en Sicile et au CERN

    CERN Multimedia

    1979-01-01

    CERN : Nouveaux records lors d'une période d'exploitation au PS/SPS ; Un nouveau rôle pour les ISR ; Deuxième région d'intersection pour le système pp du SPS ; Détermination de la durée de vie du charme ; Calcul en Sicile et au CERN

  5. NRC review of Electric Power Research Institute's advanced light water reactor utility requirements document. Passive plant designs, chapter 1, project number 669

    International Nuclear Information System (INIS)

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the open-quotes Advanced Light Water Reactor [ALWR] Utility Requirements Documentclose quotes, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume 1, open-quotes ALWR Policy and Summary of Top-Tier Requirementsclose quotes, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, open-quotes NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Program Summaryclose quotes, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  6. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer

    Directory of Open Access Journals (Sweden)

    Hao Y

    2016-06-01

    Full Text Available Yanni Hao,1 Verena Wolfram,2 Jennifer Cook2 1Novartis Pharmaceuticals, East Hanover, NJ, USA; 2Adelphi Values, Bollington, UK Background: Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Methods: Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases, online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center, and web sites of health technology assessment (HTA bodies. Publications were selected based on the search strategy and the overall study objectives. Results: A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D. Other utility measures, such as the direct methods standard gamble (SG, time trade-off (TTO, and visual analog scale (VAS, were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer 23 (EORTC QLQ-BR23, Functional Assessment of Cancer Therapy – General questionnaire (FACT-G, and Utility-Based Questionnaire-Cancer (UBQ-C; most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex

  7. Utilizing social networking sites to promote adolescents' health: a pragmatic review of the literature.

    Science.gov (United States)

    Francomano, Jesse A; Harpin, Scott B

    2015-01-01

    Social networking site use has exploded among youth in the last few years and is being adapted as an important tool for healthcare interventions and serving as a platform for adolescents to gain access to health information. The aim of this study was to examine the strengths, weaknesses, and best practices of utilizing Facebook in adolescent health promotion and research via pragmatic literature review. We also examine how sites can facilitate ethically sound healthcare for adolescents, particularly at-risk youth. We conducted a literature review of health and social sciences literature from the past 5 years related to adolescent health and social network site use. Publications were grouped by shared content then categorized by themes. Five themes emerged: access to healthcare information, peer support and networking, risk and benefits of social network site use in care delivery, overcoming technological barriers, and social network site interventions. More research is needed to better understand how such Web sites can be better utilized to provide access to adolescents seeking healthcare. Given the broad reach of social network sites, all health information must be closely monitored for accurate, safe distribution. Finally, consent and privacy issues are omnipresent in social network sites, which calls for standards of ethical use.

  8. A structured review of health utility measures and elicitation in advanced/metastatic breast cancer.

    Science.gov (United States)

    Hao, Yanni; Wolfram, Verena; Cook, Jennifer

    2016-01-01

    Health utilities are increasingly incorporated in health economic evaluations. Different elicitation methods, direct and indirect, have been established in the past. This study examined the evidence on health utility elicitation previously reported in advanced/metastatic breast cancer and aimed to link these results to requirements of reimbursement bodies. Searches were conducted using a detailed search strategy across several electronic databases (MEDLINE, EMBASE, Cochrane Library, and EconLit databases), online sources (Cost-effectiveness Analysis Registry and the Health Economics Research Center), and web sites of health technology assessment (HTA) bodies. Publications were selected based on the search strategy and the overall study objectives. A total of 768 publications were identified in the searches, and 26 publications, comprising 18 journal articles and eight submissions to HTA bodies, were included in the evidence review. Most journal articles derived utilities from the European Quality of Life Five-Dimensions questionnaire (EQ-5D). Other utility measures, such as the direct methods standard gamble (SG), time trade-off (TTO), and visual analog scale (VAS), were less frequently used. Several studies described mapping algorithms to generate utilities from disease-specific health-related quality of life (HRQOL) instruments such as European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Breast Cancer 23 (EORTC QLQ-BR23), Functional Assessment of Cancer Therapy - General questionnaire (FACT-G), and Utility-Based Questionnaire-Cancer (UBQ-C); most used EQ-5D as the reference. Sociodemographic factors that affect health utilities, such as age, sex, income, and education, as well as disease progression, choice of utility elicitation method, and country settings, were identified within the journal articles. Most

  9. Does convenience matter in health care delivery? A systematic review of convenience-based aspects of process utility.

    Science.gov (United States)

    Higgins, A; Barnett, J; Meads, C; Singh, J; Longworth, L

    2014-12-01

    To systematically review the existing literature on the value associated with convenience in health care delivery, independent of health outcomes, and to try to estimate the likely magnitude of any value found. A systematic search was conducted for previously published studies that reported preferences for convenience-related aspects of health care delivery in a manner that was consistent with either cost-utility analysis or cost-benefit analysis. Data were analyzed in terms of the methodologies used, the aspects of convenience considered, and the values reported. Literature searches generated 4715 records. Following a review of abstracts or full-text articles, 27 were selected for inclusion. Twenty-six studies reported some evidence of convenience-related process utility, in the form of either a positive utility or a positive willingness to pay. The aspects of convenience valued most often were mode of administration (n = 11) and location of treatment (n = 6). The most common valuation methodology was a discrete-choice experiment containing a cost component (n = 15). A preference for convenience-related process utility exists, independent of health outcomes. Given the diverse methodologies used to calculate it, and the range of aspects being valued, however, it is difficult to assess how large such a preference might be, or how it may be effectively incorporated into an economic evaluation. Increased consistency in reporting these preferences is required to assess these issues more accurately. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Utilization of open source electronic health record around the world: A systematic review.

    Science.gov (United States)

    Aminpour, Farzaneh; Sadoughi, Farahnaz; Ahamdi, Maryam

    2014-01-01

    Many projects on developing Electronic Health Record (EHR) systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems.

  11. Utilization of open source electronic health record around the world: A systematic review

    Directory of Open Access Journals (Sweden)

    Farzaneh Aminpour

    2014-01-01

    Full Text Available Many projects on developing Electronic Health Record (EHR systems have been carried out in many countries. The current study was conducted to review the published data on the utilization of open source EHR systems in different countries all over the world. Using free text and keyword search techniques, six bibliographic databases were searched for related articles. The identified papers were screened and reviewed during a string of stages for the irrelevancy and validity. The findings showed that open source EHRs have been wildly used by source limited regions in all continents, especially in Sub-Saharan Africa and South America. It would create opportunities to improve national healthcare level especially in developing countries with minimal financial resources. Open source technology is a solution to overcome the problems of high-costs and inflexibility associated with the proprietary health information systems.

  12. Factors associated with the utilization of institutional and home birth services among women in Ethiopia: A scoping review

    Directory of Open Access Journals (Sweden)

    Bronwyn Lapp

    2016-12-01

    Full Text Available Objective: To examine the factors associated with the use of institutional delivery and home birth services among women in Ethiopia. Methods: Fifteen peer-reviewed, primary research articles published between 2011 and 2015 were selected for this scoping review. The articles included case-control, cross-sectional, and retrospective follow-up studies conducted in Ethiopia. Results: Findings were categorized with use of content and factorial analysis. The data in this scoping review revealed a significant inequality in skilled care use among Ethiopian women with differences in economic status, education, residence, autonomy in decision making, parity, and antenatal care attendance. Conclusion: Sociodemographic, accessibility, and obstetric factors are key determinants of skilled care utilization. Strategies and policy changes to address maternal health service use should aim to improve economic status, facilitate higher education, increase access to care, promote the empowerment of women, and enhance antenatal care initiatives. Additional research should be conducted to evaluate the influence of the media and culture on skilled care utilization, since few studies have examined these factors.

  13. A review on utilization of textile composites in transportation towards sustainability

    Science.gov (United States)

    Aly, Nermin M.

    2017-10-01

    Transportation industry is rapidly developing owing to its size and importance which affects on various aspects of life. It includes all the transport means that facilitate mobility of people or goods either by air, land or sea like aircrafts, automotives, ships, trains, etc. The utilization of textiles in this industry is increasing as a result of moving towards achieving sustainability and enhancing performance, comfort and safety. Through substituting heavier materials with textiles of high performance specifications and textile reinforced composites to reduce weight, fuel consumption and CO2 emissions. Composite materials can fulfil the demands for sustainability in the transportation sector through using renewable, recycled and lightweight materials, considering the requirements of each category of transport vehicles. Textiles used in reinforcing composites are diverse including fibers, yarns or fabric preforms such as woven, nonwoven, knitted, braided which varies from 2D to complex 3D structures. This paper presents a brief review on the utilization of textiles in reinforcing composites for various transportation applications to achieve sustainability. Also, discussing the influence of textiles structural parameters like fiber material properties, fabric production technique and construction on their mechanical behaviour. Focusing on researches findings in this area and highlighting some prospects for further developments domestically.

  14. Effects of the West Africa Ebola Virus Disease on Healthcare Utilization – a Systematic Review

    Directory of Open Access Journals (Sweden)

    Kim Johanna Brolin Ribacke

    2016-10-01

    Full Text Available Significant efforts were invested in halting the recent Ebola virus disease outbreak in West Africa. Now, studies are emerging on the magnitude of the indirect health effects of the outbreak in the affected countries and the aim of this study is to systematically assess the results of these publications. The methodology for this review adhered to the Prisma guidelines for systematic reveiws. A total of 3354 articles were identified for screening and while 117 articles were read in full, 22 studies were included in the final review.Utilization of maternal health services decreased during the outbreak. The number of Caesarean sections and facility-based deliveries declined and followed a similar pattern in Guinea, Liberia and Sierra Leone. A change in the utilization of antenatal and postnatal care and family planning services was also seen, as well as a drop in utilization of children’s health services, especially in terms of vaccination coverage. In addition, the uptake of HIV/AIDS and malaria services, general hospital admissions and major surgeries decreased as well.Interestingly, it was the uptake of health service provision by the population that decreased, rather than the volume of Health service provision. Estimates from the various studies suggest that non-Ebola morbidity and mortality have increased after the onset of the outbreak in Sierra Leone, Guinea and Liberia. Reproductive, maternal and child health services was especially affected, and the decrease in facility deliveries, Caesarean sections and volume of antenatal and postnatal care visits might have significant adverse effects on maternal and newborn health. The impact of Ebola stretches far beyond Ebola cases and deaths. This review indicates that indirect health service effects are substantial and both short and long-term, and highlights the importance of support to maintain routine health service delivery and the maintenance of vaccination programs as well as preventative

  15. NRC review of Electric Power Research Institute's advanced light water reactor utility requirements document. Passive plant designs, chapters 2-13, project number 669

    International Nuclear Information System (INIS)

    1994-08-01

    The Electric Power Research Institute (EPRI) is preparing a compendium of technical requirements, referred to as the open-quotes Advanced Light Water Reactor [ALWR] Utility Requirements Documentclose quotes, that is acceptable to the design of an ALWR power plant. When completed, this document is intended to be a comprehensive statement of utility requirements for the design, construction, and performance of an ALWR power plant for the 1990s and beyond. The Requirements Document consists of three volumes. Volume I, open-quotes ALWR Policy and Summary of Top-Tier Requirementsclose quotes, is a management-level synopsis of the Requirements Document, including the design objectives and philosophy, the overall physical configuration and features of a future nuclear plant design, and the steps necessary to take the proposed ALWR design criteria beyond the conceptual design state to a completed, functioning power plant. Volume II consists of 13 chapters and contains utility design requirements for an evolutionary nuclear power plant [approximately 1350 megawatts-electric (MWe)]. Volume III contains utility design requirements for nuclear plants for which passive features will be used in their designs (approximately 600 MWe). In April 1992, the staff of the Office of Nuclear Reactor Regulation, U.S. Nuclear Regulatory Commission, issued Volume 1 and Volume 2 (Parts 1 and 2) of its safety evaluation report (SER) to document the results of its review of Volumes 1 and 2 of the Requirements Document. Volume 1, open-quotes NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document - Program Summaryclose quotes, provided a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  16. Is vaccination good value for money? A review of cost-utility analyses of vaccination strategies in eight European countries

    OpenAIRE

    Barbieri, Marco; Capri, Stefano

    2016-01-01

    Objective: The objective of this study is to review published cost-utility analyses of vaccination strategies in eight European countries and to assess whether there are differences in cost-effectiveness terms among countries and vaccinations. Methods: A systematic search of the literature was conducted using the National Health Service Economic Evaluation Database and the PubMed database. Cost-utility analyses of any type of vaccination that used quality-adjusted life years (QALYs) as me...

  17. Utilization of a technical review group during a BWR owners group technical specification improvement study

    International Nuclear Information System (INIS)

    Hansell, H.F.; Moyer, D.P.

    1986-01-01

    A BWR Owners' Group Technical Specification Improvement (TSI) Committee was formed in late 1983. A primary goal of this Committee was to encourage the development of a probabilistic methodology for technical specification improvements which could be readily applied by utilities. The TSI Committee elected to hire a Contractor to develop and demonstrate a method. After the Contractor was selected and has started work, the committee decided to establish a Technical Review Group (TRG) to efficiently and effectively review the Contractor's analyses. The TRG met frequently with the Contractor as the analyses were being performed. These meetings were held at the Contractor's facility in order to allow direct contact between reviewers and individuals performing the work. The TRG was also involved with all major interactions with the NRC. The significance and merit of using a peer review group in this manner is the theme of this paper. In order to present a discussion of the significance and merit of the TRG, the activities are described. The summary of the analytical approach is provided to more full understand the TRG activities

  18. The Diagnostic Utility of the Child Sexual Behavior Inventory for Sexual Abuse: A Systematic Review.

    Science.gov (United States)

    Vrolijk-Bosschaart, Thekla F; Verlinden, Eva; Langendam, Miranda W; De Smet, Vivienne; Teeuw, Arianne H; Brilleslijper-Kater, Sonja N; Benninga, Marc A; Lindauer, Ramón J L

    2018-06-11

    Children with alleged child sexual abuse (CSA) need to be assessed systematically. The use of validated instruments during the assessment, like the Child Sexual Behavior Inventory (CSBI), could add diagnostic value. We aim to assess the diagnostic utility of the CSBI to differentiate between sexually abused and non-abused children. We conducted a systematic review. We searched the electronic databases MEDLINE and PsychInfo for studies comparing CSBI scores in sexually abused children and non-abused children (2-12 years old). Two independent reviewers extracted data and assessed the methodological quality. We included 7 (out of 1048) articles. The CSBI total scores were significantly higher in CSA-victims compared with non-abused children (in case-control settings). However, in children with suspected CSA, the results were ambiguous. One study reported significant differences. Another study reported weak diagnostic ability for the CSBI-3 in children with suspected CSA (a sensitivity and specificity of 0.50, with a positive predictive value of 0.28, and a negative predictive value of 0.72). Research on the diagnostic utility of the CSBI for suspected CSA is limited and shows disappointing results. Until more research is done, the CSBI should not be used on its own to differentiate between sexually abused and non-abused children.

  19. Older Adults’ Social Relationships and Health Care Utilization: A Systematic Review

    Science.gov (United States)

    Moore, Danielle Collingridge; Barron, Lynn; Stow, Daniel; Hanratty, Barbara

    2018-01-01

    Background. Deficiencies in older people’s social relationships (including loneliness, social isolation, and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. Objectives. To determine whether social relationships are associated with older adults’ use of health services, independently of health-related needs. Search Methods. We searched 8 electronic databases (MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, the Cochrane Library, and the Centre for Reviews and Dissemination) for data published between 1983 and 2016. We also identified relevant sources from scanning the reference lists of included studies and review articles, contacting authors to identify additional studies, and searching the tables of contents of key journals. Selection Criteria. Studies met inclusion criteria if more than 50% of participants were older than 60 years or mean age was older than 60 years; they included a measure of social networks, received social support, or perceived support; and they reported quantitative data on the association between social relationships and older adults’ health service utilization. Data Collection and Analysis. Two researchers independently screened studies for inclusion. They extracted data and appraised study quality by using standardized forms. In a narrative synthesis, we grouped the studies according to the outcome of interest (physician visits, hospital admissions, hospital readmissions, emergency department use, hospital length of stay, utilization of home- and community-based services, contact with general health services, and mental health service use) and the domain of social relationships covered (social networks, received social support, or perceived support). For each service type and social relationship domain, we assessed the strength of the evidence across studies according to the quantity and quality of studies and consistency of

  20. Older Adults' Social Relationships and Health Care Utilization: A Systematic Review.

    Science.gov (United States)

    Valtorta, Nicole K; Moore, Danielle Collingridge; Barron, Lynn; Stow, Daniel; Hanratty, Barbara

    2018-04-01

    Deficiencies in older people's social relationships (including loneliness, social isolation, and low social support) have been implicated as a cause of premature mortality and increased morbidity. Whether they affect service use is unclear. To determine whether social relationships are associated with older adults' use of health services, independently of health-related needs. We searched 8 electronic databases (MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, the Cochrane Library, and the Centre for Reviews and Dissemination) for data published between 1983 and 2016. We also identified relevant sources from scanning the reference lists of included studies and review articles, contacting authors to identify additional studies, and searching the tables of contents of key journals. Studies met inclusion criteria if more than 50% of participants were older than 60 years or mean age was older than 60 years; they included a measure of social networks, received social support, or perceived support; and they reported quantitative data on the association between social relationships and older adults' health service utilization. Two researchers independently screened studies for inclusion. They extracted data and appraised study quality by using standardized forms. In a narrative synthesis, we grouped the studies according to the outcome of interest (physician visits, hospital admissions, hospital readmissions, emergency department use, hospital length of stay, utilization of home- and community-based services, contact with general health services, and mental health service use) and the domain of social relationships covered (social networks, received social support, or perceived support). For each service type and social relationship domain, we assessed the strength of the evidence across studies according to the quantity and quality of studies and consistency of findings. The literature search retrieved 26 077 citations, 126 of which met inclusion criteria

  1. Utilization of Microalgal Biofractions for Bioethanol, Higher Alcohols, and Biodiesel Production: A Review

    Directory of Open Access Journals (Sweden)

    Marwa M. El-Dalatony

    2017-12-01

    Full Text Available Biomass is a crucial energy resource used for the generation of electricity and transportation fuels. Microalgae exhibit a high content of biocomponents which makes them a potential feedstock for the generation of ecofriendly biofuels. Biofuels derived from microalgae are suitable carbon-neutral replacements for petroleum. Fermentation is the major process for metabolic conversion of microalgal biocompounds into biofuels such as bioethanol and higher alcohols. In this review, we explored the use of all three major biocomponents of microalgal biomass including carbohydrates, proteins, and lipids for maximum biofuel generation. Application of several pretreatment methods for enhancement the bioavailability of substrates (simple sugar, amino acid, and fatty acid was discussed. This review goes one step further to discuss how to direct these biocomponents for the generation of various biofuels (bioethanol, higher alcohol, and biodiesel through fermentation and transesterification processes. Such an approach would result in the maximum utilization of biomasses for economically feasible biofuel production.

  2. Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

    Science.gov (United States)

    Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

    2013-04-01

    Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

  3. Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

    2017-01-01

    Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

  4. Vitamin D Utilization May Improve Military Performance: A Mini-Review

    Directory of Open Access Journals (Sweden)

    Ramin Abrishami

    2017-09-01

    Full Text Available Studies from different regions of the world show that vitamin D deficiency is a common problem across the globe, even in military personnel. Risk factors of this deficiency includes elderly and female population, higher geographical latitudes, winter season, darker skins, low sunlight exposure, diet, and lack of vitamin D supplementation /fortification, although the deficiency in areas with higher sun exposure also has been documented. We reviewed some of the clinical trials and observations regarding vitamin D deficiency and supplementation. It has been shown that vitamin D deficiency is associated with more acute respiratory tract infections and acute pharyngitis resulting in more days off from training, more bone stress fractures, poor physical performance, and increased risk for suicide.Clinical trials that utilized supplemental vitamin D shows decreased incidence of stress fractures in female navy recruits, lower incidence of influenza A and lower risk of acute respiratory tract infections, and improved bone density during initial military training, although one systematic review found conflicting data in supplementation with vitamin D for the prevention of acute respiratory infection.These data opens a window for supplementation with vitamin D in populated military bases to decrease rate of respiratory infection and to minimize stress fractures for better performances; doses used for these purposes ranges from 300 to 1200 IU per day. Further clinical trials of vitamin D supplementation or dietary fortification for these military purposes should be conducted to determine the optimum dose and duration.

  5. US utility partnerships

    International Nuclear Information System (INIS)

    Worthington, B.

    1995-01-01

    Activities of the United States Energy Association were reviewed, as well as the manner in which its members are benefitting from the Association's programs. The principal cooperative program set up is the Utility Partnership Program, which was described. Through this program the Association is matching US companies, both electric utilities and gas utilities, with counterparts in Eastern Europe or the former Soviet Union. So far, about 25 partnerships were signed, e.g. in the Czech Republic, in Kazakhstan, in Poland, and in Slovakia. It was estimated that the return to the United States from the investments made by the American government in these Utility Partnership Programs has been well over 100-fold

  6. Fenugreek: A review on its nutraceutical properties and utilization in various food products

    Directory of Open Access Journals (Sweden)

    Sajad Ahmad Wani

    2018-04-01

    Full Text Available Fenugreek (Trigonella foenum-graecum is a legume and it has been used as a spice throughout the world to enhance the sensory quality of foods. It is known for its medicinal qualities such as antidiabetic, anticarcinogenic, hypocholesterolemic, antioxidant, and immunological activities. Beside its medicinal value, it is also used as a part of various food product developments as food stabilizer, adhesive, and emulsifying agent. More importantly it is used for the development of healthy and nutritious extruded and bakery product. The present paper reviews about nutraceutical properties of fenugreek and its utilization in various product developments. Keywords: Fenugreek, Nutraceutical, Hypoglycemic, Antioxidant, Extruded product

  7. Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

    Science.gov (United States)

    Rose, Micah; Rice, Stephen; Craig, Dawn

    2017-07-05

    Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

  8. Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.

    Science.gov (United States)

    Abraha, Yosef G; Gebrie, Serebe A; Garoma, Desalegn A; Deribe, Fasil M; Tefera, Mamuye H; Morankar, Sudhakar

    2017-07-01

    The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.

  9. Utilization of a Technical Peer Review to Support the Mission of the Nevada Test Site Community Advisory Board

    International Nuclear Information System (INIS)

    Dixon, Earle C.; Peterson, Kathleen

    2003-01-01

    The U. S. Department of Energy's (DOE) National Nuclear Security Administration Nevada Operations Office (NNSA/NV) Environmental Management (EM) Underground Test Area (UGTA) project addresses the characterization and needs for long-term monitoring of the subsurface contamination resulting from 828 underground nuclear weapon tests at the Nevada Test Site (NTS). EM promotes, and is required, to include stakeholders in its program. However, UGTA is a very complex program not easily understood by members of the public. The NTS Community Advisory Board (CAB), a federally chartered Site Specific Advisory Board (SSAB), has studied the UGTA project since 1996, and has found it a challenge to completely comprehend and provide NNSA/NV meaningful citizen input. The CAB realized the benefit of a technical peer review and in 2000 recommended to NNSA/NV that a peer review of the UGTA strategy would provide valuable feedback to the program to address underground contamination at the NTS. N NSA agreed to the CAB's recommendation, and moved forward with a scope of work to have the American Society of Mechanical Engineers (ASME) perform the peer review of the UGTA strategy. The ASME began the peer review in June 2001, and their final report was published in November 2001. In January 2002, the CAB devoted their monthly meeting in Las Vegas, Nevada to reporting the results of the peer review of the UGTA strategy to the public. Two public workshops were later held in the community of Amargosa, Nevada during the month of January to help educate and build interest in the CAB February 2002 monthly meeting which was also held in Amargosa. The CAB recommendation to NNSA to utilize a technical peer review has provided valuable information to NNSA, the State of Nevada, and the CAB. At other DOE sites SSABs are challenged by a number of complex, technical programs requiring considerable time and resources for the board to comprehend. It is worth considering the utilization of an independent

  10. Utility deregulation and AMR technology

    International Nuclear Information System (INIS)

    Moore, G.

    1991-01-01

    This article reviews the effects of deregulation on other utilities and services and examines how the electric utilities can avoid the worst of these effects and capitalize of the best aspects of competition in achieving marketing excellence. The article presents deregulation as a customer service and underscores the need for utilities to learn to compete aggressively and intelligently and provide additional services available through technology such as automated meter reading

  11. Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review

    Directory of Open Access Journals (Sweden)

    Hanne Marie Rostad

    2017-11-01

    Full Text Available Abstract Background The Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and clinical utility of the scale. Method We conducted a systematic search in three databases (CINAHL, Medline and PsycINFO for studies published in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers independently reviewed titles and abstracts and performed the quality assessment and data abstraction. Results A total of 24 studies were included in this systematic review. The quality of the studies varied, but many lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies addressed various aspects of the scale’s feasibility and clinical utility, but their results are limited and inconsistent across settings and samples. Support for the scale’s reliability, validity and responsiveness varied widely across the studies. Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the scale’s validity and responsiveness was incomplete. Conclusion Additional high-quality studies are warranted to determine in which populations of older adults with cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully quantify pain, measure treatment response and improve patient outcomes also needs further investigation. Trial registration PROSPERO reg. no

  12. Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review.

    Science.gov (United States)

    Rostad, Hanne Marie; Utne, Inger; Grov, Ellen Karine; Puts, Martine; Halvorsrud, Liv

    2017-11-02

    The Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and clinical utility of the scale. We conducted a systematic search in three databases (CINAHL, Medline and PsycINFO) for studies published in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers independently reviewed titles and abstracts and performed the quality assessment and data abstraction. A total of 24 studies were included in this systematic review. The quality of the studies varied, but many lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies addressed various aspects of the scale's feasibility and clinical utility, but their results are limited and inconsistent across settings and samples. Support for the scale's reliability, validity and responsiveness varied widely across the studies. Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the scale's validity and responsiveness was incomplete. Additional high-quality studies are warranted to determine in which populations of older adults with cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully quantify pain, measure treatment response and improve patient outcomes also needs further investigation. PROSPERO reg. no.: CRD42016049697 registered 20. Oct. 2016.

  13. Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

    Science.gov (United States)

    Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

    2009-07-22

    Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

  14. Performance-based ratemaking for electric utilities: Review of plans and analysis of economic and resource-planning issues. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Comnes, G.A.; Stoft, S.; Greene, N. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.; Hill, L.J. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.]|[Oak Ridge National Lab., TN (United States). Energy Div.

    1995-11-01

    Performance-Based Ratemaking (PBR) is a form of utility regulation that strengthens the financial incentives to lower rates, lower costs, or improve nonprice performance relative traditional regulation, which the authors call cost-of-service, rate-of-return (COS/ROR) regulation. Although the electric utility industry has considerable experience with incentive mechanisms that target specific areas of performance, implementation of mechanisms that cover a comprehensive set of utility costs or services is relatively rare. In recent years, interest in PBR has increased as a result of growing dissatisfaction with COS/ROR and as a result of economic and technological trends that are leading to more competition in certain segments of the electricity industry. In addition, incentive regulation has been used with some success in other public utility industries, most notably telecommunications in the US and telecommunications, energy, and water in the United Kingdom. In this report, the authors analyze comprehensive PBR mechanisms for electric utilities in four ways: (1) they describe different types of PBR mechanisms, (2) they review a sample of actual PBR plans, (3) they consider the interaction of PBR and utility-funded energy efficiency programs, and (4) they examine how PBR interacts with electric utility resource planning and industry restructuring. The report should be of interest to technical staff of utilities and regulatory commissions that are actively considering or designing PBR mechanisms. 16 figs., 17 tabs.

  15. Improving the utilization of research knowledge in agri-food public health: a mixed-method review of knowledge translation and transfer.

    Science.gov (United States)

    Rajić, Andrijana; Young, Ian; McEwen, Scott A

    2013-05-01

    Knowledge translation and transfer (KTT) aims to increase research utilization and ensure that the best available knowledge is used to inform policy and practice. Many frameworks, methods, and terms are used to describe KTT, and the field has largely developed in the health sector over the past decade. There is a need to review key KTT principles and methods in different sectors and evaluate their potential application in agri-food public health. We conducted a structured mixed-method review of the KTT literature. From 827 citations identified in a comprehensive search, we characterized 160 relevant review articles, case studies, and reports. A thematic analysis was conducted on a prioritized and representative subset of 33 articles to identify key principles and characteristics for ensuring effective KTT. The review steps were conducted by two or more independent reviewers using structured and pretested forms. We identified five key principles for effective KTT that were described within two contexts: to improve research utilization in general and to inform policy-making. To ensure general research uptake, there is a need for the following: (1) relevant and credible research; (2) ongoing interactions between researchers and end-users; (3) organizational support and culture; and (4) monitoring and evaluation. To inform policy-making, (5) researchers must also address the multiple and competing contextual factors of the policy-making process. We also describe 23 recommended and promising KTT methods, including six synthesis (e.g., systematic reviews, mixed-method reviews, and rapid reviews); nine dissemination (e.g., evidence summaries, social media, and policy briefs); and eight exchange methods (e.g., communities of practice, knowledge brokering, and policy dialogues). A brief description, contextual example, and key references are provided for each method. We recommend a wider endorsement of KTT principles and methods in agri-food public health, but there are

  16. Effets oestrogéniques du macéré aqueux des feuilles de Holarrhena floribunda (G. Don Dur & Schinz chez la rate ovariectomisée

    Directory of Open Access Journals (Sweden)

    Sawadogo l;

    2006-01-01

    Full Text Available Oestrogenic effects of macerated aqueous extracts of the leaves of Holarrhena fl oribunda (G. Don Dur & Schinz on ovariectomized rat. Estrogenic effects of aqueous extracts of leaves of Holarrhena fl oribunda have been evaluated by uterotrophic assay. Ovariectomized mice were used and treated subcutaneously during seven days with 50, 100, 200 mg.kg-1 doses of Holarrhena fl oribunda and with 100, 200 mg.kg-1 doses of Holarrhena fl oribunda plus 25 mg.kg-1 of oestradiol 17-β. Estrogenic activity was analysed by uterine dry and wet weight, surrenal gland wet weight, vaginal opening, protein and cholesterol level in uteri horn. Administration of extracts to the doses of 100 and 200 mg.kg-1 exhibits increase of uterine dry and wet weight, surrenal gland wet weight, vaginal opening, protein levels and decrease of level of cholesterol in uterine horn. The results suggest that, aqueous extracts of Holarrhena fl oribunda possesses estrogenic type effect. But when 100 and 200 mg.kg-1 of Holarrhena fl oribunda were given alone with 25 mg.kg-1 of estradiol 17-β, the estrogenic effect was slight. These results supposed that H. fl oribunda is a weak phytoestrogen and the aqueous extracts of the leaves behad as partial agonistic

  17. Evaluation of Antibacterial Utilization in Olabisi Onabanjo University ...

    African Journals Online (AJOL)

    This is particularly important as most hospitals in the country if not all have neglected the Drug Utilization Review aspects of Drug and Therapeutic Committee roles. It can also form basis for intervention be it educational, managerial or regulatory. METHODS: It is a retrospective drug utilization review studies, in addition a ...

  18. British Columbia Utilities Commission 2001 annual report

    International Nuclear Information System (INIS)

    2002-06-01

    The main responsibility of the British Columbia Utilities Commission is to regulate energy utilities under its jurisdiction to ensure that energy rates are fair and that utility operators in the province provide safe, adequate and secure service to their customers. The Commission also approves the construction of new facilities planned by utilities. It also participates in the review of utility and energy projects under the Environmental Assessment Act. Several successes were achieved in 2001 as the utility implemented its first performance plan. Oral public hearings were held for applications by Pacific Northern Gas and by Pembina Pipelines, owners of the common carrier oil pipeline from Taylor to Kamloops. A review of BC Gas' rate design to apportion utility revenue requirements fairly to different classes of customers was successfully achieved by a negotiated settlement process. In 2001, there was also a high level of proposed mergers, acquisitions and divestitures. Duke Energy Corporation's share acquisition of Westcoast Energy's two affiliated gas utilities was approved. BC Gas' application to divest its customer care activities to a joint venture company with Enbridge was also reviewed, and an oral hearing was held to review a West Kootenay Power application to sell its Kootenay River hydroelectric generation assets to Columbia Basin Trust and the Columbia Power Corp. In this case, the decision rendered was that the sale terms had to be changed so that customers could share the proceeds. The utility therefore, decided not to proceed with the sale under these conditions. The BC Hydro legislated rate freeze, which was due to expire on September 30, 2001, was extended for an additional 18 months to allow the new provincial government time to implement a new energy policy. The new energy policy is expected to give the province an energy advantage by facilitating growth and diversification in energy production while providing competition and more choice for

  19. Review of Energy Harvesters Utilizing Bridge Vibrations

    Directory of Open Access Journals (Sweden)

    Farid Ullah Khan

    2016-01-01

    Full Text Available For health monitoring of bridges, wireless acceleration sensor nodes (WASNs are normally used. In bridge environment, several forms of energy are available for operating WASNs that include wind, solar, acoustic, and vibration energy. However, only bridge vibration has the tendency to be utilized for embedded WASNs application in bridge structures. This paper reports on the recent advancements in the area of vibration energy harvesters (VEHs utilizing bridge oscillations. The bridge vibration is narrowband (1 to 40 Hz with low acceleration levels (0.01 to 3.8 g. For utilization of bridge vibration, electromagnetic based vibration energy harvesters (EM-VEHs and piezoelectric based vibration energy harvesters (PE-VEHs have been developed. The power generation of the reported EM-VEHs is in the range from 0.7 to 1450000 μW. However, the power production by the developed PE-VEHs ranges from 0.6 to 7700 μW. The overall size of most of the bridge VEHs is quite comparable and is in mesoscale. The resonant frequencies of EM-VEHs are on the lower side (0.13 to 27 Hz in comparison to PE-VEHs (1 to 120 Hz. The power densities reported for these bridge VEHs range from 0.01 to 9539.5 μW/cm3 and are quite enough to operate most of the commercial WASNs.

  20. Improving Molecular Genetic Test Utilization through Order Restriction, Test Review, and Guidance.

    Science.gov (United States)

    Riley, Jacquelyn D; Procop, Gary W; Kottke-Marchant, Kandice; Wyllie, Robert; Lacbawan, Felicitas L

    2015-05-01

    The ordering of molecular genetic tests by health providers not well trained in genetics may have a variety of untoward effects. These include the selection of inappropriate tests, the ordering of panels when the assessment of individual or fewer genes would be more appropriate, inaccurate result interpretation and inappropriate patient guidance, and significant unwarranted cost expenditure. We sought to improve the utilization of molecular genetic tests by requiring providers without specialty training in genetics to use genetic counselors and molecular genetic pathologists to assist in test selection. We used a genetic and genomic test review process wherein the laboratory-based genetic counselor performed the preanalytic assessment of test orders and test triage. Test indication and clinical findings were evaluated against the test panel composition, methods, and test limitations under the supervision of the molecular genetic pathologist. These test utilization management efforts resulted in a decrease in genetic test ordering and a gross cost savings of $1,531,913 since the inception of these programs in September 2011 through December 2013. The combination of limiting the availability of complex genetic tests and providing guidance regarding appropriate test strategies is an effective way to improve genetic tests, contributing to judicious use of limited health care resources. Copyright © 2015 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  1. Medicare program; acquisition, protection and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Proposed rule.

    Science.gov (United States)

    1984-04-16

    This proposal would govern the acquisition, protection and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organizations (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on the disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations would implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded, and used only for proper purposes.

  2. Many Miles to Go: A Systematic Review of the State of Cost-Utility Analyses in Brazil.

    Science.gov (United States)

    Campolina, Alessandro G; Rozman, Luciana M; Decimoni, Tassia C; Leandro, Roseli; Novaes, Hillegonda M D; De Soárez, Patrícia Coelho

    2017-04-01

    Little is known about the quality and quantity of cost-utility analyses (CUAs) in Brazil. The objective of this study was to provide a systematic review of published CUAs of healthcare technologies in Brazil. We performed a systematic review of economic evaluations studies published in MEDLINE, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), NHS EED (National Health Service Economic Evaluation Database), HTA (Health Technology Assessment) Database, Web of Science, Scopus, Bireme (Biblioteca Regional de Medicina), BVS ECOS (Health Economics database of the Brazilian Virtual Library of Health), and SISREBRATS (Sistema de Informação da Rede Brasileira de Avaliação de Tecnologias em Saúde [Brazilian Network for the Evaluation of Health Technologies]) from 1980 to 2013. Articles were included if they were CUAs according to the classification devised by Drummond et al. Two independent reviewers screened articles for relevance and carried out data extraction. Disagreements were resolved through discussion or through consultation with a third reviewer. We performed a qualitative narrative synthesis. Of the 535 health economic evaluations (HEEs) relating to Brazil, only 40 were CUAs and therefore included in the analysis. Most studies adhered to methodological guidelines for quality of reporting and 77.5% used quality-adjusted life-years (QALYs) as the health outcome. Of these studies, 51.6% did not report the population used to elicit preferences for outcomes and 45.2% used a specific population such as expert opinion. The preference elicitation method was not reported in 58.1% of these studies. The majority (80.6%) of studies did not report the instrument used to derive health state valuations and no publication reported whether tariffs (or preference weights) were national or international. No study mentioned the methodology used to estimate QALYs. Many published Brazilian cost-utility studies

  3. Utilization and efficacy of internet-based eHealth technology in gastroenterology: a systematic review.

    Science.gov (United States)

    Knowles, Simon R; Mikocka-Walus, Antonina

    2014-04-01

    While there have been several reviews exploring the outcomes of various eHealth studies, none have been gastroenterology-specific. This paper aims to evaluate the research conducted within gastroenterology which utilizes internet-based eHealth technology to promote physical and psychological well-being. A systematic literature review of internet-based eHealth interventions involving gastroenterological cohorts was conducted. Searched databases included: EbSCOhost Medline, CINAHL, and PsycINFO. Inclusion criteria were studies reporting on eHealth interventions (both to manage mental health problems and somatic symptoms) in gastroenterology, with no time restrictions. Exclusion criteria were non-experimental studies, or studies using only email as primary eHealth method, and studies in language other than English. A total of 17 papers were identified; seven studies evaluated the efficacy of a psychologically oriented intervention (additional two provided follow-up analyses exploring the original published data) and eight studies evaluated disease management programs for patients with either irritable bowel syndrome, inflammatory bowel disease (IBD) or celiac disease. Overall, psychological eHealth interventions were associated with significant reductions in bowel symptoms and improvement in quality of life (QoL) that tended to continue up to 12 months follow up. The eHealth disease management was shown to generally improve QoL, adherence, knowledge about the disease, and reduce healthcare costs in IBD, although the studies were associated with various methodological problems, and thus, this observation should be confirmed in well-designed interventional studies. Based on the evidence to date, eHealth internet-based technology is a promising tool that can be utilized to both promote and enhance gastrointestinal disease management and mental health.

  4. Factors associated with the utilization of dental health services by the pediatric population: an integrative review.

    Science.gov (United States)

    Curi, Davi Silva Carvalho; Figueiredo, Andreia Cristina Leal; Jamelli, Silvia Regina

    2018-05-01

    This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.

  5. Privatization of municipal electrical utilities

    International Nuclear Information System (INIS)

    Carr, J.

    1998-01-01

    The challenges and special issues which arise through the sale of a municipal electric utility were discussed. The recent sales of two utilities, the Kentville Electric Commission in Nova Scotia and Cornwall Electric in Ontario, were used as examples to show how the sale of an electric utility differs from the sale of most business enterprises. Municipal utilities are integral parts of the communities they serve which introduces several complexities into the sale. Factors that require special attention in the sale of the utilities, including electricity rates, local accountability, treatment of employees and local economic development, and the need for a comprehensive communication program to deal with the substantial public interest that sale of a municipal utility will engender, were reviewed

  6. Utilization of health care services by migrants in Europe

    DEFF Research Database (Denmark)

    Graetz, V.; Rechel, B.; Groot, W.

    2017-01-01

    : Compared with previous systematic reviews, the results indicate a clearer picture of the differences in health service utilization between migrants and non-migrants in Europe. Areas timely for developing research: A comprehensive comparison across European countries is impossible because the number......Introduction: Our study reviewed the empirical evidence on the utilization of health care services by migrants in Europe, and on differences in health service utilization between migrants and non-migrants across European countries. Sources of data: A systematic literature review was performed......, searching the databases Medline, Cinahl and Embase and covering the period from January 2009 to April 2016. The final number of articles included was 39. Areas of agreement: Utilization of accident and emergency services and hospitalizations were higher among migrants compared with non-migrants in most...

  7. Thorium utilization in power reactors

    International Nuclear Information System (INIS)

    Saraceno; Marcos.

    1978-10-01

    In this work the recent (prior to Aug, 1976) literature on thorium utilization is reviewed briefly and the available information is updated. After reviewing the nuclear properties relevant to the thorium fuel cycle we describe briefly the reactor systems that have been proposed using thorium as a fertile material. (author) [es

  8. Projeto de cadeia de suprimentos ágeis e verdes: estudos exploratórios em uma empresa de bens de consumo não duráveis

    Directory of Open Access Journals (Sweden)

    Angelica Reis Galdino Takahashi

    2015-12-01

    Full Text Available Resumo Novas tendências em gestão da cadeia de suprimentos têm fomentado grandes discussões na área, incluindo os paradigmas de alinhamento dinâmico e de gestão sustentável de cadeias. O primeiro prega que se deve gerenciar dinamicamente diferentes tipologias de cadeias (e.g. totalmente flexíveis, ágeis, enxutas e de reabastecimento contínuo a fim de responder adequadamente a comportamentos específicos dos clientes. O segundo preconiza que o projeto e a gestão dessas cadeias devem considerar questões ambientais e sociais, em complementação aos aspectos econômicos. Recentemente, alguns autores têm combinado essas tendências em um novo modelo conceitual visando melhor gerenciar trade-offs de sustentabilidade quando do projeto de cadeias de suprimentos. O objetivo deste trabalho é testar algumas das hipóteses levantadas por tal modelo em cadeias ágeis. Por meio de simulações em uma multinacional de bens de consumo não duráveis, foi possível verificar que o modelo proposto possui coerência e potencial para ajudar as empresas a projetar cadeias ágeis e verdes.

  9. Optimizing Mass Spectrometry Analyses: A Tailored Review on the Utility of Design of Experiments.

    Science.gov (United States)

    Hecht, Elizabeth S; Oberg, Ann L; Muddiman, David C

    2016-05-01

    Mass spectrometry (MS) has emerged as a tool that can analyze nearly all classes of molecules, with its scope rapidly expanding in the areas of post-translational modifications, MS instrumentation, and many others. Yet integration of novel analyte preparatory and purification methods with existing or novel mass spectrometers can introduce new challenges for MS sensitivity. The mechanisms that govern detection by MS are particularly complex and interdependent, including ionization efficiency, ion suppression, and transmission. Performance of both off-line and MS methods can be optimized separately or, when appropriate, simultaneously through statistical designs, broadly referred to as "design of experiments" (DOE). The following review provides a tutorial-like guide into the selection of DOE for MS experiments, the practices for modeling and optimization of response variables, and the available software tools that support DOE implementation in any laboratory. This review comes 3 years after the latest DOE review (Hibbert DB, 2012), which provided a comprehensive overview on the types of designs available and their statistical construction. Since that time, new classes of DOE, such as the definitive screening design, have emerged and new calls have been made for mass spectrometrists to adopt the practice. Rather than exhaustively cover all possible designs, we have highlighted the three most practical DOE classes available to mass spectrometrists. This review further differentiates itself by providing expert recommendations for experimental setup and defining DOE entirely in the context of three case-studies that highlight the utility of different designs to achieve different goals. A step-by-step tutorial is also provided.

  10. Development of a claim review and payment model utilizing diagnosis related groups under the Korean health insurance.

    Science.gov (United States)

    Shin, Y S; Yeom, Y K; Hwang, H

    1993-02-01

    This paper describes the development of a claim review and payment model utilizing the diagnosis related groups (DRGs) for the fee for service-based payment system of the Korean health insurance. The present review process, which examines all claims manually on a case-by-case basis, has been considered to be inefficient, costly, and time-consuming. Differences in case mix among hospitals are controlled in the proposed model using the Korean DRGs. They were developed by modifying the US-DRG system. An empirical test of the model indicated that it can enhance the efficiency as well as the credibility and objectivity of the claim review. Furthermore, it is expected that it can contribute effectively to medical cost containments and to optimal practice pattern of hospitals by establishing a useful mechanism in monitoring the performance of hospitals. However, the performance of this model needs to be upgraded by refining the Korean DRGs which play a key role in the model.

  11. Utilizing social media data for pharmacovigilance: A review.

    Science.gov (United States)

    Sarker, Abeed; Ginn, Rachel; Nikfarjam, Azadeh; O'Connor, Karen; Smith, Karen; Jayaraman, Swetha; Upadhaya, Tejaswi; Gonzalez, Graciela

    2015-04-01

    Automatic monitoring of Adverse Drug Reactions (ADRs), defined as adverse patient outcomes caused by medications, is a challenging research problem that is currently receiving significant attention from the medical informatics community. In recent years, user-posted data on social media, primarily due to its sheer volume, has become a useful resource for ADR monitoring. Research using social media data has progressed using various data sources and techniques, making it difficult to compare distinct systems and their performances. In this paper, we perform a methodical review to characterize the different approaches to ADR detection/extraction from social media, and their applicability to pharmacovigilance. In addition, we present a potential systematic pathway to ADR monitoring from social media. We identified studies describing approaches for ADR detection from social media from the Medline, Embase, Scopus and Web of Science databases, and the Google Scholar search engine. Studies that met our inclusion criteria were those that attempted to extract ADR information posted by users on any publicly available social media platform. We categorized the studies according to different characteristics such as primary ADR detection approach, size of corpus, data source(s), availability, and evaluation criteria. Twenty-two studies met our inclusion criteria, with fifteen (68%) published within the last two years. However, publicly available annotated data is still scarce, and we found only six studies that made the annotations used publicly available, making system performance comparisons difficult. In terms of algorithms, supervised classification techniques to detect posts containing ADR mentions, and lexicon-based approaches for extraction of ADR mentions from texts have been the most popular. Our review suggests that interest in the utilization of the vast amounts of available social media data for ADR monitoring is increasing. In terms of sources, both health

  12. Retrospective studies of end-of-life resource utilization and costs in cancer care using health administrative data: a systematic review.

    Science.gov (United States)

    Langton, Julia M; Blanch, Bianca; Drew, Anna K; Haas, Marion; Ingham, Jane M; Pearson, Sallie-Anne

    2014-12-01

    There has been an increase in observational studies using health administrative data to examine the nature, quality, and costs of care at life's end, particularly in cancer care. To synthesize retrospective observational studies on resource utilization and/or costs at the end of life in cancer patients. We also examine the methods and outcomes of studies assessing the quality of end-of-life care. A systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) methodology. We searched MEDLINE, Embase, CINAHL, and York Centre for Research and Dissemination (1990-2011). Independent reviewers screened abstracts of 14,424 articles, and 835 full-text manuscripts were further reviewed. Inclusion criteria were English-language; at least one resource utilization or cost outcome in adult cancer decedents with solid tumors; outcomes derived from health administrative data; and an exclusive end-of-life focus. We reviewed 78 studies examining end-of-life care in over 3.7 million cancer decedents; 33 were published since 2008. We observed exponential increases in service use and costs as death approached; hospital services being the main cost driver. Palliative services were relatively underutilized and associated with lower expenditures than hospital-based care. The 15 studies using quality indicators demonstrated that up to 38% of patients receive chemotherapy or life-sustaining treatments in the last month of life and up to 66% do not receive hospice/palliative services. Observational studies using health administrative data have the potential to drive evidence-based palliative care practice and policy. Further development of quality care markers will enhance benchmarking activities across health care jurisdictions, providers, and patient populations. © The Author(s) 2014.

  13. Proceedings of the advanced research and technology development direct utilization, instrumentation and diagnostics contractors' review meeting

    Energy Technology Data Exchange (ETDEWEB)

    Geiling, D.W. (USDOE Morgantown Energy Technology Center, WV (USA)); Goldberg, P.M. (eds.) (USDOE Pittsburgh Energy Technology Center, PA (USA))

    1990-01-01

    The 1990 Advanced Research and Technology Development (AR TD) Direct Utilization, and Instrumentation and Diagnostics Contractors Review Meeting was held September 16--18, 1990, at the Hyatt at Chatham Center in Pittsburgh, PA. The meeting was sponsored by the US Department of Energy (DOE), Office of Fossil Energy, and the Pittsburgh and Morgantown Energy Technology Centers. Each year the meeting provides a forum for the exchange of information among the DOE AR TD contractors and interested parties. This year's meeting was hosted by the Pittsburgh Energy Technology Center and was attended by 120 individuals from industry, academia, national laboratories, and other governmental agencies. Papers were presented on research addressing coal surface, science, devolatilization and combustion, ash behavior, emission controls for gases particulates, fluid bed combustion and utilization in diesels and turbines. Individual reports are processed separately for the data bases.

  14. ‘Historiography and the retracing of Latin American art history’: The Academy of San Carlos and Mexican Art History by Ray Hernández-Durán, Politics, History, and Art in Nineteenth-Century Mexico, London and New York: Routledge, 2017

    Directory of Open Access Journals (Sweden)

    Claudia Mattos Avolese

    2017-12-01

    Full Text Available The Academy of San Carlos and Mexican Art History presents an account of the cultural and political circumstances that led to the installation of the first gallery of colonial art at the Academy of San Carlos in mid-nineteenth century Mexico City, and to the associated publication of the first art historical account of colonial Mexico. The author proposes that these two endeavors relate closely to the ambitions of the Mexican conservative elite to create a Mexican corporate identity based on the colonial past. Ray Hernández-Durán also argues that the gallery and the associated book can be seen as the starting point for the construction of the field of Latin American art history as we know it today.

  15. Residual oxygen time model for oxygen partial pressure near 130 kPa (1.3 atm).

    Science.gov (United States)

    Shykoff, Barbara E

    2015-01-01

    A two-part residual oxygen time model predicts the probability of detectible pulmonary oxygen toxicity P(P[O2tox]) after dives with oxygen partial pressure (PO2) approximately 130 kPa, and provides a tool to plan dive series with selected risk of P[O2tox]. Data suggest that pulmonary oxygen injury at this PO2 is additive between dives. Recovery begins after a delay and continues during any following dive. A logistic relation expresses P(P[O2tox]) as a function of dive duration (T(dur)) [hours]: P(P[O2tox]) = 100/[1+exp (3.586-0.49 x T(dur))] This expression maps T(dur) to P(P[O2tox]) or, in the linear mid-portion of the curve, P(P[O2tox]) usefully to T(dur). For multiple dives or during recovery, it maps to an equivalent dive duration, T(eq). T(eq) was found after second dives of duration T(dur 2). Residual time from the first dive t(r) = T(eq) - T(dur2). With known t(r), t and T(dur) a recovery model was fitted. t(r) = T(dur) x exp [-k x((t-5)/T(dur)2], where t = t - 5 hours, k = 0.149 for resting, and 0.047 for exercising divers, and t represents time after surfacing. The fits were assessed for 1,352 man-dives. Standard deviations of the residuals were 8.5% and 18.3% probability for resting or exercise dives, respectively.

  16. Psychosocial assessments for young people: a systematic review examining acceptability, disclosure and engagement, and predictive utility

    Directory of Open Access Journals (Sweden)

    Bradford S

    2012-12-01

    Full Text Available Sally Bradford,1 Debra Rickwood1,21Faculty of Health, University of Canberra, Canberra, 2Headspace National Youth Mental Health Foundation, North Melbourne, AustraliaAbstract: Adolescence and young adulthood are often turbulent periods in a person’s life. There are high rates of accidental deaths, suicide, mental health concerns, substance use, and sexual experimentation. Health care professionals need to conduct holistic assessments of clients in these developmental life stages to identify psychosocial risks and provide targeted early intervention and implement prevention strategies. The most useful psychosocial assessments for most health care professionals are those that can provide a complete picture of the young person’s life and circumstances. This article identifies psychosocial assessment instruments that can be used as an initial assessment and engagement tool with the general population of young people presenting for health care. We review the psychometric properties of each of the instruments, determining what type of instrument is most acceptable to young people, whether any can increase disclosure and improve engagement between young people and health professionals, and whether they have predictive utility. The search strategy complied with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement. A total of 89 published articles were identified, covering 31 different assessment instruments. Results indicated that those that were self-administered were most acceptable to young people, although it is unclear whether pen-and-paper or computer formats were preferred. Most psychosocial assessments can improve rates of disclosure and enhance engagement between young people and health professionals; however, worryingly, we found evidence that clinicians did not always respond to some of the most serious identified risks. Only for one instrument was there any mention of

  17. Geothermal Program Review X: proceedings. Geothermal Energy and the Utility Market -- the Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    Each year the Geothermal Division of the US Department of Energy conducts an in-depth review of its entire geothermal R&D program. The conference serves several purposes: a status report on current R&D activities, an assessment of progress and problems, a review of management issues, and a technology transfer opportunity between DOE and the US geothermal city. This year`s conference, Program Review X, was held in San Francisco on March 24--26, 1992. The theme of the review, ``Geothermal Energy and the Utility Market -- The Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market,`` focused on the needs of the electric utility sector. Geothermal energy, with its power capacity potential of 10 GWe by the year 2010, can provide reliable, enviromentally clean electricity which can help offset the projected increase in demand. Program Review X consisted of seven sessions including an opening session with presentations by Mr. Vikram Budhraja, Vice President of System Planning and Operations, Southern California Edison Company, and Mr. Richard Jaros, President and Chief Operating Officer, California Energy Company. The six technical sessions included presentations by the relevant field researchers covering DOE-sponsored R&D in hydrothermal, hot dry rock, and geopressured energy. Individual projects are processed separately for the data bases.

  18. Multi-Utilities : Trends - Blurring Industry Boundaries

    OpenAIRE

    Sommer, Dirk

    2001-01-01

    The prospects of cost savings, increased market share, and other competitive advantages are prompting more, and more utilities to cross traditional industry lines, and offer services in several sectors. The note reviews the changes occurred during the last two decades, when deregulation, and private sector development raised the quality, and expansion of utility services, opportunities enh...

  19. Impact of early in-hospital medication review by clinical pharmacists on health services utilization.

    Directory of Open Access Journals (Sweden)

    Corinne M Hohl

    . There was no significant effect on emergency department revisits, admissions, readmissions, or mortality.We were limited by our inability to conduct a randomized controlled trial, but used quasi-random patient allocation methods and propensity score modeling to ensure balance between treatment groups, and administrative data to ensure blinded outcomes ascertainment. We were unable to account for alternate level of care days, and therefore, may have underestimated the treatment effect in frail elderly patients who are likely to remain in hospital while awaiting long-term care.Early pharmacist-led medication review was associated with reduced hospital-bed utilization compared to usual care among high-risk patients under 80 years of age, but not among those who were older. The results of our evaluation suggest that medication review by pharmacists in the emergency department may impact the length of hospital stay in select patient populations.

  20. Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the empey index

    OpenAIRE

    Brake, Maria K.; Anderson, Jennifer

    2015-01-01

    Background Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. Methods A 13-year retr...

  1. Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa-a systematic review protocol.

    Science.gov (United States)

    Geleto, Ayele; Chojenta, Catherine; Mussa, Abdulbasit; Loxton, Deborah

    2018-04-16

    Nearly 15% of all pregnancies end in fatal perinatal obstetric complications including bleeding, infections, hypertension, obstructed labor, and complications of abortion. Between 1990 and 2015, an estimated 10.7 million women died due to obstetric complications. Almost all of these deaths (99%) happened in developing countries, and 66% of maternal deaths were attributed to sub-Saharan Africa. The majority of cases of maternal mortalities can be prevented through provision of evidence-based potentially life-saving signal functions of emergency obstetric care. However, different factors can hinder women's ability to access and use emergency obstetric services in sub-Saharan Africa. Therefore, the aim of this review is to synthesize current evidence on barriers to accessing and utilizing emergency obstetric care in sub-Saharan African. Decision-makers and policy formulators will use evidence generated from this review in improving maternal healthcare particularly the emergency obstetric care. Electronic databases including MEDLINE, CINAHL, Embase, and Maternity and Infant Care will be searched for studies using predefined search terms. Articles published in English language between 2010 and 2017 with quantitative and qualitative design will be included. The identified papers will be assessed for meeting eligibility criteria. First, the articles will be screened by examining their titles and abstracts. Then, two reviewers will review the full text of the selected articles independently. Two reviewers using a standard data extraction format will undertake data extraction from the retained studies. The quality of the included papers will be assessed using the mixed methods appraisal tool. Results from the eligible studies will be qualitatively synthesized using the narrative synthesis approach and reported using the three delays model. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be employed to present the findings. This

  2. Overcoming Structural Constraints to Patient Utilization of Electronic Medical Records: A Critical Review and Proposal for an Evaluation Framework

    OpenAIRE

    Winkelman, Warren J.; Leonard, Kevin J.

    2004-01-01

    There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An ...

  3. Collegiate athletes'mental health services utilization:A systematic review of conceptualizations,operationalizations,facilitators,and barriers

    Institute of Scientific and Technical Information of China (English)

    Jennifer J.Moreland; Kathryn A.Coxe; Jingzhen Yang

    2018-01-01

    Background: While mental health among collegiate athletes is receiving increased attention,research on factors surrounding collegiate athletes' decision to seek mental health services is limited.The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes'utilization of mental health services,including the facilitators of and barriers to use of these services. Methods: The analysis was guided and organized using a socio-ecological framework,which considered the unique context in which collegiate athletes study and perform.A total of 21 articles,published between 2005 and 2016,which concern U.S.collegiate athletes'mental health services utilization(MHSU)were selected and included for the final analysis.Conceptualizations and operationalizations of MHSU were compared and contrasted.Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor(facilitator or barrier)to the athletes. Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed,which made interpretation and cross comparison difficult.Collegiate athletes are willing to utilize mental health services,but gender,perceived stigma,peer norms—for athletes and coaches—plus service availability impact their MHSU. Conclusion: Key stakeholders,administrators,and public health officials should partner to eliminate MHSU barriers,support facilitators,and generally empower collegiate athletes to actively manage their mental health.

  4. Probiotic Properties of Exopolysaccharide-Producing Lactobacillus Strains Isolated from Tempoyak

    Directory of Open Access Journals (Sweden)

    Eilaf Suliman Khalil

    2018-02-01

    Full Text Available Tempoyak is a functional Malaysian food (an acid-fermented condiment which is produced from the pulp of the durian (Durio zibethinus fruit. The current study aimed to isolate and identify potential exopolysaccharide (EPS-producing Lactobacillus strains from tempoyak for potential use as probiotics. Seven isolates (DUR2, DUR4, DUR5, DUR8, DUR12, DUR18, and DUR20 out of 44 were able to produce EPS, and exhibited resistance to acid and bile salt compared to the reference strains Lactobacillus rhmnosus (ATCC53103 and L. plantarum (ATCC8014. The seven isolated strains belonged to five different species—L. plantarum, L. fermentum, L. crispatus, L. reuteri, and L. pentosus—which were identified using API 50 CHL and 16S rRNA gene sequences (Polymerase chain reaction, PCR – based. The seven strains displayed different ability to produce EPS (100–850 mg/L. Isolates exhibited a high survivability to acid (pH 3.0, bile salts (0.3%, and gastrointestinal tract model (<70%. Results showed that the auto-aggregation and cell surface hydrophobicity ranged from 39.98% to 60.09% and 50.80% to 80.53%, respectively, whereas, the highest co-aggregation value (66.44% was observed by L. fermentum (DUR8 with Pseudomonas aeruginosa. The isolates showed good inhibitory activity against tested pathogens, high antioxidant activity (32.29% to 73.36%, and good ability to reduce cholesterol (22.55% to 75.15%. Thus, the seven tested strains have value as probiotics.

  5. A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain

    Directory of Open Access Journals (Sweden)

    King JB

    2015-08-01

    Full Text Available Jordan B King, Marisa B Schauerhamer, Brandon K Bellows Pharmacotherapy Outcomes Research Center, University of Utah College of Pharmacy, Salt Lake City, UT, USA Abstract: Diabetes mellitus is a world-wide epidemic with many long-term complications, with neuropathy being the most common. In particular, diabetic peripheral neuropathic pain (DPNP, can be one of the most distressing complications associated with diabetes, leading to decreases in physical and mental quality of life. Despite the availability of many efficient medications, DPNP remains a challenge to treat, and the optimal sequencing of pharmacotherapy remains unknown. Currently, there are only three medications approved by the US Food and Drug Administration specifically for the management of DPNP. Duloxetine (DUL, a selective serotonin-norepinephrine reuptake inhibitor, is one of these. With the goal of optimizing pharmacotherapy use in DPNP population, a review of current literature was conducted, and the clinical utility of DUL described. Along with early clinical trials, recently published observational studies and pharmacoeconomic models may be useful in guiding decision making by clinicians and managed care organizations. In real-world practice settings, DUL is associated with decreased or similar opioid utilization, increased medication adherence, and similar health care costs compared with current standard of care. DUL has consistently been found to be a cost-effective option over short time-horizons. Currently, the long-term cost-effectiveness of DUL is unknown. Evidence derived from randomized clinical trials, real-world observations, and economic models support the use of DUL as a first-line treatment option from the perspective of the patient, clinician, and managed care payer. Keywords: clinical trials, pharmacoeconomic studies, opioid-utilization, health care utilization, pregabalin, tricyclic antidepressants, gabapentin

  6. Recent market behavior of utility stocks

    International Nuclear Information System (INIS)

    Studness, C.M.

    1990-01-01

    This article reviews the recent market behavior of utility stocks as compared to the Standard and Poor's 500 and the long-term government bond yield. Utility stock's performance continues to be affected by unfavorable regulation,and it appears that it will continue to be a factor for some time to come. A continually shrinking excess capacity continues to be a concern

  7. Best Practices in School-to-Careers: The Utilities Industry.

    Science.gov (United States)

    National Employer Leadership Council, Washington, DC.

    This document highlights the school-to-careers (STC) partnerships connecting workplace experiences to classroom learning to prepare students for successful employment in the utilities industry. First, the current state of the utilities industry and careers in the utilities industry are reviewed. Next, the following organizations and employers are…

  8. Pediatric hospital discharge interventions to reduce subsequent utilization: a systematic review.

    Science.gov (United States)

    Auger, Katherine A; Kenyon, Chén C; Feudtner, Chris; Davis, Matthew M

    2014-04-01

    Reducing avoidable readmission and posthospitalization emergency department (ED) utilization has become a focus of quality-of-care measures and initiatives. For pediatric patients, no systematic efforts have assessed the evidence for interventions to reduce these events. We sought to synthesize existing evidence on pediatric discharge practices and interventions to reduce hospital readmission and posthospitalization ED utilization. PubMed and the Cumulative Index to Nursing and Allied Health Literature. Studies available in English involving pediatric inpatient discharge interventions with at least 1 outcome of interest were included. We utilized a modified Cochrane Good Practice data extraction tool and assessed study quality with the Downs and Black tool. Our search identified a total of 1296 studies, 14 of which met full inclusion criteria. All included studies examined multifaceted discharge interventions initiated in the inpatient setting. Overall, 2 studies demonstrated statistically significant reductions in both readmissions and subsequent ED visits, 4 studies demonstrated statistically significant reductions in either readmissions or ED visits, and 2 studies found statistically significant increases in subsequent utilization. Several studies were not sufficiently powered to detect changes in either subsequent utilization outcome measure. Interventions that demonstrated reductions in subsequent utilization targeted children with specific chronic conditions, providing enhanced inpatient feedback and education reinforced with postdischarge support. Interventions seeking to reduce subsequent utilization should identify an individual or team to assume responsibility for the inpatient-to-outpatient transition and offer ongoing support to the family via telephone or home visitation following discharge. © 2013 Society of Hospital Medicine.

  9. Strategies for the plutonium utilization

    International Nuclear Information System (INIS)

    Zouain, D.M.; Lima, J.O.V.; Sakamoto, L.H.

    1981-11-01

    A review of the activities involving plutonium (its recycle, utilization and technological status and perspectives) is done. These informations are useful for an economic viability study for the plutonium utilization in thermal reactors (recycling) and in fast breeders reactor (FBR), trying to collect the major number of informations about these subjects. The initial phase describes the present status and projections of plutonium accumulation and requirements. Then, the technological process are described and some strategies are analyzed. (E.G.) [pt

  10. Apa-Tappi Whole-Tree Utilization Committee: review of achievements

    Energy Technology Data Exchange (ETDEWEB)

    Plummer, G M

    1978-03-01

    The Apa-Tappi Whole-Tree Utilization Committee started its activities in mid-1974 with people who pioneered the concept of whole-tree chipping. The major problem retarding expansion of use of these chips was determined to be grit and dirt, which is primarily associated with bark and foliage. Utilization of research and tests by member companies and communication with manufacturers resulted in commercial applications that improved chip quality. Other achievements have been the establishment of a nationwide project to develop tree-weight tables, documentation of associated problems, harvesting equipment improvements, screening and separation advances, and needed research work.

  11. Advancing Partner Notification Through Electronic Communication Technology: A Review of Acceptability and Utilization Research.

    Science.gov (United States)

    Pellowski, Jennifer; Mathews, Catherine; Kalichman, Moira O; Dewing, Sarah; Lurie, Mark N; Kalichman, Seth C

    2016-06-01

    A cornerstone of sexually transmitted infection (STI) prevention is the identification, tracing, and notification of sex partners of index patients. Although partner notification reduces disease burden and prevents new infections as well as reinfections, studies show that only a limited number of partners are ever notified. Electronic communication technologies, namely, the Internet, text messaging, and phone calls (i.e., e-notification), have the potential to expand partner services. We conducted a systematic review of studies that have investigated the acceptability and utility of e-notification. We identified 23 studies that met the following criteria: (a) 9 studies presented data on the acceptability of technology-based communications for contacting sex partner(s), and (b) 14 studies reported on the utilization of communication technologies for partner notification. Studies found high levels of interest in and acceptability of e-notification; however, there was little evidence for actual use of e-notification. Taken together, results suggest that electronic communications could have their greatest impact in notifying less committed partners who would otherwise be uninformed of their STI exposure. In addition, all studies to date have been conducted in resource-rich countries, although the low cost of e-notification may have its greatest impact in resource-constrained settings. Research is needed to determine the best practices for exploiting the opportunities afforded by electronic communications for expanding STI partner services.

  12. Inter-utility trade in electricity

    International Nuclear Information System (INIS)

    Penman, A.

    1992-01-01

    Enhanced inter-utility cooperation could have a profound effect on the future of the electricity supply industry. Coordinated planning, development, and operations of electric power systems have the potential to reduce the cost of electricity to consumers and to lessen the impact of electricity supply on the environment. These effects could be achieved by being able to supply electricity from lower cost and more environmentally benign sources located over wider geographic areas, and having to install less new generating capacity. Access to transmission and wheeling services would be an important factor in allowing increased inter-utility cooperation to occur. Canada's National Energy Board conducted a review to identify measures that can be taken to enhance interprovincial trade in electricity, to encourage greater cooperation between electric utilities in the areas of systems planning and development, and to enable buyers and sellers of electricity to obtain access to available transmission capacity through intervening provinces for wheeling purposes. The work undertaken by the Board during that review is described. A total estimated economic benefit of $23-32.5 billion was identified, mainly from long-term firm sales and from seasonal diversity exchanges. Four options were developed that appear to be available to encourage and achieve enhanced inter-utility cooperation. These are continuation of voluntary cooperation, voluntary cooperation with federal monitoring, establishing voluntary regional planning entities, and establishing regional planning entities with mandated federal power

  13. Practical constraints on fuel management a utility perspective

    International Nuclear Information System (INIS)

    Grier, C.A.

    1986-01-01

    The practical and potential constraints of performing fuel management at a large utility are reviewed. Based on approximately six years of experience in performing fuel management the constraints due to commercial, technical, utility system, design methods, and personnel and computer resources are discussed in detail

  14. Methods in pharmacoepidemiology: a review of statistical analyses and data reporting in pediatric drug utilization studies.

    Science.gov (United States)

    Sequi, Marco; Campi, Rita; Clavenna, Antonio; Bonati, Maurizio

    2013-03-01

    To evaluate the quality of data reporting and statistical methods performed in drug utilization studies in the pediatric population. Drug utilization studies evaluating all drug prescriptions to children and adolescents published between January 1994 and December 2011 were retrieved and analyzed. For each study, information on measures of exposure/consumption, the covariates considered, descriptive and inferential analyses, statistical tests, and methods of data reporting was extracted. An overall quality score was created for each study using a 12-item checklist that took into account the presence of outcome measures, covariates of measures, descriptive measures, statistical tests, and graphical representation. A total of 22 studies were reviewed and analyzed. Of these, 20 studies reported at least one descriptive measure. The mean was the most commonly used measure (18 studies), but only five of these also reported the standard deviation. Statistical analyses were performed in 12 studies, with the chi-square test being the most commonly performed test. Graphs were presented in 14 papers. Sixteen papers reported the number of drug prescriptions and/or packages, and ten reported the prevalence of the drug prescription. The mean quality score was 8 (median 9). Only seven of the 22 studies received a score of ≥10, while four studies received a score of statistical methods and reported data in a satisfactory manner. We therefore conclude that the methodology of drug utilization studies needs to be improved.

  15. Assessment of Research Needs for Coal Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Penner, S.S.

    1983-08-01

    The Coal Combustion and Applications Working Group (CCAWG), at the request of J.W. Mares (Assistant Secretary for Fossil Energy) and A.W. Trivelpiece (Director, Office of Energy Research), has reviewed and evaluated the U.S. programs on coal combustion and utilization. The important topical areas of coal gasification and coal liquefaction have been deliberately excluded because R and D needs for these technologies were reviewed previously by the DOE Fossil Energy Research Working Group. The CCAWG studies were performed in order to provide an independent assessment of research areas that affect prospects for augmented coal utilization. In this report, we summarize the findings and research recommendations of CCAWG.

  16. Barriers to and Facilitators of Research Utilization among Iranian Nurses: a Literature Review.

    Science.gov (United States)

    Heydari, Abbas; Emami Zeydi, Amir

    2014-12-01

    Research utilization (RU), is an important strategy to promote the quality of patient care. The aim of this study was to present a comprehensive literature review describing barriers and facilitators of RU among Iranian nurses. Literature review was undertaken using the international databases including Pub Med/Medline, Scopus, Science Direct, and Google Scholar. Also, Persian electronic databases such as Magiran, SID and Iran Medex were searched up to May 2014. The search was limited to articles in the English and Persian languages that evaluate the barriers or facilitators of RU among Iranian nurses. A total of 11 articles were in the final dataset. The most important barriers to RU among Iranian nurses were related to the organization factors such as inadequate facilities; insufficient time on the job, lack of authority, physician cooperation, and administrative support. The most frequent facilitators of RU were education in enhancing nurses knowledge and skills in research evaluation, support from knowledgeable nursing colleagues and nursing faculty in the clinical setting, access to an expert committee for clinical appraisal, improving skills in English language and searching for articles, sufficient economic resources to carry out research, and having access to more facilities such as internet. Iranian nurses encounter with the same difficulties as to other countries regarding RU; while setting related barriers were the predominant obstacles to RU among them. Therefore, health managers are expected to plan appropriate strategies to smooth the progress of RU by nurses in their practice.

  17. VALUE-BASED MEDICINE AND OPHTHALMOLOGY: AN APPRAISAL OF COST-UTILITY ANALYSES

    Science.gov (United States)

    Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

    2004-01-01

    ABSTRACT Purpose To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Methods Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year ($/QALY) was ascertained in all instances. Results A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was $5,219/QALY, with a range from $746/QALY to $6.5 million/QALY. Conclusions The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended. PMID:15747756

  18. Ten-year study of municipal utilities. Review and forecast. Cooperations are getting ever more important; Zehn Jahre Stadtwerkestudie. Ein Rueck- und Ausblick. Kooperationen werden noch wichtiger

    Energy Technology Data Exchange (ETDEWEB)

    Edelmann, Helmut [Ernst und Young GmbH Wirtschaftspruefungsgesellschaft, Duesseldorf (Germany)

    2012-08-20

    Since 2003 Ernst and Young, in cooperation with the BDEW (Bundesverband der Energie- und Wasserwirtschaft e.V., German Association of Energy and Water Utilities), have been carrying out annual enquiries among leading managers of municipal and regional utilities in Germany. The focus is on current issues of the power supply sector and the economic situation of the organizations under investigation. This contribution presents a review and a look into the future.

  19. Estado ecológico del sistema estuarino del Río Guayas, Cantón Durán, Ecuador: Simulación numérica de su dinámica fluvial y principios ecológicos para el diseño de actuaciones de restauración y/o recuperación

    OpenAIRE

    Olaya Carbo, Peter

    2016-01-01

    46 p. El cantón Durán está emplazado en una zona de transición entre el agua dulce del río Guayas y el agua salobre del mar, las principales actividades de la región son la agricultura, ganadería, y las industrias; con la llegada del invierno, la región se somete a inundaciones que producen complicaciones socioeconómicas debido al uso antrópico de áreas inundables, además el río Guayas presenta un pobre estado de conservación ecológico (RQI, Riparian Quality Index=30), debido en gran parte...

  20. Enhanced defect of interest [DOI] monitoring by utilizing sensitive inspection and ADRTrue SEM review

    Science.gov (United States)

    Kirsch, Remo; Zeiske, Ulrich; Shabtay, Saar; Beyer, Mirko; Yerushalmi, Liran; Goshen, Oren

    2011-03-01

    As semiconductor process design rules continue to shrink, the ability of optical inspection tools to separate between true defects and nuisance becomes more and more difficult. Therefore, monitoring Defect of Interest (DOI) become a real challenge (Figure 1). This phenomenon occurs due to the lower signal received from real defects while noise levels remain almost the same, resulting in inspection high nuisance rate, which jeopardizes the ability to provide a meaningful, true defect Pareto. A non-representative defect Pareto creates a real challenge to a reliable process monitoring (Figure 4). Traditionally, inspection tool recipes were optimized to keep data load at a manageable level and provide defect maps with ~10% nuisance rate, but as defects of interest get smaller with design rule shrinkage, this requirement results in a painful compromise in detection sensitivity. The inspection is usually followed by defect review and classification using scanning electron microscope (SEM), the classification done manually and it is performed on a small sample of the inspection defect map due to time and manual resources limitations. Sample is usually 50~60 randomly selected locations, review is performed manually most of the times, and manual classification is performed for all the reviewed locations. In the approach described in this paper, the inspection tool recipe is optimized for sensitivity rather than low nuisance rate (i.e. detect all DOI with compromising on a higher nuisance rate). Inspection results with high nuisance rate introduce new challenges for SEM review methodology & tools. This paper describe a new approach which enhances process monitoring quality and the results of collaborative work of the Process Diagnostic & Control Business Unit of Applied Materials® and GLOBALFOUNDRIES® utilizing Applied Materials ADRTrueTM & SEMVisionTM capabilities. The study shows that the new approach reveals new defect types in the Pareto, and improves the ability to

  1. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review.

    Directory of Open Access Journals (Sweden)

    Cyrus A Raji

    Full Text Available PURPOSE: This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT in traumatic brain injury (TBI. METHODS: After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement, PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. RESULTS: We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94% and temporal (77% lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. CONCLUSIONS: This review demonstrates Level IIA evidence (at least one non-randomized controlled trial for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post

  2. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review.

    Science.gov (United States)

    Raji, Cyrus A; Tarzwell, Robert; Pavel, Dan; Schneider, Howard; Uszler, Michael; Thornton, John; van Lierop, Muriel; Cohen, Phil; Amen, Daniel G; Henderson, Theodore

    2014-01-01

    This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.

  3. Chemical composition and utilization of Hungarian spent sulfite liquor

    Energy Technology Data Exchange (ETDEWEB)

    Toth, B

    1968-01-01

    A review on the composition of Hungarian spent sulfite liquor and on its possible utilization, e.g., for the manufacturing of vanillin, yeast protein, or ethanol, as well as its direct utilization as a plasticizer for cement, additive for insecticides, or in adhesives.

  4. The energy-efficiency business - Energy utility strategies

    International Nuclear Information System (INIS)

    Loebbe, S.

    2009-01-01

    This article takes a look at the energy-efficiency business and the advantages it offers. The author quotes that energy-efficiency can contribute to making savings in primary energy, minimise the economic impact of global warming, improve reliability of supply and protect the gross national product. The advantages of new products for the efficient use of energy are reviewed and the resulting advantages for power customers are noted. Also, possibilities for the positioning of electricity suppliers in the environmental niche is noted. The partial markets involved and estimates concerning the impact of energy-efficiency measures are reviewed. Climate protection, co-operation with energy agencies, consulting services and public relations aspects are also discussed. The prerequisites for successful marketing by the utilities are examined and new business models are discussed along with the clear strategies needed. The development from an electricity utility to a system-competence partner is reviewed

  5. Electric energy utilization and conservation

    International Nuclear Information System (INIS)

    Tripathy, S.C.

    1991-01-01

    Various aspects of electric energy utilization and conservation are discussed. First chapter reviews thermodynamic aspects of energy conservation. Subsequent chapters describe possibilities and methods of energy conservation in thermal power plants, airconditioning and ventilation systems, electric lighting systems, electric heating systems in industries, and railway electrification. Chapter 8 describes various modes of energy storage and compares their economies. The next chapter discusses various facets of energy economics and the last chapter discusses the practical aspects of energy conservation in different industries and power utilities. (M.G.B.). 100 refs

  6. Multispecialty retrospective review of the clinical utility of pelvic magnetic resonance imaging in the setting of pelvic pain.

    Science.gov (United States)

    Moore, John R; Pathak, Ram A; Snowden, Caroline; Bolan, Candice W; Young, Paul R; Broderick, Gregory A

    2017-12-01

    Pelvic pain is a common complaint, and management of it is often difficult. We sought to evaluate the utility of magnetic resonance imaging (MRI) in the diagnosis of male pelvic pain. Though MRIs are commonly ordered to evaluate pelvic pain, there are very few studies obtaining the efficacy of pelvic MRI in determining a definitive diagnosis. The primary aim of our study was to evaluate the clinical utility of pelvic MRI for a diagnosis code that included pain. After receiving institutional review board approval, a retrospective study was performed of all pelvic MRIs completed at our institution from January 2, 2010 to December 31, 2014. These were further delineated into ordering providers by specialty and urology-specific International Classification of Diseases, Ninth Revision (ICD-9) code diagnoses (male pelvic pain, prostatitis, groin pain, scrotal pain, testicular pain, and penile pain). Clinical utility was defined as positive if MRI findings resulted in a change in management. Subanalysis was performed on patients with an ICD-9 co-diagnosis of previous oncologic concern. A total of 2,643 pelvic MRIs were ordered at our institution over a 5-year period. Of these, 597 pelvic MRIs (23%) were ordered for a diagnosis code that included pain (hip pain, rectal pain, joint pain, penile pain, scrotal pain, male pelvic pain and orchitis). Total utility for MRIs to find anatomic abnormalities potentially responsible for the present pain was 34% (205/597). When ordered by urologic providers, utility was 23%. Oncologists represented the highest positivity rate at 57%. Chronic pelvic pain is a multispecialty complaint that is difficult to treat. We were surprised to find the large number of both specialists and generalists invested in the management of pelvic pain. The increasing availability of MRI technology makes it a likely candidate to test for a clinically significant anatomic reason for pain. Though MRI is a test with minimal adverse effect and no increased risk

  7. Natural gas opportunities, utilization and trades (in a European context)

    International Nuclear Information System (INIS)

    Corke, M.J.

    1996-01-01

    The historical development of natural gas consumption in Europe has relied heavily on requirements for space heating energy in the residential/commercial sector and for process energy and feedstock in the industrial sector. This paper reviews historical gas utilization trends and considers how these are likely to develop in the future. In addition to the above somewhat negative factors, the bright outlook for gas utilization in both large scale and small scale power and cogeneration facilities is reviewed and the implications of power industry restructuring for natural gas utilization are discussed. Finally, the outlook for overall European natural gas demand and trade is briefly considered. (author)

  8. Application of the Andersen's health care utilization framework to secondary complications of spinal cord injury: a scoping review.

    Science.gov (United States)

    Guilcher, Sara J T; Craven, B Cathy; McColl, Mary Ann; Lemieux-Charles, Louise; Casciaro, Tiziana; Jaglal, Susan B

    2012-01-01

    The purpose of this scoping review was to identify research priority areas related to secondary complications and associated health care use for individuals with spinal cord injury (SCI). Peer-reviewed journals were identified using CINAHL, MEDLINE, PubMed, Embase, Social Sciences Abstracts, Social Works Abstract and PsycInfo search engines. Key references were hand searched. A total of 289 abstracts were identified from the initial search strategy. We removed studies that did not measure health care and those that did not involve analytical investigation. The selected 31 studies were reviewed in detail using a coding template based on the domains and sub-components of the Andersen model (i.e. environmental, population characteristics, health behavior and outcome). Most studies measured predisposing characteristics (e.g., age, gender) and need characteristics (e.g., level of injury). There was a notable absence of environmental characteristics (e.g., health system, neighborhood variables), enabling characteristics and health behaviors (beyond diet and nutrition). We identified a gap in the SCI literature. Future research should focus on longitudinal study designs with more representation of non-traumatic spinal cord injury, as well as utilizing more advanced statistical analyses (i.e., multivariate level) to adjust for confounding variables.

  9. Overcoming structural constraints to patient utilization of electronic medical records: a critical review and proposal for an evaluation framework.

    Science.gov (United States)

    Winkelman, Warren J; Leonard, Kevin J

    2004-01-01

    There are constraints embedded in medical record structure that limit use by patients in self-directed disease management. Through systematic review of the literature from a critical perspective, four characteristics that either enhance or mitigate the influence of medical record structure on patient utilization of an electronic patient record (EPR) system have been identified: environmental pressures, physician centeredness, collaborative organizational culture, and patient centeredness. An evaluation framework is proposed for use when considering adaptation of existing EPR systems for online patient access. Exemplars of patient-accessible EPR systems from the literature are evaluated utilizing the framework. From this study, it appears that traditional information system research and development methods may not wholly capture many pertinent social issues that arise when expanding access of EPR systems to patients. Critically rooted methods such as action research can directly inform development strategies so that these systems may positively influence health outcomes.

  10. Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

    Science.gov (United States)

    Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

    2016-07-13

    Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for

  11. Impact of power purchases from nonutilities on the utility cost of capital

    International Nuclear Information System (INIS)

    Kahn, E.; Stoft, S.; Belden, T.

    1994-03-01

    This report studies the debt-equivalence debate empirically. The topics of the study include a review of the literature on the cost of equity capital for regulated utilities, a formulation of the debate on NUGs and the utility's cost of capital, a review of variable definitions and data sources, and a discussion of statistical issues and results

  12. Decentralized method for utility regulation

    Energy Technology Data Exchange (ETDEWEB)

    Loeb, M. (North Carolina State Univ., Raleigh); Magat, W.A.

    1979-10-01

    A new institutional arrangement for regulating utilities is suggested that minimizes the costs of natural monopolies. A mixture of regulation and franchising, the plan draws on the advantages of each and eliminates many of the problems. The proposal allows utilities to set their own price on the basis of demand and marginal-cost projections. Subsidies are provided by the regulatory agency if there is a consumer surplus. The system encourages the utility to select a competitive price and to produce only the amount of service needed. Operating efficiency is encouraged by rewarding cost reductions and discouraging cost overstatement at the rate review. The regulatory agency would not need to take action to bring price and marginal costs into equality. The franchise sale can be made by competitive bidding, in which the bidders would capitalize part or all of the subsidy or the regulatory agency could recover the subsidy in a lump-sum tax on the utility.

  13. The utility and impact of information communication technology (ICT) for pre-registration nurse education: A narrative synthesis systematic review.

    Science.gov (United States)

    Webb, Lucy; Clough, Jonathan; O'Reilly, Declan; Wilmott, Danita; Witham, Gary

    2017-01-01

    To evaluate and summarise the utility and impact of information communication technology (ICT) in enhancing student performance and the learning environment in pre-registration nursing. A systematic review of empirical research across a range of themes in ICT health-related education. Science Direct, Cinahl, AMED, MEDLINE, PubMed, ASSIA, OVID and OVID SP (2008-2014). Further date parameters were imposed by theme. Evidence was reviewed by narrative synthesis, adopting Caldwell's appraisal framework and CASP for qualitative methods. Selection and inclusion was grounded in the PICOS structure, with language requirements (English), and further parameters were guided by theme appropriateness. Fifty studies were selected for review across six domains: reusable learning objects, media, audience response systems, e-portfolios, computer-based assessment and faculty adoption of e-learning. Educational ICT was found to be non-inferior to traditional teaching, while offering benefits to teaching and learning efficiency. Where support is in place, ICT improves the learning environment for staff and students, but human and environmental barriers need to be addressed. This review illuminates more advantages for ICT in nurse training than previously. The key advantage of flexibility is supported, though with little evidence for effect on depth of learning. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  14. Thorium utilization

    Energy Technology Data Exchange (ETDEWEB)

    Trauger, D B [Oak Ridge National Lab., TN (USA)

    1978-01-01

    Some of the factors that provide incentive for the utilization of thorium in specific reactor types are explored and the constraints that stand in the way are pointed out. The properties of thorium and derived fuels are discussed, and test and reactor operating experience is reviewed. In addition, symbiotic systems of breeder and converter reactor are suggested as being particularly attractive systems for energy production. Throughout the discussion, the High-Temperature Gas-Cooled Reactor and Molten Salt Reactor are treated in some detail because they have been developed primarily for use with thorium fuel cycles.

  15. An Anthological Review of Research Utilizing MontyLingua: a Python-Based End-to-End Text Processor

    Directory of Open Access Journals (Sweden)

    2008-06-01

    Full Text Available MontyLingua, an integral part of ConceptNet which is currently the largest commonsense knowledge base, is an English text processor developed using Python programming language in MIT Media Lab. The main feature of MontyLingua is the coverage for all aspects of English text processing from raw input text to semantic meanings and summary generation, yet each component in MontyLingua is loosely-coupled to each other at the architectural and code level, which enabled individual components to be used independently or substituted. However, there has been no review exploring the role of MontyLingua in recent research work utilizing it. This paper aims to review the use of and roles played by MontyLingua and its components in research work published in 19 articles between October 2004 and August 2006. We had observed a diversified use of MontyLingua in many different areas, both generic and domain-specific. Although the use of text summarizing component had not been observe, we are optimistic that it will have a crucial role in managing the current trend of information overload in future research.

  16. Electric utilities look back on 1998

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    A review of activities in the electric power industry in Canada during 1998 is presented. In general, the principal preoccupation of Canadian electric utilities in 1998 was preparation for competition in a deregulated energy market. Utilities worked with provincial and national legislatures to redraw the rules of power supply. US FERC order 888 was central to many debates. FERC order 888 stipulates the unbundling of the retail aspects of operations from those that will remain regulated. Electric utilities also continued to prepare for the Y2K phenomenon and to work towards achieving ISO 14001 environmental management accreditation. They also explored alternative means of power generation. The year began with utilities across Canada sharing expertise and manpower to mitigate the impact of the ice storm which devastated parts of Quebec, Ontario and New Brunswick. It is believed that as a result of the ice storm of 1998, the Canadian utility industry is much better prepared to deal with weather-related emergencies than ever before. 1 fig

  17. Solar thermal utilization--an overview

    International Nuclear Information System (INIS)

    Chen Deming; Xu Gang

    2007-01-01

    Solar energy is an ideal renewable energy source and its thermal utilization is one of its most important applications. We review the status of solar thermal utilization, including: (1) developed technologies which are already widely used all over the world, such as solar assisted water heaters, solar cookers, solar heated buildings and so on; (2) advanced technologies which are still in the development or laboratory stage and could have more innovative applications, including thermal power generation, refrigeration, hydrogen production, desalination, and chimneys; (3) major problems which need to be resolved for advanced utilizaiton of solar thermal energy. (authors)

  18. NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

    Science.gov (United States)

    The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

  19. Power station fly ash. A review of value-added utilization outside of the construction industry

    International Nuclear Information System (INIS)

    Iyer, R.S.; Scott, J.A.

    2001-01-01

    The disposal of fly ash from coal-fired power stations causes significant economic and environmental problems. A relatively small percentage of the material finds application as an ingredient in cement and other construction products, but the vast majority of material generated each year is held in ash dams or similar dumps. This unproductive use of land and the associated long-term financial burden of maintenance has led to realization that alternative uses for fly ash as a value-added product beyond incorporation in construction materials are needed. Utilization of fly ash in such areas as novel materials, waste management, recovery of metals and agriculture is reviewed in this article with the aim of looking at new areas that will expand the positive reuse of fly ash, thereby helping to reduce the environmental and economic impacts of disposal

  20. Indoor air quality in public utility environments-a review.

    Science.gov (United States)

    Śmiełowska, Monika; Marć, Mariusz; Zabiegała, Bożena

    2017-04-01

    Indoor air quality has been the object of interest for scientists and specialists from the fields of science such as chemistry, medicine and ventilation system design. This results from a considerable number of potential factors, which may influence the quality of the broadly understood indoor air in a negative way. Poor quality of indoor air in various types of public utility buildings may significantly affect an increase in the incidence of various types of civilisation diseases. This paper presents information about a broad spectrum of chemical compounds that were identified and determined in the indoor environment of various types of public utility rooms such as churches, museums, libraries, temples and hospitals. An analysis of literature data allowed for identification of the most important transport paths of chemical compounds that significantly influence the quality of the indoor environment and thus the comfort of living and the health of persons staying in it.

  1. The relationship between movement speed and duration during soccer matches

    Science.gov (United States)

    Mahler, Hubert; Heyde, Christian; Röll, Mareike; Gollhofer, Albert

    2017-01-01

    The relationship between the time duration of movement (t(dur)) and related maximum possible power output has been studied and modeled under many conditions. Inspired by the so-called power profiles known for discontinuous endurance sports like cycling, and the critical power concept of Monod and Scherrer, the aim of this study was to evaluate the numerical characteristics of the function between maximum horizontal movement velocity (HSpeed) and t(dur) in soccer. To evaluate this relationship, GPS data from 38 healthy soccer players and 82 game participations (≥30 min active playtime) were used to select maximum HSpeed for 21 distinct t(dur) values (between 0.3 s and 2,700 s) based on moving medians with an incremental t(dur) window-size. As a result, the relationship between HSpeed and Log(t(dur)) appeared reproducibly as a sigmoidal decay function, and could be fitted to a five-parameter equation with upper and lower asymptotes, and an inflection point, power and decrease rate. Thus, the first three parameters described individual characteristics if evaluated using mixed-model analysis. This study shows for the first time the general numerical relationship between t(dur) and HSpeed in soccer games. In contrast to former descriptions that have evaluated speed against power, HSpeed against t(dur) always yields a sigmoidal shape with a new upper asymptote. The evaluated curve fit potentially describes the maximum moving speed of individual players during the game, and allows for concise interpretations of the functional state of team sports athletes. PMID:28742832

  2. Consensus standards utilized and implemented for nuclear criticality safety in Japan

    International Nuclear Information System (INIS)

    Nomura, Yasushi; Okuno, Hiroshi; Naito, Yoshitaka

    1996-01-01

    The fundamental framework for the criticality safety of nuclear fuel facilities regulations is, in many advanced countries, generally formulated so that technical standards or handbook data are utilized to support the licensing safety review and to implement its guidelines. In Japan also, adequacy of the safety design of nuclear fuel facilities is checked and reviewed on the basis of licensing safety review guides. These guides are, first, open-quotes The Basic Guides for Licensing Safety Review of Nuclear Fuel Facilities,close quotes and as its subsidiaries, open-quotes The Uranium Fuel Fabrication Facility Licensing Safety Review Guidesclose quotes and open-quotes The Reprocessing Facility Licensing Safety Review Guides.close quotes The open-quotes Nuclear Criticality Safety Handbook close-quote of Japan and the Technical Data Collection are published and utilized to supply related data and information for the licensing safety review, such as for the Rokkasho reprocessing plant. The well-established technical standards and data abroad such as those by the American Nuclear Society and the American National Standards Institute are also utilized to complement the standards in Japan. The basic principles of criticality safety control for nuclear fuel facilities in Japan are duly stipulated in the aforementioned basic guides as follows: 1. Guide 10: Criticality control for a single unit; 2. Guide 11: Criticality control for multiple units; 3. Guide 12: Consideration for a criticality accident

  3. TWRS LDUA utilization study report

    International Nuclear Information System (INIS)

    Rieck, R.H.

    1994-01-01

    Tank Waste Remediation Systems functional requirements were reviewed. The Light Duty Utility Arm capabilities were considered as a means to support completion of these functional requirements. The recommendation is made to continue to develop the LDUA, integrating TWRS functional needs into the design to better support completion of TWRS mission needs

  4. Utility requirements for fusion power

    International Nuclear Information System (INIS)

    DeBellis, R.J.

    1977-03-01

    A four-man month study was undertaken to identify utility requirements of fusion power and define a role for the utilities in the fusion development process during the 1980s. This report, preliminary in nature, serves mainly as a planning document for future requirements analyses. A requirements organization was defined to consist of three major chronological phases: research and development, plant installation, and plant operation. Thirty-seven requirements were identified, covering all categories. In addition, training, environment, safety, licensing, and utility model were identified as five matrix-type requirements. As the requirement definition process continued during the study period, comments received from utility representatives revealed a consistency of key issues in the fusion development process. These issues form the basis for the eventual establishment of definitive roles for the utilities during the 1980s. The issues are not meant to reflect a negative view of fusion, but are items that must be solved before fusion can be introduced commercially as an electrical power source. As a result of this requirements study, preliminary candidate roles for the utilities in the fusion development process during the 1980s were identified as public education, commercialization studies, industry investment analyses, training plan implementation, alternate reactor concept development, ERDA concept design review, and requirements refinement

  5. Decision support for utility environmental risk management

    International Nuclear Information System (INIS)

    Balson, W.E.; Wilson, D.S.

    1991-01-01

    This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment

  6. Utility of serum pancreatic enzyme levels in diagnosing blunt trauma to the pancreas: a prospective study with systematic review.

    Science.gov (United States)

    Mahajan, Abhishek; Kadavigere, Rajagopal; Sripathi, Smiti; Rodrigues, Gabriel Sunil; Rao, Vedula Rajanikanth; Koteshwar, Prakashini

    2014-09-01

    Reliability of serum pancreatic enzyme levels in predicting pancreatic injuries has been a parameter of interest and the present recommendations on its utility are based primarily on anecdotal observations. The aim of this study was to evaluate the utility of serum pancreatic enzyme assessment in predicting blunt pancreatic injury with imaging and surgical correlation and compare our results with a systematic review of literature till date. A prospective cohort study conducted over 4 years in a tertiary care referral centre with 164 consecutive patients who presented to the emergency department with a history of blunt abdominal trauma and had serum pancreatic enzyme assessment, USG and subsequent diagnostic CECT were analyzed. The CT findings and AAST grade of pancreatic injury, various intra-abdominal injuries and time elapsed since injury and other associated factors were correlated with serum pancreatic enzyme levels. For systematic review of literature MEDLINE database was searched between 1940 and 2012, also the related citations and bibliographies of relevant articles were analyzed and 40 articles were included for review. We compared our results with the systematic critique of literature till date to formulate recommendations. 33(21%) patients had pancreatic injury documented on CT and were graded according to AAST. Statistically significant elevated serum amylase levels were observed in patients with pancreatic and bowel injuries. However, elevated serum lipase was observed specifically in patients with pancreatic injury with or without bowel injury. Combined serum amylase and lipase showed 100% specificity, 85% sensitivity in predicting pancreatic injury. Elevated (n=28, 85%) vs. normal (n=5, 15%) serum amylase and lipase levels showed sole statistically significant association with time elapse since injury to admission, with a cutoff of 3h. Based on our results and the systematic review of the literature till date we conclude, persistently elevated or

  7. EPCOR Utilities Inc. 1998 annual report

    International Nuclear Information System (INIS)

    1999-01-01

    Financial information from EPCOR Utilities Inc. and a review of their 1998 operations was presented. EPCOR was incorporated in 1995 and established as parent of Edmonton Power, Aqualta and Eltec in 1996. The city of Edmonton is the sole shareholder. EPCOR showed strong financial results and operational achievements in 1998. Among the many achievements were the efforts to ensure that the electric power systems are ready for the year 2000. Reduction of CO 2 emissions was another task pursued with good results. The electric power utility also invested in the re-powering of the Rossdale Generating Station and participated in the co-generation project at Joffre. The report provides details of these and other operational activities and presents consolidated financial statements. A new work management system to improve operational excellence and to better serve EPCOR customers during power disturbances was also launched during the year under review. tabs., figs

  8. A Survey of Utility Experience with Real Time Pricing

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Goldman, Charles; Neenan, Bernie

    2004-12-01

    While more than 70 utilities in the U.S. have offered voluntary RTP tariffs on either a pilot or permanent basis, most have operated in relative obscurity. To bring this broad base of experience to bear on policymakers current efforts to stimulate price responsive demand, we conducted a survey of 43 voluntary RTP tariffs offered in 2003. The survey involved telephone interviews with RTP program managers and other utility staff, as well as a review of regulatory documents, tariff sheets, program evaluations, and other publicly available sources. Based on this review of RTP program experience, we identify key trends related to: utilities motivations for implementing RTP, evolution of RTP tariff design, program participation, participant price response, and program outlook. We draw from these findings to discuss implications for policymakers that are currently considering voluntary RTP as a strategy for developing price responsive demand.

  9. Pioglitazone utilization, efficacy & safety in Indian type 2 diabetic patients: A systematic review & comparison with European Medicines Agency Assessment Report.

    Science.gov (United States)

    Pai, Sarayu A; Kshirsagar, Nilima A

    2016-11-01

    With pioglitazone ban and subsequent revoking in India along with varying regulatory decisions in other countries, it was decided to carry out a systematic review on its safety, efficacy and drug utilization in patients with type 2 diabetes mellitus (T2DM) in India and compare with the data from the European Medicines Agency Assessment Report (EMA-AR). Systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching Medline/PubMed, Google Scholar and Science Direct databases using 'pioglitazone AND India AND human' and 'pioglitazone AND India AND human AND patient' and compared with EMA-AR. Spontaneous reports in World Health Organization VigiBase from India were compared with VigiBase data from other countries. Sixty six publications, 26 (efficacy), 32 (drug utilization) and eight (safety), were retrieved. In India, pioglitazone was used at 15-30 mg/day mostly with metformin and sulphonylurea, being prescribed to 26.7 and 8.4 per cent patients in north and south, respectively. The efficacy in clinical trials (CTs) was similar to those in EMA-AR. Incidence of bladder cancer in pioglitazone exposed and non-exposed patients was not significantly different in an Indian retrospective cohort study. There were two cases and a series of eight cases of bladder cancer published but none reported in VigiBase. In India, probably due to lower dose, lower background incidence of bladder cancer and smaller sample size in epidemiological studies, association of bladder cancer with pioglitazone was not found to be significant. Reporting of CTs and adverse drug reactions to Clinical Trials Registry of India and Pharmacovigilance Programme of India, respectively, along with compliance studies with warning given in package insert and epidemiological studies with larger sample size are needed.

  10. Operation and utilizations of Dalat nuclear research reactor

    International Nuclear Information System (INIS)

    Hien, P.Z.

    1988-01-01

    The reconstructed Dalat nuclear research reactor was commissioned in March 1984 and up to September 1988 more than 6200 hours of operation at nominal power have been recorded. The major utilizations of the reactor include radioisotope production, activation analysis, nuclear data research and training. A brief review of the utilizations of the reactor is presented. Some aspects of reactor safety are also discussed. (author)

  11. A study on the utilization of forest policy to review from the aspect of climate change

    Science.gov (United States)

    Ardhana, I. Putu Gede

    2017-11-01

    The purpose of this study was to review the utilization of forests from the policy aspects of climate change. This was then associated with the implementation of governmental commitment to carry out REDD+ to cope with the impact of climate change and to achieve sustainable development. Firstly, the author studied this problem from data and information about vast forest areas and conservative water areas in Indonesia. According to provincial governments, there have been several decision letters from the Minister of Forestry from different years ranging from 1999-2014. Comparing the forest areas in letters of 2005, 2008, and 2015, it can be suggested that the areas allocated as productive forest exceeded the areas of conserved or protected forest. This indicates that the utilization of forest as a development resource has occurred, and will continue to become an important element in Indonesia. Furthermore, Indonesian forests continue to suffer deforestation and forest degradation. Therefore, the author presented data and information about deforestation and forest degradation that occurred from forest damage and forest fires. Thirdly, the author presented data and information about the deforestation rate from 2000-2014. In 1989, rehabilitation activities were carried out for critical lands, and from 2012-2014, rehabilitation of forest and riverside areas occurred. This research uses descriptive methods with an approximation of legislation and an approach to librarianship. Then, this study is described in a narrative as well as an interpretive style, and compiled in the form of a working paper. From the results of this research, it can be concluded that Indonesian governmental policy regarding forest utilization has wide potential mitigations, and it is absolutely necessary to consistently implement a number of such programs related to climate change.

  12. Leveraging network utility management practices for regulatory purposes

    International Nuclear Information System (INIS)

    2009-11-01

    Electric utilities around the globe are entering a phase where they must modernize and implement smart grid technologies. In order to optimize system architecture, asset replacement, and future operating costs, it the utilities must implement robust and flexible asset management structures. This report discussed the ways in which regulators assess investment plans. It focused on the implicit or explicit use of an asset management approach, including principles; processes; input and outputs; decision-making criteria and prioritization methods. The Ontario Energy Board staff were familiarized with the principles and objectives of established and emerging asset management processes and underlying analytic processes, systems and tools in order to ensure that investment information provided by network utilities regarding rates and other applications could be evaluated effectively. Specifically, the report discussed the need for and importance of asset management and provided further details of international markets and their regulatory approaches to asset management. The report also discussed regulatory approaches for review of asset management underlying investment plans as well as an overview of international regulatory practice for review of network utility asset management. It was concluded that options for strengthening regulatory guidance and assessment included utilizing appropriate and effective benchmarking to assess, promote and provide incentives for best practices and steer clear of the potential perverse incentives. 21 tabs., 17 figs., 1 appendix.

  13. Utility of social media and crowd-intelligence data for pharmacovigilance: a scoping review.

    Science.gov (United States)

    Tricco, Andrea C; Zarin, Wasifa; Lillie, Erin; Jeblee, Serena; Warren, Rachel; Khan, Paul A; Robson, Reid; Pham, Ba'; Hirst, Graeme; Straus, Sharon E

    2018-06-14

    A scoping review to characterize the literature on the use of conversations in social media as a potential source of data for detecting adverse events (AEs) related to health products. Our specific research questions were (1) What social media listening platforms exist to detect adverse events related to health products, and what are their capabilities and characteristics? (2) What is the validity and reliability of data from social media for detecting these adverse events? MEDLINE, EMBASE, Cochrane Library, and relevant websites were searched from inception to May 2016. Any type of document (e.g., manuscripts, reports) that described the use of social media data for detecting health product AEs was included. Two reviewers independently screened citations and full-texts, and one reviewer and one verifier performed data abstraction. Descriptive synthesis was conducted. After screening 3631 citations and 321 full-texts, 70 unique documents with 7 companion reports available from 2001 to 2016 were included. Forty-six documents (66%) described an automated or semi-automated information extraction system to detect health product AEs from social media conversations (in the developmental phase). Seven pre-existing information extraction systems to mine social media data were identified in eight documents. Nineteen documents compared AEs reported in social media data with validated data and found consistent AE discovery in all except two documents. None of the documents reported the validity and reliability of the overall system, but some reported on the performance of individual steps in processing the data. The validity and reliability results were found for the following steps in the data processing pipeline: data de-identification (n = 1), concept identification (n = 3), concept normalization (n = 2), and relation extraction (n = 8). The methods varied widely, and some approaches yielded better results than others. Our results suggest that the use of

  14. A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

    Directory of Open Access Journals (Sweden)

    Femke Jansen

    2016-01-01

    Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

  15. Utilization of mining and mineral wastes

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Ho; Hong, Seung Woong; Choi, Young Yoon; Kim, Byung Gyu; Park, Je Shin [Korea Institute of Geology Mining and Materials, Taejon (Korea)

    1998-12-01

    Up to now, it is estimated that more than 50 million tons of mineral wastes have been generated mining industries and deposited on the land in Korea. Much of cultivated land and hilly areas have been occupied by this wastes, which cause pollution of the environment. Utilization of the mineral wastes is preferable to stabilization because full use would both eliminate the waste and broaden the mineral resource base. Therefore, the development of utilization techniques of mineral wastes is very important not only for improving the environment but also for resource conservation. In countries with high population and poor natural resources like Korea, the utilization of these wastes is essential to decrease the environmental problem and the secure the resources and the study on this field play a important part. Therefore, the objective of this study is to develop the utilization techniques of the mineral wastes. In first year's research, the contents and scope of this study are 1) Present condition and Field Survey on the mineral wastes with respect of their utilization, 2) Reviews of Current effects and research to utilize mineral wastes, 3) Characterization of mineral wastes and environmental test, 4) Evaluation and study on the utilization. (author). 67 refs., 25 tabs., 54 figs.

  16. Utilization of mining and mineral wastes

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Ho; Hong, Seung Woong; Choi, Young Yoon; Kim, Byung Gyu; Park, Je Shin [Korea Institute of Geology Mining and Materials, Taejon (Korea)

    1998-12-01

    Up to now, it is estimated that more than 50 million tons of mineral wastes have been generated mining industries and deposited on the land in Korea. Much of cultivated land and hilly areas have been occupied by this wastes, which cause pollution of the environment. Utilization of the mineral wastes is preferable to stabilization because full use would both eliminate the waste and broaden the mineral resource base. Therefore, the development of utilization techniques of mineral wastes is very important not only for improving the environment but also for resource conservation. In countries with high population and poor natural resources like Korea, the utilization of these wastes is essential to decrease the environmental problem and the secure the resources and the study on this field play a important part. Therefore, the objective of this study is to develop the utilization techniques of the mineral wastes. In first year's research, the contents and scope of this study are 1) Present condition and Field Survey on the mineral wastes with respect of their utilization, 2) Reviews of Current effects and research to utilize mineral wastes, 3) Characterization of mineral wastes and environmental test, 4) Evaluation and study on the utilization. (author). 67 refs., 25 tabs., 54 figs.

  17. Utility requirements for fusion power

    International Nuclear Information System (INIS)

    DeBellis, R.J.

    1977-03-01

    A four-man-month study, jointly funded by EPRI and McDonnell Douglas Astronautics Company-EAST, was undertaken to identify the utility requirements of fusion power and define a role for the utilities in the fusion development process during the 1980's. This report, preliminary in nature, serves mainly as a planning document for future requirements analyses. A requirements organization was defined to consist of three major chronological phases: research and development, plant installation, and plant operation. Thirty-seven requirements were identified, covering all categories. In addition, training, environment, safety, licensing, and utility model were identified as five matrix-type requirements. As the requirement definition process continued during the study period, comments received from utility representatives revealed a consistency of key issues in the fusion development process. These issues form the basis for the eventual establishment of definitive roles for the utilities during the 1980's. The issues are not meant to reflect a negative view of fusion, but are items which must be solved before fusion can be introduced commercially as an electrical power source. As a result of this requirements study, preliminary candidate roles for the utilities in the fusion development process during the 1980's were identified as public education, commercialization studies, industry investment analyses, training plan implementation, alternate reactor concept development, ERDA concept design review, and requirements refinement

  18. Review on Bamboo Utilization as Biocomposites, Pulp and Bioenergy

    Science.gov (United States)

    Yusuf, Sulaeman; Syamani, F. A.; Fatriasari, W.; Subyakto

    2018-03-01

    One of potential non wood bioresources utilized in industrial application is bamboos. Bamboos are include in graminae family which have high biomass productivity, easy and rapid production, wide avability and high holocellulose content. Indonesia has a huge potential of bamboos, more than 162 bamboo species are found however only some of them are planted that have a high economic value. Bamboos have some advantages such as can be harvested at 3 years, straight culm, high strength, easy to be processed, and relatively cheap. Research Center for Biomaterials has developed utilization of bamboo culm for ply bamboo product as alternative of plywood since 1995, using gombong bamboo, tali bamboo, sembilang bamboo, andong bamboo with PF resin as adhesive. Other biocomposite products from bamboos include particle board, cement board and polymer-bamboo fiber composites. In term of processing technique and final product quality, bamboo composites from ply bamboo are the most prospectable material to be utilized in industrial application. Yellow bamboo and betung bamboo have also been developed as pulp and paper. Biopulping using soda and kraft pulping after biological pretreatment using white rot fungi to remove lignin was used as pulping method in this conversion. Biokraft pulping with Trametes versicolor for 45 days with inoculum loading of 10% resulted better pulp quality compared to the other fungi. Betung bamboo had good morphological characteristics and chemical component content to be converted into bioenergy such as bioethanol. Several pretreatment methods have been developed in order to result high sugar yield. Microwave assisted acid hydrolysis was preferedin producing higher yield from the pretreated bamboo compared to enzymatic hydrolysis. By using this method, the bamboo pretreated by biological-microwave pretreatment results higher improvement to increase sugar yield.

  19. 24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

    Science.gov (United States)

    2010-04-01

    ... (of the type affected by the energy conservation measure) after implementation of the energy...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options...

  20. Resilients, overcontrollers and undercontrollers: A systematic review of the utility of a personality typology method in understanding adult mental health problems.

    Science.gov (United States)

    Bohane, Laura; Maguire, Nick; Richardson, Thomas

    2017-11-01

    The person-centred typological approach to personality makes the distinction between overcontrolled and undercontrolled personality types. This review systematically searched for research on the utility of these personality types in adult mental health. A total of 43 papers were included, which were divided broadly into cross-sectional studies, longitudinal studies and studies with clinical populations. Three personality types have been largely replicated in both normal and clinical populations: resilients, overcontrollers and undercontrollers. These types show utility in predicting long-term functioning and mental health, understanding heterogeneous personalities within clinical subgroups and have implications for treatment. Some disagreement on the number of personality types deemed replicable across samples and differing methodologies do exist, with some finding a dimensional approach to personality to have greater predictive utility. These personality types have been shown to be important in a number of mental health problems such as eating disorders, which may prove helpful in developing new psychological interventions. These studies point to the importance of overcontrolled personality types as well as undercontrolled in mental health. More research is needed with a greater range of clinical populations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Racial and ethnic minority enrollment in randomized clinical trials of behavioural weight loss utilizing technology: a systematic review.

    Science.gov (United States)

    Rosenbaum, D L; Piers, A D; Schumacher, L M; Kase, C A; Butryn, M L

    2017-07-01

    Many racial and ethnic minority groups (minorities) are disproportionately affected by overweight and obesity; however, minorities are often under-represented in clinical trials of behavioural weight loss (BWL) treatment, potentially limiting the generalizability of these trials' conclusions. Interventions involving technology may be particularly well suited to overcoming the barriers to minority enrollment in BWL trials, such as demanding or unpredictable work schedules, caregiving responsibilities and travel burdens. Thus, this systematic review aimed to describe minority enrollment in trials utilizing technology in interventions, as well as to identify which form(s) of technology yield the highest minority enrollment. Results indicated relatively low enrollment of minorities. Trials integrating smartphone use exhibited significantly greater racial minority enrollment than trials that did not; trials with both smartphone and in-person components exhibited the highest racial minority enrollment. This review is the first to explore how the inclusion of technology in BWL trials relates to minority enrollment and can help address the need to improve minority enrollment in weight loss research. © 2017 World Obesity Federation.

  2. Industry activities to resolve utility procurement issues

    International Nuclear Information System (INIS)

    Rosch, F.

    1993-01-01

    There are several industry organizations which are active in assisting the utilities in their equipment procurement enhancement. They include the Nuclear Management Resources Council (NUMARC), the Electric Power Research Institute (EPRI), and the Nuclear Procurement Issues Committee (NUPIC). The products include the NUMARC Procurement Initiatives, EPRI procurement related guidelines and databases, and NUPIC joint audits and commercial grade surveys. The industry procurement activities and products are reviewed, and their use by utilities to enhance their procurement process is related. 1 fig

  3. Diagnostic utility of clinical and biochemical parameters in ...

    African Journals Online (AJOL)

    Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy ... Department of Surgery, Sir Run Run Shaw Hospital College of Medicine, Zhejiang University, ..... technical review on the epidemiology, diagnosis, and.

  4. Experience with nuclear fuel utilization in Bulgaria

    Energy Technology Data Exchange (ETDEWEB)

    Harizanov, Y [Committee on the Use of Atomic Energy for Peaceful Purposes, Sofia (Bulgaria)

    1997-12-01

    The presentation on experience with nuclear fuel utilization in Bulgaria briefly reviews the situation with nuclear energy in Bulgaria and then discusses nuclear fuel performance (amount of fuel loaded, type of fuel, burnup, fuel failures, assemblies deformation). 2 tabs.

  5. Metabolic engineering of the regulators in nitrogen catabolite repression to reduce the production of ethyl carbamate in a model rice wine system.

    Science.gov (United States)

    Zhao, Xinrui; Zou, Huijun; Fu, Jianwei; Zhou, Jingwen; Du, Guocheng; Chen, Jian

    2014-01-01

    Rice wine has been one of the most popular traditional alcoholic drinks in China. However, the presence of potentially carcinogenic ethyl carbamate (EC) in rice wine has raised a series of food safety issues. During rice wine production, the key reason for EC formation is urea accumulation, which occurs because of nitrogen catabolite repression (NCR) in Saccharomyces cerevisiae. NCR represses urea utilization by retaining Gln3p in the cytoplasm when preferred nitrogen sources are present. In order to increase the nuclear localization of Gln3p, some possible phosphorylation sites on the nuclear localization signal were mutated and the nuclear localization regulation signal was truncated, and the disruption of URE2 provided an additional method of reducing urea accumulation. By combining these strategies, the genes involved in urea utilization (DUR1,2 and DUR3) could be significantly activated in the presence of glutamine. During shake flask fermentations of the genetically modified strains, very little urea accumulated in the medium. Furthermore, the concentrations of urea and EC were reduced by 63% and 72%, respectively, in a model rice wine system. Examination of the normal nutrients in rice wine indicated that there were few differences in fermentation characteristics between the wild-type strain and the genetically modified strain. These results show that metabolic engineering of the NCR regulators has great potential as a method for eliminating EC during rice wine production.

  6. Contribution à l'inventaire et à la domestication des espèces ...

    African Journals Online (AJOL)

    SARAH

    30 juin 2014 ... de nombreuses espèces végétales ont disparu ou se sont raréfiées, essentiellement ..... Tableau 4 : Durée de séjour en pépinière des essences en fonction du matériel végétal utilisé. Durée de séjour. Durée courte (3-6 ... conscience sur l'importance socioéconomique de ces produits et les désagréments ...

  7. A Review on Landfill Management in the Utilization of Plastic Waste as an Alternative Fuel

    Directory of Open Access Journals (Sweden)

    Hidayah Nurul

    2018-01-01

    Full Text Available Wastes from landfills originate from many spheres of life. These are produces as a result of human activities either domestically or industrially. The global plastic production increased over years due to the vast applications of plastics in many sectors. The continuous demand of plastics caused the plastic wastes accumulation in the landfill consumed a lot of spaces that contributed to the environmental. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. The management and disposal of plastic waste have become a major concern, especially in developing cities. The idea of waste to energy recovery is one of the promising techniques used for managing the waste of plastic. Hence, this paper aims review at utilizing of plastic as an alternative fuel.

  8. A Review on Landfill Management in the Utilization of Plastic Waste as an Alternative Fuel

    Science.gov (United States)

    Hidayah, Nurul; Syafrudin

    2018-02-01

    Wastes from landfills originate from many spheres of life. These are produces as a result of human activities either domestically or industrially. The global plastic production increased over years due to the vast applications of plastics in many sectors. The continuous demand of plastics caused the plastic wastes accumulation in the landfill consumed a lot of spaces that contributed to the environmental. In addition, economic growth and development also increased our demand and dependency on plastics which leads to its accumulation in landfills imposing risk on human health, animals and cause environmental pollution problems such as ground water contamination, sanitary related issues, etc. The management and disposal of plastic waste have become a major concern, especially in developing cities. The idea of waste to energy recovery is one of the promising techniques used for managing the waste of plastic. Hence, this paper aims review at utilizing of plastic as an alternative fuel.

  9. Factors associated with institutional delivery service utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Kebede A

    2016-09-01

    Full Text Available Alemi Kebede,1 Kalkidan Hassen,2 Aderajew Nigussie Teklehaymanot1 1Department of Population and Family Health, 2College of Health Sciences, Jimma University, Ethiopia Background: Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home.Objective: The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia.Methods: The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs and their 95% confidence intervals (CIs were calculated. Heterogeneity of the study was assessed using I2 test.Results: People living in urban areas (OR =13.16, CI =1.24, 3.68, with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively, who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39, and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57 showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization.Conclusion and recommendation: Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available

  10. Utilizing thermophilic microbe in lignocelluloses based bioethanol production: Review

    Science.gov (United States)

    Sriharti, Agustina, Wawan; Ratnawati, Lia; Rahman, Taufik; Salim, Takiyah

    2017-01-01

    The utilization of thermophilic microbe has attracted many parties, particularly in producing an alternative fuel like ethanol. Bioethanol is one of the alternative energy sources substituting for earth oil in the future. The advantage of using bioethanol is that it can reduce pollution levels and global warming because the result of bioethanol burning doesn't bring in a net addition of CO2 into environment. Moreover, decrease in the reserves of earth oil globally has also contributed to the notion on searching renewable energy resources such as bioethanol. Indonesia has a high biomass potential and can be used as raw material for bioethanol. The utilization of these raw materials will reduce fears of competition foodstuffs for energy production. The enzymes that play a role in degrading lignocelluloses are cellulolytic, hemicellulolytic, and lignolytic in nature. The main enzyme with an important role in bioethanol production is a complex enzyme capable of degrading lignocelluloses. The enzyme can be produced by the thermophilik microbes of the groups of bacteria and fungi such as Trichoderma viride, Clostridium thermocellum, Bacillus sp. Bioethanol production is heavily affected by raw material composition, microorganism type, and the condition of fermentation used.

  11. 42 CFR 476.71 - QIO review requirements.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476... information supplied by the hospital; (5) The completeness, adequacy and quality of hospital care provided; (6...

  12. Circulating tumor cells: clinical validity and utility.

    Science.gov (United States)

    Cabel, Luc; Proudhon, Charlotte; Gortais, Hugo; Loirat, Delphine; Coussy, Florence; Pierga, Jean-Yves; Bidard, François-Clément

    2017-06-01

    Circulating tumor cells (CTCs) are rare tumor cells and have been investigated as diagnostic, prognostic and predictive biomarkers in many types of cancer. Although CTCs are not currently used in clinical practice, CTC studies have accumulated a high level of clinical validity, especially in breast, lung, prostate and colorectal cancers. In this review, we present an overview of the current clinical validity of CTCs in metastatic and non-metastatic disease, and the main concepts and studies investigating the clinical utility of CTCs. In particular, this review will focus on breast, lung, colorectal and prostate cancer. Three major topics concerning the clinical utility of CTC are discussed-(1) treatment based on CTCs used as liquid biopsy, (2) treatment based on CTC count or CTC variations, and (3) treatment based on CTC biomarker expression. A summary of published or ongoing phase II and III trials is also presented.

  13. Kyoto : implications for utility regulation

    International Nuclear Information System (INIS)

    Dunsky, P.

    2003-01-01

    The author provided a historical perspective of energy use and the role of carbon in the western hemisphere by displaying a series of graphs showing carbon intensity of energy, carbon emissions from energy, and the long path to green power. The 1990s represented a decade of progress. Almost three times as much wind capacity as nuclear capacity was added worldwide in 2001. The main challenge for the 21st century will be to bring under-developed countries into the fold while perpetuating the economic and human progress of the twentieth century. It was emphasized that environmental damage caused by utilities must be reversed. The contemporary context for the Kyoto Protocol was reviewed. Canada's commitment under the Kyoto Protocol is to reduce greenhouse gas emissions by 6 per cent below 1990 levels. The challenge for utility regulators to meet this commitment was examined. The costs are not entirely excessive. Some of the regulatory issues were discussed, namely revising a broad rate making framework, cost recovery and others. The Kyoto compliance plan was also reviewed with reference to internal options, external options, identification of regulatory barriers, and consideration of greenhouse gas credit markets. figs

  14. Another year of change for Canadian electric utilities as they continue to meet new challenges

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    The activities of Canadian electric utilities in the past year were highlighted. The companies reviewed were: B.C. Hydro, Edmonton Power, TransAlta Utilities Corporation, Manitoba Hydro, Ontario Hydro, Hydro-Quebec, New Brunswick Power Corporation, Nova Scotia Power Inc., and Newfoundland Power. Reviews of the industry, economic growth, market trends and forecasts were discussed

  15. Utilization of radiation protection gear for absorbed dose reduction: an integrative literature review

    International Nuclear Information System (INIS)

    Soares, Flavio Augusto Penna; Flor, Rita de Cassia; Pereira, Aline Garcia

    2011-01-01

    Objective: The present study was aimed at evaluating the relation between the use of radiation protection gear and the decrease in absorbed dose of ionizing radiation, thereby reinforcing the efficacy of its use by both the patients and occupationally exposed personnel. Materials and Methods: The integrative literature review method was utilized to analyze 21 articles, 2 books, 1 thesis, 1 monograph, 1 computer program, 4 pieces of database research (Instituto Brasileiro de Geografia e Estatistica and Departamento de Informatica do Sistema Unico de Saude) and 2 sets of radiological protection guidelines. Results: Theoretically, a reduction of 86% to 99% in the absorbed dose is observed with the use of radiation protection gear. In practice, however, the reduction may achieve 88% in patients submitted to conventional radiology, and 95% in patients submitted to computed tomography. In occupationally exposed individuals, the reduction is around 90% during cardiac catheterization, and 75% during orthopedic surgery. Conclusion: According to findings of several previous pieces of research, the use of radiation protection gear is a low-cost and effective way to reduce absorbed dose both for patients and occupationally exposed individuals. Thus, its use is necessary for the implementation of effective radioprotection programs in radiodiagnosis centers. (author)

  16. Establishing benchmarks and metrics for utilization management.

    Science.gov (United States)

    Melanson, Stacy E F

    2014-01-01

    The changing environment of healthcare reimbursement is rapidly leading to a renewed appreciation of the importance of utilization management in the clinical laboratory. The process of benchmarking of laboratory operations is well established for comparing organizational performance to other hospitals (peers) and for trending data over time through internal benchmarks. However, there are relatively few resources available to assist organizations in benchmarking for laboratory utilization management. This article will review the topic of laboratory benchmarking with a focus on the available literature and services to assist in managing physician requests for laboratory testing. © 2013.

  17. Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

    Science.gov (United States)

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-09-01

    Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

  18. 32 CFR 199.15 - Quality and utilization review peer review organization program.

    Science.gov (United States)

    2010-07-01

    ... section, are set forth in § 199.4(h). (3) Review of services covered by DRG-based payment system. Application of these objectives in the context of hospital services covered by the DRG-based payment system... hospital unit subject to the CHAMPUS DRG-based payment system to another hospital or hospital unit. (ii...

  19. Diagnostic utility of onychoscopy: Review of literature

    Directory of Open Access Journals (Sweden)

    Chander Grover

    2017-01-01

    Full Text Available Onychoscopy is being increasingly used as a diagnostic modality for various nail diseases. Initial research had focused mainly on nail pigmentation and nailfold capillaroscopy; however, it is now being evaluated in various infectious and inflammatory nail disorders as well. The present review aims to summarize current knowledge about onychoscopic diagnostic criteria in nail diseases. The best level of evidence attached to each indication is mentioned to answer the pertinent question: How much can we rely on onychoscopy in confirming diagnosis of nail disease?

  20. Understanding Collaborative capacity in an ICT context

    DEFF Research Database (Denmark)

    Rai, Sudhanshu

    In this paper my endeavor is to explore the meaning and implication of collaberation within a dynamic frame which I refer to a capacity. First I review the collaboration literature from an innovation perspective and then develop a framework that enables me to engage with the data we collected dur...... this paper discussing the new insight on collaborative capacity (CC) of firms and their implications for ICT collaboration and firm innovativness....

  1. Review of OSmanthus fragrans,/i> planting and utilization in China ...

    African Journals Online (AJOL)

    Osmanthus fragrans, an horticulture plant, is one of the National plants in China. As China's native plants, they were usually utilized in seasoning, health protection, perfuming and dressing. Based on analyzing China history literature, this paper highlights native varieties of Osmanthus fragrans as well as their planting ...

  2. The Quality of Cost-Utility Analyses in Orthopedic Trauma.

    Science.gov (United States)

    Nwachukwu, Benedict U; Schairer, William W; O'Dea, Evan; McCormick, Frank; Lane, Joseph M

    2015-08-01

    As health care in the United States transitions toward a value-based model, there is increasing interest in applying cost-effectiveness analysis within orthopedic surgery. Orthopedic trauma care has traditionally underemphasized economic analysis. The goals of this review were to identify US-based cost-utility analysis in orthopedic trauma, to assess the quality of the available evidence, and to identify cost-effective strategies within orthopedic trauma. Based on a review of 971 abstracts, 8 US-based cost-utility analyses evaluating operative strategies in orthopedic trauma were identified. Study findings were recorded, and the Quality of Health Economic Studies (QHES) instrument was used to grade the overall quality. Of the 8 studies included in this review, 4 studies evaluated hip and femur fractures, 3 studies analyzed upper extremity fractures, and 1 study assessed open tibial fracture management. Cost-effective interventions identified in this review include total hip arthroplasty (over hemiarthroplasty) for femoral neck fractures in the active elderly, open reduction and internal fixation (over nonoperative management) for distal radius and scaphoid fractures, limb salvage (over amputation) for complex open tibial fractures, and systems-based interventions to prevent delay in hip fracture surgery. The mean QHES score of the studies was 79.25 (range, 67-89). Overall, there is a paucity of cost-utility analyses in orthopedic trauma; however, the available evidence suggests that certain operative interventions can be cost-effective. The quality of these studies, however, is fair, based on QHES grading. More attention should be paid to evaluating the cost-effectiveness of operative intervention in orthopedic trauma. Copyright 2015, SLACK Incorporated.

  3. Guide 61: how the EUB responds to utility customer service complaints

    International Nuclear Information System (INIS)

    1999-07-01

    The guide answers common questions about regulated provincial utilities, how to make a formal complaint to the Electric Utilities Board (EUB) of Alberta about utility service, and how the Board handles customer concerns. The role of the EUB in regulating utilities has changed slightly with natural gas deregulation, with most consumers having the option to purchase natural gas from their supplier of choice. As the transition to electric deregulation is occuring, the EUB continues to set customer rates until the transition is complete. When a utility-related-complaint cannot be resolved, the EUB may schedule a hearing to thoroughly review the issue. The hearing and decision aspects are summarized

  4. Transporter engineering in biomass utilization by yeast.

    Science.gov (United States)

    Hara, Kiyotaka Y; Kobayashi, Jyumpei; Yamada, Ryosuke; Sasaki, Daisuke; Kuriya, Yuki; Hirono-Hara, Yoko; Ishii, Jun; Araki, Michihiro; Kondo, Akihiko

    2017-11-01

    Biomass resources are attractive carbon sources for bioproduction because of their sustainability. Many studies have been performed using biomass resources to produce sugars as carbon sources for cell factories. Expression of biomass hydrolyzing enzymes in cell factories is an important approach for constructing biomass-utilizing bioprocesses because external addition of these enzymes is expensive. In particular, yeasts have been extensively engineered to be cell factories that directly utilize biomass because of their manageable responses to many genetic engineering tools, such as gene expression, deletion and editing. Biomass utilizing bioprocesses have also been developed using these genetic engineering tools to construct metabolic pathways. However, sugar input and product output from these cells are critical factors for improving bioproduction along with biomass utilization and metabolic pathways. Transporters are key components for efficient input and output activities. In this review, we focus on transporter engineering in yeast to enhance bioproduction from biomass resources. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. US versus non-US utility procurement practices

    International Nuclear Information System (INIS)

    Clark, H.

    1991-01-01

    Utilities, particularly in the USA, have often been accused by the uranium industry of behaving like a herd with respect to their activities in the nuclear fuel market. While I disagree with this characterization, I do recognize that utilities in general have certain common motivations influencing their nuclear fuel procurement activities which may make them appear to follow each other. This paper reviews these motivations, how they differ between US and non-US utilities, how such differences lead to different procurement practices in the USA and elsewhere, the resulting impacts on the nuclear fuel market, and the changes, if, any, which one may expect in the future. The discussion in this paper is geared mainly towards the uranium market, though the concepts discussed are also somewhat applicable to the other components of nuclear fuel. (author)

  6. Current radioactive waste utilization at PA 'MAYAK'

    International Nuclear Information System (INIS)

    Merkushkin, A.O.

    2001-01-01

    The Production Association 'Mayak' is one of the largest production union of Nuclear Fuel Cycle (NFC) in Russia. In 1988 the last military reactor, which worked for making military plutonium was stopped. From this time civic history of 'Mayak' was began. Today 'Mayak' is the complex production union of NFC, which utilizes the Radiated Nuclear Fuel (RNF). The combine is dynamically develops, new technologies are domesticate and intrude, large works for liquidation of accidents and mistakes of lapsed years are in progress. The short review of radioactive waste utilization methods is present in this account. (author)

  7. Current radioactive waste utilization at PA 'MAYAK'

    Energy Technology Data Exchange (ETDEWEB)

    Merkushkin, A O [Ozyorsk Technological Institute of Moscow Physical Engineering Institute (Russian Federation)

    2001-07-01

    The Production Association 'Mayak' is one of the largest production union of Nuclear Fuel Cycle (NFC) in Russia. In 1988 the last military reactor, which worked for making military plutonium was stopped. From this time civic history of 'Mayak' was began. Today 'Mayak' is the complex production union of NFC, which utilizes the Radiated Nuclear Fuel (RNF). The combine is dynamically develops, new technologies are domesticate and intrude, large works for liquidation of accidents and mistakes of lapsed years are in progress. The short review of radioactive waste utilization methods is present in this account. (author)

  8. The electric utilities during the 1970s and 1980s

    International Nuclear Information System (INIS)

    Studness, C.M.

    1990-01-01

    This article reviews the financial performance of electric utilities during the 1970s and 1980s and the factors which have affected their performance. Topics include the effects of the energy crisis in 1973, the nuclear accident at Three Mile Island in 1979, the widespread use of imprudence disallowances by regulators after 1984, and the gradual extension of the nation's deregulation movement to the electric utilities

  9. Prudency reviews, cash management issues emerge

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    Utility management is paying increasing attention to the broadening of regulatory commission prudency reviews to cover operating generating plants as well as those under construction. Utilities can expect a prudency review after a major outage, and should investigate the possibility for legal action against a third party or be prepared to defend itself. The Shoreham nuclear plant serves as a warning to utilities of the need for on-going documentation of cost-benefit analyses conducted during the construction period. Utility managers should demand a prudency standard from their regulators, and minority owners in large projects should make independent prudency findings. There is also a growing need for utilities to develop intelligent strategies for handling excess cash. Methods for handling cash flow include the financial investment, grid refurbishment, dividend payout, decapitalization, and diversification

  10. Research on the maximum utilization of PSR (Periodic Safety Review) results

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Myung; Lee, Jae Kyung; Ahn, Jin Chul; Kim, G. U.; Ryu, Y. S.; Lee, G. B.; Park, D. H. [Chungju Univ., Cheongju (Korea, Republic of)

    2002-03-15

    This is the final report of 'research on the maximum utilization of PSR results' focused on linkage strategy of PSR with continued operation over design life of operating NPP. Study was mace mainly on the analysis of current status of continued operation over plant design life in foreign countries, analysis of domestic PSR implementation status and establishment of basic strategy for linking PSR with continued operation. The results of the study performed so far can be summarized as below, the recent worldwide trend of promoting efficiency of NPP operation is focused on life extension of the plants rather than building of new. Considering the fact that some developed countries have already implemented the plant life extension and not a few countries at least have invested a good amount of fund for R and D of plant life management, we can not disregard the owner's request for review of life extension application without any reasonable description. As a result of investigation and analysis for the current status of continued operation over plant design life in foreign countries, it is concluded that most countries tend to link PSR with continued operation over plant design life and the extended operation has already been implemented in some developed countries. From the point, it turned out to be more desirable to couple those two systems for continued operation over plant design life of Korean NPP. A less than 7 years left until the end of design life for the oldest NPP Kori unit 1, it is strongly recommended to establish institutional frame including a legal basis and regulatory guidelines for continued operation over plant design life before long. For the prioritization methods of corrective actions in consideration of safety significance of shortcomings picked up from PSR, some related systems are reviewed including IAEA guidelines, PSR implementation experience of UK and US prioritization system for GSI (Generic Safety Issue). Basic principles are

  11. Utility requirements for advanced LWR passive plants

    International Nuclear Information System (INIS)

    Yedidia, J.M.; Sugnet, W.R.

    1992-01-01

    LWR Passive Plants are becoming an increasingly attractive and prominent option for future electric generating capacity for U.S. utilities. Conceptual designs for ALWR Passive Plants are currently being developed by U.S. suppliers. EPRI-sponsored work beginning in 1985 developed preliminary conceptual designs for a passive BWR and PWR. DOE-sponsored work from 1986 to the present in conjunction with further EPRI-sponsored studies has continued this development to the point of mature conceptual designs. The success to date in developing the ALWR Passive Plant concepts has substantially increased utility interest. The EPRI ALWR Program has responded by augmenting its initial scope to develop a Utility Requirements Document for ALWR Passive Plants. These requirements will be largely based on the ALWR Utility Requirements Document for Evolutionary Plants, but with significant changes in areas related to the passive safety functions and system configurations. This work was begun in late 1988, and the thirteen-chapter Passive Plant Utility Requirements Document will be completed in 1990. This paper discusses the progress to date in developing the Passive Plant requirements, reviews the top-level requirements, and discusses key issues related to adaptation of the utility requirements to passive safety functions and system configurations. (orig.)

  12. The validity and clinical utility of purging disorder.

    Science.gov (United States)

    Keel, Pamela K; Striegel-Moore, Ruth H

    2009-12-01

    To review evidence of the validity and clinical utility of Purging Disorder and examine options for the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-V). Articles were identified by computerized and manual searches and reviewed to address five questions about Purging Disorder: Is there "ample" literature? Is the syndrome clearly defined? Can it be measured and diagnosed reliably? Can it be differentiated from other eating disorders? Is there evidence of syndrome validity? Although empirical classification and concurrent validity studies provide emerging support for the distinctiveness of Purging Disorder, questions remain about definition, diagnostic reliability in clinical settings, and clinical utility (i.e., prognostic validity). We discuss strengths and weaknesses associated with various options for the status of Purging Disorder in the DSM-V ranging from making no changes from DSM-IV to designating Purging Disorder a diagnosis on equal footing with Anorexia Nervosa and Bulimia Nervosa.

  13. Diagnostic utility of patient history and physical examination data to detect spondylolysis and spondylolisthesis in athletes with low back pain: A systematic review.

    Science.gov (United States)

    Grødahl, Linn Helen J; Fawcett, Louise; Nazareth, Madeleine; Smith, Richard; Spencer, Simon; Heneghan, Nicola; Rushton, Alison

    2016-08-01

    In adolescent athletes, low back pain has a 1-year prevalence of 57% and causes include spondylolysis and spondylolisthesis. An accurate diagnosis enables healing, prevention of progression and return to sport. To evaluate the diagnostic utility of patient history and physical examination data to identify spondylolysis and/or spondylolisthesis in athletes. Systematic review was undertaken according to published guidelines, and reported in line with PRISMA. Key databases were searched up to 13/11/15. athletic population with LBP, patient history and/or physical examination accuracy data for spondylolysis and/or spondylolisthesis, any study design including raw data. Two reviewers independently assessed risk of bias (ROB) using QUADAS-2. A data extraction sheet was pre-designed. Pooling of data and investigation for heterogeneity enabled a qualitative synthesis of data across studies. Of the eight included studies, two were assessed as low ROB, one of which also had no concerns regarding applicability. Age (75% for spondylolisthesis. Step-deformity palpation demonstrated 60-88% sensitivity and 87-100% specificity for spondylolisthesis. The one-legged hyperextension test was not supported for spondylolysis (sensitivity 50-73%, specificity 0-87%). No recommendations can be made utilising patient history data. Based on one low ROB study, step deformity palpation may be useful in diagnosing spondylolisthesis. No physical tests demonstrated diagnostic utility for spondylolysis. Further research is required. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Académica Maria Mélida Durán Merchán - Académico Miguel Trias Fargas

    Directory of Open Access Journals (Sweden)

    Alfredo Jácome Roca

    2000-08-01

    Full Text Available

    MARÍA MÉLIDA DURÁN

    Una de las secciones especialmente nostálgicas pero a su vez más trascendentales es esta de Obituarios en la revista “Medicina”. Acostumbra ser uno de los nichos literarios de la prolífica y versátil pluma del Académico Efraím Otero o de la pulida pero algo menos abundante del también Académico Zoilo Cuéllar.

    Puede ser esta sección de igual manera la semilla biográfica para aquellos ilustres médicos colombianos que por esta Institución pasaron, que llamamos “necrológica”, para darle un toque menos fúnebre y más alegre, pues destaca lo mucho de positivo que tuvo la vida de quien se escribe.

    Nos duele hacerlo hoy sobre María Mélida Durán Merchán, a quien me costó trabajo dejar de decirle “de Rueda”, en referencia a su compañero de tantas luchas y padre de su hijo Marcelo, el urólogo de Marly, Manuel Rueda Salazar.

    Y repito que siento consternación al hacerlo pues su edad distaba mucho de la de aquel personaje a quien se refería el Académico Laurentino Muñoz al conversar con su amigo Germán Arciniegas, un par de intelectuales a quienes la senectud no quitó vitalidad alguna. Vio pasar a algún conocido que rondaba en los cien años y dijo: “¿no es ese el que murió el año pasado?”...

    MIGUEL TRIAS FARGAS

    Nacido en Barcelona, Cataluña, el 9 de agosto de 1924, llegó el doctor Trías a Colombia a muy corta edad; se graduó como médico en la Universidad Nacional de Colombia y se especializó en Cirugía del Tórax en importantes instituciones de Inglaterra y Francia.

    Ejerció con brillo dicha especialidad en los Hospitales San Carlos, Santa Clara y San José de la ciudad de Bogotá, así como en la Fundación Shaio, a cuyo nacimiento contribuyó. Su trascendental labor en la Asociación Pro Bienestar de la Familia Colombiana, Profamilia, que dirigió desde 1973 hasta 1994, y en la Fundación Pro Derecho a

  15. Managing change in nuclear utilities

    International Nuclear Information System (INIS)

    2001-07-01

    important factors to consider when undertaking changes in a nuclear business. For the nuclear executive, the most important considerations are as follows. Is there a policy on change management, that gives priority to safety, that is aligned to the vision, goals and objectives of the utility, that is communicated to stakeholders? Is there a systematic, transparent and rigorous change management process applied to all types of change? Are appropriate resources provided to support the process of change? Has sufficient analysis been performed to ensure the changes are adequately justified and are in fact the correct option? What risk analysis and independent reviews have been performed to ensure any potential encroachment on safety levels has been identified and compensatory measures developed? Have these reviews been performed by individuals with commensurate nuclear knowledge and experience? Do the senior managers have a mechanism to review progress regularly? Is the information received sufficient to enable them to exercise their responsibilities as guardians of nuclear safety? Have specific performance indicators been established to monitor the effects of the change? Does the communication plan keep all staff informed of progress and performance and provide for feedback? Does this communication also reach other stakeholders including the regulators, the public and trade unions? How has the utility assessed the cumulative impact of a number of changes in a business area? Following completion, did the change achieve the improvement targets originally established and if not do I understand the cause and do we have a plan to correct the situation? Have we organized a post change peer review to ensure we are continuing to improve in both performance and safety with respect to the rest of the industry?

  16. Managing change in nuclear utilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    important factors to consider when undertaking changes in a nuclear business. For the nuclear executive, the most important considerations are as follows. Is there a policy on change management, that gives priority to safety, that is aligned to the vision, goals and objectives of the utility, that is communicated to stakeholders? Is there a systematic, transparent and rigorous change management process applied to all types of change? Are appropriate resources provided to support the process of change? Has sufficient analysis been performed to ensure the changes are adequately justified and are in fact the correct option? What risk analysis and independent reviews have been performed to ensure any potential encroachment on safety levels has been identified and compensatory measures developed? Have these reviews been performed by individuals with commensurate nuclear knowledge and experience? Do the senior managers have a mechanism to review progress regularly? Is the information received sufficient to enable them to exercise their responsibilities as guardians of nuclear safety? Have specific performance indicators been established to monitor the effects of the change? Does the communication plan keep all staff informed of progress and performance and provide for feedback? Does this communication also reach other stakeholders including the regulators, the public and trade unions? How has the utility assessed the cumulative impact of a number of changes in a business area? Following completion, did the change achieve the improvement targets originally established and if not do I understand the cause and do we have a plan to correct the situation? Have we organized a post change peer review to ensure we are continuing to improve in both performance and safety with respect to the rest of the industry?.

  17. Advance reactor and fuel-cycle systems--potentials and limitations for United States utilities

    International Nuclear Information System (INIS)

    Zebroski, E.L.; Williams, R.F.

    1979-01-01

    This paper reviews the potential benefits and limitations of advance reactor and fuel-cycle systems for United States utilities. The results of the review of advanced technologies show that for the near and midterm, the only advance reactor and fuel-cycle system with significant potential for United States utilities is the current LWR, and evolutionary, not revolutionary, enhancements. For the long term, the liquid-metal breeder reactor continues to be the most promising advance nuclear option. The major factors leading to this conclusion are summarized

  18. Metabolic Engineering of the Regulators in Nitrogen Catabolite Repression To Reduce the Production of Ethyl Carbamate in a Model Rice Wine System

    Science.gov (United States)

    Zhao, Xinrui; Zou, Huijun; Fu, Jianwei; Chen, Jian

    2014-01-01

    Rice wine has been one of the most popular traditional alcoholic drinks in China. However, the presence of potentially carcinogenic ethyl carbamate (EC) in rice wine has raised a series of food safety issues. During rice wine production, the key reason for EC formation is urea accumulation, which occurs because of nitrogen catabolite repression (NCR) in Saccharomyces cerevisiae. NCR represses urea utilization by retaining Gln3p in the cytoplasm when preferred nitrogen sources are present. In order to increase the nuclear localization of Gln3p, some possible phosphorylation sites on the nuclear localization signal were mutated and the nuclear localization regulation signal was truncated, and the disruption of URE2 provided an additional method of reducing urea accumulation. By combining these strategies, the genes involved in urea utilization (DUR1,2 and DUR3) could be significantly activated in the presence of glutamine. During shake flask fermentations of the genetically modified strains, very little urea accumulated in the medium. Furthermore, the concentrations of urea and EC were reduced by 63% and 72%, respectively, in a model rice wine system. Examination of the normal nutrients in rice wine indicated that there were few differences in fermentation characteristics between the wild-type strain and the genetically modified strain. These results show that metabolic engineering of the NCR regulators has great potential as a method for eliminating EC during rice wine production. PMID:24185848

  19. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature

    OpenAIRE

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-01-01

    Background Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and dur...

  20. Implementation of the U.S. utility industry's TEAM-UP commercialization initiative

    International Nuclear Information System (INIS)

    Bergman, M.; Bigger, J.; Hester, S.; Serfass, J.; Hoffner, J.

    1994-01-01

    TEAM-UP is a partnership program of the US electric utility industry and the US Department of Energy to help develop utility PV markets. TEAM-UP is a utility-directed program to significantly increase utility PV experience by promoting installations of utility PV systems. Two primary program areas are proposed for TEAM-UP; (1) Grid-Independent Applications (GIA) -- an initiative to aggregate utility purchases of small-scale, grid-independent applications, and (2) Grid-Connected Applications -- an initiative to identify and competitively award cost-sharing contracts for grid-connected PV systems with high market growth potential, or collective purchase programs involving multiple buyers. This paper describes these programs and outlines the schedule, the procurement status, and the results of surveys, public review workshops, and notices that are part of the TEAM-UP process

  1. Multiattribute utility theory without expected utility foundations

    NARCIS (Netherlands)

    Wakker, P.P.; Miyamoto, J.

    1996-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  2. Multiattribute Utility Theory without Expected Utility Foundations

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Wakker, P.P.

    1995-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  3. Utility Leadership in Defining Requirements for Advanced Light Water Reactors

    International Nuclear Information System (INIS)

    Sugnet, William R.; Layman, William H.

    1990-01-01

    It is appropriate, based on twenty five years of operating experience, that utilities take a position of leadership in developing the technical design and performance requirements for the next generations of nuclear electric generating plants. The U. S. utilities, through the Electric Power Research Institute, began an initiative in 1985 to develop such Utility requirements. Many international Utility organizations, including Korea Electric Power Corporation, have joined as full participants in this important Utility industry initiative. In light of the closer linkage among countries of the world due to rapid travel and telecommunications, it is also appropriate that there be international dialogue and agreement on the principal standards for nuclear power plant acceptability and performance. The Utility/EPRI Advanced Light Water Reactor Program guided by the ALRR Utility Steering Committee has been very successful in developing these Utility requirements. This paper will summarize the state of development of the ALRR Utility Requirements for Evolutionary Plants, recent developments in their review by the U. S. Nuclear Regulatory Commission, resolution of open issues, and the extension of this effort to develop a companion set of ALRR Utility Requirements for plants employing passive safety features

  4. The effect of utility time-varying pricing and load control strategies on residential summer peak electricity use. A review

    International Nuclear Information System (INIS)

    Newsham, Guy R.; Bowker, Brent G.

    2010-01-01

    Peak demand for electricity in North America is expected to grow, challenging electrical utilities to supply this demand in a cost-effective, reliable manner. Therefore, there is growing interest in strategies to reduce peak demand by eliminating electricity use, or shifting it to non-peak times. This strategy is commonly called 'demand response'. In households, common strategies are time-varying pricing, which charge more for energy use on peak, or direct load control, which allows utilities to curtail certain loads during high demand periods. We reviewed recent North American studies of these strategies. The data suggest that the most effective strategy is a critical peak price (CPP) program with enabling technology to automatically curtail loads on event days. There is little evidence that this causes substantial hardship for occupants, particularly if they have input into which loads are controlled and how, and have an override option. In such cases, a peak load reduction of at least 30% is a reasonable expectation. It might be possible to attain such load reductions without enabling technology by focusing on household types more likely to respond, and providing them with excellent support. A simple time-of-use (TOU) program can only expect to realise on-peak reductions of 5%. (author)

  5. Distributed photovoltaic systems - Addressing the utility interface issues

    Science.gov (United States)

    Firstman, S. I.; Vachtsevanos, G. J.

    This paper reviews work conducted in the United States on the impact of dispersed photovoltaic sources upon utility operations. The photovoltaic (PV) arrays are roof-mounted on residential houses and connected, via appropriate power conditioning equipment, to the utility grid. The presence of such small (4-6 Kw) dispersed generators on the distribution network raises questions of a technical, economic and institutional nature. After a brief identification of utility interface issues, the paper addresses such technical concerns as protection of equipment and personnel safety, power quality and utility operational stability. A combination of experimental and analytical approaches has been adopted to arrive at solutions to these problems. Problem areas, under various PV system penetration scenarios, are identified and conceptual designs of protection and control equipment and operating policies are developed so that system reliability is maintained while minimizing capital costs. It is hoped that the resolution of balance-of-system and grid interface questions will ascertain the economic viability of photovoltaic systems and assist in their widespread utilization in the future.

  6. Mergers and acquisitions: Guidelines for consideration by state public utility commissions

    Energy Technology Data Exchange (ETDEWEB)

    Graniere, R.J.; Burns, R.E.

    1996-11-01

    This is the first of a series of reports on utility mergers and acquisitions published by NRRI; because it was completed Nov. 1996, it does not cover FERC Order 592 (policy statement on merger policy under Federal Power Act). Since cost-benefit analyses are expensive, state regulators need guidelines that efficiently streamline the review process for mergers and acquisitions. Purpose of this paper is to suggest such guidelines; they are applicable only to mergers and acquisitions of vertically integrated electric utilities or combination electric/gas utilities.

  7. Review of electron beam therapy physics

    International Nuclear Information System (INIS)

    Hogstrom, Kenneth R; Almond, Peter R

    2006-01-01

    For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)

  8. Expected utility without utility

    OpenAIRE

    Castagnoli, E.; Licalzi, M.

    1996-01-01

    This paper advances an interpretation of Von Neumann–Morgenstern’s expected utility model for preferences over lotteries which does not require the notion of a cardinal utility over prizes and can be phrased entirely in the language of probability. According to it, the expected utility of a lottery can be read as the probability that this lottery outperforms another given independent lottery. The implications of this interpretation for some topics and models in decision theory are considered....

  9. Status and prospects of radioisotope supply and utilization in Canada

    International Nuclear Information System (INIS)

    Ratz, R.G.

    1982-01-01

    The status and prospects of radioisotope utilization in Canada was reviewed. It consisted of the history of 60 Co utilization in the past 30-year period and the increase in the annual export of 60 Co in a period 1965-80 and the areas of utilization, such as food irradiation, radiation treatment of human and animal waste, and radiation inactivation of bacteria and viruses in the bioeffluent. The progress of application to nuclear medicine was described in reference to the use of RI including 60 Co and recently developed Canadian positron ECT and Therascan 3128. (Chiba, N.)

  10. Impact of alternative energy forms on public utilities

    Science.gov (United States)

    Keith, F. W., Jr.

    1977-01-01

    The investigation of alternative energy sources by the electric utility industry is discussed. Research projects are reviewed in each of the following areas; solar energy, wind energy conversion, photosynthesis of biomass, ocean thermal energy conversion, geothermal energy, fusion, and the environmental impact of alternative energy sources.

  11. The validity and utility of subtyping bulimia nervosa

    NARCIS (Netherlands)

    van Hoeken, Daphne; Veling, Wim; Sinke, Sjoukje; Mitchell, James E.; Hoek, Hans W.

    Objective: To review the evidence for the validity and utility of subtyping bulimia nervosa (BN) into a purging (BN-P) and a nonpurging subtype (BN-NP), and of distinguishing BN-NP from binge eating disorder (BED), by comparing course, complications, and treatment. Method: A literature search of

  12. The validity and utility of subtyping bulimia nervosa

    NARCIS (Netherlands)

    van Hoeken, Daphne; Veling, Wim; Sinke, Sjoukje; Mitchell, James E.; Hoek, Hans W.

    2009-01-01

    Objective: To review the evidence for the validity and utility of subtyping bulimia nervosa (BN) into a purging (BN-P) and a nonpurging subtype (BN-NP), and of distinguishing BN-NP from binge eating disorder (BED), by comparing course, complications, and treatment. Method: A literature search of

  13. Tabular cross section file generation and utilization techniques

    International Nuclear Information System (INIS)

    Cullen, D.E.; Ozer, O.; Weisbin, C.R.

    1975-03-01

    Criteria of importance to the generation of linear cross section tabulations are presented. Algorithms for reducing or thinning such tables within a desired accuracy criterion and the implementation of paging techniques for efficient utilization of large data tables are reviewed. (1 figure, 3 tables) (U.S.)

  14. Present status and prospects of radioisotopes and radiation utilization in Indonesia

    International Nuclear Information System (INIS)

    Baiquni, A.

    1982-01-01

    The present status and prospects of RI and radiation utilization in Indonesia, which developed under the Government's assistance and supervision since the opening of the research reactor in 1965, was reviewed. Utilization of short half-life RI in various fields was described. Utilization in medicine, sterilization of medical supplies, the industrial world and hydrology was detailed. Annual changes in these fields were shown and tables were presented. The status of various types of radiation and RI utilization in Indonesia, which included nuclear analytical techniques in industry and various laboratories in agriculture, industry and biology, was reported. Finally, the plan of construction of a third research reactor was referred to. (Chiba, N.)

  15. Interference Suppression Performance of Automotive UWB Radars Using Pseudo Random Sequences

    Directory of Open Access Journals (Sweden)

    I. Pasya

    2015-12-01

    Full Text Available Ultra wideband (UWB automotive radars have attracted attention from the viewpoint of reducing traffic accidents. The performance of automotive radars may be degraded by interference from nearby radars using the same frequency. In this study, a scenario where two cars pass each other on a road was considered. Considering the utilization of cross-polarization, the desired-to-undesired signal power ratio (DUR was found to vary approximately from -10 to 30 dB. Different pseudo random sequences were employed for spectrum spreading the different radar signals to mitigate the interference effects. This paper evaluates the interference suppression provided by maximum length sequence (MLS and Gold sequence (GS through numerical simulations of the radar’s performance in terms of probability of false alarm and probability of detection. It was found that MLS and GS yielded nearly the same performance when the DUR is -10 dB (worst case; for example when fixing the probability of false alarm to 0.0001, the probabilities of detection were 0.964 and 0.946 respectively. The GS are more advantageous than MLS due to larger number of different sequences having the same length in GS than in MLS.

  16. Utilities' nuclear fuel economic evaluation methods

    International Nuclear Information System (INIS)

    Sonz, L.A.

    1987-01-01

    This paper presents the typical perceptions, methods, considerations, and procedures used by an operating electric utility in the economic evaluation of nuclear fuel preparation and utilization scenarios. The means given are probably not an exclusive review of those available, but are the author's recollection of systems employed to select and recommend preferable courses of action. Economic evaluation of proposed nuclear fuel scenarios is an important, but not exclusive, means of deciding on corporate action. If the economic evaluation is performed and coordinated with the other corporate considerations, such as technical and operational ability, electrical system operations management, tax effects, capital management, rates impact, etc., then the resultant recommendation may be employed to the benefit of the customers and, consequently, to the corporation

  17. Agp2, a Member of the Yeast Amino Acid Permease Family, Positively Regulates Polyamine Transport at the Transcriptional Level

    KAUST Repository

    Aouida, Mustapha

    2013-06-03

    Agp2 is a plasma membrane protein of the Saccharomyces cerevisiae amino acid transporter family, involved in high-affinity uptake of various substrates including L-carnitine and polyamines. The discovery of two high affinity polyamine permeases, Dur3 and Sam3, prompted us to investigate whether Agp2 directly transports polyamines or acts instead as a regulator. Herein, we show that neither dur3? nor sam3? single mutant is defective in polyamine transport, while the dur3? sam3? double mutant exhibits a sharp decrease in polyamine uptake and an increased resistance to polyamine toxicity similar to the agp2? mutant. Studies of Agp2 localization indicate that in the double mutant dur3? sam3?, Agp2-GFP remains plasma membrane-localized, even though transport of polyamines is strongly reduced. We further demonstrate that Agp2 controls the expression of several transporter genes including DUR3 and SAM3, the carnitine transporter HNM1 and several hexose, nucleoside and vitamin permease genes, in addition to SKY1 encoding a SR kinase that positively regulates low-affinity polyamine uptake. Furthermore, gene expression analysis clearly suggests that Agp2 is a strong positive regulator of additional biological processes. Collectively, our data suggest that Agp2 might respond to environmental cues and thus regulate the expression of several genes including those involved in polyamine transport. © 2013 Aouida et al.

  18. Agp2, a Member of the Yeast Amino Acid Permease Family, Positively Regulates Polyamine Transport at the Transcriptional Level

    KAUST Repository

    Aouida, Mustapha; Texeira, Marta Rubio; Thevelein, Johan M.; Poulin, Richard; Ramotar, Dindial

    2013-01-01

    Agp2 is a plasma membrane protein of the Saccharomyces cerevisiae amino acid transporter family, involved in high-affinity uptake of various substrates including L-carnitine and polyamines. The discovery of two high affinity polyamine permeases, Dur3 and Sam3, prompted us to investigate whether Agp2 directly transports polyamines or acts instead as a regulator. Herein, we show that neither dur3? nor sam3? single mutant is defective in polyamine transport, while the dur3? sam3? double mutant exhibits a sharp decrease in polyamine uptake and an increased resistance to polyamine toxicity similar to the agp2? mutant. Studies of Agp2 localization indicate that in the double mutant dur3? sam3?, Agp2-GFP remains plasma membrane-localized, even though transport of polyamines is strongly reduced. We further demonstrate that Agp2 controls the expression of several transporter genes including DUR3 and SAM3, the carnitine transporter HNM1 and several hexose, nucleoside and vitamin permease genes, in addition to SKY1 encoding a SR kinase that positively regulates low-affinity polyamine uptake. Furthermore, gene expression analysis clearly suggests that Agp2 is a strong positive regulator of additional biological processes. Collectively, our data suggest that Agp2 might respond to environmental cues and thus regulate the expression of several genes including those involved in polyamine transport. © 2013 Aouida et al.

  19. Biogas upgrading and utilization: Current status and perspectives

    DEFF Research Database (Denmark)

    Angelidaki, Irini; Treu, Laura; Tsapekos, Panagiotis

    2018-01-01

    Biogas production is an established sustainable process for simultaneous generation of renewable energy and treatment of organic wastes. The increasing interest of utilizing biogas as substitute to natural gas or its exploitation as transport fuel opened new avenues in the development of biogas...... upgrading techniques. The present work is a critical review that summarizes state-of-the-art technologies for biogas upgrading and enhancement with particular attention to the emerging biological methanation processes. The review includes comprehensive description of the main principles of various biogas...

  20. LiDAR utility for natural resource managers

    Science.gov (United States)

    Andrew Thomas Hudak; Jeffrey Scott Evans; Alistair Mattthew Stuart. Smith

    2009-01-01

    Applications of LiDAR remote sensing are exploding, while moving from the research to the operational realm. Increasingly, natural resource managers are recognizing the tremendous utility of LiDAR-derived information to make improved decisions. This review provides a cross-section of studies, many recent, that demonstrate the relevance of LiDAR across a suite of...

  1. Utility-adjusted analysis of the cost of palliative radiotherapy for bone metastases

    International Nuclear Information System (INIS)

    Barton, M.B.; Jacob, S.A.

    2003-01-01

    Palliative radiotherapy is effective in the treatment of bone metastases but is under-utilized, possibly because it is perceived to be expensive. We performed a cost-utility analysis of palliative radiotherapy for bone metastases, evaluating both the actual cost of radiotherapy as well as its impact on quality of life by adjusting for the variation in response to treatment. Hospital records between July 1991 and July 1996 were reviewed to ascertain the number of patients treated with palliative radiotherapy for bone metastases, the average number of fields of radiation delivered to each patient and the average duration of survival. Partial and complete response rates to palliative radiotherapy were obtained from a review of all published randomized controlled trials of radiation treatment of bone metastases. Utility values were assigned to the response rates, and an overall adjusted response rate to radiotherapy was derived. The cost of delivering a field of radiation was calculated. The total cost was divided by the total number of response months to give a utility-adjusted cost per month of palliative radiotherapy. The utility-adjusted cost per month of palliative radiotherapy of bone metastases was found to be AUS$ 100 per month or AUS$ 1200 per utility-adjusted life-year. This study demonstrates that, contrary to popular perception, palliative radiotherapy is a cost-effective treatment modality for bone metastases. Copyright (2003) Blackwell Science Pty Ltd

  2. 42 CFR 456.233 - Initial continued stay review date.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... must provide that— (a) When a recipient is admitted to the mental hospital under admission review... will be reviewed; (b) If an individual applies for Medicaid while in the mental hospital, the committee...

  3. The Clinical Utility and Diagnostic Performance of MRI for Identification of Early and Advanced Knee Osteoarthritis: A Systematic Review

    Science.gov (United States)

    Quatman, Carmen E.; Hettrich, Carolyn M.; Schmitt, Laura C.; Spindler, Kurt P.

    2013-01-01

    Background Current diagnostic strategies for detection of structural articular cartilage abnormalities, the earliest structural signs of osteoarthritis, often do not capture the condition until it is too far advanced for the most potential benefit of non-invasive interventions. Purpose Systematically review the literature relative to the following questions: (1) Is MRI a valid, sensitive, specific, accurate and reliable instrument to identify knee articular cartilage abnormalities compared to arthroscopy? (2) Is MRI a sensitive tool that can be utilized to identify early cartilage degeneration? Study Design Systematic Review Methods A systematic search was performed in November 2010 using PubMed MEDLINE (from 1966), CINAHL (from 1982), SPORTDiscus (from 1985), and SCOPUS (from 1996) databases. Results Fourteen level I and 13 level II studies were identified that met inclusion criteria and provided information related to diagnostic performance of MRI compared to arthroscopic evaluation. The diagnostic performance of MRI demonstrated a large range of sensitivities, specificities, and accuracies. The sensitivity for identifying articular cartilage abnormalities in the knee joint was reported between 26–96%. Specificity and accuracy was reported between 50–100% and 49–94%, respectively. The sensitivity, specificity, and accuracy for identifying early osteoarthritis were reported between 0–86%, 48–95%, and 5–94%, respectively. As a result of inconsistencies between imaging techniques and methodological shortcomings of many of the studies, a meta-analysis was not performed and it was difficult to fully synthesize the information to state firm conclusions about the diagnostic performance of MRI. Conclusions There is evidence in some MRI protocols that MRI is a relatively valid, sensitive, specific, accurate, and reliable clinical tool for identifying articular cartilage degeneration. Due to heterogeneity of MRI sequences it is not possible to make definitive

  4. Financial statistics of major U.S. publicly owned electric utilities 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    The 1997 edition of the ``Financial Statistics of Major U.S. Publicly Owned Electric Utilities`` publication presents 5 years (1993 through 1997) of summary financial data and current year detailed financial data on the major publicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decisionmaking purposes related to publicly owned electric utility issues. Generator (Tables 3 through 11) and nongenerator (Tables 12 through 20) summaries are presented in this publication. Five years of summary financial data are provided (Tables 5 through 11 and 14 through 20). Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided in Appendix C. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, operating revenue, and electric energy account data. The primary source of publicly owned financial data is the Form EIA-412, ``Annual Report of Public Electric Utilities.`` Public electric utilities file this survey on a fiscal year basis, in conformance with their recordkeeping practices. The EIA undertook a review of the Form EIA-412 submissions to determine if alternative classifications of publicly owned electric utilities would permit the inclusion of all respondents. The review indicated that financial indicators differ most according to whether or not a publicly owned electric utility generates electricity. Therefore, the main body of the report provides summary information in generator/nongenerator classifications. 2 figs., 101 tabs.

  5. Financial statistics of major U.S. publicly owned electric utilities 1997

    International Nuclear Information System (INIS)

    1998-12-01

    The 1997 edition of the ''Financial Statistics of Major U.S. Publicly Owned Electric Utilities'' publication presents 5 years (1993 through 1997) of summary financial data and current year detailed financial data on the major publicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decisionmaking purposes related to publicly owned electric utility issues. Generator (Tables 3 through 11) and nongenerator (Tables 12 through 20) summaries are presented in this publication. Five years of summary financial data are provided (Tables 5 through 11 and 14 through 20). Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided in Appendix C. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, operating revenue, and electric energy account data. The primary source of publicly owned financial data is the Form EIA-412, ''Annual Report of Public Electric Utilities.'' Public electric utilities file this survey on a fiscal year basis, in conformance with their recordkeeping practices. The EIA undertook a review of the Form EIA-412 submissions to determine if alternative classifications of publicly owned electric utilities would permit the inclusion of all respondents. The review indicated that financial indicators differ most according to whether or not a publicly owned electric utility generates electricity. Therefore, the main body of the report provides summary information in generator/nongenerator classifications. 2 figs., 101 tabs

  6. Multiattribute Utility Theory without Expected Utility Foundations

    NARCIS (Netherlands)

    J. Miyamoto (John); P.P. Wakker (Peter)

    1996-01-01

    textabstractMethods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities and simplifying decompositions of multiattribute

  7. 42 CFR 476.73 - Notification of QIO designation and implementation of review.

    Science.gov (United States)

    2010-10-01

    ... OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement... dates of the QIO contract and specifies the area and types of health care facilities to be reviewed by...

  8. Review of the Reported Measures of Clinical Validity and Clinical Utility as Arguments for the Implementation of Pharmacogenetic Testing: A Case Study of Statin-Induced Muscle Toxicity

    Directory of Open Access Journals (Sweden)

    Marleen E. Jansen

    2017-08-01

    Full Text Available Advances from pharmacogenetics (PGx have not been implemented into health care to the expected extent. One gap that will be addressed in this study is a lack of reporting on clinical validity and clinical utility of PGx-tests. A systematic review of current reporting in scientific literature was conducted on publications addressing PGx in the context of statins and muscle toxicity. Eighty-nine publications were included and information was selected on reported measures of effect, arguments, and accompanying conclusions. Most authors report associations to quantify the relationship between a genetic variation an outcome, such as adverse drug responses. Conclusions on the implementation of a PGx-test are generally based on these associations, without explicit mention of other measures relevant to evaluate the test's clinical validity and clinical utility. To gain insight in the clinical impact and select useful tests, additional outcomes are needed to estimate the clinical validity and utility, such as cost-effectiveness.

  9. A 100-year review: Carbohydrates - characterization, digestion, and utilization

    Science.gov (United States)

    Our knowledge of the role of carbohydrates in dairy cattle nutrition has advanced substantially during the 100 years in which the Journal of Dairy Science has been published. In this review, we traced the history of scientific investigation and discovery from crude fiber, nitrogen-free extract, and ...

  10. TransAlta: More than a utility

    International Nuclear Information System (INIS)

    Mikalson, D.A.

    1991-01-01

    TransAlta Utilities Corporation is Canada's largest privately owned utility and is also a major coal mining company. In 1989, TransAlta produced 20.9% of all coal mined in Canada. A brief history of TransAlta is presented along with TransAlta's present coal operations and plans for the next three years. An overview is presented of how TransAlta Fuel Supply is organized to utilize contracted mining operation, engineering and environmental services and in-house capabilities. Recent strategic initiatives to improve organizational efficiency and the mining operations are discussed. These range from developing a common departmental vision to modifying major mining equipment. TransAlta's proactive role in clean coal combustion such as low NOx-SOx burner, integrated combined cycle gasification, and other energy research projects is reviewed. A summary is provided of recent participation of TransAlta in environmental management initiatives. Recent successes of TransAlta's unregulated subsidiary in the development of cogeneration facilities and the future of this area of business are discussed. 8 refs., 4 figs

  11. Wind as a utility-grade supply resource: A planning framework for the Pacific Northwest

    International Nuclear Information System (INIS)

    Johnson, M.S.; Litchfield, J.

    1993-12-01

    Many areas throughout the United States possess favorable wind resources that, as yet, remain undeveloped. This paper provides valuable information on the type of information developers can provide, utility interpretation of the information in regard to electric energy and capacity attributes, and wind resource characteristics of interest to utilities. The paper also reviews key utility planning contexts within which prospective wind resources may be evaluated

  12. Reactor utilization, Part 1

    International Nuclear Information System (INIS)

    Martinc, R.; Stanic, A.

    1981-01-01

    The reactor operating plan for 1981 was subject to the needs of testing operation with the 80% enriched fuel and was fulfilled on the whole. This annex includes data about reactor operation, review of shorter interruptions due to demands of the experiments, data about safety shutdowns caused by power cuts. Period of operation at low power levels was used mostly for activation analyses, and the operation at higher power levels were used for testing and regular isotope production. Detailed data about samples activation are included as well as utilization of the reactor as neutron source and the operating plan for 1982 [sr

  13. Bilateral vocal fold immobility: a 13 year review of etiologies, management and the utility of the Empey index.

    Science.gov (United States)

    Brake, Maria K; Anderson, Jennifer

    2015-06-26

    Bilateral vocal fold immobility (BVFI) is a rare diagnosis causing dyspnea, dysphonia and dysphagia. Management depends on respiratory performance, airway patency, vocal ability, and quality-of-life priorities. The authors review the presentation, management and outcome in patients diagnosed with BVFI. The utility and efficacy of the Empey index (EI) and the Expiratory Disproportion Index (EDI) are evaluated as an objective monitoring tools for BVFI patients. A 13-year retrospective review was performed of BVFI patients at St. Michael's Hospital, University of Toronto, a tertiary referral centre for laryngology. Forty-eight patients were included; 46 presented with airway obstruction symptoms. Tracheotomy was required for airway management in 40% of patients throughout the course of their treatment, which was reduced to 19% at the end of the study period. Twenty-one patients underwent endoscopic arytenoidectomy/cordotomy. Non-operative management included continuous positive airway pressure devices. Pulmonary function testing was carried out in 29 patients. Only a portion of the BVFI patients met the defined upper airway obstruction criteria (45% EI and 52% EDI). Seven patients had complete pre- and post-operative PFTs for comparison and all seven had ratios that significantly improved post-operatively which correlated clinically. The EI and EDI have limited use in evaluating patients with who have variable upper airway obstruction, but may be helpful in monitoring within subject airway function changes.

  14. Utilization of used oil. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mascetti, G.J.; White, H.M.

    1978-08-01

    This report assesses the potential impact of re-refining used automotive and industrial lubricating oils on the national petroleum consumption. The technical base for this assessment is derived from a comprehensive review of the processes utilized in re-refining used oil and those processes used to produce lube oil from crude. Both existing and recently proposed processes are considered. Additionally, an extensive review of processes described in the patent literature is provided. Re-refining processes are surveyed and evaluated. Process descriptions are provided; hardware is identified; and process energy and economic requirements are calculated. Factors affecting the profitability of a re-refining operation are discussed. Economic projections of the demand for lube oil and the ability to satisfy this demand from crude oil are made and the value of lube oil as a vital resource and the need for conservation are addressed. Other factors related to re-refining are discussed, including lube oil characteristics, degradation, lube oil quality and engine sequence testing, and legislative and institutional barriers. Finally, an energy assessment of used oil utilization is made. Two options are considered in this assessment: (1) all used oil is re-refined and recycled back to lube oil; (2) all used oil is burned to recover its heat content.

  15. A survey of thorium utilization in thermal power reactors

    International Nuclear Information System (INIS)

    Oosterkamp, W.J.

    1974-01-01

    The present status of thorium utilization in thermal reactors HTGR's, HWR's and LWR's has been reviewed. Physics considerations are made to obtain the optimum use of thorium. Existing information on reprocessing and refabrication is given together with the properties of thorium metal and thoria

  16. U. S. Utility Leadership in Requirements For Passive Reactors

    International Nuclear Information System (INIS)

    Kim, Jcng H.; Layman, William H.

    1991-01-01

    Utility leadership from both U.S. utilities and international utilities, is a key element in the U. S. Advanced Light Water Reactor Program. International utilities have played a very import Design reviews by the utilities participating in the ALRR Program will ensure that all of the utility requirements are met while design work is being carried out. Our mission is to achieve NRC certification of designs that reflect the needs of the utilities and we believe that this will play an important role in the resurgence of nuclear plant construction in the United States. As stated in the Nuclear Power Oversight Committee's Strategic Plan For Building New Nuclear Power Plants : 'The extensive operating experience with today's light water reactors (LWRs), and the promise shown in recent technical developments, leads the industry to the conclusion that the next nuclear plants ordered in the United States will be advanced light water reactors (A LWRs). Two types are under development : units of large output (1300 MW) called 'evolutionary' A LWRs and units of mid-size output (600 MW) called 'Passive' A LWRs. The term 'passive' refers to the safety features which depend more on natural processes such as gravity and buoyancy than on powered equipment such as pumps

  17. The energy-efficiency business - Energy utility strategies; Geschaeftsfeld Energieeffizienz. Strategien von Energieversorgern

    Energy Technology Data Exchange (ETDEWEB)

    Loebbe, S.

    2009-07-01

    This article takes a look at the energy-efficiency business and the advantages it offers. The author quotes that energy-efficiency can contribute to making savings in primary energy, minimise the economic impact of global warming, improve reliability of supply and protect the gross national product. The advantages of new products for the efficient use of energy are reviewed and the resulting advantages for power customers are noted. Also, possibilities for the positioning of electricity suppliers in the environmental niche is noted. The partial markets involved and estimates concerning the impact of energy-efficiency measures are reviewed. Climate protection, co-operation with energy agencies, consulting services and public relations aspects are also discussed. The prerequisites for successful marketing by the utilities are examined and new business models are discussed along with the clear strategies needed. The development from an electricity utility to a system-competence partner is reviewed.

  18. Kleinke's "Bleeding Edge" sees utility role for providers.

    Science.gov (United States)

    Johnson, D E

    1998-10-01

    Hospitals will evolve into units of health care delivery systems that will eventually resemble utilities, like water and the telephone, according to a new book. Donald E.L. Johnson reviews Bleeding Edge: The Business View of Health Care in the New Century, by J.D. Kleinke, and discusses the strategic implications of Kleinke's predictions.

  19. Stakeholder Analysis in Utilizing of Environmental Services and Natural Attractions in Tuk Semuncar Utilization Zone of Gunung Merbabu National Park: A literature review

    Science.gov (United States)

    Setiawan, Muhammad Arif; Muhammad, Fuad

    2018-02-01

    Many stakeholders in the utilizing of environmental services and natural attraction of Tuk Semuncar Utilization Zone needs to get the attention of the Gunung Merbabu National Park Officer. The existence of natural resources has an important role for the life of the community, making the complexity of the relationship between various parties who have interests in natural resource management. The existence of stakeholders and their interests should receive attention and be considered to be accommodated as an effort to prevent the occurrence of losses to the conservation area of Gunung Merbabu National Park. Every stakeholder's interest can have a positive and negative impact on other stakeholders. Stakeholder analysis can help in understanding the conflict on the utilizing of environmental services and natural attraction that is happening, as well as input strategy in involving stakeholders for the achievement of goals.

  20. Stakeholder Analysis in Utilizing of Environmental Services and Natural Attractions in Tuk Semuncar Utilization Zone of Gunung Merbabu National Park: A literature review

    Directory of Open Access Journals (Sweden)

    Setiawan Muhammad Arif

    2018-01-01

    Full Text Available Many stakeholders in the utilizing of environmental services and natural attraction of Tuk Semuncar Utilization Zone needs to get the attention of the Gunung Merbabu National Park Officer. The existence of natural resources has an important role for the life of the community, making the complexity of the relationship between various parties who have interests in natural resource management. The existence of stakeholders and their interests should receive attention and be considered to be accommodated as an effort to prevent the occurrence of losses to the conservation area of Gunung Merbabu National Park. Every stakeholder's interest can have a positive and negative impact on other stakeholders. Stakeholder analysis can help in understanding the conflict on the utilizing of environmental services and natural attraction that is happening, as well as input strategy in involving stakeholders for the achievement of goals.

  1. Selenium Utilization Strategy by Microalgae

    Directory of Open Access Journals (Sweden)

    Hiroya Araie

    2009-11-01

    Full Text Available The diversity of selenoproteins raises the question of why so many life forms require selenium. Selenoproteins are found in bacteria, archaea, and many eukaryotes. In photosynthetic microorganisms, the essential requirement for selenium has been reported in 33 species belonging to six phyla, although its biochemical significance is still unclear. According to genome databases, 20 species are defined as selenoprotein-producing organisms, including five photosynthetic organisms. In a marine coccolithophorid, Emiliania huxleyi (Haptophyta, we recently found unique characteristics of selenium utilization and novel selenoproteins using 75Se-tracer experiments. In E. huxleyi, selenite, not selenate, is the main substrate used and its uptake is driven by an ATP-dependent highaffinity, active transport system. Selenite is immediately metabolized to low-molecular mass compounds and partly converted to at least six selenoproteins, named EhSEP1–6. The most (EhSEP2 and second-most abundant selenoproteins (EhSEP1 are disulfide isomerase (PDI homologous protein and thioredoxin reductase (TR 1, respectively. Involvement of selenium in PDI is unique in this organism, while TR1 is also found in other organisms. In this review, we summarize physiological, biochemical, and molecular aspects of selenium utilization by microalgae and discuss their strategy of selenium utilization.

  2. The Contribution of Wildlife to Sustainable Natural Resource Utilization in Namibia: A Review

    Directory of Open Access Journals (Sweden)

    Diana L. van Schalkwyk

    2010-11-01

    Full Text Available Namibia is the driest country in sub-Saharan Africa, but well known for its richness in species and sustainable natural resource utilization. The Namibian farming sector consists mainly of extensive farming systems. Cattle production contributes 54% of the livestock sector’s production output, followed by sheep and goats (25%, hides and skins (9%, and other forms of agricultural production (12%. Namibia’s freehold farmers have obtained ownership rights over land and livestock since the early 1900s; commercial rights over wildlife and plants were given to freehold farmers in 1967 and to communal farmers in 1996. Natural resource-based production systems then overtook agricultural production systems and exceeded it by a factor of at least two. The shift from practicing conservation to sustainable utilization of natural resources contributed to the rapid growth of wildlife utilization. The wildlife industry in Namibia is currently the only animal production system that is expanding. There are in total at least two million head of different wildlife species. The broader impact of the utilization of wildlife on the economy is estimated to be around N$ 1.3 billion. Tourism, live sales and trophy hunting, cannot sustain further growth. Wildlife farming could offer better opportunities for ensuring long-term sustainability. As the game meat trade in Namibia is not formalized, harvesting wildlife to satisfy the demand for game meat in export markets is still in its infancy. Sustainable harvesting of wildlife for meat production, however, has the potential to increase earnings to the beneficiaries in the wildlife sector.

  3. A Review of Avian Monitoring and Mitigation Information at Existing Utility-Scale Solar Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Walston, Leroy J. [Argonne National Lab. (ANL), Argonne, IL (United States); Rollins, Katherine E. [Argonne National Lab. (ANL), Argonne, IL (United States); Smith, Karen P. [Argonne National Lab. (ANL), Argonne, IL (United States); LaGory, Kirk E. [Argonne National Lab. (ANL), Argonne, IL (United States); Sinclair, Karin [National Renewable Energy Lab. (NREL), Golden, CO (United States); Turchi, Craig [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wendelin, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Souder, Heidi [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2015-01-01

    There are two basic types of solar energy technology: photovoltaic and concentrating solar power. As the number of utility-scale solar energy facilities using these technologies is expected to increase in the United States, so are the potential impacts on wildlife and their habitats. Recent attention is on the risk of fatality to birds. Understanding the current rates of avian mortality and existing monitoring requirements is an important first step in developing science-based mitigation and minimization protocols. The resulting information also allows a comparison of the avian mortality rates of utility-scale solar energy facilities with those from other technologies and sources, as well as the identification of data gaps and research needs. This report will present and discuss the current state of knowledge regarding avian issues at utility-scale solar energy facilities.

  4. The view of Japanese utilities on uranium procurement

    International Nuclear Information System (INIS)

    Kishida, Tetsuji

    1991-01-01

    Since Japan is entirely dependent on imports to meet its demand for uranium, its foremost consideration is security of supply. From this point of view, the long-term strategy for uranium procurement followed by the Japanese Government and utilities can be summarized in four points; diversification of supply sources, long term contracts, holding of sufficient inventory and self-supply (ie. involvement in exploration activity and mine development). Under this basic strategy, Japanese utilities have made decisions on which suppliers they buy uranium from, and which purchasing method to adopt, based on the principles of securing stable sources of supply and stable prices. This position is reviewed and discussed. (author)

  5. Utilization of High-Temperature Slags From Metallurgy Based on Crystallization Behaviors

    Science.gov (United States)

    Sun, Yongqi; Zhang, Zuotai

    2018-05-01

    Here, following the principle of modifying crystallization behaviors, including avoidance and optimization, we review recent research on the utilization of hot slags. Because of the high-temperature property (1450-1650°C), the utilization of hot slags are much different from that of other wastes. We approach this issue from two main directions, namely, material recycling and heat utilization. From the respect of material recycling, the utilization of slags mainly follows total utilization and partial utilization, whereas the heat recovery from slags follows two main paths, namely, physical granulation and chemical reaction. The effective disposal of hot slags greatly depends on clarifying the crystallization behaviors, and thus, we discuss some optical techniques and their applicable scientific insights. For the purpose of crystallization avoidance, characterizing the glass-forming ability of slags is of great significance, whereas for crystallization modification, the selection of chemical additives and control of crystallization conditions comprise the central routes.

  6. Utilization of Volatile Organic Compounds as an Alternative for Destructive Abatement

    Directory of Open Access Journals (Sweden)

    Satu Ojala

    2015-07-01

    Full Text Available The treatment of volatile organic compounds (VOC emissions is a necessity of today. The catalytic treatment has already proven to be environmentally and economically sound technology for the total oxidation of the VOCs. However, in certain cases, it may also become economical to utilize these emissions in some profitable way. Currently, the most common way to utilize the VOC emissions is their use in energy production. However, interesting possibilities are arising from the usage of VOCs in hydrogen and syngas production. Production of chemicals from VOC emissions is still mainly at the research stage. However, few commercial examples exist. This review will summarize the commercially existing VOC utilization possibilities, present the utilization applications that are in the research stage and introduce some novel ideas related to the catalytic utilization possibilities of the VOC emissions. In general, there exist a vast number of possibilities for VOC utilization via different catalytic processes, which creates also a good research potential for the future.

  7. The history of soil erosion: Interpreting historical sources, buried soils and colluvial sediments as archives of past soil erosion and human-environment interactions in the Longue Durée

    Science.gov (United States)

    Dotterweich, Markus

    2015-04-01

    of human-environment interactions in the Longue Durée.

  8. The impact of utilizing mobile phones to promote physical activity among post-secondary students: a scoping review.

    Science.gov (United States)

    Ly, Hieu

    2016-01-01

    A commitment to regular physical activity may reduce the risks of chronic diseases for young adults. Internationally, the majority of post-secondary students are insufficiently active for health benefits. Novel health strategies and interventions utilizing mobiles phones could increase post-secondary students' physical activity levels. However, there is contradictory evidence to support the use of mobile phones to promote physical activity, and a scoping review could provide further insights into this topic. The purpose of this study was to conduct a scoping review to explore the existing literature and investigate what is currently known about the use of mobile phones to enhance physical activity levels among post-secondary students. A total of 84 articles were identified from the literature search, and six studies were selected for data analysis. Two major themes were supported by the evidence, which included: (I) the relationship between mobile phones and physical activity levels; and (II) students' perceptions of mobile phones. Goal setting principles combined with text message interventions were reported to have significant influences on students' physical activity levels. Students expressed mixed feelings about coaching elements of apps and posting personal results on social networking websites. No studies reported the use of objective physical activity measurements. In conclusion, mobile phone technologies such as text message reminders could be included in health interventions to enhance post-secondary students' physical activity levels. There is limited evidence available on this topic and additional research is warranted to establish a clearer understanding of the relationship between mobile phones and post-secondary students' physical activity.

  9. Drug-related problems and changes in drug utilization after medication reviews in nursing homes in Oslo, Norway.

    Science.gov (United States)

    Fog, Amura Francesca; Kvalvaag, Gunnar; Engedal, Knut; Straand, Jørund

    2017-12-01

    We describe the drug-related problems (DRPs) identified during medication reviews (MRs) and the changes in drug utilization after MRs at nursing homes in Oslo, Norway. We explored predictors for the observed changes. Observational before-after study. Forty-one nursing homes. MRs performed by multidisciplinary teams during November 2011 to February 2014. In all, 2465 long-term care patients. DRPs identified by explicit criteria (STOPP/START and NORGEP) and drug-drug interaction database; interventions to resolve DRPs; drug use changes after MR. A total of 6158 DRPs were identified, an average of 2.6 DRPs/patient, 2.0 for regular and 0.6 for pro re nata (prn) drugs. Of these patients, 17.3% had no DRPs. The remaining 82.7% of the patients had on average 3.0 DRPs/patient. Use of unnecessary drugs (43.5%), excess dosing (12.5%) and lack of monitoring of the drug use (11%) were the most frequent DRPs. Opioids and psychotropic drugs were involved in 34.4% of all DRPs. The mean number of drugs decreased after the MR from 6.8 to 6.3 for regular drugs and from 3.0 to 2.6 for prn drugs. Patients with DRPs experienced a decrease of 1.1 drugs after MR (0.5 for regular and 0.6 for prn drugs). The reduction was most pronounced for the regular use of antipsychotics, antidepressants, hypnotics/sedatives, diuretics, antithrombotic agents, antacid drugs; and for prn use of anxiolytics, opioids, hypnotics/sedatives, metoclopramide and NSAIDs. The medication review resulted in less drug use, especially opioids and psychotropic drugs.

  10. A Prospective Cohort Study on the Clinical Utility of Second ...

    African Journals Online (AJOL)

    2017-06-28

    Jun 28, 2017 ... the clinical utility of second trimester MABP in the prediction of preeclampsia. Methods: This ..... the convenience of a single cutoff value for decision making, a systematic review and meta‑analysis[17] showed that MABP was a ...

  11. Periphytic biofilms: A promising nutrient utilization regulator in wetlands.

    Science.gov (United States)

    Wu, Yonghong; Liu, Junzhuo; Rene, Eldon R

    2018-01-01

    Low nutrient utilization efficiency in agricultural ecosystems is the main cause of nonpoint source (NPS) pollution. Therefore, novel approaches should be explored to improve nutrient utilization in these ecosystems. Periphytic biofilms composed of microalgae, bacteria and other microbial organisms are ubiquitous and form a 'third phase' in artificial wetlands such as paddy fields. Periphytic biofilms play critical roles in nutrient transformation between the overlying water and soil/sediment, however, their contributions to nutrient utilization improvement and NPS pollution control have been largely underestimated. This mini review summarizes the contributions of periphytic biofilms to nutrient transformation processes, including assimilating and storing bioavailable nitrogen and phosphorus, fixing nitrogen, and activating occluded phosphorus. Future research should focus on augmenting the nitrogen fixing, phosphate solubilizing and phosphatase producing microorganisms in periphytic biofilms to improve nutrient utilization and thereby reduce NPS pollution production in artificial and natural wetland ecosystems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Managing carbon regulatory risk in utility resource planning: Current practices in the Western United States

    International Nuclear Information System (INIS)

    Barbose, Galen; Wiser, Ryan; Phadke, Amol; Goldman, Charles

    2008-01-01

    Concerns about global climate change have substantially increased the likelihood that future policy will seek to minimize carbon dioxide emissions. As such, even today, electric utilities are making resource planning and investment decisions that consider the possible implications of these future carbon regulations. In this article, we examine the manner in which utilities assess the financial risks associated with future carbon regulations within their long-term resource plans. We base our analysis on a review of the most recent resource plans filed by 15 electric utilities in the Western United States. Virtually all of these utilities made some effort to quantitatively evaluate the potential cost of future carbon regulations when analyzing alternate supply- and demand-side resource options for meeting customer load. Even without federal climate regulation in the US, the prospect of that regulation is already having an impact on utility decision-making and resource choices. That said, the methods and assumptions used by utilities to analyze carbon regulatory risk, and the impact of that analysis on their choice of a particular resource strategy, vary considerably, revealing a number of opportunities for analytic improvement. Though our review focuses on a subset of US electric utilities, this work holds implications for all electric utilities and energy policymakers who are seeking to minimize the compliance costs associated with future carbon regulations

  13. Preparation, characterization and utilization of starch nanoparticles.

    Science.gov (United States)

    Kim, Hee-Young; Park, Sung Soo; Lim, Seung-Taik

    2015-02-01

    Starch is one of the most abundant biopolymers in nature and is typically isolated from plants in the form of micro-scale granules. Recent studies reported that nano-scale starch particles could be readily prepared from starch granules, which have unique physical properties. Because starch is environmentally friendly, starch nanoparticles are suggested as one of the promising biomaterials for novel utilization in foods, cosmetics, medicines as well as various composites. An overview of the most up-to-date information regarding the starch nanoparticles including the preparation processes and physicochemical characterization will be presented in this review. Additionally, the prospects and outlooks for the industrial utilization of starch nanoparticles will be discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Beyond expected utility: rethinking behavioral decision research.

    Science.gov (United States)

    Frisch, D; Clemen, R T

    1994-07-01

    Much research in psychology has evaluated the quality of people's decisions by comparisons with subjective expected utility (SEU) theory. This article suggests that typical arguments made for the status of utility theory as normative do not justify its use by psychologists as a standard by which to evaluate decision quality. It is argued that to evaluate decision quality, researchers need to identify those decision processes that tend to lead to desirable outcomes. It is contended that a good decision-making process must be concerned with how (and whether) decision makers evaluate potential consequences of decisions, the extent to which they accurately identify all relevant consequences, and the way in which they make final choices. Research that bears on these issues is reviewed.

  15. Purchasing non-utility power

    International Nuclear Information System (INIS)

    Brackeen, L.G.

    1990-01-01

    The author discusses Houston Lighting and Power Company's procedure for purchasing power from cogenerators. By way of introduction, HL and P is the eighth largest electric utility in the United States in terms of kilowatt-hour sales and the second largest purchaser of natural gas in the nation. HL and P is also the principal utility providing electric service to the massive petrochemical industry in Southeast Texas. Of the 4,800 MW of cogeneration available, HL and P buys 945 MW under firm contracts, wheel 1,600 MW to other utilities, buy 400 MW under non-firm contracts and the balance is self-generation used to displace power which would otherwise be purchased from HL and P. With all this cogeneration capacity available, the problem until recently has been managing the surplus. HL and P now is finding itself in the unaccustomed position of needing to buy additional power or build plants to meet the modest growth it forecasts for Houston. The need for additional capacity coincides with the expiration of cogeneration contracts in 1993 and 1994. To meet this capacity need, they are determined to avoid buying cogeneration at a very high price and on delivery terms which do not reflect realistic benefits to their electric customers. The paper gives information on the background on PUC regulations and legislation, then briefly reviews the procedure for purchase of cogenerated power in Texas

  16. Interrupted time series analysis in drug utilization research is increasing: systematic review and recommendations.

    Science.gov (United States)

    Jandoc, Racquel; Burden, Andrea M; Mamdani, Muhammad; Lévesque, Linda E; Cadarette, Suzanne M

    2015-08-01

    To describe the use and reporting of interrupted time series methods in drug utilization research. We completed a systematic search of MEDLINE, Web of Science, and reference lists to identify English language articles through to December 2013 that used interrupted time series methods in drug utilization research. We tabulated the number of studies by publication year and summarized methodological detail. We identified 220 eligible empirical applications since 1984. Only 17 (8%) were published before 2000, and 90 (41%) were published since 2010. Segmented regression was the most commonly applied interrupted time series method (67%). Most studies assessed drug policy changes (51%, n = 112); 22% (n = 48) examined the impact of new evidence, 18% (n = 39) examined safety advisories, and 16% (n = 35) examined quality improvement interventions. Autocorrelation was considered in 66% of studies, 31% reported adjusting for seasonality, and 15% accounted for nonstationarity. Use of interrupted time series methods in drug utilization research has increased, particularly in recent years. Despite methodological recommendations, there is large variation in reporting of analytic methods. Developing methodological and reporting standards for interrupted time series analysis is important to improve its application in drug utilization research, and we provide recommendations for consideration. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Improving utility conservation programs: outcomes, interventions, and evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Condelli, L; Archer, D; Aronson, E; Curbow, B; McLeod, B; Pettigrew, T F; White, L T; Yates, S

    1984-06-01

    Four major California utility companies have active energy conservation programs mandated by the State's Public Utilities Commission (CPUC). These companies evaluate their programs and send reports of the evaluations to the CPUC. A review of 213 of these reports revealed a marketing research approach toward promoting conservation. Advertising and informational campaigns characterize most programs, and attitudes and self-reported behavior were the major outcome measures. This approach is shown to be ineffective. Suggestions for improvement include: (1) the use of actual energy consumption as the primary outcome measure in evaluating conservation programs; (2) the abandonment of conventional advertising, and the use of it only for the promotion of ''hard'' interventions; (3) increased use of social diffusion methods to disseminate information; (4) the design of more effective educational material by incorporating cognitive social psychological principles; and (5) the utilization of ''hard'' interventions that have a direct, verifiable link to conservation.

  18. U.S. electric utility demand-side management 1995

    International Nuclear Information System (INIS)

    1997-01-01

    The US Electric Utility Demand-Side Management report is prepared by the Coal and Electric Data and Renewables Division; Office of Coal, Nuclear, Electric and Alternative Fuels; Energy Information Administration (EIA); US Department of Energy. The report presents comprehensive information on electric power industry demand-side management (DSM) activities in the US at the national, regional, and utility levels. The objective of the publication is to provide industry decision makers, government policy makers, analysts, and the general public with historical data that may be used in understanding DSM as it relates to the US electric power industry. The first chapter, ''Profile: US Electric Utility Demand-Side Management'', presents a general discussion of DSM, its history, current issues, and a review of key statistics for the year. Subsequent chapters present discussions and more detailed data on energy savings, peak load reductions and costs attributable to DSM. 9 figs., 24 tabs

  19. A systematic review of the accuracy and clinical utility of the Addenbrooke's Cognitive Examination and the Addenbrooke's Cognitive Examination-Revised in the diagnosis of dementia.

    Science.gov (United States)

    Crawford, Stephanie; Whitnall, Leigh; Robertson, Joanne; Evans, Jonathan J

    2012-07-01

    To review the evidence relating to the diagnostic accuracy and clinical utility of the Addenbrooke's Cognitive Examination (ACE) and its updated version, the Addenbrooke's Cognitive Examination-Revised (ACE-R) in relation to the diagnosis of dementia. A systematic search of relevant databases was conducted, covering the period 2000 to April 2010. Specific journals and reference lists were hand searched. Identified studies that fulfilled the inclusion criteria were reviewed using a tailored, methodological quality rating checklist. The systematic search process identified nine studies for review (seven relating to the ACE, two on the ACE-R). Strengths and weaknesses across studies are considered, and diagnostic accuracy measures are presented for six out of the nine studies. The evidence suggests that the ACE/ACE-R is capable of providing information on a range of cognitive domains and of differentiating well between those with and those without cognitive impairment. Further research examining how the tools distinguish between dementia subtypes and mild cognitive impairment will further benefit the evidence base. Copyright © 2011 John Wiley & Sons, Ltd.

  20. The changing utility workforce and the emergence of building information modeling in utilities

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, A. [Autodesk Inc., San Rafael, CA (United States)

    2010-07-01

    Utilities are faced with the extensive replacement of a workforce that is now reaching retirement age. New personnel will have varying skill levels and different expectations in relation to design tools. This paper discussed methods of facilitating knowledge transfer from the retiring workforce to new staff using rules-based design software. It was argued that while nothing can replace the experiential knowledge of long-term engineers, software with built-in validations can accelerate training and building information modelling (BIM) processes. Younger personnel will expect a user interface paradigm that is based on their past gaming and work experiences. Visualization, simulation, and modelling approaches were reviewed. 3 refs.

  1. 42 CFR 456.231 - Continued stay review required.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... a review of each recipient's continued stay in the mental hospital to decide whether it is needed...

  2. Utility of positron emission tomography-magnetic resonance imaging in musculoskeletal imaging

    Institute of Scientific and Technical Information of China (English)

    Ammar A Chaudhry; Maryam Gul; Elaine Gould; Mathew Teng; Kevin Baker; Robert Matthews

    2016-01-01

    Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging(MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still has several key limitations which require supplemental information from additional modalities to complete evaluation of various disorders. This has led to the development hybrid positron emission tomography(PET)-MRI which is rapidly evolving to address key clinical questions by using the morphological strengths of MRI and functional information of PET imaging. In this article, we aim to review physical principles and techniques of PET-MRI and discuss clinical utility of functional information obtained from PET imaging and structural information obtained from MRI imaging for the evaluation of musculoskeletal pathology. More specifically, this review highlights the role of PET-MRI in musculoskeletal oncology including initial diagnosis and staging, treatment planning and posttreatment follow-up. Also we will review utility of PET-MRI in evaluating musculoskeletal infections(especially in the immunocompromised and diabetics) and inflammatory condition. Additionally, common pitfalls of PET-MRI will be addressed.

  3. Naval Undersea Warfare Center Division Newport utilities metering, Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    Carroll, D.M.

    1992-11-01

    Pacific Northwest Laboratory developed this report for the US Navy`s Naval Undersea Warfare Center Division Newport, Rhode Island (NUWC). The purpose of the report was to review options for metering electricity and steam used in the NUWC compound, and to make recommendations to NUWC for implementation under a follow-on project. An additional NUWC concern is a proposed rate change by the servicing utility, Newport Electric, which would make a significant shift from consumption to demand billing, and what effect that rate change would have on the NUWC utility budget. Automated, remote reading meters are available which would allow NUWC to monitor its actual utility consumption and demand for both the entire NUWC compound and by end-use in individual buildings. Technology is available to perform the meter reads and manipulate the data using a personal computer with minimal staff requirement. This is not meant to mislead the reader into assuming that there is no requirement for routine preventive maintenance. All equipment requires routine maintenance to maintain its accuracy. While PNL reviewed the data collected during the site visit, however, it became obvious that significant opportunities exist for reducing the utility costs other than accounting for actual consumption and demand. Unit costs for both steam and electricity are unnecessarily high, and options are presented in this report for reducing them. Additionally, NUWC has an opportunity to undertake a comprehensive energy resource management program to significantly reduce its energy demand, consumption, and costs.

  4. Naval Undersea Warfare Center Division Newport utilities metering, Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    Carroll, D.M.

    1992-11-01

    Pacific Northwest Laboratory developed this report for the US Navy's Naval Undersea Warfare Center Division Newport, Rhode Island (NUWC). The purpose of the report was to review options for metering electricity and steam used in the NUWC compound, and to make recommendations to NUWC for implementation under a follow-on project. An additional NUWC concern is a proposed rate change by the servicing utility, Newport Electric, which would make a significant shift from consumption to demand billing, and what effect that rate change would have on the NUWC utility budget. Automated, remote reading meters are available which would allow NUWC to monitor its actual utility consumption and demand for both the entire NUWC compound and by end-use in individual buildings. Technology is available to perform the meter reads and manipulate the data using a personal computer with minimal staff requirement. This is not meant to mislead the reader into assuming that there is no requirement for routine preventive maintenance. All equipment requires routine maintenance to maintain its accuracy. While PNL reviewed the data collected during the site visit, however, it became obvious that significant opportunities exist for reducing the utility costs other than accounting for actual consumption and demand. Unit costs for both steam and electricity are unnecessarily high, and options are presented in this report for reducing them. Additionally, NUWC has an opportunity to undertake a comprehensive energy resource management program to significantly reduce its energy demand, consumption, and costs.

  5. Pareto utility

    NARCIS (Netherlands)

    Ikefuji, M.; Laeven, R.J.A.; Magnus, J.R.; Muris, C.H.M.

    2013-01-01

    In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility

  6. Antibiothérapie : les questions qu'il faut se poser avant toute prescription

    OpenAIRE

    2011-01-01

    La prescription d’un antibiotique doit être individualisée. Après s’être demandé si la prescription est réellement utile, il faut évaluer la capacité de l’antibiotique à aider les défenses de l’organisme à éradiquer la bactérie dans le site infectieux. Le choix de la dose et de la durée de traitement doit être ensuite optimisé pour favoriser la guérison et éviter la sélection de résistances tout en garantissant l’observance du propriétaire...

  7. Electric utility resource expansion planning using environmental externalities

    International Nuclear Information System (INIS)

    Mitchell, D.

    1992-01-01

    This paper describes the recent experience of San Diego Gas ampersand Electric Company using environmental externalities in the expansion planning of its electrical system. This is the first time that this method of planning has been used in the electric utility industry in California. The paper reviews the conceptual development of the monetary values for environmental externalities and shows how the application of these values modifies the resource selection process. This paper should be of interest to professionals involved in policy issues relating to the use of environmental externalities as a means to improve the environment. The experience gained through this analyses should also benefit electric utility personnel involved in planning, and regulators interested in planning

  8. UTILIZATION OF PLANT PROTEINS IN FUNCTIONAL NUTRITION

    Directory of Open Access Journals (Sweden)

    V. G. Kulakov

    2017-01-01

    Full Text Available Development of functional food products technology is considered to be a prospect way for creating new food products. Such products are known to be popular among consumers. Utilization of plant proteins allows to widen and improve food assortment and quality. The article represents a review of plant proteins utilization in production of functional food. For optimization of flour confectionery chemical composition the authors utilized a method of receipts modeling. Simulation of combined products is based on the principles of food combinatorics and aims to create recipes of new types of food products on basis of methods of mathematical optimization by reasonable selection of the basic raw materials, ingredients, food additives and dietary supplements, totality of which ensures formation desired organoleptic, physical and chemical properties product as well as a predetermined level of food, biological and energy value. Modeling process of combined products recipes includes the following three stages: preparation of input data for the design, formalization requirements for the composition and properties of raw ingredients and quality final product, process modeling; product design with desired structural properties.

  9. Utility guide to advanced UT systems for PSI and ISI

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    The number of automated UT inspection systems and techniques, currently in the marketplace or being developed, has grown in recent years to the point where a utility engineer reviewing this field is faced with a major task in trying to decide what inspection technique and system will meet his inspection requirements. Recognizing the utility engineer's problem, EPRI initiated this project to produce a utility engineer's guide to advanced, automated UT systems. Of principal concern are those that have been recently introduced, and designed for problem areas such as BWR piping. Older automated scanning systems, used primarily for pressure vessel inspection, are not being ignored, but are not covered here. Costs, benefits and inspection time are addressed for several systems in this report

  10. A Novel Approach to Improving Utilization of Laboratory Testing.

    Science.gov (United States)

    Zhou, Yaolin; Procop, Gary W; Riley, Jacquelyn D

    2018-02-01

    - The incorporation of best practice guidelines into one's institution is a challenging goal of utilization management, and the successful adoption of such guidelines depends on institutional context. Laboratorians who have access to key clinical data are well positioned to understand existing local practices and promote more appropriate laboratory testing. - To apply a novel approach to utilization management by reviewing international clinical guidelines and current institutional practices to create a reliable mechanism to improve detection and reduce unnecessary tests in our patient population. - We targeted a frequently ordered genetic test for HFE-related hereditary hemochromatosis, a disorder of low penetrance. After reviewing international practice guidelines, we evaluated 918 HFE tests and found that all patients with new diagnoses had transferrin saturation levels that were significantly higher than those of patients with nonrisk genotypes (72% versus 42%; P < .001). - Our "one-button" order that restricts HFE genetic tests to patients with transferrin saturation greater than 45% is consistent with published practice guidelines and detected 100% of new patients with HFE-related hereditary hemochromatosis. - Our proposed algorithm differs from previously published approaches in that it incorporates both clinical practice guidelines and local physician practices, yet requires no additional hands-on effort from pathologists or clinicians. This novel approach to utilization management embraces the role of pathologists as leaders in promoting high-quality patient care in local health care systems.

  11. Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model.

    Science.gov (United States)

    Zeeman, Jacqueline M; McLaughlin, Jacqueline E; Cox, Wendy C

    2017-11-01

    With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model. A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty. The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty. Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Maintenance Management in Network Utilities Framework and Practical Implementation

    CERN Document Server

    Gómez Fernández, Juan F

    2012-01-01

    In order to satisfy the needs of their customers, network utilities require specially developed maintenance management capabilities. Maintenance Management information systems are essential to ensure control, gain knowledge and improve-decision making in companies dealing with network infrastructure, such as distribution of gas, water, electricity and telecommunications. Maintenance Management in Network Utilities studies specified characteristics of maintenance management in this sector to offer a practical approach to defining and implementing  the best management practices and suitable frameworks.   Divided into three major sections, Maintenance Management in Network Utilities defines a series of stages which can be followed to manage maintenance frameworks properly. Different case studies provide detailed descriptions which illustrate the experience in real company situations. An introduction to the concepts is followed by main sections including: • A Literature Review: covering the basic concepts an...

  13. Improving Military Integration in Coalitions in Africa

    Science.gov (United States)

    2014-12-01

    of California, Santa Cruz , April 3, 2009), http://history.ucsc.edu/undergraduate/undergraduate-research/electronic- journal/journal-pdfs/Edwards2009...44 José Manuel Durão Barroso, François Hollande, and Dioncounda Traoré, “International Donors...media/Brief_28.pdf. Barroso, José Manuel Durão, François Hollande, and Dioncounda Traoré. “International Donors Conference Joint Chairs’ Conclusions

  14. A review on the utilization of the Japan materials testing reactor (JMTR)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, D. H.; Kang, Y. H.; Kim, B. G.; Choo, K. N.; Oh, J. M.; Park, S. J.; Shin, Y. T

    1999-04-01

    The HANARO has possessed the potential capability for the testing of materials and fuels since the beginning of its operation in 1995. Recently, this reactor has contributed to various activities in nuclear power research in Korea. We need the recent technical data of developed countries to support these activities in nuclear power. Most of the developed countries in nuclear power have more than thirty years' experience in the irradiation test of nuclear fuel and material for performing their complicated in-core measurements of the change of material properties. They also have developed various types of sensors, equipment and techniques. This report describes the status of utilization of the irradiation facilities of the Japan Materials Testing Reactor(JMTR). It also describes the recent efforts of the JMTR in order to develop new irradiation test techniques. It will be our great pleasure for this report to help a broad range of people understand the generic contents (JMTR utilization, new techniques) of the JMTR. (author)

  15. A review on the utilization of the Japan materials testing reactor (JMTR)

    International Nuclear Information System (INIS)

    Kim, D. H.; Kang, Y. H.; Kim, B. G.; Choo, K. N.; Oh, J. M.; Park, S. J.; Shin, Y. T.

    1999-04-01

    The HANARO has possessed the potential capability for the testing of materials and fuels since the beginning of its operation in 1995. Recently, this reactor has contributed to various activities in nuclear power research in Korea. We need the recent technical data of developed countries to support these activities in nuclear power. Most of the developed countries in nuclear power have more than thirty years' experience in the irradiation test of nuclear fuel and material for performing their complicated in-core measurements of the change of material properties. They also have developed various types of sensors, equipment and techniques. This report describes the status of utilization of the irradiation facilities of the Japan Materials Testing Reactor(JMTR). It also describes the recent efforts of the JMTR in order to develop new irradiation test techniques. It will be our great pleasure for this report to help a broad range of people understand the generic contents (JMTR utilization, new techniques) of the JMTR. (author)

  16. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Hanson Kara G

    2007-11-01

    Full Text Available Abstract Background There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. Methods The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. Results A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions

  17. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature.

    Science.gov (United States)

    Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

    2007-11-07

    There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Few studies provided evidence on the impact of private sector

  18. Can working with the private for-profit sector improve utilization of quality health services by the poor? A systematic review of the literature

    Science.gov (United States)

    Patouillard, Edith; Goodman, Catherine A; Hanson, Kara G; Mills, Anne J

    2007-01-01

    Background There has been a growing interest in the role of the private for-profit sector in health service provision in low- and middle-income countries. The private sector represents an important source of care for all socioeconomic groups, including the poorest and substantial concerns have been raised about the quality of care it provides. Interventions have been developed to address these technical failures and simultaneously take advantage of the potential for involving private providers to achieve public health goals. Limited information is available on the extent to which these interventions have successfully expanded access to quality health services for poor and disadvantaged populations. This paper addresses this knowledge gap by presenting the results of a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. Methods The search topic of the systematic literature review was the effectiveness of interventions working with the private for-profit sector to improve utilization of quality health services by the poor. Interventions included social marketing, use of vouchers, pre-packaging of drugs, franchising, training, regulation, accreditation and contracting-out. The search for published literature used a series of electronic databases including PubMed, Popline, HMIC and CabHealth Global Health. The search for grey and unpublished literature used documents available on the World Wide Web. We focused on studies which evaluated the impact of interventions on utilization and/or quality of services and which provided information on the socioeconomic status of the beneficiary populations. Results A total of 2483 references were retrieved, of which 52 qualified as impact evaluations. Data were available on the average socioeconomic status of recipient communities for 5 interventions, and on the distribution of benefits across socioeconomic groups for 5 interventions. Conclusion Few studies provided

  19. Rapid Evidence Assessment of the Literature (REAL(©)): streamlining the systematic review process and creating utility for evidence-based health care.

    Science.gov (United States)

    Crawford, Cindy; Boyd, Courtney; Jain, Shamini; Khorsan, Raheleh; Jonas, Wayne

    2015-11-02

    Systematic reviews (SRs) are widely recognized as the best means of synthesizing clinical research. However, traditional approaches can be costly and time-consuming and can be subject to selection and judgment bias. It can also be difficult to interpret the results of a SR in a meaningful way in order to make research recommendations, clinical or policy decisions, or practice guidelines. Samueli Institute has developed the Rapid Evidence Assessment of the Literature (REAL) SR process to address these issues. REAL provides up-to-date, rigorous, high quality SR information on health care practices, products, or programs in a streamlined, efficient and reliable manner. This process is a component of the Scientific Evaluation and Review of Claims in Health Care (SEaRCH™) program developed by Samueli Institute, which aims at answering the question of "What works?" in health care. The REAL process (1) tailors a standardized search strategy to a specific and relevant research question developed with various stakeholders to survey the available literature; (2) evaluates the quantity and quality of the literature using structured tools and rulebooks to ensure objectivity, reliability and reproducibility of reviewer ratings in an independent fashion and; (3) obtains formalized, balanced input from trained subject matter experts on the implications of the evidence for future research and current practice. Online tools and quality assurance processes are utilized for each step of the review to ensure a rapid, rigorous, reliable, transparent and reproducible SR process. The REAL is a rapid SR process developed to streamline and aid in the rigorous and reliable evaluation and review of claims in health care in order to make evidence-based, informed decisions, and has been used by a variety of organizations aiming to gain insight into "what works" in health care. Using the REAL system allows for the facilitation of recommendations on appropriate next steps in policy, funding

  20. Northeast Utilities' participation in the Kaman/NASA wind power program

    Science.gov (United States)

    Lotker, M.

    1975-01-01

    The role of Northeast Utilities in the Kaman/NASA large wind generator study is reviewed. The participation falls into four principal areas: (1) technical assistance; (2) economic analysis; (3) applications; and (4) institutional and legal. A model for the economic viability of wind power is presented.

  1. The impact of cost recovery on electric utilities' Clean Air Act compliance strategies

    International Nuclear Information System (INIS)

    Bensinger, D.L.

    1993-01-01

    By 1995, over 200 electric power plant units in twenty one states must comply with Phase I of the acid rain requirements in Title IV of the 1990 Clean Air Act Amendments (CAAA). By the year 2000, an additional 2200 units must comply with the Title IV. Compliance costs are expected to necessitate significant electricity rate increases. In order to recover their compliance costs, utilities must file rate increase requests with state public utility commissions (PUC's), and undergo a rate proceeding involving public heatings. Because of the magnitude of cost and the complexity of compliance options, including interaction with Titles I and III of the CAAA, extensive PUC reviews of compliance strategies are likely. These reviews could become as adversarial as the nuclear prudence reviews of the 1980's. A lack of understanding of air pollution and the CAA by much of the general public and the flexibility of compliance options creates an environment conducive to adverse public reaction to the cost of complying with the Clean Air Act. Public attitudes toward pollution control technologies will be greatly affected by these hearings, and the early plant hearings will shape the utility rate making process under the Clean Air Act. Inadequate cost recovery due to constrained compliance strategies or adverse hearings could significantly inhibit industry willingness to invest in certain control technologies or advanced combustion technologies. There are already signs that Clean Air Act compliance will be the prudence issue of the 1990's for utilities, even where state statutes mandate particular compliance approaches. Specific actions should be undertaken now by the utility industry to improve the probability of sound cost recovery decisions, preserve compliance options, including multimedia strategies, and avoid the social- and cost-acceptance problems of nuclear power

  2. Use of social media across US hospitals: descriptive analysis of adoption and utilization.

    Science.gov (United States)

    Griffis, Heather M; Kilaru, Austin S; Werner, Rachel M; Asch, David A; Hershey, John C; Hill, Shawndra; Ha, Yoonhee P; Sellers, Allison; Mahoney, Kevin; Merchant, Raina M

    2014-11-27

    Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes, including links between social media use and the

  3. Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization

    Science.gov (United States)

    Griffis, Heather M; Kilaru, Austin S; Werner, Rachel M; Asch, David A; Hershey, John C; Hill, Shawndra; Ha, Yoonhee P; Sellers, Allison; Mahoney, Kevin

    2014-01-01

    Background Use of social media has become widespread across the United States. Although businesses have invested in social media to engage consumers and promote products, less is known about the extent to which hospitals are using social media to interact with patients and promote health. Objective The aim was to investigate the relationship between hospital social media extent of adoption and utilization relative to hospital characteristics. Methods We conducted a cross-sectional review of hospital-related activity on 4 social media platforms: Facebook, Twitter, Yelp, and Foursquare. All US hospitals were included that reported complete data for the Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Systems survey and the American Hospital Association Annual Survey. We reviewed hospital social media webpages to determine the extent of adoption relative to hospital characteristics, including geographic region, urban designation, bed size, ownership type, and teaching status. Social media utilization was estimated from user activity specific to each social media platform, including number of Facebook likes, Twitter followers, Foursquare check-ins, and Yelp reviews. Results Adoption of social media varied across hospitals with 94.41% (3351/3371) having a Facebook page and 50.82% (1713/3371) having a Twitter account. A majority of hospitals had a Yelp page (99.14%, 3342/3371) and almost all hospitals had check-ins on Foursquare (99.41%, 3351/3371). Large, urban, private nonprofit, and teaching hospitals were more likely to have higher utilization of these accounts. Conclusions Although most hospitals adopted at least one social media platform, utilization of social media varied according to several hospital characteristics. This preliminary investigation of social media adoption and utilization among US hospitals provides the framework for future studies investigating the effect of social media on patient outcomes

  4. An approach for evaluating utility-financed energy conservation programs. The economic welfare model

    Energy Technology Data Exchange (ETDEWEB)

    Costello, K W; Galen, P S

    1985-09-01

    The main objective of this paper is to illustrate how the economic welfare model may be used to measure the economic efficiency effects of utility-financed energy conservation programs. The economic welfare model is the theoretical structure that was used in this paper to develop a cost/benefit test. This test defines the net benefit of a conservation program as the change in the sum of consumer and producer surplus. The authors advocate the operation of the proposed cost/benefit model as a screening tool to eliminate from more detailed review those programs where the expected net benefits are less than zero. The paper presents estimates of the net benefit derived from different specified cost/benefit models for four illustrative pilot programs. These models are representative of those which have been applied or are under review by utilities and public utility commissions. From the numerical results, it is shown that net benefit is greatly affected by the assumptions made about the nature of welfare gains to program participants. The main conclusion that emerges from the numerical results is that the selection of a cost/benefit model is a crucial element in evaluating utility-financed energy conservation programs. The paper also briefly addresses some of the major unresolved issues in utility-financed energy conservation programs. 2 figs., 3 tabs., 10 refs. (A.V.)

  5. Problems related to fossil fuels utilization

    International Nuclear Information System (INIS)

    Rota, R.

    1999-01-01

    Fossil fuels still present the main energy source in the world since about 90% of the energy produced comes from combustion. This paper, based on the lectures given at the conference of Energy and Environment hold at the Accademia dei Lincei in 1998, presents a short review of some of the problems related to the utilization of fossil fuels, such as their availability in the medium period, the effect of pollutant dispersion in the atmosphere as well as the available technologies to deal with such problems [it

  6. Morphology of reprocessing: a case for regional utility planning

    International Nuclear Information System (INIS)

    Stoller, S.M.

    1976-01-01

    The change in entrepreneurial climate in reprocessing and recycle, which has taken place in the last few years, is reviewed. The climatic change, which has reached the point where the economic benefits of that fuel cycle segment are being questioned, is characterized. The author outlines the reasons he feels the benefits are positive. Some of the principal risks facing the entrepreneur are outlined and the suggestion is made that participation by the utility customers for a major project throughout its planning process is critical. In this context, the logic for a regional organization of such utilities, customers, drawing heavily from a study conducted by a group of utilities in the western United States during 1975, is outlined. The paper concludes with some general observations in support of the thesis that new structural forms are likely required for reprocessing facilities, as well as those for other major segments of the fuel cycle, if utilities are to be able to view with confidence the prospect of having such facilities in place in a timely fashion

  7. The impact of demographic, health-related and social factors on dental services utilization: Systematic review and meta-analysis.

    Science.gov (United States)

    Reda, Seif Magdy; Krois, Joachim; Reda, Sophie Franziska; Thomson, William Murray; Schwendicke, Falk

    2018-04-16

    Regular and/or preventive dental services utilization is an indicator of healthcare access and associated with improved health outcomes. We assessed the proportion of individuals regularly/preventively utilizing dental services, and how this was affected by demographic, health-related and social factors. Three electronic databases (Medline, Embase, Central) were searched (2005-2017). We included observational studies investigating the association between preventive/regular dental service utilization and age, oral and general health, edentulism, family structure and health literacy. The proportion of individuals with regular/preventive utilization overall and in different sub-groups were extracted. Random-effects meta-analyses, with subgroup analyses by region, were performed. Meta-regression was used to assess whether and how associations changed with time and countries' human developmental status (HDI). 103 studies on 7,395,697 participants from 28 countries were included. The global mean (95% CI) proportion of individuals regularly/preventively utilizing dental services was 54% (50-59%). In countries with higher HDI, more individuals regularly/preventively utilized services (p Age did not have a significant impact on utilization in adults (OR = 1.00; 0.89-1.12). Utilization was significantly lower in younger than older children (OR = 0.52; 0.46-0.59), individuals with poorer general health (OR = 0.73; 0.65-0.80) and poorer oral health (OR = 0.64; 0.52-0.75), edentulous individuals (OR = 0.32; 0.23-0.41), and individuals with less supportive family structures (OR = 0.81; 0.73-0.89) or poor health literacy (OR = 0.41; 0.01-0.81). The observed differences within populations did not significantly change with time and were universally present. Regular/preventive utilization varied widely between and within countries. Understanding and tackling the reasons underlying this may help to consistently improve utilization. Higher developmental

  8. The evolution of utility functions and psychological altruism.

    Science.gov (United States)

    Clavien, Christine; Chapuisat, Michel

    2016-04-01

    Numerous studies show that humans tend to be more cooperative than expected given the assumption that they are rational maximizers of personal gain. As a result, theoreticians have proposed elaborated formal representations of human decision-making, in which utility functions including "altruistic" or "moral" preferences replace the purely self-oriented "Homo economicus" function. Here we review mathematical approaches that provide insights into the mathematical stability of alternative utility functions. Candidate utility functions may be evaluated with help of game theory, classical modeling of social evolution that focuses on behavioral strategies, and modeling of social evolution that focuses directly on utility functions. We present the advantages of the latter form of investigation and discuss one surprisingly precise result: "Homo economicus" as well as "altruistic" utility functions are less stable than a function containing a preference for the common welfare that is only expressed in social contexts composed of individuals with similar preferences. We discuss the contribution of mathematical models to our understanding of human other-oriented behavior, with a focus on the classical debate over psychological altruism. We conclude that human can be psychologically altruistic, but that psychological altruism evolved because it was generally expressed towards individuals that contributed to the actor's fitness, such as own children, romantic partners and long term reciprocators. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Systematic review

    DEFF Research Database (Denmark)

    Enggaard, Helle

    Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...

  10. Long-range goal setting in the nuclear utility industry

    International Nuclear Information System (INIS)

    Beard, P.M.

    1986-01-01

    The Institute of Nuclear Power Operation's (INPO's) programs support the industry's efforts to improve performance in nuclear plant safety and reliability. The success of these programs can best be measured by the progress of the industry. As utilities focused their attention on nuclear plant performance, the Institute's goal was to make sure its programs and activities provided the best possible support for these efforts. INPO continues to coordinate an industry-wide plant performance indicator program to assist member utilities in assessing station performance. Closely related to this effort is the nuclear industry's establishment of long-range plant performance goals. The US nuclear utility industry currently sends INPO quarterly data on 28 key performance indicators. INPO analyzes these data and provides periodic reports to its members and participants. Selected highlights of INPO's Performance Indicators for the US Nuclear Utility, dated June 1986, are discussed. Throughout 1985, INPO interacted with members, participants, and three external ad hoc review groups to refine the overall performance indicators and to develop background for each unit. By April 1986, each utility had developed long-term goals for each unit. By April 1986, each utility had developed long-term goals for most of the overall indicators. These goals represent a commitment to achievement of excellence when applied to the day-to-day conduct of plant operations, and provide a framework for action

  11. Utilization management in radiology, part 2: perspectives and future directions.

    Science.gov (United States)

    Duszak, Richard; Berlin, Jonathan W

    2012-10-01

    Increased utilization of medical imaging in the early part of the last decade has resulted in numerous efforts to reduce associated spending. Recent initiatives have focused on managing utilization with radiology benefits managers and real-time order entry decision support systems. Although these approaches might seem mutually exclusive and their application to radiology appears unique, the historical convergence and broad acceptance of both programs within the pharmacy sector may offer parallels for their potential future in medical imaging. In this second installment of a two-part series, anticipated trends in radiology utilization management are reviewed. Perspectives on current and future potential roles of radiologists in such initiatives are discussed, particularly in light of emerging physician payment models. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Book reviews

    Directory of Open Access Journals (Sweden)

    T. Abdel-Motey., C. Urfels., K. Rodriguez., J. Mardikian., J.A. Drobnicki., V. Diodato.

    2000-10-01

    Full Text Available Title:(1 The Library and Information Professional’s Guide to the Internet. (2 Reinvention of the Public Library for the 21st Century. (3 Public Library Collection Development in the Information Age. (4 Making Sense of Journals in the Life Science: From Specialty Origins to Contemporary Assortment. (5 The Holocaust: Memories, Research, Reference. (6 How to Index Your Local Newspaper Using WordPerfect or Microsoft Word for Windows. (7 Effective Utilization and Management of Emerging Information Technologies. (8 Information Technology and Organizations: Challenges of New Technologies. (9 Facilities Planning for School Media and Technology Centers. (10 Libraries Without Walls 2: The Delivery of Library Services to Distance Users. (11 New International Directions in HIV Prevention for Gay and Bisexual Men. (12 Soaring to Excellence Videos: Tools of Our Trade III: Books, the Internet, and Beyond.Author:(1Reviewed by Teresa Abdel-Motey. (2Review by Claire Urfels. (3Reviewed by Dr. Ketty Rodriguez. (4Reviewed by Jackie Mardikian. (5Reviewed by John A. Drobnicki.(6Reviewed by Dr. Virgil Diodato. (7Reviewed by Dr. Lisa M. Covi. (8Reviewed by Tom Zillner. (9Reviewed by Dr. W. Bernard Lukenbill. (10Reviewed by Dr. Elizabeth Buchanan. (11Reviewed by Aisha White. (12Reviewed by Phyllis Tragash

  13. The Potential Utility of Pharmacogenetic Testing in Psychiatry

    Directory of Open Access Journals (Sweden)

    Kathryn R. Gardner

    2014-01-01

    Full Text Available Over the last decade, pharmacogenetics has become increasingly significant to clinical practice. Psychiatric patients, in particular, may benefit from pharmacogenetic testing as many of the psychotropic medications prescribed in practice lead to varied response rates and a wide range of side effects. The use of pharmacogenetic testing can help tailor psychotropic treatment and inform personalized treatment plans with the highest likelihood of success. Recently, many studies have been published demonstrating improved patient outcomes and decreased healthcare costs for psychiatric patients who utilize genetic testing. This review will describe evidence supporting the clinical utility of genetic testing in psychiatry, present several case studies to demonstrate use in everyday practice, and explore current patient and clinician opinions of genetic testing.

  14. Adapting United States training practices to European utilities

    International Nuclear Information System (INIS)

    Walsh, T.E.

    1983-01-01

    The factors which must be considered in the process of adapting United States nuclear utility training programs to the needs of a European utility are discussed. Following a review of the present situation and drawing up of a new training program, the management commitments in terms of personnel and finance must be considered. Short term, medium and long term programs are outlined. The long term objectives should include the establishment of a total training centre. This facility should be capable of providing all the training necessary to operate a power plant safely. This would include specific simulator training, classroom training for operators, technician training, staff training, management training etc. In addition to a simulator, it should include an emergency response facility to train personnel. (U.K.)

  15. Current status of radio-isotopes utilization

    Energy Technology Data Exchange (ETDEWEB)

    Singh, M [Banaras Hindu Univ. (India)

    1974-08-01

    Utilization of radioisotopes were reviewed briefly in a categorized manner. In plant biochemistry, long lived radioactive carbon ,/sup 14/C, was applied to clarify such metabolic processes as photosynthesis, respiration and protein synthesis, etc., while radioactive oxygen ,/sup 18/O, was used to study the O/sub 2/ generation mechanism. Radioactive phosphorus ,/sup 32/P, was used to detect the amount, grain size of phosphatic fertilizer as well as the time and depth for better utilization. Radioactive sulphur ,/sup 35/S, and nitrogen ,/sup 15/N, could be of use in studies of protein metabolism in plants. Radioactive tracers of other minerals such as N, P, K, Ca, Mg, Zn, Mo, B, and Co were also used to detect their specific role in plants. Use of radioactive isotopes in protein synthesis and transfer of genetic information was described. Radioactive iodine ,/sup 131/I, binding capacity of milk proteins, and radio trace studies in the iodine turn over in the use of radioactive iodine were summarized.

  16. Trends in telemedicine utilizing artificial intelligence

    Science.gov (United States)

    Pacis, Danica Mitch M.; Subido, Edwin D. C.; Bugtai, Nilo T.

    2018-02-01

    With the growth and popularity of the utilization of artificial intelligence (AI) in several fields and industries, studies in the field of medicine have begun to implement its capabilities in handling and analyzing data to telemedicine. With the challenges in the implementation of telemedicine, there has been a need to expand its capabilities and improve procedures to be specialized to solve specific problems. The versatility and flexibility of both AI and telemedicine gave the endless possibilities for development and these can be seen in the literature reviewed in this paper. The trends in the development of the utilization of this technology can be classified in to four: patient monitoring, healthcare information technology, intelligent assistance diagnosis, and information analysis collaboration. Each trend will be discussed and presented with examples of recent literature and the problems they aim to address. Related references will also be tabulated and categorized to see the future and potential of this current trend in telemedicine.

  17. SYMPOSIUM - MACRONUTRIENT UTILIZATION DURING EXERCISE: IMPLICATIONS FOR PERFORMANCE AND SUPPLEMENTATION

    Directory of Open Access Journals (Sweden)

    Darryn S. Willoughby

    2004-09-01

    Full Text Available The review articles constitute a mini-symposium entitled "Macronutrient Utilization During Exercise: Implications for Performance and Supplementation" that were recently presented at the 2004 annual conference of the International Society of Sports Nutrition in Las Vegas, NV. Much controversy often surrounds macronutrient intake, utilization, and subsequent metabolism regarding exercise and athletic performance. Furthermore, the role of macronutrient supplementation with the specificintent of improving body composition and exercise performance by way of nutrient timing is also an important issue. As such, the articles provide a comprehensive overview of metabolic and performance-enhancing implications regarding carbohydrate, fat, and protein.

  18. Lunchkonsert:orgelfestival

    OpenAIRE

    Segurado, Joao

    2012-01-01

    12.30 Lunchkonsert. Musikhogskolan, orgelsalen.Sverker Jullander, orgel.Svenskt 1900-talStig Gustav Schonberg - Toccata concertante I (1954)f. 1933Hilding Rosenberg Preludio e fuga (1948)1892 -1985Erland von Koch Kontraster (1973)1910- 2009 - Ritmo - Misterioso - GiubiolosoEmil Sjögren Ur "Legender" (tr. 1907)1853-1918 - Legend B-dur - Legend c-moll - Legend D-durOtto Olsson Preludium och fuga diss-moll, op. 56 (1935)1879-1964

  19. A bayesian approach to laboratory utilization management

    Directory of Open Access Journals (Sweden)

    Ronald G Hauser

    2015-01-01

    Full Text Available Background: Laboratory utilization management describes a process designed to increase healthcare value by altering requests for laboratory services. A typical approach to monitor and prioritize interventions involves audits of laboratory orders against specific criteria, defined as rule-based laboratory utilization management. This approach has inherent limitations. First, rules are inflexible. They adapt poorly to the ambiguity of medical decision-making. Second, rules judge the context of a decision instead of the patient outcome allowing an order to simultaneously save a life and break a rule. Third, rules can threaten physician autonomy when used in a performance evaluation. Methods: We developed an alternative to rule-based laboratory utilization. The core idea comes from a formula used in epidemiology to estimate disease prevalence. The equation relates four terms: the prevalence of disease, the proportion of positive tests, test sensitivity and test specificity. When applied to a laboratory utilization audit, the formula estimates the prevalence of disease (pretest probability [PTP] in the patients tested. The comparison of PTPs among different providers, provider groups, or patient cohorts produces an objective evaluation of laboratory requests. We demonstrate the model in a review of tests for enterovirus (EV meningitis. Results: The model identified subpopulations within the cohort with a low prevalence of disease. These low prevalence groups shared demographic and seasonal factors known to protect against EV meningitis. This suggests too many orders occurred from patients at low risk for EV. Conclusion: We introduce a new method for laboratory utilization management programs to audit laboratory services.

  20. [Application of synthetic biology to sustainable utilization of Chinese materia medica resources].

    Science.gov (United States)

    Huang, Lu-Qi; Gao, Wei; Zhou, Yong-Jin

    2014-01-01

    Bioactive natural products are the material bases of Chinese materia medica resources. With successful applications of synthetic biology strategies to the researches and productions of taxol, artemisinin and tanshinone, etc, the potential ability of synthetic biology in the sustainable utilization of Chinese materia medica resources has been attracted by many researchers. This paper reviews the development of synthetic biology, the opportunities of sustainable utilization of Chinese materia medica resources, and the progress of synthetic biology applied to the researches of bioactive natural products. Furthermore, this paper also analyzes how to apply synthetic biology to sustainable utilization of Chinese materia medica resources and what the crucial factors are. Production of bioactive natural products with synthetic biology strategies will become a significant approach for the sustainable utilization of Chinese materia medica resources.

  1. The value of peer reviews to nuclear plant safety

    International Nuclear Information System (INIS)

    Subalusky, W.T. Jr.

    1994-01-01

    On a global basis, the nuclear utility industry has clearly demonstrated the value of peer reviews for improving nuclear safety and overall plant performance. Peer reviews are conducted by small teams of technical experts who review various aspects of plant operation, recognize strengths and recommend improvements, thereby stimulating a positive response to the recommendations. U.S. nuclear utilities initiated the operator-to-operator peer review process first through the Institute of Nuclear Power Operations (INPO). Now, voluntary peer reviews are an important activity of the World Association of Nuclear Operators (WANO). Formed just five years ago. WANO has made significant progress in its key activities of the operator-to-operator exchanges, operating experience exchange, monitoring of plant performance indicators and sharing of good practices worldwide. A fifth activity, peer review on a strictly voluntary basis, is pertinent to this paper

  2. Operational safety review programmes for nuclear power plants. Guidelines for assessment

    International Nuclear Information System (INIS)

    2002-01-01

    The IAEA has been offering the Operational Safety Review Team (OSART) programme to provide advice and assistance to Member States in enhancing the operational safety of nuclear power plants (NPPs). Simultaneously, the IAEA has encouraged self-assessment and review by Member States of their own nuclear power plants to continuously improve nuclear safety. Currently, some utilities have been implementing safety review programmes to independently review their own plants. Corporate or national operational safety review programmes may be compliance or performance based. Successful utilities have found that both techniques are necessary to provide assurance that (i) as a minimum the NPP meets specific corporate and legal requirements and (ii) management at the NPP is encouraged to pursue continuous improvement principles. These programmes can bring nuclear safety benefits to the plants and utilities. The IAEA has conducted two pilot missions to assess the effectiveness of the operational review programme. Based on these missions and on the experience gained during OSART missions, this document has been developed to provide guidance on and broaden national/corporate safety review programmes in Member States, and to assist in maximizing their benefits. These guidelines are intended primarily for the IAEA team to conduct assessment of a national/corporate safety review programme. However, this report may also be used by a country or utility to establish its own national/corporate safety review programme. The guidelines may likewise be used for self-assessment or for establishing a baseline when benchmarking other safety review programmes. This report consists of four parts. Section 2 addresses the planning and preparation of an IAEA assessment mission and Sections 3 and 4 deal with specific guidelines for conducting the assessment mission itself

  3. Utility led rural electrification in Morocco: combining grid extension, mini-grids, and solar home systems

    DEFF Research Database (Denmark)

    Nygaard, Ivan; Dafrallah, Touria

    2016-01-01

    Morocco has become known for being an example of a well-performing utility-led rural electrification program, but so far little independent research has scrutinized this extraordinary case. Based on a critical review of the available literature, this study attempts to draw a picture of the evolut......Morocco has become known for being an example of a well-performing utility-led rural electrification program, but so far little independent research has scrutinized this extraordinary case. Based on a critical review of the available literature, this study attempts to draw a picture...... of the evolution of rural electrification in Morocco, the policies and programs that have been implemented, and their institutional, technical, and financial dimensions. The review reveals that information available about the success of the programme has almost entirely been provided by the utility ONE, which has......) a level of rural electrification in Morocco that from the outset was far below that in comparable neighboring countries; (2) a high GDP compared to sub-Saharan African (SSA) countries; and (3) a high level of urban electrification that allowed cross-subsidization from urban consumers. So while...

  4. Resource utilization after introduction of a standardized clinical assessment and management plan.

    Science.gov (United States)

    Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

    2010-01-01

    A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

  5. Experience in the review of utility control room design review and safety parameter display system programs

    International Nuclear Information System (INIS)

    Moore, V.A.

    1985-01-01

    The Detailed Control Room Design Review (DCRDR) and the Safety Parameter Display System (SPDS) had their origins in the studies and investigations conducted as the result of the TMI-2 accident. The President's Commission (Kemeny Commission) critized NRC for not examining the man-machine interface, over-emphasizing equipment, ignoring human beings, and tolerating outdated technology in control rooms. The Commission's Special Inquiry Group (Rogovin Report) recommended greater application of human factors engineering including better instrumentation displays and improved control room design. The NRC Lessons Learned Task Force concluded that licensees should review and improve control rooms using NRC Human engineering guidelines, and install safety parameter display systems (then called the safety staff vector). The TMI Action Plan Item I.D.1 and I.D.2 were based on these recommendations

  6. A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

    Science.gov (United States)

    Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

    2015-01-01

    The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

  7. The Health Utilities Index (HUI®: concepts, measurement properties and applications

    Directory of Open Access Journals (Sweden)

    Horsman John

    2003-10-01

    Full Text Available Abstract This is a review of the Health Utilities Index (HUI® multi-attribute health-status classification systems, and single- and multi-attribute utility scoring systems. HUI refers to both HUI Mark 2 (HUI2 and HUI Mark 3 (HUI3 instruments. The classification systems provide compact but comprehensive frameworks within which to describe health status. The multi-attribute utility functions provide all the information required to calculate single-summary scores of health-related quality of life (HRQL for each health state defined by the classification systems. The use of HUI in clinical studies for a wide variety of conditions in a large number of countries is illustrated. HUI provides comprehensive, reliable, responsive and valid measures of health status and HRQL for subjects in clinical studies. Utility scores of overall HRQL for patients are also used in cost-utility and cost-effectiveness analyses. Population norm data are available from numerous large general population surveys. The widespread use of HUI facilitates the interpretation of results and permits comparisons of disease and treatment outcomes, and comparisons of long-term sequelae at the local, national and international levels.

  8. Prognostic utility of baseline neutrophil-to-lymphocyte ratio in patients receiving immune checkpoint inhibitors: a review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Sacdalan DB

    2018-02-01

    Full Text Available Danielle Benedict Sacdalan,1 Josephine Anne Lucero,2 Dennis Lee Sacdalan1 1Section of Medical Oncology, Department of Medicine, University of the Philippines Manila and Philippine General Hospital, Manila, Philippines; 2Department of Medicine, University of the Philippines Manila and Philippine General Hospital, Manila, Philippines Introduction: Systemic inflammation is associated with prognosis in solid tumors. The neutrophil-to-lymphocyte ratio (NLR is a marker for the general immune response to various stress stimuli. Studies have shown correlation of NLR to outcomes in immune checkpoint blockade, peripheral neutrophil count to intratumor neutrophil population, and NLR to intratumoral levels of myeloid-derived suppressor cells. Studies have shown elevated peripheral blood regulator T cells accompanied by elevated NLR are associated with poor outcomes further highlighting the importance of inflammation in the prognosis of cancer patients.Methods: We performed a meta-analysis of published articles on the utility of baseline NLR in predicting outcomes in patients treated with immune checkpoint inhibitors (ICIs using Review Manager, version 5.3. Seven studies on the prognostic utility of NLR in ICI treatment were included in this analysis. For outcomes of interest, the hazard ratios (HRs were computed. Subgroup analyses were planned based on type of malignancy and type of immune checkpoint inhibitor.Results/discussion: A high NLR resulted in worse overall survival (OS (HR, 1.92; 95% CI, 1.29–2.87; p=0.001 and progression-free survival (PFS; HR, 1.66; 95% CI, 1.38–2.01; p<0.00001 across types of malignancies studied (melanoma, non-small-cell lung cancer, and genitourinary cancer. Subgroup analysis across different types of malignancies treated with ICI showed similar results for OS and PFS. The single study on genitourinary cancers also showed worse OS and PFS (OS: HR, 1.82; 95% CI, 1.29–2.87; p=0.001 and PFS: HR, 1.83; 95% CI, 0.97–3

  9. Developing strategic plans for effective utilization of research reactors

    International Nuclear Information System (INIS)

    Ridikas, Danas

    2015-01-01

    Strategic plans are indispensable documents for research reactors (RRs) to ensure their efficient, optimized and well managed utilization. A strategic plan provides a framework for increasing utilization, while helping to create a positive safety culture, a motivated staff, a clear understanding of real costs and a balanced budget. A strategic plan should be seen as an essential tool for a responsible manager of any RR, from the smallest critical facility to the largest reactor. Results and lessons learned are shown from the IAEA efforts to help the RR facilities developing strategic plans, provide review and advise services, organize national and regional stakeholder/user workshops, prepare further guidance and recommendations, document and publish guidance documents and other supporting materials.

  10. Developing strategic plans for effective utilization of research reactors

    Energy Technology Data Exchange (ETDEWEB)

    Ridikas, Danas [International Atomic Energy Agency, Vienna (Austria). Dept. of Nuclear Sciences and Applications

    2015-12-15

    Strategic plans are indispensable documents for research reactors (RRs) to ensure their efficient, optimized and well managed utilization. A strategic plan provides a framework for increasing utilization, while helping to create a positive safety culture, a motivated staff, a clear understanding of real costs and a balanced budget. A strategic plan should be seen as an essential tool for a responsible manager of any RR, from the smallest critical facility to the largest reactor. Results and lessons learned are shown from the IAEA efforts to help the RR facilities developing strategic plans, provide review and advise services, organize national and regional stakeholder/user workshops, prepare further guidance and recommendations, document and publish guidance documents and other supporting materials.

  11. Illustrative comparison of one utility's coal and nuclear choices

    International Nuclear Information System (INIS)

    Keeney, R.L.; Sicherman, A.

    1983-01-01

    The technology choices facing an individual utility are complex decision problems. The paper illustrates a method designed to assist an individual utility company in making the choices in a logically consisnt manner. The resulting evaluation model, based on the principles of decision analysis, explicitly addresses the complexity to provide a basis for decision making and support for defending the decision before reviewers. The model, which incorporates economic, environmental, social, safety, and regulatory effects, is demonstrated using a coal/nuclear choice which may be faced by Utah Power and Light Company in the near future. This analysis is meant to be illustrative; more effort would be needed to gather information to support a policy decision

  12. Systematic review of model-based analyses reporting the cost-effectiveness and cost-utility of cardiovascular disease management programs.

    Science.gov (United States)

    Maru, Shoko; Byrnes, Joshua; Whitty, Jennifer A; Carrington, Melinda J; Stewart, Simon; Scuffham, Paul A

    2015-02-01

    The reported cost effectiveness of cardiovascular disease management programs (CVD-MPs) is highly variable, potentially leading to different funding decisions. This systematic review evaluates published modeled analyses to compare study methods and quality. Articles were included if an incremental cost-effectiveness ratio (ICER) or cost-utility ratio (ICUR) was reported, it is a multi-component intervention designed to manage or prevent a cardiovascular disease condition, and it addressed all domains specified in the American Heart Association Taxonomy for Disease Management. Nine articles (reporting 10 clinical outcomes) were included. Eight cost-utility and two cost-effectiveness analyses targeted hypertension (n=4), coronary heart disease (n=2), coronary heart disease plus stoke (n=1), heart failure (n=2) and hyperlipidemia (n=1). Study perspectives included the healthcare system (n=5), societal and fund holders (n=1), a third party payer (n=3), or was not explicitly stated (n=1). All analyses were modeled based on interventions of one to two years' duration. Time horizon ranged from two years (n=1), 10 years (n=1) and lifetime (n=8). Model structures included Markov model (n=8), 'decision analytic models' (n=1), or was not explicitly stated (n=1). Considerable variation was observed in clinical and economic assumptions and reporting practices. Of all ICERs/ICURs reported, including those of subgroups (n=16), four were above a US$50,000 acceptability threshold, six were below and six were dominant. The majority of CVD-MPs was reported to have favorable economic outcomes, but 25% were at unacceptably high cost for the outcomes. Use of standardized reporting tools should increase transparency and inform what drives the cost-effectiveness of CVD-MPs. © The European Society of Cardiology 2014.

  13. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  14. Transforming EQ-5D utilities for use in cost–value analysis of health programs.

    Science.gov (United States)

    Nord, Erik; Johansen, Rune

    2015-04-01

    In a number of jurisdictions there is increasing interest in incorporating concerns for fairness in models for economic evaluation of health interventions. Cost–value analysis is a name for evaluations with such a broader aim. The most widely held concern for fairness is a concern for the worse off, i.e. the idea that severity of illness should count in determining priorities. In economic evaluations of improvements in health-related quality of life this concern may be taken into account by replacing conventional health state utilities with societal values for health states that are characterised by strong upper end compression and decreasing marginal value of utility gains. We review evidence on the strength of concerns for the worse off--measured at the cardinal level--in 15 articles published in peer-reviewed journals in the time period 1978–2010, with reports from altogether 20 individual studies in nine different countries. We report 116 individual observations of paired comparisons of utility improvements with different start levels. Concerns for severity show up quite strongly across countries, sample types and question framings. By means of regression analyses we fit a societal value function to the data that has the property of decreasing marginal value of utility gains. Using the central tendency in the data we present two plausible transformations of EQ-5D utilities into societal values that reflect concerns for the worse off.

  15. Allocating service parts in two-echelon networks at a utility company

    NARCIS (Netherlands)

    van den Berg, D.; van der Heijden, Matthijs C.; Schuur, Peter

    2014-01-01

    We study a multi-item, two-echelon, continuous-review inventory problem at a Dutch utility company, Liander. We develop a model that optimizes the quantities of service parts and their allocation in the two-echelon network under an aggregate waiting time restriction. Specific aspects that we address

  16. Case series

    African Journals Online (AJOL)

    abp

    23 nov. 2015 ... moyenne de la ventilation des patients atteints de PN était de 10,46 j alors que celle des patients non infectés était de 6,60 j. ... facteurs de risque: l'âge, la durée de la ventilation mécanique, la durée de séjour en réanimation, l'existence d'une .... ventillacion mecanica. Med Intensiva (Spanish). 2010 Jun-.

  17. EPRI Guide to Managing Nuclear Utility Protective Clothing Programs

    International Nuclear Information System (INIS)

    Kelly, J.J.; Kelly, D.M.

    1993-10-01

    The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) in 1989 to produce a guide for developing and managing nuclear plant protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to ensure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with standardizing protective clothing programs and in controlling the potentially escalating economics of such programs. The initial Guide to Managing Nuclear Utility Protective Clothing Programs, NP-7309, was published in May 1991. Since that time, a number of utilities have reviewed and/or used the report to enhance their protective clothing programs. Some of these utilities requested that a computer program be developed to assist utilities in evaluating the economics of protective clothing programs consistent with the guidance in NP-7309. The PCEVAL computer code responds to that industry need. This report, the PCEVAL User's Manual, provides detailed instruction on use of the software

  18. Safety review advisor

    International Nuclear Information System (INIS)

    Boshers, J.A.; Uhrig, R.E.; Alguindigue, I.A.; Burnett, C.G.

    1991-01-01

    The University of Tennessee's Nuclear Engineering department, in cooperation with the Tennessee Valley Authority (TVA), is evaluating the feasibility of utilizing an expert system to aid in 10CFR50.59 evaluations. This paper discusses the history of 10CFR50.59 reviews, and details the development approach used in the construction of a prototype Safety Review Advisor (SRA). The goals for this expert system prototype are to aid the engineer in the evaluation process by directing his attention to the appropriate critical issues, increase the efficiency, consistency, and thoroughness of the evaluation process, and provide a foundation of appropriate Safety Analysis Report (SAR) references for the reviewer

  19. Overview of Steel Slag Application and Utilization

    Directory of Open Access Journals (Sweden)

    Lim J.W.

    2016-01-01

    Full Text Available Significant quantities of steel slag are generated as waste material or byproduct every day from steel industries. Slag is produced from different types of furnaces with different operating conditions. Slag contains Ferrous Oxide, Calcium Oxide, Silica etc. Physical and chemical properties of slag are affected by different methods of slag solidification such as air cooled, steam, and injection of additives. Several material characterization methods, such as X-ray Diffraction (XRD, Scanned Electron Microscopy (SEM and Inductive Coupled Plasma (ICP-OES are used to determine elemental composition in the steel slag. Therefore, slags can become one of the promising materials in various applications such as in transportation industry, construction, cement production, waste water and water treatment. The various applications of steel slag indicate that it can be reused and utilized rather than being disposed to the landfill. This paper presents a review of its applications and utilization.

  20. Is vaccination good value for money? A review of cost-utility analyses of vaccination strategies in eight European countries

    Directory of Open Access Journals (Sweden)

    Marco Barbieri

    2016-12-01

    Full Text Available Objective: The objective of this study is to review published cost-utility analyses of vaccination strategies in eight European countries and to assess whether there are differences in cost-effectiveness terms among countries and vaccinations. Methods: A systematic search of the literature was conducted using the National Health Service Economic Evaluation Database and the PubMed database. Cost-utility analyses of any type of vaccination that used quality-adjusted life years (QALYs as measure of benefit and conducted in Belgium, France, Germany, Italy, Spain, Sweden, the Netherlands or the UK were included. Results: A total of 94 studies were identified. As a result of our search methodology, the vast majority of studies were conducted in the Netherlands or UK (33 and 30 studies, respectively. The most frequent vaccination types were against Human papillomavirus (HPV with 23 studies, followed by vaccination against pneumococcal infections (19 studies. The analysed vaccinations were generally cost-effective but with high variability. Considering an incremental cost effectiveness ratio (ICER of 40,000€/QALY, we noticed that the following vaccinations studies are below this threshold, i.e. all varicella and influenza (with one outlier studies, 90% of the studies for HPV and 75% of the studies for pneumococcal vaccinations. Rotavirus vaccination was considered as not cost-effective, with only 30% of studies below the threshold of 40,000€/QALY. There was no clear trend for vaccinations being more cost-effective in some countries. Conclusions: The published literature has shown that vaccination strategies are generally cost-effective in European countries. High heterogeneity in the results among studies and countries was found.

  1. Can cost utility evaluations inform decision making about interventions for low back pain?

    Science.gov (United States)

    Dagenais, Simon; Roffey, Darren M; Wai, Eugene K; Haldeman, Scott; Caro, Jaime

    2009-11-01

    Low back pain (LBP) is associated with high health-care utilization and lost productivity. Numerous interventions are routinely used, although few are supported by strong evidence. Cost utility analyses (CUAs) may be helpful to inform decision makers. To conduct a systematic review of CUAs of interventions for LBP. Systematic review. A search strategy combining medical subject headings and free text related to LBP and health economic evaluations was executed in MEDLINE. Cost utility analyses combined with randomized controlled trials for LBP were included. Studies that were published before 1998, non-English, decision analyses, and duplicate reports were excluded. Search results were evaluated by two reviewers, who extracted data independently related to clinical study design, economic study design, direct cost components, utility results, cost results, and CUA results. The search produced 319 citations, and of these 15 met eligibility criteria. Most were from the United Kingdom (n=8), published in the past 3 years (n=12), studied chronic LBP or radiculopathy (n=13), and had a follow-up >12 months (n=13). Combined, there were 33 study groups who received a mean 2.1 interventions, most commonly education (n=17), exercise therapy (n=13), spinal manipulation therapy (n=7), surgery (n=7), and usual care from a general practitioner (n=7). Mean baseline utility was 0.57, improving to 0.67 at follow-up; the mean difference in utility improvement between study groups was 0.04. Based on available data and converted to US dollars, the cost per quality-adjusted life year ranged from $304 to 579,527 dollars, with a median of 13,015 dollars. Few CUAs were identified for LBP, and there was heterogeneity in the interventions compared, direct cost components measured, indirect costs, other methods, and results. Reporting quality was mixed. Currently published CUAs do not provide sufficient information to assist decision makers. Future CUAs should attempt to measure all known

  2. Translating state-of-the-art spinal cord MRI techniques to clinical use: A systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI.

    Science.gov (United States)

    Martin, Allan R; Aleksanderek, Izabela; Cohen-Adad, Julien; Tarmohamed, Zenovia; Tetreault, Lindsay; Smith, Nathaniel; Cadotte, David W; Crawley, Adrian; Ginsberg, Howard; Mikulis, David J; Fehlings, Michael G

    2016-01-01

    A recent meeting of international imaging experts sponsored by the International Spinal Research Trust (ISRT) and the Wings for Life Foundation identified 5 state-of-the-art MRI techniques with potential to transform the field of spinal cord imaging by elucidating elements of the microstructure and function: diffusion tensor imaging (DTI), magnetization transfer (MT), myelin water fraction (MWF), MR spectroscopy (MRS), and functional MRI (fMRI). However, the progress toward clinical translation of these techniques has not been established. A systematic review of the English literature was conducted using MEDLINE, MEDLINE-in-Progress, Embase, and Cochrane databases to identify all human studies that investigated utility, in terms of diagnosis, correlation with disability, and prediction of outcomes, of these promising techniques in pathologies affecting the spinal cord. Data regarding study design, subject characteristics, MRI methods, clinical measures of impairment, and analysis techniques were extracted and tabulated to identify trends and commonalities. The studies were assessed for risk of bias, and the overall quality of evidence was assessed for each specific finding using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. A total of 6597 unique citations were identified in the database search, and after full-text review of 274 articles, a total of 104 relevant studies were identified for final inclusion (97% from the initial database search). Among these, 69 studies utilized DTI and 25 used MT, with both techniques showing an increased number of publications in recent years. The review also identified 1 MWF study, 11 MRS studies, and 8 fMRI studies. Most of the studies were exploratory in nature, lacking a priori hypotheses and showing a high (72%) or moderately high (20%) risk of bias, due to issues with study design, acquisition techniques, and analysis methods. The acquisitions for each technique varied widely across

  3. 32 CFR 199.7 - Claims submission, review, and payment.

    Science.gov (United States)

    2010-07-01

    ... review or audit, whether the review or audit is prospective, concurrent, or retroactive, OCHAMPUS or... preauthorization must be attached to the appropriate CHAMPUS claim. (4) Advance payment prohibited. No CHAMPUS... and supplies will be subject to utilization review and quality assurance standards, norms, and...

  4. Turmoil and transition: Electric utility industry trends

    International Nuclear Information System (INIS)

    1994-06-01

    In a review of electric utility industry trends, focusing on North America, it is noted that four critical influences are dominant: competition in the electricity supply business; technological advances; the recognized need for environmental protection; and a favoring of market economics and customer choice. As energy costs rose in the 1970s and 1980s, electricity usage growth rates decreased and demand side management became an accepted alternative to building new power plants. In large areas of Canada and the USA, substantial surplus generation capacity arose, transmission linkages improved, and regional electricity markets developed. Privatization measures in the British electric sector were closely studied in North America and electric markets in the USA were pushed toward more competition with the 1992 Energy Policy Act. Non-utility generators have entered the market, including industrial companies, pipeline companies, independent renewable-energy providers, and power companies set up by the utilities themselves. Power pools may evolve into regional transmission grids in which the transmission owning utilities would exchange their lines for an interest in the grid. California is likely to lead in opening access to transmission on a regional scale. Distribution systems are likely to remain a regulated monopoly as before. Substantial change is expected in customer services as functions such as power purchase and conservation are being performed by independent companies. Other possible developments in the industry include emissions trading and spot markets for power. The implications of these trends for British Columbia Hydro are discussed

  5. Utility of MRCP in clinical decision making of suspected choledocholithiasis: An institutional analysis and literature review.

    Science.gov (United States)

    Badger, Wesley R; Borgert, Andrew J; Kallies, Kara J; Kothari, Shanu N

    2017-08-01

    The ideal treatment algorithm for suspected choledocholithiasis is not yet well defined. Imaging options include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative cholangiogram (IOC). MRCP is diagnostic, while the other two modalities can also be therapeutic. Each of these modalities for diagnosis and treatment carries its own set of risks, benefits, and institutional costs. We hypothesized that there would be a significant difference between the biochemical profiles and characteristics of patients who undergo ERCP vs. MRCP vs. operative intervention as the initial choice of treatment/imaging modality. We performed a retrospective review of the electronic medical records for all patients with a coded diagnosis of choledocholithiasis from 2011 to 2014. The initial diagnostic modality was assessed for each hospital encounter. The statistical characteristics of MRCP as compared to fluoroscopic imaging of the biliary tree (ERCP, IOC) were analyzed. Overall, 527 hospital encounters were identified. Initial intervention included ERCP in 63%, MRCP in 12%, and cholecystectomy in 25% of patients. Patients undergoing cholecystectomy first, compared to MRCP or ERCP, tended to have lower values for alkaline phosphatase (P utility in this patient population should be questioned. Further research is needed to better define the pretest characteristics which would predict which patients do not need further intervention after MRCP as well as defining the most cost-effective strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. The Naïve Utility Calculus: Computational Principles Underlying Commonsense Psychology.

    Science.gov (United States)

    Jara-Ettinger, Julian; Gweon, Hyowon; Schulz, Laura E; Tenenbaum, Joshua B

    2016-08-01

    We propose that human social cognition is structured around a basic understanding of ourselves and others as intuitive utility maximizers: from a young age, humans implicitly assume that agents choose goals and actions to maximize the rewards they expect to obtain relative to the costs they expect to incur. This 'naïve utility calculus' allows both children and adults observe the behavior of others and infer their beliefs and desires, their longer-term knowledge and preferences, and even their character: who is knowledgeable or competent, who is praiseworthy or blameworthy, who is friendly, indifferent, or an enemy. We review studies providing support for the naïve utility calculus, and we show how it captures much of the rich social reasoning humans engage in from infancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Economic fluctuation affects vasectomy utilization: A single-institution study

    OpenAIRE

    Chang, Yi-Huei; Hsiao, Po-Jen; Chen, Guang-Heng; Chang, Chao-Hsiang; Chen, Wen-Chi; Yeh, Chin-Chung; Huang, Chi-Ping; Chung, Chi-Jung; Chou, Eric Chieh-Lung; Chen, Kuo-Liang

    2015-01-01

    Objective: Vasectomies are safe and effective family-planning options, however, the factors associated with their utilization are poorly understood. Here, we examine differences in vasectomy rates according to socioeconomic status, education, and family composition. Materials and methods: Retrospective surgical records were reviewed of vasectomies completed between January 2008 and September 2011 in China Medical University Hospital, Taichung, Taiwan. Men who received a vasectomy were ques...

  8. Diagnostic utility of selective nerve root blocks in the diagnosis of lumbosacral radicular pain: systematic review and update of current evidence.

    Science.gov (United States)

    Datta, Sukdeb; Manchikanti, Laxmaiah; Falco, Frank J E; Calodney, Aaron K; Atluri, Sairam; Benyamin, Ramsin M; Buenaventura, Ricardo M; Cohen, Steven P

    2013-04-01

      Lumbosacral selective nerve root blocks and/ or transforaminal epidural injections are used for diagnosis and treatment of different disorders causing low back and lower extremity pain. A clear consensus on the use of selective nerve root injections as a diagnostic tool does not currently exist. Additionally, the validity of this procedure as a diagnostic tool is not clear. To evaluate and update the accuracy of selective nerve root injections in diagnosing lumbar spinal disorders. A systematic review of selective nerve root blocks for the diagnosis of low back and lower extremity pain. Methodological quality assessment of included studies was performed using the Quality Appraisal of Reliability Studies (QAREL) checklist. Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. Studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, or limited or poor based on the quality of evidence grading scale developed by the United States Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles. In this review, we evaluated studies in which controlled local anesthetic blocks were performed using at least 50% pain relief as the reference standard. There is limited evidence for the accuracy of selective nerve root injections as a diagnostic tool for lumbosacral disorders. There is limited evidence for their use in the preoperative evaluation of patients with negative or inconclusive imaging studies. The limitations of this systematic review include a paucity of literature, variations in technique, and variable criterion standards for the diagnosis of lumbar radicular pain. There is limited evidence for selective nerve root injections as a diagnostic tool in

  9. 42 CFR 456.236 - Continued stay review process.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... each continued stay of a recipient in the mental hospital, the committee, subgroup or designee reviews... committee, subgroup or designee finds that a recipient's continued stay in the mental hospital is needed...

  10. Electrocardiographic Characteristics of Potential Organ Donors and Associations with Cardiac Allograft Utilization

    Science.gov (United States)

    Khush, Kiran K.; Menza, Rebecca; Nguyen, John; Goldstein, Benjamin A.; Zaroff, Jonathan G.; Drew, Barbara J.

    2012-01-01

    Background Current regulations require that all cardiac allograft offers for transplantation must include an interpreted 12-lead electrocardiogram (ECG). However, little is known about the expected ECG findings in potential organ donors, or the clinical significance of any identified abnormalities in terms of cardiac allograft function and suitability for transplantation. Methods and Results A single experienced reviewer interpreted the first ECG obtained after brainstem herniation in 980 potential organ donors managed by the California Transplant Donor Network from 2002-2007. ECG abnormalities were summarized, and associations between specific ECG findings and cardiac allograft utilization for transplantation were studied. ECG abnormalities were present in 51% of all cases reviewed. The most common abnormalities included voltage criteria for left ventricular hypertrophy (LVH), prolongation of the corrected QT interval (QTc), and repolarization changes (ST/T wave abnormalities). Fifty seven percent of potential cardiac allografts in this cohort were accepted for transplantation. LVH on ECG was a strong predictor of allograft non-utilization. No significant associations were seen between QTc prolongation, repolarization changes and allograft utilization for transplantation, after adjusting for donor clinical variables and echocardiographic findings. Conclusions We have performed the first comprehensive study of ECG findings in potential donors for cardiac transplantation. Many of the common ECG abnormalities seen in organ donors may result from the heightened state of sympathetic activation that occurs after brainstem herniation, and are not associated with allograft utilization for transplantation. PMID:22615333

  11. Suicide contagion: a systematic review of definitions and research utility.

    Directory of Open Access Journals (Sweden)

    Qijin Cheng

    Full Text Available Despite the common use of contagion to analogize the spread of suicide, there is a lack of rigorous assessment of the underlying concept or theory supporting the use of this term. The present study aims to examine the varied definitions and potential utility of the term contagion in suicide-related research.100 initial records and 240 reference records in English were identified as relevant with our research objectives, through systematic literature screening. We then conducted narrative syntheses of various definitions and assessed their potential value for generating new research.20.3% of the 340 records used contagion as equivalent to clustering (contagion-as-cluster; 68.5% used it to refer to various, often related mechanisms underlying the clustering phenomenon (contagion-as-mechanism; and 11.2% without clear definition. Under the category of contagion-as-mechanism, four mechanisms have been proposed to explain how suicide clusters occurred: transmission (contagion-as-transmission, imitation (contagion-as-imitation, contextual influence (contagion-as-context, and affiliation (contagion-as-affiliation. Contagion-as-cluster both confounds and constrains inquiry into suicide clustering by blending proposed mechanism with the phenomenon to be studied. Contagion-as-transmission is, in essence, a double or internally redundant metaphor. Contagion-as-affiliation and contagion-as-context involve mechanisms that are common mechanisms that often occur independently of apparent contagion, or may serve as a facilitating background. When used indiscriminately, these terms may create research blind spots. Contagion-as-imitation combines perspectives from psychology, sociology, and public health research and provides the greatest heuristic utility for examining whether and how suicide and suicidal behaviors may spread among persons at both individual and population levels.Clarifying the concept of "suicide contagion" is an essential step for more

  12. Microcomputer applications for NSSS data package review

    International Nuclear Information System (INIS)

    Eng, D.J.; Smith, F.M.

    1984-01-01

    Associated with each component of a Nuclear Steam Supply System are the necessary supporting documents which demonstrate compliance with applicable codes, specifications and design criteria. The documents are grouped into individual data packages, and may exceed 800 in number for a major installation. A complete review, initiated by a utility in response to federal code regulations (10 CFR 50), can involve a tremendous number of review transactions. A data management system to assist the reviewer in the tracking and resolution of discrepancy items is currently under development and use. The system uses microcomputer-based relational database management software and provides complete and flexible capabilities to process database components and attributes based on user specified criteria. The completed database is a ''portable'' system, and can be utilized on an as-needed basis after the review is completed. A discrepancy analysis is performed to identify relations between manufacturer and discrepancy occurrence, part type vs. discrepancy type, etc. These results may prove useful in subsequent reviews or application to existing QA procedures

  13. 1907-IJBCS-Article-Bernice Kingha

    African Journals Online (AJOL)

    hp

    Campo, Tchuenguem Fohouo et al. (2000) ont trouvé 4 ouvrières de Apis mellifica sur un pied de A. hypogaea. La durée moyenne d'une visite de récolte de pollen varie avec l'insecte et ceci d'une année à une autre. La durée des visites semble être liée à l'accessibilité au pollen de. A. hypogaea. Nos données confirment ...

  14. Trigeneration: A new way for landfill gas utilization and its feasibility in Hong Kong

    International Nuclear Information System (INIS)

    Hao Xiaoli; Yang Hongxing; Zhang Guoqiang

    2008-01-01

    Application of landfill gas (LFG) means a synergy between environmental protection and energy production. This paper presents a review of the status of LFG application. To more efficiently utilize the LFG in Hong Kong, a trigeneration scheme is proposed as a new way of LFG utilization. The feasibility of LFG trigeneration in Hong Kong is evaluated from the views of primary energy-saving and greenhouse gas (GHG) emission reduction as well as economic benefit. The proposed scenario is compared with the conventional scenarios of LFG treatment and utilization. It is shown that LFG for trigeneration has a higher energy saving and GHG emission reduction potentials. The new scheme is also more economical than the conventional way of LFG utilization. Some policy recommendations are also given to promote the biomass energy utilization from waste landfills in Hong Kong

  15. The genome structure of Arachis hypogaea (Linnaeus, 1753 and an induced Arachis allotetraploid revealed by molecular cytogenetics

    Directory of Open Access Journals (Sweden)

    Eliza F. de M. B. do Nascimento

    2018-03-01

    Full Text Available Peanut, Arachis hypogaea (Linnaeus, 1753 is an allotetraploid cultivated plant with two subgenomes derived from the hybridization between two diploid wild species, A. duranensis (Krapovickas & W. C. Gregory, 1994 and A. ipaensis (Krapovickas & W. C. Gregory, 1994, followed by spontaneous chromosomal duplication. To understand genome changes following polyploidy, the chromosomes of A. hypogaea, IpaDur1, an induced allotetraploid (A. ipaensis × A. duranensis4x and the diploid progenitor species were cytogenetically compared. The karyotypes of the allotetraploids share the number and general morphology of chromosomes; DAPI+ bands pattern and number of 5S rDNA loci. However, one 5S rDNA locus presents a heteromorphic FISH signal in both allotetraploids, relative to corresponding progenitor. Whilst for A. hypogaea the number of 45S rDNA loci was equivalent to the sum of those present in the diploid species, in IpaDur1, two loci have not been detected. Overall distribution of repetitive DNA sequences was similar in both allotetraploids, although A. hypogaea had additional CMA3+ bands and few slight differences in the LTR-retrotransposons distribution compared to IpaDur1. GISH showed that the chromosomes of both allotetraploids had preferential hybridization to their corresponding diploid genomes. Nevertheless, at least one pair of IpaDur1 chromosomes had a clear mosaic hybridization pattern indicating recombination between the subgenomes, clear evidence that the genome of IpaDur1 shows some instability comparing to the genome of A. hypogaea that shows no mosaic of subgenomes, although both allotetraploids derive from the same progenitor species. For some reasons, the chromosome structure of A. hypogaea is inherently more stable, or, it has been at least, partially stabilized through genetic changes and selection.

  16. AN APPROACH FOR REVIEWING AND RANKING THE CUSTOMERS’ REVIEWS THROUGH QUALITY OF REVIEW (QoR

    Directory of Open Access Journals (Sweden)

    Sumit Kawate

    2017-01-01

    Full Text Available Quality is referred as the degree of excellence that means the expected product or service being considered to achieve desired requirements. Whereas, Quality of Reviews (QoR relates to the task of determining the quality, efficiency, suitability, or utility of each review by addressing Quality of Product (QoP and Quality of Service (QoS. It is an essential task of ranking, the reviews based on the quality and efficiency of the reviews given by the users. Whatever the reviews are provided to the particular product or services are from user experiences. The Quality of Reviews (QoR is one of a kind method that defines how the customer’s standpoint for the service or product that he/she experienced. The main issue while reviewing any product, the reviewer provides his/her opinion in the form of reviews and might be a few of those reviews are malicious spam entries to skew the rating of the product. Also in another case, many times customers provide the reviews which are quite common and that won’t helpful for the buyer to interpret the helpful feedback on their products because of too many formal reviews from distinct customers. Hence, we proposed novel approaches: i to statistical analyzes the customer reviews on products by Amazon to identify top most useful or helpful reviewers; ii to analyze the products and its reviews associated for malicious reviews ratings that skewed the overall product ranking. As this is one of the efficient approaches to avoid spam reviewers somehow from reviewing the products. With this, we can use this method for distinguishing between nominal users and spammers. This method helps to quest for helpful reviewers not only to make the product better from best quality reviewers, but also these quality reviewers themselves can able to review future products.

  17. Hawaii Utility Integration Initiatives to Enable Wind (Wind HUI) Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Dora Nakafuji; Lisa Dangelmaier; Chris Reynolds

    2012-07-15

    monitoring using PMU devices and enhanced grid analysis tools; and Initiative 3: Identifying grid automation and smart technology architecture retrofit/improvement opportunities following a systematic review approach, inclusive of increasing renewables and variable distributed generation. Each of the initiative was conducted in partnership with industry technology and equipment providers to facilitate utility deployment experiences inform decision making, assess supporting infrastructure cost considerations, showcase state of the technology, address integration hurdles with viable workarounds. For each initiative, a multi-phased approach was followed that included 1) investigative planning and review of existing state-of-the-art, 2) hands on deployment experiences and 3) process implementation considerations. Each phase of the approach allowed for mid-course corrections, process review and change to any equipment/devices to be used by the utilities. To help the island grids transform legacy infrastructure, the Wind HUI provided more systematic approaches and exposure with vendor/manufacturers, hand-on review and experience with the equipment not only from the initial planning stages but through to deployment and assessment of field performance of some of the new, remote sensing and high-resolution grid monitoring technologies. HELCO became one of the first utilities in the nation to install and operate a high resolution (WindNet) network of remote sensing devices such as radiometers and SODARs to enable a short-term ramp event forecasting capability. This utility-industry and federal government partnership produced new information on wind energy forecasting including new data additions to the NOAA MADIS database; addressed remote sensing technology performance and O&M (operations and maintenance) challenges; assessed legacy equipment compatibility issues and technology solutions; evaluated cyber-security concerns; and engaged in community outreach opportunities that will

  18. Diospyros, an under-utilized, multi-purpose plant genus: A review.

    Science.gov (United States)

    Rauf, Abdur; Uddin, Ghias; Patel, Seema; Khan, Ajmal; Halim, Sobia Ahsan; Bawazeer, Saud; Ahmad, Khalid; Muhammad, Naveed; Mubarak, Mohammad S

    2017-07-01

    The genus Diospyros from family Ebenaceae has versatile uses including edible fruits, valuable timber, and ornamental uses. The plant parts of numerous species have been in use as remedies in various folk healing practices, which include therapy for hemorrhage, incontinence, insomnia, hiccough, diarrhea etc. Phytochemical constituents such as terpenoids, ursanes, lupanes, polyphenols, tannins, hydrocarbons, and lipids, benzopyrones, naphthoquinones, oleananes, and taraxeranes have been isolated from different species of this genus. The biological activities of these plants such as antioxidant, anti-inflammatory, analgesic, antipyretic, anti-diabetic, antibacterial, anthelmintic, antihypertensive, cosmeceutical, enzyme-inhibitory etc. have been validated by means of an in vitro, in vivo, and clinical tests. As a rich reserve of pharmacologically important components, this genus can accelerate the pace of drug discovery. Accordingly, the aim of the present review is to survey and summarize the recent literature pertaining to the medicinal and pharmacological uses of Diospyros, and to select experimental evidence on the pharmacological properties of this genus. In addition, the review also aims at identifying areas that need development to make use of this genus, especially its fruit and phytochemicals as means for economic development and for drug discovery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Utility of semi-rigid thoracoscopy in undiagnosed exudative pleural effusion.

    Science.gov (United States)

    Nattusamy, Loganathan; Madan, Karan; Mohan, Anant; Hadda, Vijay; Jain, Deepali; Madan, Neha Kawatra; Arava, Sudheer; Khilnani, Gopi C; Guleria, Randeep

    2015-01-01

    Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed pleural effusion. Literature on its utility from developing countries is limited. We herein describe our initial experience on the utility of semi-rigid thoracoscopy from a tertiary care teaching and referral center in north India. We also perform a systematic review of studies reporting the utility of semi-rigid thoracoscopy from India. The primary objective was to evaluate the diagnostic utility of semi-rigid thoracoscopy in patients with undiagnosed exudative pleural effusion. Semi-rigid thoracoscopy was performed under local anesthesia and conscious sedation in the bronchoscopy suite. A total of 48 patients underwent semi-rigid thoracoscopy between August 2012 and December 2013 for undiagnosed pleural effusion. Mean age was 50.9 ± 14.1 years (range: 17-78 years). Pre-procedure clinico-radiological diagnoses were malignant pleural effusion [36 patients (75%)], tuberculosis (TB) [10 (20.83%) patients], and empyema [2 patients (4.17%)]. Patients with empyema underwent the procedure for pleural biopsy, optimal placement of intercostal tube and adhesiolysis. Thoracoscopic pleural biopsy diagnosed pleural malignancy in 30 (62.5%) patients and TB in 2 (4.17%) patients. Fourteen (29.17%) patients were diagnosed with non-specific pleuritis and normal pleura was diagnosed on a pleural biopsy in 2 (4.17%) patients. Overall, a definitive diagnosis of either pleural malignancy or TB was obtained in 32 (66.7%) patients. Combined overall sensitivity, specificity, positive predictive value and negative predictive value of thoracoscopic pleural biopsy for malignant pleural effusion were 96.77%, 100%, 100% and 66.67%, respectively. There was no procedure-related mortality. On performing a systematic review of literature, four studies on semi-rigid thoracoscopy from India were identified. Semi-rigid thoracoscopy is a safe and efficacious procedure in patients with undiagnosed exudative

  20. Safety review advisor

    International Nuclear Information System (INIS)

    Boshers, J.A.; Alguindigue, I.E.; Uhrig, R.E.

    1989-01-01

    The University of Tennessee's Nuclear Engineering Department, in cooperation with the Tennessee Valley Authority (TVA), is evaluating the feasibility of utilizing an expert system to aid in 10CFR50.59 evaluations. This paper discusses the history of 10CFR50.59 reviews, and details the development approach used in the construction of a prototype Safety Review Advisor (SRA). The goals for this expert system prototype are to (1) aid the engineer in the evaluation process by directing his attention to the appropriate critical issues, (2) increase the efficiency, consistency, and thoroughness of the evaluation process, and (3) provide a foundation of appropriate Safety Analysis Report (SAR) references for the reviewer. 6 refs., 2 figs

  1. A survey of utility experience with real time pricing: implications for policymakers seeking price responsive demand

    International Nuclear Information System (INIS)

    Barbose, Galen; Goldman, Charles; Neenan, Bernard

    2005-01-01

    Economists and policy makers frequently propose real time pricing (RTP) as a strategy for facilitating price responsive demand, thereby improving the performance of electricity markets and regional networks. While theoretically appealing, many practical and empirical issues related to RTP remain unresolved or poorly understood. Over the past two decades, more than 70 utilities in the U.S. have offered voluntary RTP tariffs, on either a pilot or permanent basis. However, most have operated in relative obscurity, and little information has made its way into the public domain. To address this gap, we conducted a conducted a comprehensive review of voluntary RTP programs in the U.S. by surveying 43 U.S. utilities and reviewing regulatory documents, tariffs, program evaluations, and other publicly available sources. Based on this review of RTP program experience, we identify key trends related to utilities' motivations and goals for implementing RTP, evolution of RTP tariff design, program participation, participant price response, and program outlook. Experience with voluntary RTP programs has been mixed. Several utilities have demonstrated that voluntary RTP programs are capable of generating significant load reductions. However, most programs have attracted relatively few participants and therefore have generated quite limited load reductions. About 2700 non-residential customers were enrolled in RTP programs in 2003, representing more than 11 000 MW of load. We then draw from these findings to identify implications for policy makers and regulators that are currently considering RTP as a strategy for facilitating price responsive demand

  2. Narrating Palaeolithic Human Settlement History : the case of the Imjin-Hantan River Area, Korea

    Directory of Open Access Journals (Sweden)

    Yongwook Yoo

    2014-02-01

    Full Text Available This article intends to furnish a narrative story-telling with the broad perspective on the human past rather than simply depending on the analytical examination of archaeological data. For the purpose of this task, Ferdinand Braudel’s concept of “la longue durée” is applied to parallel the environmental background and hominid’s life/land-use patterns based on the geological data and archaeological remains. The Imjin-Hantan River Area (IHRA, known for the discovery of Acheulian-like handaxe, was occupied from ca 0.23 mya to the final Pleistocene; the hominids continuously changed their residing patterns in the landscape with actively modifying the lithic technological organization as a response to the environmental change. Integrating the geological features, absolute dates and characteristics of lithic assemblages from individual sites, we can recognize six phases of environmental changes based on the development of river channel system. These six phases witness different patterns of hominid’s adaptation in this area and correspondingly yield different mode of raw material utilization and lithic procurement. While more accurate geological dates are yet to be published and the description of lithic assemblages may be changed by new data, it is prospecting that Braudel’s la longue durée is a useful concept for meaningfully narrating a long-term human occupation history in the discipline of prehistoric archaeology.

  3. Polymères en ambiance nucléaire comportement à long terme

    CERN Document Server

    Audouin, Ludmila; Fayolle, Bruno; Richaud, Emmanuel; Verdu, Jacques

    2012-01-01

    Ce livre présente des outils théoriques originaux, indispensables pour ta prédiction de la durée de vie des matériaux polymères en ambiance nucléaire. Le problème de vieillissement des polymères est avant tout un problème d'ingénieur, dont la préoccupation majeure est la prédiction de durée de vie selon des critères pertinents du point de vue de l'application. Partant de ce constat, les auteurs ont focalisé leur intérêt sur les aspects les plus souvent négligés dans les ouvrages classiques mais cruciaux : la modélisation cinétique de l'oxydation radio-amorcée à faible débit de dose et les conséquences de l'irradiation sur les propriétés thermomécaniques. Ces deux aspects font l'objet de développements qui confèrent à l'ouvrage son originalité, lui permettant d'être un complément utile aux ouvrages classiques. Présenté de manière claire et pédagogique, cet ouvrage permettra à l'étudiant de Master, au jeune chercheur comme à l'ingénieur de rejoindre un courant de reche...

  4. The utility of the contrast enema in neonates with suspected Hirschsprung disease.

    Science.gov (United States)

    Putnam, Luke R; John, Susan D; Greenfield, Susan A; Kellagher, Caroline M; Austin, Mary T; Lally, Kevin P; Tsao, Kuojen

    2015-06-01

    The contrast enema (CE) is commonly utilized for suspected Hirschsprung disease (HD) patients. We set out to determine the utility of the CE in the newborn for clinically suspicious HD. All CEs performed for suspicion of HD in neonates from January 2004 to December 2013 were reviewed by two pediatric radiologists who were blinded to the original interpretations and final diagnoses. A standardized scoring sheet was utilized to document essential radiographic findings. Definitive diagnoses were determined by pathology. Descriptive statistics, likelihood ratios, and interrater agreement were determined. 158 CEs were reviewed. Interrater agreement was 89% with kappa (95% CI) of 0.63 (0.47-0.76). Common indications for CE were similar between non-HD and HD groups. The positive, inconclusive, and negative likelihood ratios (95% CI) were 38 (10-172), 3.2 (1.3-9.1), and 0.15 (0.06-0.47), respectively, leading to posttest probabilities for positive, inconclusive, and negative tests of 83%, 32%, and 2.5%, respectively. Although radiographic positive CE for HD portends a high probability of HD, inconclusive studies still represent a significant increased risk. In clinically suspicious infants for HD, those with inconclusive studies may benefit from a lower threshold to perform follow-up rectal biopsy. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Daily Migraine Prevention and Its Influence on Resource Utilization in the Military Health System

    Science.gov (United States)

    2006-08-01

    Connection Between Prevention and Resource Use .....................17 Synthesis of Literature Review...Utilization ..................................26 Treatment Evaluation with Observational Designs .........................31 Synthesis of Conceptual...amitriptyline atenolol cyproheptadine methysergide carbamazepine divalproex fluoxetine bupropion clomipramine propranolol gabapentin diltiazem

  6. Knowledge-based utility

    International Nuclear Information System (INIS)

    Chwalowski, M.

    1997-01-01

    This presentation provides industry examples of successful marketing practices by companies facing deregulation and competition. The common thread through the examples is that long term survival of today's utility structure is dependent on the strategic role of knowledge. As opposed to regulated monopolies which usually own huge physical assets and have very little intelligence about their customers, unregulated enterprises tend to be knowledge-based, characterized by higher market value than book value. A knowledge-based enterprise gathers data, creates information and develops knowledge by leveraging it as a competitive weapon. It institutionalizes human knowledge as a corporate asset for use over and over again by the use of databases, computer networks, patents, billing, collection and customer services (BCCS), branded interfaces and management capabilities. Activities to become knowledge-based such as replacing inventory/fixed assets with information about material usage to reduce expenditure and achieve more efficient operations, and by focusing on integration and value-adding delivery capabilities, were reviewed

  7. Utilization of MVP for research on fast reactor

    International Nuclear Information System (INIS)

    Yokoyama, Kenji

    2001-01-01

    Utilization of the continuous energy Monte-Carlo code, MVP, for research on fast reactor in Power Reactor and Nuclear Fuel Development Corporation(PNC) is described. In this report, three types of utilization are reviewed; (1) a comparison of the eigenvalues calculated by MVP with the results by the deterministic methods, (2) an improvement of U-238 reaction rate evaluation in JUPITER experimental Analysis and (3) an evaluation of heterogeneity effects for Am reaction rates of the moderated subassemblies. Since the results of MVP can be used as references, MVP is very useful code in research on fast reactor. It is one of indispensable tools in order to verify the models in the deterministic methods. Furthermore, it can be used so as to investigate the new concept reactors, such as a reactor aiming to transmute minor actinides(MA). On the other hand, a problem of the variance reduction remains. Especially, a small reactivity cannot be estimated by MVP because of large variances. The development of a Monte-Carlo method for a small reactivity calculation will promote the utilization of MVP for research on fast reactor. (author)

  8. 77 FR 38036 - Submission for OMB Review; Comment Request

    Science.gov (United States)

    2012-06-26

    ... DEPARTMENT OF COMMERCE Submission for OMB Review; Comment Request The Department of Commerce will... source of capacity rates at industry levels. Changes in capacity utilization are considered important... utilizes a multi-mode data collection process that includes internet reporting, fax, telephone and mail...

  9. Standard review plan for the review of environmental restoration remedial action quality assurance program plans

    International Nuclear Information System (INIS)

    1991-09-01

    This plan establishes both the scope of the review and the acceptance criteria to be utilized for the review of Quality Assurance Program Plans (QAPPs) developed in accordance with the requirements of DOE/RL-90-28. DOE/RL-90-28, the Environmental Restoration Remedial Action Quality Assurance Requirements Document (QARD) defines all quality assurance (QA) requirements governing activities that affect the quality of the Environmental Restoration Remedial Action (ERRA) program at the Hanford Site. These requirements are defined in three parts, Part 1 of Quality Management and Administration tasks, Part 2 for Environmental Data Operations, and Part 3 of the Design and Construction of items, systems, and facilities. The purpose of this document is to identify the scope of the review by the DOE Field Office, Richland staff, and establish the acceptance criteria (Parts 1, 2, and 3) that the DOE Field Office, Richland staff will utilize to evaluate the participant QAPPs. Use of the standard review plan will (1) help ensure that participant QAPPs contain the information required by DOE/RL-90-28, (2) aid program participant and DOE Field Office, Richland staff is ensuring that the information describing the participant's QAPP is complete, (3) help persons regarding DOE/RL- 90-28 to locate information, and (4) contribute to decreasing the time needed for the review process. In addition, the Standard Review Plan (SRP) ensures the quality and uniformity of the staff reviews and presents a well-defined base from which to evaluate compliance of participant quality programs against DOE/RL-90-28

  10. Influence of mycotoxins on protein and amino acid utilization.

    Science.gov (United States)

    Smith, T K

    1982-09-01

    The interrelationships between mycotoxins and the utilization of dietary protein are reviewed. Acute aflatoxicosis is characterized by reduced growth and fatty infiltration of the liver. Studies with poultry, swine, and monkeys have shown that supplements of dietary protein beyond normal requirements can overcome these conditions. High-protein diets, however, have been shown to promote hepatoma characteristic of chronic aflatoxicosis in rats. Aflatoxin interferes with utilization of dietary protein by inhibiting synthesis of DNA, RNA, and protein. High-protein diets promote the metabolism of aflatoxin by the hepatic microsomal drug-metabolizing enzyme system. The Fusarium mycotoxin zearalenone increases membrane permeability and promotes uterine synthesis of DNA, RNA, and protein. Supplements of dietary protein overcome growth reduction due to zearalenone and reduce the metabolic half-life of the toxin by promoting urinary excretion of free, unmetabolized zearalenone in the rat. The trichothecene mycotoxins disrupt normal protein metabolism by inactivating the ribosomal cycle. Protein supplements appear to have little effect on trichothecene mycotoxicoses. Most mycotoxins impair utilization of dietary protein. The effectiveness of protein supplements in overcoming mycotoxicoses will depend on the mycotoxin in question.

  11. Direct utilization of geothermal energy

    International Nuclear Information System (INIS)

    Lund, J. W.

    2010-01-01

    The worldwide application of geothermal energy for direct utilization is reviewed. This paper is based on the world update for direct-use presented at the World Geothermal Congress 2010 in Bali, Indonesia (WGC2010) which also includes material presented at three world geothermal congresses in Italy, Japan and Turkey (WGC95, WGC2000 and WGC2005). This report is based on country update papers prepared for WGC2010 and data from other sources. Final update papers were received from 70 countries of which 66 reported some direct utilization of geothermal energy for WGC2010. Twelve additional countries were added to the list based on other sources of information. The 78 countries having direct utilization of geothermal energy, is a significant increase from the 72 reported in 2005, the 58 reported in 2000, and the 28 reported in 1995. An estimate of the installed thermal power for direct utilization at the end of 2009, reported from WGC2010 is 48,493 MW th , almost a 72 % increased over the 2005 data, growing at a compound rate of 11.4% annually with a capacity factor of 0.28. The thermal energy used is 423,830 TJ/year (117,740 GWh/yr), about a 55% increase over 2005, growing at a compound rate of 9.2% annually. The distribution of thermal energy used by category is approximately 47.2% for ground-source heat pumps, 25.8% for bathing and swimming (including balneology), 14.9% for space heating (of which 85% is for district heating), 5.5% for greenhouses and open ground heating, 2.8% for industrial process heating, 2.7% for aquaculture pond and raceway heating, 0.4% for agricultural drying, 0.5% for snow melting and cooling, and 0.2% for other uses. Energy savings amounted to 250 million barrels (38 million tonnes) of equivalent oil annually, preventing 33 million tonnes of carbon and 107 million tonnes of CO 2 being released to the atmosphere which includes savings in geothermal heat pump cooling (compared to using fuel oil to generate electricity). (author)

  12. Direct Utilization of Geothermal Energy

    Directory of Open Access Journals (Sweden)

    John W. Lund

    2010-08-01

    Full Text Available The worldwide application of geothermal energy for direct utilization is reviewed. This paper is based on the world update for direct-use presented at the World Geothermal Congress 2010 in Bali, Indonesia (WGC2010 [1] which also includes material presented at three world geothermal congresses in Italy, Japan and Turkey (WGC95, WGC2000 and WGC2005. This report is based on country update papers prepared for WGC2010 and data from other sources. Final update papers were received from 70 countries of which 66 reported some direct utilization of geothermal energy for WGC2010. Twelve additional countries were added to the list based on other sources of information. The 78 countries having direct utilization of geothermal energy, is a significant increase from the 72 reported in 2005, the 58 reported in 2000, and the 28 reported in 1995. An estimate of the installed thermal power for direct utilization at the end of 2009, reported from WGC2010 is 48,493 MWt, almost a 72 % increased over the 2005 data, growing at a compound rate of 11.4% annually with a capacity factor of 0.28. The thermal energy used is 423,830 TJ/year (117,740 GWh/yr, about a 55% increase over 2005, growing at a compound rate of 9.2% annually. The distribution of thermal energy used by category is approximately 47.2% for ground-source heat pumps, 25.8% for bathing and swimming (including balneology, 14.9% for space heating (of which 85% is for district heating, 5.5% for greenhouses and open ground heating, 2.8% for industrial process heating, 2.7% for aquaculture pond and raceway heating, 0.4% for agricultural drying, 0.5% for snow melting and cooling, and 0.2% for other uses. Energy savings amounted to 250 million barrels (38 million tonnes of equivalent oil annually, preventing 33 million tonnes of carbon and 107 million tonnes of CO2 being release to the atmosphere which includes savings in geothermal heat pump cooling (compared to using fuel oil to generate electricity.

  13. British Columbia Utilities Commission service plan 2004/2005 - 2006/2007

    International Nuclear Information System (INIS)

    2004-01-01

    The mandate of the British Columbia Utilities Commission (BCUC) is to ensure that customers receive safe, reliable and non-discriminatory energy services at fair rates from the utilities. It must also ensure that the shareholders of the utilities have a reasonable opportunity to earn a fair return on the invested capital. This report describes the following six key areas that underlie the Commission's strategic planning for the next 3 years: (1) regulation of automobile insurance, (2) energy policy implementation, (3) natural gas commodity costs, (4) commercial unbundling and customer choice, (5) energy trade, and (6) benchmarking. The report also describes strategic issues with reference to priorities, shifts and risk management. Alignment with the government's strategic plan was also reviewed. The financial outlook for 2003/04 and 2006/07 shows that the Commission intends to fully recover costs from the utilities it regulates. The budget for 2003/04 has increased somewhat from the forecasted amount for the same period reported in the previous year's service plan. This is due to an expanded mandate. Forecast values for the 2004/05 and 2005/06 planning periods have decreased slightly compared to the previous year's plan. tabs., figs

  14. Preference-based measures to obtain health state utility values for use in economic evaluations with child-based populations: a review and UK-based focus group assessment of patient and parent choices.

    Science.gov (United States)

    Wolstenholme, Jane L; Bargo, Danielle; Wang, Kay; Harnden, Anthony; Räisänen, Ulla; Abel, Lucy

    2018-03-21

    No current guidance is available in the UK on the choice of preference-based measure (PBM) that should be used in obtaining health-related quality of life from children. The aim of this study is to review the current usage of PBMs for obtaining health state utility values in child and adolescent populations, and to obtain information on patient and parent-proxy respondent preferences in completing PBMs in the UK. A literature review was conducted to determine which instrument is most frequently used for child-based economic evaluations and whether child or proxy responses are used. Instruments were compared on dimensions, severity levels, elicitation and valuation methods, availability of value sets and validation studies, and the range of utility values generated. Additionally, a series of focus groups of parents and young people (11-20 years) were convened to determine patient and proxy preferences. Five PBMs suitable for child populations were identified, although only the Health Utilities Index 2 (HUI2) and Child Heath Utility 9D (CHU-9D) have UK value sets. 45 papers used PBMs in this population, but many used non-child-specific PBMs. Most respondents were parent proxies, even in adolescent populations. Reported missing data ranged from 0.5 to 49.3%. The focus groups reported their experiences with the EQ-5D-Y and CHU-9D. Both the young persons' group and parent/proxy groups felt that the CHU-9D was more comprehensive but may be harder for a proxy to complete. Some younger children had difficulty understanding the CHU-9D questions, but the young persons' group nonetheless preferred responding directly. The use of PBMs in child populations is increasing, but many studies use PBMs that do not have appropriate value sets. Parent proxies are the most common respondents, but the focus group responses suggest it would be preferred, and may be more informative, for older children to self-report or for child-parent dyads to respond.

  15. Recent advances in modeling nutrient utilization in ruminants.

    Science.gov (United States)

    Kebreab, E; Dijkstra, J; Bannink, A; France, J

    2009-04-01

    Mathematical modeling techniques have been applied to study various aspects of the ruminant, such as rumen function, postabsorptive metabolism, and product composition. This review focuses on advances made in modeling rumen fermentation and its associated rumen disorders, and energy and nutrient utilization and excretion with respect to environmental issues. Accurate prediction of fermentation stoichiometry has an impact on estimating the type of energy-yielding substrate available to the animal, and the ratio of lipogenic to glucogenic VFA is an important determinant of methanogenesis. Recent advances in modeling VFA stoichiometry offer ways for dietary manipulation to shift the fermentation in favor of glucogenic VFA. Increasing energy to the animal by supplementing with starch can lead to health problems such as subacute rumen acidosis caused by rumen pH depression. Mathematical models have been developed to describe changes in rumen pH and rumen fermentation. Models that relate rumen temperature to rumen pH have also been developed and have the potential to aid in the diagnosis of subacute rumen acidosis. The effect of pH has been studied mechanistically, and in such models, fractional passage rate has a large impact on substrate degradation and microbial efficiency in the rumen and should be an important theme in future studies. The efficiency with which energy is utilized by ruminants has been updated in recent studies. Mechanistic models of N utilization indicate that reducing dietary protein concentration, matching protein degradability to the microbial requirement, and increasing the energy status of the animal will reduce the output of N as waste. Recent mechanistic P models calculate the P requirement by taking into account P recycled through saliva and endogenous losses. Mechanistic P models suggest reducing current P amounts for lactating dairy cattle to at least 0.35% P in the diet, with a potential reduction of up to 1.3 kt/yr. A model that

  16. Microbes as interesting source of novel insecticides: A review ...

    African Journals Online (AJOL)

    ... strains with good insecticidal properties can be identified, evaluated and utilized for pest control. This paper reviews the insecticidal properties of microbes and their potential utility in pest management. Keywords: Microbes, insecticides, metabolites, pest management. African Journal of Biotechnology, Vol 13(26) 2582- ...

  17. Patterns of health service utilization at a medical school clinic in Ghana.

    Science.gov (United States)

    Yawson, A E; Malm, K L; Adu, A A; Wontumi, G-M; Biritwum, R B

    2012-09-01

    The University of Ghana Medical School (UGMS) Clinic provides healthcare service which is free at point of service to students, staff, retired staff and dependents of staff of the College of Health Sciences. However, since 1983, no in-depth review of health service provision or utilization has been undertaken. This study reviewed client characteristics, utilization and disease patterns at the clinic and also compared the disease patterns to that of other primary health facilities nationwide. This was an analytical cross-sectional study undertaken at the UGMS clinic in Korle-Bu. It was a retrospective review of records of all clients attending the facility from January 2002 to December, 2004. More males than females attended the clinic and majority (63.9%) of clients were between 15-44 years (median age was 26 years). Dependents of staff constituted the highest attendants (41%) to the clinic. Among staff, junior staffs were in the majority. Malaria, respiratory tract infection and musculoskeletal pain were the most common conditions seen. Overall, 83% of clients were treated and discharged per visit without the need for review visits. Dependents of staff used the facility the most and they live in many different part of the city of Accra, and to ask them to attend the clinic for care is not efficient. It will be better to provide or supplement their securing of insurance so that they could access health care close to their homes and save time and attention to students and staff.

  18. Utilization of protein-rich residues in biotechnological processes.

    Science.gov (United States)

    Pleissner, Daniel; Venus, Joachim

    2016-03-01

    A drawback of biotechnological processes, where microorganisms convert biomass constituents, such as starch, cellulose, hemicelluloses, lipids, and proteins, into wanted products, is the economic feasibility. Particularly the cost of nitrogen sources in biotechnological processes can make up a large fraction of total process expenses. To further develop the bioeconomy, it is of considerable interest to substitute cost-intensive by inexpensive nitrogen sources. The aim of this mini-review was to provide a comprehensive insight of utilization methods of protein-rich residues, such as fish waste, green biomass, hairs, and food waste. The methods described include (i) production of enzymes, (ii) recovery of bioactive compounds, and/or (iii) usage as nitrogen source for microorganisms in biotechnological processes. In this aspect, the utilization of protein-rich residues, which are conventionally considered as waste, allows the development of value-adding processes for the production of bioactive compounds, biomolecules, chemicals, and materials.

  19. Utilizing today's technology to improve the procedure development process

    International Nuclear Information System (INIS)

    Morgan, R.A.; White, P.A.

    1995-01-01

    The purpose of this paper is to describe the systematic approach being utilized by the Civilian Radioactive Waste Management System, Managing and Operating (M ampersand O) Contractor to electronically connect geographically-separated organizational work units for the common goal of developing, reviewing, and approving Quality Administrative Procedures. The Board members were equipped with a common electronic network access. The results of establishing a GRB and an electronic network have proven to be very cost effective

  20. Regulation of Legislation in Utilization of Foreign Health Workers (FHW in Indonesia

    Directory of Open Access Journals (Sweden)

    Tri Juni Angkasawati

    2015-06-01

    Full Text Available Background: One of the impact of AFTA 2010 (Asean Free Trade Area is a broader aspect of global world trade. Trade flows not only occur on public goods but also services, including health workers which now can freely get access to various countries. Objective:The aim of this study was to review policies on the employment of foreign health workers (FHW in order to provide recommendations on specific matters concerning legal protection to people who utilize health services and were treated by FHW. Methods:The method of this study was conducting a policy review with a normative and predictive approaches. This review depicted a clear and deep understanding of the form and implementation of policies related to planning, utilization as well as guidance and supervision of foreign health workers (FHW in Indonesia. Results: This study discovered that there were 7 (seven fundamental policies to regulate FHW that covers licensing, certification and registration, competence, area of activities, time restriction, compensation and sanction. Recommendation: This study recommends a socialization on FHW regulations. In addition, the Ministry of Health, Ministry of Manpower, Ministry of Home Affairs and the immigration office need to enhance their commitment to promote FHW regulations.

  1. A municipal guide to least cost utility planning

    International Nuclear Information System (INIS)

    1992-03-01

    The recent track record of ''traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process

  2. A municipal guide to least cost utility planning

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The recent track record of ``traditional`` electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states` least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

  3. A municipal guide to least cost utility planning

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The recent track record of traditional'' electricity planning, which entails selection of supply side resources to meet forecasted demand, has not been good. There are numerous examples of utilities incorrectly forecasting demand and over-building generating capacity while others underestimated growth and have had to cut demand and find alternate power sources to avoid outages. A potential solution to this problem is the continuing development of Least Cost Utility Plannning (LCUP). Regulatory commissions, consumer advocates and utilities are increasingly relying an LCUP as the most responsible way to avoid construction of new capacity and alleviate anticipated shortages caused by cancellation of construction projects, load growth, or natural replacement of aging capacity. The purpose of this report is to provide municipalities a starting point for evaluating their servicing utilities or states' least cost plan. This was accomplished by: Identifying key issues in LCUP; reviewing examples of the collaborative and classic approaches to LCUP in Illinois, California, New York State and Michigan; cataloging municipal authorities and strategies which can influence or support LCUP activities. Results of the project indicate that through a basic understanding of LCUP processes and issues, municipalities will be in a better position to influence plans or, if necessary, intervene in regulatory proceedings where plans are adopted. Constraints to municipal involvement in LCUP include statutory limitations, resource constraints, and a lack of knowledge of indirect authorities that support the LCUP process.

  4. Use of audits and reviews to improve plant performance, INPO'S experience

    International Nuclear Information System (INIS)

    Mc Coy, C.K.

    1986-01-01

    INPO's primary mission is to assist utilities in improving their nuclear plants performance. Consequently, the author has viewed utility audits and reviews as potential tools for improving plant performance. He has attempted to find examples where these tools are used effectively, and to find common elements of effective utility audit and review programs. One thing the author noted was that the words ''audit'' and ''review'' were not consistently used or understood. So to begin, he likes to stick to Webster's definitions in the context of nuclear power activities. First, Webster defines the verb audit as ''to examine with intent to verify.'' In this context this means to verify compliance with requirements. Second, Webster defines a review as ''a general survey'' or ''a critical evaluation.'' In this context this means an evaluation of an activity or program for effectiveness in accomplishing its intended purpose. INPO's evaluations are reviews, not audits, and they are intended to provide information to utility managers upon which they may make changes to improve performance. INPO does make ''recommendations'' based on effective practices seen at other plants, but the author insists that line management develop the corrective action. INPO provides follow-up at the next evaluation to ensure the corrective actions taken by management were effective. INPO bases most of its findings on observations of work and conditions in the plant as noted by knowledgeable personnel trained in observation techniques

  5. Recent progress in the utility of anti-Müllerian hormone in female infertility

    DEFF Research Database (Denmark)

    Grynnerup, Anna G-A; Lindhard, Anette; Sørensen, Steen

    2014-01-01

    PURPOSE OF REVIEW: To discuss the recent developments in the utility of anti-Müllerian hormone (AMH) in the context of female infertility. RECENT FINDINGS: AMH measurements have entered the clinical practice in counseling of women before in-vitro fertilization (IVF) treatment. AMH measurements ca...

  6. Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.

    Science.gov (United States)

    de Sa, Darren; Horner, Nolan S; MacDonald, Austin; Simunovic, Nicole; Slobogean, Gerard; Philippon, Marc J; Belzile, Etienne L; Karlsson, Jon; Ayeni, Olufemi R

    2016-12-01

    Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods. EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon's patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted. There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379). There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year. Systematic Review of Level IV Studies, Level IV.

  7. Report of the Office of Chief Counsel on the role of the managing utility and its suppliers

    International Nuclear Information System (INIS)

    Gorinson, S.M.; Kane, K.P.

    1979-10-01

    Information is presented concerning the role of General Public Utilities Service Corp.; site change; role of Met Ed in design of TMI-2; control room design; containment isolation criteria selection; GPUSC startup and test group; commercial operation; management relationships within the utility; site management; review committees; procedures; attention to experience; NRC inspections; management approach to the emergency; and the TMI-2 recovery program

  8. Report of the Office of Chief Counsel on the role of the managing utility and its suppliers

    International Nuclear Information System (INIS)

    Gorinson, S.M.; Kane, K.P.

    1979-10-01

    Information is presented concerning the role of General Public Utilities Service Corp.; site change; role of Met Ed in design of TMI-2; control room design; containment isolation criteria selection; GPUSC startup and test group; commercial operation; managment relationships within the utility; site management; review committees; procedures; attention to experience; NRC inspections; management approach to the emergency; and the TMI-2 recovery program

  9. Financial statistics of major US publicly owned electric utilities 1992

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    The 1992 edition of the Financial Statistics of Major US Publicly Owned Electric Utilities publication presents 4 years (1989 through 1992) of summary financial data and current year detailed financial data on the major publicly owned electric utilities. The objective of the publication is to provide Federal and State governments, industry, and the general public with current and historical data that can be used for policymaking and decisionmaking purposes related to publicly owned electric utility issues. Generator and nongenerator summaries are presented in this publication. Four years of summary financial data are provided. Summaries of generators for fiscal years ending June 30 and December 31, nongenerators for fiscal years ending June 30 and December 31, and summaries of all respondents are provided. The composite tables present aggregates of income statement and balance sheet data, as well as financial indicators. Composite tables also display electric operation and maintenance expenses, electric utility plant, number of consumers, sales of electricity, and operating revenue, and electric energy account data. The primary source of publicly owned financial data is the Form EIA-412, {open_quotes}Annual Report of Public Electric Utilities.{close_quotes} Public electric utilities file this survey on a fiscal year, rather than a calendar year basis, in conformance with their recordkeeping practices. In previous editions of this publication, data were aggregated by the two most commonly reported fiscal years, June 30 and December 31. This omitted approximately 20 percent of the respondents who operate on fiscal years ending in other months. Accordingly, the EIA undertook a review of the Form EIA-412 submissions to determine if alternative classifications of publicly owned electric utilities would permit the inclusion of all respondents.

  10. High utility-itemset mining and privacy-preserving utility mining

    Directory of Open Access Journals (Sweden)

    Jerry Chun-Wei Lin

    2016-03-01

    Full Text Available In recent decades, high-utility itemset mining (HUIM has emerging a critical research topic since the quantity and profit factors are both concerned to mine the high-utility itemsets (HUIs. Generally, data mining is commonly used to discover interesting and useful knowledge from massive data. It may, however, lead to privacy threats if private or secure information (e.g., HUIs are published in the public place or misused. In this paper, we focus on the issues of HUIM and privacy-preserving utility mining (PPUM, and present two evolutionary algorithms to respectively mine HUIs and hide the sensitive high-utility itemsets in PPUM. Extensive experiments showed that the two proposed models for the applications of HUIM and PPUM can not only generate the high quality profitable itemsets according to the user-specified minimum utility threshold, but also enable the capability of privacy preserving for private or secure information (e.g., HUIs in real-word applications.

  11. Sea King SHOL Support for Post-HCM/FELEX HALIFAX Class Ships

    Science.gov (United States)

    2014-05-01

    modernisation de mi-durée. Les modifica- tions techniques apportées aux navires pendant le radoub ont entraïné des changements im- portants à la...classe Halifax connaissent une modernisation (MCH) de mi-durée. Les modifications techniques apportées aux navires pendant le radoub ont entraïné des...ship DAQ components were distributed about the ship at the bow, mast, port bridge wing, port breezeway, howdah (a.k.a. LSO compartment), Flyco (a.k.a

  12. Review process of PSA level 2 of KBR - Concept and Experience

    International Nuclear Information System (INIS)

    Andernacht, M.; Glaser, H.; Sonnenkalb, M.

    2013-01-01

    In Germany, a periodic safety review (PSR) has to be performed every ten years by the utility. In the past, a PSR only included a plant-specific probabilistic safety analysis (PSA) Level 1 study. Since a revised version of the German PSA guideline has been released in 2005, these plant-specific PSAs have to include a PSA Level 2, too. For the NPP Brokdorf (KBR) PSA Level 2 project, an agreement was reached between all parties involved that the study will be performed not as a part of the PSR process, but supplementary to it. This paper will focus on conclusions and findings from an ongoing parallel review process of the first full scope PSA Level 2 performed by the utility for KBR, a typical German PWR-1300. The responsible authority 'Ministerium fuer Soziales, Gesundheit, Familie, Jugend und Senioren des Landes Schleswig- Holstein' (MSGF) initiated this parallel review process in agreement with the utility KBR and the E.ON Kernkraft in 2006. The project will be completed soon. Such a review process allows that essential steps of the PSA will be reviewed and commented before the PSA Level 2 will be finished. So the benefit from this parallel review process is a significant enhancement of the quality and completeness of the PSA Level 2 study as the majority of the recommendations given by the review team has been taken over by the utility and the developer of the PSA, the AREVA NP company. Further, a common understanding and agreement will be reached at the end between all parties involved on the major topics of the PSA Level 2 study. The paper is followed by the slides of the presentation. (authors)

  13. Review process of PSA Level 2 of KBR. Concept and experience

    International Nuclear Information System (INIS)

    Andernacht, Martin; Glaser, Hendrik; Sonnenkalb, Martin

    2009-01-01

    In Germany, a periodic safety review (PSR) has to be performed every 10 years by the utility. In the past, a PSR only included a plant-specific probabilistic safety analysis (PSA) Level 1 study. For the NPP Brokdorf (KBR) PSA Level 2 project, an agreement was reached between all parties involved that the study will be performed not as a part of the PSR process, but supplementary to it. Since a revised version of the German PSA guideline has been released in 2005, these plant-specific PSAs have to include a PSA Level 2, too. This paper will focus on conclusions and findings from a ongoing parallel review process of the first full scope PSA Level 2 performed by the utility for KBR, a typical German PWR-1300. The responsible authority 'Ministerium fuer Soziales, Gesundheit, Familie, Jugend und Senioren des Landes Schleswig-Holstein (MSGF)' (Ministry of Social Affairs, Health, Family, Youth and Senior Citizens of Schleswig-Holstein) initiated this parallel review process in agreement with the utility KBR and the E.ON Kernkraft in 2006. The project will be completed soon. Such a review process allows that essential steps of the PSA will be reviewed and commented before the PSA Level 2 will be finished. So the benefit from this parallel review process is a significant enhancement of the quality and completeness of the PSA Level 2 study as the majority of the recommendations given by the review team has been taken over by the utility and the developer of the PSA, the Areva NP company. Further, a common understanding and agreement will be reached at the end between all parties involved on the major topics of the PSA Level 2 study. (orig.)

  14. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

    Science.gov (United States)

    Patel, Rupa R; Mena, Leandro; Nunn, Amy; McBride, Timothy; Harrison, Laura C; Oldenburg, Catherine E; Liu, Jingxia; Mayer, Kenneth H; Chan, Philip A

    2017-01-01

    Pre-exposure prophylaxis (PrEP) can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island) from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%), 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003). Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

  15. Impact of insurance coverage on utilization of pre-exposure prophylaxis for HIV prevention.

    Directory of Open Access Journals (Sweden)

    Rupa R Patel

    Full Text Available Pre-exposure prophylaxis (PrEP can reduce U.S. HIV incidence. We assessed insurance coverage and its association with PrEP utilization. We reviewed patient data at three PrEP clinics (Jackson, Mississippi; St. Louis, Missouri; Providence, Rhode Island from 2014-2015. The outcome, PrEP utilization, was defined as patient PrEP use at three months. Multivariable logistic regression was performed to determine the association between insurance coverage and PrEP utilization. Of 201 patients (Jackson: 34%; St. Louis: 28%; Providence: 28%, 91% were male, 51% were White, median age was 29 years, and 21% were uninsured; 82% of patients reported taking PrEP at three months. Insurance coverage was significantly associated with PrEP utilization. After adjusting for Medicaid-expansion and individual socio-demographics, insured patients were four times as likely to use PrEP services compared to the uninsured (OR: 4.49, 95% CI: 1.68-12.01; p = 0.003. Disparities in insurance coverage are important considerations in implementation programs and may impede PrEP utilization.

  16. The geothermal partnership: Industry, utilities, and government meeting the challenges of the 90's

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    Each year the Geothermal Division of the US Department of Energy conducts an in-depth review of its entire geothermal R D program. The conference serves several purposes: a status report on current R D activities, an assessment of progress and problems, a review of management issues, and a technology transfer opportunity between DOE and the US geothermal community. This year's conference, Program Review IX, was held in San Francisco on March 19--21, 1991. The theme of this review was The Geothermal Partnership -- Industry, Utilities, and Government Meeting the Challenges of the 90's.'' The importance of this partnership has increased markedly as demands for improved technology must be balanced with available research resources. By working cooperatively, the geothermal community, including industry, utilities, DOE, and other state and federal agencies, can more effectively address common research needs. The challenge currently facing the geothermal partnership is to strengthen the bonds that ultimately will enhance opportunities for future development of geothermal resources. Program Review IX consisted of eight sessions including an opening session. The seven technical sessions included presentations by the relevant field researchers covering DOE-sponsored R D in hydrothermal, hot dry rock, and geopressured energy and the progress associated with the Long Valley Exploratory Well. Individual papers have been cataloged separately.

  17. Fleet management tools for the utility industry

    Energy Technology Data Exchange (ETDEWEB)

    Caywood, J. [Terex Telelect, Watertown, SD (United States)

    2002-08-01

    In order to enable fleet managers to make the appropriate decisions concerning buying, selling, renting, leasing or repairing vehicles, information about ownership and operating cost and utilization are important. Fleet management tools are now available in the heavy construction industry. The author describes one such fleet management services customized for the utility industry: FleetEdge. This system utilizes current and future technologies to enable the managers to take proactive or predictive approaches to fleet management. An example of a company that has opted for this system was reviewed: Reliant Energy-Houston Metro. The data collection process was explained. A mini-computer processor is fitted on the equipment, and the requested monitoring parameters in turn determine the variety of sensors and alarms to be selected. Location can also be monitored through the use of Global Positioning System (GPS) equipment. The parameters normally include low engine oil pressure, high engine operating temperature, high transmission operating temperature, high hydraulic oil temperature, engine hours. Wireless data transfer is effected via cellular or satellite networks. The data is then collected and checked for errors and format at a hub before going to the computer server through the Internet. Information is transmitted from the accounting system to fleet management service through a secure interface. The data is then configured to meet the client's needs. It results in up to date, understandable information to the client. Equipment utilization, downtime and cost by machine or category is easily accessible and printed if required. Fleet equipment status is provided, as well as hourly cost analysis. Other reports are also available. 2 tabs., 2 figs.

  18. How reliably can climate change and mitigation policy impacts on electric utilities be assessed?

    International Nuclear Information System (INIS)

    Dowlatabadi, H.; Kopp, R.J.; Palmer, K.; De Witt, D.

    1993-01-01

    Numerous mechanisms link climate change and electric utilities. Electricity generation releases radiatively active trace substances (RATS). Significant changes in atmospheric concentration of RATS can lead to a change in regional and global climate regimes. Mitigation action designed to prevent or limit climate change is possible through curbing emissions. Climate change and related mitigation actions impact on electric utilities. Foresight in electric utility planning requires reliable predictions of how the utilities may be affected in the decades ahead. In this paper the impacts of climate change and mitigation policies are noted, and our ability to assess these is reviewed. To this end a suite of models exploring supply and demand questions have been developed. The overall conclusion of the study is that the demand-side uncertainties dominate other unknowns and need to be better characterized and understood. (author)

  19. A critical review of objective personality inventories with sex offenders.

    Science.gov (United States)

    Davis, Karen M; Archer, Robert P

    2010-12-01

    This review provides a critical analysis of the ability of multiscale inventories to distinguish between sex offender and nonoffender control groups, as well as to discriminate sex offenders from other types of offenders. In addition to expanding upon previous reviews that examined the utility of the Minnesota Multiphasic Personality Inventory (MMPI) with this population (e.g., Levin & Stava, 1987), the current review included studies that utilized other multiscale inventories commonly used in forensic practice (i.e., MMPI-2, Millon Clinical Multiaxial Inventory-III [MCMI-III], Personality Assessment Inventory) and, when possible, provides effect sizes to evaluate group differences. Based on the review, the various forms of the MMPI and MCMI are clearly the most widely used instruments in sex offender populations. The MMPI Pd scale has shown moderate to large effect sizes when distinguishing between sex offender and nonsex offender groups, but this relationship may be reflective of antisocial behavior in general rather than traits specific to sex offenders. Recommendations to standardize future research classification strategies and more effectively utilize these instruments when assessing sex offenders are also provided. © 2010 Wiley Periodicals, Inc.

  20. Determinants of late and/or inadequate use of prenatal healthcare in high-income countries: a systematic review

    NARCIS (Netherlands)

    Feijen-de Jong, E.I.; Jansen, D.E.M.C.; Baarveld, F.; van der Schans, C.P.; Schellevis, F.G.; Reijneveld, S.A.

    2012-01-01

    Background: Prenatal healthcare is likely to prevent adverse outcomes, but an adequate review of utilization and its determinants is lacking. Objective: To review systematically the evidence for the determinants of prenatal healthcare utilization in high-income countries. Method: Search of

  1. Utilization of organic residues using heterotrophic microalgae and insects.

    Science.gov (United States)

    Pleissner, Daniel; Rumpold, Birgit A

    2018-02-01

    Various organic residues occur globally in the form of straw, wood, green biomass, food waste, feces, manure etc. Other utilization strategies apart from anaerobic digestion, composting and incineration are needed to make use of the whole potential of organic residues as sources of various value added compounds. This review compares the cultivation of heterotrophic microalgae and insects using organic residues as nutrient sources and illuminates their potential with regard to biomass production, productivity and yield, and utilization strategies of produced biomasses. Furthermore, cultivation processes as well as advantages and disadvantages of utilization processes are identified and discussed. It was shown that both heterotrophic algae and insects are able to reduce a sufficient amount of organic residues by converting it into biomass. The biomass composition of both organisms is similar which allows similar utilization strategies in food and feed, chemicals and materials productions. Even though insect is the more complex organism, biomass production can be carried out using simple equipment without sterilization and hydrolysis of organic residues. Contrarily, heterotrophic microalgae require a pretreatment of organic residues in form of sterilization and in most cases hydrolysis. Interestingly, the volumetric productivity of insect biomass exceeds the productivity of algal biomass. Despite legal restrictions, it is expected that microalgae and insects will find application as alternative food and feed sources in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Characteristics and utilization of thermoplastic elastomers (TPE)-an overview

    Energy Technology Data Exchange (ETDEWEB)

    Roestamsjah, [R and D Center for Applied Chemistry, Indonesian Inst. of Sciences (Indonesia)

    1998-10-01

    The unique feature of thermoplastic elastomer, the combining of processing characteristics of thermoplastics with the physical properties of vulcanized rubber is reviewed. Highlights of TPE and its characteristics is aimed to generate interest in TPE, where SANS technique will be utilized for its characterization. The topics discussed include rubber elasticity, state of aggregation of polymers, microseparation in block copolymer system, application of TPE, and finally some notes in developing interest in TPE and SANS in Indonesia. (author)

  3. Improved biomass utilization through the use of nuclear techniques

    International Nuclear Information System (INIS)

    1988-10-01

    Biomass is a major by-product resource of agriculture and food manufacturing, but it is under-utilized as a source of food, fibre, and chemicals. Nuclear techniques provide unique tools for studies of the capabilities of micro-organisms in methane digestor operation and in the transformation of lignocellulosic materials to useful products. Nuclear techniques have also been effectively employed as mutagenic agents in the preparation of more efficient microbial strains for the conversion of biomass. This report reviews the variety and diversity of such applications with focus on the development of microbial processes to utilize agricultural wastes and by-products. The value of nuclear techniques is manifestly demonstrated in the production of efficient microbial mutant strains, in the tracing of metabolic pathways, in the monitoring of lignin degradation and also of fermenter operation. Refs, figs and tabs

  4. A need for an augmented review when reviewing rehabilitation research.

    Science.gov (United States)

    Gerber, Lynn H; Nava, Andrew; Garfinkel, Steven; Goel, Divya; Weinstein, Ali A; Cai, Cindy

    2016-10-01

    There is a need for additional strategies for performing systematic reviews (SRs) to improve translation of findings into practice and to influence health policy. SRs critically appraise research methodology and determine level of evidence of research findings. The standard type of SR identifies randomized controlled trials (RCTs) as providing the most valid data and highest level of evidence. RCTs are not among the most frequently used research design in disability and health research. RCTs usually measure impairments for the primary research outcome rather than improved function, participation or societal integration. It forces a choice between "validity" and "utility/relevance." Other approaches have effectively been used to assess the validity of alternative research designs, whose outcomes focus on function and patient-reported outcomes. We propose that utilizing existing evaluation tools that measure knowledge, dissemination and utility of findings, may help improve the translation of findings into practice and health policy. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The main challenges for manufacturing companies in implementing and utilizing configurators

    DEFF Research Database (Denmark)

    Kristjansdottir, Katrin; Shafiee, Sara; Hvam, Lars

    2018-01-01

    Companies providing customized products increasingly apply configurators in supporting sales and design activities, thus improving lead-times, quality, cost, benefits perceived by customers, and customer satisfaction. While configurator advantages have been substantially investigated....... Finally, it is investigated whether the importance of the main categories of challenges varies according to a number of potential context variables. The results of the survey, which studies manufacturing companies that use configurators in providing customized products, offer new insights......, the challenges of implementing and utilizing configurators have less often been considered. By reviewing relevant literature, the present study first categorizes the main challenges faced by manufacturing companies when implementing and utilizing configurators. Six main categories of challenges are identified...

  6. Utilization of geothermal energy in the mining and processing of tungsten ore. Quarterly report

    Energy Technology Data Exchange (ETDEWEB)

    Lane, C.K.; Erickson, M.V.; Lowe, G.D.

    1980-02-01

    The status of the engineering and economic feasibility study of utilizing geothermal energy for the mining and processing of tungsten ore at the Union Carbide-Metals Division Pine Creek tungsten complex near Bishop, Calfironia is reviewed. Results of geophysical data analysis including determination of assumed resource parameters are presented. The energy utilization evaluation identifies potential locations for substituting geothermal energy for fossil fuel energy using current technology. Preliminary analyses for local environmental and institutional barriers to development of a geothermal system are also provided.

  7. Initiatives in training program evaluation outside the nuclear utility industry

    International Nuclear Information System (INIS)

    Allen, C.J.

    1987-01-01

    Training literature is reviewed, and program evaluative practices outside the nuclear utility industry are reported. The findings indicate some innovations in philosophy and practice and program evaluation, although not necessarily in the context of evaluation as a route to assessing the impact of training. Program evaluation is described in the context of the impact of training, suggesting continued efforts to accept a multivariate concept of individual and organizational performance

  8. Climate change, phenology, and butterfly host plant utilization.

    Science.gov (United States)

    Navarro-Cano, Jose A; Karlsson, Bengt; Posledovich, Diana; Toftegaard, Tenna; Wiklund, Christer; Ehrlén, Johan; Gotthard, Karl

    2015-01-01

    Knowledge of how species interactions are influenced by climate warming is paramount to understand current biodiversity changes. We review phenological changes of Swedish butterflies during the latest decades and explore potential climate effects on butterfly-host plant interactions using the Orange tip butterfly Anthocharis cardamines and its host plants as a model system. This butterfly has advanced its appearance dates substantially, and its mean flight date shows a positive correlation with latitude. We show that there is a large latitudinal variation in host use and that butterfly populations select plant individuals based on their flowering phenology. We conclude that A. cardamines is a phenological specialist but a host species generalist. This implies that thermal plasticity for spring development influences host utilization of the butterfly through effects on the phenological matching with its host plants. However, the host utilization strategy of A. cardamines appears to render it resilient to relatively large variation in climate.

  9. A review of some characteristics, socio-economic aspects and utilization of Zulu sheep: implications for conservation.

    Science.gov (United States)

    Kunene, Nokuthula Winfred; Bezuidenhout, Carlos C; Nsahlai, Ignatius V; Nesamvuni, Edward A

    2011-08-01

    Zulu sheep are Nguni sheep of Zululand and are adapted to the harsh conditions of KwaZulu-Natal. They are used by rural farmers for economic purposes. Their numbers are declining, indicating a potential extinction threat. Knowledge of their phenotypic and genotypic characteristics is essential for conservation planning. In this review, there is a focus on the utilization, socio-economic aspects, phenotypic and genotypic characteristics as well as a proposed breeding programme. A survey has shown that rural farmers in the areas of northern KwaZulu-Natal prefer to keep this breed for its adaptability, resistance to diseases and meat quality. Zulu sheep are small-framed multi-coloured animals. Mature males weigh up to 38 kg and females up to 32 kg. Based on four morphological traits and live weight, phenotypic diversity between three populations was estimated at 48%. A genetic diversity between these three populations was estimated at 22%. Live weight of Zulu sheep can be estimated using the heart girth and wither height measurements. Scrotum circumference of young rams (up to 22 months old) is reliable for estimating the live weight. Animals that were characterized in the studies were grazed extensively and no supplements were provided. There is therefore a potential of weight increase if these animals are reared in a semi-extensive environment. An open nucleus breeding scheme is thus recommended for a sustainable use and conservation of this breed. For more conclusive results, larger numbers of phenotypic and genetic characteristics, in larger numbers of Zulu sheep populations, should be investigated.

  10. Peer review in design: Understanding the impact of collaboration on the review process and student perception

    Science.gov (United States)

    Mandala, Mahender Arjun

    A cornerstone of design and design education is frequent situated feedback. With increasing class sizes, and shrinking financial and human resources, providing rich feedback to students becomes increasingly difficult. In the field of writing, web-based peer review--the process of utilizing equal status learners within a class to provide feedback to each other on their work using networked computing systems--has been shown to be a reliable and valid source of feedback in addition to improving student learning. Designers communicate in myriad ways, using the many languages of design and combining visual and descriptive information. This complex discourse of design intent makes peer reviews by design students ambiguous and often not helpful to the receivers of this feedback. Furthermore, engaging students in the review process itself is often difficult. Teams can complement individual diversity and may assist novice designers collectively resolve complex task. However, teams often incur production losses and may be impacted by individual biases. In the current work, we look at utilizing a collaborative team of reviewers, working collectively and synchronously, in generating web based peer reviews in a sophomore engineering design class. Students participated in a cross-over design, conducting peer reviews as individuals and collaborative teams in parallel sequences. Raters coded the feedback generated on the basis of their appropriateness and accuracy. Self-report surveys and passive observation of teams conducting reviews captured student opinion on the process, its value, and the contrasting experience they had conducting team and individual reviews. We found team reviews generated better quality feedback in comparison to individual reviews. Furthermore, students preferred conducting reviews in teams, finding the process 'fun' and engaging. We observed several learning benefits of using collaboration in reviewing including improved understanding of the assessment

  11. The upgraded JRR-3 and future scope of its utilization

    International Nuclear Information System (INIS)

    Miyasaka, Yasuhiko; Umei, Hiroshi; Takahashi, Hidetake; Sakamoto, Masanobu

    1985-10-01

    At the time of start to construct the upgraded JRR-3, the present report describes general features on the upgraded JRR-3 and future scope of its utilization on the purpose of the mutual understanding with researchers who use the reactor and the utilization facilities. The materials edited in the report have been written by 28 reactor engineers and scientists in JAERI, and 35 scientists in universities. According to the reviewed subjects as shown below, it was confirmed that the upgraded JRR-3 would be extensively expected by much more fields. (1) Reactor and utilization facilities. 1. Plan and main features of the upgraded JRR-3, Reactor building 2. Irradiation facilities: Hydraulic rabbits, Pneumatic tubes, Rig Hot Cell, etc. 3. Neutron beam facilities: Horizontal tubes, Cold neutron source and Neutron guide tubes (2) Neutron beam experimental facilities. 1. Neutron diffractometer, neutron spectrometer, Small-angle neutron scattering, Neutron radiography, etc. (3) Recent trends. 1. Irradiation research of fuels and materials in research reactor 2. Activation analysis, Radioisotope, Neutron transmutation doping, etc. 3. Neutron scattering research. (author)

  12. Multiattribute Utility Theory, Intertemporal Utility and Correlation Aversion

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten

    2018-01-01

    Convenient assumptions about qualitative properties of the intertemporal utility function have generated counterintuitive implications for the relationship between atemporal risk aversion and the intertemporal elasticity of substitution. If the intertemporal utility function is additively separable...... aversion. Our results show that subjects are correlation averse over lotteries with intertemporal income profiles....

  13. Clinical librarian support for rapid review of clinical utility of cancer molecular biomarkers.

    Science.gov (United States)

    Geng, Yimin; Fowler, Clara S; Fulton, Stephanie

    2015-01-01

    The clinical librarian used a restricted literature searching and quality-filtering approach to provide relevant clinical evidence for the use of cancer molecular biomarkers by institutional policy makers and clinicians in the rapid review process. The librarian-provided evidence was compared with the cited references in the institutional molecular biomarker algorithm. The overall incorporation rate of the librarian-provided references into the algorithm was above 80%. This study suggests the usefulness of clinical librarian expertise for clinical practice. The searching and filtering methods for high-level evidence can be adopted by information professionals who are involved in the rapid literature review.

  14. Proceedings of the 1999 U.S. DOE Hydrogen Program Review

    Energy Technology Data Exchange (ETDEWEB)

    NREL

    2000-08-28

    The Proceedings of the 1999 US Department of Energy (DOE) Hydrogen Program Review serve as an important technology reference for the DOE Hydrogen Program. This document contains technical progress reports on 60 research and technology validation projects funded by the DOE Hydrogen Program in Fiscal Year 1999, in support of its mission to make hydrogen a cost-effective energy carrier for utility, building, and transportation applications. Each year, the Program conducts a rigorous review of its portfolio of projects, utilizing teams of experts to provide vital feedback on the progress of research.

  15. Progresses and challenges of utilizing traditional birth attendants in maternal and child health in Nigeria.

    Science.gov (United States)

    Amutah-Onukagha, Ndidiamaka; Rodriguez, Monica; Opara, Ijeoma; Gardner, Michelle; Assan, Maame Araba; Hammond, Rodney; Plata, Jesus; Pierre, Kimberly; Farag, Ehsan

    2017-01-01

    Despite advances in modern healthcare, Traditional Birth Attendants (TBA) have continued to be heavily utilized in rural communities in Nigeria. Major disparities in maternal health care in Nigeria remain present despite the goal of the United Nations Millennium Development Goal to reduce maternal mortality by 2015. The objective of this study is to review the contribution of TBAs in the birthing process in Nigeria, and to examine barriers and opportunities for utilizing TBAs in improving maternal and child health outcomes in Nigeria. A literature review of two major electronic databases was conducted using the PRISMA framework to identify English language studies conducted between 2006 and 2016. Inclusion criteria included articles that examined the role of traditional birth attendants as a factor influencing maternal health in Nigeria. The value of TBAs has not been fully examined as few studies have aimed to examine its potential role in reducing maternal mortality with proper training. Eight manuscripts that were examined highlighted the role of TBAs in maternal health including outcomes of utilizing trained versus non-trained TBAs. Specific areas of training for TBAs that were identified and recommended in review including: recognizing delivery complications, community support for TBA practices through policy, evaluation of TBA training programs and increasing collaboration between healthcare facilities and TBAs. Policies focused on improving access to health services and importantly, formal health education training to TBAs, are required to improve maternal health outcomes and underserved communities.

  16. Review of problems associated with the utilization of available thorium resources

    International Nuclear Information System (INIS)

    O'Hara, F.A.; Gray, R.A.

    1975-01-01

    Portions of the U. S. Thorium Stockpile are in danger of literally ''going to waste.'' These raw materials, with their high concentrations of thorium, are valuable resources which can be utilized to fuel thermal converter reactors. A portion of this stockpile was transferred to Mound Laboratory in the early 1950's. In 1972, the material was determined to be excess to all present and foreseeable future national requirements. Disposal by burial was recommended by the AEC. Following a detailed study of the potential usefulness of the material and the costs associated with land burial, the AEC agreed to offer the material on surplus sale. Risks and benefits associated with retention of the thorium stockpile are described. Nuclear Materials Managers are uniquely situated to exercise influence and direct the future course of remaining thorium reserves

  17. Diastereoselective and enantioselective conjugate addition reactions utilizing α,β-unsaturated amides and lactams

    Directory of Open Access Journals (Sweden)

    Katherine M. Byrd

    2015-04-01

    Full Text Available The conjugate addition reaction has been a useful tool in the formation of carbon–carbon bonds. The utility of this reaction has been demonstrated in the synthesis of many natural products, materials, and pharmacological agents. In the last three decades, there has been a significant increase in the development of asymmetric variants of this reaction. Unfortunately, conjugate addition reactions using α,β-unsaturated amides and lactams remain underdeveloped due to their inherently low reactivity. This review highlights the work that has been done on both diastereoselective and enantioselective conjugate addition reactions utilizing α,β-unsaturated amides and lactams.

  18. Survey of state regulatory activities on least cost planning for gas utilities

    International Nuclear Information System (INIS)

    Goldman, C.A.; Hopkins, M.E.

    1991-04-01

    Integrated resource planning involves the creation of a process in which supply-side and demand-side options are integrated to create a resource mix that reliably satisfies customers' short-term and long-term energy service needs at the lowest cost. Incorporating the concept of meeting customer energy service needs entails a recognition that customers' costs must be considered along with the utility's costs in the economic analysis of energy options. As applied to gas utilities, an integrated resource plan seeks to balance cost and reliability, and should not be interpreted simply as the search for lowest commodity costs. All state commissions were surveyed to assess the current status of gas planning and demand-side management and to identify significant regulatory issues faced by commissions during the next several years. The survey was to determine the extent to which they have undertaken least-cost planning for gas utilities. The survey included the following topics: (1) status of state PUC least-cost planning regulations and practices for gas utilities; (2) type and scope ofnatural gas DSM programs in effect, includeing fuel substitution; (3) economic tests and analysis methods used to evaluate DSM programs; (4) relationship between prudence reviews of gas utility purchasing practices and integrated resource planning; and (5) key regulatory issues facing gas utilities during the next five years. 34 refs., 6 figs., 10 tabs

  19. Promoting high efficiency residential HVAC equipment: Lessons learned from leading utility programs

    Energy Technology Data Exchange (ETDEWEB)

    Neme, C.; Peters, J.; Rouleau, D.

    1998-07-01

    The Consortium for Energy Efficiency recently sponsored a study of leading electric utility efforts to promote high efficiency residential HVAC equipment. Given growing concerns from some utilities about the level of expenditures associated with rebate programs, special emphasis was placed on assessing the success of financing and other non-rebate options for promoting efficiency. Emphasis was also placed on review of efforts--rebate or otherwise--to push the market to very high levels of efficiency (i.e., SEER 13). This paper presents the results of the study. It includes discussion of key lessons from the utility programs analyzed. It also examines program participation rates and other potential indicators of market impacts. One notable conclusion is that several utility programs have pushed market shares for SEER 12 equipment to about 50% (the national average is less than 20%). At least one utility program has achieved a 50% market share for SEER 13 equipment (the national average is less than 3%). In general, financing does not appear to have as broad an appeal as consumer rebates. However, one unique utility program which combines the other of customer financing with modest incentives to contractors--in the form of frequent seller points that can be redeemed for advertising, technician training, travel and other merchandise--offers some promise that high participation rates can be achieved without customer rebates.

  20. The predictive validity of prospect theory versus expected utility in health utility measurement.

    Science.gov (United States)

    Abellan-Perpiñan, Jose Maria; Bleichrodt, Han; Pinto-Prades, Jose Luis

    2009-12-01

    Most health care evaluations today still assume expected utility even though the descriptive deficiencies of expected utility are well known. Prospect theory is the dominant descriptive alternative for expected utility. This paper tests whether prospect theory leads to better health evaluations than expected utility. The approach is purely descriptive: we explore how simple measurements together with prospect theory and expected utility predict choices and rankings between more complex stimuli. For decisions involving risk prospect theory is significantly more consistent with rankings and choices than expected utility. This conclusion no longer holds when we use prospect theory utilities and expected utilities to predict intertemporal decisions. The latter finding cautions against the common assumption in health economics that health state utilities are transferable across decision contexts. Our results suggest that the standard gamble and algorithms based on, should not be used to value health.

  1. Workshop on agricultural and agro-industrial residue utilization in the ESCAP region

    Energy Technology Data Exchange (ETDEWEB)

    Vimal, O P

    1980-02-01

    A summary of the workshop held at Pattaya, Thailand is given at which the present status of both technological and non-technical aspects of utilization of agricultural and industrial residues in the ESCAP region are reviewed. A course of action was recommended whereby national programmes could develop and international assistance be focussed through follow up activities.

  2. Electrical deicing utilizing carbon fiber tape for asphalt approach and crosswalk phase I - literature review.

    Science.gov (United States)

    2016-06-30

    The purpose of this study is to provide a comprehensive literature review of electrical deicing technology for possible application in asphalt approach and crosswalks. A : thorough review of existing and emerging deicing technology for snow/ice melti...

  3. Low Fertility Preservation Utilization Among Transgender Youth.

    Science.gov (United States)

    Nahata, Leena; Tishelman, Amy C; Caltabellotta, Nicole M; Quinn, Gwendolyn P

    2017-07-01

    Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic. An Institutional Review Board-approved retrospective review of electronic medical records was conducted of all patients with ICD-9/10 codes for gender dysphoria referred to Pediatric Endocrinology for hormone therapy (puberty suppression and/or cross-sex hormones) from January 2014 to August 2016. Seventy-eight patients met inclusion criteria. Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded. Of the remaining 73 patients, 72 had documented fertility counseling prior to initiation of hormone therapy and 2 subjects attempted FP; 45% of subjects mentioned a desire or plan to adopt, and 21% said they had never wanted to have children. Utilization rates of FP are low among transgender adolescents. More research is needed to understand parenthood goals among transgender youth at different ages and developmental stages and to explore the impact of gender dysphoria on decision-making about FP and parenthood. Discussions about infertility risk, FP, and other family building options should be prioritized in this vulnerable adolescent population. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  4. The world trends of high temperature gas-cooled reactors and the mode of utilization

    International Nuclear Information System (INIS)

    Ishikawa, Hiroshi; Shimokawa, Jun-ichi

    1974-01-01

    After a long period of research and development, high temperature gas-cooled reactors are going to enter the practical stage. The combination of a HTGR with a closed cycle helium gas turbine is advantageous in thermal efficiency, reduction of environmental impact and economy. In recent years, the direct utilization of nuclear heat energy in industries has been attracting interest. The multi-purpose utilization of high temperature gas-cooled reactors is thus now the world trend. Reviewing the world developments in this field, the following matters are described: (1) development of HTGRs in the U.K., West Germany, France and the United States; (2) development of He gas turbine, etc. in West Germany; and (3) multi-purpose utilization of HTGRs in West Germany and Japan. (Mori, K.)

  5. African Leafy Vegetables: A Review of Status, Production and Utilization in South Africa

    Directory of Open Access Journals (Sweden)

    Innocent Maseko

    2017-12-01

    Full Text Available African leafy vegetables (ALVs are mostly gathered from the wild, with few selected species being cultivated, usually as part of a mixed cropping system in home gardens or smallholder plots. They have important advantages over exotic vegetable species, because of their adaptability to marginal agricultural production areas and their ability to provide dietary diversity in poor rural communities. Despite their significance in food and nutrition security, there is limited availability or access to these crops leading to underutilisation. The objective of this review was to document the state of utilisation and production of ALVs in South Africa. A qualitative systematic approach review of online sources, peer reviewed papers published in journals, books and other publications was conducted. There is lack of suitable production systems, innovative processing, and value-adding techniques that promote utilisation of ALVs. Furthermore, there is a perception that ALVs are food for the poor among the youth and urban folks, while, among the affluent, they are highly regarded as being nutritious. To promote ALVs from household consumption and commercialisation, further research on agronomy, post-harvest handling, storage and processing is required in South Africa.

  6. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes a......, with the current approach tending to systematically overestimate (underestimate) poverty in urban (rural) zones.......A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes...... an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially...

  7. 44 CFR 12.14 - Annual comprehensive review.

    Science.gov (United States)

    2010-10-01

    ... should be abolished. (b) Pertinent factors to be considered in the comprehensive review required by... programs or operations; (4) An evaluation of the utilization by the Agency of the committee's policy...

  8. The role of utilities in developing low carbon, electric megacities

    International Nuclear Information System (INIS)

    Kennedy, Chris; Stewart, Iain D.; Facchini, Angelo; Mele, Renata

    2017-01-01

    Development of electric cities, with low carbon power supply, is a key strategy for reducing global CO2 emissions. We analyze the role of electric utilities as important actors to catalyze the transition to electric cites, drawing upon data for the world's 27 megacities. Progress towards the ideal electric city is most advanced for Paris, Rio de Janeiro, Sao Paulo and Buenos Aires for low carbon electricity, while Indian megacities have relatively high use of carbon-intensive electricity as a percentage of total energy use. There is wide variety in the structure of markets for electricity provision in megacities, with a dominant, public utility being the most common model. We review literature on electricity sector business models and broadly propose future models dependent on the predominance of locally dispersed generation and the nature of the ownership of the electric grid within the city. Where a high proportion of electricity can be provided by locally distributed supply within a city, the role of utilities could predominantly become that of enabler of exchange with the grid, but new pricing structures are required. A further challenge for utilities in enabling the electric city is to provide a higher level of resilience to events that disrupt power supply. - Highlights: • Amongst 27 megacities, Paris, Rio, Sao Paulo and Buenos Aires are most progressed low carbon electric cities. • Indian megacities have relatively high use of electricity as a percentage of total energy use. • Wide variety in electricity market structure in megacities; dominant, public utility the most common model. • Utilities could become enablers of exchange with the grid, but new pricing models required.

  9. Evaluation in a competitive utility environment: the threat of confidentiality

    International Nuclear Information System (INIS)

    Vine, Edward

    1997-01-01

    Utilities have become concerned that their competitors will desire access to energy-related data--including energy-efficiency data collected by utilities from their energy- efficiency programs--that they may regard as proprietary or confidential. In the future, disputes about confidentiality may focus more on costs and market information (as well as energy use and load data) than on energy-efficiency data per se. So far, the discussion has been limited to ratepayer-funded data. Consequently, many utilities are now requesting that the data (including evaluation data) they submit to their utility regulatory commissions remain confidential. Withholding utility information from the public is likely to harm the evaluation community that depends on the free flow of information for improving the practice of evaluation as well as for disseminating the lessons learned from particular program evaluations. Confidentiality will also have significant policy implications. In response to these concerns, in late 1995 and early 1996, we conducted a survey of state public utility commissions (PUCs) in the U.S. to assess: (1) the relative importance of the issue of confidential data in the regulatory arena; (2) the regulatory response to utility requests for confidentiality (e.g., formal policies, guidelines, rules and procedures, and decisions); and (3) the type of data filed as confidential with PUCS. We focus on the first two objectives of this study. In addition to our interviews, we reviewed selected state statutes, judicial and PUC decisions, rules and procedures, protective orders, and interim policy documents. Evaluators need to understand the context of confidentiality as well as the response of the regulatory commissions to confidentiality, because evaluators will need to adapt to a new environment where energy-related data and information may be harder to obtain and distribute. We propose that regulators conduct the following activities as soon as possible: 1. Assess

  10. High utilization of inpatient detoxification: predictors among US veterans.

    Science.gov (United States)

    Chang, Grace; Raffi, Edwin; Tang, Michael; Fernando, Gerard I; Zucker, Jarred; Schein, Abigail Z

    2016-05-01

    Readmissions are among the most problematic and expensive problems in the treatment of substance use disorders. To evaluate the characteristics associated with four or more inpatient medically managed detoxification admissions in FY 2012, when all had post-discharge appointments within 7 days. A retrospective case control study. A total of 38 (6.0%) of 623 unique veterans had four or more detoxification admissions (high utilizers). A random sample of 42 was selected from the remaining 585 people (comparison group). In all, 264 detoxification and 70 hospital admissions for other reasons were reviewed. The high utilizers had more alcohol use disorder (AUD, 82% versus 59%, p = 0.03) of significantly longer duration (mean 28.9 years [SD = 17] vs. 19.6 [SD = 13.4], p = 0.01). AUD increased the odds of being a high utilizer three-fold [OR = 3.0, 95% CI 1.1, 8.4], and every additional year of AUD, increased the number of admissions 1.3%, p = 0.0006. The high utilizers did not differ from the comparison group with regards to either number of hospitalizations for other reasons (mean 1.2 [SD = 1.9] vs. 0.57 [SD = 0.8], p = 0.06) or rate of 7 day post discharge appointments kept (46.9% vs. 49.3%, p = 0.82). High utilizers were a small percentage of patients (6.0%) who accounted for a disproportionate number (23%) of 977 detoxification admissions. They had greater disease severity as manifest by more years of AUD. They were not more likely to have hospitalizations for other reasons or less likely to keep post discharge appointments. These patients may warrant different services tailored to prevent hospital readmissions for detoxification.

  11. The changing utility workforce and the evolution of utility design

    Energy Technology Data Exchange (ETDEWEB)

    Saunders, A. [Autodesk Inc., (United States); Zeiss, G. [Autodesk Inc., (Canada)

    2008-07-01

    Electric utilities are experiencing an unprecedented workforce turnover as a wave of retirement approaches. The challenge for the industry is to mitigate the loss of industry knowledge and attract talented new designers and engineers. Utilities need to effectively transfer knowledge from an existing workforce with up to three decades of experience to their new hires who have very different skill levels as well as different expectations regarding design tools compared to their predecessors. Knowledge transfer from the retiring workforce to the new hires can be facilitated with rules-based design software. Easy-to-use design software with built-in validations can accelerate training. By investing in utility design software that incorporates the best elements of design processes from other industries, utilities can attract the new generation of engineers and designers to help utilities define new processes to upgrade existing infrastructure, bring online new distributed and renewable generation facilities, implement smart devices and meters, and improve customer service. 3 refs.

  12. Cardiovascular Parameters of Nigerian Physiotherapy Students Dur ...

    African Journals Online (AJOL)

    Examination and tests are routine academic task during which students engage in mental exercis-es, writing, and/or practical demonstrations under pressure with stress placed on the cardiovascu-lar system. This study was aimed at investigating the cardiovascular parameters of students before, during and after an ...

  13. Present status of research on radiation utilization in 1994 at JAERI. Utilization of irradiation and RI production and utilization

    International Nuclear Information System (INIS)

    1994-10-01

    In Japan Atomic Energy Research Institute, Takasaki Radiation Chemistry Research Establishment is in charge of the utilization of irradiation, and Tokai Research Establishment is in charge of the production and utilization of radioisotopes. As for the utilization of irradiation the development of new polymers, the development of environment preservation technology such as flue gas treatment, and by using various ion beams from four accelerators, the development of the materials used for space environment, nuclear fusion and new functional materials, the research on the radiation application to biotechnology, the development of the production and utilization of new radioisotopes have been carried out. As for the production and utilization of radioisotopes, the development of new products and new utilization techniques, the technology of producing and using a large amount of tritium, and the research on the chemical behavior of tritium have been carried out. The international cooperations have been promoted positively. In this report, the research activities in 1994 are described. (K.I.)

  14. NON-EXPECTED UTILITY THEORIES: WEIGHTED EXPECTED, RANK DEPENDENT, AND CUMULATIVE PROSPECT THEORY UTILITY

    OpenAIRE

    Tuthill, Jonathan W.; Frechette, Darren L.

    2002-01-01

    This paper discusses some of the failings of expected utility including the Allais paradox and expected utility's inadequate one dimensional characterization of risk. Three alternatives to expected utility are discussed at length; weighted expected utility, rank dependent utility, and cumulative prospect theory. Each alternative is capable of explaining Allais paradox type problems and permits more sophisticated multi dimensional risk preferences.

  15. Assessment of depression in medical patients: a systematic review of the utility of the Beck Depression Inventory-II.

    Science.gov (United States)

    Wang, Yuan-Pang; Gorenstein, Clarice

    2013-09-01

    To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depression Inventory-II for measuring depression in medical settings to provide guidelines for practicing clinicians. Considering the inclusion and exclusion criteria seventy articles were retained. Validation studies of the Beck Depression Inventory-II, in both primary care and hospital settings, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The Beck Depression Inventory-II showed high reliability and good correlation with measures of depression and anxiety. Its threshold for detecting depression varied according to the type of patients, suggesting the need for adjusted cut-off points. The somatic and cognitive-affective dimension described the latent structure of the instrument. The Beck Depression Inventory-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in patients with medical conditions, the clinician should seek evidence for how to interpret the score before using the Beck Depression Inventory-II to make clinical decisions.

  16. Cooperative newsvendor games : a review

    NARCIS (Netherlands)

    Montrucchio, L.; Norde, H.; Ozen, U.; Scarsini, M.; Slikker, M.; Choi, T.-M.

    2012-01-01

    In this survey, we review some of the main contributions to the cooperative approach of newsvendor situations. We show how newsvendor situations with several retailers can be modeled as a transferable-utility cooperative game and we concentrate on one solution concept: the core. First, we examine

  17. Kadın Üniversite Gençliği ve Mezunlarına Yönelik Cinsel Saldırı Mağdur Araştırması

    Directory of Open Access Journals (Sweden)

    Zehra Kayı

    2000-12-01

    Full Text Available Çalışmamızda ülkemizde üniversite gençliği ve mezunlarına yönelik olarak kadınlarda hangi oranlarda cinsel şiddet eylemlerinin gerçekleştiği, kimler tarafından, nerede, ne zaman uygulandığı, adli makamlara ne derece yansıdığı, yansımıyorsa nedenleri ve mağdurların etkilenme dereceleri araştırılmıştır. Araştırmamıza üniversite öğrencisi ve mezunu toplam 700 kadın katılmıştır. İddia ettiğimiz veriler literatürlerle uyumlu olarak kadınların bu eylemlere yüksek oranlarda maruz, kaldığını ve özellikle temas içeren cinsel şiddet türlerinin sanılanın aksine yabancılar tarafından değil, çoğunlukla tanıdık kişilerce gerçekleştirildiği, çok büyük oranının adli makamlara yansımadığını ortaya koymuştur. Sözel, görsel ve dokunsal cinsel şiddet türlerinden herhangi birine maruz kalma oranı kadınlarda % 84 tür. Basit cinsel içerikli dokunuştan zorla cinsel ilişkiye kadar uzanan dokunsal cinsel şiddet türlerine maruz kalma oranı ise % 44.8 olarak bulunmuştur. Mağduriyet oranının yüksekliğinin yanı sıra adli makamlara iletilme oranlarının düşük olması, özellikle adli tıp açısından olayı ispatlama zorluğunu aşacak çalışmaların (etkin muayene ve delillerin değerlendirilmesi önemini ortaya koymaktadır. Anahtar Kelimeler: Cinsel şiddet, kadın, mağdur.

  18. Environmental performance reviews. Republic of Moldova

    International Nuclear Information System (INIS)

    1998-01-01

    This environmental performance review document for Moldova presents assessments of existing environmental policies; management of air, water and land pollutions originating from various sources including energy production and utilization. It also contains policy recommendations foe implementation by Moldovan Government

  19. Impact of power purchases from non-utilities on the utility cost of capital

    International Nuclear Information System (INIS)

    Kahn, E.; Stoft, S.; Belden, T.

    1995-01-01

    The bond rating agencies in the USA have asserted that long-term power purchase contracts between non-utility generators and utilities are the equivalent of debt to the utilities, and therefore raise the cost of capital to the purchaser. Non-Utility generators claim that these contracts reduce risk to the utilities. This debate is reflected in the 1992 Energy Policy Act. This paper investigates this controversy from the perspective of the equity markets. Using a CAPM framework, various specifications of the cost of equity capital are estimated, to shed light on this question. No evidence is found for the hypothesis that non-utility generation contracts raise the cost of capital. There does appear to be a slight increase in this cost for those utilities seeking to build their own generation capacity as opposed to purchasing it from non-utility suppliers. (author)

  20. Technical review of externalities issues. Final report

    International Nuclear Information System (INIS)

    Niemeyer, V.

    1994-12-01

    Externalities has become the catchword for a major experiment in electric utility regulation. Together with increased competition as a means for economic regulation, this experiment represents a potential revolution in how electric utilities are regulated. It is very important for utilities and policy makers to understand the technical issues and arguments driving the externality experiment. This Technical Review presents four papers covering topics in economics that may play important roles in this revolution. The four papers are: Economic Issues in the Application of Externalities to Electricity Resource Selection; Climate Change, the Marginal Cost of Carbon Dioxide Emissions and the Implications for Carbon Dioxide Emissions Adders; Positive Externalities and Benefits from Electricity; and Socioeconomic Effects of Externality Adders for Electric Utility Emissions

  1. Virginia ADS consortium - thorium utilization

    International Nuclear Information System (INIS)

    Myneni, Ganapati

    2015-01-01

    A Virginia ADS consortium, consisting of Virginia Universities (UVa, VCU, VT), Industry (Casting Analysis Corporation, GEM*STAR, MuPlus Inc.), Jefferson Lab and not-for-profit ISOHIM, has been organizing International Accelerator-Driven Sub-Critical Systems (ADS) and Thorium Utilization (ThU) workshops. The third workshop of this series was hosted by VCU in Richmond, Virginia, USA Oct 2014 with CBMM and IAEA sponsorship and was endorsed by International Thorium Energy Committee (IThEC), Geneva and Virginia Nuclear Energy Consortium Authority. In this presentation a brief summary of the successful 3 rd International ADS and ThU workshop proceedings and review the worldwide ADS plans and/or programs is given. Additionally, a report on new start-ups on Molten Salt Reactor (MSR) systems is presented. Further, a discussion on potential simplistic fertile 232 Th to fissile 233 U conversion is made

  2. Development of stump utilization in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Karkkainen, M

    1975-01-01

    Presents a historical review of the utilization of stump- and rot-wood in Finland, based on Finnish literature from the mid 19th century until to-day. Pine stumps were used for tar production to a small extent during the 19th century, and on a much larger scale during the two World Wars. Other industrial uses of stumpwood have hitherto been of minor importance, but stumps are now beginning to be used in the pulp industry. The largest quantity of stumpwood used has always been that taken by the rural population for fuel; it amounted to >200 000 m/sup 3/ solid measure in the 1930's, and was still >100 000 m/sup 3/ in the 1960's.

  3. The clinical utility of ambulatory blood pressure monitoring (ABPM): a review.

    Science.gov (United States)

    Harianto, Harry; Valente, Michael; Hoetomo, Soenarno; Anpalahan, Mahesan

    2014-01-01

    The current evidence suggests that ambulatory blood pressure monitoring (ABPM) should be an integral part of the diagnosis and management of hypertension. However, its uptake in routine clinical practice has been variable. This paper reviews the current evidence for the role of ABPM in clinical practice, including in hypotensive disorders and in specific comorbidities. It further discusses the clinical significance of abnormal ambulatory blood pressure patterns and hypertensive syndromes such as white coat, masked and resistant hypertension.

  4. Utility of Immature Granulocyte Percentage in Pediatric Appendicitis

    Science.gov (United States)

    Mathews, Eleanor K.; Griffin, Russell L.; Mortellaro, Vincent; Beierle, Elizabeth A.; Harmon, Carroll M.; Chen, Mike K.; Russell, Robert T.

    2014-01-01

    Background Acute appendicitis is the most common cause of abdominal surgery in children. Adjuncts are utilized to help clinicians predict acute or perforated appendicitis, which may affect treatment decisions. Automated hematologic analyzers can perform more accurate automated differentials including immature granulocyte percentages (IG%). Elevated IG% has demonstrated improved accuracy for predicting sepsis in the neonatal population than traditional immature to total neutrophil count (I/T) ratios. We intended to assess the additional discriminatory ability of IG% to traditionally assessed parameters in the differentiation between acute and perforated appendicitis. Materials and Methods We identified all patients with appendicitis from July 2012 to June 2013 by ICD-9 code. Charts were reviewed for relevant demographic, clinical, and outcome data, which were compared between acute and perforated appendicitis groups using Fischer’s exact and t-test for categorical and continuous variables, respectively. We utilized an adjusted logistic regression model utilizing clinical lab values to predict the odds of perforated appendicitis. Results 251 patients were included in the analysis. Those with perforated appendicitis had a higher white blood cell (WBC) count (p=0.0063), C-reactive protein (CRP) (pappendicitis. The c-statistic of the final model was 0.70, suggesting fair discriminatory ability in predicting perforated appendicitis. Conclusions IG% did not provide any additional benefit to elevated CRP and presence of left shift in the differentiation between acute and perforated appendicitis. PMID:24793450

  5. Peer review in forensic science.

    Science.gov (United States)

    Ballantyne, Kaye N; Edmond, Gary; Found, Bryan

    2017-08-01

    Peer review features prominently in the forensic sciences. Drawing on recent research and studies, this article examines different types of peer review, specifically: editorial peer review; peer review by the scientific community; technical and administrative review; and verification (and replication). The article reviews the different meanings of these quite disparate activities and their utility in relation to enhancing performance and reducing error. It explains how forensic practitioners should approach and use peer review, as well as how it should be described in expert reports and oral testimony. While peer review has considerable potential, and is a key component of modern quality management systems, its actual value in most forensic science settings has yet to be determined. In consequence, forensic practitioners should reflect on why they use specific review procedures and endeavour to make their actual practices and their potential value transparent to consumers; whether investigators, lawyers, jurors or judges. Claims that review increases the validity of a scientific technique or accuracy of opinions within a particular case should be avoided until empirical evidence is available to support such assertions. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Early site reviews for nuclear power facilities: procedures and possible technical review options. Draft

    International Nuclear Information System (INIS)

    1978-02-01

    The document provides guidance for utility companies, State and other governmental agencies, and others who may request or may wish to participate in an early review of site suitability issues related to a site proposed for a nuclear power or test reactor. Although the emphasis of this document is on a nuclear electric generating station, the guidance provided can be used for a test reactor or other kinds of reactors. The procedures to be followed by applicants for construction permits and by others are described and the possible significant areas of technical review are delineated

  7. Tools for PSA reviews

    International Nuclear Information System (INIS)

    Linden, J. von

    1998-01-01

    It is desirable to have a uniform and competent procedure for the review of PSAs which are performed within the framework of the Periodic Safety Review of German Nuclear Power Plants. Guidelines for the review process should therefore be evaluated within task A. 1 of project SR 2096. The basis for this work is the experience and knowledge within GRS derived from PSA-related work and from several review projects as well as the German PSA Guide with its appendices. Furthermore, the review processes in the USA, Switzerland and Sweden and the Guidelines for the International Peer Review Service (IPERS Guidelines) were utilized. As a result, recommendations are given for the review process, with individual recommendations concerning the organization of the review, task allocation between the reviewers, interface problems, assessment criteria, the scope and depth of the review as well as the supporting documents. An additional result are checklists for the technical elements of the PSA, which are listed to facilicate the review work. It is not the intention of this report to work out complete review guidelines. Its aims is rather more to give recommondations and support for the review in addition to what can be derived from the existing documents that should be used for the review. The recommendations reflect the view of GRS and go beyond the statements given in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) in some points. (orig.) [de

  8. Environmental impacts of utility-scale solar energy

    Science.gov (United States)

    Hernandez, R.R.; Easter, S.B.; Murphy-Mariscal, M. L.; Maestre, F.T.; Tavassoli, M.; Allen, E.B.; Barrows, C.W.; Belnap, J.; Ochoa-Hueso, R.; Ravi, S.; Allen, M.F.

    2014-01-01

    Renewable energy is a promising alternative to fossil fuel-based energy, but its development can require a complex set of environmental tradeoffs. A recent increase in solar energy systems, especially large, centralized installations, underscores the urgency of understanding their environmental interactions. Synthesizing literature across numerous disciplines, we review direct and indirect environmental impacts – both beneficial and adverse – of utility-scale solar energy (USSE) development, including impacts on biodiversity, land-use and land-cover change, soils, water resources, and human health. Additionally, we review feedbacks between USSE infrastructure and land-atmosphere interactions and the potential for USSE systems to mitigate climate change. Several characteristics and development strategies of USSE systems have low environmental impacts relative to other energy systems, including other renewables. We show opportunities to increase USSE environmental co-benefits, the permitting and regulatory constraints and opportunities of USSE, and highlight future research directions to better understand the nexus between USSE and the environment. Increasing the environmental compatibility of USSE systems will maximize the efficacy of this key renewable energy source in mitigating climatic and global environmental change.

  9. Utility oversight of Cask System Development Program

    International Nuclear Information System (INIS)

    Vincent, J.A.; Jordan, J.M.; Schwartz, M.H.

    1993-01-01

    This paper will present the electric utility industry's perspective on the status and scope of the DOE's Office of Civilian Radioactive Waste Management's (DOE/OCRWM) transportation cask systems development activities, including the Cask Systems Development Program (CSDP) Initiative I transportation cask projects. This presentation is particularly timely because the CSDP Independent Management Review Group (IMRG), os which one of the authors is a member, completed an objective assessment of OCRWM's transportation cask system development activities and issued its first report in late August 1992. The perspective on these cask systems development activities that will be presented reflects conclusions based on (1) the industry's review of CSDP Preliminary and Draft Final Design Reports for the Initiative I cask projects, (2) the activities of one of the authors as a member of the IMRG, and (3) the positions that the industry has consistently taken on what it believes to be the appropriate scope and pace of the CSDP and its integration with other OCRWM activities. Background information on the OCRWM transportation cask systems development activities and the relevant industry activities will also be provided

  10. A Practice-Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization.

    Science.gov (United States)

    Zebrack, Brad; Kayser, Karen; Bybee, Deborah; Padgett, Lynne; Sundstrom, Laura; Jobin, Chad; Oktay, Julianne

    2017-07-01

    Background: This study examined the extent to which cancer programs demonstrated adherence to their own prescribed screening protocol, and whether adherence to that protocol was associated with medical service utilization. The hypothesis is that higher rates of service utilization are associated with lower rates of adherence to screening protocols. Methods: Oncology social workers at Commission on Cancer-accredited cancer programs reviewed electronic health records (EHRs) in their respective cancer programs during a 2-month period in 2014. Rates of overall adherence to a prescribed distress screening protocol were calculated based on documentation in the EHR that screening adherence and an appropriate clinical response had occurred. We examined documentation of emergency department (ED) use and hospitalization within 2 months after the screening visit. Results: Review of 8,409 EHRs across 55 cancer centers indicated that the overall adherence rate to screening protocols was 62.7%. The highest rates of adherence were observed in Community Cancer Programs (76.3%) and the lowest rates were in NCI-designated Cancer Centers (43.3%). Rates of medical service utilization were significantly higher than expected when overall protocol adherence was lacking. After controlling for patient and institutional characteristics, risk ratios for ED use (0.82) and hospitalization (0.81) suggest that when overall protocol adherence was documented, 18% to 19% fewer patients used these medical services. Conclusions: The observed associations between a mandated psychosocial care protocol and medical service utilization suggest opportunities for operational efficiencies and costs savings. Further investigations of protocol integrity, as well as the clinical care models by which psychosocial care is delivered, are warranted. Copyright © 2017 by the National Comprehensive Cancer Network.

  11. Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review

    Science.gov (United States)

    Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

    2017-01-01

    Introduction Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. Methods and analysis A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion This systematic review will

  12. An integrative review on coping skills in nursing students: implications for policymaking.

    Science.gov (United States)

    Labrague, L J; McEnroe-Petitte, D M; Al Amri, M; Fronda, D C; Obeidat, A A

    2018-06-01

    This study critically appraised both quantitative and qualitative studies describing coping strategies utilized by nursing students when faced with stress. Stress in nursing students during clinical training is well documented in the nursing literature. The need to utilize positive-coping strategies is necessary to effectively deal with stress and its accompanying stressors. An integrative review method was used in this review. PsycINFO, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and Scopus were the databases used in searching for relevant literature using the following search terms; 'coping', 'nursing students', clinical training', 'ways of coping' and 'clinical practice'. A total of 27 studies published from 2001 to 2016 were included in this review. Findings demonstrated that nursing students utilized problem-focused coping strategies rather than emotion-focused coping strategies. Specific coping behaviours utilized included problem-solving behaviours, self-confident approaches and seeking of support from family and friends. The review contributes to the growing literature on coping strategies in nursing students and may have implications on nursing education and nursing policy. This review also demonstrated a scarcity of studies that links specific coping strategies to nursing school stressors and examines predictors of coping skills in nursing students. Institutionalization of structured student orientation programme, implementation of well-planned mentoring programmes and establishment of support unit/centres may be helpful in supporting nursing students during their clinical placement. By developing empirically based interventions, nursing faculty can assist nursing students in strengthening their positive-coping skills to effectively deal with various stressors encountered. © 2017 International Council of Nurses.

  13. State-of-the-art assessment of requirements for attachments of WiFi equipments to electric utility facilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    Electric utilities are receiving a growing number of requests to attach WiFi equipment to their systems. However, many utilities are not prepared to meet these requests because they have not had enough time to formally review and comment on the particular issues associated with Wi-Fi attachments. Although electric utilities are required to allow the attachments, there is no uniform standard to govern those attachments. This paper discussed the state-of-the-art philosophies and requirements of electric utilities who have allowed WiFi equipment on their systems. The advantages and limitations of each philosophy or practice were also discussed. The requirements for codes and standards in the United States and Canada for high voltage construction were also evaluated.

  14. Key data elements for use in cost-utility modeling of biological treatments for rheumatoid arthritis.

    Science.gov (United States)

    Ganz, Michael L; Hansen, Brian Bekker; Valencia, Xavier; Strandberg-Larsen, Martin

    2015-05-01

    Economic evaluation is becoming more common and important as new biologic therapies for rheumatoid arthritis (RA) are developed. While much has been published about how to design cost-utility models for RA to conduct these evaluations, less has been written about the sources of data populating those models. The goal is to review the literature and to provide recommendations for future data collection efforts. This study reviewed RA cost-utility models published between January 2006 and February 2014 focusing on five key sources of data (health-related quality-of-life and utility, clinical outcomes, disease progression, course of treatment, and healthcare resource use and costs). It provided recommendations for collecting the appropriate data during clinical and other studies to support modeling of biologic treatments for RA. Twenty-four publications met the selection criteria. Almost all used two steps to convert clinical outcomes data to utilities rather than more direct methods; most did not use clinical outcomes measures that captured absolute levels of disease activity and physical functioning; one-third of them, in contrast with clinical reality, assumed zero disease progression for biologic-treated patients; little more than half evaluated courses of treatment reflecting guideline-based or actual clinical care; and healthcare resource use and cost data were often incomplete. Based on these findings, it is recommended that future studies collect clinical outcomes and health-related quality-of-life data using appropriate instruments that can convert directly to utilities; collect data on actual disease progression; be designed to capture real-world courses of treatment; and collect detailed data on a wide range of healthcare resources and costs.

  15. Oil Palm Empty Fruit Bunches (OPEFB): Existing Utilization and Current Trends Bio Refinery in Indonesia

    Science.gov (United States)

    Rame

    2018-02-01

    In a future carbon-constrained global economy, the use of fossil fuels will be restricted. Biomass resources will be increased demand for renewable products. Oil Palm Empty Fruit Bunches (OPEFB) can be used as lignocellulose feedstock. The production of biofuels from lignocellulose feedstock can be achieved through biochemical or thermo-chemical routes. OPEFB contain chemical blocks of cellulose, hemicellulose and lignocellulose. Due to these substances, OPEFB can be converted into bio-products and chemical. Special attention to biorefinery approach that is present at relatively high potential in bio-products such as polymers, nutraceuticals, chemical building blocks, biofuels, and bioenergy. Different utilization types were considered and reviewed, and the most common and efficient process were discussed. In general, there is no single product which could be considered a solution to the utilization of managing OPEFB - in this review a number of product are more economic, effective and environmentally friendly.

  16. Reporting of Systematic Reviews of Micronutrients and Health: A Critical Appraisal

    Science.gov (United States)

    Context: Systematic review is a valuable tool for evaluating nutrition-related research and formulating nutrition recommendation. Lack of standardized criteria for generating these reviews has restricted their potential utility. Objective: To evaluate the characteristics and reporting quality of pub...

  17. Resolving inconsistencies in utility measurement under risk: Tests of generalizations of expected utility

    OpenAIRE

    Han Bleichrodt; José María Abellán-Perpiñan; JoséLuis Pinto; Ildefonso Méndez-Martínez

    2005-01-01

    This paper explores inconsistencies that occur in utility measurement under risk when expected utility theory is assumed and the contribution that prospect theory and some other generalizations of expected utility can make to the resolution of these inconsistencies. We used five methods to measure utilities under risk and found clear violations of expected utility. Of the theories studied, prospect theory was the most consistent with our data. The main improvement of prospect theory over expe...

  18. Grey Literature Searching for Health Sciences Systematic Reviews: A Prospective Study of Time Spent and Resources Utilized.

    Science.gov (United States)

    Saleh, Ahlam A; Ratajeski, Melissa A; Bertolet, Marnie

    To identify estimates of time taken to search grey literature in support of health sciences systematic reviews and to identify searcher or systematic review characteristics that may impact resource selection or time spent searching. A survey was electronically distributed to searchers embarking on a new systematic review. Characteristics of the searcher and systematic review were collected along with time spent searching and what resources were searched. Time and resources were tabulated and resources were categorized as grey or non-grey. Data was analyzed using Kruskal-Wallis tests. Out of 81 original respondents, 21% followed through with completion of the surveys in their entirety. The median time spent searching all resources was 471 minutes, and of those a median of 85 minutes were spent searching grey literature. The median number of resources used in a systematic review search was four and the median number of grey literature sources searched was two. The amount of time spent searching was influenced by whether the systematic review was grant funded. Additionally, the number of resources searched was impacted by institution type and whether systematic review training was received. This study characterized the amount of time for conducting systematic review searches including searching the grey literature, in addition to the number and types of resources used. This may aid searchers in planning their time, along with providing benchmark information for future studies. This paper contributes by quantifying current grey literature search patterns and associating them with searcher and review characteristics. Further discussion and research into the search approach for grey literature in support of systematic reviews is encouraged.

  19. Incentive regulation of investor-owned nuclear power plants by public utility regulators

    International Nuclear Information System (INIS)

    McKinney, M.D.; Elliot, D.B.

    1993-01-01

    The US Nuclear Regulatory Commission (NRC) periodically surveys the Federal Energy Regulatory Commission (FERC) and state regulatory commissions that regulate utility owners of nuclear power plants. The NRC is interested in identifying states that have established economic or performance incentive programs applicable to nuclear power plants, including states with new programs, how the programs are being implemented, and in determining the financial impact of the programs on the utilities. The NRC interest stems from the fact that such programs have the potential to adversely affect the safety of nuclear power plants. The information in this report was obtained from interviews conducted with each state regulatory agency that administers an incentive program and each utility that owns at least 10% of an affected nuclear power plant. The agreements, orders, and settlements that form the basis for each incentive program were reviewed as required. The interviews and supporting documentation form the basis for the individual state reports describing the structure and financial impact of each incentive program

  20. Japanese utilities' plutonium utilization program

    International Nuclear Information System (INIS)

    Matsuo, Yuichiro.

    1996-01-01

    Japan's 10 utility companies are working and will continue to work towards establishing a fully closed nuclear fuel cycle. The key goals of which are: (1) reprocessing spent fuel; (2) recycling recovered uranium and plutonium; and (3) commercializing fast breeder technology by around the year 2030. This course of action by the Japanese electric power industry is in full accordance with Japan's national policy outlined in the government's report ''The Long-Term Program for Research, Development, and Nuclear Energy,'' which was published in June 1994. The Japanese civilian nuclear program is a long-term program that looks into the 21st century and beyond. It is quite true that sustaining the recycling option for energy security and the global environment demands a large investment. For it to be accepted by the public, safety must be the highest priority and will be pursued at a great cost if necessary. In its history, Japan has learned that as technology advances, costs will come down. The Japanese utility industry will continue investment in technology without compromising safety until the recycling option becomes more competitive with other options. This effort will be equally applied to the development of the commercial FBRs. The Japanese utility industry is confident that Japan's stable policy and strong objective to develop competitive and peaceful technology will contribute to the global economy and the environment without increasing the threat of plutonium proliferation