WorldWideScience

Sample records for volumes appropriately identified

  1. PATTERNS FOR IDENTIFYING APPROPRIATE KNOWLEDGE MANAGEMENT STRATEGIES IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Khadijeh Salmani

    2012-06-01

    Full Text Available Nowadays, striving to find an efficient way for developing or identifying appropriate knowledge management strategies in organizations has become so critical. Researchers and practitioners have attached great importance to information pyramids in organizations and have highlighted the lack of trained and skilled staff as a serious problem. On the other hand, having more flexibility at workplace, offering better service, and fulfilling customers' demands require a strategy for managing knowledge and its consequence. Knowledge management provides a wide range of different strategies and methods for identifying, creating, and sharing knowledge in organizations. This deep insight which consists of individual, organization’s experience, knowledge, and understanding helps organization respond to both internal and external stimuli and act in harmony. One fact which has seemingly achieved a consensus is the need for different strategies of knowledge management. Among the wide range of various and often unclear knowledge management strategies one can choose a strategy in a specific situation. The aim of this paper is to respond to strategic questions which emphasize competitive intelligence and internal knowledge retrieval system. The implications are discussed in detail.

  2. Appropriateness of using a symbol to identify dementia and/or delirium: a systematic review.

    Science.gov (United States)

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

    2009-01-01

    Alzheimer's Australia contracted the Dementia Collaborative Research Centre - Consumers, Carers and Social Research to conduct a systematic review to explore the appropriateness of a symbol for dementia.The concept of a symbol for people with dementia was an outcome of the Alzheimer's Australia National Consumer Summit on Dementia held in Canberra in October 2005. People living with dementia and their carers identified that a national symbol would be helpful in order to encourage appropriate treatment of people with dementia.Funding was provided as part of the Australian Government's Dementia Initiative to Alzheimer's Australia to work in collaboration with the Queensland University of Technology and Catholic Health Australia to explore, through research, the viability and potential impact of such a symbol in a range of care settings. The main objective of this systematic review was to evaluate any published and unpublished evidence regarding the appropriateness of developing a symbol for dementia and/or delirium, which could be used in a variety of settings to indicate that a person has dementia and/or delirium. A literature search was performed using the following databases: Ageline, APAIS Health, CINAHL, Dissertations and Theses Abstracts, Embase, MEDLINE, PsycEXTRAS, PsycINFO, PsycArticles, Current Contents, LegalTrac, Health and Society, Sociological Abstracts, Family and Society, CINCH, and Hein Online databases. The reference lists of articles retrieved were hand searched, as well as a range of literature from health, legal, ethical and emergency services. Grey literature was searched for using a number of Internet sites, and personal email communication with authors of relevant studies and known researchers in the field was initiated. Papers were retrieved if they provided information about attitudes or perceptions towards the appropriateness of symbols, identifiers or alerts used to inform others that someone has dementia, delirium and/or another medical

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

    Science.gov (United States)

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

    2010-09-01

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

  4. Identifying the most appropriate age threshold for TNM stage grouping of well-differentiated thyroid cancer.

    Science.gov (United States)

    Hendrickson-Rebizant, J; Sigvaldason, H; Nason, R W; Pathak, K A

    2015-08-01

    Age is integrated in most risk stratification systems for well-differentiated thyroid cancer (WDTC). The most appropriate age threshold for stage grouping of WDTC is debatable. The objective of this study was to evaluate the best age threshold for stage grouping by comparing multivariable models designed to evaluate the independent impact of various prognostic factors, including age based stage grouping, on the disease specific survival (DSS) of our population-based cohort. Data from population-based thyroid cancer cohort of 2125 consecutive WDTC, diagnosed during 1970-2010, with a median follow-up of 11.5 years, was used to calculate DSS using the Kaplan Meier method. Multivariable analysis with Cox proportional hazard model was used to assess independent impact of different prognostic factors on DSS. The Akaike information criterion (AIC), a measure of statistical model fit, was used to identify the most appropriate age threshold model. Delta AIC, Akaike weight, and evidence ratios were calculated to compare the relative strength of different models. The mean age of the patients was 47.3 years. DSS of the cohort was 95.6% and 92.8% at 10 and 20 years respectively. A threshold of 55 years, with the lowest AIC, was identified as the best model. Akaike weight indicated an 85% chance that this age threshold is the best among the compared models, and is 16.8 times more likely to be the best model as compared to a threshold of 45 years. The age threshold of 55 years was found to be the best for TNM stage grouping. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Shawahna, Ramzi

    2016-05-01

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

  6. Antibiotic Resistances in Livestock: A Comparative Approach to Identify an Appropriate Regression Model for Count Data

    Directory of Open Access Journals (Sweden)

    Anke Hüls

    2017-05-01

    Full Text Available Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model and (ii to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate

  7. 41 CFR 102-80.50 - Are Federal agencies responsible for identifying/estimating risks and for appropriate risk...

    Science.gov (United States)

    2010-07-01

    ... Environmental Management Risks and Risk Reduction Strategies § 102-80.50 Are Federal agencies responsible for... identify and estimate safety and environmental management risks and appropriate risk reduction strategies... responsible for identifying/estimating risks and for appropriate risk reduction strategies? 102-80.50 Section...

  8. GIS and Multi Criteria Decision Method Based Approach of Identifying Appropriate Landfill Sites for the City Of Chittagong

    Directory of Open Access Journals (Sweden)

    M. Ali Ashraf

    2015-02-01

    were identified initially. Out of these sites four were found to be most appropriate and suitable for use as landfill. DOI: http://dx.doi.org/10.3126/ije.v4i1.12174International Journal of Environment Volume-4, Issue-1, Dec-Feb 2014/15, page: 1-15  

  9. Identifying and selecting the most appropriate social media for the development of SCRM systems

    Directory of Open Access Journals (Sweden)

    Masoud Khoshheykal

    2015-01-01

    Full Text Available Undoubtedly, information technology is one of the main factors for change in modern societies. As the other components involved in the community, organizational customers have undergone changes to the extent that they are referred to as "social customers"; So, the inability to follow the desires needs and tastes pertaining to them which presents challenge for organizations using the previous tools, such as CRM. In fact, the emergence of the concept of SCRM in early 2009 is considered to be a response to such a requirement. However, regarding the variety of social media, the process for developing such systems seems more difficult to track. Hence, in the present study, we are seeking for the identification of the best social media to develop aforementioned systems, using the concept of multi-criteria decision making. To do this, survey data were collected from experts working in two areas, namely, marketing and informatics of Bank Melli Iran. Then, the collected data were analyzed. The results represented "social sites and networks" as the most appropriate media for the development of SCRM systems.

  10. Tools to identify the men with prostate cancer most appropriate for active surveillance?

    Directory of Open Access Journals (Sweden)

    Robert H Getzenberg

    2014-02-01

    Full Text Available A great deal of effort is underway in order to identify those men with prostate cancer felicitous for active surveillance with greater precision than that afforded to us today. In the manuscript by Irshad et al. the authors evaluate a novel set of genes associated with senescence and aging as tools that can provide guidance regarding the indolent nature of an individual's prostate cancer with validation using both mRNA and protein analyses. While additional studies are required to understand the full impact of these findings, the innovative approach taken enhances our understanding of distinct phenotypes of prostate cancer.

  11. Budget estimates, fiscal year 1987. Appropriation: salaries and expenses. Volume 2

    International Nuclear Information System (INIS)

    1986-02-01

    This volume presents the salaries and expenses of the following US NRC programs: nuclear reactor regulation, nuclear material safety and safeguards, inspection and enforcement, nuclear regulatory research, program technical support, and program direction and administration. Special supporting tables are included

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

    Science.gov (United States)

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

    2014-04-01

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

  13. Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results

    Science.gov (United States)

    Rubin, Jennifer K.; Hesketh, Rachel; Martin, Adam; Herman, William H.; Rubino, Francesco

    2016-01-01

    Despite increasing recognition of the efficacy, safety, and cost-effectiveness of bariatric/metabolic surgery in the treatment of type 2 diabetes, few patients who may be appropriate candidates and may benefit from this type of surgery avail themselves of this treatment option. To identify conceptual and practical barriers to appropriate use of surgical procedures, a Policy Lab was hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes on 29 September 2015. Twenty-six stakeholders participated in the Policy Lab, including academics, clinicians, policy-makers, industry leaders, and patient representatives. Participants were provided with a summary of available evidence about the cost-effectiveness of bariatric/metabolic surgery and the costs of increasing the use of bariatric/metabolic surgery, using U.K. and U.S. scenarios as examples of distinct health care systems. There was widespread agreement among this group of stakeholders that bariatric/metabolic surgery is a legitimate and cost-effective approach to the treatment of type 2 diabetes in obese patients. The following four building blocks were identified to facilitate policy changes: 1) communicating the scale of the costs and harms associated with rising prevalence of type 2 diabetes; 2) properly articulating the role of bariatric/metabolic surgery for certain population groups; 3) identifying new funding sources for bariatric/metabolic surgery; and 4) incorporating bariatric/metabolic surgery into the appropriate clinical pathways. Although more research is needed to identify specific clinical scenarios for the prioritization of bariatric/metabolic surgery, the case appears to be strong enough to engage relevant policy-makers and practitioners in a concerted discussion of how to better use metabolic surgical resources in conjunction with other interventions in good diabetes practice. PMID:27222554

  14. Individual differences in the ability to identify, select and use appropriate frames of reference for perceptuo-motor control.

    Science.gov (United States)

    Isableu, B; Ohlmann, T; Cremieux, J; Vuillerme, N; Amblard, B; Gresty, M A

    2010-09-01

    The causes of the interindividual differences (IDs) in how we perceive and control spatial orientation are poorly understood. Here, we propose that IDs partly reflect preferred modes of spatial referencing and that these preferences or "styles" are maintained from the level of spatial perception to that of motor control. Two groups of experimental subjects, one with high visual field dependency (FD) and one with marked visual field independency (FI) were identified by the Rod and Frame Test, which identifies relative dependency on a visual frame of reference (VFoR). FD and FI subjects were tasked with standing still in conditions of increasing postural difficulty while visual cues of self-orientation (a visual frame tilted in roll) and self-motion (in stroboscopic illumination) were varied and in darkness to assess visual dependency. Postural stability, overall body orientation and modes of segmental stabilization relative to either external (space) or egocentric (adjacent segments) frames of reference in the roll plane were analysed. We hypothesized that a moderate challenge to balance should enhance subjects' reliance on VFoR, particularly in FD subjects, whereas a substantial challenge should constrain subjects to use a somatic-vestibular based FoR to prevent falling in which case IDs would vanish. The results showed that with increasing difficulty, FD subjects became more unstable and more disoriented shown by larger effects of the tilted visual frame on posture. Furthermore, their preference to coalign body/VFoR coordinate systems lead to greater fixation of the head-trunk articulation and stabilization of the hip in space, whereas the head and trunk remained more stabilized in space with the hip fixed on the leg in FI subjects. These results show that FD subjects have difficulties at identifying and/or adopting a more appropriate FoR based on proprioceptive and vestibular cues to regulate the coalignment of posturo/exocentric FoRs. The FI subjects' resistance

  15. Implementing Embedded Training (ET): Volume 4. Identifying ET Requirements

    Science.gov (United States)

    1988-11-01

    Database Step 1.1Step 1.6 On System and Identify Libary and Pf(t iinAnnotated: SMEs and Other Data Contats Phsases Commonality - DabawAnalysis and...convenient approach is to use two digit numbers to represent mission phases (or other functional break-outs) (e.g., 02, Mission Preparation phase), two...additional digits separated from the phase digits by periods to represent tasks (e.g., 02.06, Load Ammunition), two mcre digits to represent subtasks, and

  16. Identifying Multi-Level Culturally Appropriate Smoking Cessation Strategies for Aboriginal Health Staff: A Concept Mapping Approach

    Science.gov (United States)

    Dawson, Anna P.; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

    2013-01-01

    Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco…

  17. Identifying parents with risky alcohol consumption habits in a paediatric unit--are screening and brief intervention appropriate methods?

    Science.gov (United States)

    Bjerregaard, Lene B L; Gerke, Oke; Rubak, Sune; Høst, Arne; Wagner, Lis

    2011-06-01

    There is no systematic identification of parents with excessive alcohol use who have a child admitted to hospital. Children in families with excessive alcohol issues form a high risk group as substantial alcohol consumption has a damaging influence on a child emotionally, cognitively, socially and physically. Alcohol consumption is a sensitive issue, and health staff needs knowledge, qualifications and adequate training in communicating with parents about this taboo. • To identify specific patterns in subgroups of parents by comparing results from screening and demographic variables • To identify systematic patterns in staff members by demographic variables to decide whether these factors influence the screening results. During 1 year, screening and brief intervention (SBI) was accomplished, including health staff conducting dialogues with parents of a hospitalized child using motivational interviewing (MI) and screening for risky alcohol behaviour by Cut down, Annoyance from others, feel Guilty, Early-morning Craving (CAGE)-C. Data were analysed by descriptive statistics, and relationships were tested with a statistical significance level of 0.05, using SPSS (version 16.0). Motivational dialogues with 779 parents were conducted by 43 staff members, and 11% of the parents were screened positive for risky alcohol behaviour. Drinking alcohol 4 days a week or more and drinking alcohol outside mealtimes were main risk factors. Parents' gender was the strongest predictor of screening positive and OR was 6.8 for men (CI 4.03-11.74) compared to women, pparents' age (CI 1.02-1.42) indicates the risk of screening positive increases with age, p=0.027. Brief intervention using CAGE-C and MI has proven successful in mapping parents' alcohol consumption patterns and in identifying parents with risky alcohol consumption habits. Health staff is able to manage health promotion and prevention when having the right competences and when being supervised. © 2010 The Authors

  18. Can Physicians Identify Inappropriate Nuclear Stress Tests? An Examination of Inter-rater Reliability for the 2009 Appropriate Use Criteria for Radionuclide Imaging

    Science.gov (United States)

    Ye, Siqin; Rabbani, LeRoy E.; Kelly, Christopher R.; Kelly, Maureen R.; Lewis, Matthew; Paz, Yehuda; Peck, Clara L.; Rao, Shaline; Bokhari, Sabahat; Weiner, Shepard D.; Einstein, Andrew J.

    2014-01-01

    Background We sought to determine inter-rater reliability of the 2009 Appropriate Use Criteria (AUC) for radionuclide imaging (RNI) and whether physicians at various levels of training can effectively identify nuclear stress tests with inappropriate indications. Methods and Results Four hundred patients were randomly selected from a consecutive cohort of patients undergoing nuclear stress testing at an academic medical center. Raters with different levels of training (including cardiology attending physicians, cardiology fellows, internal medicine hospitalists, and internal medicine interns) classified individual nuclear stress tests using the 2009 AUC. Consensus classification by two cardiologists was considered the operational gold standard, and sensitivity and specificity of individual raters for identifying inappropriate tests was calculated. Inter-rater reliability of the AUC was assessed using Cohen’s kappa statistics for pairs of different raters. The mean age of patients was 61.5 years; 214 (54%) were female. The cardiologists rated 256 (64%) of 400 NSTs as appropriate, 68 (18%) as uncertain, 55 (14%) as inappropriate; 21 (5%) tests were unable to be classified. Inter-rater reliability for non-cardiologist raters was modest (unweighted Cohen’s kappa, 0.51, 95% confidence interval, 0.45 to 0.55). Sensitivity of individual raters for identifying inappropriate tests ranged from 47% to 82%, while specificity ranged from 85% to 97%. Conclusions Inter-rater reliability for the 2009 AUC for RNI is modest, and there is considerable variation in the ability of raters at different levels of training to identify inappropriate tests. PMID:25563660

  19. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    Science.gov (United States)

    Adams, Hieab HH; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Rentería, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivières, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C; Blanken, Laura ME; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher RK; Cuellar-Partida, Gabriel; Den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Greven, Corina U; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liao, Jiemin; Liewald, David CM; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; Mazoyer, Bernard; McKay, David R; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L; Maniega, Susana Muñoz; Nho, Kwangsik; Nugent, Allison C; Olde Loohuis, Loes M; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Pütz, Benno; Rajan, Kumar B; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein MJ; Van Eijk, Kristel R; Van Erp, Theo GM; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Aggarwal, Neelum T; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Chen, Christopher; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Geus, Eco JC; De Jager, Philip L; de Zubicaray, Greig I; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Erk, Susanne; Espeseth, Thomas; Evans, Denis A; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald HH; Grabe, Hans J; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Hulshoff Pol, Hilleke E; Ikeda, Masashi; Ikram, M Kamran; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Longstreth, WT; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Katie L; McMahon, Francis J; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda WJH; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schofield, Peter R; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Srikanth, Velandai; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Turner, Jessica A; Tzourio, Christophe; Uitterlinden, Andre G; Valdés Hernández, Maria C; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic JA; Van Duijn, Cornelia M; Van Haren, Neeltje EM; Van 't Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Veltman, Dick J; Vernooij, Meike W; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, H Ronald; Zonderman, Alan B; Deary, Ian J; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G; De Craen, Anton JM; Wright, Margaret J; Launer, Lenore J; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stéphanie; Medland, Sarah E; Ikram, M Arfan; Thompson, Paul M

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five novel loci for intracranial volume and confirmed two known signals. Four of the loci are also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρgenetic=0.748), which indicated a similar genetic background and allowed for the identification of four additional loci through meta-analysis (Ncombined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, Parkinson’s disease, and enriched near genes involved in growth pathways including PI3K–AKT signaling. These findings identify biological underpinnings of intracranial volume and provide genetic support for theories on brain reserve and brain overgrowth. PMID:27694991

  20. Hierarchical population monitoring of greater sage-grouse (Centrocercus urophasianus) in Nevada and California—Identifying populations for management at the appropriate spatial scale

    Science.gov (United States)

    Coates, Peter S.; Prochazka, Brian G.; Ricca, Mark A.; Wann, Gregory T.; Aldridge, Cameron L.; Hanser, Steven E.; Doherty, Kevin E.; O'Donnell, Michael S.; Edmunds, David R.; Espinosa, Shawn P.

    2017-08-10

    Population ecologists have long recognized the importance of ecological scale in understanding processes that guide observed demographic patterns for wildlife species. However, directly incorporating spatial and temporal scale into monitoring strategies that detect whether trajectories are driven by local or regional factors is challenging and rarely implemented. Identifying the appropriate scale is critical to the development of management actions that can attenuate or reverse population declines. We describe a novel example of a monitoring framework for estimating annual rates of population change for greater sage-grouse (Centrocercus urophasianus) within a hierarchical and spatially nested structure. Specifically, we conducted Bayesian analyses on a 17-year dataset (2000–2016) of lek counts in Nevada and northeastern California to estimate annual rates of population change, and compared trends across nested spatial scales. We identified leks and larger scale populations in immediate need of management, based on the occurrence of two criteria: (1) crossing of a destabilizing threshold designed to identify significant rates of population decline at a particular nested scale; and (2) crossing of decoupling thresholds designed to identify rates of population decline at smaller scales that decouple from rates of population change at a larger spatial scale. This approach establishes how declines affected by local disturbances can be separated from those operating at larger scales (for example, broad-scale wildfire and region-wide drought). Given the threshold output from our analysis, this adaptive management framework can be implemented readily and annually to facilitate responsive and effective actions for sage-grouse populations in the Great Basin. The rules of the framework can also be modified to identify populations responding positively to management action or demonstrating strong resilience to disturbance. Similar hierarchical approaches might be beneficial

  1. Using caregivers’ perceptions of rehabilitation services for children with Cerebral Palsy at public sector hospitals to identify the components of an appropriate service

    Directory of Open Access Journals (Sweden)

    G.M. Saloojee

    2011-01-01

    Full Text Available Despite  a  growing  body  of  evidence  favouring  a  family-centred approach to rehabilitation services for children with cerebral palsy (cp, the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA settings  remains unknown.  The  study  aimed  to  identify  key  components of  an appropriate  rehabilitation  service  which  would  meet  the  needs of children  with  CP  and  their  caregivers  at  SA  public  sector  hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20 questionnaire together with two open-endedquestions with  a  convenience  sample  of  caregivers attending therapy  at  CP  Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child,  and  practical  assistance  (handling  ideas  and suggestions,  assistive devices, food supplements, nappies, advice were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved.  Key components for  an  appropriate  therapy  service  include  caring  and respectful  attitudes,  hands-on  therapy,  handling  suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.

  2. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    International Nuclear Information System (INIS)

    Protto, Sara; Pienimäki, Juha-Pekka; Seppänen, Janne; Numminen, Heikki; Sillanpää, Niko

    2017-01-01

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  3. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Protto, Sara, E-mail: sara.protto@pshp.fi; Pienimäki, Juha-Pekka; Seppänen, Janne [Tampere University Hospital, Medical Imaging Center (Finland); Numminen, Heikki [Tampere University Hospital, Department of Neurology (Finland); Sillanpää, Niko [Tampere University Hospital, Medical Imaging Center (Finland)

    2017-04-15

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  4. Effective use of forensic science in volume crime investigations: identifying recurring themes in the literature.

    Science.gov (United States)

    Ludwig, Anika; Fraser, Jim

    2014-01-01

    New scientific, technological and legal developments, particularly the introduction of national databases for DNA and fingerprints, have led to increased use of forensic science in the investigation of crime. There is an assumption, and in some instances specific assertions, that such developments bring improvements either in broad criminal justice terms or more narrowly in terms of economic or practical efficiencies. The underlying presumption is that the new technological opportunities will be understood and effectively implemented. This research investigates whether such increases in activity have also been accompanied by improvements in the effective use of forensic science. A systematic review of thirty-six reports published (predominantly in England and Wales) since the 1980s, which have considered the use of forensic science in the investigation of volume crimes, was carried out. These reports have identified a number of recurrent themes that influenced how effectively forensic science was used in investigations. The themes identified included forensic knowledge and training of investigators, communication and information exchange between specialists and investigators, timeliness of forensic results, interagency relationships and deployment of crime scene examiner resources. The research findings suggest that these factors continue to hinder the effective use of forensic science despite technological advances and this paper considers their potential causes. © 2013.

  5. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    OpenAIRE

    Adams, Hieab HH; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Renter��a, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivi��res, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously unknown loci for intracranial volume and confirmed two known signals. Four of the loci were also associated with adult human stature, but these remained associated with intracranial volume after adjus...

  6. Appropriate strategies.

    Science.gov (United States)

    Halty, M

    1979-01-01

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

  7. Building Quality Report Cards for Geriatric Care in The Netherlands: Using Concept Mapping to Identify the Appropriate "Building Blocks" from the Consumer's Perspective

    Science.gov (United States)

    Groenewoud, A. Stef; van Exel, N. Job A.; Berg, Marc; Huijsman, Robbert

    2008-01-01

    Purpose: This article reports on a study to identify "building blocks" for quality report cards for geriatric care. Its aim is to present (a) the results of the study and (b) the innovative step-by-step approach that was developed to arrive at these results. Design and Methods: We used Concept Mapping/Structured Conceptualization to…

  8. Good Practice Chaplaincy: An Exploratory Study Identifying the Appropriate Skills, Attitudes and Practices for the Selection, Training and Utilisation of Chaplains.

    Science.gov (United States)

    Carey, Lindsay B; Rumbold, Bruce

    2015-08-01

    This article presents an overview of exploratory research regarding the skills, knowledge, attitudes and practices considered necessary for chaplains to be highly competent in providing holistic care to clients and staff. Utilising a qualitative methodology, two focus groups comprising Salvation Army chaplains and their managers provided data about their expectations of chaplaincy personnel and about the pastoral care interventions undertaken by chaplains. The results indicated that while there were some differences in opinion, nevertheless, in overall terms, there was general agreement between chaplains and their managers about particular personal and professional qualities necessary for chaplains to be considered appropriate and proficient. Evidence was also obtained indicating a need for change with regard to the organisational attitude and culture of The Salvation Army towards chaplaincy. Recommendations are presented concerning (1) the selection criteria for chaplaincy, (2) training and utilisation of chaplains plus (3) issues relating to organizational cultural change necessary to develop a future-ready chaplaincy more suitable for the twenty-first century.

  9. Novel genetic loci underlying human intracranial volume identified through genome-wide association

    NARCIS (Netherlands)

    Adams, Hieab H H; Hibar, Derrek P; Chouraki, Vincent; Stein, Jason L; Nyquist, Paul A; Rentería, Miguel E; Trompet, Stella; Arias-Vasquez, Alejandro; Seshadri, Sudha; Desrivières, Sylvane; Beecham, Ashley H; Jahanshad, Neda; Wittfeld, Katharina; Van der Lee, Sven J; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S; Armstrong, Nicola J; Athanasiu, Lavinia; Axelsson, Tomas; Beiser, Alexa; Bernard, Manon; Bis, Joshua C; Blanken, Laura M E; Blanton, Susan H; Bohlken, Marc M; Boks, Marco P; Bralten, Janita; Brickman, Adam M; Carmichael, Owen; Chakravarty, M Mallar; Chauhan, Ganesh; Chen, Qiang; Ching, Christopher R K; Cuellar-Partida, Gabriel; Braber, Anouk Den; Doan, Nhat Trung; Ehrlich, Stefan; Filippi, Irina; Ge, Tian; Giddaluru, Sudheer; Goldman, Aaron L; Gottesman, Rebecca F; Greven, Corina U; Grimm, Oliver; Griswold, Michael E; Guadalupe, Tulio; Hass, Johanna; Haukvik, Unn K; Hilal, Saima; Hofer, Edith; Hoehn, David; Holmes, Avram J; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H; Liao, Jiemin; Liewald, David C M; Lopez, Lorna M; Luciano, Michelle; Macare, Christine; Marquand, Andre; Matarin, Mar; Mather, Karen A; Mattheisen, Manuel; Mazoyer, Bernard; McKay, David R; McWhirter, Rebekah; Milaneschi, Yuri; Mirza-Schreiber, Nazanin; Muetzel, Ryan L; Maniega, Susana Muñoz; Nho, Kwangsik; Nugent, Allison C; Loohuis, Loes M Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pappa, Irene; Pirpamer, Lukas; Pudas, Sara; Pütz, Benno; Rajan, Kumar B; Ramasamy, Adaikalavan; Richards, Jennifer S; Risacher, Shannon L; Roiz-Santiañez, Roberto; Rommelse, Nanda; Rose, Emma J; Royle, Natalie A; Rundek, Tatjana; Sämann, Philipp G; Satizabal, Claudia L; Schmaal, Lianne; Schork, Andrew J; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V; Sprooten, Emma; Strike, Lachlan T; Teumer, Alexander; Thomson, Russell; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Vaidya, Dhananjay; Van der Grond, Jeroen; Van der Meer, Dennis; Van Donkelaar, Marjolein M J; Van Eijk, Kristel R; Van Erp, Theo G M; Van Rooij, Daan; Walton, Esther; Westlye, Lars T; Whelan, Christopher D; Windham, Beverly G; Winkler, Anderson M; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Xu, Bing; Yanek, Lisa R; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P; Agartz, Ingrid; Aggarwal, Neelum T; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A; Arepalli, Sampath; Assareh, Amelia A; Barral, Sandra; Bastin, Mark E; Becker, Diane M; Becker, James T; Bennett, David A; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I; Brodaty, Henry; Brouwer, Rachel M; Brunner, Han G; Buckner, Randy L; Buitelaar, Jan K; Bulayeva, Kazima B; Cahn, Wiepke; Calhoun, Vince D; Cannon, Dara M; Cavalleri, Gianpiero L; Chen, Christopher; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E; Czisch, Michael; Dale, Anders M; Davies, Gareth E; De Geus, Eco J C; De Jager, Philip L; de Zubicaray, Greig I; Delanty, Norman; Depondt, Chantal; DeStefano, Anita L; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C; Duggirala, Ravi; Dyer, Thomas D; Erk, Susanne; Espeseth, Thomas; Evans, Denis A; Fedko, Iryna O; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E; Fleischman, Debra A; Ford, Ian; Foroud, Tatiana M; Fox, Peter T; Francks, Clyde; Fukunaga, Masaki; Gibbs, J Raphael; Glahn, David C; Gollub, Randy L; Göring, Harald H H; Grabe, Hans J; Green, Robert C; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Hansell, Narelle K; Hardy, John; Hartman, Catharina A; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G; Heslenfeld, Dirk J; Ho, Beng-Choon; Hoekstra, Pieter J; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Pol, Hilleke E Hulshoff; Ikeda, Masashi; Ikram, M Kamran; Jack, Clifford R; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G; Jukema, J Wouter; Kahn, René S; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S; Kochunov, Peter; Kwok, John B; Lawrie, Stephen M; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L; Longstreth, W T; Lopez, Oscar L; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S; McDonald, Colm; McIntosh, Andrew M; McMahon, Katie L; McMahon, Francis J; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W; Morris, Derek W; Mosley, Thomas H; Mühleisen, Thomas W; Müller-Myhsok, Bertram; Nalls, Michael A; Nauck, Matthias; Nichols, Thomas E; Niessen, Wiro J; Nöthen, Markus M; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L; Ophoff, Roel A; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W J H; Pike, G Bruce; Potkin, Steven G; Psaty, Bruce M; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L; Romanczuk-Seiferth, Nina; Rotter, Jerome I; Ryten, Mina; Sacco, Ralph L; Sachdev, Perminder S; Saykin, Andrew J; Schmidt, Reinhold; Schofield, Peter R; Sigurdsson, Sigurdur; Simmons, Andy; Singleton, Andrew; Sisodiya, Sanjay M; Smith, Colin; Smoller, Jordan W; Soininen, Hilkka; Srikanth, Velandai; Steen, Vidar M; Stott, David J; Sussmann, Jessika E; Thalamuthu, Anbupalam; Tiemeier, Henning; Toga, Arthur W; Traynor, Bryan J; Troncoso, Juan; Turner, Jessica A; Tzourio, Christophe; Uitterlinden, Andre G; Hernández, Maria C Valdés; Van der Brug, Marcel; Van der Lugt, Aad; Van der Wee, Nic J A; Van Duijn, Cornelia M; Van Haren, Neeltje E M; Van T Ent, Dennis; Van Tol, Marie-Jose; Vardarajan, Badri N; Veltman, Dick J; Vernooij, Meike W; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M; Wassink, Thomas H; Weale, Michael E; Weinberger, Daniel R; Weiner, Michael W; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y; Wright, Clinton B; Zielke, H Ronald; Zonderman, Alan B; Deary, Ian J; DeCarli, Charles; Schmidt, Helena; Martin, Nicholas G; De Craen, Anton J M; Wright, Margaret J; Launer, Lenore J; Schumann, Gunter; Fornage, Myriam; Franke, Barbara; Debette, Stéphanie; Medland, Sarah E; Ikram, M Arfan; Thompson, Paul M

    2016-01-01

    Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five previously

  10. On the use of an appropriate TdT-mediated dUTP-biotin nick end labeling assay to identify apoptotic cells.

    OpenAIRE

    Lebon, C.; Rodriguez, G.V.; Zaoui, I.E.; Jaadane, I.; Behar-Cohen, F.; Torriglia, A.

    2015-01-01

    Apoptosis is an essential cellular mechanism involved in many processes such as embryogenesis, metamorphosis, and tissue homeostasis. DNA fragmentation is one of the key markers of this form of cell death. DNA fragmentation is executed by endogenous endonucleases such as caspase-activated DNase (CAD) in caspase-dependent apoptosis. The TUNEL (TdT-mediated dUTP-biotin nick end labeling) technique is the most widely used method to identify apoptotic cells in a tissue or culture and to assess dr...

  11. FLIS Procedures Manual. Document Identifier Code Input/Output Formats (Fixed Length). Volume 8.

    Science.gov (United States)

    1997-04-01

    DATA ELE- MENTS. SEGMENT R MAY BE REPEATED A MAXIMUM OF THREE (3) TIMES IN ORDER TO ACQUIRE THE REQUIRED MIX OF SEGMENTS OR INDIVIDUAL DATA ELEMENTS TO...preceding record. Marketing input DICs. QI Next DRN of appropriate segment will be QF The assigned NSN or PSCN being can- reflected in accordance with Table...Classified KFC Notification of Possible Duplicate (Sub- KRP Characteristics Data mitter) Follow-Up Interrogation LFU Notification of Return, SSR Transaction

  12. Identifying and Selecting Plants for the Landscape. Volume 23, Number 5.

    Science.gov (United States)

    Rodekohr, Sherie; Harris, Clark Richard

    This handbook on identifying and selecting landscape plants can be used as a reference in landscaping courses or on an individual basis. The first of two sections, Identifying Plants for the Landscape, contains the following tables: shade tree identification; flowering tree identification; evergreen tree identification; flowering shrub…

  13. Identifying appropriate spatial scales for marine conservation and management using a larval dispersal model: The case of Concholepas concholepas (loco) in Chile

    Science.gov (United States)

    Garavelli, Lysel; Kaplan, David Michael; Colas, François; Stotz, Wolfgang; Yannicelli, Beatriz; Lett, Christophe

    2014-05-01

    Along the coast of Chile, fisheries targeting the marine gastropod Concholepas concholepas, commonly named “loco”, were highly valuable until the end of the 80s when catches declined significantly. Since the late 90s, a management plan based on territorial-user-rights areas has been implemented, with limited effect on stock recovery. More effective loco conservation and management is impeded by lack of information regarding connectivity via larval dispersal between these individually-managed areas. To develop a regional view of loco connectivity, we integrate loco life history information into a biophysical, individual-based larval dispersal model. This model is used to evaluate scales of loco connectivity and seasonality in connectivity patterns, as well as to partition the coast into largely disconnected subpopulations using a recently developed connectivity-matrix clustering algorithm. We find mean dispersal distances ranging from 170 to 220 km depending on release depth of larvae and planktonic larval duration. Settlement success levels depend quantitatively on the physical and biological processes included in the model, but connectivity patterns remain qualitatively similar. Model estimates of settlement success peak for larval release dates in late austral autumn, consistent with field results and with favorable conditions for larval coastal retention due to weak upwelling during austral autumn. Despite the relatively homogeneous Chilean coastline, distinct subpopulations with minimal connectivity between them are readily identifiable. Barriers to connectivity that are robust to changes in model configuration exist at 23°S and 29°S latitudes. These zones are all associated with important headlands and embayments of the Chilean coast.

  14. Combining creatinine and volume kinetics identifies missed cases of acute kidney injury following cardiac arrest

    Science.gov (United States)

    2013-01-01

    Introduction Fluid resuscitation in the critically ill often results in a positive fluid balance, potentially diluting the serum creatinine concentration and delaying diagnosis of acute kidney injury (AKI). Methods Dilution during AKI was quantified by combining creatinine and volume kinetics to account for fluid type, and rates of fluid infusion and urine output. The model was refined using simulated patients receiving crystalloids or colloids under four glomerular filtration rate (GFR) change scenarios and then applied to a cohort of critically ill patients following cardiac arrest. Results The creatinine concentration decreased during six hours of fluid infusion at 1 litre-per-hour in simulated patients, irrespective of fluid type or extent of change in GFR (from 0% to 67% reduction). This delayed diagnosis of AKI by 2 to 9 hours. Crystalloids reduced creatinine concentration by 11 to 19% whereas colloids reduced concentration by 36 to 43%. The greatest reduction was at the end of the infusion period. Fluid dilution alone could not explain the rapid reduction of plasma creatinine concentration observed in 39 of 49 patients after cardiac arrest. Additional loss of creatinine production could account for those changes. AKI was suggested in six patients demonstrating little change in creatinine, since a 52 ± 13% reduction in GFR was required after accounting for fluid dilution and reduced creatinine production. Increased injury biomarkers within a few hours of cardiac arrest, including urinary cystatin C and plasma and urinary Neutrophil-Gelatinase-Associated-Lipocalin (biomarker-positive, creatinine-negative patients) also indicated AKI in these patients. Conclusions Creatinine and volume kinetics combined to quantify GFR loss, even in the absence of an increase in creatinine. The model improved disease severity estimation, and demonstrated that diagnostic delays due to dilution are minimally affected by fluid type. Creatinine sampling should be delayed at least

  15. Evaluating the effectiveness of a training program that builds teachers' capability to identify and appropriately refer middle and high school students with mental health problems in Brazil: an exploratory study.

    Science.gov (United States)

    Vieira, Marlene A; Gadelha, Ary A; Moriyama, Taís S; Bressan, Rodrigo A; Bordin, Isabel A

    2014-02-28

    In Brazil, like many countries, there has been a failure to identify mental health problems (MHP) in young people and refer them to appropriate care and support. The school environment provides an ideal setting to do this. Therefore, effective programs need to be developed to train teachers to identify and appropriately refer children with possible MHP. We aimed to evaluate teachers' ability to identify and appropriately refer students with possible MHP, and the effectiveness of a psychoeducational strategy to build teachers' capability in this area. To meet the first objective, we conducted a case-control study using a student sample. To meet the second, we employed longitudinal design with repeated measures before and after introducing the psychoeducational strategy using a teacher sample. In the case control study, the Youth Self-Report was used to investigate internalizing and externalizing problems. Before training, teachers selected 26 students who they thought were likely to have MHP. Twenty-six non-selected students acted as controls and were matched by gender, age and grade. The underlying principle was that if teachers could identify abnormal behaviors among their actual students, those with some MHP would likely be among the case group and those without among the control group. In the longitudinal study, 32 teachers were asked to evaluate six vignettes that highlighted behaviors indicating a high risk for psychosis, depression, conduct disorder, hyperactivity, mania, and normal adolescent behavior. We calculated the rates of correct answers for identifying the existence of some MHP and the need for referral before and after training; teachers were not asked to identify the individual conditions. Teachers were already able to identify the most symptomatic students, who had both internalizing and externalizing problems, as possibly having MHP, but teachers had difficulty in identifying students with internalizing problems alone. At least 50.0% of teachers

  16. Special Appropriation Act Projects

    Science.gov (United States)

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

  17. Identifying appropriate information and communication technology ...

    African Journals Online (AJOL)

    One of the most important factors for agricultural development is marketing of agricultural products. ... and main core of the marketing system, has an effective role in increasing the marketing system efficiency. ... AJOL African Journals Online.

  18. Identifying practice-related factors for high-volume prescribers of antibiotics in Danish general practice

    DEFF Research Database (Denmark)

    Aabenhus, Rune; Siersma, Volkert Dirk; Sandholdt, Håkon

    2017-01-01

    practice-related factors driving high antibiotic prescribing rates. Results: We included 98% of general practices in Denmark (n = 1962) and identified a 10% group of high prescribers who accounted for 15% of total antibiotic prescriptions and 18% of critically important antibiotic prescriptions. Once case...... prescriptions issued over the phone compared with all antibiotic prescriptions; and a high number of consultations per 1000 patients. We also found that a low number of consultations per 1000 patients was associated with a reduced likelihood of being a high prescriber of antibiotics. Conclusions: An apparent...

  19. Risk Factors for Chronic Subdural Hematoma Recurrence Identified Using Quantitative Computed Tomography Analysis of Hematoma Volume and Density.

    Science.gov (United States)

    Stavrinou, Pantelis; Katsigiannis, Sotirios; Lee, Jong Hun; Hamisch, Christina; Krischek, Boris; Mpotsaris, Anastasios; Timmer, Marco; Goldbrunner, Roland

    2017-03-01

    Chronic subdural hematoma (CSDH), a common condition in elderly patients, presents a therapeutic challenge with recurrence rates of 33%. We aimed to identify specific prognostic factors for recurrence using quantitative analysis of hematoma volume and density. We retrospectively reviewed radiographic and clinical data of 227 CSDHs in 195 consecutive patients who underwent evacuation of the hematoma through a single burr hole, 2 burr holes, or a mini-craniotomy. To examine the relationship between hematoma recurrence and various clinical, radiologic, and surgical factors, we used quantitative image-based analysis to measure the hematoma and trapped air volumes and the hematoma densities. Recurrence of CSDH occurred in 35 patients (17.9%). Multivariate logistic regression analysis revealed that the percentage of hematoma drained and postoperative CSDH density were independent risk factors for recurrence. All 3 evacuation methods were equally effective in draining the hematoma (71.7% vs. 73.7% vs. 71.9%) without observable differences in postoperative air volume captured in the subdural space. Quantitative image analysis provided evidence that percentage of hematoma drained and postoperative CSDH density are independent prognostic factors for subdural hematoma recurrence. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Optical Quantification of Cellular Mass, Volume, and Density of Circulating Tumor Cells Identified in an Ovarian Cancer Patient

    International Nuclear Information System (INIS)

    Phillips, Kevin G.; Velasco, Carmen Ruiz; Li, Julia; Kolatkar, Anand; Luttgen, Madelyn; Bethel, Kelly; Duggan, Bridgette; Kuhn, Peter; McCarty, Owen J. T.

    2012-01-01

    Clinical studies have demonstrated that circulating tumor cells (CTCs) are present in the blood of cancer patients with known metastatic disease across the major types of epithelial malignancies. Recent studies have shown that the concentration of CTCs in the blood is prognostic of overall survival in breast, prostate, colorectal, and non-small cell lung cancer. This study characterizes CTCs identified using the high-definition (HD)-CTC assay in an ovarian cancer patient with stage IIIC disease. We characterized the physical properties of 31 HD-CTCs and 50 normal leukocytes from a single blood draw taken just prior to the initial debulking surgery. We utilized a non-interferometric quantitative phase microscopy technique using brightfield imagery to measure cellular dry mass. Next we used a quantitative differential interference contrast microscopy technique to measure cellular volume. These techniques were combined to determine cellular dry mass density. We found that HD-CTCs were more massive than leukocytes: 33.6 ± 3.2 pg (HD-CTC) compared to 18.7 ± 0.6 pg (leukocytes), p < 0.001; had greater volumes: 518.3 ± 24.5 fL (HD-CTC) compared to 230.9 ± 78.5 fL (leukocyte), p < 0.001; and possessed a decreased dry mass density with respect to leukocytes: 0.065 ± 0.006 pg/fL (HD-CTC) compared to 0.085 ± 0.004 pg/fL (leukocyte), p < 0.006. Quantification of HD-CTC dry mass content and volume provide key insights into the fluid dynamics of cancer, and may provide the rationale for strategies to isolate, monitor or target CTCs based on their physical properties. The parameters reported here can also be incorporated into blood cell flow models to better understand metastasis.

  1. High baseline left ventricular and systolic volume may identify patients at risk of chemotherapy-induced cardiotoxicity

    International Nuclear Information System (INIS)

    Atiar Rahman; Alex Gedevanishvili; Seham Ali; Elma G Briscoe; Vani Vijaykumar

    2004-01-01

    contribute to cardiac toxicity, but neither low baseline peak filling rates nor left ventricular en d diastolic volume predicted future progression to chemotherapy induced cardiotoxicity. Summary: We conclude that high baseline left ventricular end systolic volumes may identify patients at risk of chemotherapy-induced cardiotoxicity, this parameter should be carefully evaluated prior to initiation for chemotherapy. (authors)

  2. Value Appropriation in Business Exchange

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  3. A comparison of case volumes among urologic surgeons identified on an industry-sponsored website to an all provider peer group.

    Science.gov (United States)

    See, William A; Jacobson, Kenneth; Derus, Sue; Langenstroer, Peter

    2014-11-01

    Industry-sponsored websites for robotic surgery direct to surgeons listed as performing specific robotic surgical procedures. The purpose of this study was to compare average annual, surgeon-specific, case volumes for those procedures for which they were listed as performing on the commercial website with the volumes of all providers performing these same procedures across a defined geographic region. A list of providers within the state of Wisconsin cited as performing specific urologic procedures was obtained through the Intuitive Surgical website 〈http://www.davincisurgery.com/da-vinci-urology/〉. Surgeon-specific annual case volumes from 2009 to 2013 for these same cases were obtained for all Wisconsin providers through DataBay Resources (Warrendale, PA) based on International classification of diseases-9 codes. Procedural activity was rank ordered, and surgeons were placed in "volume deciles" derived from the total annual number of cases performed by all surgeons. The distribution of commercially listed surgeon volumes, both 5-year average and most recent year, was compared with the average and 2013 volumes of all surgeons performing a specific procedure. A total of 35 individual urologic surgeons listed as performing robotic surgery in Wisconsin were identified through a "search" using the Intuitive Surgical website. Specific procedure analysis returned 5, 12, 9, and 15 surgeon names for cystectomy, partial nephrectomy, radical nephrectomy, and prostatectomy, respectively. This compared with the total number of surgeons who had performed the listed procedure in Wisconsin at least 1 time during the prior 5 years of 123, 153, 242, and 165, respectively. When distributed by surgeon-volume deciles, surgeons listed on industry-sponsored sites varied widely in their respective volume decile. More than half of site-listed, procedure-specific surgeons fell below the fifth decile for surgeon volume. Data analysis based solely on 2013 case volumes had no effect on

  4. Appropriability, services and reputation

    NARCIS (Netherlands)

    Dolfsma, W.A.

    2011-01-01

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

  5. Federal Logistics Information System (FLIS) Procedures Manual. Volume 8. Document Identifier Code Input/Output Formats (Fixed Length)

    Science.gov (United States)

    1994-07-01

    REQUIRED MIX OF SEGMENTS OR INDIVIDUAL DATA ELEMENTS TO BE EXTRACTED. IN SEGMENT R ON AN INTERROGATION TRANSACTION (LTI), DATA RECORD NUMBER (DRN 0950) ONLY...and zation and Marketing input DICs. insert the Continuation Indicator Code (DRN 8555) in position 80 of this record. Maximum of OF The assigned NSN...for Procurement KFR, File Data Minus Security Classified Characteristics Data KFC 8.5-2 DoD 4100.39-M Volume 8 CHAPTER 5 ALPHABETIC INDEX OF DIC

  6. Libertarianism and Original Appropriation

    OpenAIRE

    Dominiak, Łukasz

    2017-01-01

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

  7. Appropriering, system, bogobjekt

    DEFF Research Database (Denmark)

    Kromann, Thomas Hvid

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

  8. Crowding as appropriation

    DEFF Research Database (Denmark)

    Thelle, Mikkel

    2016-01-01

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

  9. Appropriation of Information Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Annemette Leonhardt; Jensen, Tina Blegind

    2008-01-01

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

  10. Narrative self-appropriation

    DEFF Research Database (Denmark)

    Køster, Allan

    2017-01-01

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

  11. Choosing Appropriate Business Models

    OpenAIRE

    UNCTAD; World Bank

    2018-01-01

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

  12. Angle β of greater than 80° at the start of spirometry may identify high-quality flow volume curves.

    Science.gov (United States)

    Lian, Ningfang; Li, Li; Ren, Weiying; Jiang, Zhilong; Zhu, Lei

    2017-04-01

    The American Thoracic Society (ATS) and European Respiratory Society (ERS) emphasize a satisfactory start in maximal expiratory flow-volume (MEFV) curves and highlight subjective parameters: performance without hesitation and expiration with maximum force. We described a new parameter, angle β for characterization of the start to the MEFV curve. Subjects completed the MEFV curve at least three times and at least two curves met ATS/ERS quality. Subjects were divided into normal, restrictive and obstructive groups according to pulmonary function test results. The tangent line was drawn at the start of the MEFV curve's ascending limb to the x-axis and the angle β between the tangent line and x-axis was obtained. The relationships between tangent of β, pulmonary function parameters (PFPs) and anthropometric data were assessed. The MEFV curves with insufficient explosion at the start were considered as poor-quality MEFV curves. In 998 subjects with high-quality spirometry, although PFP varied in relation to the three aspects: the angle β and its tangent were similar (P > 0.05), the tangent of β did not correlate with PFP or anthropometric measurements (P > 0.05) and the lower limit of normal (LLN) of the angle β was 80° in the group with high-quality spirometry (P < 0.05). Angle β derived from poor-quality MEFV curves was smaller than that from good quality one (P < 0.05). Angle β may function as a parameter to assess the expiratory efforts, which can be used to assess the quality of the MEFV curve start. © 2016 Asian Pacific Society of Respirology.

  13. Virtual Whipple: preoperative surgical planning with volume-rendered MDCT images to identify arterial variants relevant to the Whipple procedure.

    Science.gov (United States)

    Brennan, Darren D; Zamboni, Giulia; Sosna, Jacob; Callery, Mark P; Vollmer, Charles M V; Raptopoulos, Vassilios D; Kruskal, Jonathan B

    2007-05-01

    The purposes of this study were to combine a thorough understanding of the technical aspects of the Whipple procedure with advanced rendering techniques by introducing a virtual Whipple procedure and to evaluate the utility of this new rendering technique in prediction of the arterial variants that cross the anticipated surgical resection plane. The virtual Whipple is a novel technique that follows the complex surgical steps in a Whipple procedure. Three-dimensional reconstructed angiographic images are used to identify arterial variants for the surgeon as part of the preoperative radiologic assessment of pancreatic and ampullary tumors.

  14. Genome-wide association identifies genetic variants associated with lentiform nucleus volume in N = 1345 young and elderly subjects.

    Science.gov (United States)

    Hibar, Derrek P; Stein, Jason L; Ryles, April B; Kohannim, Omid; Jahanshad, Neda; Medland, Sarah E; Hansell, Narelle K; McMahon, Katie L; de Zubicaray, Greig I; Montgomery, Grant W; Martin, Nicholas G; Wright, Margaret J; Saykin, Andrew J; Jack, Clifford R; Weiner, Michael W; Toga, Arthur W; Thompson, Paul M

    2013-06-01

    Deficits in lentiform nucleus volume and morphometry are implicated in a number of genetically influenced disorders, including Parkinson's disease, schizophrenia, and ADHD. Here we performed genome-wide searches to discover common genetic variants associated with differences in lentiform nucleus volume in human populations. We assessed structural MRI scans of the brain in two large genotyped samples: the Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 706) and the Queensland Twin Imaging Study (QTIM; N = 639). Statistics of association from each cohort were combined meta-analytically using a fixed-effects model to boost power and to reduce the prevalence of false positive findings. We identified a number of associations in and around the flavin-containing monooxygenase (FMO) gene cluster. The most highly associated SNP, rs1795240, was located in the FMO3 gene; after meta-analysis, it showed genome-wide significant evidence of association with lentiform nucleus volume (P MA  = 4.79 × 10(-8)). This commonly-carried genetic variant accounted for 2.68 % and 0.84 % of the trait variability in the ADNI and QTIM samples, respectively, even though the QTIM sample was on average 50 years younger. Pathway enrichment analysis revealed significant contributions of this gene to the cytochrome P450 pathway, which is involved in metabolizing numerous therapeutic drugs for pain, seizures, mania, depression, anxiety, and psychosis. The genetic variants we identified provide replicated, genome-wide significant evidence for the FMO gene cluster's involvement in lentiform nucleus volume differences in human populations.

  15. Identifying open-volume defects in doped and undoped perovskite-type LaCoO3, PbTiO3, and BaTiO3

    International Nuclear Information System (INIS)

    Ghosh, Vinita J.; Nielsen, Bent; Friessnegg, Thomas

    2000-01-01

    Dopants, vacancies, and impurity-vacancy clusters have a substantial impact on the properties of perovskite-type metal oxides (general formula ABO 3 ). In order to determine synthesis and processing conditions that optimize the desirable properties of these materials a careful study of these defects is required. It is essential to identify the defects and to map the defect densities. Positron annihilation spectroscopy has often been used to identify vacancy-type defects. Calculations of the positron lifetime and Doppler-broadened profiles of the positron-electron annihilation radiation in undoped and doped LaCoO 3 , PbTiO 3 , and BaTiO 3 are reported, and compared with available experimental data. The results show that these positron techniques are excellent for studying open-volume defects, vacancy-impurity complexes, and for identifying the sublattice occupied by the dopants. (c) 2000 The American Physical Society

  16. Workspace appropriation and attachment

    Directory of Open Access Journals (Sweden)

    M. PAVALACHE-ILIE

    2016-11-01

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

  17. Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

    Science.gov (United States)

    Arjomandi, Mehrdad; Zeng, Siyang; Geerts, Jeroen; Stiner, Rachel K; Bos, Bruce; van Koeverden, Ian; Keene, Jason; Elicker, Brett; Blanc, Paul D; Gold, Warren M

    2018-01-01

    Exposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV 1 /FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear. To investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO 2max ) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)). RV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV 1 /FVC and FEV 1 , respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r 2 =0.03; p=0.011) and lower VO 2max (n=179; r 2 =0.47; p=0.013), and %EFL was negatively associated with VO 2max (n=32; r 2 =0.40; p=0.017). In those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity.

  18. ACR appropriateness criteria jaundice.

    Science.gov (United States)

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

    2013-06-01

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

  19. Discussion about the use of the volume-specific surface area (VSSA) as criteria to identify nanomaterials according to the EU definition

    International Nuclear Information System (INIS)

    Lecloux, André J.

    2015-01-01

    In the EU regulation, a material containing particles is considered as nano if, for 50 % or more of the particles in the number size distribution, one or more external dimensions is in the size range 1–100 nm. Due to the difficulty to measure in a reliable way the number particle size distribution, it is suggested to use the volume-specific surface area (VSSA) >60 m 2 /cm 3 as simple screening criterion to identify nanomaterials. This threshold corresponds to monodispersed spherical particles with a size of 100 nm. In this paper, a theoretical study is carried out to identify the effect of the particle shape, polydispersity, agglomeration and aggregation on the VSSA threshold. It appears that the VSSA approach is overprotective because a lot of samples are identified as nanomaterials even if less than 50 % of the particles have a size lower than 100 nm, this 50 % in number criterion being the main identification criterion in the EU definition. Even if the VSSA is leading to many false positive results, it can be used to identify non-nanomaterials as soon as its value is lower than the threshold at the condition to take into account the shape of the particles and their external surface area. This conclusion is true for monomodal distributions of particles but is subject to some restrictions for bimodal distributions

  20. Discussion about the use of the volume-specific surface area (VSSA) as criteria to identify nanomaterials according to the EU definition

    Energy Technology Data Exchange (ETDEWEB)

    Lecloux, André J., E-mail: alecloux@nanocyl.com, E-mail: envicat@skynet.be [ENVICAT Consulting (Belgium)

    2015-11-15

    In the EU regulation, a material containing particles is considered as nano if, for 50 % or more of the particles in the number size distribution, one or more external dimensions is in the size range 1–100 nm. Due to the difficulty to measure in a reliable way the number particle size distribution, it is suggested to use the volume-specific surface area (VSSA) >60 m{sup 2}/cm{sup 3} as simple screening criterion to identify nanomaterials. This threshold corresponds to monodispersed spherical particles with a size of 100 nm. In this paper, a theoretical study is carried out to identify the effect of the particle shape, polydispersity, agglomeration and aggregation on the VSSA threshold. It appears that the VSSA approach is overprotective because a lot of samples are identified as nanomaterials even if less than 50 % of the particles have a size lower than 100 nm, this 50 % in number criterion being the main identification criterion in the EU definition. Even if the VSSA is leading to many false positive results, it can be used to identify non-nanomaterials as soon as its value is lower than the threshold at the condition to take into account the shape of the particles and their external surface area. This conclusion is true for monomodal distributions of particles but is subject to some restrictions for bimodal distributions.

  1. Descriptive Summaries of the Research, Development, Test and Evaluation, Army Appropriation FY 1982. Supporting Data FY 1982. Supporting Data FY 1982, Budget Estimate Submitted to Congress January 1981, Amended 30 March 1981. Volume III.

    Science.gov (United States)

    1981-01-01

    UNCLASSIFIED BIDGET ACTIVITY PROGRAM ELEMENT PROJECT/SCIENTIFIC AHFA/TECIINICAL AREA VOLUME III INTELLIGENCE AND COMMUNICATIONS PAGE NO. 6.31.12.A MAPPING AND...System prototype. Continue depot prototype of Tracked CP Assemblage. Initiate depot prototype of new Shelterized Assemblage. Execute second increment ...new Shelterized Assemblage. Execute secondi Increment of Long-ilaul Fiber Optics Tranui:oiton System prototype UNCLASSIFIED ill-7 i UNCLASSIFIED Project

  2. Using computer technology to identify the appropriate radioactive materials packaging

    International Nuclear Information System (INIS)

    Driscoll, K.L.; Conan, M.R.

    1989-01-01

    The Radioactive Materials Packaging (RAMPAC) database is designed to store and retrieve information on all non-classified packages certified for the transport of radioactive materials within the boundaries of the US. The information in RAMPAC is publicly available, and the database has been designed so that individuals without programming experience can search for and retrieve information using a menu-driven system. RAMPAC currently contains information on over 650 radioactive material shipping packages. Information is gathered from the US Department of Energy (DOE), the US Department of transportation (DOT), and the US Nuclear Regulatory Commission (NRC). RAMPAC is the only tool available to radioactive material shippers that contains and reports packaging information from all three Federal Agencies. The DOT information includes package listings from Canada, France, Germany, Great Britain, and Japan, which have DOT revalidations for their certificates of competent authority and are authorized for use within the US for import and export shipments only. RAMPAC was originally developed in 1981 by DOE as a research and development tool. In recent years, however, RAMPAC has proven to be highly useful to operational personnel. As packages become obsolete or materials to be transported change, shippers of radioactive materials must be able to determine if alternative packages exist before designing new packages. RAMPAC is designed to minimize the time required to make this determination, thus assisting the operational community in meeting their goals

  3. Unauthorized Appropriations and Expiring Authorizations

    Science.gov (United States)

    2015-01-15

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

  4. Discussion about the use of the volume specific surface area (VSSA) as a criterion to identify nanomaterials according to the EU definition. Part two: experimental approach.

    Science.gov (United States)

    Lecloux, André J; Atluri, Rambabu; Kolen'ko, Yury V; Deepak, Francis Leonard

    2017-10-12

    The first part of this study was dedicated to the modelling of the influence of particle shape, porosity and particle size distribution on the volume specific surface area (VSSA) values in order to check the applicability of this concept to the identification of nanomaterials according to the European Commission Recommendation. In this second part, experimental VSSA values are obtained for various samples from nitrogen adsorption isotherms and these values were used as a screening tool to identify and classify nanomaterials. These identification results are compared to the identification based on the 50% of particles with a size below 100 nm criterion applied to the experimental particle size distributions obtained by analysis of electron microscopy images on the same materials. It is concluded that the experimental VSSA values are able to identify nanomaterials, without false negative identification, if they have a mono-modal particle size, if the adsorption data cover the relative pressure range from 0.001 to 0.65 and if a simple, qualitative image of the particles by transmission or scanning electron microscopy is available to define their shape. The experimental conditions to obtain reliable adsorption data as well as the way to analyze the adsorption isotherms are described and discussed in some detail in order to help the reader in using the experimental VSSA criterion. To obtain the experimental VSSA values, the BET surface area can be used for non-porous particles, but for porous, nanostructured or coated nanoparticles, only the external surface of the particles, obtained by a modified t-plot approach, should be considered to determine the experimental VSSA and to avoid false positive identification of nanomaterials, only the external surface area being related to the particle size. Finally, the availability of experimental VSSA values together with particle size distributions obtained by electron microscopy gave the opportunity to check the

  5. O emprego da geoestatística na determinação do tamanho "ótimo" de amostras aleatórias com vistas à obtenção de estimativas dos volumes dos fustes de espécies florestais em Paragominas, estado do Pará The use of geostatistics to determine the appropriate sample size in order to obtain stem volume estimates of tropical wood species

    Directory of Open Access Journals (Sweden)

    Paulo Cerqueira dos Santos

    2011-01-01

    Full Text Available O objetivo do trabalho foi determinar o tamanho adequado de amostra para estimar o volume de fustes de espécies florestais de uma população de árvores a serem cortadas no sistema de manejo florestal da empresa Cikel Brasil Verde Madeiras - Pará. Utilizaram-se as metodologias da amostragem sistemática e do estimador geoestatístico da krigagem ordinária com simulação sequencial, respectivamente para a escolha das amostras e estimação dos volumes dos fustes das árvores. Os resultados mostraram que os métodos podem ser utilizados no cálculo dos volumes de fustes de árvores. Entretanto, o método da krigagem apresenta um efeito de suavização, tendo como conseqüência uma subestimação dos volumes calculados. Neste caso, um fator de correção foi aplicado para minimizar o efeito da suavização. A simulação sequencial indicativa apresentou resultados mais precisos em relação à krigagem, uma vez que tal método apresentou algumas vantagens, tal como a não exigência de amostras com distribuições normais e ausência de efeito de suavização, característico dos métodos de interpolação.The objective of this study was to determine the appropriate size sample to estimate the stem volumes stems of tree species from a population of trees to be cut in the forest management system of the timber company Cikel Brasil Verde Madeiras - Pará State, Brazil. The methodologies of systematic sampling and geostatistical kriging with sequential simulation were used, respectively, for the choice of samples and estimation of stem volumes of trees. The results showed that the methods can be used to calculate the stem volumes of trees. However, the kriging method has a smoothing effect, which resulted in an underestimation of the volumes. In such case, a correction factor was applied to minimize the effect of smoothing. The sequential simulation indicative presented more accurate results compared to kriging, since this method has certain

  6. Appropriate Technology as Indian Technology.

    Science.gov (United States)

    Barry, Tom

    1979-01-01

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

  7. Perspectives on Conceptualizing Developmentally Appropriate Sexuality Education

    Science.gov (United States)

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

    2017-01-01

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

  8. Appropriate roads for rural access

    CSIR Research Space (South Africa)

    Paige-Green, P

    2006-03-01

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

  9. Appropriate use of diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-11-16

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

  10. The moral appropriateness of shame

    Directory of Open Access Journals (Sweden)

    M. Ally

    2005-07-01

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

  11. Military Construction: FY2017 Appropriations

    Science.gov (United States)

    2016-10-04

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

  12. Identifying Structure-Property Relationships Through DREAM.3D Representative Volume Elements and DAMASK Crystal Plasticity Simulations: An Integrated Computational Materials Engineering Approach

    Science.gov (United States)

    Diehl, Martin; Groeber, Michael; Haase, Christian; Molodov, Dmitri A.; Roters, Franz; Raabe, Dierk

    2017-05-01

    Predicting, understanding, and controlling the mechanical behavior is the most important task when designing structural materials. Modern alloy systems—in which multiple deformation mechanisms, phases, and defects are introduced to overcome the inverse strength-ductility relationship—give raise to multiple possibilities for modifying the deformation behavior, rendering traditional, exclusively experimentally-based alloy development workflows inappropriate. For fast and efficient alloy design, it is therefore desirable to predict the mechanical performance of candidate alloys by simulation studies to replace time- and resource-consuming mechanical tests. Simulation tools suitable for this task need to correctly predict the mechanical behavior in dependence of alloy composition, microstructure, texture, phase fractions, and processing history. Here, an integrated computational materials engineering approach based on the open source software packages DREAM.3D and DAMASK (Düsseldorf Advanced Materials Simulation Kit) that enables such virtual material development is presented. More specific, our approach consists of the following three steps: (1) acquire statistical quantities that describe a microstructure, (2) build a representative volume element based on these quantities employing DREAM.3D, and (3) evaluate the representative volume using a predictive crystal plasticity material model provided by DAMASK. Exemplarily, these steps are here conducted for a high-manganese steel.

  13. Academic appropriation and Impact Indicators

    Directory of Open Access Journals (Sweden)

    Wilson López López

    2012-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Hossein Yousefi Manesh

    2013-01-01

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

  15. Chemicals identified in feral and food animals: a data base. First annual report, October 1981. Volume I. Records 1-532

    International Nuclear Information System (INIS)

    Cone, M.V.; Faust, R.A.; Baldauf, M.F.

    1981-12-01

    This data file is a companion to Chemicals Identified in Human Biological Media, A Data Base, and follows basically the same format. The data base on human burden is in its third year of publication. This is the first annual report for the feral and food animal file. Data were obtained primarily from the open literature through manual searches (retrospective to 1979) of the journals listed in Appendix A. The data base now contains information on 60 different substances. Chemicals are listed by Chemical Abstracts Service (CAS) registry numbers and preferred names in Appendix B. For the user's convenience, cross-referenced chemical lists of CAS preferred and common names are provided in Appendix C. The animals, tissues, and body fluids found to be contaminated by these chemicals are listed in Appendix D. The data base is published annually in tabular format with indices and chemical listings that allow specific searching. A limited number of custom computer searches of the data base are available in special cases when the published format does not allow for retrieval of needed information

  16. Chemicals identified in feral and food animals: a data base. First annual report, October 1981. Volume I. Records 1-532

    Energy Technology Data Exchange (ETDEWEB)

    Cone, M.V.; Faust, R.A.; Baldauf, M.F. (comps.)

    1981-12-01

    This data file is a companion to Chemicals Identified in Human Biological Media, A Data Base, and follows basically the same format. The data base on human burden is in its third year of publication. This is the first annual report for the feral and food animal file. Data were obtained primarily from the open literature through manual searches (retrospective to 1979) of the journals listed in Appendix A. The data base now contains information on 60 different substances. Chemicals are listed by Chemical Abstracts Service (CAS) registry numbers and preferred names in Appendix B. For the user's convenience, cross-referenced chemical lists of CAS preferred and common names are provided in Appendix C. The animals, tissues, and body fluids found to be contaminated by these chemicals are listed in Appendix D. The data base is published annually in tabular format with indices and chemical listings that allow specific searching. A limited number of custom computer searches of the data base are available in special cases when the published format does not allow for retrieval of needed information.

  17. Appropriate fluid regimens to prevent bronchopulmonary dysplasia.

    Science.gov (United States)

    Tammela, O K

    1995-01-01

    Pulmonary oedema is an important problem in premature neonates with surfactant deficiency because of fluid accumulation in the lung interstitium and reduced urine output. Some retrospective reports suggest that excessive early hydration might increase the risk of bronchopulmonary dysplasia (BPD). Only three prospective studies evaluating low or conventional fluid administration regimens to very low birth weight infants have been published. According to their results no significant differences in the incidence of BPD have been shown. However, fluid restriction seems to improve the outcome of the infants because of decreased incidence of haemodynamically significant patent ductus arteriosus, necrotizing enterocolitis, pulmonary air leaks and decreased mortality. The appropriate amount of sodium in the intravenous fluids during the first days of life needs further evaluation. In tiny infants with birth weights from 500 to 800g intensive monitoring of fluid balance is essential to control the extremely high fluid losses due to evaporation. Undernutrition is a risk factor of BPD and therefore it is important to start parenteral nutrition early. The benefit of the use of colloids as volume expanders is controversial. According to some retrospective reports there might be an association with increased use of colloidal fluids during the first days of life and the development of BPD. Early excessive fluid administration might constitute a potential risk for low birth weight infants with hyaline membrane disease.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. ACR Appropriateness Criteria® Multiple Gestations.

    Science.gov (United States)

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

    2017-11-01

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

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

    Directory of Open Access Journals (Sweden)

    R Ostovar

    2009-07-01

    .5% were considered as inappropriate. Also 22 cases (7.8% were considered as appropriate indications for drug therapy and none were found to be suitable for waiting and watching. There were 94 scenarios related to surgery that 75 scenarios (80% were grouped in appropriate and 8 scenarios (8.5% identified inappropriate. Conclusion: At the present time, due to the lack of scientific evidence for suitable decision-making in providing health services, methods based upon agreement, including the one used in the present study, and the use of treatment standards derived from similar studies, are amongst the most important measures taken to improve the standard of health, provide suitable health services, and to reduce unnecessary costs. In addition, RAM appropriateness method could be an ideal method in determining the appropriateness of health care and in reducing the rate of inappropriate services provided. The similarity of results derived from other studies performed by the RAND method in determining the appropriateness of benign prostatic hyperplasia treatment with the current study shows the validity and reliability of this method. Keywords: Appropriate criteria, Benign Prostatic Hyperplasia (BPH, Appraisal of Guidelines for Research and Evaluation (AGREE.

  20. 32 CFR 3.5 - Appropriate use.

    Science.gov (United States)

    2010-07-01

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

  1. Ghost-Story Telling: Keeping It Appropriate.

    Science.gov (United States)

    Weintraub, Jeff

    1996-01-01

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

  2. 7 CFR 457.9 - Appropriation contingency.

    Science.gov (United States)

    2010-01-01

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

  3. Viability Assessment Volume 1

    International Nuclear Information System (INIS)

    1998-01-01

    Since May 1996, under its draft Civilian Radioactive Waste Management Program Plan (DOE 1996), DOE has been carrying out a 5-year program of work to support the decision in 2001 by the Secretary of Energy on whether or not to recommend the site to the President. Part of this program was to address major unresolved technical issues and to complete an assessment of the viability of the Yucca Mountain site by 1998. Affirming the DOE plans, Congress directed DOE in the 1997 Energy and Water Development Appropriations Act to provide a viability assessment of the Yucca Mountain site to Congress and the President. This Viability Assessment (VA) document is the DOE report to Congress and the President. They are expected to use the VA to make an informed decision about program direction and funding. Drawing on 15 years of scientific investigation and design work at Yucca Mountain, the VA summarizes a large technical basis of field investigations, laboratory tests, models, analyses, and engineering, described in cited references. The VA identifies the major uncertainties relevant to the technical defensibility of DOE analyses and designs, the DOE approach to managing these uncertainties, and the status of work toward the site recommendation and LA. The VA also identifies DOE plans for the remaining work, and the estimated costs of completing an LA and constructing and operating a repository. The attention to uncertainties is important because DOE must evaluate how the repository will perform during the next 10,000 years or longer. Uncertainties exist because of variability in the natural (geologic and hydrologic) systems at Yucca Mountain and because of imperfect scientific understanding of the natural processes that might affect the repository system. This is Volume 1 and it covers, Introduction and Site Characteristics, includes a high-level summary of the results of the VA and some additional background information. (The overview is bound separately.) Section 1 of Volume

  4. Identification of appropriate tools of information and communication ...

    African Journals Online (AJOL)

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

  5. 22 CFR 710.13 - Appropriate action.

    Science.gov (United States)

    2010-04-01

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

  6. ACR Appropriateness Criteria on Resectable Rectal Cancer

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  7. Appropriate flow forecasting for reservoir operation

    NARCIS (Netherlands)

    Dong, Xiaohua

    2005-01-01

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

  8. Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

    African Journals Online (AJOL)

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

  9. Ways of art appropriation by the advertising

    Directory of Open Access Journals (Sweden)

    Roberta Fernandes Esteves

    2013-09-01

    Full Text Available Based on the different ways of appropriation of the artistic visualrepresentations by the advertising communication, proposed by Lucia Santaella (2005 – imitation of the ways of composing and incorporation of the artistic image – this article presents, as of the examination of advertisements broadcast in different countries, seven new categories outlined on the basis of partial or total use of the appropriated image and the interference performed in them.

  10. Chautauqua notebook: appropriate technology on radio

    Energy Technology Data Exchange (ETDEWEB)

    Renz, B.

    1981-01-01

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

  11. ASP Strategies and Appropriate Antibiotic Use

    Science.gov (United States)

    Lee, Brian R; Tribble, Alison; Handy, Lori; Gerber, Jeffrey S; Hersh, Adam L; Kronman, Matthew; Terrill, Cindy; Newland, Jason

    2017-01-01

    Abstract Background The Infectious Diseases Society of America (IDSA) recommends hospitals implement antimicrobial stewardship programs (ASP) in order to decrease inappropriate antibiotic use due to the rise in antibiotic-resistant infections. Data are limited on the extent to which different ASP strategies influence appropriate antibiotic use. Methods We conducted an online survey in 2016 of U.S. Children’s Hospitals to collect hospital-level information on dedicated ASP effort, ASP monitoring activities, use of audit-feedback, formulary restrictions, rapid diagnostics, etc. During the same period the ASP teams at these hospitals completed 3 point prevalence surveys that documented details on all admitted patients 0–17 years receiving any antibiotics, determined what ASP modifications could be made, and if the antibiotic was appropriate. We employed hierarchical, multivariable logit models to examine which ASP-related, hospital-level strategies were associated with appropriate antibiotic use. Results Thirty hospitals participated. A total of 6,921 patients were included, representing 10,068 total antibiotics. Of these orders, 8,554 (85.0%) were categorized as appropriate, though this varied across sites (range: 68-92%). Additionally, 78.2% of antibiotics did not have recommended modifications. Appropriate antibiotic use was significantly higher for hospitals that relied on rapid diagnostics (aOR: 1.6; P Terrill, Merck: Grant Investigator, Research grant Allergan: Grant Investigator, Research grant. J. Newland, Merck: Grant Investigator, Research grant. Allergan: Grant Investigator, Research grant

  12. ACR Appropriateness Criteria® Tinnitus.

    Science.gov (United States)

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

    2017-11-01

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

  13. Technological transfer. 1. Appropriateness for developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Berrie, T W

    1978-12-01

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

  14. An appropriate level for reactor regulatory research

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  15. Energy and water development appropriations for 1994. Hearings before a Subcommittee of the Committee on Appropriations, House of Representatives, One Hundred Third Congress, First Session. Part 5

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Part 5 of the hearings for the Energy and Water Development Appropriations for 1994 contains budget hearings for the Department of Energy. Contained in this volume is the statement of the Secretary of Energy and budget proposals and justifications for Departmental Administration, Energy Research, Nuclear Energy and Commercial Waste Management, Solar and Renewables, and Power Marketing Administrations

  16. Rediscovering Enterprise: Developing Appropriate University Entrepreneurship Education

    Science.gov (United States)

    Bridge, Simon; Hegarty, Cecilia; Porter, Sharon

    2010-01-01

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

  17. Desktop Publishing Choices: Making an Appropriate Decision.

    Science.gov (United States)

    Crawford, Walt

    1991-01-01

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

  18. Appropriate administrative structures in harnessing water resources ...

    African Journals Online (AJOL)

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

  19. Audit incorporating avoidability and appropriate intervention can ...

    African Journals Online (AJOL)

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

  20. Using Appropriate Strategies to Improve Students' Comprehension ...

    African Journals Online (AJOL)

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

  1. Nationally Appropriate Mitigation Action: Understanding NAMA Cycle

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

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

  2. APPROPRIATE ALLOCATION OF CONTINGENCY USING RISK ANALYSIS METHODOLOGY

    Directory of Open Access Journals (Sweden)

    Andi Andi

    2004-01-01

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

  3. Neural mechanism for judging the appropriateness of facial affect.

    Science.gov (United States)

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

    2005-12-01

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

  4. Effect of hospital volume on processes of breast cancer care: A National Cancer Data Base study.

    Science.gov (United States)

    Yen, Tina W F; Pezzin, Liliana E; Li, Jianing; Sparapani, Rodney; Laud, Purushuttom W; Nattinger, Ann B

    2017-05-15

    The purpose of this study was to examine variations in delivery of several breast cancer processes of care that are correlated with lower mortality and disease recurrence, and to determine the extent to which hospital volume explains this variation. Women who were diagnosed with stage I-III unilateral breast cancer between 2007 and 2011 were identified within the National Cancer Data Base. Multiple logistic regression models were developed to determine whether hospital volume was independently associated with each of 10 individual process of care measures addressing diagnosis and treatment, and 2 composite measures assessing appropriateness of systemic treatment (chemotherapy and hormonal therapy) and locoregional treatment (margin status and radiation therapy). Among 573,571 women treated at 1755 different hospitals, 38%, 51%, and 10% were treated at high-, medium-, and low-volume hospitals, respectively. On multivariate analysis controlling for patient sociodemographic characteristics, treatment year and geographic location, hospital volume was a significant predictor for cancer diagnosis by initial biopsy (medium volume: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.05-1.25; high volume: OR = 1.30, 95% CI = 1.14-1.49), negative surgical margins (medium volume: OR = 1.15, 95% CI = 1.06-1.24; high volume: OR = 1.28, 95% CI = 1.13-1.44), and appropriate locoregional treatment (medium volume: OR = 1.12, 95% CI = 1.07-1.17; high volume: OR = 1.16, 95% CI = 1.09-1.24). Diagnosis of breast cancer before initial surgery, negative surgical margins and appropriate use of radiation therapy may partially explain the volume-survival relationship. Dissemination of these processes of care to a broader group of hospitals could potentially improve the overall quality of care and outcomes of breast cancer survivors. Cancer 2017;123:957-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

  5. Soil Respiration on an Aging Managed Heathland: Identifying an Appropriate Empirical Model for Predictive Purposes

    NARCIS (Netherlands)

    Kopittke, G.R.; van Loon, E.E.; Tietema, A.; Asscheman, D.

    2013-01-01

    Heathlands are cultural landscapes which are managed through cyclical cutting, burning or grazing practices. Understanding the carbon (C) fluxes from these ecosystems provides information on the optimal management cycle time to maximise C uptake and minimise C output. The interpretation of field

  6. Long-Term Military Contingency Operations: Identifying the Factors Affecting Budgeting in Annual or Supplemental Appropriations

    National Research Council Canada - National Science Library

    Evans, Amanda B

    2006-01-01

    .... The results show that planning, timing, accountability, visibility, politics and policy, stakeholder influence, military objectives, and fear of change are the most important factors. These findings can help stakeholders shape funding strategy.

  7. Inferring the drivers of discarding practices from observer data to identify appropriate fishery‐specific solutions

    DEFF Research Database (Denmark)

    Catchpole, Tom; Rochet, Marie‐Joëlle; Madsen, Niels

    2012-01-01

    with associated quota that are above the MLS or minimum length landed. The model is applied to data from the full English observer programme and to French, Danish, Greek, and Spanish case study métiers. The proportionate contribution of the different categories is determined, the differences between métiers...

  8. HPV status, cancer stem cell marker expression, hypoxia gene signatures and tumour volume identify good prognosis subgroups in patients with HNSCC after primary radiochemotherapy: A multicentre retrospective study of the German Cancer Consortium Radiation Oncology Group (DKTK-ROG)

    DEFF Research Database (Denmark)

    Linge, Annett; Lohaus, Fabian; Löck, Steffen

    2016-01-01

    OBJECTIVE: To investigate the impact of the tumour volume, HPV status, cancer stem cell (CSC) marker expression and hypoxia gene signatures, as potential markers of radiobiological mechanisms of radioresistance, in a contemporary cohort of patients with locally advanced head and neck squamous cell...

  9. Software appropriation over time: from adoption to stabilization and beyond

    Directory of Open Access Journals (Sweden)

    Antonette Mendoza

    2010-01-01

    Full Text Available Technologies are introduced into an organization with the aim of improving productivity. However, persistent use of an information system is required to enhance productivity and user satisfaction. In this paper, we examine the process of technology appropriation and the factors that encourage and discourage use of an information system over time. In a longitudinal field study in an educational setting, we identify changing expectations and influences that encourage persistent use of a technology above and beyond adoption. Our work indicates that stabilization of a technology may only be a temporary plateau. Further appropriation may occur beyond initial stabilization as expectations and influences encourage persistent use of a technology. We have found that the driving forces in encouraging productive use of a technology are the ability for users to experience the technology as useful and to have easy access to ongoing training.

  10. Appropriate Determination of Net Working Capital in Corporate Financial Management

    Directory of Open Access Journals (Sweden)

    Zdeněk Motlíček

    2015-01-01

    Full Text Available Liquidity and working capital management belongs to one of the fundamental tasks of short-term financial management. However, in the context of net working capital, the issue of management of current assets and liabilities significantly overlaps with long-term financial management, in which the effects of various decisions have long-term consequences, with considerable inertia and possibility of high losses. The present study is therefore focused on the determination of appropriate amount of working capital, as an important part of financial decision making process in the company. The paper presents an empirical research aiming to identify the appropriate approach to accurate calculations of net working capital and determining its needs. The main contribution of the study can be found in the verification of calculation method of net working capital needs, which, according to the authors, may be beneficial both for business practice and teaching of financial management at universities.

  11. Selection of appropriate greenhouse gas mitigation options

    Energy Technology Data Exchange (ETDEWEB)

    Ramanathan, R. [Indira Ghandi Institute of Development Research, Mumbai (India)

    1999-10-01

    Greenhouse gas mitigation options help in reducing greenhouse gas emissions so as to avoid the adverse environmental impacts due to global warming/climate change. They have different characteristics when evaluated using different criteria. For example, some options may be very cost effective, while some may have an additional advantage of reducing local pollution. Hence, selection of these options, for consideration by a national government or by a funding agency, has to incorporate multiple criteria. In this paper, some important criteria relevant to the selection are discussed, and a multi-criteria methodology is suggested for making appropriate selection. The methodology, called the Analytic Hierarchy Process, is described using two illustrations. (author)

  12. ACR Appropriateness Criteria® rib fractures.

    Science.gov (United States)

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

    2014-11-01

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

  13. Food appropriation through large scale land acquisitions

    International Nuclear Information System (INIS)

    Cristina Rulli, Maria; D’Odorico, Paolo

    2014-01-01

    The increasing demand for agricultural products and the uncertainty of international food markets has recently drawn the attention of governments and agribusiness firms toward investments in productive agricultural land, mostly in the developing world. The targeted countries are typically located in regions that have remained only marginally utilized because of lack of modern technology. It is expected that in the long run large scale land acquisitions (LSLAs) for commercial farming will bring the technology required to close the existing crops yield gaps. While the extent of the acquired land and the associated appropriation of freshwater resources have been investigated in detail, the amount of food this land can produce and the number of people it could feed still need to be quantified. Here we use a unique dataset of land deals to provide a global quantitative assessment of the rates of crop and food appropriation potentially associated with LSLAs. We show how up to 300–550 million people could be fed by crops grown in the acquired land, should these investments in agriculture improve crop production and close the yield gap. In contrast, about 190–370 million people could be supported by this land without closing of the yield gap. These numbers raise some concern because the food produced in the acquired land is typically exported to other regions, while the target countries exhibit high levels of malnourishment. Conversely, if used for domestic consumption, the crops harvested in the acquired land could ensure food security to the local populations. (letter)

  14. Designing appropriate blended courses: a students' perspective.

    Science.gov (United States)

    Tsai, Chia-Wen

    2010-10-01

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

  15. Shoosing the appropriate size wind turbine

    Energy Technology Data Exchange (ETDEWEB)

    Lynette, R. [FloWind Corp., San Rafael, CA (United States)

    1996-12-31

    Within the past several years, wind turbines rated at 400 kW and higher have been introduced into the market, and some manufacturers are developing machines rated at 750 - 1,000+ kW. This raises the question: What is the appropriate size for utility-grade wind turbines today? The answer depends upon the site where the machines will be used and the local conditions. The issues discussed in the paper are: (1) Site-Related (a) Visual, noise, erosion, television interference, interference with aviation (b) Siting efficiency (2) Logistics (a) Adequacy of roads and bridges to accept large vehicles (b) Availability and cost of cranes for erection and maintenance (c) Capability of local repair/overhauls (3) Cost Effectiveness (a) Capital costs (1) Wind Turbine (2) Infrastructure costs (b) Maintenance costs (4) Technical/Financial Risk. 1 fig., 1 tab.

  16. Selecting appropriate cases when tracing causal mechanisms

    DEFF Research Database (Denmark)

    Beach, Derek; Pedersen, Rasmus Brun

    2016-01-01

    The last decade has witnessed resurgence in the interest in studying the causal mechanisms linking causes and outcomes in the social sciences. This article explores the overlooked implications for case selection when tracing mechanisms using in-depth case studies. Our argument is that existing case...... selection guidelines are appropriate for research aimed at making cross-case claims about causal relationships, where case selection is primarily used to control for other causes. However, existing guidelines are not in alignment with case-based research that aims to trace mechanisms, where the goal...... is to unpack the causal mechanism between X and Y, enabling causal inferences to be made because empirical evidence is provided for how the mechanism actually operated in a particular case. The in-depth, within-case tracing of how mechanisms operate in particular cases produces what can be termed mechanistic...

  17. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    NARCIS (Netherlands)

    Grol, C.E.J.

    2012-01-01

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

  19. Testicular Volume: Size Does Matter

    International Nuclear Information System (INIS)

    Reyes Lobo, Alexander; Segovia Fuentes, Javier; Cerpa Reyes, Edgar

    2011-01-01

    Testicular volume is critical for semen production and, consequently, for fertility. Hence the importance of knowing the normal size ranges and the different methods for calculating size, in order to classify patients at risk and refer them for appropriate management. Ultrasound is the first-line diagnostic method for the evaluation of testicular pathology, and it is also the best tool for estimating the volume of both testicles, bearing in mind that a testicular volume below 15 cc results in fertility problems. Although there are many causes of infertility, varicocele is undoubtedly the most important of all, because of its frequency and because it is amenable to curative surgical treatment.

  20. Searching for an Appropriate Exchange Rate Regime

    Directory of Open Access Journals (Sweden)

    Yunjong Wang

    2001-06-01

    Full Text Available This paper attempts to survey current debates on the choice of exchange rate regime in emerging market economies. The issue of choosing an appropriate exchange rate regime is being actively discussed since the recent Asian crisis. As a lesson from the recent crises, one widely shared conclusion is that soft peg exchange rate regimes are extremely vulnerable in a world of volatile capital movements. Consequently, new orthodoxy based on the impossible trinity hypothesis favours two corner solutions ― greater flexibility or credible institutional assurance, like a currency board system or dollarization. Nevertheless, questions whether such corner solutions are adequate for developing countries are rising of late. "Fear of floating" is still conspicuous in many developing countries having adopted nominally a free-floating exchange rate regime. Developing countries are sensitive to exchange rate fluctuations because the cost of exchange rate volatility is greater than the benefit when compared to developed countries. Monitoring bands is a compromise solution, but it still needs further enhancement of estimation techniques for fundamental equilibrium exchange rates in order to make those estimation results more workable in practice. Other alternatives include the creation of soft peg of the G-3 currencies. Despite counterarguments, the stability of G-3 currencies could prove to be beneficial to emerging market economies.

  1. Public Library Representations and Internet Appropriations

    Directory of Open Access Journals (Sweden)

    Paula Sequeiros

    2013-11-01

    Full Text Available May the changes in the representations of the public library be propitiated by readers' appropriations of the Internet? To answer this question, a theoretically-driven and empirically-based research was developed in a public library in Portugal, combining the analysis of documents uses, the ethnography of space and Internet use, of social relations developed while reading, with the analysis of representations of the public library. No clear-cut association emerged between social-demographics or user profiles, and representations, in general. No disruptive Internet "impact" was found: Internet use may contribute to reinforce traditional representations of the library, while it may also update and democratise other representations. If the library and the Internet are represented as synonymous, the former does not make sense without the latter; but an Internet widespread and intensive use conflicts with the image of an institution dedicated to high-brow culture. Changes in uses of the public library are, instead, clearly associated with new types of readers, which in their turn reflect changes in urban social composition. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1401141

  2. Gender Inequality Index Appropriateness for Measuring Inequality.

    Science.gov (United States)

    Amin, Elham; Sabermahani, Asma

    2017-01-01

    Gender inequality means unequal distribution of wealth, power, and benefits among women and men. The gender inequality index (GII) measures the lost human development in three important dimensions: reproductive health, political empowerment, and economic status. The first purpose of this study was to calculate the index for provinces of Iran, and the second purpose was to survey the appropriateness of that, for comparing different regions, through regression estimations. In this study, GII has been calculated for Iran between the years 2006-2011 and provinces have been ranked based on it. Then, a panel composed of 30 sections was estimated for five years to determine the most important factor affecting level of index. Some changes have been made to analyze values of the index and the ranking of provinces. Based on panel model, share of parliamentary seats was the most effective factor for determination of the index. After applying adjustments, some differences were seen in the ranking of provinces and general level of index. Weighing of dimensions of the index and considering an overall variable, such as life expectancy in the field of health, will give a more accurate comparison of the GII among different regions though concurrent attention to non-discriminatory cultural dimensions of political participation of women; therefore, making more analyses possible for a more correct comparison of the extensive geographical regions, such as countries.

  3. Neurophysiological appropriateness of ionizing radiation effects

    International Nuclear Information System (INIS)

    Nyagu, A.I.; Loganovsky, K.N.

    1997-01-01

    The goal of this study was to compare bioelectrical activity of the brain in remote period of acute radiation sickness (ARS), chronic and prenatal irradiation as a result of the Chernobyl disaster. Registration of computerized 19-channel EEG, visual and somato-sensory evoked potentials have been carried out for 70 patients who had a verified ARS, 100 Chernobyl disaster survivors, who have been working in the Chernobyl exclusion zone since 1986-87 during 5 and more years, 50 prenatally irradiated children, and relevant controls. The relative risks of neurophysiological abnormalities are 4.5 for the ARS-patients, 3.6 for the chronically irradiated persons and 3.7 for the prenatally irradiated children. The data obtained testify to possibility of radiation-induced neurophysiological abnormalities in examined Chernobyl accident survivors which seems to be non-stochastic effects of ionizing radiation. For all examined irradiated patients it was typically an increasing of δ- and β- powers of EEG, particularly, in the frontal lobe shifted to the left fronto-temporal region, but spectral power of both θ- and α-range was significantly depressed. Aforesaid signs together with data of evoked potentials reflect the structural and functional abnormalities of limbic system and the left hemisphere as the first revealed neurophysiological appropriateness of ionizing radiation effects. (author)

  4. Neurophysiological appropriateness of ionizing radiation effects

    Energy Technology Data Exchange (ETDEWEB)

    Nyagu, A I; Loganovsky, K N [Department of Neurology, Inst. of Clinical Radiology, Scientific Centre for Radiation Medicine of Academy of Medical Sciences of Ukraine, Kiev (Ukraine)

    1997-11-01

    The goal of this study was to compare bioelectrical activity of the brain in remote period of acute radiation sickness (ARS), chronic and prenatal irradiation as a result of the Chernobyl disaster. Registration of computerized 19-channel EEG, visual and somato-sensory evoked potentials have been carried out for 70 patients who had a verified ARS, 100 Chernobyl disaster survivors, who have been working in the Chernobyl exclusion zone since 1986-87 during 5 and more years, 50 prenatally irradiated children, and relevant controls. The relative risks of neurophysiological abnormalities are 4.5 for the ARS-patients, 3.6 for the chronically irradiated persons and 3.7 for the prenatally irradiated children. The data obtained testify to possibility of radiation-induced neurophysiological abnormalities in examined Chernobyl accident survivors which seems to be non-stochastic effects of ionizing radiation. For all examined irradiated patients it was typically an increasing of {delta}- and {beta}- powers of EEG, particularly, in the frontal lobe shifted to the left fronto-temporal region, but spectral power of both {theta}- and {alpha}-range was significantly depressed. Aforesaid signs together with data of evoked potentials reflect the structural and functional abnormalities of limbic system and the left hemisphere as the first revealed neurophysiological appropriateness of ionizing radiation effects. (author). 25 refs.

  5. Financial Audit and Spending of Appropriations

    Directory of Open Access Journals (Sweden)

    Ivo Mijoč

    2013-07-01

    Full Text Available Local and district (regional governments receive various forms of revenue. The entitlement to and purpose of this income is determined by law. Likewise for companies owned by local government there are revenues with allocated use, which are also associated with the budget of the local unit. The importance of proper recording of the revenue collected, as well as claims for different types of income is significant because it affects the proper presentation of the financial statements. The presented data are the basis for making decisions, which result in opportunities to meet the needs of local communities. When it comes to the disposal of revenue collected, misconduct or even illegal activities might occur. It is crucial to spot them early on, and here the internal control system and the accounting system have a key role, as they examine the financial and other information for management purposes. The aim of the paper was to investigate irregularities in the use of local funds by examining the data obtained by Financial Audits and to show the movement of appropriations (allocated funds at the county level.

  6. Methylphenidate: increased abuse or appropriate use?

    Science.gov (United States)

    Llana, M E; Crismon, M L

    1999-01-01

    To address the question of the significant increase in methylphenidate (MPD) prescriptions being written and to make recommendations for health care providers involved in providing care for patients with attention deficit hyperactivity disorder (ADHD) and their families. Medline search 1966-1998 for professional articles using the following search terms--methylphenidate, children, adolescents, abuse; Internet search using MPD, Ritalin, and ADHD; and Paper Chase search using methylphenidate. The available literature regarding potential abuse or diversion of MPD consists of case reports, review articles, newspaper articles, and a Drug Enforcement Administration (DEA) publication. All available literature sources were used. Although the media and DEA report significant abuse and diversion of prescribed MPD, a review of the available literature did not reveal data to substantiate these claims. Nonetheless, there are reasons to suspect that abuse and diversion occur. A potential contributing factor to abuse is the reported similarities in pharmacodynamics and pharmacokinetics between MPD and cocaine. Recommendations are made to decrease the possibility of abuse and diversion of prescribed MPD. A balanced middle ground must be found regarding the benefits of MPD and its abuse potential. Education of clinicians, patients, and family members is key in ensuring that MPD is used appropriately.

  7. Correlation Coefficients: Appropriate Use and Interpretation.

    Science.gov (United States)

    Schober, Patrick; Boer, Christa; Schwarte, Lothar A

    2018-05-01

    Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.

  8. HANPP Collection: Human Appropriation of Net Primary Productivity as a Percentage of Net Primary Productivity

    Data.gov (United States)

    National Aeronautics and Space Administration — The Human Appropriation of Net Primary Productivity (HANPP) as a Percentage of Net Primary Product (NPP) portion of the HANPP Collection represents a map identifying...

  9. Status Report on Nationally Appropriate Mitigation Actions (NAMAs). Mid-year update June 2013

    Energy Technology Data Exchange (ETDEWEB)

    Van Tilburg, X.; Bristow, S. [ECN Policy Studies, Amsterdam (Netherlands); Roeser, F.; Escalante, D.; Fekete, H. [Ecofys, Cologne (Germany)

    2013-06-15

    This mid-year update of the Annual Status Report on Nationally Appropriate Mitigation Actions, last published by Ecofys and ECN in November 2012, highlights recent trends in NAMA development and support and identifies where more progress is needed.

  10. Change in Seroma Volume During Whole-Breast Radiation Therapy

    International Nuclear Information System (INIS)

    Sharma, Rajiv; Spierer, Marnee; Mutyala, Subhakar; Thawani, Nitika; Cohen, Hillel W.; Hong, Linda; Garg, Madhur K.; Kalnicki, Shalom

    2009-01-01

    Purpose: After breast-conserving surgery, a seroma often forms in the surgical cavity. If not drained, it may affect the volume of tumor bed requiring a boost after whole-breast radiation therapy (WBRT). Our objective was to evaluate the change in seroma volume that occurs during WBRT, before boost planning. Methods and Materials: A retrospective review was performed of women receiving breast-conserving therapy with evidence of seroma at the time of WBRT planning. Computed tomography (CT) simulation was performed before WBRT and before the tumor bed boost. All patients received either a hypofractionated (42.4 Gy/16 fraction + 9.6 Gy/4 fraction boost) or standard fractionated (50.4 Gy/28 fraction + 10 Gy/5 fraction boost) regimen. Seroma volumes were contoured and compared on CT at the time of WBRT simulation and tumor bed boost planning. Results: Twenty-four patients with evidence of seroma were identified and all patients received WBRT without drainage of the seroma. Mean seroma volume before WBRT and at boost planning were significantly different at 65.7 cm 3 (SD, 50.5 cm 3 ) and 35.6 cm 3 (SD, 24.8 cm 3 ), respectively (p < 0.001). Mean and median reduction in seroma volume during radiation were 39.6% (SD, 23.8%) and 46.2% (range, 10.7-76.7%), respectively. Fractionation schedule was not correlated with change in seroma volume. Length of time from surgery to start of radiation therapy showed an inverse correlation with change in seroma volume (Pearson correlation r = -0.53, p < 0.01). Conclusions: The volume of seroma changes significantly during WBRT. Consequently, the accuracy of breast boost planning is likely affected, as is the volume of normal breast tissue irradiated. CT-based boost planning before boost irradiation is suggested to ensure appropriate coverage.

  11. NJP VOLUME 39 No 4

    African Journals Online (AJOL)

    Prof Ezechukwu

    2012-02-28

    Feb 28, 2012 ... Disorders affecting fluid volume and electrolyte compo- sition are common ... knowledge of the mechanism of action of diuretic drugs and appropriate ... Presence of non-permeable solute will oppose H2O ex- traction. NaCl is actively .... loop not affected. • In oral administration rate and extent of absorption.

  12. ACR Appropriateness Criteria®  Resectable Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Jones William E

    2012-09-01

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

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

    Science.gov (United States)

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

    2017-01-01

    is limited. This pilot study documents the feasibility of measuring appropriateness and guideline adherence in clinical practice and identifies substantial opportunities for quality improvement. Trial registration number NCT02748603. PMID:28877948

  14. Applying ARIMA model for annual volume time series of the Magdalena River

    OpenAIRE

    Gloria Amaris; Humberto Ávila; Thomas Guerrero

    2017-01-01

    Context: Climate change effects, human interventions, and river characteristics are factors that increase the risk on the population and the water resources. However, negative impacts such as flooding, and river droughts may be previously identified using appropriate numerical tools. Objectives: The annual volume (Millions of m3/year) time series of the Magdalena River was analyzed by an ARIMA model, using the historical time series of the Calamar station (Instituto de Hidrología, Meteoro...

  15. From Adaptation to Appropriation: Framing the World Through News Translation

    Directory of Open Access Journals (Sweden)

    Valdeón Roberto A.

    2014-02-01

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

  16. Appropriateness of lumbar spine magnetic resonance imaging in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Kovacs, Francisco M. [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Research Department, Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Arana, Estanislao, E-mail: aranae@uv.es [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Servicio de Radiología, Fundación Instituto Valenciano de Oncología, Valencia (Spain); Fundación Instituto de Investigación en Servicios de Salud, Valencia (Spain); Royuela, Ana [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); CIBER Epidemiología y Salud Pública (CIBERESP) (Spain); Unidad de Bioestadística Clínica, Hospital Ramón y Cajal, IRYCIS, Ctra. Colmenar Km. 9.1, 28034 Madrid (Spain); Cabrera, Alberto [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao, Vizcaya (Spain); Casillas, Carlos [Spanish Back Pain Research Network (REIDE), Fundación Kovacs, Paseo de Mallorca 36, 07012 Palma de Mallorca (Spain); Instituto de Traumatología Unión de Mutuas, Av. del Lledó, C/Juan de Herrera, 27 12004 Castellón (Spain); and others

    2013-06-15

    Objectives: To determine the minimum percentage of lumbar spine magnetic resonance imaging (LSMRI) which are inappropriately prescribed in routine practice. Methods: LSMRI performed prospectively on 602 patients in 12 Radiology Services across 6 regions in Spain, were classified as “appropriate”, “uncertain” or “inappropriate” based on the indication criteria established by the National Institute for Clinical Excellence, the American College of Physicians and Radiology, and current evidence-based clinical guidelines. Studies on patients reporting at least one “red flag” were classified as “appropriate”. A logistic regression model was developed to identify factors associated with a higher likelihood of inappropriate LSMRI, including gender, reporting of referred pain, health care setting (private/public), and specialty of prescribing physician. Before performing the LSMRI, the radiologists also assessed the appropriateness of the prescription. Results: Eighty-eight percent of LSMRI were appropriate, 1.3% uncertain and 10.6% inappropriate. The agreement of radiologists’ assessment with this classification was substantial (k = 0.62). The odds that LSMRI prescriptions were inappropriate were higher for patients without referred pain [OR (CI 95%): 13.75 (6.72; 28.16)], seen in private practice [2.25 (1.20; 4.22)], by orthopedic surgeons, neurosurgeons or primary care physicians [2.50 (1.15; 5.56)]. Conclusion: Efficiency of LSMRI could be improved in routine practice, without worsening clinical outcomes.

  17. Appropriateness of lumbar spine magnetic resonance imaging in Spain

    International Nuclear Information System (INIS)

    Kovacs, Francisco M.; Arana, Estanislao; Royuela, Ana; Cabrera, Alberto; Casillas, Carlos

    2013-01-01

    Objectives: To determine the minimum percentage of lumbar spine magnetic resonance imaging (LSMRI) which are inappropriately prescribed in routine practice. Methods: LSMRI performed prospectively on 602 patients in 12 Radiology Services across 6 regions in Spain, were classified as “appropriate”, “uncertain” or “inappropriate” based on the indication criteria established by the National Institute for Clinical Excellence, the American College of Physicians and Radiology, and current evidence-based clinical guidelines. Studies on patients reporting at least one “red flag” were classified as “appropriate”. A logistic regression model was developed to identify factors associated with a higher likelihood of inappropriate LSMRI, including gender, reporting of referred pain, health care setting (private/public), and specialty of prescribing physician. Before performing the LSMRI, the radiologists also assessed the appropriateness of the prescription. Results: Eighty-eight percent of LSMRI were appropriate, 1.3% uncertain and 10.6% inappropriate. The agreement of radiologists’ assessment with this classification was substantial (k = 0.62). The odds that LSMRI prescriptions were inappropriate were higher for patients without referred pain [OR (CI 95%): 13.75 (6.72; 28.16)], seen in private practice [2.25 (1.20; 4.22)], by orthopedic surgeons, neurosurgeons or primary care physicians [2.50 (1.15; 5.56)]. Conclusion: Efficiency of LSMRI could be improved in routine practice, without worsening clinical outcomes

  18. Research program plan: piping. Volume 3

    International Nuclear Information System (INIS)

    Vagins, M.; Strosnider, J.

    1985-07-01

    Regulatory issues related to piping can be divided into the three areas of pipe cracking, postulated design basis pipe breaks, and design of piping for seismic and other dynamic loads. The first two of these issues are in the domain of the Materials Engineering Branch (MEBR), while the last of the three issues is the responsibility of the Mechanical/Structural Engineering Branch. This volume of the MEBR Research Plan defines the critical aspects of the pipe cracking and postulated design basis pipe break issues and identifies those research efforts and results necessary for their resolution. In general, the objectives of the MERB Piping Research Program are to provide experimentally validated analytic techniques and appropriate material properties characterization methods and data to support regulatory activities related to evaluating and ensuring piping integrity

  19. Are advertisements in dental journals supported by an appropriate evidence-base?

    Science.gov (United States)

    Chestnutt, Ivor G; Hardy, Robert

    2013-09-01

    Dental professionals are constantly exposed to advertisements in the dental literature. These promote products, either for use in the operatory or to recommend to patients. In an era of evidence-based practice, what references are provided to support claims made by the advertisers? This study aimed to determine if advertisements in four major dental journals, whose target audience is general dental practitioners, were supported by an appropriate evidence-base, readily accessible to readers. The 2010 printed volumes of the Australian Dental Journal, British Dental Journal, Dental Update and the Journal of the American Dental Association were hand searched to identify advertisements which made a claim of clinical benefit or superiority to competing products. Advertisements were categorized according to type of product being promoted and the availability, nature and number of any supporting references was recorded. Repeated advertisements were analyzed only once. A total of 390 advertisements were identified and 369 made a claim of benefit or superiority. When the 222 duplicates of the same advertisement were removed, 147 unique advertisements remained. Of these: 54 (37%) were advertisements related to dental devices for in-surgery use; 44 (30%) for dental materials, and 27 (18%) for dentifrices/medicaments. 113 (76.9%) advertisements offered no evidential support for claims made. Of the 34 advertisements that provided evidential support, only 20 provided a complete reference that could readily be sourced by an interested reader: 15 articles in refereed journals; 5 data on file; 3 in-house studies and combinations thereof. Four references were not accessible due to incomplete referencing. Two advertisements provided evidence that was not relevant to the product being advertised. The majority of advertisements in the dental literature do not provide an adequate evidence-base, readily available to readers, to support the claims being made. If evidence-based practice is

  20. Aperiodic Volume Optics

    Science.gov (United States)

    Gerke, Tim D.

    Presented in this thesis is an investigation into aperiodic volume optical devices. The three main topics of research and discussion are the aperiodic volume optical devices that we call computer-generated volume holograms (CGVH), defects within periodic 3D photonic crystals, and non-periodic, but ordered 3D quasicrystals. The first of these devices, CGVHs, are designed and investigated numerically and experimentally. We study the performance of multi-layered amplitude computer-generated volume holograms in terms of efficiency and angular/frequency selectivity. Simulation results show that such aperiodic devices can increase diffraction efficiency relative to periodic amplitude volume holograms while maintaining angular and wavelength selectivity. CGVHs are also designed as voxelated volumes using a new projection optimization algorithm. They are investigated using a volumetric diffraction simulation and a standard 3D beam propagation technique as well as experimentally. Both simulation and experiment verify that the structures function according to their design. These represent the first diffractive structures that have the capacity for generating arbitrary transmission and reflection wave fronts and that provide the ability for multiplexing arbitrary functionality given different illumination conditions. Also investigated and discussed in this thesis are 3D photonic crystals and quasicrystals. We demonstrate that these devices can be fabricated using a femtosecond laser direct writing system that is particularly appropriate for fabrication of such arbitrary 3D structures. We also show that these devices can provide 3D partial bandgaps which could become complete bandgaps if fabricated using high index materials or by coating lower index materials with high index metals. Our fabrication method is particularly suited to the fabrication of engineered defects within the periodic or quasi-periodic systems. We demonstrate the potential for fabricating defects within

  1. Improving the radiologist–CAD interaction: designing for appropriate trust

    International Nuclear Information System (INIS)

    Jorritsma, W.; Cnossen, F.; Ooijen, P.M.A. van

    2015-01-01

    Computer-aided diagnosis (CAD) has great potential to improve radiologists' diagnostic performance. However, the reported performance of the radiologist–CAD team is lower than what might be expected based on the performance of the radiologist and the CAD system in isolation. This indicates that the interaction between radiologists and the CAD system is not optimal. An important factor in the interaction between humans and automated aids (such as CAD) is trust. Suboptimal performance of the human–automation team is often caused by an inappropriate level of trust in the automation. In this review, we examine the role of trust in the radiologist–CAD interaction and suggest ways to improve the output of the CAD system so that it allows radiologists to calibrate their trust in the CAD system more effectively. Observer studies of the CAD systems show that radiologists often have an inappropriate level of trust in the CAD system. They sometimes under-trust CAD, thereby reducing its potential benefits, and sometimes over-trust it, leading to diagnostic errors they would not have made without CAD. Based on the literature on trust in human–automation interaction and the results of CAD observer studies, we have identified four ways to improve the output of CAD so that it allows radiologists to form a more appropriate level of trust in CAD. Designing CAD systems for appropriate trust is important and can improve the performance of the radiologist–CAD team. Future CAD research and development should acknowledge the importance of the radiologist–CAD interaction, and specifically the role of trust therein, in order to create the perfect artificial partner for the radiologist. This review focuses on the role of trust in the radiologist–CAD interaction. The aim of the review is to encourage CAD developers to design for appropriate trust and thereby improve the performance of the radiologist–CAD team. - Highlights: • Radiologists often have an inappropriate

  2. 43 CFR 20.506 - Appropriations, legislation and lobbying.

    Science.gov (United States)

    2010-10-01

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

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

    International Nuclear Information System (INIS)

    Foust, Henry; Ghosehajra, Malay

    2007-01-01

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

  4. 17 CFR 256.215 - Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

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

  5. 45 CFR 84.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

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

  6. 7 CFR 15b.22 - Free appropriate public education.

    Science.gov (United States)

    2010-01-01

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

  7. 45 CFR 605.33 - Free appropriate public education.

    Science.gov (United States)

    2010-10-01

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

  8. The anterior cerebral artery is an appropriate arterial input function for perfusion-CT processing in patients with acute stroke

    International Nuclear Information System (INIS)

    Wintermark, Max; Lau, Benison C.; Chien, Jeffrey; Arora, Sandeep

    2008-01-01

    Dynamic perfusion-CT (PCT) with deconvolution requires an arterial input function (AIF) for postprocessing. In clinical settings, the anterior cerebral artery (ACA) is often chosen for simplicity. The goals of this study were to determine how the AIF selection influences PCT results in acute stroke patients and whether the ACA is an appropriate default AIF. We retrospectively identified consecutive patients suspected of hemispheric stroke of less than 48 h duration who were evaluated on admission by PCT. PCT datasets were postprocessed using multiple AIF, and cerebral blood volume (CBV) and flow (CBF), and mean transit time (MTT) values were measured in the corresponding territories. Results from corresponding territories in the same patients were compared using paired t-tests. The volumes of infarct core and tissue at risk obtained with different AIFs were compared to the final infarct volume. Of 113 patients who met the inclusion criteria, 55 with stroke were considered for analysis. The MTT values obtained with an ''ischemic'' AIF tended to be shorter (P=0.055) and the CBF values higher (P=0.108) than those obtained using a ''nonischemic'' AIF. CBV values were not influenced by the selection of the AIF. No statistically significant difference was observed between the size of the PCT infarct core (P=0.121) and tissue at risk (P=0.178), regardless of AIF selection. In acute stroke patients, the selection of the AIF has no statistically significant impact of the PCT results; standardization of the PCT postprocessing using the ACA as the default AIF is adequate. (orig.)

  9. Encouraging appropriate, evidence-based use of oral nutritional supplements.

    Science.gov (United States)

    Stratton, Rebecca J; Elia, Marinos

    2010-11-01

    With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

  10. Produced Water Treatment Using Geothermal Energy from Oil and Gas Wells: An Appropriateness of Decommissioned Wells Index (ADWI) Approach

    Science.gov (United States)

    Kiaghadi, A.; Rifai, H. S.

    2016-12-01

    This study investigated the feasibility of harnessing geothermal energy from retrofitted oil and gas decommissioned wells to power desalination units and overcome the produced water treatment energy barrier. Previous studies using heat transfer models have indicated that well depth, geothermal gradient, formation heat conductivity, and produced water salt levels were the most important constraints that affect the achievable volume of treated water. Thus, the challenge of identifying which wells would be best suited for retrofit as geothermal wells was addressed by defining an Appropriateness of Decommissioned Wells Index (ADWI) using a 25 km x 25 km grid over Texas. Heat transfer modeling combined with fuzzy logic methodology were used to estimate the ADWI at each grid cell using the scale of Very Poor, Poor, Average, Good and Excellent. Values for each of the four constraints were extracted from existing databases and were used to select 20 representative values that covered the full range of the data. A heat transfer model was run for all the 160,000 possible combination scenarios and the results were regressed to estimate weighting coefficients that indicate the relative effect of well depth, geothermal gradient, heat conductivity, and produced water salt levels on the volume of treated water in Texas. The results indicated that wells located in cells with ADWI of "Average", "Good" or "Excellent" can potentially deliver 35,000, 106,000, or 240,000 L/day of treated water, respectively. Almost 98% of the cells in the Granite Wash, 97% in Eagle Ford Shale, 90% in Haynesville Shale, 79% in Permian Basin, and 78% in Barnett Shale were identified as better than "Average" locations; whereas, south of the Eagle Ford, southwestern Permian Basin, and the center of Granite Wash were "Excellent". Importantly, most of the locations with better than "Average" ADWI are within drought prone agricultural regions that would benefit from this resilient source of clean water.

  11. Identifying incompatible combinations of concrete materials : volume I, final report.

    Science.gov (United States)

    2006-08-01

    Unexpected interactions between otherwise acceptable ingredients in portland cement concrete are becoming increasingly common as cementitious systems become more and more complex and demands on the systems are more rigorous. Such incompatibilities ar...

  12. Increased intracranial volume in Parkinson's disease

    DEFF Research Database (Denmark)

    Krabbe, Katja; Karlsborg, Merete; Hansen, Andreas

    2005-01-01

    segmentation and outlining of regions in order to identify regional volume changes that might be useful in the diagnosis of the two diseases. RESULTS: Patients with PD had significantly larger intracranial volumes (ICVs) and significantly smaller putaminal and sustantia nigra volumes than controls. MSA...... patients had significantly smaller substantia nigra and caudate volumes than controls but normal intracranial volume. In both patient groups there was a further trend towards smaller amygdala volumes. DISCUSSION: Increased ICV in PD patients is a new finding that may be explained by genetic factors...

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

    Science.gov (United States)

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

    2018-04-01

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

  14. Defense Authorization and Appropriations Bills: FY1970-FY2017

    Science.gov (United States)

    2017-01-18

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

  15. Random volumes from matrices

    Energy Technology Data Exchange (ETDEWEB)

    Fukuma, Masafumi; Sugishita, Sotaro; Umeda, Naoya [Department of Physics, Kyoto University,Kitashirakawa Oiwake-cho, Kyoto 606-8502 (Japan)

    2015-07-17

    We propose a class of models which generate three-dimensional random volumes, where each configuration consists of triangles glued together along multiple hinges. The models have matrices as the dynamical variables and are characterized by semisimple associative algebras A. Although most of the diagrams represent configurations which are not manifolds, we show that the set of possible diagrams can be drastically reduced such that only (and all of the) three-dimensional manifolds with tetrahedral decompositions appear, by introducing a color structure and taking an appropriate large N limit. We examine the analytic properties when A is a matrix ring or a group ring, and show that the models with matrix ring have a novel strong-weak duality which interchanges the roles of triangles and hinges. We also give a brief comment on the relationship of our models with the colored tensor models.

  16. Translation research: from accurate diagnosis to appropriate treatment

    Directory of Open Access Journals (Sweden)

    Pass Harvey I

    2004-10-01

    Full Text Available Abstract This review article focuses on the various aspects of translational research, where research on human subjects can ultimately enhance the diagnosis and treatment of future patients. While we will use specific examples relating to the asbestos related cancer mesothelioma, it should be stressed that the general approach outlined throughout this review is readily applicable to other diseases with an underlying molecular basis. Through the integration of molecular-based technologies, systematic tissue procurement and medical informatics, we now have the ability to identify clinically applicable "genotype"-"phenotype" associations across cohorts of patients that can rapidly be translated into useful diagnostic and treatment strategies. This review will touch on the various steps in the translational pipeline, and highlight some of the most essential elements as well as possible roadblocks that can impact success of the program. Critical issues with regard to Institutional Review Board (IRB and Health Insurance Portability and Accountability Act (HIPAA compliance, data standardization, sample procurement, quality control (QC, quality assurance (QA, data analysis, preclinical models and clinical trials are addressed. The various facets of the translational pipeline have been incorporated into a fully integrated computational system, appropriately named Dx2Tx. This system readily allows for the identification of new diagnostic tests, the discovery of biomarkers and drugable targets, and prediction of optimal treatments based upon the underlying molecular basis of the disease.

  17. Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

    Data.gov (United States)

    Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

  18. Appropriate Technology and Journal Writing: Structured Dialogues that Enhance Learning

    Science.gov (United States)

    Longhurst, James; Sandage, Scott A.

    2004-01-01

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

  19. 18 CFR 367.2150 - Account 215, Appropriated retained earnings.

    Science.gov (United States)

    2010-04-01

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

  20. Evaluation of the appropriate perioperative antibiotic prophylaxis in Italy.

    Directory of Open Access Journals (Sweden)

    Francesco Napolitano

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

  1. 16 CFR 614.1 - Appropriate proof of identity.

    Science.gov (United States)

    2010-01-01

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

  2. 38 CFR 18.433 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    2017-02-27

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

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

    Science.gov (United States)

    Anderson, Stephen P.

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

  5. 34 CFR 300.101 - Free appropriate public education (FAPE).

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  7. APPROPRIATING CREATIVE WORKS PROTECTED BY INTELLECTUAL PROPERTY RIGHTS

    Directory of Open Access Journals (Sweden)

    Cornelia DUMITRU

    2015-07-01

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

  8. Appropriate Educational Means of Dealing with the Phenomenon of Smoking among Zarqa University Students

    Science.gov (United States)

    hatamleh, habes Moh'd; al Khaza'leh, Mohammed Salman

    2016-01-01

    The study aimed to identify the (appropriate educational means of dealing with the phenomenon of smoking among Zarqa University students), and to achieve this goal, the descriptive approach has been used, also used a questionnaire submitted to (800) students of the sample, and a couple of open questions has been submitted to 70 members of the…

  9. Kindergarten Teachers' Perspectives on Developmentally Appropriate Practices (DAP): A Study Conducted in Mumbai (India)

    Science.gov (United States)

    Hegde, Archana V.; Cassidy, Deborah J.

    2009-01-01

    A qualitative study examining teachers' beliefs regarding developmentally appropriate practices was conducted in the city of Mumbai, India. Twelve kindergarten teacher's were interviewed for this study, and a constant comparative method was used to analyze the interviews. Six themes were identified within this study. The themes highlighted…

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

    Science.gov (United States)

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

    2012-01-01

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

  11. Situating globality : African agency in the appropriation of global culture

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.; Dijk, van R.A.

    2004-01-01

    The papers in this volume were earlier presented at the conference 'Globalization and new questions of ownership', which was held in Leiden, The Netherlands, from 26-27 April 2002. The volume challenges the dominant view that globalization is a primary threat to African societies. Instead, it

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

    Science.gov (United States)

    Longhurst, Max L.

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

  13. Appropriate Utilization and Stocking of Antidotes in Qatar Public Hospitals

    Directory of Open Access Journals (Sweden)

    Rawan Salameh

    2017-09-01

    Full Text Available Background: There are a few studies that evaluate preparedness and availability of antidotes in the emergency setting and none have been conducted in Qatar. Published studies show that timely availability of antidotes in the emergency department setting is a common issue. To address this, we conducted a study to evaluate antidote stocking and utilization in Qatar hospital pharmacies and emergency departments. Methods: In order to evaluate the appropriate use and timely administration of antidotes, research assistants prospectively collected data on ED patients. All ED patients who received any key antidote over the 6-month study period were identified through both ED and pharmacy records. In order to evaluate the stocking of the 31 most important antidotes in our main public hospitals, a survey assessing the stocking of these key antidotes was sent to the four general hospitals in Qatar, to determine their availability and whether they are stocked in the ED or only in the main pharmacy. Results: Poison exposure was evaluated in 471 cases. Antidotes were given within 30 minutes in 73% of cases, which included atropine, calcium, dextrose, flumazenil, naloxone, pralidoxime, sodium bicarbonate, thiamine, vitamin K and scorpion and snake antivenoms. Administration occurred later than 60 minutes in 2% of cases, exclusively with N-acetylcysteine and activated charcoal. Atropine, calcium, dextrose, naloxone, pralidoxime (2-PAM, sodium bicarbonate, and anti-venoms were clinically indicated 92% of the times they were ordered. N-acetylcysteine was indicated in only 51.5% of administrations. Significant variation in antidote stocking existed between hospitals, and there was no stocked hydroxocobalamin as antidotes for cyanide poisoning or fomepizole for toxic alcohol poisoning. Conclusion: Antidote stocking varied significantly between hospitals, and antidotes necessary for cyanide and toxic alcohol poisoning were deficient in all public hospitals. The

  14. Fluxes of radiocesium to milk and appropriate countermeasures

    International Nuclear Information System (INIS)

    Howard, J.; Hove, K.; Prister, B.; Sobolev, A; Ratnikov, A; Travnikova, I.; Averin, V.; Tronevitch, V.; Strand, P.; Bogdanov, G.

    1996-01-01

    Radiocesium contamination of milk persists in some areas of Belarus, Ukraine and Russian Federation which received fallout from the Chernobyl accident. In general, effective countermeasures have been used which ensure that radiocesium activity concentrations in milk from collective farms does not exceed intervention limits. However, farming practices differ greatly between the large collective farms, and the small, family operated private farms which are responsible for a major part of the food consumed in many rural areas. As a result of comparative low rate of use of fertilizers and utilization of poor quality land 137 Cs activity concentrations in milk from family-owned cows continues to exceed intervention limits in some areas. It is therefore important to be able reliably to quantify the rates of transfer of 137 Cs to private milk, so that all areas where persistent problems occur are identified, and appropriate countermeasure strategies applied. Where there is considerable variation, within a few km 2 , in both soil type and deposition, the 137 Cs content of private milk is highly variable. However, combining information about soil type, transfer rates for each major soil type, deposition, pasture size and grazing strategies can be a useful method of quantifying transfer of radiocesium to milk. Geographical information systems provide a promising new tool to integrate these factors. Effective Countermeasures are available to reduce radiocesium transfer to private milk. Private farmers are more sceptical of such methods than the scientists, administrators and agriculturalists in their society, particularly those methods involving the use of chemical additives given to their animals. Increased information efforts on the local level appears to be a prerequisite for a successful implementation of necessary Countermeasures

  15. The Appropriateness of Renal Angioplasty. The ANPARIA Software: A Multidisciplinary Expert Panel Approach

    International Nuclear Information System (INIS)

    Gerbaud, Laurent; Manhes, Geraud; Debourse, Juliette; Gouby, Gerald; Glanddier, Phyllis-Yvonne; Vader, John-Paul; Boyer, Louis; Deteix, Patrice

    2008-01-01

    Percutaneous transluminal renal angioplasty (PTRA) is an invasive technique that is costly and involves the risk of complications and renal failure. The ability of PTRA to reduce the administration of antihypertensive drugs has been demonstrated. A potentially greater benefit, which nevertheless remains to be proven, is the deferral of the need for chronic dialysis. The aim of the study (ANPARIA) was to assess the appropriateness of PTRA to impact on the evolution of renal function. A standardized expert panel method was used to assess the appropriateness of medical treatment alone or medical treatment with revascularization in various clinical situations. The choice of revascularization by either PTRA or surgery was examined for each clinical situation. Analysis was based on a detailed literature review and on systematically elicited expert opinion, which were obtained during a two-round modified Delphi process. The study provides detailed responses on the appropriateness of PTRA for 1848 distinct clinical scenarios. Depending on the major clinical presentation, appropriateness of revascularization varied from 32% to 75% for individual scenarios (overal 48%). Uncertainty as to revascularization was 41% overall. When revascularization was appropriate, PTRA was favored over surgery in 94% of the scenarios, except in certain cases of aortic atheroma where sugery was the preferred choice. Kidney size >7 cm, absence of coexisting disease, acute renal failure, a high degree of stenosis (≥70%), and absence of multiple arteries were identified as predictive variables of favorable appropriateness ratings. Situations such as cardiac failure with pulmonary edema or acute thrombosis of the renal artery were defined as indications for PTRA. This study identified clinical situations in which PTRA or surgery are appropriate for renal artery disease. We built a decision tree which can be used via Internet: the ANPARIA software (http://www

  16. Budget estimates fiscal year 1989: Appropriation, Salaries and expenses

    International Nuclear Information System (INIS)

    1988-02-01

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

  17. ACR Appropriateness Criteria® Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

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

    2017-05-01

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

  18. Interior, Environment, and Related Agencies: FY2007 Appropriations

    National Research Council Canada - National Science Library

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

    2007-01-01

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

  19. Appropriate technology: Often, the best answers can be found right ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-10-28

    Oct 28, 2010 ... In each case, however, the technologies have done their job – they have led to lasting solutions ... Appropriate technology: Often, the best answers can be found right at home ... In a Bookless Society, Why Start With Books?

  20. Appropriate models for estimating stresses and strains in asphalt layers

    CSIR Research Space (South Africa)

    Jooste, FJ

    1998-09-01

    Full Text Available The broad objective is to make recommendations for appropriate modelling procedures to be used in the structural design of asphalt layers. Findings of this investigation are intended to be used in refining and validating existing asphalt pavement...

  1. Financial Status of Air Force Expired Year Appropriations

    National Research Council Canada - National Science Library

    1994-01-01

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

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

    African Journals Online (AJOL)

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

  3. The application of appropriate technologies and systems for sustainable sanitation

    CSIR Research Space (South Africa)

    Duncker, Louiza C

    2014-11-01

    Full Text Available and environmental factors into planning, implementation and decision-making so as to ensure that development serves present and future generations. The chapter discusses the use of appropriate technologies and systems to render sanitation technologies and services...

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

    African Journals Online (AJOL)

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

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

    African Journals Online (AJOL)

    Dinesh Kumar

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

  6. Organisational and extraorganisational determinants of volume of service delivery by English community pharmacies: a cross-sectional survey and secondary data analysis

    Science.gov (United States)

    Hann, Mark; Schafheutle, Ellen I; Bradley, Fay; Elvey, Rebecca; Wagner, Andrew; Halsall, Devina; Hassell, Karen

    2017-01-01

    Objectives This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies. Design and setting Linear and ordered logistic regression of linked national data from secondary sources—community pharmacy activity, socioeconomic and health need datasets—and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England. Outcome measures Annual dispensing volume; annual volume of medicines use reviews (MURs). Results National dataset (n=10 454 pharmacies): greater dispensing volume was significantly associated with pharmacy ownership type (large chains>independents>supermarkets), greater deprivation, higher local prevalence of cardiovascular disease and depression, older people (aged >75 years) and infants (aged 0–4 years) but lower prevalence of mental health conditions. Greater volume of MURs was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, and lower disease prevalence. Survey dataset (n=285 pharmacies; response=34.6%): greater dispensing volume was significantly associated with staffing, skill-mix, organisational culture, years open and greater deprivation. Greater MUR volume was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, weekly opening hours and lower asthma prevalence. Conclusions Organisational and extraorganisational factors were found to impact differently on dispensing volume and MUR activity, the latter being driven more by corporate ownership than population need. While levels of staffing and skill-mix were associated with dispensing volume, they did not influence MUR activity. Despite recent changes to the contractual framework, the existing fee-for-service reimbursement may therefore not be the most appropriate for the delivery of

  7. Brain volume measurement using three-dimensional magnetic resonance images

    International Nuclear Information System (INIS)

    Ishimaru, Yoshihiro

    1996-01-01

    This study was designed to validate accurate measurement method of human brain volume using three dimensional (3D) MRI data on a workstation, and to establish optimal correcting method of human brain volume on diagnosis of brain atrophy. 3D MRI data were acquired by fast SPGR sequence using 1.5 T MR imager. 3D MRI data were segmented by region growing method and 3D image was displayed by surface rendering method on the workstation. Brain volume was measured by the volume measurement function of the workstation. In order to validate the accurate measurement method, phantoms and a specimen of human brain were examined. Phantom volume was measured by changing the lower level of threshold value. At the appropriate threshold value, percentage of error of phantoms and the specimen were within 0.6% and 0.08%, respectively. To establish the optimal correcting method, 130 normal volunteers were examined. Brain volumes corrected with height weight, body surface area, and alternative skull volume were evaluated. Brain volume index, which is defined as dividing brain volume by alternative skull volume, had the best correlation with age (r=0.624, p<0.05). No gender differences was observed in brain volume index in contrast to in brain volume. The clinical usefulness of this correcting method for brain atrophy diagnosis was evaluated in 85 patients. Diagnosis by 2D spin echo MR images was compared with brain volume index. Diagnosis of brain atrophy by 2D MR image was concordant with the evaluation by brain volume index. These results indicated that this measurement method had high accuracy, and it was important to set the appropriate threshold value. Brain volume index was the appropriate indication for evaluation of human brain volume, and was considered to be useful for the diagnosis of brain atrophy. (author)

  8. ACR Appropriateness Criteria® Colorectal Cancer Screening.

    Science.gov (United States)

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

    2018-05-01

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

  9. Mental Health Services, Free Appropriate Public Education, and Students with Disabilities: Legal Considerations in Identifying, Evaluating, and Providing Services

    Science.gov (United States)

    Yell, Mitchell; Smith, Carl; Katsiyannis, Antonis; Losinski, Mickey

    2018-01-01

    In the past few years, the provision of mental health services in public schools has received considerable attention. When students with disabilities are eligible for special education and related services under the Individuals With Disabilities Education Act (IDEA), mental health services are required if such services are needed to provide…

  10. Identifying appropriate reference data models for comparative effectiveness research (CER) studies based on data from clinical information systems.

    Science.gov (United States)

    Ogunyemi, Omolola I; Meeker, Daniella; Kim, Hyeon-Eui; Ashish, Naveen; Farzaneh, Seena; Boxwala, Aziz

    2013-08-01

    The need for a common format for electronic exchange of clinical data prompted federal endorsement of applicable standards. However, despite obvious similarities, a consensus standard has not yet been selected in the comparative effectiveness research (CER) community. Using qualitative metrics for data retrieval and information loss across a variety of CER topic areas, we compare several existing models from a representative sample of organizations associated with clinical research: the Observational Medical Outcomes Partnership (OMOP), Biomedical Research Integrated Domain Group, the Clinical Data Interchange Standards Consortium, and the US Food and Drug Administration. While the models examined captured a majority of the data elements that are useful for CER studies, data elements related to insurance benefit design and plans were most detailed in OMOP's CDM version 4.0. Standardized vocabularies that facilitate semantic interoperability were included in the OMOP and US Food and Drug Administration Mini-Sentinel data models, but are left to the discretion of the end-user in Biomedical Research Integrated Domain Group and Analysis Data Model, limiting reuse opportunities. Among the challenges we encountered was the need to model data specific to a local setting. This was handled by extending the standard data models. We found that the Common Data Model from the OMOP met the broadest complement of CER objectives. Minimal information loss occurred in mapping data from institution-specific data warehouses onto the data models from the standards we assessed. However, to support certain scenarios, we found a need to enhance existing data dictionaries with local, institution-specific information.

  11. Identifying parents with risky alcohol consumption habits in a paediatric unit - are screening and brief intervention appropriate methods?

    DEFF Research Database (Denmark)

    Bjerregaard, Lene B L; Gerke, Oke; Rubak, Sune Leisgaard Mørck

    2011-01-01

    child using motivational interviewing (MI) and screening for risky alcohol behaviour by Cut down, Annoyance from others, feel Guilty, Early-morning Craving (CAGE)-C. Data were analysed by descriptive statistics, and relationships were tested with a statistical significance level of 0.05, using SPSS...

  12. Identifying the appropriate time for deep brain stimulation to achieve spatial memory improvement on the Morris water maze.

    Science.gov (United States)

    Jeong, Da Un; Lee, Jihyeon; Chang, Won Seok; Chang, Jin Woo

    2017-03-07

    The possibility of using deep brain stimulation (DBS) for memory enhancement has recently been reported, but the precise underlying mechanisms of its effects remain unknown. Our previous study suggested that spatial memory improvement by medial septum (MS)-DBS may be associated with cholinergic regulation and neurogenesis. However, the affected stage of memory could not be distinguished because the stimulation was delivered during the execution of all memory processes. Therefore, this study was performed to determine the stage of memory affected by MS-DBS. Rats were administered 192 IgG-saporin to lesion cholinergic neurons. Stimulation was delivered at different times in different groups of rats: 5 days before the Morris water maze test (pre-stimulation), 5 days during the training phase of the Morris water maze test (training-stimulation), and 2 h before the Morris water maze probe test (probe-stimulation). A fourth group of rats was lesioned but received no stimulation. These four groups were compared with a normal (control) group. The most effective memory restoration occurred in the pre-stimulation group. Moreover, the pre-stimulation group exhibited better recall of the platform position than the other stimulation groups. An increase in the level of brain derived neurotrophic factor (BDNF) was observed in the pre-stimulation group; this increase was maintained for 1 week. However, acetylcholinesterase activity in the pre-stimulation group was not significantly different from the lesion group. Memory impairment due to cholinergic denervation can be improved by DBS. The improvement is significantly correlated with the up-regulation of BDNF expression and neurogenesis. Based on the results of this study, the use of MS-DBS during the early stage of disease may restore spatial memory impairment.

  13. VOLUMNECT: measuring volumes with Kinect

    Science.gov (United States)

    Quintino Ferreira, Beatriz; Griné, Miguel; Gameiro, Duarte; Costeira, João. Paulo; Sousa Santos, Beatriz

    2014-03-01

    This article presents a solution to volume measurement object packing using 3D cameras (such as the Microsoft KinectTM). We target application scenarios, such as warehouses or distribution and logistics companies, where it is important to promptly compute package volumes, yet high accuracy is not pivotal. Our application auto- matically detects cuboid objects using the depth camera data and computes their volume and sorting it allowing space optimization. The proposed methodology applies to a point cloud simple computer vision and image processing methods, as connected components, morphological operations and Harris corner detector, producing encouraging results, namely an accuracy in volume measurement of 8mm. Aspects that can be further improved are identified; nevertheless, the current solution is already promising turning out to be cost effective for the envisaged scenarios.

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

    Science.gov (United States)

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

    2014-01-01

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

  15. When high-volume PCI operators in high-volume hospitals move to lower volume hospitals-Do they still maintain high volume and quality of outcomes?

    Science.gov (United States)

    Lu, Tsung-Hsueh; Li, Sheng-Tun; Liang, Fu-Wen; Lee, Jo-Chi; Yin, Wei-Hsian

    2017-10-31

    The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i.e., skill and experience) and is portable across organizations or whether it is due to hospital characteristics (i.e., equipment, team, and management system) and is less portable. We used Taiwan National Health Insurance claims data 2000-2012 to identify 98 high-volume PCI operators, 10 of whom moved from one hospital to another during the study period. We compared the PCI volume, risk-adjusted mortality ratio, and major adverse cardiovascular event (MACE) ratio before and after moving. Of the 10 high-volume operators who moved, 6 moved from high- to moderate- or low-volume hospitals, with median annual PCI volumes (interquartile range) of 130 (117-165) in prior hospitals and 54 (46-84) in subsequent hospitals (the hospital the operator moved to), and the remaining 4 moved from high to high-volume hospitals, with median annual PCI volumes (interquartile range) of 151 (133-162) in prior hospitals and 193 (178-239) in subsequent hospitals. No significant differences were observed in the risk-adjusted mortality ratios and MACE ratios between high-volume operators and matched controls before and after moving. High-volume operators cannot maintain high volume when they moved from high to moderate or low-volume hospitals; however, the quality of care is maintained. High PCI volume and high-quality outcomes are less portable and more hospital bound. © 2017 Wiley Periodicals, Inc.

  16. A conceptual review of decision making in social dilemmas: applying a logic of appropriateness.

    Science.gov (United States)

    Weber, J Mark; Kopelman, Shirli; Messick, David M

    2004-01-01

    Despite decades of experimental social dilemma research, "theoretical integration has proven elusive" (Smithson & Foddy, 1999, p. 14). To advance a theory of decision making in social dilemmas, this article provides a conceptual review of the literature that applies a "logic of appropriateness" (March, 1994) framework. The appropriateness framework suggests that people making decisions ask themselves (explicitly or implicitly), "What does a person like me do in a situation like this? " This question identifies 3 significant factors: recognition and classification of the kind of situation encountered, the identity of the individual making the decision, and the application of rules or heuristics in guiding behavioral choice. In contrast with dominant rational choice models, the appropriateness framework proposed accommodates the inherently social nature of social dilemmas, and the role of rule and heuristic based processing. Implications for the interpretation of past findings and the direction of future research are discussed.

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

    Science.gov (United States)

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

    2014-01-01

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

  18. Identifying the Junction

    DEFF Research Database (Denmark)

    Hansen, Kim Toft

    2009-01-01

    of myth and realism, across the different modal views in the Old and New Testaments, to the related study of fantasy and crime fiction and the juncture of the two in Simon R. Green’s novel Hawk & Fisher – the first volume of a series in which logic and magic exist side by side. As a result this article...

  19. Lung volumes: measurement, clinical use, and coding.

    Science.gov (United States)

    Flesch, Judd D; Dine, C Jessica

    2012-08-01

    Measurement of lung volumes is an integral part of complete pulmonary function testing. Some lung volumes can be measured during spirometry; however, measurement of the residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC) requires special techniques. FRC is typically measured by one of three methods. Body plethysmography uses Boyle's Law to determine lung volumes, whereas inert gas dilution and nitrogen washout use dilution properties of gases. After determination of FRC, expiratory reserve volume and inspiratory vital capacity are measured, which allows the calculation of the RV and TLC. Lung volumes are commonly used for the diagnosis of restriction. In obstructive lung disease, they are used to assess for hyperinflation. Changes in lung volumes can also be seen in a number of other clinical conditions. Reimbursement for measurement of lung volumes requires knowledge of current procedural terminology (CPT) codes, relevant indications, and an appropriate level of physician supervision. Because of recent efforts to eliminate payment inefficiencies, the 10 previous CPT codes for lung volumes, airway resistance, and diffusing capacity have been bundled into four new CPT codes.

  20. Annual Status Report on Nationally Appropriate Mitigation Actions (NAMAs) 2013

    Energy Technology Data Exchange (ETDEWEB)

    Haensel, G.; Roeser, F.; Hoehne, N. [Ecofys, Utrecht (Netherlands); Van Tilburg, X.; Cameron, L. [ECN Policy Studies, Amsterdam (Netherlands)] (eds.)

    2013-11-15

    NAMAs are moving gradually from concept to concrete action. A fully functional and publicly available version of the UNFCCC NAMA registry was released on 16 October 2013, and the first dedicated fund for NAMA implementation was launched earlier this year. Countries with no previous NAMA activities engaged in NAMA development and new NAMAs emerged around the world. These are encouraging steps, although more evidence of finance and NAMA implementation is needed to establish NAMAs firmly as a mitigation mechanism and ease the emerging scepticism in some quarters. The reports begins with an overview of the latest statistics in NAMA development, drawing from the UNFCCC NAMA registry and the Ecofys NAMA Database. Currently, 40 NAMAs are included in the registry, and the database contains information on 82 NAMAs and 33 feasibility studies from 34 countries. This is followed by an analysis of areas in which progress is most needed to create widespread acceptance of the NAMA mechanism and implement actions that achieve significant GHG emissions reductions within the context of sustainable development. The chapter has four main sections, on: defining, financing, monitoring and operationalising NAMAs. The subsequent contributions on specific NAMA related topics are authored by different organisations. The Center for Clean Air Policy (CCAP) discusses the role of finance in advancing transformational NAMAs. The Energy research Centre of the Netherlands (ECN) takes a close look at the convergence in the structure and level of detail of current NAMA proposals. Ecofys defines transformational change and shows how transformational elements can be identified and incorporated into the design and implementation of a NAMA. GIZ highlights experiences and lessons learnt from applications of the NAMA Tool that has been presented and used as methodology for NAMA development in a variety of workshops and trainings all over the world. The Energy and Resources Institute (TERI) presents the

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

    Science.gov (United States)

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

    2006-01-01

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

  2. Crowdfunding as an Alternative Means for Funding Sustainable Appropriate Technology: Acceptance Determinants of Backers

    Directory of Open Access Journals (Sweden)

    Younghwan Moon

    2018-05-01

    Full Text Available The research and development as well as the propagation of sustainable, appropriate technology requires the availability of stable funding. Crowdfunding is a form of funding whereby small sums of investments or contributions are collected from the general public and used to finance the development of goods or services. This method has been widely used in the arts and cultural fields and presents a useful alternative means by which to fund appropriate technology projects. The aim of this study is to identify the factors that influence backers who participate in appropriate technology projects through crowdfunding platforms, analyze the connections among these factors, and thereby establish the usefulness of crowdfunding as a viable new funding alternative. Results indicate that the key factors influencing user intention to crowdfund appropriate technology projects include social influence, effort expectancy, and perceived trust. In comparison to the findings of previous studies, performance expectancy was not found to have a significant effect. When compared to crowdfunding conducted in other fields, these results suggest that crowdfunding for appropriate technology is closer in nature to donations. Accordingly, for funding of these projects to be successful, aggressive online exposure using the social network service (SNS of backers should be pursued from the earliest stages of funding.

  3. Beyond Brazilian Coalition Presidentialism: the Appropriation of the Legislative Agenda

    Directory of Open Access Journals (Sweden)

    Rafael Silveira e Silva

    2014-12-01

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

  4. Korean guidelines for the appropriate use of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

  5. Appropriate selection for omalizumab treatment in patients with severe asthma?

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  6. Evaluation of appropriate technologies for grey water treatments and reuses.

    Science.gov (United States)

    Li, Fangyue; Wichmann, Knut; Otterpohl, Ralf

    2009-01-01

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

  7. The Appropriation of Fine Art into Contemporary Narrative Picturebooks

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

    Many picturebook artists have been formally trained in specific artistic styles, movements, and techniques. These artists appropriate and transform works of fine art to varying degrees to fit the themes and designs of the stories they illustrate and publish, and to increase the significance and impact of their illustrations. The…

  8. 14 CFR 1261.403 - Consultation with appropriate officials; negotiation.

    Science.gov (United States)

    2010-01-01

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

  9. MySQL based selection of appropriate indexing technique in ...

    African Journals Online (AJOL)

    This paper deals with selection of appropriate indexing technique applied on MySQL Database for a health care system and related performance issues using multiclass support vector machine (SVM). The patient database is generally huge and contains lot of variations. For the quick search or fast retrieval of the desired ...

  10. Appropriate assessment of English language competency for South ...

    African Journals Online (AJOL)

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

  11. Educating Parents on Developmentally Age-Appropriate Learning in Preschool.

    Science.gov (United States)

    Brown, Mitzi C.

    This practicum paper reports on a project undertaken to enhance the knowledge of age-appropriate learning for parents of 3-year-old preschoolers. The project implemented a variety of techniques and strategies to improve parent knowledge, including parent education classes, a monthly newsletter for parents that addressed current research on…

  12. Relations between the technological standards and technological appropriation

    Directory of Open Access Journals (Sweden)

    Carlos Alberto PRADO GUERRERO

    2010-06-01

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

  13. The appropriateness of emergency medical service responses in the ...

    African Journals Online (AJOL)

    The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa. PR Newton, R Naidoo, P Brysiewicz. Abstract. Introduction. Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high ...

  14. 12 CFR 269.4 - Determination of appropriate bargaining unit.

    Science.gov (United States)

    2010-01-01

    ... requesting a representation election signed by at least thirty percent (30%) of the employees in a unit which... the labor organization should disagree with the Special Tribunal's decision, the party in disagreement... percent (30%) of the employees in a unit claimed by a labor organization as appropriate or subsequently...

  15. 5 CFR 532.217 - Appropriated fund survey jobs.

    Science.gov (United States)

    2010-01-01

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

  16. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-11-15

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

  17. towards an appropriate extension approach for agricultural and rural ...

    African Journals Online (AJOL)

    empowered to do so, an important condition is an appropriate organisational structure, which can support the process and take it forward. The community structure required is one that serves as an effective linkage structure to facilitate an effective partnership interaction between the development agent. (or organisation) and ...

  18. Is the New Partnership for Africa's Development an Appropriate ...

    African Journals Online (AJOL)

    The New Partnership for Africa's Development (NEPAD) is the African Union's socio-political and economic development programme, and one of its tasks is to accelerate African continental integration. The fundamental question is, however, whether it is the appropriate programme for this. Its success depends on the ...

  19. 34 CFR 104.33 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

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

  20. 34 CFR 300.17 - Free appropriate public education.

    Science.gov (United States)

    2010-07-01

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

  1. FTA Training Programs: Searching for Appropriate Teaching Styles.

    Science.gov (United States)

    Byrd, Patricia; Constantinides, Janet C.

    1988-01-01

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

  2. Herbal dietary supplements and knowledge of appropriate use ...

    African Journals Online (AJOL)

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

  3. In search of an appropriate contemporary approach in Christian ...

    African Journals Online (AJOL)

    The article addresses the question: 'To what extent can Max Weber's ethic of responsibility be a helpful resource in the search of Christian Social Ethics for an appropriate contemporary approach'? This question is addressed by, first of all, providing a summary of Weber's famous speech Politics as a Vocation in which he ...

  4. A case study of culturally appropriate conservation education

    Science.gov (United States)

    David N. Bengston; Michele Schermann

    2016-01-01

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

  5. Counselling as a psychological approach to fostering appropriate ...

    African Journals Online (AJOL)

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

  6. Developing an Appropriate Goalball Unit for Secondary Physical Education

    Science.gov (United States)

    Laughlin, Michael K.; Happel, Kathleen

    2016-01-01

    Goalball, a sport designed for those with visual impairments, is a competitive and recreational sport enjoyed by athletes around the world. Students with and without visual impairments can experience positive outcomes when teachers appropriately include a goalball unit as part of their inclusive secondary physical education curriculum. This…

  7. Social Appropriateness in EU Counter-Terrorism Law and Policy

    DEFF Research Database (Denmark)

    Martins, Bruno Oliveira

    2015-01-01

    versus justice equation, on the issues of privacy and data protection, and on the broader respect for fundamental rights more generally. In this process, the legitimacy and the social appropriateness of some of these measures have been questioned, both at the societal level and before or by European...

  8. ACR Appropriateness Criteria® Ovarian Cancer Screening.

    Science.gov (United States)

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

    2017-11-01

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

  9. The anaerobic baffled reactor (ABR): An appropriate technology for ...

    African Journals Online (AJOL)

    This project has studied the appropriateness of the ABR for on-site primary sanitation in low-income communities. The baffled design of the ABR ensures high solids retention resulting in high treatment rates, while the overall sludge production is characteristically low. Effluent COD values measured from a 3 000 l pilot ABR ...

  10. Differences between Males and Females Concerning Perceived Electronic Mail Appropriateness

    Science.gov (United States)

    Harper, Vernon B., Jr.

    2008-01-01

    Electronic mail is one of the most successfully diffused modern communication technologies. Yet, few researchers have investigated whether gender differences exist in perceptions of the types of appropriateness embedded within electronic mail messages. A framework originally created by Wiemann and Backlund (1980) served as the basis for the…

  11. Appropriate hydrological modelling of climate change on river flooding

    NARCIS (Netherlands)

    Booij, Martijn J.; Rizzoli, A.E.; Jakeman, A.J.

    2002-01-01

    How good should a river basin model be to assess the impact of climate change on river flooding for a specific geographical area? The determination of such an appropriate model should reveal which physical processes should be incorporated and which data and mathematical process descriptions should

  12. Appropriability mechanisms, innovation and productivity: Evidence from the UK

    NARCIS (Netherlands)

    Hall, B.H.; Sena, V.

    2014-01-01

    We use an extended version of the well-established Crepon, Duguet and Mairesse model (1998) to model the relationship between appropriability mechanisms, innovation and firm-level productivity. We enrich this model in several ways. First, we consider different types of innovation spending and study

  13. Mediating Third-Wave Feminism: Appropriation as Postmodern Media Practice.

    Science.gov (United States)

    Shugart, Helene A.; Waggoner, Catherine Egley; Hallstein, D. Lynn O'Brien

    2001-01-01

    Analyzes gendered representations of Alanis Morissette, Kate Moss, and Ally McBeal. Argue that, in each case, the appropriation of third-wave feminist tenets is accomplished via a postmodern aesthetic code of juxtaposition that serves to recontextualize and reinscribe those sensibilities in a way that ultimately functions to reify dominant…

  14. Appropriate working hours for surgical training according to Australasian trainees.

    Science.gov (United States)

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

    2012-04-01

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

  15. Appropriateness of Intra-Operative Blood Transfusion In Children at ...

    African Journals Online (AJOL)

    Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

  16. Thoughts on identifiers

    CERN Multimedia

    CERN. Geneva

    2005-01-01

    As business processes and information transactions have become an inextricably intertwined with the Web, the importance of assignment, registration, discovery, and maintenance of identifiers has increased. In spite of this, integrated frameworks for managing identifiers have been slow to emerge. Instead, identification systems arise (quite naturally) from immediate business needs without consideration for how they fit into larger information architectures. In addition, many legacy identifier systems further complicate the landscape, making it difficult for content managers to select and deploy identifier systems that meet both the business case and long term information management objectives. This presentation will outline a model for evaluating identifier applications and the functional requirements of the systems necessary to support them. The model is based on a layered analysis of the characteristics of identifier systems, including: * Functional characteristics * Technology * Policy * Business * Social T...

  17. MEDIA APPROPRIATIONS OF BLACK FEMINISM IN BRAZILIAN CONTEMPORANEITY

    Directory of Open Access Journals (Sweden)

    Telma Sueli Pinto Johnson

    2017-03-01

    Full Text Available RESUMO Este artigo examina apropriações midiáticas pelo feminismo negro baseadas em reflexões teórico-conceituais sobre a problemática da comunicação em sociedades midiatizadas e suas relações com a literacia midiática. O Instituto da Mulher Negra Geledés, fundado em 1998 no período da redemocratização brasileira, constitui-se no objeto de investigação. O movimento Geledés foi observado e mapeado em sua página no site de rede social Facebook, durante um período consecutivo de oito semanas em 2016, com o propósito de identificar modalidades de interações entre seus visitantes. A análise dedica-se, para além das postagens do Geledés, a apreender e compreender o que acontece na esfera da recepção quando se trata de tipos de usos, apropriações e produções de sentidos. Um construto metodológico baseado na Cartografia de Controvérsias (CC foi operacionalizado para analisar as interações dos actantes sociais do Geledés no Facebook, revelando predominância de interações passivas e elevado número de comentários participativos desqualificados sob a ótica do debate público racional.   PALAVRAS-CHAVE: Comunicação; Redes Sociais; Feminismo Negro; Literacia Midiática; Cartografia de Controvérsias.     ABSTRACT This article examines media appropriations by black feminism based on theoretical-conceptual reflections on the problem of communication in mediatized societies and their relations with media literacy. The Geledés Black Women's Institute, founded in 1998 in the period of Brazilian redemocratization, is the object of this research. The Geledés movement was observed and mapped on its page on the social networking site Facebook, during a consecutive period of eight weeks in 2016, with the purpose of identifying modalities of interactions among its visitors. The analysis is dedicated, in addition to the posts of the Geledés, to apprehend and to understand what happens in the sphere of the reception when

  18. Application of Appropriate Use Criteria for Initial Transthoracic Echocardiography in an Academic Outpatient Pediatric Cardiology Program.

    Science.gov (United States)

    Safa, Raya; Aggarwal, Sanjeev; Misra, Amrit; Kobayashi, Daisuke

    2017-08-01

    Transthoracic echocardiography (TTE) is a non-invasive diagnostic modality for children with suspected heart disease. The American College of Cardiology published Appropriate Use Criteria (AUC) for an initial outpatient pediatric TTE in 2014 to promote effective care and improve resource utilization. The objective was to determine the appropriateness of TTE per the published AUC in a single academic pediatric cardiology clinic as a baseline performance quality measure. The echocardiography database was used to identify initial outpatient TTE in children during January-March 2014. TTE indications (appropriate [A], may be appropriate [M], or rarely appropriate [R]) and findings (normal, incidental, or abnormal) were recorded. The effect of AUC and age groups on yield of abnormal TTE findings was analyzed. Of the 2166 screened studies, our study cohort consisted of 247 TTEs. Indications rated A, M, and R were found in 129, 27, and 90, respectively, and 1 was unclassifiable. Majority of TTE (n = 183) were normal, although incidental findings were noted in 32 and abnormal findings in 32 cases. Abnormal findings were noted in 26/129 of A, 2/27 of M, and 4/90 of R. Indications rated A were significantly associated with yield of abnormal TTE findings, adjusted by age group. Infants and adolescents were more likely to have abnormal TTE findings compared to young children. Recently published AUC were validated for initial TTE in the outpatient pediatric cardiology clinic. Appropriateness rated by AUC was highly associated with yield of abnormal TTE findings and worked best in infants and adolescent.

  19. Identifiability in stochastic models

    CERN Document Server

    1992-01-01

    The problem of identifiability is basic to all statistical methods and data analysis, occurring in such diverse areas as Reliability Theory, Survival Analysis, and Econometrics, where stochastic modeling is widely used. Mathematics dealing with identifiability per se is closely related to the so-called branch of ""characterization problems"" in Probability Theory. This book brings together relevant material on identifiability as it occurs in these diverse fields.

  20. Does Flywheel Paradigm Training Improve Muscle Volume and Force? A Meta-Analysis.

    Science.gov (United States)

    Nuñez Sanchez, Francisco J; Sáez de Villarreal, Eduardo

    2017-11-01

    Núñez Sanchez, FJ and Sáez de Villarreal, E. Does flywheel paradigm training improve muscle volume and force? A meta-analysis. J Strength Cond Res 31(11): 3177-3186, 2017-Several studies have confirmed the efficacy of flywheel paradigm training for improving or benefiting muscle volume and force. A meta-analysis of 13 studies with a total of 18 effect sizes was performed to analyse the role of various factors on the effectiveness of flywheel paradigm training. The following inclusion criteria were employed for the analysis: (a) randomized studies; (b) high validity and reliability instruments; (c) published in a high quality peer-reviewed journal; (d) healthy participants; (e) studies where the eccentric programme were described; and (f) studies where increases in muscle volume and force were measured before and after training. Increases in muscle volume and force were noted through the use of flywheel systems during short periods of training. The increase in muscle mass appears was not influenced by the existence of eccentric overload during the exercise. The increase in force was significantly higher with the existence of eccentric overload during the exercise. The responses identified in this analysis are essential and should be considered by strength and conditioning professionals regarding the most appropriate dose response trends for flywheel paradigm systems to optimize the increase in muscle volume and force.

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

    International Nuclear Information System (INIS)

    2000-01-01

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

  2. Novel genetic loci associated with hippocampal volume

    NARCIS (Netherlands)

    D.P. Hibar (Derrek); H.H.H. Adams (Hieab); N. Jahanshad (Neda); G. Chauhan (Ganesh); J.L. Stein; E. Hofer (Edith); M.E. Rentería (Miguel); J.C. Bis (Joshua); A. Arias-Vásquez (Alejandro); Ikram, M.K. (M. Kamran); S. Desrivières (Sylvane); M.W. Vernooij (Meike); L. Abramovic (Lucija); S. Alhusaini (Saud); N. Amin (Najaf); M. Andersson (Micael); K. Arfanakis (Konstantinos); B. Aribisala (Benjamin); N.J. Armstrong (Nicola J.); L. Athanasiu (Lavinia); T. Axelsson (Tomas); A.H. Beecham (Ashley); A. Beiser (Alexa); M. Bernard (Manon); S.H. Blanton (Susan H.); M.M. Bohlken (Marc M.); M.P.M. Boks (Marco); L.B.C. Bralten (Linda); A.M. Brickman (Adam M.); Carmichael, O. (Owen); M.M. Chakravarty (M. Mallar); Q. Chen (Qiang); C.R.K. Ching (Christopher); V. Chouraki (Vincent); G. Cuellar-Partida (Gabriel); F. Crivello (Fabrice); A. den Braber (Anouk); Doan, N.T. (Nhat Trung); S.M. Ehrlich (Stefan); S. Giddaluru (Sudheer); A.L. Goldman (Aaron L.); R.F. Gottesman (Rebecca); O. Grimm (Oliver); M.D. Griswold (Michael); T. Guadalupe (Tulio); Gutman, B.A. (Boris A.); J. Hass (Johanna); U.K. Haukvik (Unn); D. Hoehn (David); A.J. Holmes (Avram); M. Hoogman (Martine); D. Janowitz (Deborah); T. Jia (Tianye); Jørgensen, K.N. (Kjetil N.); N. Karbalai (Nazanin); D. Kasperaviciute (Dalia); S. Kim (Shinseog); M. Klein (Marieke); B. Kraemer (Bernd); P.H. Lee (Phil); D.C. Liewald (David C.); L.M. Lopez (Lorna); M. Luciano (Michelle); C. MacAre (Christine); Marquand, A.F. (Andre F.); M. Matarin (Mar); R. Mather; M. Mattheisen (Manuel); McKay, D.R. (David R.); Milaneschi, Y. (Yuri); S. Muñoz Maniega (Susana); K. Nho (Kwangsik); A.C. Nugent (Allison); P. Nyquist (Paul); Loohuis, L.M.O. (Loes M. Olde); J. Oosterlaan (Jaap); M. Papmeyer (Martina); Pirpamer, L. (Lukas); B. Pütz (Benno); A. Ramasamy (Adaikalavan); Richards, J.S. (Jennifer S.); S.L. Risacher (Shannon); R. Roiz-Santiañez (Roberto); N. Rommelse (Nanda); S. Ropele (Stefan); E.J. Rose (Emma); N.A. Royle (Natalie); T. Rundek (Tatjana); P.G. Sämann (Philipp); Saremi, A. (Arvin); C.L. Satizabal (Claudia L.); L. Schmaal (Lianne); N.J. Schork (Nicholas); Shen, L. (Li); J. Shin (Jean); Shumskaya, E. (Elena); A.V. Smith (Albert Vernon); R. Sprooten (Roy); L.T. Strike (Lachlan); A. Teumer (Alexander); D. Tordesillas-Gutierrez (Diana); R. Toro (Roberto); D. Trabzuni (Danyah); S. Trompet (Stella); D. Vaidya (Dhananjay); J. van der Grond (Jeroen); S.J. van der Lee (Sven); Van Der Meer, D. (Dennis); M.M.J. Van Donkelaar (Marjolein M. J.); K.R. van Eijk (Kristel); T.G.M. van Erp (Theo G.); Van Rooij, D. (Daan); E. Walton (Esther); L.T. Westlye (Lars); C.D. Whelan (Christopher); B.G. Windham (B Gwen); A.M. Winkler (Anderson); K. Wittfeld (Katharina); G. Woldehawariat (Girma); A. Björnsson (Asgeir); Wolfers, T. (Thomas); L.R. Yanek (Lisa); Yang, J. (Jingyun); A.P. Zijdenbos; M.P. Zwiers (Marcel); I. Agartz (Ingrid); L. Almasy (Laura); D.J. Ames (David); Amouyel, P. (Philippe); O.A. Andreassen (Ole); S. Arepalli (Sampath); A.A. Assareh; S. Barral (Sandra); M.E. Bastin (Mark); Becker, D.M. (Diane M.); J.T. Becker (James); D.A. Bennett (David A.); J. Blangero (John); H. van Bokhoven (Hans); D.I. Boomsma (Dorret); H. Brodaty (Henry); R.M. Brouwer (Rachel); H.G. Brunner; M. Buckner; J.K. Buitelaar (Jan); K. Bulayeva (Kazima); W. Cahn (Wiepke); V.D. Calhoun Vince D. (V.); D.M. Cannon (Dara); G. Cavalleri (Gianpiero); Cheng, C.-Y. (Ching-Yu); S. Cichon (Sven); M.R. Cookson (Mark); A. Corvin (Aiden); B. Crespo-Facorro (Benedicto); J.E. Curran (Joanne); M. Czisch (Michael); A.M. Dale (Anders); G.E. Davies (Gareth); A.J. de Craen (Anton); E.J.C. de Geus (Eco); P.L. de Jager (Philip); G.I. de Zubicaray (Greig); I.J. Deary (Ian J.); S. Debette (Stéphanie); C. DeCarli (Charles); N. Delanty; C. Depondt (Chantal); A.L. DeStefano (Anita); A. Dillman (Allissa); S. Djurovic (Srdjan); D.J. Donohoe (Dennis); D.A. Drevets (Douglas); Duggirala, R. (Ravi); M.D. Dyer (Matthew); C. Enzinger (Christian); S. Erk; T. Espeseth (Thomas); Fedko, I.O. (Iryna O.); Fernández, G. (Guillén); L. Ferrucci (Luigi); S.E. Fisher (Simon); D. Fleischman (Debra); I. Ford (Ian); M. Fornage (Myriam); T. Foroud (Tatiana); P.T. Fox (Peter); C. Francks (Clyde); Fukunaga, M. (Masaki); Gibbs, J.R. (J. Raphael); D.C. Glahn (David); R.L. Gollub (Randy); H.H.H. Göring (Harald H.); R.C. Green (Robert C.); O. Gruber (Oliver); V. Gudnason (Vilmundur); S. Guelfi (Sebastian); Håberg, A.K. (Asta K.); N.K. Hansell (Narelle); J. Hardy (John); C.A. Hartman (C.); Hashimoto, R. (Ryota); K. Hegenscheid (Katrin); J. Heinz (Judith); S. Le Hellard (Stephanie); D.G. Hernandez (Dena); D.J. Heslenfeld (Dirk); Ho, B.-C. (Beng-Choon); P.J. Hoekstra (Pieter); W. Hoffmann (Wolfgang); A. Hofman (Albert); F. Holsboer (Florian); G. Homuth (Georg); N. Hosten (Norbert); J.J. Hottenga (Jouke Jan); M.J. Huentelman (Matthew); H.H. Pol; Ikeda, M. (Masashi); Jack, C.R. (Clifford R.); S. Jenkinson (Sarah); R. Johnson (Robert); Jönsson, E.G. (Erik G.); J.W. Jukema; R. Kahn (René); Kanai, R. (Ryota); I. Kloszewska (Iwona); Knopman, D.S. (David S.); P. Kochunov (Peter); Kwok, J.B. (John B.); S. Lawrie (Stephen); H. Lemaître (Herve); X. Liu (Xinmin); D.L. Longo (Dan L.); O.L. Lopez (Oscar L.); S. Lovestone (Simon); Martinez, O. (Oliver); J.-L. Martinot (Jean-Luc); V.S. Mattay (Venkata S.); McDonald, C. (Colm); A.M. McIntosh (Andrew); McMahon, F.J. (Francis J.); McMahon, K.L. (Katie L.); P. Mecocci (Patrizia); I. Melle (Ingrid); Meyer-Lindenberg, A. (Andreas); S. Mohnke (Sebastian); Montgomery, G.W. (Grant W.); D.W. Morris (Derek W); T.H. Mosley (Thomas H.); T.W. Mühleisen (Thomas); B. Müller-Myhsok (B.); M.A. Nalls (Michael); M. Nauck (Matthias); T.E. Nichols (Thomas); W.J. Niessen (Wiro); M.M. Nöthen (Markus); L. Nyberg (Lars); Ohi, K. (Kazutaka); R.L. Olvera (Rene); R.A. Ophoff (Roel); M. Pandolfo (Massimo); T. Paus (Tomas); Z. Pausova (Zdenka); B.W.J.H. Penninx (Brenda); Pike, G.B. (G. Bruce); S.G. Potkin (Steven); B.M. Psaty (Bruce); S. Reppermund; M. Rietschel (Marcella); J.L. Roffman (Joshua); N. Seiferth (Nina); J.I. Rotter (Jerome I.); M. Ryten (Mina); Sacco, R.L. (Ralph L.); P.S. Sachdev (Perminder); A.J. Saykin (Andrew); R. Schmidt (Reinhold); Schmidt, H. (Helena); C.J. Schofield (Christopher); Sigursson, S. (Sigurdur); Simmons, A. (Andrew); A. Singleton (Andrew); S.M. Sisodiya (Sanjay); Smith, C. (Colin); J.W. Smoller; H. Soininen (H.); V.M. Steen (Vidar); D.J. Stott (David J.); J. Sussmann (Jessika); A. Thalamuthu (Anbupalam); A.W. Toga (Arthur W.); B. Traynor (Bryan); J.C. Troncoso (Juan); M. Tsolaki (Magda); C. Tzourio (Christophe); A.G. Uitterlinden (André); Hernández, M.C.V. (Maria C. Valdés); M.P. van der Brug (Marcel); A. van der Lugt (Aad); N.J. van der Wee (Nic); N.E.M. van Haren (Neeltje E.); D. van 't Ent (Dennis); M.J.D. van Tol (Marie-José); B.N. Vardarajan (Badri); B. Vellas (Bruno); D.J. Veltman (Dick); H. Völzke (Henry); H.J. Walter (Henrik); J. Wardlaw (Joanna); A.M.J. Wassink (Annemarie); M.E. Weale (Michael); Weinberger, D.R. (Daniel R.); Weiner, M.W. (Michael W.); Wen, W. (Wei); E. Westman (Eric); T.J.H. White (Tonya); Wong, T.Y. (Tien Y.); Wright, C.B. (Clinton B.); R.H. Zielke (Ronald H.); A.B. Zonderman; N.G. Martin (Nicholas); C.M. van Duijn (Cornelia); M.J. Wright (Margaret); W.T. Longstreth Jr; G. Schumann (Gunter); H.J. Grabe (Hans Jörgen); B. Franke (Barbara); L.J. Launer (Lenore); S.E. Medland (Sarah Elizabeth); S. Seshadri (Sudha); P.M. Thompson (Paul); M.K. Ikram (Kamran)

    2017-01-01

    textabstractThe hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic

  3. Novel genetic loci associated with hippocampal volume

    NARCIS (Netherlands)

    Hibar, Derrek P.; Adams, Hieab H. H.; Jahanshad, Neda; Chauhan, Ganesh; Stein, Jason L.; Hofer, Edith; Renteria, Miguel E.; Bis, Joshua C.; Arias-Vasquez, Alejandro; Ikram, M. Kamran; Desrivières, Sylvane; Vernooij, Meike W.; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf; Andersson, Micael; Arfanakis, Konstantinos; Aribisala, Benjamin S.; Armstrong, Nicola J.; Athanasiu, Lavinia; Axelsson, Tomas; Beecham, Ashley H.; Beiser, Alexa; Bernard, Manon; Blanton, Susan H.; Bohlken, Marc M.; Boks, Marco P.; Bralten, Janita; Brickman, Adam M.; Carmichael, Owen; Chakravarty, M. Mallar; Chen, Qiang; Ching, Christopher R. K.; Chouraki, Vincent; Cuellar-Partida, Gabriel; Crivello, Fabrice; den Braber, Anouk; Doan, Nhat Trung; Ehrlich, Stefan; Giddaluru, Sudheer; Goldman, Aaron L.; Gottesman, Rebecca F.; Grimm, Oliver; Griswold, Michael E.; Guadalupe, Tulio; Gutman, Boris A.; Hass, Johanna; Haukvik, Unn K.; Hoehn, David; Holmes, Avram J.; Hoogman, Martine; Janowitz, Deborah; Jia, Tianye; Jørgensen, Kjetil N.; Karbalai, Nazanin; Kasperaviciute, Dalia; Kim, Sungeun; Klein, Marieke; Kraemer, Bernd; Lee, Phil H.; Liewald, David C. M.; Lopez, Lorna M.; Luciano, Michelle; Macare, Christine; Marquand, Andre F.; Matarin, Mar; Mather, Karen A.; Mattheisen, Manuel; McKay, David R.; Milaneschi, Yuri; Muñoz Maniega, Susana; Nho, Kwangsik; Nugent, Allison C.; Nyquist, Paul; Loohuis, Loes M. Olde; Oosterlaan, Jaap; Papmeyer, Martina; Pirpamer, Lukas; Pütz, Benno; Ramasamy, Adaikalavan; Richards, Jennifer S.; Risacher, Shannon L.; Roiz-Santiañez, Roberto; Rommelse, Nanda; Ropele, Stefan; Rose, Emma J.; Royle, Natalie A.; Rundek, Tatjana; Sämann, Philipp G.; Saremi, Arvin; Satizabal, Claudia L.; Schmaal, Lianne; Schork, Andrew J.; Shen, Li; Shin, Jean; Shumskaya, Elena; Smith, Albert V.; Sprooten, Emma; Strike, Lachlan T.; Teumer, Alexander; Tordesillas-Gutierrez, Diana; Toro, Roberto; Trabzuni, Daniah; Trompet, Stella; Vaidya, Dhananjay; van der Grond, Jeroen; van der Lee, Sven J.; van der Meer, Dennis; van Donkelaar, Marjolein M. J.; van Eijk, Kristel R.; van Erp, Theo G. M.; van Rooij, Daan; Walton, Esther; Westlye, Lars T.; Whelan, Christopher D.; Windham, Beverly G.; Winkler, Anderson M.; Wittfeld, Katharina; Woldehawariat, Girma; Wolf, Christiane; Wolfers, Thomas; Yanek, Lisa R.; Yang, Jingyun; Zijdenbos, Alex; Zwiers, Marcel P.; Agartz, Ingrid; Almasy, Laura; Ames, David; Amouyel, Philippe; Andreassen, Ole A.; Arepalli, Sampath; Assareh, Amelia A.; Barral, Sandra; Bastin, Mark E.; Becker, Diane M.; Becker, James T.; Bennett, David A.; Blangero, John; van Bokhoven, Hans; Boomsma, Dorret I.; Brodaty, Henry; Brouwer, Rachel M.; Brunner, Han G.; Buckner, Randy L.; Buitelaar, Jan K.; Bulayeva, Kazima B.; Cahn, Wiepke; Calhoun, Vince D.; Cannon, Dara M.; Cavalleri, Gianpiero L.; Cheng, Ching-Yu; Cichon, Sven; Cookson, Mark R.; Corvin, Aiden; Crespo-Facorro, Benedicto; Curran, Joanne E.; Czisch, Michael; Dale, Anders M.; Davies, Gareth E.; de Craen, Anton J. M.; de Geus, Eco J. C.; de Jager, Philip L.; de Zubicaray, Greig I.; Deary, Ian J.; Debette, Stéphanie; Decarli, Charles; Delanty, Norman; Depondt, Chantal; DeStefano, Anita; Dillman, Allissa; Djurovic, Srdjan; Donohoe, Gary; Drevets, Wayne C.; Duggirala, Ravi; Dyer, Thomas D.; Enzinger, Christian; Erk, Susanne; Espeseth, Thomas; Fedko, Iryna O.; Fernández, Guillén; Ferrucci, Luigi; Fisher, Simon E.; Fleischman, Debra A.; Ford, Ian; Fornage, Myriam; Foroud, Tatiana M.; Fox, Peter T.; Francks, Clyde; Fukunaga, Masaki; Gibbs, J. Raphael; Glahn, David C.; Gollub, Randy L.; Göring, Harald H. H.; Green, Robert C.; Gruber, Oliver; Gudnason, Vilmundur; Guelfi, Sebastian; Håberg, Asta K.; Hansell, Narelle K.; Hardy, John; Hartman, Catharina A.; Hashimoto, Ryota; Hegenscheid, Katrin; Heinz, Andreas; Le Hellard, Stephanie; Hernandez, Dena G.; Heslenfeld, Dirk J.; Ho, Beng-Choon; Hoekstra, Pieter J.; Hoffmann, Wolfgang; Hofman, Albert; Holsboer, Florian; Homuth, Georg; Hosten, Norbert; Hottenga, Jouke-Jan; Huentelman, Matthew; Pol, Hilleke E. Hulshoff; Ikeda, Masashi; Jack, Clifford R.; Jenkinson, Mark; Johnson, Robert; Jönsson, Erik G.; Jukema, J. Wouter; Kahn, René S.; Kanai, Ryota; Kloszewska, Iwona; Knopman, David S.; Kochunov, Peter; Kwok, John B.; Lawrie, Stephen M.; Lemaître, Hervé; Liu, Xinmin; Longo, Dan L.; Lopez, Oscar L.; Lovestone, Simon; Martinez, Oliver; Martinot, Jean-Luc; Mattay, Venkata S.; McDonald, Colm; McIntosh, Andrew M.; McMahon, Francis J.; McMahon, Katie L.; Mecocci, Patrizia; Melle, Ingrid; Meyer-Lindenberg, Andreas; Mohnke, Sebastian; Montgomery, Grant W.; Morris, Derek W.; Mosley, Thomas H.; Mühleisen, Thomas W.; Müller-Myhsok, Bertram; Nalls, Michael A.; Nauck, Matthias; Nichols, Thomas E.; Niessen, Wiro J.; Nöthen, Markus M.; Nyberg, Lars; Ohi, Kazutaka; Olvera, Rene L.; Ophoff, Roel A.; Pandolfo, Massimo; Paus, Tomas; Pausova, Zdenka; Penninx, Brenda W. J. H.; Pike, G. Bruce; Potkin, Steven G.; Psaty, Bruce M.; Reppermund, Simone; Rietschel, Marcella; Roffman, Joshua L.; Romanczuk-Seiferth, Nina; Rotter, Jerome I.; Ryten, Mina; Sacco, Ralph L.; Sachdev, Perminder S.; Saykin, Andrew J.; Schmidt, Reinhold; Schmidt, Helena; Schofield, Peter R.; Sigursson, Sigurdur; Simmons, Andrew; Singleton, Andrew; Sisodiya, Sanjay M.; Smith, Colin; Smoller, Jordan W.; Soininen, Hilkka; Steen, Vidar M.; Stott, David J.; Sussmann, Jessika E.; Thalamuthu, Anbupalam; Toga, Arthur W.; Traynor, Bryan J.; Troncoso, Juan; Tsolaki, Magda; Tzourio, Christophe; Uitterlinden, Andre G.; Hernández, Maria C. Valdés; van der Brug, Marcel; van der Lugt, Aad; van der Wee, Nic J. A.; van Haren, Neeltje E. M.; van 't Ent, Dennis; van Tol, Marie-Jose; Vardarajan, Badri N.; Vellas, Bruno; Veltman, Dick J.; Völzke, Henry; Walter, Henrik; Wardlaw, Joanna M.; Wassink, Thomas H.; Weale, Michael E.; Weinberger, Daniel R.; Weiner, Michael W.; Wen, Wei; Westman, Eric; White, Tonya; Wong, Tien Y.; Wright, Clinton B.; Zielke, Ronald H.; Zonderman, Alan B.; Martin, Nicholas G.; van Duijn, Cornelia M.; Wright, Margaret J.; Longstreth, W. T.; Schumann, Gunter; Grabe, Hans J.; Franke, Barbara; Launer, Lenore J.; Medland, Sarah E.; Seshadri, Sudha; Thompson, Paul M.; Ikram, M. Arfan

    2017-01-01

    The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of

  4. Le processus d'appropriation du référentiel IAS/IFRS : Une analyse des pratiques organisationnelles

    OpenAIRE

    Couleau-Dupont, Annelise

    2010-01-01

    International audience; The matter of this paper aims to present the appropriation process of the IAS/IFRS in organizations regarded as identifiable forms where there are collective actions (Crozier and Friedberg 1977). Reflection leans to work on innovations, management tools and their appropriation. Our qualitative study, based on two case studies, can show that the IAS/IFRS, like any management tool, generates change within organizations and that its adoption requires a long process of own...

  5. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

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

    2012-01-01

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

  6. ACR Appropriateness Criteria® Routine Chest Radiography.

    Science.gov (United States)

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

    2016-03-01

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

  7. Development planning and appropriate technology: a dilemma and a proposal

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, G.

    1981-03-01

    This paper examines the present system of project paper preparation and project planning used by the US Agency for International Development and many donor agencies. Three approaches for meeting the evident weaknesses of the system - a holistic approach to the planning problem, an operant-conditioning approach to implementation, and a process approach to planning and implementation - are presented and critiqued. On the basis of the critique, an approach grounded in a search for an approximately appropriate technology is supported; and a proposal for an appropriate-technology evaluation system which would analyze alternative technologies, deliver information to the field level, supply needed information on technologies and implementation, constrain donor planners, reduce lag time, incorporate evaluations into future planning, and reduce dependence upon planners is presented. 66 references.

  8. Methods of achieving and maintaining an appropriate caesarean section rate.

    LENUS (Irish Health Repository)

    Robson, Michael

    2013-04-01

    Caesarean section rates continue to increase worldwide. The appropriate caesarean section rate remains a topic of debate among women and professionals. Evidence-based medicine has not provided an answer and depends on interpretation of the literature. Overall caesarean section rates are unhelpful, and caesarean section rates should not be judged in isolation from other outcomes and epidemiological characteristics. Better understanding of caesarean section rates, their consequences and their benefits will improve care, and enable learning between delivery units nationally and internationally. To achieve and maintain an appropriate caesarean section rate requires a Multidisciplinary Quality Assurance Programme in each delivery unit, recognising caesarean section rates as one of many factors that determine quality. Women will always choose the type of delivery that seems safest to them and their babies. Professionals need to monitor the quality of their practice continuously in a standardised way to ensure that women can make the right choice.

  9. Diligence in determining the appropriate form of stationarity

    Directory of Open Access Journals (Sweden)

    André Heymans

    2014-11-01

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

  10. State, Foreign Operations, and Related Programs: FY2008 Appropriations

    Science.gov (United States)

    2007-12-14

    and social reforms. The President initially pledged $5 billion annually by FY2006, although funds requested and appropriated have never reached this...to Cuba. The BBG is planning to eliminate several VOA services including Uzbek, Greek, and Cantonese as well as the RFE/RL Macedonia service. BBG also...increased to $230.0 million. The increase of $195 million is entirely for social services to Iraqi refugees. FY2007 Supplemental Request. On April 25

  11. Appropriate Utilization and Stocking of Antidotes in Qatar Public Hospitals

    OpenAIRE

    Rawan Salameh; Waleed Awad Salem; ISMA Qureshi; Asma Al-Bukari; Eman Shaat; Jibin Moinudheen; Galal Aleassi; Robert Hoffman

    2017-01-01

    Background: There are a few studies that evaluate preparedness and availability of antidotes in the emergency setting and none have been conducted in Qatar. Published studies show that timely availability of antidotes in the emergency department setting is a common issue. To address this, we conducted a study to evaluate antidote stocking and utilization in Qatar hospital pharmacies and emergency departments. Methods: In order to evaluate the appropriate use and timely administration of antid...

  12. Appeal to fear in health care: appropriate or inappropriate?

    OpenAIRE

    Simpson, J. Keith

    2017-01-01

    Aim This paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use. Background Appeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use a...

  13. Appropriability mechanisms, innovation and productivity: Evidence from the UK

    OpenAIRE

    Hall, B.H.; Sena, V.

    2014-01-01

    We use an extended version of the well-established Crepon, Duguet and Mairesse model (1998) to model the relationship between appropriability mechanisms, innovation and firm-level productivity. We enrich this model in several ways. First, we consider different types of innovation spending and study the differences in estimates when innovation spending (rather than R&D spending) is used to predict innovation in the CDM model. Second, we assume that a firm simultaneously innovates and chooses a...

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

    Science.gov (United States)

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

    2017-06-01

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

  15. Cell swelling and volume regulation

    DEFF Research Database (Denmark)

    Hoffmann, Else Kay

    1992-01-01

    The extracellular space in the brain is typically 20% of the tissue volume and is reduced to at least half its size under conditions of neural insult. Whether there is a minimum size to the extracellular space was discussed. A general model for cell volume regulation was presented, followed...... by a discussion on how many of the generally involved mechanisms are identified in neural cells and (or) in astrocytes. There seems to be clear evidence suggesting that parallel K+ and Cl- channels mediate regulatory volume decrease in primary cultures of astrocytes, and a stretch-activated cation channel has...... been reported. The role of the different channels was discussed. A taurine leak pathway is clearly activated after cell swelling both in astrocytes and in neurones. The relations between the effect of glutamate and cell swelling were discussed. Discussion on the clearance of potassium from...

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

    Science.gov (United States)

    Eckel, Edward J

    2011-09-01

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

  17. The Concept of Appropriateness in Issuing Administrative Acts

    Directory of Open Access Journals (Sweden)

    Iulian Nedelcu

    2011-05-01

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

  18. Guideline for appropriate use of cardiac CT in heart disease

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  19. ACR Appropriateness Criteria® Suspected Pulmonary Hypertension.

    Science.gov (United States)

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

    2017-05-01

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

  20. The emergency department: An appropriate referral rate for radiography

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  1. Identifying Strategic Scientific Opportunities

    Science.gov (United States)

    As NCI's central scientific strategy office, CRS collaborates with the institute's divisions, offices, and centers to identify research opportunities to advance NCI's vision for the future of cancer research.

  2. TCGA study identifies genomic features of cervical cancer

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have identified novel genomic and molecular characteristics of cervical cancer that will aid in subclassification of the disease and may help target therapies that are most appropriate for each patient.

  3. Identifying Breast Cancer Oncogenes

    Science.gov (United States)

    2011-10-01

    cells we observed that it promoted transformation of HMLE cells, suggesting a tumor suppressive role of Merlin in breast cancer (Figure 4B). A...08-1-0767 TITLE: Identifying Breast Cancer Oncogenes PRINCIPAL INVESTIGATOR: Yashaswi Shrestha...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18 W81XWH-08-1-0767 Identifying Breast Cancer Oncogenes Yashaswi Shrestha Dana-Farber

  4. Health Disparities Research Among Small Tribal Populations: Describing Appropriate Criteria for Aggregating Tribal Health Data.

    Science.gov (United States)

    Van Dyke, Emily R; Blacksher, Erika; Echo-Hawk, Abigail L; Bassett, Deborah; Harris, Raymond M; Buchwald, Dedra S

    2016-07-01

    In response to community concerns, we used the Tribal Participatory Research framework in collaboration with 5 American-Indian communities in Washington, Idaho, and Montana to identify the appropriate criteria for aggregating health data on small tribes. Across tribal sites, 10 key informant interviews and 10 focus groups (n = 39) were conducted between July 2012 and April 2013. Using thematic analysis of focus group content, we identified 5 guiding criteria for aggregating tribal health data: geographic proximity, community type, environmental exposures, access to resources and services, and economic development. Preliminary findings were presented to focus group participants for validation at each site, and a culminating workshop with representatives from all 5 tribes verified our final results. Using this approach requires critical assessment of research questions and study designs by investigators and tribal leaders to determine when aggregation or stratification is appropriate and how to group data to yield robust results relevant to local concerns. At project inception, tribal leaders should be consulted regarding the validity of proposed groupings. After regular project updates, they should be consulted again to confirm that findings are appropriately contextualized for dissemination. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Establishing the Appropriate Attributes in Current Human Reliability Assessment Techniques for Nuclear Safety

    International Nuclear Information System (INIS)

    Bowie, Jane; Munley, Gary; Dang, Vinh; Wreathall, John; Bye, Andreas; Cooper, Susan; Marble, Julie; Peters, Sean; Xing, Jing; Fauchille, Veronique; Fiset, Jean Yves; Haage, Monica; Johanson, Gunnar; Jung, Won Dae; Kim, Jaewhan; Lee, Seung Jung; Kubicek, Jan; Le Bot, Pierre; Pesme, Helene; Preischl, Wolfgang; Salway, Alice; Amri, Abdallah; Lamarre, Greg; White, Andrew; )

    2015-03-01

    This report presents the results of a joint task of the Working Groups on Risk Assessment (WGRISK) and on Human and Organisational Factors (WGHOF) of the OECD/NEA CSNI, to identify desirable attributes of Human Reliability Assessment (HRA) methods, and to evaluate a range of HRA methods used in OECD member countries against those attributes. The purpose of this project is to provide information that will support regulators and operators of nuclear facilities when making judgements about the appropriateness of HRA methods for conducting assessments in support of Probabilistic Safety Assessments (PSA). The task was performed by an international team of Human Factors, HRA and PSA experts from a broad range of OECD member countries. As in other reviews of HRA methods, the study did not set out to recommend or promote the use of any particular HRA method. Rather the study aims to identify the strengths and limitations of commonly used and developing methods to aid those responsible for production of HRAs in selecting appropriate tools for specific HRA applications. The study also aims to assist regulators when making judgements on the appropriateness of the application of an HRA technique within nuclear-related probabilistic safety assessments. The report is aimed at practitioners in the field of human reliability assessment, human factors, and risk assessment more generally

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

    Science.gov (United States)

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

    2018-01-01

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

  7. The right to appropriate and meaningful education for children with ASD.

    Science.gov (United States)

    Marshall, David; Goodall, Craig

    2015-10-01

    This paper will explore from a 'child's rights perspective' the 'right' of children with autistic spectrum disorder (ASD) to appropriate and meaningful education. Human 'rights' principles within international law will be evaluated in relation to how they have been interpreted and applied in relation to achieving this 'right'. The International Convention of the Rights of the Child (United Nations in Convention on the rights of the child, office of the high commissioner, United Nations, Geneva, 1989) and the convention on the rights of the person with disability (United Nations in Convention on the rights of person's with disabilities and optional protocol, office of the high commissioner, United Nations, Geneva, 2006) amongst others will be utilised to argue the case for 'inclusive' educational opportunities to be a 'right' of every child on the autistic spectrum. The efficacy of mainstream inclusion is explored, identifying the position that a 'one size fits all' model of education is not appropriate for all children with ASD.

  8. Mean nuclear volume

    DEFF Research Database (Denmark)

    Mogensen, O.; Sørensen, Flemming Brandt; Bichel, P.

    1999-01-01

    We evaluated the following nine parameters with respect to their prognostic value in females with endometrial cancer: four stereologic parameters [mean nuclear volume (MNV), nuclear volume fraction, nuclear index and mitotic index], the immunohistochemical expression of cancer antigen (CA125...

  9. ACR Appropriateness Criteria Assessment of Fetal Well-Being.

    Science.gov (United States)

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

    2016-12-01

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

  10. ACR Appropriateness Criteria® First Trimester Vaginal Bleeding.

    Science.gov (United States)

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

    2018-05-01

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

  11. Trends in metformin utilisation and dose appropriateness in Australia.

    Science.gov (United States)

    Moon, J; Kumar, S S; Graham, G G; Baysari, M T; Williams, K M; Chen, W; Viardot, A; Greenfield, J R; Day, R O

    2016-12-01

    The study aimed to (1) determine the trends in the utilisation of metformin in Australia, (2) determine the appropriateness of metformin dosing in an Australian teaching hospital and (3) gather the opinions of prescribers on the relationship between metformin dose and renal function. National prescription data between 1990 and 2012 were accessed. A retrospective audit (2008-2012) of metformin doses and patient renal function (20 % random sample of all in-patients prescribed metformin) was conducted at St Vincent's Hospital (SVH), Sydney. Prescribers of metformin were interviewed (semi-structured; consultants at SVH) or surveyed (Australian endocrinologists) to gather their understanding of metformin dosing in relation to renal function. Metformin utilisation increased fivefold nationally between 1995 and 2012. Metformin tended to be under-dosed in SVH patients with normal renal function (83.5 %) and over-dosed in patients with impaired renal function (estimated glomerular filtration rate (eGFR) metformin doses needed to be reduced in renal impairment. Most endocrinologists (61 %) were comfortable prescribing metformin down to eGFRs around 30 mL/min. The use of metformin increased greatly over the period of the study. Metformin is prescribed frequently for patients with eGFR values below the minimal level approved in the product label (60 mL/min). While prescribers expressed their understanding of the need to reduce metformin doses in patients with renal impairment, we found that metformin doses were higher than appropriate in patients with impaired renal function. Metformin may be used safely when renal function is poor provided dosage is appropriately reduced.

  12. Is BMD testing appropriate for all menopausal women?

    Science.gov (United States)

    Kleerekoper, Michael; Nelson, Dorothy A

    2005-01-01

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

  13. ACR Appropriateness Criteria® Breast Cancer Screening.

    Science.gov (United States)

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

    2017-11-01

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

  14. Identifying Knowledge and Communication

    Directory of Open Access Journals (Sweden)

    Eduardo Coutinho Lourenço de Lima

    2006-12-01

    Full Text Available In this paper, I discuss how the principle of identifying knowledge which Strawson advances in ‘Singular Terms and Predication’ (1961, and in ‘Identifying Reference and Truth-Values’ (1964 turns out to constrain communication. The principle states that a speaker’s use of a referring expression should invoke identifying knowledge on the part of the hearer, if the hearer is to understand what the speaker is saying, and also that, in so referring, speakers are attentive to hearers’ epistemic states. In contrasting it with Russell’s Principle (Evans 1982, as well as with the principle of identifying descriptions (Donnellan 1970, I try to show that the principle of identifying knowledge, ultimately a condition for understanding, makes sense only in a situation of conversation. This allows me to conclude that the cooperative feature of communication (Grice 1975 and reference (Clark andWilkes-Gibbs 1986 holds also at the understanding level. Finally, I discuss where Strawson’s views seem to be unsatisfactory, and suggest how they might be improved.

  15. Appropriateness criteria of FDG PET/CT in oncology

    International Nuclear Information System (INIS)

    Agrawal, Archi; Rangarajan, Venkatesh

    2015-01-01

    18 Fluorine-2-fluoro-2-Deoxy-d-glucose ( 18 F-FDG) positron emission tomography/computerized tomography (PET/CT) is a well-established functional imaging method widely used in oncology. In this article, we have incorporated the various indications for 18 FDG PET/CT in oncology based on available evidence and current guidelines. Growing body of evidence for use of 18 FDG PET/CT in select tumors is also discussed. This article attempts to give the reader an overview of the appropriateness of using 18 F-FDG PET/CT in various malignancies

  16. Development and appropriation of an integration policy for sport

    DEFF Research Database (Denmark)

    Agergaard, Sine

    2011-01-01

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

  17. The Subordinates in the Fictions of Appropriation of Minors

    OpenAIRE

    Souto, Luz Celestina

    2013-01-01

    the rol of the subordinates in the appropriation of children during the Argentinian Dictatorship has been questioned in several disciplines. However, are the works of  the writer Martín Kohan which have managed to tell the untold history in a very effective way by condensing it in the creation of a credible fictional world and, because of that, grinding. In Dos veces junio, as well as in Cuentas pendientes, the consequences of the banality of evil are obvious, since it represents the consensu...

  18. Appropriate Contrast Enhancement Measures for Brain and Breast Cancer Images

    Directory of Open Access Journals (Sweden)

    Suneet Gupta

    2016-01-01

    Full Text Available Medical imaging systems often produce images that require enhancement, such as improving the image contrast as they are poor in contrast. Therefore, they must be enhanced before they are examined by medical professionals. This is necessary for proper diagnosis and subsequent treatment. We do have various enhancement algorithms which enhance the medical images to different extents. We also have various quantitative metrics or measures which evaluate the quality of an image. This paper suggests the most appropriate measures for two of the medical images, namely, brain cancer images and breast cancer images.

  19. Understanding the Concept of Nationally Appropriate Mitigation Action

    DEFF Research Database (Denmark)

    Sharma, Sudhir; Desgain, Denis DR

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept...... and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman’s terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA...

  20. The appropriate use of the emergengy department for paediatric patients

    OpenAIRE

    Benahmed, Nadia; Laokri, Samia; Zhang, Wei Hong; Cohen, Laurent; Karlin, Sophie; De Wever, Alain

    2011-01-01

    Objective: To determine the factors associated with paediatric inappropriate use (IU) of the accident and emergency department (A&E). Method: An observational prospective survey was performed. All the patients (< 16 years) attending A&E in 12 Belgian hospitals during 2 weeks in 2010 were included. The use of A&E was considered appropriate if, at least, one of the following criteria was met: child referred by a doctor or the police, brought by ambulance, need for a short stay, need for technic...

  1. What is "appropriate" for school-aged children with autism?

    Science.gov (United States)

    Conroy, Tim; Conroy, Terrye

    2006-10-01

    Compliance with the IDEA and S.C. Board of Education procedures is only the first step toward providing a student with autism with an IEP that is reasonably calculated to enable that student to receive educational benefits--a FAPE. At the heart of the IEP process is instruction specially designed to meet the unique needs, talents, and experiences of each child. While disagreements over the appropriateness of the IEP, including the methodologies used to provide such instruction, may arise, it is through the successful collaboration of parents, health care providers, and school professionals that a child with autism will develop into an adult with a life of community and meaning.

  2. Blood volume studies

    International Nuclear Information System (INIS)

    Lewis, S.M.; Yin, J.A.L.

    1986-01-01

    The use of dilution analysis with such radioisotopes as 51 Cr, 32 P, sup(99m)Tc and sup(113m)In for measuring red cell volume is reviewed briefly. The use of 125 I and 131 I for plasma volume studies is also considered and the subsequent determination of total blood volume discussed, together with the role of the splenic red cell volume. Substantial bibliography. (UK)

  3. Topologically-based visualization of large-scale volume data

    International Nuclear Information System (INIS)

    Takeshima, Y.; Tokunaga, M.; Fujishiro, I.; Takahashi, S.

    2004-01-01

    Due to the recent progress in the performance of computing/measurement environments and the advent of ITBL environments, volume datasets have become larger and more complicated. Although computer visualization is one of the tools to analyze such datasets effectively, it is almost impossible to adjust the visualization parameter value by trial and error without taking the feature of a given volume dataset into consideration. In this article, we introduce a scheme of topologically-based volume visualization, which is intended to choose appropriate visualization parameter values automatically through topological volume skeletonization. (author)

  4. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  5. The relationship between patient volume and mortality in American trauma centres: a systematic review of the evidence.

    Science.gov (United States)

    Caputo, Lisa M; Salottolo, Kristin M; Slone, Denetta Sue; Mains, Charles W; Bar-Or, David

    2014-03-01

    To synthesise published and unpublished findings examining the relationship between institutional trauma centre volume or trauma patient volume per surgeon and mortality. Evidence on the relationship between patient volume and survival in trauma patients is inconclusive in the literature and remains controversial. A literature search was performed to identify studies published between 1976 and 2013 via MEDLINE (Pubmed) and the Cumulative Index to Nursing and Allied Health Literature (EbscoHost) as well as footnote chasing. Abstracts from appropriate conferences and ProQuest Dissertations and Theses were also searched. Inclusion criteria required studies to be original research published in English that examined the relationship between mortality and either institutional or per surgeon volume in American trauma centres. We employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement checklist and flowchart. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the quality of the evidence. Of 1392 studies reviewed, 19 studies met defined inclusion criteria; all studies were retrospective. The definition of volume was heterogeneous across the studies. Patient population and analysis methods also varied across the studies. Sixteen studies (84%) examined the relationship between institutional trauma centre volume and mortality. Of the 16 studies, 12 examined the volume of severely injured patients and eight examined overall trauma patient volume. High institutional volume was associated with at least somewhat improved mortality in ten of 16 studies (63%); however, nearly half of these studies found only some subpopulations experienced benefits. In the remaining six studies, volume was not associated with any benefits. Four studies (25%) analysed the impact of surgeon volume on mortality. High volume per surgeon was associated with improved mortality in only one of four studies

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

    Science.gov (United States)

    Volpicelli, Kathryn; Buttenheim, Alison M

    2016-11-01

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

  7. ACR Appropriateness Criteria® Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer.

    Science.gov (United States)

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

    2017-11-01

    Patients with locally advanced invasive breast cancers are often treated with neoadjuvant chemotherapy prior to definitive surgical intervention. The primary aims of this approach are to: 1) reduce tumor burden thereby permitting breast conservation rather than mastectomy; 2) promptly treat possible metastatic disease, whether or not it is detectable on preoperative staging; and 3) potentially tailor future chemotherapeutic decisions by monitoring in-vivo tumor response. Accurate radiological assessment permits optimal management and planning in this population. However, assessment of tumor size and response to treatment can vary depending on the modality used, the measurement technique (such as single longest diameter, 3-D measurements, or calculated tumor volume), and varied response of different tumor subtypes to neoadjuvant chemotherapy (such as concentric shrinkage or tumor fragmentation). As discussed in further detail, digital mammography, digital breast tomosynthesis, US and MRI represent the key modalities with potential to help guide patient management. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Offpost Operable Unit Remedial Investigation and Chemical Specific Applicable or Relevant and Appropriate Requirements, Version 3.1. Volume 3

    Science.gov (United States)

    1988-12-01

    dried eggs and processed herbs and spices;... (iii) 250 parts per million in or on concentrated tomato products and dried figs; and (iv) 125 parts...eggplant, peppers, potatoes, summer squash and tomatoes . 4 4 4 H-25 4 38. PRIMARY NAME: Ethyl benzene (Ethylbenzene) CERCLA Hazardous Substance: Yes...C’. .R. § 141. 12 and the aquatic life standard as poenrtial ’\\ RAIZS reqa ire no( further discus~it n in this" con text. I8 Q h )tn omen ts ()n Fthfi

  9. Hiring appropriate providers for different populations: acute care nurse practitioners.

    Science.gov (United States)

    Haut, Cathy; Madden, Maureen

    2015-06-01

    Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm. Despite national support for the model, nurse practitioners and employers continue to struggle with finding the right fit. Nurse practitioners often use their interest and previous nursing experience to apply for an available position, and hospitals may not understand preparation or regulations related to matching the appropriate provider to the work environment. Evidence and regulatory guidelines indicate appropriate providers for population-focused positions. This article presents history and recommendations for hiring acute care nurse practitioners as providers for different populations of patients. ©2015 American Association of Critical-Care Nurses.

  10. Diverse structural approaches to haem appropriation by pathogenic bacteria.

    Science.gov (United States)

    Hare, Stephen A

    2017-04-01

    The critical need for iron presents a challenge for pathogenic bacteria that must survive in an environment bereft of accessible iron due to a natural low bioavailability and their host's nutritional immunity. Appropriating haem, either direct from host haemoproteins or by secreting haem-scavenging haemophores, is one way pathogenic bacteria can overcome this challenge. After capturing their target, haem appropriation systems must remove haem from a high-affinity binding site (on the host haemoprotein or bacterial haemophore) and transfer it to a binding site of lower affinity on a bacterial receptor. Structural information is now available to show how, using a combination of induced structural changes and steric clashes, bacteria are able to extract haem from haemophores, haemopexin and haemoglobin. This review focuses on structural descriptions of these bacterial haem acquisition systems, summarising how they bind haem and their target haemoproteins with particularly emphasis on the mechanism of haem extraction. Copyright © 2017 The Author. Published by Elsevier B.V. All rights reserved.

  11. Appropriate methodologies for empirical bioethics: it's all relative.

    Science.gov (United States)

    Ives, Jonathan; Draper, Heather

    2009-05-01

    In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached.

  12. HOW TO SELECT APPROPRIATE STATISTICAL TEST IN SCIENTIFIC ARTICLES

    Directory of Open Access Journals (Sweden)

    Vladimir TRAJKOVSKI

    2016-09-01

    Full Text Available Statistics is mathematical science dealing with the collection, analysis, interpretation, and presentation of masses of numerical data in order to draw relevant conclusions. Statistics is a form of mathematical analysis that uses quantified models, representations and synopses for a given set of experimental data or real-life studies. The students and young researchers in biomedical sciences and in special education and rehabilitation often declare that they have chosen to enroll that study program because they have lack of knowledge or interest in mathematics. This is a sad statement, but there is much truth in it. The aim of this editorial is to help young researchers to select statistics or statistical techniques and statistical software appropriate for the purposes and conditions of a particular analysis. The most important statistical tests are reviewed in the article. Knowing how to choose right statistical test is an important asset and decision in the research data processing and in the writing of scientific papers. Young researchers and authors should know how to choose and how to use statistical methods. The competent researcher will need knowledge in statistical procedures. That might include an introductory statistics course, and it most certainly includes using a good statistics textbook. For this purpose, there is need to return of Statistics mandatory subject in the curriculum of the Institute of Special Education and Rehabilitation at Faculty of Philosophy in Skopje. Young researchers have a need of additional courses in statistics. They need to train themselves to use statistical software on appropriate way.

  13. Bounded authority: Expanding "appropriate" police behavior beyond procedural justice.

    Science.gov (United States)

    Trinkner, Rick; Jackson, Jonathan; Tyler, Tom R

    2018-06-01

    This paper expands previous conceptualizations of appropriate police behavior beyond procedural justice. The focus of the current study is on the notion of bounded authority-that is, acting within the limits of one's rightful authority. According to work on legal socialization, U.S. citizens come to acquire three dimensions of values that determine how authorities ought to behave: (a) neutral, consistent, and transparent decision-making; (b) interpersonal treatment that conveys respect, dignity, and concern; and (c) respecting the limits of one's rightful power. Using survey data from a nationally representative sample of U.S. adults, we show that concerns over bounded authority, respectful treatment, and neutral decision-making combine to form a strong predictor of police and legal legitimacy. We also find that legal legitimacy is associated with greater compliance behavior, controlling for personal morality and perceived likelihood of sanctions. We discuss the implications of a boundary perspective with respect to ongoing debates over the appropriate scope of police power and the utility of concentrated police activities. We also highlight the need for further research specifically focused on the psychological mechanisms underlying the formation of boundaries and why they shape the legitimacy of the police and law. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Classifying decommissioning wastes for allocation to appropriate final repositories

    International Nuclear Information System (INIS)

    Alder, J.C.; Tunaboylu, K.

    1982-01-01

    For the safe disposal of radioactive wastes in different repositories, it is of advantage to classify them in well-defined conditioned categories, appropriate for final disposal. These categories, the so-called waste sorts are characterized by similar radionuclide distribution, similar nuclide-specific activity concentrations and similar waste matrix. A methodology is presented for classifying decommissioning wastes and is applied to the decommissioning wastes arising from a Swiss program of 6 GWe. The amounts and nuclide-specific activity inventories of the decommissioning waste sorts have been estimated. A first allocation into two different repository types has been performed. Such a classification enables one to define the source parameters for repository safety analysis and allows one to allocate the different waste categories into appropriate final repositories. This work presents a first iteration to determine which waste sorts belong to which repository type. The characteristics of waste sorts have to be better defined and the protective strength of the repository barriers has to be optimized. 7 references, 2 figures, 4 tables

  15. Natura 2000 appropriate assessment: Shortcomings and improvements in Finnish practice

    International Nuclear Information System (INIS)

    Soederman, Tara

    2009-01-01

    The EU Habitats Directive 92/43/EEC requires impact assessments called Appropriate Assessments (AA) for plans and projects probably having adverse effects on the sites of European ecological importance, Natura 2000 sites. Seventy-three Appropriate Assessment reports and seventy official opinions given on them by regional environmental authorities from 1997 to 2005 were reviewed. The findings of the study demonstrate typical shortcomings of ecological impact assessment: a weak information basis for assessment outcomes and lack of proper cumulative impact assessment with respect to ecological structures and processes. The quality of reporting has improved over time with respect to direct impacts on individual habitat types and species and detailed mitigation measures. Regional environment centres considered one fifth of the AA reports to be inadequate because of lacking data. In most cases the regional environment centres demanded a change of plan or project, added mitigation measures, choice of only one alternative for further planning or a new completed assessment with additional information in order to be able to evaluate the significance of the effects. The study underlines the need for iterative planning practices in which the preparation of a plan or project with alternative options goes hand in hand with the impact assessment equipped with sufficient data

  16. Appropriating religion: understanding religion as an object of science

    Directory of Open Access Journals (Sweden)

    Donald Wiebe

    1999-01-01

    Full Text Available In this paper, the author focuses on the study of religion as a scientific project, for it is the scientific interest in religion which has constituted the grounds for admitting the study of religion into the curriculum of the modern Western university. Despite that academic legitimation, however, the study of religion in the setting of the modern research university is not held in high esteem relative to the other sciences. It if the scientific study of religion is to be legitimately ensconced in the modern research university, the notion of religion will have to be wholly appropriated by science; only then will we be able to establish a conceptual foundation from which to make valid knowledge claims about religion on a level commensurate with the pronouncements of the natural and social sciences. Indeed, to go one step further, given the hold on the concept of religion by those committed to the humanistic study of religion, we might need to talk here not of the appropriation but of expropriation of religion by science—that is, of wresting ownership of the concept from the humanists by using it solely as a taxonomic device to differentiate and explain a peculiar range of human behaviour demonstrated in religious practices.

  17. Identifying and Managing Risk.

    Science.gov (United States)

    Abraham, Janice M.

    1999-01-01

    The role of the college or university chief financial officer in institutional risk management is (1) to identify risk (physical, casualty, fiscal, business, reputational, workplace safety, legal liability, employment practices, general liability), (2) to develop a campus plan to reduce and control risk, (3) to transfer risk, and (4) to track and…

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

    Science.gov (United States)

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

    2016-08-01

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

  19. Internally readable identifying tag

    International Nuclear Information System (INIS)

    Jefferts, K.B.; Jefferts, E.R.

    1980-01-01

    A method of identifying non-metallic objects by means of X-ray equipment is described in detail. A small metal pin with a number of grooves cut in a pre-determined equi-spaced pattern is implanted into the non-metallic object and by decoding the groove patterns using X-ray equipment, the object is uniquely identified. A specific example of such an application is in studying the migratory habits of fish. The pin inserted into the snout of the fish is 0.010 inch in diameter, 0.040 inch in length with 8 possible positions for grooves if spaced 0.005 inch apart. With 6 of the groove positions available for data, the capacity is 2 6 or 64 combinations; clearly longer pins would increase the data capacity. This method of identification is a major advance over previous techniques which necessitated destruction of the fish in order to recover the identification tag. (UK)

  20. Identifying Breast Cancer Oncogenes

    Science.gov (United States)

    2010-10-01

    tyrosine kinases with an SH3, SH2 and catalytic domain, it lacks a native myristylation signal shared by most members of this class [14], [38]. The...therapeutics and consequently, improve clinical outcomes. We aim to identify novel drivers of breast oncogenesis. We hypothesize that a kinase gain-of...human mammary epithelial cells. A pBabe-Puro-Myr-Flag kinase open reading frame (ORF) library was screened in immortalized human mammary epithelial

  1. Rock disposal problems identified

    Energy Technology Data Exchange (ETDEWEB)

    Knox, R

    1978-06-01

    Mathematical models are the only way of examining the return of radioactivity from nuclear waste to the environment over long periods of time. Work in Britain has helped identify areas where more basic data is required, but initial results look very promising for final disposal of high level waste in hard rock repositories. A report by the National Radiological Protection Board of a recent study, is examined.

  2. 24 CFR 100.143 - Appropriate corrective action.

    Science.gov (United States)

    2010-04-01

    ... the employees involved; (4) Developing outreach programs, marketing strategies, or loan products to... effect of the likely violation and must: (1) Identify the policies or practices that are the likely cause...

  3. Technical rigidity and appropriate technology in less-developed countries

    Energy Technology Data Exchange (ETDEWEB)

    Forsyth, D J.C. [Univ. of Strathyclyde, England; McBain, N S; Solomon, R F

    1980-05-01

    The extent to which the use of capital-intensive methods in LDCs can properly be ascribed to the inherent rigidity of the factor proportions embodied in modern technology - rather than to distortions and aberrrations in the process of technology choice - is still a matter of considerable uncertainty after two decades of debate. In this study, an engineering-based index is developed to summarize the opportunities for, and barriers to, substitution of labor for capital in a wide range of industries. The index is used to compare the technology actually installed in manufacturing in Ghana, the Philippines, Turkey, and Malaysia with the feasible alternatives. The finding that opportunities for use of labor-intensive methods are to a large extent exploited is interpreted as casting doubt on the ability of even the most appropriate choice from currently feasible technologies to reduce unemployment significantly. 46 references, 5 figures, 6 tables.

  4. Appropriate electromagnetic techniques for imaging geothermal fracture zones

    Energy Technology Data Exchange (ETDEWEB)

    Groom, R; Walker, P [PetRos EiKon Incorporated, Ontario (Canada)

    1996-05-01

    Electromagnetic surface detection of fracture zones has often been approached by using the magnetotelluric method. This technique suffers greatly from the quantity and scale of the conductive inhomogeneities lying above the fracture zones. Additionally, it suffers from the inherent inability to focus the source on the target. There are no such source focusing capabilities in magnetotellurics. Accordingly, the quantity of magnetotelluric data required to resolve targets in such complex conditions can make the technique inefficient and insufficient from a cost perspective. When attempting to reveal a subsurface structure and image it, the basic physical responses at hand must be kept in mind, and the appropriate source must be utilized, which most effectively illuminates the target. A further advantage to controlled sources is that imaging techniques may be used to accentuate the response due to knowledge and control of the source.

  5. Determination of appropriate models and parameters for premixing calculations

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ik-Kyu; Kim, Jong-Hwan; Min, Beong-Tae; Hong, Seong-Wan

    2008-03-15

    The purpose of the present work is to use experiments that have been performed at Forschungszentrum Karlsruhe during about the last ten years for determining the most appropriate models and parameters for premixing calculations. The results of a QUEOS experiment are used to fix the parameters concerning heat transfer. The QUEOS experiments are especially suited for this purpose as they have been performed with small hot solid spheres. Therefore the area of heat exchange is known. With the heat transfer parameters fixed in this way, a PREMIX experiment is recalculated. These experiments have been performed with molten alumina (Al{sub 2}O{sub 3}) as a simulant of corium. Its initial temperature is 2600 K. With these experiments the models and parameters for jet and drop break-up are tested.

  6. Registered indians and tobacco taxation: a culturally-appropriate strategy?

    Science.gov (United States)

    Wardman, A E Dennis; Khan, Nadia A

    2005-01-01

    Taxation of tobacco is a widely-used strategy that prompts smoking cessation among adults and reduces cigarette consumption among continuing smokers. Registered Indian tobacco use prevalence is at least double that of the rest of Canadians and is in part due to the lower cost of tobacco products purchased on reserve by Registered Indians (RIs) as they are tax exempt. Although registered Indian communities have the ability to collect tax on tobacco products and direct the use of these revenues, this strategy is rarely utilized. Tobacco taxation could have substantial health and economic benefits to RI communities, but perhaps is not culturally-appropriate. In order to better support RI communities, governments and other organizations need to examine this policy instrument in the context of RI populations.

  7. Appropriate location of the nipple-areola complex in males.

    Science.gov (United States)

    Shulman, O; Badani, E; Wolf, Y; Hauben, D J

    2001-08-01

    Gynecomastia is a common deformity encountered by plastic surgeons. The appropriate location of the nipple-areola complex is a major determinant of the aesthetic success of the procedure. To study the natural location of the nipple-areola complex in the normally built male, 50 nonobese men with no evidence of gynecomastia and an average age of 27.9 years were examined. Three ratios were calculated and found to be relatively constant; they were the ratio between the height of the nipple and the height of the patient, the ratio between the distance between the nipples and chest circumference, and the ratio between the suprasternal notch-to-nipple distance and the height of the patient. Using these three parameters, a method of locating the nipple-areola complex on the male chest wall was devised. The method is advocated as a reliable, simple, and useful technique.

  8. An Assessment of Culturally Appropriate Design: A Malaysian University Context

    Directory of Open Access Journals (Sweden)

    Shamsul Arrieya Ariffin

    2018-03-01

    Full Text Available The growing popularity of mobile devices, together with the constant technological improvement of mobile websites and applications informed about the quality of the user interface design. However, the particularities of mobile devices require special attention in terms of their usability aspects, such as culture. Therefore, this study evaluated the use of culturally appropriate design guidelines for a mobile learning web site. The research methodology used comprised a survey from heuristic evaluation questionnaires with undergraduate students. This research captured the students’ experiences in using the MLearn website of Universiti Pendidikan Sultan Idris, Malaysia.  From the study, the lowest ranking is realistic error management at 3.5, and the highest is suitable content for local culture at 4.6.  This study affirmed that general usability and cultural principles in design are important for a usable mobile learning website system in a local university context.

  9. Determination of appropriate models and parameters for premixing calculations

    International Nuclear Information System (INIS)

    Park, Ik-Kyu; Kim, Jong-Hwan; Min, Beong-Tae; Hong, Seong-Wan

    2008-03-01

    The purpose of the present work is to use experiments that have been performed at Forschungszentrum Karlsruhe during about the last ten years for determining the most appropriate models and parameters for premixing calculations. The results of a QUEOS experiment are used to fix the parameters concerning heat transfer. The QUEOS experiments are especially suited for this purpose as they have been performed with small hot solid spheres. Therefore the area of heat exchange is known. With the heat transfer parameters fixed in this way, a PREMIX experiment is recalculated. These experiments have been performed with molten alumina (Al 2 O 3 ) as a simulant of corium. Its initial temperature is 2600 K. With these experiments the models and parameters for jet and drop break-up are tested

  10. Narrative Intertextuality: How Pacheco Appropriates The Go-Between

    Directory of Open Access Journals (Sweden)

    Jorge Alcázar

    2016-01-01

    Full Text Available This essay explores the role of rewriting in postmodern fiction, whether it goes under such names as appropriation, adaptation or the interaction between a hypotext and a hypertext. The core of the article is concerned with a minute comparison between H. P. Hartley’s novel The Go-Between (1953 and José Emilio Pacheco’s Las batallas en el desierto (1981. Similarities such as the role of a child/adult narrator, his infatuation with a mature woman, the traumatic experience it entails, how a distant past is recreated, the clash of opposite social classes, the narrative thematics of music, as well as other minor details are brought to the fore.

  11. Cultural Appropriations; Ethnic-Racial Representations; Black Press

    Directory of Open Access Journals (Sweden)

    Maria Angélica Zubaran

    2015-12-01

    Full Text Available This paper investigates the exchange and circulation of ideas in the black diaspora, particularly in the newspaper The Example, mapping and discussing the ethnic-racial and gender representations constructed in the narratives produced by the editors of this newspaper, during the campaign for the construction of a monument to the “Black Mother”. The aim is to analyze how the newspaper’s editors have appropriated texts that circulated in other newspapers about the campaign to the monument of the “Black Mother”, adapted them to their own interests and given them new meanings. From the theoretical approach of Cultural Studies, we understand the black press as a cultural artifact that not only informs but also produces discourses and representations that contribute to the formation of black subjectivities and identities.

  12. The appropriateness of a proton pump inhibitor prescription.

    LENUS (Irish Health Repository)

    Moran, N

    2014-11-01

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

  13. Determination of the appropriate energy policy for Turkey

    International Nuclear Information System (INIS)

    Ulutas, B.H.

    2005-01-01

    Energy is an inevitable necessity for human beings. But the energy source is predicted to be scarce in the coming years as a result of population growth. Therefore people prefer energy sources that are renewable, clean and cost effective. Unfortunately there is not a sole energy source to meet these demands. Determination of the appropriate energy policy problem with interactive criteria and alternatives can be viewed as a multiple criteria decision making (MCDM) problem within the context of the long range and strategic process. The analytic network process (ANO), one of MCDM methods, deals with the dependency and feedback that the problem has. The goal of this paper is to apply the ANP model to evaluate the alternative energy sources for the country. Finally when the results are discussed, it is apparent that the model can produce reasonable and applicable solutions for the case. (author)

  14. The importance of having an appropriate data segmentation (partitioning)

    CERN Document Server

    Dimitrov, Gancho; The ATLAS collaboration

    2014-01-01

    In this presentation will be shown real life examples from database applications in the ATLAS experiment @ LHC where we make use of many Oracle partitioning techniques available in Oracle 11g. With the broadly used range partitioning and its option of automatic interval partitioning we add our own logic in PLSQL for sustaining data sliding windows in order to enforce various data retention policies. We also make use of the reference partitioning in some use cases, however the most challenging was to segment the data of a large bookkeeping system which resulted in tens of thousands list partitions and list sub-partitions. Partition and sub-partition management, index strategy, statistics gathering and queries execution plan stability are important factors when choosing an appropriate for the use case data management model. The gained experience with all of those will be shared with the audience.

  15. The importance of applying an appropriate data partitioning

    CERN Document Server

    Dimitrov, Gancho; The ATLAS collaboration

    2015-01-01

    In this presentation are described specific technical solutions put in place in various database applications of the ATLAS experiment at LHC where we make use of several partitioning techniques available in Oracle 11g. With the broadly used range partitioning and its option of automatic interval partitioning we add our own logic in PLSQL procedures and scheduler jobs to sustain data sliding windows in order to enforce various data retention policies. We also make use of the new Oracle 11g reference partitioning in the ATLAS Nightly Build System to achieve uniform data segmentation. However the most challenging was to segment the data of the new ATLAS Distributed Data Management system, which resulted in tens of thousands list type partitions and sub-partitions. Partition and sub-partition management, index strategy, statistics gathering and queries execution plan stability are important factors when choosing an appropriate physical model for the application data management. The so-far accumulated knowledge wi...

  16. The 1995 forum on appropriate criteria and methods for seismic design of nuclear piping

    International Nuclear Information System (INIS)

    Slagis, G.C.

    1996-01-01

    A record of the 1995 Forum on Appropriate Criteria and Methods for Seismic Design of Nuclear Piping is provided. The focus of the forum was the earthquake experience data base and whether the data base demonstrates that seismic inertia loads will not cause failure in ductile piping systems. This was a follow-up to the 1994 Forum when the use of earthquake experience data, including the recent Northridge earthquake, to justify a design-by-rule method was explored. Two possible topics for the next forum were identified--inspection after an earthquake and design for safe-shutdown earthquake only

  17. Features for culturally appropriate avatars for behavior-change promotion in at-risk populations

    Directory of Open Access Journals (Sweden)

    Lisetti C

    2009-09-01

    Full Text Available We explore how avatars can be used as social orthotics defined as therapeutic computer-based social companions aimed at promoting healthy behaviors. We review some of the health interventions deployed in helping at-risk populations along with some of the unique advantages that computer-based interventions can add to face-to-face interventions. We posit that artificial intelligence has rendered possible the creation of culturally appropriate dialog-agents for interventions and we identify specific features for social avatars that are important - if not necessary - when applied to the domain of social orthotic systems for health promotion.

  18. Extracorporeal membrane oxygenation (ECMO) as a treatment strategy for severe acute respiratory distress syndrome (ARDS) in the low tidal volume era: A systematic review.

    Science.gov (United States)

    Tillmann, Bourke W; Klingel, Michelle L; Iansavichene, Alla E; Ball, Ian M; Nagpal, A Dave

    2017-10-01

    To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included. All identified studies were assessed independently by two reviewers. Of 1782 citations, 27 studies (n=1674) met inclusion criteria. Hospital survival for ECMO patients ranged from 33.3 to 86%, while survival with conventional therapy ranged from 36.3 to 71.2%. Five studies were identified with appropriate control groups allowing comparison, but due to the high degree of variability between studies (I 2 =63%), their results could not be pooled. Two of these studies demonstrated a significant difference, both favouring ECMO over conventional therapy. Given the lack of studies with appropriate control groups, our confidence in a difference in outcome between the two therapies remains weak. Future studies on the use of ECMO for severe ARDS are needed to clarify the role of ECMO in this disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Appropriate use of the increment entropy for electrophysiological time series.

    Science.gov (United States)

    Liu, Xiaofeng; Wang, Xue; Zhou, Xu; Jiang, Aimin

    2018-04-01

    The increment entropy (IncrEn) is a new measure for quantifying the complexity of a time series. There are three critical parameters in the IncrEn calculation: N (length of the time series), m (dimensionality), and q (quantifying precision). However, the question of how to choose the most appropriate combination of IncrEn parameters for short datasets has not been extensively explored. The purpose of this research was to provide guidance on choosing suitable IncrEn parameters for short datasets by exploring the effects of varying the parameter values. We used simulated data, epileptic EEG data and cardiac interbeat (RR) data to investigate the effects of the parameters on the calculated IncrEn values. The results reveal that IncrEn is sensitive to changes in m, q and N for short datasets (N≤500). However, IncrEn reaches stability at a data length of N=1000 with m=2 and q=2, and for short datasets (N=100), it shows better relative consistency with 2≤m≤6 and 2≤q≤8 We suggest that the value of N should be no less than 100. To enable a clear distinction between different classes based on IncrEn, we recommend that m and q should take values between 2 and 4. With appropriate parameters, IncrEn enables the effective detection of complexity variations in physiological time series, suggesting that IncrEn should be useful for the analysis of physiological time series in clinical applications. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. A guide to public engagement and appropriate dispute resolution

    Energy Technology Data Exchange (ETDEWEB)

    Jonsson, C.

    2006-10-15

    This guide was developed to help oil and gas companies operating in British Columbia to understand what tools are available to them when entering a public engagement process. It describes the BC Oil and Gas Commission's (OGC's) expectations regarding public engagement and appropriate dispute resolutions (ADR) associated with applications for oil and gas exploration, development and production in the province. The OGC's comprehensive application review process is designed to balance environmental, economic and social factors. The public engagement process is intended to allow the public to express concerns about how proposed oil and gas operations may affect them. This document also emphasized the government's responsibility to consult with First Nations on their treaty rights. The guide presented key concepts and best practices in the public engagement process and explained how to engage participants before, during and after application decisions are made. The OGC may impose conditions on the applicant to mitigate concerns of the affected public. The concerns typically range from noise of oil and gas machinery; air pollution; concern for health and safety; traffic control; water quality; and, aesthetics. A table of possible mitigative measures to these concerns was presented to demonstrate some options that may be used by industry and the affected public in resolving issues related to oil and gas activities. The OGC promotes the independent resolution of concerns. However, if conflicts exist, the OGC encourages participants to use appropriate dispute resolution (ADR) to help resolve any differences. Although participation in ADR is voluntary, its use allows affected parties to gain a sense of ownership over the proceedings and outcomes. In addition to being less costly than legal proceedings, ADR can lead to win-win outcomes, improve relationships and lead to more routine applications for oil and gas activities. refs., tabs., figs.

  1. Male appropriation and medicalization of childbirth: an historical analysis.

    Science.gov (United States)

    Cahill, H A

    2001-02-01

    This paper aims to explore through historical analysis some of the means by which medicine successfully appropriated and medicalized pregnancy and childbirth and to consider the impact that this has had on women's experiences within maternity care. The appropriation and medicalization of pregnancy and childbirth by men are rooted in a patriarchal model that has been centuries in the making. A model that perceives women as essentially abnormal, as victims of their reproductive systems and hormones, it is also one that defines pregnancy as inherently pathological - a clinical crisis worthy of active intervention. In both law and medicine men have used their power to define reproduction as a biological defect (LeMoncheck L. 1996 Journal of Clinical Ethics 7, 160--176), requiring both legal regulation and medical intervention, whilst feminist writers have long argued that women's experiences within the health care system at least to some extent reflects their social position. Male justifications of female inferiority have been developed and nurtured through professional discourses and socialization processes inherent within medical education and practice (Cahill H. 1999 MA Thesis, University of Keele). These assumptions are internalized and reproduced to shape quite profoundly, the nature of doctors' interactions with women in their care. Perhaps more fundamentally, such discursive explanations of women's bodies as inherently defective continue to shape women's position in society. Maternity care is a key area in which women's ability to exercise real choice and make informed decisions is limited and where doctor-patient interactions are themselves constructions of existing gender orders; women's autonomy continues to be violated through both quite subtle and overt discourse and practice.

  2. Defining appropriate incentive levels: A review of theory and practice

    International Nuclear Information System (INIS)

    Parfett, R.S.; Lodola, J.C.

    1990-01-01

    The theoretical and practical aspects related to determining the incentive levels for demand-side management (DSM) programs are discussed. The theoretical aspects comprise the efficiency criteria, from a social point of view; the equity issue, or ensuring that no one pays higher rates as a result of conservation programs; and the method of recovering the customer's investment, or the implicit discount rate method. The study of these theoretical aspects takes into account the perspectives of all the concerned parties and focuses on the need to harmonize the efficiency criteria which are in opposition. From this process are derived general criteria for aiding program planners and managers to determine the incentive levels for their DSM programs. Past experience has shown that incentive levels cannot be determined in an isolated manner. Other characteristics affecting the carrying out of DSM programs will also have repercussions on the success rate. To determine the appropriate incentives, it is important to have a clear understanding of what the DSM program intends to achieve. Factors such as the market sector, the technology chosen, and demographic characteristics can influence all aspects of the design and implementation of the program, including the type and level of incentive offered. When the goals of the program are clearly established and the intended market is clearly determined, a strategy should be formed which will have the greatest chance of fulfilling the program objectives. The role of each element in the program must be well understood. It is only at this stage that it is possible to determine an appropriate level of incentive. 7 refs

  3. MPCV Exercise Operational Volume Analysis

    Science.gov (United States)

    Godfrey, A.; Humphreys, B.; Funk, J.; Perusek, G.; Lewandowski, B. E.

    2017-01-01

    identified by determining which markers from the motion capture exceed the operational volume and by how much. A credibility assessment of this analysis was performed in accordance with NASA-STD-7009 prior to delivery to the MPCV program.

  4. Identifying phenomenal consciousness.

    Science.gov (United States)

    Schier, Elizabeth

    2009-03-01

    This paper examines the possibility of finding evidence that phenomenal consciousness is independent of access. The suggestion reviewed is that we should look for isomorphisms between phenomenal and neural activation spaces. It is argued that the fact that phenomenal spaces are mapped via verbal report is no problem for this methodology. The fact that activation and phenomenal space are mapped via different means does not mean that they cannot be identified. The paper finishes by examining how data addressing this theoretical question could be obtained.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

  7. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? A comparison study.

    NARCIS (Netherlands)

    Ivanovska, V.; Leufkens, H.G.; Rademaker, C.M.A.; Zisovska, E.; Pijnenbrug, M.W.; Dijk, L. van; Mantel-Teeuwisse, A.K.

    2017-01-01

    Objective: There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  8. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? : A comparison study

    NARCIS (Netherlands)

    Ivanovska, Verica; Leufkens, Hubert G; Rademaker, Carin Ma; Zisovska, Elizabeta; Pijnenburg, Mariëlle W; van Dijk, Liset; Mantel-Teeuwisse, Aukje K

    OBJECTIVE: There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  9. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? : A comparison study

    NARCIS (Netherlands)

    Ivanovska, Verica; Leufkens, Hubert G.; Rademaker, Carin M A; Zisovska, Elizabeta; Pijnenburg, Mariëlle W.; van Dijk, Liset; Mantel-Teeuwisse, Aukje K.

    Objective There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  10. Improving Student Success by Understanding Reasons for, Types of, and Appropriate Responses to Stressors Affecting Asian Graduate Students in Canada

    Science.gov (United States)

    Kim, Andrew

    2015-01-01

    An increasing number of university students in Canada are from East Asian countries and enrolled in graduate programs. For these students, unique factors may contribute to a stressful study environment, which in turn can impact academic performance. This article draws on literature to identify five such factors and appropriate coping strategies:…

  11. Barriers and enablers in the implementation of a provider-based intervention to stimulate culturally appropriate hypertension education

    NARCIS (Netherlands)

    Beune, Erik J. A. J.; Haafkens, Joke A.; Bindels, Patrick J. E.

    2011-01-01

    Objective: To identify barriers and enablers influencing the implementation of an intervention to stimulate culturally appropriate hypertension education (CANE) among health care providers in primary care. Methods: The intervention was piloted in three Dutch health centers. It consists of a toolkit

  12. Diagnosis of ADHD in Adults: What Is the Appropriate "DSM-5" Symptom Threshold for Hyperactivity-Impulsivity?

    Science.gov (United States)

    Solanto, Mary V.; Wasserstein, Jeanette; Marks, David J.; Mitchell, Katherine J.

    2012-01-01

    Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal "DSM-IV" criteria for ADHD combined or predominantly inattentive subtypes based on a structured…

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  14. Volume regulation in epithelia

    DEFF Research Database (Denmark)

    Larsen, Erik Hviid; Hoffmann, Else Kay

    2016-01-01

    to amphibian skin and mammalian cortical collecting tubule of low and intermediate osmotic permeability. Crosstalk between entrance and exit mechanisms interferes with volume regulation both at aniso-osmotic and iso-osmotic volume perturbations. It has been proposed that cell volume regulation is an intrinsic...... regulation are cloned. The volume-regulated anion channel (VRAC) exhibiting specific electrophysiological characteristics seems exclusive to serve cell volume regulation. This is contrary to K+ channels as well as cotransporters and exchange mechanisms that may serve both transepithelial transport and cell...... volume regulation. In the same cell, these functions may be maintained by different ion pathways that are separately regulated. RVD is often preceded by increase in cytosolic free Ca2+, probably via influx through TRP channels, but Ca2+ release from intracellular stores has also been observed. Cell...

  15. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist.

  16. DOE standard: Integration of environment, safety, and health into facility disposition activities. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1998-05-01

    This volume contains the appendices that provide additional environment, safety, and health (ES and H) information to complement Volume 1 of this Standard. Appendix A provides a set of candidate DOE ES and H directives and external regulations, organized by hazard types that may be used to identify potentially applicable directives to a specific facility disposition activity. Appendix B offers examples and lessons learned that illustrate implementation of ES and H approaches discussed in Section 3 of Volume 1. Appendix C contains ISMS performance expectations to guide a project team in developing and implementing an effective ISMS and in developing specific performance criteria for use in facility disposition. Appendix D provides guidance for identifying potential Applicable or Relevant and Appropriate Requirements (ARARs) when decommissioning facilities fall under the Comprehensive Environmental Response, Compensation, Liability Act (CERCLA) process. Appendix E discusses ES and H considerations for dispositioning facilities by privatization. Appendix F is an overview of the WSS process. Appendix G provides a copy of two DOE Office of Nuclear Safety Policy and Standards memoranda that form the bases for some of the guidance discussed within the Standard. Appendix H gives information on available hazard analysis techniques and references. Appendix I provides a supplemental discussion to Sections 3.3.4, Hazard Baseline Documentation, and 3.3.6, Environmental Permits. Appendix J presents a sample readiness evaluation checklist

  17. Appropriate Use Criteria for Fluoroscopically Guided Diagnostic and Therapeutic Sacroiliac Interventions: Results from the Spine Intervention Society Convened Multispecialty Collaborative.

    Science.gov (United States)

    MacVicar, John; Kreiner, D Scott; Duszynski, Belinda; Kennedy, David J

    2017-11-01

    To provide an overview of a multisociety effort to formulate appropriate use criteria for image-guided injections and radiofrequency procedures in the diagnosis and treatment of sacroiliac joint and posterior sacroiliac complex pain. The Spine Intervention Society convened a multisociety effort to guide physicians and define for payers the appropriate use of image-guided injections and radiofrequency procedures. An evidence panel was established to write systematic reviews, define key terms and assumptions, and develop clinical scenarios to be addressed. The rating panel considered the evidence presented in the systematic reviews, carefully reviewed the definitions and assumptions, and rated the clinical scenarios. Final median ratings, in combination with the level of agreement, determined the final ratings for the appropriate use of sacroiliac injections and radiofrequency neurotomy. More than 10,000 scenarios were addressed in the appropriate use criteria and are housed within five modules in the portal, available on the Spine Intervention Society website: Module 1: Clinical Indications and Imaging; Module 2: Anticoagulants; Module 3: Timing of Injections; Module 4: Number of Injections; and Module 5: Lateral Branch Radiofrequency Neurotomy. Within several of these modules, several issues of interest are identified and discussed. Physicians and payers can access the appropriate use criteria portal on the Spine Intervention Society's website and select specific clinical indications for a particular patient in order to learn more about the appropriateness of the intervention(s) under consideration. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. A TOTAL MANUFACTURING SOLUTIONS TECHNIQUE TO SELECT APPROPRIATE IMPROVEMENT STRATEGY: CASE STUDY OF A FOOTWEAR FACTORY

    Directory of Open Access Journals (Sweden)

    Gezahegn Tesfaye

    2014-09-01

    Full Text Available The Government of Ethiopia is promoting the manufacturing sector to join the global market in a large scale. Due to its comparative advantages, the Ethiopian leather and leather products industry have been given due attention. To fully utilize such advantages, the country shifted its export items from hides/skins to footwear products. Nevertheless, the performance of the leather sector in general and footwear sub-sector in particular is far below the desired standards. The improvement strategies applied hitherto were mainly to tackle a small portion of their total problems. If the Ethiopian footwear companies have to become globally competitive, their entire business spectrum has to be assessed and appropriate improvement strategies must be selected. In this research, we used a Total manufacturing solutions (TMS technique to identify areas of improvement and improvement strategy of one of Ethiopian footwear companies. For this purpose, we conducted two surveys using structured questionnaire. The first survey was to test the TMS technique against the context of footwear industry. The result proved that the original TMS model can be used to measure the performance of footwear companies. The second survey was done to identify company's total problems, map its current position and select appropriate improvement strategy. The result revealed that the company has company-wide problems and its current position is a plodder. For plodders which have company-wide problems, the improvement strategy must include aggressive application of BPR; and the implementation of best practices to develop workers skills that encourages networking and promotion, a market-led manufacturing strategy, employee involvement and team work cultures. According to the findings of this research, we suggested that a BPR technique followed by a continuous improvement programme could be an appropriate improvement strategy for this company. The company requires long-term improvement

  19. List identifies threatened ecosystems

    Science.gov (United States)

    Showstack, Randy

    2012-09-01

    The International Union for Conservation of Nature (IUCN) announced on 9 September that it will develop a new Red List of Ecosystems that will identify which ecosystems are vulnerable or endangered. The list, which is modeled on the group's Red List of Threatened Species™, could help to guide conservation activities and influence policy processes such as the Convention on Biological Diversity, according to the group. “We will assess the status of marine, terrestrial, freshwater, and subterranean ecosystems at local, regional, and global levels,” stated Jon Paul Rodriguez, leader of IUCN's Ecosystems Red List Thematic Group. “The assessment can then form the basis for concerted implementation action so that we can manage them sustainably if their risk of collapse is low or restore them if they are threatened and then monitor their recovery.”

  20. Global Microbial Identifier

    DEFF Research Database (Denmark)

    Wielinga, Peter; Hendriksen, Rene S.; Aarestrup, Frank Møller

    2017-01-01

    ) will likely also enable a much better understanding of the pathogenesis of the infection and the molecular basis of the host response to infection. But the full potential of these advances will only transpire if the data in this area become transferable and thereby comparable, preferably in open-source...... of microorganisms, for the identification of relevant genes and for the comparison of genomes to detect outbreaks and emerging pathogens. To harness the full potential of WGS, a shared global database of genomes linked to relevant metadata and the necessary software tools needs to be generated, hence the global...... microbial identifier (GMI) initiative. This tool will ideally be used in amongst others in the diagnosis of infectious diseases in humans and animals, in the identification of microorganisms in food and environment, and to track and trace microbial agents in all arenas globally. This will require...

  1. Generation Y students: Appropriate learning styles and teaching ...

    African Journals Online (AJOL)

    Generation Y students (born after 1982) have developed a different set of attitudes and aptitudes as a result of growing up in an IT and media-rich environment. This article has two objectives: firstly to discuss the learning styles preferred by generation Y students in order to identify the effect of these preferences on tertiary ...

  2. [Appropriateness of ketorolac use in a trauma hospital].

    Science.gov (United States)

    Angeles González-Fernández, M

    2009-06-01

    To evaluate the suitability of ketorolac and non-steroidal anti-inflamatory drugs (NSAIDs) and other analgesic drugs currently used in the hospital. We have followed the steps to develop a PDCA cycle (plan, do, check, act) or quality improvement cycle. The quality problem was analysed using an Ishikawa diagram. We defined both qualitative quality indicators, those that measure prescription quality, and quantitative ones (defined daily dose, DDD/100BDs), which measure drug consumption, being the objectives to achieve. The study was conducted in all patients admitted to the hospital and who were admitted to orthopaedic and trauma surgery and plastic surgery departments with unit-dose dispensing systems. The strategy used was to give information to physicians through meetings and documentation. Finally, the results were analysed and compared with the initial objectives. The study was performed on 260 patients in the first study period and 292 in the second. Qualitative indicators: intravenous ketorolac use or =65 years old at dose < or =60 mg/day it increased 27.7% (p<0.05). Quantitative indicators: in the second study period, ketorolac use decreased (plastic surgery department: 61.8 DDD/100BDs to 14.8), whereas tramadol, ibuprofen and metamizole increased (plastic surgery department: 0 to 14.1 in tramadol, 8.7 to 48.6 in ibuprofen and 50.1 to 71 in metamizole). Appropriateness of ketorolac, NSAIDs and tramadol use has been achieved, thus improving patient safety. Strategies have been effective.

  3. Appropriate Separator Sizing: A Modified Stewart and Arnold Method

    Directory of Open Access Journals (Sweden)

    F. Boukadi

    2012-01-01

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

  4. Cambridge Polytrauma Pathway: Are we making appropriately guided decisions?

    Science.gov (United States)

    Wynell-Mayow, William; Guevel, Borna; Quansah, Benjamin; O'Leary, Ronan; Carrothers, Andrew D

    2016-10-01

    Addenbrooke's Hospital, the Major Trauma Centre for the East of England Trauma Network, received 1070 major trauma patients between 1st January and 31st December 2014. In order to improve care, an audit was performed of 59 patients meeting our own selection criteria for orthopaedic polytrauma between 1st January 2013 and 31st December 2013. The Cambridge Polytrauma Pathway was devised through NCEPOD guidelines, literature review, internal and external discussion. It facilitates provision of best practice Early Appropriate Care, encompassing - multidisciplinary consultant decisions around the patient in our Neurological and Trauma Critical Care Unit, early full body trauma CT scans, serial measurements of lactate and fibrinogen levels, and out-of-hours orthopaedic theatre reserved for life-and-limb threatening injuries. Re-audit was conducted of 15 patients meeting selection criteria, admitted between 1st October 2014 and 31st March 2015. Significant improvements in recording of lactate and fibrinogen were demonstrated, both on admission (lactate - ppolytrauma patients and it is recommended that either the GOS-E, or the EQ-5D scoring systems be introduced to assess this. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  5. Sugammadex: Appropriate Use in the Context of Budgetary Constraints.

    Science.gov (United States)

    Cammu, Guy

    2018-01-01

    The purpose of this review is to assess how sugammadex impacts postoperative residual curarization using appropriate doses based on neuromuscular transmission monitoring and whether the advantages of sugammadex versus neostigmine outweigh its higher cost. An accurate assessment of neuromuscular blockade with monitoring is necessary before selecting neostigmine versus sugammadex for reversal at the end of surgery to overcome incomplete neuromuscular recovery. The main advantages of sugammadex over neostigmine are its predictability and its ability to extend the range of blockade reversal. The cost of sugammadex is greater when higher doses of sugammadex are required for antagonism of deep block. Sugammadex probably has the potential to be cost-effective compared with neostigmine if its time savings are put to productive use in clinical practice. However, to date, the economic benefits of the drug are unknown. With sugammadex, almost any degree of neuromuscular block can be antagonized within 2-3 min; neostigmine is the only reversal agent effective against benzylisoquinolines and can ideally be used for reversal of lower levels of residual paralysis. The performance of the more expensive sugammadex on improving patient outcomes may depend on several elements of clinical strategy.

  6. SUSTAINABLE URBAN LANDSCAPE: AN APPROACH FOR ASSESSING AND APPROPRIATING INDICATORS

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Amin

    2012-07-01

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

  7. Survey of appropriate endothermic processes for association with the HTR

    International Nuclear Information System (INIS)

    Brown, G.; Harrison, G.E.; Gent, C.W.; Plummer, J.

    1975-01-01

    Emphasis is placed on association of the HTR system as a heat source with chemical processes requiring temperatures up to 850 to 900 0 C, corresponding to a reactor coolant temperature of 950 0 C, though processes requiring temperatures up to 1100 0 C and above are reviewed. Particular attention is given to processes for the production of hydrogen-containing gases, including coal/lignite gasification which has been the subject of a recent study. Rising fuel prices make the HTR an attractive proposition if design concepts and materials can be developed to match the requirements. Other appropriate endothermic processes considered are oil processing, including tar sands and shales, and also energy production. Since the full temperature range of the reactor system must be utilised mention is made of low grade heat uses. Even very large chemical works have relatively small energy requirement by nuclear heat standards and adoption of the HTR as a heat source is likely only if it is associated with a large chemical/metallurgical complex or with the processing of a natural resource. (author)

  8. Hepatitis B virus reactivation during immunosuppressive therapy: Appropriate risk stratification.

    Science.gov (United States)

    Seto, Wai-Kay

    2015-04-28

    Our understanding of hepatitis B virus (HBV) reactivation during immunosuppresive therapy has increased remarkably during recent years. HBV reactivation in hepatitis B surface antigen (HBsAg)-positive individuals has been well-described in certain immunosuppressive regimens, including therapies containing corticosteroids, anthracyclines, rituximab, antibody to tumor necrosis factor (anti-TNF) and hematopoietic stem cell transplantation (HSCT). HBV reactivation could also occur in HBsAg-negative, antibody to hepatitis B core antigen (anti-HBc) positive individuals during therapies containing rituximab, anti-TNF or HSCT.For HBsAg-positive patients, prophylactic antiviral therapy is proven to the effective in preventing HBV reactivation. Recent evidence also demonstrated entecavir to be more effective than lamivudine in this aspect. For HBsAg-negative, anti-HBc positive individuals, the risk of reactivations differs with the type of immunosuppression. For rituximab, a prospective study demonstrated the 2-year cumulative risk of reactivation to be 41.5%, but prospective data is still lacking for other immunosupressive regimes. The optimal management in preventing HBV reactivation would involve appropriate risk stratification for different immunosuppressive regimes in both HBsAg-positive and HBsAg-negative, anti-HBc positive individuals.

  9. Developing a culturally appropriate mental health care service for Samoa.

    Science.gov (United States)

    Enoka, Matamua Iokapeta Sina; Tenari, Aliilelei; Sili, Tupou; Peteru, Latama; Tago, Pisaina; Blignault, Ilse

    2013-06-01

    Mental Health Care Services are part of the National Health Services for Samoa. Their function is to provide mental health care services to the population of Samoa, which numbers 180,000 people. However, like many other countries in the Pacific region, mental health is considered a low priority. The mental health budget allocation barely covers the operation of mental health care services. More broadly, there is a lack of political awareness about mental health care services and mental health rarely becomes an issue of deliberation in the political arena. This article outlines the recent development of mental health care services in Samoa, including the Mental Health Policy 2006 and Mental Health Act 2007. It tells the story of the successful integration of aiga (family) as an active partner in the provision of care, and the development of the Aiga model utilizing Samoan cultural values to promote culturally appropriate family-focused community mental health care for Samoa. Mental Health Care Services today encompass both clinical and family-focused community mental health care services. The work is largely nurse-led. Much has been achieved over the past 25 years. Increased recognition by government and increased resourcing are necessary to meet the future health care needs of the Samoan people. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

  10. Evaluating the Appropriateness and Use of Domain Critical Errors

    Directory of Open Access Journals (Sweden)

    Chad W. Buckendahl

    2012-10-01

    Full Text Available The consequences associated with the uses and interpretations of scores for many credentialing testing programs have important implications for a range of stakeholders. Within licensure settings specifically, results from examination programs are often one of the final steps in the process of assessing whether individuals will be allowed to enter practice. This article focuses on the concept of domain critical errors and suggests a framework for considering their use in practice. Domain critical errors are defined here as knowledge, skills, abilities, or judgments that are essential to the definition of minimum qualifications in a testing program's pass-'fail decision-making process. Using domain critical errors has psychometric and policy implications, particularly for licensure programs that are mandatory for entry-level practice. Because these errors greatly influence pass-'fail decisions, the measurement community faces an ongoing challenge to promote defensible practices while concurrently providing assessment literacy development about the appropriate design and use of testing methods like domain critical errors.

  11. Understanding the concept of nationally appropriate mitigation action

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S.; Desgain, D.

    2013-05-15

    This publication is intended to enable national policy makers and other stakeholders, such as the private sector and technical experts, to acquaint themselves with the concept of NAMA. It aims to provide a comprehensive overview of the Nationally Appropriate Mitigation Action (NAMA) concept and enhance the understanding of NAMAs by explaining the underlying decisions of the Conference of the Parties in layman's terms. The first chapter describes how the concept of NAMA emerged in the context of the negotiations on climate change. The chapter gives an overview of how the concepts of NAMA and related MRV and financing issues have evolved through the different COPs. The second chapter clarifies the understanding of NAMAs in the context of the global temperature goal, and moves on to discuss the legal nature and scope of NAMAs. The chapter subsequently analyses the diversity of NAMAs submitted by developing countries to the UNFCCC, and ends by proposing a structure for formal submission of a NAMA. The third chapter specifically addresses the concept of measurement, reporting and verification (MRV), and describes the implications for countries implementing the MRV requirements. The last chapter discusses institutional arrangements, under the Convention, for providing financing to develop and implement NAMAs. The chapter also briefly discusses the different financial sources for implementing NAMAs, and concludes by explaining the concept of incremental cost in this specific context. (Author)

  12. Appropriate treatment of acute sigmoid volvulus in the emergency setting

    Science.gov (United States)

    Lou, Zheng; Yu, En-Da; Zhang, Wei; Meng, Rong-Gui; Hao, Li-Qiang; Fu, Chuan-Gang

    2013-01-01

    AIM: To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency setting. METHODS: A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery, Changhai Hospital, Shanghai from January 2001 to July 2012 was performed. Following the diagnosis of acute sigmoid volvulus, an initial colonoscopic approach was adopted if there was no evidence of diffuse peritonitis. RESULTS: Of the 28 patients with acute sigmoid volvulus, 19 (67.9%) were male and 9 (32.1%) were female. Their mean age was 63.1 ± 22.9 years (range, 21-93 years). Six (21.4%) patients had a history of abdominal surgery, and 17 (60.7%) patients had a history of constipation. Abdominal radiography or computed tomography was performed in all patients. Colonoscopic detorsion was performed in all 28 patients with a success rate of 92.8% (26/28). Emergency surgery was required in the other two patients. Of the 26 successfully treated patients, seven (26.9%) had recurrent volvulus. CONCLUSION: Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid volvulus. Emergency surgery is only for patients in whom nonoperative treatment is unsuccessful, or in those with peritonitis. PMID:23946604

  13. Who owns urban waste? Appropriation conflicts in emerging countries.

    Science.gov (United States)

    Cavé, Jérémie

    2014-09-01

    Managing solid waste in developing cities is not an easy task and many public policies have failed to bring the expected results. It is here argued that comprehending the solid waste handling in the South implies reconsidering the proper definition of waste. Where does the product end and where does rubbish begin? The answer to this question is far from being obvious. Solid waste appears as a blurred concept. Such a thorny issue is all the more relevant today, as municipal solid waste management approaches in the developing world are being reformulated: dumping sites are banned, sanitary landfills are imposed, and separate collection is being introduced. The current sector transformations are here analysed through a novel theoretical analysis combined with an original qualitative and quantitative empirical work. Through two case-studies of one-million inhabitant cities from emerging countries, it is shown that if appropriation conflicts arise that is because the urban solid waste deposit in Southern countries can be defined as an impure public good. This issue does not only involve private service operators and informal wastepickers; several other actors covet the urban solid waste deposit's cream, that is, recyclable items. In emerging countries, huge industrial groups are starting to target domestic recyclable waste as an alternative for raw materials, which costs are increasing ever more. © The Author(s) 2014.

  14. Tracer methodology: an appropriate tool for assessing compliance with accreditation standards?

    Science.gov (United States)

    Bouchard, Chantal; Jean, Olivier

    2017-10-01

    Tracer methodology has been used by Accreditation Canada since 2008 to collect evidence on the quality and safety of care and services, and to assess compliance with accreditation standards. Given the importance of this methodology in the accreditation program, the objective of this study is to assess the quality of the methodology and identify its strengths and weaknesses. A mixed quantitative and qualitative approach was adopted to evaluate consistency, appropriateness, effectiveness and stakeholder synergy in applying the methodology. An online questionnaire was sent to 468 Accreditation Canada surveyors. According to surveyors' perceptions, tracer methodology is an effective tool for collecting useful, credible and reliable information to assess compliance with Qmentum program standards and priority processes. The results show good coherence between methodology components (appropriateness of the priority processes evaluated, activities to evaluate a tracer, etc.). The main weaknesses are the time constraints faced by surveyors and management's lack of cooperation during the evaluation of tracers. The inadequate amount of time allowed for the methodology to be applied properly raises questions about the quality of the information obtained. This study paves the way for a future, more in-depth exploration of the identified weaknesses to help the accreditation organization make more targeted improvements to the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Working with culture: culturally appropriate mental health care for Asian Americans.

    Science.gov (United States)

    Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

    2011-11-01

    The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

  16. Basketball training increases striatum volume.

    Science.gov (United States)

    Park, In Sung; Lee, Kea Joo; Han, Jong Woo; Lee, Nam Joon; Lee, Won Teak; Park, Kyung Ah; Rhyu, Im Joo

    2011-02-01

    The striatum is associated with the learning and retention of motor skills. Several studies have shown that motor learning induces neuronal changes in the striatum. We investigated whether macroscopic change in striatum volume occurs in a segment of the human population who learned basketball-related motor skills and practiced them throughout their entire athletic life. Three-dimensional magnetic resonance imaging volumetry was performed in basketball players and healthy controls, and striatum volumes were compared based on basketball proficiency, region and side. We identified morphological enlargement in the striatum of basketball players in comparison with controls. Our results suggest that continued practice and repetitive performance of basketball-related motor skills may induce plastic structural changes in the human striatum. Copyright © 2010 Elsevier B.V. All rights reserved.

  17. Estimating traffic volume on Wyoming low volume roads using linear and logistic regression methods

    Directory of Open Access Journals (Sweden)

    Dick Apronti

    2016-12-01

    Full Text Available Traffic volume is an important parameter in most transportation planning applications. Low volume roads make up about 69% of road miles in the United States. Estimating traffic on the low volume roads is a cost-effective alternative to taking traffic counts. This is because traditional traffic counts are expensive and impractical for low priority roads. The purpose of this paper is to present the development of two alternative means of cost-effectively estimating traffic volumes for low volume roads in Wyoming and to make recommendations for their implementation. The study methodology involves reviewing existing studies, identifying data sources, and carrying out the model development. The utility of the models developed were then verified by comparing actual traffic volumes to those predicted by the model. The study resulted in two regression models that are inexpensive and easy to implement. The first regression model was a linear regression model that utilized pavement type, access to highways, predominant land use types, and population to estimate traffic volume. In verifying the model, an R2 value of 0.64 and a root mean square error of 73.4% were obtained. The second model was a logistic regression model that identified the level of traffic on roads using five thresholds or levels. The logistic regression model was verified by estimating traffic volume thresholds and determining the percentage of roads that were accurately classified as belonging to the given thresholds. For the five thresholds, the percentage of roads classified correctly ranged from 79% to 88%. In conclusion, the verification of the models indicated both model types to be useful for accurate and cost-effective estimation of traffic volumes for low volume Wyoming roads. The models developed were recommended for use in traffic volume estimations for low volume roads in pavement management and environmental impact assessment studies.

  18. De Minimis Thresholds for Federal Building Metering Appropriateness

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, Jordan W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-03-31

    The U.S. Department of Energy (DOE) is required by statute and Presidential Memorandum to establish guidelines for agencies to meter their Federal buildings for energy (electricity, natural gas, and steam) and water. See 42 U.S.C. § 8253(e). DOE issued guidance in February 2006 on the installation of electric meters in Federal buildings. A recent update to the 2006 guidance accounts for more current metering practices within the Federal Government. The updated metering guidance specifies that all Federal buildings shall be considered “appropriate” for energy or water metering unless identified for potential exclusion. In developing the updated guidance to carry out the statue, Congress also directed DOE to (among other things) establish exclusions from the metering requirements based on the de minimis quantity of energy use of a Federal building, industrial process, or structure. This paper discusses the method used to identify de minimis values.

  19. Radiograph identifying means

    International Nuclear Information System (INIS)

    Sheldon, A.D.

    1983-01-01

    A flexible character-indentable plastics embossing tape is backed by and bonded to a lead strip, not more than 0.025 inches thick, to form a tape suitable for identifying radiographs. The lead strip is itself backed by a relatively thin and flimsy plastics or fabric strip which, when removed, allows the lead plastic tape to be pressure-bonded to the surface to be radiographed. A conventional tape-embossing gun is used to indent the desired characters in succession into the lead-backed tape, without necessarily severing the lead; and then the backing strip is peeled away to expose the layer of adhesive which pressure-bonds the indented tape to the object to be radiographed. X-rays incident on the embossed tape will cause the raised characters to show up dark on the subsequently-developed film, whilst the raised side areas will show up white. Each character will thus stand out on the developed film. (author)

  20. Appropriate bare potentials for studying fusion induced by 6He

    International Nuclear Information System (INIS)

    Crema, E; Chamon, L.C; Gomes, P.R.S.

    2007-01-01

    Although there are some recent studies questioning the use of the same optical potential to explain simultaneously fusion and quasi-elastic experimental data [1] or even to explain deep sub-barrier- and above-barrier fusion [2], during the last decades, the bare nuclear interaction between the nuclei at near barrier energies has been widely represented by a frozen potential with a Woods-Saxon shape. Another well established fact is the strong dependence of nuclear reaction calculations on the choice of the primary interaction. Of course, comparison between data and theoretical calculations are strongly potential-dependent. So, the choice of an appropriate nuclear bare interaction between two colliding nuclei, although it is a difficult task, is a crucial step in the data interpretation. As one has not direct access to the true bare potential, some procedures have been developed in order to constrain the choice of the bare potential to be used. The first procedure is the analysis of the elastic scattering data within the context of an optical potential, where an imaginary potential is added to the real potential, in order to take into account the flux deviated from the elastic channel. The optical potential that gives the best fit to the elastic scattering data is then used to describe other reaction channels, even in coupled channel calculations including inelastic and transfer reactions in the coupling matrix. However, this kind of calculation suffers from several inconsistencies. Another procedure that has been widely used to obtain the bare potential is the fit of the high-energy fusion data by a single barrier penetration model (BPM). However this method also has its uncertainties, since there might be channels that hinder the fusion cross section at energies near and above the Coulomb barrier. Hence, the bare potential extracted through this method can be contaminated by different processes. The derivation of experimental barrier distributions probably is the

  1. Selection of appropriate template for spatial normalization of brain images: tensor based morphometry

    International Nuclear Information System (INIS)

    Lee, Jae Sung; Lee, Dong Soo; Kim, Yu Kyeong; Chung, June Key; Lee, Myung Chul

    2004-01-01

    Although there have been remarkable advances in spatial normalization techniques, the differences in the shape of the hemispheres and the sulcal pattern of brains relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques. T1 SPGR MR images in 16 elderly male normal volunteers (>55 y. mean age: = 61.8 ± 3.5 y) were spatially normalized onto the age/gender specific Korean templates, and the Caucasian MNI template and the extent of the deformations were compared. These particular subjects were never included in the development of the templates. First , the images were matched into the templates using an affine transformation to eliminate the global difference between the templates and source images. Second the affine registration was followed by an estimation of nonlinear deformation. Determinants of the Jacobian matrices of the nonlinear deformation were then calculated for every voxel to estimate the regional volume change during the nonlinear transformation Jacobian determinant images highlighted the great magnitude of the relative local volume changes obtained when the elderly brains were spatially normalized onto the young/midlife male or female templates. They reflect the enlargement of CSF space in the lateral ventricles, sylvian fissures and cisterna magna, and the shrinkage of the cortex noted mainly in frontal, insular and lateral temporal cortexes, and the cerebellums in the aged brains. In the Jacobian determinant images, a regional shrinkage of the brain in the left middle prefrontal cortex was observed in addition to the regional expansion in the ventricles and sylvian fissures, which may be due to the age differences between the template and source images. The regional anatomical difference between template and source images could impose an extreme deformation of the source images during the spatial normalization and therefore. Individual brains should be placed into the appropriate template

  2. Selection of appropriate template for spatial normalization of brain images: tensor based morphometry

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Sung; Lee, Dong Soo; Kim, Yu Kyeong; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2004-07-01

    Although there have been remarkable advances in spatial normalization techniques, the differences in the shape of the hemispheres and the sulcal pattern of brains relative to age, gender, races, and diseases cannot be fully overcome by the nonlinear spatial normalization techniques. T1 SPGR MR images in 16 elderly male normal volunteers (>55 y. mean age: = 61.8 {+-} 3.5 y) were spatially normalized onto the age/gender specific Korean templates, and the Caucasian MNI template and the extent of the deformations were compared. These particular subjects were never included in the development of the templates. First , the images were matched into the templates using an affine transformation to eliminate the global difference between the templates and source images. Second the affine registration was followed by an estimation of nonlinear deformation. Determinants of the Jacobian matrices of the nonlinear deformation were then calculated for every voxel to estimate the regional volume change during the nonlinear transformation Jacobian determinant images highlighted the great magnitude of the relative local volume changes obtained when the elderly brains were spatially normalized onto the young/midlife male or female templates. They reflect the enlargement of CSF space in the lateral ventricles, sylvian fissures and cisterna magna, and the shrinkage of the cortex noted mainly in frontal, insular and lateral temporal cortexes, and the cerebellums in the aged brains. In the Jacobian determinant images, a regional shrinkage of the brain in the left middle prefrontal cortex was observed in addition to the regional expansion in the ventricles and sylvian fissures, which may be due to the age differences between the template and source images. The regional anatomical difference between template and source images could impose an extreme deformation of the source images during the spatial normalization and therefore. Individual brains should be placed into the appropriate

  3. Identifiability of PBPK Models with Applications to ...

    Science.gov (United States)

    Any statistical model should be identifiable in order for estimates and tests using it to be meaningful. We consider statistical analysis of physiologically-based pharmacokinetic (PBPK) models in which parameters cannot be estimated precisely from available data, and discuss different types of identifiability that occur in PBPK models and give reasons why they occur. We particularly focus on how the mathematical structure of a PBPK model and lack of appropriate data can lead to statistical models in which it is impossible to estimate at least some parameters precisely. Methods are reviewed which can determine whether a purely linear PBPK model is globally identifiable. We propose a theorem which determines when identifiability at a set of finite and specific values of the mathematical PBPK model (global discrete identifiability) implies identifiability of the statistical model. However, we are unable to establish conditions that imply global discrete identifiability, and conclude that the only safe approach to analysis of PBPK models involves Bayesian analysis with truncated priors. Finally, computational issues regarding posterior simulations of PBPK models are discussed. The methodology is very general and can be applied to numerous PBPK models which can be expressed as linear time-invariant systems. A real data set of a PBPK model for exposure to dimethyl arsinic acid (DMA(V)) is presented to illustrate the proposed methodology. We consider statistical analy

  4. Variable volume combustor

    Science.gov (United States)

    Ostebee, Heath Michael; Ziminsky, Willy Steve; Johnson, Thomas Edward; Keener, Christopher Paul

    2017-01-17

    The present application provides a variable volume combustor for use with a gas turbine engine. The variable volume combustor may include a liner, a number of micro-mixer fuel nozzles positioned within the liner, and a linear actuator so as to maneuver the micro-mixer fuel nozzles axially along the liner.

  5. Postoperative volume balance

    DEFF Research Database (Denmark)

    Frost, H; Mortensen, C.R.; Secher, Niels H.

    2017-01-01

    In healthy humans, stroke volume (SV) and cardiac output (CO) do not increase with expansion of the central blood volume by head-down tilt or administration of fluid. Here, we exposed 85 patients to Trendelenburg's position about one hour after surgery while cardiovascular variables were determin...

  6. Volume Regulated Channels

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjær

    of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume...... but are also essential for a number of physiological processes such as proliferation, controlled cell death, migration and endocrinology. The thesis have been focusing on two Channels, namely the swelling activated Cl- channel (ICl, swell) and the transient receptor potential Vanilloid (TRPV4) channel. I: Cl......- serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

    Directory of Open Access Journals (Sweden)

    Yoshito Kawakatsu

    2017-02-01

    Full Text Available Abstract Background The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW. The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. Methods The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS. In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Results Factors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Conclusions Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate

  9. Assessing sensitivity to change: choosing the appropriate change coefficient

    Directory of Open Access Journals (Sweden)

    Stratford Paul W

    2005-04-01

    Full Text Available Abstract The past 20-years have seen the development and evaluation of many health status measures. Unlike the high standards demanded of those who conduct and report clinical intervention trials, the methodological rigor for studies examining the sensitivity to change of health status measures are less demanding. It is likely that the absence of a criterion standard for change in health status contributes to this shortcoming. To increase confidence in the results of these types of studies investigators have often calculated multiple change coefficients for the same patient sample. The purpose of this report is to identify the conflict that arises when multiple change coefficients are applied to the same patient sample. Three families of change coefficients based on different assumptions concerning the sample composition are identified: (1 the sample is homogeneous with respect to change; (2 subgroups of patients who truly change by different amounts exist; (3 individual patients, many of whom truly change by different amounts exist. We present several analyses which illustrate a major conceptual conflict: the signal (a measure's true ability to detect change for some of these coefficients appears in the noise term (measurement error of the others. We speculate that this dilemma occurs as a result of insufficient preparatory work such as pilot studies to establish the likely change characteristic of the patient population of interest. Uncertainty in the choice of change coefficient could be overcome by conducting pilot studies to ascertain the likely change characteristic of the population of interest. Once the population's change characteristic is identified, the choice of change coefficient should be clear.

  10. Decision Analysis System for Selection of Appropriate Decontamination Technologies

    International Nuclear Information System (INIS)

    Ebadian, M.A.; Boudreaux, J.F.; Chinta, S.; Zanakis, S.H.

    1998-01-01

    The principal objective for designing Decision Analysis System for Decontamination (DASD) is to support DOE-EM's endeavor to employ the most efficient and effective technologies for treating radiologically contaminated surfaces while minimizing personnel and environmental risks. DASD will provide a tool for environmental decision makers to improve the quality, consistency, and efficacy of their technology selection decisions. The system will facilitate methodical comparisons between innovative and baseline decontamination technologies and aid in identifying the most suitable technologies for performing surface decontamination at DOE environmental restoration sites

  11. Selection of an appropriately simple storm runoff model

    Directory of Open Access Journals (Sweden)

    A. I. J. M. van Dijk

    2010-03-01

    Full Text Available An appropriately simple event runoff model for catchment hydrological studies was derived. The model was selected from several variants as having the optimum balance between simplicity and the ability to explain daily observations of streamflow from 260 Australian catchments (23–1902 km2. Event rainfall and runoff were estimated from the observations through a combination of baseflow separation and storm flow recession analysis, producing a storm flow recession coefficient (kQF. Various model structures with up to six free parameters were investigated, covering most of the equations applied in existing lumped catchment models. The performance of alternative structures and free parameters were expressed in Aikake's Final Prediction Error Criterion (FPEC and corresponding Nash-Sutcliffe model efficiencies (NSME for event runoff totals. For each model variant, the number of free parameters was reduced in steps based on calculated parameter sensitivity. The resulting optimal model structure had two or three free parameters; the first describing the non-linear relationship between event rainfall and runoff (Smax, the second relating runoff to antecedent groundwater storage (CSg, and a third that described initial rainfall losses (Li, but which could be set at 8 mm without affecting model performance too much. The best three parameter model produced a median NSME of 0.64 and outperformed, for example, the Soil Conservation Service Curve Number technique (median NSME 0.30–0.41. Parameter estimation in ungauged catchments is likely to be challenging: 64% of the variance in kQF among stations could be explained by catchment climate indicators and spatial correlation, but corresponding numbers were a modest 45% for CSg, 21% for Smax and none for Li, respectively. In gauged catchments, better

  12. Appeal to fear in health care: appropriate or inappropriate?

    Science.gov (United States)

    Simpson, J Keith

    2017-01-01

    This paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use. Appeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use appeal to fear to promote subluxation awareness and thereby encourage the use of chiropractic treatment. Research supporting its use is equivocal; nevertheless, when used judiciously, appeal to fear probably has sufficient strengths to warrant its continued conditional use. When used to promote care for which there is no supporting evidence, its use is fallacious. Appeal to fear has been used in health promotion campaigns for sixty years or more with the intent of modifying behaviours. While there is evidence to suggest that appeal to fear may motivate some individuals to modify offending behaviour or adopt recommended behaviour there is growing resistance to the use of appeal to fear on ethical and psychological grounds. Using appeal to fear as a tool of persuasion can be valid or fallacious depending on the truth of the premises within the argument. When used to raise awareness about genuine health concerns such as smoking, drunk driving and hypertension appeal to fear is considered to be a valid approach with certain caveats. However, when appeal to fear, not based on evidence or reason, is used as motivator to get others to accept unnecessary interventions for unproven disorders, the use of appeal to fear is fallacious. In spite of the evidence against its use, it seems likely that appeal to fear will continue to be used in conjunction with other public awareness initiatives to modify recognized detrimental behaviours such as smoking and drunk driving as well as silent killers such as

  13. 18 CFR 367.4360 - Account 436, Appropriations of retained earnings.

    Science.gov (United States)

    2010-04-01

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

  14. Identifying Relevant Studies in Software Engineering

    DEFF Research Database (Denmark)

    Zhang, He; Ali Babar, Muhammad; Tell, Paolo

    2011-01-01

    Context: Systematic literature review (SLR) has become an important research methodology in software engineering since the introduction of evidence-based software engineering (EBSE) in 2004. One critical step in applying this methodology is to design and execute appropriate and effective search....... Objective: The main objective of the research reported in this paper is to improve the search step of undertaking SLRs in software engineering (SE) by devising and evaluating systematic and practical approaches to identifying relevant studies in SE. Method: We have systematically selected and analytically...

  15. Stereological analysis of nuclear volume in recurrent meningiomas

    DEFF Research Database (Denmark)

    Madsen, C; Schrøder, H D

    1994-01-01

    A stereological estimation of nuclear volume in recurrent and non-recurrent meningiomas was made. The aim was to investigate whether this method could discriminate between these two groups. We found that the mean nuclear volumes in recurrent meningiomas were all larger at debut than in any...... of the control tumors. The mean nuclear volume of the individual recurrent tumors appeared to change with time, showing a tendency to diminish. A relationship between large nuclear volume at presentation and number of or time interval between recurrences was not found. We conclude that measurement of mean...... nuclear volume in meningiomas might help identify a group at risk of recurrence....

  16. AISF-SIMTI Position Paper: The appropriate use of albumin in patients with liver cirrhosis.

    Science.gov (United States)

    2016-01-01

    The use of human albumin is common in hepatology since international scientific societies support its administration to treat or prevent severe complications of cirrhosis, such as the prevention of post-paracentesis circulatory dysfunction after large-volume paracentesis and renal failure induced by spontaneous bacterial peritonitis, and the treatment of hepatorenal syndrome in association with vasoconstrictors. However, these indications are often disregarded, mainly because the high cost of human albumin leads health authorities and hospital administrations to restrict its use. On the other hand, physicians often prescribe human albumin in patients with advanced cirrhosis for indications that are not supported by solid scientific evidence and/or are still under investigation in clinical trials. In order to implement appropriate prescription of human albumin and to avoid its futile use, the Italian Association for the Study of the Liver (AISF) and the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) nominated a panel of experts, who reviewed the available clinical literature and produced practical clinical recommendations for the use of human albumin in patients with cirrhosis. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2013-08-01

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

  18. Coronary CT angiography: How should physicians use it wisely and when do physicians request it appropriately?

    International Nuclear Information System (INIS)

    Sun Zhonghua; Aziz, Yang Faridah Abdul; Ng, Kwan-Hoong

    2012-01-01

    Coronary CT angiography has been increasingly used in the diagnosis of coronary artery disease due to rapid technological developments, which are reflected in the improved spatial and temporal resolution of the images. High diagnostic accuracy has been achieved with 64- and more slice CT scanners and in selected patients, coronary CT angiography is regarded as a reliable alternative to invasive coronary angiography. Although the tremendous contributions of coronary CT angiography to cardiac imaging are acknowledged, appropriate use of cardiac CT as the first line technique by physicians has not been well established. Optimal selection of cardiac CT is essential to ensure acquisition of valuable diagnostic information and avoid unnecessary invasive procedures. This is of paramount importance since cardiac CT not only involves patient risk assessment, prediction of major cardiac events, but also impacts physician decision-making on patient management. Applications of CT in cardiac imaging include coronary artery calcium scoring for predicting the patient risk of developing major cardiac events, followed by coronary CT angiography which is commonly used to determine the diagnostic and prognostic accuracy in the coronary artery disease. This review presents an overview of the applications of CT in cardiac imaging in terms of coronary calcium scoring and coronary CT angiography. Judicious use of both cardiac CT tools will be discussed with regard to their value in different patient risk groups with the aim of identifying the appropriate criteria for choosing a cardiac CT modality. An effective diagnostic pathway is finally recommended to physicians for appropriate selection of cardiac CT in clinical practice.

  19. Fostering appropriate reflective learning in an undergraduate radiography course

    International Nuclear Information System (INIS)

    Hamilton, John; Druva, Ruth

    2010-01-01

    Reflective learning is an important feature of many radiography courses. Writing tasks are used both to promote and monitor student reflective learning. However, students may not always fully understand the rationale behind this form of learning, nor have clear expectations about the writing required. This paper reports on an intervention to address issues identified in student reflective writing tasks based on clinical experiences. Lecturers noted a lack of depth in student observations and tendency to express criticism in a judgemental and self-righteous tone. In response to this, a workshop was developed to prepare students for reflective learning and to develop their awareness and skills in the reflective writing process. Potential areas of difficulty in reflective learning are considered in this article, as well as how to promote a critical perspective while also encouraging students to maintain a positive regard for the patients, practitioners and institutions that enable them to learn on clinical placement.

  20. Bedside teaching with unwell patients: Can it ever be appropriate?

    Science.gov (United States)

    Jayakumar, Nithish

    2017-03-01

    Bedside teaching has seen a decline in its popularity since the heady days of Boerhaave and Osler; a number of hurdles have been noted in the literature including time constraints on senior clinicians. While organizing a bedside teaching course for final-year medical students, it was apparent that the availability of suitable patients was also a limiting factor. Often, we would be turned away from patients with physical signs because they were deemed to be too unwell for an examination. However, the benefits to medical students of examining unwell patients with physical signs cannot be underestimated. Identifying the unwell patient, and the associated physical signs relevant to the underlying diagnosis, should be a priority; although simulation is increasingly being used in teaching, it cannot fully replicate the learning experience gained in bedside teaching. As long as the patient is not under duress, bedside teaching with unwell patients should be encouraged.

  1. Fostering appropriate reflective learning in an undergraduate radiography course

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, John, E-mail: john.hamilton@med.monash.edu.a [Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne (Australia); Druva, Ruth [Department of Medical Imaging and Radiation Sciences, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne (Australia)

    2010-11-15

    Reflective learning is an important feature of many radiography courses. Writing tasks are used both to promote and monitor student reflective learning. However, students may not always fully understand the rationale behind this form of learning, nor have clear expectations about the writing required. This paper reports on an intervention to address issues identified in student reflective writing tasks based on clinical experiences. Lecturers noted a lack of depth in student observations and tendency to express criticism in a judgemental and self-righteous tone. In response to this, a workshop was developed to prepare students for reflective learning and to develop their awareness and skills in the reflective writing process. Potential areas of difficulty in reflective learning are considered in this article, as well as how to promote a critical perspective while also encouraging students to maintain a positive regard for the patients, practitioners and institutions that enable them to learn on clinical placement.

  2. Annual Status Report on Nationally Appropriate Mitigation Actions (NAMAs) 2012

    Energy Technology Data Exchange (ETDEWEB)

    Haensel, G.; Roeser, F.; Hoehne, N. [Ecofys, Utrecht (Netherlands); Van Tilburg, X.; Cameron, L. [ECN Policy Studies, Amsterdam (Netherlands)] (eds.)

    2012-11-15

    The development of Nationally Appropriate Mitigation Actions (NAMAs) has increased significantly over the last few years. The flexibility of the NAMA mechanism is widely regarded as an opportunity to deliver benefits that go far beyond greenhouse gas (GHG) emission reductions. Many developing countries are developing pilot NAMAs that deliver important insights into the challenges of, and opportunities for, NAMA development from a national perspective. A few countries are already a step ahead and experiences gained from pilot NAMA development are feeding into the formulation of national climate change policies in which NAMAs are becoming a key element. To maintain the momentum in NAMA development, clear signs at the international level are needed that developed countries will follow through with their financial commitments made under the Copenhagen Accord. Without this financial support, NAMAs will not be able to realise their full potential and induce transformational change. The Annual Status Report on NAMAs 2012 is a continuation of previously published NAMA Status Reports. The report presents an overview of the state of play of NAMAs and of support activities for NAMA development and implementation. A new feature of the Annual Status Report on NAMAs 2012 is that it is produced as a joint effort by several organizations that are closely involved in analysing and supporting NAMA development processes worldwide. The Annual Status Report on NAMAs 2012 is written by authors from Ecofys, the Energy research Centre of the Netherlands, the Center of Clean Air Policy (CCAP), the World Resources Institute (WRI) and Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ). In the section on 'Selected contributions on NAMAs', each organization discusses a specific topic of interest in relation to NAMA development that is closely related to their current NAMA activities or that is expected to provide 'food for thought' on potential ways forward for

  3. Sparse PDF Volumes for Consistent Multi-Resolution Volume Rendering

    KAUST Repository

    Sicat, Ronell Barrera; Kruger, Jens; Moller, Torsten; Hadwiger, Markus

    2014-01-01

    This paper presents a new multi-resolution volume representation called sparse pdf volumes, which enables consistent multi-resolution volume rendering based on probability density functions (pdfs) of voxel neighborhoods. These pdfs are defined

  4. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  5. Savannah River Site Approved Site Treatment Plan, 2001 Annual Update (Volumes I and II)

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2001-04-30

    The Compliance Plan Volume (Volume I) identifies project activity scheduled milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

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

    Science.gov (United States)

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

    2004-01-01

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

  7. Dose-volume considerations in stereotaxic brain radiation therapy

    International Nuclear Information System (INIS)

    Houdek, P.V.; Schwade, J.G.; Pisciotta, V.J.; Medina, A.J.; Lewin, A.A.; Abitbol, A.A.; Serago, C.F.

    1988-01-01

    Although brain radiation therapy experience suggests that a gain in the therapeutic ratio may be achieved by optimizing the dose-volume relationship, no practical system for quantitative assessment of dose-volume data has been developed. This presentation describes the rationale for using the integral dose function for this purpose and demonstrates that with the use of a conventional treatment planning computer and a series of computed tomographic scans, first-order optimization of the dose-volume function can be accomplished in two steps: first, high-dose volume is minimized by selecting an appropriate treatment technique and tumor margin, and then dosage is maximized by calculating the brain tolerance dose as a function of the irradiated volume

  8. Is Early Appropriate Care of axial and femoral fractures appropriate in multiply-injured elderly trauma patients?

    Science.gov (United States)

    Reich, M S; Dolenc, A J; Moore, T A; Vallier, H A

    2016-09-26

    Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied. Patients aged ≤30 years (n = 114), 30 to 60 years (n = 184), and ≥60 years (n = 37) with Injury Severity Scores (ISS) ≥16 and unstable fractures of the pelvis, acetabulum, spine, and/or diaphyseal femur were treated within 36 h, provided they showed evidence of adequate resuscitation. ISS, Glasgow Coma Scale (GCS), and American Society of Anesthesiologists (ASA) classification were determined. Lactate, pH, and base excess (BE) were measured at 8-h intervals. Complications included pneumonia, pulmonary embolism (PE), acute renal failure, acute respiratory distress syndrome (ARDS), multiple organ failure (MOF), deep vein thrombosis, infection, sepsis, and death. Patients ≤30 years old (y/o) were more likely to sustain gunshot wounds (p = 0.039), while those ≥60 y/o were more likely to fall from a height (p = 0.002). Complications occurred at similar rates for patients ≤30 y/o, 30 to 60 y/o, and ≥60 y/o. There were no differences in lactate, pH, or BE at the time of surgery. For patients ≤30 y/o, there were increased overall complications if pH was <7.30 (p = 0.042) or BE <-6.0 (p = 0.049); patients ≥60 y/o demonstrated more sepsis if BE was <-6.0 (p = 0.046). EAC aims to definitively manage axial and femoral shaft fractures once patients have been adequately resuscitated to minimize complications. EAC is associated with comparable complication rates in young and elderly

  9. Organisational and extraorganisational determinants of volume of service delivery by English community pharmacies: a cross-sectional survey and secondary data analysis.

    Science.gov (United States)

    Hann, Mark; Schafheutle, Ellen I; Bradley, Fay; Elvey, Rebecca; Wagner, Andrew; Halsall, Devina; Hassell, Karen; Jacobs, Sally

    2017-10-10

    This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies. Linear and ordered logistic regression of linked national data from secondary sources-community pharmacy activity, socioeconomic and health need datasets-and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England. Annual dispensing volume; annual volume of medicines use reviews (MURs). National dataset (n=10 454 pharmacies): greater dispensing volume was significantly associated with pharmacy ownership type (large chains>independents>supermarkets), greater deprivation, higher local prevalence of cardiovascular disease and depression, older people (aged >75 years) and infants (aged 0-4 years) but lower prevalence of mental health conditions. Greater volume of MURs was significantly associated with pharmacy ownership type (large chains/supermarkets>independents), greater dispensing volume, and lower disease prevalence.Survey dataset (n=285 pharmacies; response=34.6%): greater dispensing volume was significantly associated with staffing, skill-mix, organisational culture, years open and greater deprivation. Greater MUR volume was significantly associated with pharmacy ownership type (large chains/supermarkets>independents), greater dispensing volume, weekly opening hours and lower asthma prevalence. Organisational and extraorganisational factors were found to impact differently on dispensing volume and MUR activity, the latter being driven more by corporate ownership than population need. While levels of staffing and skill-mix were associated with dispensing volume, they did not influence MUR activity. Despite recent changes to the contractual framework, the existing fee-for-service reimbursement may therefore not be the most appropriate for the delivery of cognitive (rather than supply) services, still appearing to incentivise quantity

  10. Pharmaceutical assistance in the enteral administration of drugs: choosing the appropriate pharmaceutical formulation

    Directory of Open Access Journals (Sweden)

    Gisele de Lima

    2009-03-01

    Full Text Available Objective: To study solid medications for oral delivery on the formulary of Hospital Israelita Albert Einstein (HIAE, investigating the  possibility of using these drugs through enteral feeding tubes, and recommending appropriate administration. Methods: Study carried out through survey of solid medications for oral delivery included on the formulary of HIAE, literature review, and analysis of medication monographs, manufacturer information and pharmacotechnical data of active ingredients and excipients. It was observed the factors that might hinder or complicate the administration of these drugs though enteral tubes, and was drawn an information chart with recommendations about drug administration in this context. Rresults: The study evaluated 234 medications; and the main problems of administering these drugs through enteral feeding tubes were as follows: changes in drug pharmacokinetics (38; gastrointestinal damage (9; risk of obstruction (40, drug-nutrient interactions (7; biological hazards (5 and no information (33. Cconclusions: Compiling this information helps the healthcare team to choose the appropriate pharmaceutical formulation for medications administered through enteral tubes, and may help identify adverse events related to this technique.

  11. Analysis of volatile organic compounds in compost samples: A potential tool to determine appropriate composting time.

    Science.gov (United States)

    Zhu, Fengxiang; Pan, Zaifa; Hong, Chunlai; Wang, Weiping; Chen, Xiaoyang; Xue, Zhiyong; Yao, Yanlai

    2016-12-01

    Changes in volatile organic compound contents in compost samples during pig manure composting were studied using a headspace, solid-phase micro-extraction method (HS-SPME) followed by gas chromatography with mass spectrometric detection (GC/MS). Parameters affecting the SPME procedure were optimized as follows: the coating was carbon molecular sieve/polydimethylsiloxane (CAR/PDMS) fiber, the temperature was 60°C and the time was 30min. Under these conditions, 87 compounds were identified from 17 composting samples. Most of the volatile components could only be detected before day 22. However, benzenes, alkanes and alkenes increased and eventually stabilized after day 22. Phenol and acid substances, which are important factors for compost quality, were almost undetectable on day 39 in natural compost (NC) samples and on day 13 in maggot-treated compost (MC) samples. Our results indicate that the approach can be effectively used to determine the composting times by analysis of volatile substances in compost samples. An appropriate composting time not only ensures the quality of compost and reduces the loss of composting material but also reduces the generation of hazardous substances. The appropriate composting times for MC and NC were approximately 22days and 40days, respectively, during the summer in Zhejiang. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Developing Criteria for Lumbar Spine Magnetic Resonance Imaging (MRI) Using RAND Appropriateness Method (RAM)

    International Nuclear Information System (INIS)

    Keshtkaran, Ali; Bagheri, Mohammad Hadi; Ostovar, Rahim; Salari, Hedayat; Farokhi, Majid Reza; Esfandiari, Atefeh; Yousefimanesh, Hossein

    2012-01-01

    Studies show that a large proportion of healthcare offered may be inappropriate or unnecessary. Magnetic resonance imaging (MRI) is a new and expensive diagnostic technology which has been increasingly used all over the world. Moreover, this trend has been more rapidly increasing in Iran. Low back pain is a common disorder all over the world and MRI technique is one of the several ways to assess its cause. The present study aims to develop scenarios for lumbar spine MRI. In the present study, the RAND Appropriateness Method (RAM) was used in order to reach consensus regarding developing scenarios for lumbar spine MRI. We generated scenarios from valid clinical guidelines as well as the experts’ opinion. The panel members included nine specialists from various medical specialties that had scored scenarios in two rounds, the first of which was without interaction, while the second one was with interaction. We extracted 97 scenarios for the lumbar spine MRI in the scenario extracting phase of the study and the panel members added 18 scenarios. After implementation of two rounds, the scenarios were categorized into three ranges. Sixty seven (58%) of the scenarios were considered as appropriate, 45 (39%) as uncertain, and three (2.6%) as inappropriate. RAM is useful for identifying stakeholder views in settings with limited resources. Since RAM has precise instructions for consensus developing, a large number of scenarios were considered as uncertain. Therefore, more research has to be conducted on the issue

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

    Science.gov (United States)

    Kendall, Elizabeth; Barnett, Leda

    2015-01-01

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

  14. Exegesis seeking appropriation; appropriation seeking exegesis: Re-reading 2 Samuel 13:1−22 in search of redemptive masculinities

    Directory of Open Access Journals (Sweden)

    Gerald West

    2013-09-01

    Full Text Available Exegesis in the traditional sense is concerned with generating as much (scientific detail about a biblical text as possible. Whilst the two primary modes of biblical exegesis � socio-historical and literary-semiotic � do this differently, they share a common concern for the detail of the text as an ancient artefact. Critical distance is a key concept here, with the exegetes bracketing (for a moment their own contexts and concerns. However, such bracketing is impossible to sustain, and so the exegetes� interests (shaped by their contexts and concerns �leak� into the act of exegesis. Most exegetes today recognise this leakage, and whilst some still view such leakage as contaminating the exegesis, others, including the tradition of African biblical scholarship, actively identify the contextual concerns they bring to the task of exegesis, both respecting the detail of the text and desiring to be accountable to their contexts in which the Bible is a significant text. This article explored some of the dimensions of forms of exegesis that actively seek appropriation, using 2 Samuel 13:1�22 as an example. In this case, the article analysed the contextual shift from a focus on women as the victims of sexual violence to an emerging emphasis on masculinities. Reading the same text from these different contextual concerns �activates� particular details of the text, and so both draw on different elements of the text and thus guides the gaze of exegesis.

  15. Integers annual volume 2013

    CERN Document Server

    Landman, Bruce

    2014-01-01

    ""Integers"" is a refereed online journal devoted to research in the area of combinatorial number theory. It publishes original research articles in combinatorics and number theory. This work presents all papers of the 2013 volume in book form.

  16. Volume 9 Number 1

    African Journals Online (AJOL)

    OLUWOLE

    Agro-Science Journal of Tropical Agriculture, Food, Environment and Extension. Volume 9 Number 1 ... of persistent dumping of cheap subsidized food imports from developed ... independence of the inefficiency effects in the two estimation ...

  17. Indications for Use of Damage Control Surgery in Civilian Trauma Patients: A Content Analysis and Expert Appropriateness Rating Study.

    Science.gov (United States)

    Roberts, Derek J; Bobrovitz, Niklas; Zygun, David A; Ball, Chad G; Kirkpatrick, Andrew W; Faris, Peter D; Brohi, Karim; D'Amours, Scott; Fabian, Timothy C; Inaba, Kenji; Leppäniemi, Ari K; Moore, Ernest E; Navsaria, Pradeep H; Nicol, Andrew J; Parry, Neil; Stelfox, Henry T

    2016-05-01

    To characterize and evaluate indications for use of damage control (DC) surgery in civilian trauma patients. Although DC surgery may improve survival in select, severely injured patients, the procedure is associated with significant morbidity, suggesting that it should be used only when appropriately indicated. Two investigators used an abbreviated grounded theory method to synthesize indications for DC surgery reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications. An international panel of trauma surgery experts (n = 9) then rated the appropriateness (expected benefit-to-harm ratio) of the coded indications for use in surgical practice. The 1107 indications identified in the literature were synthesized into 123 unique pre- (n = 36) and intraoperative (n = 87) indications. The panel assessed 101 (82.1%) of these indications to be appropriate. The indications most commonly reported and assessed to be appropriate included pre- and intraoperative hypothermia (median temperature 10 units), inability to close the abdominal wall without tension, development of abdominal compartment syndrome during attempted abdominal wall closure, and need to reassess extent of bowel viability. This study identified a comprehensive list of candidate indications for use of DC surgery. These indications provide a practical foundation to guide surgical practice while studies are conducted to evaluate their impact on patient care and outcomes.

  18. BP volume reduction equipment

    International Nuclear Information System (INIS)

    Kitamura, Yoshinori; Muroo, Yoji; Hamanaka, Isao

    2003-01-01

    A new type of burnable poison (BP) volume reduction system is currently being developed. Many BP rods, a subcomponent of spent fuel assemblies are discharged from nuclear power reactors. This new system reduces the overall volume of BP rods. The main system consists of BP rod cutting equipment, equipment for the recovery of BP cut pieces, and special transport equipment for the cut rods. The equipment is all operated by hydraulic press cylinders in water to reduce operator exposure to radioactivity. (author)

  19. Electroanalytical chemistry. Volume 14

    International Nuclear Information System (INIS)

    Bard, A.J.

    1986-01-01

    This volume is part of a series aimed at authoritative reviews of electroanalytical techniques and related areas of investigation. Volume 14 clearly maintains the high standards and proven usefulness of the series. Topics covered include conformation change and isomerization associated with electrode reactions, infrared vibrational spectroscopy of the electrode-solution interface, and precision in linear sweep and cyclic voltametry. A short history of electrochemical techniques which include the term square wave is provided

  20. Mitigation and adaptation cost assessment: Concepts, methods and appropriate use

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-12-31

    The present report on mitigation and adaptation costs addresses the complex issue of identifying synergies and tradeoffs between national priorities and mitigation policies, an issue that requires the integration of various disciplines so as to provide a comprehensive overview of future development trends, available technologies and economic policies. Further, the report suggests a new conceptual framework for treating the social aspects in assessing mitigation and adaptation costs in climate change studies. The impacts of certain sustainability indicators such as employment and poverty reduction on mitigation costing are also discussed in the report. Among the topics to be considered by over 120 distinguished international experts, are the elements of costing methodologies at both the micro and macro levels. Special effort will be made to include the impacts of such parameters as income, equity, poverty, employment and trade. Hence, the contents of this report are highly relevant to the authors of the Third Working Group in the development of the TAR. The report contains a chapter on Special Issues and Problems Related to Cost Assessment for Developing Countries. This chapter will provide valuable background in the further development of these concepts in the TAR because it is an area that has not received due attention in previous work. (au)

  1. Mitigation and adaptation cost assessment: Concepts, methods and appropriate use

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-31

    The present report on mitigation and adaptation costs addresses the complex issue of identifying synergies and tradeoffs between national priorities and mitigation policies, an issue that requires the integration of various disciplines so as to provide a comprehensive overview of future development trends, available technologies and economic policies. Further, the report suggests a new conceptual framework for treating the social aspects in assessing mitigation and adaptation costs in climate change studies. The impacts of certain sustainability indicators such as employment and poverty reduction on mitigation costing are also discussed in the report. Among the topics to be considered by over 120 distinguished international experts, are the elements of costing methodologies at both the micro and macro levels. Special effort will be made to include the impacts of such parameters as income, equity, poverty, employment and trade. Hence, the contents of this report are highly relevant to the authors of the Third Working Group in the development of the TAR. The report contains a chapter on Special Issues and Problems Related to Cost Assessment for Developing Countries. This chapter will provide valuable background in the further development of these concepts in the TAR because it is an area that has not received due attention in previous work. (au)

  2. Is empiric therapy with fluconazole appropriate for esophageal candidiasis?

    Science.gov (United States)

    Sajith, Kattiparambil Gangadharan; Dutta, Amit Kumar; Sahni, Rani Diana; Esakimuthu, Saritha; Chacko, Ashok

    2014-03-01

    We studied the prevalence of fluconazole resistance in esophageal candidiasis. Patients with suspected esophageal candidiasis during gastroscopy underwent culture of white plaques. Minimum inhibitory concentration (MIC) >64 μg/mL of fluconazole for Candida was indicative of resistance. Sensitivity of itraconazole was tested in a subset of resistant strains. Sixty-five patients were included. Mean (SD) age was 50.03 (13.5) years and 67.7 % were males. Predisposing factors for candidiasis were found in 42 (64.6 %) patients. C. albicans was identified in 64 (97.4 %) patients and C. glabrata in one patient. Fluconazole resistance was seen in 38 (59.4 %) patients with C. albicans and also in the one patient with C. glabrata. All the fluconazole resistant isolates of C. albicans had MIC >128 μg/mL suggesting very high resistance. Twelve patients with fluconazole resistance had itraconazole resistance as well. The study shows a high rate of fluconazole resistance in patients with esophageal candidiasis.

  3. Mitigation and adaptation cost assessment: Concepts, methods and appropriate use

    International Nuclear Information System (INIS)

    1998-01-01

    The present report on mitigation and adaptation costs addresses the complex issue of identifying synergies and tradeoffs between national priorities and mitigation policies, an issue that requires the integration of various disciplines so as to provide a comprehensive overview of future development trends, available technologies and economic policies. Further, the report suggests a new conceptual framework for treating the social aspects in assessing mitigation and adaptation costs in climate change studies. The impacts of certain sustainability indicators such as employment and poverty reduction on mitigation costing are also discussed in the report. Among the topics to be considered by over 120 distinguished international experts, are the elements of costing methodologies at both the micro and macro levels. Special effort will be made to include the impacts of such parameters as income, equity, poverty, employment and trade. Hence, the contents of this report are highly relevant to the authors of the Third Working Group in the development of the TAR. The report contains a chapter on Special Issues and Problems Related to Cost Assessment for Developing Countries. This chapter will provide valuable background in the further development of these concepts in the TAR because it is an area that has not received due attention in previous work. (au)

  4. Juvenile wood volume and its proportion to stem volume vs. selected biometric features of Scots pine (Pinus sylvestris L. trees

    Directory of Open Access Journals (Sweden)

    Arkadiusz Tomczak

    2011-01-01

    Full Text Available The aim of the study was to determine whether there is a correlation between breast height diameter, tree height and stem total volume of Scots pines, on the one hand, and volume and proportion of juvenile wood, on the other. The investigations comprised pure pine stands of the IInd, IIIrd, IVth and Vth age classes developed in conditions of fresh mixed coniferous forest. A distinct curvilinear correlation was found between volume and proportion of juvenile wood in tree stems and breast height diameter, height and stem total volume. Because of high values of determination coefficients (R2, which characterised the above-mentioned correlations, it seems appropriate to use these regularities to assess the quality of the timber raw material regarding the proportions of its volume and juvenile wood in stems of Scots pine trees.

  5. Increasing the Understanding and Demonstration of Appropriate Affection in Children with Asperger Syndrome: A Pilot Trial

    Directory of Open Access Journals (Sweden)

    Kate Sofronoff

    2011-01-01

    Full Text Available The study was conducted to examine relationships between affectionate behavior in children with Asperger syndrome and variables likely to influence its expression (e.g., tactile sensitivity, social ability. It also evaluated the impact of a cognitive behavioral intervention that aimed to improve a child's understanding and expression of affection. Twenty-one children, aged 7 to 12 years, participated in the trial. The results showed significant correlations between measures of affection and tactile sensitivity and social ability. After attending the 5-week program, parents identified significant increases in the appropriateness of children's affectionate behavior both towards immediate family and people outside the immediate family, despite reporting no significant changes in their child's general difficulties with affectionate behavior. There was a significant improvement in children's understanding of the purpose of affection. The findings are discussed as well as the limitations of the study.

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

    Directory of Open Access Journals (Sweden)

    Kabbara WK

    2015-04-01

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

  7. Use of manual alveolar recruitment maneuvers to eliminate atelectasis artifacts identified during thoracic computed tomography of healthy neonatal foals.

    Science.gov (United States)

    Lascola, Kara M; Clark-Price, Stuart C; Joslyn, Stephen K; Mitchell, Mark A; O'Brien, Robert T; Hartman, Susan K; Kline, Kevin H

    2016-11-01

    OBJECTIVE To evaluate use of single manual alveolar recruitment maneuvers (ARMs) to eliminate atelectasis during CT of anesthetized foals. ANIMALS 6 neonatal Standardbred foals. PROCEDURES Thoracic CT was performed on spontaneously breathing anesthetized foals positioned in sternal (n = 3) or dorsal (3) recumbency when foals were 24 to 36 hours old (time 1), 4 days old (time 2), 7 days old (time 3), and 10 days old (time 4). The CT images were collected without ARMs (all times) and during ARMs with an internal airway pressure of 10, 20, and 30 cm H 2 O (times 2 and 3). Quantitative analysis of CT images measured whole lung and regional changes in attenuation or volume with ARMs. RESULTS Increased attenuation and an alveolar pattern were most prominent in the dependent portion of the lungs. Subjectively, ARMs did not eliminate atelectasis; however, they did incrementally reduce attenuation, particularly in the nondependent portion of the lungs. Quantitative differences in lung attenuation attributable to position of foal were not identified. Lung attenuation decreased significantly (times 2 and 3) and lung volume increased significantly (times 2 and 3) after ARMs. Changes in attenuation and volume were most pronounced in the nondependent portion of the lungs and at ARMs of 20 and 30 cm H 2 O. CONCLUSIONS AND CLINICAL RELEVANCE Manual ARMs did not eliminate atelectasis but reduced attenuation in nondependent portions of the lungs. Positioning of foals in dorsal recumbency for CT may be appropriate when pathological changes in the ventral portion of the lungs are suspected.

  8. Reachable volume RRT

    KAUST Repository

    McMahon, Troy

    2015-05-01

    © 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.

  9. Ovarian volume throughout life

    DEFF Research Database (Denmark)

    Kelsey, Thomas W; Dodwell, Sarah K; Wilkinson, A Graham

    2013-01-01

    conception to 82 years of age. This model shows that 69% of the variation in ovarian volume is due to age alone. We have shown that in the average case ovarian volume rises from 0.7 mL (95% CI 0.4-1.1 mL) at 2 years of age to a peak of 7.7 mL (95% CI 6.5-9.2 mL) at 20 years of age with a subsequent decline...... to about 2.8 mL (95% CI 2.7-2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis......The measurement of ovarian volume has been shown to be a useful indirect indicator of the ovarian reserve in women of reproductive age, in the diagnosis and management of a number of disorders of puberty and adult reproductive function, and is under investigation as a screening tool for ovarian...

  10. Reachable volume RRT

    KAUST Repository

    McMahon, Troy; Thomas, Shawna; Amato, Nancy M.

    2015-01-01

    © 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.

  11. IOM and DHHS meeting on making clinical practice guidelines appropriate for patients with multiple chronic conditions.

    Science.gov (United States)

    Goodman, Richard A; Boyd, Cynthia; Tinetti, Mary E; Von Kohorn, Isabelle; Parekh, Anand K; McGinnis, J Michael

    2014-01-01

    The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are inattentive to issues related to comorbidities. In response to the need for guideline developers to address comorbidities in guidelines, the Department of Health and Human Services convened a meeting in May 2012 in partnership with the Institute of Medicine to identify principles and action options. Eleven principles to improve guidelines' attentiveness to the population with multiple chronic conditions were identified during the meeting. They are grouped into 3 interrelated categories: (1) principles intended to improve the stakeholder technical process for developing guidelines; (2) principles intended to strengthen content of guidelines in terms of multiple chronic conditions; and (3) principles intended to increase focus on patient-centered care. This meeting built upon previously recommended actions by identifying additional principles and options for government, guideline developers, and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with multiple chronic conditions. The suggested principles are helping professional societies to improve guidelines' attentiveness to persons with multiple chronic conditions.

  12. Evaluating which plan quality metrics are appropriate for use in lung SBRT.

    Science.gov (United States)

    Yaparpalvi, Ravindra; Garg, Madhur K; Shen, Jin; Bodner, William R; Mynampati, Dinesh K; Gafar, Aleiya; Kuo, Hsiang-Chi; Basavatia, Amar K; Ohri, Nitin; Hong, Linda X; Kalnicki, Shalom; Tome, Wolfgang A

    2018-02-01

    Several dose metrics in the categories-homogeneity, coverage, conformity and gradient have been proposed in literature for evaluating treatment plan quality. In this study, we applied these metrics to characterize and identify the plan quality metrics that would merit plan quality assessment in lung stereotactic body radiation therapy (SBRT) dose distributions. Treatment plans of 90 lung SBRT patients, comprising 91 targets, treated in our institution were retrospectively reviewed. Dose calculations were performed using anisotropic analytical algorithm (AAA) with heterogeneity correction. A literature review on published plan quality metrics in the categories-coverage, homogeneity, conformity and gradient was performed. For each patient, using dose-volume histogram data, plan quality metric values were quantified and analysed. For the study, the radiation therapy oncology group (RTOG) defined plan quality metrics were: coverage (0.90 ± 0.08); homogeneity (1.27 ± 0.07); conformity (1.03 ± 0.07) and gradient (4.40 ± 0.80). Geometric conformity strongly correlated with conformity index (p plan quality guidelines-coverage % (ICRU 62), conformity (CN or CI Paddick ) and gradient (R 50% ). Furthermore, we strongly recommend that RTOG lung SBRT protocols adopt either CN or CI Padddick in place of prescription isodose to target volume ratio for conformity index evaluation. Advances in knowledge: Our study metrics are valuable tools for establishing lung SBRT plan quality guidelines.

  13. Designing appropriate complementary feeding recommendations: tools for programmatic action.

    Science.gov (United States)

    Daelmans, Bernadette; Ferguson, Elaine; Lutter, Chessa K; Singh, Neha; Pachón, Helena; Creed-Kanashiro, Hilary; Woldt, Monica; Mangasaryan, Nuné; Cheung, Edith; Mir, Roger; Pareja, Rossina; Briend, André

    2013-09-01

    Suboptimal complementary feeding practices contribute to a rapid increase in the prevalence of stunting in young children from age 6 months. The design of effective programmes to improve infant and young child feeding requires a sound understanding of the local situation and a systematic process for prioritizing interventions, integrating them into existing delivery platforms and monitoring their implementation and impact. The identification of adequate food-based feeding recommendations that respect locally available foods and address gaps in nutrient availability is particularly challenging. We describe two tools that are now available to strengthen infant and young child-feeding programming at national and subnational levels. ProPAN is a set of research tools that guide users through a step-by-step process for identifying problems related to young child nutrition; defining the context in which these problems occur; formulating, testing, and selecting behaviour-change recommendations and nutritional recipes; developing the interventions to promote them; and designing a monitoring and evaluation system to measure progress towards intervention goals. Optifood is a computer-based platform based on linear programming analysis to develop nutrient-adequate feeding recommendations at lowest cost, based on locally available foods with the addition of fortified products or supplements when needed, or best recommendations when the latter are not available. The tools complement each other and a case study from Peru illustrates how they have been used. The readiness of both instruments will enable partners to invest in capacity development for their use in countries and strengthen programmes to address infant and young child feeding and prevent malnutrition. © 2013 John Wiley & Sons Ltd.

  14. SPARQL-enabled identifier conversion with Identifiers.org

    Science.gov (United States)

    Wimalaratne, Sarala M.; Bolleman, Jerven; Juty, Nick; Katayama, Toshiaki; Dumontier, Michel; Redaschi, Nicole; Le Novère, Nicolas; Hermjakob, Henning; Laibe, Camille

    2015-01-01

    Motivation: On the semantic web, in life sciences in particular, data is often distributed via multiple resources. Each of these sources is likely to use their own International Resource Identifier for conceptually the same resource or database record. The lack of correspondence between identifiers introduces a barrier when executing federated SPARQL queries across life science data. Results: We introduce a novel SPARQL-based service to enable on-the-fly integration of life science data. This service uses the identifier patterns defined in the Identifiers.org Registry to generate a plurality of identifier variants, which can then be used to match source identifiers with target identifiers. We demonstrate the utility of this identifier integration approach by answering queries across major producers of life science Linked Data. Availability and implementation: The SPARQL-based identifier conversion service is available without restriction at http://identifiers.org/services/sparql. Contact: sarala@ebi.ac.uk PMID:25638809

  15. SPARQL-enabled identifier conversion with Identifiers.org.

    Science.gov (United States)

    Wimalaratne, Sarala M; Bolleman, Jerven; Juty, Nick; Katayama, Toshiaki; Dumontier, Michel; Redaschi, Nicole; Le Novère, Nicolas; Hermjakob, Henning; Laibe, Camille

    2015-06-01

    On the semantic web, in life sciences in particular, data is often distributed via multiple resources. Each of these sources is likely to use their own International Resource Identifier for conceptually the same resource or database record. The lack of correspondence between identifiers introduces a barrier when executing federated SPARQL queries across life science data. We introduce a novel SPARQL-based service to enable on-the-fly integration of life science data. This service uses the identifier patterns defined in the Identifiers.org Registry to generate a plurality of identifier variants, which can then be used to match source identifiers with target identifiers. We demonstrate the utility of this identifier integration approach by answering queries across major producers of life science Linked Data. The SPARQL-based identifier conversion service is available without restriction at http://identifiers.org/services/sparql. © The Author 2015. Published by Oxford University Press.

  16. An audit of clinical practice, referral patterns, and appropriateness of clinical indications for brain MRI examinations: A single-centre study in Ghana.

    Science.gov (United States)

    Piersson, A D; Nunoo, G; Gorleku, P N

    2018-05-01

    The aim of this study was to investigate current brain MRI practice, pattern of brain MRI requests, and their appropriateness using the American College of Radiology (ACR) Appropriateness Criteria. We used direct observation and questionnaires to obtain data concerning routine brain MRI practice. We then retrospectively analyzed (i) demographic characteristics, (ii) clinical history, and (iii) appropriateness of brain MRI requests against published criteria. All patients were administered the screening questionnaire; however, no reviews were undertaken directly with patients, and no signature of the radiographer was recorded. Apart from routine brain protocol, there were dedicated protocols for epilepsy and stroke. Brain MRI images from 161 patients (85 Males; 76 Females) were analyzed. The age group with most brain MRI requests were from 26 to 45 year olds. The commonest four clinical indications for imaging were brain tumour, headache, seizure, and stroke. Using the ACR Appropriateness Criteria, almost 43% of the brain MRI scans analyzed were found to be "usually appropriate", 38% were "maybe appropriate" and 19% were categorized as "usually not appropriate". There was knowledge gap with regards to MRI safety in local practice, thus there is the utmost need for MRI safety training. Data on the commonest indications for performing brain MRI in this study should be used to inform local neuroradiological practice. Dedicated stroke and epilepsy MRI protocols require additional sequences i.e. MRA and 3D T1 volume acquisition, respectively. The ACR Appropriateness Criteria is recommended for use by the referring practitioners to improve appropriateness of brain MRI requests. Copyright © 2017 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  17. Obstacles using amorphous materials for volume applications

    Energy Technology Data Exchange (ETDEWEB)

    Kiessling, Albert [Festo AG and Co. KG, 73734, Esslingen (Germany); Reininger, Thomas, E-mail: drn@de.festo.com [Festo AG and Co. KG, 73734, Esslingen (Germany)

    2012-10-15

    This contribution is especially focussed on the attempt to use amorphous or nanocrystalline metals in position sensor applications and to describe the difficulties and obstacles encountered in coherence with the development of appropriate industrial high volume series products in conjunction with the related quality requirements. The main motivation to do these investigations was to beat the generally known sensors especially silicon based Hall-sensors as well as AMR- and GMR-sensors - well known from mobile phones and electronic storage devices like hard discs and others - in terms of cost-effectiveness and functionality.

  18. Right Ventricular Volumes and Systolic Function by Cardiac Magnetic Resonance and the Impact of Sex, Age, and Obesity in a Longitudinally Followed Cohort Free of Pulmonary and Cardiovascular Disease: The Framingham Heart Study.

    Science.gov (United States)

    Foppa, Murilo; Arora, Garima; Gona, Philimon; Ashrafi, Arman; Salton, Carol J; Yeon, Susan B; Blease, Susan J; Levy, Daniel; O'Donnell, Christopher J; Manning, Warren J; Chuang, Michael L

    2016-03-01

    Cardiac magnetic resonance is uniquely well suited for noninvasive imaging of the right ventricle. We sought to define normal cardiac magnetic resonance reference values and to identify the main determinants of right ventricular (RV) volumes and systolic function using a modern imaging sequence in a community-dwelling, longitudinally followed cohort free of clinical cardiovascular and pulmonary disease. The Framingham Heart Study Offspring cohort has been followed since 1971. We scanned 1794 Offspring cohort members using steady-state free precession cardiac magnetic resonance and identified a reference group of 1336 adults (64±9 years, 576 men) free of prevalent cardiovascular and pulmonary disease. RV trabeculations and papillary muscles were considered cavity volume. Men had greater RV volumes and cardiac output before and after indexation to body size (all Pheart rate account for most of the variability in RV volumes and function in this community-dwelling population. We report sex-specific normative values for RV measurements among principally middle-aged and older adults. RV ejection fraction is greater in women. RV volumes increase with body size, are greater in men, and are smaller in older people. Body surface area seems to be appropriate for indexation of cardiac magnetic resonance-derived RV volumes. © 2016 American Heart Association, Inc.

  19. Assessment of left atrial volume and function

    DEFF Research Database (Denmark)

    Kühl, J Tobias; Lønborg, Jacob; Fuchs, Andreas

    2012-01-01

    dynamic LA volume changes. Conversely, cardiac magnetic resonance imaging (CMR) and multi-slice computed tomography (MSCT) appears more appropriate for such measures. We sought to determine the relationship between LA size assessed with TTE and LA size and function assessed with CMR and MSCT. Fifty......-four patients were examined 3 months post myocardial infarction with echocardiography, CMR and MSCT. Left atrial volumes and LA reservoir function were assessed by TTE. LA time-volume curves were determined and LA reservoir function (cyclic change and fractional change), passive emptying function (reservoir...... between CMR and MSCT, with a small to moderate bias in LA(max) (4.9 ± 10.4 ml), CC (3.1 ± 9.1 ml) and reservoir volume (3.4 ± 9.1 ml). TTE underestimates LA(max) with up to 32% compared with CMR and MSCT (P ...

  20. Making Grasslands Sustainable in Mongolia: Assessment of Key Elements in Nationally Appropriate Mitigation Actions for Grassland and Livestock Management

    OpenAIRE

    Asian Development Bank (ADB)

    2014-01-01

    Climate change is a threat to Mongolia’s economic growth, sustainable development, and fragile environment. Well-designed actions to mitigate climate change can provide multiple benefits, including socioeconomic development and resilience to climate variability and change. Nationally appropriate mitigation actions (NAMAs) can provide a framework for the identification and implementation of mitigation actions. This publication identifies and assesses technical, institutional, and policy elemen...

  1. Altitude Acclimatization and Blood Volume: Effects of Exogenous Erythrocyte Volume Expansion

    National Research Council Canada - National Science Library

    Sawka, M

    1996-01-01

    ...: (a) altitude acclimatization effects on erythrocyte volume and plasma volume; (b) if exogenous erythrocyte volume expansion alters subsequent erythrocyte volume and plasma volume adaptations; (c...

  2. SLSF loop handling system. Volume I. Structural analysis

    International Nuclear Information System (INIS)

    Ahmed, H.; Cowie, A.; Ma, D.

    1978-10-01

    SLSF loop handling system was analyzed for deadweight and postulated dynamic loading conditions, identified in Chapters II and III in Volume I of this report, using a linear elastic static equivalent method of stress analysis. Stress analysis of the loop handling machine is presented in Volume I of this report. Chapter VII in Volume I of this report is a contribution by EG and G Co., who performed the work under ANL supervision

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

    Data.gov (United States)

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

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

    Data.gov (United States)

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

  5. Finding the Truth in Medical Imaging: Painting the Picture of Appropriateness for Magnetic Resonance Imaging in Canada.

    Science.gov (United States)

    Vanderby, Sonia; Peña-Sánchez, Juan Nicolás; Kalra, Neil; Babyn, Paul

    2015-11-01

    Questions about the appropriateness of medical imaging exams, particularly related to magnetic resonance exams, have arisen in recent years. However, the prevalence of inappropriate imaging in Canada is unclear as inappropriate exam proportion estimates are often based on studies from other countries. Hence, we sought to compare and summarize Canadian studies related to magnetic resonance imaging appropriateness. We completed a systematic literature search identifying studies related to magnetic resonance appropriateness in Canada published between 2003 and 2013. Two researchers independently searched and evaluated the literature available. Articles that studied or discussed magnetic resonance appropriateness in Canada were selected based on titles, abstracts, and, where necessary, full article review. Articles relating solely to other modalities or countries were excluded, as were imaging appropriateness guidelines and reviews. Fourteen articles were included: 8 quantitative studies and 6 editorials/commentaries. The quantitative studies reported inappropriate proportions of magnetic resonance exams ranging from 2%-28.5%. Our review also revealed substantial variations among study methods and analyses. Common topics identified among editorials/commentaries included reasons for obtaining imaging in general and for selecting a specific modality, consequences of inappropriate imaging, factors contributing to demand, and suggested means of mitigating inappropriate medical imaging use. The available studies do not support the common claim that 30% of medical imaging exams in Canada are inappropriate. The actual proportion of inappropriate magnetic resonance exams has not yet been established conclusively in Canada. Further research, particularly on a widespread national scale, is needed to guide healthcare policies. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  6. High volume medical web sites.

    Science.gov (United States)

    Elliott, B; Elliott, G

    2000-01-01

    In 1998, 22 million individuals reported surfing the web for medical information, and this number will increase to over 30 million by 2000. Fifteen of the highest volume medical web sites are described in this paper. Sponsorship and/or ownership of the fifteen sites varied. The government sponsors one, and some are the products of well-known educational institutions. One site is supported by a consumer health organization, and the American Medical Association was in the top 15. However, the most common owners are commercial, for-profit businesses. Attributes of the ideal site were categorized, and include a robust privacy and disclosure statement with an emphasis on education and an appropriate role for advertising. The covering of Complementary and Alternative Medicine (CAM) should be in a balanced and unbiased manner. There has to be an emphasis on knowledge based evidence as opposed to testimonials, and sources should be timely and reviewed. Bibliographies of authors need to be available. Hyperlinking to other web resources is valuable, as even the largest of sites cannot come close to covering all of medicine.

  7. Lanthanum additions and the toughness of ultra-high strength steels and the determination of appropriate lanthanum additions

    International Nuclear Information System (INIS)

    Garrison, Warren M.; Maloney, James L.

    2005-01-01

    Studies of commercial heats of AF1410 steel suggest that under appropriate conditions additions of rare-earth elements can significantly enhance fracture toughness. This improvement in toughness is not due to an extremely low inclusion volume fraction but is apparently due to the formation of larger and more widely spaced inclusions. The purpose of this work is to discuss our experience in using rare-earth additions to laboratory scale vacuum induction melted and subsequently vacuum arc remelted heats of ultra-high strength steels to achieve inclusion distributions similar to those observed in commercial heats modified with lanthanum additions. The results indicate that lanthanum additions of 0.015 wt.% to low sulfur steels which have been well deoxidized using carbon-vacuum deoxidation can result in lanthanum rich inclusions which are similar in size, volume fraction and spacing to those obtained in commercially produced heats of ultra-high strength steel to which lanthanum has been added. The heat of steel to which lanthanum additions of 0.015 wt.% were made had significantly higher toughness than did the heat of the same steel in which the sulfur had been gettered as small and closely spaced particles of MnS and which had an inclusion volume fraction similar to that of the heat modified by the addition of 0.015 wt.% lanthanum. This improvement in toughness was attributed to an increase in inclusion spacing. An addition of 0.06 wt.% lanthanum was excessive. Such an addition of lanthanum resulted in a huge volume fraction of large cuboidal inclusions which primarily contain lanthanum and oxygen and which are extremely detrimental to toughness

  8. HARNESSING BIG DATA VOLUMES

    Directory of Open Access Journals (Sweden)

    Bogdan DINU

    2014-04-01

    Full Text Available Big Data can revolutionize humanity. Hidden within the huge amounts and variety of the data we are creating we may find information, facts, social insights and benchmarks that were once virtually impossible to find or were simply inexistent. Large volumes of data allow organizations to tap in real time the full potential of all the internal or external information they possess. Big data calls for quick decisions and innovative ways to assist customers and the society as a whole. Big data platforms and product portfolio will help customers harness to the full the value of big data volumes. This paper deals with technical and technological issues related to handling big data volumes in the Big Data environment.

  9. Identifying the Physical Properties of Showers That Influence User Satisfaction to Aid in Developing Water-Saving Showers

    Directory of Open Access Journals (Sweden)

    Minami Okamoto

    2015-07-01

    Full Text Available This research was conducted with the goal of clarifying the required conditions of water-saving showerheads. In order to this, the research analyzes the mutual relationship between water usage flow, the level of satisfaction and the physical properties of spray of showerheads. The physical properties of spray were measured using physical properties test apparatus of standard or scheme for water-saving showerheads issued in several water-saving countries, and satisfaction evaluation data was acquired through bathing experiments. The evaluated showerheads were separated into three groups according to usage water flow and the level of satisfaction. The relationships between usage water flow, the level of satisfaction and physical properties were compared. The results identified that Spray Force and Spray Force-per-Hole were physical properties that influence usage water flow. Spray force-per-hole, water volume ratio in Spray Patterns within φ 100 and φ 150, Temperature Drop and Spray Angle were identified as physical properties that influenced the level of satisfaction. The level of satisfaction and usage water flow has a spurious correlation through the physical properties of Spray Force-per-Hole and Temperature Drop. It is possible to improve the level of satisfaction independent of amount of water usage through designs that set an appropriate value for water volume ratio and Spray Angle for Spray Patterns within φ 100 and φ 150.

  10. The volume of a soliton

    International Nuclear Information System (INIS)

    Adam, C.; Haberichter, M.; Wereszczynski, A.

    2016-01-01

    There exists, in general, no unique definition of the size (volume, area, etc., depending on dimension) of a soliton. Here we demonstrate that the geometric volume (area etc.) of a soliton is singled out in the sense that it exactly coincides with the thermodynamical or continuum-mechanical volume. In addition, this volume may be defined uniquely for rather arbitrary solitons in arbitrary dimensions.

  11. The volume of a soliton

    Energy Technology Data Exchange (ETDEWEB)

    Adam, C., E-mail: adam@fpaxp1.usc.es [Departamento de Física de Partículas, Universidad de Santiago de Compostela and Instituto Galego de Física de Altas Enerxias (IGFAE), E-15782 Santiago de Compostela (Spain); Haberichter, M. [School of Mathematics, Statistics and Actuarial Science, University of Kent, Canterbury, CT2 7NF (United Kingdom); Wereszczynski, A. [Institute of Physics, Jagiellonian University, Lojasiewicza 11, Kraków (Poland)

    2016-03-10

    There exists, in general, no unique definition of the size (volume, area, etc., depending on dimension) of a soliton. Here we demonstrate that the geometric volume (area etc.) of a soliton is singled out in the sense that it exactly coincides with the thermodynamical or continuum-mechanical volume. In addition, this volume may be defined uniquely for rather arbitrary solitons in arbitrary dimensions.

  12. Volume holographic memory

    Directory of Open Access Journals (Sweden)

    Cornelia Denz

    2000-05-01

    Full Text Available Volume holography represents a promising alternative to existing storage technologies. Its parallel data storage leads to high capacities combined with short access times and high transfer rates. The design and realization of a compact volume holographic storage demonstrator is presented. The technique of phase-coded multiplexing implemented to superimpose many data pages in a single location enables to store up to 480 holograms per storage location without any moving parts. Results of analog and digital data storage are shown and real time optical image processing is demonstrated.

  13. Appropriate and inappropriate influences on outpatient discharge decision making in dermatology: a prospective qualitative study.

    Science.gov (United States)

    Harun, N A; Finlay, A Y; Salek, M S; Piguet, V

    2015-09-01

    Outpatient discharge decision making in dermatology is poorly understood. To identify the influences on clinicians' thought processes when making discharge decisions in dermatology outpatient clinics. Forty clinicians from 11 National Health Service Trusts in England were interviewed. The interviews were audiorecorded, transcribed, coded and thematically analysed. The mean age of the clinicians was 48.8 years (range 33.0-67.0), 17 (43%) were men and 19 (48%) had > 20 years of clinical experience. One hundred and forty-eight influences were reported, with five main themes: (i) disease-based influences included type of diagnosis (100% of clinicians), guidelines (100%) and treatment needed (100%); (ii) clinician-based influences included the clinician's level of experience (100%), seniority (37%), emotional attitude (95%), 'gut feeling' (25%), personal attitude towards discharge (45%) and level of perception (100%); (iii) patient-based influences included patients' ability to cope with their disease (100%), wishes (70%), quality of life (32%), command of English (40%) and cultural background (25%); (iv) practice-based influences included good primary care (100%), secondary support structure (100%) and clinic capacity pressure (67%); (v) policy-based influences included pressure from hospital managers (57%) and an active discharge policy (7%). Fourteen (9%) influences were potentially inappropriate. This study has identified multiple factors influencing outpatient discharge decision making. This provides the basis for developing evidence-based training to improve discharge decision appropriateness. © 2015 British Association of Dermatologists.

  14. Target volume delineation and treatment planning for particle therapy a practical guide

    CERN Document Server

    Leeman, Jonathan E; Cahlon, Oren; Sine, Kevin; Jiang, Guoliang; Lu, Jiade J; Both, Stefan

    2018-01-01

    This handbook is designed to enable radiation oncologists to treat patients appropriately and confidently by means of particle therapy. The orientation and purpose are entirely practical, in that the focus is on the physics essentials of delivery and treatment planning , illustration of the clinical target volume (CTV) and associated treatment planning for each major malignancy when using particle therapy, proton therapy in particular. Disease-specific chapters provide guidelines and concise knowledge on CTV selection and delineation and identify aspects that require the exercise of caution during treatment planning. The treatment planning techniques unique to proton therapy for each disease site are clearly described, covering beam orientation, matching/patching field techniques, robustness planning, robustness plan evaluation, etc. The published data on the use of particle therapy for a given disease site are also concisely reported. In addition to fully meeting the needs of radiation oncologists, this "kn...

  15. Topic A. Have all the relevant issues been identified

    International Nuclear Information System (INIS)

    Bernero, R.M.

    1994-01-01

    This work is an answer to the question : have all the relevant issues been identified? The author tries to answer more particularly to the following three points : 1) can risk or responsibility for action be imposed on future generations. 2) Are current safety norms suitable for the future? 3) what controls are appropriate for inter generational cost/benefit evaluations. (O.L.)

  16. Use of DNA barcodes to identify flowering plants

    OpenAIRE

    Kress, W. John; Wurdack, Kenneth J.; Zimmer, Elizabeth A.; Weigt, Lee A.; Janzen, Daniel H.

    2005-01-01

    Methods for identifying species by using short orthologous DNA sequences, known as “DNA barcodes,” have been proposed and initiated to facilitate biodiversity studies, identify juveniles, associate sexes, and enhance forensic analyses. The cytochrome c oxidase 1 sequence, which has been found to be widely applicable in animal barcoding, is not appropriate for most species of plants because of a much slower rate of cytochrome c oxidase 1 gene evolution in higher plants than in animals. We ther...

  17. Feasibility study report for Operable Unit 4: Volume 2

    International Nuclear Information System (INIS)

    1994-02-01

    This report documents the Feasibility Study (FS) phase of the Fernald Environmental Management Project (FEMP) Operable Unit 4 Remedial Investigation/Feasibility Study (RI/FS) Program. The FEMP, formerly known as the Feed Materials Production Center (FMPC), is a US Department of Energy (DOE) facility that operated from 1952 to 1989. The facility's primarily function was to provide high purity uranium metal products to support United States defense programs. Production operations were suspended in 1989 to focus on environmental restoration and waste management activities at the facility. The RI/FS is being conducted pursuant to the terms of a Consent Agreement between DOE and the US Environmental Protection Agency (EPA) under Sections 120 and 106(a) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended. The Ohio Environmental Protection Agency (OEPA) is also participating in the RI/FS process at the FEMP through direct involvement in program review meetings and technical review of project documentation. The objective of the RI/FS process is to gather information to support an informed risk management decision regarding which remedy appears to be the most appropriate action for addressing the environmental concerns identified at the FEMP. This volume contains appendices A--E

  18. Structure-volume relationships: singular volume effects produced by cupric ion-globular protein interaction.

    Science.gov (United States)

    Katz, S; Shinaberry, G; Heck, E L; Squire, W

    1980-08-05

    The nature of the volume isotherms produced by the coordination of Cu(II) with ovalbumin and bovine serum albumin differs substantially from the adsorption isotherms produced by these systems. Whereas there was increased binding of Cu(II) associated with a pH increase from pH 5.3 to pH 7.4, the volume isotherms for these systems did not exhibit this type of pH dependence. The volume changes were determined at 30.0 +/- 0.001 degrees C with microdilatometers which could be read to 0.01 muL. The binding isotherms for ovalbumin at pH 5.3 and 7.4 and for bovine serum albumin at pH 5.3 was resolved by a Scatchard plot to yield the appropriate thermodynamic parameters. An algorithm was derived to calculate the distribution of the individual PMi complexes, i.e., PMi-1 + M in equilibrium (Ki) PMi where i equals 1, 2, 3, ..., n moles of cation, M, bound per mole of protein, P, for the above systems. The volume isotherms were then resolved in terms of the constituent delta Vi terms, i.e., the volume change produced by the formation of the individual PMi complexes. These values were verified by an independent graphical differentiation procedure. The coordination of Cu(II) to BSA at pH 7.4 produced a cooperative adsorption isotherm which was not amenable to a Scatchard analysis. The resultant anomalous volume isotherm was resolved into a component related to Cu(II)-site interaction and a negative volume effect attributable to a conformational change induced by complex formation. This structural transition which occurs at physiological pH may constitute a control mechanism for regulating the serum level of Cu(II) and possibly other divalent ions.

  19. Target volumes in gastric cancer radiation therapy

    International Nuclear Information System (INIS)

    Caudry, M.; Maire, J.P.; Ratoanina, J.L.; Escarmant, P.

    2001-01-01

    The spread of gastric adenocarcinoma may follow three main patterns: hemato-genic, lymphatic and intraperitoneal. A GTV should be considered in preoperative or exclusive radiation therapy. After non-radical surgery, a 'residual GTV' will be defined with the help of the surgeon. The CTV encompasses three intricated volumes. a) A 'tumor bed' volume. After radical surgery, local recurrences appear as frequent as distant metastases. The risk depends upon the depth of parietal invasion and the nodal status. Parietal infiltration may extend beyond macroscopic limits of the tumor, especially in dinitis plastica. Therefore this volume will include: the tumor and the remaining stomach or their 'bed of resection', a part of the transverse colon, the duodenum, the pancreas and the troncus of the portal vein. In postoperative RT, this CTV also includes the jejuno-gastric or jejuno-esophageal anastomosis. b) A peritoneal volume. For practical purposes, two degrees of spread must be considered: (1) contiguous microscopic extension from deeply invasive T3 and T4 tumors, that remain amenable to local sterilization with doses of 45-50 Gy, delivered in a CTV including the peritoneal cavity at the level of the gastric bed, and under the parietal incision; (2) true 'peritoneal carcinomatosis', with widespread seeds, where chemotherapy (systemic or intraperitoneal) is more appropriate. c) A lymphatic volume including the lymph node groups 1 to 16 of the Japanese classification. This volume must encompass the hepatic pedicle and the splenic hilum. In proximal tumors, it is possible to restrict the lover part of the CTV to the lymphatic volume, and therefore to avoid irradiation of large intestinal and renal volumes. In distal and proximal tumors, involvement of resection margins is of poor prognosis -a radiation boost must be delivered at this level. The CTV in tumors of the cardia should encompass the lover part of the thoracic esophagus and the corresponding posterior mediastinum. In

  20. Life-threatening ventricular tachyarrhythmias in the cardiology department: Implications for appropriate prescription of telemetry monitoring.

    Science.gov (United States)

    Zorzi, Alessandro; Peruzza, Francesco; Stella, Federica; Del Monte, Alvise; Migliore, Federico; Gasparetto, Nicola; Badano, Luigi; Iliceto, Sabino; Corrado, Domenico

    2016-04-01

    in-hospital life-threatening ventricular arrhythmias (LT-VA) may complicate the course of cardiovascular patients. We aimed to assess the incidence, circumstances, determinants, and outcome of in-hospital LT-VA in order to help clinicians in prescribing appropriate levels of monitoring. the study population consisted of all 10,741 consecutive patients (65 ± 15 years, 67.7% males) admitted to a cardiology department in 2009-2014. Terminally ill patients and those with primary arrhythmia diagnosis were excluded. The composite end-point included sudden arrhythmic death, ventricular fibrillation, unstable ventricular tachycardia and appropriate ICD shock unrelated to invasive interventions. the incidence of LT-VA was 0.6%, with no differences regarding age, gender and primary diagnosis of coronary artery disease between patients with and without LT-VA. The incidence of LT-VA was significantly higher (1.2% versus 0.1%, p<0.001) among urgent compared with elective admissions and among patients with left ventricular ejection fraction (LV-EF) <45% (1.7% versus 0.2%, p<0.001). At multivariable analysis, urgent admission and LV-EF <45%, but not primary diagnosis of coronary artery disease, remained independent predictors of LT-VA. At the time of the event, 97.1% fulfilled either class I or class II indications for telemetry monitoring according to the American Heart Association guidelines. Survival to discharge with good neurological status was 70.6%. acutely ill patients with heart failure and LV systolic dysfunction showed the highest rate of LT-VAs, regardless of the underlying cardiac disease (ischemic or non-ischemic). Current guidelines demonstrated high sensitivity in identifying patients at risk. These findings may favor proper utilization of telemetry monitoring resources. Copyright © 2016. Published by Elsevier Ireland Ltd.

  1. Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department.

    Science.gov (United States)

    Miller, Joseph B; Arter, Andrew; Wilson, Suprat S; Janke, Alexander T; Brody, Aaron; Reed, Brian P; Levy, Phillip D

    2017-08-01

    While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18-89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4%) were considered inappropriately treated. Overall, labetalol (61%) was the most commonly used medication, followed by enalaprilat (18%), hydralazine (18%), and metoprolol (3%). There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2%) patients in the inappropriate treatment cohort and in two (1%) patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant resources could perhaps be saved through education of

  2. Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Joseph B. Miller

    2017-07-01

    Full Text Available Introduction: While moderate to severely elevated blood pressure (BP is present in nearly half of all emergency department (ED patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. Methods: We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18–89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. Results: We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4% were considered inappropriately treated. Overall, labetalol (61% was the most commonly used medication, followed by enalaprilat (18%, hydralazine (18%, and metoprolol (3%. There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2% patients in the inappropriate treatment cohort and in two (1% patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. Conclusion: More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant

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

    Science.gov (United States)

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

    2015-11-14

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

  4. Design for volume reduction

    NARCIS (Netherlands)

    Wever, R.; Boks, C.; Stevels, A.

    2007-01-01

    Traditionally packaging design-for-sustainability (DfS) strongly focuses on resource conservation and material recycling. The type and amount of materials used has been the driver in design. For consumer electronics (CE) products this weight-based approach is too limited; a volume-based approach is

  5. Another year, another volume

    Science.gov (United States)

    Bill Block

    2012-01-01

    This issue represents the final one in volume 76 of Journal of Wildlife Management. As this one is pretty much in the books, one cannot help but wonder what the future holds for the journal. Lenny Brennan is putting together a piece for Wildlife Society Bulletin to examine how The Wildlife Society publications have changed through time. He solicited input from past and...

  6. The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases : The Neuromodulation Appropriateness Consensus Committee

    NARCIS (Netherlands)

    Deer, Timothy R.; Mekhail, Nagy; Provenzano, David; Pope, Jason; Krames, Elliot; Leong, Michael; Levy, Robert M.; Abejon, David; Buchser, Eric; Burton, Allen; Buvanendran, Asokumar; Candido, Kenneth; Caraway, David; Cousins, Michael; de Jongste, Micheal; Diwan, Sudhir; Eldabe, Sam; Gatzinsky, Kliment; Foreman, Robert D.; Hayek, Salim; Kim, Philip; Kinfe, Thomas; Kloth, David; Kumar, Krishna; Rizvi, Syed; Lad, Shivanand P.; Liem, Liong; Linderoth, Bengt; Mackey, Sean; McDowell, Gladstone; McRoberts, Porter; Poree, Lawrence; Prager, Joshua; Raso, Lou; Rauck, Richard; Russo, Marc; Simpson, Brian; Slavin, Konstantin; Staats, Peter; Stanton-Hicks, Michael; Verrills, Paul; Wellington, Joshua; Williams, Kayode; North, Richard

    Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended

  7. Pre-treatment amygdala volume predicts electroconvulsive therapy response

    NARCIS (Netherlands)

    ten Doesschate, Freek; van Eijndhoven, Philip; Tendolkar, Indira; van Wingen, Guido A.; van Waarde, Jeroen A.

    2014-01-01

    Electroconvulsive therapy (ECT) is an effective treatment for patients with severe depression. Knowledge on factors predicting therapeutic response may help to identify patients who will benefit most from the intervention. Based on the neuroplasticity hypothesis, volumes of the amygdala and

  8. CPD Appropriations

    Data.gov (United States)

    Department of Housing and Urban Development — The datasets are the full-year allocations for HUD's Office of Community Planning and Development (CPD) formula programs: Community Development Block Grants (CDBG);...

  9. Constrained Appropriations

    DEFF Research Database (Denmark)

    Wildermuth, Norbert

    2008-01-01

    cultures of media consumption which unify and divide Brazil's (urban) youth, attention is also given to an  understanding of the relationship between young people and media, as developed in concrete attempts to increase the cultural competences of young, ‘disprivileged' media consumers. The contribution......  A discussion of the contingent character of young Brazilian's media culture is the focus of my contribution's theoretical approach. Thus, while giving recognition to young people's active agency in the creation of media-centred lifestyles and youth cultures, I will seek to demonstrate...

  10. Appropriate technology

    International Development Research Centre (IDRC) Digital Library (Canada)

    was not the primary target species and fetched a much lower price. Fortunately, in recent decades both the ... even if they have low market value, may nonetheless be vital components of the marine ecosystem. Bert Allsopp ... First, the catch of non-target species is being reduced through the use of “excluder” devices on ...

  11. Collaborative Appropriation

    DEFF Research Database (Denmark)

    Muller, Michael; Neureiter, Katja; Verdezoto, Nervo

    2016-01-01

    Previous workshops and papers have examined how individual users adopt and adapt technologies to meet their own local needs, by “completing design through use.” However, there has been little systematic study of how groups of people engage collaboratively in these activities. This workshop opens ...

  12. Appropriate Pupilness

    DEFF Research Database (Denmark)

    Kofoed, Jette

    2008-01-01

    for football are selected. The article opens up for a microanalysis of everyday practices at the margins and at the core of what this article terms `pupilness'. The concept of intersectionality is suggested as a useful analytical tool to understand the multiple activities of pupils in everyday school life...

  13. Appropriate Arrangement of Nori Aquafarming Grounds in the Ariake Sea on the Basis of Convective Dispersion Simulation Model

    Science.gov (United States)

    Tabata, Toshinori; Hiramatsu, Kazuaki; Harada, Masayoshi; Shiraishi, Hideto; Shuto, Toshio

    This study investigated appropriate arrangement of nori aquafarming grounds from the view point of nori growth in the Ariake Sea coastal waters. Databases of the sea-bed topography and nori aquafarming grounds were constructed using GIS. Then the tidal currents and salinity in the Ariake Sea were simulated using a two-dimensional depth-integrated model, which was developed by integrating the three-dimensional continuity, momentum, and diffusion equations. The wetting and drying scheme was also introduced to account for the appearance and disappearance of tidal flats. The velocities and directions of the simulated tidal currents, salinity, and tidal land appearance were in good agreement with observed data. Five scenarios considered by the Fukuoka Prefectural Government were introduced in the simulation model to identify the most appropriate arrangement. An experimental formula for nitrogen assimilation kinetics in the nori body was introduced to evaluate the simulation results for the five scenarios. The scenarios with a reduced density of aquafarming grounds had increased nori growth, suggesting that the arrangement of the aquafarming grounds affected the nori growth. The simulation results were used to identify the most appropriate arrangement of aquafarming grounds.

  14. PETRO-SAFE '94 conference papers: Book 2. Volume 5: Emergency response ampersand spill control; Volume 6: Remediation; Volume 7: Health ampersand safety issues

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    The Fifth Annual Environmental, Safety and Health Conference and Exhibition for the oil, gas and petrochemical industries was held January 25--27, 1994 in Houston, Texas. The objective of this conference was to provide a multidisciplinary forum dealing with state-of-the-art environmental and safety issues. This volume focuses on the following: emergency response and spill control; remediation; and health and safety issues. Individual papers have been processed separately for inclusion in the appropriate data bases

  15. Decision-making in irrigation networks: Selecting appropriate canal structures using multi-attribute decision analysis.

    Science.gov (United States)

    Hosseinzade, Zeinab; Pagsuyoin, Sheree A; Ponnambalam, Kumaraswamy; Monem, Mohammad J

    2017-12-01

    of the Neyrpic® gate are ease of operation and capacity to measure discharge flows. Overall, the application to the Qazvin irrigation network demonstrates the utility of the proposed DA framework in selecting appropriate structures for regulating water flows in irrigation canals. This framework systematically aids the decision process by capturing decisions made at various levels (individual farmers to high-level management). It can be applied to other cases where a new irrigation network is being designed, or where changes in irrigation structures need to be identified to improve flow control in existing networks. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Interpretations of referral appropriateness by senior health managers in five PCT areas in England: a qualitative investigation.

    Science.gov (United States)

    Blundell, N; Clarke, Aileen; Mays, N

    2010-06-01

    To explore interpretations of "appropriate" and "inappropriate" elective referral from primary to secondary surgical care among senior clinical and non-clinical managers in five purposively sampled primary care trusts (PCTs) and their main associated acute hospitals in the English National Health Service (NHS). Semi-structured face-to-face interviews were undertaken with senior managerial staff from clinical and non-clinical backgrounds. Interviews were tape-recorded, transcribed and analysed according to the Framework approach developed at the National Centre for Social Research using N6 (NUD*IST6) qualitative data analysis software. Twenty-two people of 23 approached were interviewed (between three and five respondents per PCT and associated acute hospital). Three attributes relating to appropriateness of referral were identified: necessity: whether a patient with given characteristics was believed suitable for referral; destination or level: where or to whom a patient should be referred; and quality (or process): how a referral was carried out, including (eg, investigations undertaken before referral, information contained in the referral and extent of patient involvement in the referral decision. Attributes were hierarchical. "Necessity" was viewed as the most fundamental attribute, followed by "destination" and, finally, "quality". In general, but not always, all three attributes were perceived as necessary for a referral to be defined as appropriate. For senior clinical and non-clinical managers at the local level in the English NHS, three hierarchical attributes (necessity, appropriateness of destination and quality of referral process) contributed to the overall concept of appropriateness of referral from primary to secondary surgical care.

  17. It isn't no slang that can be said about this stuff: Language, identity, and appropriating science discourse

    Science.gov (United States)

    Brown, Bryan A.

    2006-01-01

    This investigation explores how underrepresented urban students made sense of their first experience with high school science. The study sought to identify how students' assimilation into the science classroom reflected their interpretation of science itself in relation to their academic identities. The primary objectives were to examine students' responses to the epistemic, behavioral, and discursive norms of the science classroom. At the completion of the academic year, 29 students were interviewed regarding their experiences in a ninth and tenth-grade life science course. The results indicate that students experienced relative ease in appropriating the epistemic and cultural behaviors of science, whereas they expressed a great deal of difficulty in appropriating the discursive practices of science. The implications of these findings reflect the broader need to place greater emphasis on the relationship between students' identity and their scientific literacy development.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-15

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

  20. Volume of the adrenal and pituitary glands in depression

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Willer, Inge Stoel; Knorr, Ulla

    2011-01-01

    Numerous studies have shown that the hypothalamic-pituitary-adrenal (HPA) axis is hyperactive in some depressed patients. It is unclear whether such hyperactivity results in changed volumes of the adrenal glands, pituitary gland and hypothalamus. We systematically reviewed all controlled studies...... on the adrenal or pituitary glands or hypothalamus volume in unipolar depressive disorder published in PubMed 1966 to December 2009. We identified three studies that investigated the volume of the adrenal glands and eight studies that examined the volume of the pituitary gland, but no studies on hypothalamus...... were found. Two out of three studies found a statistically significant increase in adrenal volume in patients compared to controls. Four out of eight studies found a statistically significant increase in pituitary volume in patients compared to controls. Different methodological problems were...

  1. Quantum volume hologram

    International Nuclear Information System (INIS)

    Vasilyev, Denis V.; Sokolov, Ivan V.; Polzik, Eugene S.

    2010-01-01

    We propose a scheme for parallel spatially multimode quantum memory for light. The scheme is based on a counterpropagating quantum signal wave and a strong classical reference wave as in a classical volume hologram and therefore can be called a quantum volume hologram. The medium for the hologram consists of a spatially extended ensemble of atoms placed in a magnetic field. The write-in and readout of this quantum hologram is as simple as that of its classical counterpart and consists of a single-pass illumination. In addition, we show that the present scheme for a quantum hologram is less sensitive to diffraction and therefore is capable of achieving a higher density of storage of spatial modes as compared to previous proposals. We present a feasibility study and show that experimental implementation is possible with available cold atomic samples. A quantum hologram capable of storing entangled images can become an important ingredient in quantum information processing and quantum imaging.

  2. Modeling Approach for Estimating Co-Produced Water Volumes and Saltwater Disposal Volumes in Oklahoma

    Science.gov (United States)

    Murray, K. E.

    2016-12-01

    Management of produced fluids has become an important issue in Oklahoma because large volumes of saltwater are co-produced with oil and gas, and disposed into saltwater disposal wells at high rates. Petroleum production increased from 2009-2015, especially in central and north-central Oklahoma where the Mississippian and Hunton zones were redeveloped using horizontal wells and dewatering techniques that have led to a disproportional increase in produced water volumes. Improved management of co-produced water, including desalination for beneficial reuse and decreased saltwater disposal volumes, is only possible if spatial and temporal trends can be defined and related to the producing zones. It is challenging to quantify the volumes of co-produced water by region or production zone because co-produced water volumes are generally not reported. Therefore, the goal of this research is to estimate co-produced water volumes for 2008-present with an approach that can be replicated as petroleum production shifts to other regions. Oil and gas production rates from subsurface zones were multiplied by ratios of H2O:oil and H2O:gas for the respective zones. Initial H2O:oil and H2O:gas ratios were adjusted/calibrated, by zone, to maximize correlation of county-scale produced H2O estimates versus saltwater disposal volumes from 2013-2015. These calibrated ratios were then used to compute saltwater disposal volumes from 2008-2012 because of apparent data gaps in reported saltwater disposal volumes during that timeframe. This research can be used to identify regions that have the greatest need for produced water treatment systems. The next step in management of produced fluids is to explore optimal energy-efficient strategies that reduce deleterious effects.

  3. Real-time particle volume fraction measurement in centrifuges by wireless electrical resistance detector

    International Nuclear Information System (INIS)

    Nagae, Fumiya; Okawa, Kazuya; Matsuno, Shinsuke; Takei, Masahiro; Zhao Tong; Ichijo, Noriaki

    2015-01-01

    In this study, wireless electrical resistance detector is developed as first step in order to develop electrical resistance tomography (ERT) that are attached wireless communication, and miniaturized. And the particle volume fraction measurement results appropriateness is qualitatively examined. The real-time particle volume fraction measurement is essential for centrifuges, because rotational velocity and supply should be controlled based on the results in order to obtain the effective separation, shorten process time and save energy. However, a technique for the particle volume fraction measurement in centrifuges has not existed yet. In other words, the real-time particle volume fraction measurement in centrifuges becomes innovative technologies. The experiment device reproduces centrifugation in two-phase using particle and salt solution as measuring object. The particle concentration is measured changing rotational velocity, supply and measurement section position. The measured concentration changes coincide with anticipated tendency of concentration changes. Therefore the particle volume fraction measurement results appropriateness are qualitatively indicated. (author)

  4. Near Identifiability of Dynamical Systems

    Science.gov (United States)

    Hadaegh, F. Y.; Bekey, G. A.

    1987-01-01

    Concepts regarding approximate mathematical models treated rigorously. Paper presents new results in analysis of structural identifiability, equivalence, and near equivalence between mathematical models and physical processes they represent. Helps establish rigorous mathematical basis for concepts related to structural identifiability and equivalence revealing fundamental requirements, tacit assumptions, and sources of error. "Structural identifiability," as used by workers in this field, loosely translates as meaning ability to specify unique mathematical model and set of model parameters that accurately predict behavior of corresponding physical system.

  5. Viability Assessment Volume 2

    International Nuclear Information System (INIS)

    1998-01-01

    This volume describes the major design features of the Monitored Geologic Repository. This document is not intended to provide an exhaustive, detailed description of the repository design. Rather, this document summarizes the major systems and primary elements of the design that are radiologically significant, and references the specific technical documents and design analyses wherein the details can be found. Not all portions of the design are at the same level of completeness. Highest priority has been given to assigning resources to advance the design of the Monitored Geologic Repository features that are important to radiological safety and/or waste isolation and for which there is no NRC licensing precedent. Those features that are important to radiological safety and/or waste isolation, but for which there is an NRC precedent, receive second priority. Systems and features that have no impact on radiological safety or waste isolation receive the lowest priority. This prioritization process, referred to as binning, is discussed in more detail in Section 2.3. Not every subject discussed in this volume is given equal treatment with regard to the level of detail provided. For example, less detail is provided for the surface facility design than for the subsurface and waste package designs. This different level of detail is intentional. Greater detail is provided for those functions, structures, systems, and components that play key roles with regard to protecting radiological health and safety and that are not common to existing nuclear facilities already licensed by NRC. A number of radiological subjects are not addressed in the VA, (e.g., environmental qualification of equipment). Environmental qualification of equipment and other radiological safety considerations will be addressed in the LA. Non-radiological safety considerations such as silica dust control and other occupational safety considerations are considered equally important but are not addressed in

  6. Small-Volume Injections: Evaluation of Volume Administration Deviation From Intended Injection Volumes.

    Science.gov (United States)

    Muffly, Matthew K; Chen, Michael I; Claure, Rebecca E; Drover, David R; Efron, Bradley; Fitch, William L; Hammer, Gregory B

    2017-10-01

    In the perioperative period, anesthesiologists and postanesthesia care unit (PACU) nurses routinely prepare and administer small-volume IV injections, yet the accuracy of delivered medication volumes in this setting has not been described. In this ex vivo study, we sought to characterize the degree to which small-volume injections (≤0.5 mL) deviated from the intended injection volumes among a group of pediatric anesthesiologists and pediatric postanesthesia care unit (PACU) nurses. We hypothesized that as the intended injection volumes decreased, the deviation from those intended injection volumes would increase. Ten attending pediatric anesthesiologists and 10 pediatric PACU nurses each performed a series of 10 injections into a simulated patient IV setup. Practitioners used separate 1-mL tuberculin syringes with removable 18-gauge needles (Becton-Dickinson & Company, Franklin Lakes, NJ) to aspirate 5 different volumes (0.025, 0.05, 0.1, 0.25, and 0.5 mL) of 0.25 mM Lucifer Yellow (LY) fluorescent dye constituted in saline (Sigma Aldrich, St. Louis, MO) from a rubber-stoppered vial. Each participant then injected the specified volume of LY fluorescent dye via a 3-way stopcock into IV tubing with free-flowing 0.9% sodium chloride (10 mL/min). The injected volume of LY fluorescent dye and 0.9% sodium chloride then drained into a collection vial for laboratory analysis. Microplate fluorescence wavelength detection (Infinite M1000; Tecan, Mannedorf, Switzerland) was used to measure the fluorescence of the collected fluid. Administered injection volumes were calculated based on the fluorescence of the collected fluid using a calibration curve of known LY volumes and associated fluorescence.To determine whether deviation of the administered volumes from the intended injection volumes increased at lower injection volumes, we compared the proportional injection volume error (loge [administered volume/intended volume]) for each of the 5 injection volumes using a linear

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

    OpenAIRE

    Hamid Allami; Nasim Boustani

    2017-01-01

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

  8. Design and Construction for Community Health Service Precision Fund Appropriation System Based on Performance Management.

    Science.gov (United States)

    Gao, Xing; He, Yao; Hu, Hongpu

    2017-01-01

    Allowing for the differences in economy development, informatization degree and characteristic of population served and so on among different community health service organizations, community health service precision fund appropriation system based on performance management is designed, which can provide support for the government to appropriate financial funds scientifically and rationally for primary care. The system has the characteristic of flexibility and practicability, in which there are five subsystems including data acquisition, parameter setting, fund appropriation, statistical analysis system and user management.

  9. Delineation of Internal Mammary Nodal Target Volumes in Breast Cancer Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jethwa, Krishan R.; Kahila, Mohamed M. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Hunt, Katie N. [Department of Radiology, Mayo Clinic, Rochester, Minnesota (United States); Brown, Lindsay C.; Corbin, Kimberly S.; Park, Sean S.; Yan, Elizabeth S. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Boughey, Judy C. [Department of Surgery, Mayo Clinic, Rochester, Minnesota (United States); Mutter, Robert W., E-mail: mutter.robert@mayo.edu [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2017-03-15

    Purpose: The optimal clinical target volume for internal mammary (IM) node irradiation is uncertain in an era of increasingly conformal volume-based treatment planning for breast cancer. We mapped the location of gross internal mammary lymph node (IMN) metastases to identify areas at highest risk of harboring occult disease. Methods and Materials: Patients with axial imaging of IMN disease were identified from a breast cancer registry. The IMN location was transferred onto the corresponding anatomic position on representative axial computed tomography images of a patient in the treatment position and compared with consensus group guidelines of IMN target delineation. Results: The IMN location in 67 patients with 130 IMN metastases was mapped. The location was in the first 3 intercostal spaces in 102 of 130 nodal metastases (78%), whereas 18 of 130 IMNs (14%) were located caudal to the third intercostal space and 10 of 130 IMNs (8%) were located cranial to the first intercostal space. Of the 102 nodal metastases within the first 3 intercostal spaces, 54 (53%) were located within the Radiation Therapy Oncology Group consensus volume. Relative to the IM vessels, 19 nodal metastases (19%) were located medially with a mean distance of 2.2 mm (SD, 2.9 mm) whereas 29 (28%) were located laterally with a mean distance of 3.6 mm (SD, 2.5 mm). Ninety percent of lymph nodes within the first 3 intercostal spaces would have been encompassed within a 4-mm medial and lateral expansion on the IM vessels. Conclusions: In women with indications for elective IMN irradiation, a 4-mm medial and lateral expansion on the IM vessels may be appropriate. In women with known IMN involvement, cranial extension to the confluence of the IM vein with the brachiocephalic vein with or without caudal extension to the fourth or fifth interspace may be considered provided that normal tissue constraints are met.

  10. Wasp venom is appropriate for immunotherapy of patients with allergic reaction to the European hornet sting.

    Science.gov (United States)

    Kosnik, Mitja; Korosec, Peter; Silar, Mira; Music, Ema; Erzen, Renato

    2002-02-01

    To identify whether it is the yellow jacket (Vespula germanica) or European hornet (Vespa crabro) venom that induces sensitization in patients with IgE-mediated allergic reaction to the venom from the sting of a European hornet. Since these patients usually have positive skin tests and specific IgE to all vespid venoms, it would be useful to distinguish cross-reactors from non-cross-reactors to perform immunotherapy with the venom that induced the sensitization. We performed inhibition tests in 24 patients who had experienced anaphylactic reaction after being stung by a European hornet. Of 24 patients with allergic reaction after Vespa crabro sting, 17 were sensitized only to epitopes of Vespula germanica venom. Only 4 out of 24 patients were sensitized to epitopes completely cross-reactive with Dolichovespula arenaria venom. In Slovenia, the vast majority of patients with anaphylactic reaction to Vespa crabro sting seem to be sensitized to Vespula germanica venom. We consider wasp venom an appropriate immunotherapeutic agent for such patients, except for those with proven primary sensitization to specific epitopes of Vespa crabro venom. Fluorescence enzyme immunoassay inhibition should be considered a convenient tool for the identification of primary sensitization in patients allergic to vespid venoms.

  11. The home as an appropriate setting for women undertaking cervical ripening before the induction of labour.

    Science.gov (United States)

    Reid, Margaret; Lorimer, Karen; Norman, Jane E; Bollapragada, Shrikant S; Norrie, John

    2011-02-01

    to explore women's experiences of cervical ripening using isosorbide mononitrate (IMN) in the home as part of the main randomised controlled trial. qualitative study with semi-structured interviews carried out at three weeks post partum. Interview transcripts were analysed to identify recurrent themes, focusing on why women became involved in the study, their views about both the self-medication and the home setting, and whether they would repeat the experience. the home. twenty women enrolled in the main randomised controlled trial. the study is part of a double-blind randomised controlled trial with 350 patients investigating whether a nitric oxide donor (IMN) used in cervical ripening improves the process of induction of labour. women liked the opportunity to remain at home during the cervical ripening process. Timing and setting were central issues; women hoped that it would hasten labour, while the home was seen as a setting offering freedom, security and reassurance, as opposed to the hospital, seen as constraining. Two women reported problems with IMN but the remainder reported that they would repeat the experience. women were very positive about the opportunity to undertake cervical ripening at home. It is important to explore this setting further for appropriate interventions. Copyright © 2009 Elsevier Ltd. All rights reserved.

  12. ‘Machinic Trajectories’: Appropriated Devices as Post-Digital Drawing Machines

    Directory of Open Access Journals (Sweden)

    Andres Wanner

    2014-12-01

    Full Text Available This article presents a series of works called Machinic Trajectories, consisting of domestic devices appropriated as mechanical drawing machines. These are contextualized within the post-digital discourse, which integrates messy analog conditions into the digital realm. The role of eliciting and examining glitches for investigating a technology is pointed out. Glitches are defined as short-lived, unpremeditated aesthetic results of a failure; they are mostly known as digital phenomena, but I argue that the concept is equally applicable to the output of mechanical machines. Three drawing machines will be presented: The Opener, The Mixer and The Ventilator. In analyzing their drawings, emergent patterns consisting of unpremeditated visual artifacts will be identified and connected to irregularities of the specific technologies. Several other artists who work with mechanical and robotic drawing machines are introduced, to situate the presented works and reflections in a larger context of practice and to investigate how glitch concepts are applicable to such mechanical systems. 

  13. Selecting appropriate energy efficiency indicators for the Thai Energy Conservation Promotion Programme. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Eichhammer, W.; Gruber, E.; Cremer, C.

    2000-06-01

    In 1992 the Thai Government passed the Energy Conservation Promotion (ECP) Act to improve energy efficiency in Thai industry and commerce. The Thai-German Energy Efficiency Promotion Project (ENEP) is supporting the Department of Energy Development and Promotion (DEDP) in its effort to implement the Energy Conservation Program for large buildings and designated factories. About 4000 buildings and factories under the Compulsory Program, have to report every 6 months their energy consumption data to DEDP. Every 3 years energy audits have to be conducted by registered energy consultants, to identify energy saving opportunities, to set saving targets and to recommend energy conservation measures. Investments in energy efficient technologies are subsidized from an Energy Conservation Fund. Data from the energy consumption reports and the energy audit reports are collected in DEDP's database for further processing. The database is structured according to the Thai Standard Industrial Classification. In order to exploit the wealth of information provided by the auditing procedure the objective of the present work carried out by the consultant FhG-ISI for DEDP/BERC on behalf of the German Gesellschaft fuer Technische Zusammenarbeit (GTZ) was to recommend an appropriate set of energy efficiency indicators. This indicator set should allow DEDP to extract from the energy consumption reports, energy audit reports and other sources, useful statistical information to monitor and improve energy efficiency in Thailand. (orig.)

  14. The adaptation of cities to climate change: appropriating the tools and accessing financing

    International Nuclear Information System (INIS)

    Depoues, Vivian; Leseur, Alexia

    2015-12-01

    Cities and urban areas are particularly affected because of their geographical location and the large share of the population and economic activities they bring together. This Climate Report provides a synthetic and problematized review of the literature on climate change adaptation at the urban scale, the tools and resources available to cities to implement strategies and adaptation actions. It is primarily intended for local officials in French-speaking cities. It provides a checkpoint of current dynamics, questions the real ownership of these resources by local stakeholders and identifies the openings for: - monitoring and evaluation adaptation to climate change; - Understand and use economic analysis as a help to the decision; - Access to funding to implement adaptation actions. This overview of the literature provides elements to understand how cities take ownership of the tools to design, select, monitor and evaluate adaptation projects. It highlights a mismatch between the maturity of the tools inventory and of the guidance available and the actual demand of cities. Except in a few well documented pioneers cases, the process of appropriation of adaptation issues is still at a relatively upstream stage

  15. Induction of appropriate Th-cell phenotypes: cellular decision-making in heterogeneous environments.

    Science.gov (United States)

    van den Ham, H-J; Andeweg, A C; de Boer, R J

    2013-11-01

    Helper T (Th)-cell differentiation is a key event in the development of the adaptive immune response. By the production of a range of cytokines, Th cells determine the type of immune response that is raised against an invading pathogen. Th cells can adopt many different phenotypes, and Th-cell phenotype decision-making is crucial in mounting effective host responses. This review discusses the different Th-cell phenotypes that have been identified and how Th cells adopt a particular phenotype. The regulation of Th-cell phenotypes has been studied extensively using mathematical models, which have explored the role of regulatory mechanisms such as autocrine cytokine signalling and cross-inhibition between self-activating transcription factors. At the single cell level, Th responses tend to be heterogeneous, but corrections can be made soon after T-cell activation. Although pathogens and the innate immune system provide signals that direct the induction of Th-cell phenotypes, these instructive mechanisms could be easily subverted by pathogens. We discuss that a model of success-driven feedback would select the most appropriate phenotype for clearing a pathogen. Given the heterogeneity in the induction phase of the Th response, such a success-driven feedback loop would allow the selection of effective Th-cell phenotypes while terminating incorrect responses. © 2013 John Wiley & Sons Ltd.

  16. The availability of appropriately fitting personal protective aprons and jackets for angiographic and interventional radiology personnel

    International Nuclear Information System (INIS)

    Cremen, S.A.; McNulty, J.P.

    2014-01-01

    Purpose: This study explored the availability of personal protective equipment, lead or lead-free aprons or jackets, in angiographic and interventional radiology suites in the Republic of Ireland with a focus on the sizes available, appropriateness of fit and purchasing practices. Methods: All centres providing an angiographic or interventional radiology service in the Republic of Ireland were invited to participate with data being collected by means of a postal questionnaire exploring the above issues. Results: The mean number of aprons or jackets available across the centres who responded to the survey was 18.4 with the majority of these, 72%, being medium or large in size. Clinical specialists in three centres identified that there were insufficient aprons or jackets sized extra small or extra large within their departments and only one centre had a purchasing policy in place where individual staff were assigned a personal apron or jacket. Conclusion: Ill-fitting aprons or jackets will reduce the shielding provided to certain body regions by personal protective equipment. The use of over-sized aprons or jackets by staff is of particular concern based on the potential for inadvertent exposure to tissues where cancers may potentially be induced due to poor armhole fit. It is important to carefully consider purchasing practices and range of personal protective equipment sizes available in order to ensure that all staff receive the greatest possible protection from occupational radiation exposure

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

    Science.gov (United States)

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

    2010-11-01

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

  18. Are carrots, corn and cattle really provided by Nature- If not, how can we appropriately identify the goods and services derived from agroecosystems?

    Science.gov (United States)

    People harbor different perspectives regarding the aspects of agroecosystems or cultivated lands that are or could be considered ecosystem services. The first issues that need to be addressed in this regard are to define agro-ecosystem services and to establish their potential p...

  19. Vulnerability of a low-income community in South Africa to air pollution: Exploring the use of structural equations modelling to identify appropriate interventions

    CSIR Research Space (South Africa)

    John, J

    2012-03-01

    Full Text Available diseases that affect their immune system. Structural equations modelling was used to capture the possible web of relationships between the household traits and a combined respiratory health outcome variable. Specifically, the two traits considered...

  20. A novel two-stage evaluation system based on a Group-G1 approach to identify appropriate emergency treatment technology schemes in sudden water source pollution accidents.

    Science.gov (United States)

    Qu, Jianhua; Meng, Xianlin; Hu, Qi; You, Hong

    2016-02-01

    Sudden water source pollution resulting from hazardous materials has gradually become a major threat to the safety of the urban water supply. Over the past years, various treatment techniques have been proposed for the removal of the pollutants to minimize the threat of such pollutions. Given the diversity of techniques available, the current challenge is how to scientifically select the most desirable alternative for different threat degrees. Therefore, a novel two-stage evaluation system was developed based on a circulation-correction improved Group-G1 method to determine the optimal emergency treatment technology scheme, considering the areas of contaminant elimination in both drinking water sources and water treatment plants. In stage 1, the threat degree caused by the pollution was predicted using a threat evaluation index system and was subdivided into four levels. Then, a technique evaluation index system containing four sets of criteria weights was constructed in stage 2 to obtain the optimum treatment schemes corresponding to the different threat levels. The applicability of the established evaluation system was tested by a practical cadmium-contaminated accident that occurred in 2012. The results show this system capable of facilitating scientific analysis in the evaluation and selection of emergency treatment technologies for drinking water source security.

  1. The importance of using food and nutrient intake data to identify appropriate vehicles and estimate potential benefits of food fortification in Uganda.

    Science.gov (United States)

    Kyamuhangire, William; Lubowa, Abdelrahman; Kaaya, Archileo; Kikafunda, Joyce; Harvey, Philip W J; Rambeloson, Zo; Dary, Omar; Dror, Daphna K; Allen, Lindsay H

    2013-06-01

    Concern over micronutrient inadequacies in Uganda has prompted the introduction of mass fortification. To use food intake to determine nutrient inadequacies in children aged 24 to 59 months and nonpregnant women of reproductive age, and to model the adequacy of mass fortification. Data were collected by the 24-hour recall method in three regions. Usual nutrient intakes were calculated by adjusting actual intake distribution for the intraindividual variance. The impact of fortification on intake adequacy was simulated. The nutrients with the highest prevalence of inadequate intake across regions were vitamin A (30% to 99%), vitamin B12 (32% to 100%), iron (55% to 89%), zinc (18% to 82%), and calcium (84% to 100%). According to simulations, fortification of vegetable oil and sugar with vitamin A would reduce the prevalence of vitamin A inadequacy in the Western and Northern regions; in Kampala it would eliminate vitamin A inadequacy but would cause 2% to 48% of children to exceed the Tolerable Upper Intake Level (UL). The proposed fortification of wheat flour would reduce the prevalence of inadequate intakes of thiamine, riboflavin, folate, and niacin in Kampala, but would have little impact in the other two regions due to low flour consumption. Micronutrient fortification of vegetable oil and sugar in all regions and of wheat flour in Kampala would reduce the prevalence of micronutrient inadequacies. However, the wheat flour formulation should be modified to better meet requirements, and the vitamin A content in sugar should be reduced to minimize the risk of high intakes. Maize flour may be suitable for targeted fortification, but prior consolidation of the industry would be required for maize flour to become a good vehicle for mass fortification.

  2. Position paper for health authorities: archived clinical pathology data-treasure to revalue and appropriate.

    Science.gov (United States)

    Nwose, E U; Richards, R S; Butkowski, E; Cann, Nathan

    2010-12-01

    Archived clinical pathology data (ACPD) is recognized as useful for research. Given our privileged de-identified ACPD from South West Pathology Service (SWPS), attempt is made to estimate what it would cost any researcher without such privilege to generate the same data. The Ethics Committee of the Area Health Service approved a request for Dr. Uba Nwose to use de-identified ACPD acquired by the SWPS for clinical laboratory-based translational biomedical science research. 10-years (1999-2008) have been pooled to constitute the database. Data include blood sugar, cholesterol, D-dime, ESR, glucose tolerance, haematocrit, HbA 1 c, homocysteine, serum creatinine, total protein and vitamins [C & E] amongst others. For this report, the bulk-billed-cost of tests were estimated based on number and unit price of each test performed. AU$ 17,507,136.85 is the cost paid by Medicare in the period. This amount is a conservative estimate that could be spent to generate such 10-years data in the absence of ACPD. The health/pathology service has not given any financial research grant. However, the support-in-kind is worth more than celebrated competitive research grants. It calls for revaluatrion by academic, research and scientific institutions the use ofACPD. For the countries where such provision is non-existent, this report provides a 'Position Paper' to present to the directorates or institutes of health authorities to appropriate the value of ACPD and approve of their use as a research treasure and resource management tool.

  3. Use of Indirect Calorimetry to Detect Overfeeding in Critically Ill Children: Finding the Appropriate Definition.

    Science.gov (United States)

    Kerklaan, Dorian; Hulst, Jessie M; Verhoeven, Jennifer J; Verbruggen, Sascha C A T; Joosten, Koen F M

    2016-10-01

    Overfeeding during critical illness is associated with adverse effects such as metabolic disturbances and increased risk of infection. Because of the lack of sound studies with clinical endpoints, overfeeding is arbitrarily defined as the ratio caloric intake/measured resting energy expenditure (mREE) or alternatively as a comparison of measured respiratory quotient (RQ) to the predicted RQ based on the macronutrient intake (RQmacr). We aimed to compare definitions of overfeeding in critically ill mechanically ventilated children based on mREE, RQ, and caloric intake to find an appropriate definition. Indirect calorimetry measurements were performed in 78 mechanically ventilated children, median age 6.3 months. Enteral and/or parenteral nutrition was provided according to the local guidelines. Definitions used to indicate overfeeding were the ratio caloric intake/mREE of >110% and >120% and by the measured RQ > RQmacr + 0.05. The proportion of patients identified as overfed varied widely depending on the definition used, ranging from 22% (RQ > RQmacr + 0.05), to 40% and 50% (caloric intake/mREE of >120% and >110%, respectively). Linear regression analysis showed that all patients would be identified as overfed with the definition RQ > RQmacr + 0.05 when the ratio caloric intake/mREE exceeded 165%. Caloric intake was higher in children with a standard deviation-score weight for age definition applied. These currently used definitions fail to take into account several relevant factors affecting metabolism during critical illness and are therefore not generally applicable to the pediatric intensive care unit population.

  4. Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus.

    Science.gov (United States)

    Attridge, Madeleine; Creamer, John; Ramsden, Michael; Cannings-John, Rebecca; Hawthorne, Kamila

    2014-09-04

    Ethnic minority groups in upper-middle-income and high-income countries tend to be socioeconomically disadvantaged and to have a higher prevalence of type 2 diabetes than is seen in the majority population. To assess the effectiveness of culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. A systematic literature search was performed of the following databases: The Cochrane Library, MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and Google Scholar, as well as reference lists of identified articles. The date of the last search was July 2013 for The Cochrane Library and September 2013 for all other databases. We contacted authors in the field and handsearched commonly encountered journals as well. We selected randomised controlled trials (RCTs) of culturally appropriate health education for people over 16 years of age with type 2 diabetes mellitus from named ethnic minority groups residing in upper-middle-income or high-income countries. Two review authors independently assessed trial quality and extracted data. When disagreements arose regarding selection of papers for inclusion, two additional review authors were consulted for discussion. We contacted study authors to ask for additional information when data appeared to be missing or needed clarification. A total of 33 trials (including 11 from the original 2008 review) involving 7453 participants were included in this review, with 28 trials providing suitable data for entry into meta-analysis. Although the interventions provided in these studies were very different from one study to another (participant numbers, duration of intervention, group versus individual intervention, setting), most of the studies were based on recognisable theoretical models, and we tried to be inclusive in considering the wide variety of available culturally appropriate health education.Glycaemic control (as measured by glycosylated haemoglobin A1c (HbA1c

  5. Environmental Report 1996, Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    Harrach, R.J.

    1996-01-01

    This is Volume 2 of the Lawrence Livermore National Laboratory`s (LLNL`s) annual Environmental Report 1996, prepared for the US Department of Energy. Volume 2 supports Volume 1 summary data and is essentially a detailed data report that provides individual data points, where applicable. Volume 2 includes information on monitoring of air, air effluents, sewerable water, surface water, ground water, soil and sediment, vegetation and foodstuff, environmental radiation, and quality assurance.

  6. Quantifying Human Appropriated Net Primary Productivity (HANPP) in a Ghanaian Cocoa System

    Science.gov (United States)

    Morel, A.; Adu-Bredu, S.; Adu Sasu, M.; Ashley Asare, R.; Boyd, E.; Hirons, M. A.; Malhi, Y.; Mason, J.; Norris, K.; Robinson, E. J. Z.; McDermott, C. L.

    2015-12-01

    Ghana is the second largest producer of cocoa (Theobroma cacoa), exporting approximately 18 percent of global volumes. These cocoa farms are predominantly small-scale, ranging in size from 2-4 hectares (ha). Traditionally, the model of cocoa expansion in Ghana relied on clearing new areas of forest and establishing a farm under remnant forest trees. This is increasingly less practical due to few unprotected forest areas remaining and management practices favoring close to full sun cocoa to maximize short-term yields. This study is part of a larger project, ECOLMITS, which is an interdisciplinary, ESPA-funded[1] initiative exploring the ecological limits of ecosystem system services (ESS) for alleviating poverty in small-scale agroforestry systems. The ecological study plots are situated within and around the Kakum National Forest, a well-protected, moist-evergreen forest of the Lower Guinea Forest region. Net primary productivity (NPP) is a measure of the rate at which carbon dioxide (CO2) is incorporated into plant tissues (e.g. canopy, stem and root). For this study, NPP was monitored in situ using methods developed by the Global Environmental Monitoring Network (GEM, http://gem.tropicalforests.ox.ac.uk/). By comparing NPP measured in intact forest and farms, the human appropriated NPP (HANPP) of this system can be estimated. The forest measures provide the "potential" NPP of the region, and then the reduction in NPP for farm plots is calculated for both land-cover change (HANPPLUC) and cocoa harvesting (HANPPHARV). The results presented are of the first year of NPP measurements across the cocoa landscape, including measurements from intact forest, logged forest and cocoa farms across a shade gradient and located at varying distances from the forest edge (e.g. 100 m, 500 m, 1 km and 5 km). These measures will have implications for carbon sequestration potential over the region and long-term sustainability of the Ghanaian cocoa sector. [1] Ecosystem Services for

  7. Behavioral Dynamics in Swimming: The Appropriate Use of Inertial Measurement Units.

    Science.gov (United States)

    Guignard, Brice; Rouard, Annie; Chollet, Didier; Seifert, Ludovic

    2017-01-01

    Motor control in swimming can be analyzed using low- and high-order parameters of behavior. Low-order parameters generally refer to the superficial aspects of movement (i.e., position, velocity, acceleration), whereas high-order parameters capture the dynamics of movement coordination. To assess human aquatic behavior, both types have usually been investigated with multi-camera systems, as they offer high three-dimensional spatial accuracy. Research in ecological dynamics has shown that movement system variability can be viewed as a functional property of skilled performers, helping them adapt their movements to the surrounding constraints. Yet to determine the variability of swimming behavior, a large number of stroke cycles (i.e., inter-cyclic variability) has to be analyzed, which is impossible with camera-based systems as they simply record behaviors over restricted volumes of water. Inertial measurement units (IMUs) were designed to explore the parameters and variability of coordination dynamics. These light, transportable and easy-to-use devices offer new perspectives for swimming research because they can record low- to high-order behavioral parameters over long periods. We first review how the low-order behavioral parameters (i.e., speed, stroke length, stroke rate) of human aquatic locomotion and their variability can be assessed using IMUs. We then review the way high-order parameters are assessed and the adaptive role of movement and coordination variability in swimming. We give special focus to the circumstances in which determining the variability between stroke cycles provides insight into how behavior oscillates between stable and flexible states to functionally respond to environmental and task constraints. The last section of the review is dedicated to practical recommendations for coaches on using IMUs to monitor swimming performance. We therefore highlight the need for rigor in dealing with these sensors appropriately in water. We explain the

  8. Quantifying Appropriate PTV Setup Margins: Analysis of Patient Setup Fidelity and Intrafraction Motion Using Post-Treatment Megavoltage Computed Tomography Scans

    International Nuclear Information System (INIS)

    Drabik, Donata M.; MacKenzie, Marc A.; Fallone, Gino B.

    2007-01-01

    Purpose: To present a technique that can be implemented in-house to evaluate the efficacy of immobilization and image-guided setup of patients with different treatment sites on helical tomotherapy. This technique uses an analysis of alignment shifts between kilovoltage computed tomography and post-treatment megavoltage computed tomography images. The determination of the shifts calculated by the helical tomotherapy software for a given site can then be used to define appropriate planning target volume internal margins. Methods and Materials: Twelve patients underwent post-treatment megavoltage computed tomography scans on a helical tomotherapy machine to assess patient setup fidelity and net intrafraction motion. Shifts were studied for the prostate, head and neck, and glioblastoma multiforme. Analysis of these data was performed using automatic and manual registration of the kilovoltage computed tomography and post-megavoltage computed tomography images. Results: The shifts were largest for the prostate, followed by the head and neck, with glioblastoma multiforme having the smallest shifts in general. It appears that it might be more appropriate to use asymmetric planning target volume margins. Each margin value reported is equal to two standard deviations of the average shift in the given direction. Conclusion: This method could be applied using individual patient post-image scanning and combined with adaptive planning to reduce or increase the margins as appropriate

  9. [Target volume margins for lung cancer: internal target volume/clinical target volume].

    Science.gov (United States)

    Jouin, A; Pourel, N

    2013-10-01

    The aim of this study was to carry out a review of margins that should be used for the delineation of target volumes in lung cancer, with a focus on margins from gross tumour volume (GTV) to clinical target volume (CTV) and internal target volume (ITV) delineation. Our review was based on a PubMed literature search with, as a cornerstone, the 2010 European Organisation for Research and Treatment of Cancer (EORTC) recommandations by De Ruysscher et al. The keywords used for the search were: radiotherapy, lung cancer, clinical target volume, internal target volume. The relevant information was categorized under the following headings: gross tumour volume definition (GTV), CTV-GTV margin (first tumoural CTV then nodal CTV definition), in field versus elective nodal irradiation, metabolic imaging role through the input of the PET scanner for tumour target volume and limitations of PET-CT imaging for nodal target volume definition, postoperative radiotherapy target volume definition, delineation of target volumes after induction chemotherapy; then the internal target volume is specified as well as tumoural mobility for lung cancer and respiratory gating techniques. Finally, a chapter is dedicated to planning target volume definition and another to small cell lung cancer. For each heading, the most relevant and recent clinical trials and publications are mentioned. Copyright © 2013. Published by Elsevier SAS.

  10. REFLECTION AND REFRACTION, VOLUME 2.

    Science.gov (United States)

    KLAUS, DAVID J.; AND OTHERS

    THIS VOLUME 2 OF A TWO-VOLUME SET PROVIDES AUTOINSTRUCTION IN PHYSICS. THE UNITS COVERED IN THIS VOLUME ARE (1) REFLECTION OF LIGHT, (2) PHOTOMETRY, (3) POLARIZATION, (4) REFRACTION OF LIGHT, (5) SNELL'S LAW, (6) LENSES, FOCUS, AND FOCAL POINTS, (7) IMAGE FORMATION, AND (8) ABERRATIONS, THE EYE, AND MAGNIFICATION. THE INTRODUCTION AND UNITS ON…

  11. Identifying Topics in Microblogs Using Wikipedia.

    Directory of Open Access Journals (Sweden)

    Ahmet Yıldırım

    Full Text Available Twitter is an extremely high volume platform for user generated contributions regarding any topic. The wealth of content created at real-time in massive quantities calls for automated approaches to identify the topics of the contributions. Such topics can be utilized in numerous ways, such as public opinion mining, marketing, entertainment, and disaster management. Towards this end, approaches to relate single or partial posts to knowledge base items have been proposed. However, in microblogging systems like Twitter, topics emerge from the culmination of a large number of contributions. Therefore, identifying topics based on collections of posts, where individual posts contribute to some aspect of the greater topic is necessary. Models, such as Latent Dirichlet Allocation (LDA, propose algorithms for relating collections of posts to sets of keywords that represent underlying topics. In these approaches, figuring out what the specific topic(s the keyword sets represent remains as a separate task. Another issue in topic detection is the scope, which is often limited to specific domain, such as health. This work proposes an approach for identifying domain-independent specific topics related to sets of posts. In this approach, individual posts are processed and then aggregated to identify key tokens, which are then mapped to specific topics. Wikipedia article titles are selected to represent topics, since they are up to date, user-generated, sophisticated articles that span topics of human interest. This paper describes the proposed approach, a prototype implementation, and a case study based on data gathered during the heavily contributed periods corresponding to the four US election debates in 2012. The manually evaluated results (0.96 precision and other observations from the study are discussed in detail.

  12. Identifying Topics in Microblogs Using Wikipedia.

    Science.gov (United States)

    Yıldırım, Ahmet; Üsküdarlı, Suzan; Özgür, Arzucan

    2016-01-01

    Twitter is an extremely high volume platform for user generated contributions regarding any topic. The wealth of content created at real-time in massive quantities calls for automated approaches to identify the topics of the contributions. Such topics can be utilized in numerous ways, such as public opinion mining, marketing, entertainment, and disaster management. Towards this end, approaches to relate single or partial posts to knowledge base items have been proposed. However, in microblogging systems like Twitter, topics emerge from the culmination of a large number of contributions. Therefore, identifying topics based on collections of posts, where individual posts contribute to some aspect of the greater topic is necessary. Models, such as Latent Dirichlet Allocation (LDA), propose algorithms for relating collections of posts to sets of keywords that represent underlying topics. In these approaches, figuring out what the specific topic(s) the keyword sets represent remains as a separate task. Another issue in topic detection is the scope, which is often limited to specific domain, such as health. This work proposes an approach for identifying domain-independent specific topics related to sets of posts. In this approach, individual posts are processed and then aggregated to identify key tokens, which are then mapped to specific topics. Wikipedia article titles are selected to represent topics, since they are up to date, user-generated, sophisticated articles that span topics of human interest. This paper describes the proposed approach, a prototype implementation, and a case study based on data gathered during the heavily contributed periods corresponding to the four US election debates in 2012. The manually evaluated results (0.96 precision) and other observations from the study are discussed in detail.

  13. Utility of the AAOS Appropriate Use Criteria (AUC) for Pediatric Supracondylar Humerus Fractures in Clinical Practice.

    Science.gov (United States)

    Ibrahim, Talal; Hegazy, Abdelsalam; Abulhail, Safa I S; Ghomrawi, Hassan M K

    2017-01-01

    The American Academy of Orthopaedic Surgeons (AAOS) recently developed an Appropriate Use Criteria (AUC) for pediatric supracondylar humerus fractures (PSHF). The AUC is intended to improve quality of care by informing surgeon decision making. The aim of our study was to cross-reference the management of operatively treated PSHF with the AAOS-published AUC. The AUC for PSHF include 220 patient scenarios, based on different combinations of 6 factors. For each patient scenario, 8 treatment options are evaluated as "appropriate," "maybe appropriate," and "rarely appropriate." We retrospectively reviewed the medical charts and radiographs of all operatively treated PSHF at our hospital from January 2013 to December 2014 and determined the appropriateness of the treatment. Over the study period, 94 children (mean age: 5.2 y; 51 male, 43 female) were admitted with PSHF and underwent a surgical procedure (type IIA: 7, type IIB: 14, type III: 70, flexion type: 3). Only 8 of the 220 scenarios were observed in our patient cohort. The most frequent scenario was represented by a type III fracture, palpable distal pulse, no nerve injury, closed soft-tissue envelope, no radius/ulna fracture, and typical swelling. Of the 94 fractures, the AUC was "appropriate" for 84 cases and "maybe appropriate" for 9 cases. There was only 1 case of "rarely appropriate" management. Closed reduction with lateral pinning and immobilization was the most prevalent treatment option (58.5%). The rate of appropriateness was not affected by the operating surgeon. However, the definition of a case as emergent had a significant impact on the rate of appropriateness. Application of the AUC to actual clinical data was relatively simple. The majority of operatively treated PSHF (89.4%) were managed appropriately. With the introduction of electronic medical charts, an AUC application becomes attractive and easy for orthopaedic surgeons to utilize in clinical practice. However, validity studies of the AUC in

  14. Novel genetic loci associated with hippocampal volume

    OpenAIRE

    Hibar, Derrek P.; Adams, Hieab H. H.; Jahanshad, Neda; Chauhan, Ganesh; Stein, Jason L.; Hofer, Edith; Renteria, Miguel E.; Bis, Joshua C.; Arias-Vasquez, Alejandro; Ikram, M. Kamran; Desrivieres, Sylvane; Vernooij, Meike W.; Abramovic, Lucija; Alhusaini, Saud; Amin, Najaf

    2017-01-01

    International audience; The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal ...

  15. Increased intracranial volume in Parkinson's disease

    DEFF Research Database (Denmark)

    Krabbe, Katja; Karlsborg, Merete; Hansen, Andreas

    2005-01-01

    Parkinson's disease (PD) and multiple system atrophy (MSA) are neurodegenerative diseases that can be difficult to diagnose and distinguish from each other. STUDY AIMS AND METHODS: Patients with PD and MSA and controls were studied with magnetic resonance imaging (MRI) using tissue segmentation a...... and outlining of regions in order to identify regional volume changes that might be useful in the diagnosis of the two diseases....

  16. Atmospheric Electricity and Tethered Aerostats, Volume 2

    Science.gov (United States)

    1976-05-11

    EASTERN TEST RANGE PATRICK AIR FORCE BASE, FLORIDA 11 MAY 1976 028 099 AFETR -TR-76-07 ATMOSPHERIC ELECTRICITY AND ~TETHERED AEROSTATS, VOLUME 11 Range...number) Atmospheric Electricity Lightning- Effects , Protection, Warning Balloons Systems Conducting & Nonconducting Tethers Potential Gradient Anomalies...if necessary and Identify by block number) Part A, "Atmospheric Electrical Effects of and on Tethered Balloon Systems," by Latham includes airborne

  17. Identifying Bitcoin users by transaction behavior

    Science.gov (United States)

    Monaco, John V.

    2015-05-01

    Digital currencies, such as Bitcoin, offer convenience and security to criminals operating in the black marketplace. Some Bitcoin marketplaces, such as Silk Road, even claim anonymity. This claim contradicts the findings in this work, where long term transactional behavior is used to identify and verify account holders. Transaction timestamps and network properties observed over time contribute to this finding. The timestamp of each transaction is the result of many factors: the desire purchase an item, daily schedule and activities, as well as hardware and network latency. Dynamic network properties of the transaction, such as coin flow and the number of edge outputs and inputs, contribute further to reveal account identity. In this paper, we propose a novel methodology for identifying and verifying Bitcoin users based on the observation of Bitcoin transactions over time. The behavior we attempt to quantify roughly occurs in the social band of Newell's time scale. A subset of the Blockchain 230686 is taken, selecting users that initiated between 100 and 1000 unique transactions per month for at least 6 different months. This dataset shows evidence of being nonrandom and nonlinear, thus a dynamical systems approach is taken. Classification and authentication accuracies are obtained under various representations of the monthly Bitcoin samples: outgoing transactions, as well as both outgoing and incoming transactions are considered, along with the timing and dynamic network properties of transaction sequences. The most appropriate representations of monthly Bitcoin samples are proposed. Results show an inherent lack of anonymity by exploiting patterns in long-term transactional behavior.

  18. The NOAA Dataset Identifier Project

    Science.gov (United States)

    de la Beaujardiere, J.; Mccullough, H.; Casey, K. S.

    2013-12-01

    The US National Oceanic and Atmospheric Administration (NOAA) initiated a project in 2013 to assign persistent identifiers to datasets archived at NOAA and to create informational landing pages about those datasets. The goals of this project are to enable the citation of datasets used in products and results in order to help provide credit to data producers, to support traceability and reproducibility, and to enable tracking of data usage and impact. A secondary goal is to encourage the submission of datasets for long-term preservation, because only archived datasets will be eligible for a NOAA-issued identifier. A team was formed with representatives from the National Geophysical, Oceanographic, and Climatic Data Centers (NGDC, NODC, NCDC) to resolve questions including which identifier scheme to use (answer: Digital Object Identifier - DOI), whether or not to embed semantics in identifiers (no), the level of granularity at which to assign identifiers (as coarsely as reasonable), how to handle ongoing time-series data (do not break into chunks), creation mechanism for the landing page (stylesheet from formal metadata record preferred), and others. Decisions made and implementation experience gained will inform the writing of a Data Citation Procedural Directive to be issued by the Environmental Data Management Committee in 2014. Several identifiers have been issued as of July 2013, with more on the way. NOAA is now reporting the number as a metric to federal Open Government initiatives. This paper will provide further details and status of the project.

  19. Evidence-based estimate of appropriate radiotherapy utilization rate for prostate cancer

    International Nuclear Information System (INIS)

    Foroudi, Farshad; Tyldesley, Scott; Barbera, Lisa; Huang, Jenny; Mackillop, William J.

    2003-01-01

    Purpose: Current estimates of the proportion of cancer patients who will require radiotherapy (RT) are based almost entirely on expert opinion. The objective of this study was to use an evidence-based approach to estimate the proportion of incident cases of prostate cancer that should receive RT at any point in the evolution of the illness. Methods and Materials: A systematic review of the literature was undertaken to identify indications for RT for prostate cancer and to ascertain the level of evidence that supported each indication. An epidemiologic approach was then used to estimate the incidence of each indication for RT in a typical North American population of prostate cancer patients. The effect of sampling error on the estimated appropriate rate of RT was calculated mathematically, and the effect of systematic error using alternative sources of information was estimated by sensitivity analysis. Results: It was estimated that 61.2% ±5.6% of prostate cancer cases develop one or more indications for RT at some point in the course of the illness. The plausible range for this rate was 57.3%-69.8% on sensitivity analysis. Of all prostate cancer patients, 32.2%±3.8% should receive RT in their initial treatment and 29.0% ± 4.1% later for recurrence or progression. The proportion of cases that ever require RT is risk grouping dependent; 43.9%±2.2% in low-risk disease, 68.7%± .5% in intermediate-risk disease; and 79.0% ± 3.8% in high-risk locoregional disease. For metastatic disease, the predicted rate was 66.4%±0.3%. Conclusion: This method provides a rational starting point for the long-term planning of radiation services and for the audit of access to RT at the population level. By completing such evaluations in major cancer sites, it will be possible to estimate the appropriate RT rate for the cancer population as a whole

  20. Resources for Middle Eastern patients: online resources for culturally and linguistically appropriate services in home healthcare and hospice, part 3.

    Science.gov (United States)

    Young, Judith S

    2013-01-01

    As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.