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Sample records for utilization review dur

  1. 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.

  2. 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...

  3. 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.

  4. 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

  5. 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.

  6. 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.

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

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    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.

  8. 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

  9. 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

  10. 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"

  11. 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.

  12. Chiropractic and CAM Utilization: A Descriptive Review

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    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. 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.

  14. 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)

  15. 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

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

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    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.

  17. 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

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

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    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.

  19. 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

  20. 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.

  1. Review of Energy Harvesters Utilizing Bridge Vibrations

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    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.

  2. 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

  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. 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...

  5. Diagnostic utility of onychoscopy: Review of literature

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    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?

  6. PEMIKIRAN GUS DUR TENTANG PENDIDIKAN KARAKTER DAN KEARIFAN LOKAL

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    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

  7. 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.

  8. 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

  9. 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 ...

  10. 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")

  11. 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")

  12. 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)

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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 ...

  1. 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.

  2. 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)

  3. 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.

  4. 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 ...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. A review of population data utilization in beef cattle research.

    Science.gov (United States)

    Jones, R; Langemeier, M

    2010-04-01

    Controlled experimentation has been the most common source of research data in most biological sciences. However, many research questions lend themselves to the use of population data, or combinations of population data and data resulting from controlled experimentation. Studies of important economic outcomes, such as efficiency, profits, and costs, lend themselves particularly well to this type of analysis. Analytical methods that have been most commonly applied to population data in studies related to livestock production and management include statistical regression and mathematical programming. In social sciences, such as applied economics, it has become common to utilize more than one method in the same study to provide answers to the various questions at hand. Of course, care must be taken to ensure that the methods of analysis are appropriately applied; however, a wide variety of beef industry research questions are being addressed using population data. Issues related to data sources, aggregation levels, and consistency of collection often surface when using population data. These issues are addressed by careful consideration of the questions being addressed and the costs of data collection. Previous research across a variety of cattle production and marketing issues provides a broad foundation upon which to build future research. There is tremendous opportunity for increased use of population data and increased collaboration across disciplines to address issues of importance to the cattle industry.

  12. 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.

  13. Utilizing an integrated infrastructure for outcomes research: a systematic review.

    Science.gov (United States)

    Dixon, Brian E; Whipple, Elizabeth C; Lajiness, John M; Murray, Michael D

    2016-03-01

    To explore the ability of an integrated health information infrastructure to support outcomes research. A systematic review of articles published from 1983 to 2012 by Regenstrief Institute investigators using data from an integrated electronic health record infrastructure involving multiple provider organisations was performed. Articles were independently assessed and classified by study design, disease and other metadata including bibliometrics. A total of 190 articles were identified. Diseases included cognitive, (16) cardiovascular, (16) infectious, (15) chronic illness (14) and cancer (12). Publications grew steadily (26 in the first decade vs. 100 in the last) as did the number of investigators (from 15 in 1983 to 62 in 2012). The proportion of articles involving non-Regenstrief authors also expanded from 54% in the first decade to 72% in the last decade. During this period, the infrastructure grew from a single health system into a health information exchange network covering more than 6 million patients. Analysis of journal and article metrics reveals high impact for clinical trials and comparative effectiveness research studies that utilised data available in the integrated infrastructure. Integrated information infrastructures support growth in high quality observational studies and diverse collaboration consistent with the goals for the learning health system. More recent publications demonstrate growing external collaborations facilitated by greater access to the infrastructure and improved opportunities to study broader disease and health outcomes. Integrated information infrastructures can stimulate learning from electronic data captured during routine clinical care but require time and collaboration to reach full potential. © 2015 Health Libraries Group.

  14. Clinical utility of foam dressings in wound management: a review

    Directory of Open Access Journals (Sweden)

    Nielsen J

    2015-02-01

    Full Text Available Jakob Nielsen, Karsten Fogh Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark Background: The management of chronic wounds is a significant medical burden associated with large health care expenditures. Since the establishment of moist wound healing in the 1960s, several types of wound dressings have been developed. However, the evidence for effectiveness when comparing various types of wound dressings is limited. Objectives: The purpose of this review is 1 to provide a general description of the role of foam in wound therapy and 2 to evaluate the evidence for effectiveness of foam dressings compared to other frequently used products. Summary and conclusion: Foam has a significant role in the clinical management of chronic wounds and in moist wound healing. There are only a few randomized controlled trials, which in general, show no significant difference in the healing effect of different dressing types. The choice of wound dressing should therefore be based on clinical evaluation of the wound and the periwound skin. Keywords: foam dressing, chronic wounds, comparative effectiveness, healing, periwound skin, ulcers 

  15. A comprehensive review on utilization of wastewater from coffee processing.

    Science.gov (United States)

    Rattan, Supriya; Parande, A K; Nagaraju, V D; Ghiwari, Girish K

    2015-05-01

    The coffee processing industry is one of the major agro-based industries contributing significantly in international and national growth. Coffee fruits are processed by two methods, wet and dry process. In wet processing, coffee fruits generate enormous quantities of high strength wastewater requiring systematic treatment prior to disposal. Different method approach is used to treat the wastewater. Many researchers have attempted to assess the efficiency of batch aeration as posttreatment of coffee processing wastewater from an upflow anaerobic hybrid reactor (UAHR)-continuous and intermittent aeration system. However, wet coffee processing requires a high degree of processing know-how and produces large amounts of effluents which have the potential to damage the environment. Characteristics of wastewater from coffee processing has a biological oxygen demand (BOD) of up to 20,000 mg/l and a chemical oxygen demand (COD) of up to 50,000 mg/l as well as the acidity of pH below 4. In this review paper, various methods are discussed to treat coffee processing wastewaters; the constitution of wastewater is presented and the technical solutions for wastewater treatment are discussed.

  16. Growth Hormone Utilization Review in a Pediatric Primary Care Setting.

    Science.gov (United States)

    Sayarifard, Fatemeh; Imcheh, Fereshteh Bakhshi; Badri, Shirinsadat; Faghihi, Toktam; Qorbani, Mostafa; Radfar, Mania

    2017-01-01

    One of the main problems facing public health providers and administrators in many countries is ensuring the rational use of high-cost drugs. In this regard, on-going process of medication use evaluation can be considered as a useful tool. In this study, we evaluated certain usage aspects of a highly-cost medication, that is, recombinant growth hormone (GH). This cross-sectional study conducted from August 2012 to August 2014. Children receiving GH ± gonadotropin releasing hormone (GnRH) analogs were included in the study. A researcher-designed checklist was developed to evaluate the GH utilization in these patients. Baseline demographic characteristics and background clinical and growth data, as well as any aspects of drug therapy including indications, dosing, monitoring, and discontinuation were collected from the patients' medical records. Seventy children receiving GH entered the study, of which 23 patients (32.85%) received GH and GnRH analogs simultaneously. At the baseline, 67 children (95.7%) had GH stimulation test, whereas serum insulin-like growth factor-1 (IGF-1) levels were measured in 63 (90%) patients. Sixty-seven patients (95.71%) had thyroid function test, whereas bone age was determined in 68 children (97.14%). The mean ± standard deviation of GH dose for idiopathic short stature, GH deficiency, Turner's syndrome and born small for gestational age in our study was 0.22 ± 0.025 mg/kg/week, 0.23 ± 0.04 mg/kg/week, 0.22 ± 0.015 mg/kg/week, and 0.23 ± 0.02 mg/kg/week, respectively. Height and weight of all patients were followed every 3-6 months, regularly. Thirty patients were treated with GH for at least 1 year, of which thyroid hormones and IGF-1 levels were measured annually in 25 (83.33%) and 26 (86.66%) patients, respectively; while bone age was evaluated in 13 (43.33%) children, annually. GH treatment was discontinued in 15 patients (21.42%), while financial problem was the major reason. Diagnostic tests and monitoring of height, weight

  17. 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")

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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...

  3. [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.

  4. 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.

  5. 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.

  6. 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.…

  7. 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.

  8. 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

  9. 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...

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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...

  19. 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...

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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)

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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,...

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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

  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)

    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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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...

  9. 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

  10. 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

  11. 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.

  12. 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)

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. 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.

  3. 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...

  4. 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 ...

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  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. 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

  12. Utilization of rice straw and different treatments to improve its feed value for ruminants: A review

    NARCIS (Netherlands)

    Sarnklong, C.; Cone, J.W.; Pellikaan, W.F.; Hendriks, W.H.

    2010-01-01

    This paper gives an overview of the availability, nutritive quality, and possible strategies to improve the utilization of rice straw as a feed ingredient for ruminants. Approximately 80% of the rice in the world is grown by small-scale farmers in developing countries, including South East Asia. The

  13. 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.

  14. 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 ...

  15. 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

  16. Neuroendoscopy and pineal tumors: A review of the literature and our considerations regarding its utility.

    Science.gov (United States)

    Mottolese, C; Szathamari, A; Beuriat, P A; Grassiot, B; Simon, E

    2015-01-01

    Endoscopy has entered into the armamentarium of pineal and pineal region tumor treatment. The technique permits not only to control hydrocephalus but also to obtain tissue samples for histological diagnosis. In this paper, we explain the utility of endoscopy for the treatment of pineal tumors and as well as report some personal considerations regarding this topic. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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)

  3. 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)

  4. 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.

  5. A Review of Acculturation Measures and Their Utility in Studies Promoting Latino Health

    Science.gov (United States)

    Wallace, Phyllis M.; Pomery, Elizabeth A.; Latimer, Amy E.; Martinez, Josefa L.; Salovey, Peter

    2010-01-01

    The authors reviewed the acculturation literature with the goal of identifying measures used to assess acculturation in Hispanic populations in the context of studies of health knowledge, attitudes, and behavior change. Twenty-six acculturation measures were identified and summarized. As the Hispanic population continues to grow in the United…

  6. Utility of Acculturation in Physical Activity Research in Latina Adults: An Integrative Review of Literature

    Science.gov (United States)

    Benitez, Tanya J.; Dodgson, Joan E.; Coe, Kathryn; Keller, Colleen

    2016-01-01

    Latina adults in the United States have a disproportionately higher prevalence of chronic diseases related to low physical activity levels than non-Hispanic women. Literature indicates that acculturation may be a contributing factor to being physically active, but the extent of this association remains unclear. An integrative review of literature…

  7. 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...

  8. 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

  9. 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)

  10. Use of transglutaminases in foods and potential utilization of plants as a transglutaminase source – Review

    Directory of Open Access Journals (Sweden)

    Fernando Bittencourt Luciano

    2012-09-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2012v25n4p1   Transglutaminases (TGases are enzymes able to catalyze acyl-transfer reactions introducing covalent cross-links between proteins, peptides and primary amines. Animal TGases were the first studied and are divided in nine different groups of isoenzymes. They have a wide range of functions in the metabolism of most animal cells, and share the characteristic of being Ca2+-dependent. Microbial and plant TGases were also identified, and there is a vast heterogeneity among their amino acid sequences. Interestingly, it seems that all transglutaminases share a specific amino acid triad of Cys-His-Asp in their catalytic site, which can be found in all tertiary structures of the enzymes yet studied so far. Microbial TGases are the most widely used for food modification due to lower costs and high yields involved with their extraction and purification when compared to mammal sources. TGases are ubiquitously found in a variety of plants, and their utilization for food transformation has been proposed. However, there is only a single attempt using vegetal TGase in food systems, where apple pomace was used to improve the quality of pork meat. The transference of mammalian TGase genes to plants has also been considered and they were found to be successfully expressed in rice and tobacco leaves. These results lead to a new approach, where TGases could be literally farmed for food utilization.

  11. Use of transglutaminases in foods and potential utilization of plants as a transglutaminase source – Review

    Directory of Open Access Journals (Sweden)

    Fernando B. Luciano

    2012-11-01

    Full Text Available Transglutaminases (TGases are enzymes able to catalyze acyl-transfer reactions introducing covalent cross-links between proteins, peptides and primary amines. Animal TGases were the first studied and are divided in nine different groups of isoenzymes. They have a wide range of functions in the metabolism of most animal cells, and share the characteristic of being Ca2+-dependent. Microbial and plant TGases were also identified, and here is a vast heterogeneity among their amino acid sequences. Interestingly, it seems that all transglutaminases share a specific amino acid triad of Cys-His-Asp in their catalytic site, which can be found in all tertiary structures of the enzymes yet studied so far. Microbial TGases are the most widely used for food modification due to lower costs and high yields involved with their extraction and purification when compared to mammal sources. TGases are ubiquitously found in a variety of plants, and their utilization for food transformation has been proposed. However, there is only a single attempt using vegetal TGase in food systems, where apple pomace was used to improve the quality of pork meat. The transference of mammalian TGase genes to plants has also been considered and they were found to be successfully expressed in rice and tobacco leaves. These results lead to a new approach, where TGases could be literally farmed for food utilization.

  12. 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)

  13. 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

  14. 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.

  15. Review of the utilization of laser and electron beam methods in the nuclear domain

    International Nuclear Information System (INIS)

    Charissoux, C.; Bonnin, P.; Calvet, J.N.; Contre, M.

    1987-01-01

    The use of laser and electron beams by the nuclear industry for making components, fabricating fuels, waste processing, maintenance, and dismantling installations is reviewed. The advantages in welding include very rapid thermal cycles, deep weld zones with a restricted effect on surrounding material, and reduced residual stress. Surface treatments can also take advantage of these benefits. In cutting, the intrinsic advantages of the laser are completed by its high potential for robotization [fr

  16. Clinical Utility of Virtual Reality in Pain Management: A Comprehensive Research Review from 2009 to 2016

    OpenAIRE

    Matsangidou, Maria; Ang, Chee Siang; Sakel, Mohamed

    2017-01-01

    Virtual Reality is a technology that allows users to experience a computer-simulated reality with visual, auditory, tactile and olfactory interactions. In the past decades, there have been considerable interests in using Virtual Reality for clinical purposes, including pain management. This article provides a systematic review of research on Virtual Reality and pain management, with an aim to understand the feasibilities of current Virtual Reality technologies and content design approaches in...

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. Graft Utilization in the Bridging Reconstruction of Irreparable Rotator Cuff Tears: A Systematic Review.

    Science.gov (United States)

    Lewington, Matthew R; Ferguson, Devin P; Smith, T Duncan; Burks, Robert; Coady, Catherine; Wong, Ivan Ho-Bun

    2017-11-01

    Rotator cuff tears are one of the most common conditions affecting the shoulder. Because of the difficulty in managing massive rotator cuff tears and the inability of standard techniques to prevent arthropathy, surgeons have developed several novel techniques to improve outcomes and ideally alter the natural history. To systematically review the existing literature and analyze reported outcomes to evaluate the effectiveness of using a bridging graft reconstruction technique to treat large to massive irreparable rotator cuff tears. Systematic review. A systematic search of PubMed, EMBASE, CINAHL, and CENTRAL was employed with the key terms "tear," "allograft," and "rotator cuff." Eligibility was determined by a 3-phase screening process according to the outlined inclusion/exclusion criteria. Data in relation to the primary and secondary outcomes were summarized. The results were synthesized according to the origin of the graft and the level of evidence. Fifteen studies in total were included in this review: 2 comparative studies and 13 observational case series. Both the biceps tendon and the fascia lata autograft groups had significantly superior structural integrity rates on magnetic resonance imaging at 12-month minimum follow-up when compared with their partial primary repair counterparts (58% vs 26%, P = .036; 79% vs 58%, P rotator cuff tears demonstrated high structural healing rates (74%-90%, 73%-100%, and 60%-90%, respectively). Additionally, both comparative studies and case series demonstrated a general improvement of patients' functional outcome scores. Using a graft for an anatomic bridging rotator cuff repair results in improved function on objective testing and may be functionally better than nonanatomic or partial repair of large to massive rotator cuff tears. Allograft or xenograft techniques appear to be favorable options, given demonstrated functional improvement, imaging-supported graft survival, and lack of harvest complication risk. More high

  4. State environmental review of a proposed utility independent spent fuel storage installation

    International Nuclear Information System (INIS)

    Sabel, G.; Halstead, R.

    1991-01-01

    This paper describes the environmental review process which was applied by the State of Minnesota to a proposed dry cask storage facility. An environmental analysis of the proposed project is summarized, as are alternatives including other dry storage technologies, increased in-pool storage, transhipment, reprocessing, use of higher burnup fuel and conservation. Public comments and concerns included potential cask failures, health impacts, and the possibility of the site becoming a open-quotes permanentclose quotes storage facility. State intervention in the federal license process is also described

  5. 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.

  6. Utilization of maternal health services among adolescent women in Bangladesh: A scoping review of the literature.

    Science.gov (United States)

    Shahabuddin, A S M; Delvaux, Thérèse; Abouchadi, Saloua; Sarker, Malabika; De Brouwere, Vincent

    2015-07-01

    To understand the health-seeking behaviour of adolescent women in Bangladesh with respect to the use of maternal health services. Literature review of seven electronic databases: PubMed, ISI Web of Knowledge, PsycINFO, Embase, CINAHL, POPLINE and Global Health. Studies published in English between 1990 and 2013 which describe Bangladeshi adolescent women's healthcare-seeking behaviour during pregnancy, delivery and post-partum were included. Twelve studies were included in this review. 11 used quantitative methods and one used a mixed-methods approach. All studies included married adolescent women only. Women with lower educational levels are less likely to seek skilled maternal health services than those with higher levels of education. Use of maternal health services is also less common among rural married adolescent women than women in urban areas. Being part of the richest bands of wealth, having had previous experiences of childbirth and higher women's autonomy positively influence the use of skilled maternal health services among married adolescent women in Bangladesh. Antenatal care is a key predictor of the use of skilled birth attendants for delivery and post-natal care. Maternal health-related programmes should be designed targeting rural and uneducated married adolescent women in Bangladesh. More qualitative investigations are required to broaden our understanding on maternal health-seeking behaviour of both married and unmarried adolescent women. © 2015 John Wiley & Sons Ltd.

  7. 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.

  8. 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.

  9. A systematic review of minimally invasive sacroiliac joint fusion utilizing a lateral transarticular technique.

    Science.gov (United States)

    Heiney, Jake; Capobianco, Robyn; Cher, Daniel

    2015-01-01

    A number of studies have been published regarding minimally invasive surgical (MIS) fusion of the sacroiliac (SI) joint using a lateral transarticular approach. Herein we report a systematic review and meta-analysis to summarize operative measures and clinical outcomes reported in published studies of MIS SI joint fusion. The systematic review was done according to PRISMA standards. PubMed and EMBASE were searched using the terms sacroiliac joint AND fusion. Original peer-reviewed articles in the English language that reported clinical outcomes on at least 5 cases of MIS SI joint fusion using a lateral transarticular approach were included. Random effects meta-analysis (RMA) was performed on selected variables using the DerSimonian and Laird method, including operative measures, VAS SI joint pain ratings (0-10 scale) and Oswestry Disability Index (ODI). Mean and 95% confidence intervals (CI) were calculated and heterogeneity was assessed. Other findings were summarized qualitatively. A total of 18 articles met the inclusion criteria. After accounting for overlapping cohorts, 12 unique cohorts from 4 countries were extracted for a total of 432 subjects. The RMA mean (range) was 59 minutes (27-78) for procedure time, 36.9cc (10-70) for estimated blood loss and 1.7 days (range 0-7) for length of stay (LOS). The RMA mean [95% CI] pain score dropped by 5.2 points at 6 months and 5.3 points at 12 months (baseline score of 8.1 [7.8-8.4], 12-month score of 2.7 [2.1-3.3]), and a 24-month score of 2.0(1.4-2.5). ODI decreased by 31 points at 12 months (baseline score of 56.2 [51.0-61.5], 6-month score of 30.7 [21.8-39.6], and 12-month score of 25.1 [12.3-37.9]). Some estimates showed significant variation across studies and between the types of implants used. Other reported outcomes were supportive of the positive effects of SI joint fusion. Published studies of MIS SI joint fusion using a lateral transarticular approach confirm its minimally invasive characteristics with

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

    Science.gov (United States)

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

    2016-12-01

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

  11. Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review.

    Science.gov (United States)

    Yoo, Byong Chul; Yeo, Seung-Gu

    2017-03-01

    Approximately 20% of all patients with locally advanced rectal cancer experience pathologically complete responses following neoadjuvant chemoradiotherapy (CRT) and standard surgery. The utility of radical surgery for patients exhibiting good CRT responses has been challenged. Organ-sparing strategies for selected patients exhibiting complete clinical responses include local excision or no immediate surgery. The subjects of this tailored management are patients whose presenting disease corresponds to current indications of neoadjuvant CRT, and their post-CRT tumor response is assessed by clinical and radiological examinations. However, a model predictive of the CRT response, applied before any treatment commenced, would be valuable to facilitate such a personalized approach. This would increase organ preservation, particularly in patients for whom upfront CRT is not generally prescribed. Molecular biomarkers hold the greatest promise for development of a pretreatment predictive model of CRT response. A combination of clinicopathological, radiological, and molecular markers will be necessary to render the model robust. Molecular research will also contribute to the development of drugs that can overcome the radioresistance of rectal tumors. Current treatments for rectal cancer are based on the expected prognosis given the presenting disease extent. In the future, treatment schemes may be modified by including the predicted CRT response evaluated at presentation.

  12. Agricultural utilization of biosolids: A review on potential effects on soil and plant grown.

    Science.gov (United States)

    Sharma, Bhavisha; Sarkar, Abhijit; Singh, Pooja; Singh, Rajeev Pratap

    2017-06-01

    Environmental and economic implications linked with the proper ecofriendly disposal of modern day wastes, has made it essential to come up with alternative waste management practices that reduce the environmental pressures resulting from unwise disposal of such wastes. Urban wastes like biosolids are loaded with essential plant nutrients. In this view, agricultural use of biosolids would enable recycling of these nutrients and could be a sustainable approach towards management of this hugely generated waste. Therefore biosolids i.e. sewage sludge can serve as an important resource for agricultural utilization. Biosolids are characterized by the occurrence of beneficial plant nutrients (essential elements and micro and macronutrients) which can make help them to work as an effective soil amendment, thereby minimizing the reliance on chemical fertilizers. However, biosolids might contain toxic heavy metals that may limit its usage in the cropland. Heavy metals at higher concentration than the permissible limits may lead to food chain contamination and have fatal consequences. Biosolids amendment in soil can improve physical and nutrient property of soil depending on the quantity and portion of the mixture. Hence, biosolids can be a promising soil ameliorating supplement to increase plant productivity, reduce bioavailability of heavy metals and also lead to effective waste management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Review of remediation techniques for arsenic (As) contamination: a novel approach utilizing bio-organisms.

    Science.gov (United States)

    Rahman, Shahedur; Kim, Ki-Hyun; Saha, Subbroto Kumar; Swaraz, A M; Paul, Dipak Kumar

    2014-02-15

    Arsenic (As) contamination has recently become a worldwide problem, as it is found to be widespread not only in drinking water but also in various foodstuffs. Because of the high toxicity, As contamination poses a serious risk to human health and ecological system. To cope with this problem, a great deal of effort have been made to account for the mechanisms of As mineral formation and accumulation by some plants and aquatic organisms exposed to the high level of As. Hence, bio-remediation is now considered an effective and potent approach to breakdown As contamination. In this review, we provide up-to-date knowledge on how biological tools (such as plants for phytoremediation and to some extent microorganisms) can be used to help resolve the effects of As problems on the Earth's environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. The Complementary and Alternative Medicine for Endometriosis: A Review of Utilization and Mechanism

    Directory of Open Access Journals (Sweden)

    Sai Kong

    2014-01-01

    Full Text Available Endometriosis (EM is one of the common gynecological conditions causing menstrual and pelvic pain and affects 10%–15% of women of reproductive age. In recent years, the complementary and alternative medical (CAM treatment for EM has become popular due to the few adverse reactions reported. The CAM therapy for EM includes several different treatments such as herbs (herbal prescription, extract, and patent, acupuncture, microwave physiotherapy, and Chinese herb medicine enema (CHM enema. These CAM therapies are effective at relieving dysmenorrhoea, shrinking adnexal masses, and promoting pregnancy, with less unpleasant side effects when compared to hormonal and surgical treatments. In this review, we focus on the status quo of CAM on EM and try to identify therapeutic efficacy and mechanisms based on some clinical and experimental studies. We hope to provide some instructive suggestions for clinical treatment and experimental research in the future.

  15. UTILIZING WASTE PLASTIC POLYPROPYLENE AND POLYETHYLENE TEREPHTHALATE AS ALTERNATIVE AGGREGATES TO PRODUCE LIGHTWEIGHT CONCRETE: A REVIEW

    Directory of Open Access Journals (Sweden)

    IBRAHIM H. ALFAHDAWI

    2016-08-01

    Full Text Available In recent times, there is an increasing need for the fabrication of mortar and concrete that can be characterised as sustainable and environmentally friendly. Ideally, this concrete should be inexpensive, lightweight, and outstanding in terms of its physical and mechanical specifications. Plastic materials have increasingly been used in the fabrication of different types of concrete admixtures and mortar constituents. These plastic materials take the form of fillers or shredded fibres derived from polypropylene and polyethylene terephthalate. The use of plastic materials presents the following benefits: (i enhanced mixture quality and (ii a reduction in the amount of accumulated single-use plastic materials that negatively impact the environment. This work reviews several previous studies on the utilisation and preparations of plastic materials and their effects on the physical and mechanical properties of concrete. Other topics, including hardened concrete, fresh concrete, application, and thermo-physical characteristics, are also elaborated.

  16. The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

    Science.gov (United States)

    Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

    2018-01-01

    A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

  17. 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.

  18. Review on utilization and research on harbour seal (Phoca vitulina in Iceland

    Directory of Open Access Journals (Sweden)

    Erlingur Hauksson

    2010-09-01

    Full Text Available Harbour seals (Phoca vitulina have been harvested in Iceland since the first settlers arrived in the 9th century. Pups were generally netted, clubbed and harpooned until 1875 when general use of guns for hunting began. Seal-hunting has been traditional amongst the farms legal rights. Seal hunting was an important supplement to other economic resources. Harbour seal skins, salted ordried, were exported and large dataset of catch statistics is available from trading logbooks since the late 19th century. In the early 20th century catch was about 6,000. In the ‘bounty’ period 1982 – 1989, maximum catches were of 4,000 animals with about 350 hunters participated; in 2006 catches were only about 100 animals with 18 hunters. After 1989 the population continued to decline even though catches decreased markedly. Unreported by-catch in fishing gear, hunt for local consumption and shooting of seals swimming in salmon rivers estuaries may have kept the total removal from the stock above sustainable levels. A considerable Icelandic knowledge base had been compiled about the biology of the harbour seal since the late 16th century, with the first written reference in 1588-1589. In the last decades, research on various aspects of its biology and monitoring have been intensified, with focus on abundance, distribution, diet and nematode infestation. The main results show that the Icelandic harbour seal population - has declined annually about 5% in the period 1980-2006, - was most abundant on the NW-coast, - feeds mainly on sand-eels and gadoids, - and was less infected with anisakid nematodes than grey seals. Seal watching, as a low-consumptive indirect utilization, may represent a new economical opportunity if properly regulated.

  19. 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.

  20. Review on utilization of the pervaporation membrane for passive vapor feed direct methanol fuel cell

    International Nuclear Information System (INIS)

    Fauzi, N F I; Hasran, U A; Kamarudin, S K

    2013-01-01

    The Direct Methanol Fuel Cell (DMFC) is a promising portable power source for mobile electronic devices because of its advantages including easy fuel storage, high energy density, low temperature operation and compact structure. In DMFC, methanol is used as a fuel source where it can be fed in liquid or vapor phase. However, the vapor feed DMFC has an advantage over the liquid feed system as it has the potential to have a higher operating temperature to increase the reaction rates and power outputs, to enhance the mass transfers, to reduce methanol crossover, reliable for high methanol concentration and it can increase the fuel cell performance. Methanol vapor can be delivered to the anode by using a pervaporation membrane, heating the liquid methanol or another method that compatible. Therefore, this paper is a review on vapor feed DMFC as a better energy source than liquid feed DMFC, the pervaporation membrane used to vaporize methanol feed from the reservoir and its applications in vapor feed DMFC

  1. Review Article : Utilization of Environmental Radiochemistry Techniques for Selection and Evaluation of Nuclear Facility Sites

    International Nuclear Information System (INIS)

    Atta, E.R.; Madbouly, A.M.; Zakaria, Kh.M.

    2016-01-01

    This research review puts necessary considerations on the available environmental radiochemistry techniques for selection and evaluation of a nuclear facility sites.The main bjective in site evaluation for nuclear facilities in terms of nuclear safety is to protect the site workers, the public and the environment from the effects of ionizing radiation release from nuclear facilities due to accidents. The extreme sensitivity and speed of radiochemical methods make their applications of considerable importance in several fields and they have found many uses. Information about the existed radioactivity in the different nuclear facilities is an essential requirement for their environmental assessment. It is necessary to estimate the various radioactivity levels in the environment through qualitative and quantitative analytical techniques and to assess the potential effects of the nuclear facility in the region by considering the characteristics of sites.The siting and site evaluation requirements are discussed. Emphasis was given to types of radiochemical techniques used for characterization of the site parameters which determine the potential hazards of the site on the facility and the facility on the site. Emphasis has been also given to the quantitative and qualitative analysis of naturally occurring radionuclides for monitoring and control .There are some techniques employed such as radioactive tracer technique, liquid scintillation technique, gamma spectrometry technique, neutron activation analysis technique, fluorimetric technique and isotope hydrology technique.

  2. Review on utilization of biochar for metal-contaminated soil and sediment remediation.

    Science.gov (United States)

    Wang, Mingming; Zhu, Yi; Cheng, Lirong; Andserson, Bruce; Zhao, Xiaohui; Wang, Dayang; Ding, Aizhong

    2018-01-01

    Biochar is a carbon-neutral or even carbon-negative material produced through thermal decomposition of plant- and animal-based biomass under oxygen-limited conditions. Recently, there has been an increasing interest in the application of biochar as an adsorbent, soil ameliorant and climate mitigation approach in many types of applications. Metal-contaminated soil remediation using biochar has been intensively investigated in small-scale and pilot-scale trials with obtained beneficial results and multifaceted effects. But so far, the study and application of biochar in contaminated sediment management has been very limited, and this is also a worldwide problem. Nonetheless, there is reason to believe that the same multiple benefits can also be realized with these sediments due to similar mechanisms for stabilizing contaminants. This paper provides a review on current biochar properties and its use as a sorbent/amendment for metal-contaminated soil/sediment remediation and its effect on plant growth, fauna habits as well as microorganism communities. In addition, the use of biochar as a potential strategy for contaminated sediment management is also discussed, especially as regards in-situ planning. Finally, we highlight the possibility of biochar application as an effective amendment and propose further research directions to ensure the safe and sustainable use of biochar as an amendment for remediation of contaminated soil and sediment. Copyright © 2017. Published by Elsevier B.V.

  3. Recent developments in biochar utilization as an additive in organic solid waste composting: A review.

    Science.gov (United States)

    Xiao, Ran; Awasthi, Mukesh Kumar; Li, Ronghua; Park, Jonghwan; Pensky, Scott M; Wang, Quan; Wang, Jim J; Zhang, Zengqiang

    2017-12-01

    In recent years, considerable studies have been devoted to investigating the effect of biochar application on organic solid waste composting. This review provides an up-to-date overview of biochar amendment on composting processes and compost quality. Biochar production, characteristics, and its application coupled with the basic concepts of composting are briefly introduced before detailing the effects of biochar addition on composting. According to recent studies, biochar has exhibited great potential for enhancing composting. It is evident that biochar addition in composting can: (1) improve compost mixture physicochemical properties, (2) enhance microbial activities and promote organic matter decomposition, (3) reduce ammonia (NH 3 ) and greenhouse gas (GHG) emissions, and (4) upgrade compost quality by increasing the total/available nutrient content, enhancing maturity, and decreasing phytotoxicity. Despite that, further research is needed to explore the mechanism of biochar addition on composting and to evaluate the agricultural and environmental performances of co-composted biochar compost. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Early tracheostomy in intensive care trauma patients improves resource utilization: a cohort study and literature review

    Science.gov (United States)

    2004-01-01

    prolonged ICU stay (>14 days). Conclusion Early tracheostomy in trauma ICU patients is associated with shorter duration of mechanical ventilation and ICU LOS, without affecting ICU or hospital outcome. Adopting a standardized strategy of early tracheostomy in appropriately selected patients may help in reducing unnecessary resource utilization. PMID:15469579

  5. 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

  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. Medicine utilization review at a university teaching hospital in New Delhi

    Directory of Open Access Journals (Sweden)

    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  8. 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)

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  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. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. The Prospect of Using Complete Feed in Goat Production: A Review on its Utility and Physical Form and Animal Responses

    Directory of Open Access Journals (Sweden)

    Simon P Ginting

    2009-06-01

    Full Text Available Complete feed is a strategic feeding system that has been widely adopted by the dairy cattle industry, but it has been rarely practised in goat enterprises. The prospect of using complete feed for goat production could be considered from two aspects, namely 1 its relevancy to the goat metabolic requirement, and 2 its potential as an effective means for maximal utilization of crop residues and agro-industrial byproducts as alternative feeds. Metabolically, the higher energy requirement and the lower gut capacity of goats due to its relatively smaller body size make this animal more adapted to feedstuffs with denser nutrient contents as typified by the complete feed. As complete feed is characteristically dry, it has potential to cause hypovolemia and induce later a lower feed consumption when fed to goats. But, this event occurs only during the initial meal and the condition returns to the normal state thereafter. Total saliva secretion tend to decrease by consuming dry feed which can cause parakeratosis, laminitis or acidosis. However, these metabolic disorder could be prevented by formulating complete feed with optimal roughage/concentrate ratio. Review from literatures showed that, when used in complete feed, the inclusion rate of several low palatability crop residues or agro-industrial ranged from 15 to 60%. The roughage/concentrate ratio was in the range of 0.25 to 3.0. Some physical characteristics are important for effective complete feed such as the particle size of roughage, the content of physically effective fibre and the form of the complete feed. Complete feed processed into pellet generally resulted in better performances. The ME and CP content of complete feed used ranged from 1800 to 2800 kcal/kg DM and from 15 to 20%, respectively. The rate of feed intake by goats receiving complete feed ranged from 2.0 to 4.9% BW, the ADG ranged from 40 to 145 g, FCR ranged from 5.2 to 13.0 and DM digestibility ranged from 62 to 81%. These

  6. 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....

  7. 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

  8. 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

  9. Utilizing Physiological Principles of Motor Unit Recruitment to Reduce Fatigability of Electrically-Evoked Contractions: A Narrative Review.

    Science.gov (United States)

    Barss, Trevor S; Ainsley, Emily N; Claveria-Gonzalez, Francisca C; Luu, M John; Miller, Dylan J; Wiest, Matheus J; Collins, David F

    2018-04-01

    Neuromuscular electrical stimulation (NMES) is used to produce contractions to restore movement and reduce secondary complications for individuals experiencing motor impairment. NMES is conventionally delivered through a single pair of electrodes over a muscle belly or nerve trunk using short pulse durations and frequencies between 20 and 40Hz (conventional NMES). Unfortunately, the benefits and widespread use of conventional NMES are limited by contraction fatigability, which is in large part because of the nonphysiological way that contractions are generated. This review provides a summary of approaches designed to reduce fatigability during NMES, by using physiological principles that help minimize fatigability of voluntary contractions. First, relevant principles of the recruitment and discharge of motor units (MUs) inherent to voluntary contractions and conventional NMES are introduced, and the main mechanisms of fatigability for each contraction type are briefly discussed. A variety of NMES approaches are then described that were designed to reduce fatigability by generating contractions that more closely mimic voluntary contractions. These approaches include altering stimulation parameters, to recruit MUs in their physiological order, and stimulating through multiple electrodes, to reduce MU discharge rates. Although each approach has unique advantages and disadvantages, approaches that minimize MU discharge rates hold the most promise for imminent translation into rehabilitation practice. The way that NMES is currently delivered limits its utility as a rehabilitative tool. Reducing fatigability by delivering NMES in ways that better mimic voluntary contractions holds promise for optimizing the benefits and widespread use of NMES-based programs. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Patterns, Policy and Appropriateness: A 12-Year Utilization Review of Blood Glucose Test Strip Use in Insulin Users.

    Science.gov (United States)

    Falk, Jamie; Friesen, Kevin J; Okunnu, Anuoluwapo; Bugden, Shawn

    2017-08-01

    Considerable attention has been paid to the rising costs of the use of blood glucose test strips (BGTS). Insulin users have generally been treated as a single homogeneous group, resulting in policies that cap usage (8.2 strips/day) in provincial drug insurance programs. The objective of this study was to conduct a utilization review of BGTS by insulin users and to evaluate use patterns against current insulin use patterns and BGTS policy. BGTS usage was examined in a cohort of insulin users with type 1 and type 2 diabetes over a 12-year period (2001 to 2013) using the population-based administrative data in Manitoba, Canada. Total BGTS strip use increased by 121%, from $4.3 to $9.5 million. However, the number of insulin users also increased by 115%. Use has been stable at 1.5 strips per day per person since 2004 by insulin users with type 2 diabetes but has risen from 1.9 to 3.0 strips per day per person in those with type 1 diabetes. Mean daily test strip use was below the number of daily tests recommended for patients using insulin as per the current Canadian guidelines, with 11% and 15% of insulin users with type 1 and type 2 diabetes not claiming any BGTS use and a further 15% (type 1) and 28% (type 2) using fewer than 1 strip per day. BGTS use per insulin user has been stable for most of the past decade, and the vast majority of use falls well below provincial insurance caps. The amount of low-level testing (0 to <1 strip/day) suggests that greater attention should be directed to ensuring a safe level of testing by all insulin users. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Interventions for Increasing Alcohol Treatment Utilization Among Patients with Alcohol Use Disorders from Emergency Departments: A Systematic Review.

    Science.gov (United States)

    Simioni, Nicolas; Rolland, Benjamin; Cottencin, Olivier

    2015-11-01

    Alcohol use disorders (AUDs) are characterized by low treatment coverage. Emergency departments (EDs) have great potential to increase alcohol treatment coverage. While ED-based brief interventions (BIs) are rarely effective for reducing alcohol use and related consequences in people with AUDs, utilization of formal alcohol treatment has been demonstrated to be useful. Thus we conducted a systematic review to determine efficacious interventions for increasing subsequent alcohol treatment from EDs. A systematic search of the literature up to 31 December 2013 was undertaken in three electronic databases: PubMed, PsycINFO and The Cochrane Library. Only randomized controlled trials (RCTs), controlled clinical trials (CCTs) and non-randomized controlled trials (NRCTs) were included. A meta-analysis was judged inappropriate because of substantial discrepancies in term of interventions' characteristics across studies. From the 2182 identified records, 7 studies (4RCTs, 2 CCTs, 1NRCT) met inclusion criteria. Onsite brief advice (BA) was found efficacious in comparison to no active control condition, but no evidence of efficacy was found when compared to active control conditions. Referral to post-discharge BIs was not found efficacious either used alone or in addition to onsite BA. There is evidence, albeit limited, suggesting that more intensive interventions, such as referral to extended post-discharge interventions and onsite extended BI, might be useful. Based on the available evidence, onsite BA with leaflets appears to be the minimum level of intervention since it enables to actively intervene while fitting in the time concerns experienced in EDs. Further research is needed to confirm these findings given the limited quantity and quality of existing data and to determine whether more intensive interventions could actually be useful. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. 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.

  13. The Burrard utilization study report: Review and analysis of the future role of Burrard Thermal Generating Station

    International Nuclear Information System (INIS)

    1993-01-01

    The Burrard Thermal Generating Station is located at Port Moody, British Columbia, and burns natural gas to supply steam to six turbine units for generating up to 912 MW of electricity. The Burrard plant accounts for ca 8.7% of the provincial generating capability. Burrard is expected to continue to fill a vital role as a supplier of displaceable firm energy to the British Columbia Hydro system. In parallel with a renewed focus on Burrard from a system planning perspective, there have also been concerns about air pollution from the plant in the context of its possible effect on the region's air quality. To address this and other issues surrounding Burrard's future, B.C. Hydro established a project team to conduct a utilization study. The team's work focused on the role of Burrard in providing a reliable and profitable role in electricity generation, the options for dealing with the air quality issue, and the implications of choosing one option over another. The team examined a wide range of issues including the remaining useful productive life of the plant, air quality, emissions reduction technologies, long-term gas prices and availability, and seismic stability of the plant. Key findings and recommendations of the study team are reviewed. A financial analysis showed that operating the plant in the displaceable firm energy mode is clearly superior to shutting the plant down and $100 million superior to operation in the full baseload mode. Selective catalytic reduction technology applied to at least the first four of the plant units is the favored option for ensuring better air quality. The value of Burrard would be increased further if its availability factor could be increased to 85%. 7 figs., 3 tabs

  14. 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.

  15. 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

  16. 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

  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. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    OpenAIRE

    Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

    2017-01-01

    Background 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. Methods Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: “Healthcar...

  6. 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

  7. 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

  8. 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

  9. Quiggin's Rank Dependent Model. Review of Generalized Expected Utility Theory: The Rank-Dependent Model, by John Quiggin

    OpenAIRE

    Wakker, Peter

    1994-01-01

    textabstractJohn Quiggin is a professor at the centre for Economic Policy Research of the Australian National University. His research interests are decision making under risk and agricultural economics. The reviewer is an associate professor at the Medical Decision Making Unit, University of Leiden, Leiden, The Netherlands. His main interest is decision making under uncertainty.

  10. Statistical Techniques Utilized in Analyzing PISA and TIMSS Data in Science Education from 1996 to 2013: A Methodological Review

    Science.gov (United States)

    Liou, Pey-Yan; Hung, Yi-Chen

    2015-01-01

    We conducted a methodological review of articles using the Programme for International Student Assessment (PISA) or Trends in International Mathematics and Science Study (TIMSS) data published by the SSCI-indexed science education journals, such as the "International Journal of Science and Mathematics Education," the "International…

  11. Virtual reality in the assessment and treatment of psychosis: a systematic review of its utility, acceptability and effectiveness.

    Science.gov (United States)

    Rus-Calafell, M; Garety, P; Sason, E; Craig, T J K; Valmaggia, L R

    2018-02-01

    Over the last two decades, there has been a rapid increase of studies testing the efficacy and acceptability of virtual reality in the assessment and treatment of mental health problems. This systematic review was carried out to investigate the use of virtual reality in the assessment and the treatment of psychosis. Web of Science, PsychInfo, EMBASE, Scopus, ProQuest and PubMed databases were searched, resulting in the identification of 638 articles potentially eligible for inclusion; of these, 50 studies were included in the review. The main fields of research in virtual reality and psychosis are: safety and acceptability of the technology; neurocognitive evaluation; functional capacity and performance evaluation; assessment of paranoid ideation and auditory hallucinations; and interventions. The studies reviewed indicate that virtual reality offers a valuable method of assessing the presence of symptoms in ecologically valid environments, with the potential to facilitate learning new emotional and behavioural responses. Virtual reality is a promising method to be used in the assessment of neurocognitive deficits and the study of relevant clinical symptoms. Furthermore, preliminary findings suggest that it can be applied to the delivery of cognitive rehabilitation, social skills training interventions and virtual reality-assisted therapies for psychosis. The potential benefits for enhancing treatment are highlighted. Recommendations for future research include demonstrating generalisability to real-life settings, examining potential negative effects, larger sample sizes and long-term follow-up studies. The present review has been registered in the PROSPERO register: CDR 4201507776.

  12. Improving digestive utilization of fiber-rich feedstuffs in pigs and poultry by processing and enzyme technologies: A review

    NARCIS (Netherlands)

    Vries, de S.; Pustjens, A.M.; Schols, H.A.; Hendriks, W.H.; Gerrits, W.J.J.

    2012-01-01

    The effects of processing technologies, whether or not combined with cell wall degrading enzymes, on the physicochemical properties of non-starch polysaccharides (NSP) and the resulting effects on NSP degradation in both pigs and poultry were reviewed. Evaluation of the effects of processing

  13. Quiggin's Rank Dependent Model. Review of Generalized Expected Utility Theory: The Rank-Dependent Model, by John Quiggin

    NARCIS (Netherlands)

    P.P. Wakker (Peter)

    1994-01-01

    textabstractJohn Quiggin is a professor at the centre for Economic Policy Research of the Australian National University. His research interests are decision making under risk and agricultural economics. The reviewer is an associate professor at the Medical Decision Making Unit, University of

  14. 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.

  15. Drug utilization review of potassium chloride injection formulations available in a private hospital in kuching, sarawak, malaysia.

    Science.gov (United States)

    Melissa, Mohammad Hirman; Azmi, Sarriff

    2013-07-01

    The concentrated potassium chloride injection is a high-alert medication and replacing it with a pre-mixed formulation can reduce the risks associated with its use. The aim of this study was to determine the clinical characteristics of patients receiving different potassium chloride formulations available at a private institution. The study also assessed the effectiveness and safety of pre-mixed formulations in the correction of hypokalaemia. This was a retrospective observational study consisting of 296 cases using concentrated and pre-mixed potassium chloride injections in 2011 in a private hospital in Kuching, Sarawak, Malaysia. There were 135 (45.6%) cases that received concentrated potassium chloride, and 161 (54.4%) cases that received pre-mixed formulations. The patients' clinical characteristics that were significantly related to the utilization of the different formulations were diagnosis (P < 0.001), potassium serum blood concentration (P < 0.05), and fluid overload risk (P < 0.05). The difference observed for the cases that achieved or maintained normokalaemia was statistically insignificant (P = 0.172). Infusion-related adverse effects were seen more in pre-mixes compared to concentrated formulations (6.8% versus 2.2%, P < 0.05). This study provides insight into the utilization of potassium chloride injections at this specific institution. The results support current recommendations to use pre-mixed formulations whenever possible.

  16. Improving appropriateness of blood utilization through prospective review of requests for blood products: the role of pathology residents as consultants.

    Science.gov (United States)

    Haldiman, Lindsey; Zia, Hamid; Singh, Gurmukh

    2014-01-01

    To evaluate the effectiveness of prospective review of orders for fresh-frozen plasma (FFP) and platelets in reducing blood-product use, and of the effectiveness of preparing pathology residents to serve as clinical consultants. At our 572-bed tertiary-care hospital, we developed guidelines for the use of blood products in collaboration with a variety of departments. For patients whose condition(s) met generally accepted criteria, we identified trigger points to allow for quick release by blood bank staff of blood products. For patients whose condition(s) did not meet the applicable criteria, the on-call pathology resident reviewed the medical record of that patient to determine whether there were any extenuating circumstances; consulted with the ordering physician and attending pathologist, as needed; and advised the house staff on appropriate use of blood products. We evaluated the change in use of blood products between the years 2009 and 2012 to assess the effectiveness of the program. We observed a decrease of 38.8% and 31.4% in the use of FFP and platelets, respectively (29.7% and 21.1%, respectively, when normalized for the number of discharges). If projected to the national level, this improvement would translate to an annual cost reduction of approximately $130 million. Prospective review of orders for blood products can significantly improve use of these products, thereby reducing risk to patients and avoiding unnecessary healthcare costs. The involvement of pathology residents in the prospective review process provides an excellent opportunity for their training as laboratory consultants. Copyright© by the American Society for Clinical Pathology (ASCP).

  17. Clinical utility of anti-p53 auto-antibody: systematic review and focus on colorectal cancer.

    Science.gov (United States)

    Suppiah, Aravind; Greenman, John

    2013-08-07

    Mutation of the p53 gene is a key event in the carcinogenesis of many different types of tumours. These can occur throughout the length of the p53 gene. Anti-p53 auto-antibodies are commonly produced in response to these p53 mutations. This review firstly describes the various mechanisms of p53 dysfunction and their association with subsequent carcinogenesis. Following this, the mechanisms of induction of anti-p53 auto-antibody production are shown, with various hypotheses for the discrepancies between the presence of p53 mutation and the presence/absence of anti-p53 auto-antibodies. A systematic review was performed with a descriptive summary of key findings of each anti-p53 auto-antibody study in all cancers published in the last 30 years. Using this, the cumulative frequency of anti-p53 auto-antibody in each cancer type is calculated and then compared with the incidence of p53 mutation in each cancer to provide the largest sample calculation and correlation between mutation and anti-p53 auto-antibody published to date. Finally, the review focuses on the data of anti-p53 auto-antibody in colorectal cancer studies, and discusses future strategies including the potentially promising role using anti-p53 auto-antibody presence in screening and surveillance.

  18. 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.

  19. 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.

  20. Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review.

    Science.gov (United States)

    Koffel, Erin; Bramoweth, Adam D; Ulmer, Christi S

    2018-04-04

    The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review. Implementation research testing specific interventions to increase routine and sustained use of CBT-I was lacking. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. These findings are organized using a conceptual model to represent the many challenges inherent in providing guideline-concordant insomnia care. We conclude with an agenda for future implementation research to systematically address these challenges.

  1. Systematic Review of Smoking Initiation among Asian Adolescents, 20052015: Utilizing the Frameworks of Triadic Influence and Planned Behavior.

    Science.gov (United States)

    Talip, Tajidah; Murang, Zaidah; Kifli, Nurolaini; Naing, Lin

    2016-01-01

    A recent WHO data report on mortality attributable to tobacco use including cigarette smoking indicated a very high burden of deaths in Asia and that people often initiate smoking as early as young adolescents. The objectives of this study were to systematically review peerreviewed articles on cigarette smoking initiation among Asian adolescents and to develop a conceptual model of factors influencing smoking initiation by integrating all relevant factors based on existing data. Following a PRISMA guideline, a systematic review of articles published between 2005 and June 2015 was conducted using 5 databases on cigarette smoking initiation among adolescents (aged 1019 years) living in Asia. We summarized the main findings of each study according to our research questions and data that emerged during the data extraction process. Analysis and categorization were based on the TTI and TPB models and classification of factors extracted from the study, were as follows: personal factors, social factors, broader environmental factors, mediators, and intention to initiate smoking and smoking behavior. Of 1,227 identified studies, only 20 were included in this review. Our findings found that the mean age of cigarette smoking initiation ranged from 10 to 14 years and those who are more likely to initiate smoking are male, older adolescents, adolescents with low parental SES, individuals with low parental monitoring, low parental education level and having no discussion on smoking at home, those living in public housing and those exhibiting healthrisk behavior. Our study also revealed that the risk of smoking initiation increased when they are exposed to smokers, influenced by peers, exposed to tobacco advertisements, receive pocket money, have lack of knowledge about smoking, have poor school performance, have a family conflict and have psychological problems. The conceptual model developed demonstrated complex networks of factors influencing initiation. This systematic review

  2. Reviewing three dimensional dosimetry: basics and utilization as presented over 17 Years of DosGel and IC3Ddose

    Science.gov (United States)

    Schreiner, L. J.

    2017-05-01

    For seventeen years a community of basic and clinical scientists and researchers has been meeting bi-annually to promote the clinical advance of techniques to measure radiation dose in three dimensions. The interest in this dosimetry was motivated by its promise as an effective methodology for 3D measurement of the complex conformal dose distributions achieved by modern techniques such as Intensity Modulated and Volumetric Arc Radiation Therapy. Each of the International Conferences on 3D Radiation Dosimetry resulted in the publication of informative proceedings [1-8], the majority openly available on the internet. The proceedings included papers that: i) reviewed the basic science of the radiation sensitive materials used to accumulate the dose information, ii) introduced the science and engineering of the imaging systems required to read the information out, iii) described the work flows and systems required for efficient dosimetry, iv) reported the protocols required for reproducible dosimetry, and v) showed examples of clinical use illustrating advantage and limitations of the dosimetry. This paper is intended to use the framework provided by these proceedings to review the current 3D chemical dosimeters available and to discuss the requirements for their use. The paper describes how 3D dosimetry can complement other dose delivery validation approaches available in the clinic. It closes with some personal reflections of how the motivation for, and practice of, 3D dosimetry have changed (or not) over the years.

  3. The Utility of Expert Diagnosis in Surgical Neuropathology: Analysis of Consultations Reviewed at 5 National Comprehensive Cancer Network Institutions.

    Science.gov (United States)

    Bruner, Janet M; Louis, David N; McLendon, Roger; Rosenblum, Marc K; Archambault, W Tad; Most, Susan; Tihan, Tarik

    2017-03-01

    The aim of this study was to characterize the type and degree of discrepancies between non-expert and expert diagnoses of CNS tumors to identify the value of consultations in surgical neuropathology. Neuropathology experts from 5 National Comprehensive Cancer Network (NCCN) member institutions participated in the review of 1281 consultations selected based on inclusion criteria. The consultation cases were re-reviewed at the NCCN headquarters to determine concordance with the original diagnoses. Among all consultations, 249 (19.4%) were submitted for expert diagnoses without final diagnoses from the submitting institution. Within the remaining 1032 patients, the serious/major discrepancy rate was 4.8%, and less serious and minor discrepancies were seen in 19.4% of the cases. The discrepancy rate was higher among patients who were referred to NCCN institutions for consultation compared to those who were referred for treatment only. The discrepancy rates, patient demographics, type of consultations and submitting institutions varied among participating NCCN institutions. Expert consultations identified a subset of cases with significant diagnostic discrepancies, and constituted the initial diagnoses in some cases. These data indicate that expert consultations in glial tumors and all types of pediatric CNS tumors can improve accurate diagnosis and enable appropriate management. © 2017 American Association of Neuropathologists, Inc. All rights reserved.

  4. Reviewing three dimensional dosimetry: basics and utilization as presented over 17 Years of DosGel and IC3Ddose

    International Nuclear Information System (INIS)

    Schreiner, L J

    2017-01-01

    For seventeen years a community of basic and clinical scientists and researchers has been meeting bi-annually to promote the clinical advance of techniques to measure radiation dose in three dimensions. The interest in this dosimetry was motivated by its promise as an effective methodology for 3D measurement of the complex conformal dose distributions achieved by modern techniques such as Intensity Modulated and Volumetric Arc Radiation Therapy. Each of the International Conferences on 3D Radiation Dosimetry resulted in the publication of informative proceedings [1-8], the majority openly available on the internet. The proceedings included papers that: i) reviewed the basic science of the radiation sensitive materials used to accumulate the dose information, ii) introduced the science and engineering of the imaging systems required to read the information out, iii) described the work flows and systems required for efficient dosimetry, iv) reported the protocols required for reproducible dosimetry, and v) showed examples of clinical use illustrating advantage and limitations of the dosimetry. This paper is intended to use the framework provided by these proceedings to review the current 3D chemical dosimeters available and to discuss the requirements for their use. The paper describes how 3D dosimetry can complement other dose delivery validation approaches available in the clinic. It closes with some personal reflections of how the motivation for, and practice of, 3D dosimetry have changed (or not) over the years. (paper)

  5. 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.

  6. 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...

  7. “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 ...

  8. 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

  9. Detection of Frauds and Other Non-technical Losses in Power Utilities using Smart Meters: A Review

    Science.gov (United States)

    Ahmad, Tanveer; Ul Hasan, Qadeer

    2016-06-01

    Analysis of losses in power distribution system and techniques to mitigate these are two active areas of research especially in energy scarce countries like Pakistan to increase the availability of power without installing new generation. Since total energy losses account for both technical losses (TL) as well as non-technical losses (NTLs). Utility companies in developing countries are incurring of major financial losses due to non-technical losses. NTLs lead to a series of additional losses, such as damage to the network (infrastructure and the reduction of network reliability) etc. The purpose of this paper is to perform an introductory investigation of non-technical losses in power distribution systems. Additionally, analysis of NTLs using consumer energy consumption data with the help of Linear Regression Analysis has been carried out. This data focuses on the Low Voltage (LV) distribution network, which includes: residential, commercial, agricultural and industrial consumers by using the monthly kWh interval data acquired over a period (one month) of time using smart meters. In this research different prevention techniques are also discussed to prevent illegal use of electricity in the distribution of electrical power system.

  10. 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 ...

  11. Utilization of Stone Waste in the Development of Value Added Products: A State of the Art Review

    Directory of Open Access Journals (Sweden)

    Rajni Lakhani

    2014-07-01

    Full Text Available The utilisation of stone waste, in the form of mineral admixture as a pozzolanic and non-pozzolanic material for mortar and concrete has received considerable attention in recent years. This interest is part of the widely spread attention directed towards the utilisation of wastes and industrial by-products in order to minimise Portland cement (PC and sand consumption, the utilisationof which being environmentally damaging. Another reason is that mortar and concrete, which contain pozzolanic as well as non-pozzolanic materials, exhibit considerable enhancement in durability properties. This paper reviews work carried out on the use of stone waste as a partial non-pozzolanic replacement for sand in mortar and concrete and in the containment of hazardous wastes. The literature demonstrates that different stone wastes is an effective inert filler which causes great improvement in the pore structure and hence the resistance of the concrete to the action of harmful solutions.

  12. Critical Role of the Sphingolipid Pathway in Stroke: a Review of Current Utility and Potential Therapeutic Targets.

    Science.gov (United States)

    Sun, Na; Keep, Richard F; Hua, Ya; Xi, Guohua

    2016-10-01

    Sphingolipids are a series of cell membrane-derived lipids which act as signaling molecules and play a critical role in cell death and survival, proliferation, recognition, and migration. Sphingosine-1-phosphate acts as a key signaling molecule and regulates lymphocyte trafficking, glial cell activation, vasoconstriction, endothelial barrier function, and neuronal death pathways which plays a critical role in numerous neurological conditions. Stroke is a second leading cause of death all over the world and effective therapies are still in great demand, including ischemic stroke and hemorrhagic stroke as well as poststroke repair. Significantly, sphingolipid activities change after stroke and correlate with stroke outcome, which has promoted efforts to testify whether the sphingolipid pathway could be a novel therapeutic target in stroke. The sphingolipid metabolic pathway, the connection between the pathway and stroke, as well as therapeutic interventions to manipulate the pathway to reduce stroke-induced brain injury are discussed in this review.

  13. Comparison of utility of blood cultures from intravascular catheters and peripheral veins: a systematic review and decision analysis.

    Science.gov (United States)

    Falagas, Matthew E; Kazantzi, Maria S; Bliziotis, Ioannis A

    2008-01-01

    Blood cultures are sometimes obtained from intravascular catheters for convenience. However, there is controversy regarding this practice. The authors compared the diagnostic test characteristics of blood cultures obtained from intravascular catheters and peripheral veins. Relevant studies for inclusion in this review were identified through PubMed (January 1970-October 2005) and the Cochrane Central Register of Controlled Trials. Studies that reported clear definitions of true bacteraemia were included in the analysis. Two reviewers independently extracted the data. Six studies were included in the analysis, providing data for 2677 pairs of blood cultures obtained from an intravascular catheter and a peripheral venipuncture. A culture obtained from an intravascular catheter was found to be a diagnostic test for bacteraemia with better sensitivity (OR 1.85, 95 % CI 1.14-2.99, fixed effects model) and better negative predictive value (almost with statistical significance) (OR 1.55, 95 % CI 0.999-2.39, fixed effects model) but with less specificity (OR 0.33, 95 % CI 0.18-0.59, random effects model) and lower positive predictive value (OR 0.41, 95 % CI 0.23-0.76, random effects model) compared to a culture taken by peripheral venipuncture. In a group of 1000 patients, eight additional patients with true bacteraemia would be identified and 59 falsely diagnosed as having bacteraemia by a blood culture obtained from an intravascular catheter compared to results of the peripheral blood culture. Given the consequences of undertreating patients with bacteraemia, the authors believe that, based on the available evidence, at least one blood culture should be obtained from the intravascular catheter.

  14. Utility of 2-Pyridine Aldoxime Methyl Chloride (2-PAM) for Acute Organophosphate Poisoning: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Blumenberg, Adam; Benabbas, Roshanak; deSouza, Ian S; Conigliaro, Alyssa; Paladino, Lorenzo; Warman, Elliot; Sinert, Richard; Wiener, Sage W

    2018-03-01

    Organophosphates (OP) account for the majority of pesticide-related unintentional or intentional poisonings in lower- and middle-income countries. The therapeutic role of atropine is well-established for patients with acute OP poisoning. The benefit of adding 2-pyridine aldoxime methyl chloride (2-PAM), however, is controversial. We performed a systematic review and meta-analysis of available randomized controlled trials (RCT) to compare 2-PAM plus atropine in comparison to atropine alone for acute OP poisoning. We searched PubMed, EMBASE, and SCOPUS up to March 2017. The Cochrane review handbook was used to assess the risk of bias. Data were abstracted and risk ratios (RR) were calculated for mortality, rate of intubation, duration of intubation, intermediate syndrome, and complications such as hospital-acquired infections, dysrhythmias, and pulmonary edema. We found five studies comprising 586 patients with varying risks of bias. The risk of death (RR = 1.5, 95% CI 0.9-2.5); intubation (RR = 1.3, 95% CI 1.0-1.6); intermediate syndrome (RR = 1.6, 95% CI 1.0-2.6); complications (RR = 1.2, 95% CI 0.8-1.8); and the duration of intubation (mean difference 0.0, 95% CI - 1.6-1.6) were not significantly different between the atropine plus 2-PAM and atropine alone. Based on our meta-analysis of the available RCTs, 2-PAM was not shown to improve outcomes in patients with acute OP poisoning.

  15. 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.

  16. Calcium Carbonate Precipitation for CO{sub 2} Storage and Utilization: A Review of the Carbonate Crystallization and Polymorphism

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Ribooga; Kim, Semin; Lee, Seungin; Choi, Soyoung; Kim, Minhee; Park, Youngjune, E-mail: young@gist.ac.kr [Carbon and Energy Systems, School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju (Korea, Republic of)

    2017-07-10

    The transformation of CO{sub 2} into a precipitated mineral carbonate through an ex situ mineral carbonation route is considered a promising option for carbon capture and storage (CCS) since (i) the captured CO{sub 2} can be stored permanently and (ii) industrial wastes (i.e., coal fly ash, steel and stainless-steel slags, and cement and lime kiln dusts) can be recycled and converted into value-added carbonate materials by controlling polymorphs and properties of the mineral carbonates. The final products produced by the ex situ mineral carbonation route can be divided into two categories—low-end high-volume and high-end low-volume mineral carbonates—in terms of their market needs as well as their properties (i.e., purity). Therefore, it is expected that this can partially offset the total cost of the CCS processes. Polymorphs and physicochemical properties of CaCO{sub 3} strongly rely on the synthesis variables such as temperature, pH of the solution, reaction time, ion concentration and ratio, stirring, and the concentration of additives. Various efforts to control and fabricate polymorphs of CaCO{sub 3} have been made to date. In this review, we present a summary of current knowledge and recent investigations entailing mechanistic studies on the formation of the precipitated CaCO{sub 3} and the influences of the synthesis factors on the polymorphs.

  17. The Biological Function and Clinical Utilization of CD147 in Human Diseases: A Review of the Current Scientific Literature

    Science.gov (United States)

    Xiong, Lijuan; Edwards, Carl K.; Zhou, Lijun

    2014-01-01

    CD147 or EMMPRIN is a member of the immunoglobulin superfamily in humans. It is widely expressed in human tumors and plays a central role in the progression of many cancers by stimulating the secretion of matrix metalloproteinases (MMPs) and cytokines. CD147 regulates cell proliferation, apoptosis, and tumor cell migration, metastasis and differentiation, especially under hypoxic conditions. CD147 is also important to many organ systems. This review will provide a detailed overview of the discovery, characterization, molecular structure, diverse biological functions and regulatory mechanisms of CD147 in human physiological and pathological processes. In particular, recent studies have demonstrated the potential application of CD147 not only as a phenotypic marker of activated regulatory T cells but also as a potential diagnostic marker for early-stage disease. Moreover, CD147 is recognized as an effective therapeutic target for hepatocellular carcinoma (HCC) and other cancers, and exciting clinical progress has been made in HCC treatment using CD147-directed monoclonal antibodies. PMID:25268615

  18. Calcium Carbonate Precipitation for CO2 Storage and Utilization: A Review of the Carbonate Crystallization and Polymorphism

    Directory of Open Access Journals (Sweden)

    Ribooga Chang

    2017-07-01

    Full Text Available The transformation of CO2 into a precipitated mineral carbonate through an ex situ mineral carbonation route is considered a promising option for carbon capture and storage (CCS since (i the captured CO2 can be stored permanently and (ii industrial wastes (i.e., coal fly ash, steel and stainless-steel slags, and cement and lime kiln dusts can be recycled and converted into value-added carbonate materials by controlling polymorphs and properties of the mineral carbonates. The final products produced by the ex situ mineral carbonation route can be divided into two categories—low-end high-volume and high-end low-volume mineral carbonates—in terms of their market needs as well as their properties (i.e., purity. Therefore, it is expected that this can partially offset the total cost of the CCS processes. Polymorphs and physicochemical properties of CaCO3 strongly rely on the synthesis variables such as temperature, pH of the solution, reaction time, ion concentration and ratio, stirring, and the concentration of additives. Various efforts to control and fabricate polymorphs of CaCO3 have been made to date. In this review, we present a summary of current knowledge and recent investigations entailing mechanistic studies on the formation of the precipitated CaCO3 and the influences of the synthesis factors on the polymorphs.

  19. Antibiotic Prophylaxis for Gynecologic Procedures prior to and during the Utilization of Assisted Reproductive Technologies: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Nigel Pereira

    2016-01-01

    Full Text Available The use of assisted reproductive technologies (ART has increased steadily. There has been a corresponding increase in the number of ART-related procedures such as hysterosalpingography (HSG, saline infusion sonography (SIS, hysteroscopy, laparoscopy, oocyte retrieval, and embryo transfer (ET. While performing these procedures, the abdomen, upper vagina, and endocervix are breached, leading to the possibility of seeding pelvic structures with microorganisms. Antibiotic prophylaxis is therefore important to prevent or treat any procedure-related infections. After careful review of the published literature, it is evident that routine antibiotic prophylaxis is generally not recommended for the majority of ART-related procedures. For transcervical procedures such as HSG, SIS, hysteroscopy, ET, and chromotubation, patients at risk for pelvic infections should be screened and treated prior to the procedure. Patients with a history of pelvic inflammatory disease (PID or dilated fallopian tubes are at high risk for postprocedural infections and should be given antibiotic prophylaxis during procedures such as HSG, SIS, or chromotubation. Antibiotic prophylaxis is recommended prior to oocyte retrieval in patients with a history of endometriosis, PID, ruptured appendicitis, or multiple prior pelvic surgeries.

  20. The Biological Function and Clinical Utilization of CD147 in Human Diseases: A Review of the Current Scientific Literature

    Directory of Open Access Journals (Sweden)

    Lijuan Xiong

    2014-09-01

    Full Text Available CD147 or EMMPRIN is a member of the immunoglobulin superfamily in humans. It is widely expressed in human tumors and plays a central role in the progression of many cancers by stimulating the secretion of matrix metalloproteinases (MMPs and cytokines. CD147 regulates cell proliferation, apoptosis, and tumor cell migration, metastasis and differentiation, especially under hypoxic conditions. CD147 is also important to many organ systems. This review will provide a detailed overview of the discovery, characterization, molecular structure, diverse biological functions and regulatory mechanisms of CD147 in human physiological and pathological processes. In particular, recent studies have demonstrated the potential application of CD147 not only as a phenotypic marker of activated regulatory T cells but also as a potential diagnostic marker for early-stage disease. Moreover, CD147 is recognized as an effective therapeutic target for hepatocellular carcinoma (HCC and other cancers, and exciting clinical progress has been made in HCC treatment using CD147-directed monoclonal antibodies.

  1. A framework and review of customer outage costs: Integration and analysis of electric utility outage cost surveys

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, Leora; Sullivan, Michael; Van Liere, Kent; Katz, Aaron; Eto, Joseph

    2003-11-01

    A clear understanding of the monetary value that customers place on reliability and the factors that give rise to higher and lower values is an essential tool in determining investment in the grid. The recent National Transmission Grid Study recognizes the need for this information as one of growing importance for both public and private decision makers. In response, the U.S. Department of Energy has undertaken this study, as a first step toward addressing the current absence of consistent data needed to support better estimates of the economic value of electricity reliability. Twenty-four studies, conducted by eight electric utilities between 1989 and 2002 representing residential and commercial/industrial (small, medium and large) customer groups, were chosen for analysis. The studies cover virtually all of the Southeast, most of the western United States, including California, rural Washington and Oregon, and the Midwest south and east of Chicago. All variables were standardized to a consistent metric and dollar amounts were adjusted to the 2002 CPI. The data were then incorporated into a meta-database in which each outage scenario (e.g., the lost of electric service for one hour on a weekday summer afternoon) is treated as an independent case or record both to permit comparisons between outage characteristics and to increase the statistical power of analysis results. Unadjusted average outage costs and Tobit models that estimate customer damage functions are presented. The customer damage functions express customer outage costs for a given outage scenario and customer class as a function of location, time of day, consumption, and business type. One can use the damage functions to calculate outage costs for specific customer types. For example, using the customer damage functions, the cost experienced by an ''average'' customer resulting from a 1 hour summer afternoon outage is estimated to be approximately $3 for a residential customer, $1

  2. 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

  3. 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

  4. 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

  5. Breast Imaging Utilizing Dedicated Gamma Camera and (99m)Tc-MIBI: Experience at the Tel Aviv Medical Center and Review of the Literature Breast Imaging.

    Science.gov (United States)

    Even-Sapir, Einat; Golan, Orit; Menes, Tehillah; Weinstein, Yuliana; Lerman, Hedva

    2016-07-01

    The scope of the current article is the clinical role of gamma cameras dedicated for breast imaging and (99m)Tc-MIBI tumor-seeking tracer, as both a screening modality among a healthy population and as a diagnostic modality in patients with breast cancer. Such cameras are now commercially available. The technology utilizing a camera composed of a NaI (Tl) detector is termed breast-specific gamma imaging. The technology of dual-headed camera composed of semiconductor cadmium zinc telluride detectors that directly converts gamma-ray energy into electronic signals is termed molecular breast imaging. Molecular breast imaging system has been installed at the Department of Nuclear medicine at the Tel Aviv Sourasky Medical Center, Tel Aviv in 2009. The article reviews the literature well as our own experience. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Utility of repeated praziquantel dosing in the treatment of schistosomiasis in high-risk communities in Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Charles H King

    2011-09-01

    Full Text Available Controversy persists about the optimal approach to drug-based control of schistosomiasis in high-risk communities. In a systematic review of published studies, we examined evidence for incremental benefits from repeated praziquantel dosing, given 2 to 8 weeks after an initial dose, in Schistosoma-endemic areas of Africa.We performed systematic searches of electronic databases PubMed and EMBASE for relevant data using search terms 'schistosomiasis', 'dosing' and 'praziquantel' and hand searches of personal collections and bibliographies of recovered articles. In 10 reports meeting study criteria, improvements in parasitological treatment outcomes after two doses of praziquantel were greater for S. mansoni infection than for S. haematobium infection. Observed cure rates (positive to negative conversion in egg detection assays were, for S. mansoni, 69-91% cure after two doses vs. 42-79% after one dose and, for S. haematobium, 46-99% cure after two doses vs. 37-93% after a single dose. Treatment benefits in terms of reduction in intensity (mean egg count were also different for the two species-for S. mansoni, the 2-dose regimen yielded an weighted average 89% reduction in standardized egg counts compared to a 83% reduction after one dose; for S. haematobium, two doses gave a 93% reduction compared to a 94% reduction with a single dose. Cost-effectiveness analysis was performed based on Markov life path modeling.Although schedules for repeated treatment with praziquantel require greater inputs in terms of direct costs and community participation, there are incremental benefits to this approach at an estimated cost of $153 (S. mansoni-$211 (S. haematobium per additional lifetime QALY gained by double treatment in school-based programs. More rapid reduction of infection-related disease may improve program adherence, and if, as an externality of the program, transmission can be reduced through more effective coverage, significant additional benefits are

  7. Utilizing bi-spectral index (BIS) for the monitoring of sedated adult ICU patients: a systematic review.

    Science.gov (United States)

    Bilgili, Beliz; Montoya, Juan C; Layon, A J; Berger, Andrea L; Kirchner, H L; Gupta, Leena K; Gloss, David S

    2017-03-01

    The ideal level of sedation in the ICU is an ongoing source of scrutiny. At higher levels of sedation, the current scoring systems are not ideal. BIS may be able to improve both. We evaluated literature on effectiveness of BIS monitoring in sedated mechanically ventilated (MV) ICU patients compared to clinical sedation scores (CSS). For this systematic review, full text articles were searched in OVID, MEDLINE, EMBASE, and Cochrane databases from 1986 - 2014. Additional studies were identified searching bibliographies/abstracts from national/international Critical Care Medicine conferences and references from searched articles retrieved. Search terms were: 'Clinical sedation scale, Bi-spectral Index, Mechanical ventilation, Intensive care Unit'. Included were prospective, randomized and non-randomized studies comparing BIS monitoring with any CSS in MV adult (>18 yr old) ICU patients. Studies were graded for quality of evidence based on bias as established by the GRADE guidelines. Additional sources of bias were examined. There were five studies which met inclusion criteria. All five studies were either unclear or high risk for blinding of participants and blinding of outcome assessment. All papers had at least one source of additional high risk, or unclear/unstated. BIS monitoring in the mechanically ventilated ICU patient may decrease sedative drug dose, recall, and time to wake-up. The studies suggesting this are severely limited methodologically. BIS, when compared to subjective CSSs, is not, at this time, clearly indicated. An appropriately powered randomized, controlled study is needed to determine if this monitoring modality is of use on the ICU.

  8. 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...

  9. Invited review: Current representation and future trends of predicting amino acid utilization in the lactating dairy cow.

    Science.gov (United States)

    Arriola Apelo, S I; Knapp, J R; Hanigan, M D

    2014-07-01

    In current dairy production systems, an average of 25% of dietary N is captured in milk, with the remainder being excreted in urine and feces. About 60% of total N losses occur postabsorption. Splanchnic tissues extract a fixed proportion of total inflow of each essential AA (EAA). Those EAA removed by splanchnic tissues and not incorporated into protein are subjected to catabolism, with the resulting N converted to urea. Splanchnic affinity varies among individual EAA, from several fold lower than mammary glands' affinity for the branched-chain AA to similar or higher affinity for Phe, Met, His, and Arg. On average, 85% of absorbed EAA appear in peripheral circulation, indicating that first-pass removal is not the main source of loss. Essential AA in excess of the needs of the mammary glands return to general circulation. High splanchnic blood flow dictates that a large proportion of EAA that return to general circulation flow through splanchnic tissues. In association with this constant recycling, EAA are removed and catabolized by splanchnic tissues. This results in splanchnic catabolism equaling or surpassing the use of many EAA for milk protein synthesis. Recent studies have demonstrated that EAA, energy substrates, and hormones activate signaling pathways that in turn regulate local blood flow, tissue extraction of EAA, and rates of milk protein synthesis. These recent findings would allow manipulation of dairy diets to maximize mammary uptake of EAA and reduce catabolism by splanchnic tissues. Dairy cattle nutrient requirement systems consider EAA requirements in aggregate as metabolizable protein (MP) and assume a fixed efficiency of MP use for milk protein. Lysine and Met sufficiency is only considered after MP requirements have been met. By doing so, requirement systems limit the scope of diet manipulation to achieve improved gross N efficiency. Therefore, this review focuses on understanding the dynamics of EAA metabolism in mammary and splanchnic

  10. 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

  11. 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

  12. 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

  13. Revisitando a literatura sobre custo-efetividade e utilidade em saúde Reviewing the literature of cost-effectiveness and cost-utility analysis in health

    Directory of Open Access Journals (Sweden)

    Leyla Gomes Sancho

    2008-12-01

    Full Text Available Este trabalho tem por finalidade contribuir com a disseminação do conteúdo teórico desta área do conhecimento, assim como oferecer subsídios para reflexões no que tange à consecução de estudos, os quais resultem em reais benefícios para a população e a gestão do sistema de saúde. Para tanto se realizou, sob uma perspectiva histórica e com base no ponto de vista de reconhecidos autores, ampla revisão da literatura que abrangeu desde sua fundamentação teórica até a formalização de guias metodológicos. O estudo ressalta, inclusive, as controvérsias metodológicas conseqüentes da diversidade das abordagens teóricas. E, como decorrência, recomenda a realização de pesquisas sobre a fundamentação teórica, particularmente a abordada pelos extrawelfaristas.This study aims to contribute to the dissemination of the theoretical foundations for cost-effectiveness and cost-utility analysis. It also provides backing for reflections on the implementation of studies leading to real benefits for both the population and health system management. Taking a historical perspective, and drawing on the work of renowned authors, the study provides an extensive literature review on cost-effectiveness and cost-utility analysis, from the theoretical formulation to the definition of methodological guidelines. The study also highlights the methodological controversies resulting from the diversity of theoretical approaches. As a result, it recommends conducting research on the theoretical foundations, and particularly the position of the extra-welfarists.

  14. 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.

  15. Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

    Science.gov (United States)

    Strike, Carol; Miskovic, Miroslav

    2018-02-08

    Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts

  16. Clinical utility of therapeutic drug monitoring in biological disease modifying anti-rheumatic drug treatment of rheumatic disorders: a systematic narrative review.

    Science.gov (United States)

    Van Herwaarden, Noortje; Van Den Bemt, Bart J F; Wientjes, Maike H M; Kramers, Cornelis; Den Broeder, Alfons A

    2017-08-01

    Biological Disease Modifying Anti-Rheumatic Drugs (bDMARDs) have improved the treatment outcomes of inflammatory rheumatic diseases including Rheumatoid Arthritis and spondyloarthropathies. Inter-individual variation exists in (maintenance of) response to bDMARDs. Therapeutic Drug Monitoring (TDM) of bDMARDs could potentially help in optimizing treatment for the individual patient. Areas covered: Evidence of clinical utility of TDM in bDMARD treatment is reviewed. Different clinical scenarios will be discussed, including: prediction of response after start of treatment, prediction of response to a next bDMARD in case of treatment failure of the first, prediction of successful dose reduction or discontinuation in case of low disease activity, prediction of response to dose-escalation in case of active disease and prediction of response to bDMARD in case of flare in disease activity. Expert opinion: The limited available evidence does often not report important outcomes for diagnostic studies, such as sensitivity and specificity. In most clinical relevant scenarios, predictive value of serum (anti-) drug levels is absent, therefore the use of TDM of bDMARDs cannot be advocated. Well-designed prospective studies should be done to further investigate the promising scenarios to determine the place of TDM in clinical practice.

  17. 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.

  18. 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

  19. 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...

  20. 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.

  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. Conceptual and empirical themes regarding the design of technology transfer programs : a review of wood utilization research in the United States

    Science.gov (United States)

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

    2011-01-01

    Transfer of technologies produced by research is critical to innovation within all organizations. The intent of this paper is to take stock of the conceptual underpinnings of technology transfer processes as they relate to wood utilization research and to identify conditions that promote the successful transfer of research results. Conceptually, research utilization...

  3. 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.

  4. 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

  5. Utilities objectives

    International Nuclear Information System (INIS)

    Cousin, Y.; Fabian, H.U.

    1996-01-01

    The policy of French and german utilities is to make use of nuclear energy as a long term, competitive and environmentally friendly power supply. The world electricity generation is due to double within the next 30 years. In the next 20 to 30 years the necessity of nuclear energy will be broadly recognized. More than for most industries, to deal properly with nuclear energy requires the combination of a consistent political will, of a proper institutional framework, of strong and legitimate control authorities, of a sophisticated industry and of operators with skilled management and human resources. One of the major risk facing nuclear energy is the loss of competitiveness. This can be achieved only through the combination of an optimized design, a consistent standardization, a proper industrial partnership and a stable long term strategy. Although the existing plants in Western Europe are already very safe, the policy is clearly to enhance the safety of the next generation of nuclear plants which are designing today. The French and German utilities have chosen an evolutionary approach based on experience and proven technologies, with an enhanced defense in depth and an objective of easier operation and maintenance. The cost objective is to maintain and improve what has been achieved in the best existing power plants in both countries. This calls for rational choices and optimized design to meet the safety objectives, a strong standardization policy, short construction times, high availability and enough flexibility to enable optimization of the fuel cycle throughout the lifetime of the plants. The conceptual design phase has proven that the French and German teams from industry and from the utilities are able to pursue both the safety and the cost objectives, basing their decision on a rational approach which could be accepted by the safety authorities. (J.S.)

  6. 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

  7. Reviews

    Science.gov (United States)

    2002-11-01

    CD-ROM REVIEW (551) Essential Physics BOOK REVIEWS (551) Collins Advanced Science: Physics, 2nd edition Quarks, Leptons and the Big Bang, 2nd edition Do Brilliantly: A2 Physics IGCSE Physics Geophysics in the UK Synoptic Skills in Advanced Physics Flash! The hunt for the biggest explosions in the universe Materials Maths for Advanced Physics

  8. 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

  9. 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 ...

  10. 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

  11. Une intervention en centres d’hébergement et de soins de longue durée visant à réduire les problèmes de santé mentale liés au travail

    Directory of Open Access Journals (Sweden)

    Michel Vézina

    2005-05-01

    Full Text Available Une intervention visant la diminution des contraintes de l’environnement psychosocial du travail et de leurs effets sur la santé mentale a été mise en place à l’hiver 2002. Cette intervention se résume en cinq étapes : l’engagement du milieu et la constitution d’une équipe d’intervention, l’identification des contraintes, l’élaboration des plans d’action, l’actualisation des plans d’action et l’évaluation de l’intervention. La recherche se déroule dans douze centres d’hébergement et de soins de longue durée (CHSLD et inclut l’ensemble du personnel soignant en contact direct avec la clientèle (N = 493. Un devis quasi-expérimental avec quatre groupes expérimentaux, huit groupes témoins et des mesures avant et après l’intervention a été utilisé.La description des phases de développement et d’implantation de la démarche d’intervention est présent��e ainsi que l’évaluation à 12 mois des effets de l’intervention sur la prévalence des contraintes psychosociales au travail et des problèmes de santé mentale.An intervention aimed at reducing adverse occupational psychosocial factors and their mental health effects was begun during the winter of 2002. This intervention can be summarized in five steps: commitment of stakeholders and setting up of an intervention team, identification of adverse occupational psychosocial factors, development of an action plan, implementation of the action plans, and evaluation of the intervention. The study was conducted in twelve residential and extended care centres (CHSLD and included all care-giving staff in direct contact with patients (N= 493. A quasi-experimental design was used with four experimental groups and eight control groups, and with pre- and post-intervention measurements.The description of the intervention’s development and implementation phases and the evaluation at 12 months of the effects of the intervention on the prevalence of

  12. 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.

  13. Reviews.

    Science.gov (United States)

    Journal of Chemical Education, 1987

    1987-01-01

    Provides a review of both the Apple and IBM versions of ENZPACK, a software package which is designed to assist in the teaching of enzyme kinetics in courses where this topic is treated in some depth. (TW)

  14. Review

    Indian Academy of Sciences (India)

    2012-03-29

    Mar 29, 2012 ... The present review documents an overview of speciation mediated through behavioural ...... The Drosophila model (New York: Oxford University Press) .... second part of his big species book written from 1856–1858. (New ...

  15. A review of the clinical utility of INR to monitor and guide administration of prothrombin complex concentrate to orally anticoagulated patients

    DEFF Research Database (Denmark)

    Sølbeck, Sacha; Ostrowski, Sisse R; Johansson, Pär I

    2012-01-01

    the initiation steps of the haemostatic process. The objective of the present review was to reassess the evidence for using INR as a tool to guide administration of prothrombin complex concentrates (PCC) to OAC patients. A Medline and Cochrane database search was conducted using the following keywords...... value to aim for when reversing OAC was found. In three of the studies it was reported that patients reaching their target INR continued to bleed, whereas three studies reviewed reported good haemostatic response also in patients that did not reach their target INR. The present review found limited...

  16. 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

  17. Utility training

    International Nuclear Information System (INIS)

    Villaros, P.E.; Luxo, Armando; Bruant, Jacques

    1977-01-01

    The study of operational training systems for electro-nuclear utilities may be conducted through two different approaches. A first analytical approach consists of determining, for each position of a given organization chart, the necessary qualifications required and the corresponding complementary training to be provided. This approach applies preferentially to existing classical systems which are converted to nuclear operation with objectives of minimum structural changes and conservation of maximum efficiency. A second synthetical approach consists of determining the specific characteristics of nuclear plant operation, then, of deducting the training contingencies and the optimized organization chart of the plant, while taking into account, at each step, the parameters linked to local conditions. This last approach is studied in some detail in the present paper, taking advantage of its better suitability to the problems raised at the first stage of an electro-nuclear program development. In this respect, the possibility offered by this apprach to coordinate the training system of a given nuclear power station personnel with the overall problem of developing a skilled industrial labor force in the country, may lead to reconsideration of some usual priorities in the economy of operation of the nuclear power plant

  18. The role of arthroscopy in the dysplastic hip—a systematic review of the intra-articular findings, and the outcomes utilizing hip arthroscopic surgery

    Science.gov (United States)

    Jo, Suenghwan; Lee, Sang Hong; Wang, Sung Il; Smith, Bjorn; O’Donnell, John

    2016-01-01

    Acetabular dysplasia is one of the most common sources of hip arthritis. With the recent innovation in hip arthroscopy, the question has been raised whether arthroscopy can be used to treat dysplastic hip conditions. The purposes of this systematic review are (i) describe the prevalence of intra-articular pathologies and (ii) report the outcomes of dysplastic hip treatment with hip arthroscopy as a sole treatment. Medical databases were searched for articles including arthroscopic findings and treatment of dysplastic hip with predetermined criteria. PubMed, Ovid database and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched up until 7 January 2015. Two reviewers independently assess the eligibility of retrieved studies using titles, abstracts and full-text articles. Thirteen studies were eligible to be included for the systematic review. Overall, labral tear was the most common pathology with a prevalence rate of 77.3%. All of the four studies describing arthroscopic treatment for only borderline dysplasia reported favorable outcome. With regard to more severely dysplastic hips, two out of three studies reported acceptable outcomes while one study reported negative results. This review indicates that intra-articular pathology is commonly observed in symptomatic dysplastic hips with a labral tear being the most common pathology. Arthroscopic treatment of borderline dysplasia could provide benefits whereas treatment of more dysplastic hips is controversial. Nevertheless, there is a lack of evidence for using arthroscopy alone in hips with a center edge angle <20°. Level IV, systematic review of Level IV studies. PMID:27583155

  19. Review

    DEFF Research Database (Denmark)

    Van Den Hazel, H B; Kielland-Brandt, Morten; Winther, Jakob R.

    1996-01-01

    The yeast vacuole, which is equivalent to the lysosome of higher eukaryotes, is one of the best characterized degradative organelles. This review describes the biosynthesis and function of yeast vacuolar proteases. Most of these enzymes are delivered to the vacuole via the early compartments...

  20. Reviews

    NARCIS (Netherlands)

    Adema, Frits

    1995-01-01

    This is the second volume of a revision of Tabernaemontana (Apocynaceae). The volume covers the New World species (44) and the genus Stemmadenia (10 species). This part of the revision of Tabernaemontana comes up to the high standards set in the first volume [see the review by Leenhouts, Blumea 38

  1. Reviews.

    Science.gov (United States)

    Science Teacher, 1989

    1989-01-01

    Reviews a software planetarium package called "Sky Travel." Includes two audiovisuals: "Conquest of Space" and "Windows on Science: Earth Science"; and four books: "Small Energy Sources: Choices that Work,""Stonehenge Complete,""Uneasy Careers and Intimate Lives: Women in Science…

  2. REVIEW

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... narrowing the gap between recommended treatment protocols in ... for pregnant women is complicated by the need to take into account the health and safety of both the ... meta-analysis as at July 2011 (which reviews the APR and other ... 0.82 - 3.18) and relative risk of birth defects in EFV-containing ART.

  3. Review

    Indian Academy of Sciences (India)

    Review. J. Astrophys. Astr., Vol. 36, No. 4, December 2015, pp. 623–634 ..... 4000 K ≤ T ≤ 10000 K. The processes (1b) are characterized in this paper via ..... Mihajlov, A. A., Sreckovic, V. A., Ignjatovic, L. M., Klyucharev, A. N. 2012, J. Cluster.

  4. Review

    NARCIS (Netherlands)

    Kalkman, C.; Adema, F.

    1998-01-01

    This book intends (according to the preface) to afford at once a review, a general outline of what has been accomplished, and a set of signposts for the future. It attempts to do so in three sections on Origin and Diversification of Primitive Land Plants (4 papers), Origin and Diversification of

  5. Review

    NARCIS (Netherlands)

    Wilde, de W.J.J.O.

    1994-01-01

    This review marks the appearance of Volume II, after the publication of Volume I, Pteridophytes and Gymnosperms, in 1990; several more volumes are expected in the future before completion of the Vascular plants as a whole. The present volume contains 73 families out of some 250-500 families which

  6. Evidence of accessibility and utility of point-of-care diagnostics as an integral part of prevention of mother-to-child transmission services: systematic scoping review protocol.

    Science.gov (United States)

    Katoba, Juliet; Hangulu, Lydia; Mashamba-Thompson, Tivani Phosa

    2017-11-04

    Point-of-care (POC) testing has been shown to help improve healthcare access in resource-limited settings. However, there is paucity of evidence on accessibility of POC testing for prevention of mother-to-child transmission (PMTCT) in resource-limited settings. We propose to conduct a systematic scoping review to map the evidence on POC testing services for PMTCT. A scoping review framework, proposed by Arksey and O'Malley, will guide the study. A comprehensive literature search will be performed in the following electronic databases: PubMed, Science Direct, Cochrane Central, Google Scholar and databases within EBSCOhost (Medline and CINAHL). The primary research articles published in peer-reviewed journals and grey articles addressing our question will be included. One reviewer will conduct title screening and the results will be exported to endnote library. Two independent reviewers will perform abstract, then full article screening in parallel. The same process shall be employed to extract data from eligible studies. Data analysis will involve a narrative summary of included studies and thematic content analysis aided by NVIVO software V.11. The mixed methods assessment tool will be used to assess the quality of studies that will be included. Ethical approval is not applicable to this study. The study findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences related to syphilis, HIV, PMTCT, bacterial infections and POC diagnostics. CRD42017056267. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Reviews

    Directory of Open Access Journals (Sweden)

    Philip Barker

    1998-12-01

    Full Text Available There were two copy-editing blunders in Clive Betts's review, in ALT-J 5 (3, of Shirley Fletcher's Designing Competence-Based Training, one in paragraph 2 line 1, the other in paragraph 3 line 8. The errors (the result of the Editor, Gabriel Jacobs, trying to perform a final proof of the journal at lightning speed in order to meet the printing deadline, and not of any mistake on the part of either Philip Barker or the University of Wales Press hardly affected meaning, but the fact that they appeared in a review of a book on competence makes the embarrassment all the more telling. The Editor apologizes, and thanks eagle-eyed readers. He has decided to read the book in the hope that such errors will not recur.

  8. Reviews

    Directory of Open Access Journals (Sweden)

    Wilma D'Ambrosio

    2013-12-01

    Full Text Available In the wake of the great interest raised by Maurizio Gabrieli’s review of the book Musical Networks. Parallel Distributed Perception and Performance (various authors; edited by Niall Griffith and Peter M. Todd, MA: MIT Press, Cambridge, 1999 which appeared in our last issue of Analitica, the present review section no longer follows the format used up to now but offers a survey of texts dedicated to the relationship between music analysis and technology. This decision was also made as a result of the request for more information on the subject by many of our readers. In coming issues we plan to extend this bibliography and comment on at least some of the most interesting texts published in recent years, among which we would immediately like to draw attention to the important work by Baroni, Dalmonte and Jacoboni published in 1999 (Le regole della musica. Indagine sui meccanismi della comunicazione, Torino, I Manuali EDT/SIdM, 1999.

  9. Performance-based ratemaking for electric utilities: Review of plans and analysis of economic and resource-planning issues. Volume 2, Appendices

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-11-01

    This document contains summaries of the electric utilities performance-based rate plans for the following companies: Alabama Power Company; Central Maine Power Company; Consolidated Edison of New York; Mississippi Power Company; New York State Electric and Gas Corporation; Niagara Mohawk Power Corporation; PacifiCorp; Pacific Gas and Electric; Southern California Edison; San Diego Gas & Electric; and Tucson Electric Power. In addition, this document also contains information about LBNL`s Power Index and Incentive Properties of a Hybrid Cap and Long-Run Demand Elasticity.

  10. 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

    Directory of Open Access Journals (Sweden)

    Allan R. Martin

    2016-01-01

    Conclusions: State-of-the-art spinal cord MRI techniques are emerging with great potential to improve the diagnosis and management of various spinal pathologies, but the current body of evidence has only showed limited clinical utility to date. Among these imaging tools DTI is the most mature, but further work is necessary to standardize and validate its use before it will be adopted in the clinical realm. Large, well-designed studies with a priori hypotheses, standardized acquisition methods, detailed clinical data collection, and robust automated analysis techniques are needed to fully demonstrate the potential of these rapidly evolving techniques.

  11. 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

  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. A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

    Directory of Open Access Journals (Sweden)

    Møller AH

    2015-07-01

    Full Text Available Anders Holmen Møller,1 Sandra Erntoft,1 Gabrielle R Vinding,2 Gregor BE Jemec21LEO Pharma A/S, Ballerup, Denmark; 2Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, DenmarkBackground: Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden.Objective: The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D index scores reported in the published literature, and to compare this to patients with other chronic diseases.Methods: Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL. The first search (December 2013 used search terms psoria* AND (EQ5D OR EQ OR EUROQoL. Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014 used the terms (systematic review AND (EQ5D OR EQ 5D OR EuroQoL. Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search.Results: Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities ranged from 0.52 (standard deviation: 0.39 to 0.9 (standard deviation: 0.1. Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus to 0.66 (liver diseases. The highest EQ-5D estimates for other diseases ranged

  14. Conceptual and Empirical Themes regarding the Design of Technology Transfer Programs: A Review of Wood Utilization Research in the United States

    Directory of Open Access Journals (Sweden)

    Paul V. Ellefson

    2011-01-01

    Full Text Available Transfer of technologies produced by research is critical to innovation within all organizations. The intent of this paper is to take stock of the conceptual underpinnings of technology transfer processes as they relate to wood utilization research and to identify conditions that promote the successful transfer of research results. Conceptually, research utilization can be viewed from multiple perspectives, including the haphazard diffusion of knowledge in response to vague and imprecise demands for information, scanning of multiple information sources by individuals and organizations searching for useful scientific knowledge, engagement of third parties to organize research results and communicate them to potential users, and ongoing and active collaboration between researchers and potential users of research. Empirical evidence suggests that various types of programs can promote technology transfer (venture capital, angel investors, business incubators, extension services, tax incentives, and in-house entities, the fundamental effectiveness of which depends on research results that are scientifically valid and consistent with the information needs of potential users. Furthermore, evidence suggests preference toward programs that are appropriately organized and governed, suitably led and creatively administered, and periodically evaluated in accordance with clear standards of success.

  15. Utility of Tissue Transglutaminase Immunohistochemistry in Pediatric Duodenal Biopsies: Patterns of Expression and Role in Celiac Disease—A Clinicopathologic Review

    Directory of Open Access Journals (Sweden)

    Saeeda Almarzooqi

    2013-01-01

    Full Text Available Tissue transglutaminase (tTG is a ubiquitous multifunctional protein. It has roles in various cellular processes. tTG is a major target of autoantibodies in celiac disease, and its expression by immunohistochemistry in pediatric celiac disease has not been fully examined. We studied tTG expression in 78 pediatric duodenal biopsies by utilizing an antibody to transglutaminase 2. Serum tTG was positive in all celiac cases evaluated. Serum antiserum endomysial antibody (EMA and tTG were negative in all control subjects and in inflammatory bowel disease and eosinophilic gastroenteritis. There was a statistically significant difference between cases of celiac disease and normal controls in terms of tTG immunohistochemical staining in duodenal biopsies surface epithelium ( value = 0.0012. There was no significant statistical difference in terms of staining of the villous surface or crypt between the cases of celiac disease and cases with IBD ( value = 0.5970 and 0.5227, resp.. There was no detected correlation between serum tTG values and immunohistochemical positivity on duodenal biopsy in cases of celiac disease ( value = 1. There was no relationship between Marsh classification and positivity of villous surface for tTG ( value = 0.4955. We conclude that tTG has limited utility in diagnosis of celiac disease in pediatric duodenal biopsies.

  16. 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

  17. Utilizing Wetlands for Phosphorus Reduction in Great Lakes Watersheds: A Review of Available Literature Examining Soil Properties and Phosphorus Removal Efficiency

    Science.gov (United States)

    2017-10-01

    term application of P as organic and inorganic fertilizers has resulted in non-point source P pollution by runoff (Daniel et al. 1998). Best...sites fertilized at rates greater than recommended. Average annual concentrations of NO3-N in drainage water from organic soils ranged from 14.8 to...soil P concentrations from long-term over fertilization and/or excessive use of organic wastes). In this paper we review research on P leaching and

  18. Consultancy to review and finalize the IAEA publication 'Compendium on the use of fusion/fission hybrids for the utilization and transmutation of actinides and long-lived fission products'. Working material

    International Nuclear Information System (INIS)

    2004-01-01

    In addition to the traditional fission reactor research, fusion R and D activities are becoming of interest also to nuclear fission power development. There is renewed interest in utilizing fusion neutrons, Heavy Liquid Metals, and molten salts for innovative systems (energy production and transmutation). Indeed, for nuclear power development to become sustainable as a long-term energy option, innovative fuel cycle and reactor technologies will have to be developed to solve the problems of resource utilization and long-lived radioactive waste management. In this context Member States clearly expressed the need for comparative assessments of various transmutation reactors. Both the fusion and fission communities are currently investigating the potential of innovative reactor and fuel cycle strategies that include a fusion/fission system. The attention is mainly focused on substantiating the potential advantages of such systems: utilization and transmutation of actinides and long-lived fission products, intrinsic safety features, enhanced proliferation resistance, and fuel breeding capabilities. An important aspect of the ongoing activities is the comparison with the accelerator driven subcritical system (spallation neutron source), which is the other main option for producing excess neutrons. Apart from comparative assessments, knowledge preservation is another subject of interest to the Member States: the goal, applied to fusion/fission systems, is to review the status of, and to produce a 'compendium' of past and present achievements in this area

  19. Transforming maternal and newborn health social norms and practices to increase utilization of health services in rural Bangladesh: a qualitative review.

    Science.gov (United States)

    Taleb, Fahmida; Perkins, Janet; Ali, Nabeel Ashraf; Capello, Cecilia; Ali, Muzahid; Santarelli, Carlo; Hoque, Dewan Md Emdadul

    2015-03-29

    Since 2008, Participatory Action for Rural Development Innovation (PARI) Development Trust, with the support of Enfants du Monde, has been implementing a maternal and newborn health (MNH) program based on the World Health Organization's (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH in Netrokona district, Bangladesh. This program aims to empower women and families and increase utilization of quality health services, thereby helping women realize their rights related to maternal health. Birth preparedness and complication readiness and working with traditional birth attendants (TBAs) to exercise a new role in MNH and have formed key interventions of this program. The purpose of this study was to explore how the program has contributed to changing social norms and practices surrounding MNH at midpoint. This study relied primarily on qualitative data collection. Two focus group discussions (FGDs) were conducted with women who were pregnant or had recently given birth and one FGD with each of the following groups: husbands, family members, TBAs, and health workers. In-depth interviews were conducted with women who were pregnant or had recently given birth, family members of these women, health care providers, TBAs and community health workers in selected intervention areas. Since implementation of interventions informants report an increase in planning for birth and complications and a shift in preference toward skilled care at birth. However, women still prefer to receive services at home. TBAs report encouraging women to access skilled care for both routine and emergency services. While community members' understanding of rights related to maternal health remains limited, they report increased women's participation in household decision- making processes, an important indicator of the realization of rights. Results suggest that community-level interventions aiming to affect change in social norms and practices surrounding

  20. Wetland craft plants in KwaZulu-Natal: an ecological review of har­vesting impacts and implications for sustainable utilization

    Directory of Open Access Journals (Sweden)

    C. H. Traynor

    2010-07-01

    Full Text Available In South Africa, wetland plants have been used for centuries and they continue to be harvested for subsistence and commercial purposes. Fibres for crafts are collected by cutting the aboveground parts. KwaZulu-Natal is one of the major basket-producing regions in southern Africa and at least twenty-two species of wetland plants are harvested for crafts. A literature review of the harvested species revealed that the impacts of cutting have only been extensively investigated for Phragmites australis (Cav. Steud. and Juncus kraussii Hochst. The review suggested that, where plants display strong seasonal aboveground productivity patterns, cutting should take place after shoot senescence and before new shoot emergence to minimize damage to plants. Cutting in the short term could increase the density of green stems. However, in the long term in  Phragmites australis, it may deplete the rhizome reserves and reduce the density of useable (longer and thicker culms.The opportunity for sustainable harvests was investigated by considering the geographic distribution, whether species are habitat specific or not, and local population sizes of the craft plants. Juncus kraussii is of the greatest conservation concern.Ecologically sustainable wetland plant harv esting could contribute to the wise use of wetlands, an approach promoted nationally and internationally.

  1. A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis.

    Science.gov (United States)

    Kim, Elliott; Chotai, Silky; Stonko, David; Wick, Joseph; Sielatycki, Alex; Devin, Clinton J

    2018-03-01

    The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis. Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected. Two-year resource use was multiplied by unit costs based on Medicare payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost was used to assess mean total 2-year cost per QALYs gained after surgery. 62 and 37 patients underwent TLIF and PLF, respectively. Patients in the PLF group were older (p differences were seen in baseline or 24-month PROs between the two groups. There was a significant improvement in all PROs from baseline to 24 months after surgery (p difference in 24-month direct, indirect, and total cost. Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.

  2. A systematic review on the prevalence and utilization of health care services for reproductive tract infections/sexually transmitted infections: Evidence from India.

    Science.gov (United States)

    Nagarkar, Aarti; Mhaskar, Pallavi

    2015-01-01

    Several studies have reported prevalence rate of reproductive tract infections (RTIs) but very few studies have described health seeking behavior of patients. This paper critically looks at and summarizes the available evidence, systematically. A structured search strategy was used to identify relevant articles, published during years 2000-2012. Forty-one full-text papers discussing prevalence and treatment utilization pattern were included as per PRISMA guidelines. Papers examining prevalence of sexually transmitted diseases used biochemical methods and standard protocol for diagnosis while studies on RTIs used different methods for diagnosis. The prevalence of RTIs has not changed much over the years and found to vary from 11% to 72% in the community-based studies. Stigma, embarrassment, illiteracy, lack of privacy, cost of care found to limit the use of services, but discussion on pathways of nonutilization remains unclear. Lack of methodological rigor, statistical power, specificity in case definitions as well as too little discussion on the limitation of selected method of diagnosis and reliance on observational evidence hampered the quality of studies on RTIs. Raising awareness among women regarding symptoms of RTIs and sexually transmitted infections and also about appropriate treatment has remained largely a neglected area and, therefore, we observed absence of health system studies in this area.

  3. Chromosomal mutation by fission neutrons and X-rays in higher plants. A review on results of the joint research program utilizing Kinki University reactor

    International Nuclear Information System (INIS)

    Yonezawa, Yoshihiko

    2010-01-01

    We have studied the efficiency of fission neutrons from the nuclear reactor of Kinki University (UTR-KINKI) and X-rays to chromosomes of higher plants for over 20 years. In this review, we described the development of bio-dosimeter using hyper-sensibility of germinating onion roots for irradiation, the analysis of chromosome structure in Haplopappus gracilis (Asteraceae), with the special reference of latent centromeres and survived telomeres throughout chromosomal evolution, the experimental studies on the induction of chromosomal rearrangement in Zebrina pendula (Commelinaceae), the behavior of chromosome fragments with non-localized centromeres in Carex and Eleocharis (Cyperaceae), and the possibility as a bio-dosimeter of pollen mother cells of Tradescantia paludosa (Commelinaceae) for the detection of low-dose radiation. (author)

  4. The search for relevant outcome measures for cost-utility analysis of systemic family interventions in adolescents with substance use disorder and delinquent behavior: a systematic literature review.

    Science.gov (United States)

    Schawo, S; Bouwmans, C; van der Schee, E; Hendriks, V; Brouwer, W; Hakkaart, L

    2017-09-19

    Systemic family interventions have shown to be effective in adolescents with substance use disorder and delinquent behavior. The interventions target interactions between the adolescent and involved systems (i.e. youth, family, peers, neighbors, school, work, and society). Next to effectiveness considerations, economic aspects have gained attention. However, conventional generic quality of life measures used in health economic evaluations may not be able to capture the broad effects of systemic interventions. This study aims to identify existing outcome measures, which capture the broad effects of systemic family interventions, and allow use in a health economic framework. We based our systematic review on clinical studies in the field. Our goal was to identify effectiveness studies of psychosocial interventions for adolescents with substance use disorder and delinquent behavior and to distill the instruments used in these studies to measure effects. Searched databases were PubMed, Education Resource Information Center (ERIC), Cochrane and Psychnet (PsycBOOKSc, PsycCRITIQUES, print). Identified instruments were ranked according to the number of systems covered (comprehensiveness). In addition, their use for health economic analyses was evaluated according to suitability characteristics such as brevity, accessibility, psychometric properties, etc. One thousand three hundred seventy-eight articles were found and screened for eligibility. Eighty articles were selected, 8 instruments were identified covering 5 or more systems. The systematic review identified instruments from the clinical field suitable to evaluate systemic family interventions in a health economic framework. None of them had preference-weights available. Hence, a next step could be to attach preference-weights to one of the identified instruments to allow health economic evaluations of systemic family interventions.

  5. A structured review of spinal stiffness as a kinesiological outcome of manipulation: its measurement and utility in diagnosis, prognosis and treatment decision-making.

    Science.gov (United States)

    Snodgrass, Suzanne J; Haskins, Robin; Rivett, Darren A

    2012-10-01

    To review and discuss the methods used for measuring spinal stiffness and factors associated with stiffness, how stiffness is used in diagnosis, prognosis, and treatment decision-making and the effects of manipulative techniques on stiffness. A systematic search of MEDLINE, EMBASE, CINAHL, AMED and ICL databases was conducted. Included studies addressed one of four constructs related to stiffness: measurement, diagnosis, prognosis and/or treatment decision-making, and the effects of manipulation on stiffness. Spinal stiffness was defined as the relationship between force and displacement. One hundred and four studies are discussed in this review, with the majority of studies focused on the measurement of stiffness, most often in asymptomatic persons. Eight studies investigated spinal stiffness in diagnosis, providing limited evidence that practitioner-judged stiffness is associated with radiographic findings of sagittal rotational mobility. Fifteen studies investigated spinal stiffness in prognosis or treatment decision-making, providing limited evidence that spinal stiffness is unlikely to independently predict patient outcomes, though stiffness may influence a practitioner's application of non-thrust manipulative techniques. Nine studies investigating the effects of manipulative techniques on spinal stiffness provide very limited evidence that there is no change in spinal stiffness following thrust or non-thrust manipulation in asymptomatic individuals and non-thrust techniques in symptomatic persons, with only one study supporting an immediate, but not sustained, stiffness decrease following thrust manipulation in symptomatic individuals. The existing limited evidence does not support an association between spinal stiffness and manipulative treatment outcomes. There is a need for additional research investigating the effects of manipulation on spinal stiffness in persons with spinal pain. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. The impact of fire suppression tasks on firefighter hydration: a critical review with consideration of the utility of reported hydration measures.

    Science.gov (United States)

    Walker, Adam; Pope, Rodney; Orr, Robin Marc

    2016-01-01

    Firefighting is a highly stressful occupation with unique physical challenges, apparel and environments that increase the potential for dehydration. Dehydration leaves the firefighter at risk of harm to their health, safety and performance. The purpose of this review was to critically analyse the current literature investigating the impact of fighting 'live' fires on firefighter hydration. A systematic search was performed of four electronic databases for relevant published studies investigating the impact of live fire suppression on firefighter hydration. Study eligibility was assessed using strict inclusion and exclusion criteria. The included studies were critically appraised using the Downs and Black protocol and graded according to the Kennelly grading system. Ten studies met the eligibility criteria for this review. The average score for methodological quality was 55 %, ranging from 50 % ('fair' quality) to 61 % ('good' quality) with a 'substantial agreement' between raters ( k  = .772). Wildfire suppression was considered in five studies and structural fire suppression in five studies. Results varied across the studies, reflecting variations in outcome measures, hydration protocols and interventions. Three studies reported significant indicators of dehydration resulting from structural fire suppression, while two studies found mixed results, with some measures indicating dehydration and other measures an unchanged hydration status. Three studies found non-significant changes in hydration resulting from wildfire firefighting and two studies found significant improvements in markers of hydration. Ad libitum fluid intake was a common factor across the studies finding no, or less severe, dehydration. The evidence confirms that structural and wildfire firefighting can cause dehydration. Ad libitum drinking may be sufficient to maintain hydration in many wildfire environments but possibly not during intense, longer duration, hot structural fire operations

  7. 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

  8. A critical appraisal of 2007 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Interventional Pain Management: an independent review utilizing AGREE, AMA, IOM, and other criteria.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Helm, Standiford; Trescot, Andrea M; Hirsch, Joshua A

    2008-01-01

    Today, with the growing interest of the medical community and others in practice guidelines, there is greater emphasis on formal procedures and methods for arriving at a widely scrutinized and endorsed consensus than ever before. Conflicts in terminology and technique are notable for the confusion that guidelines create and for what they reflect about differences in values, experiences, and interests among different parties. While public and private development activities continue to multiply, the means for coordinating these efforts to resolve inconsistencies, fill in gaps, track applications and results, and assess the soundness of particular guidelines continue to be limited. In this era of widespread guideline development by private organizations, the American College of Occupational and Environment Medicine (ACOEM) has developed guidelines that evaluate areas of clinical practice well beyond the scope of occupational medicine and yet fail to properly involve physicians expert in these, especially those in the field of interventional pain management. As the field of guidelines suffers from imperfect and incomplete scientific knowledge as well as imperfect and uneven means of applying that knowledge without a single or correct way to develop guidelines, ACOEM guidelines have been alleged to hinder patient care, reduce access to interventional pain management procedures, and transfer patients into a system of disability, Medicare, and Medicaid. To critically appraise occupational medicine practice guidelines for interventional pain management by an independent review utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE), American Medical Association (AMA), Institute of Medicine (IOM), and other commonly utilized criteria. Revised chapters of ACOEM guidelines, low back pain and chronic pain, developed in 2007 and 2008 are evaluated, utilizing AGREE, AMA, IOM instruments, and Shaneyfelt et al's criteria, were independently reviewed by 4

  9. 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.

  10. Regulatory Forum Review*: Utility of in Vitro Secondary Pharmacology Data to Assess Risk of Drug-induced Valvular Heart Disease in Humans: Regulatory Considerations.

    Science.gov (United States)

    Papoian, Thomas; Jagadeesh, Gowraganahalli; Saulnier, Muriel; Simpson, Natalie; Ravindran, Arippa; Yang, Baichun; Laniyonu, Adebayo A; Khan, Imran; Szarfman, Ana

    2017-04-01

    Drug-induced valvular heart disease (VHD) is a serious side effect linked to long-term treatment with 5-hydroxytryptamine (serotonin) receptor 2B (5-HT 2B ) agonists. Safety assessment for off-target pharmacodynamic activity is a common approach used to screen drugs for this undesired property. Such studies include in vitro assays to determine whether the drug is a 5-HT 2B agonist, a necessary pharmacological property for development of VHD. Measures of in vitro binding affinity (IC 50 , K i ) or cellular functional activity (EC 50 ) are often compared to maximum therapeutic free plasma drug levels ( fC max ) from which safety margins (SMs) can be derived. However, there is no clear consensus on what constitutes an appropriate SM under various therapeutic conditions of use. The strengths and limitations of SM determinations and current risk assessment methodology are reviewed and evaluated. It is concluded that the use of SMs based on K i values, or those relative to serotonin (5-HT), appears to be a better predictor than the use of EC 50 or EC 50 /human fC max values for determining whether known 5-HT 2B agonists have resulted in VHD. It is hoped that such a discussion will improve efforts to reduce this preventable serious drug-induced toxicity from occurring and lead to more informed risk assessment strategies.

  11. Uncovering the real outcomes of active renal stone treatment by utilizing non-contrast computer tomography: a systematic review of the current literature.

    Science.gov (United States)

    Tokas, Theodoros; Habicher, Martin; Junker, Daniel; Herrmann, Thomas; Jessen, Jan Peter; Knoll, Thomas; Nagele, Udo

    2017-06-01

    To evaluate the stone-free rates (SFRs) and stone clearance rates (SCRs) of extracorporeal shock-wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS), and percutaneous nephrolitholapaxy (PCNL) according to non-contrast computer tomography (NCCT) findings. Original articles were identified from PubMed. After exclusion of ineligible papers, twenty-three studies with 2494 cases were included in the review. Six SWL, five RIRS and eight PCNL studies were selected. Additionally, four comparative articles were identified. SWL presents SFRs ranging 35-61.3 % and SCRs for residuals <4 mm being 43.2-92.9 %. RIRS studies report SFRs of 34.8-59.7 % and SCRs for residuals <4 mm ranging 48-96.7 %. Finally, PCNL presents SFRs of 20.8-100 % and SCRs for residuals <4 mm being 41.5-91.4 %. According to the comparative studies, SFRs are 17-61.3 % for SWL, 50 % for RIRS, and 95-100 % for PCNL. According to NCCT findings, it seems that PCNL provides better SFRs than ESWL and RIRS. However, further research with comparable and complete preoperative parameters and outcomes could reduce the heterogeneity of current data.

  12. A systematic review of the utility of 1.5 versus 3 Tesla magnetic resonance brain imaging in clinical practice and research

    Energy Technology Data Exchange (ETDEWEB)

    Wardlaw, Joanna M. [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Western General Hospital, SINAPSE Collaboration, Brain Research Imaging Centre, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Brindle, Will; Casado, Ana M.; Thomas, Brenda; Morris, Zoe [University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Shuler, Kirsten; Henderson, Moira; Munoz Maniega, Susana; Lymer, Katherine; Pernet, Cyril; Tao, Yuehui [Terry; Parikh, Jehill; Royle, Natalie A.; Bastin, Mark E.; Farrall, Andrew; Valdes Hernandez, Maria C. [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Macfarlane, Jennifer [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Dundee, Dundee (United Kingdom); Nailon, William [University of Edinburgh, Edinburgh Cancer Centre, Edinburgh (United Kingdom); Ahearn, Trevor [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Aberdeen, Institute of Medical Sciences, Aberdeen (United Kingdom); Mumuni, Abdul Nashirudeen [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Glasgow, Department of Clinical Physics, Glasgow (United Kingdom); Mugruza, Carlos [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Dundee, School of Psychology, Dundee (United Kingdom); McLean, John [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Glasgow, Institute of Neurological Sciences, Glasgow (United Kingdom); Chakirova, Goultchira [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Psychiatry, Edinburgh (United Kingdom); Simpson, Johanna [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Stirling, Department of Psychology, Stirling (United Kingdom); Stanfield, Andrew C. [University of Edinburgh, Division of Psychiatry, Edinburgh (United Kingdom); Johnston, Harriet [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of St Andrews, Department of Psychology, St Andrews (United Kingdom); De Wilde, Janet [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); The Higher Education Academy, York (United Kingdom); Weir, Nick [Royal Infirmary of Edinburgh, Department of Medical Physics, Edinburgh (United Kingdom); Collaboration: SINAPSE Collaborative Group

    2012-11-15

    MRI at 3 T is said to be more accurate than 1.5 T MR, but costs and other practical differences mean that it is unclear which to use. We systematically reviewed studies comparing diagnostic accuracy at 3 T with 1.5 T. We searched MEDLINE, EMBASE and other sources from 1 January 2000 to 22 October 2010 for studies comparing diagnostic accuracy at 1.5 and 3 T in human neuroimaging. We extracted data on methodology, quality criteria, technical factors, subjects, signal-to-noise, diagnostic accuracy and errors according to QUADAS and STARD criteria. Amongst 150 studies (4,500 subjects), most were tiny, compared old 1.5 T with new 3 T technology, and only 22 (15 %) described diagnostic accuracy. The 3 T images were often described as ''crisper'', but we found little evidence of improved diagnosis. Improvements were limited to research applications [functional MRI (fMRI), spectroscopy, automated lesion detection]. Theoretical doubling of the signal-to-noise ratio was not confirmed, mostly being 25 %. Artefacts were worse and acquisitions took slightly longer at 3 T. Objective evidence to guide MRI purchasing decisions and routine diagnostic use is lacking. Rigorous evaluation accuracy and practicalities of diagnostic imaging technologies should be the routine, as for pharmacological interventions, to improve effectiveness of healthcare. (orig.)

  13. Clinical utility of orally disintegrating olanzapine in Chinese patients with schizophrenia: a review of effectiveness, patient preference, adherence, and other properties

    Directory of Open Access Journals (Sweden)

    Zhao J

    2014-02-01

    Full Text Available Jingping Zhao,1 Jianjun Ou,1 Haibo Xue,2 Li Liu,2 William Montgomery,3 Tamas Treuer4 1Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 2Lilly Suzhou Pharmaceutical Co, Ltd, Jiangsu, People's Republic of China; 3Global Health Outcomes, Eli Lilly and Company, Sydney, Australia; 4Emerging Markets Business Unit (Neuroscience, Eli Lilly and Company, Budapest, Hungary Abstract: The primary objective of this systematic review was to examine the evidence for the efficacy, effectiveness, and safety of orally disintegrating olanzapine in Chinese populations. A systematic literature search was conducted using databases covering international and Chinese journals, ClinicalTrials.gov, and internal and external trial registries at Eli Lilly and Company using search terms related to target countries (People's Republic of China, Hong Kong, and Taiwan and orally disintegrating olanzapine treatment. A publication and one clinical study report were retrieved. The clinical study showed orally disintegrating olanzapine and the standard oral tablet to have similar efficacy and tolerability profiles. A bioequivalence study has shown that orally disintegrating olanzapine and the standard oral tablet have similar pharmacokinetic profiles. Orally disintegrating olanzapine and the standard oral tablet have similar efficacy and tolerability profiles. Keywords: orally disintegrating, olanzapine, Chinese, schizophrenia, patients

  14. Retrospective review to determine the utility of follow-up skeletal surveys in child abuse evaluations when the initial skeletal survey is normal

    Directory of Open Access Journals (Sweden)

    Kachelmeyer Andrea

    2011-09-01

    Full Text Available Abstract Objective The AAP recommends that a follow-up skeletal survey be obtained for all children Methods A retrospective review of radiology records from September 1, 1998 - January 31, 2007 was conducted. Suspected victims of child abuse who were Results Forty-seven children had a negative initial skeletal survey and were included for analysis. The mean age was 6.9 months (SD 5.7; the mean number of days between skeletal surveys was 18.7 (SD 10.1 Four children (8.5% had signs of healing bone trauma on a follow-up skeletal survey. Three of these children (75% had healing rib fractures and one child had a healing proximal humerus fracture. The findings on the follow-up skeletal survey yielded forensically important information in all 4 cases and strengthened the diagnosis of non-accidental trauma. Conclusion 8.5 percent of children with negative initial skeletal surveys had forensically important findings on follow-up skeletal survey that increased the certainty of the diagnosis of non-accidental trauma. A follow-up skeletal survey can be useful even when the initial skeletal survey is negative.

  15. Iodine kinetics and effectiveness of stable iodine prophylaxis after intake of radioiodine: a review; Pharmacocinetique de l'iode: revue des connaissances utiles en radioprotection accidentelle

    Energy Technology Data Exchange (ETDEWEB)

    Geoffroy, B.; Verger, P.; Le Guen, B. [CEA/Fontenay-aux-Roses, Inst. de Protection et de Surete Nucleaire, IPSN, 92 (France)

    2000-06-01

    Ingestion of stable iodine (potassium iodide) offers an efficient protection against the irradiation of the thyroid when an accidental exposure to radioiodine occurs. This prophylaxis aims at obtaining a rapid and maximum thyroid protection without antithyroid effects. This article reviews studies on iodine kinetics in the human and on stable iodine effectiveness to protect the thyroid. In adults with a normal thyroid function, ingestion of 100 mg of iodide just before exposure to radioiodine allows a percentage of thyroid averted dose equal or greater than 95%. If the exposure persists after iodide ingestion (100 mg), the percentage of averted dose may decrease significantly. Repeated ingestion of daily amounts of 15 mg of stable iodine would then allow to maintain a 90% effectiveness. Iodide effectiveness and antithyroid effects also depend on external and individual factors such as iodine amounts in the diet, thyroid function and age. It is recommended to adapt the amount of ingested stable iodine according to age at the time of exposure. (author)

  16. Beyond labels: A review of the application of quantum dots as integrated components of assays, bioprobes, and biosensors utilizing optical transduction

    Energy Technology Data Exchange (ETDEWEB)

    Algar, W. Russ; Tavares, Anthony J. [Chemical Sensors Group, Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6 (Canada); Krull, Ulrich J., E-mail: ulrich.krull@utoronto.ca [Chemical Sensors Group, Department of Chemical and Physical Sciences, University of Toronto Mississauga, Mississauga, Ontario L5L 1C6 (Canada)

    2010-07-12

    A comprehensive review of the development of assays, bioprobes, and biosensors using quantum dots (QDs) as integrated components is presented. In contrast to a QD that is selectively introduced as a label, an integrated QD is one that is present in a system throughout a bioanalysis, and simultaneously has a role in transduction and as a scaffold for biorecognition. Through a diverse array of coatings and bioconjugation strategies, it is possible to use QDs as a scaffold for biorecognition events. The modulation of QD luminescence provides the opportunity for the transduction of these events via fluorescence resonance energy transfer (FRET), bioluminescence resonance energy transfer (BRET), charge transfer quenching, and electrochemiluminescence (ECL). An overview of the basic concepts and principles underlying the use of QDs with each of these transduction methods is provided, along with many examples of their application in biological sensing. The latter include: the detection of small molecules using enzyme-linked methods, or using aptamers as affinity probes; the detection of proteins via immunoassays or aptamers; nucleic acid hybridization assays; and assays for protease or nuclease activity. Strategies for multiplexed detection are highlighted among these examples. Although the majority of developments to date have been in vitro, QD-based methods for ex vivo biological sensing are emerging. Some special attention is given to the development of solid-phase assays, which offer certain advantages over their solution-phase counterparts.

  17. A systematic review of the utility of 1.5 versus 3 Tesla magnetic resonance brain imaging in clinical practice and research

    International Nuclear Information System (INIS)

    Wardlaw, Joanna M.; Brindle, Will; Casado, Ana M.; Thomas, Brenda; Morris, Zoe; Shuler, Kirsten; Henderson, Moira; Munoz Maniega, Susana; Lymer, Katherine; Pernet, Cyril; Tao, Yuehui; Parikh, Jehill; Royle, Natalie A.; Bastin, Mark E.; Farrall, Andrew; Valdes Hernandez, Maria C.; Macfarlane, Jennifer; Nailon, William; Ahearn, Trevor; Mumuni, Abdul Nashirudeen; Mugruza, Carlos; McLean, John; Chakirova, Goultchira; Simpson, Johanna; Stanfield, Andrew C.; Johnston, Harriet; De Wilde, Janet; Weir, Nick

    2012-01-01

    MRI at 3 T is said to be more accurate than 1.5 T MR, but costs and other practical differences mean that it is unclear which to use. We systematically reviewed studies comparing diagnostic accuracy at 3 T with 1.5 T. We searched MEDLINE, EMBASE and other sources from 1 January 2000 to 22 October 2010 for studies comparing diagnostic accuracy at 1.5 and 3 T in human neuroimaging. We extracted data on methodology, quality criteria, technical factors, subjects, signal-to-noise, diagnostic accuracy and errors according to QUADAS and STARD criteria. Amongst 150 studies (4,500 subjects), most were tiny, compared old 1.5 T with new 3 T technology, and only 22 (15 %) described diagnostic accuracy. The 3 T images were often described as ''crisper'', but we found little evidence of improved diagnosis. Improvements were limited to research applications [functional MRI (fMRI), spectroscopy, automated lesion detection]. Theoretical doubling of the signal-to-noise ratio was not confirmed, mostly being 25 %. Artefacts were worse and acquisitions took slightly longer at 3 T. Objective evidence to guide MRI purchasing decisions and routine diagnostic use is lacking. Rigorous evaluation accuracy and practicalities of diagnostic imaging technologies should be the routine, as for pharmacological interventions, to improve effectiveness of healthcare. (orig.)

  18. 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.

  19. ‘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.

  20. 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...

  1. Rapid Discrimination of Malignant Breast Lesions from Normal Tissues Utilizing Raman Spectroscopy System: A Systematic Review and Meta-Analysis of In Vitro Studies.

    Directory of Open Access Journals (Sweden)

    Ke Deng

    Full Text Available The aim of this study is to evaluate the diagnostic accuracy of Raman spectroscopy system in the detection of malignant breast lesions through a systemic review and meta-analysis of published studies.We conducted a comprehensive literature search of PubMed and Embase from 2000 to June 2015. Published studies that evaluated the diagnostic performance of Raman spectroscopy in distinguishing malignant breast lesions from benign lesions and normal tissues were included in our study. The pooled sensitivity, specificity, diagnostic odds ratio, and the area under the curve of summary receiver-operating characteristic curves was derived. A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies guidelines was used to assess the quality of included studies.The initial search produced a total of 157 articles after removing duplicates. Nine studies (8 in vitro and 1 in vivo were eligible in this meta-analysis. We analyzed the eight in vitro studies with 1756 lesions, the pooled sensitivity and specificity of Raman spectroscopy system for the diagnosis of malignant breast lesions were 0.92 (95% CI 0.86-0.96 and 0.97 (97% CI 0.93-0.98, respectively. Diagnostic odds ratio was 266.70 (95% CI 89.38-795.79, and the area under the curve of summary receiver-operating characteristic curves was 0.98 (95% CI 0.97-0.99. Significant heterogeneity was found between studies. There was no evidence of considerable publication bias.Raman spectroscopy system is an optical diagnostic technology with great value for detecting malignant breast lesions. At the same time, it has advantages of being non-invasive, real-time, and easy to use. Thus it deserves to be further explored for intra-operatory breast tumor margin detection.

  2. Utility and Safety of Endoscopic Ultrasound With Bronchoscope-Guided Fine-Needle Aspiration in Mediastinal Lymph Node Sampling: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Dhooria, Sahajal; Aggarwal, Ashutosh N; Gupta, Dheeraj; Behera, Digambar; Agarwal, Ritesh

    2015-07-01

    The use of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration (EUS-B-FNA) has been described in the evaluation of mediastinal lymphadenopathy. Herein, we conduct a meta-analysis to estimate the overall diagnostic yield and safety of EUS-B-FNA combined with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), in the diagnosis of mediastinal lymphadenopathy. The PubMed and EmBase databases were searched for studies reporting the outcomes of EUS-B-FNA in diagnosis of mediastinal lymphadenopathy. The study quality was assessed using the QualSyst tool. The yield of EBUS-TBNA alone and the combined procedure (EBUS-TBNA and EUS-B-FNA) were analyzed by calculating the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio for each study, and pooling the study results using a random effects model. Heterogeneity and publication bias were assessed for individual outcomes. The additional diagnostic gain of EUS-B-FNA over EBUS-TBNA was calculated using proportion meta-analysis. Our search yielded 10 studies (1,080 subjects with mediastinal lymphadenopathy). The sensitivity of the combined procedure was significantly higher than EBUS-TBNA alone (91% vs 80%, P = .004), in staging of lung cancer (4 studies, 465 subjects). The additional diagnostic gain of EUS-B-FNA over EBUS-TBNA was 7.6% in the diagnosis of mediastinal adenopathy. No serious complication of EUS-B-FNA procedure was reported. Clinical and statistical heterogeneity was present without any evidence of publication bias. Combining EBUS-TBNA and EUS-B-FNA is an effective and safe method, superior to EBUS-TBNA alone, in the diagnosis of mediastinal lymphadenopathy. Good quality randomized controlled trials are required to confirm the results of this systematic review. Copyright © 2015 by Daedalus Enterprises.

  3. Clinical utility of eco-color-power Doppler ultrasonography and contrast enhanced magnetic resonance imaging for interpretation and quantification of joint synovitis: a review.

    Science.gov (United States)

    Carotti, Marina; Galeazzi, Vittoria; Catucci, Francesca; Zappia, Marcello; Arrigoni, Francesco; Barile, Antonio; Giovagnoni, Andrea

    2018-01-19

    With the introduction of new biologics such as anti-TNF-alpha antibodies and other therapies in the treatment of inflammatory arthritis, capable of halting joint destruction and functional disability, there are new pressures on diagnostic and prognostic imaging. Early demonstration of pre-erosive inflammatory features and monitoring of the long-term effects of treatment are becoming increasingly important. Early detection of synovitis offers advantages in terms of allowing early instigation of therapy and may allow the identification of those patients displaying more aggressive disease who might benefit from early intervention with expensive DMARD therapy. Advanced imaging techniques such as ultrasound (US) and magnetic resonance imaging (MRI) have focussed on the demonstration and quantification of synovitis and allow early diagnosis of inflammatory arthropathies such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Synovitis represents a potential surrogate measure of disease activity that can be monitored using either MRI or US; the techniques have, generally, focused on monitoring synovial volume or quality as assessed by its vascularity. However to achieve these goals, standardisation and validation of US and MRI are required to ensure accurate diagnosis, reproducibility and reliability. Each modality has different strengths and weaknesses and levels of validation. This article aims to increase the awareness of radiologists and rheumatologists about this field and to encourage them to participate and contribute to the ongoing development of these modalities. Without this collaboration, it is unlikely that these modalities will reach their full potential in the field of rheumatological imaging. This review is in two parts. The first part addresses the role of US and colour or power Doppler sonography (PDUS) in the detection and monitoring of synovitis in inflammatory arthropathies. The second part will look at advanced MR imaging and Dynamic contrast

  4. Is there room for resilience? A scoping review and critique of substance use literature and its utilization of the concept of resilience.

    Science.gov (United States)

    Rudzinski, Katherine; McDonough, Peggy; Gartner, Rosemary; Strike, Carol

    2017-09-15

    Research in the area of illicit substance use remains preoccupied with describing and analyzing the risks of people who use drugs (PWUD), however more recently there has been a drive to use a strengths-based or resilience approach as an alternative to investigating drug use. This leads us to ask: what can be known about PWUD from the point of view of resilience? The objective of this scoping review is to analyze how the concept of resilience is defined, operationalized, and applied in substance use research. Popular health, social science, psychology, and inter-disciplinary databases namely: SCOPUS, PUBMED, PsycINFO, and Sociological Abstracts were searched. Studies were selected if they used the concept of resilience and if substance use was a key variable under investigation. A total of 77 studies were identified which provided a definition of resilience, or attempted to operationalize (e.g., via scales) the concept of resilience in some manner. Data were charted and sorted using key terms and fundamental aspects of resilience. The majority of studies focus on youth and their resistance to, or engagement in, substance use. There is also a small but growing area of research that examines recovery from substance addiction as a form of resilience. Very few studies were found that thoroughly investigated resilience among PWUD. Consistently throughout the literature drug use is presented as a 'risk factor' jeopardizing one's ability to be resilient, or drug use is seen as a 'maladaptive coping strategy', purporting one's lack of resilience. Currently, substance use research provides a substantial amount of information about the internal strengths that can assist in resisting future drug use; however there is less information about the external resources that play a role, especially for adults. Though popular, outcome-based conceptualizations of resilience are often static, concealing the potential for developing resilience over time or as conditions change. Studies of

  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. 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.

  7. 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

  8. 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

  9. 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...

  10. 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

  11. FTTS Utility Vehicle (UVI) Concept Review

    National Research Council Canada - National Science Library

    Drake, Branden

    2005-01-01

    Government concepts to support the future tactical truck systems (FTTS) development. This briefing explains the truck concept by describing the vehicle through major subsystem categories such as mobility, survivability, and C4I technologies...

  12. FTTS Utility Vehicle UV2 Concept Review

    National Research Council Canada - National Science Library

    Drake, Branden

    2005-01-01

    Government concepts to support the future tactical truck systems (FTTS) development. This briefing explains the truck concept by describing the vehicle through major subsystem categories such as mobility, survivability, and C4I technologies...

  13. Review: Utilization of Waste From Coffee Production

    Science.gov (United States)

    Blinová, Lenka; Sirotiak, Maroš; Bartošová, Alica; Soldán, Maroš

    2017-06-01

    Coffee is one of the most valuable primary products in the world trade, and also a central and popular part of our culture. However, coffees production generate a lot of coffee wastes and by-products, which, on the one hand, could be used for more applications (sorbent for the removal of heavy metals and dyes from aqueous solutions, production of fuel pellets or briquettes, substrate for biogas, bioethanol or biodiesel production, composting material, production of reusable cups, substrat for mushroom production, source of natural phenolic antioxidants etc.), but, on the other hand, it could be a source of severe contamination posing a serious environmental problem. In this paper, we present an overview of utilising the waste from coffee production.

  14. A systematic review of the application and utility of geographical information systems for exploring disease-disease relationships in paediatric global health research: the case of anaemia and malaria.

    Science.gov (United States)

    Aimone, Ashley Mariko; Perumal, Nandita; Cole, Donald C

    2013-01-10

    Malaria and anaemia are important health problems among children globally. Iron deficiency anaemia may offer protection against malaria infection and iron supplementation may increase the risk of malaria-related hospitalization and mortality. The nature and mechanism of these relationships, however, remain largely unresolved, resulting in concern and uncertainty around policies for non-selective iron supplementation in malaria endemic areas. Use of geographical information systems (GIS) to investigate this disease-disease interaction could contribute important new information for developing safe and effective anaemia and malaria interventions. To assess the current state of knowledge we conducted a systematic review of peer-reviewed and grey literature. Our primary objective was to qualitatively assess the application and utility of geographical concepts or spatial analyses in paediatric global health research. The secondary objective was to identify geographical factors that may be associated with anaemia and malaria prevalence or incidence among children 0-5 years of age living in low- and middle-income countries. Evaluation tools for assessing the quality of geographical data could not be found in the peer-reviewed or grey literature, and thus adapted versions of the STROBE (Strengthening The Reporting of Observational Studies in Epidemiology) and GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods were used to create reporting, and overall evidence quality scoring systems. Among the 20 included studies, we found that both malaria and anaemia were more prevalent in rural communities compared to urban areas. Geographical factors associated with malaria prevalence included regional transmission stability, and proximity to a mosquito breeding area. The prevalence of anaemia tended to vary inversely with greater or poorer access to community services such as piped water. Techniques for investigating geographic relationships ranged from

  15. A systematic review of the application and utility of geographical information systems for exploring disease-disease relationships in paediatric global health research: the case of anaemia and malaria

    Directory of Open Access Journals (Sweden)

    Aimone Ashley Mariko

    2013-01-01

    Full Text Available Abstract Malaria and anaemia are important health problems among children globally. Iron deficiency anaemia may offer protection against malaria infection and iron supplementation may increase the risk of malaria-related hospitalization and mortality. The nature and mechanism of these relationships, however, remain largely unresolved, resulting in concern and uncertainty around policies for non-selective iron supplementation in malaria endemic areas. Use of geographical information systems (GIS to investigate this disease-disease interaction could contribute important new information for developing safe and effective anaemia and malaria interventions. To assess the current state of knowledge we conducted a systematic review of peer-reviewed and grey literature. Our primary objective was to qualitatively assess the application and utility of geographical concepts or spatial analyses in paediatric global health research. The secondary objective was to identify geographical factors that may be associated with anaemia and malaria prevalence or incidence among children 0–5 years of age living in low- and middle-income countries. Evaluation tools for assessing the quality of geographical data could not be found in the peer-reviewed or grey literature, and thus adapted versions of the STROBE (Strengthening The Reporting of Observational Studies in Epidemiology and GRADE (Grades of Recommendation, Assessment, Development and Evaluation methods were used to create reporting, and overall evidence quality scoring systems. Among the 20 included studies, we found that both malaria and anaemia were more prevalent in rural communities compared to urban areas. Geographical factors associated with malaria prevalence included regional transmission stability, and proximity to a mosquito breeding area. The prevalence of anaemia tended to vary inversely with greater or poorer access to community services such as piped water. Techniques for investigating geographic

  16. 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

  17. Entrez Programming Utilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Entrez Programming Utilities (E-utilities) are a set of eight server-side programs that provide a stable interface into the Entrez query and database system at...

  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. 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 ...

  20. 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…

  1. 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

  2. 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.

  3. X-rays utilization

    International Nuclear Information System (INIS)

    Rebigan, F.

    1979-03-01

    The modality of X-ray utilization in different activities and economy is given. One presents firstly quantities and units used in radiation dosimetry and other fields. One gives the generation of X-rays, their properties as well as the elements of radiation protection. The utilization characteristics of these radiations in different fields are finally given. (author)

  4. 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

  5. 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

  6. 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.

  7. 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

  8. Utility portfolio diversification

    International Nuclear Information System (INIS)

    Griffes, P.H.

    1990-01-01

    This paper discusses portfolio analysis as a method to evaluate utility supply decisions. Specifically a utility is assumed to increase the value of its portfolio of assets whenever it invests in a new supply technology. This increase in value occurs because the new asset either enhances the return or diversifies the risks of the firm's portfolio of assets. This evaluation method is applied to two supply innovations in the electric utility industry: jointly-owned generating plants and supply contracts with independent power producers (IPPs)

  9. Gas and electrical utilities owned by local governments. A development reviewed from the viewpoint of price control in the framework of the antitrust laws and the German Energy Act

    International Nuclear Information System (INIS)

    Wolf, A.

    1994-01-01

    There is no legal obligation of local governments to run electric utilities or gas works as public utilities, but logal governments have the right to do so. If they so wish, a vital requirement is to produce evidence of the long-term economic efficiency, to be presented among others to the supervisory Land authority for public utilities, which has to grant a licence under section 5 EnWG. The licence should not be issued unless proof is given of the long-term economic efficiency on the basis of near-to-competition prices and taking into account cost advantages due to local infrastructural conditions. The costs of deprivatisation - take-over costs, deconcentration and integration costs - must not be used to justify higher rates charged by public, local government utilities in comparison to regional utilies. (orig./HSCH) [de

  10. MSIS Drug Utilization Datamart

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page provides background needed to take advantage of the capabilities of the MSIS Drug Utilization Datamart. This mart allows the user to develop high-level...

  11. Utility franchises reconsidered

    Energy Technology Data Exchange (ETDEWEB)

    Weidner, B.

    1981-11-01

    It is easier to obtain a public utility franchise than one for a fast food store because companies like Burger King value the profit share and control available with a franchise arrangement. The investor-owned utilities (IOUs) in Chicago and elsewhere gets little financial or regulatory benefit, although they do have an alternative because the franchise can be taken over by the city with a one-year notice. As IOUs evolved, the annual franchise fee has been incorporated into the rate in a move that taxes ratepayers and maximizes profits. Cities that found franchising unsatisfactory are looking for ways to terminate the franchise and finance a takeover, but limited-term and indeterminate franchises may offer a better mechanism when public needs and utility aims diverge. A directory lists franchised utilities by state and comments on their legal status. (DCK)

  12. Chemical Search Web Utility

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Chemical Search Web Utility is an intuitive web application that allows the public to easily find the chemical that they are interested in using, and which...

  13. Utility requirements for HTGRs

    International Nuclear Information System (INIS)

    Nicholls, D.R.

    1997-01-01

    Eskom, the state utility of South Africa, is currently evaluating the technical and economic feasibility of the helium cooled Pebble Bed Modular Reactor with a closed cycle gas turbine power conversion system for future power generating additions to its electric system. This paper provides an overview of the Eskom system including the needs of the utility for future generation capacity and the key performance requirements necessary for incorporation of this gas cooled reactor plant. (author)

  14. Utility, games, and narratives

    OpenAIRE

    Fioretti, Guido

    2009-01-01

    This paper provides a general overview of theories and tools to model individual and collective decision-making. In particular, stress is laid on the interaction of several decision-makers. A substantial part of this paper is devoted to utility maximization and its application to collective decision-making, Game Theory. However, the pitfalls of utility maximization are thoroughly discussed, and the radically alternative approach of viewing decision-making as constructing narratives is pre...

  15. Utility requirements for fusion

    International Nuclear Information System (INIS)

    Vondrasek, R.J.

    1982-02-01

    This report describes work done and results obtained during performance of Task 1 of a study of Utility Requirements and Criteria for Fusion Options. The work consisted of developing a list of utility requirements for fusion optics containing definition of the requirements and showing their relative importance to the utility industry. The project team members developed a preliminary list which was refined by discussions and literature searches. The refined list was recast as a questionnaire which was sent to a substantial portion of the utility industry in this country. Forty-three questionnaire recipients responded including thirty-two utilities. A workshop was held to develop a revised requirements list using the survey responses as a major input. The list prepared by the workshop was further refined by a panel consisting of vice presidents of the three project team firms. The results of the study indicate that in addition to considering the cost of energy for a power plant, utilities consider twenty-three other requirements. Four of the requirements were judged to be vital to plant acceptability: Plant Capital Cost, Financial Liability, Plant Safety and Licensability

  16. 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?

  17. 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?.

  18. 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

  19. Measurement of utility.

    Science.gov (United States)

    Thavorncharoensap, Montarat

    2014-05-01

    The Quality Adjusted Life Year (QALY) is the most widely recommended health outcome measure for use in economic evaluations. The QALY gives a value to the effect of a given health intervention in terms of both quantity and quality. QALYs are calculated by multiplying the duration of time spent in a given health state, in years, by the quality of life weighted, known as utility. Utility can range from 0 (the worst health state-the equivalent of death) to 1 (the best health state-full health). This paper provides an overview of the various methods that can be used to measure utility and outlines the recommended protocol for measuring utility, as described in the Guidelines for Health Technology Assessment in Thailand (second edition). The recommendations are as follows: Wherever possible, primary data collection using EQ-5D-3L in patients using Thai value sets generated from the general public should be used. Where the EQ-5D-3L is considered inappropriate, other methods such as Standard gamble (SG), Time-trade-off (TTO), Visual analogue scale (VAS), Health Utilities Index (HUI), SF-6D, or Quality of well being (QWB) can be used. However, justification and full details on the chosen instrument should always be provided.

  20. Electric utility report '80

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    A collection of brief atricles describes the trends and developments in Canada's electric utilities for the 1980's. Generating stations planned or under construction are listed. The trends in technology discused at a recent Canadian Electrical Association meeting are summarized in such areas as turbine stability control, power line vibration control, system reliability, substations and transformer specifications. Developments in nuclear generation are discussed and compared on the world scale where Japan, for example, has the world's largest nuclear program. Progress on fusion is discussed. In Canada the electric utilities are receiving the support of the comprehensive nuclear R and D program of Atomic Energy of Canada Ltd. New innovations in utility technology such as street lighting contactors, superconductive fault limiters and demand profile analyzers are discussed. (T.I.)

  1. Utility planning for decommissioning

    International Nuclear Information System (INIS)

    Williams, D.H.

    1982-01-01

    Though the biggest impact on a utility of nuclear power plant decommissioning may occur many years from now, procrastination of efforts to be prepared for that time is unwarranted. Foresight put into action through planning can significantly affect that impact. Financial planning can assure the recovery of decommissioning costs in a manner equitable to customers. Decision-making planning can minimize adverse affects of current decisions on later decommissioning impacts and prepare a utility to be equipped to make later decommissioning decisions. Technological knowledge base planning can support all other planning aspects for decommissioning and prepare a utility for decommissioning decisions. Informed project planning can ward off potentially significant pitfalls during decommissioning and optimize the effectiveness of the actual decommissioning efforts

  2. Markets: green utilities

    International Nuclear Information System (INIS)

    Wood, Elisa

    2006-01-01

    Publicly owned utilities have consistently led the United States in the rate of customer participation in green power programmes. The US has about 2000 community and state-owned utilities, which serve 43 million customers and account for about 16.6% of kilowatt-hour sales to consumers. In all, public power is responsible for about 10% of the nation's installed electric capacity. Investor owned utilities account for 39%, with the remainder of the nation's power mostly from independent power generators. Although IOUs have almost four times as much electric capacity as public power, they edge out public power by only a small margin when it comes to renewable capacity. IOUs are responsible for 24,577.5 MW of renewable capacity, compared to the 21,338 MW installed by public power. The reasons discussed by the author range from small town advantage to clean and cheap power. (Author)

  3. 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.

  4. 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.

  5. Octopus: LLL's computing utility

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The Laboratory's Octopus network constitutes one of the greatest concentrations of computing power in the world. This power derives from the network's organization as well as from the size and capability of its computers, storage media, input/output devices, and communication channels. Being in a network enables these facilities to work together to form a unified computing utility that is accessible on demand directly from the users' offices. This computing utility has made a major contribution to the pace of research and development at the Laboratory; an adequate rate of progress in research could not be achieved without it. 4 figures

  6. Geothermal energy utilization and technology

    CERN Document Server

    Dickson, Mary H; Fanelli, Mario

    2013-01-01

    Geothermal energy refers to the heat contained within the Earth that generates geological phenomena on a planetary scale. Today, this term is often associated with man's efforts to tap into this vast energy source. Geothermal Energy: utilization and technology is a detailed reference text, describing the various methods and technologies used to exploit the earth's heat. Beginning with an overview of geothermal energy and the state of the art, leading international experts in the field cover the main applications of geothermal energy, including: electricity generation space and district heating space cooling greenhouse heating aquaculture industrial applications The final third of the book focuses upon environmental impact and economic, financial and legal considerations, providing a comprehensive review of these topics. Each chapter is written by a different author, but to a set style, beginning with aims and objectives and ending with references, self-assessment questions and answers. Case studies are includ...

  7. 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

  8. Electric utilities in Illinois

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    Although the conference dealt specifically with concerns of the electric utilities in Illinois, the issues were dealt with in the national context as well. A separate abstract was prepared for each of the 5 sections of this proceeding. A total of 25 papers were presented. Section titles are: Forecasting, Planning and Siting, Reliability, Rates and Financing, and Future Developments.

  9. Male Adolescent Contraceptive Utilization.

    Science.gov (United States)

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  10. "Utilizing" signal detection theory.

    Science.gov (United States)

    Lynn, Spencer K; Barrett, Lisa Feldman

    2014-09-01

    What do inferring what a person is thinking or feeling, judging a defendant's guilt, and navigating a dimly lit room have in common? They involve perceptual uncertainty (e.g., a scowling face might indicate anger or concentration, for which different responses are appropriate) and behavioral risk (e.g., a cost to making the wrong response). Signal detection theory describes these types of decisions. In this tutorial, we show how incorporating the economic concept of utility allows signal detection theory to serve as a model of optimal decision making, going beyond its common use as an analytic method. This utility approach to signal detection theory clarifies otherwise enigmatic influences of perceptual uncertainty on measures of decision-making performance (accuracy and optimality) and on behavior (an inverse relationship between bias magnitude and sensitivity optimizes utility). A "utilized" signal detection theory offers the possibility of expanding the phenomena that can be understood within a decision-making framework. © The Author(s) 2014.

  11. The Longue Durée of Black Lives Matter.

    Science.gov (United States)

    Nelson, Alondra

    2016-10-01

    Black Lives Matter was first articulated just a few years ago, but it has been the leitmotif of antiracist struggles for generations. The Movement for Black Lives extends the work of previous movements that challenged forms of oppression that act on Black bodies with impunity. It should be understood in the context of Ida B. Wells' anti-lynching campaign, Fannie Lou Hamer's reproductive justice demands, and the Black Panther Party's health activism. The 50th anniversary of the Black Panther Party is an occasion to recall that its work confronted the callous neglect and the corporeal surveillance and abuse of poor Black communities. Similar demands have been the centrifugal force of social movements that for centuries have refused to have Black lives cast beyond the human boundary.

  12. A comprehensive analysis of the geomagnetic storms occurred dur

    Directory of Open Access Journals (Sweden)

    Essam Ghamry

    2016-06-01

    Full Text Available The Geomagnetic storms are considered as one of the major natural hazards. Egyptian geomagnetic observatories observed multiple geomagnetic storms during 18 February to 2 March 2014. During this period, four interplanetary shocks successively hit the Earth’s magnetosphere, leading to four geomagnetic storms. The storm onsets occurred on 18, 20, 23 and 27 February. A non-substorm Pi2 pulsation was observed on 26 February. This Pi2 pulsation was detected in Egyptian observatories (Misallat and Abu Simbel, Kakioka station in Japan and Carson City station in US with nearly identical waveforms. Van Allen Probe missions observed non-compressional Pc4 pulsations on the recovery phase of the third storm. This Pc4 event is may be likely attributed to the decay of the ring current in the recovery phase.

  13. Dora Bruder and the Longue Durée

    Directory of Open Access Journals (Sweden)

    Susan Weiner

    2007-06-01

    Full Text Available Modiano's methods in Dora Bruder recall the Annales historiographer's rejection of the history of events in favor of the "long duration," but with human history as its object. Modiano's long duration draws out repetitions and variations between his own life and Dora's as he reconstructs and imagines it, between Dora and fictional characters, between Dora's story and the lives of Holocaust victims and survivors known and unknown. Moreover, the author encourages the reader to take part in the uncanny connections the novel makes, through movements of the imagination not unlike Modiano's own. In so doing, we approach Dora and those who shared her fate through their lives rather than their death, restoring to them the everyday freedom of their thoughts and actions alongside our own.

  14. consumers' understanding and use of textile eco-labels dur

    African Journals Online (AJOL)

    user

    textile industry to introduce greener technology textiles (Momberg ... E mail: daleen.vandermerwe@nwu.ac.za. — Ms N le Roux ..... African market, as such products are relatively unavailable and ...... Beauty 2(1&2):117-138. CLEVELAND, M.

  15. 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)

  16. 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)

  17. 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.

  18. 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)

  19. 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.

  20. The clinical utility of posturography.

    Science.gov (United States)

    Visser, Jasper E; Carpenter, Mark G; van der Kooij, Herman; Bloem, Bastiaan R

    2008-11-01

    Postural instability and falls are common and devastating features of ageing and many neurological, visual, vestibular or orthopedic disorders. Current management of these problems is hampered by the subjective and variable nature of the available clinical balance measures. In this narrative review, we discuss the clinical utility of posturography as a more objective and quantitative measure of balance and postural instability, focusing on several areas where clinicians presently experience the greatest difficulties in managing their patients: (a) to make an appropriate differential diagnosis in patients presenting with falls or balance impairment; (b) to reliably identify those subjects who are at risk of falling; (c) to objectively and quantitatively document the outcome of therapeutic interventions; and (d) to gain a better pathophysiological understanding of postural instability and falls, as a basis for the development of improved treatment strategies to prevent falling. In each of these fields, posturography offers several theoretical advantages and, when applied correctly, provides a useful tool to gain a better understanding of pathophysiological mechanisms in patients with balance disorders, at the group level. However, based on the available evidence, none of the existing techniques is currently able to significantly influence the clinical decision making in individual patients. We critically review the shortcomings of posturography as it is presently used, and conclude with several recommendations for future research.

  1. 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...

  2. 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)

  3. 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.

  4. 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.)

  5. Biomass ash utilization

    Energy Technology Data Exchange (ETDEWEB)

    Bristol, D.R.; Noel, D.J.; O`Brien, B. [HYDRA-CO Operations, Inc., Syracuse, NY (United States); Parker, B. [US Energy Corp., Fort Fairfield, ME (United States)

    1993-12-31

    This paper demonstrates that with careful analysis of ash from multiple biomass and waste wood fired power plants that most of the ash can serve a useful purpose. Some applications require higher levels of consistency than others. Examples of ash spreading for agricultural purposes as a lime supplement for soil enhancement in Maine and North Carolina, as well as a roadbase material in Maine are discussed. Use of ash as a horticultural additive is explored, as well as in composting as a filtering media and as cover material for landfills. The ash utilization is evaluated in a framework of environmental responsibility, regulations, handling and cost. Depending on the chemical and physical properties of the biomass derived fly ash and bottom ash, it can be used in one or more applications. Developing a program that utilizes ash produced in biomass facilities is environmentally and socially sound and can be financially attractive.

  6. Utilization of research reactors

    International Nuclear Information System (INIS)

    1962-01-01

    About 200 research reactors are now in operation in different parts of the world, and at least 70 such facilities, which are in advanced stages of planning and construction, should be critical within the next two or three years. In the process of this development a multitude of problems are being encountered in formulating and carrying out programs for the proper utilization of these facilities, especially in countries which have just begun or are starting their atomic energy work. An opportunity for scientific personnel from different Member States to discuss research reactor problems was given at an international symposium on the Programing and Utilization of Research Reactors organized by the Agency almost immediately after the General Conference session. Two hundred scientists from 35 countries, as well as from the European Nuclear Energy Agency and EURATOM, attended the meeting which was held in Vienna from 16 to 21 October 1961

  7. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

  8. Industrial coal utilization

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-01-01

    The effects of the National Energy Act on the use of coal in US industrial and utility power plants are considered. Innovative methods of using coal in an environmentally acceptable way are discussed: furnace types, fluidized-bed combustion, coal-oil-mixtures, coal firing in kilns and combustion of synthetic gas and liquid fuels. Fuel use in various industries is discussed with trends brought about by uncertain availability and price of natural gas and fuel oils: steel, chemical, cement, pulp and paper, glass and bricks. The symposium on Industrial Coal Utilization was sponsored by the US DOE, Pittsburgh Energy Technology Center, April 3 to 4, 1979. Twenty-one papers have been entered individually into the EDB. (LTN)

  9. Utility customer issues

    International Nuclear Information System (INIS)

    Downey, W.H.

    1997-01-01

    Customer issues affected by the restructuring of the $250 billion US electric power industry were discussed. In the past the industry's vertically integrated utilities conducted their business in protected geographic markets. With deregulation and greater competition, that industry structure will change. This presentation highlighted the strategies that Unicom is using to react to the restructuring of the electric power industry. The underlying principle is for the utility to reinvent itself to change its market orientation and focus on customer services, such as reliability, responsiveness, custom tailored solutions, and guaranteed savings over time. Attempting to become total energy providers and delivering integrated solutions to meet the needs of large industrial and commercial consumers, intensive market research, improved service and installation, and sophisticated customer retention initiatives will also have to be high on the agenda

  10. Role of the utility

    International Nuclear Information System (INIS)

    Bellin, A.

    1986-03-01

    It is common to say that a nuclear programme needs basic infrastructures such as an appropriate educational system, governmental organizations for regulation, decision and inspection, engineering organizations for design and implementation, industrial infrastructures for manufacturing, erection and commissioning, operation organizations for running and maintaining power plants. This schematic organization is not sufficient to succeed in a nuclear programme: one has to consider very carefully the attribution of responsibilities. It appears, that, among all the different systems which exist in the world for the organization of a nuclear project, it is always the utility which bears the overall responsibility for the implementation of the project. It defines objectives such as production capacity, schedule, price; it takes part in the definition of a national policy for energy supply, for the choice of a type of reactor, for the implementation of a national nuclear industry; it selects sites and conducts feasibility studies including a preliminary project; it participates in the definition of organization charts and selects contractors; it calls for and obtains authorizations from regulatory bodies; it manages the project, coordinates contractors and permanently ensures that goals are attained as regards safety, quality, schedule, costs. The French utility has directly taken charge of all these basic responsibilities and this is commonly considered as a major reason of the success of the French nuclear programme. Depending on its capacities, the utility may delegate some of these responsibilities - mainly concerning engineering and project management - to experienced firms. Nevertheless, one has to remember that the utility bears the final responsibility and that it is probably the organization most fully aware of the fact that the final goal is not the construction of a nuclear power station but the production of nuclear electricity in the best and safest conditions

  11. Reactor utilization, Annex A

    International Nuclear Information System (INIS)

    Martinc, R.; Stanic, A.

    1984-01-01

    Reactor was operated until August 1984 due to prohibition issued by the Ministry since the reactor does not have the emergency cooling system nor special filters in the ventilation system yet. This means that the operation plan was fulfilled by 69%. This annex includes detailed tables containing data about utilization of reactor experimental channels, irradiated samples, as well as interruptions of operation. Detailed data about reactor power during this period are shown as well

  12. Electric utilities in 2007

    Energy Technology Data Exchange (ETDEWEB)

    Hyman, L.S. [Smith Barney Inc., New York, NY (United States)

    1998-10-01

    A century ago--in the year J.J. Thomson discovered the electron--electricity, gas and traction companies battled for markets, and corrupt city councils demanded their fair share of the take. One tycoon became so disgusted with the confusion and dishonesty that he decided to bribe the legislature to set up an honest, state-run regulatory agency that would bring order to chaos. But he was found out. The scandal set back the cause of regulation until 1907, the year in which the electric washing machine and the vacuum cleaner were invented. By then, electricity sales had septupled from 1897 levels, and three states had established utility regulation. In the coming decade, 1997 to 2007, the utility business could undergo similar dramatic change, but it will move toward less regulation and more competition during a period of slow growth. Management will have to work harder to achieve success, however, because much of the profits will have to come not from a growing market but from the pockets of competitors. By 2007, electricity will constitute a component of a larger energy and utility services industry that sells electricity, natural gas and possibly water, propane and telecommunications. Customized service will meet the needs of consumers of all sizes. The dominant firm in the industry, the virtual utility, may look more like a financial organization or a mass marketer than the traditional converter of raw material to energy. Emphasis on market-based pricing should lead to more efficient use of resources. If the process works right, the consumer wins.

  13. Utilization of biogas

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, J L; Ross, C C; Smith, M S; Harper, S R [Georgia Tech Research Corp., Atlanta, GA (USA)

    1989-01-01

    A comprehensive study of the systems and equipment required to convert biogas into useful thermal and/or electrical energy was conducted, and the results published in the Handbook on Biogas Utilization (Walsh et al., Georgia Institute of Technology, Atlanta, GA, 1988). The physical, chemical and combustion characteristics of biogas, and the impact of these characteristics on both new and modified combustion equipment, were considered. The study also included consideration of auxiliary equipment for biogas collection, clean-up, compression and storage. (author).

  14. UTILITY OF SIMPLIFIED LABANOTATION

    Directory of Open Access Journals (Sweden)

    Maria del Pilar Naranjo

    2016-02-01

    Full Text Available After using simplified Labanotation as a didactic tool for some years, the author can conclude that it accomplishes at least three main functions: efficiency of rehearsing time, social recognition and broadening of the choreographic consciousness of the dancer. The doubts of the dancing community about the issue of ‘to write or not to write’ are highly determined by the contexts and their own choreographic evolution, but the utility of Labanotation, as a tool for knowledge, is undeniable.

  15. 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.

  16. 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

  17. 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)

  18. Clean energy utilization technology

    International Nuclear Information System (INIS)

    Honma, Takuya

    1992-01-01

    The technical development of clean energy including the utilization of solar energy was begun in 1973 at the time of the oil crisis, and about 20 years elapsed. Also in Japan, the electric power buying system by electric power companies for solar light electric power and wind electric power has been started in 1992, namely their value as a merchandise was recognized. As for these two technologies, the works of making the international standards and JIS were begun. The range of clean energy or natural energy is wide, and its kinds are many. The utilization of solar heat and the electric power generation utilizing waves, tide and geotherm already reached the stage of practical use. Generally in order to practically use new energy, the problem of price must be solved, but the price is largely dependent on the degree of spread. Also the reliability, durability and safety must be ensured, and the easiness of use, effectiveness and trouble-saving maintenance and operation are required. For the purpose, it is important to packaging those skillfully in a system. The cases of intelligent natural energy systems are shown. Solar light and wind electric power generation systems and the technology of transporting clean energy are described. (K.I.)

  19. 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.

  20. 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

  1. Market research for electric utilities

    International Nuclear Information System (INIS)

    Shippee, G.

    1999-01-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to

  2. Utilization of beech

    Energy Technology Data Exchange (ETDEWEB)

    Heckemann, H

    1980-01-01

    The paper reviews (for beech in W. Germany, and, in many cases for competitive hardwoods/softwoods): regional felling statistics/assortment structures; age class structures; profitability/prices; import/export trends; sales trends (for beech timber from Hesse State Forests); beech plywood production; ownership of forests, and specific uses of beech, including as an energy source, in sleepers, and in furniture.

  3. Time Functions as Utilities

    Science.gov (United States)

    Minguzzi, E.

    2010-09-01

    Every time function on spacetime gives a (continuous) total preordering of the spacetime events which respects the notion of causal precedence. The problem of the existence of a (semi-)time function on spacetime and the problem of recovering the causal structure starting from the set of time functions are studied. It is pointed out that these problems have an analog in the field of microeconomics known as utility theory. In a chronological spacetime the semi-time functions correspond to the utilities for the chronological relation, while in a K-causal (stably causal) spacetime the time functions correspond to the utilities for the K + relation (Seifert’s relation). By exploiting this analogy, we are able to import some mathematical results, most notably Peleg’s and Levin’s theorems, to the spacetime framework. As a consequence, we prove that a K-causal (i.e. stably causal) spacetime admits a time function and that the time or temporal functions can be used to recover the K + (or Seifert) relation which indeed turns out to be the intersection of the time or temporal orderings. This result tells us in which circumstances it is possible to recover the chronological or causal relation starting from the set of time or temporal functions allowed by the spacetime. Moreover, it is proved that a chronological spacetime in which the closure of the causal relation is transitive (for instance a reflective spacetime) admits a semi-time function. Along the way a new proof avoiding smoothing techniques is given that the existence of a time function implies stable causality, and a new short proof of the equivalence between K-causality and stable causality is given which takes advantage of Levin’s theorem and smoothing techniques.

  4. 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

  5. Electricity utilities: Nuclear sector

    International Nuclear Information System (INIS)

    Brosche, D.

    1992-01-01

    The safe and economic operation of nuclear power plants requires an appropriate infrastructure on the part of the operator as well as a high level of technical quality of the plants and of qualification of the personnel. Added to this are a variety of services rendered by specialist firms. The Bayernwerk utility, with plants of its own, has played a major role in the development of nuclear power in the Federal Republic of Germany. The importance of nuclear power to this firm is reflected in the pattern of its electricity sources and in the composition of its power plants. (orig.) [de

  6. Energy utilization in Canada

    International Nuclear Information System (INIS)

    Klassen, J.

    1976-04-01

    The situation of the energy supply of Canada is characterized by its geographic location and by the dispersal of the energy consumers over a wide area. At present, the energy supply leaving the successful CANDU nuclear energy programme out of account, is based mainly on crude oil, natural gas, and electricity as well as on coal imported from the USA. The targets of Canadian enery policies and energy research are stated as follows: a) Reducing and optimizing energy consumption, b) introducing district heating, and c) utilizing the extensive local coal deposits. (GG) [de

  7. Managing the nuclear utility

    International Nuclear Information System (INIS)

    Williams, J.W. Jr.

    1985-01-01

    The Florida Power and Light Company (FP and L) is the fifth largest investor-owned utility in the country. The success of nuclear power generation at the St. Lucie Units 1 and 2 and Turkey Point Units 3 and 4 has resulted from a continuing management commitment to the nuclear program. The management of the power plants rely strongly on teamwork for most large projects and activities whether they entail plant operation, construction, or maintenance. Various examples of how teamwork has been used to realize the successful completion of projects or solutions to problems are given

  8. Tribal Utility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Engel, R. A.; Zoellick, J. J.

    2007-06-30

    The Schatz Energy Research Center (SERC) assisted the Yurok Tribe in investigating the feasibility of creating a permanent energy services program for the Tribe. The original purpose of the DOE grant that funded this project was to determine the feasibility of creating a full-blown Yurok Tribal electric utility to buy and sell electric power and own and maintain all electric power infrastructure on the Reservation. The original project consultant found this opportunity to be infeasible for the Tribe. When SERC took over as project consultant, we took a different approach. We explored opportunities for the Tribe to develop its own renewable energy resources for use on the Reservation and/or off-Reservation sales as a means of generating revenue for the Tribe. We also looked at ways the Tribe can provide energy services to its members and how to fund such efforts. We identified opportunities for the development of renewable energy resources and energy services on the Yurok Reservation that fall into five basic categories: • Demand-side management – This refers to efforts to reduce energy use through energy efficiency and conservation measures. • Off-grid, facility and household scale renewable energy systems – These systems can provide electricity to individual homes and Tribal facilities in areas of the Reservation that do not currently have access to the electric utility grid. • Village scale, micro-grid renewable energy systems - These are larger scale systems that can provide electricity to interconnected groups of homes and Tribal facilities in areas of the Reservation that do not have access to the conventional electric grid. This will require the development of miniature electric grids to serve these interconnected facilities. • Medium to large scale renewable energy development for sale to the grid – In areas where viable renewable energy resources exist and there is access to the conventional electric utility grid, these resources can be

  9. Social group utility maximization

    CERN Document Server

    Gong, Xiaowen; Yang, Lei; Zhang, Junshan

    2014-01-01

    This SpringerBrief explains how to leverage mobile users' social relationships to improve the interactions of mobile devices in mobile networks. It develops a social group utility maximization (SGUM) framework that captures diverse social ties of mobile users and diverse physical coupling of mobile devices. Key topics include random access control, power control, spectrum access, and location privacy.This brief also investigates SGUM-based power control game and random access control game, for which it establishes the socially-aware Nash equilibrium (SNE). It then examines the critical SGUM-b

  10. Deprival value: information utility analysis

    Directory of Open Access Journals (Sweden)

    Marco Antonio Pereira

    Full Text Available ABSTRACT This article contributes to the perception that the users’ learning process plays a key role in order to apply an accounting concept and this involves a presentation that fits its informative potential, free of previous accounting fixations. Deprival value is a useful measure for managerial and corporate purposes, it may be applied to the current Conceptual Framework of the International Accounting Standards Board (IASB. This study analyzes its utility, taking into account cognitive aspects. Also known as value to the business, deprival value is a measurement system that followed a path where it was misunderstood, confused with another one, it faced resistance to be implemented and fell into disuse; everything that a standardized measurement method tries to avoid. In contrast, deprival value has found support in the academy and in specific applications, such as those related to the public service regulation. The accounting area has been impacted by sophistication of the measurement methods that increasingly require the ability to analyze accounting facts on an economic basis, at the risk of loss of their information content. This development becomes possible only when the potential of a measurement system is known and it is feasible to be achieved. This study consists in a theoretical essay based on literature review to discuss its origin, presentation, and application. Considering the concept’s cognitive difficulties, deprival value was analyzed, as well as its corresponding heteronym, value to the business, in order to explain some of these changes. The concept’s utility was also explored through cross-analysis with impairment and the scheme developed was applied to actual economic situations faced by a company listed on stock exchange.

  11. 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)

  12. Geothermal Resource Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, Paul J.

    1998-01-03

    Man has utilized the natural heat of the earth for centuries. Worldwide direct use of geothermal currently amounts to about 7,000 MWt, as compared to 1,500 MWe, now being used for the generation of electricity. Since the early 1970s, dwindling domestic reservoirs of oil and gas, continued price escalation of oil on the world market and environmental concerns associated with coal and nuclear energy have created a growing interest in the use of geothermal energy in the United States. The Department of Energy goals for hydrothermal resources utilization in the United States, expressed in barrels of oil equivalent, is 50 to 90 million bbl/yr by 1985 and 350 to 900 million bbl/yr by the year 2000. This relatively clean and highly versatile resource is now being used in a multitude of diverse applications (e.g., space heating and cooling, vegetable dehydration, agriculture, aquaculture, light manufacturing), and other applications requiring a reliable and economic source of heat.

  13. Utilization of coalbed methane

    Energy Technology Data Exchange (ETDEWEB)

    Gustavson, J.B. [Gustavson Associates Inc., Boulder, CO (United States)

    1996-02-01

    Substantial progress has been made in capturing coalbed methane (CBM gas), which constitutes a valuable source of clean burning energy. It is of importance to study the various potential uses of coalbed methane and to understand the various technologies required, as well as their economics and any institutional constraints. In industrialised countries, the uses of coalbed methane are almost solely dependent on microeconomics; coalbed methane must compete for a market against natural gas and other energy sources - and frequently, coalbed methane is not competitive against other energy sources. In developing countries, on the other hand, particularly where other sources of energy are in short supply, coalbed methane economics yield positive results. Here, constraints to development of CBM utilization are mainly lack of technology and investment capital. Sociological aspects such as attitude and cultural habits, may also have a strong negative influence. This paper outlines the economics of coalbed methane utilization, particularly its competition with natural gas, and touches upon the many different uses to which coalbed methane may be applied. 24 refs., 4 figs.

  14. 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

  15. 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.

  16. 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...

  17. Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose

    Energy Technology Data Exchange (ETDEWEB)

    Menke, Jan [University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Goettingen (Germany); Kowalski, Joerg [Dr. Lauterbach-Klinik, Department of Cardiology, Bad Liebenstein (Germany)

    2016-02-15

    To meta-analyze diagnostic accuracy, test yield and utility of coronary computed tomography angiography (CCTA) in coronary artery disease (CAD) by an intention-to-diagnose approach with inclusion of unevaluable results. Four databases were searched from 1/2005 to 3/2013 for prospective studies that used 16-320-row or dual-source CTs and provided 3 x 2 patient-level data of CCTA (positive, negative, or unevaluable) versus catheter angiography (positive or negative) for diagnosing ≥50 % coronary stenoses. A Bayesian multivariate 3 x 2 random-effects meta-analysis considered unevaluable CCTAs. Thirty studies (3422 patients) were included. Compared to 16-40 row CT, test yield and accuracy of CCTA has significantly increased with ≥64-row CT (P < 0.05). In ≥64-row CT, about 2.5 % (95 %-CI, 0.9-4.8 %) of diseased patients and 7.5 % (4.5-11.2 %) of non-diseased patients had unevaluable CCTAs. A positive likelihood ratio of 8.9 (6.1-13.5) indicated moderate suitability for identifying CAD. A negative likelihood ratio of 0.022 (0.01-0.04) indicated excellent suitability for excluding CAD. Unevaluable CCTAs had an equivocal likelihood ratio of 0.42 (0.22-0.71). In the utility analysis, CCTA was useful at intermediate pre-test probabilities (16-70 %). CCTA is useful at intermediate CAD pre-test probabilities. Positive CCTAs require verification to confirm CAD, unevaluable CCTAs require alternative diagnostics, and negative CCTAs exclude obstructive CAD with high certainty. (orig.)

  18. Utilities in UNIX

    International Nuclear Information System (INIS)

    Perez, L.

    2002-01-01

    This manual goes to the users with some or much experience in the unix operating system. In such manner that they can get more efficiency using the unix of the most vendors. Include the majority of UNIX commands, shell built-in functions to create scripts, and a brief explication of the variables in several environments. In addition, other products are included, more and more integrated in the most of the unix operating systems. For example: the scanning and processing language awk, the print server LPRng, GNU Utilities, batch subsystem, etc. The manual was initially based in an specific unix. But it and been written for use of the most unix that exist: Tru64 unix, aix, iris, hpux. solaris y linux. In this way, many examples in the chapter had been included. The purpose of this manual is to provide an UNIX reference for advanced users in any of the unix operating systems family. (Author)

  19. Hydrogen and energy utilities

    Energy Technology Data Exchange (ETDEWEB)

    Hustadt, Daniel [Vattenfall Europe Innovation GmbH (Germany)

    2010-07-01

    Renewable electricity generation plays one major role with the biggest share being wind energy. At the end of the year 2009 a wind power plant capacity of around 26 GW was installed in Germany. Several outlooks come to the conclusion that this capacity can be doubled in ten years (compare Figure 1). Additionally the German government has set a target of 26 GW installed off-shore capacity in North and Baltic Sea until 2030. At Vattenfall only a minor percentage of the electricity production comes from wind power today. This share will be increased up to 12% until 2030 following Vattenfall's strategy 'Making Electricity Clean'. This rapid development of wind power offers several opportunities but also means some challenges to Utilities. (orig.)

  20. Utility prudency issues

    International Nuclear Information System (INIS)

    Charnoff, G.

    1986-01-01

    The conventional legal standard of prudence found in the common law of public utility regulation precludes a judgment about past decisions based on present knowledge of whether the decisions proved in time to have been right or wrong. The proper inquiry is not whether every management decision proved to be correct. Rather, the proper inquiry as stated by the New York Public Service Commission in Re Consolidated Edison Co. of New York, Inc. is ...whether the company's conduct was reasonable at the time, under all of the circumstances, considering that the company had to solve its problems prospectively.... The exercise of prudence does not guarantee performance on schedule or within budget, or the making of correct decisions, when judged after the fact. But it does require or involve the exercise of reasoned decision making within a framework of reasonably available alternatives

  1. Electric utilities and clean air

    International Nuclear Information System (INIS)

    Evans, J.E.

    1991-01-01

    This paper reports that electricity has become essential to American life. Approximately 70 percent of the nation's electricity is produced by burning fossil fuels, with coal, the most abundant, domestically-available, extracted natural resource, providing over 55 percent of the total electricity consumed. Emissions resulting from the burning of fossil fuels are regulated by both the federal and state governments. In 1970, Congress passed the comprehensive Clean Air Act which established a national program to protect the nation's air quality. In 1977, additional strict regulations were passed, which mandated even more stringent emission controls for factories, power plants and auto emissions. Prior to passage of the Clean Air Act of 1990, utilities were required to adhere to three major types of clean air regulations: National Ambient Air Quality Standards (NAAQS), New Source Performance Standards (NSPS), and Prevention of Significant Deterioration (PSD) review. NAAQS established limits for the maximum concentration levels of specific air pollutants in the ambient atmosphere. For example, for an area to be in compliance with the NAAQS for sulfur dioxide (SO 2 ), its annual average SO 2 concentration must not exceed 0.03 ppm of SO 2 and a peak 24 hour level of 0.14 ppm of SO 2 must not be exceeded more than once per year

  2. Utilization of 'pluthermal' in Japan

    International Nuclear Information System (INIS)

    Itakura, Tetsuro; Takahashi, Yoshinobu

    1982-01-01

    The plutonium recycle subscommittee of the atomic energy committee in the Advisory Committee for Energy of the Ministry of International Trade and Industry reported that the use of plutonium to thermal reactors should be positively promoted, and the establishment of plutonium technology and the effective utilization of plutonium, which is a semi-domestic resource, should be attempted. The use of plutonium to thermal reactors, specifically to light water reactors, is called ''Pluthermal'', and hereafter, the use of plutonium for this purpose will be written as ''Pluthermal''. In this review, first the outline of the interim report of the plutonium recycle subcommittee is described, next, the plutonium balance, SGR (self generating recycle) and technical problems for ''Pluthermal'', and the ATRs (advanced thermal reactor) for ''Pluthermal'' are discussed. If the present capacity of nuclear power generation is assumed to be 17 million kW, it is estimated that about 10 tons of plutonium is in reactors, and 3 tons or more plutonium are taken out every year, contained in spent fuel. For those, reprocessing techniques must be fully established to prepare for future fast reactor operation. At present, 400 to 500 kg of plutonium is always in a light water reactor. If it is assumed that the MOX (mixed oxide fuel) of 30 % Pu is loaded to these reactors, no essential difference arises because its quantity only becomes about 900 kg. Finally, the results of ''Pulthermal'' in foreign countries are briefly reported. (Sakatsuki, Y.)

  3. Energy utilities and the Internet

    International Nuclear Information System (INIS)

    2000-01-01

    The chances for energy utilities in the Netherlands to present themselves on the Internet are briefly outlined. It appears that other businesses are ahead of the Dutch utilities in offering electronic services with respect to energy

  4. Développement d’un modèle statistique de prédiction de la durée de vie du rachis lombaire, dépendant de la contrainte appliquée, de l’âge et de la densité osseuse

    Directory of Open Access Journals (Sweden)

    Houcine Ayari

    2005-05-01

    Full Text Available École de technologie supérieure, 1100, rue Notre-Dame Du fait de l’inhomogénéité densimétrique et structurale des vertèbres entre les individus et du fait que la résistance osseuse dépende de la densité osseuse et de la continuité du réseau trabéculaire, qui change avec l’âge, on ne peut pas considérer que le comportement en fatigue des vertèbres dépende uniquement de la contrainte appliquée. Dans cette étude, un modèle de prédiction de durée de vie est proposé permettant d’évaluer le nombre de cycles de fatigue avant dommage en fonction de la contrainte appliquée, de la densité osseuse et de l’âge du spécimen. Vu leur grande dispersion, les résultats des essais de fatigue publiés par Brinckmann (1988 ont été classifiés afin de pouvoir être analysés par la méthode des plans d’expériences. Un modèle non linéaire présentant un coefficient de détermination R2 de 94 % est établi. En comparant les valeurs prédites par ce modèle avec les résultats des essais de fatigue de Hansson (1987, on constate une certaine cohérence entre les résultats. Cette étude justifie l’hypothèse que la densité osseuse et l’âge outre la contrainte appliquée ont un effet sur la fatigue du rachis.Due to vertebral densimetric and structural inhomogeneity between individuals and the fact that bone strength varies with bone density and discontinuities within the trabecular lattice which changes with age, vertebral fatigue behavior cannot be considered as depending only on the cyclic stress. In this study, a lifetime prediction model is proposed for evaluating the number of cycles before damage as a function of the cyclic stress, bone density and age of the specimen. Due to their large dispersion, the results of the fatigue tests published by Brinckmann (1988 have been classified for analysis using the experiment design method. A nonlinear model presenting a coefficient of determination R2 of 94% has been

  5. YEAR 2 BIOMASS UTILIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Christopher J. Zygarlicke

    2004-11-01

    This Energy & Environmental Research Center (EERC) Year 2 Biomass Utilization Final Technical Report summarizes multiple projects in biopower or bioenergy, transportation biofuels, and bioproducts. A prototype of a novel advanced power system, termed the high-temperature air furnace (HITAF), was tested for performance while converting biomass and coal blends to energy. Three biomass fuels--wood residue or hog fuel, corn stover, and switchgrass--and Wyoming subbituminous coal were acquired for combustion tests in the 3-million-Btu/hr system. Blend levels were 20% biomass--80% coal on a heat basis. Hog fuel was prepared for the upcoming combustion test by air-drying and processing through a hammer mill and screen. A K-Tron biomass feeder capable of operating in both gravimetric and volumetric modes was selected as the HITAF feed system. Two oxide dispersion-strengthened (ODS) alloys that would be used in the HITAF high-temperature heat exchanger were tested for slag corrosion rates. An alumina layer formed on one particular alloy, which was more corrosion-resistant than a chromia layer that formed on the other alloy. Research activities were completed in the development of an atmospheric pressure, fluidized-bed pyrolysis-type system called the controlled spontaneous reactor (CSR), which is used to process and condition biomass. Tree trimmings were physically and chemically altered by the CSR process, resulting in a fuel that was very suitable for feeding into a coal combustion or gasification system with little or no feed system modifications required. Experimental procedures were successful for producing hydrogen from biomass using the bacteria Thermotoga, a deep-ocean thermal vent organism. Analytical procedures for hydrogen were evaluated, a gas chromatography (GC) method was derived for measuring hydrogen yields, and adaptation culturing and protocols for mutagenesis were initiated to better develop strains that can use biomass cellulose. Fly ash derived from

  6. National Utility Rate Database: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Ong, S.; McKeel, R.

    2012-08-01

    When modeling solar energy technologies and other distributed energy systems, using high-quality expansive electricity rates is essential. The National Renewable Energy Laboratory (NREL) developed a utility rate platform for entering, storing, updating, and accessing a large collection of utility rates from around the United States. This utility rate platform lives on the Open Energy Information (OpenEI) website, OpenEI.org, allowing the data to be programmatically accessed from a web browser, using an application programming interface (API). The semantic-based utility rate platform currently has record of 1,885 utility rates and covers over 85% of the electricity consumption in the United States.

  7. Utility service entrance in boreholes

    International Nuclear Information System (INIS)

    1987-08-01

    This study evaluates alternatives for utility service entrances to the repository. We determined the requirements for a repository utility supply. These requirements were defined as safety, maintainability, flexibility, reliability, cost efficiency, voltage regulation, and simplicity of operation. The study showed that repository shafts can best satisfy all requirements for location of the utility supply without the use of borehole penetrations into the repository. It is recommended that the shafts be utilized for utility distribution to the repository, and that the current NWTS program position to minimize the number of boreholes penetrating the repository horizon be maintained. 42 refs., 2 figs., 3 tabs

  8. Utility application of simulation software

    International Nuclear Information System (INIS)

    Sudduth, A.L.

    1986-01-01

    The purpose of this paper is to discuss dynamic system simulation from the perspective of a successful utility user. In it, four aspects of the issue of utility use of simulation will be addressed: (1) What simulation software is available to utilities which can be of practical assistance with a modest investment in staff and training. (2) To what specific problems can utilities apply the technique of simulation and achieve reasonably cost effective results. (3) What the advantages are of in-house dynamic simulation capability, as opposed to depending on NSSS vendors or consultants. (4) What the prospects are for wider use of dynamic simulation in the utility industry

  9. Market research for electric utilities

    Energy Technology Data Exchange (ETDEWEB)

    Shippee, G.

    1999-12-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to.

  10. Utilization management in anatomic pathology.

    Science.gov (United States)

    Lewandrowski, Kent; Black-Schaffer, Steven

    2014-01-01

    There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management. © 2013.

  11. SYMPAL: utilities guide

    International Nuclear Information System (INIS)

    Simpson, J.A.; Sublet, J.-Ch.

    1997-02-01

    The processing code SYMPAL is used to perform the data treatment for creating a new version of the European Activation File (EAF). The entire process is handled by different modules of the code in a sequential and orderly manner. The modular code system accesses, translates and processes cross section data from a wide variety of libraries and calculations with nuclear model codes. Two major data bases are accessed and merged so as to create a new library version. The Master Data File (MDF) contains the original cross section data extracted, unmodified but reformatted, from numerous sources. The Master Parameter File (MPF) contains a compilation of all physical information necessary to renormalise, split and internally validate any particular type of cross section. The combination of these two files generates a new activation library in pointwise and various groupwise formats. The SYMPAL utilities guide describes a set of programs developed to handle certain aspects of the procedure done outside of the main processing tasks. These include counting, translating, selecting and plotting data streams. Special printing and plotting procedures have been written to handle the large amounts of information present in activation libraries. (author)

  12. Gnuastro: GNU Astronomy Utilities

    Science.gov (United States)

    Akhlaghi, Mohammad

    2018-01-01

    Gnuastro (GNU Astronomy Utilities) manipulates and analyzes astronomical data. It is an official GNU package of a large collection of programs and C/C++ library functions. Command-line programs perform arithmetic operations on images, convert FITS images to common types like JPG or PDF, convolve an image with a given kernel or matching of kernels, perform cosmological calculations, crop parts of large images (possibly in multiple files), manipulate FITS extensions and keywords, and perform statistical operations. In addition, it contains programs to make catalogs from detection maps, add noise, make mock profiles with a variety of radial functions using monte-carlo integration for their centers, match catalogs, and detect objects in an image among many other operations. The command-line programs share the same basic command-line user interface for the comfort of both the users and developers. Gnuastro is written to comply fully with the GNU coding standards and integrates well with all Unix-like operating systems. This enables astronomers to expect a fully familiar experience in the source code, building, installing and command-line user interaction that they have seen in all the other GNU software that they use. Gnuastro's extensive library is included for users who want to build their own unique programs.

  13. Gas utilization technologies

    International Nuclear Information System (INIS)

    Biljetina, R.

    1994-01-01

    One of the constant challenges facing the research community is the identification of technology needs 5 to 15 years from now. A look back into history indicates that the forces driving natural gas research have changed from decade to decade. In the 1970s research was driven by concerns for adequate supply; in the 1980s research was aimed at creating new markets for natural gas. What then are the driving forces for the 1990s? Recent reports from the natural gas industry have helped define a new direction driven primarily by market demand for natural gas. A study prepared by the Interstate Natural Gas Association of America Foundation entitled ''Survey of Natural Research, Development, and Demonstration RD ampersand D Priorities'' indicated that in the 1990s the highest research priority should be for natural gas utilization and that technology development efforts should not only address efficiency and cost, but environmental and regulatory issues as well. This study and others, such as the report by the American Gas Association (A.G.A.) entitled ''Strategic Vision for Natural Gas Through the Year 2000,'' clearly identify the market sectors driving today's technology development needs. The biggest driver is the power generation market followed by the industrial, transportation, appliance, and gas cooling markets. This is best illustrated by the GRI 1994 Baseline Projection on market growth in various sectors between the year 1992 and 2010. This paper highlights some of the recent technology developments in each one of these sectors

  14. Automated ISS Flight Utilities

    Science.gov (United States)

    Offermann, Jan Tuzlic

    2016-01-01

    During my internship at NASA Johnson Space Center, I worked in the Space Radiation Analysis Group (SRAG), where I was tasked with a number of projects focused on the automation of tasks and activities related to the operation of the International Space Station (ISS). As I worked on a number of projects, I have written short sections below to give a description for each, followed by more general remarks on the internship experience. My first project is titled "General Exposure Representation EVADOSE", also known as "GEnEVADOSE". This project involved the design and development of a C++/ ROOT framework focused on radiation exposure for extravehicular activity (EVA) planning for the ISS. The utility helps mission managers plan EVAs by displaying information on the cumulative radiation doses that crew will receive during an EVA as a function of the egress time and duration of the activity. SRAG uses a utility called EVADOSE, employing a model of the space radiation environment in low Earth orbit to predict these doses, as while outside the ISS the astronauts will have less shielding from charged particles such as electrons and protons. However, EVADOSE output is cumbersome to work with, and prior to GEnEVADOSE, querying data and producing graphs of ISS trajectories and cumulative doses versus egress time required manual work in Microsoft Excel. GEnEVADOSE automates all this work, reading in EVADOSE output file(s) along with a plaintext file input by the user providing input parameters. GEnEVADOSE will output a text file containing all the necessary dosimetry for each proposed EVA egress time, for each specified EVADOSE file. It also plots cumulative dose versus egress time and the ISS trajectory, and displays all of this information in an auto-generated presentation made in LaTeX. New features have also been added, such as best-case scenarios (egress times corresponding to the least dose), interpolated curves for trajectories, and the ability to query any time in the

  15. Fuel manufacturing and utilization

    International Nuclear Information System (INIS)

    2005-01-01

    The efficient utilisation of nuclear fuel requires manufacturing facilities capable of making advanced fuel types, with appropriate quality control. Once made, the use of such fuels requires a proper understanding of their behaviour in the reactor environment, so that safe operation for the design life can be achieved. The International Atomic Energy Agency supports Member States to improve in-pile fuel performance and management of materials; and to develop advanced fuel technologies for ensuring reliability and economic efficiency of the nuclear fuel cycle. It provides assistance to Member States to support fuel-manufacturing capability, including quality assurance techniques, optimization of manufacturing parameters and radiation protection. The IAEA supports the development fuel modelling expertise in Member States, covering both normal operation and postulated and severe accident conditions. It provides information and support for the operation of Nuclear Power Plant to ensure that the environment and water chemistry is appropriate for fuel operation. The IAEA supports fuel failure investigations, including equipment for failed fuel detection and for post-irradiation examination and inspection, as well as fuel repair, it provides information and support research into the basic properties of fuel materials, including UO 2 , MOX and zirconium alloys. It further offers guidance on the relationship with back-end requirement (interim storage, transport, reprocessing, disposal), fuel utilization and management, MOX fuels, alternative fuels and advanced fuel technology

  16. Utilization of whey

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    Compositions of wheys from cheesemaking and ultrafiltration are tabulated and some indications of the pollution potential and the cost of disposal of whey are given. The following treatments are described: ion exchange and electrodialysis for demineralization and deacidification; concentration by reverse osmosis, evaporation, spray drying, ''Hatmaker'' (roller) drying, and a drying technique using small Teflon balls; separation of proteins by ''Centri-Whey'' (Alfa-Laval) and ''Bel-Industrie'' heat/acid coagulation, ultrafiltration and other methods; purification and enzymic hydrolysis of lactose, and use of lactose as a substrate for protein biosynthesis by ''Bel'' (lactic acid yeast), ''Devos'' (Saccharomyces yeast) and ''Caliqua-Sireb'' (using fungi) processes. The use of whey for producing ethanol, lactic acid, vinegar, vitamins, antibiotics, enzymes and fats; and development of industrial whey processing in France are reviewed.

  17. Utilization of whey

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    Compositions of wheys from cheesemaking and ultrafiltration are tabulated and some indications of the pollution potential and the cost of disposal of whey are given. The following treatments are described: ion exchange and electrodialysis for demineralization and deacidification; concentration by reverse osmosis, evaporation, spray drying, ''Hatmaker'' (roller) drying, and a drying technique using small Teflon balls; separation of proteins by ''Centri-Whey'' (Alfa-Laval) and ''Bel-Industrie'' heat/acid coagulation, ultrafiltration and other methods; purification and enzymic hydrolysis of lactose, and use of lactose as a substrate for protein biosynthesis by ''Bel'' (lactic acid yeast), ''Devos'' (Saccharomyces yeast) and ''Caliqua-Sireb'' (using fungi) processes. The use of whey for producing ethanol, lactic acid, vinegar, vitamins, antibiotics, enzymes and fats; and development of industrial whey processing in France are reviewed.

  18. 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...

  19. 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

  20. 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.

  1. 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

  2. Utilización del adhesivo tisular tisuacryl en Estomatología: Revisión bibliográfica Utilization of tisuacryl tissue adhesive in dentistry: Bibliographic review

    Directory of Open Access Journals (Sweden)

    Mildres Barroso Palomino

    2005-12-01

    Full Text Available El trabajo presenta una revisión de la literatura nacional e internacional actualizada, así como experiencias realizadas en el campo de la Estomatología con los cianoacrilatos, haciendo énfasis en el adhesivo tisular tisuacryl , que es producido por el Centro de Biomateriales de la Universidad de La Habana. Se exponen resultados relevantes observados con su utilización como: sustituto de la sutura, apósito periodontal, en los autoinjertos gingivales, en el selle de alvéolos posextracción dentaria, en la toma de biopsias en la cavidad bucal y en el tratamiento de la estomatitis aftosa recurrente. Se detallan los avances logrados con esta terapia y la aceptación por parte de los pacientes que lo reciben.An updated review of the national and international literature, as well as the experiences obtained in the field of Stomatology with the cyanoacrylates are presented, making emphasis on the tisuacryl tissue adhesive, which is produced by the Center of Biomaterials of the University of Havana. The significant results attained with its use as a suture substitute and a periodontal dressing, and in the gingival autografts, the closure of the sockets after dental extraction, the taking of biopsies in the oral cavity, and the treatment of recurrent aphthous stomatitis, are exposed. The advances achieved with this therapy and the patient's acceptance are stressed.

  3. Facility Utilization Reports - FAA Aviation Information Utilization Reports

    Data.gov (United States)

    Department of Transportation — Provides: (1) Space management and planning, including area calculations, tracking space by organization and employee, and monitoring space utilization information....

  4. Utility Computing: Reality and Beyond

    Science.gov (United States)

    Ivanov, Ivan I.

    Utility Computing is not a new concept. It involves organizing and providing a wide range of computing-related services as public utilities. Much like water, gas, electricity and telecommunications, the concept of computing as public utility was announced in 1955. Utility Computing remained a concept for near 50 years. Now some models and forms of Utility Computing are emerging such as storage and server virtualization, grid computing, and automated provisioning. Recent trends in Utility Computing as a complex technology involve business procedures that could profoundly transform the nature of companies' IT services, organizational IT strategies and technology infrastructure, and business models. In the ultimate Utility Computing models, organizations will be able to acquire as much IT services as they need, whenever and wherever they need them. Based on networked businesses and new secure online applications, Utility Computing would facilitate "agility-integration" of IT resources and services within and between virtual companies. With the application of Utility Computing there could be concealment of the complexity of IT, reduction of operational expenses, and converting of IT costs to variable `on-demand' services. How far should technology, business and society go to adopt Utility Computing forms, modes and models?

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Useful information; Informations utiles

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This small booklet provides some indispensable notions to understand the problems related to any energy policy. After a short introduction of the French atomic energy commission (CEA), the following topics are reviewed successively: energy units and conversion tables; energy resources, consumption and costs (energy equivalence between fossil fuels, petroleum products and uranium, energy counting, calorific value of coals, annual consumption and production from thermal power plants, reserves and production of solid fuels and uranium worldwide, renewable energy consumption and energy independence of European Union countries, evolution of the worldwide energy consumption and population from 1800 to 2020, energy status of the European Union and France, electric power costs), the electric and electro-nuclear power (production, consumption, exports, nuclear share, characteristics of reactors, nuclear fuels management, fuel cycle, uranium needs, laser isotope separation, fuel processing and reprocessing, waste management), energy and environment (Kyoto conference, greenhouse gases and greenhouse effect, CO{sub 2} emissions, radioactive wastes, ultimate wastes generated by a 1000 MWe PWR, effluents produced by nuclear power plants), man and radiations (definitions and units, radioactive decay, half-life, penetration depth, exposures, radon, natural radioactivity), radioprotection and nuclear safety (international institutions, nuclear safety controls, INES scale, organisation of the CEA), general considerations and useful addresses. (J.S.)

  11. Successful liver transplantation from donor with Plesiomonas shigelloides sepsis after freshwater drowning: case report and review of literature on gram-negative bacterial aspiration during drowning and utilization of organs from bacteremic donors.

    Science.gov (United States)

    Bonatti, Hugo; Sifri, Costi; Sawyer, Robert G

    2012-04-01

    Plesiomonas shigelloides is a freshwater, non-fermentative gram-negative bacillus associated with diarrheal disease. Rare cases of invasive infection in human beings usually involve immunosuppressed individuals. We report a patient who underwent successful liver transplantation (LT) using a graft from a 14-year-old boy who had drowned in a freshwater lake. PUBMED was searched for both reported drowning victims with sepsis and outcomes of LT using organs from infected donors. Our patient received prophylactic piperacillin-tazobactam, which was switched to cefepime one day after transplantation when gram-negative bacteria grew in blood cultures of the donor. The next day, the organism was identified as P. shigelloides resistant to third- and fourth-generation cephalosporins; ciprofloxacin was given for seven days, and surveillance cultures remained negative. After an uneventful course the patient was discharged on day 10 after LT without signs of infection and is alive with a well-functioning graft. Literature review revealed one case of P. shigelloides in a potential allograft, in which the organism was isolated from heart valves of a drowning victim; the organs were discarded. Reports of freshwater drowning show that bacteremia is universally found post-mortem. Isolated pathogens correspond to specimens from the drowning site, with Aeromonas spp. being the most common and many other microorganisms described anecdotally. Livers from infected donors have been used, in most cases with good results if the recipient and, when possible, donor were treated appropriately; however, cases of fatal pathogen transmission have been reported. This is the first reported case of a LT using a graft from a donor with P. shigelloides sepsis. Drowning victims should be considered potentially infected with rare pathogens and therefore represent extended-criteria donors.

  12. Mox fuel utilization in ATR

    OpenAIRE

    下村 和生; 川太 徳夫

    1987-01-01

    ATR, a heavy-water moderated boiling-light-water cooled reactor developed in Japan, is a unique reactor with out-standing flexibility regarding nuclear fuel utilization, because it has superior properties concerning the utilization of plutonium, recovered uranium and depleted uranium. The development of this type of reactor is expected to contribute both to the stable supply of energy and to the establishment of plutonium utilization in Japan. Much effort has been and will be made on the deve...

  13. Subjective expected utility without preferences

    OpenAIRE

    Bouyssou , Denis; Marchant , Thierry

    2011-01-01

    This paper proposes a theory of subjective expected utility based on primitives only involving the fact that an act can be judged either "attractive" or "unattractive". We give conditions implying that there are a utility function on the set of consequences and a probability distribution on the set of states such that attractive acts have a subjective expected utility above some threshold. The numerical representation that is obtained has strong uniqueness properties.

  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. 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

  16. 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...

  17. VT Electric Utility Franchise Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) ELCFRANCHISE includes Vermont's Electric Utility Franchise boundaries. It is a compilation of many data sources. The boundaries are approximate...

  18. 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....

  19. 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

  20. 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