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Sample records for waiting point nucleus

  1. Shape study of the N=Z waiting-point nucleus 72Kr via beta decay

    CERN Document Server

    Briz Monago, Jose Antonio; Nácher González, Enrique

    The Ph.D. thesis entitled “Shape study of the N=Z waiting-point nucleus 72Kr via beta decay” is devoted to the study of the shape of the ground state of the 72Kr nucleus. It is an N=Z nucleus in the mass region A~70-80 where shape transitions and the shape coexistence phenomena have been identified. Furthermore, this nucleus participates in the rp-process as a waiting point due to the slowdown of the process taking place at the arrival to this nucleus. The study of the properties of this nucleus is interesting from the Nuclear Structure point of view, for the phenomena occurring in its mass region and have been predicted for it, and from the Nuclear Astrophysics for the accurate performance of astrophysical calculations. The β+/EC decay of the 72Kr nucleus has been studied through two complementary experiments at the ISOLDE facility at CERN in Geneva (Switzerland). In one of them, the low-spin structure of the daughter nucleus, 72Br, has been revised via conversion electron spectroscopy where the convers...

  2. Nuclear binding around the RP-process waiting points $^{68}$Se and $^{72}$Kr

    CERN Multimedia

    2002-01-01

    Encouraged by the success of mass determinations of nuclei close to the Z=N line performed at ISOLTRAP during the year 2000 and of the recent decay spectroscopy studies on neutron-deficient Kr isotopes (IS351 collaboration), we aim to measure masses and proton separation energies of the bottleneck nuclei defining the flow of the astrophysical rp-process beyond A$\\sim$70. In detail, the program includes mass measurements of the rp-process waiting point nuclei $^{68}$Se and $^{72}$Kr and determination of proton separation energies of the proton-unbound $^{69}$Br and $^{73}$Rb via $\\beta$-decays of $^{69}$Kr and $^{73}$Sr, respectively. The aim of the project is to complete the experimental database for astrophysical network calculations and for the liquid-drop type of mass models typically used in the modelling of the astrophysical rp process in the region. The first beamtime is scheduled for the August 2001 and the aim is to measure the absolute mass of the waiting-point nucleus $^{72}$Kr.

  3. Approaching the r-process "waiting point" nuclei below $^{132}$Sn: quadrupole collectivity in $^{128}$Cd

    CERN Multimedia

    Reiter, P; Blazhev, A A; Nardelli, S; Voulot, D; Habs, D; Schwerdtfeger, W; Iwanicki, J S

    We propose to investigate the nucleus $^{128}$Cd neighbouring the r-process "waiting point" $^{130}$Cd. A possible explanation for the peak in the solar r-abundances at A $\\approx$ 130 is a quenching of the N = 82 shell closure for spherical nuclei below $^{132}$Sn. This explanation seems to be in agreement with recent $\\beta$-decay measurements performed at ISOLDE. In contrast to this picture, a beyond-mean-field approach would explain the anomaly in the excitation energy observed for $^{128}$Cd rather with a quite large quadrupole collectivity. Therefore, we propose to measure the reduced transition strengths B(E2) between ground state and first excited 2$^{+}$-state in $^{128}$Cd applying $\\gamma$-spectroscopy with MINIBALL after "safe" Coulomb excitation of a post-accelerated beam obtained from REX-ISOLDE. Such a measurement came into reach only because of the source developments made in 2006 for experiment IS411, in particular the use of a heated quartz transfer line. The result from the proposed measure...

  4. β-delayed proton emission of 69Kr and the 68Se rp-process waiting point

    Directory of Open Access Journals (Sweden)

    M. Del Santo

    2014-11-01

    Full Text Available The slow β-decay of the 68Se waiting point in the astrophysical rp-process can in principle be bypassed by a sequential two proton capture. The rate of this reaction sequence depends exponentially on the 69Br proton separation energy. We studied β-delayed proton emission of 69Kr and extracted a proton separation energy of −641(42 keV. In addition, we determined a 69Kr β-decay half-life of T1/2=28(1 ms and an excitation energy of 3153(55 keV of the 69Kr isobaric analog state in 69Br. X-ray burst model calculations show that regardless of the values of other uncertain masses in the region, the new Sp(Br69 allows for a reaction flow via Se68(2p,γ of at most 20%. Uncertainties are sufficiently reduced to conclude that Se68(2p,γ has at best a very small effect on burst light curve and composition, and that 68Se is a strong rp-process waiting point. Our results also exclude the possibility of a suggested longer lived, so far unobserved, 69Br ground state.

  5. Compound nucleus decay: Comparison between saddle point and scission point barriers

    Energy Technology Data Exchange (ETDEWEB)

    Santos, T. J.; Carlson, B. V. [Depto. de Física, Instituto Tecnológico de Aeronáutica, São José dos Campos, SP (Brazil)

    2014-11-11

    One of the principal characteristics of nuclear multifragmentation is the emission of complex fragments of intermediate mass. An extension of the statistical multifragmentation model has been developed, in which the process can be interpreted as the near simultaneous limit of a series of sequential binary decays. In this extension, intermediate mass fragment emissions are described by expressions almost identical to those of light particle emission. At lower temperatures, similar expressions have been shown to furnish a good description of very light intermediate mass fragment emission but not of the emission of heavier fragments, which seems to be determined by the transition density at the saddle-point rather than at the scission point. Here, we wish to compare these different formulations of intermediate fragmment emission and analyze the extent to which they remain distinguishable at high excitation energy.

  6. Neural set point for the control of arterial pressure: role of the nucleus tractus solitarius

    Directory of Open Access Journals (Sweden)

    Valentinuzzi Max E

    2010-01-01

    Full Text Available Abstract Background Physiological experiments have shown that the mean arterial blood pressure (MAP can not be regulated after chemo and cardiopulmonary receptor denervation. Neuro-physiological information suggests that the nucleus tractus solitarius (NTS is the only structure that receives information from its rostral neural nuclei and from the cardiovascular receptors and projects to nuclei that regulate the circulatory variables. Methods From a control theory perspective, to answer if the cardiovascular regulation has a set point, we should find out whether in the cardiovascular control there is something equivalent to a comparator evaluating the error signal (between the rostral projections to the NTS and the feedback inputs. The NTS would function as a comparator if: a its lesion suppresses cardiovascular regulation; b the negative feedback loop still responds normally to perturbations (such as mechanical or electrical after cutting the rostral afferent fibers to the NTS; c perturbation of rostral neural structures (RNS to the NTS modifies the set point without changing the dynamics of the elicited response; and d cardiovascular responses to perturbations on neural structures within the negative feedback loop compensate for much faster than perturbations on the NTS rostral structures. Results From the control theory framework, experimental evidence found currently in the literature plus experimental results from our group was put together showing that the above-mentioned conditions (to show that the NTS functions as a comparator are satisfied. Conclusions Physiological experiments suggest that long-term blood pressure is regulated by the nervous system. The NTS functions as a comparator (evaluating the error signal between its RNS and the cardiovascular receptor afferents and projects to nuclei that regulate the circulatory variables. The mean arterial pressure (MAP is regulated by the feedback of chemo and cardiopulmonary receptors and

  7. Cardiac EASE (Ensuring Access and Speedy Evaluation) – the impact of a single-point-of-entry multidisciplinary outpatient cardiology consultation program on wait times in Canada

    Science.gov (United States)

    Bungard, Tammy J; Smigorowsky, Marcie J; Lalonde, Lucille D; Hogan, Terry; Doliszny, Katharine M; Gebreyesus, Ghirmay; Garg, Sipi; Archer, Stephen L

    2009-01-01

    BACKGROUND: Universal access to health care is valued in Canada but increasing wait times for services (eg, cardiology consultation) raise safety questions. Observations suggest that deficiencies in the process of care contribute to wait times. Consequently, an outpatient clinic was designed for Ensuring Access and Speedy Evaluation (Cardiac EASE) in a university group practice, providing cardiac consultative services for northern Alberta. Cardiac EASE has two components: a single-point-of-entry intake service (prospective testing using physician-approved algorithms and previsit triage) and a multidisciplinary clinic (staffed by cardiologists, nurse practitioners and doctoral-trained pharmacists). OBJECTIVES: It was hypothesized that Cardiac EASE would reduce the time to initial consultation and a definitive diagnosis, and also increase the referral capacity. METHODS: The primary and secondary outcomes were time from referral to initial consultation, and time to achieve a definitive diagnosis and management plan, respectively. A conventionally managed historical control group (three-month pre-EASE period in 2003) was compared with the EASE group (2004 to 2006). The conventional referral mechanism continued concurrently with EASE. RESULTS: A comparison between pre-EASE (n=311) and EASE (n=3096) revealed no difference in the mean (± SD) age (60±16 years), sex (55% and 52% men, respectively) or reason for referral, including chest pain (31% and 40%, respectively) and arrhythmia (27% and 29%, respectively). Cardiac EASE reduced the time to initial cardiac consultation (from 71±45 days to 33±19 days) and time to a definitive diagnosis (from 120±86 days to 51±58 days) (P<0.0001). The annual number of new referrals increased from 1512 in 2002 to 2574 in 2006 due to growth in the Cardiac EASE clinic. The number of patients seen through the conventional referral mechanism and their wait times remained constant during the study period. CONCLUSIONS: Cardiac EASE reduced

  8. The 5-HT1A/1B-receptor agonist eltoprazine increases both catecholamine release in the prefrontal cortex and dopamine release in the nucleus accumbens and decreases motivation for reward and "waiting" impulsivity, but increases "stopping" impulsivity.

    Science.gov (United States)

    Korte, S Mechiel; Prins, Jolanda; Van den Bergh, Filip S; Oosting, Ronald S; Dupree, Rudy; Korte-Bouws, Gerdien A H; Westphal, Koen G C; Olivier, Berend; Denys, Damiaan A; Garland, Alexis; Güntürkün, Onur

    2017-01-05

    The 5-HT1A/1B-receptor agonist eltoprazine has a behavioral drug signature that resembles that of a variety of psychostimulant drugs, despite the differences in receptor binding profile. These psychostimulants are effective in treating impulsivity disorders, most likely because they increase norepinephrine (NE) and dopamine (DA) levels in the prefrontal cortex. Both amphetamine and methylphenidate, however, also increase dopamine levels in the nucleus accumbens (NAc), which has a significant role in motivation, pleasure, and reward. How eltoprazine affects monoamine release in the medial prefrontal cortex (mPFC), the orbitofrontal cortex (OFC), and the NAc is unknown. It is also unknown whether eltoprazine affects different forms of impulsivity and brain reward mechanisms. Therefore, in the present study, we investigate the effects of eltoprazine in rats in the following sequence: 1) the activity of the monoaminergic systems using in vivo microdialysis, 2) motivation for reward measured using the intracranial self-stimulation (ICSS) procedure, and finally, 3) "waiting" impulsivity in the delay-aversion task, and the "stopping" impulsivity in the stop-signal task. The microdialysis studies clearly showed that eltoprazine increased DA and NE release in both the mPFC and OFC, but only increased DA concentration in the NAc. In contrast, eltoprazine decreased 5-HT release in the mPFC and NAc (undetectable in the OFC). Remarkably, eltoprazine decreased impulsive choice, but increased impulsive action. Furthermore, brain stimulation was less rewarding following eltoprazine treatment. These results further support the long-standing hypothesis that "waiting" and "stopping" impulsivity are regulated by distinct neural circuits, because 5-HT1A/1B-receptor activation decreases impulsive choice, but increases impulsive action. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. [Deviations of spontaneous firing in the cochlear nucleus of the frog from the renewal point process].

    Science.gov (United States)

    Bibikov, N G; Dymov, A B

    2007-01-01

    The analysis of statistical characteristics of spontaneous activity (distribution of interpulse intervals, hazard function, autocorrelation function, autocorrelation function for a process with shifted intervals, interdependence between adjoining intervals) for 123 units located in the cochlear nucleus of the frog has been performed. In the majority of cells, this activity was distinct from the poissonic process, and in some cases firing periodicity was noticed. Besides, deviations of the spontaneous activity from the renewal process were usually observed. A reliable positive correlation of interpulse intervals was typical for the majority of the units, though in some cases a negative correlation of short adjoining intervals was revealed. The data indicate the occurrence of effects of memory in the activity of single units of the acoustical system.

  10. Designs for Testing Group-Based Interventions with Limited Numbers of Social Units: The Dynamic Wait-Listed and Regression Point Displacement Designs.

    Science.gov (United States)

    Wyman, Peter A; Henry, David; Knoblauch, Shannon; Brown, C Hendricks

    2015-10-01

    The dynamic wait-listed design (DWLD) and regression point displacement design (RPDD) address several challenges in evaluating group-based interventions when there is a limited number of groups. Both DWLD and RPDD utilize efficiencies that increase statistical power and can enhance balance between community needs and research priorities. The DWLD blocks on more time units than traditional wait-listed designs, thereby increasing the proportion of a study period during which intervention and control conditions can be compared, and can also improve logistics of implementing intervention across multiple sites and strengthen fidelity. We discuss DWLDs in the larger context of roll-out randomized designs and compare it with its cousin the Stepped Wedge design. The RPDD uses archival data on the population of settings from which intervention unit(s) are selected to create expected posttest scores for units receiving intervention, to which actual posttest scores are compared. High pretest-posttest correlations give the RPDD statistical power for assessing intervention impact even when one or a few settings receive intervention. RPDD works best when archival data are available over a number of years prior to and following intervention. If intervention units were not randomly selected, propensity scores can be used to control for non-random selection factors. Examples are provided of the DWLD and RPDD used to evaluate, respectively, suicide prevention training (QPR) in 32 schools and a violence prevention program (CeaseFire) in two Chicago police districts over a 10-year period. How DWLD and RPDD address common threats to internal and external validity, as well as their limitations, are discussed.

  11. Determining the resonance strength of the 56Ni rp-process waiting point through (d,n) with VANDLE and MoNA-LISA

    Science.gov (United States)

    Peters, W.; Grzywacz, R.; Madurga, M.; Paulauskas, S. V.; Taylor, S.; Allen, J.; Cizewski, J. A.; Manning, B.; Howard, M. E.; Smith, J.; Jones, M.; Baumann, T.; Thoennessen, M.; Bardayan, D. W.; Pain, S. D.; Clement, R. C. C.; Brown, J.; Luther, B.; Ilyushkin, S.; O'Malley, P. D.; Ikeyama, R.; Kozub, R. L.; Bergstrom, Z. J.; Deyoung, P. A.; Rogers, W.

    2014-03-01

    The rapid proton capture (rp) process of explosive nucleosynthesis is believed to be the driver of X-ray bursts and creates nuclei up to around mass 110. Whereas much of this process burns in an equilibrium determined by half-lives and masses, the waiting point at 56Ni is unique. At this point the process reaches its peak luminosity and the synthesis of almost all heavier nuclei pass through the 56Ni(p,γ)57Cu reaction. Since the gamma-decay width dominates the relevant resonance in 57Cu, a measurement of its proton partial width can be used to extract the proton-capture resonance strength. An experiment to do this was performed at the NSCL using the Versatile Array of Neutron Detectors at Low Energy (VANDLE) along with the MoNA-LISA neutron detector arrays; and was the commissioning experiment for VANDLE with a transfer reaction. The events in the digitizing electronics of VANDLE were event-matched to the MoNA-LISA-Sweeper data acquisition system. Work supported in part by U.S. DOE, the NNSA SSAA, and the NSF.

  12. Neutron-Rich Silver Isotopes Produced by a Chemically Selective Laser Ion-Source: Test of the R-Process " Waiting-Point " Concept

    CERN Multimedia

    2002-01-01

    The r-process is an important nucleosynthesis mechanism for several reasons: \\begin{enumerate} \\item It is crucial to an understanding of about half of the A>60 elemental composition of the Galaxy; \\item It is the mechanism that forms the long-lived Th-U-Pu nuclear chronometers which are used for cosmochronolgy; \\item It provides an important probe for the temperature (T$ _{9} $)-neutron density ($n_{n}$) conditions in explosive events; and last but not least \\item It may serve to provide useful clues to and constraints upon the nuclear properties of very neutron-rich heavy nuclei. \\end{enumerate} \\\\ \\\\With regard to nuclear-physics data, of particular interest are the T$ _{1/2} $ and P$_{n-} $ values of certain$\\,$ "waiting-point"$\\,$ isotopes in the regions of the A $ \\approx $ 80 and 130. r-abundance peaks. Previous studies of $^{130}_{\\phantom{1}48}$Cd$_{82}$ and $^{79}_{29}$Cu$_{50}$. $\\beta$-decay properties at ISOLDE using a hot plasma ion source were strongly complicated by isobar and molecular-ion c...

  13. $\\beta$- decay of the N=Z, rp-process waiting points: $^{64}$Ge, $^{68}$Se and the N=Z+2: $^{66}$Ge, $^{70}$Se for accurate stellar weak-decay rates

    CERN Document Server

    The contribution of electron capture to weak-decay rates has been neglected in model calculations of Type I X-ray bursts so far. Nucleosynthesis in these astrophysical events eventually proceeds through the rp-process near the proton drip-line. In particular, several N=Z nuclei such as $^{64}$Ge and $^{68}$Se act as waiting points in the nuclear flow due to the low S${_P}$ values of their Z+1 neighbours. Recent theoretical calculations have shown that, in these high density ($\\thicksim10^{6}$ g/cm$^3$) and high temperature (1 - 2 GK) scenarios, continuum electron capture rates might play an important role, in particular for species at and around these waiting point nuclei. This proposal is aimed at the study of the $\\beta^{+}$/EC-decay of the waiting point nuclei $^{64}$Ge, $^{68}$Se and their N=Z+2 second neighbours $^{66}$Ge and $^{70}$Se with the Total Absorption Spectroscopy method. This will allow for a detailed analysis of their contribution to the EC-decay rates in X-Ray burst explosions. The proposed ...

  14. Waiting for a pacemaker

    DEFF Research Database (Denmark)

    Risgaard, B.; Elming, H.; Jensen, G.V.

    2012-01-01

    to implantation. A lack of implantation capacity was responsible for 4.5 of the waiting days. Twenty-nine patients (11.2) developed infection while waiting, primarily urinary tract infections. Thirteen patients (5.0) suffered non-sustained ventricular tachycardia, and eight patients (3.1) suffered clinical...... event during the waiting period. The present study indicates that a waiting period is dangerous as it is associated with an increased risk of adverse events. Acute PPMs should be implanted with a 24-h pacemaker implantation service capacity. Published on behalf of the European Society of Cardiology. All...

  15. Challenging "Waiting for Superman"

    Science.gov (United States)

    Bruhn, Molle

    2014-01-01

    A group of New York City public school teachers, angry about the depiction of public schools in 'Waiting for Superman," decide to make their own film about the realities of the current education reform movement. They persevered even though they had no budget when they started and lacked a background in filmmaking. "The Inconvenient Truth…

  16. Two definitions of waiting well.

    Science.gov (United States)

    Sweeny, Kate; Reynolds, Chandra A; Falkenstein, Angelica; Andrews, Sara E; Dooley, Michael D

    2016-02-01

    Waiting for uncertain news is often distressing, at times even more distressing than facing bad news. The goal of this article was to investigate strategies for "waiting well" during these periods of uncertainty. Specifically, we propose 2 definitions of waiting well. First, people can wait in such a way as to ease their distress during the waiting period. Second, people could wait in such a way as to ease the pain of bad news or enhance the thrill of good news. We conducted a longitudinal study of law graduates (N = 230) awaiting their result on the California bar exam. Participants completed questionnaires prior to the exam, every 2 weeks during the 4-month waiting period, and shortly after learning whether they passed or failed. Cross-lagged models revealed that participants were quite unsuccessful at waiting well by our first definition. That is, their coping strategies were ineffective for reducing distress associated with uncertainty, apparently even backfiring in some cases. However, multiple regression analyses examining relationships between waiting experiences and responses to good and bad news found that many participants were successful at waiting well according to our second definition: Participants who suffered through a waiting period marked by anxiety, rumination, and pessimism responded more productively to bad news and more joyfully to good news, as compared with participants who suffered little during the wait. These findings substantiate the difficulty of enduring a stressful waiting period but suggest that this difficulty may pay off once the news arrives. (c) 2016 APA, all rights reserved).

  17. Concentration Sensing by the Moving Nucleus in Cell Fate Determination: A Computational Analysis.

    Directory of Open Access Journals (Sweden)

    Varun Aggarwal

    Full Text Available During development of the vertebrate neuroepithelium, the nucleus in neural progenitor cells (NPCs moves from the apex toward the base and returns to the apex (called interkinetic nuclear migration at which point the cell divides. The fate of the resulting daughter cells is thought to depend on the sampling by the moving nucleus of a spatial concentration profile of the cytoplasmic Notch intracellular domain (NICD. However, the nucleus executes complex stochastic motions including random waiting and back and forth motions, which can expose the nucleus to randomly varying levels of cytoplasmic NICD. How nuclear position can determine daughter cell fate despite the stochastic nature of nuclear migration is not clear. Here we derived a mathematical model for reaction, diffusion, and nuclear accumulation of NICD in NPCs during interkinetic nuclear migration (INM. Using experimentally measured trajectory-dependent probabilities of nuclear turning, nuclear waiting times and average nuclear speeds in NPCs in the developing zebrafish retina, we performed stochastic simulations to compute the nuclear trajectory-dependent probabilities of NPC differentiation. Comparison with experimentally measured nuclear NICD concentrations and trajectory-dependent probabilities of differentiation allowed estimation of the NICD cytoplasmic gradient. Spatially polarized production of NICD, rapid NICD cytoplasmic consumption and the time-averaging effect of nuclear import/export kinetics are sufficient to explain the experimentally observed differentiation probabilities. Our computational studies lend quantitative support to the feasibility of the nuclear concentration-sensing mechanism for NPC fate determination in zebrafish retina.

  18. Waiting when hospitalised

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    2004-01-01

    , and interpret the meaning of having fellow-patients during hospitalisation. Three main dimensions are explored; attitudes toward own illness, interpersonal relationships and environmental factors. Questions such as how do patients pass time, find out about illnesses, examinations, treatment, and staff members...... increasingly important in today's health care environment. The indicative conclusions form this study suggest that nurses play an important role in ensuring that patients are satisfied and receive quality care when waiting....

  19. Waiting for care

    Science.gov (United States)

    Goel, Ritika; Bloch, Gary; Caulford, Paul

    2013-01-01

    Abstract Objective To describe the experiences of a group of new immigrants and caregivers of new immigrants who were subject to the 3-month waiting period for the Ontario Health Insurance Plan and needed to access health care services during that time. Design Qualitative study using a phenomenologic framework. Setting Participants were recruited through the Scarborough Community Volunteer Clinic in Toronto, Ont. Interviews were conducted in person at the clinic or by telephone. Participants Seven participants were interviewed who themselves needed to access health care during the 3-month waiting period for the Ontario Health Insurance Plan or who were caring for someone who did. Methods Seven semistructured, in-depth interviews were conducted using an interview guide; these were recorded and transcribed verbatim. Data were analyzed for themes to arrive at the essence of the participants’ experiences. Main findings Participants believed that there was a lack of clear information and a lack of help from officials. Other common themes included poor social situations, financial loss or threat of financial loss related to health care, a choice to delay seeking care owing to cost, difficulty accessing alternative care, and appreciation for those who advocated on their behalf. Other themes that arose included emotional hardship, poor health outcomes or threat of poor health outcomes resulting from not seeking care, the importance and unpredictability of health, as well as negative impressions of Canada as a country as a result of the negative experience of seeking care. Conclusion New immigrants to Ontario who need to access health care services during the 3-month waiting period for provincial health insurance and the caregivers of such newcomers can have potentially very negative experiences. They might be unable to access care without financial barriers and might, therefore, choose to delay seeking health care until the end of the waiting period; this can lead to

  20. Waiting experience in railway environments

    NARCIS (Netherlands)

    van Hagen, M.; Galetzka, Mirjam; Pruyn, Adriaan T.H.

    2014-01-01

    At railway stations, waiting time is usually an unavoidable aspect of the journey for train passengers. According to the attentional model of time, pleasant surroundings and other forms of distraction reduce perceived waiting time. Not every individual reacts identically in the same surroundings.

  1. Organ Type and Waiting Time

    Science.gov (United States)

    ... Your Child Adjust Camps Resources LIVING DONATION Facts Types Being a Living Donor About the Operation Financing Living Donation Home / Before The Transplant / About Organ Allocation / Organ Type & Waiting Time Organ Facts Heart ...

  2. Wait times for gastroenterology consultation in Canada: The patients’ perspective

    Science.gov (United States)

    Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

    2010-01-01

    Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

  3. Mrs. Manumbu's wait: a case for reducing client waiting time.

    Science.gov (United States)

    1992-01-01

    Management Sciences for Health has published a case study on reducing client waiting time, case discussion questions, and a case analysis for training and group discussion for family planning (FP) managers. A married mother of 3 children carries her 5-week-old son as she walks for 1 hour on a hot day to a FP clinic. She wants to learn how to prevent another birth too soon. After registering, she joins at least 35 other women and children under a tree. She sits next to a good friend who has been waiting for 2 hours. They listen to another woman who tells about waiting for 3 hours only to be told she needed to return the following day because too many people wanted to visit the physician. The woman adds that she just wanted a new supply of oral contraceptives. The long walk to the clinic was not the problem, leaving her children alone by themselves was the problem. The new client begins to be concerned about waiting for 3 hours while her children are also home alone; plus, she had chores to do. The case discussion questions ask participants how the waiting time can discourage the new client from using FP, what the clinic can do to ameliorate the situation, and what programs and policies can reduce long client waits. Some solutions to improving the waiting situation include providing transportation, appointments, and fast routes for resupplying contraceptives as well as analyzing client flow and implementing the findings. Mid- and senior-level managers could begin a community-based service delivery program in villages, support a triage policy, and implement higher level training for nurses to perform more medical functions.

  4. 46 CFR 9.10 - Waiting time.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour. ...

  5. [The international adoption waiting period: waiting experience and coping strategies].

    Science.gov (United States)

    Pedro-Viejo, Ana Berástegui

    2008-11-01

    The adoption waiting period is a powerful stressor that can affect the well-being and configuration of future family life. Adoption research and practice have not paid enough attention to this phase. The principal aim of this study is to address prospective adoptive parents' experience of and coping with this period. For this purpose, 63 families answered a feelings scale, a coping resources scale and a needs questionnaire, all elaborated for the study. Results show that a shorter length of waiting time, using cognitive and learning coping strategies and associative participation were related to a better general experience of adoption whereas process-centred strategies were related to a worse experience of adoption. Families would like to see more speed in the process, more warmth and humanity in their relation with institutions and better information about their expedients. We conclude by proposing some activities and services during the waiting period that could be useful for post adoption.

  6. Review of "Waiting for Superman"

    Science.gov (United States)

    Dutro, Elizabeth

    2011-01-01

    "Waiting for Superman" offers what appear to be straightforward, commonsense solutions to inequities in schooling. The film argues that heroic action can be taken to fix what it portrays as the disaster of public schooling. The film disregards poverty as a factor in school performance and connection--and therefore never addresses anti-poverty…

  7. SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, A; Herrera, D; Hijal, T; Kildea, J [McGill University Health Centre, Montreal, Quebec (Canada); Hendren, L; Leung, A; Wainberg, J; Sawaf, M; Gorshkov, M; Maglieri, R; Keshavarz, M [McGill University, Montreal, Quebec (Canada)

    2016-06-15

    Purpose: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful. In the present era of electronic health records (EHRs), waiting times need not be so uncertain. Extensive EHRs provide unprecedented amounts of data that can statistically cluster towards representative values when appropriate patient cohorts are selected. Predictive modelling, such as machine learning, is a powerful approach that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The application of a machine learning algorithm to waiting time data has the potential to produce personalized waiting time predictions such that the uncertainty may be removed from the patient’s waiting experience. Methods: In radiation oncology, patients typically experience several types of waiting (eg waiting at home for treatment planning, waiting in the waiting room for oncologist appointments and daily waiting in the waiting room for radiotherapy treatments). A daily treatment wait time model is discussed in this report. To develop a prediction model using our large dataset (with more than 100k sample points) a variety of machine learning algorithms from the Python package sklearn were tested. Results: We found that the Random Forest Regressor model provides the best predictions for daily radiotherapy treatment waiting times. Using this model, we achieved a median residual (actual value minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes

  8. Client waiting time in an urban primary health care centre in Lagos ...

    African Journals Online (AJOL)

    Background: Primary Health Care is the usual entry point into the health system and has the potential to touch the lives of most people. However one of the reasons for poor uptake of health services at primary health care facilities in Nigeria is long waiting time. This study was carried out to assess client waiting time and ...

  9. Multifractal analysis of nucleus-nucleus interactions

    Energy Technology Data Exchange (ETDEWEB)

    Sengupta, K.; Cherry, M.L.; Jones, W.V.; Wefel, J.P. (Department of Physics and Astronomy, Louisiana State University, Baton Rouge, Louisiana 70803 (United States)); Dabrowska, A.; Holynski, R.; Jurak, A.; Olszewski, A.; Szarska, M.; Trzupek, A.; Wilczynska, B.; Wilczynski, H.; Wolter, W.; Wosiek, B.; Wozniak, K. (Institute of Nuclear Physics, Kawiory 26 A, 30-055, Krakow (Poland)); Freier, P.S.; Waddington, C.J. (School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455 (United States)); (KLM Collaboration)

    1993-10-01

    We have performed a multifractal ([ital G]-moment) analysis of 14.6--200 GeV/nucleon nucleus-nucleus and 200--800 GeV proton-nucleus interactions from KLM and Fermilab E-90 and E-508 emulsion data, including explicit corrections for the finite statistical sample. The corrected slopes of the [ital G] moments for protons, [sup 16]O, [sup 28]Si, and [sup 32]S nuclei show only slight evidence for departures from random behavior, while the normalized entropies appear to show a more consistent departure from randomness, particularly for protons. Given the size of the uncertainties, the results of the fractal analysis are not consistent either with results of intermittency analyses for nucleus-nucleus collisions or with the nonrandom behavior previously reported for leptonic and hadronic collisions. However, because of the effects of statistical noise, the fractal analysis is not as sensitive as the intermittency analysis for detecting nonrandom fluctuations.

  10. Indefinite waitings in MIRELA systems

    Directory of Open Access Journals (Sweden)

    Johan Arcile

    2015-06-01

    Full Text Available MIRELA is a high-level language and a rapid prototyping framework dedicated to systems where virtual and digital objects coexist in the same environment and interact in real time. Its semantics is given in the form of networks of timed automata, which can be checked using symbolic methods. This paper shows how to detect various kinds of indefinite waitings in the components of such systems. The method is experimented using the PRISM model checker.

  11. Consumer behaviour in the waiting area.

    Science.gov (United States)

    Mobach, Mark P

    2007-02-01

    To determine consumer behaviour in the pharmacy waiting area. The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each waiting area (brochures, books, illuminated new trailer, children's play area, etc.). Per patient each activity was registered, and at each pharmacy the behaviour was studied for 2 weeks. Most patients only waited during the waiting time at the studied pharmacies. Few consumers obtained written information during their wait. The waiting area may have latent possibilities to expand the information function of the pharmacy and combine this with other activities that distract the consumer from the wait. Transdisciplinary research, combining knowledge from pharmacy practice research with consumer research, has been a useful approach to add information on queueing behaviour of consumers.

  12. Activation of dorsal raphe serotonin neurons is necessary for waiting for delayed rewards.

    Science.gov (United States)

    Miyazaki, Kayoko W; Miyazaki, Katsuhiko; Doya, Kenji

    2012-08-01

    The forebrain serotonergic system is a crucial component in the control of impulsive behaviors. We previously reported that the activity of serotonin neurons in the midbrain dorsal raphe nucleus increased when rats performed a task that required them to wait for delayed rewards. However, the causal relationship between serotonin neural activity and the tolerance for the delayed reward remained unclear. Here, we test whether the inhibition of serotonin neural activity by the local application of the 5-HT(1A) receptor agonist 8-hydroxy-2-(di-n-propylamino) tetralin in the dorsal raphe nucleus impairs rats' tolerance for delayed rewards. Rats performed a sequential food-water navigation task that required them to visit food and water sites alternately via a tone site to get rewards at both sites after delays. During the short (2 s) delayed reward condition, the inhibition of serotonin neural activity did not significantly influence the numbers of reward choice errors (nosepoke at an incorrect reward site following a conditioned reinforcer tone), reward wait errors (failure to wait for the delayed rewards), or total trials (sum of reward choice errors, reward wait errors, and acquired rewards). By contrast, during the long (7-11 s) delayed reward condition, the number of wait errors significantly increased while the numbers of total trials and choice errors did not significantly change. These results indicate that the activation of dorsal raphe serotonin neurons is necessary for waiting for long delayed rewards and suggest that elevated serotonin activity facilitates waiting behavior when there is the prospect of forthcoming rewards.

  13. Onuf's nucleus X

    DEFF Research Database (Denmark)

    Schrøder, H D

    1981-01-01

    The first, second and third sacral segments of 59 human spinal cords were examined in order to localize and describe Onuf's nucleus X. The nucleus was found to be situated in the ventral horn of the segments S2 and S3; only in very few spinal cords did it extend into S1. A significant variation...... in the length of the nucleus was observed. Based on the cytoarchitecture the nucleus could be divided in three parts, a cranial, a dorsomedial and a ventrolateral. All parts of the nucleus consisted of chromatin-rich medium-sized neurons, and apparent direct appositions between different cells bodies as well...... as between cell bodies and large dendrites were observed. Characteristic findings in the neuropil surrounding the nucleus were the sparsity of myelinated fibers and the presence of dendritic bundles. The present observations are compared to the descriptions of a morphologically similar nucleus...

  14. Fission product studies at WAIT

    Energy Technology Data Exchange (ETDEWEB)

    De Laeter, J.R.; Rosman, K.J.R.; Loss, R.D. (Western Australian Inst. of Tech., South Bentley)

    1985-07-01

    A general review of fission yields is presented. The Mass Spectrometry Laboratory in the Department of Applied Physics at WAIT has been involved in a continuing programme of measuring the cumulative fission yields of the elements palladium, silver, cadmium, tin and tellurium for a variety of fissile materials (/sup 233/U, /sup 235/U, /sup 238/U and /sup 239/Pu) over a range of neutron energies. Results of studies into the isotopic composition and fission yields of samples from the Oklo natural reactor in Gabon, West Africa are summarised.

  15. Half Life of the Doubly-magic r-Process Nucleus 78Ni

    CERN Document Server

    Hosmer, P T; Aprahamian, A; Arndt, O; Clément, R; Estrade, A; Kratz, K L; Liddick, S N; Mantica, P F; Müller, W F; Montes, F; Morton, A C; Ouellette, M S; Pellegrini, E; Pfeiffer, B; Reeder, P; Santi, P; Steiner, M; Stolz, A; Tomlin, B E; Walters, W B; Wöhr, A

    2005-01-01

    Nuclei with magic numbers serve as important benchmarks in nuclear theory. In addition, neutron-rich nuclei play an important role in the astrophysical rapid neutron-capture process (r-process). 78Ni is the only doubly-magic nucleus that is also an important waiting point in the r-process, and serves as a major bottleneck in the synthesis of heavier elements. The half-life of 78Ni has been experimentally deduced for the first time at the Coupled Cyclotron Facility of the National Superconducting Cyclotron Laboratory at Michigan State University, and was found to be 110 (+100 -60) ms. In the same experiment, a first half-life was deduced for 77Ni of 128 (+27 -33) ms, and more precise half-lives were deduced for 75Ni and 76Ni of 344 (+20 -24) ms and 238 (+15 -18) ms respectively.

  16. In the queue for coronary artery bypass grafting: patients' perceptions of risk and 'maximal acceptable waiting time'.

    Science.gov (United States)

    Llewellyn-Thomas, H; Thiel, E; Paterson, M; Naylor, D

    1999-04-01

    To elicit patients' maximal acceptable waiting times (MAWT) for non-urgent coronary artery bypass grafting (CABG), and to determine if MAWT is related to prior expectations of waiting times, symptom burden, expected relief, or perceived risks of myocardial infarction while waiting. Seventy-two patients on an elective CABG waiting list chose between two hypothetical but plausible options: a 1-month wait with 2% risk of surgical mortality, and a 6-month wait with 1% risk of surgical mortality. Waiting time in the 6-month option was varied up if respondents chose the 6-month/lower risk option, and down if they chose the 1-month/higher risk option, until the MAWT switch point was reached. Patients also reported their expected waiting time, perceived risks of myocardial infarction while waiting, current function, expected functional improvement and the value of that improvement. Only 17 (24%) patients chose the 6-month/1% risk option, while 55 (76%) chose the 1-month/2% risk option. The median MAWT was 2 months; scores ranged from 1 to 12 months (with two outliers). Many perceived high cumulative risks of myocardial infarction if waiting for 1 (upper quartile, > or = 1.45%) or 6 (upper quartile, > or = 10%) months. However, MAWT scores were related only to expected waiting time (r = 0.47; P queue. These results suggest a need for interventions to modify patients' inaccurate risk perceptions, particularly if a scheduled surgical date must be deferred.

  17. Handgun waiting periods reduce gun deaths.

    Science.gov (United States)

    Luca, Michael; Malhotra, Deepak; Poliquin, Christopher

    2017-11-14

    Handgun waiting periods are laws that impose a delay between the initiation of a purchase and final acquisition of a firearm. We show that waiting periods, which create a "cooling off" period among buyers, significantly reduce the incidence of gun violence. We estimate the impact of waiting periods on gun deaths, exploiting all changes to state-level policies in the Unites States since 1970. We find that waiting periods reduce gun homicides by roughly 17%. We provide further support for the causal impact of waiting periods on homicides by exploiting a natural experiment resulting from a federal law in 1994 that imposed a temporary waiting period on a subset of states. Copyright © 2017 the Author(s). Published by PNAS.

  18. Queues with waiting time dependent service

    DEFF Research Database (Denmark)

    Bekker, R.; Koole, G. M.; Nielsen, Bo Friis

    2011-01-01

    Motivated by service levels in terms of the waiting-time distribution seen, for instance, in call centers, we consider two models for systems with a service discipline that depends on the waiting time. The first model deals with a single server that continuously adapts its service rate based...... on the waiting time of the first customer in line. In the second model, one queue is served by a primary server which is supplemented by a secondary server when the waiting of the first customer in line exceeds a threshold. Using level crossings for the waiting-time process of the first customer in line, we...... derive steady-state waiting-time distributions for both models. The results are illustrated with numerical examples....

  19. WAITING TIME IN THE WAITING ROOM IN FAMILY PRACTICE AND PATIENT SATISFACTION

    Directory of Open Access Journals (Sweden)

    Janko Kersnik

    2001-05-01

    Full Text Available Background: Appointment system shortens the waiting time in the waiting room for the patient and allows better use of time for the doctor. We wanted to examine how long patients are willing to wait in the waiting room, how long they waited at the last visit, patient satisfaction with the last visit, the satisfaction with the length of waiting in the past 12 months and the overall patient satisfaction score for the last 12 months. Appointment system proved to be effective means of organising practice time. Waiting time in the waiting room with appointment system was considerably shorter (mean 18.5 minutes as compared to the waiting time in the practices without appointment system (mean 55.4 minutes, the fact which is reflected also in higher satisfaction with waiting in the waiting room in the past 12 months. Three quarters of patients in practices with appointment system waited standard 20 minutes or less, as opposed to the other practices where only one quarter of patients waited 20 minutes or less.Conclusions: The overall satisfaction with the doctor with the appointment system does not differ in both types of practices. The patients from practices with appointment system evaluated better possibility to get an appointment to suit the patients, but worse help of the doctors’ staff, possibility to get through to the office by phone, the length of time during the consultation and the doctors’ thoroughness.

  20. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    Science.gov (United States)

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

  1. Consumer Perception and Evaluation of Waiting Time

    NARCIS (Netherlands)

    G. Antonides (Gerrit); P.C. Verhoef (Peter)

    2000-01-01

    textabstractTelephone waiting times for a commercial service were varied in two different experiments. In the first experiment, the telephone rate was either zero or fixed at Dfl.1.- (approx. $0.40) per minute. Consumer perceptions of waiting times could be described best by a psychophysical power

  2. Improving Patient Satisfaction with Waiting Time

    Science.gov (United States)

    Eilers, Gayleen M.

    2004-01-01

    Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

  3. Waiting for scheduled surgery: A complex patient experience.

    Science.gov (United States)

    Carr, Tracey; Teucher, Ulrich; Casson, Alan G

    2017-03-01

    The aim of this study was to understand experiences of wait time among patients awaiting scheduled orthopaedic or cardiac surgery. Using a qualitative approach, 32 patients completed two interviews each regarding their wait time experiences, including effects of waiting. Patient experiences of wait time varied regardless of actual wait time and included reports of restriction, uncertainty, resignation, coping and opportunity. Participants' waiting experiences indicate a complex relationship between greater symptom severity and less tolerance for wait time. We suggest healthcare resources focus on alleviating the deleterious effects of waiting for certain patients rather than reducing absolute wait times.

  4. Waiting time care guarantees: necessity or nemesis?

    Science.gov (United States)

    Joshi, N P; Noseworthy, F T; Noseworthy, T W

    2006-01-01

    One of the priorities of governments in Canada is to reduce long waiting times for health services. This has raised the prospect of introducing waiting time care guarantees. Such guarantees affirm the healthcare system's social contract with the public and provide an entitlement to Canadians to receive timely care. There are clinical, legal and political implications, which must be considered and well managed before introduction. Other countries have ventured down this path. They teach us that waiting time care guarantees are good policy and make good sense. Correspondingly, they remind us not to make a promise we are not ready to keep.

  5. Colour Consideration for Waiting areas in hospitals

    Science.gov (United States)

    Zraati, Parisa

    2012-08-01

    Colour is one the most important factors in the nature that can have some affects on human behaviour. Many years ago, it was proven that using colour in public place can have some affect on the users. Depend of the darkness and lightness; it can be vary from positive to negative. The research will mainly focus on the colour and psychological influences and physical factors. The statement of problem in this research is what is impact of colour usually applied to waiting area? The overall aim of the study is to explore the visual environment of hospitals and to manage the colour psychological effect of the hospital users in the waiting area by creating a comfortable, pleasant and cozy environment for users while spend their time in waiting areas. The analysisconcentrate on satisfaction and their interesting regarding applied colour in two private hospital waiting area in Malaysia.

  6. The effect of deep brain stimulation of the subthalamic nucleus on executive functions: impaired verbal fluency and intact updating, planning and conflict resolution in Parkinson's disease.

    Science.gov (United States)

    Demeter, Gyula; Valálik, István; Pajkossy, Péter; Szőllősi, Ágnes; Lukács, Ágnes; Kemény, Ferenc; Racsmány, Mihály

    2017-04-24

    Although the improvement of motor symptoms in Parkinson's disease (PD) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) is well documented, there are open questions regarding its impact on cognitive functions. The aim of this study was to assess the effect of bilateral DBS of the STN on executive functions in PD patients using a DBS wait-listed PD control group. Ten PD patients with DBS implantation (DBS group) and ten PD wait-listed patients (Clinical control group) participated in the study. Neuropsychological tasks were used to assess general mental ability and various executive functions. Each task was administered twice to each participant: before and after surgery (with the stimulators on) in the DBS group and with a matched delay between the two task administration points in the control group. There was no significant difference between the DBS and the control groups' performance in tasks measuring the updating of verbal, spatial or visual information (Digit span, Corsi and N-back tasks), planning and shifting (Trail Making B), and conflict resolution (Stroop task). However, the DBS group showed a significant decline on the semantic verbal fluency task after surgery compared to the control group, which is in line with findings of previous studies. Our results provide support for the relative cognitive safety of the STN DBS using a wait-listed PD control group. Differential effects of the STN DBS on frontostriatal networks are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Determinants of Patient Waiting Time in the General Outpatient ...

    African Journals Online (AJOL)

    satisfied with the care received is strongly related to the quality ... clinic wait.[1] Failure to incorporate consumer‑driven features into the design of wait experience could lead to patient and provider dissatisfaction. Waiting time ... respondents waited for 90‑180 min in the clinic, whereas 36.1% (35/96) of the patients spent.

  8. Willing to wait?: The influence of patient wait time on satisfaction with primary care

    Directory of Open Access Journals (Sweden)

    Balkrishnan Rajesh

    2007-02-01

    Full Text Available Abstract Background This study examined the relationship between patient waiting time and willingness to return for care and patient satisfaction ratings with primary care physicians. Methods Cross-sectional survey data on a convenience sample of 5,030 patients who rated their physicians on a web-based survey developed to collect detailed information on patient experiences with health care. The survey included self-reported information on wait times, time spent with doctor, and patient satisfaction. Results Longer waiting times were associated with lower patient satisfaction (p Conclusion The time spent with the physician is a stronger predictor of patient satisfaction than is the time spent in the waiting room. These results suggest that shortening patient waiting times at the expense of time spent with the patient to improve patient satisfaction scores would be counter-productive.

  9. Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting.

    Science.gov (United States)

    Gravelle, Hugh; Siciliani, Luigi

    2009-08-01

    In many public healthcare systems treatments are rationed by waiting time. We examine the optimal allocation of a fixed supply of a given treatment between different groups of patients. Even in the absence of any distributional aims, welfare is increased by third degree waiting time discrimination: setting different waiting times for different groups waiting for the same treatment. Because waiting time imposes dead weight losses on patients, lower waiting times should be offered to groups with higher marginal waiting time costs and with less elastic demand for the treatment.

  10. Protocol to Exploit Waiting Resources for UASNs

    Directory of Open Access Journals (Sweden)

    Li-Ling Hung

    2016-03-01

    Full Text Available The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols.

  11. Waiting times for radiation therapy in Ontario.

    Science.gov (United States)

    Benk, Veronique; Przybysz, Raymond; McGowan, Tom; Paszat, Lawrence

    2006-02-01

    The mass media and clinical journals have reported lengthy waiting times after surgery before initiation of radiation therapy (RT) for cancer across Canada. We aimed to describe the length of time between the last date of surgery or biopsy or chemotherapy and first date of RT. This is a population-based study measuring waiting times for RT in Ontario among all patients with potentially curable cancer of the cervix, tonsil and larynx and a random sample of women who had had breast cancer resection, whose first date of RT fell between Sept. 1, 2001, and Aug. 31, 2002. Abstraction of original health care records provided each patient's demographics, cancer stage and cancer treatment (last surgery, consultation, simulation, first RT). Last dates of chemotherapy before RT were obtained from abstraction or from Ontario Health Insurance Plan (OHIP) files, and last dates of surgery before RT were compared with dates in the Canadian Institute for Health Information (CIHI) Discharge Abstract Database. Waiting times between the last date of surgery or chemotherapy and the first date of RT varied significantly among the health regions of Ontario. Increasing age, but not the presence of comorbidity, was associated with longer waiting times. Women who did not receive postoperative chemotherapy before RT for breast cancer waited significantly longer than all others. Measurement of waiting times for cancer RT must discount time during which adjuvant intravenous chemotherapy is administered after surgery and before RT. There appears to be a formal or informal process by which those at highest risk begin RT most rapidly.

  12. Time while waiting: patients' experiences of scheduled surgery.

    Science.gov (United States)

    Carr, Tracey; Teucher, Ulrich C; Casson, Alan G

    2014-12-01

    Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care. © The Author(s) 2014.

  13. Teaching Evaluation: Waiting for Initiatives

    Directory of Open Access Journals (Sweden)

    Alejandro Canales Sánchez

    2008-08-01

    Full Text Available In this text, it is sustained that, despite the fact that the teaching activity is one of the main functions of higher education institutions or even the only one in most of them, it hasn’t been reflected in the leading initiatives that have been set in motion in this area for the last two decades. In particular, it points out that the wide evaluation politics established in the education system during the late eighties, didn’t consider the teaching activity as a concern issue for the mechanisms or rewards in the evaluation system. Even though the implementation of new actions tried to repair the situation, mainly by improving the quality of working time and the qualifications of the personnel performing these activities; teaching, in strict sense, and the design or application of a new evaluation scheme to strengthen it, didn’t get better.

  14. Time to wait: a systematic review of strategies that affect out-patient waiting times.

    Science.gov (United States)

    Naiker, Ugenthiri; FitzGerald, Gerry; Dulhunty, Joel M; Rosemann, Michael

    2017-03-30

    Objective Out-patient waiting times pose a significant challenge for public patients in need of specialist evaluation and intervention. The aim of the present study was to identify and categorise effective strategies to reduce waiting times for specialist out-patient services with a focus on the Australian healthcare system.Methods A systematic review of major health databases was conducted using the key terms 'outpatient*' AND 'waiting time', 'process*' AND 'improvement in outpatient clinics'. Identified articles were assessed for their relevance by sequential review of the title, abstract and full text. References of the selected manuscripts were scanned for additional relevant articles. Selected articles were evaluated for consistent and emerging themes.Results In all, 152 articles were screened, of which 38 were included in the present review. Numerous strategies identified in the articles were consolidated into 26 consistent approaches. Three overarching themes were identified as significantly affecting waiting times: resource realignment, operational efficiency and process improvement.Conclusions Strategies to align resources, increase operational efficiency and improve processes provide a comprehensive approach that may reduce out-patient waiting times.What is known about the topic? Out-patient waiting times are a challenge in most countries that seek to provide universal access to health care for all citizens. Although there has been extensive research in this area, many patients still experience extensive delays accessing specialist care, particularly in the public health sector. The multiple factors that contribute to bottlenecks and inefficiencies in the referral process and affect patient waiting times are often poorly understood.What does this paper add? This paper reviews the published healthcare literature to identify strategies that affect specialist out-patient waiting times for patients. The findings suggest that there are numerous operational

  15. Study of Relativistic Nucleus - Nucleus Collisions

    CERN Multimedia

    2002-01-01

    The aim of the experiment is to survey the reaction mechanisms involved in the collision of 60~GeV/nucleon and 200~GeV/nucleon light ions ($^{16}$0 and $^{32}$S provided by a new GSI-LBL injector) with different nuclei, to determine the stopping power of nuclear matter and to search for evidence of the formation of quark matter by comparison to hadron-nucleus reactions at the same incident energies. \\\\ The experimental set-up consists of a 2 m Streamer Chamber in the Vertex Magnet used to detect all the charged particles emerging from the interaction as well as the neutral strange particles that decay inside the chamber. The high energy of the forward-going particles are detected by four sets of calorimeters. A highly segmented Photon Position Detector (PPD) backed up by a 240 segment Ring Calorimeter will cover one unit of rapidity around mid-rapidity. An Intermediate Calorimeter will cover the rest of the forward phase space except for the region around beam rapidity, where a Veto Calorimeter will detect be...

  16. Consumer behaviour in the waiting area

    NARCIS (Netherlands)

    Mobach, M.P.

    Objective of the study: To determine consumer behaviour in the pharmacy waiting area. Method: The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each

  17. A pomeron approach to hadron-nucleus and nucleus-nucleus 'soft' interaction at high energy

    CERN Document Server

    Bondarenko, S; Levin, E; Maor, U

    2001-01-01

    We formulate a generalization of the Glauber formalism for hadron-nucleus and nucleus-nucleus collisions based on the pomeron approach to high-energy interaction. Our treatment is based on two physical assumptions (i.e. two small parameters): (i) that only sufficiently small distances contribute to the pomeron structure; and (ii) the triple-pomeron vertex G sub 3 sub P /g sub P sub N <<1 (where g sub P sub N is the pomeron-nucleon vertex) is small. A systematic method is developed for calculating the total, elastic and diffractive dissociation cross sections as well as the survival probability of large rapidity gap processes and inclusive observables, both for hadron-nucleus and nucleus-nucleus collisions. Our approach suggests saturation of the density of the produced hadrons in nucleus-nucleus collisions, the value of the saturation density turns out to be large.

  18. UNCOVERING THE NUCLEUS CANDIDATE FOR NGC 253

    Energy Technology Data Exchange (ETDEWEB)

    Günthardt, G. I.; Camperi, J. A. [Observatorio Astronómico, Universidad Nacional de Córdoba (Argentina); Agüero, M. P. [Observatorio Astronómico, Universidad Nacional de Córdoba, and CONICET (Argentina); Díaz, R. J.; Gomez, P. L.; Schirmer, M. [Gemini Observatory, AURA (United States); Bosch, G., E-mail: gunth@oac.uncor.edu, E-mail: camperi@oac.uncor.edu, E-mail: mpaguero@oac.uncor.edu, E-mail: rdiaz@gemini.edu, E-mail: pgomez@gemini.edu, E-mail: mschirmer@gemini.edu, E-mail: guille@fcaglp.unlp.edu.ar [Instituto de Astrofísica de La Plata (CONICET-UNLP) (Argentina)

    2015-11-15

    NGC 253 is the nearest spiral galaxy with a nuclear starburst that becomes the best candidate for studying the relationship between starburst and active galactic nucleus activity. However, this central region is veiled by large amounts of dust, and it has been so far unclear which is the true dynamical nucleus to the point that there is no strong evidence that the galaxy harbors a supermassive black hole co-evolving with the starburst as was supposed earlier. Near-infrared (NIR) spectroscopy, especially NIR emission line analysis, could be advantageous in shedding light on the true nucleus identity. Using Flamingos-2 at Gemini South we have taken deep K-band spectra along the major axis of the central structure and through the brightest infrared source. In this work, we present evidence showing that the brightest NIR and mid-infrared source in the central region, already known as radio source TH7 and so far considered just a large stellar supercluster, in fact presents various symptoms of a genuine galactic nucleus. Therefore, it should be considered a valid nucleus candidate. Mentioning some distinctive aspects, it is the most massive compact infrared object in the central region, located at 2.″0 of the symmetry center of the galactic bar, as measured in the K-band emission. Moreover, our data indicate that this object is surrounded by a large circumnuclear stellar disk and it is also located at the rotation center of the large molecular gas disk of NGC 253. Furthermore, a kinematic residual appears in the H{sub 2} rotation curve with a sinusoidal shape consistent with an outflow centered in the candidate nucleus position. The maximum outflow velocity is located about 14 pc from TH7, which is consistent with the radius of a shell detected around the nucleus candidate, observed at 18.3 μm (Qa) and 12.8 μm ([Ne ii]) with T-ReCS. Also, the Brγ emission line profile shows a pronounced blueshift and this emission line also has the highest equivalent width at this

  19. Analysis of emergency department waiting lines

    Directory of Open Access Journals (Sweden)

    Urška Močnik

    2014-10-01

    Full Text Available Background: Steady increase in the numbers of patients seeking medical assistance has recently been observed at the emergency department of the health center under study. This has led to increases in waiting times for patients. The management of the health center has been considering to implement certain measures to remedy this situation. One proposed solution is to add an additional physician to the emergency department. A computer model was constructed to simulate waiting lines and analyze the economic feasibility of employing an additional physician.Aim: This paper analyzes the waiting lines at the emergency department and performs an economic feasibility study to determine whether adding an additional physician to the department would be economically justified.Methods: Data about waiting times at the emergency department were collected to study the situation. For each patient, the arrival time at the waiting room and the starting and ending times of the examination were registered. The data were collected from 13 June 2011 to 25 September 2011. The sample included data on 65 nightly standbys, nine standbys on Saturdays, and 16 standbys on Sundays. Due to incomplete entries, data for nine weekly standbys and six Saturday standbys were excluded from the sample. Based on the data collected, we calculated the waiting and examination times per patient, average number of patients, average waiting time, average examination time, share of active standby teams in total standby time, and number of patients in different time periods. The study involved 1,039 patients. Using a synthesis method, we designed a computer model of waiting lines and economic feasibility. The model was validated using comparative analysis. A what-if analysis was performed using various computer simulations with various scenarios to consider the outcomes of decision alternatives. We applied economic analysis to select the best possible solution.Results: The research results

  20. VHA Support Service Center Electronic Wait List (EWL)

    Data.gov (United States)

    Department of Veterans Affairs — The goal of the Electronic Wait List (EWL) is to provide care to the patient as quickly as possible. To facilitate this goal, patients may be placed on a Wait List...

  1. Nucleus-Nucleus Collision as Superposition of Nucleon-Nucleus Collisions

    Energy Technology Data Exchange (ETDEWEB)

    Orlova, G.I.; Adamovich, M.I.; Aggarwal, M.M.; Alexandrov, Y.A.; Andreeva, N.P.; Badyal, S.K.; Basova, E.S.; Bhalla, K.B.; Bhasin, A.; Bhatia, V.S.; Bradnova, V.; Bubnov, V.I.; Cai, X.; Chasnikov, I.Y.; Chen, G.M.; Chernova, L.P.; Chernyavsky, M.M.; Dhamija, S.; Chenawi, K.El; Felea, D.; Feng, S.Q.; Gaitinov, A.S.; Ganssauge, E.R.; Garpman, S.; Gerassimov, S.G.; Gheata, A.; Gheata, M.; Grote, J.; Gulamov, K.G.; Gupta, S.K.; Gupta, V.K.; Henjes, U.; Jakobsson, B.; Kanygina, E.K.; Karabova, M.; Kharlamov, S.P.; Kovalenko, A.D.; Krasnov, S.A.; Kumar, V.; Larionova, V.G.; Li, Y.X.; Liu, L.S.; Lokanathan, S.; Lord, J.J.; Lukicheva, N.S.; Lu, Y.; Luo, S.B.; Mangotra, L.K.; Manhas, I.; Mittra, I.S.; Musaeva, A.K.; Nasyrov, S.Z.; Navotny, V.S.; Nystrand, J.; Otterlund, I.; Peresadko, N.G.; Qian, W.Y.; Qin, Y.M.; Raniwala, R.; Rao, N.K.; Roeper, M.; Rusakova, V.V.; Saidkhanov, N.; Salmanova, N.A.; Seitimbetov, A.M.; Sethi, R.; Singh, B.; Skelding, D.; Soderstrem, K.; Stenlund, E.; Svechnikova, L.N.; Svensson, T.; Tawfik, A.M.; Tothova, M.; Tretyakova, M.I.; Trofimova, T.P.; Tuleeva, U.I.; Vashisht, Vani; Vokal, S.; Vrlakova, J.; Wang, H.Q.; Wang, X.R.; Weng, Z.Q.; Wilkes, R.J.; Yang, C.B.; Yin, Z.B.; Yu, L.Z.; Zhang, D.H.; Zheng, P.Y.; Zhokhova, S.I.; Zhou, D.C

    1999-03-01

    Angular distributions of charged particles produced in {sup 16}O and {sup 32}S collisions with nuclear track emulsion were studied at momenta 4.5 and 200 A GeV/c. Comparison with the angular distributions of charged particles produced in proton-nucleus collisions at the same momentum allows to draw the conclusion, that the angular distributions in nucleus-nucleus collisions can be seen as superposition of the angular distributions in nucleon-nucleus collisions taken at the same impact parameter b{sub NA}, that is mean impact parameter between the participating projectile nucleons and the center of the target nucleus.

  2. Outpatient waiting time in Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

  3. Waiting time distribution in M/D/1 queueing systems

    DEFF Research Database (Denmark)

    Iversen, Villy Bæk; Staalhagen, Lars

    1999-01-01

    The well-known formula for the waiting time distribution of M/D/1 queueing systems is numerically unsuitable when the load is close to 1.0 and/or the results for a large waiting time are required. An algorithm for any load and waiting time is presented, based on the state probabilities of M/D/1...

  4. Maternity waiting homes in Rural Health Centers of Ethiop: The ...

    African Journals Online (AJOL)

    Background: Maternity waiting homes have been promoted to improve pregnant women's access to quality obstetric care. The main aim of this study was to assess the situation of maternity waiting homes and the experiences and challenges of mothers using waiting homes. Methods: A cross-sectional study was conducted ...

  5. Outpatient waiting time in Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Lessons learned In-house training of records staff had little long-term impact on reducing the time patients waited to collect their cards. Increased staffing and coordinating staff strength to correspond to times of peak patient load had the greatest effect in reducing outpatient waiting time. Constructive use of patient waiting ...

  6. Neutrino-nucleus interactions

    Energy Technology Data Exchange (ETDEWEB)

    Gallagher, H.; /Tufts U.; Garvey, G.; /Los Alamos; Zeller, G.P.; /Fermilab

    2011-01-01

    The study of neutrino oscillations has necessitated a new generation of neutrino experiments that are exploring neutrino-nuclear scattering processes. We focus in particular on charged-current quasi-elastic scattering, a particularly important channel that has been extensively investigated both in the bubble-chamber era and by current experiments. Recent results have led to theoretical reexamination of this process. We review the standard picture of quasi-elastic scattering as developed in electron scattering, review and discuss experimental results, and discuss additional nuclear effects such as exchange currents and short-range correlations that may play a significant role in neutrino-nucleus scattering.

  7. Bracing Later and Coping Better: Benefits of Mindfulness During a Stressful Waiting Period.

    Science.gov (United States)

    Sweeny, Kate; Howell, Jennifer L

    2017-10-01

    People frequently await uncertain news, yet research reveals that the strategies people naturally use to cope with uncertainty are largely ineffective. We tested the role of mindfulness for improving the experience of a stressful waiting period. Law graduates awaiting their bar exam results either reported their trait mindfulness (Study 1; N = 150) or were instructed to practice mindfulness meditation (Study 2; N = 90). As hypothesized, participants who were naturally more mindful or who practiced mindfulness managed their expectations more effectively by bracing for the worst later in the waiting period and perceived themselves as coping better. Additionally, participants who were low in dispositional optimism and high in intolerance of uncertainty benefited most from mindfulness (relative to control) meditation. These findings point to a simple and effective way to wait better, particularly for those most vulnerable to distress.

  8. Higgs-Boson Production in Nucleus-Nucleus Collisions

    Science.gov (United States)

    Norbury, John W.

    1992-01-01

    Cross section calculations are presented for the production of intermediate-mass Higgs bosons produced in ultrarelativistic nucleus-nucleus collisions via two photon fusion. The calculations are performed in position space using Baur's method for folding together the Weizsacker-Williams virtual-photon spectra of the two colliding nuclei. It is found that two photon fusion in nucleus-nucleus collisions is a plausible way of finding intermediate-mass Higgs bosons at the Superconducting Super Collider or the CERN Large Hadron Collider.

  9. Rescattering effects and intermittent exponents in nucleus-nucleus interactions

    Energy Technology Data Exchange (ETDEWEB)

    Pajares, C. (Universidad de Santiago de Compostela (Spain). Dept. de Particulas Elementales)

    1991-04-11

    It is shown that the rescattering in nucleus-nucleus collisions provides a natural branching mechanism which explains the dependence of the intermittent exponents on the energy, projectile and target. The possibility of finding some new coherent phenomena by studying the dependence of the intermittent exponents on the number of collisions is discussed. (orig.).

  10. The Nondeterministic Waiting Time Algorithm: A Review

    Directory of Open Access Journals (Sweden)

    John Jack

    2009-07-01

    Full Text Available We present briefly the Nondeterministic Waiting Time algorithm. Our technique for the simulation of biochemical reaction networks has the ability to mimic the Gillespie Algorithm for some networks and solutions to ordinary differential equations for other networks, depending on the rules of the system, the kinetic rates and numbers of molecules. We provide a full description of the algorithm as well as specifics on its implementation. Some results for two well-known models are reported. We have used the algorithm to explore Fas-mediated apoptosis models in cancerous and HIV-1 infected T cells.

  11. Emergency department waiting room nurse role: A key informant perspective.

    Science.gov (United States)

    Innes, Kelli; Jackson, Debra; Plummer, Virginia; Elliott, Doug

    2017-02-01

    Emergency departments have become overcrowded with increased waiting times. Strategies to decrease waiting times include time-based key performance indicators and introduction of a waiting room nurse role. The aim of the waiting room nurse role is to expedite care by assessing and managing patients in the waiting room. There is limited literature examining this role. This paper presents results of semi-structured interviews with five key informants to explore why and how the waiting room nurse role was implemented in Australian emergency departments. Data were thematically analysed. Five key informants from five emergency departments across two Australian jurisdictions (Victoria and New South Wales) reported that the role was introduced to reduce waiting times and improve quality and safety of care in the ED waiting room. Critical to introducing the role was defining and supporting the scope of practice, experience and preparation of the nurses. Role implementation required champions to overcome identified challenges, including funding. There has been limited evaluation of the role. The waiting room nurse role was introduced to decrease waiting times and contributed to risk mitigation. Common to all roles was standing orders, while preparation and experience varied. Further research into the role is required. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  12. The intercalatus nucleus of Staderini.

    Science.gov (United States)

    Cascella, Marco

    2016-01-01

    Rutilio Staderini was one of the leading Italian anatomists of the twentieth century, together with some scientists, such as Giulio Chiarugi, Giovanni Vitali, and others. He was also a member of a new generation of anatomists. They had continued the tradition of the most famous Italian scientists, which started from the Renaissance up until the nineteenth century. Although he carried out important studies of neuroanatomy and comparative anatomy, as well as embryology, his name is rarely remembered by most medical historians. His name is linked to the nucleus he discovered: the Staderini nucleus or intercalated nucleus, a collection of nerve cells in the medulla oblongata located lateral to the hypoglossal nucleus. This article focuses on the biography of the neuroanatomist as well as the nucleus that carries his name and his other research, especially on comparative anatomy and embryology.

  13. Waiting list in a public health facility in Santiago, Chile

    Directory of Open Access Journals (Sweden)

    Alejandro Letelier

    2014-07-01

    Full Text Available Introduction Waiting lists are a well-known problem in public healthcare systems worldwide. For instance, England had over one million people in waiting lists for elective surgical procedures in 2000. Spain had over 360 000 patients in surgical waiting lists in 2007. Chile has been trying to manage waiting times through the GES (Explicit Guarantees in Healthcare plan, which was established by the Chilean government in 2005. Waiting lists for the guaranteed-care diseases in the GES plan had 380 000 patients at the beginning of 2010, and that number was reduced to zero in 2011. Internationally, there are some descriptive studies about waiting lists that focus on variables such as waiting times and number of patients in the list. In Chile, however, this type of study is lacking. Purpose This study aims to describe the characteristics of waiting lists for medical specialties between April and October 2011. It also aims to identify the components of management models in public healthcare centers, and to identify and analyze waiting-time frames of patients referred to a secondary or tertiary healthcare public center from a public primary healthcare center. Methods A descriptive cross-sectional study of the waiting list for first-time consultations for medical specialties was carried out. Referred patients were described and grouped using indicators of access to healthcare and waiting time between April and October 2011. Each consultation request or referral of a new patient was included in the waiting list and analyzed. Results There were 15 935 requests for consultations; 5 717 requests were resolved, and 8 544 were not (54% of the total requests for consultation. There was a mean waiting time of 498 days for non-resolved requests for consultation, and a mean of 141 days for resolved requests. The specialties in highest demand were orthopedic surgery and ophthalmology. The main waiting-list management processes were referral and reception of requests

  14. Revisiting Waiting Times in DNA evolution

    CERN Document Server

    Nicodeme, Pierre

    2012-01-01

    Transcription factors are short stretches of DNA (or $k$-mers) mainly located in promoters sequences that enhance or repress gene expression. With respect to an initial distribution of letters on the DNA alphabet, Behrens and Vingron consider a random sequence of length $n$ that does not contain a given $k$-mer or word of size $k$. Under an evolution model of the DNA, they compute the probability $\\mathfrak{p}_n$ that this $k$-mer appears after a unit time of 20 years. They prove that the waiting time for the first apparition of the $k$-mer is well approximated by $T_n=1/\\mathfrak{p}_n$. Their work relies on the simplifying assumption that the $k$-mer is not self-overlapping. They observe in particular that the waiting time is mostly driven by the initial distribution of letters. Behrens et al. use an approach by automata that relaxes the assumption related to words overlaps. Their numerical evaluations confirms the validity of Behrens and Vingron approach for non self-overlapping words, but provides up to 44...

  15. State anxiety during watchful waiting for urinary lithiasis.

    Science.gov (United States)

    Kalaitzi, C; Kalantzis, A; Gravas, S; Georgiadis, J; Christodoulou, C

    2006-01-01

    Guidelines on many disorders recommend a variable period of watchful waiting between diagnosis and indicated action. In this study, we assessed stress during the watchful waiting period for urinary lithiasis, a benign disorder treated with minimally invasive procedures, without the pitfall of the emotional burden of a terminal or debilitating disease or fear of impending major surgery and to assess the distress caused by waiting per se. Furthermore, we attempt to identify individual patients at risk of prolonged or debilitating psychological distress. A total of 112 lithiasis patients with stones pain during the waiting period. Clinicians should be more flexible when they face the above group of patients, as far as the duration of watchful waiting period is concerned, because a long waiting sets those patients under significant emotional burden.

  16. Waiting for coronary angiography: is there a clinically ordered queue?

    Science.gov (United States)

    Hemingway, H; Crook, A M; Feder, G; Dawson, J R; Timmis, A

    2000-03-18

    Among over 3000 patients undergoing coronary angiography in the absence of a formal queue-management system, we found that a-priori urgency scores were strongly associated with waiting times, prevalence of coronary-artery disease, rate of revascularisation, and mortality. These data challenge the widely held assumption that such waiting lists are not clinically ordered; however, the wide variation in waiting times within urgency categories suggests the need for further improvements in clinical queueing.

  17. Hospital waiting time: the forgotten premise of healthcare service delivery?

    Science.gov (United States)

    Pillay, Datuk Ir M S; Ghazali, Roslan Johari Dato Mohd; Manaf, Noor Hazilah Abd; Abdullah, Abu Hassan Asaari; Bakar, Azman Abu; Salikin, Faisal; Umapathy, Mathyvani; Ali, Roslinah; Bidin, Noriah; Ismail, Wan Ismefariana Wan

    2011-01-01

    This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem. Self-administered questionnaires were the main method of data collection. Two sets of questionnaires were used. The first set solicited information from patients on their waiting time expereince. The second set elucidated information from hospital employees on the possible causes of lengthy waiting time. The questionnaires were administered in 21 public hospitals throughout all 13 states in Malaysia. A total of 13,000 responses were analysed for the patient survey and almost 3,000 were analysed for the employee survey. The findings indicate that on average, patients wait for more than two hours from registration to getting the prescription slip, while the contact time with medical personnel is only on average 15 minutes. Employee surveys on factors contributing to the lengthy waiting time indicate employee attitude and work process, heavy workload, management and supervision problems, and inadequate facilities to be among the contributory factors to the waiting time problem. Public healthcare in Malaysia is in a state of "excess demand", where demand for subsidised healthcare far outstrips supply, due to the large fee differential between public and private healthcare services. There is a need for hospital managers to reduce the boredom faced by patients while waiting, and to address the waiting time problem in a more scientific manner, as has been carried out in other countries through simulation and modelling techniques. Healthcare organisations are keen to address their waiting time problem. However, not much research has been carried out in this area. The study thus fills the lacuna in waiting time studies in healthcare organisations.

  18. TSA Security Checkpoint Wait Times – API (PMIS)

    Data.gov (United States)

    Department of Homeland Security — TSA operational data including: Airport wait time (hourly) data Airport throughput (hourly) data Prohibited item (hourly) data Monthly Objectives Report (MOR) data...

  19. In the post-colonial waiting room

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca; Gad, Ulrik Pram

    2017-01-01

    This chapter investigates this puzzle of choosing non-sovereignty in a postcolonial setting. Historically, the question of freedom from imperial hegemony has been linked to how Western colonialism involved keeping the colonized in ‘the waiting room of history’ by insisting that they were not yet...... ready for sovereignty. It explores a number of European overseas countries and territories. More specifically, it focuses on French dependencies in the Pacific and Indian Oceans, and North Atlantic Greenland constitutionally connected to Denmark. The immediate aim of anti-colonial struggles was to make...... acknowledge. A number of overseas territories take alternative routes to agency; not by resisting the norm of sovereignty - but by creatively articulating it beyond its claim to represent an 'either/or' distinction. The chapter demonstrates that territories not formally decolonized may very well perform...

  20. "Waiting and the waiting room: how do you experience them?" emotional implications and suggestions from patients with cancer.

    Science.gov (United States)

    Catania, Chiara; De Pas, Tommaso; Minchella, Ida; De Braud, Filippo; Micheli, Daniela; Adamoli, Laura; Spitaleri, Gianluca; Noberasco, Cristina; Milani, Alessandra; Zampino, Maria Giulia; Toffalorio, Francesca; Radice, Davide; Goldhirsch, Aron; Nolè, Franco

    2011-06-01

    Waiting can increase discomfort. The goal of this study was to identify moods and fears of cancer patients while in a waiting room and to capture their concrete suggestions for an anthropocentric transformation of waiting itself. A 15-item questionnaire was given to 355 patients who came to our Out-patient Oncology Clinic. Eighty-three percent of patients felt that waiting has an emotional cost, 35% were upset by talking about their condition with others while waiting, and 26% suffered a major emotional impact seeing other sick people and witnessing their clinical decline. Eighty-nine percent of patients suggested that alternative activities, such as meetings with professionals, doctors, and psychologists, be organized during the waiting period; 65% suggested fun activities (music therapy, drawing courses, library, TV). Most patients asked to have the freedom to leave the waiting room. This option, feasibly by means of IMs/"beepers," would limit their sense of having a lack of freedom or being robbed of their time. This study highlighted the complexity and heterogeneity of emotional implications that waiting causes in patients with cancer and collected many patients' suggestions about how to create a constructive, free, and personalized waiting period, overcoming the boredom, distress, and psychological suffering it causes.

  1. The subthalamic nucleus, Part I

    NARCIS (Netherlands)

    Marani, Enrico; Heida, Tjitske; Lakke, Egbert A.J.F.; Usunoff, Kamen G.

    2008-01-01

    Part I. Development, cytology, topography and connections. This monograph on the subthalamic nucleus accentuates in Part I the gap between experimental animal and human information concerning subthalamic development, cytology, topography and connections. The light and electron microscopical cytology

  2. Heavy flavors in nucleus-nucleus and proton-nucleus collisions

    Directory of Open Access Journals (Sweden)

    Nardi Marzia

    2016-01-01

    Full Text Available A multi-step setup for heavy-flavor studies in high-energy nucleus-nucleus (AA and proton-nucleus (pA collisions is presented. The propagation of the heavy quarks in the medium is described in a framework provided by the relativistic Langevin equation, here solved using weak-coupling transport coefficients. Successively, the heavy quarks hadronize in the medium. We compute the nuclear modification factor and the elliptic flow parameter of the final Dmesons both in AA and in pA collisions and compare our results to experimental data.

  3. [Waiting list registration for kidney transplants must improve

    NARCIS (Netherlands)

    Haase-Kromwijk, B.J.; Heemskerk, M.B.; Weimar, W.; Berger, S.P.; Hoitsma, A.J.

    2017-01-01

    OBJECTIVE: To investigate how the composition of the waiting list for postmortem kidney transplant has developed, and whether the waiting list reflects actual demand. DESIGN: Retrospective research and cohort study. METHOD: We used data from the period 2000-2014 from the Dutch Transplant Foundation,

  4. Wait times, patient satisfaction scores, and the perception of care.

    Science.gov (United States)

    Bleustein, Clifford; Rothschild, David B; Valen, Andrew; Valatis, Eduardas; Schweitzer, Laura; Jones, Raleigh

    2014-05-01

    To analyze the impact of waiting time on patient satisfaction scores; not only of satisfaction with the provider in general, but also with the specific perception of the quality of care and physician abilities. Using surveys regarding patient satisfaction with provider care, data was collected from a sample of 11,352 survey responses returned by patients over the course of 1 year across all 44 ambulatory clinics within a large academic medical center. While a small minority of patients volunteered identification, the surveys were made anonymously. A questionnaire with Health Consumer Assessment of Healthcare Providers and Systems patient satisfaction and waiting time queries was administered via mail to all clinic patients-roughly 49,000-with a response rate of 23%. Employing a standard statistical approach, results were tabulated and stratified according to provider scores and wait time experience, and then analyzed using statistical modeling techniques. While it is well established that longer wait times are negatively associated with clinical provider scores of patient satisfaction, results indicated that every aspect of patient experience-specifically confidence in the care provider and perceived quality of care-correlated negatively with longer wait times. The clinical ambulatory patient experience is heavily influenced by time spent waiting for provider care. Not only are metrics regarding the likelihood to recommend and the overall satisfaction with the experience negatively impacted by longer wait times, but increased wait times also affect perceptions of information, instructions, and the overall treatment provided by physicians and other caregivers.

  5. Determinants of Patient Waiting Time in the General Outpatient ...

    African Journals Online (AJOL)

    Patients spend substantial amount of time in the clinics waiting for services to be delivered by physicians and other allied health professionals. The degree to which health consumers are satisfied with the care received is strongly related to the quality of the waiting experience. Healthcare organizations that strive to deliver ...

  6. Maternity waiting homes: A panacea for maternal/neonatal ...

    African Journals Online (AJOL)

    Maternity waiting homes were introduced in Eritrea in 2007 as a strategy to mitigate against the attendant high maternal mortality rates in hard to reach regions. Objective: To assess pregnancy outcomes verified through maternal mortality and perinatal mortality rates since the introduction of maternity waiting homes in some ...

  7. Mean Waiting Time and Patients' Satisfaction in GOPD, Federal ...

    African Journals Online (AJOL)

    Background: Waiting time is a major determinant of the patients' level of satisfaction. It is the average time spent by the patient from the time of presentation in the hospital to the time of contact with a health service provider. Objective: To determine the mean waiting time in the Records department/card room and the General ...

  8. 8 CFR 207.5 - Waiting lists and priority handling.

    Science.gov (United States)

    2010-01-01

    ... from these lists in a manner that will best support the policies and interests of the United States... association with the United States, compelling humanitarian concerns, and public interest factors. ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated...

  9. Wait-Time and Multiple Representation Levels in Chemistry Lessons

    Science.gov (United States)

    Li, Winnie Sim Siew; Arshad, Mohammad Yusof

    2014-01-01

    Wait-time is an important aspect in a teaching and learning process, especially after the teacher has posed questions to students, as it is one of the factors in determining quality of students' responses. This article describes the practices of wait-time one after teacher's questions at multiple representation levels among twenty three chemistry…

  10. A novel intervention for medical waiting periods in IVF and early pregnancy

    NARCIS (Netherlands)

    Ockhuijsen, H.D.L.

    2014-01-01

    Patients who make use of healthcare services have to deal with all kind of waiting periods like waiting for the results of a biopsy or waiting for the results of a fertility treatment. Waiting periods can cause high levels of distress because the outcomes of these waiting periods are often

  11. Waiting for Merlot: anticipatory consumption of experiential and material purchases.

    Science.gov (United States)

    Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

    2014-10-01

    Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. © The Author(s) 2014.

  12. Access to specialist gastroenterology care in Canada: Comparison of wait times and consensus targets

    Science.gov (United States)

    Leddin, Desmond; Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Paterson, William G

    2008-01-01

    consensus targets; 51% to 88% of patients were not seen within the target wait time. Multiple interventions, including adoption of evidence-based management guidelines and provision of economic and human resources, are needed to ensure appropriate access to digestive health care in Canada. Outcomes can be evaluated by the ‘point-of-care’, practice audit methodology used for the present study. PMID:18299735

  13. Impact of diagnostic interval on mortality after diagnosis of colorectal cancer: A new perspective on the waiting list paradox

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Frydenberg, Morten; Hansen, Rikke Pilegaard

    INTRODUCTION: The impact of diagnostic delay on colorectal cancer mortality has never been conclusively evaluated. Most studies show either no association or find that rapidly diagnosed patients have higher mortality rates than patients with longer waits in the primary and secondary health care s...... interval had been treated as a categorical variable with standard cut-off points....

  14. The effect of waiting: A meta-analysis of wait-list control groups in trials for tinnitus distress.

    Science.gov (United States)

    Hesser, Hugo; Weise, Cornelia; Rief, Winfried; Andersson, Gerhard

    2011-04-01

    The response rates and effects of being placed on a wait-list control condition are well documented in psychiatric populations. Despite the usefulness of such estimates and the frequent use of no-treatment controls in clinical trials for tinnitus, the effect of waiting in a tinnitus trial has not been investigated systematically. The aim of the present study was to quantify the overall effect of wait-list control groups on tinnitus distress. Studies were retrieved via a systematic review of randomised controlled trials of cognitive behaviour therapy for tinnitus distress. Outcomes of psychometrically robust tinnitus-specific measures (Tinnitus Handicap Inventory, Tinnitus Questionnaire, Tinnitus Reaction Questionnaire) from wait-list control groups were quantified using meta-analytic techniques. Percentage of change and standard mean difference effect sizes were calculated using the pre and post wait period. Eleven studies involving 314 wait-list subjects with tinnitus were located. The analysis for a waiting period of 6 to 12 weeks revealed a mean decrease in scores on tinnitus-specific measures of 3% to 8%. Across studies, a statically significant small mean within-group effect size was obtained (Hedges' g=.17). The effects were moderated by methodological quality of the trial, sample characteristics (i.e., age, tinnitus duration), time of the wait-list and how diagnosis was established. Subjects in a tinnitus trial improve in tinnitus distress over a short waiting phase. The effects of waiting are highly variable and depend on the characteristics of the sample and of the trial. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Ethics in radiology: wait lists queue jumping.

    Science.gov (United States)

    Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

    2013-08-01

    Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  16. [Influence of waiting time on patient and companion satisfaction].

    Science.gov (United States)

    Fontova-Almató, A; Juvinyà-Canal, D; Suñer-Soler, R

    2015-01-01

    To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Prospective, observational study. Hospital de Figueres Emergency Department (Girona, Spain). sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). Perceived waiting time and the information about estimated waiting time determined overall satisfaction. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  17. Parental satisfaction with paediatric care, triage and waiting times.

    Science.gov (United States)

    Fitzpatrick, Nicholas; Breen, Daniel T; Taylor, James; Paul, Eldho; Grosvenor, Robert; Heggie, Katrina; Mahar, Patrick D

    2014-04-01

    The present study aims to determine parental and guardian's perceptions of paediatric emergency care and satisfaction with care, waiting times and triage category in a community ED. A structured questionnaire was provided to parents or guardians of paediatric patients presenting to emergency. The survey evaluated parent perceptions of waiting time, environment/facilities, professionalism and communication skills of staff and overall satisfaction of care. One hundred and thirty-three completed questionnaires were received from parents of paediatric patients. Responses were overall positive with respect to the multiple domains assessed. Parents generally considered waiting times to be appropriate and consistent with triage categories. Overall satisfaction was not significantly different for varying treatment or waiting times. Patients triaged as semi-urgent were of the opinion that waiting times were less appropriate than urgent, less-urgent or non-urgent patients. On the basis of the present study, patient perceptions and overall satisfaction of care does not appear to be primarily influenced by time spent waiting or receiving treatment. Attempts made at the triage process to ensure that semi-urgent patients have reasonable expectations of waiting times might provide an opportunity to improve these patients' expectations and perceptions. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Reducing outpatient waiting time: a simulation modeling approach.

    Science.gov (United States)

    Aeenparast, Afsoon; Tabibi, Seyed Jamaleddin; Shahanaghi, Kamran; Aryanejhad, Mir Bahador

    2013-09-01

    The objective of this study was to provide a model for reducing outpatient waiting time by using simulation. A simulation model was constructed by using the data of arrival time, service time and flow of 357 patients referred to orthopedic clinic of a general teaching hospital in Tehran. The simulation model was validated before constructing different scenarios. In this study 10 scenarios were presented for reducing outpatient waiting time. Patients waiting time was divided into three levels regarding their physicians. These waiting times for all scenarios were computed by simulation model. According to the final scores the 9th scenario was selected as the best way for reducing outpatient's waiting time. Using the simulation as a decision making tool helps us to decide how we can reduce outpatient's waiting time. Comparison of outputs of this scenario and the based- case scenario in simulation model shows that combining physician's work time changing with patient's admission time changing (scenario 9) would reduce patient waiting time about 73.09%. Due to dynamic and complex nature of healthcare systems, the application of simulation for the planning, modeling and analysis of these systems has lagged behind traditional manufacturing practices. Rapid growth in health care system expenditures, technology and competition has increased the complexity of health care systems. Simulation is a useful tool for decision making in complex and probable systems.

  19. Enhancing outpatient clinics management software by reducing patients' waiting time.

    Science.gov (United States)

    Almomani, Iman; AlSarheed, Ahlam

    The Kingdom of Saudi Arabia (KSA) gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients-which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS) and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient's satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients' distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients' waiting time will consequently affect patients' satisfaction and improve the quality of health care services

  20. Cholelithiasis in patients on the kidney transplant waiting list

    Directory of Open Access Journals (Sweden)

    André Thiago Scandiuzzi Brito

    2010-01-01

    Full Text Available OBJECTIVES: To evaluate the prevalence of cholecystopathy in chronic renal patients awaiting kidney transplants. INTRODUCTION: The prevalence and management of cholelithiasis in renal transplant patients is not well established. METHODS: A total of 342 chronic renal failure patients on the waiting list for a kidney transplant were studied. Patients were evaluated for the presence of cholelithiasis and related symptoms, previous cholecystectomies and other abdominal surgeries, time on dialysis, and general data (gender, age, number of pregnancies, and body mass index. RESULTS: Cholelithiasis was found in 41 out of 342 patients (12%. Twelve of these patients, all symptomatic, had previously undergone cholecystectomies. Five out of 29 patients who had not undergone surgery were symptomatic. Overall, 17 patients (41.5% were symptomatic. Their mean age was 54 (range 32-74 years old; 61% were female, and their mean body mass index was 25.4. Nineteen (76% out of 25 women had previously been pregnant, with an average of 3.6 pregnancies per woman. CONCLUSIONS: The frequency of cholelithiasis was similar to that reported in the literature for the general population. However, the high frequency of symptomatic patients points toward an indication of routine pre-transplant cholecystectomy to avoid serious post-transplant complications.

  1. Fast mixing condensation nucleus counter

    OpenAIRE

    Flagan, Richard C.; Wang, Jian

    2003-01-01

    A fast mixing condensation nucleus counter useful for detecting particles entrained in a sample gas stream is provided. The fast mixing condensation nucleus counter comprises a detector and a mixing condensation device having a mixing chamber adapted to allow gas to flow from an inlet to an outlet, wherein the outlet directs the gas flow to the detector. The mixing chamber has an inlet for introducing vapor-laden gas into the chamber and at least one nozzle for introducing a sample gas having...

  2. Waiting for care: effects of Ontario's 3-month waiting period for OHIP on landed immigrants.

    Science.gov (United States)

    Goel, Ritika; Bloch, Gary; Caulford, Paul

    2013-06-01

    To describe the experiences of a group of new immigrants and caregivers of new immigrants who were subject to the 3-month waiting period for the Ontario Health Insurance Plan and needed to access health care services during that time. Qualitative study using a phenomenologic framework. Participants were recruited through the Scarborough Community Volunteer Clinic in Toronto, Ont. Interviews were conducted in person at the clinic or by telephone. Seven participants were interviewed who themselves needed to access health care during the 3-month waiting period for the Ontario Health Insurance Plan or who were caring for someone who did. Seven semistructured, in-depth interviews were conducted using an interview guide; these were recorded and transcribed verbatim. Data were analyzed for themes to arrive at the essence of the participants' experiences. Participants believed that there was a lack of clear information and a lack of help from officials. Other common themes included poor social situations, financial loss or threat of financial loss related to health care, a choice to delay seeking care owing to cost, difficulty accessing alternative care, and appreciation for those who advocated on their behalf. Other themes that arose included emotional hardship, poor health outcomes or threat of poor health outcomes resulting from not seeking care, the importance and unpredictability of health, as well as negative impressions of Canada as a country as a result of the negative experience of seeking care. New immigrants to Ontario who need to access health care services during the 3-month waiting period for provincial health insurance and the caregivers of such newcomers can have potentially very negative experiences. They might be unable to access care without financial barriers and might, therefore, choose to delay seeking health care until the end of the waiting period; this can lead to emotional hardship for themselves and their caregivers as well as to potentially poor

  3. [Improving the CMP appointment waiting time for children and adolescents].

    Science.gov (United States)

    Cani, Pascale

    2014-01-01

    The increasing activity of mental health centres for children and adolescents and longer waiting times in obtaining a first appointment have led an area of child psychiatry to question the organisation of new consultation applications. Two CMP in the sector had a waiting period of over 40 days for half of the patients. Two improvement actions were implemented:the implementation of organisation and reception nurses and the development of a new applications management process. The evaluation after one year showed a decrease of half of the appointment waiting time without changing the non showed up rate.

  4. Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

    DEFF Research Database (Denmark)

    Linnet, Jakob; Pedersen, Anders Sune

    2014-01-01

    completion in gambling disorder. We compared 48 gambling disorder sufferers with a 56% completion rate (21 non-completers and 27 completers). Binomial logistic regression analysis showed that waiting time from initial contact to the first session with a therapist was a significant predictor of risk...... of attrition: longer waiting times were associated with increased risk of attrition. Age, gender, or comorbidity was not associated with an increased risk of attrition. These data suggest that gambling disorder sufferers benefit from fast access to treatment, and that longer waiting time increases the risk...

  5. Burden of waiting for surveillance CT colonography in patients with screen-detected 6-9 mm polyps

    Energy Technology Data Exchange (ETDEWEB)

    Tutein Nolthenius, Charlotte J. [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Boellaard, Thierry N.; Nio, C.Y.; Bipat, Shandra; Stoker, Jaap [University of Amsterdam, Department of Radiology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Haan, Margriet C. de [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Thomeer, Maarten G.J. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Montauban van Swijndregt, Alexander D. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Essink-Bot, Marie-Louise [University of Amsterdam, Public Health, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands); Kuipers, Ernst J. [Erasmus University Medical Center, Gastroenterology and Hepatology, Rotterdam (Netherlands); Erasmus University Medical Center, Internal medicine, Rotterdam (Netherlands); Dekker, Evelien [University of Amsterdam, Gastroenterology and Hepatology, Academic Medical Center, PO Box 22700, Amsterdam (Netherlands)

    2016-11-15

    We assessed the burden of waiting for surveillance CT colonography (CTC) performed in patients having 6-9 mm colorectal polyps on primary screening CTC. Additionally, we compared the burden of primary and surveillance CTC. In an invitational population-based CTC screening trial, 101 persons were diagnosed with <3 polyps 6-9 mm, for which surveillance CTC after 3 years was advised. Validated questionnaires regarding expected and perceived burden (5-point Likert scales) were completed before and after index and surveillance CTC, also including items on burden of waiting for surveillance CTC. McNemar's test was used for comparison after dichotomization. Seventy-eight (77 %) of 101 invitees underwent surveillance CTC, of which 66 (85 %) completed the expected and 62 (79 %) the perceived burden questionnaire. The majority of participants (73 %) reported the experience of waiting for surveillance CTC as 'never' or 'only sometimes' burdensome. There was almost no difference in expected and perceived burden between surveillance and index CTC. Waiting for the results after the procedure was significantly more burdensome for surveillance CTC than for index CTC (23 vs. 8 %; p = 0.012). Waiting for surveillance CTC after primary CTC screening caused little or no burden for surveillance participants. In general, the burden of surveillance and index CTC were comparable. (orig.)

  6. Functionalized active-nucleus complex sensor

    Science.gov (United States)

    Pines, Alexander; Wemmer, David E.; Spence, Megan; Rubin, Seth

    2003-11-25

    A functionalized active-nucleus complex sensor that selectively associates with one or more target species, and a method for assaying and screening for one or a plurality of target species utilizing one or a plurality of functionalized active-nucleus complexes with at least two of the functionalized active-nucleus complexes having an attraction affinity to different corresponding target species. The functionalized active-nucleus complex has an active-nucleus and a targeting carrier. The method involves functionalizing an active-nucleus, for each functionalized active-nucleus complex, by incorporating the active-nucleus into a macromolucular or molecular complex that is capable of binding one of the target species and then bringing the macromolecular or molecular complexes into contact with the target species and detecting the occurrence of or change in a nuclear magnetic resonance signal from each of the active-nuclei in each of the functionalized active-nucleus complexes.

  7. Heavy-ion nucleus scattering

    CERN Document Server

    Rahman, M A; Haque, S

    2003-01-01

    Heavy ion-nucleus scattering is an excellent laboratory to probe high spin phenomena, exotic nuclei and for the analysis of various exit channels. The Strong Absorption Model or the generalized diffraction models, which are semi-classical in nature, have been employed in the description of various heavy ion-nucleus scattering phenomena with reasonable success. But one needs to treat the deflection function (scattering angles) quantum mechanically in the Wave Mechanical picture for the appropriate description of the heavy-ion nucleus scattering phenomena. We have brought the mathematics for the cross-section of the heavy-ion nucleus scattering to an analytic expression taking account of the deflection function (scattering angles) quantum mechanically. sup 9 Be, sup 1 sup 6 O, sup 2 sup 0 Ne and sup 3 sup 2 S heavy-ion beams elastic scattering from sup 2 sup 8 Si, sup 2 sup 4 Mg and sup 4 sup 0 Ca target nuclei at various projectile energies over the range 20-151 MeV have been analysed in terms of the 2-paramet...

  8. Determinants of Patient Waiting Time in the General Outpatient ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research | Oct-Dec 2013 | Vol 3 | Issue 4 | ... clinic waiting time is an important indicator of quality of ... healthcare services. ... Subjects and Methods: This descriptive cross‑sectional study was carried.

  9. Moderate alcohol consumption and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbæk, Morten

    2001-01-01

    BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time...... to pregnancy (0-2, 3-5, 6-12 and >12 months) was used for 39 612 pregnant women, recruited to the Danish National Birth Cohort within the first 24 weeks of pregnancy from 1997 to 2000. Main outcome measures were odds ratios (OR) for a prolonged waiting time to pregnancy according to alcohol intake. RESULTS......: In nulliparous women neither moderate nor high alcohol intake was related with longer waiting time to pregnancy compared with a low intake. In parous women, a modest association was seen only among those with an intake of >14 drinks per week (subfecundity OR 1.3; 95% confidence interval 1.0-1.7). Women who...

  10. Moderate alcohol consumption and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Andersen, Anne-Marie Nybo; Grønbaek, Morten

    2001-01-01

    BACKGROUND: Recent research indicates that even a moderate consumption of alcohol in women trying to become pregnant is associated with longer waiting time to pregnancy. The findings, though, are based upon few observations. METHODS: Self-reported data on alcohol intake and waiting time......: In nulliparous women neither moderate nor high alcohol intake was related with longer waiting time to pregnancy compared with a low intake. In parous women, a modest association was seen only among those with an intake of >14 drinks per week (subfecundity OR 1.3; 95% confidence interval 1.0-1.7). Women who...... to pregnancy (0-2, 3-5, 6-12 and >12 months) was used for 39 612 pregnant women, recruited to the Danish National Birth Cohort within the first 24 weeks of pregnancy from 1997 to 2000. Main outcome measures were odds ratios (OR) for a prolonged waiting time to pregnancy according to alcohol intake. RESULTS...

  11. Ultrasound waiting lists: rational queue or extended capacity?

    Science.gov (United States)

    Brasted, Christopher

    2008-06-01

    The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

  12. Effect of emergency physician burnout on patient waiting times

    OpenAIRE

    De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

    2017-01-01

    International audience; Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint wa...

  13. Interior effects on comfort in healthcare waiting areas.

    Science.gov (United States)

    Bazley, C; Vink, P; Montgomery, J; Hedge, A

    2016-07-21

    This study compared the effects of pre-experience and expectations on participant comfort upon waking, arrival to, and after an appointment, as well as the assessment of properly placed Feng Shui elements in three healthcare waiting rooms. Participants assessed comfort levels using self-report surveys. The researcher conducted 'intention interviews' with each doctor to assess the goals of each waiting area design, and conducted a Feng Shui assessment of each waiting area for properly placed Feng Shui elements. The waiting area designed by the Feng Shui expert rated 'most comfortable', followed by the waiting area design by a doctor, and the lowest comfort rating for the conventional waiting room design. Results show a sufficiently strong effect to warrant further research. Awareness of the external environment, paired with pre-experience and expectation, influences comfort for people over time. Fostering and encouraging a holistic approach to comfort utilizing eastern and western concepts and ergonomic principles creates a sense of "placeness" and balance in the design for comfort in built environments. This is new research information on the influences of the comfort experience over time, to include pre-experience, expectations and the placement of elements in the external environment.

  14. Long-waiting outpatients: target audience for health education.

    Science.gov (United States)

    Bamgboye, E A; Jarallah, J S

    1994-04-01

    The study examines the meaning of waiting time in an outpatient department. Attention is payed to the activities of the patients and companions during the waiting time, the potential for health education programmes during the waiting time and the form such a health education programme should take. The setting was the King Khalid University Hospital Outpatient Department, Riyadh, Saudi Arabia. The study sample was selected by a systematic random sample approach of one in every 10 patients or companions visiting the clinic in a period of 2 weeks. The results showed an average waiting time of 148 min with a standard deviation of 11 min. Patients currently engage in reading, sleeping or talking during long waiting time. However, they showed a preference for health education programmes for specific diseases such as heart disease, diabetes mellitus and bowel diseases during the waiting time. Leaflets were favoured to be the most preferred mode for disseminating such information. A sizeable proportion of patients also wanted religious programmes included. We conclude that education programmes for preferred specific health topics at outpatient clinic services would be of potential benefit to patients' overall health.

  15. Effect of emergency physician burnout on patient waiting times.

    Science.gov (United States)

    De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

    2017-07-04

    Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

  16. Respiratory viral RNA on toys in pediatric office waiting rooms.

    Science.gov (United States)

    Pappas, Diane E; Hendley, J Owen; Schwartz, Richard H

    2010-02-01

    Toys in pediatric office waiting rooms may be fomites for transmission of viruses. Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B. In addition, 15 samples were obtained from the sick waiting room before and after cleaning. Polymerase chain reaction was used to detect picornavirus, respiratory syncytial virus, and influenza A or B virus. Finally, 20 samples were obtained from the fingers of a researcher after handling different toys in the sick waiting room, and samples were then obtained from all the same toys; all samples were tested for picornavirus by polymerase chain reaction. Viral RNA was detected on 11 of 52 (21%) of toys sampled. Ten of the positives were picornavirus; 1 was influenza B virus. Three (30%) of 10 toys from the new toy bag, 6 of 30 (20%) in the sick child waiting room, and 2 of 12 (17%) in the well child waiting room were positive. Six (40%) of 15 toys in the sick waiting room were positive for picornaviral RNA before cleaning; after cleaning, 4 (27%) of 15 were positive in spite of the fact that RNA was removed from 4 of 6 of the original positives. Three (15%) of 20 toys in the sick waiting room were positive for picornaviral RNA, but RNA was not transferred to the fingers of the investigator who handled these toys. About 20% of the objects in a pediatric office may be contaminated with respiratory viral RNA, most commonly picornavirus RNA. Cleaning with a disinfectant cloth was only modestly effective in removing the viral RNA from the surfaces of toys, but transfer of picornaviral RNA from toys to fingers was inefficient.

  17. Satisfaction and Wait Time of Patients Visiting a Family Practice Clinic

    Science.gov (United States)

    Bestvater, David; Dunn, Earl V.; Townsend, Connie; Nelson, Wendy

    1988-01-01

    Data relating to wait times and time spent with nurses and physicians were recorded for 656 patients visiting a large family-practice unit. Patients were asked to provide estimates of their wait times and ratings of the acceptability of these wait intervals. Actual wait times were usually longer than those estimated by the patient, and total wait times were considered reasonable. The results of the study show high levels of patient satisfaction and indicate that few patients are dissatisfied until total wait time exceeds forty-five minutes. Different age groups appear to have different expectations, however, and younger patients are more likely to be dissatisfied with their wait times. PMID:21264021

  18. Don't stop the clock: manipulating hospital waiting lists.

    Science.gov (United States)

    Buchanan, David A; Storey, John

    2010-01-01

    This paper aims to explore the theoretical and practical management implications of a case involving the falsification of hospital patient waiting lists for elective orthopaedic surgery. This case study is based on qualitative schedule-structured interviews with 20 senior hospital staff (managerial and clinical), including the head of the investigation team, downloads from the hospital website, and internal hospital documentation. Those data were used to construct an event narrative exploring the underlying causes and implications of the incident. The blame for misconduct pointed at three surgeons, a senior manager, a general manager, an assistant general manager, one administrative staff member, and several organizational factors. In addition to censuring some of those involved, an investigation recommended changes to training and working practices, policies and procedures, governance arrangements, and organization culture, and led to an external evaluation of the hospital board. However, one year later, another similar incident occurred. This is a single case, and events are viewed through a management lens, the individuals concerned being protected by research ethics considerations. By detailing the sequence of events, surrounding conditions, and the reactions of multiple players, this analysis reveals typified responses to incidents of this kind, and the limitations inherent in post-event investigations. If the benefits derived from national targets are to be realized in a manner which commands support from staff at all levels, then greater attention should be paid by managers and regulators to issues of transparency, responsiveness, and honesty. As core dimensions of good governance, managers must be accountable for helping to meet targets, and also for tracking how targets are met, ensuring that resources are made available, and that problematic issues raised are promptly and effectively addressed. Studies of organizational misbehaviour are rare in healthcare

  19. Waiting Lists for Radiation Therapy: A Case Study

    Directory of Open Access Journals (Sweden)

    Singer Peter A

    2001-04-01

    Full Text Available Abstract Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

  20. Watchful Waiting Strategy May Reduce Low-Value Diagnostic Testing.

    Science.gov (United States)

    May, Larissa; Franks, Peter; Jerant, Anthony; Fenton, Joshua

    PCPs need effective communication strategies to address patient requests for low-value testing while sustaining patient-provider partnerships. Watchful waiting - allowing a negotiated period of time to pass before making a firm testing decision - shows promise as a tool for addressing patient requests for low-value testing. Observational analysis of data from a randomized controlled trial of a communication intervention designed to boost patient-centeredness and reduce low-value test ordering among 61 resident primary care physicians. Intervention effectiveness was assessed during follow-up encounters of unannounced standardized patients (SPs) who requested low-value tests. We examined associations between five physician counseling behaviors and overall patient-centeredness (Measure of Patient-Centered Communication) and requested test ordering. During 155 SP encounters, residents most commonly used reassurance (96% of encounters), evidence-based recommendations (97%), and watchful waiting (68 %). Resident advice to pursue watchful waiting was associated with 39% lower likelihood of test ordering (adjusted marginal effect of -38.6% [95% CI -43.6 to -33.6]). When all communication behaviors were examined together, only watchful waiting was significantly associated with test ordering (marginal effect of -38% [95% CI -44.3% to -31.7%]). Overall patient-centeredness was not associated with low-value testing. Resident physician counseling to pursue watchful waiting was associated with less ordering of requested low-value diagnostic tests, while overall patient-centeredness was not. © Copyright 2016 by the American Board of Family Medicine.

  1. Separable Representation of Nucleon-Nucleus Optical Potentials as Input to (d; p) Reaction Calculations

    Science.gov (United States)

    Hlophe, Linda D.

    The three-body description of deuteron-induced nuclear reactions requires the nucleon-nucleon (NN) and effective nucleon-nucleus interactions as input. The latter are given by Optical Model Potentials (OMPs), which are complex as well as energy-dependent. While a lot of effort has been dedicated to creating separable NN potentials, the same is not true for the nucleon-nucleus OMPs. In this work, separable representations of nucleon-nucleus OMPs are presented. To construct separable representations of neutron-nucleus OMPs, a scheme due to Ernst, Shakin, and Thaler (EST) is adopted as a starting point. It is shown that, by including both incoming and outgoing scattering states in the EST scheme, separable expansions for complex neutron-nucleus potentials that partially obey reciprocity are obtained. For the application to neutron-nucleus potentials that are complex as well as energy-dependent, a further generalization is carried out leading to an energy-dependent separable expansion that exactly fulfills reciprocity. By working exclusively with half-shell transition matrices in momentum space, the implementation of these separable representation schemes is straightforward. The proton-nucleus interaction consists of a short-ranged nuclear piece as well as the long-ranged point-Coulomb potential. After separating the point-Coulomb piece via the Gell-Mann-Goldberger relation, one is left with the short-ranged potential in the Coulomb basis. An extension of the separable representation schemes for neutron-nucleus OMPs to proton-nucleus systems thus requires scattering solutions in the Coulomb basis. This complicates a momentum space implementation of the aforementioned separable expansions. However, by employing the techniques first suggested by Elster, Liu, and Thaler, the separable representation schemes generalized for proton-nucleus OMPs are implemented in a similar manner to neutron-nucleus OMPs. Taking into account the internal structure of the nucleus leads to

  2. Blood pressure self-measurement in the obstetric waiting room

    DEFF Research Database (Denmark)

    Wagner, Stefan; Kamper, Christina H.; Toftegaard, Thomas Skjødeberg

    2013-01-01

    Background: Pregnant diabetic patients are often required to self- measure their blood pressure in the waiting room before consulta- tion. Currently used blood pressure devices do not guarantee valid measurements when used unsupervised. This could lead to misdi- agnosis and treatment error. The aim...... of this study was to investigate current use of blood pressure self-measurement in the waiting room in order to identify challenges that could influence the resulting data quality. Also, we wanted to investigate the potential for addressing these challenges with e-health and telemedicine technology. Subjects...... a reliable blood pressure reading. Results: We found that the patients did not adhere to given instructions when performing blood pressure self-measurement in the waiting room. None of the 81 patients adhered to all six inves- tigated recommendations, while around a quarter adhered to five out of six...

  3. Waiting lists and elective surgery: ordering the queue.

    Science.gov (United States)

    Curtis, Andrea J; Russell, Colin O H; Stoelwinder, Johannes U; McNeil, John J

    2010-02-15

    In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed-upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high-demand procedures in other areas of health care.

  4. Absence of jet quenching in peripheral nucleus-nucleus collisions

    Science.gov (United States)

    Loizides, Constantin; Morsch, Andreas

    2017-10-01

    Medium effects on the production of high-pT particles in nucleus-nucleus (AA) collisions are generally quantified by the nuclear modification factor (RAA), defined to be unity in absence of nuclear effects. Modeling particle production including a nucleon-nucleon impact parameter dependence, we demonstrate that RAA at midrapidity in peripheral AA collisions can be significantly affected by event selection and geometry biases. Even without jet quenching and shadowing, these biases cause an apparent suppression for RAA in peripheral collisions, and are relevant for all types of hard probes and all collision energies. Our studies indicate that calculations of jet quenching in peripheral AA collisions should account for the biases, or else they will overestimate the relevance of parton energy loss. Similarly, expectations of parton energy loss in light-heavy collision systems based on comparison with apparent suppression seen in peripheral RAA should be revised. Our interpretation of the peripheral RAA data would unify observations for lighter collision systems or lower energies where significant values of elliptic flow are observed despite the absence of strong jet quenching.

  5. Waiting Time as an Index of Quality of Nursing Care

    Science.gov (United States)

    Haussmann, R. K. Dieter

    1970-01-01

    A model of the patient care process, based on queueing theory, is described and its parameters defined empirically for application to a burn unit. For the particular case, the model is shown to provide a close approximation to observed data. The model is descriptive, with an output of expected waiting times for various priorities of patient demand. The waiting times so estimated constitute an index of the quality of nursing care and afford a means of predicting changes in quality with changes in staffing or inpatient load. The model facilitates investigation of the relationships among three factors: patient condition, nurses' activity priorities, and patient load per nurse. PMID:5482376

  6. Pricing in M/M/1 queues when cost of waiting in queue differs from cost of waiting in service

    Directory of Open Access Journals (Sweden)

    Görkem Sarıyer

    2016-11-01

    Full Text Available Service providers can adjust the entrance price to the state of the demand in real life service systems where the customers' decision to receive the service, is based on this price, state of demand and other system parameters. We analyzed service provider's short and long term pricing problems in unobservable M/M/1 queues having the rational customers, where, for customers, the unit cost of waiting in the queue is higher than unit cost of waiting in the service. We showed that waiting in the queue has a clear negative effect on customers’ utilities, hence the service provider's price values. We also showed that, in the short term, monopolistic pricing is optimal for congested systems with high server utilization levels, whereas in the long term, market capturing pricing is more profitable.

  7. Patient Satisfaction with Wait-Times for Breast Cancer Surgery in Newfoundland and Labrador.

    Science.gov (United States)

    Mathews, Maria; Ryan, Dana; Gadag, Vereesh; West, Roy

    2016-02-01

    Do shorter waits for breast cancer surgery lead to greater wait-related patient satisfaction? Using survey and cancer clinic chart data of 99 patients with breast cancer from Newfoundland and Labrador, we found that median wait-time from first visit to a surgeon to surgery was 22.0 days and 87% were satisfied with their wait-time. Wait-related satisfaction was not associated with the length of wait but rather with the stage, severity of treatment, wait-time for a diagnosis and satisfaction with diagnosis-related wait. These findings highlight the importance of an early and timely diagnosis in patients' perceptions of breast cancer care wait-times. Copyright © 2016 Longwoods Publishing.

  8. Reducing wait time in a hospital pharmacy to promote customer service.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

    2008-01-01

    The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

  9. Determination of Coil Inductances Cylindrical Iron Nucleus

    Directory of Open Access Journals (Sweden)

    Azeddine Mazouz

    2014-03-01

    Full Text Available The paper describes the investigation and development of a structure and performance characteristics of a coil iron nucleus cylindrical (C.I.N.C. The coil iron nucleus cylindrical is a nonlinear electro radio in which the moving of the nucleus in a sense or in other causes change in inductance and can reach extreme values at the superposition of nucleus and coil centers. The variation of the inductance and the degree of freedom of movement of the nucleus can lead to a device with electromechanical conversion The aim of this paper is the determination and visualization of self inductance and mutual of the (C.I.N.C based on geometric dimensions and the displacement of the nucleus.  

  10. Maternity waiting homes: A panacea for maternal/neonatal ...

    African Journals Online (AJOL)

    obstetric care including the application of task shifting of higher responsibilities to relatively lowly qualified health workers markedly improved outcomes in many developing countries 4,8. While maternity waiting homes have been successfully used in reducing maternal mortality in other setups9,10, little quantitative research ...

  11. Quality Improvement Cycles that Reduced Waiting Times at ...

    African Journals Online (AJOL)

    Surveys were done in May and September to analyse the problems causing prolonged waiting times. The implemented change included instituting a functional triage system, improvement of the process of up- and down-referrals to and from the tertiary hospital, easy access to stock, reorganisation of doctors' duty roster, ...

  12. Waiting time among acute abdominal emergencies in a Nigerian ...

    African Journals Online (AJOL)

    Background-In many patients presenting with an acute surgical abdomen, the outcome of management is determined by the promptness of the appropriate surgical intervention. The average interval the patient has to spent waiting for treatment at first presentation to hospital with an acute abdominal emergency is unknown ...

  13. The Ultimate $uperpower: Supersized Dollars Drive "Waiting for "Superman"" Agenda

    Science.gov (United States)

    Miner, Barbara

    2011-01-01

    For nearly 40 years, according to this author, "follow the money" has been an axiom in both journalism and politics--although, as Shakespeare might complain, one "more honour'd in the breach than the observance." It is useful to resurrect the axiom in analyzing the multimedia buzz and policy debates swirling around the movie "Waiting for…

  14. Maternity waiting homes in Rural Health Centers of Ethiop: The ...

    African Journals Online (AJOL)

    kim

    had modern corrugated iron roof and brick wall structures that were ... 123.64. Fisher's=0.00. The roof of the waiting home ..... and sometimes, we would walk in the compound which is neat and green.” The health care staff's courtesy, passion, and cooperation were an excellent experience for women staying at the MWHs.

  15. Waiting times in discrete-time cyclic-service systems

    Science.gov (United States)

    Boxma, O. J.; Groenendijk, W. P.

    1987-03-01

    Single-server, multiqueue systems with cyclic service in discrete time are considered. Nonzero switchover times between consecutive queues are assumed; the service strategies at the various queues may differ. A decomposition for the amount of work in such systems is obtained, leading to an exact expression for a weighted sum of the mean waiting times at the various queues.

  16. Did Not Wait Patient Management Strategy (DNW PMS) Study.

    LENUS (Irish Health Repository)

    O'Keeffe, Fran

    2011-06-14

    Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

  17. Did Not Wait Patient Management Strategy (DNW PMS) Study.

    LENUS (Irish Health Repository)

    2012-02-01

    Objectives This study was undertaken to assess the usefulness of senior emergency medicine specialists\\' review of all \\'did not wait\\' (DNW) patients\\' triage notes and the recall of at-risk patients. Methods A prospective study of all DNW patients was performed from 1 January to 31 December 2008. Following a daily review of charts of those who failed to wait to be seen, those patients considered to be at risk of adverse outcome were contacted by the liaison team and advised to return. Data were gathered on all DNW patients on the Oracle database and interrogated using the Diver solution. Results 2872 (6.3%) of 45 959 patients did not wait to be seen. 107 (3.7%) were recalled on the basis of senior emergency medicine doctor review of the patients\\' triage notes. Variables found to be associated with increased likelihood of being recalled included triage category (p<0.001), male sex (p<0.004) and certain clinical presentations. The presenting complaints associated with being recalled were chest pain (p<0.001) and alcohol\\/drug overdose (p=0.001). 9.4% of DNW patients required admission following recall. Conclusion The systematic senior doctor review of triage notes led to 3.7% of patients who failed to wait being recalled. 9.4% of those recalled required acute admission. The daily review of DNW patients\\' triage notes and the recalling of at-risk patients is a valuable addition to our risk management strategy.

  18. Potential impact of enhanced practice efficiency on endoscopy waiting times.

    LENUS (Irish Health Repository)

    Harewood, G C

    2009-06-01

    With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

  19. EVALUTION OF THE SINGLE INTERCITY FREIGHT TRANSPORTATION WAITING TIME

    Directory of Open Access Journals (Sweden)

    N. Ponomariova

    2015-07-01

    Full Text Available The example of vechicle operation on the pendulum intercity route during single freightages processing is considered. Two approaches to the definition of the single freightage waiting time by the carrier are proposed. These approaches allow to take into account the probability of the single freightage obtaining by the carrier during the different load level of the transport enterprise capacity.

  20. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

  1. Waiting for the Russians: Coetzee's The Master of Petersburg and ...

    African Journals Online (AJOL)

    A meditation on transition time and on the protracted dimension of waiting for a new world to be born, the novel also presents a model of connectivity between Russia and South Africa. It places post-apartheid culture in a special relationship to postcolonialism and the global configuration born at the end of the Cold War.

  2. Waiting to Drive (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-04-09

    Over the past 10 years, the number of fatal motor-vehicle crashes involving teenage drivers has declined by more than 50 percent. This podcast discusses the trend of teens waiting until they are older to drive.  Created: 4/9/2015 by MMWR.   Date Released: 4/9/2015.

  3. Info card for surgery waiting room improves satisfaction.

    Science.gov (United States)

    2015-11-01

    A hospital is reporting improved patient satisfaction from providing an information card in the surgery department. The card includes expected wait times. The card is provided by the patient transport team. Telephone numbers are included for more information. Staff update family members hourly during surgery.

  4. Waiting in the wings : New parties in the Netherlands

    NARCIS (Netherlands)

    Krouwel, Andre; Lucardie, Paul

    Even in the relatively open political system of the Netherlands, most new parties never pass the threshold of representation and keep waiting in vain in the wings of political power. Since 1989 only 10 out of 63 newcomers gained one or more seats in parliament, owing to a favourable political

  5. Waiting in the wings: New parties in the Netherlands

    NARCIS (Netherlands)

    Krouwel, A.P.M.; Lucardie, P.

    2008-01-01

    Even in the relatively open political system of the Netherlands, most new parties never pass the threshold of representation and keep waiting in vain in the wings of political power. Since 1989 only 10 out of 63 newcomers gained one or more seats in parliament, owing to a favourable political

  6. Self-Stabilization of Wait-Free Shared Memory Objects

    NARCIS (Netherlands)

    Hoepman, J.H.; Papatriantafilou, Marina; Tsigas, Philippas

    2002-01-01

    This paper proposes a general definition of self-stabilizing wait-free shared memory objects. The definition ensures that, even in the face of processor failures, every execution after a transient memory failure is linearizable except for an a priori bounded number of actions. Shared registers have

  7. Public Mode Access And Waiting Time Variability In Maiduguri ...

    African Journals Online (AJOL)

    This work examines public mode access and waiting time variations in Maiduguri Metropolitan Area. Data for the study were sought through a comprehensive field survey using a travel diary questionnaire. A total of 623 households were surveyed in 342 dwelling units. The results indicate that variations in modal access and ...

  8. Waiting line, the border and modernity

    Directory of Open Access Journals (Sweden)

    José Luis Tejeda González

    2004-07-01

    Full Text Available The philosophic discussion is the departure point related to Nietzsche and Heiddeger, about the coming of the nihilism to introduce us in the subjects of the border in the modern and postmodern world. That existencial condition approaches us the experience in the border, and to the fact to transfer and to live in the edges. In other dimensions, we found the present time of that philosophic debate, since the border subject acquires centrality. In the social, politic, and cultural land we paradoxically see as globalization leads to an weakeing of the borders and an increase of its importances. The border demarcation continues being important, but now it has to do with the proliferation of agents, regional and global forces, and tendencies make of the border a blurred and opened institution. The increase of the interdependence are causing that migration and border transfering to be changing the face of communities of many countries of the present world. The national states are painted of color by those migratory movements that give the diversity, the pluralidad and the multiculturalismo in the before homogeneous societies.

  9. Worth the Wait? Using Past Patterns to Determine Wait Periods for E-Books Released after Print

    Science.gov (United States)

    Kohn, Karen

    2018-01-01

    This paper asks if there is an optimal wait period for e-books that balances libraries' desire to acquire books soon after their publication with the frequent desire to purchase books electronically whenever feasible. Analyzing 13,043 titles that Temple University Libraries received on its e-preferred approval plan in 2014-15, the author looks at…

  10. Hadron-nucleus bound states

    CERN Document Server

    Yamazaki, T

    2000-01-01

    A new type of nuclear spectroscopy to study hadron-nucleus bound states is described. The first successful experiment was to search for deeply bound pi sup - states in heavy nuclei using the sup 2 sup 0 sup 8 Pb(d, sup 3 He) reaction at GSI, in which a narrow peak arising from the 2p pi sup - orbital coupled with the neutron-hole states was observed at 135 MeV excitation energy. An improved experiment has just been carried out to separately identify the 1s and 2p pi sup - states. These experiments provide important information on the local potential strength, from which the effective mass of pi sup - is deduced to be 20 MeV. This method will be extended to search for eta and omega bound states as well as for K sup - bound states. The advantage of the bound-state spectroscopy versus invariant mass spectroscopy is emphasized.

  11. After 24-hour scrub, the Boeing Delta II rocket carrying Stardust waits for launch

    Science.gov (United States)

    1999-01-01

    After a 24-hour postponement, the Boeing Delta II rocket carrying the Stardust spacecraft waits on Launch Pad 17-A, Cape Canaveral Air Station, for its scheduled launch at 4:04 p.m. EST. Umbilical lines (at top) still attached to the fixed utility tower (at right) feed electricity, air conditioning and coolants for the Stardust spacecraft inside the fairing (enclosing the upper stage) before launch. Stardust is destined for a close encounter with the comet Wild 2 in January 2004. Using a silicon-based substance called aerogel, Stardust will capture comet particles flying off the nucleus of the comet. The spacecraft also will bring back samples of interstellar dust. These materials consist of ancient pre-solar interstellar grains and other remnants left over from the formation of the solar system. Scientists expect their analysis to provide important insights into the evolution of the sun and planets and possibly into the origin of life itself. The collected samples will return to Earth in a sample return capsule to be jettisoned as Stardust swings by Earth in January 2006.

  12. Capture reactions into borromean two-proton systems at rp-waiting points

    DEFF Research Database (Denmark)

    Hove, D.; Jensen, A. S.; Fynbo, H. O. U.

    2016-01-01

    bound state is described both based on a full three-body calculation and on a very simple analytic rate expression for temperatures about $1-5$~GK. This rate is valid for both direct and sequential capture paths, and it only depends on the three-body resonance energy. As a result the relevant path...... of the radiative capture reactions can be determined. We present numerical results for $E1$ and $E2$ photon emission, and discuss occurrence preferences in general as well as relative sizes of these most likely processes. Finally, we present narrow estimated intervals for the proton capture rates relevant...

  13. Tipping Point

    Medline Plus

    Full Text Available ... OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point The Tipping Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture ...

  14. Patient satisfaction with ambulatory healthcare services: waiting time and filling time.

    Science.gov (United States)

    Dansky, K H; Miles, J

    1997-01-01

    Customer satisfaction is an important measure of service quality in healthcare organizations. This study investigated the relationship between patient waiting and satisfaction with ambulatory healthcare services, with waiting times divided into segments of the patient-care episode. Two management techniques to alter perceptions of waiting were also examined. Regression models measuring the effect of waiting times on satisfaction found that the total time spent waiting for the clinician was the most significant predictor of patient satisfaction. Informing patients how long their wait would be and being occupied during the wait were also significant predictors of patient satisfaction. These results show that waiting times, even if they cannot be shortened, can be managed more effectively to improve patient satisfaction.

  15. The effectiveness of interventions aimed at reducing anxiety in health care waiting spaces: a systematic review of randomized and nonrandomized trials.

    Science.gov (United States)

    Biddiss, Elaine; Knibbe, Tara Joy; McPherson, Amy

    2014-08-01

    lowered-state anxiety (-5.1 ± 0.53 points on the State Trait Anxiety Scale) than those who received standard care. The efficacy of aromatherapy was inconclusive. Studies reporting on the impact of improved interior design of waiting areas, while positive, are minimal and heterogeneous. For children, insufficient evidence is available to corroborate the effectiveness of play opportunities, media distractions, and music for mitigating anxiety in children awaiting medical procedures. Music is a well-established means of decreasing anxiety in adult patients awaiting medical interventions. The effect of music on children's anxiety is not known. Limited studies and heterogeneity of interventions and methods in the areas of aromatherapy, interior design, digital media, and play opportunities (for children) suggest the need for future research.

  16. Epilepsy, electroacupuncture and the nucleus of the solitary tract.

    Science.gov (United States)

    Cakmak, Yusuf Ozgur

    2006-12-01

    Vagal nerve stimulation and electroacupuncture have some promise as neuroprotective therapies for patients with poorly controlled epilepsy. It has been demonstrated that stimulation of acupuncture points on the extremities results in stimulation of the vagus nerve. It is possible that the antiepileptic effects of these two applications might be targeting the same centre in the brain. The nucleus of the solitary tract, which is a primary site at which vagal afferents terminate, is also the site for afferent pathways of facial, scalp and auricular acupuncture via trigeminal, cervical spinal and glossopharyngeal nerves. Taken together with laboratory findings, the neuroprotective pathways of electroacupuncture in epileptic models may stem from the collaboration of its anti-inflammatory and neurotrophic actions through the nucleus of the solitary tract via vagus nerve stimulation.

  17. Action potentials: to the nucleus and beyond.

    Science.gov (United States)

    Saha, Ramendra N; Dudek, Serena M

    2008-04-01

    The neuronal nucleus is now widely accepted as playing a vital role in maintaining long-term changes in synaptic effectiveness. To act, however, the nucleus must be appropriately relayed with information regarding the latest round of synaptic plasticity. Several constraints of doing so in a neuron pertain to the often significant spatial distance of synapses from the nucleus and the number of synapses required for such a signal to reach functional levels in the nucleus. Largely based on the sensitivity of transcriptional responses to NMDA receptor antagonists, it has been postulated that the signals are physically relayed by biochemical messengers from the synapse to the nucleus. Alternatively, a second, less often considered but equally viable method of signal transduction may be initiated by action potentials generated proximal to the nucleus, wherefrom the signal can be relayed directly by calcium or indirectly by biochemical second messengers. We consider action potential-dependent signaling to the nucleus to have its own computational advantages over the synapse-to-nucleus signal for some functions. This minireview summarizes the logic and experimental support for these two modes of signaling and attempts to validate the action potential model as playing an important role in transcriptional regulation relating specifically to long-term synaptic plasticity.

  18. Perceptions of cardiac rehabilitation patients, specialists and rehabilitation programs regarding cardiac rehabilitation wait times

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-08-01

    Full Text Available Abstract Background In 2006, the Canadian Cardiovascular Society (CCS Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR. The objectives of the current study were to: (1 describe cardiac patient perceptions of actual and ideal CR wait times, (2 describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3 investigate actual wait times and factors that CR programs perceive to affect these wait times. Methods Postal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared. Results Responses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate, and 92 CR programs (61.7% response rate. Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days, while their ideal median wait time was 28 days. Most patients (91.5% considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p  Conclusions Wait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time

  19. Comparing Realistic Subthalamic Nucleus Neuron Models

    Science.gov (United States)

    Njap, Felix; Claussen, Jens C.; Moser, Andreas; Hofmann, Ulrich G.

    2011-06-01

    The mechanism of action of clinically effective electrical high frequency stimulation is still under debate. However, recent evidence points at the specific activation of GABA-ergic ion channels. Using a computational approach, we analyze temporal properties of the spike trains emitted by biologically realistic neurons of the subthalamic nucleus (STN) as a function of GABA-ergic synaptic input conductances. Our contribution is based on a model proposed by Rubin and Terman and exhibits a wide variety of different firing patterns, silent, low spiking, moderate spiking and intense spiking activity. We observed that most of the cells in our network turn to silent mode when we increase the GABAA input conductance above the threshold of 3.75 mS/cm2. On the other hand, insignificant changes in firing activity are observed when the input conductance is low or close to zero. We thus reproduce Rubin's model with vanishing synaptic conductances. To quantitatively compare spike trains from the original model with the modified model at different conductance levels, we apply four different (dis)similarity measures between them. We observe that Mahalanobis distance, Victor-Purpura metric, and Interspike Interval distribution are sensitive to different firing regimes, whereas Mutual Information seems undiscriminative for these functional changes.

  20. Reading of Waiting, Time and Social Change in S. N. A. Agoro's ...

    African Journals Online (AJOL)

    The act of waiting as a critical feature of the human condition is the most significant and intense thematic engagement in Beckett's Waiting for Godot. The study notes that aside the circle of the absurd art in drama, the subject of waiting and time has not been given adequate dramatic representation by dramatists outside the ...

  1. Hip and knee arthroplasty waiting list – how accurate and fair ...

    African Journals Online (AJOL)

    Background. Resource-intensive procedures require the use of patient waiting lists in an attempt to increase fairness of access to surgery and improve surgical efficiency. Total hip and knee arthroplasty has waiting lists in excess of years. Objectives. To analyse our tertiary state institution's hip and knee arthroplasty waiting ...

  2. How Tolerable is Delay? Consumers' Evaluations of Internet Web Sites After Waiting

    NARCIS (Netherlands)

    Dellaert, B.G.C.; Kahn, B.

    1998-01-01

    How consumers’ waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative effects of waiting

  3. A Triage Approach to Managing a Two Year Wait-List in a Chronic Pain Program

    Directory of Open Access Journals (Sweden)

    Alexander J Clark

    2005-01-01

    Full Text Available OBJECTIVE: Individuals with chronic pain referred to specialist chronic pain management programs frequently wait months to years for assessment and care. In the authors' pain management program, approximately 600 patients are on the waiting list. An innovative recommendation program to encourage and educate referring physicians to continue active care of pain during this waiting period was developed.

  4. Fluctuations and correlations in nucleus-nucleus collisions within transport approaches

    Energy Technology Data Exchange (ETDEWEB)

    Konchakovski, Volodymyr P.

    2009-10-01

    The current thesis is devoted to a systematic study of fluctuations and correlations in heavy-ion collisions, which might be considered as probes for the phase transition and the critical point in the phase diagram, within the Hadron-String- Dynamics (HSD) microscopic transport approach. This is a powerful tool to study nucleus-nucleus collisions and allows to completely simulate experimental collisions on an event-by-event basis. Thus, the transport model has been used to study fluctuations and correlations including the influence of experimental acceptance as well as centrality, system size and collision energy. The comparison to experimental data can separate the effects induced by a phase transition since there is no phase transition in the HSD version used here. Firstly the centrality dependence of multiplicity fluctuations has been studied. Different centrality selections have been performed in the analysis in correspondence to the experimental situation. For the fixed target experiment NA49 events with fixed numbers of the projectile participants have been studied while in the collider experiment PHENIX centrality classes of events have been defined by the multiplicity in certain phase space region. A decrease of participant number fluctuations (and thus volume fluctuations) in more central collisions for both experiments has been obtained. Another area of this work addresses to transport model calculations of multiplicity fluctuations in nucleus-nucleus collisions as a function of colliding energy and system size. This study is in full correspondence to the experimental program of the NA61 Collaboration at the SPS. Central C+C, S+S, In+In, and Pb+Pb nuclear collisions at Elab = 10, 20, 30, 40, 80, 158 AGeV have been investigated. The expected enhanced fluctuations - attributed to the critical point and phase transition - can be observed experimentally on top of a monotonic and smooth 'hadronic background'. These findings should be helpful for the

  5. $N-N$, $P_{T}-N$ and $P_{T}-P_{T}$ fluctuations in nucleus-nucleus collisions at the NA61/SHINE experiment arXiv

    CERN Document Server

    Andronov, Evgeny

    The NA61/SHINE experiment aims to discover the critical point of strongly interacting matter and study the properties of the onset of deconfinement. For these goals a scan of the two dimensional phase diagram ($T-\\mu_{B}$) is being performed at the SPS by measurements of hadron production in proton-proton, proton-nucleus and nucleus-nucleus interactions as a function of collision energy. This paper presents preliminary results from Be+Be collisions on pseudorapidity dependences of transverse momentum and multiplicity fluctuations expressed in terms of strongly intensive quantities. It is shown that non-trivial effects evolve from the Poissonian-like fluctuations for small pseudorapidity intervals with expansion of the acceptance. These fluctuations are supposed to be sensitive to the existence of the critical point. The results will be compared to the predictions from the EPOS model.

  6. The everyday of people waiting for kidney transplantation

    Directory of Open Access Journals (Sweden)

    Micheli Rezende Ferreira Cruz

    2016-01-01

    Full Text Available Objective: to understand the everyday of people experiencing the waiting list for kidney transplantation. Methods: this is a qualitative research, based on Heideggerian phenomenology. 14 deponents participated in hemodialysis and registered on the waiting list for kidney transplantation. Phenomenological interview with the research question: How is the experience awaiting the kidney transplant? Color marking technique for analyzing demarcating lines that show similarity, of these, emerged the essential structures that enabled the units of meaning. Results: changing lifestyles, imposing a routine and rigidity of treatment signaling everyday stress and exhaustion of hemodialysis being. Emerging from the modes of gossip, curiosity, and bureaucracy, unfolding-inauthentic and impersonal regarding their care. Conclusion: hemodialysis dependence and awaiting kidney transplantation transfer care for family/professional caregivers. To understand the everyday marked by impositions and restrictions, the reflection about how professional health interaction/being-care becomes important.

  7. Waiting time dynamics of priority-queue networks.

    Science.gov (United States)

    Min, Byungjoon; Goh, K-I; Kim, I-M

    2009-05-01

    We study the dynamics of priority-queue networks, generalizations of the binary interacting priority-queue model introduced by Oliveira and Vazquez [Physica A 388, 187 (2009)]. We found that the original AND-type protocol for interacting tasks is not scalable for the queue networks with loops because the dynamics becomes frozen due to the priority conflicts. We then consider a scalable interaction protocol, an OR-type one, and examine the effects of the network topology and the number of queues on the waiting time distributions of the priority-queue networks, finding that they exhibit power-law tails in all cases considered, yet with model-dependent power-law exponents. We also show that the synchronicity in task executions, giving rise to priority conflicts in the priority-queue networks, is a relevant factor in the queue dynamics that can change the power-law exponent of the waiting time distribution.

  8. Interactive media as a tool for reducing waiting anxiety at paediatric rehabilitation hospitals: a randomized controlled trial.

    Science.gov (United States)

    Biddiss, Elaine; Knibbe, Tara Joy; Fehlings, Darcy; Mckeever, Patricia; Cohen, Ashley; Mcpherson, Amy

    2017-12-15

    To investigate the efficacy of waiting room media for reducing anxiety and increasing satisfaction at a paediatric rehabilitation hospital. In this clustered, parallel, randomized controlled trial, 310 young people with disabilities (age range 5-19y) and their parents attending outpatient clinics were assigned to interactive media (n=113), a silent nature video (n=97), or media-free comparison (n=100) groups. Young person and parent anxiety was reported using the State-Trait Anxiety Inventory (STAI) on arrival and after 10 minutes in the waiting space. Questionnaires measured young person, parent, and staff satisfaction. Young people exposed to interactive media reported a postexposure state anxiety that was 1.1 raw points (2.7 standardized points) lower on the STAI than the comparison group (95% confidence interval [CI] -1.9 to -0.22). There was no difference in postexposure state anxiety between the passive media and comparison groups (95% CI -0.64 to 1.1). Parents' state anxiety did not differ between conditions, but interactive media were associated with greater satisfaction (p=0.009). Of 120 staff, 119 reported that interactive media improved the clinic experience for families. Interactive media designed for accessible, hands-free play mitigate waiting anxiety and increases satisfaction. This paper provides evidence to guide design and decision-making around the use of interactive media in health care spaces. Interactive media reduced preclinic waiting anxiety for young people with disabilities. Interactive media were accessible to young people with a range of mobility. Interactive media increased parental and staff satisfaction in the clinic. Guidelines for the design of hands-free, inclusive interactive media for health care facilities are presented. © 2017 Mac Keith Press.

  9. Music and the nucleus accumbens.

    Science.gov (United States)

    Mavridis, Ioannis N

    2015-03-01

    Music is a universal feature of human societies over time, mainly because it allows expression and regulation of strong emotions, thus influencing moods and evoking pleasure. The nucleus accumbens (NA), the most important pleasure center of the human brain (dominates the reward system), is the 'king of neurosciences' and dopamine (DA) can be rightfully considered as its 'crown' due to the fundamental role that this neurotransmitter plays in the brain's reward system. Purpose of this article was to review the existing literature regarding the relation between music and the NA. Studies have shown that reward value for music can be coded by activity levels in the NA, whose functional connectivity with auditory and frontal areas increases as a function of increasing musical reward. Listening to music strongly modulates activity in a network of mesolimbic structures involved in reward processing including the NA. The functional connectivity between brain regions mediating reward, autonomic and cognitive processing provides insight into understanding why listening to music is one of the most rewarding and pleasurable human experiences. Musical stimuli can significantly increase extracellular DA levels in the NA. NA DA and serotonin were found significantly higher in animals exposed to music. Finally, passive listening to unfamiliar although liked music showed activations in the NA.

  10. Reducing pharmacy wait time to promote customer service: a follow-up study.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E

    2015-01-01

    The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

  11. The effect of waiting time and distance on hospital choice for English cataract patients.

    Science.gov (United States)

    Sivey, Peter

    2012-04-01

    This paper applies latent-class multinomial logit models to the choice of hospital for cataract operations in the UK NHS. We concentrate on the effects of travel time and waiting time and especially on estimating the waiting time elasticity of demand. Models including hospital fixed effects rely on changes over time in waiting time to indentify coefficients. We show how using a latent-class multinomial logit model characterises the unobserved heterogeneity in GP practices' choice behaviour and affects the estimated elasticities of travel time and waiting time. The models estimate waiting time elasticities of demand of approximately -0.1, comparable with previous waiting time-demand models. For the average waiting time elasticity, the simple multinomial logit models are good approximations of the latent-class logit results. Copyright © 2011 John Wiley & Sons, Ltd.

  12. Study of Hadron Production in Hadron-Nucleus and Nucleus-Nucleus Collisions at the CERN SPS

    CERN Multimedia

    Selyuzhenkov, I; Klochkov, V; Herve, A E; Kowalski, S; Kaptur, E A; Kowalik, K L; Dominik, W M; Matulewicz, T N; Krasnoperov, A; Feofilov, G; Vinogradov, L; Kovalenko, V; Johnson, S R; Mills, G B; Planeta, R J; Rubbia, A; Marton, K; Messerly, B A; Puzovic, J; Bogomilov, M V; Bravar, A; Renfordt, R A E; Deveaux, M; Engel, R R; Grzeszczuk, A; Davis, N; Kuich, M; Lyubushkin, V; Kondratev, V; Kadija, K; Diakonos, F; Slodkowski, M A; Rauch, W H; Pistillo, C; Laszlo, A; Nakadaira, T; Hasegawa, T; Sadovskiy, A; Morozov, S; Petukhov, O; Mathes, H; Roehrich, D; Marcinek, A J; Marino, A D; Grebieszkow, K; Wlodarczyk, Z; Rybczynski, M A; Wojtaszek-szwarc, A; Nirkko, M C; Sakashita, K; Golubeva, M; Kurepin, A; Manic, D; Kolev, D I; Kisiel, J E; Koziel, M E; Rondio, E; Larsen, D T; Czopowicz, T R; Seyboth, P; Turko, L; Guber, F; Marin, V; Busygina, O; Strikhanov, M; Taranenko, A; Cirkovic, M; Roth, M A; Pulawski, S M; Aduszkiewicz, A M; Bunyatov, S; Vechernin, V; Nagai, Y; Anticic, T; Dynowski, K M; Mackowiak-pawlowska, M K; Stefanek, G; Pavin, M; Fodor, Z P; Nishikawa, K; Tada, M; Blondel, A P P; Stroebele, H W; Posiadala, M Z; Kolesnikov, V; Andronov, E; Zimmerman, E D; Antoniou, N; Majka, Z; Di luise, S; Veberic, D; Dumarchez, J; Naskret, M; Ivashkin, A; Tsenov, R V; Koziel, M G; Schmidt, K J; Melkumov, G; Popov, B; Panagiotou, A; Richter-was, E M; Ereditato, A; Paolone, V; Damyanova, A; Gazdzicki, M; Unger, M T; Wilczek, A G; Stepaniak, J M; Seryakov, A; Susa, T; Staszel, P P; Brzychczyk, J; Maksiak, B; Tefelski, D B

    2007-01-01

    The NA61/SHINE (SHINE = SPS Heavy Ion and Neutrino Experiment) experiment is a large acceptance hadron spectrometer at the CERN SPS for the study of the hadronic final states produced in interactions of various beam particles (pions, protons, C, S and In) with a variety of fixed targets at the SPS energies. The main components of the current detector were constructed and used by the NA49 experiment. The physics program of NA61/SHINE consists of three main subjects. In the first stage of data taking (2007-2009) measurements of hadron production in hadron-nucleus interactions needed for neutrino (T2K) and cosmic-ray (Pierre Auger and KASCADE) experiments will be performed. In the second stage (2009-2011) hadron production in proton-proton and proton-nucleus interactions needed as reference data for a better understanding of nucleus-nucleus reactions will be studied. In the third stage (2009-2013) energy dependence of hadron production properties will be measured in nucleus-nucleus collisions as well as in p+p a...

  13. Nucleus accumbens surgery for addiction.

    Science.gov (United States)

    Li, Nan; Wang, Jing; Wang, Xue-lian; Chang, Chong-wang; Ge, Shun-nan; Gao, Li; Wu, He-ming; Zhao, Hai-kang; Geng, Ning; Gao, Guo-dong

    2013-01-01

    Opiate addiction remains intractable in a large percentage of patients, and relapse is the biggest hurdle to recovery because of psychological dependence. Multiple studies identify a central role of the nucleus accumbens (NAc) in addiction; several studies note decreased addictive behavior after interventions in this area. Based on animal experiments, our institute started the clinical trial for the treatment of drug addicts' psychological dependence by making lesions in the bilateral NAc with stereotactic surgery from July 2000. The short-term outcomes were encouraging and triggered rapid application of this treatment in China from 2003 to 2004. However, lack of long-term outcomes and controversy eventually led to halting the surgery for addiction by the Ministry of Health of China in November 2004 and a nationwide survey about it later. Our institute had performed this surgery in 272 patients with severe heroin addiction. The follow-up study showed that the 5-year nonrelapse rate was 58% and the quality of life was significantly improved. Patients had several kinds of side effects, but the incidence rate was relatively low. The patients gradually recovered more than 5 years after the surgery. The side effects did not severely influence an individual's life or work. Nationwide surgery showed that the nonrelapse rate was 50% in the sample of 150 cases, from 1167 patients overall who underwent stereotactic surgery in China. Although sometimes accompanied by neuropsychological adverse events, stereotactic ablation of NAc may effectively treat opiate addiction. Lesion location has a significant impact on treatment efficacy and requires further study. Because ablation is irreversible, the NAc surgery for addiction should be performed with cautiousness, and deep brain stimulation (DBS) is an ideal alternative. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Tipping Point

    Medline Plus

    Full Text Available ... en español Blog About OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point The Tipping Point by ... danger death electrical fall furniture head injury product safety television tipover tv Watch the video in Adobe ...

  15. The pattern for waiting time in the context of multiple stochastic process

    CERN Document Server

    Jamali, Tayeb; Farahani, S Vasheghani

    2015-01-01

    The aim here is to provide a deeper understanding on the concept of waiting time in application to multiple stochastic processes. This obliges us to work with the vector stochastic process which enables considering at least two stochastic process at simultaneous time instances. In the present study the plan is to master vector stochastic processes by developing the level crossing method. The reason that the previous level-crossing methods lack generality is based on their individual element studies, where the coupling between the components of the vector stochastic process had been simply neglected. In the present work by introducing the generalized level crossing method, consideration of coupling between the components has become possible. This enables analyzing and hence extracting information out of coupled processes usually faced when working in tensor environments. The results obtained by this technique state that in addition to the point distribution of the vector stochastic process, the coupling plays ...

  16. Lean-driven improvements slash wait times, drive up patient satisfaction scores.

    Science.gov (United States)

    2012-07-01

    Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis.

  17. Skewering the subthalamic nucleus via a parietal approach.

    Science.gov (United States)

    Zrinzo, Ludvic; Holl, Etienne M; Petersen, Erika A; Limousin, Patricia; Foltynie, Thomas; Hariz, Marwan I

    2011-01-01

    A frontal burr hole around the level of the coronal suture is the conventional entry point when performing subthalamic nucleus (STN) deep brain stimulation (DBS). However, alternative approaches may sometimes be necessary. We present a report of delayed hardware erosion through the scalp in the left frontal region after successful bilateral STN DBS for Parkinson's disease. The left STN was retargeted via a parietal entry point. Significant improvement in UPDRS motor score (59%) was obtained with bilateral stimulation 6 months after re-operation. The literature was examined for similar approaches and the rationale, risks and benefits of non-frontal entry points in functional neurosurgery were explored. Together with a brief review of STN anatomy, this report demonstrates that the parietal approach to the STN remains a viable option in addition to the more traditional frontal access. Copyright © 2011 S. Karger AG, Basel.

  18. Large philipsite crystal as ferromanganese nodule nucleus

    Digital Repository Service at National Institute of Oceanography (India)

    Ghosh, A.K.; Mukhopadhyay, R.

    We report here the occurrence of, to date, the largest (21 x 10 x 8 mm) phillipsite crystal forming the nucleus of a diagenetically formed ferromanganese nodule from the Central Indian Ocean Basin (CIOB). Assuming an average rate of ferromanganese...

  19. Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation.

    Science.gov (United States)

    Florian, Juliessa; Rubin, Adalberto; Mattiello, Rita; Fontoura, Fabrício Farias da; Camargo, José de Jesus Peixoto; Teixeira, Paulo Jose Zimermann

    2013-01-01

    To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47%) had pulmonary fibrosis, 13 (22%) had pulmonary emphysema, and 18 (31%) had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001), the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001), role-physical, up 10 (p = 0.045); vitality, up 10 (p mental health, up 8 (p = 0.001). Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

  20. Testing string dynamics in lepton nucleus reactions

    Energy Technology Data Exchange (ETDEWEB)

    Gyulassy, M.; Pluemer, M.

    1989-10-01

    The sensitivity of nuclear attenuation of 10-100 GeV lepton nucleus ({ell}A) reactions to space-time aspects of hadronization is investigated within the context of the Lund string model. We consider two mechanisms for attenuation in a nucleus: final state cascading and string flip excitations. Implications for the evolution of the energy density in nuclear collisions are discussed. 16 refs., 10 figs.

  1. Advances in hard nucleus cataract surgery

    Directory of Open Access Journals (Sweden)

    Wei Cui

    2013-11-01

    Full Text Available Security and perfect vision and fewer complications are our goals in cataract surgery, and hard-nucleus cataract surgery is always a difficulty one. Many new studies indicate that micro-incision phacoemulsification in treating hard nucleus cataract is obviously effective. This article reviews the evolution process of hard nuclear cataract surgery, the new progress in the research of artificial intraocular lens for microincision, and analyse advantages and disadvantages of various surgical methods.

  2. Guided Online or Face-to-Face Cognitive Behavioral Treatment for Insomnia: A Randomized Wait-List Controlled Trial.

    Science.gov (United States)

    Lancee, Jaap; van Straten, Annemieke; Morina, Nexhmedin; Kaldo, Viktor; Kamphuis, Jan H

    2016-01-01

    To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were administered to all conditions, along with 3- and 6-mo follow-up assessments to the online and face-to-face conditions. Ninety media-recruited participants meeting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for insomnia were randomly allocated to either guided online CBT-I (n = 30), individual face-to-face CBT-I (n = 30), or wait-list (n = 30). At post-assessment, the online (Cohen d = 1.2) and face-to-face (Cohen d = 2.3) intervention groups showed significantly larger treatment effects than the wait-list group on insomnia severity (insomnia severity index). Large treatment effects were also found for the sleep diary estimates (except for total sleep time), and anxiety and depression measures (for depression only in the face-to-face condition). Face-to-face treatment yielded a statistically larger treatment effect (Cohen d = 0.9) on insomnia severity than the online condition at all time points. In addition, a moderate differential effect size favoring face-to-face treatment emerged at the 3- and 6-mo follow-up on all sleep diary estimates. Face-to-face treatment further outperformed online treatment on depression and anxiety outcomes. These data show superior performance of face-to-face treatment relative to online treatment. Yet, our results also suggest that online treatment may offer a potentially cost-effective alternative to and complement face-to-face treatment. Clinicaltrials.gov, NCT01955850. A commentary on this article appears in this issue on page 13. © 2016 Associated Professional Sleep Societies, LLC.

  3. Average waiting time profiles of uniform DQDB model

    Energy Technology Data Exchange (ETDEWEB)

    Rao, N.S.V. [Oak Ridge National Lab., TN (United States); Maly, K.; Olariu, S.; Dharanikota, S.; Zhang, L.; Game, D. [Old Dominion Univ., Norfolk, VA (United States). Dept. of Computer Science

    1993-09-07

    The Distributed Queue Dual Bus (DQDB) system consists of a linear arrangement of N nodes that communicate with each other using two contra-flowing buses; the nodes use an extremely simple protocol to send messages on these buses. This simple, but elegant, system has been found to be very challenging to analyze. We consider a simple and uniform abstraction of this model to highlight the fairness issues in terms of average waiting time. We introduce a new approximation method to analyze the performance of DQDB system in terms of the average waiting time of a node expressed as a function of its position. Our approach abstracts the intimate relationship between the load of the system and its fairness characteristics, and explains all basic behavior profiles of DQDB observed in previous simulation. For the uniform DQDB with equal distance between adjacent nodes, we show that the system operates under three basic behavior profiles and a finite number of their combinations that depend on the load of the network. Consequently, the system is not fair at any load in terms of the average waiting times. In the vicinity of a critical load of 1 {minus} 4/N, the uniform network runs into a state akin to chaos, where its behavior fluctuates from one extreme to the other with a load variation of 2/N. Our analysis is supported by simulation results. We also show that the main theme of the analysis carries over to the general (non-uniform) DQDB; by suitably choosing the inter-node distances, the DQDB can be made fair around some loads, but such system will become unfair as the load changes.

  4. Improved Cloud Condensation Nucleus Spectrometer

    Science.gov (United States)

    Leu, Ming-Taun

    2010-01-01

    An improved thermal-gradient cloud condensation nucleus spectrometer (CCNS) has been designed to provide several enhancements over prior thermal- gradient counters, including fast response and high-sensitivity detection covering a wide range of supersaturations. CCNSs are used in laboratory research on the relationships among aerosols, supersaturation of air, and the formation of clouds. The operational characteristics of prior counters are such that it takes long times to determine aerosol critical supersaturations. Hence, there is a need for a CCNS capable of rapid scanning through a wide range of supersaturations. The present improved CCNS satisfies this need. The improved thermal-gradient CCNS (see Figure 1) incorporates the following notable features: a) The main chamber is bounded on the top and bottom by parallel thick copper plates, which are joined by a thermally conductive vertical wall on one side and a thermally nonconductive wall on the opposite side. b) To establish a temperature gradient needed to establish a supersaturation gradient, water at two different regulated temperatures is pumped through tubes along the edges of the copper plates at the thermally-nonconductive-wall side. Figure 2 presents an example of temperature and supersaturation gradients for one combination of regulated temperatures at the thermally-nonconductive-wall edges of the copper plates. c) To enable measurement of the temperature gradient, ten thermocouples are cemented to the external surfaces of the copper plates (five on the top plate and five on the bottom plate), spaced at equal intervals along the width axis of the main chamber near the outlet end. d) Pieces of filter paper or cotton felt are cemented onto the interior surfaces of the copper plates and, prior to each experimental run, are saturated with water to establish a supersaturation field inside the main chamber. e) A flow of monodisperse aerosol and a dilution flow of humid air are introduced into the main

  5. Computation and evaluation of scheduled waiting time for railway networks

    DEFF Research Database (Denmark)

    Landex, Alex

    2010-01-01

    Timetables are affected by scheduled waiting time (SWT) that prolongs the travel times for trains and thereby passengers. SWT occurs when a train hinders another train to run with the wanted speed. The SWT affects both the trains and the passengers in the trains. The passengers may be further...... affected due to longer transfer times to other trains. SWT can be estimated analytically for a given timetable or by simulation of timetables and/or plans of operation. The simulation of SWT has the benefit that it is possible to examine the entire network. This makes it possible to improve the future...

  6. Waiting to go into a Danish Nursing Home - Generations Review

    DEFF Research Database (Denmark)

    Kofod, Jens Erik

    2006-01-01

    that their relationship toward their home care assistant became increasingly important as they waited to go into the nursing home. Assessments for home care were constrained by municipal authorities and their regulations, and the overall attitude was that the needs of older people were not being appropriately defined......The number of older people from their own home into a nursing home is likely to increase. This study intends to examine important aspects in the transition process by applying ethnographic methods. Ten older people and their relatives were interviewed and observed. It was found...... and met. This left them barely able to maintain their homes and, as a consequence of this, their identity....

  7. The surgical waiting time initiative: A review of the Nigerian situation.

    Science.gov (United States)

    Abdulkareem, Imran Haruna

    2014-11-01

    The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24

  8. Waiting room oral rehydration in the paediatric emergency department.

    Science.gov (United States)

    Craven, J A; Campbell, L; Martin, C T

    2009-03-01

    Oral rehydration is well established in the treatment of acute gastroenteritis, however it is profoundly underutilised as a treatment in the hospital setting. We introduced a protocol of waiting room oral rehydration for children presenting to the Paediatric Emergency Department with vomiting and/or diarrhoea. These children were given oral rehydration from the time of triage prior to medical assessment. During the study period, 251 children presented 269 times with vomiting and/or diarrhoea, of which 205 (76%) were diagnosed with acute gastroenteritis. A similar period 1 year previously was used as comparison, during which 129 children were diagnosed with acute gastroenteritis. During the study period, 58 children (28%) were given intravenous fluids and 47 (23%) were admitted, compared with 72 (56%) given intravenous fluids and 42 (32%) admitted in the comparison group. This protocol is now part of our routine management of children presenting with symptoms of acute gastroenteritis. Waiting room oral rehydration is a simple yet successful intervention that can be implemented in any Emergency Department.

  9. Identity Construction In Samuel Beckett’s Waiting For Godot

    Directory of Open Access Journals (Sweden)

    Yusri Fajar

    2013-12-01

    Full Text Available This paper scrutinizes the formation of the identity of the characters in Samuel Beckett’s famous play Waiting for Godot. One of the characters whose identity is constructed is Godot, a mysterious absent figure. The other characters, such as Vladimir and Estragon actively construct Godot’s identity. Thus, the formation of identity cannot be separated from the social construction in which a lot of characteristics are attributed by the members of the large community. The theory of identity elaborated by Stuart Hall and Erikson is employed to examine the play. The study shows that Godot and other characters’ identity is unstable and fluid. The characteristics of their identity are ambiguous and even challenged. Abstrak: Artikel ini mengkaji pembentukan identitas karakter dalam drama terkenal Waiting for Godot karya Samuel Beckett. Salah satu karakter yang dikonstruksi identitasnya adalah Godot, sosok misterius yang tidak pernah muncul. Karakter lain, seperti Vladimir dan Estragon secara aktif mengonstruksi identitas Godot. Oleh sebab itu, pembentukan identitas tidak dapat dipisahkan dari konstruksi sosial yang dimasuki banyak karakteristik oleh anggota masyarakat luas. Teori identitas Stuart Hall dan Erikson digunakan untuk menganalisis drama tersebut. Hasil analisis menunjukkan bahwa identitas Godot dan karakter lain tidak stabil dan cair. Karakteristik identitas mereka ambigu dan bahkan meragukan. Kata-­Kata Kunci: identit; ambiguitas; Godot

  10. Patient deaths blamed on long waits at the Phoenix VA

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. This morning the lead article in the Arizona Republic was a report blaming as many as 40 deaths at the Phoenix VA on long waits (1. Yesterday, Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, held a hearing titled “A Continued Assessment of Delays in VA Medical Care and Preventable Veteran Deaths.” “It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care,” Miller announced to a stunned audience. The committee has spent months investigating patient-care scandals and allegations at VA facilities in Pittsburgh, Atlanta, Miami and other cities. said that dozens of VA hospital patients in Phoenix may have died while awaiting medical care. He went on to say that staff investigators have evidence that the Phoenix VA Health Care System keeps two sets of records to conceal prolonged waits that patients must endure for ...

  11. An automaton approach for waiting times in DNA evolution

    CERN Document Server

    Behrens, S; Nicodeme, P

    2011-01-01

    In a recent article, Behrens and Vingron (JCB 17, 12, 2010) compute waiting times for k-mers to appear during DNA evolution under the assumption that the considered k-mers do not occur in the initial DNA sequence, an issue arising when studying the evolution of regulatory DNA sequences with regard to transcription factor (TF) binding site emergence. The mathematical analysis underlying their computation assumes that occurrences of words under interest do not overlap. We relax here this assumption by use of an automata approach. In an alphabet of size 4 like the DNA alphabet, most words have no or a low autocorrelation; therefore, globally, our results confirm those of Behrens and Vingron. The outcome is quite different when considering highly autocorrelated k-mers; in this case, the autocorrelation pushes down the probability of occurrence of these k-mers at generation 1 and, consequently, increases the waiting time for apparition of these k-mers up to 40%. An analysis of existing TF binding sites unveils a s...

  12. Healthcare Use for Pain in Women Waiting for Gynaecological Surgery

    Directory of Open Access Journals (Sweden)

    Sarah Walker

    2016-01-01

    Full Text Available Background. Pain while waiting for surgery may increase healthcare utilization (HCU preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n=360 reported a total of 2026 healthcare visits, with 21% (n=126 reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10 pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30 and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system.

  13. Joint optimisation of transmission and waiting times in cognitive radio

    Science.gov (United States)

    Amini, Mohammadreza; Samimi, Abouzar; Mirzavandi, Asra

    2016-04-01

    Transmission time optimisation is one of the key considerations of cognitive network design. There are many studies in cognitive radio networks (CRNs) focusing on finding the best transmission time for secondary users (SUs) to maximise transmission or energy efficiency. While longer sensing duration leads to a higher sensing accuracy and causes less interference, the SU spends less time for transmission and more energy on sensing spectrum. On the other hand, when the transmission duration becomes longer, although the SU has more opportunities to access the channel, it may encounter higher interference due to primary user (PU) returns and the probability of collision becomes higher. In this article, in a decentralised slotted protocol for CRN, the SU spectrum access is proved as a renewal process, then the interference due to PU return during SU transmission, the missed opportunities due to waiting for the channel to become idle and the energy consumed by the SU in the whole spectrum access process including idling energy, transmission energy and sensing energy consumption are formulated and integrated into newly defined efficiency to obtain the optimum transmission time and waiting time.

  14. Fixed Points

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 5. Fixed Points - From Russia with Love - A Primer of Fixed Point Theory. A K Vijaykumar. Book Review Volume 5 Issue 5 May 2000 pp 101-102. Fulltext. Click here to view fulltext PDF. Permanent link:

  15. Tipping Point

    Medline Plus

    Full Text Available ... OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point ... 24 hours a day. For young children whose home is a playground, it’s the best way to ...

  16. A-Dependence of $\\pi^0$-Meson Production in Proton-Nucleus and Nucleus-Nucleus Collisions at High Energies

    CERN Document Server

    Tokarev, M V; Dedovich, T G

    2000-01-01

    The A-dependence of pi^0-meson production in proton-nucleus and nucleus-nucleus collisions at a high transverse momentum is studied. The concept of z-scaling reflecting the general features of particle interactions is developed for the description of pi^0-meson production. Experimental data on the cross section obtained at ISR, SpS and Tevatron are usen in the analysis. The A-dependence of scale transformation z to alpha cdot z, psi to alpha^-1 cdot psi is established. An indication of the power law, psi (z) approx z^-beta, at high p_T > 4 GeV/c is found. Based on the properties of z-scaling, the dependence of the cross section of pi^0-mesons produced in pA and AA collisions on transverse momentum over the central rapidity range at RHIC energies is predicted.

  17. The effect of waiting times on demand and supply for elective surgery: Evidence from Italy.

    Science.gov (United States)

    Riganti, Andrea; Siciliani, Luigi; Fiorio, Carlo V

    2017-09-01

    Waiting times are a major policy concern in publicly funded health systems across OECD countries. Economists have argued that, in the presence of excess demand, waiting times act as nonmonetary prices to bring demand for and supply of health care in equilibrium. Using administrative data disaggregated by region and surgical procedure over 2010-2014 in Italy, we estimate demand and supply elasticities with respect to waiting times. We employ linear regression models with first differences and instrumental variables to deal with endogeneity of waiting times. We find that demand is inelastic to waiting times while supply is more elastic. Estimates of demand elasticity are between -0.15 to -0.24. Our results have implications on the effectiveness of policies aimed at increasing supply and their ability to reduce waiting times. Copyright © 2017 John Wiley & Sons, Ltd.

  18. The uncertainty room: strategies for managing uncertainty in a surgical waiting room.

    Science.gov (United States)

    Stone, Anne M; Lammers, John C

    2012-01-01

    To describe experiences of uncertainty and management strategies for staff working with families in a hospital waiting room. A 288-bed, nonprofit community hospital in a Midwestern city. Data were collected during individual, semistructured interviews with 3 volunteers, 3 technical staff members, and 1 circulating nurse (n = 7), and during 40 hours of observation in a surgical waiting room. Interview transcripts were analyzed using constant comparative techniques. The surgical waiting room represents the intersection of several sources of uncertainty that families experience. Findings also illustrate the ways in which staff manage the uncertainty of families in the waiting room by communicating support. Staff in surgical waiting rooms are responsible for managing family members' uncertainty related to insufficient information. Practically, this study provided some evidence that staff are expected to help manage the uncertainty that is typical in a surgical waiting room, further highlighting the important role of communication in improving family members' experiences.

  19. Open heavy-flavour production in high energy nucleus-nucleus collisions

    NARCIS (Netherlands)

    Mischke, A.

    2010-01-01

    Heavy quarks (charm and bottom) provide sensitive penetrating probes of hot quark matter produced in high energy nucleus-nucleus collisions. Due to their large mass, heavy quarks are believed to be predominantly produced in the initial state of the collision by gluon fusion processes. The study

  20. Observation of high energy gamma rays in intermediate energy nucleus-nucleus collisions

    NARCIS (Netherlands)

    Beard, K.B.; Benenson, W.; Bloch, C.; Kashy, E.; Stevenson, J.; Morrissey, D.J.; Plicht, J. van der; Sherrill, B.; Winfield, J.S.

    1985-01-01

    High energy electrons and positrons observed in medium energy nucleus-nucleus collisions are shown to be primarily due to the external conversion of high energy gamma rays. The reaction 14N+Cu was studied at E/A=40 MeV, and a magnetic spectrograph was used with a specially constructed multiwire

  1. Structural dynamics of the cell nucleus

    Science.gov (United States)

    Wiegert, Simon; Bading, Hilmar

    2011-01-01

    Neuronal morphology plays an essential role in signal processing in the brain. Individual neurons can undergo use-dependent changes in their shape and connectivity, which affects how intracellular processes are regulated and how signals are transferred from one cell to another in a neuronal network. Calcium is one of the most important intracellular second messengers regulating cellular morphologies and functions. In neurons, intracellular calcium levels are controlled by ion channels in the plasma membrane such as NMDA receptors (NMDARs), voltage-gated calcium channels (VGCCs) and certain α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) as well as by calcium exchange pathways between the cytosol and internal calcium stores including the endoplasmic reticulum and mitochondria. Synaptic activity and the subsequent opening of ligand and/or voltage-gated calcium channels can initiate cytosolic calcium transients which propagate towards the cell soma and enter the nucleus via its nuclear pore complexes (NPCs) embedded in the nuclear envelope. We recently described the discovery that in hippocampal neurons the morphology of the nucleus affects the calcium dynamics within the nucleus. Here we propose that nuclear infoldings determine whether a nucleus functions as an integrator or detector of oscillating calcium signals. We outline possible ties between nuclear mophology and transcriptional activity and discuss the importance of extending the approach to whole cell calcium signal modeling in order to understand synapse-to-nucleus communication in healthy and dysfunctional neurons. PMID:21738832

  2. Cell Biology of the Caenorhabditis elegans Nucleus.

    Science.gov (United States)

    Cohen-Fix, Orna; Askjaer, Peter

    2017-01-01

    Studies on the Caenorhabditis elegans nucleus have provided fascinating insight to the organization and activities of eukaryotic cells. Being the organelle that holds the genetic blueprint of the cell, the nucleus is critical for basically every aspect of cell biology. The stereotypical development of C. elegans from a one cell-stage embryo to a fertile hermaphrodite with 959 somatic nuclei has allowed the identification of mutants with specific alterations in gene expression programs, nuclear morphology, or nuclear positioning. Moreover, the early C. elegans embryo is an excellent model to dissect the mitotic processes of nuclear disassembly and reformation with high spatiotemporal resolution. We review here several features of the C. elegans nucleus, including its composition, structure, and dynamics. We also discuss the spatial organization of chromatin and regulation of gene expression and how this depends on tight control of nucleocytoplasmic transport. Finally, the extensive connections of the nucleus with the cytoskeleton and their implications during development are described. Most processes of the C. elegans nucleus are evolutionarily conserved, highlighting the relevance of this powerful and versatile model organism to human biology. Copyright © 2017 by the Genetics Society of America.

  3. The surgical waiting time initiative: A review of the Nigerian situation

    OpenAIRE

    Imran Haruna Abdulkareem

    2014-01-01

    SUMMARY The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athe...

  4. Change in hearing during 'wait and scan' management of patients with vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Caye-Thomasen, P.; Tos, M.

    2008-01-01

    Aim: To evaluate hearing changes during 'wait and scan' management of patients with vestibular schwannoma. Subjects: Over a 10-year period, 636 patients have prospectively been allocated to 'wait and scan' management, with annual magnetic resonance scanning and audiological examination. Results...... surgery and of radiation therapy with those of 'wait and scan' management, it appears that, in vestibular schwannoma patients with a small tumour and normal speech discrimination, the main indication for active treatment should be established tumour growth Udgivelsesdato: 2008/7...

  5. How Long Are Patients Willing to Wait in the Emergency Department Before Leaving Without Being Seen?

    Directory of Open Access Journals (Sweden)

    Michael N Brodeur

    2012-12-01

    Full Text Available Introduction: Our goal was to evaluate patients’ threshold for waiting in an emergency department(ED waiting room before leaving without being seen (LWBS. We analyzed whether willingness to wait was influenced by perceived illness severity, age, race, triage acuity level, or insurance status.Methods: We conducted this survey-based study from March to July 2010 at an urban academic medical center. After triage, patients were given a multiple-choice questionnaire, designed to as certain how long they would wait for medical care. We collected data including age, gender, race,insurance status, and triage acuity level. We looked at the association between willingness to wait and these variables, using stratified analysis and logistic regression.Results: Of the 375 patients who were approached, 340 (91% participated. One hundred seventy one(51% were willing to wait up to 2 hours before leaving, 58 (17% would wait 2 to 8 hours, and110 (32% would wait indefinitely. No association was found between willingness to wait and race,gender, insurance status, or perceived symptom severity. Patients willing to wait >2 hours tended to be older than 25, have higher acuity, and prefer the study site ED.Conclusion: Many patients have a defined, limited period that they are willing to wait for emergency care. In our study, 50% of patients were willing to wait up to 2 hours before leaving the ED without being seen. This result suggests that efforts to reduce the percentage of patients who LWBS must factor in time limits.

  6. Oscillatory activity in the medial prefrontal cortex and nucleus accumbens correlates with impulsivity and reward outcome.

    Directory of Open Access Journals (Sweden)

    Nicholas A Donnelly

    Full Text Available Actions expressed prematurely without regard for their consequences are considered impulsive. Such behaviour is governed by a network of brain regions including the prefrontal cortex (PFC and nucleus accumbens (NAcb and is prevalent in disorders including attention deficit hyperactivity disorder (ADHD and drug addiction. However, little is known of the relationship between neural activity in these regions and specific forms of impulsive behaviour. In the present study we investigated local field potential (LFP oscillations in distinct sub-regions of the PFC and NAcb on a 5-choice serial reaction time task (5-CSRTT, which measures sustained, spatially-divided visual attention and action restraint. The main findings show that power in gamma frequency (50-60 Hz LFP oscillations transiently increases in the PFC and NAcb during both the anticipation of a cue signalling the spatial location of a nose-poke response and again following correct responses. Gamma oscillations were coupled to low-frequency delta oscillations in both regions; this coupling strengthened specifically when an error response was made. Theta (7-9 Hz LFP power in the PFC and NAcb increased during the waiting period and was also related to response outcome. Additionally, both gamma and theta power were significantly affected by upcoming premature responses as rats waited for the visual cue to respond. In a subgroup of rats showing persistently high levels of impulsivity we found that impulsivity was associated with increased error signals following a nose-poke response, as well as reduced signals of previous trial outcome during the waiting period. Collectively, these in-vivo neurophysiological findings further implicate the PFC and NAcb in anticipatory impulsive responses and provide evidence that abnormalities in the encoding of rewarding outcomes may underlie trait-like impulsive behaviour.

  7. The acceptability of waiting times for elective general surgery and the appropriateness of prioritising patients

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2007-02-01

    Full Text Available Abstract Background Problematic waiting lists in public health care threaten the equity and timeliness of care provision in several countries. This study assesses different stakeholders' views on the acceptability of waiting lists in health care, their preferences for priority care of patients, and their judgements on acceptable waiting times for surgical patients. Methods A questionnaire survey was conducted among 257 former patients (82 with varicose veins, 86 with inguinal hernia, and 89 with gallstones, 101 surgeons, 95 occupational physicians, and 65 GPs. Judgements on acceptable waiting times were assessed using vignettes of patients with varicose veins, inguinal hernia, and gallstones. Results Participants endorsed the prioritisation of patients based on clinical need, but not on ability to benefit. The groups had significantly different opinions (p Acceptable waiting times ranged between 2 and 25 weeks depending on the type of disorder (p Conclusion The explicit prioritisation of patients seems an accepted means for reducing the overall burden from waiting lists. The disagreement about appropriate prioritisation criteria and the need for uniformity, however, raises concern about equity when implementing prioritisation in daily practice. Single factor waiting time thresholds seem insufficient for securing timely care provision in the presence of long waiting lists as they do not account for the different consequences of waiting between patients.

  8. An accelerated failure time model for investigating pedestrian crossing behavior and waiting times at signalized intersections.

    Science.gov (United States)

    Yang, Xiaobao; Abdel-Aty, Mohamed; Huan, Mei; Peng, Yichuan; Gao, Ziyou

    2015-09-01

    The waiting process is crucial to pedestrians in the street-crossing behavior. Once pedestrians terminate their waiting behavior during the red light period, they would cross against the red light and put themselves in danger. A joint hazard-based duration model is developed to investigate the effect of various covariates on pedestrian crossing behavior and to estimate pedestrian waiting times at signalized intersections. A total of 1181 pedestrians approaching the intersections during red light periods were observed in Beijing, China. Pedestrian crossing behaviors are classified into immediate crossing behavior and waiting behavior. The probability and effect of various covariates for pedestrians' immediate crossing behavior are identified by a logit model. Four accelerated failure time duration models based on the exponential, Weibull, lognormal and log-logistic distributions are proposed to examine the significant risk factors affecting duration times for pedestrians' waiting behavior. A joint duration model is developed to estimate pedestrian waiting times. Moreover, unobserved heterogeneity is considered in the proposed model. The results indicate that the Weibull AFT model with shared frailty is appropriate for modelling pedestrian waiting durations. Failure to account for heterogeneity would significantly underestimate the effects of covariates on waiting duration times. The proposed model provides a better understanding of pedestrian crossing behavior and more accurate estimation of pedestrian waiting times. It may be applicable in traffic system analysis in developing countries with high flow of mixed traffic. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

    Directory of Open Access Journals (Sweden)

    Renée M. Janssen

    2016-01-01

    Full Text Available Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul’s Hospital (SPH. Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes. Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis. Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul’s Hospital Division of Gastroenterology exceed current guidelines.

  10. Factors Associated with Residential Long-Term Care Wait-List Placement in North West Ontario.

    Science.gov (United States)

    Laporte, Audrey; Rohit Dass, Adrian; Kuluski, Kerry; Peckham, Allie; Berta, Whitney; Lum, Janet; Williams, A Paul

    2017-09-01

    This article is based on a study that investigated factors associated with long-term care wait list placement in Ontario, Canada. We based the study's analysis on Resident Assessment Instrument for Home Care (RAI-HC) data for 2014 in the North West Local Health Integration Network (LHIN). Our analysis quantified the contribution of three factors on the likelihood of wait list placement: (1) care recipient, (2) informal caregiver, and (3) formal system. We find that all three factors are significantly related to wait list placement. The results of this analysis could have implications for policies aimed at reducing the number of wait-listed individuals in the community.

  11. Tipping Point

    Medline Plus

    Full Text Available ... Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture head ... see news reports about horrible accidents involving young children and furniture, appliance and tv tip-overs. The ...

  12. Tipping Point

    Medline Plus

    Full Text Available ... Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture head ... TV falls with about the same force as child falling from the third story of a building. ...

  13. Decoding calcium signaling across the nucleus.

    Science.gov (United States)

    Oliveira, André G; Guimarães, Erika S; Andrade, Lídia M; Menezes, Gustavo B; Fatima Leite, M

    2014-09-01

    Calcium (Ca(2+)) is an important multifaceted second messenger that regulates a wide range of cellular events. A Ca(2+)-signaling toolkit has been shown to exist in the nucleus and to be capable of generating and modulating nucleoplasmic Ca(2+) transients. Within the nucleus, Ca(2+) controls cellular events that are different from those modulated by cytosolic Ca(2+). This review focuses on nuclear Ca(2+) signals and their role in regulating physiological and pathological processes. ©2014 Int. Union Physiol. Sci./Am. Physiol. Soc.

  14. Estimation of Diafenthiuron Residues in Cardamom (Elettaria cardamomum (L. Maton Using Normal Phase HPLC: Dissipation Pattern and Safe Waiting Period in Green and Cured Cardamom Capsules

    Directory of Open Access Journals (Sweden)

    Johnson Stanley

    2014-01-01

    Full Text Available Diafenthiuron is an effective insecticide used for pest management in cardamom. Residues of diafenthiuron and its degradation/dissipation pattern in cardamom were determined to work out safe waiting period. Samples were collected after three sprays of diafenthiuron @ 400 and 800 g a.i ha−1 and the residues extracted in acetonitrile and quantified in normal phase HPLC in UV detector. Diafenthiuron was detected in 6.61±0.1 min. The limits of detection (LOD and limits of quantification (LOQ were determined to be 0.01 and 0.05 μgmL−1. The initial deposits were found to be 3.82 and 4.10 μg g−1 after sprays of diafenthiuron @ 400 g a.i ha−1 in the first and second experiments, respectively. Nearly cent percent of residues dissipated at 10 days after treatment in the recommended dose of diafenthiuron 400 g a.i ha−1 and the half life varied from 2.0 to 2.8 days with a waiting period of 5.5 to 6.7 days in green capsules of cardamom. The waiting period was 5.4 to 7.0 days in cured capsules of cardamom. With harvest being the focal point for enforcement of residue tolerances, the suggested waiting period of seven days is safe without the problem of pesticide residues in harvestable produce.

  15. Enabling narrative pedagogy: inviting, waiting, and letting be.

    Science.gov (United States)

    Ironside, Pamela M

    2014-01-01

    This article describes how teachers enable Narrative Pedagogy in their courses by explicating the Concernful Practice Inviting: Waiting and Letting Be. Narrative Pedagogy, a research-based, phenomenological approach to teaching and learning, extends conventional pedagogies and offers nursing faculty an alternative way of transforming their schools and courses. Using hermeneutic phenomenology, interview data collected over a 10-year period were analyzed by coding practical examples of teachers' efforts to enact Narrative Pedagogy. When Narrative Pedagogy is enacted, teachers and students focus on thinking and learning together about nursing phenomena and seek new understandings about how they may provide care in the myriad situations they encounter. Although the Concernful Practices co-occur, explicating inviting experiences can assist new teachers, and those seeking to extend their pedagogical literacy, by providing new understandings of how Narrative Pedagogy can be enacted.

  16. Turn to staff for dramatic improvement in wait times, productivity.

    Science.gov (United States)

    2011-09-01

    Baylor Medical Center in Garland,TX, has been able to drastically reduce ED wait times, as well as the LWBS rate by streamlining the triage process and implementing a staff-driven improvement effort aimed at identifying inefficiencies and replacing them with solutions that work. The result is 11 beds of added capacity just from changes in patient flow. A cross section of volunteers from the ED staff reviewed metrics and devised solutions that they felt would work best to boost efficiency and eliminate bottlenecks. Solutions included letting low-acuity patients move themselves between care settings, freeing the charge nurse from patient care duties so that he or she could oversee patient flow, and empowering physician-nurse teams to see patients more quickly. ED managers say leadership is important, but letting staff drive the improvement process is key to their success.

  17. Empowered citizen 'health hackers' who are not waiting.

    Science.gov (United States)

    Omer, Timothy

    2016-08-17

    Due to the easier access to information, the availability of low cost technologies and the involvement of well educated, passionate patients, a group of citizen 'Health Hackers', who are building their own medical systems to help them overcome the unmet needs of their conditions, is emerging. This has recently been the case in the type 1 diabetes community, under the movement #WeAreNotWaiting, with innovative use of current medical devices hacked to access data and Open-Source code producing solutions ranging from remote monitoring of diabetic children to producing an Artificial Pancreas System to automate the management and monitoring of a patient's condition. Timothy Omer is working with the community to utilise the technology already in his pocket to build a mobile- and smartwatch-based Artificial Pancreas System.

  18. Two years changes in the development of caudate nucleus are involved in restricted repetitive behaviors in 2-5-year-old children with autism spectrum disorder.

    Science.gov (United States)

    Qiu, Ting; Chang, Chen; Li, Yun; Qian, Lu; Xiao, Chao Yong; Xiao, Ting; Xiao, Xiang; Xiao, Yun Hua; Chu, Kang Kang; Lewis, Mark H; Ke, Xiaoyan

    2016-06-01

    Caudate nucleus volume is enlarged in autism spectrum disorder (ASD) and is associated with restricted and repetitive behaviors (RRBs). However, the trajectory of caudate nucleus volume in RRBs of young children remains unclear. Caudate nucleus volume was measured in 36 children with ASD and 18 matched 2-3-year-old subjects with developmentally delayed (DD) at baseline (Time 1) and at 2-year follow-up (Time 2). The differential growth rate in caudate nucleus volume was calculated. Further, the relationships between the development of caudate nucleus volume and RRBs were analyzed. Our results showed that caudate nucleus volume was significantly larger in the ASD group at both time points and the magnitude of enlargement was greater at Time 2. The rate of caudate nucleus growth during this 2-year interval was faster in children with ASD than DD. Right caudate nucleus volume growth was negatively correlated with RRBs. Findings from this study suggest developmental abnormalities of caudate nucleus volume in ASD. Longitudinal MRI studies are needed to explore the correlation between atypical growth patterns of caudate nucleus and phenotype of RRBs. Copyright © 2016. Published by Elsevier Ltd.

  19. Two years changes in the development of caudate nucleus are involved in restricted repetitive behaviors in 2–5-year-old children with autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Ting Qiu

    2016-06-01

    Full Text Available Caudate nucleus volume is enlarged in autism spectrum disorder (ASD and is associated with restricted and repetitive behaviors (RRBs. However, the trajectory of caudate nucleus volume in RRBs of young children remains unclear. Caudate nucleus volume was measured in 36 children with ASD and 18 matched 2–3-year-old subjects with developmentally delayed (DD at baseline (Time 1 and at 2-year follow-up (Time 2. The differential growth rate in caudate nucleus volume was calculated. Further, the relationships between the development of caudate nucleus volume and RRBs were analyzed. Our results showed that caudate nucleus volume was significantly larger in the ASD group at both time points and the magnitude of enlargement was greater at Time 2. The rate of caudate nucleus growth during this 2-year interval was faster in children with ASD than DD. Right caudate nucleus volume growth was negatively correlated with RRBs. Findings from this study suggest developmental abnormalities of caudate nucleus volume in ASD. Longitudinal MRI studies are needed to explore the correlation between atypical growth patterns of caudate nucleus and phenotype of RRBs.

  20. Pooled Open Blocks Shorten Wait Times for Nonelective Surgical Cases.

    Science.gov (United States)

    Zenteno, Ana C; Carnes, Tim; Levi, Retsef; Daily, Bethany J; Price, Devon; Moss, Susan C; Dunn, Peter F

    2015-07-01

    Assess the impact of the implementation of a data-driven scheduling strategy that aimed to improve the access to care of nonelective surgical patients at Massachusetts General Hospital (MGH). Between July 2009 and June 2010, MGH experienced increasing throughput challenges in its perioperative environment: approximately 30% of the nonelective patients were waiting more than the prescribed amount of time to get to surgery, hampering access to care and aggravating the lack of inpatient beds. This work describes the design and implementation of an "open block" strategy: operating room (OR) blocks were reserved for nonelective patients during regular working hours (prime time) and their management centralized. Discrete event simulation showed that 5 rooms would decrease the percentage of delayed patients from 30% to 2%, assuming that OR availability was the only reason for preoperative delay. Implementation began in January 2012. We compare metrics for June through December of 2012 against the same months of 2011. The average preoperative wait time of all nonelective surgical patients decreased by 25.5% (P < 0.001), even with a volume increase of 9%. The number of bed-days occupied by nonurgent patients before surgery declined by 13.3% whereas the volume increased by 4.5%. The large-scale application of an open-block strategy significantly improved the flow of nonelective patients at MGH when OR availability was a major reason for delay. Rigorous metrics were developed to evaluate its performance. Strong managerial leadership was crucial to enact the new practices and turn them into organizational change.

  1. Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients.

    Science.gov (United States)

    Patterson, Brendan M; Eskildsen, Scott M; Clement, R Carter; Lin, Feng-Chang; Olcott, Christopher W; Del Gaizo, Daniel J; Tennant, Joshua N

    2017-01-01

    Clinic wait time is considered an important predictor of patient satisfaction. The goal of this study was to determine whether patient satisfaction among orthopedic patients is associated with clinic wait time and time with the provider. The authors prospectively enrolled 182 patients at their outpatient orthopedic clinic. Clinic wait time was defined as the time between patient check-in and being seen by the surgeon. Time spent with the provider was defined as the total time the patient spent in the examination room with the surgeon. The Consumer Assessment of Healthcare Providers and Systems survey was used to measure patient satisfaction. Factors associated with increased patient satisfaction included patient age and increased time with the surgeon (P=.024 and P=.037, respectively), but not clinic wait time (P=.625). Perceived wait time was subject to a high level of error, and most patients did not accurately report whether they had been waiting longer than 15 minutes to see a provider until they had waited at least 60 minutes (P=.007). If the results of the current study are generalizable, time with the surgeon is associated with patient satisfaction in orthopedic clinics, but wait time is not. Further, the study findings showed that patients in this setting did not have an accurate perception of actual wait time, with many patients underestimating the time they waited to see a provider. Thus, a potential strategy for improving patient satisfaction is to spend more time with each patient, even at the expense of increased wait time. [Orthopedics. 2017; 40(1):43-48.]. Copyright 2016, SLACK Incorporated.

  2. Direct projection from the suprachiasmatic nucleus to hypophysiotrophic corticotropin-releasing factor immunoreactive cells in the paraventricular nucleus of the hypothalamus demonstrated...

    DEFF Research Database (Denmark)

    Vrang, N.; Larsen, P.J.; Mikkelsen, J.D.

    1995-01-01

    Suprachiasmatic nucleus, paraventricular nucleus, circadian rhythms, phaseolus vulgaris-leucoagglutinin, corticotropin-releasing factor, dual immunocytochemistry......Suprachiasmatic nucleus, paraventricular nucleus, circadian rhythms, phaseolus vulgaris-leucoagglutinin, corticotropin-releasing factor, dual immunocytochemistry...

  3. Neutrino–nucleus cross sections for oscillation experiments

    Science.gov (United States)

    Katori, Teppei; Martini, Marco

    2018-01-01

    Neutrino oscillations physics is entering an era of high precision. In this context, accelerator-based neutrino experiments need a reduction in systematic errors to the level of a few percent. Today, one of the most important sources of systematic errors are neutrino–nucleus cross sections which, in the energy region of hundreds of MeV to a few GeV, are known to a precision not exceeding 20%. In this article we review the present experimental and theoretical knowledge of neutrino–nucleus interaction physics. After introducing neutrino-oscillation physics and accelerator-based neutrino experiments, we give an overview of general aspects of neutrino–nucleus cross sections, from both the theoretical and experimental point of view. Then, we focus on these cross sections in different reaction channels. We start with the quasi-elastic and quasi-elastic-like cross section, placing a special emphasis on the multinucleon emission channel, which has attracted a lot of attention in the last few years. We review the main aspects of the different microscopic models for this channel by discussing analogies and the differences among them. The discussion is always driven by a comparison with the experimental data. We then consider the one-pion production channel where agreement between data and theory remains highly unsatisfactory. We describe how to interpret pion data, and then analyze, in particular, the puzzle related to the difficulty of theoretical models and Monte Carlo to simultaneously describe MiniBooNE and MINERvA experimental results. Inclusive cross sections are also discussed, as well as the comparison between the {ν }μ and {ν }e cross sections, relevant for the charge-conjugation-parity violation experiments. The impact of nuclear effects on the reconstruction of neutrino energy and on the determination of the neutrino-oscillation parameters is also reviewed. Finally, we look to the future by discussing projects and efforts in relation to future detectors

  4. Opportunistic Buffered Decode-Wait-and-Forward (OBDWF) Protocol for Mobile Wireless Relay Networks

    CERN Document Server

    Wang, Rui; Huang, Huang

    2011-01-01

    In this paper, we propose an opportunistic buffered decode-wait-and-forward (OBDWF) protocol to exploit both relay buffering and relay mobility to enhance the system throughput and the end-to-end packet delay under bursty arrivals. We consider a point-to-point communication link assisted by K mobile relays. We illustrate that the OBDWF protocol could achieve a better throughput and delay performance compared with existing baseline systems such as the conventional dynamic decode-and-forward (DDF) and amplified-and-forward (AF) protocol. In addition to simulation performance, we also derived closed-form asymptotic throughput and delay expressions of the OBDWF protocol. Specifically, the proposed OBDWF protocol achieves an asymptotic throughput O(logK) with O(1) total transmit power in the relay network. This is a significant gain compared with the best known performance in conventional protocols (O(logK) throughput with O(K) total transmit power). With bursty arrivals, we show that both the stability region and...

  5. TWO-PHOTON PHYSICS IN NUCLEUS-NUCLEUS COLLISIONS AT RHIC.

    Energy Technology Data Exchange (ETDEWEB)

    NYSTRAND,J.

    1998-09-10

    Ultra-relativistic heavy-ions carry strong electromagnetic and nuclear fields. Interactions between these fields in peripheral nucleus-nucleus collisions can probe many interesting physics topics. This presentation will focus on coherent two-photon and photonuclear processes at RHIC. The rates for these interactions will be high. The coherent coupling of all the protons in the nucleus enhances the equivalent photon flux by a factor Z{sup 2} up to an energy of {approx} 3 GeV. The plans for studying coherent interactions with the STAR experiment will be discussed. Experimental techniques for separating signal from background will be presented.

  6. Two-photon physics in nucleus-nucleus collisions at RHIC

    Energy Technology Data Exchange (ETDEWEB)

    Nystrand, J.; Klein, S.

    1998-09-01

    Ultra-relativistic heavy-ions carry strong electromagnetic and nuclear fields. Interactions between these fields in peripheral nucleus-nucleus collisions can probe many interesting physics topics. This presentation will focus on coherent two-photon and photonuclear processes at RHIC. The rates for these interactions will be high. The coherent coupling of all the protons in the nucleus enhances the equivalent photon flux by a factor Z{sup 2} up to an energy of {approx} 3 GeV. The plans for studying coherent interactions with the STAR experiment will be discussed. Experimental techniques for separating signal from background will be presented.

  7. ULTRASTRUCTURE OF THE RAT MESENCEPHALIC TRIGEMINAL NUCLEUS

    NARCIS (Netherlands)

    LIEM, RSB; COPRAY, JCVM; VANWILLIGEN, JD

    The subcellular morphology of the mesencephalic trigeminal (Me5) nucleus in the rat was studied by transmission electron microscopy. Most neurons in the thin rostral as well as in the major caudal part of Me5 appeared as large (40-50-mu-m), round-to ovoid-shaped unipolar cells. A few neurons

  8. Resonances in η-light nucleus systems

    Indian Academy of Sciences (India)

    2Departamento de Fisica, Universidad de los Andes, Bogota, Colombia. E-mail: kanchanp@magnum.barc.ernet.in. Abstract. We locate resonances in η-light nucleus elastic scattering using the time delay method. We solve few-body equations within the finite rank approximation in order to calculate the t-matrices and hence ...

  9. Oral alprazolam acutely increases nucleus accumbens perfusion

    OpenAIRE

    Wolf, Daniel H.; Pinkham, Amy E.; Satterthwaite, Theodore D.; Ruparel, Kosha; Elliott, Mark A.; Valdez, Jeffrey; Smith, Mark A.; Detre, John A.; Gur, Ruben C.; Gur, Raquel E.

    2012-01-01

    Benzodiazepines treat anxiety, but can also produce euphoric effects, contributing to abuse. Using perfusion magnetic resonance imaging, we provide the first direct evidence in humans that alprazolam (Xanax) acutely increases perfusion in the nucleus accumbens, a key reward-processing region linked to addiction.

  10. Resonances in η-light nucleus systems

    Indian Academy of Sciences (India)

    We locate resonances in -light nucleus elastic scattering using the time delay method. We solve few-body equations within the finite rank approximation in order to calculate the -matrices and hence the time delay for the - 3He and - 4He systems. We find a resonance very close to the threshold in - 3 He elastic ...

  11. The Checkerboard Model of the Nucleus

    Science.gov (United States)

    Lach, Theodore

    2015-04-01

    The Checker Board Model (CBM) of the nucleus and the associated extended standard model predicts that nature has 5 generations of quarks not 3 and that Nucleus is 2 dimensional. The CBM theory began with an insight into the structure of the He nucleus around the year 1989. Details of how this theory evolved which took many years, and is found on my web site (http://checkerboard.dnsalias.net) or in the following references One independent check of this model is that the wavelength of the ``up'' quark orbiting inside the proton at 84.8123% the speed of light (around the ``dn'' quark in the center of the proton) turns out to be exactly one de Broglie wavelength something determined after the mass and speed of the up quark were determined by other means. This theory explains the mass of the proton and neutron and their magnetic moments and this along with the beautiful symmetric 2D structure of the He nucleus led to the evolution of this theory. When this theory was first presented at Argonne in 1996, it was the first time that anyone had predicted the quarks orbited inside the proton at relativistic speeds and it was met with skepticism.

  12. Compound nucleus studies withy reverse kinematics

    Energy Technology Data Exchange (ETDEWEB)

    Moretto, L.G.

    1985-06-01

    Reverse kinematics reactions are used to demonstrate the compound nucleus origin of intermediate mass particles at low energies and the extension of the same mechanism at higher energies. No evidence has appeared in our energy range for liquid-vapor equilibrium or cold fragmentation mechanisms. 11 refs., 12 figs.

  13. Waiting for Godot is an Irish Endgame: A Postcolonial Reading of Samuel Beckett’s Waiting for Godot and Endgame

    Directory of Open Access Journals (Sweden)

    Sayyed Rahim Moosavinia

    2013-01-01

    Full Text Available Irish National Drama is very sensitive when it comes to the issue of English Colonization, colonial forces, independence and the matter of post-colonial. In fact, a kind of Irish consciousness is present in all the dramas of this nation and all playwrights in this trend- even indirectly or by implication- have tried to portray these matters through their works. This study is an attempt to prove the claim that even a playwright like Samuel Beckett, whose works have been written out of the canon of Irish Literature because of living on exile, adopting another language or semi-taboo labels like Absurdism, Universality and Placlessness, can be read in light postcolinalism. To this aim, two of Beckett’s plays Waiting for Godot and End Game are chosen here as the representative and put into explication.

  14. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    Science.gov (United States)

    Vitus, Kathrine

    2010-01-01

    This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

  15. Effects of Wait Time When Communicating with Children Who Have Sensory and Additional Disabilities

    Science.gov (United States)

    Johnson, Nicole; Parker, Amy T.

    2013-01-01

    Introduction: This study utilized wait-time procedures to determine if they are effective in helping children with deafblindness or multiple disabilities that include a visual impairment communicate in their home. Methods: A single subject with an alternating treatment design was used for the study. Zero- to one-second wait time was utilized…

  16. Strategic Attention Deployment for Delay of Gratification in Working and Waiting Situations.

    Science.gov (United States)

    Peake, Philip K.; Hebl, Michelle; Mischel, Walter

    2002-01-01

    Two studies examined whether effects of attention to rewards during a delay of gratification task in waiting situations affects preschoolers' ability to delay gratification in working situations. Findings show that when work provides distraction, attention on rewards reduces delay time whether working or waiting; when work is not engaging,…

  17. The relationship between educational attainment and waiting time among the elderly in Norway.

    Science.gov (United States)

    Carlsen, Fredrik; Kaarboe, Oddvar Martin

    2015-11-01

    We investigate whether educational attainment affects waiting time of elderly patients in somatic hospitals. We consider three distinct pathways; that patients with different educational attainment have different disease patterns, that patients with different levels of education receive treatments at different hospitals, and that patient choice and supply of local health services within hospital catchment areas explain unequal waiting time of different educational groups. We find evidence of an educational gradient in waiting time for male patients, but not for female patients. Conditional on age, male patients with tertiary education wait 45% shorter than male patients with secondary or primary education. The first pathway is not quantitatively important as controlling for disease patters has little effect on relative waiting times. The second pathway is important. Relative to patients with primary education, variation in waiting time and education level across local hospitals contributes to higher waiting time for male patients with secondary education and female patients with secondary or tertiary education and lower waiting time for male patients with tertiary education. These effects are in the order of 15-20%. The third pathway is also quantitatively important. The educational gradients within catchment areas disappear when we control for travel distance and supply of private specialists. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Access to Specialist Gastroenterology Care in Canada: The Practice Audit in Gastroenterology (PAGE Wait Times Program

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2008-01-01

    Full Text Available BACKGROUND: Canadian wait time data are available for the treatment of cancer and heart disease, as well as for joint replacement, cataract surgery and diagnostic imaging procedures. Wait times for gastroenterology consultation and procedures have not been studied, although digestive diseases pose a greater economic burden in Canada than cancer or heart disease.

  19. Synchronization Control of Scheduled Train Services to Minimize Passenger Waiting Times

    NARCIS (Netherlands)

    Goverde, R.M.P.

    1998-01-01

    During operation a transportation service may wait on delayed feeder services to secure scheduled transfers. For low-frequent connecting services this has a major positive impact on the transfer waiting times. However, the resulting synchronization control time of the connecting service also affects

  20. Customer waiting times in an (R,S) inventory system with compound Poisson demand

    NARCIS (Netherlands)

    van der Heijden, Matthijs C.; de Kok, A.G.

    1992-01-01

    Besides service level and mean physical stock, customer waiting time is an important performance characteristic for an inventory system. In this paper we discuss the calculation of this waiting time in case a periodic review control policy with order-up-to-levelS is used and customers arrive

  1. Impact of waiting on the perception of service quality in nuclear medicine

    NARCIS (Netherlands)

    De Man, S; Vlerick, P; Gemmel, P; De Bondt, P; Matthys, D; Dierckx, RA

    Background This is the first study examining the link between waiting and various dimensions of perceived service quality in nuclear medicine. Methods We tested the impact of selected waiting experience variables on the evaluation of service quality, measured using the Servqual tool, of 406 patients

  2. First in Line Waiting Times as a Tool for Analysing Queueing Systems

    DEFF Research Database (Denmark)

    Koole, G. M.; Nielsen, Bo Friis; Nielsen, Thomas Bang

    2012-01-01

    We introduce a new approach to modelling queueing systems where the priority or the routing of customers depends on the time the first customer has waited in the queue. This past waiting time of the first customer in line, WFIL, is used as the primary variable for our approach. A Markov chain...

  3. Cigarette smoking and waiting time to pregnancy: results of a pilot study.

    Science.gov (United States)

    Zilaitiene, Birute; Dirzauskas, Marius; Preiksa, Romualdas Tomas; Matulevicius, Valentinas

    2007-01-01

    Waiting time to pregnancy is an important characteristic of human reproductive health, which has not been investigated in Lithuania until now. Data on waiting time to pregnancy have been collected from medical records of 111 women admitted to the Department of Obstetrics, Klaipeda Hospital. Seven women in whom pregnancy was the result of infertility treatment were excluded from the analysis, and the rest 104 cases were analyzed. We evaluated waiting time to pregnancy in respect to the age of couples, contraceptive use, cigarette smoking of both partners, and some other features of obstetric history. The mean waiting time to pregnancy in the cohort was 5.21+/-7.03 months. If both partners smoked, the mean waiting time to pregnancy was significantly longer than in nonsmoking couples (7.68+/-9.41 vs. 4.30+/-5.73, P<0.05). Risk to have waiting time to pregnancy longer than 6 months was significantly higher if both partners smoked as compared to nonsmoking couples (OR 3.32, 95% CI 1.07-10.30, P=0.03), while paternal smoking and smoking of any partner did not increase this risk significantly. The other possible factors - age, living place (rural or city), previous contraceptive use, regularity of menstrual cycle, and frequency of intercourse - did not influence waiting time to pregnancy significantly. Results obtained from this pilot study enable us to plan and implement a larger-scale study of waiting time to pregnancy in Lithuanian population.

  4. How tolerable is delay? : Consumers' evaluations of internet web sites after waiting

    NARCIS (Netherlands)

    B.G.C. Dellaert (Benedict); B.E. Kahn

    1998-01-01

    textabstractHow consumer's waiting times affect their retrospective evaluations of Internet Web Sites is investigated in four computer-based experiments. Results show that waiting can but does not always negatively affect evaluations of Web Sites. Results also show that the potential negative

  5. Ambulatory health service users' experience of waiting time and expenditure and factors associated with the perception of low quality of care in Mexico.

    Science.gov (United States)

    Sauceda-Valenzuela, Alma Lucila; Wirtz, Veronika J; Santa-Ana-Téllez, Yared; de la Luz Kageyama-Escobar, Maria

    2010-06-23

    A principal reason for low use of public health care services is the perception of inferior quality of care. Studying health service user (HSU) experiences with their care and their perception of health service quality is critical to understanding health service utilization. The aim of this study was to define reference points for some aspects of health care quality and to analyze which HSU experiences resulted in perceptions of overall low quality of care. Data from the National Health Survey 2006 were used to compare the experiences of HSUs with their ambulatory care at Ministry of Health and affiliated institutions (MOH), social security institutions (SSI) and private institutions (PrivI). Reference points of quality of care related to waiting time and expenditure were defined for each of the three types of institutions by analyzing HSU experiences rated as 'acceptable'. A multivariable logistic regression model was used to identify the principal factors associated with the general perception of low quality of care. A total of 11,959 HSUs were included in the analysis, of whom 37.6% (n = 4,500) HSUs received care at MOH facilities; 31.2% (n = 3,730) used SSI and 31.2% (n = 3,729) PrivI. An estimated travel and waiting time of 10 minutes respectively was rated as acceptable by HSUs from all institutions. The differences between the waiting time rated as acceptable and the actual waiting time were the largest for SSI (30 min) in comparison to MoH (20 min) and PrivI (5 min) users. The principal factors associated with an overall perception of low quality of care are type of institution (OR 4.36; 95% CI 2.95-6.44), waiting time (OR 3.20; 95% CI 2.35-4.35), improvement of health after consultation (OR 2.93; CI 2.29-3.76) and consultation length of less than 20 minutes (2.03; 95% CI 1.60-2.57). The reference points derived by the HSUs' own ratings are useful in identifying where quality improvements are required. Prioritizing the reduction of waiting times and

  6. Ambulatory health service users' experience of waiting time and expenditure and factors associated with the perception of low quality of care in Mexico

    Directory of Open Access Journals (Sweden)

    Santa-Ana-Téllez Yared

    2010-06-01

    Full Text Available Abstract Background A principal reason for low use of public health care services is the perception of inferior quality of care. Studying health service user (HSU experiences with their care and their perception of health service quality is critical to understanding health service utilization. The aim of this study was to define reference points for some aspects of health care quality and to analyze which HSU experiences resulted in perceptions of overall low quality of care. Methods Data from the National Health Survey 2006 were used to compare the experiences of HSUs with their ambulatory care at Ministry of Health and affiliated institutions (MOH, social security institutions (SSI and private institutions (PrivI. Reference points of quality of care related to waiting time and expenditure were defined for each of the three types of institutions by analyzing HSU experiences rated as 'acceptable'. A multivariable logistic regression model was used to identify the principal factors associated with the general perception of low quality of care. Results A total of 11,959 HSUs were included in the analysis, of whom 37.6% (n = 4,500 HSUs received care at MOH facilities; 31.2% (n = 3,730 used SSI and 31.2% (n = 3,729 PrivI. An estimated travel and waiting time of 10 minutes respectively was rated as acceptable by HSUs from all institutions. The differences between the waiting time rated as acceptable and the actual waiting time were the largest for SSI (30 min in comparison to MoH (20 min and PrivI (5 min users. The principal factors associated with an overall perception of low quality of care are type of institution (OR 4.36; 95% CI 2.95-6.44, waiting time (OR 3.20; 95% CI 2.35-4.35, improvement of health after consultation (OR 2.93; CI 2.29-3.76 and consultation length of less than 20 minutes (2.03; 95% CI 1.60-2.57. Conclusions The reference points derived by the HSUs' own ratings are useful in identifying where quality improvements are required

  7. Suprachiasmatic Nucleus Interaction with the Arcuate Nucleus; Essential for Organizing Physiological Rhythms

    NARCIS (Netherlands)

    Buijs, Frederik N.; Guzmán-Ruiz, Mara; León-Mercado, Luis; Basualdo, Mari Carmen; Escobar, Carolina; Kalsbeek, Andries; Buijs, Ruud M.

    2017-01-01

    The suprachiasmatic nucleus (SCN) is generally considered the master clock, independently driving all circadian rhythms. We recently demonstrated the SCN receives metabolic and cardiovascular feedback adeptly altering its neuronal activity. In the present study, we show that microcuts effectively

  8. Nonequilibrium distribution functions of nucleons in relativistic nucleus-nucleus collisions

    Directory of Open Access Journals (Sweden)

    D. Anchishkin

    2013-03-01

    Full Text Available The collision smearing of the nucleon momenta about their initial values during relativistic nucleus-nucleus collisions is investigated. To a certain degree, our model belongs to the transport type, and we investigate the evolution of the nucleon system created at a nucleus-nucleus collision. However, we parameterize this development by the number of collisions of every particle during evolution rather than by the time variable. It is assumed that the group of nucleons which leave the system after the same number of collisions can be joined in a particular statistical ensemble. The nucleon nonequilibrium distribution functions are derived which depend on a certain number of collisions of a nucleon before a freeze-out.

  9. The production of strangeness and charmonium in nucleus-nucleus collisions

    CERN Document Server

    Geiss, J

    1998-01-01

    The aim of the present theis is to study the space-time evolution of highly relativistic nucleus-nucleus collisions in a microscopic purely hadronic transport theory. Especially the production of strangeness in nucleus-nucleus collisions over a large energy range from SIS- (E sub l sub a sub b =1-2 A.GeV) up to SPS-energies (E sub l sub a sub b +200 A.GeV) for many different systems are studied, whereby for the elementary production cross sections as conservative assumptions as possible are made. The aim is to obtain an excitation function for the production of strangeness over the whole energy range. Furthermore the production of J/psi particles at SPS energies is studied for different systems, whereby a new absorption mechanism of the c anti c pairs is tested.

  10. An investigation of the relationship between cataract surgery wait times and rates of surgery.

    Science.gov (United States)

    Hodge, William G; Ramsay, Timothy; Fergusson, Dean; Si, Francie; Pan, Irene; Su, Yinghua; Buhrmann, Ralf

    2012-02-01

    The relationship between cataract surgery wait times and rates of surgery was investigated to determine whether wait times correlate with rates of surgery. Cross-sectional study. We collected 2 Ontario registries for cataract surgeries: (i) Cancer Care Ontario wait time registry; and (ii) The Ontario Health Insurance Plan billing records. Both registries were used to determine whether wait times correlated with rates of surgery, and the data were then stratified by region of the province, priority (severity) of cases, age, and sex. The total number of surgeries performed between April 2, 2007, and March 31, 2008, was 65,520. The overall mean number of wait days was 69.8 days; the mean patient age was 72.5 years; and the surgery rate was 540.3 per 100,000 members of the population. For high-priority cases (priorities 1 and 2), there was a very weak inverse correlation (p = -0.27 and -0.21) between wait time and surgery rate, whereas the overall correlation between wait time and surgical rate was close to zero in both databases, regardless of the region, the patients' ages, and the patients' genders. This study demonstrates a very weak correlation between wait times for and rates of cataract surgery, and this should be a concern for policy makers. Further study is needed to see whether this null relationship persists over time and whether it exists for other monitored wait time procedures. Reasons for this null relationship will have to be determined and remedied as the use of wait times becomes a more widespread outcome in Canadian Healthcare. Copyright © 2012 Canadian Ophthalmological Society. All rights reserved.

  11. Impact of pulmonary rehabilitation on quality of life and functional capacity in patients on waiting lists for lung transplantation

    Directory of Open Access Journals (Sweden)

    Juliessa Florian

    2013-06-01

    Full Text Available OBJECTIVE: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. METHODS: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36. The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. RESULTS: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47% had pulmonary fibrosis, 13 (22% had pulmonary emphysema, and 18 (31% had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001, the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001, role-physical, up 10 (p = 0.045; vitality, up 10 (p < 0.001; social functioning, up 15 (p = 0.001; and mental health, up 8 (p = 0.001. CONCLUSIONS: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.

  12. Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized Wait-List Controlled Trial

    Science.gov (United States)

    Duncan, Larissa G.; Moskowitz, Judith Tedlie; Neilands, Torsten B.; Dilworth, Samantha E.; Hecht, Frederick M.; Johnson, Mallory O.

    2011-01-01

    Context Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV. Objectives This study tested the efficacy of mindfulness-based stress reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning. Methods Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to MBSR or a wait-list control standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms. Results Compared to a wait-list control, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to antiretroviral therapies at three months post intervention (mean difference = 0.33; 95% confidence interval [CI] = 0.01, 0.66; t(132) = 2.04, P = 0.044) and at six months post intervention (mean difference = 0.38; 95% CI = 0.05, 0.71; t(132) = 2.27, P = 0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post intervention (mean difference = 0.47; 95% CI = 0.003, 0.94; t(132) = 1.99, P = 0.048) compared with the wait-list control condition. Conclusion Mindfulness-based stress reduction is a promising approach for reducing HIV treatment-related side effects. PMID:21925831

  13. The effects of publishing emergency department wait time on patient utilization patterns in a community with two emergency department sites: a retrospective, quasi-experiment design.

    Science.gov (United States)

    Xie, Bin; Youash, Sabrina

    2011-06-14

    Providing emergency department (ED) wait time information to the public has been suggested as a mechanism to reduce lengthy ED wait times (by enabling patients to select the ED site with shorter wait time), but the effects of such a program have not been evaluated. We evaluated the effects of such a program in a community with two ED sites. Descriptive statistics for wait times of the two sites before and after the publication of wait time information were used to evaluate the effects of the publication of wait time information on wait times. Multivariate logistical regression was used to test whether or not individual patients used published wait time to decide which site to visit. We found that the rates of wait times exceeding 4 h, and the 95th percentile of wait times in the two sites decreased after the publication of wait time information, even though the average wait times experienced a slight increase. We also found that after controlling for other factors, the site with shorter wait time had a higher likelihood of being selected after the publication of wait time information, but there was no such relationship before the publication. These findings were consistent with the hypothesis that the publication of wait time information leads to patients selecting the site with shorter wait time. While publishing ED wait time information did not improve average wait time, it reduced the rates of lengthy wait times.

  14. Advanced access: reducing waiting and delays in primary care.

    Science.gov (United States)

    Murray, Mark; Berwick, Donald M

    2003-02-26

    Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support.

  15. Mars can wait: facing the challenges of our civilization.

    Science.gov (United States)

    Goodman, Geoffrey; Gershwin, M Eric; Bercovich, Dani

    2014-12-01

    We are overwhelmed by warnings about inevitable geophysical and human problems. Earth is beset by escalating, manmade, environmental crises and our exploding population will eventually lack water, food and vital materials. This suggests, together with increasing poverty, deepening social unrest and advanced techniques for mass killing, that civilization will break down long before atmospheric CO2 or resistant microbes become catastrophic. Despite intensive searching, life has not been found in space, even though thousands of planets have been found and life there may be as problematic and unpredictable as on Earth. The human brain is already a 'universe', with 85 billion neurons and a hundred trillion synapses, more than the stars in our galaxy. Understanding consciousness, the brain, its aging and pathologies, and eliminating the propensity for human aggression are urgent challenges. During 1958-2012, NASA spent $800 billion. In contrast, the annual cost of brain disease in the U.S. is $600 billion, more than cardiovascular disease and cancer combined. We suggest that a massive switching of financial and human resources is required to explore the full potential of the human brain. Visiting Mars can wait. We further propose a novel Two-Brain Hypothesis: the animal 'brain' evolved as two fundamentally different though interdependent, complementary organs: one electroionic (tangible, known and accessible), and the other, electromagnetic (intangible and difficult to access)--a relatively independent, stable, structured and functional 3D compendium of variously induced interacting EM fields.

  16. Models of emergency departments for reducing patient waiting times.

    Directory of Open Access Journals (Sweden)

    Marek Laskowski

    Full Text Available In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial-topographical and social inputs (staffing, patient care models, etc.. Real data obtained through proximity location and tracking system technologies is one example discussed.

  17. Strangeness production in antiproton-nucleus annihilation

    Directory of Open Access Journals (Sweden)

    Mosel U.

    2012-12-01

    Full Text Available The results of the microscopic transport calculations of p¯ $ar p$-nucleus interactions within a GiBUU model are presented. The dominating mechanism of hyperon production is the strangeness exchange processes K¯N $ar KN$ → γπ and K¯N $ar KN$ → ΞK. The calculated rapidity spectra of Ξ hyperons are significantly shifted to forward rapidities with respect to the spectra of S = −1 hyperons. We argue that this shift should be a sensitive test for the possible exotic mechanisms of p¯ $ar p$-nucleus annihilation. The production of the double Λ-hypernuclei by Ξ− interaction with a secondary target is calculated.

  18. Protein quality control in the nucleus

    DEFF Research Database (Denmark)

    Nielsen, Sofie V.; Poulsen, Esben Guldahl; Rebula, Caio A.

    2014-01-01

    to aggregate, cells have evolved several elaborate quality control systems to deal with these potentially toxic proteins. First, various molecular chaperones will seize the misfolded protein and either attempt to refold the protein or target it for degradation via the ubiquitin-proteasome system...... to be particularly active in protein quality control. Thus, specific ubiquitin-protein ligases located in the nucleus, target not only misfolded nuclear proteins, but also various misfolded cytosolic proteins which are transported to the nucleus prior to their degradation. In comparison, much less is known about...... these mechanisms in mammalian cells. Here we highlight recent advances in our understanding of nuclear protein quality control, in particular regarding substrate recognition and proteasomal degradation....

  19. Cell Biology of the Plant Nucleus.

    Science.gov (United States)

    Meier, Iris; Richards, Eric J; Evans, David E

    2017-04-28

    The eukaryotic nucleus is enclosed by the nuclear envelope, which is perforated by the nuclear pores, the gateways of macromolecular exchange between the nucleoplasm and cytoplasm. The nucleoplasm is organized in a complex three-dimensional fashion that changes over time and in response to stimuli. Within the cell, the nucleus must be viewed as an organelle (albeit a gigantic one) that is a recipient of cytoplasmic forces and capable of morphological and positional dynamics. The most dramatic reorganization of this organelle occurs during mitosis and meiosis. Although many of these aspects are less well understood for the nuclei of plants than for those of animals or fungi, several recent discoveries have begun to place our understanding of plant nuclei firmly into this broader cell-biological context.

  20. Development of a Mobile Ice Nucleus Counter

    Energy Technology Data Exchange (ETDEWEB)

    Kok, Gregory [Droplet Measurement Technologies, Boulder, CO (United States); Kulkarni, Gourihar [Droplet Measurement Technologies, Boulder, CO (United States)

    2014-07-10

    An ice nucleus counter has been constructed. The instrument uses built-in refrigeration systems for wall cooling. A cascade refrigeration system will allow the cold wall to operate as low as -70°C, and a single stage system can operate the warm wall at -45C. A unique optical particle counter has been constructed using polarization detection of the scattered light. This allows differentiation of the particles exiting the chamber to determine if they are ice or liquid.

  1. Systematics of $\\alpha$--nucleus optical potentials

    OpenAIRE

    Mohr, P; Abele, H.; Atzrott, U.; Staudt, G.; Bieber, R; Grün, K.; Oberhummer, H.; Rauscher, T.; Somorjai, E.

    1994-01-01

    Double--folded optical $\\alpha$--nucleus potentials can be used to calculate elastic scattering cross sections in a wide mass-- and energy region. Because of the systematic behavior of the potential parameters we are able to obtain reliable optical potentials for astrophysically relevant reactions even without scattering data in low--energy region. As example we analyze the capture reaction ${^{144}{\\rm Sm}}(\\alpha,\\gamma){^{148}{\\Gd}}$.

  2. Improved Neuroimaging Atlas of the Dentate Nucleus.

    Science.gov (United States)

    He, Naying; Langley, Jason; Huddleston, Daniel E; Ling, Huawei; Xu, Hongmin; Liu, Chunlei; Yan, Fuhua; Hu, Xiaoping P

    2017-07-01

    The dentate nucleus (DN) of the cerebellum is the major output nucleus of the cerebellum and is rich in iron. Quantitative susceptibility mapping (QSM) provides better iron-sensitive MRI contrast to delineate the boundary of the DN than either T2-weighted images or susceptibility-weighted images. Prior DN atlases used T2-weighted or susceptibility-weighted images to create DN atlases. Here, we employ QSM images to develop an improved dentate nucleus atlas for use in imaging studies. The DN was segmented in QSM images from 38 healthy volunteers. The resulting DN masks were transformed to a common space and averaged to generate the DN atlas. The center of mass of the left and right sides of the QSM-based DN atlas in the Montreal Neurological Institute space was -13.8, -55.8, and -36.4 mm, and 13.8, -55.7, and -36.4 mm, respectively. The maximal probability and mean probability of the DN atlas with the individually segmented DNs in this cohort were 100 and 39.3%, respectively, in contrast to the maximum probability of approximately 75% and the mean probability of 23.4 to 33.7% with earlier DN atlases. Using QSM, which provides superior iron-sensitive MRI contrast for delineating iron-rich structures, an improved atlas for the dentate nucleus has been generated. The atlas can be applied to investigate the role of the DN in both normal cortico-cerebellar physiology and the variety of disease states in which it is implicated.

  3. Formation of tRNA granules in the nucleus of heat-induced human cells

    Energy Technology Data Exchange (ETDEWEB)

    Miyagawa, Ryu [Radioisotope Center, The University of Tokyo, 2-11-16 Yayoi, Bunkyo-ku, Tokyo 113-0032 (Japan); Department of Biological Science, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654 (Japan); Mizuno, Rie [Radioisotope Center, The University of Tokyo, 2-11-16 Yayoi, Bunkyo-ku, Tokyo 113-0032 (Japan); Watanabe, Kazunori, E-mail: watanabe@ric.u-tokyo.ac.jp [Radioisotope Center, The University of Tokyo, 2-11-16 Yayoi, Bunkyo-ku, Tokyo 113-0032 (Japan); Ijiri, Kenichi [Radioisotope Center, The University of Tokyo, 2-11-16 Yayoi, Bunkyo-ku, Tokyo 113-0032 (Japan); Department of Biological Science, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654 (Japan)

    2012-02-03

    Highlights: Black-Right-Pointing-Pointer tRNAs are tranlocated into the nucleus in heat-induced HeLa cells. Black-Right-Pointing-Pointer tRNAs form the unique granules in the nucleus. Black-Right-Pointing-Pointer tRNA ganules overlap with nuclear stress granules. -- Abstract: The stress response, which can trigger various physiological phenomena, is important for living organisms. For instance, a number of stress-induced granules such as P-body and stress granule have been identified. These granules are formed in the cytoplasm under stress conditions and are associated with translational inhibition and mRNA decay. In the nucleus, there is a focus named nuclear stress body (nSB) that distinguishes these structures from cytoplasmic stress granules. Many splicing factors and long non-coding RNA species localize in nSBs as a result of stress. Indeed, tRNAs respond to several kinds of stress such as heat, oxidation or starvation. Although nuclear accumulation of tRNAs occurs in starved Saccharomyces cerevisiae, this phenomenon is not found in mammalian cells. We observed that initiator tRNA{sup Met} (Meti) is actively translocated into the nucleus of human cells under heat stress. During this study, we identified unique granules of Meti that overlapped with nSBs. Similarly, elongator tRNA{sup Met} was translocated into the nucleus and formed granules during heat stress. Formation of tRNA granules is closely related to the translocation ratio. Then, all tRNAs may form the specific granules.

  4. Public views on a wait time management initiative: a matter of communication.

    Science.gov (United States)

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2010-08-05

    Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

  5. Survey of Access to GastroEnterology in Canada: The SAGE wait times program

    Science.gov (United States)

    Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

    2010-01-01

    BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; Pgastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

  6. Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

    Science.gov (United States)

    Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

    2017-07-01

    This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

  7. The Influence of Ambient Scent and Music on Patients' Anxiety in a Waiting Room of a Plastic Surgeon

    NARCIS (Netherlands)

    Fenko, Anna; Loock, Caroline

    2014-01-01

    OBJECTIVE: This study investigates the influence of ambient scent and music, and their combination, on patients' anxiety in a waiting room of a plastic surgeon. BACKGROUND: Waiting for an appointment with a plastic surgeon can increase a patient's anxiety. It is important to make the waiting time

  8. Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

    DEFF Research Database (Denmark)

    Lyhne, N M; Christensen, A; Alanin, M C

    2012-01-01

    BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot...

  9. Improving wait times to care for individuals with multimorbidities and complex conditions using value stream mapping.

    Science.gov (United States)

    Sampalli, Tara; Desy, Michel; Dhir, Minakshi; Edwards, Lynn; Dickson, Robert; Blackmore, Gail

    2015-04-05

    Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely - an adaptation of Value Stream Mapping (VSM) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC) and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS) intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions. © 2015 by Kerman University of Medical Sciences.

  10. Improving wait times to care for individuals with multimorbidities and complex conditions using value stream mapping

    Science.gov (United States)

    Sampalli, Tara; Desy, Michel; Dhir, Minakshi; Edwards, Lynn; Dickson, Robert; Blackmore, Gail

    2015-01-01

    Background: Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods: Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC) and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results: The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS) intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion: Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions. PMID:26188810

  11. General practice cooperatives: long waiting times for home visits due to long distances?

    Science.gov (United States)

    Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

    2007-02-12

    The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

  12. Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

    Science.gov (United States)

    Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

    2017-07-10

    Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

  13. Wait-time, classroom discourse, and the influence of sociocultural factors in science teaching

    Science.gov (United States)

    Jegede, Olugbemiro J.; Olajide, Janet O.

    Wait-time, a variable related to questioning in a teaching-learning situation, has been found to have implications for the inquiry mode of science teaching especially in Western classroom environments. Aside from the fact that the literature is very sparse in this area about what obtains in developing countries, nothing appears to be available with regard to how wait-time interacts with the sociocultural factors within non-Western science classrooms. In a non-Western country such as Nigeria where most science programs in schools are inquiry-oriented, do teachers take notice of, and effectively use, wait-time in the teaching-learning process? Are science teachers able to effectively use the mediating role of sociocultural factors in science teaching in a traditional environment which expects children to be seen only and not heard? The main purpose of this study was to investigate the wait-time of Nigerian integrated science teachers in relation to the amount of students' participation in inquiry. This study also investigated the relationship between wait-time and sociocultural attitudinal factors prevalent in traditional societies. The instruments used for data collection were the Hough's Observational Schedule and a modified version of the Socio-Cultural Environment Scale (SCES); a stop-watch was used to measure the wait-time of audio-recorded integrated science lessons of 37 integrated science teachers from selected junior secondary schools in Kaduna State, Nigeria. The results showed that the average wait-time TT and wait-time ST of the integrated science teachers was 3.0 seconds and 0.7 seconds, respectively. The study reported the amount of student participation in the student-teacher classroom discourse to be very low. Wait-time was also shown to have a strong relationship with sociocultural factors of authoritarianism, goal structure, societal expectation, and traditional worldview. The pedagogical and curricular implications of the results have been

  14. Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping

    Directory of Open Access Journals (Sweden)

    Tara Sampalli

    2015-07-01

    Full Text Available Background Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.

  15. Mobile Fences: J.M. Coetzee’s Waiting for the Barbarians

    Directory of Open Access Journals (Sweden)

    Eleonora Pizzinat

    2011-04-01

    Full Text Available Fences usually enclose and separate, but they are also places of exchange neither inside nor outside. This concept is well represented in J.M. Coetzee’s Waiting for the Barbarians, because not only this novel is setted on the border between an undefined Empire and the barbarians’ lands, but it also plays with various declinations of the idea of limit and boundary. Through a reading which intends to highlight every kind of frame in the novel, it will emerge that no border is fixed and conclusive. Namely, in this book every real or metaphoric fence is called into question: the distinction between the duality of “us and them” is actually determined by the Empire’s walls which separate the inside from the outside in an arbitrary way; the magistrate (with the empathy he feels for the barbarian girl is inevitably caught in a double bind; and, according to Emmanuel Lévinas’ philosophy, the desire to understand otherness reveals its predatory intentions from a post-colonial point of view. It is not possible to delineate an ultimate bordeline, and it will emerge that instead of a binary logic there is a more fruitful way of thinking, a way based on frames, paradoxes and literary texts which cannot be read as flat mirroring devices.      

  16. Low P sub T hadron-nucleus interactions

    Science.gov (United States)

    Holynski, R.; Wozniak, K.

    1985-01-01

    The possibility of describing hadron-nucleus (hA) interactions is discussed in terms of a number of independent collisions of the projectile inside the target nucleus. This multiple rescattering may occur on a particle or quark parton level. To investigate the characteristics of hA interactions as a function of antineutrinos advantage is taken of the correlation between the average number antineutrinos of collisions of the projectile inside the nucleus and the number Ng of fast protons ejected from the struck nucleus. The relation antineutrinos vs Ng obtained in antineutrinos was used. For a given target nucleus this allows the selection of interactions occurring at different impact parameters.

  17. Day surgery: patients' felt abandoned during the preoperative wait.

    Science.gov (United States)

    Gilmartin, Jo; Wright, Kerrie

    2008-09-01

    The rapid expansion in day surgery has facilitated a shift in surgical nursing intervention. The evolving evidence base has a major part to play in influencing nurse-led preassessment, information provision, pain management and postoperative intervention. However, the literature is characterised by a number of deficits: poor attention to patient experience from admission to discharge, anxieties evoked and the potential needs of patients are not well articulated. The purpose of this paper is to describe and interpret patients' experiences of contemporary day surgery. This hermeneutic phenomenological approach focused on the experience of 20 adult patients. Data was collected by using unstructured interviews. The transcripts were interpreted through the identification of four prevalent themes using the phenomenological method. The themes that emerged from the data are emphasised, ranging from the feeling of empowerment during preparation, through apprehensions encountered and the feeling of abandonment in the preoperative waiting area, to recovery dynamics. The study demonstrates that the majority of the patients felt abandoned in the preoperative stage and nurses did not recognise the importance of ongoing psychological support. Therefore, it is crucial to strengthen the provision of emotional support and person-centred care in a day surgery context. There is also a need to be aware that environmental factors can impact on patient anxiety, promoting the use of music preoperatively can reduce anxiety and increase well-being. Crucially health professionals need to facilitate person-centred and continuity of care throughout the day surgery experience. Using dynamic interpersonal skills, such as active listening 'holding''containment' and attunement to reduce anxiety and feelings of abandonment in the preoperative period. Moreover, being alert to verbal utterances, para-language and non-verbal cues demonstrated by the patient. Specific information about delays regarding

  18. Extinction and anti-extinction: the "attentional waiting" hypothesis.

    Science.gov (United States)

    Watling, Rosamond; Danckert, James; Linnell, Karina J; Cocchini, Gianna

    2013-03-01

    Patients with visual extinction have difficulty detecting a single contralesional stimulus when a second stimulus is simultaneously presented on the ipsilesional side. The rarely reported phenomenon of visual anti-extinction describes the opposite behavior, in which patients show greater difficulty in reporting a stimulus presented in isolation than they do in reporting 2 simultaneously presented stimuli. S. J. Goodrich and R. Ward (1997, Anti-extinction following unilateral parietal damage, Cognitive Neuropsychology, Vol. 14, pp. 595-612) suggested that visual anti-extinction is the result of a task-specific mechanism in which processing of the ipsilesional stimulus facilitates responses to the contralesional stimulus; in contrast, G. W. Humphreys, M. J. Riddoch, G. Nys, and D. Heinke (2002, Transient binding by time: Neuropsychological evidence from anti-extinction, Cognitive Neuropsychology, Vol. 19, pp. 361-380) suggested that temporal binding groups contralesional and ipsilesional stimuli together at brief exposure durations. We investigated extinction and anti-extinction phenomena in 3 brain-damaged patients using an extinction paradigm in which the stimulus exposure duration was systematically manipulated. Two patients showed both extinction and anti-extinction depending on the exposure duration of stimuli. Data confirmed the crucial role of duration in modulating the effect of extinction and anti-extinction. However, contrary to Humphreys and colleagues' (2002) single case, our patients showed extinction for short and anti-extinction for long exposure durations, suggesting that different mechanisms might underlie our patients' pattern of data. We discuss a novel "attentional waiting" hypothesis, which proposes that anti-extinction may be observed in patients showing extinction if the exposure duration of stimuli is increased. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  19. Cardiac evaluation in pediatric patients waiting for liver transplantation

    Directory of Open Access Journals (Sweden)

    Seyed Mohsen Dehghani, Naser Honar, Hamid Amoozegar, Ahad Eshraghian, Mohammad Borzooei, Mohammad Hadi Imanieh, Seyed Ali Malek-Hosseini

    2010-01-01

    Full Text Available Background: Cardiovascular abnormalities are among common complication in patients with cirrhosis waiting for liver transplantation (LT. The aim of the present study was to investigate cardiac abnormalities among pediatric liver transplant candidates.Methods: We prospectively evaluated the pediatric patient aged less than 18 years listed for LT between 2006 and 2008. Besides history taking and physical examination all the patients underwent electrocardiogram, chest radiograph, contrast echocardiography and color Doppler echocardiography, as well as arterial blood gas analyses.Results: Totally 89 patients with mean age of 8.1±4.6 years were included in the study. The most common causes for liver disease were cryptogenic cirrhosis followed by biliary atresia and autoimmune cirrhosis. Clubbing was found in 27 out of 89 patients and was the most common abnormalities in physical examination. In 22 patients (24.7% heart murmur was heard by a pediatric cardiologist. Sixty nine patients (77.5% had normal cardiac findings in chest radiograph. Cardiomegaly was found in 17 (19.1% patients as the most common abnormal finding in chest radiograph. Electrocardiogram showed sinus tachycardia in 16 (18% patients. Eleven patients (12.4% had tricuspid regurgitation as the most common abnormal findings in echocardiography. Thirteen (14.6% patients had positive contrast echocardiography in favor of intrapulmonary shunt.Conclusion: As the leading cause of post transplant death after graft rejection are cardiovascular complications cardiac evaluation should be considered in all pediatric patients before LT to lower morbidity and mortality during and after transplantation.

  20. J/$\\psi$ production in proton-nucleus and nucleus-nucleus interactions at the CERN SPS

    CERN Document Server

    Abreu, M C; Alexa, C; Arnaldi, R; Ataian, M R; Baglin, C; Baldit, A; Bedjidian, Marc; Beolè, S; Boldea, V; Bordalo, P; Borges, G; Bussière, A; Capelli, L; Castanier, C; Castor, J I; Chaurand, B; Chevrot, I; Cheynis, B; Chiavassa, E; Cicalò, C; Claudino, T; Comets, M P; Constans, N; Constantinescu, S; Cortese, P; De Falco, A; De Marco, N; Dellacasa, G; Devaux, A; Dita, S; Drapier, O; Ducroux, L; Espagnon, B; Fargeix, J; Force, P; Gallio, M; Gavrilov, Yu K; Gerschel, C; Giubellino, P; Golubeva, M B; Gonin, M; Grigorian, A A; Grossiord, J Y; Guber, F F; Guichard, A; Gulkanian, H R; Hakobyan, R S; Haroutunian, R; Idzik, M; Jouan, D; Karavitcheva, T L; Kluberg, L; Kurepin, A B; Le Bornec, Y; Lourenço, C; Macciotta, P; MacCormick, M; Marzari-Chiesa, A; Masera, M; Masoni, A; Monteno, M; Musso, A; Petiau, P; Piccotti, A; Pizzi, J R; Prado da Silva, W L; Prino, F; Puddu, G; Quintans, C; Ramello, L; Ramos, S; Rato-Mendes, P; Riccati, L; Romana, A; Santos, H; Saturnini, P; Scalas, E; Scomparin, E; Serci, S; Shahoyan, R; Sigaudo, F; Silva, S; Sitta, M; Sonderegger, P; Tarrago, X; Topilskaya, N S; Usai, G L; Vercellin, Ermanno; Villatte, L; Willis, N

    2002-01-01

    The NA38 and NA50 experiments at the CERN SPS have measured charmonium production in different colliding systems with the aim of observing a phase transition from ordinary hadronic matter towards a state in which quarks and gluons are deconfined (quark-gluon plasma, QGP). This experimental research is based on the prediction that the J/ psi yield should be suppressed in deconfined matter. The analysis of the data collected by the NA50 experiment with Pb-Pb collisions at 158 GeV/c per nucleon shows that the J/ psi is anomalously suppressed with respect to the pattern observed in proton-nucleus and light ion reactions. (9 refs).

  1. Wait watchers. Smart organizations are demonstrating that while they can't erase ED wait times, they can leverage technology to keep patients better informed.

    Science.gov (United States)

    Gamble, Kate Huvane

    2010-04-01

    Increases in ED visits are significantly affecting patient access, quality, cost and care management--a trend that is expected to continue. A number of organizations are dealing with the increased demand for services by implementing technologies to keep patients better informed of wait times. Publishing ED wait times online offers hospitals a way to communicate information to patients quickly without requiring a significant investment from the IT staff. Hospitals are also utilizing visibility boards to keep both patients and staff updated on patient conditions and room status.

  2. DNW--"did not wait" or "demographic needing work": a study of the profile of patients who did not wait to be seen in an Irish emergency department.

    LENUS (Irish Health Repository)

    Gilligan, P

    2009-11-01

    Patients who fail to wait for medical assessment in the emergency department (ED) have been referred to in the international literature as "did not wait" (DNW) or "left without being seen" (LWBS) patients or, indeed, simply as "walkouts". This is taken as a performance indicator internationally. In common with many countries, Ireland has very considerable problems in the delivery of ED care due largely to inadequate resources and the inappropriate use of EDs as holding bays for admitted patients. This is the first study of this size to profile the DNW phenomenon in Ireland.

  3. Alleyway Points

    DEFF Research Database (Denmark)

    Lunde Nielsen, Espen; Kruse Aagaard, Anders

    2017-01-01

    topografier. Alleyway Points består af en række eksperimenter, som søger at udforske denne sammenvævning af disse to parallelle domæner gennem en pendulering imellem det fysiske og det digitale. En gyde danner rammen om disse forsøg, hvor den etablerede punktsky i sig selv bliver anskuet som en digital......Forskelligartede former for fotogrammetri og 3D-scanning muliggør indfangelse af den fysiske verden i det digitale domæne. Dette har vist sig instrumentelt i et utal af forskellige henseender. Når virkeligheden bliver digitaliseret, bliver den frigjort fra sine materielle forpligtigelser: der er...... dialog og pendulering mellem de to domæner, hvor grænsen mellem, hvad der kan anskues som det virkelige og repræsentionen deraf, bliver gradvis mere utydelig. Dette adskiller sig fra to dominerende diskurser inden for arbejdsgange mellem det virkelige og det digitale, der ofte er ensrettede bevægelser...

  4. Meson-nucleus potentials and the search for meson-nucleus bound states

    Science.gov (United States)

    Metag, V.; Nanova, M.; Paryev, E. Ya.

    2017-11-01

    Recent experiments studying the meson-nucleus interaction to extract meson-nucleus potentials are reviewed. The real part of the potentials quantifies whether the interaction is attractive or repulsive while the imaginary part describes the meson absorption in nuclei. The review is focused on mesons which are sufficiently long-lived to potentially form meson-nucleus quasi-bound states. The presentation is confined to meson production off nuclei in photon-, pion-, proton-, and light-ion induced reactions and heavy-ion collisions at energies near the production threshold. Tools to extract the potential parameters are presented. In most cases, the real part of the potential is determined by comparing measured meson momentum distributions or excitation functions with collision model or transport model calculations. The imaginary part is extracted from transparency ratio measurements. Results on K+ ,K0 ,K- , η ,η‧ , ω, and ϕ mesons are presented and compared with theoretical predictions. The interaction of K+ and K0 mesons with nuclei is found to be weakly repulsive, while the K- , η ,η‧ , ω and ϕ meson-nucleus potentials are attractive, however, with widely different strengths. Because of meson absorption in the nuclear medium the imaginary parts of the meson-nucleus potentials are all negative, again with a large spread. An outlook on planned experiments in the charm sector is given. In view of the determined potential parameters, the criteria and chances for experimentally observing meson-nucleus quasi-bound states are discussed. The most promising candidates appear to be the η and η‧ mesons.

  5. Application of a Quality Control Circle to Reduce the Wait Times between Continuous Surgeries.

    Science.gov (United States)

    Zhang, Hairong; Wang, Li; Cai, Yueye; Ye, Ronghua; Lin, Jingyi; Jiang, Dongdong

    2015-06-01

    To investigate how to shorten patient wait times between continuous ocular operations and to evaluate the influence of a quality control circle (QCC) on operating room management. QCC management was established to conduct activities. Clinical data were collected to analyze the causes of long wait times between continuous surgeries. Effective measures were undertaken correspondingly. The staff from QCC actively undertook measures that would significantly shorten patient wait times between continuous ocular surgeries (P < 0.05). Multiple measures, such as setting up a QCC, enhancing the arrangement of surgical procedures, establishing effective communication channels, optimizing human resources, and integrating the use of instruments, can effectively shorten patient wait times between continuous vitreous or retinal surgeries.

  6. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about the waiting time and patience distribution in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent...

  7. Restricting kidney transplant wait-listing for obese patients: let's stop defending the indefensible.

    Science.gov (United States)

    Kovesdy, Csaba P; Molnar, Miklos Z

    2014-01-01

    The allocation of limited medical resources represents an ethical dilemma that continues to generate lively debates. While the allocation of allografts to wait-listed patients is done in a transparent manner, with its rules open to public debate and prone to continuous improvement, the practice of wait-listing is not centrally regulated, and its rules are often less scrutinized. Denial of kidney transplant wait-listing to obese individuals has been a common practice by most transplant centers. On the face of it, this practice is justified by commonly accepted ethical standards, yet there is now mounting evidence that these justifications do not withstand closer scrutiny. A candid and open debate in the Nephrology and Transplant community is needed to examine the true motivations that underlie the practice of denying wait-listing to obese individuals, and to find a solution that is truly in the best interest of our patients. © 2014 Wiley Periodicals, Inc.

  8. Study on the interaction between the food and beverage servicescape and customer waiting experience

    National Research Council Canada - National Science Library

    Yang, Chih-Yun

    2014-01-01

    .... Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service...

  9. Continuous time random walk with generic waiting time and external force.

    Science.gov (United States)

    Fa, Kwok Sau; Wang, K G

    2010-05-01

    We derive an integrodifferential diffusion equation for decoupled continuous time random walk that is valid for a generic waiting time probability density function and external force. Using this equation we also study diffusion behaviors for a couple of specific waiting time probability density functions such as exponential, a combination of power law and generalized Mittag-Leffler function and a sum of exponentials under the influence of a harmonic trap. We show that first two waiting time probability density functions can reproduce the results of the ordinary and fractional diffusion equations for all the time regions from small to large times. But the third one shows a much more complicated pattern. Furthermore, from the integrodifferential diffusion equation we show that the second Einstein relation can hold for any waiting time probability density function.

  10. Psychosocial and Patient Education Needs of Prostate Cancers Selecting Watchful Waiting

    National Research Council Canada - National Science Library

    Knight, Sara J; Latini, David M

    2006-01-01

    ... of this approach to disease management. We propose to gather data from prostate cancer patients selecting watchful waiting in lieu of an active treatment for their cancer in order to understand the psychosocial and symptom management...

  11. Aspects of Coulomb dissociation and interference in peripheral nucleus-nucleus collisions

    Energy Technology Data Exchange (ETDEWEB)

    Nystrand, Joakim; Baltz, Anthony; Klein, Spencer R.

    2001-10-21

    Coherent vector meson production in peripheral nucleus-nucleus collisions is discussed. These interactions may occur for impact parameters much larger than the sum of the nuclear radii. Since the vector meson production is always localized to one of the nuclei, the system acts as a two-source interferometer in the transverse plane. By tagging the outgoing nuclei for Coulomb dissociation it is possible to obtain a measure of the impact parameter and thus the source separation in the interferometer. This is of particular interest since the life-time of the vector mesons are generally much shorter than the impact parameters of the collisions.

  12. Gender Disparity in Liver Transplant Waiting List Mortality: The Importance of Kidney Function

    Science.gov (United States)

    Mindikoglu, Ayse L.; Regev, Arie; Seliger, Stephen L.; Magder, Laurence S.

    2011-01-01

    Previous studies of men and women on the liver transplant (LT) waiting list suggested a higher risk of mortality for women while on the waiting list without taking transplantation rates into account. The objective of this study was to compare men and women with respect of dying within three years of registration on the LT waiting list taking into account both the immediate mortality risks and transplantation rates. The analysis was based on Organ Procurement and Transplantation Network data of patients with End-Stage Liver Disease (ESLD) on the waiting list registered between February 2002 and August 2009. Competing risk survival analysis was performed to assess gender disparity in waiting list mortality. 42,322 patients and 610,762 person-months of waiting list experience were included in the analysis. The risk of dying within three years of listing was 19% and 17% in women and men, respectively (P<0.0001). Among patients with kidney disease, especially those with estimated glomerular filtration rate (eGFR) ≥ 15 and < 30 ml/min/1.73m2, not on dialysis, women had a substantially higher risk of dying on the waiting list within three years of registration than men (26% vs. 20%, P=0.001). This disparity was related to lower transplantation rates in women; (transplantation rate ratio=0.68, P<0.0001). Controlling for eGFR and other variables related to mortality risk, the overall female-male disparity disappeared. In conclusion, among patients with ESLD with kidney dysfunction, not on dialysis, there is a substantial gender disparity in LT waiting list mortality. Our analysis suggests that this is explained by the fact that, in this group, women had lower transplant rates than men. The lower transplant rates can be explained, in part, by the fact that MELD scores tend to be lower for women than for men as they are based on serum creatinine rather than GFR. PMID:20879013

  13. Radiotherapy waiting times for women with breast cancer: a population-based cohort study.

    OpenAIRE

    Jack, RH; Davies, EA; Robinson, D; Sainsbury, R.; Moller, H.

    2007-01-01

    Abstract Background Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods 35,354 women resid...

  14. Radiotherapy waiting times for women with breast cancer: a population-based cohort study

    OpenAIRE

    Jack, R H; Davies, E A; Robinson, D; Sainsbury, R.; Møller, H

    2007-01-01

    Background: Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods: 35,354 women r...

  15. Intake of wine, beer and spirits and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

    2003-01-01

    A high intake of alcohol may prolong waiting time to pregnancy, whereas a moderate intake may have no or perhaps even a positive effect on fecundity. In previous studies on fecundity, different types of beverages have not been taken into consideration, although moderate wine drinkers appear to ha...... fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy....

  16. Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safe

    DEFF Research Database (Denmark)

    Kokotovic, D; Sjølander, H; Gögenur, I

    2016-01-01

    PURPOSE: Due to risks of postoperative morbidity and recurrence some patients with a ventral hernia are not offered surgical repair. There is limited data on the rate and consequences of a watchful waiting (WW) strategy for these patients. The objective of this cohort study was to analyse outcome...... and umbilical/epigastric hernias. CONCLUSIONS: Watchful waiting appears to be a safe strategy in the treatment of incisional, umbilical and epigastric hernias....

  17. Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department.

    Science.gov (United States)

    Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

    2016-01-01

    Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the "bed area" server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

  18. 'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot

    Directory of Open Access Journals (Sweden)

    Amy Burnside

    2011-01-01

    Full Text Available 'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot Amy Burnside, Queen's University BelfastFollow Recommended Citation Burnside, Amy (2013 "'He Thinks He's Entangled in a Net': the Web of Continental Associations in Waiting for Godot," Journal of Franco-Irish Studies: Vol. 3: Iss. 1, Article 7. Available at: http://arrow.dit.ie/jofis/vol3/iss1/7

  19. An exceptionally bright, compact starburst nucleus

    Science.gov (United States)

    Margon, Bruce; Anderson, Scott F.; Mateo, Mario; Fich, Michel; Massey, Philip

    1988-01-01

    Observations are reported of a remarkably bright (V about 13) starburst nucleus, 0833 + 652, which has been detected at radio, infrared, optical, ultraviolet, and X-ray wavelengths. Despite an observed flux at each of these wavelengths which is comparable to that of NGC 7714, often considered the 'prototypical' example of the starburst phenomenon, 0833 + 652 appears to be a previously uncataloged object. Its ease of detectability throughout the electromagnetic spectrum should make it useful for a variety of problems in the study of compact emission-line galaxies.

  20. Lectures on the theory of the nucleus

    CERN Document Server

    Sitenko, Aleksej Grigorevich

    1975-01-01

    Provides an advanced and up-to-date account of the theory of nuclear structure and discusses in considerable detail both the superfluid and collective models of the nucleus, in addition to earlier complementary models and theories. The book also examines other important topics such as the rotational and vibrational spectra of nuclei which have not previously been treated in such depth. To summarize, it covers a large amount of theoretical ground in one volume and attempts to fill a serious gap in the literature. Many problems are included

  1. Contemporary models of the atomic nucleus

    CERN Document Server

    Nemirovskii, P E

    2013-01-01

    Contemporary Models of the Atomic Nucleus discusses nuclear structure and properties, expounding contemporary theoretical concepts of the low-energy nuclear processes underlying in nuclear models. This book focuses on subjects such as the optical nuclear model, unified or collective model, and deuteron stripping reaction. Other topics discussed include the basic nuclear properties; shell model; theoretical analysis of the shell model; and radiative transitions and alpha-decay. The deuteron theory and the liquid drop nuclear model with its application to fission theory are also mentioned, but o

  2. The experience of waiting and life during breast cancer follow-up.

    Science.gov (United States)

    Gaudine, Alice; Sturge-Jacobs, Marilyn; Kennedy, Mary

    2003-01-01

    Much research exists on quality of life issues with breast cancer survivors. However, there has been little done on the waiting experience itself, and on the experience of follow-up from the women's perspective. Women who have been diagnosed and treated for breast cancer live with the condition for a minimum of 5 years, waiting for the next medical intervention; waiting for the next battery of tests; waiting for the next physician check-up. Throughout most of these years they may feel healthy, but they experience visits to cancer clinics, medical testing, and physician interactions. Women's accounts of their experiences of waiting and life during follow-up for breast cancer has not been the focus of research on the quality of life of breast cancer survivors. In particular research that uses a qualitative approach, in which women recount their experiences in their own language, has been missing. This study used a phenomenological approach, telling the stories of waiting and life throughout follow-up of nine women. The women's experiences are captured in four themes: life-changing; a sense of belonging; uncertainty; needing to know.

  3. Effect of an audiovisual message for tetanus booster vaccination broadcast in the waiting room.

    Science.gov (United States)

    Eubelen, Caroline; Brendel, Fannette; Belche, Jean-Luc; Freyens, Anne; Vanbelle, Sophie; Giet, Didier

    2011-09-28

    General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination. A quasi experimental study was conducted in a Belgian medical practice consisting of 6 GPs and 4 waiting rooms (total: 20,000 contacts/year). A tetanus booster vaccination audiovisual message was continuously broadcast for 6 months in 2 randomly selected waiting rooms (intervention group--3 GPs) while the other 2 waiting rooms remained unequipped (control group--3 GPs). At the end of the 6-month period, the number of vaccine adult-doses delivered by local pharmacies in response to GPs' prescriptions was recorded. As a reference, the same data were also collected retrospectively for the general practice during the same 6-month period of the previous year. During the 6-month reference period where no audiovisual message was broadcast in the 4 waiting rooms, the number of prescriptions presented for tetanus vaccines was respectively 52 (0.44%) in the intervention group and 33 (0.38%) in the control group (p = 0.50). By contrast, during the 6-month study period, the number of prescriptions differed between the two groups (p Broadcasting an audiovisual health education message in the GPs' waiting room was associated with a significant increase in the number of adult tetanus booster vaccination prescriptions delivered by local pharmacies.

  4. Scaling laws of ambush predator 'waiting' behaviour are tuned to a common ecology.

    Science.gov (United States)

    Wearmouth, Victoria J; McHugh, Matthew J; Humphries, Nicolas E; Naegelen, Aurore; Ahmed, Mohammed Z; Southall, Emily J; Reynolds, Andrew M; Sims, David W

    2014-05-07

    The decisions animals make about how long to wait between activities can determine the success of diverse behaviours such as foraging, group formation or risk avoidance. Remarkably, for diverse animal species, including humans, spontaneous patterns of waiting times show random 'burstiness' that appears scale-invariant across a broad set of scales. However, a general theory linking this phenomenon across the animal kingdom currently lacks an ecological basis. Here, we demonstrate from tracking the activities of 15 sympatric predator species (cephalopods, sharks, skates and teleosts) under natural and controlled conditions that bursty waiting times are an intrinsic spontaneous behaviour well approximated by heavy-tailed (power-law) models over data ranges up to four orders of magnitude. Scaling exponents quantifying ratios of frequent short to rare very long waits are species-specific, being determined by traits such as foraging mode (active versus ambush predation), body size and prey preference. A stochastic-deterministic decision model reproduced the empirical waiting time scaling and species-specific exponents, indicating that apparently complex scaling can emerge from simple decisions. Results indicate temporal power-law scaling is a behavioural 'rule of thumb' that is tuned to species' ecological traits, implying a common pattern may have naturally evolved that optimizes move-wait decisions in less predictable natural environments.

  5. Improvement of Waiting Time for Patients Referring to Emergency Room Using Discrete Event Simulation

    Directory of Open Access Journals (Sweden)

    Y Zare Mehrjardi

    2011-07-01

    Full Text Available Introduction: Many simulation studies have been conducted in the hospitals and first in the emergency departments to increase the productivity. The first issue in the field of service quality and hence the patient right is “waiting time”. The goal of this study was to reduce patients waiting times, emergency service timing, modeling and improving using discrete event simulation. Methods: This was a descriptive - analytical study by the cross-sectional method on 150 patients referred to the emergency department in a public hospital. All necessary data were collected using questionnaire and through observation. Simulation model was designed using Arena software. Results: Our computer simulation model indicates that the maximum waiting time is the time waited for the test request till the results are received by the MD and also the time is necessary for the consultation and examination purposes. Among the five different scenarios, alternative 5 is more interesting economically since it requires only three additional staffs to bring down waiting times. Conclusion: According to research results, to reduce patient waiting time, the Triage processing in the emergency departments and the employment of emergency medicine expert, and the ordering of the diagnostic processes in the early stages of treatment as such as laboratory ordering for emergency patients are of main necessity.

  6. [Reducing patient waiting time for the outpatient phlebotomy service using six sigma].

    Science.gov (United States)

    Kim, Yu Kyung; Song, Kyung Eun; Lee, Won Kil

    2009-04-01

    One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

  7. Waiting times for surgical and diagnostic procedures in public hospitals in Mexico.

    Science.gov (United States)

    Contreras-Loya, David; Gómez-Dantés, Octavio; Puentes, Esteban; Garrido-Latorre, Francisco; Castro-Tinoco, Manuel; Fajardo-Dolci, Germán

    2015-01-01

    A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS), the Institute for Social Security and Social Services for Civil Servants (ISSSTE) and the Ministry of Health (MoH). Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions. We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems. Mean waiting time for the seven surgical procedures in the three institutions was 14 weeks. IMSS and ISSSTE hospitals showed better performance (12 and 13 weeks) than the MoH hospitals (15 weeks). Mean waiting time for the four diagnostic procedures was 11 weeks. IMSS hospitals (10 weeks) showed better average waiting times than ISSSTE (12 weeks) and MoH hospitals (11 weeks). Substantial variations were revealed, not only among institutions but also within the same institution. These variations need to be addressed in order to improve patient satisfaction.

  8. Waiting times for surgical and diagnostic procedures in public hospitals in Mexico

    Directory of Open Access Journals (Sweden)

    David Contreras-Loya

    2015-01-01

    Full Text Available Objective. A retrospective evaluation of waiting times for elective procedures was conducted in a sample of Mexican public hospitals from the following institutions: the Mexican Institute for Social Security (IMSS, the Institute for Social Security and Social Services for Civil Servants (ISSSTE and the Ministry of Health (MoH. Our aim was to describe current waiting times and identify opportunities to redistribute service demand among public institutions. Materials and methods. We examined current waiting times and productivity for seven elective surgical and four diagnostic imaging procedures, selected on the basis of their relative frequency and comparability with other national health systems. Results. Mean waiting time for the seven surgical procedures in the three institutions was 14 weeks. IMSS and ISSSTE hospitals showed better performance (12 and 13 weeks than the MoH hospitals (15 weeks. Mean waiting time for the four diagnostic procedures was 11 weeks. IMSS hospitals (10 weeks showed better average waiting times than ISSSTE (12 weeks and MoH hospitals (11 weeks. Conclusion. Substantial variations were revealed, not only among institutions but also within the same institution. These variations need to be addressed in order to improve patient satisfaction.

  9. Waiting time distribution revealing the internal spin dynamics in a double quantum dot

    Science.gov (United States)

    Ptaszyński, Krzysztof

    2017-07-01

    Waiting time distribution and the zero-frequency full counting statistics of unidirectional electron transport through a double quantum dot molecule attached to spin-polarized leads are analyzed using the quantum master equation. The waiting time distribution exhibits a nontrivial dependence on the value of the exchange coupling between the dots and the gradient of the applied magnetic field, which reveals the oscillations between the spin states of the molecule. The zero-frequency full counting statistics, on the other hand, is independent of the aforementioned quantities, thus giving no insight into the internal dynamics. The fact that the waiting time distribution and the zero-frequency full counting statistics give a nonequivalent information is associated with two factors. Firstly, it can be explained by the sensitivity to different timescales of the dynamics of the system. Secondly, it is associated with the presence of the correlation between subsequent waiting times, which makes the renewal theory, relating the full counting statistics and the waiting time distribution, no longer applicable. The study highlights the particular usefulness of the waiting time distribution for the analysis of the internal dynamics of mesoscopic systems.

  10. The design and testing of interactive hospital spaces to meet the needs of waiting children.

    Science.gov (United States)

    Biddiss, Elaine; McPherson, Amy; Shea, Geoffrey; McKeever, Patricia

    2013-01-01

    To design an innovative interactive media display in a pediatric hospital clinic waiting space that addresses the growing demand for accessible, contact-surface-free options for play. In healthcare settings, waiting can be anxiety provoking for children and their accompanying family members. Opportunities for positive distraction have been shown to reduce waiting anxiety, leading to positive health outcomes. An interactive media display, ScreenPlay, was created and evaluated using a participatory design approach and a combination of techniques including quality function deployment and mixed data elicitation methods (questionnaires, focus groups, and observations). The user and organizational design requirements were established and used to review contemporary strategies for positive distraction in healthcare waiting spaces and to conceptualize and test ScreenPlay. Ten staff members, 11 children/youths, and 6 parents participated in the design and evaluation of ScreenPlay. ScreenPlay provided a positive, engaging experience without the use of contact surfaces through which infections can be spread. It was accessible to children, youth, and adults of all motor abilities. All participants strongly agreed that the interactive media display would improve the healthcare waiting experience. ScreenPlay is an interactive display that is the result of a successful model for the design of healthcare waiting spaces that is collaborative, interdisciplinary, and responsive to the needs of its community. Design process, healing environments, hospital, interdisciplinary, pediatric.

  11. Reasons military patients with primary care access leave an emergency department waiting room before seeing a provider.

    Science.gov (United States)

    Varney, Shawn M; Vargas, Toni E; Pitotti, Rebecca L; Bebarta, Vikhyat S

    2012-10-01

    Our objective was to assess patients' understanding of emergency department (ED) wait times and why patients may leave the waiting room before seeing a provider. Survey of patients in the ED waiting room of an urban tertiary care military hospital where civilian and military patients are treated. A total of 508/517 surveys (98%) were completed. Age ranges were 18 to 35 years (49%), 36 to 60 (31%), or older than 60 (20%). Education levels were high school (20%), some college (37%), or college graduate (39%). Of 503 respondents, 125 (25%) had left an ED waiting room before seeing a provider. The reasons included excessive wait times (91%) and family responsibilities (5%). Five hundred eight reported the factors that would motivate them to wait to see the physician (not leave without being seen [LWOBS]) were the severity of illness (64%), and if they received an update of wait times (26%); 82% (391/480) understood that severely ill patients were seen first. Patients attributed long wait times to doctors and nurses caring for other patients (292/583, 50%) and insufficient physician and nurse staffing (245, 42%). Of 802 responses for ideas to improve the wait, 34% said regular updates on estimated wait times, 21% said television shows or movies to view, 20% said books and magazines to read, and 11% said computers to access. Long wait times were the primary reason that patients left before seeing a provider, despite having ready access to care. Respondents attributed long wait times to patient volume and inadequate staffing. Regular updates on wait times and material for entertainment may improve the waiting experience and reduce LWOBS.

  12. Reducing Patient Waiting Times for Radiation Therapy and Improving the Treatment Planning Process: a Discrete-event Simulation Model (Radiation Treatment Planning).

    Science.gov (United States)

    Babashov, V; Aivas, I; Begen, M A; Cao, J Q; Rodrigues, G; D'Souza, D; Lock, M; Zaric, G S

    2017-06-01

    We analysed the radiotherapy planning process at the London Regional Cancer Program to determine the bottlenecks and to quantify the effect of specific resource levels with the goal of reducing waiting times. We developed a discrete-event simulation model of a patient's journey from the point of referral to a radiation oncologist to the start of radiotherapy, considering the sequential steps and resources of the treatment planning process. We measured the effect of several resource changes on the ready-to-treat to treatment (RTTT) waiting time and on the percentage treated within a 14 calendar day target. Increasing the number of dosimetrists by one reduced the mean RTTT by 6.55%, leading to 84.92% of patients being treated within the 14 calendar day target. Adding one more oncologist decreased the mean RTTT from 10.83 to 10.55 days, whereas a 15% increase in arriving patients increased the waiting time by 22.53%. The model was relatively robust to the changes in quantity of other resources. Our model identified sensitive and non-sensitive system parameters. A similar approach could be applied by other cancer programmes, using their respective data and individualised adjustments, which may be beneficial in making the most effective use of limited resources. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  13. Not all waits are equal: an exploratory investigation of emergency care patient pathways.

    Science.gov (United States)

    Swancutt, Dawn; Joel-Edgar, Sian; Allen, Michael; Thomas, Daniel; Brant, Heather; Benger, Jonathan; Byng, Richard; Pinkney, Jonathan

    2017-06-24

    Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals. VSM timing data were collected for patients accessing acute care at four hospitals in South West England. Data were categorised according to waits and activities, which were compared across sites to identify variations in practice from the patient viewpoint. We included Public and Patient Involvement (PPI) to fully interpret our findings; observations and initial findings were considered in a PPI workshop. One hundred eight patients were recruited, comprising 25,432 min of patient time containing 4098 episodes of care or waiting. The median patient journey was 223 min (3 h, 43 min); just within the 4-h target. Although total patient journey times were similar between sites, the stage where the greatest proportion of waiting occurred varied. Reasons for waiting were dominated by waits for beds, investigations or results to be available. From our sample we observed that EDs without a discharge/clinical decision area exhibited a greater proportion of waiting time following an admission or discharge decision. PPI interpretation indicated that patients who experience waits at the beginning of their journey feel more anxious because they are 'not in the system yet'. The novel application of VSM analysis across different hospitals, coupled with PPI interpretation, provides important insight into the impact of care provision on patient experience. Measures that could reduce patient

  14. Emergency department waiting times: Do the raw data tell the whole story?

    Science.gov (United States)

    Green, Janette; Dawber, James; Masso, Malcolm; Eagar, Kathy

    2014-02-01

    To determine whether there are real differences in emergency department (ED) performance between Australian states and territories. Cross-sectional analysis of 2009-10 attendances at an ED contributing to the Australian non-admitted patient ED care database. The main outcome measure was difference in waiting time across triage categories. There were more than 5.8 million ED attendances. Raw ED waiting times varied by a range of factors including jurisdiction, triage category, geographic location and hospital peer group. All variables were significant in a model designed to test the effect of jurisdiction on ED waiting times, including triage category, hospital peer group, patient socioeconomic status and patient remoteness. When the interaction between triage category and jurisdiction entered the model, it was found to have a significant effect on ED waiting times (P<0.001) and triage was also significant (P<0.001). Jurisdiction was no longer statistically significant (P=0.248 using all triage categories and 0.063 using only Australian Triage Scale 2 and 3). Although the Council of Australian Governments has adopted raw measures for its key ED performance indicators, raw waiting time statistics are misleading. There are no consistent differences in ED waiting times between states and territories after other factors are accounted for. WHAT IS KNOWN ABOUT THE TOPIC? The length of time patients wait to be treated after presenting at an ED is routinely used to measure ED performance. In national health agreements with the federal government, each state and territory in Australia is expected to meet waiting time performance targets for the five ED triage categories. The raw data indicate differences in performance between states and territories. WHAT DOES THIS PAPER ADD? Measuring ED performance using raw data gives misleading results. There are no consistent differences in ED waiting times between the states and territories after other factors are taken into account

  15. Neurochemical organization of the nucleus paramedianus dorsalis in the human

    OpenAIRE

    Baizer, Joan S.; Baker, James F.; Haas, Kristin; Lima, Raquel

    2007-01-01

    We have characterized the neurochemical organization of a small brainstem nucleus in the human brain, the nucleus paramedianus dorsalis (PMD). PMD is located adjacent and medial to the nucleus prepositus hypoglossi (PH) in the dorsal medulla, and is distinguished by the pattern of immunoreactivity of cells and fibers to several markers including calcium-binding proteins, a synthetic enzyme for nitric oxide (neuronal nitric oxide synthase, nNOS) and a nonphosphorylated neurofilament protein (a...

  16. Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: randomised controlled trial in primary care

    Science.gov (United States)

    Wiegersma, Marian; Panman, Chantal M C R; Kollen, Boudewijn J; Berger, Marjolein Y; Lisman-Van Leeuwen, Yvonne

    2014-01-01

    Objective To compare the effects of pelvic floor muscle training and watchful waiting on pelvic floor symptoms in a primary care population of women aged 55 years and over with symptomatic mild pelvic organ prolapse. Design Randomised controlled trial. Setting Dutch primary care. Participants Women aged 55 years or over with symptomatic mild prolapse (leading edge above the hymen) were identified by screening. Exclusion criteria were current prolapse treatment or treatment in the previous year, malignancy of pelvic organs, current treatment for another gynaecological disorder, severe/terminal illness, impaired mobility, cognitive impairment, and insufficient command of the Dutch language. Interventions Pelvic floor muscle training versus watchful waiting. Main outcome measures The primary outcome was change in bladder, bowel, and pelvic floor symptoms measured with the Pelvic Floor Distress Inventory-20 (PFDI-20), three months after the start of treatment. Secondary outcomes were changes in condition specific and general quality of life, sexual function, degree of prolapse, pelvic floor muscle function, and patients’ perceived change in symptoms. Results Of the 287 women who were randomised to pelvic floor muscle training (n=145) or watchful waiting (n=142), 250 (87%) completed follow-up. Participants in the intervention group improved by (on average) 9.1 (95% confidence interval 2.8 to 15.4) points more on the PFDI-20 than did participants in the watchful waiting group (P=0.005). Of women in the pelvic floor muscle training group, 57% (82/145) reported an improvement in overall symptoms from the start of the study compared with 13% (18/142) in the watchful waiting group (Ppelvic floor muscle training led to a significantly greater improvement in PFDI-20 score, the difference between the groups was below the presumed level of clinical relevance (15 points). Nevertheless, 57% of the participants in the intervention group reported an improvement of overall symptoms

  17. The experience of waiting for a kidney transplant: A qualitative study.

    Science.gov (United States)

    Burns, Tania; Fernandez, Ritin; Stephens, Moira

    2017-12-01

    In Australia over 1100 people are living on dialysis while waiting for a kidney transplant from a deceased donor. Worldwide there are an estimated 170,000 people who wait an average of three years before an organ becomes available. To provide an understanding of the lived experience of people waiting on dialysis for a kidney transplant from a deceased donor. A qualitative descriptive research design was used. Participants were recruited from a large metropolitan hospital. Two focus groups were conducted with six participants ranging in age from 29-63 years, with dialysis experience of 10-72 months. Data saturation was achieved and thematic analysis was used to interpret the data providing a descriptive account of the experience of waiting for a kidney transplant. Waiting for a kidney transplant takes place in the context of living on dialysis. Four main themes were identified: living on dialysis is physically and mentally demanding; living with uncertainty; altered relationship dynamics; and feelings towards the deceased donor. This study provides a descriptive summary of what it is like to live on dialysis while waiting for a kidney transplant from a deceased donor from the perspective of the person waiting. People are burdened by; uncertainty; the experience of the dialysis therapy; and the thought of the human cost of transplantation. These findings suggest that this cohort may benefit from strategies to relieve uncertainty such as effective communication from the treating team and peer support from the dialysis community. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  18. List and liver transplant survival according to waiting time in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Salvalaggio, P R; Felga, G; Axelrod, D A; Della Guardia, B; Almeida, M D; Rezende, M B

    2015-03-01

    The time that patients with hepatocellular carcinoma (HCC) can safely remain on the waiting list for liver transplantation (LT) is unknown. We investigated whether waiting time on the list impacts transplant survival of HCC candidates and transplant recipients. This is a single-center retrospective study of 283 adults with HCC. Patients were divided in groups according to waiting-list time. The main endpoint was survival. The median waiting time for LT was 4.9 months. The dropout rates at 3-, 6-, and 12-months were 6.4%, 12.4%, and 17.7%, respectively. Mortality on the list was 4.8%, but varied depending of the time on the list. Patients who waited less than 3-months had an inferior overall survival when compared to the other groups (p = 0.027). Prolonged time on the list significantly reduced mortality in this analysis (p = 0.02, HR = 0.28). Model for End Stage Liver Disease (MELD) score at transplantation did also independently impact overall survival (p = 0.03, HR = 1.06). MELD was the only factor that independently impacted posttransplant survival (p = 0.048, HR = 1.05). We conclude that waiting time had no relation with posttransplant survival. It is beneficial to prolong the waiting list time for HCC candidates without having a negative impact in posttransplant survival. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  19. Radiotherapy waiting times for women with breast cancer: a population-based cohort study.

    Science.gov (United States)

    Jack, Ruth H; Davies, Elizabeth A; Robinson, David; Sainsbury, Richard; Møller, Henrik

    2007-05-01

    Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%), and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments.

  20. Radiotherapy waiting times for women with breast cancer: a population-based cohort study

    Directory of Open Access Journals (Sweden)

    Sainsbury Richard

    2007-05-01

    Full Text Available Abstract Background Waiting times for cancer patients are a national priority in the UK. Previous studies have shown variation between cancer networks in the time between diagnosis and start of radiotherapy for all cancer patients. Studies of the relationship between delay in receiving treatment and survival of breast cancer patients have been inconsistent. This study aimed to examine factors associated with waiting times for radiotherapy for breast cancer patients. Methods 35,354 women resident in South East England and diagnosed with breast cancer between 1992 and 2001 who received radiotherapy within six months of diagnosis were identified from the Thames Cancer Registry. Time to radiotherapy was measured from either the date of diagnosis or the start of the previous treatment, whichever was shorter. Unadjusted and adjusted logistic regression models were fitted to examine whether patients received radiotherapy within 60 days of their diagnosis or previous treatment. Results The adjusted proportions of patients receiving radiotherapy within 60 days varied significantly between different cancer networks (range: 43% to 81%, and decreased from 68% in 1992 to 33% in 2001. After adjustment there was no association between deprivation of area of residence, age or stage and radiotherapy wait. Median time waited to radiotherapy increased over the study period whether measured from the start of chemotherapy, hormone therapy, surgery or the date of diagnosis. Conclusion This study covered a period of time before the investment following the Cancer Plan of 2000. Results are consistent with other findings suggesting variation between cancer networks and increasing waits over time. Further studies should examine different methods of measuring waiting time, the causes and consequences of waits for radiotherapy and the effect of current initiatives and investments.

  1. Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

    Directory of Open Access Journals (Sweden)

    Hourvash Akbari Haghighinejad

    2016-01-01

    Full Text Available Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14 was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity. The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the numberwaiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution.

  2. Nucleus and nucleus-cytoskeleton connections in 3D cell migration

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Lingling, E-mail: liulingling2012@163.com; Luo, Qing, E-mail: qing.luo@cqu.edu.cn; Sun, Jinghui, E-mail: sunjhemail@163.com; Song, Guanbin, E-mail: song@cqu.edu.cn

    2016-10-15

    Cell migration plays an important role in many physiological and pathological settings, ranging from embryonic development to cancer metastasis. Currently, accumulating data suggest that cells migrating in three-dimensional (3D) environments show well-defined differences compared to their well-established two-dimensional (2D) counterparts. During 3D migration, the cell body and nucleus must deform to allow cellular passage through the available spaces, and the deformability of the relatively rigid nucleus may constitute a limiting step. Here, we highlight the key evidence regarding the role of the nuclear mechanics in 3D migration, including the molecular components that govern the stiffness of the nucleus and review how the nuclear dynamics are connected to and controlled by cytoskeleton-based migration machinery. Intriguingly, nuclear movement must be coordinated with the cytoskeletal dynamics at the leading and trailing edges, which in turn impact the cytoplasmic dynamics that affect the migration efficiency. Thus, we suggest that alterations in the nuclear structure may facilitate cellular reorganizations that are necessary for efficient migration. - Graphical abstract: Schematic representations of a cell migrating on a 2D substrate and a cell migrating in a 3D extracellular matrix environment. (A) Nucleus-cytoskeleton connections are essential to 3D migration. Mechanical signals are transduced by integrins at the cell surface and channeled to cytoskeletal proteins, which generates prestress. The nucleus-cytoskeleton connections can either act as a stable skeleton to anchor the nuclei or provide active force to move the nuclei. The LINC complex is responsible for the nucleo-cytoskeletal coupling. Nesprins connect the cytoskeletal proteins to the inner nuclear membrane proteins SUN1 and SUN2. The SUN proteins connect to the lamins that form the lamina, which attaches to the chromatin. This physical connectivity transmits the mechanical signals from receptors at

  3. Freeze, Wait, Reanimate: Cryonic Suspension and Science Fiction

    Science.gov (United States)

    Shoffstall, Grant

    2010-01-01

    This essay takes as its chief point of departure Jacques Ellul's contention that imaginative treatments of malevolent technology in antitechnological science fiction, by way of inviting rejection, refusal, dismissal, or condemnation, conspire in facilitating human acceptance of and adjustment to technology as it otherwise presently is. The author…

  4. HIV MANAGEMENT ON A NEVER-ENDING WAITING LIST

    African Journals Online (AJOL)

    2006-12-01

    Poor Health Policy Team, and, .... the director of a local hospice pointed out, 'The problem with clinics is that they don't see those behind their wall' – in .... Ministry of Education. The practice of privileging the employed and civil ...

  5. Delta-nucleus dynamics: proceedings of symposium

    Energy Technology Data Exchange (ETDEWEB)

    Lee, T.S.H.; Geesaman, D.F.; Schiffer, J.P. (eds.)

    1983-10-01

    The appreciation of the role in nuclear physics of the first excited state of the nucleon, the delta ..delta..(1232), has grown rapidly in the past decade. The delta resonance dominates nuclear reactions induced by intermediate energy pions, nucleons, and electromagnetic probes. It is also the most important non-nucleonic degree of freedom needed to resolve many fundamental problems encountered in the study of low-energy nuclear phenomena. Clearly, a new phase of nuclear physics has emerged and conventional thinking must be extended to account for this new dimension of nuclear dynamics. The most challenging problem we are facing is how a unified theory can be developed to describe ..delta..-nucleus dynamics at all energies. In exploring this new direction, it is important to have direct discussions among researchers with different viewpoints. Separate entries were prepared for the 49 papers presented. (WHK)

  6. Observation of the antimatter helium-4 nucleus.

    Science.gov (United States)

    2011-05-19

    High-energy nuclear collisions create an energy density similar to that of the Universe microseconds after the Big Bang; in both cases, matter and antimatter are formed with comparable abundance. However, the relatively short-lived expansion in nuclear collisions allows antimatter to decouple quickly from matter, and avoid annihilation. Thus, a high-energy accelerator of heavy nuclei provides an efficient means of producing and studying antimatter. The antimatter helium-4 nucleus (4He), also known as the anti-α (α), consists of two antiprotons and two antineutrons (baryon number B = -4). It has not been observed previously, although the α-particle was identified a century ago by Rutherford and is present in cosmic radiation at the ten per cent level. Antimatter nuclei with B antimatter nuclei and a benchmark for possible future observations of 4He in cosmic radiation.

  7. MR findings of degenerative changes of nucleus pulposus in lumbar spine: sequential changes after disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Joon [Choong-Ang Gil Hospital, Seoul (Korea, Republic of); Cha, Yoo Mi; Hwang, Hee Young [College of Medicine, Dankook University, Chenoan (Korea, Republic of)

    1994-04-15

    To evaluate the relationship between MR changes of the nucleus pulposus and the time interval after traumatic disc herniation. T2-weighted MR images of 132 patients with back pain and/or sciatica were reviewed. The changes of signal intensity, central cleft and height of the nucleus pulposus were used as criteria of disc degeneration and they were graded as normal, mild, moderate and severe degree of degeneration. Putting these criteria together we provided integrated grade of degeneration of the nucleus pulposus(grade 0-3). To get the preliminary data for normal and age-related disc degeneration, we measured the disc height by age groups and disc levels and analyzed the relationship between the age of the patients and the signal intensity, cleft and height in normal disc levels of the 132 patients. In 68 patients of 88 levels disc herniation, we analyzed the relationship between symptom duration and the degree of degeneration. Among these 68 patients we selected 14 patients(16 levels) who were under 30 years of age and had history of recent trauma to minimize data distortion from age related degeneration and ambiguity of initiation point of degeneration. In this group we analyzed the relationship between the time period after traumatic disc herniation and the degree of degeneration. The age of the patient had close relationship with the grade of signal intensity, central cleft, and disc height and grade of degeneration of the nucleus pulposus in normal discs. In 88 levels of herniated discs, the duration of symptom and degree of degeneration showed moderate correlation. In 14 patients of disc herniation who were under 30 years old and had trauma history in recent 2 years, grade 1 disc degeneration occurred in average 3.7 months after trauma. Although it was difficult to proceed statistical analysis in the last group because of small patients number, the degree of degeneration of nucleus pulposus had close relationship with the duration after traumas or duration of

  8. Calcium microdomains in mitochondria and nucleus.

    Science.gov (United States)

    Alonso, María Teresa; Villalobos, Carlos; Chamero, Pablo; Alvarez, Javier; García-Sancho, Javier

    2006-01-01

    Endomembranes modify the progression of the cytosolic Ca(2+) wave and contribute to generate Ca(2+) microdomains, both in the cytosol and inside the own organella. The concentration of Ca(2+) in the cytosol ([Ca(2+)](C)), the mitochondria ([Ca(2+)](M)) and the nucleus ([Ca(2+)](N)) are similar at rest, but may become very different during cell activation. Mitochondria avidly take up Ca(2+) from the high [Ca(2+)](C) microdomains generated during cell activation near Ca(2+) channels of the plasma membrane and/or the endomembranes and prevent propagation of the high Ca(2+) signal to the bulk cytosol. This shaping of [Ca(2+)](C) signaling is essential for independent regulation of compartmentalized cell functions. On the other hand, a high [Ca(2+)](M) signal is generated selectively in the mitochondria close to the active areas, which tunes up respiration to the increased local needs. The progression of the [Ca(2+)](C) signal to the nucleus may be dampened by mitochondria, the nuclear envelope or higher buffering power inside the nucleoplasm. On the other hand, selective [Ca(2+)](N) signals could be generated by direct release of stored Ca(2+) into the nucleoplasm. Ca(2+) release could even be restricted to subnuclear domains. Putative Ca(2+) stores include the nuclear envelope, their invaginations inside the nucleoplasm (nucleoplasmic reticulum) and nuclear microvesicles. Inositol trisphosphate, cyclic ADP-ribose and nicotinic acid adenine dinucleotide phosphate have all been reported to produce release of Ca(2+) into the nucleoplasm, but contribution of these mechanisms under physiological conditions is still uncertain.

  9. Analisis Perbandingan Perhitungan Re-Order Point

    Directory of Open Access Journals (Sweden)

    Haryadi Sarjono

    2014-05-01

    Full Text Available The purpose of this study was to compare the Re-Order point (ROP between the ongoing policy of the company to the theoretical calculation according to the method of Economic Order Quantity (EOQ in manufacturing company. The research methodology that is used in this research is the method of quantitative analysis. It is a scientific approach to managerial decision making in which the source data is the primary data obtained directly from resource persons to provide the necessary data. The data is taken from the data the raw materials the company from 2007 to 2012. The results of this study state that the re-order point calculations specific to the year 2012 only, according to the company policy is 34,508 Kg, while according to the calculation method of EOQ is 91 925 Kg. This difference is due to the calculation of safety stock and the use of time while waiting.

  10. Impact of visual art on patient behavior in the emergency department waiting room.

    Science.gov (United States)

    Nanda, Upali; Chanaud, Cheryl; Nelson, Michael; Zhu, Xi; Bajema, Robyn; Jansen, Ben H

    2012-07-01

    Wait times have been reported to be one of the most important concerns for people visiting emergency departments (EDs). Affective states significantly impact perception of wait time. There is substantial evidence that art depicting nature reduces stress levels and anxiety, thus potentially impacting the waiting experience. To analyze the effect of visual art depicting nature (still and video) on patients' and visitors' behavior in the ED. A pre-post research design was implemented using systematic behavioral observation of patients and visitors in the ED waiting rooms of two hospitals over a period of 4 months. Thirty hours of data were collected before and after new still and video art was installed at each site. Significant reduction in restlessness, noise level, and people staring at other people in the room was found at both sites. A significant decrease in the number of queries made at the front desk and a significant increase in social interaction were found at one of the sites. Visual art has positive effects on the ED waiting experience. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Stress Caused by Waiting: A Theoretical Evaluation of a Mathematical Model

    Science.gov (United States)

    Suck; Holling

    1997-09-01

    According to cognitive stress theories, stress caused by waiting is influenced by two components, the (psychological) cost of waiting, that is, a function C of time, and a probability distribution over waiting times. Osuna (1985a) suggested a model by which stress as a function of time could be calculated from these constituents. The aim of this paper is (1) to generalize the model, (2) to investigate its mathematical properties, (3) to derive predictions for experimental tests of the model, and (4) to give a precise meaning to the variability and duration hypothesis discussed in the experimental literature. In particular, several theorems are derived which specify situations in which the model enables the user to compare conditions for their stress inducing potential. Such conditions are the duration of the waiting time and the predictability of the length of a waiting period. The core of the mathematical derivations is an identity for expected stress which simplifies the calculations of the Osuna model considerably. Copyright 1997 Academic Press

  12. Waiting times for cancer patients in Sweden: A nationwide population-based study.

    Science.gov (United States)

    Robertson, Stephanie; Adolfsson, Jan; Stattin, Pär; Sjövall, Annika; Winnersjö, Rocio; Hanning, Marianne; Sandelin, Kerstin

    2017-05-01

    The reported long waiting times for cancer patients have mostly been related to prognostic outcome and less to patient-related experience to outcome. We assessed waiting times for patients with cancer of the breast, prostate, colon or rectum in Sweden. The median time from referral to start of treatment was assessed using data from clinical cancer registers for patients who received curative treatment during 2011, 2012 and 2013. The median overall waiting time in different counties ranged from 7 to 28 days for breast cancer, from 117 to 280 days for prostate cancer, from 27 to 64 days for colon cancer and from 48 to 80 days for rectal cancer. For the entire nation, the median time from referral to start of treatment remained unchanged from 2011 to 2013 for each cancer diagnosis. Large variations were found in waiting times between different counties in Sweden and between different types of cancer. The long waiting times identified in this study emphasize the need to improve national programmes for more rapid diagnosis and treatment.

  13. The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada

    Science.gov (United States)

    Leddin, Desmond; Armstrong, David; Borgaonkar, Mark; Bridges, Ronald J; Fallone, Carlo A; Telford, Jennifer J; Chen, Ying; Colacino, Palma; Sinclair, Paul

    2013-01-01

    BACKGROUND: Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time. METHODS: During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005. RESULTS: Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (Pgastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005. PMID:23472243

  14. A state of limbo: the politics of waiting in neo-liberal Latvia.

    Science.gov (United States)

    Ozoliņa-Fitzgerald, Liene

    2016-09-01

    This article presents an ethnographic study of politics of waiting in a post-Soviet context. While activation has been explored in sociological and anthropological literature as a neo-liberal governmental technology and its application in post-socialist context has also been compellingly documented, waiting as a political artefact has only recently been receiving increased scholarly attention. Drawing on ethnographic fieldwork at a state-run unemployment office in Riga, this article shows how, alongside activation, state welfare policies also produce passivity and waiting. Engaging with the small but developing field of sociological literature on the politics of waiting, I argue that, rather than interpreting it as a clash between 'neo-liberal' and 'Soviet' regimes, we should understand the double-move of activation and imposition of waiting as a key mechanism of neo-liberal biopolitics. This article thus extends the existing theorizations of the temporal politics of neo-liberalism. © London School of Economics and Political Science 2016.

  15. Experimental and phenomenological investigations of QCD matter in high-energy nucleus-nucleus collisions

    Energy Technology Data Exchange (ETDEWEB)

    Andronic, Anton

    2014-07-15

    This thesis is heterogeneous, comprising experimental papers at low energies (SIS-18 at GSI) and at the LHC, papers on phenomenology of high-energy nucleus-nucleus collisions, and papers on detectors. The overview covers the experimental papers and those on phenomenology. I have chosen to write it in a general manner, intended to be accessible to non-experts. It emphasizes recent measurements and their understanding at the LHC. The detector papers, which address many principle aspects of gaseous detectors, are summarized and placed in context in the review I co-wrote and which closes the stack. The detector papers included here are the outcome of an R and D program for the Transition Radiation Detector of ALICE.

  16. Dynamical and statistical aspects in nucleus-nucleus collisions around the Fermi energy

    Energy Technology Data Exchange (ETDEWEB)

    Tamain, B.; Bocage, F.; Bougault, R.; Brou, R. [Caen Univ., 14 (France). Lab. de Physique Corpusculaire; Assenard, M. [Centre National de la Recherche Scientifique, 44 - Nantes (France). Lab. de Physique Subatomique et des Technologies Associees; Auger, G.; Benlliure, J. [Grand Accelerateur National d`Ions Lourds (GANIL), 14 - Caen (France); Bacri, C.O.; Borderie, B. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire; Bisquer, E. [Lyon-1 Univ., 69 - Villeurbanne (France). Inst. de Physique Nucleaire] [and others

    1997-12-31

    Nucleus-nucleus collisions at low incident energy are mainly governed by statistical dissipative processes, fusion and deep inelastic reactions being the most important ones. Conversely, in the relativistic energy regime, dynamical effects play a dominant role and one should apply a participant-spectator picture in order to understand the data. In between, the intermediate energy region is a transition one in which it is necessary to disentangle dynamics from statistical effects. Moreover, the Fermi energy region corresponds to available energies comparable with nuclear binding energies and one may except to observe phase transition effects. Experiments performed recently with 4{pi} devices have given quite new data and a much better insight into involved mechanisms and hot nuclear matter properties. INDRA data related to reaction mechanisms and multifragmentation are presented. (author) 53 refs.

  17. A versatile dielectron trigger for nucleon-nucleon and nucleus-nucleus collisions

    CERN Document Server

    Schicker, R; Tsertos, H

    1998-01-01

    A novel approach for a versatile first level dielectron trigger is presented. This trigger operates in the low multiplicity environment of nucleon-nucleon reactions as well as in the high multiplicity situation of nucleus-nucleus collisions. For optimal trigger performance, time of flight conditions for the two fastest particles of the event are combined with event multiplicity requirements. The dielectron trigger efficiency is given. The event reduction factor of such a trigger approach is studied for a low, a medium and a high multiplicity environment. The impact parameter dependence of the event reduction is given. The timing properties of the trigger signal are described. The losses due to deadtime are specified. Finally, the first level trigger rate is reported.

  18. New quasibound states of the compound nucleus in α -particle capture by the nucleus

    Science.gov (United States)

    Maydanyuk, Sergei P.; Zhang, Peng-Ming; Zou, Li-Ping

    2017-07-01

    We generalize the theory of nuclear decay and capture of Gamow that is based on tunneling through the barrier and internal oscillations inside the nucleus. In our formalism an additional factor is obtained, which describes distribution of the wave function of the the α particle inside the nuclear region. We discover new most stable states (called quasibound states) of the compound nucleus (CN) formed during the capture of α particle by the nucleus. With a simple example, we explain why these states cannot appear in traditional calculations of the α capture cross sections based on monotonic penetrabilities of a barrier, but they appear in a complete description of the evolution of the CN. Our result is obtained by a complete description of the CN evolution, which has the advantages of (1) a clear picture of the formation of the CN and its disintegration, (2) a detailed quantum description of the CN, (3) tests of the calculated amplitudes based on quantum mechanics (not realized in other approaches), and (4) high accuracy of calculations (not achieved in other approaches). These peculiarities are shown with the capture reaction of α +44Ca . We predict quasibound energy levels and determine fusion probabilities for this reaction. The difference between our approach and theory of quasistationary states with complex energies applied for the α capture is also discussed. We show (1) that theory does not provide calculations for the cross section of α capture (according to modern models of the α capture), in contrast with our formalism, and (2) these two approaches describe different states of the α capture (for the same α -nucleus potential).

  19. The mitogaligin protein is addressed to the nucleus via a non-classical localization signal

    Energy Technology Data Exchange (ETDEWEB)

    Robinet, Pauline; Mollet, Lucile; Gonzalez, Patrick; Normand, Thierry; Charpentier, Stephane; Brule, Fabienne; Dubois, Martine [Centre de Biophysique Moleculaire (Affiliated with the University of Orleans), CNRS UPR4301, Rue Charles Sadron, 45071 Orleans Cedex 2 (France); Legrand, Alain, E-mail: alain.legrand@cnrs-orleans.fr [Centre de Biophysique Moleculaire (Affiliated with the University of Orleans), CNRS UPR4301, Rue Charles Sadron, 45071 Orleans Cedex 2 (France)

    2010-01-29

    Mitogaligin, a protein encoded by galig, an internal cytotoxic gene of the galectin-3 locus, is mostly a mitochondrial protein. Mitochondrial targeting is due to an already identified mitochondrial localization signal. Interaction of mitogaligin with mitochondria leads to cytochrome c cytosolic leakage and ultimately to cell death. We have previously pointed out that mitogaligin can also be directed to the nucleus when the mitochondrial addressing signal is inactivated, indicating a possible dual intracellular localization of the protein. When expressed in the nucleus, mitogaligin exhibits also apoptotic properties leading to cell death. In this report, we show that nuclear addressing of mitogaligin depends on a sequence differing from classical signals containing basic, lysine or proline-tyrosine rich residues. The signal consists of a long sequence of amino acids residues based on a series of a short repetitive degenerated sequence.

  20. The Confined Hydrogen Atom with a Moving Nucleus

    Science.gov (United States)

    Fernandez, Francisco M.

    2010-01-01

    We study the hydrogen atom confined to a spherical box with impenetrable walls but, unlike earlier pedagogical articles on the subject, we assume that the nucleus also moves. We obtain the ground-state energy approximately by means of first-order perturbation theory and show that it is greater than that for the case in which the nucleus is clamped…

  1. Lateral geniculate nucleus histopathology in the rat experimental ...

    African Journals Online (AJOL)

    Although trypanosomosis has a well knownaetiology, histopathological studies on brain regions involved in the control of circadian rhythms are scanty. Lateral geniculate nucleus works in conjunction with the suprachiasmatic nucleus, the master circadian rhythm pacemaker, in regulating circadian rhythms. The purpose of ...

  2. Waiting for Shadows from the Distant Solar System

    Science.gov (United States)

    Kohler, Susanna

    2016-03-01

    How can we hope to measure the hundreds of thousands of objects in our distant solar system? A team of astronomers is harnessing citizen science to begin to tackle this problem!A light curve from an occultation collected by a RECON site in Quincy, California. As the objects shadow passes, the background stars light dims. [RECON/Charley Arrowsmith (Feather River College)]Occultation InformationEstimates currently place the number of Kuiper belt objects larger than 100 km across at over 100,000. Knowing the sizes and characteristics of these objects is important for understanding the composition of the outer solar system and constraining models of the solar systems formation and evolution.Unfortunately, measuring small, dim bodies at large distances is incredibly difficult! One of the best ways to obtain the sizes of these objects is to watch as they occult a distant star. Timing the object as it passes across the face of the star can give us a good measure of its size and shape, when observed from multiple stations in the path of the shadow.An Extended NetworkOccultations by nearby objects (like main-belt asteroids) can be predicted fairly accurately, but those by trans-Neptunian objects are much more poorly constrained. Only ~900 trans-Neptunian objects have approximately known paths, and occultation-shadow predictions for these objects are often only accurate to ~1000km on the Earths surface. So how can we ensure that theres a telescope in the right location, ready to observe when an occultation occurs?Map of the 56 RECON sites distributed over 2000 km in the western United States. [Buie et al. 2016]The simplest answer is to set up a huge network of observing stations, and wait for the shadows to come to the network. With this approach, even if the predicted path isnt precisely known, some of the stations will still observe the occultation.Due to the number of stations needed, this project lends itself perfectly to citizen science. In a recently published paper by

  3. On the control, stability, and waiting time in a slotted ALOHA random-access system

    Science.gov (United States)

    Ferguson, M. J.

    1975-01-01

    This paper explores some of the boundaries in performance of slotted ALOHA systems by analyzing a simple and almost optimal centrally supervised control. The control results in a very simple Markov chain model and allows an examination of stability, conditional waiting time distribution of transmitting terminals, and many other system measures. The key to the simplicity is to have a probability of successful packet transmission that is independent of the number of transmitting terminals. In considering waiting time, we calculate the mean and other moments of the waiting time of a terminal when it enters the system to find (n - 1) other terminals already there competing for the channel. Under this control, the average time is proportional to n. The control requires exact knowledge of the number of terminals contending for the channel, and hence is not implementable, except as an approximation.

  4. Processing communications events in parallel active messaging interface by awakening thread from wait state

    Science.gov (United States)

    Archer, Charles J; Blocksome, Michael A; Ratterman, Joseph D; Smith, Brian E

    2013-10-22

    Processing data communications events in a parallel active messaging interface (`PAMI`) of a parallel computer that includes compute nodes that execute a parallel application, with the PAMI including data communications endpoints, and the endpoints are coupled for data communications through the PAMI and through other data communications resources, including determining by an advance function that there are no actionable data communications events pending for its context, placing by the advance function its thread of execution into a wait state, waiting for a subsequent data communications event for the context; responsive to occurrence of a subsequent data communications event for the context, awakening by the thread from the wait state; and processing by the advance function the subsequent data communications event now pending for the context.

  5. Intake of wine, beer and spirits and waiting time to pregnancy

    DEFF Research Database (Denmark)

    Juhl, Mette; Olsen, Jørn; Andersen, Anne-Marie Nybo

    2003-01-01

    ,844 pregnant women, recruited to the Danish National Birth Cohort in 1997-2000. Main outcome measures were odds ratios for a prolonged waiting time to pregnancy according to consumption of wine, beer and spirits. RESULTS: All levels of wine intake compared with non-wine drinking or with consumption of beer...... appear to have fewer strokes, lung and digestive tract cancers, and overall mortality than both abstainers and moderate drinkers of beer or spirits. We examined the association between different types of alcoholic beverages and waiting time to pregnancy. METHODS: Self-reported data were used for 29...... or spirits had subfecundity odds ratios between 0.7 and 0.9. No association was seen regarding beer drinking, while the association with spirits was J-shaped. CONCLUSION: Our findings suggest that wine drinkers have slightly shorter waiting times to pregnancy than both non-wine drinkers and consumers...

  6. The waiting time distribution as a graphical approach to epidemiologic measures of drug utilization

    DEFF Research Database (Denmark)

    Hallas, J; Gaist, D; Bjerrum, L

    1997-01-01

    The emergence of large, computerized pharmacoepidemiologic databases has enabled us to study drug utilization with the individual user as the statistical unit. A recurrent problem in such analyses, however, is the overwhelming volume and complexity of data. We here describe a graphical approach...... that effectively conveys some essential utilization parameters for a drug. The waiting time distribution for a group of drug users is a charting of their first prescription presentations within a specified time window. For a drug used for chronic treatment, most current users will be captured at the beginning...... of the window. After a few months, the graph will be dominated by new, incident users. As examples, we present waiting time distributions for insulin, ulcer drugs, systemic corticosteroids, antidepressants, and disulfiram. Appropriately analyzed and interpreted, the waiting time distributions can provide...

  7. Identification of waiting time distribution of M/G/1, Mx/G/1, GIr/M/1 queueing systems

    Directory of Open Access Journals (Sweden)

    A. Ghosal

    1988-01-01

    Full Text Available This paper brings out relations among the moments of various orders of the waiting time of the 1st customer and a randomly selected customer of an arrival group for bulk arrivals queueing models, and as well as moments of the waiting time (in queue for M/G/1 queueing system. A numerical study of these relations has been developed in order to find the (β1,β2 measures of waiting time distribution in a comutable form. On the basis of these measures one can look into the nature of waiting time distribution of bulk arrival queues and the single server M/G/1 queue.

  8. The control of deliberate waiting strategies in a stop-signal task

    Directory of Open Access Journals (Sweden)

    R.P. Sylwan

    2004-06-01

    Full Text Available To inhibit an ongoing flow of thoughts or actions has been largely considered to be a crucial executive function, and the stop-signal paradigm makes inhibitory control measurable. Stop-signal tasks usually combine two concurrent tasks, i.e., manual responses to a primary task (go-task are occasionally countermanded by a stimulus which signals participants to inhibit their response in that trial (stop-task. Participants are always instructed not to wait for the stop-signal, since waiting strategies cause the response times to be unstable, invalidating the data. The aim of the present study was to experimentally control the strategies of waiting deliberately for the stop-signal in a stop-task by means of an algorithm that measured the variation in the reaction times to go-stimuli on-line, and displayed a warning legend urging participants to be faster when their reaction times were more than two standard deviations of the mean. Thirty-four university students performed a stop-task with go- and stop-stimuli, both of which were delivered in the visual modality and were lateralized within the visual field. The participants were divided into two groups (group A, without the algorithm, vs group B, with the algorithm. Group B exhibited lower variability of reaction times to go-stimuli, whereas no significant between-group differences were found in any of the measures of inhibitory control, showing that the algorithm succeeded in controlling the deliberate waiting strategies. Differences between deliberate and unintentional waiting strategies, and anxiety as a probable factor responsible for individual differences in deliberate waiting behavior, are discussed.

  9. Community-based birth waiting homes in Northern Sierra Leone: Factors influencing women's use.

    Science.gov (United States)

    Kyokan, Michiko; Whitney-Long, Melissa; Kuteh, Mabel; Raven, Joanna

    2016-08-01

    to explore the factors influencing women's use of birth waiting homes in the Northern Bombali district, Sierra Leone. this was a descriptive exploratory study using qualitative research methodology, which included in depth interviews, key informant interviews, focus group discussions, document review and observations. two chiefdoms in the Northern Bombali district, Sierra Leone. eight interviews were conducted with women who had delivered in the past one year and used birth waiting homes; eight key informant interviews with a project manager, birth waiting homes hosts, and community members; thirteen women who delivered in the past year without using birth waiting homes (four interviews and two focus group discussions). there are several factors influencing the use of birth waiting homes (BWHs) including: past experience of childbirth, promotion of the birth waiting homes by traditional birth attendance, distance and costs of transport to the homes, child care and other family commitments, family's views of the importance of the homes, the costs of food during women's stay, and information given to women and families about when and how to use the homes. some barriers, especially those related to family commitments and costs of food, are challenging to solve. In order to make a BWH a user-friendly and viable option, it may be necessary to adjust ways in which BWHs are used. Good linkage with the health system is strength of the programme. However, further strengthening of community participation in monitoring and managing the BWHs is needed for the long term success and sustainability of the BWHs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial.

    Science.gov (United States)

    Kim, Jong-In; Kim, Tae-Hun; Lee, Myeong Soo; Kang, Jung Won; Kim, Kun Hyung; Choi, Jun-Yong; Kang, Kyung-Won; Kim, Ae-Ran; Shin, Mi-Suk; Jung, So-Young; Choi, Sun-mi

    2011-06-10

    Persistent non-specific low back pain (PNSLBP) is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP. We recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group) who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to 100 numerical rating scale (NRS) for pain, the McGill Pain Questionnaire for pain intensity (PPI) and the Oswestry Disability Questionnaire (ODQ), and we assessed acetaminophen use and safety issues. The results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group), but there was no statistical difference between the groups (p = 0.52). However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p cupping group during 4 weeks (p = 0.09). The ODQ score did not show significant differences between the two groups (-5.60 [-8.90 to -2.30] in the wet-cupping group and -1.8 [-5.8 to 2.2] in the waiting-list group, p = 0.14). There was no report of adverse events due to wet-cupping. This pilot study may

  11. Appoximation Formula for Estimation of Waiting-Time in Multiple-Channel Queuing Systems

    DEFF Research Database (Denmark)

    Maaløe, Erik

    1973-01-01

    The article deals with two approxiamation formulae for estimation of W, Waiting-times in a M/E/R queuing system.m First is shown how W for the multiple-channel system is approximately an Rth part of the mean waiting time in a single channel system. A second approximation applies the exact ratio...... for W(multi-channel/W(single channel) and M/M/1-systems to general M/Ek/R-systems. This is particularly illustrated in the case og M/M/R and M/D/R-systems as a general warning against general practices...

  12. Gender disparity in liver transplant waiting-list mortality: the importance of kidney function.

    Science.gov (United States)

    Mindikoglu, Ayse L; Regev, Arie; Seliger, Stephen L; Magder, Laurence S

    2010-10-01

    Previous studies of men and women on the liver transplantation (LT) waiting list, without taking transplantation rates into account, have suggested a higher risk of mortality for women on the waiting list. The objective of this study was to compare men and women with respect to dying within 3 years of registration on the LT waiting list and to take into account both the immediate mortality risks and the transplantation rates. The analysis was based on Organ Procurement and Transplantation Network data for patients with end-stage liver disease (ESLD) on the waiting list who were registered between February 2002 and August 2009. Competing risk survival analysis was performed to assess the gender disparity in waiting-list mortality; 42,322 patients and 610,762 person-months of waiting-list experience were included in the analysis. The risk of dying within 3 years of listing was 19% and 17% in women and men, respectively (P < 0.0001). Among patients with kidney disease and especially those not on dialysis with an estimated glomerular filtration rate (eGFR) ≥15 and <30 mL/minute/1.73 m(2), women had a substantially higher risk of dying on the waiting list within 3 years of registration versus men (26% versus 20%, P = 0.001). This disparity was related to lower transplantation rates in women (transplantation rate ratio = 0.68, P < 0.0001). Controlling for eGFR and other variables related to mortality risk, we found that the overall female-male disparity disappeared. In conclusion, among patients with ESLD and kidney dysfunction who are not on dialysis, there is a substantial gender disparity in LT waiting-list mortality. Our analysis suggests as an explanation the fact that women have lower transplantation rates than men in this group. The lower transplantation rates can be explained in part by the fact that Model for End-Stage Liver Disease scores tend to be lower for women versus men because they are based on serum creatinine rather than the glomerular filtration

  13. Interventions to reduce wait times for primary care appointments: a systematic review.

    Science.gov (United States)

    Ansell, Dominique; Crispo, James A G; Simard, Benjamin; Bjerre, Lise M

    2017-04-20

    Accessibility and availability are important characteristics of efficient and effective primary healthcare systems. Currently, timely access to a family physician is a concern in Canada. Adverse outcomes are associated with longer wait times for primary care appointments and often leave individuals to rely on urgent care. When wait times for appointments are too long patients may experience worse health outcomes and are often left to use emergency department resources. The primary objective of our study was to systematically review the literature to identify interventions designed to reduce wait times for primary care appointments. Secondary objectives were to assess patient satisfaction and reduction of no-show rates. We searched multiple databases, including: Medline via Ovid SP (1947 to present), Embase (from 1980 to present), PsychINFO (from 1806 to present), Cochrane Central Register of Controlled Trials (CENTRAL; all dates), Cumulative Index to Nursing and Allied Health (CINAHL; 1937 to present), and Pubmed (all dates) to identify studies that reported outcomes associated with interventions designed to reduce wait times for primary care appointments. Two independent reviewers assessed all identified studies for inclusion using pre-defined inclusion/exclusion criteria and a multi-level screening approach. Our study methods were guided by the Cochrane Handbook for Systematic Reviews of Interventions. Our search identified 3,960 articles that were eligible for inclusion, eleven of which satisfied all inclusion/exclusion criteria. Data abstraction of included studies revealed that open access scheduling is the most commonly used intervention to reduce wait times for primary care appointments. Additionally, included studies demonstrated that dedicated telephone calls for follow-up consultation, presence of nurse practitioners on staff, nurse and general practitioner triage, and email consultations were effective at reducing wait times. To our knowledge, this is

  14. Study on the interaction between the food and beverage servicescape and customer waiting experience

    Directory of Open Access Journals (Sweden)

    Yang, Chih-Yun

    2014-11-01

    Full Text Available Past research on the customer waiting experience tended to focus on two primary areas, namely managing the wait and managing the perception of the wait. Very few studies conducted in-depth analysis and discus¬sion of how external environmental factors affect the experience of customer waiting, which it was also viewed as a negative factor that decreases customer satisfaction toward service. However, in reality, the waiting experience can be positive as a result of certain environmental factors, and subsequently increases customer satisfaction toward the service. This study aimed to further examine the potential influencing factors arising from the servicescape during the customer waiting process, and the interaction between the servicescape and customers during their wait time. This paper is based on the causal feedback loop. A system dynamics perspective was applied to construct a conceptual systems model showing the interaction between the servi¬cescape and the customer waiting experience.Estudios previos sobre la experiencia de espera de los clients suelen centrarse sobre todo en dos áreas: la gestión de la espera y la gestión de la experiencia de espera. Existen muy pocos estudios que hayan realizado análisis y discusiones en profundidad sobre cómo los factores ambientales externos afectan a la experiencia de espera de los clientes, que se ha considerado siempre como un factor negativo que reduce la satisfacción del cliente hacia el servicio. Sin embargo, la experiencia de espera puede incrementar en reali¬dad la satisfacción del cliente hacia el servicio. Este estudio pretende profundizar en la influencia potencial de los factores que surgen del “servicescape” durante el proceso de espera del cliente, así como la interacción entre el “servicescape” y los clientes durante el tiempo de espera. Ese artículo se basa en el bucle de retroa¬limentación causal. Desde la perspectiva de la dinámica de sistemas se construye un

  15. A study on iron ore transportation model with penalty value of transportation equipment waiting

    Directory of Open Access Journals (Sweden)

    Kailing Pan

    2017-03-01

    Full Text Available As some steel enterprises are at a disadvantage in the choice of the mode of transportation, this paper made further studies of the characteristics of the iron ore logistics, taking comprehensive consideration of optimizing the waiting time under the conditions with limited loading capacity and setting up a procedural model of the iron ore logistics system with minimum cost of transportation, storage, loading, unloading, and transportation equipment waiting. Finally, taking the iron ore transport system of one steel enterprise as example, the solution and the validity of the model were analyzed and verified in this paper.

  16. Critical Points of the Electric Field from a Collection of Point Charges

    Energy Technology Data Exchange (ETDEWEB)

    Max, N; Weinkauf, T

    2007-02-16

    The electric field around a molecule is generated by the charge distribution of its constituents: positively charged atomic nuclei, which are well approximated by point charges, and negatively charged electrons, whose probability density distribution can be computed from quantum mechanics. For the purposes of molecular mechanics or dynamics, the charge distribution is often approximated by a collection of point charges, with either a single partial charge at each atomic nucleus position, representing both the nucleus and the electrons near it, or as several different point charges per atom. The critical points in the electric field are useful in visualizing its geometrical and topological structure, and can help in understanding the forces and motion it induces on a charged ion or neutral dipole. Most visualization tools for vector fields use only samples of the field on the vertices of a regular grid, and some sort of interpolation, for example, trilinear, on the grid cells. There is less risk of missing or misinterpreting topological features if they can be derived directly from the analytic formula for the field, rather than from its samples. This work presents a method which is guaranteed to find all the critical points of the electric field from a finite set of point charges. To visualize the field topology, we have modified the saddle connector method to use the analytic formula for the field.

  17. In the queue for total joint replacement: patients' perspectives on waiting times. Ontario Hip and Knee Replacement Project Team.

    Science.gov (United States)

    Llewellyn-Thomas, H A; Arshinoff, R; Bell, M; Williams, J I; Naylor, C D

    1998-02-01

    We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P = 0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z = 2.951; P = 0.004) and shorter times since their surgeon first advised them of the need for surgery (z = 3.014; P = 0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.

  18. Functional network inference of the suprachiasmatic nucleus

    Energy Technology Data Exchange (ETDEWEB)

    Abel, John H.; Meeker, Kirsten; Granados-Fuentes, Daniel; St. John, Peter C.; Wang, Thomas J.; Bales, Benjamin B.; Doyle, Francis J.; Herzog, Erik D.; Petzold, Linda R.

    2016-04-04

    In the mammalian suprachiasmatic nucleus (SCN), noisy cellular oscillators communicate within a neuronal network to generate precise system-wide circadian rhythms. Although the intracellular genetic oscillator and intercellular biochemical coupling mechanisms have been examined previously, the network topology driving synchronization of the SCN has not been elucidated. This network has been particularly challenging to probe, due to its oscillatory components and slow coupling timescale. In this work, we investigated the SCN network at a single-cell resolution through a chemically induced desynchronization. We then inferred functional connections in the SCN by applying the maximal information coefficient statistic to bioluminescence reporter data from individual neurons while they resynchronized their circadian cycling. Our results demonstrate that the functional network of circadian cells associated with resynchronization has small-world characteristics, with a node degree distribution that is exponential. We show that hubs of this small-world network are preferentially located in the central SCN, with sparsely connected shells surrounding these cores. Finally, we used two computational models of circadian neurons to validate our predictions of network structure.

  19. Subthalamic nucleus detects unnatural android movement.

    Science.gov (United States)

    Ikeda, Takashi; Hirata, Masayuki; Kasaki, Masashi; Alimardani, Maryam; Matsushita, Kojiro; Yamamoto, Tomoyuki; Nishio, Shuichi; Ishiguro, Hiroshi

    2017-12-19

    An android, i.e., a realistic humanoid robot with human-like capabilities, may induce an uncanny feeling in human observers. The uncanny feeling about an android has two main causes: its appearance and movement. The uncanny feeling about an android increases when its appearance is almost human-like but its movement is not fully natural or comparable to human movement. Even if an android has human-like flexible joints, its slightly jerky movements cause a human observer to detect subtle unnaturalness in them. However, the neural mechanism underlying the detection of unnatural movements remains unclear. We conducted an fMRI experiment to compare the observation of an android and the observation of a human on which the android is modelled, and we found differences in the activation pattern of the brain regions that are responsible for the production of smooth and natural movement. More specifically, we found that the visual observation of the android, compared with that of the human model, caused greater activation in the subthalamic nucleus (STN). When the android's slightly jerky movements are visually observed, the STN detects their subtle unnaturalness. This finding suggests that the detection of unnatural movements is attributed to an error signal resulting from a mismatch between a visual input and an internal model for smooth movement.

  20. Control of nucleus accumbens activity with neurofeedback.

    Science.gov (United States)

    Greer, Stephanie M; Trujillo, Andrew J; Glover, Gary H; Knutson, Brian

    2014-08-01

    The nucleus accumbens (NAcc) plays critical roles in healthy motivation and learning, as well as in psychiatric disorders (including schizophrenia and attention deficit hyperactivity disorder). Thus, techniques that confer control of NAcc activity might inspire new therapeutic interventions. By providing second-to-second temporal resolution of activity in small subcortical regions, functional magnetic resonance imaging (fMRI) can resolve online changes in NAcc activity, which can then be presented as "neurofeedback." In an fMRI-based neurofeedback experiment designed to elicit NAcc activity, we found that subjects could increase their own NAcc activity, and that display of neurofeedback significantly enhanced their ability to do so. Subjects were not as capable of decreasing their NAcc activity, however, and enhanced control did not persist after subsequent removal of neurofeedback. Further analyses suggested that individuals who recruited positive aroused affect were better able to increase NAcc activity in response to neurofeedback, and that NAcc neurofeedback also elicited functionally correlated activity in the medial prefrontal cortex. Together, these findings suggest that humans can modulate their own NAcc activity and that fMRI-based neurofeedback may augment their efforts. The observed association between positive arousal and effective NAcc control further supports an anticipatory affect account of NAcc function. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Parity Measurements in the 70Ga Nucleus

    Science.gov (United States)

    Venegas Vargas, D. C.; Haring-Kaye, R. A.; Jones, K. D.; Le, K. Q.; Harbin, B. L.; Döring, J.; Abromeit, B.; Dungan, R.; Lubna, R.; Tabor, S. L.; Tai, P.-L.; Tripati, Vandana; Vonmoss, J. M.; Morrow, S. I.

    2017-09-01

    The odd-odd 70Ga nucleus was studied at high spin after being produced at Florida State University using the 62Ni(14C,αpn) fusion-evaporation reaction at a beam energy of 50 MeV. The resulting γ rays were detected in coincidence using an array of Compton-suppressed Ge detectors consisting of three Clover detectors and seven single-crystal detectors. The linear polarizations of eight γ-ray transitions in 70Ga were measured by comparing their scattering yields within a Clover detector in the parallel and perpendicular directions relative to the beam axis, under the requirement that at least one other γ ray in 70Ga was recorded by a single-crystal detector in the array. As a result of these measurements, the parities of six states were confirmed and those of two other states were established for the first time based on a comparison of the experimental polarizations with the predicted ones determined from known spin assignments. The resulting level spectrum of 70Ga shows both similarities and differences with the predictions of previous shell-model calculations. This work was supported by the U.S. National Science Foundation and the Ohio Wesleyan University Summer Science Research Program.

  2. Restoring Segmental Biomechanics Through Nucleus Augmentation: An In Vitro Study.

    Science.gov (United States)

    Pelletier, Matthew H; Cohen, Charles S; Ducheyne, Paul; Walsh, William R

    2016-12-01

    In vitro biomechanical laboratory study. The purpose of this study is to evaluate a mechanical treatment to create a degenerative motion segment and the ability of nucleus augmentation to restore biomechanics. In cases with an intact annulus fibrosus, the replacement or augmentation of the nucleus pulposus alone may provide a less invasive option to restore normal biomechanics and disk height when compared with spinal fusion or total disk replacement. Laboratory testing allows these changes to be fully characterized. However, without preexisting pathology, nucleus augmentation therapies are difficult to evaluate in vitro. The present study evaluated pure moment bending and compressive biomechanics in 3 states (n=6): (1) intact, (2) after creep loading and nucleus disruption to induce degenerative biomechanical changes, and (3) after nucleus augmentation through an injectable polymer (DiscCell). Neutral zone and ROM were increased in all modes of bending after the degenerative treatment. The most sensitive mode of bending was lateral bending, with intact ROM (20.0±2.9 degrees) increased to 22.3±2.6 degrees after degenerative treatment and reduced to 18.4±1.6 degrees after injection of the polymer. All bending ROM and NZ changes induced by the degenerative treatment were reversed by nucleus augmentation. This material was shown to be effective at altering motion segment biomechanics and restoring disk height during time zero tests. This technique may provide a model to examine the time zero performance of a nucleus augmentation device/material.

  3. Minimizing makespan for a no-wait flowshop using genetic algorithm

    Indian Academy of Sciences (India)

    This paper explains minimization of makespan or total completion time for -jobs, -machine, no-wait flowshop problem (NW-FSSP). A spread sheet based general purpose genetic algorithm is proposed for the NW-FSSP. The example analysis shows that the proposed approach produces results are comparable to the ...

  4. Waiting times for prostate cancer diagnosis in KwaZulu-Natal, South ...

    African Journals Online (AJOL)

    Background. There is currently no evidence in the South African (SA) literature to suggest how long patients with clinically suspected prostate cancer (an elevated prostate-specific antigen level or abnormal findings on digital rectal examination) wait to have a prostate biopsy. Objectives. To improve the overall efficiency of ...

  5. Minimizing makespan for a no-wait flowshop using genetic algorithm

    Indian Academy of Sciences (India)

    approaches cited in the literature. Additionally, it is .... literature. Pan et al (2008c) presented an improved iterated greedy algorithm to minimize makespan for the no-wait flowshop scheduling problem. The superiority .... one possible chromosome according to permutation representation would be A-C-D-E-B, while another ...

  6. Reviewing Policy: Starting the Wrong Conversations--The Public School Crisis and "Waiting for Superman"

    Science.gov (United States)

    Swalwell, Katy; Apple, Michael W.

    2011-01-01

    The documentary "Waiting for Superman" has become one of those rare things, a (supposed) documentary that generates a wider audience. It also is one of the more recent embodiments of what Nancy Fraser (1989) labels as the "politics of needs and needs discourses." Dominant groups listen carefully to the language and issues that…

  7. Waiting for Superman: Neoliberal Educational Reform and the Craft of Filmic Direction

    Science.gov (United States)

    Prado, Jose; Montez de Oca, Jeffrey

    2014-01-01

    The Waiting for Superman (WFS) cultural project and its push to transform the public school system has had great appeal among those sympathetic and unsympathetic to the victims of exclusionary and exploitative school agendas. To address the workings of hegemony in the WFS cultural project the authors examine three general scenes in the WFS trailer…

  8. Popular Media Portrayals of Inequity and School Reform in "The Wire" and "Waiting for 'Superman'"

    Science.gov (United States)

    Gerstl-Pepin, Cynthia

    2015-01-01

    Two popular media forms are examined--the documentary film "Waiting for 'Superman'" and the HBO television series, "The Wire"--that present distinct, and at times conflicting, depictions of how to address educational inequity. Qualitative media content analysis was used to analyze the two media documents and to situate them…

  9. School, Activism and Politics at the Movies: Educator Reactions to the Film "Waiting for 'Superman'"

    Science.gov (United States)

    Wessel Powell, Christy

    2014-01-01

    Context: The documentary film about U.S. education reform, "Waiting for 'Superman'," was met with acclaim and controversy when released to theaters in 2010, and again when launching its grassroots "host a screening" campaign in 2011. The campaign ran concurrent with 2011 state legislative sessions, during which several states…

  10. Patients\\' response to waiting time in an out-patient pharmacy in ...

    African Journals Online (AJOL)

    Purpose: To identify the dispensing procedure at a pharmacy, investigate the possible operational problems that may lead to excessive patient waiting times as prescriptions are filled and to examine patient disposition to perceived delays at the pharmacy. Methods: The study was carried out in a 574-bed university teaching ...

  11. Stress reducing effects of real and artificial nature in a hospital waiting room

    NARCIS (Netherlands)

    Beukeboom, C.J.; Langeveld, D.; Tanja-Dijkstra, Karin

    2012-01-01

    Objectives: This field study investigated the potential stress-reducing effects of exposure to real or artificial nature on patients in a hospital waiting room. Additionally, it was investigated whether perceived attractiveness of the room could explain these effects. Design: In this

  12. A prospective study on the impact of waiting times for radiotherapy ...

    African Journals Online (AJOL)

    Background: Radiotherapy plays a vital role in the management of cervical cancer. However, because of high patient load and limited resources, waiting lists are unacceptably long. This is a highly curable malignancy that often occurs in economically active, relatively young women. The impact of treatment delays on society ...

  13. A delay discounting task produces a greater likelihood of waiting than a deferred gratification task.

    Science.gov (United States)

    Young, Michael E; McCoy, Anthony W

    2015-01-01

    A first-person-shooter video game was adapted for the study of choice between smaller sooner and larger later outcomes to compare the behavioral patterns produced by deferred gratification (DG) and delay discounting (DD) tasks. Participants played a game in which they could either fire their weapon sooner and do a small amount of damage or wait a few seconds to fire their weapon and do a larger amount of damage. For the DD task, a failure to fire within one second committed the player to waiting for the larger later outcome thus removing the opportunity to defect during the delay that is present in the DG task. The incentive structure changed multiple times during game play so that at times the optimal decision was to choose the smaller sooner outcome whereas at other times the optimal decision was to wait for the larger later outcome. Players assigned to the DD task showed a greater tendency to wait and lower sensitivity to the changing incentives. © Society for the Experimental Analysis of Behavior.

  14. A Study on Effects of Waiting Period in Software Operation on the Operator's Psychophysiological State

    Science.gov (United States)

    Hayasaka, Yoshiaki; Kimura, Tatsuhiro; Segawa, Norihisa; Miyazaki, Masatoshi; Yamazaki, Kiyoyuki; Murayama, Yuko

    The authors have been studying psychophysiological workload of human interface (HI) with physiological measurements and analysis. In this study, we investigated a kind of mental workload produced by user's unexpected waiting period from the request input to the termination of data processing during personal computer (PC) operation. As the experimental setting of HI, we used interactive software containing easy questions with unexpected time interval between each question. The effects of progress indicator (PI) indicating during waiting period on psychophysiological status of users were analyzed by using respiration, finger plethysmogram (PTG), heart rate (HR) and electroencephalogram (EEG) measurements. Results showed that the theta wave component of the EEG increased in the non-PI condition, even though autonomic nervous system parameters showed no significant change. Negative correlation between preference score for HI and integrated theta component percentage was observed only in non-PI condition. It is supposed that the PI was controlling theta activity coused by waiting stress in experimental condition. Utilizing physiological indices for HI assessment, this experimental method could be available to waiting stress estimation.

  15. Wait Time and Service Satisfaction at the Outpatient Clinic of a ...

    African Journals Online (AJOL)

    Background: In February 2006, Neuropsychiatric Hospital, Aro, Abeokuta launched the local charter of SERVICOM and promised the clients timely and quality services delivered with fairness, honesty, courtesy, and transparency. Implementation of this promise is yet to be evaluated. Objectives: To determine the wait time ...

  16. Corruption in The African Novels: A Study of Helon Habila's Waiting ...

    African Journals Online (AJOL)

    Corruption in The African Novels: A Study of Helon Habila's Waiting for An Angel and Ayi Kwei Armah's The Beautyful One's Are Not Yet Born. ... generation of leaders will not emulate bad leadership style from older leaders. The study will be of benefit to students, politicians and other people. The study will sensitize students ...

  17. To Construction and Standardization of the Waiting Anxiety Questionnaire (WAQ in Iran.

    Directory of Open Access Journals (Sweden)

    Sodeh Tavakkoli

    2014-09-01

    Full Text Available This study aimed to develop and validate a questionnaire to measure waiting anxiety.This was a cross-sectional study. Extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire. A sample of 321 participants was recruited through random cluster sampling (n= 190 Iranian men and n= 131 women. The participants filled out WAQ, the Speilberger's State-Trait Anxiety Inventory (STAI, Burtner Rating scale (BRS and Eysenk Personality questionnaire (EPQ for adults.Internal consistency of WAQ was revealed, meaning that all the 20 items were highly correlated with the total score. The Cronbach alpha equaled 0.83 for the Waiting Anxiety Questionnaire. The Pearson correlation coefficient of the questionnaire with the STAI, BRS and extraversion and neuroticism subscales of EPQ was 0.65, 0.78, - 0.47 and 0.43, respectively, which confirmed its convergent and divergent validity. Factors analysis extracting four cognitive, behavioral, sentimental and physiological factors could explain 67% of the total variance with an Eigen value of greater than 1.Our findings suggest that WAQ possesses appropriate validity and reliability to measure the individuals' anxiety during the waiting time.

  18. 169 Trend and Style in Habila's Waiting for an Angel Anthony ...

    African Journals Online (AJOL)

    User

    Abstract. The event of the mid 80's through the 90's in Nigeria is what Helon Habila captures in his novel Waiting for an Angel. The marriage of fiction with faction makes it a unique genre and attractive for literary scholars to explore the novel's mechanics and techniques. Consequently, this essay attempts to unravel some of ...

  19. Waiting as a determinant of store image and customer satisfaction: a ...

    African Journals Online (AJOL)

    Several studies have proposed multi-dimensional conceptualisations of service quality, store image and consumers' satisfaction with service delivery in a retail context. Although waiting time is included in a hierarchical conceptualisation of perceived service quality and is explicitly considered in the literature on service ...

  20. Waiting to Move: Stress, Coping and the Meaning of Home in Anticipation of Relocation.

    Science.gov (United States)

    Rutman, Deborah L.; Freedman, Jonathan L.

    Research has examined the effects of relocation on the physical and psychological well-being of the elderly, but has usually neglected the pre-relocation or anticipatory period. A study was conducted to examine the experiences of older persons waiting to relocate to subsidized age-segregated apartments. Subjects were interviewed twice over a…

  1. Quantitative modelling for wait time reduction: A comprehensive simulation applied in general surgery

    NARCIS (Netherlands)

    Vanberkel, Peter T.; Blake, J.T.

    2008-01-01

    This thesis describes the use of operational research techniques to analyze the wait list for the division of general surgery at the Capital District Health Authority (CDHA) in Halifax, Nova Scotia, Canada. A comprehensive simulation model was developed to facilitate capacity planning decisions and

  2. A comprehensive simulation for wait time reduction and capacity planning applied in general surgery

    NARCIS (Netherlands)

    Vanberkel, P.T.; Blake, John T.

    2007-01-01

    This paper describes the use of operational research techniques to analyze the wait list for the Division of General Surgery at the Capital District Health Authority in Halifax, Nova Scotia, Canada. A discrete event simulation model was developed to aid capacity planning decisions and to analyze the

  3. A prospective study on the impact of waiting times for radiotherapy ...

    African Journals Online (AJOL)

    Background. Radiotherapy plays a vital role in the management of cervical cancer. However, because of high patient load and limited resources, waiting lists are unacceptably long. This is a highly curable malignancy that often occurs in economically active, relatively young women. The impact of treatment delays on society ...

  4. Pregnancy chances on an IVF/ICSI waiting list: a national prospective cohort study.

    NARCIS (Netherlands)

    Eijkemans, M.J.; Lintsen, A.M.E.; Hunault, C.C.; Bouwmans, C.A.; Hakkaart, L.; Braat, D.D.M.; Habbema, J.D.

    2008-01-01

    BACKGROUND: The effectiveness of IVF over expectant management has been proven only for bilateral tubal occlusion. We aimed to estimate the chance of pregnancy without treatment for IVF patients, using data on the waiting period before the start of IVF. METHODS: A prospective cohort study included

  5. Adult tonsillectomy – are long waiting lists putting patients at risk?

    African Journals Online (AJOL)

    patients had been booked for surgery between January 2000 and December 2003. Only those patients who had been waiting for at least 1½ years were included in the study. Patients were questioned on the following: (i) the number of episodes of tonsillitis per year at time of booking; (ii) number of episodes of tonsillitis per ...

  6. Hip and knee arthroplasty waiting list – how accurate and fair?

    African Journals Online (AJOL)

    Orthopaedic surgery is an expensive procedure with high patient demand for reconstructive service. This mismatch between patient demand and available service results in the requirement for surgical waiting lists. Hip- and knee-joint replacement surgery (arthroplasty) is a life-changing procedure in terms of pain reduction ...

  7. Quarkonium-nucleus bound states from lattice QCD

    Energy Technology Data Exchange (ETDEWEB)

    Beane, S.  R. [Univ. of Washington, Seattle, WA (United States); Chang, E. [Univ. of Washington, Seattle, WA (United States); Cohen, S.  D. [Univ. of Washington, Seattle, WA (United States); Detmold, W. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Lin, H. -W. [Univ. of Washington, Seattle, WA (United States); Orginos, K. [College of William and Mary, Williamsburg, VA (United States); Thomas Jefferson National Accelerator Facility (TJNAF), Newport News, VA (United States); Parreño, A. [Univ., de Barcelona, Marti Franques (Spain); Savage, M.  J. [Univ. of Washington, Seattle, WA (United States)

    2015-06-11

    Quarkonium-nucleus systems are composed of two interacting hadronic states without common valence quarks, which interact primarily through multi-gluon exchanges, realizing a color van der Waals force. We present lattice QCD calculations of the interactions of strange and charm quarkonia with light nuclei. Both the strangeonium-nucleus and charmonium-nucleus systems are found to be relatively deeply bound when the masses of the three light quarks are set equal to that of the physical strange quark. Extrapolation of these results to the physical light-quark masses suggests that the binding energy of charmonium to nuclear matter is B < 40 MeV.

  8. 77 FR 75253 - Culturally Significant Objects Imported for Exhibition Determinations: “Wait, Later This Will Be...

    Science.gov (United States)

    2012-12-19

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Culturally Significant Objects Imported for Exhibition Determinations: ``Wait, Later This Will Be Nothing..., 2003), I hereby determine that the objects to be included in the exhibition ``Wait, Later This Will Be...

  9. Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival.

    Science.gov (United States)

    van Harten, Michel C; Hoebers, Frank J P; Kross, Kenneth W; van Werkhoven, Erik D; van den Brekel, Michiel W M; van Dijk, Boukje A C

    2015-03-01

    Waiting to start treatment has been shown to be associated with tumor progression and upstaging in head and neck squamous cell carcinomas (HNSCCs). This diminishes the chance of cure and might lead to unnecessary mortality. We investigated the association between waiting times and survival in the Netherlands and assessed which factors were associated to longer waiting times. Patient (age, sex, socioeconomic status (SES), tumor (site, stage) and treatment (type, of institute of diagnosis/treatment) characteristics for patients with HNSCC who underwent treatment were extracted from the Netherlands Cancer Registry (NCR) for 2005-2011. Waiting time was defined as the number of days between histopathological diagnosis and start of treatment. Univariable and multivariable Cox regression was used to evaluate survival. In total, 13,140 patients were included, who had a median waiting time of 37days. Patients who were more likely to wait longer were men, patients with a low SES, oropharynx tumors, stage IV tumors, patients to be treated with radiotherapy or chemoradiation, and patients referred for treatment to a Head and Neck Oncology Center (HNOC) from another hospital. The 5-year overall survival was 58% for all patients. Our multivariable Cox regression model showed that longer waiting time, was significantly related to a higher hazard of dying (p<0.0001). This is the first large population-based study showing that longer waiting time for surgery, radiotherapy or chemoradiation is a significant negative prognostic factor for HNSCC patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Application of Queueing Theory to the Analysis of Changes in Outpatients' Waiting Times in Hospitals Introducing EMR.

    Science.gov (United States)

    Cho, Kyoung Won; Kim, Seong Min; Chae, Young Moon; Song, Yong Uk

    2017-01-01

    This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.

  11. Changing Course: Exploring Impacts of "Waiting for Superman" on Future Teachers' Perspectives on the State of Education

    Science.gov (United States)

    Jensen, Aaron; Janak, Edward; Slater, Timothy F.

    2012-01-01

    The controversial video documentary "Waiting for Superman," released in 2010, has helped to ignite a firestorm of national debate on current educational reforms in the United States. The purpose of this study is to determine the possible impacts of the video documentary "Waiting for Superman" potentially influencing pre-service…

  12. Guided online or face-to-face cognitive behavioral treatment for insomnia: A randomized wait-list controlled trial

    NARCIS (Netherlands)

    Lancee, J.; van Straten, A.; Morina, N.; Kaldo, V.; Kamphuis, J.H.

    2016-01-01

    Study Objectives: To compare the efficacy of guided online and individual face-to-face cognitive behavioral treatment for insomnia (CBT-I) to a wait-list condition. Methods: A randomized controlled trial comparing three conditions: guided online; face-to-face; wait-list. Posttest measurements were

  13. Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey.

    Science.gov (United States)

    Xie, Zhenzhen; Or, Calvin

    2017-01-01

    The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.

  14. Using administrative databases to measure waiting times for patients undergoing major cancer surgery in Ontario, 1993-2000.

    Science.gov (United States)

    Simunovic, Marko; Thériault, Marc-Erick; Paszat, Lawrence; Coates, Angela; Whelan, Timothy; Holowaty, Eric; Levine, Mark

    2005-04-01

    To determine how long patients in Ontario waited for major breast, colorectal, lung or prostate cancer surgery in the years 1993-2000. "Surgical waiting time" was defined as the interval from date of preoperative surgeon consult to date of hospital admission for surgery. We created patient cohorts by linking appropriate diagnosis and procedure codes from Canadian Institutes of Health Information data. Scrambled unique surgeon identifiers were obtained from Ontario Health Insurance Plan data. Changes in median surgical waiting times were assessed with univariate time-trend analyses and multilevel models. Models were controlled for year of surgery and other patient (age, gender, comorbid conditions, income level, area of residence) and hospital level characteristics (teaching status, procedure volume status). Compared with 1993, median surgical waiting times in the year 2000 increased 36% for patients with breast cancer (to 19 d), 46% with colorectal (to 19 d), 36% with lung (to 34 d) and 4% with prostate cancer (to 83 d). Multilevel models confirmed significant increases in waiting times for all procedures. There were no concerning or consistent differences in waiting times among the categories of hospitals and patients examined. There were significant increases in surgical waiting times among patients undergoing breast, colorectal, lung or prostate cancer surgery in Ontario over years 1993-2000. Administrative databases can be used to efficiently measure such waits.

  15. Challenges of deflecting an asteroid or cometary nucleus with a nuclear burst

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Paul A [Los Alamos National Laboratory; Plesko, Cathy S [Los Alamos National Laboratory; Clement, Ryan R C [Los Alamos National Laboratory; Conlon, Leann M [Los Alamos National Laboratory; Weaver, Robert P [Los Alamos National Laboratory; Guzik, Joyce A [Los Alamos National Laboratory; Pritchett - Sheets, Lori A [Los Alamos National Laboratory; Huebner, Walter F [SOUTHWEST RESEARCH INSTITUTE

    2009-01-01

    There are many natural disasters that humanity has to deal with over time. These include earthquakes, tsunami, hurricanes, floods, asteroid strikes, and so on. Many of these disasters occur slowly enough that some advance warning of which areas will be affected is possible. However, in almost all cases, the response is to evacuate the area to be affected and deal with the damage later. The evacuations for hurricanes Katrina and Rita on the US Gulf Coast in 2005 demonstrated the chaos that can result. In contrast with other natural disasters. it is likely that an asteroid or cometary nucleus on a collision course with Earth is likely to be detected with enough warning time to possibly deflect it away from the collision course. Thanks to near-Earth object (NEO) surveys, people are working towards a goal of cataloging at least 90% of all near-Earth objects with diameters larger than {approx}140 meters in the next decade. The question is how to mitigate the threat from an asteroid or cometary nucleus found to be on a collision course. We briefly review some possible methods, describing their good and bad points, and then embark on a more detailed description of using a nuclear munition in standoff mode to deflect an asteroid or cometary nucleus before it can hit Earth.

  16. Challenges of deflecting an asteroid or comet nucleus with a nuclear burst

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, Paul A [Los Alamos National Laboratory; Plesko, Cathy S [Los Alamos National Laboratory; Clement, Ryan R. C. [Los Alamos National Laboratory; Conlon, Le Ann M [Los Alamos National Laboratory; Weaver, Robert P [Los Alamos National Laboratory; Guzik, Joyce A [Los Alamos National Laboratory; Pritchett - Sheets, Lori A [Los Alamos National Laboratory; Huebner, Walter F [SWRI

    2009-01-01

    There are many natural disasters that humanity has to deal with over time. These include earthquakes, tsunamis, hurricanes, floods, asteroid strikes, and so on. Some of these disasters occur slowly enough that some advance warning is possible for affected areas. In this case, the response is to evacuate the affected area and deal wilh the damage later. The Katrina and Rita hurricane evacuations on the U.S. Gulf Coasl in 2005 demonstrated the chaos that can result from such a response. In contrast with other natural disasters, it is likely that an asteroid or comet nucleus on a collision course with Earth will be detected with enough warning time to possibly deflect it away. Thanks to Near-Earth Object (NED) surveys, people are working towards a goal of cataloging at least 90% of all near-Earth objects with diameters larger than {approx} 140 meters in the next fifteen years. The important question then, is how to mitigate the threat from an asteroid or comet nucleus found to be on a collision course with Earth. In this paper. we briefly review some possible deflection methods, describe their good and bad points, and then embark on a more detailed description of using nuclear munitions in a standoff mode to deflect the asteroid or comet nucleus before it can hit Earth.

  17. The nucleus retroambiguus control of respiration.

    Science.gov (United States)

    Subramanian, Hari H; Holstege, Gert

    2009-03-25

    The role of the nucleus retroambiguus (NRA) in the context of respiration control has been subject of debate for considerable time. To solve this problem, we chemically (using d, l-homocysteic acid) stimulated the NRA in unanesthetized precollicularly decerebrated cats and studied the respiratory effect via simultaneous measurement of tracheal pressure and electromyograms of diaphragm, internal intercostal (IIC), cricothyroid (CT), and external oblique abdominal (EO) muscles. NRA-stimulation 0-1 mm caudal to the obex resulted in recruitment of IIC muscle and reduction in respiratory frequency. NRA-stimulation 1-3 mm caudal to the obex produced vocalization along with CT activation and slight increase in tracheal pressure, but no change in respiratory frequency. NRA-stimulation 3-5 mm caudal to the obex produced CT muscle activation and an increase in respiratory frequency, but no vocalization. NRA-stimulation 5-8 mm caudal to the obex produced EO muscle activation and reduction in respiratory frequency. A change to the inspiratory effort was never observed, regardless of which NRA part was stimulated. The results demonstrate that NRA does not control eupneic inspiration but consists of topographically separate groups of premotor interneurons each producing detailed motor actions. These motor activities have in common that they require changes to eupneic breathing. Different combination of activation of these premotor neurons determines the final outcome, e.g., vocalization, vomiting, coughing, sneezing, mating posture, or child delivery. Higher brainstem regions such as the midbrain periaqueductal gray (PAG) decides which combination of NRA neurons are excited. In simple terms, the NRA is the piano, the PAG one of the piano players.

  18. Developmental changes in anger expression and attention focus: learning to wait.

    Science.gov (United States)

    Cole, Pamela M; Tan, Patricia Z; Hall, Sarah E; Zhang, Yiyun; Crnic, Keith A; Blair, Clancy B; Li, Runze

    2011-07-01

    Being able to wait is an essential part of self-regulation. In the present study, the authors examined the developmental course of changes in the latency to and duration of target-waiting behaviors by following 65 boys and 55 girls from rural and semirural economically strained homes from ages 18 months to 48 months. Age-related changes in latency to and duration of children's anger expressions and attention focus (e.g., self-initiated distraction) during an 8-min wait for a gift were found. On average, at 18 and 24 months of age, children were quick to react angrily and slower to shift attention away from the desired object than they were at later ages. Over time, children were quicker to distract themselves. By 36 months, distractions occurred before children expressed anger, and anger expressions were briefer. At 48 months, children typically made a quick bid to their mothers about having to wait before distracting themselves; on average, they did not appear angry until the latter half of the wait. Unexpectedly, children bid to their mothers as much at age 48 months as they had at 18 months; however, bids became less angry as children got older. Developmental changes in distraction and bidding predicted age-related changes in the latency to anger. Findings are discussed in terms of the neurocognitive control of attention around age 30 months, the limitations of children's self-regulatory efforts at age 48 months, and the importance of fostering children's ability to forestall, as well as modulate, anger. PsycINFO Database Record (c) 2011 APA, all rights reserved

  19. Quantitative analysis of the fusion cross sections using different microscopic nucleus-nucleus interactions

    Energy Technology Data Exchange (ETDEWEB)

    Adel, A. [Cairo University, Physics Department, Faculty of Science, Giza (Egypt); Majmaah University, Physics Department, College of Science, Al-Zulfi (Saudi Arabia); Alharbi, T. [Majmaah University, Physics Department, College of Science, Al-Zulfi (Saudi Arabia)

    2017-01-15

    The fusion cross sections for reactions involving medium and heavy nucleus-nucleus systems are investigated near and above the Coulomb barrier using the one-dimensional barrier penetration model. The microscopic nuclear interaction potential is computed by four methods, namely: the double-folding model based on a realistic density-dependent M3Y NN interaction with a finite-range exchange part, the Skyrme energy density functional in the semiclassical extended Thomas-Fermi approximation, the generalized Proximity potential, and the Akyuez-Winther interaction. The comparison between the calculated and the measured values of the fusion excitation functions indicates that the calculations of the DFM give quite satisfactory agreement with the experimental data, being much better than the other methods. New parameterized forms for the fusion barrier heights and positions are presented. Furthermore, the effects of deformation and orientation degrees of freedom on the distribution of the Coulomb barrier characteristics as well as the fusion cross sections are studied for the reactions {sup 16}O + {sup 70}Ge and {sup 28}Si + {sup 100}Mo. The calculated values of the total fusion cross sections are compared with coupled channel calculations using the code CCFULL and compared with the experimental data. Our results reveal that the inclusion of deformations and orientation degrees of freedom improves the comparison with the experimental data. (orig.)

  20. Formation and identification of Centauro and Strangelets in nucleus- nucleus collisions at the LHC

    CERN Document Server

    Angelis, Aris L S; Bogolyubsky, M Yu; Filippov, S N; Gladysz-Dziadus, E; Kharlov, Yu V; Kurepin, A B; Maevskaya, A I; Mavromanolakis, G; Panagiotou, A D; Sadovsky, S A; Stefanski, P; Wlodarczyk, Z

    1999-01-01

    We present a phenomenological model for the formation and decay of a cosmic ray Centauro fireball in the baryon-rich projectile fragmentation rapidity region in nucleus-nucleus interactions. Our model naturally incorporates the $9 possibility of strangelet formation, Strangelets being conjectured to be the "strongly penetrating component" observed in hadron-rich cosmic ray events. Based on this model we have performed Monte-Carlo simulations to study the $9 Centauro and strangelet dynamic and kinematic characteristics in central Pb+Pb collisions at LHC energies, as well as their identification by the detector system CASTOR. CASTOR is being developed for the ALICE heavy ion experiment at $9 the LHC and will probe the very forward pseudorapidity region 5.6

  1. EOS: A time projection chamber for the study of nucleus-nucleus collisions at the Bevalac

    Energy Technology Data Exchange (ETDEWEB)

    Pugh, H.G.; Odyniec, G.; Rai, G.; Seidl, P.

    1986-12-01

    The conceptual design is presented for a detector to identify and measure (..delta..p/p approx. = 1%) most of the 200 or so mid-rapidity charged particles (p, d, t, /sup 3/He, /sup 4/He, ..pi../sup + -/, K/sup + -/) produced in each central nucleus-nucleus collision (Au + Au) at Bevalac energies, as well as K/sub 3//sup 0/ and ..lambda../sup 0/. The beam particles and heavy spectator fragments are excluded from the detection volume by means of a central vacuum pipe. Particle identification is achieved by a combination of dE/dx measurements in the TPC, and of time-of-flight measurements in a scintillator array. The TPC is single-ended and its end cap is entirely covered with cathode pads (about 25,000 pads and about 1000 anode wires). A non-uniform pad distribution is proposed to accommodate the high multiplicity of particles emitted at forward angles. The performance of the detector is assessed with regard to multihit capability, tracking, momentum resolution, particle identification, ..lambda../sup 0/ reconstruction, space charge effects, field non-uniformity, dynamic range, data acquisition rate, and data analysis rate. 72 refs., 48 figs., 11 tabs.

  2. How do Patients Trade-Off Surgeon Choice and Waiting Times for Total Joint Replacement: A Discrete Choice Experiment.

    Science.gov (United States)

    Marshall, Deborah A; Deal, Ken; Conner-Spady, Barbara; Bohm, Eric; Hawker, Gillian; Loucks, Lynda; MacDonald, Karen V; Noseworthy, Tom

    2018-02-06

    Patients face significant waiting times for hip and knee total joint replacement (TJR) in publicly funded healthcare systems. We aimed to assess how surgeon selection and reputation affect patients' willingness to wait for TJR. We assessed patient preferences using a discrete choice experiment questionnaire with 12 choice scenarios administered to patients referred for TJR. Based on qualitative research, pre- and pilot-testing, we characterized each scenario by five attributes: surgeon reputation, surgeon selection, waiting time to surgeon visit (initial consultation), waiting time to surgery, and travel time to hospital. Preferences were assessed using hierarchical Bayes analysis and evaluated for goodness-of-fit. We conducted simulation analyses to understand how patients value surgeon reputation and surgeon selection in terms of willingness to wait for surgeon visit and surgery. Of 422 participants, 68% were referred for knee TJR. The most important attribute was surgeon reputation followed by waiting times, surgeon selection process and travel time. Patients appear willing to wait 10 months for a visit with an excellent reputation surgeon before switching to a good reputation surgeon. Patients in the highest pain category were willing to wait 7.3 months before accepting the next available surgeon, compared to 12 months for patients experiencing the least pain. Our findings confirm that patients value surgeon reputation in the context of wait times and surgeon selection. We suggest opportunities to reduce wait times by explicitly offering the next available surgeon to increase patient choice, and by reporting surgeon performance to reduce potential misinformation about reputation. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  3. Apathy in Parkinson's disease is associated with nucleus accumbens atrophy: a magnetic resonance imaging shape analysis.

    Science.gov (United States)

    Carriere, Nicolas; Besson, Pierre; Dujardin, Kathy; Duhamel, Alain; Defebvre, Luc; Delmaire, Christine; Devos, David

    2014-06-01

    Apathy is characterized by lack of interest, loss of initiative, and flattening of affect. It is a frequent, very disabling nonmotor complication of Parkinson's disease (PD). The condition may notably occur when dopaminergic medications are tapered after the initiation of subthalamic stimulation and thus can be referred to as "dopaminergic apathy." Even in the absence of tapering, some patients may develop a form of apathy as PD progresses. This form is often related to cognitive decline and does not respond to dopaminergic medications (dopa-resistant apathy). We aimed at determining whether dopa-resistant apathy in PD is related to striatofrontal morphological changes. We compared the shape of the striatum (using spherical harmonic parameterization and sampling in a three-dimensional point distribution model [SPHARM-PDM]), cortical thickness, and fractional anisotropy (using tract-based spatial statistics) in 10 consecutive patients with dopamine-refractory apathy, 10 matched nonapathetic PD patients and 10 healthy controls. Apathy in PD was associated with atrophy of the left nucleus accumbens. The SPHARM-PDM analysis highlighted (1) a positive correlation between the severity of apathy and atrophy of the left nucleus accumbens, (2) greater atrophy of the dorsolateral head of the left caudate in apathetic patients than in nonapathetic patients, and (3) greater atrophy in the bilateral nucleus accumbens in apathetic patients than in controls. There were no significant intergroup differences in cortical thickness or fractional anisotropy. Dopa-resistant apathy in PD was associated with atrophy of the left nucleus accumbens and the dorsolateral head of the left caudate. © 2014 International Parkinson and Movement Disorder Society.

  4. Nucleus management in manual small incision cataract surgery by phacosection

    Directory of Open Access Journals (Sweden)

    Ravindra M

    2009-01-01

    Full Text Available Nucleus management is critical in manual small incision cataract surgery (MSICS, as the integrity of the tunnel, endothelium and posterior capsule needs to be respected. Several techniques of nucleus management are in vogue, depending upon the specific technique of MSICS. Nucleus can be removed in toto or bisected or trisected into smaller segments. The pressure in the eye can be maintained at the desired level with the use of an anterior chamber maintainer or kept at atmospheric levels. In MSICS, unlike phacoemulsification, there is no need to limit the size of the tunnel or restrain the size of capsulorrhexis. Large well-structured tunnels and larger capsulorrhexis provide better control on the surgical maneuvers. Safety and simplicity of MSICS has made it extremely popular. The purpose of this article is to describe nucleus management by phacosection in MSICS.

  5. Colour, albedo and nucleus size of Halley's comet

    Science.gov (United States)

    Cruikshank, D. P.; Tholen, D. J.; Hartmann, W. K.

    1985-01-01

    Photometry of Halley's comet in the B, J, V, and K broadband filters during a time when the coma was very weak and presumed to contribute negligibly to the broadband photometry is reported. The V-J and J-K colors suggest that the color of the nucleus of Halley's comet is similar to that of the D-type asteroids, which in turn suggests that the surface of the nucleus has an albedo less than 0.1.

  6. The TLC: A Novel Auditory Nucleus of the Mammalian Brain

    OpenAIRE

    Saldaña Fernández, Enrique; Viñuela, Antonio; Marshall, Allen F.; Fitzpatrick, Douglas C.; Aparicio Vaquero, María Auxiliadora

    2007-01-01

    [EN]We have identified a novel nucleus of the mammalian brain and termed it the tectal longitudinal column (TLC). Basic histologic stains, tract-tracing techniques and three-dimensional reconstructions reveal that the rat TLC is a narrow, elongated structure spanning themidbrain tectum longitudinally. This paired nucleus is located close to the midline, immediately dorsal to the periaqueductal gray matter.It occupies what has traditionally been considered the most medial region of the deep su...

  7. Atmospheric Aerosols: Cloud Condensation Nucleus Activity of Selected Organic Molecules

    Science.gov (United States)

    Rosenorn, T.; Henning, S.; Hartz, K. H.; Kiss, G.; Pandis, S.; Bilde, M.

    2005-12-01

    Gas/particle partitioning of vapors in the atmosphere plays a major role in both climate through micro meteorology and in the physical and chemical processes of a single particle. This work has focused on the cloud droplet activation of a number of pure and mixed compounds. The means used to investigate these processes have been the University of Copenhagen cloud condensation nucleus counter setup and the Carnegie Mellon University CCNC setup. The importance of correct water activity modeling has been addressed and it has been pointed out that the molecular mass is an important parameter to consider when choosing model compounds for cloud activation models. It was shown that both traditional Kohler theory and Kohler theory modified to account for limited solubility reproduce measurements of soluble compounds well. For less soluble compounds it is necessary to use Kohler theory modified to account for limited solubility. It was also shown that this works for mixtures of compounds containing both inorganic salts and dicarboxylic acids. It has also been shown that particle phase and humidity history is important for activation behavior of particles consisting of two slightly soluble organic substances (succinic and adipic acid) and a soluble salt (NaCl). Model parameters for terpene oxidation product cloud activation have been derived. These are based on two sets of average parameters covering monoterpene oxidation products and sesquiterpene oxidation products. All parameters except the solubility were estimated and an effective solubility was calculated as the fitting parameter. The average solubility of the model compound found for mono terpene oxidation products is similar to those of sodium chloride and ammonium sulfate; however the higher molecular weight leads to a slightly higher activation diameter at fixed supersaturation. On a molar basis the monoterpene oxidation products show a 1.5 times higher effective solubility than the sesquiterpene oxidation products.

  8. A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time

    Directory of Open Access Journals (Sweden)

    Santori Gregorio

    2009-01-01

    Full Text Available Abstract Background Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy, where no detailed national reports are available. This is true although since 2002 the National Government has defined implicit Urgency-Related Groups (URGs associated with Maximum Time Before Treatment (MTBT, similar to the Australian classification. The aim of this paper is to propose a model to manage waiting lists and prioritize admissions to elective surgery. Methods In 2001, the Italian Ministry of Health funded the Surgical Waiting List Info System (SWALIS project, with the aim of experimenting solutions for managing elective surgery waiting lists. The project was split into two phases. In the first project phase, ten surgical units in the largest hospital of the Liguria Region were involved in the design of a pre-admission process model. The model was embedded in a Web based software, adopting Italian URGs with minor modifications. The SWALIS pre-admission process was based on the following steps: 1 urgency assessment into URGs; 2 correspondent assignment of a pre-set MTBT; 3 real time prioritization of every referral on the list, according to urgency and waiting time. In the second project phase a prospective descriptive study was performed, when a single general surgery unit was selected as the deployment and test bed, managing all registrations from March 2004 to March 2007 (1809 ordinary and 597 day cases. From August 2005, once the SWALIS model had been modified, waiting lists were monitored and analyzed, measuring the impact of the model by a set of performance indexes (average waiting time, length of the waiting list and Appropriate Performance Index (API. Results The SWALIS pre-admission model was used for all registrations in the

  9. The Sit-and-Wait Hypothesis in Bacterial Pathogens: A Theoretical Study of Durability and Virulence

    Science.gov (United States)

    Wang, Liang; Liu, Zhanzhong; Dai, Shiyun; Yan, Jiawei; Wise, Michael J.

    2017-01-01

    The intriguing sit-and-wait hypothesis predicts that bacterial durability in the external environment is positively correlated with their virulence. Since its first proposal in 1987, the hypothesis has been spurring debates in terms of its validity in the field of bacterial virulence. As a special case of the vector-borne transmission versus virulence tradeoff, where vector is now replaced by environmental longevity, there are only sporadic studies over the last three decades showing that environmental durability is possibly linked with virulence. However, no systematic study of these works is currently available and epidemiological analysis has not been updated for the sit-and-wait hypothesis since the publication of Walther and Ewald’s (2004) review. In this article, we put experimental evidence, epidemiological data and theoretical analysis together to support the sit-and-wait hypothesis. According to the epidemiological data in terms of gain and loss of virulence (+/-) and durability (+/-) phenotypes, we classify bacteria into four groups, which are: sit-and-wait pathogens (++), vector-borne pathogens (+-), obligate-intracellular bacteria (--), and free-living bacteria (-+). After that, we dive into the abundant bacterial proteomic data with the assistance of bioinformatics techniques in order to investigate the two factors at molecular level thanks to the fast development of high-throughput sequencing technology. Sequences of durability-related genes sourced from Gene Ontology and UniProt databases and virulence factors collected from Virulence Factor Database are used to search 20 corresponding bacterial proteomes in batch mode for homologous sequences via the HMMER software package. Statistical analysis only identified a modest, and not statistically significant correlation between mortality and survival time for eight non-vector-borne bacteria with sit-and-wait potentials. Meanwhile, through between-group comparisons, bacteria with higher host

  10. The Sit-and-Wait Hypothesis in Bacterial Pathogens: A Theoretical Study of Durability and Virulence.

    Science.gov (United States)

    Wang, Liang; Liu, Zhanzhong; Dai, Shiyun; Yan, Jiawei; Wise, Michael J

    2017-01-01

    The intriguing sit-and-wait hypothesis predicts that bacterial durability in the external environment is positively correlated with their virulence. Since its first proposal in 1987, the hypothesis has been spurring debates in terms of its validity in the field of bacterial virulence. As a special case of the vector-borne transmission versus virulence tradeoff, where vector is now replaced by environmental longevity, there are only sporadic studies over the last three decades showing that environmental durability is possibly linked with virulence. However, no systematic study of these works is currently available and epidemiological analysis has not been updated for the sit-and-wait hypothesis since the publication of Walther and Ewald's (2004) review. In this article, we put experimental evidence, epidemiological data and theoretical analysis together to support the sit-and-wait hypothesis. According to the epidemiological data in terms of gain and loss of virulence (+/-) and durability (+/-) phenotypes, we classify bacteria into four groups, which are: sit-and-wait pathogens (++), vector-borne pathogens (+-), obligate-intracellular bacteria (--), and free-living bacteria (-+). After that, we dive into the abundant bacterial proteomic data with the assistance of bioinformatics techniques in order to investigate the two factors at molecular level thanks to the fast development of high-throughput sequencing technology. Sequences of durability-related genes sourced from Gene Ontology and UniProt databases and virulence factors collected from Virulence Factor Database are used to search 20 corresponding bacterial proteomes in batch mode for homologous sequences via the HMMER software package. Statistical analysis only identified a modest, and not statistically significant correlation between mortality and survival time for eight non-vector-borne bacteria with sit-and-wait potentials. Meanwhile, through between-group comparisons, bacteria with higher host-mortality are

  11. The Sit-and-Wait Hypothesis in Bacterial Pathogens: A Theoretical Study of Durability and Virulence

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-11-01

    Full Text Available The intriguing sit-and-wait hypothesis predicts that bacterial durability in the external environment is positively correlated with their virulence. Since its first proposal in 1987, the hypothesis has been spurring debates in terms of its validity in the field of bacterial virulence. As a special case of the vector-borne transmission versus virulence tradeoff, where vector is now replaced by environmental longevity, there are only sporadic studies over the last three decades showing that environmental durability is possibly linked with virulence. However, no systematic study of these works is currently available and epidemiological analysis has not been updated for the sit-and-wait hypothesis since the publication of Walther and Ewald’s (2004 review. In this article, we put experimental evidence, epidemiological data and theoretical analysis together to support the sit-and-wait hypothesis. According to the epidemiological data in terms of gain and loss of virulence (+/- and durability (+/- phenotypes, we classify bacteria into four groups, which are: sit-and-wait pathogens (++, vector-borne pathogens (+-, obligate-intracellular bacteria (--, and free-living bacteria (-+. After that, we dive into the abundant bacterial proteomic data with the assistance of bioinformatics techniques in order to investigate the two factors at molecular level thanks to the fast development of high-throughput sequencing technology. Sequences of durability-related genes sourced from Gene Ontology and UniProt databases and virulence factors collected from Virulence Factor Database are used to search 20 corresponding bacterial proteomes in batch mode for homologous sequences via the HMMER software package. Statistical analysis only identified a modest, and not statistically significant correlation between mortality and survival time for eight non-vector-borne bacteria with sit-and-wait potentials. Meanwhile, through between-group comparisons, bacteria with higher

  12. Study of high energy densities over extended nuclear volumes via nucleus-nucleus collisions at the SPS

    CERN Multimedia

    2002-01-01

    This experiment examines in detail the characteristics of ultra-relativistic nucleus-nucleus interactions using $^{16}$O beams of 200 GeV/A from the SPS. The experiment combines 4$\\pi$ calorimeter coverage with measurements of inclusive particle spectra, two-particle correlations, low and high-mass lepton pairs and photons. A multiwire active target allows maximum interaction rates with a minimum of secondary interactions. Additional data are taken with an emulsion target.

  13. Assessing the impact of a waiting time survey on reducing waiting times in urban primary care clinics in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Johann Daniels

    2017-09-01

    Full Text Available A waiting time survey (WTS conducted in several clinics in Cape Town, South Africa provided recommendations on how to shorten waiting times (WT. A follow-up study was conducted to assess whether WT had reduced. Using a stratified sample of 22 clinics, a before and after study design assessed changes in WT. The WT was measured and perceptions of clinic managers were elicited, about the previous survey’s recommendations. The overall median WT decreased by 21 minutes (95%CI: 11.77- 30.23, a 28% decrease from the previous WTS. Although no specific factor was associated with decreases in WT, implementation of recommendations to reduce WT was 2.67 times (95%CI: 1.33-5.40 more likely amongst those who received written recommendations and 2.3 times (95%CI: 1.28- 4.19 more likely amongst managers with 5 or more years’ experience. The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts. Experienced facility managers who timeously receive customised reports of their clinic’s performance are more likely to implement changes that positively impact on reducing WT.

  14. Learning to wait for more likely or just more: greater tolerance to delays of reward with increasingly longer delays.

    Science.gov (United States)

    Rung, Jillian M; Young, Michael E

    2015-01-01

    Little research has focused on training greater tolerance to delays of rewards in the context of delayed gratification. In delayed gratification, waiting for a delayed outcome necessitates the ability to resist defection for a continuously available smaller, immediate outcome. The present research explored the use of a fading procedure for producing greater waiting in a video-game based, delayed gratification task. Participants were assigned to conditions in which either the reward magnitude, or the probability of receiving a reward, was a function of time waited and the delay to the maximum reward was gradually increased throughout this training. Waiting increased for all participants but less for those waiting for a greater reward magnitude than a greater reward probability. All participants showed a tendency to wait in a final testing phase, but training with probabilistic outcomes produced a significantly greater likelihood of waiting during testing. The behavioral requirements of delay discounting versus delay gratification are discussed, as well as the benefits of training greater self-control in a variety of contexts. © Society for the Experimental Analysis of Behavior.

  15. The concept of a waiting period for preoperative patient consent: Prospective study of 51 shoulder arthroscopy cases.

    Science.gov (United States)

    Coudane, H; Mangin, M; Karam, Y; Seivert, V; Mainard, D; Danan, J L; Py, B; Lighezzolo-Alnot, J

    2017-09-01

    The French Code of Public Health (CSP) does not explicitly require that patients should be given a certain amount of time to think about a procedure, except for cosmetic surgery, where 15 days is required (Art. L 6322-2 CSP). We hypothesized that patients require a waiting period during their decision-making process for scheduled shoulder arthroscopy procedure. This prospective observational study of 51 patients analysed the concept of a waiting period based on a 10-item questionnaire. A comparative statistical approach was used and the P values were calculated using a paired Wilcoxon rank-sum test. Of the 51 patients, 42 (82%) rejected the concept of a waiting period before the procedure and 37 patients (73%) did not want a mandatory waiting period imposed by law. This study looked at the decision-making process during scheduled orthopaedic surgery and differentiated between the conscious and unconscious approach corresponding to an active and passive waiting period. A waiting period does not allow patients to make a conceptually deliberative decision that conforms to the criteria defined by the French Health Authority. This study rejects the need for a mandatory waiting period imposed on surgeons and patients as it does not integrate itself into the informative model of ethical decision-making for scheduled shoulder arthroscopy. Prospective, observational; level of evidence IV. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial

    Directory of Open Access Journals (Sweden)

    Kim Kun

    2011-06-01

    Full Text Available Abstract Background Persistent non-specific low back pain (PNSLBP is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP. Methods We recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to100 numerical rating scale (NRS for pain, the McGill Pain Questionnaire for pain intensity (PPI and the Oswestry Disability Questionnaire (ODQ, and we assessed acetaminophen use and safety issues. Results The results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group, but there was no statistical difference between the groups (p = 0.52. However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p Conclusion This pilot study may provide preliminary data on the effectiveness and safety of wet-cupping treatments for PNSLBP. Future full-scale randomised controlled trials will be needed to provide firm evidence of the effectiveness of this intervention

  17. Clinical Impact and Risk Factors of Portal Vein Thrombosis for Patients on Wait List for Liver Transplant.

    Science.gov (United States)

    Montenovo, Martin; Rahnemai-Azar, Amir; Reyes, Jorge; Perkins, James

    2017-06-16

    The effect of portal vein thrombosis on the progression of liver disease is controversial, with no consensus on optimal treatment. We aimed to assess how portal vein thrombosis affects wait list outcomes, identify risk factors associated with its development while on a wait list, and assess its effects on patient and graft survival. This US-based retrospective cohort study analyzed 134 109 adult patients on wait lists for or undergoing primary orthotopic liver transplant between January 2002 and June 2014. Rate of portal vein thrombosis development, time from entry on wait list to transplant, comparisons of wait list drop-off rates between patients with versus those without portal vein thrombosis, risk factors associated with its development while on a wait list, and its effects on patient and graft survival were analyzed. We found that the rate of portal vein thrombosis at listing increased. Patients with the disease at listing were more likely to be removed from wait lists because of being too sick. Portal vein thrombosis at listing was an independent risk factor for being removed from a wait list. Of 63 265 patients who underwent primary orthotopic liver transplant, those with the disease were more likely to have higher Model for End-Stage Liver Disease scores and incidence of nonalcoholic steatohepatitis and diabetes mellitus. Portal vein thrombosis had a negative effect on patient and graft survival. Nonalcoholic steatohepatitis, body mass index, diabetes, and hepatocellular carcinoma were identified as risk factors for its development. Portal vein thrombosis represents an increasing management and outcome burden in liver transplant. Having this disease at listing and/or at time of transplant is associated with worse patient and graft survival. Nonalcoholic steatohepatitis and hepatocellular carcinoma are among the biggest risk factors for its development while on a wait list.

  18. A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care.

    Science.gov (United States)

    Yadav, Geeta; Goldberg, Hanna R; Barense, Morgan D; Bell, Chaim M

    2016-01-01

    Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4-3.4), followed by Urgent care (9.0 weeks; IQR = 2.1-12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4-16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care.

  19. PREFACE: 11th International Conference on Nucleus-Nucleus Collisions (NN2012)

    Science.gov (United States)

    Li, Bao-An; Natowitz, Joseph B.

    2013-03-01

    The 11th International Conference on Nucleus-Nucleus Collisions (NN2012) was held from 27 May to 1 June 2012, in San Antonio, Texas, USA. It was jointly organized and hosted by The Cyclotron Institute at Texas A&M University, College Station and The Department of Physics and Astronomy at Texas A&M University-Commerce. Among the approximately 300 participants were a large number of graduate students and post-doctoral fellows. The Keynote Talk of the conference, 'The State of Affairs of Present and Future Nucleus-Nucleus Collision Science', was given by Dr Robert Tribble, University Distinguished Professor and Director of the TAMU Cyclotron Institute. During the conference a very well-received public lecture on neutrino astronomy, 'The ICEcube project', was given by Dr Francis Halzen, Hilldale and Gregory Breit Distinguished Professor at the University of Wisconsin, Madison. The Scientific program continued in the general spirit and intention of this conference series. As is typical of this conference a broad range of topics including fundamental areas of nuclear dynamics, structure, and applications were addressed in 42 plenary session talks, 150 parallel session talks, and 21 posters. The high quality of the work presented emphasized the vitality and relevance of the subject matter of this conference. Following the tradition, the NN2012 International Advisory Committee selected the host and site of the next conference in this series. The 12th International Conference on Nucleus-Nucleus Collisions (NN2015) will be held 21-26 June 2015 in Catania, Italy. It will be hosted by The INFN, Laboratori Nazionali del Sud, INFN, Catania and the Dipartimento di Fisica e Astronomia of the University of Catania. The NN2012 Proceedings contains the conference program and 165 articles organized into the following 10 sections 1. Heavy and Superheavy Elements 2. QCD and Hadron Physics 3. Relativistic Heavy-Ion Collisions 4. Nuclear Structure 5. Nuclear Energy and Applications of

  20. DVD training for depression identification and treatment in older adults: a two-group, randomized, wait-list control study.

    Science.gov (United States)

    Lysack, Cathy; Leach, Carrie; Russo, Theresa; Paulson, Daniel; Lichtenberg, Peter A

    2013-01-01

    OBJECTIVE. To test the effectiveness of an educational intervention aimed at improving mental health knowledge and skills in occupational therapists working with older rehabilitation patients. METHOD. The DVD-format educational intervention was evaluated using a two-group randomized wait-list control design. Occupational therapists (n = 75) completed a 32-item knowledge questionnaire at three time points. Patient charts were reviewed (n = 960) at 3 months before and 3 and 6 months after DVD training to evaluate clinical practice change. RESULTS. A two-way analysis of variance showed knowledge scores increased significantly for both groups after DVD training. A significant Group × Time interaction and significant main effects for time and group were found. Chart review data also showed significant increases in desired clinical behaviors in both groups after training. The greatest single item of clinical practice change was use of a standardized depression screen. CONCLUSION. DVD-based training can significantly improve mental health practice. Copyright © 2013 by the American Occupational Therapy Association, Inc.

  1. Heterogeneous calretinin expression in the avian cochlear nucleus angularis.

    Science.gov (United States)

    Bloom, S; Williams, A; MacLeod, K M

    2014-08-01

    Multiple calcium-binding proteins (CaBPs) are expressed at high levels and in complementary patterns in the auditory pathways of birds, mammals, and other vertebrates, but whether specific members of the CaBP family can be used to identify neuronal subpopulations is unclear. We used double immunofluorescence labeling of calretinin (CR) in combination with neuronal markers to investigate the distribution of CR-expressing neurons in brainstem sections of the cochlear nucleus in the chicken (Gallus gallus domesticus). While CR was homogeneously expressed in cochlear nucleus magnocellularis, CR expression was highly heterogeneous in cochlear nucleus angularis (NA), a nucleus with diverse cell types analogous in function to neurons in the mammalian ventral cochlear nucleus. To quantify the distribution of CR in the total NA cell population, we used antibodies against neuronal nuclear protein (NeuN), a postmitotic neuron-specific nuclear marker. In NA neurons, NeuN label was variably localized to the cell nucleus and the cytoplasm, and the intensity of NeuN immunoreactivity was inversely correlated with the intensity of CR immunoreactivity. The percentage of CR + neurons in NA increased from 31 % in embryonic (E)17/18 chicks, to 44 % around hatching (E21), to 51 % in postnatal day (P) 8 chicks. By P8, the distribution of CR + neurons was uniform, both rostrocaudal and in the tonotopic (dorsoventral) axis. Immunoreactivity for the voltage-gated potassium ion channel Kv1.1, used as a marker for physiological type, showed broad and heterogeneous postsynaptic expression in NA, but did not correlate with CR expression. These results suggest that CR may define a subpopulation of neurons within nucleus angularis.

  2. Delayed gratification: A grey parrot (Psittacus erithacus) will wait for a better reward.

    Science.gov (United States)

    Koepke, Adrienne E; Gray, Suzanne L; Pepperberg, Irene M

    2015-11-01

    Delay of gratification, the ability to forgo an immediate reward to gain either better quality or quantity, has been used as a metric for temporal discounting, self-control, and the ability to plan for the future in both humans (particularly children) and nonhumans. The task involved can be parsed in several ways, such that the subjects can be required to wait, not only for a better or a larger reward, but also such that the rewards can either be in view or hidden during the delay interval. We have demonstrated that a Grey parrot (Psittacus erithacus) trained in the use of English speech could respond to the label "wait" for up to 15 min, in a task that has many similarities to those used with young children, to receive a better quality reward, whether or not the better quality reward or the experimenter was in view. (c) 2015 APA, all rights reserved).

  3. Controlling synchrony in oscillatory networks via an act-and-wait algorithm.

    Science.gov (United States)

    Ratas, Irmantas; Pyragas, Kestutis

    2014-09-01

    The act-and-wait control algorithm is proposed to suppress synchrony in globally coupled oscillatory networks in the situation when the simultaneous registration and stimulation of the system is not possible. The algorithm involves the periodic repetition of the registration (wait) and stimulation (act) stages, such that in the first stage the mean field of the free system is recorded in a memory and in the second stage the system is stimulated with the recorded signal. A modified version of the algorithm that takes into account the charge-balanced requirement is considered as well. The efficiency of our algorithm is demonstrated analytically and numerically for globally coupled Landau-Stuart oscillators and synaptically all-to-all coupled FitzHugh-Nagumo as well as Hodgkin-Huxley neurons.

  4. Act-and-wait time-delayed feedback control of autonomous systems

    Science.gov (United States)

    Pyragas, Viktoras; Pyragas, Kestutis

    2018-02-01

    Recently an act-and-wait modification of time-delayed feedback control has been proposed for the stabilization of unstable periodic orbits in nonautonomous dynamical systems (Pyragas and Pyragas, 2016 [30]). The modification implies a periodic switching of the feedback gain and makes the closed-loop system finite-dimensional. Here we extend this modification to autonomous systems. In order to keep constant the phase difference between the controlled orbit and the act-and-wait switching function an additional small-amplitude periodic perturbation is introduced. The algorithm can stabilize periodic orbits with an odd number of real unstable Floquet exponents using a simple single-input single-output constraint control.

  5. Is Waiting the Hardest Part? Comparing the Emotional Experiences of Awaiting and Receiving Bad News.

    Science.gov (United States)

    Sweeny, Kate; Falkenstein, Angelica

    2015-11-01

    Awaiting uncertain news is stressful, but is it more stressful than receiving bad news? We compared these emotional experiences in two studies. Participants in Study 1 reflected on a personal experience awaiting news that ultimately turned out badly, and participants in Study 2 were law graduates awaiting their results on the bar exam who ultimately failed the exam. In Study 1, participants were ambivalent as to whether awaiting or receiving bad news was more difficult, and emotion ratings in both studies confirmed this ambivalence. Anxiety was higher in anticipation of bad news (at least at the moment of truth) than in the face of it, whereas other negative emotions were more intense following the news than during the waiting period. Thus, whether waiting is "the hardest part" depends on whether one prefers to be racked with anxiety or afflicted with other negative emotions such as anger, disappointment, depression, and regret. © 2015 by the Society for Personality and Social Psychology, Inc.

  6. Kidney transplantation: experience of men in hemodialysis entered on the waiting list

    Directory of Open Access Journals (Sweden)

    Ana Mariele de Souza

    2016-04-01

    Full Text Available Objective: to know the experiences of men with chronic renal failure under hemodialysis treatment entered on the kidney transplant waiting list. Method: qualitative study based on the principles of the National Policy for Integral Attention to Men’s Health and Masculinity, conducted with 11 participants in a hemodialysis service, through serial semi-structured interviews and inductive data analysis. Results: the following categories emerged: Gaps between the health policies and the reality of the male population and Challenges and possibilities of change in the life process. Conclusion: although many of these men see hemodialysis as synonym of imprisonment, others understand it as the possibility of maintaining survival and this help them waiting for the kidney transplant.

  7. Outcome Probability versus Magnitude: When Waiting Benefits One at the Cost of the Other

    Science.gov (United States)

    Young, Michael E.; Webb, Tara L.; Rung, Jillian M.; McCoy, Anthony W.

    2014-01-01

    Using a continuous impulsivity and risk platform (CIRP) that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1) or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2). Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART). PMID:24892657

  8. Outcome probability versus magnitude: when waiting benefits one at the cost of the other.

    Directory of Open Access Journals (Sweden)

    Michael E Young

    Full Text Available Using a continuous impulsivity and risk platform (CIRP that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1 or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2. Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART.

  9. Outcome probability versus magnitude: when waiting benefits one at the cost of the other.

    Science.gov (United States)

    Young, Michael E; Webb, Tara L; Rung, Jillian M; McCoy, Anthony W

    2014-01-01

    Using a continuous impulsivity and risk platform (CIRP) that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1) or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2). Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART).

  10. Not all waits are equal: An exploratory investigation of emergency care patient pathways

    OpenAIRE

    Swancutt, D; Joel-Edgar, S; Allen, M; Thomas, D.; Brant, H; Benger, J.; Byng, R.; Pinkney, J.

    2017-01-01

    BACKGROUND: Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Strea...

  11. Patients with Chronic Hepatitis C Undergoing Watchful Waiting: Exploring Trajectories of Illness Uncertainty and Fatigue

    OpenAIRE

    Bailey, Donald E.; Barroso, Julie; Muir, Andrew J.; Sloane, Richard; Richmond, Jacqui; McHutchison, John; Patel, Keyur; Landerman, Lawrence; Mishel, Merle H.

    2010-01-01

    We identified trajectories of illness uncertainty in chronic hepatitis C patients and examined their association with fatigue levels during 12 months of disease monitoring without treatment (watchful waiting). Sixty-two men and 63 women completed uncertainty and fatigue measures. Groups were formed by uncertainty scores (high, medium, low) at baseline. Baseline fatigue levels were higher in the high uncertainty group than in the medium and low groups. Over time, uncertainty levels did not cha...

  12. Waiting-time distributions of magnetic discontinuities: clustering or Poisson process?

    Science.gov (United States)

    Greco, A; Matthaeus, W H; Servidio, S; Dmitruk, P

    2009-10-01

    Using solar wind data from the Advanced Composition Explorer spacecraft, with the support of Hall magnetohydrodynamic simulations, the waiting-time distributions of magnetic discontinuities have been analyzed. A possible phenomenon of clusterization of these discontinuities is studied in detail. We perform a local Poisson's analysis in order to establish if these intermittent events are randomly distributed or not. Possible implications about the nature of solar wind discontinuities are discussed.

  13. A marketing perspective on the influences of waiting time and servicescape on perceived value

    OpenAIRE

    Costinel DOBRE; Anca Cristina DRAGOMIR; Anca-Maria MILOVAN-CIUTA

    2013-01-01

    Customer’s value perception of products and services is a variable with important implications on the marketing performance of the organizations. In this article we intend to analyse influences of waiting time and servicescape perception on the perceived value of customers of a dental clinic. The empirical research carried out for the elaboration of this article is part of a wider research concerning the multidimensional approach of the service value perceived by clients. Survey findings show...

  14. The effects of music intervention on anxiety in the patient waiting for cardiac catheterization.

    Science.gov (United States)

    Hamel, W J

    2001-10-01

    Hospitalization causes anxiety for many patients. It increases when patients anticipate their turn for cardiac catheterization. Music therapy reduces the psychophysiologic effects of anxiety and stress through the relaxation response. To determine the effects of music therapy an anxiety, heart rate and arterial blood pressure in patients waiting for their scheduled cardiac catheterization. In a quasi-experimental, pretest-posttest design, 101 subjects were randomly assigned to either the test group: those who listened to 20 minutes of preselected music, or the control group: those who received treatment as usual. Subject anxiety levels and physiological values were measured while waiting their turn for cardiac catheterization and just prior to departure to the cardiac lab. 63 males and 38 females participated in the study. There was a statistically significant reduction in anxiety in the test group alone (P = 0.003) and in comparing the test to the control group (P = 0.004). In comparing the initial and departure physiologic values, it was noted that both heart rate and systolic blood pressure dropped in the test group, but increased in the control group. Within gender groups, there were no statistically significant differences in hemodynamics or STAI scores, but between gender groups there were significantly higher diastolic blood pressure in males and STAI initial and departure scores for females. Patients waiting for their cardiac catheterization benefit from music therapy. Anxiety and the heightened physiological values elicited by the stress response are reduced. Results also suggest that women waiting for cardiac catheterization experience a higher level of anxiety than males.

  15. Asymptotic inference for waiting times and patiences in queues with abandonment

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Hansen, Martin Bøgsted

    2009-01-01

    Motivated by applications in call center management, we propose a framework based on empirical process techniques for inference about waiting time and patience distributions in multiserver queues with abandonment. The framework rigorises heuristics based on survival analysis of independent and id...... and statistical tests, including a simple bootstrap two-sample test for comparing patience distributions. A small simulation study and a real data example are presented....

  16. Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study.

    Science.gov (United States)

    Grossert, Astrid; Urech, Corinne; Alder, Judith; Gaab, Jens; Berger, Thomas; Hess, Viviane

    2016-11-03

    Being diagnosed with cancer causes major psychological distress, yet the majority of newly diagnosed cancer patients lack psychological support. Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place. We assess efficacy and feasibility of the first web-based stress management intervention (STREAM: STREss-Aktiv-Mindern) for newly diagnosed, German-speaking cancer patients. In a prospective, wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and randomized between an immediate (intervention group) or delayed (control group) 8-week, web-based intervention. The intervention consists of eight modules with weekly written feedback by a psychologist ("minimal-contact") based on well-established stress management manuals including downloadable audio-files and exercises. The aim of this study is to evaluate efficacy in terms of improvement in quality of life (FACT-F), as well as decrease in anxiety and depression (HADS), as compared to patients in the wait-list control group. A sample size of 120 patients allows demonstrating a clinically relevant difference of nine points in the FACT score after the intervention (T2) with a two-sided alpha of 0.05 and 80 % power. As this is the first online stress management intervention for German-speaking cancer patients, more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials. These descriptive endpoints include: patients' characteristics (type of cancer, type of treatment, socio-demographic factors), dropout rate and dropout reasons, adherence and satisfaction with the program. New technologies open new opportunities: minimal-contact psychological interventions are becoming standard of care in several psychological disorders, where their efficacy is often

  17. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation.

    Science.gov (United States)

    Pompili, Maurizio; Francica, Giampiero; Ponziani, Francesca Romana; Iezzi, Roberto; Avolio, Alfonso Wolfango

    2013-11-21

    Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). The most used treatments include transarterial chemoembolization and radiofrequency ablation. Surgical resection has also been successfully used as a bridging procedure, and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function. The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation, reducing HCC recurrence after transplantation, and improving post-transplant overall survival. To date, no data from prospective randomized studies are available; however, for HCC patients listed for LT within the Milan criteria, prolonging the waiting time over 6-12 mo is a risk factor for tumor spread. Bridging treatments are useful in containing tumor progression and decreasing dropout. Furthermore, the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT. Lastly, although a definitive conclusion can not be reached, the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival. Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT. Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging.

  18. Improving the waiting list by using 75-year-old donors for recipients with hepatocellular carcinoma.

    Science.gov (United States)

    Cascales Campos, P A; Romero, P R; Gonzalez, R; Zambudio, A R; Martinez Frutos, I M; de la Peña, J; Bueno, F S; Robles Campos, R; Miras, M; Pons Miñano, J A; Sanmartin Monzo, A; Domingo, J; Bixquert Montagud, V; Parrilla Paricio, P

    2010-03-01

    The best treatment for hepatocellular carcinoma (HCC) associated with liver cirrhosis is liver transplantation and the best results are obtained when the tumors fulfill the Milan criteria. However, although the number of transplants is increasing, the organ deficit is growing, which lengthens time on the waiting list, increasing the risk of tumor progression of and exclusion from the list. The use of elderly donors is a valid option for patients on the transplant waiting list with HCC, reducing time on the waiting list. We report our experience with patients transplanted for HCC associated with hepatic cirrhosis using livers from donors >75 years of age. Our preliminary results supported the use of elderly suboptimal donors making it possible to give priority to these patients. All patients in the series achieved good graft function after a follow-up of 2 years with a 100% disease-free survival rate. More extensive long-term studies are needed to confirm these findings. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. [Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

    Science.gov (United States)

    Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

    2015-12-01

    Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. A Scheduling Method to Reduce Waiting Time for Close-Range Broadcasting

    Directory of Open Access Journals (Sweden)

    Yusuke Gotoh

    2012-01-01

    Full Text Available Due to the recent popularization of digital broadcasting systems, close-range broadcasting using continuous media data, i.e. audio and video, has attracted great attention. For example, in a drama, after a user watches interesting content such as a highlight scene, he/she will watch the main program continuously. In close-range broadcasting, the necessary bandwidth for continuously playing the two types of data increases. Conventional methods reduce the necessary bandwidth by producing an effective broadcast schedule for continuous media data. However, these methods do not consider the broadcast schedule for two types of continuous media data. When the server schedules two types of continuous media data, waiting time that occurs from finishing the highlight scene to starting the main scene, may increase. In this paper, we propose a scheduling method to reduce the waiting time for close-range broadcasting. In our proposed method, by dividing two types of data and producing an effective broadcast schedule considering the available bandwidth, we can reduce the waiting time.

  1. Specific timely appointments for triage reduced waiting lists in an outpatient physiotherapy service.

    Science.gov (United States)

    Harding, K E; Bottrell, J

    2016-12-01

    Waiting lists with triage systems are commonly used in outpatient physiotherapy but may not be effective. Could an alternative model of access and triage reduce waiting times over a sustained period with no additional resources? Observational study comparing retrospective data for 11 months prior to the introduction of a new model of access compared with data for the equivalent 11 months afterwards. Patients referred to a physiotherapy outpatient department at an outer metropolitan hospital before (n=721) and after (n=707) the introduction of the new model. A model of access and triage known as 'specific timely appointments for triage' (STAT), in which appointment slots are preserved in advance specifically for new patients based on calculation of average demand. Time from referral to first assessment, number of appointments per patient, occasions of non-attendance and total length of stay in the service. Median time from referral to first appointment was 18 days [interquartile range (IQR) 11 to 33 days] in the pre-intervention group, compared with 14 days (IQR 9 to 21 days) in the post-intervention group (Pphysiotherapy appointments also reduced (IQR 2 to 6 vs IQR 1 to 4; Pphysiotherapy was 22% lower in the year following the introduction of the STAT model. While acknowledging the limitations of a pre- and post-measurement design, this model may have potential for reducing waiting times for outpatient physiotherapy without additional resources. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  2. A comparison of walk-in counselling and the wait list model for delivering counselling services().

    Science.gov (United States)

    Stalker, Carol A; Riemer, Manuel; Cait, Cheryl-Anne; Horton, Susan; Booton, Jocelyn; Josling, Leslie; Bedggood, Joanna; Zaczek, Margaret

    2016-10-01

    Walk-in counselling has been used to reduce wait times but there are few controlled studies to compare outcomes between walk-in and the traditional model of service delivery. To compare change in psychological distress by clients receiving services from two models of service delivery, a walk-in counselling model and a traditional counselling model involving a wait list. Mixed-methods sequential explanatory design including quantitative comparison of groups with one pre-test and two follow-ups, and qualitative analysis of interviews with a sub-sample. Five-hundred and twenty-four participants ≥16 years were recruited from two Family Counselling Agencies; the General Health Questionnaire-12 assessed change in psychological distress. Hierarchical linear modelling revealed clients of the walk-in model improved faster and were less distressed at the four-week follow-up compared to the traditional service delivery model. Ten weeks later, both groups had improved and were similar. Participants receiving instrumental services prior to baseline improved more slowly. The qualitative data confirmed participants highly valued the accessibility of the walk-in model, and were frustrated by the lengthy waits associated with the traditional model. This study improves methodologically on previous studies of walk-in counselling, an approach to service delivery not conducive to randomized controlled trials.

  3. The effect of superfluid hydrodynamics on pulsar glitch sizes and waiting times

    Science.gov (United States)

    Haskell, B.

    2016-09-01

    Pulsar glitches, sudden jumps in frequency observed in many radio pulsars, may be the macroscopic manifestation of superfluid vortex avalanches on the microscopic scale. Small-scale quantum mechanical simulations of vortex motion in a decelerating container have shown that such events are possible and predict power-law distributions for the size of the events, and exponential distributions for the waiting time. Despite a paucity of data, this prediction is consistent with the size and waiting time distributions of most glitching pulsars. Nevertheless, a few object appear to glitch quasi-periodically, and exhibit many large glitches, while a recent study of the Crab pulsar has suggested deviations from a power-law distribution for smaller glitches. In this Letter, we incorporate the results of quantum mechanical simulations in a macroscopic superfluid hydrodynamics simulation. We show that the effect of vortex coupling to the neutron and proton fluids in the star naturally leads to deviations from power-law distributions for sizes, and from exponential distributions for waiting times, and we predict a cutoff in the size distribution for small glitches.

  4. Calculated dynamical evolution of the nucleus of comet Hartley 2

    Science.gov (United States)

    Ksanfomality, Leonid

    2013-04-01

    The nucleus of comet Hartley 2 has a relatively regular dumbbell shape with unequal heads. The narrow part of elongated shape contains a relatively smooth region whose covering material is highly different in its shallow structure compared to other parts of this celestial body. The surface of crudely spherical parts of the nucleus is different from the surface of the "neck", which implies a hypothesis that the shape of the nucleus of Hartley 2 is indicative of destruction of this celestial body occurring in our days. The nucleus rotates around its axis passing through the center of mass, and centrifugal forces arise. This process is hindered by gravitation between parts of the nucleus and gradual slowing of rotation due to body lengthening because of the increase in the moment of inertia (proportional to R2) and due to friction losses in the neck material. We posed the task to determine centrifugal and gravitational forces in the neck (and, respectively, the strains of stretching and compression), the moment of inertia of the body and supply of its rotational energy E, the volume of the nucleus and its average density, and the position of the barycenter and center of rotation. It can be assumed that these forces cause slow but progressive lengthening of the neck which should eventually result in fragmentation of the nucleus. Centrifugal forces can be found as a result of summation of forces produced by parts of the body. According to the calculation model, the total stretching forces in the section passing through the narrowest cut of the neck are 1.21E6 N. The corresponding compression forces in the section passing through the narrow section are 1.04E6 N. The comparison of these values indicates a paradoxical result: stretching strains dominate in the neck, while compressions are dominant in the section passing through the common center of mass. The excess of stretching strains in the neck is 11%. The inference is as follows: the right part of the neck and the

  5. Qualitative analysis neurons in the adult human dentate nucleus

    Directory of Open Access Journals (Sweden)

    Marić Dušica

    2012-01-01

    Full Text Available Although many relevant findings regarding to the morphology and cytoarchitectural development of the dentate nucleus have been presented so far, very little qualitative information has been collected on neuronal morphology in the adult human dentate nucleus. The neurons were labelled by Golgi staining from thirty human cerebella, obtained from medico-legal forensic autopsies of adult human bodies and free of significant brain pathology. The human dentate neurons were qualitatively analyzed and these cells were classified into two main classes: the small and the large multipolar neurons. Considering the shape of the cell body, number of the primary dendrites, shape of the dendritic tree and their position within the dentate nucleus, three subclasses of the large multipolar neurons have been recognized. The classification of neurons from the human dentate nucleus has been qualitatively confirmed in fetuses and premature infants. This study represents the first qualitative analysis and classification of the large multipolar neurons in the dentate nucleus of the adult human.

  6. Classical cadherins control nucleus and centrosome position and cell polarity.

    Science.gov (United States)

    Dupin, Isabelle; Camand, Emeline; Etienne-Manneville, Sandrine

    2009-06-01

    Control of cell polarity is crucial during tissue morphogenesis and renewal, and depends on spatial cues provided by the extracellular environment. Using micropatterned substrates to impose reproducible cell-cell interactions, we show that in the absence of other polarizing cues, cell-cell contacts are the main regulator of nucleus and centrosome positioning, and intracellular polarized organization. In a variety of cell types, including astrocytes, epithelial cells, and endothelial cells, calcium-dependent cadherin-mediated cell-cell interactions induce nucleus and centrosome off-centering toward cell-cell contacts, and promote orientation of the nucleus-centrosome axis toward free cell edges. Nucleus and centrosome off-centering is controlled by N-cadherin through the regulation of cell interactions with the extracellular matrix, whereas the orientation of the nucleus-centrosome axis is determined by the geometry of N-cadherin-mediated contacts. Our results demonstrate that in addition to the specific function of E-cadherin in regulating baso-apical epithelial polarity, classical cadherins control cell polarization in otherwise nonpolarized cells.

  7. Cochlear nucleus whole mount explants promote the differentiation of neuronal stem cells from the cochlear nucleus in co-culture experiments.

    Science.gov (United States)

    Rak, Kristen; Völker, Johannes; Jürgens, Lukas; Völker, Christine; Frenz, Silke; Scherzad, Agmal; Schendzielorz, Philipp; Jablonka, Sibylle; Mlynski, Robert; Radeloff, Andreas; Hagen, Rudolf

    2015-08-07

    The cochlear nucleus is the first brainstem nucleus to receive sensory input from the cochlea. Depriving this nucleus of auditory input leads to cellular and molecular disorganization which may potentially be counteracted by the activation or application of stem cells. Neuronal stem cells (NSCs) have recently been identified in the neonatal cochlear nucleus and a persistent neurogenic niche was demonstrated in this brainstem nucleus until adulthood. The present work investigates whether the neurogenic environment of the cochlear nucleus can promote the survival of engrafted NSCs and whether cochlear nucleus-derived NSCs can differentiate into neurons and glia in brain tissue. Therefore, cochlear nucleus whole-mount explants were co-cultured with NSCs extracted from either the cochlear nucleus or the hippocampus and compared to a second environment using whole-mount explants from the hippocampus. Factors that are known to induce neuronal differentiation were also investigated in these NSC-explant experiments. NSCs derived from the cochlear nucleus engrafted in the brain tissue and differentiated into all cells of the neuronal lineage. Hippocampal NSCs also immigrated in cochlear nucleus explants and differentiated into neurons, astrocytes and oligodendrocytes. Laminin expression was up-regulated in the cochlear nucleus whole-mounts and regulated the in vitro differentiation of NSCs from the cochlear nucleus. These experiments confirm a neurogenic environment in the cochlear nucleus and the capacity of cochlear nucleus-derived NSCs to differentiate into neurons and glia. Consequently, the presented results provide a first step for the possible application of stem cells to repair the disorganization of the cochlear nucleus, which occurs after hearing loss. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Evaluation of two dairy herd reproductive performance indicators that are adjusted for voluntary waiting period

    Directory of Open Access Journals (Sweden)

    Löf Emma

    2012-01-01

    Full Text Available Abstract Background Overall reproductive performance of dairy herds is monitored by various indicators. Most of them do not consider all eligible animals and do not consider different management strategies at farm level. This problem can be alleviated by measuring the proportion of pregnant cows by specific intervals after their calving date or after a fixed time period, such as the voluntary waiting period. The aim of this study was to evaluate two reproductive performance indicators that consider the voluntary waiting period at the herd. The two indicators were: percentage of pregnant cows in the herd after the voluntary waiting period plus 30 days (PV30 and percentage of inseminated cows in the herd after the voluntary waiting period plus 30 days (IV30. We wanted to assess how PV30 and IV30 perform in a simulation of herds with different reproductive management and physiology and to compare them to indicators of reproductive performance that do not consider the herd voluntary waiting period. Methods To evaluate the reproductive indicators we used the SimHerd-program, a stochastic simulation model, and 18 scenarios were simulated. The scenarios were designed by altering the reproductive management efficiency and the status of reproductive physiology of the herd. Logistic regression models, together with receiver operating characteristics (ROC, were used to examine how well the reproductive performance indicators could discriminate between herds of different levels of reproductive management efficiency or reproductive physiology. Results The logistic regression models with the ROC analysis showed that IV30 was the indicator that best discriminated between different levels of management efficiency followed by PV30, calving interval, 200-days not-in calf-rate (NotIC200, in calf rate at100-days (IC100 and a fertility index. For reproductive physiology the ROC analysis showed that the fertility index was the indicator that best discriminated

  9. Using Social Media While Waiting in Pain: A Clinical 12-Week Longitudinal Pilot Study.

    Science.gov (United States)

    Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando; Mantopoulos, Steven; Hogg, Malcolm

    2015-08-07

    Chronic pain places an enormous burden on health care systems. Multidisciplinary pain management services are well documented as an effective means to improve patient outcomes. However, waiting lists to access these services are long and outcomes deteriorate. Innovative solutions such as social media are gaining attention as a way to decrease this burden and improve outcomes. It is a challenge to design research that demonstrates whether social media are acceptable to patients and clinically effective. The aim was to conduct a longitudinal pilot study to understand what aspects of research design are key to the success of running a larger-scale study of social media use in the clinical management of chronic pain. A 12-week study examined social media use by patients on the waiting list for the Royal Melbourne Hospital Pain Management Service. Selected social media resources were suggested for use by patients waiting for an appointment at the clinic. Patients filled out measures for pain interference and pain self-efficacy before and after the study. Follow-up was conducted at monthly intervals via telephone semistructured interviews to discuss engagement and garner individual perceptions towards social media use. A social media-use instrument was also administered as part of the after-study questionnaire. Targeted recruitment refined 235 patient referrals to 138 (58.7%) suitable potential participants. Contact was made with 84 out of 138 (60.9%) patients. After a further exclusion of 54 out of 84 (64%) patients for various reasons, this left 30 out of 84 (36%) patients fitting the inclusion criteria and interested in study participation. A final study cohort of 17 out of 30 (57%) was obtained. Demographics of the 17 patients were mixed. Low back pain was the primary condition reported as leading to chronic pain. Semistructured interviews collected data from 16 out of 17 (94%) patients who started the trial, and at final follow-up 9 out of 17 (53%) patients

  10. An Estimation Method of Waiting Time for Health Service at Hospital by Using a Portable RFID and Robust Estimation

    Science.gov (United States)

    Ishigaki, Tsukasa; Yamamoto, Yoshinobu; Nakamura, Yoshiyuki; Akamatsu, Motoyuki

    Patients that have an health service by doctor have to wait long time at many hospitals. The long waiting time is the worst factor of patient's dissatisfaction for hospital service according to questionnaire for patients. The present paper describes an estimation method of the waiting time for each patient without an electronic medical chart system. The method applies a portable RFID system to data acquisition and robust estimation of probability distribution of the health service and test time by doctor for high-accurate waiting time estimation. We carried out an health service of data acquisition at a real hospital and verified the efficiency of the proposed method. The proposed system widely can be used as data acquisition system in various fields such as marketing service, entertainment or human behavior measurement.

  11. Individual and Regional Factors of Access to the Renal Transplant Waiting List in France in a Cohort of Dialyzed Patients

    National Research Council Canada - National Science Library

    Bayat, S; Macher, M. A; Couchoud, C; Bayer, F; Lassalle, M; Villar, E; Caillé, Y; Mercier, S; Joyeux, V; Noel, C; Kessler, M; Jacquelinet, C

    2015-01-01

    This study demonstrates that in addition to individual factors such as age and comorbidities, the accumulation of patients on the waiting list, likely related to regional variations in organ shortage...

  12. Improved functional outcome after hip fracture is associated with duration of rehabilitation, but not with waiting time for rehabilitation

    DEFF Research Database (Denmark)

    Pedersen, Tonny Jaeger; Bogh, Louise Nicole Bie; Lauritsen, Jens Martin

    2017-01-01

    INTRODUCTION: The aim of this study was to explore the relationship between “waiting time to onset of municipal rehabilitation”, “length of municipal rehabilitation” and the attained level of function four months after the hip fracture. METHODS: Among a consecutive series of 156 patients, the 116...... patients who were recommended a municipal rehabilitation sequence after discharge were included. The exposures were waiting time in days and duration in hours of the municipal rehabilitation. The outcome was lower-extremity functional level as measured with the Short Physical Performance Battery. Effects...... were assessed with non-parametric gamma coefficients. RESULTS: The median waiting time to initiation of rehabilitation was ten days. A weak and insignificant correlation was observed between waiting time and outcome at four months, and a statistically significant correlation was recorded between...

  13. Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department

    National Research Council Canada - National Science Library

    Ng, David; Vail, Gord; Thomas, Sophia; Schmidt, Nicki

    2010-01-01

    ...) without adding any new funding or beds. In 2005 all staff in the ED at Hôtel-Dieu Grace Hospital began a transformation, employing Toyota Lean manufacturing principles to improve ED wait times and quality of care...

  14. ADAPTATION OF JOHNSON SEQUENCING ALGORITHM FOR JOB SCHEDULING TO MINIMISE THE AVERAGE WAITING TIME IN CLOUD COMPUTING ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    SOUVIK PAL

    2016-09-01

    Full Text Available Cloud computing is an emerging paradigm of Internet-centric business computing where Cloud Service Providers (CSPs are providing services to the customer according to their needs. The key perception behind cloud computing is on-demand sharing of resources available in the resource pool provided by CSP, which implies new emerging business model. The resources are provisioned when jobs arrive. The job scheduling and minimization of waiting time are the challenging issue in cloud computing. When a large number of jobs are requested, they have to wait for getting allocated to the servers which in turn may increase the queue length and also waiting time. This paper includes system design for implementation which is concerned with Johnson Scheduling Algorithm that provides the optimal sequence. With that sequence, service times can be obtained. The waiting time and queue length can be reduced using queuing model with multi-server and finite capacity which improves the job scheduling model.

  15. Insulin induces calcium signals in the nucleus of rat hepatocytes.

    Science.gov (United States)

    Rodrigues, Michele A; Gomes, Dawidson A; Andrade, Viviane A; Leite, M Fatima; Nathanson, Michael H

    2008-11-01

    Insulin is an hepatic mitogen that promotes liver regeneration. Actions of insulin are mediated by the insulin receptor, which is a receptor tyrosine kinase. It is currently thought that signaling via the insulin receptor occurs at the plasma membrane, where it binds to insulin. Here we report that insulin induces calcium oscillations in isolated rat hepatocytes, and that these calcium signals depend upon activation of phospholipase C and the inositol 1,4,5-trisphosphate receptor, but not upon extracellular calcium. Furthermore, insulin-induced calcium signals occur in the nucleus, and are temporally associated with selective depletion of nuclear phosphatidylinositol bisphosphate and translocation of the insulin receptor to the nucleus. These findings suggest that the insulin receptor translocates to the nucleus to initiate nuclear, inositol 1,4,5-trisphosphate-mediated calcium signals in rat hepatocytes. This novel signaling mechanism may be responsible for insulin's effects on liver growth and regeneration.

  16. The association between waiting for psychological therapy and therapy outcomes as measured by the CORE-OM.

    Science.gov (United States)

    Beck, Alison; Burdett, Mark; Lewis, Helen

    2015-06-01

    To investigate the impact of waiting for psychological therapy on client well-being as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) global distress (GD) score. Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE-OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE-OM during the last therapy session were also reviewed. The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post-therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE-OM. The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy. There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or

  17. Evidence for involvement of the subcoeruleus nucleus and nucleus raphe magnus in urine storage and penile erection in decerebrate rats.

    Science.gov (United States)

    Sugaya, K; Ogawa, Y; Hatano, T; Koyama, Y; Miyazato, T; Oda, M

    1998-06-01

    Micturition and male sexual activity require the lower urinary tract to function. During the sexual act, micturition must be inhibited and urine stored in the bladder. We studied the role of the brainstem in relation to both micturition/urine storage and penile erection in rats. Wire electrodes were placed on the dorsal nerve of the penis and microelectrodes for stimulation were introduced into the brainstem in decerebrate male rats. Electrical stimulation was used to locate optimally responding sites by monitoring the isovolumetric intravesical pressure and intracavernous pressure. Electrical stimulation of the dorsal nerve of the penis, the subcoeruleus nucleus in the rostral pons, and the nucleus raphe magnus in the caudal pons increased intracavernous pressure, but inhibited rhythmic bladder contractions. Electrical stimulation of Barrington's nucleus (the pontine micturition center in the rat) in the rostral pons induced bladder contraction. Stimulation of the pontine reticular formation did not increase intracavernous pressure. Acute transection of the thoracic spinal cord eliminated rhythmic bladder contractions, but gave rise to sporadic increments of intracavernous pressure. This electrophysiological study demonstrated that the subcoeruleus nucleus and nucleus raphe magnus are involved in both urine storage and penile erection, and that their physiological functions are reciprocally controlled; so that erection leads to inhibition of micturition.

  18. Silk fibroin porous scaffolds for nucleus pulposus tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Chao; Yang, Qiang [Department of Spine Surgery, Tianjin Hospital, Tianjin 300211 (China); Tianjin Medical University, Tianjin 300070 (China); Zhu, Meifeng [The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071 (China); Du, Lilong [Department of Spine Surgery, Tianjin Hospital, Tianjin 300211 (China); Tianjin Medical University, Tianjin 300070 (China); Zhang, Jiamin [The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071 (China); Ma, Xinlong [Department of Spine Surgery, Tianjin Hospital, Tianjin 300211 (China); Xu, Baoshan, E-mail: xubaoshan99@126.com [Department of Spine Surgery, Tianjin Hospital, Tianjin 300211 (China); Wang, Lianyong, E-mail: wly@nankai.edu.cn [The Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071 (China)

    2014-04-01

    Intervertebral discs (IVDs) are structurally complex tissue that hold the vertebrae together and provide mobility to spine. The nucleus pulposus (NP) degeneration often results in degenerative IVD disease that is one of the most common causes of back and neck pain. Tissue engineered nucleus pulposus offers an alternative approach to regain the function of the degenerative IVD. The aim of this study is to determine the feasibility of porous silk fibroin (SF) scaffolds fabricated by paraffin-sphere-leaching methods with freeze-drying in the application of nucleus pulposus regeneration. The prepared scaffold possessed high porosity of 92.38 ± 5.12% and pore size of 165.00 ± 8.25 μm as well as high pore interconnectivity and appropriate mechanical properties. Rabbit NP cells were seeded and cultured on the SF scaffolds. Scanning electron microscopy, histology, biochemical assays and mechanical tests revealed that the porous scaffolds could provide an appropriate microstructure and environment to support adhesion, proliferation and infiltration of NP cells in vitro as well as the generation of extracellular matrix. The NP cell–scaffold construction could be preliminarily formed after subcutaneously implanted in a nude mice model. In conclusion, The SF porous scaffold offers a potential candidate for tissue engineered NP tissue. - Highlights: • Paraffin microsphere-leaching method is used to fabricate silk fibroin scaffold. • The scaffold has appropriate mechanical property, porosity and pore size • The scaffold supports growth and infiltration of nucleus pulposus cells. • Nucleus pulposus cells can secrete extracellular matrix in the scaffolds. • The scaffold is a potential candidate for tissue engineered nucleus pulposus.

  19. Brain networks modulated by subthalamic nucleus deep brain stimulation.

    Science.gov (United States)

    Accolla, Ettore A; Herrojo Ruiz, Maria; Horn, Andreas; Schneider, Gerd-Helge; Schmitz-Hübsch, Tanja; Draganski, Bogdan; Kühn, Andrea A

    2016-09-01

    Deep brain stimulation of the subthalamic nucleus is an established treatment for the motor symptoms of Parkinson's disease. Given the frequent occurrence of stimulation-induced affective and cognitive adverse effects, a better understanding about the role of the subthalamic nucleus in non-motor functions is needed. The main goal of this study is to characterize anatomical circuits modulated by subthalamic deep brain stimulation, and infer about the inner organization of the nucleus in terms of motor and non-motor areas. Given its small size and anatomical intersubject variability, functional organization of the subthalamic nucleus is difficult to investigate in vivo with current methods. Here, we used local field potential recordings obtained from 10 patients with Parkinson's disease to identify a subthalamic area with an analogous electrophysiological signature, namely a predominant beta oscillatory activity. The spatial accuracy was improved by identifying a single contact per macroelectrode for its vicinity to the electrophysiological source of the beta oscillation. We then conducted whole brain probabilistic tractography seeding from the previously identified contacts, and further described connectivity modifications along the macroelectrode's main axis. The designated subthalamic 'beta' area projected predominantly to motor and premotor cortical regions additional to connections to limbic and associative areas. More ventral subthalamic areas showed predominant connectivity to medial temporal regions including amygdala and hippocampus. We interpret our findings as evidence for the convergence of different functional circuits within subthalamic nucleus' portions deemed to be appropriate as deep brain stimulation target to treat motor symptoms in Parkinson's disease. Potential clinical implications of our study are illustrated by an index case where deep brain stimulation of estimated predominant non-motor subthalamic nucleus induced hypomanic behaviour. © The

  20. Improved functional outcome after hip fracture is associated with duration of rehabilitation, but not with waiting time for rehabilitation

    OpenAIRE

    Pedersen, Tonny Jaeger; Bogh, Louise Nicole Bie; Lauritsen, Jens Martin

    2017-01-01

    INTRODUCTION: The aim of this study was to explore the relationship between “waiting time to onset of municipal rehabilitation”, “length of municipal rehabilitation” and the attained level of function four months after the hip fracture. METHODS: Among a consecutive series of 156 patients, the 116 patients who were recommended a municipal rehabilitation sequence after discharge were included. The exposures were waiting time in days and duration in hours of the municipal rehabilitation. The out...

  1. Final State Interactions Effects in Neutrino-Nucleus Interactions

    Energy Technology Data Exchange (ETDEWEB)

    Golan, Tomasz [Univ. of Wroctaw (Poland); Juszczak, Cezary [Univ. of Wroctaw (Poland); Sobczyk, Jan T. [Fermi National Accelerator Laboratory (FNAL), Batavia, IL (United States)

    2012-07-01

    Final State Interactions effects are discussed in the context of Monte Carlo simulations of neutrino-nucleus interactions. A role of Formation Time is explained and several models describing this effect are compared. Various observables which are sensitive to FSI effects are reviewed including pion-nucleus interaction and hadron yields in backward hemisphere. NuWro Monte Carlo neutrino event generator is described and its ability to understand neutral current $\\pi^0$ production data in $\\sim 1$ GeV neutrino flux experiments is demonstrated.

  2. Intrinsically disordered proteins in the nucleus of human cells.

    Science.gov (United States)

    Frege, Telma; Uversky, Vladimir N

    2015-05-01

    Intrinsically disordered proteins are known to perform a variety of important functions such as macromolecular recognition, promiscuous binding, and signaling. They are crucial players in various cellular pathway and processes, where they often have key regulatory roles. Among vital cellular processes intimately linked to the intrinsically disordered proteins is transcription, an intricate biological performance predominantly developing inside the cell nucleus. With this work, we gathered information about proteins that exist in various compartments and sub-nuclear bodies of the nucleus of the human cells, with the goal of identifying which ones are highly disordered and which functions are ascribed to the disordered nuclear proteins.

  3. Formation and decay of a hot compound nucleus

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, B.V.; Dalmolin, F.T.; Dutra, M.; Santos, T.J., E-mail: brett@ita.br [Instituto Tecnologico de Aeronautica (ITA), Sao Jose dos Campos SP (Brazil); Souza, S.R. [Universidade Federal de Rio Grande do Sul (UFRS), Porto Alegre RS, (Brazil); Universidade Federal de Rio de Janeiro (UFRJ), RJ (Brazil). Instituto de Fisica; Donangelo, R. [Instituto de Fisica, Universidad de la Republica de Uruguay, Montevideo (Uruguay); Universidade Federal de Rio Grande do Sul (UFRS), Porto Alegre RS, (Brazil)

    2014-07-01

    The compound nucleus plays an important role in nuclear reactions over a wide range of projectile-target combinations and energies. The limits that angular momentum places on its formation and existence are, for the most part, well understood. The limits on its excitation energy are not as clear. Here we first analyze general geometrical and thermodynamical features of a hot compound nucleus. We then discuss the manners by which it can decay and close by speculating on the high energy limit to its formation and existence. (author)

  4. Recent Developments in Neutrino/Antineutrino-Nucleus Interactions

    Directory of Open Access Journals (Sweden)

    Jorge G. Morfín

    2012-01-01

    Full Text Available Recent experimental results and developments in the theoretical treatment of neutrino-nucleus interactions in the energy range of 1–10 GeV are discussed. Difficulties in extracting neutrino-nucleon cross sections from neutrino-nucleus scattering data are explained and significance of understanding nuclear effects for neutrino oscillation experiments is stressed. Detailed discussions of the status of two-body current contribution in the kinematic region dominated by quasielastic scattering and specific features of partonic nuclear effects in weak DIS scattering are presented.

  5. Recent Developments in Neutrino/Antineutrino-Nucleus Interactions

    Energy Technology Data Exchange (ETDEWEB)

    Morfín, Jorge G.; Nieves, Juan; Sobczyk, Jan T.

    2012-01-01

    Recent experimental results and developments in the theoretical treatment of neutrino-nucleus interactions in the energy range of 1–10 GeV are discussed. Difficulties in extracting neutrino-nucleon cross sections from neutrino-nucleus scattering data are explained and significance of understanding nuclear effects for neutrino oscillation experiments is stressed. Detailed discussions of the status of two-body current contribution in the kinematic region dominated by quasielastic scattering and specific features of partonic nuclear effects in weak DIS scattering are presented.

  6. Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal

    Science.gov (United States)

    Naidoo, Logandran

    2016-01-01

    Background Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. Aim The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. Setting The study was conducted at the Catherine Booth Hospital (CBH) – a rural district hospital in KwaZulu-Natal, South Africa. Methods This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. Results All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p post-intervention). Conclusion The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators. PMID:27543283

  7. Normas, justiça, atribuição e poder: uma revisão e agenda de pesquisa sobre filas de espera Norms, justice, attribution and power: a revision and research agenda about waiting lines

    Directory of Open Access Journals (Sweden)

    Fabio Iglesias

    2007-04-01

    Full Text Available Partindo do pressuposto de que a fila de espera é um sistema social, são analisados brevemente sua natureza e seus tipos de ocorrência. Quatro temáticas da psicologia social que podem ser usadas para abordar os fenômenos de comportamento envolvidos em filas são analisadas: (a normas sociais e influência social; (b justiça, em suas vertentes distributiva, processual e interacional; (c atribuição de causalidade; (d relações de poder e de status. Como agenda de pesquisa, são identificadas ainda as lacunas empíricas em cada uma dessas temáticas, considerando a relevância teórica e prática dos problemas relacionados a situações reais de atendimento por filas de espera.Considering waiting lines as social systems, a short analysis of the nature and types of queues is presented. Four themes of social psychology are used to analyze behavior in waiting lines: (a social norms and social influence, (b distributive, procedural and interactional justice, (c causal attribution, and (d relations of power and status. Possible topics of research are pointed out in each of these themes, considering the theoretical and applied relevance of problems involving real waiting line situations.

  8. TRH injected into the nucleus accumbens shell releases dopamine and reduces feeding motivation in rats.

    Science.gov (United States)

    Puga, L; Alcántara-Alonso, V; Coffeen, U; Jaimes, O; de Gortari, P

    2016-06-01

    The thyrotropin-releasing hormone (TRH), an anorexigenic factor that reduces food intake in food-restricted animals, may be involved in motivation for food. Injected centrally, TRH impairs acquisition of food-rewarded behavior. Through the TRH-R1 receptors, TRH injected in the nucleus accumbens increases dopamine content-perhaps the mechanism by which the peptide modulates food motivation. This, however, is still to be demonstrated. We sought to evaluate dopamine release by microdialysis after a TRH injection into the nucleus accumbens shell in free-moving fasted rats. In addition, we assessed dopamine content and turnover by HPLC and the relationship with the motivation for food by analyzing the performance of rats during a progressive-ratio (PR) operant-conditioning test. Finally, we determined serum leptin and triiodothyronine (T3) levels in order to evaluate the animals' metabolic response to food restriction and the impact of intra-accumbal TRH administration on circulating hormones. Intra-accumbal injections of TRH reduced food intake in food-restricted rats-compared to counterparts treated with saline-, without further decreasing T3 or leptin levels, which dropped due to their dietary regime. TRH-injected rats had lower breaking points on the PR schedule, which indicated lower motivation to eat. Accordingly, compared to saline-treated animals, dopamine release and turnover increased in the nucleus accumbens of TRH-injected rats, a finding that suggests a relationship between motivation for food and TRH-induced release of dopamine. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Nucleus geometry and mechanical properties of resistance spot ...

    Indian Academy of Sciences (India)

    show that nugget diameter, indentation depth and tensile load-bearing capacity are affected by weld parameters. Coating prevents full joining at low parameters. Microhardness increased in heat-affected zone and weld metal. Keywords. Automotive steels; resistance spot welding; mechanical properties; nucleus geometry.

  10. Study of the variability of the nucleus of Centaurus A.

    Science.gov (United States)

    Fernandes de Mello Rabaca, D.; Abraham, Z.

    1990-11-01

    ABSTRACT. This work consists in the study of the variability of the nucleus of the peculiar galaxy NGC 5128 (Centaurus A) at the radio continuum frequency of 43 GHz. The data were obtained with the 13.7 m itapetinga Radiotelescope. The radio source presents a pair of inner radio lobes and a compact variable nucleus. The observational technique used was scans through the inner radio lobes and the nucleus. The quasi- simultaneous measurements of the flux density of each source allowed us to derive accurately the relative flux between them, and to obtain the real variability of the nucleus. RESUMO. Este trabalho consiste no estudo da variabilidade do nucleo da galaxia peculiar NGC 5128 (Centaurus A) no de radio na de 43 GHz. Os dados foram obtidos com 0 Radiotelescopio do Itapetinga. A radio fonte apresenta um par de lobulos internos e um nucleo compacto variavel. A tetnica observacional utilizada foi a de varreduras passando pelos lobulos e pelo nucleo. As medidas quase simultaneas da densidade de fluxo de cada fonte permitiu obter precisa- mente 0 fluxo relativo entre elas e a variabilidade real do nucleo. Keq woit : GALAXIES-RADIO

  11. Deexcitation of superdeformed bands in the nucleus Tb-151

    NARCIS (Netherlands)

    Finck, C; Appelbe, D; Beck, FA; Byrski, T; Cullen, D; Curien, D; deFrance, G; Duchene, G; Erturk, S; Haas, B; Khadiri, N; Kharraja, B; Prevost, D; Rigollet, C; Stezowski, O; Twin, P; Vivien, JP; Zuber, K

    1997-01-01

    The aim of this work is to get more informations about the decay-out of superdeformed bands. One of the best candidates in the mass A similar or equal to 150 region for that kind of research is the nucleus Tb-151. From previous works, it has been established that the first excited band goes lower in

  12. Subthalamic nucleus stimulation reverses mediofrontal influence over decision threshold

    NARCIS (Netherlands)

    Cavanagh, J.F.; Wiecki, T.V.; Cohen, M.X.; Figueroa, C.M.; Samanta, J.; Sherman, S.J.; Frank, M.J.

    2011-01-01

    It takes effort and time to tame one's impulses. Although medial prefrontal cortex (mPFC) is broadly implicated in effortful control over behavior, the subthalamic nucleus (STN) is specifically thought to contribute by acting as a brake on cortico-striatal function during decision conflict, buying

  13. Inelastic magnetic electron scattering form factors of the Mg nucleus

    Indian Academy of Sciences (India)

    states of the 26Mg nucleus have been studied using shell model calculations. The universal sd of the Wildenthal interaction, universal sd-shell interaction A, universal sd-shell interaction B, are used for the sd-shell orbits. Core polarization effects accord- ing to microscopic theory are taken into account by the excitations of ...

  14. Nuclear structure in odd-odd nucleus [sup 138]Pr

    Energy Technology Data Exchange (ETDEWEB)

    Rizzutto, M.A.; Cybulska, E.W.; Vanin, V.R.; Oliveira, J.R.B.; Emediato, L.G.R.; Ribas, R.V.; Seale, W.A.; Rao, M.N.; Medina, N.H.; Botelho, S.; Acquadro, J.C.; Lima, C.L. (Sao Paulo Univ., SP (Brazil). Lab. Pelletron)

    1992-12-01

    With the view of extending the systematics of odd-odd Pr nuclei toward the N=82 closed shell, high-spin states in [sup 138]Pr nucleus have been investigated with the [sup 128]Te([sup 14]N, 4n[gamma]) reaction. Configurations and spin assignments are suggested for three of the observed band-structures. (orig.).

  15. Sex hormone receptors are present in the human suprachiasmatic nucleus

    NARCIS (Netherlands)

    Kruijver, Frank P. M.; Swaab, Dick F.

    2002-01-01

    The suprachiasmatic nucleus (SCN) is the clock of the brain that orchestrates circadian and circannual biological rhythms, such as the rhythms of hormones, body temperature, sleep and mood. These rhythms are frequently disturbed in menopause and even more so in dementia and can be restored in

  16. KINEMATIC DETECTION OF THE DOUBLE NUCLEUS IN M31

    NARCIS (Netherlands)

    GERSSEN, J; KUIJKEN, K; MERRIFIELD, MR

    1995-01-01

    Using a spectrum obtained under moderate (similar to 1 arcsec) seeing, we show that the double nucleus in M31 produces a strong kinematic signature even though the individual components are not spatially resolved. The signature consists of a significant asymmetric wing in the stellar velocity

  17. CTP synthase forms cytoophidia in the cytoplasm and nucleus

    Energy Technology Data Exchange (ETDEWEB)

    Gou, Ke-Mian [MRC Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT (United Kingdom); State Key Laboratory for Agrobiotechnology, College of Biological Sciences, China Agricultural University, Beijing 100193 (China); Chang, Chia-Chun [Institute of Biotechnology, National Taiwan University, Taipei, Taiwan, ROC (China); Shen, Qing-Ji [MRC Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT (United Kingdom); Sung, Li-Ying, E-mail: liyingsung@ntu.edu.tw [Institute of Biotechnology, National Taiwan University, Taipei, Taiwan, ROC (China); Agricultural Biotechnology Research Center, Academia Sinica, Taipei 115, Taiwan, ROC (China); Liu, Ji-Long, E-mail: jilong.liu@dpag.ox.ac.uk [MRC Functional Genomics Unit, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford OX1 3PT (United Kingdom)

    2014-04-15

    CTP synthase is an essential metabolic enzyme responsible for the de novo synthesis of CTP. Multiple studies have recently showed that CTP synthase protein molecules form filamentous structures termed cytoophidia or CTP synthase filaments in the cytoplasm of eukaryotic cells, as well as in bacteria. Here we report that CTP synthase can form cytoophidia not only in the cytoplasm, but also in the nucleus of eukaryotic cells. Both glutamine deprivation and glutamine analog treatment promote formation of cytoplasmic cytoophidia (C-cytoophidia) and nuclear cytoophidia (N-cytoophidia). N-cytoophidia are generally shorter and thinner than their cytoplasmic counterparts. In mammalian cells, both CTP synthase 1 and CTP synthase 2 can form cytoophidia. Using live imaging, we have observed that both C-cytoophidia and N-cytoophidia undergo multiple rounds of fusion upon glutamine analog treatment. Our study reveals the coexistence of cytoophidia in the cytoplasm and nucleus, therefore providing a good opportunity to investigate the intracellular compartmentation of CTP synthase. - Highlights: • CTP synthase forms cytoophidia not only in the cytoplasm but also in the nucleus. • Glutamine deprivation and Glutamine analogs promotes cytoophidium formation. • N-cytoophidia exhibit distinct morphology when compared to C-cytoophidia. • Both CTP synthase 1 and CTP synthase 2 form cytoophidia in mammalian cells. • Fusions of cytoophidia occur in the cytoplasm and nucleus.

  18. Calcium-regulated import of myosin IC into the nucleus.

    Science.gov (United States)

    Maly, Ivan V; Hofmann, Wilma A

    2016-06-01

    Myosin IC is a molecular motor involved in intracellular transport, cell motility, and transcription. Its mechanical properties are regulated by calcium via calmodulin binding, and its functions in the nucleus depend on import from the cytoplasm. The import has recently been shown to be mediated by the nuclear localization signal located within the calmodulin-binding domain. In the present paper, it is demonstrated that mutations in the calmodulin-binding sequence shift the intracellular distribution of myosin IC to the nucleus. The redistribution is displayed by isoform B, described originally as the "nuclear myosin," but is particularly pronounced with isoform C, the normally cytoplasmic isoform. Furthermore, experimental elevation of the intracellular calcium concentration induces a rapid import of myosin into the nucleus. The import is blocked by the importin β inhibitor importazole. These findings are consistent with a mechanism whereby calmodulin binding prevents recognition of the nuclear localization sequence by importin β, and the steric inhibition of import is released by cell signaling leading to the intracellular calcium elevation. The results establish a mechanistic connection between the calcium regulation of the motor function of myosin IC in the cytoplasm and the induction of its import into the nucleus. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Nitric oxide and reactive oxygen species in the nucleus revisited.

    Science.gov (United States)

    Provost, Chantale; Choufani, Faten; Avedanian, Levon; Bkaily, Ghassan; Gobeil, Fernand; Jacques, Danielle

    2010-03-01

    Recent work from our group showed that the nuclear envelope membranes contain several G protein-coupled receptors, including prostaglandin E2 (EP3R) and endothelin-1 (ET-1) receptors. Activation of EP3R increased endothelial nitric oxide synthase (eNOS) RNA expression in nuclei. eNOS and inducible NOS (iNOS) are reported to also be present at the nuclear level. Furthermore, reactive oxygen species (ROS) were also localized at the nuclear level. In this review, we show that stimulation with NO donor sodium nitroprusside results in an increase of intranuclear calcium that was dependent on guanylate cyclase activation, but independent of MAPK. This increase in nuclear calcium correlated with an increase in nuclear transcription of iNOS. H2O2 and ET-1 increase both cytosolic and nuclear ROS in human endocardial endothelial cells and in human aortic vascular smooth muscle cells. This increase in ROS levels by H2O2 and ET-1 was reversed by the antioxidant glutathione. In addition, our results strongly suggest that cytosolic signalization is not only transmitted to the nucleus but is also generated by the nucleus. Furthermore, we demonstrate that oxidative stress can be sensed by the nucleus. These results highly suggest that ROS formation is also generated directly by the nucleus and that free radicals may contribute to ET-1 regulation of nuclear Ca2+ homeostasis.

  20. Inclusive jet production in ultrarelativistic proton-nucleus collisions

    CERN Document Server

    Perepelitsa, Dennis

    High-$p_\\mathrm{T}$ processes in proton- and deuteron-nucleus collisions at TeV energies are the best presently available way to study the partonic structure of the nucleus in a high-density regime. Jet production over a wide range of phase space can significantly constrain the current knowledge of nuclear parton distribution functions (nPDFs), which are substantially less well understood than the corresponding PDFs in protons and which have only recently begun to be treated in a spatially-dependent way. An accurate knowledge of nPDFs is crucial for a definitive control of perturbative processes in a cold nuclear environment, since high-$p_\\mathrm{T}$ probes are used to quantitatively investigate the hot QCD matter created in ultrarelativistic nucleus-nucleus collisions. Furthermore, jets from low Bjorken-$x$ partons can probe the transition from the dilute to saturated nuclear regimes. Jet production is investigated in $d$+Au collisions at $\\sqrt{s} = 200$ GeV with the PHENIX detector at the Relativistic Hea...

  1. The human granulocyte nucleus: Unusual nuclear envelope and heterochromatin composition.

    Science.gov (United States)

    Olins, Ada L; Zwerger, Monika; Herrmann, Harald; Zentgraf, Hanswalter; Simon, Amos J; Monestier, Marc; Olins, Donald E

    2008-05-01

    The human blood granulocyte (neutrophil) is adapted to find and destroy infectious agents. The nucleus of the human neutrophil has a segmented appearance, consisting of a linear or branched array of three or four lobes. Adequate levels of lamin B receptor (LBR) are necessary for differentiation of the lobulated nucleus. The levels of other components of the nuclear envelope may also be important for nuclear shape determination. In the present study, immunostaining and immunoblotting procedures explored the levels of various components of the nuclear envelope and heterochromatin, comparing freshly isolated human neutrophils with granulocytic forms of HL-60 cells, a tissue culture model system. In comparison to granulocytic HL-60 cells, blood neutrophil nuclear envelopes contain low-to-negligible amounts of LBR, lamins A/C, B1 and B2, LAP2beta and emerin. Surprisingly, a "mitotic" chromosome marker, H3(S10)phos, is elevated in neutrophil nuclei, compared to granulocytic HL-60 cells. Furthermore, neutrophil nuclei appear to be more fragile to methanol fixation, than observed with granulocytic HL-60 cells. Thus, the human neutrophil nucleus appears to be highly specialized, possessing a paucity of nuclear envelope-stabilizing proteins. In consequence, the neutrophil nucleus appears to be very malleable, supporting rapid migration through tight tissue spaces.

  2. Cortically evoked potentials in the human subthalamic nucleus

    NARCIS (Netherlands)

    Zwartjes - de Klerk, D.G.M; Janssen, M.L.F; Heida, Tjitske; van Kranen-Mastenbroek, V.; Bour, L.; Temel, Y.; Visser-Vandewalle, V.; Martens, H.C.F.; Veltink, Petrus H.

    2013-01-01

    Deep brain stimulation (DBS) of the subthalamic nucleus (STN) alleviates motor symptoms in Parkinson’s disease (PD) patients. However, in a substantial number of patients the beneficial effects of STN DBS are overshadowed by psychiatric side effects. We hypothesize that stimulation of the STN motor

  3. Saturating Cronin effect in ultrarelativistic proton-nucleus collisions

    OpenAIRE

    Papp, Gabor; Levai, Peter; Fai, George

    1999-01-01

    Pion and photon production cross sections are analyzed in proton-proton and proton-nucleus collisions at energies 20 GeV < s^1/2 < 60 GeV. We separate the proton-proton and nuclear contributions to transverse-momentum broadening and suggest a new mechanism for the nuclear enhancement in the high transverse-momentum region.

  4. Red nucleus connectivity as revealed by constrained spherical deconvolution tractography.

    Science.gov (United States)

    Milardi, Demetrio; Cacciola, Alberto; Cutroneo, Giuseppina; Marino, Silvia; Irrera, Mariangela; Cacciola, Giorgio; Santoro, Giuseppe; Ciolli, Pietro; Anastasi, Giuseppe; Calabrò, Rocco Salvatore; Quartarone, Angelo

    2016-07-28

    Previous Diffusion Tensor Imaging studies have demonstrated that the human red nucleus is widely interconnected with sensory-motor and prefrontal cortices. In this study, we assessed red nucleus connectivity by using a multi-tensor model called non- negative Constrained Spherical Deconvolution (CSD), which is able to resolve more than one fiber orientation per voxel. Connections of the red nuclei of fifteen volunteers were studied at 3T using CSD axonal tracking. We found significant connectivity between RN and the following cortical and subcortical areas: cerebellar cortex, thalamus, paracentral lobule, postcentral gyrus, precentral gyrus, superior frontal gyrus and dentate nucleus. We confirmed that red nucleus is tightly linked with the cerebral cortex and has dense subcortical connections with thalamus and cerebellar cortex. These findings may be useful in a clinical context considering that RN is involved in motor control and it is known to have potential to compensate for injury of the corticospinal tract. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Glucocorticoids suppress vasopressin gene expression in human suprachiasmatic nucleus.

    NARCIS (Netherlands)

    Liu, R.-Y.; Unmehopa, U.A.; Zhou, J.-N.; Swaab, D.F.

    2006-01-01

    Sleep impairment is one of the major side effects of glucocorticoid therapy. The mechanism responsible for this circadian disorder is unknown, but alterations in the suprachiasmatic nucleus (SCN), the biological clock of the human brain, are presumed to play a major role. In the present study, the

  6. Glucocorticoids suppress vasopressin gene expression in human suprachiasmatic nucleus

    NARCIS (Netherlands)

    Liu, Rong-Yu; Unmehopa, Unga A.; Zhou, Jiang-Ning; Swaab, Dick F.

    2006-01-01

    Sleep impairment is one of the major side effects of glucocorticoid therapy. The mechanism responsible for this circadian disorder is unknown, but alterations in the suprachiasmatic nucleus (SCN), the biological clock of the human brain, are presumed to play a major role. In the present study, the

  7. Maternity waiting facilities for improving maternal and neonatal outcome in low-resource countries.

    Science.gov (United States)

    van Lonkhuijzen, Luc; Stekelenburg, Jelle; van Roosmalen, Jos

    2012-10-17

    A maternity waiting home (MWH) is a facility within easy reach of a hospital or health centre which provides emergency obstetric care (EmOC). Women may stay in the MWH at the end of their pregnancy and await labour. Once labour starts, women move to the health facility so that labour and giving birth can be assisted by a skilled birth attendant. The aim of the MWH is to improve accessibility to skilled care and thus reduce morbidity and mortality for mother and neonate should complications arise. Some studies report a favourable effect on the outcomes for women and their newborns. Others show that utilisation is low and barriers exist. However, these data are limited in their reliability. To assess the effects of a maternity waiting facility on maternal and perinatal health. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 January 2012), CENTRAL (The Cochrane Library 2011, Issue 4 of 4), MEDLINE (1966 to January 2012), EMBASE (1980 to January 2012), CINAHL (1982 to January 2012), African Journals Online (AJOL) (January 2012), POPLINE (January 2012), Dissertation Abstracts (January 2012) and reference lists of retrieved papers. Randomised controlled trials including quasi-randomised and cluster-randomised trials that compared perinatal and maternal outcome in women using a MWH and women who did not. There were no randomised controlled trials or cluster-randomised trials identified from the search. There were no randomised controlled trials or cluster-randomised trials identified from the search. There is insufficient evidence to determine the effectiveness of maternity waiting facilities for improving maternal and neonatal outcomes.

  8. Utah's 72-Hour Waiting Period for Abortion: Experiences Among a Clinic-Based Sample of Women.

    Science.gov (United States)

    Roberts, Sarah C M; Turok, David K; Belusa, Elise; Combellick, Sarah; Upadhyay, Ushma D

    2016-12-01

    In 2012, Utah became the first state to enact a 72-hour waiting period for abortion. Despite debate about the law's potential effects, research has not examined women's experiences with it. A cohort of 500 women recruited at four family planning facilities in Utah in 2013-2014 completed baseline surveys at the time of an abortion information visit and follow-up telephone interviews three weeks later. Logistic regression and coding of open-ended responses were used to examine which women had abortions and, for those who did not, their reasons. Among the 309 women completing follow-up, 86% had had an abortion, 8% were no longer seeking abortion, 3% had miscarried or discovered they had not been pregnant, and 2% were still seeking abortion; one woman was still deciding, and the waiting period had pushed one woman beyond her facility's gestational limit for abortion. At the information visit, women reported little conflict about the abortion decision (mean score on a scale of 0-100 was 13.9 for those who eventually had an abortion and 28.5 for others). Low decisional conflict, but not socioeconomic status, was associated with having an abortion (odds ratio, 1.1). On average, eight days elapsed between the information visit and the abortion. As most women in this cohort were not conflicted about their decision when they sought care, the 72-hour waiting requirement seems to have been unnecessary. Individualized patient counseling for the small minority who were conflicted when they presented for care may have been more appropriate. Copyright © 2016 by the Guttmacher Institute.

  9. Clinical effectiveness of exenatide in diabetic patients waiting for bariatric surgery.

    Science.gov (United States)

    Iglesias, P; Civantos, S; Vega, B; Pavón, I; Guijarro, G; Monereo, S

    2015-03-01

    Bariatric surgery constitutes the most effective treatment for severely obese type 2 diabetic patients. Exenatide is a glucagon-like peptide 1 receptor agonist that can improve glycemic control and cause weight loss in patients with type 2 diabetes. Clinical experience with exenatide in obese patients with type 2 diabetes waiting for bariatric surgery has not been reported. The aim of the study was to evaluate, in clinical practice, weight and metabolic effects of exenatide (after 3 and 6 months) in patients with type 2 diabetes and obesity waiting for bariatric surgery. A total of 100 diabetic adult subjects with a BMI ≥ 35 kg/m(2) were included. Primary endpoints were changes in weight and HbA1c after 6 months of treatment. Secondary endpoints were changes from baseline of a variety of clinical measures (triglycerides levels, blood pressure, and waist circumference). Data were analyzed at 3 and 6 months of follow-up. Treatment for 6 months with exenatide decreased significantly body weight (-12.5 kg) and waist circumference (-13 cm). Twenty percent of patients reduced their BMI under 35 kg/m(2) and significantly improved their metabolic profile (HbA1c <7 %). Significant and maintained decreases in HbA1c of 1 % were observed in the 3 and 6 months cohorts. Triglycerides levels and blood pressure also decreased from baseline to the end of the study. Treatment was discontinued in 19 % of patients mainly due to drug inefficacy (6 %) or adverse events (4 %). Exenatide twice daily (BID) leads to early, robust, and significant weight loss in a subset of patients with diabetes and severe obesity before bariatric surgery. Clinical trials are needed to confirm the benefits of GLP-1 agonists in type 2 diabetic obese patients or high-risk super-obese patients waiting for bariatric surgery.

  10. Functional Status, Time to Transplantation, and Survival Benefit of Kidney Transplantation Among Wait-Listed Candidates

    Science.gov (United States)

    Reese, Peter P.; Shults, Justine; Bloom, Roy D.; Mussell, Adam; Harhay, Meera N.; Abt, Peter; Levine, Matthew; Johansen, Kirsten L.; Karlawish, Jason T.; Feldman, Harold I.

    2015-01-01

    Background In the context of an aging end-stage renal disease population with multiple comorbidities, transplantation professionals face challenges in evaluating the global health of patients awaiting kidney transplantation. Functional status might be useful for identifying which patients will derive a survival benefit from transplantation versus dialysis. Study Design Retrospective cohort study of wait-listed patients using data on functional status from a national dialysis provider linked to United Network for Organ Sharing registry data. Setting & Participants Adult kidney transplant candidates added to the waiting list between the years 2000 and 2006. Predictor Physical function scale of the Medical Outcomes Study 36-Item Short Form Healthy Survey, analyzed as a time-varying covariate. Outcomes Kidney transplantation; Survival benefit of transplantation versus remaining wait-listed. Measurements We used multivariable Cox regression to assess the association between physical function with study outcomes. In survival benefit analyses, transplant status was modeled as a time-varying covariate. Results The cohort comprised 19,242 kidney transplant candidates (median age, 51 years; 36% black race) receiving maintenance dialysis. Candidates in the lowest baseline physical function quartile were more likely to be inactivated (adjusted HR vs. highest quartile, 1.30; 95% CI, 1.21-1.39) and less likely to undergo transplantation (adjusted HR vs. highest quartile, 0.64; 95% CI, 0.61-0.68). After transplantation, worse physical function was associated with shorter 3-year survival (84% vs. 92% for the lowest vs. highest function quartiles). However, compared to dialysis, transplantation was associated with a statistically significant survival benefit by 9 months for patients in every function quartile. Limitations Functional status is self-reported. Conclusions Even patients with low function appear to live longer with kidney transplantation versus dialysis. For waitlisted

  11. The Effectiveness Analysis of Waiting Processes in the Different Branches of a Bank by Queue Model

    Directory of Open Access Journals (Sweden)

    Abdullah ÖZÇİL

    2015-06-01

    Full Text Available Despite the appreciable increase in the number of bank branches every year, nowadays queues for services don’t decrease and even become parts of our daily lives. By minimizing waiting processes the least, increasing customer satisfaction should be one of branch managers’ main goals. A quick and also customer oriented service with high quality is the most important factor for customer loyalty. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in six different branches of two banks operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by six branches of two banks called as A1, A2, A3, B1, B2 and B3. At the end of study it is presented to the company some advices that can bring benefits to the staff and customers. In this study, Queueing theory, one of Operation Research techniques, is handled and in application, the data are obtained related to waiting in queue of customer in three different branches of a bank operating in Denizli and then they are analyzed by Queueing theory and also calculated the average effectiveness of the system. The study’s data are obtained by three branches of the bank called A1, A2 and A3. At last it is presented to the company some advices that can bring more benefits to the staff and clients.

  12. Quality of life in patients with unilateral vestibular schwannoma on wait and see - strategy.

    Science.gov (United States)

    Klersy, P C; Arlt, F; Hofer, M; Meixensberger, J

    2018-01-01

    A 'wait and see' strategy is an option when managing patients with small vestibular schwannomas (VS). A risk of growth and worsening of hearing may influence a patient's daily quality of life (QOL). Therefore, the present study focused on QOL parameters in patients who are on a 'wait and see' strategy following magnetic resonance imaging (MRI)-based diagnosis of small unilateral VS. Sixty-five patients (mean age 64.4 years; male:female, 32:33) who suffered from a small unilateral VS (9.34 mm, range 1.5-23 mm) between 2013 and 2016 were included in a prospective single center study. During follow-up, in addition to clinical and neurological examinations and MRI imaging, all patients answered the Short Form 36 questionnaire once to characterize QOL. Additionally, the severity of tinnitus was determined by the Mini-TQ-12 from Hiller and Goebel. It was found during follow-up that there was no lowering of QOL in patients with small VS who were on 'wait and see' strategy compared with Germany's general population and no tumor growth was detected in 53 patients (81.5%). Patients with a tumor diameter larger than 10 mm did not suffer from stronger tinnitus, vertigo or unsteadiness than the group with an average tumor size, which is smaller than 10 mm. Sixty-two patients (95.4%) showed ipsilateral hearing loss and three of these reported deafness (4.6%). Severe vertigo or tinnitus is connected with lower levels of mental component scale and physical component scale. These findings reduced the QOL (p = 0.05). In our series, QOL is not influenced in patients with unilateral untreated small VS in comparison to Germany's general population. This is helpful information when advising patients during follow-up and finding out the optimal timing of individual treatment.

  13. Wait times and volume of cataract surgery in Ontario: 2000-2012.

    Science.gov (United States)

    Szigiato, Andrei-Alexandru; Trope, Graham E; Jin, Yaping; Buys, Yvonne M

    2016-02-01

    To review cataract surgery trends and wait times in Ontario. Retrospective analysis of health records. Ontario Health Insurance Plan billing service claims between 2000 and 2012 were analyzed for the yearly number of cataract surgeries, alone and in combination with other procedures. The number of Ontarians with cataracts was estimated by applying composite prevalence curves derived from published population data. This was then used to calculate the yearly number of procedures per 1000 Ontarians with cataracts. Per 1000 people with cataract, the rate of cataract extraction increased 18.9% overall from 2000 to 2012, increasing by 38.3% from 2000 to 2006 and decreasing by 14.6% from 2006 to 2012. Mean wait times for cataract surgery decreased by 45.8% from 2006 to 2009 and increased 28.5% from 2009 to 2013. The proportion of surgeries that were same-day bilateral cataract extraction increased 2.21-fold from 2000 to 2012 but represented only 0.82% of total cataract surgeries in 2012. In 2000, 3% of cataract surgeries were combined with other procedures, and this decreased to 1.8% in 2012. Of these combinations, the rates of combined glaucoma filtration procedures decreased by 44.3%, anterior vitrectomy decreased by 32.5%, posterior vitrectomy increased by 58.3%, and corneal transplantation decreased by 10.7% during this time period. The yearly rate of cataract surgery has decreased since 2006, and wait times have increased from 2009. Same-day bilateral cataract extraction represented less than 1% of the total cataract surgical volume. Rates of cataract combined with posterior vitrectomy have increased (58%), whereas anterior vitrectomy at the time of cataract surgery decreased (33%). Copyright © 2015 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  14. Physical interrelation of volatile and refractories in a cometary nucleus

    Science.gov (United States)

    Fulle, Marco; Alice Team; Stern, Alan; CONSTERT Team; Kofman, Wlodek; COSIMA Team; Hilchenbach, Martin; GIADA Team; Rotundi, Alessandra; MIDAS Team; Bentley, Mark; MIRO Team; Hofstadter, Mark; OSIRIS Team; Sierks, Holger; ROSINA Team; Altwegg, Kathrin; RPC Team; Nilsson, Hans; Burch, James; Eriksson, Anders; Heinz-Glassmeier, Karl; Henri, Pierre; Carr, Christopher; RSI Team; Paetzold, Martin; , VIRTIS Team; Capaccioni, Fabrizio; Lander Team; Boehnhardt, Hermann; Bibring, Jean-Pierre; IDS Team; Gruen, Eberhard; Fulchignoni, Marcello; Weissman, Paul; Project Scientist Team; Taylor, Matt; Buratti, Bonnie; Altobelli, Nicolas; Choukroun, Mathieu; Ground-Based Observations Team; Snodgrass, Colin

    2016-10-01

    The Rosetta mission has been taking measurements of its target comet Comet 67P/Churyumov-Gerasimenko since early 2014 and will complete operations at the end of September 2016. The mission Science Management Plan, in 1994, laid out the the prime goals and themes of the mission. These five themes were: 1) To study the global characterisation of the Nuclues, the determination of the dynamics properties , surface morpholy and composition of the comet. 2) Examination of the Chemical, Mineralogical and isotopic compositions of volatiles and refractories in a cometary nucleus.3) Physical interrelation of volatile and refractories in a cometary nucleus4) Study the development of cometary activity and the process in the surface layer of the nucleus and in the inner coma5) The origins of comets, the relationship between cometary and interstellar material and the implications for the origin of the solar system,To cover all aspects of the Rosetta mission in this special Show case session, this abstracts is one of 5, with this particular presentation focusing on theme 3, in particular on a) The dust-to-gas ratio; b) distributed sources of volatiles; c) seasonal evolution of the dust size distribution.a) The dust-to-gas ratio has been provided by coma observations measuring the gas and dust loss rates from the nucleus surface. The ratio of these two loss rates provides a lower limit of the dust-to-gas ratio at the nucleus surface, since it does not take into account the largest chunks unable to leave the nucleus, or falling back due to the dominant gravity. We review the value inferred so far, its time evolution, and new techniques to directly measure it in the nucleus.b) Evidences offered by Rosetta observations of gas sublimating from dust particles are up to now faint. We report the few available observations and an estimate of the probable average water content in dust particles inferred by 3D gas-dynamical codes of 67P coma.c) The dust-size distribution tunes the sizes

  15. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial

    Science.gov (United States)

    2011-01-01

    Background Persistent non-specific low back pain (PNSLBP) is one of the most frequently experienced types of back pain around the world. Wet-cupping is a common intervention for various pain conditions, especially in Korea. In this context, we conducted a pilot study to determine the effectiveness and safety of wet-cupping treatment for PNSLBP. Methods We recruited 32 participants (21 in the wet-cupping group and 11 in the waiting-list group) who had been having PNSLBP for at least 3 months. The participants were recruited at the clinical research centre of the Korea Institute of Oriental Medicine, Korea. Eligible participants were randomly allocated to wet-cupping and waiting-list groups. Following the practice of traditional Korean medicine, the treatment group was provided with wet-cupping treatment at two acupuncture points among the BL23, BL24 and BL25 6 times within 2 weeks. Usual care, including providing brochures for exercise, general advice for PNSLBP and acetaminophen, was allowed in both groups. Separate assessors participated in the outcome assessment. We used the 0 to100 numerical rating scale (NRS) for pain, the McGill Pain Questionnaire for pain intensity (PPI) and the Oswestry Disability Questionnaire (ODQ), and we assessed acetaminophen use and safety issues. Results The results showed that the NRS score for pain decreased (-16.0 [95% CI: -24.4 to -7.7] in the wet-cupping group and -9.1 [-18.1 to -0.1] in the waiting-list group), but there was no statistical difference between the groups (p = 0.52). However, the PPI scores showed significant differences between the two groups (-1.2 [-1.6 to -0.8] for the wet-cupping group and -0.2 [-0.8 to 0.4] for the waiting-list group, p wet-cupping group during 4 weeks (p = 0.09). The ODQ score did not show significant differences between the two groups (-5.60 [-8.90 to -2.30] in the wet-cupping group and -1.8 [-5.8 to 2.2] in the waiting-list group, p = 0.14). There was no report of adverse events due to wet

  16. Functional status, time to transplantation, and survival benefit of kidney transplantation among wait-listed candidates.

    Science.gov (United States)

    Reese, Peter P; Shults, Justine; Bloom, Roy D; Mussell, Adam; Harhay, Meera N; Abt, Peter; Levine, Matthew; Johansen, Kirsten L; Karlawish, Jason T; Feldman, Harold I

    2015-11-01

    In the context of an aging end-stage renal disease population with multiple comorbid conditions, transplantation professionals face challenges in evaluating the global health of patients awaiting kidney transplantation. Functional status might be useful for identifying which patients will derive a survival benefit from transplantation versus dialysis. Retrospective cohort study of wait-listed patients using data for functional status from a national dialysis provider linked to United Network for Organ Sharing registry data. Adult kidney transplantation candidates added to the waiting list between 2000 and 2006. Physical Functioning scale of the Medical Outcomes Study 36-Item Short Form Health Survey, analyzed as a time-varying covariate. Kidney transplantation; survival benefit of transplantation versus remaining wait-listed. We used multivariable Cox regression to assess the association between physical function with study outcomes. In survival benefit analyses, transplantation status was modeled as a time-varying covariate. The cohort comprised 19,242 kidney transplantation candidates (median age, 51 years; 36% black race) receiving maintenance dialysis. Candidates in the lowest baseline Physical Functioning score quartile were more likely to be inactivated (adjusted HR vs highest quartile, 1.30; 95% CI, 1.21-1.39) and less likely to undergo transplantation (adjusted HR vs highest quartile, 0.64; 95% CI, 0.61-0.68). After transplantation, worse Physical Functioning score was associated with shorter 3-year survival (84% vs 92% for the lowest vs highest function quartiles). However, compared to dialysis, transplantation was associated with a statistically significant survival benefit by 9 months for patients in every function quartile. Functional status is self-reported. Even patients with low function appear to live longer with kidney transplantation versus dialysis. For wait-listed patients, global health measures such as functional status may be more useful in

  17. Reliable blood pressure self-measurement in the obstetric waiting room

    DEFF Research Database (Denmark)

    Wagner, Stefan; Kamper, C. H.; Rasmussen, Niels H

    2014-01-01

    Background: Patients often fail to adhere to clinical recommendations when using current blood pressure self-measurement (BPSM) methods and equipment. As existing BPSM equipment is not able to detect non-adherent behavior, this could result in misdiagnosis and treatment error. To overcome...... patients scheduled for self-measuring their blood pressure (BP) in the waiting room at an obstetrics department's outpatient clinic to perform an additional BPSM using ValidAid. We then compared the automatically measured and classified values from ValidAid with our manual observations. Results: We found...

  18. Optimal Research and Numerical Simulation for Scheduling No-Wait Flow Shop in Steel Production

    Directory of Open Access Journals (Sweden)

    Huawei Yuan

    2013-01-01

    Full Text Available This paper considers the m-machine flow shop scheduling problem with the no-wait constraint to minimize total completion time which is the typical model in steel production. First, the asymptotic optimality of the Shortest Processing Time (SPT first rule is proven for this problem. To further evaluate the performance of the algorithm, a new lower bound with performance guarantee is designed. At the end of the paper, numerical simulations show the effectiveness of the proposed algorithm and lower bound.

  19. The use of mobile technology in waiting rooms to leverage women's empowerment: A conceptual context.

    Science.gov (United States)

    Reychav, Iris; Parush, Avi; McHaney, Roger; Hazan, Maya; Moshonov, Rami

    2016-10-13

    This article focuses on a conceptual framework that can be applied to the use of mobile technology in the waiting room with the goal of empowering women recently diagnosed with abnormal Pap test results. It further describes trends which indicate a need for improved and timely information dissemination. Genecology practice outpatients report a predominant feeling of worry on receipt of abnormal medical test results, along with a clearly expressed wish for additional information. This research suggests that there is room for improvement in existing processes through use of mobile technology with carefully vetted materials which indicate a doctor is interested in the patient's well-being. © The Author(s) 2016.

  20. Structures and functions in the crowded nucleus: new biophysical insights

    Directory of Open Access Journals (Sweden)

    Ronald eHancock

    2014-09-01

    Full Text Available Concepts and methods from the physical sciences have catalysed remarkable progress in understanding the cell nucleus in recent years. To share this excitement with physicists and encourage their interest in this field, this review offers an overview of how the physics which underlies structures and functions in the nucleus is becoming more clear thanks to methods which have been developed to simulate and study macromolecules, polymers, and colloids. The environment in the nucleus is very crowded with macromolecules, making entropic (depletion forces major determinants of interactions. Simulation and experiments are consistent with their key role in forming membraneless compartments such as nucleoli, PML and Cajal bodies, and discrete territories for chromosomes. The chromosomes, giant linear polyelectrolyte polymers, exist in vivo in a state like a polymer melt. Looped conformations are predicted in crowded conditions, and have been confirmed experimentally and are central to the regulation of gene expression. Polymer theory has revealed how the chromosomes are so highly compacted in the nucleus, forming a crumpled globule with fractal properties which avoids knots and entanglements in DNA while allowing facile accessibility for its replication and transcription. Entropic repulsion between looped polymers can explain the confinement of each chromosome to a discrete region of the nucleus. Crowding and looping are predicted to facilitate finding the specific targets of factors which modulate activities of DNA. Simulation shows that entropic effects contribute to finding and repairing potentially lethal double-strand breaks in DNA by increasing the mobility of the broken ends, favouring their juxtaposition for repair. Signaling pathways are strongly influenced by crowding, which favours a processive mode of response (consecutive reactions without releasing substrates. This new information contributes to understanding the sometimes counter