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Sample records for adl results provide

  1. HomeADL for adaptive ADL monitoring within smart homes.

    PubMed

    Hong, Xin; Nugent, Chris D; Finlay, Dewar D; Mulvenna, Maurice

    2008-01-01

    In this paper we present homeADL: a representation standard for an inference hierarchy of activities of daily living which may be monitored in a sensor equipped smart home. The approach allows a free exchange of ADL monitoring structures between different communities who share the same concern of providing high quality healthcare to the elderly. Its ability of matching different ADL protocols enables a mapping between an ADL protocol to a suitable smart home which makes an effective management of smart homes within a community hence, not only being able to satisfy an individual's healthcare requirements but also efficiently using monitoring resources at hand. PMID:19163419

  2. To What Degree Does Provider Performance Affect a Quality Indicator? The Case of Nursing Homes and ADL Change

    ERIC Educational Resources Information Center

    Phillips, Charles D.; Chen, Min; Sherman, Michael

    2008-01-01

    Purpose: This research investigates what factors affect the degree to which nursing home performance explains variance in residents' change in status of activities of daily living (ADL) after admission. Design and Methods: The database included all residents admitted in 2002 to a 10% random sample of nursing homes in the United States.…

  3. Trainee Occupational Therapists Scoring the Barthel ADL.

    PubMed

    Martin, Elizabeth; Nugent, Chris; Bond, Raymond; Martin, Suzanne

    2015-09-01

    Within medical applications there are two main types of information design; paper-based and digital information [1]. As technology is constantly changing, information within healthcare management and delivery is continually being transitioned from traditional paper documents to digital and online resources. Activity of Daily Living (ADL) charts are still predominantly paper based and are therefore prone to "human error" [2]. In light of this, an investigation has taken place into the design for reducing the amount of human error, between a paper based ADL, specifically the Barthel Index, and the same ADL created digitally. The digital ADL was developed as an online platform as this offers the best method of data capture for a large group of participants all together [3]. The aim of the study was to evaluate the usability of the Barthel Index ADL in paper format and then reproduce the same ADL digitally. This paper presents the findings of a study involving 26 participants who were familiar with ADL charts, and used three scenarios requiring them to complete both a paper ADL and a digital ADL. An evaluation was undertaken to ascertain if there were any 'human errors' in completing the paper ADL and also to find similarities/differences through using the digital ADL. The results from the study indicated that 22/26 participants agreed that the digital ADL was better, if not the same as a paper based ADL. Further results indicated that participants rate highly the added benefit of the digital ADL being easy to use and also that calculation of assessment scores were performed automatically. Statistically the digital BI offered a 100 % correction rate in the total calculation, in comparison to the paper based BI where it is more common for users to make mathematical calculation errors. Therefore in order to minimise handwriting and calculation errors, the digital BI proved superior than the traditional paper based method. PMID:26250757

  4. An ADL measure for spinal cord injury.

    PubMed

    Bryden, Anne; Bezruczko, Nikolaus

    2011-01-01

    Occupational therapists do not have a comprehensive, objective method for measuring how persons with tetraplegia perform activities of daily living (ADL) in their homes and communities, because SCI ADL performance is usually determined in rehabilitation. The ADL Habits Survey (ADLHS) is designed specifically to address this knowledge gap by surveying performance on relevant and meaningful activities in homes and communities. After a comprehensive task analysis and pilot development, 30 activities were selected that emphasize a broad range of hand and wrist, reaching, and grasping movements in compound activities. A sample of 49 persons with cervical spinal cord injuries responded to items. The sample was predominantly male, median age was 41 years, and ASIA motor classification levels ranged from C2 through C8/T1 with majority concentration in C4, C5, or C6 (68%). Each participant report was rated by an occupational therapist using a seven category rating scale, and the item by participant response matrix (30 X 49) was analyzed with a Rasch model for rating scales. Results showed excellent participant separation (>4) and very high reliability (>.95), and both item and participant fit values were adequate (STANDARDIZED INFIT less than absolute value of 3). With only two exceptions, all participants fit the Rasch rating scale model, and only one item "Light housekeeping" presented significant fit issues. Principal Components Analysis an analysis of item residuals did not reveal serious threats to unidimensionality. A between group fit comparison of participants with more versus less movement found invariant item calibrations, and ANOVA of participant measures found statistically significant differences across ASIA motor classification levels. These ADLHS results offer occupational therapists a new method for measuring ADL that is potentially more sensitive to functional changes in tetraplegia than most instruments in common use. Accommodation of step disorder with a

  5. Alternate Communications Spectrum Study (ACSS) for Aviation Data Links (ADL)

    NASA Technical Reports Server (NTRS)

    Matolak, David W.

    2003-01-01

    and parameters that must be selected in the design. Two appendices show example versions and initial results of the first few technical steps in the design approach. Some conclusions are then drawn, and in the final section, recommendations are provided, the most important of which are repeated here: 1. Continue the effort begun here. As detailed in this report, we have only uncovered much of the work that needs to be done in order to provide the foundation for a flexible, high- performance, robust ADL. 2. Seize the opportunity to begin testing in the MLS band. The wide bandwidths and low level of usage of this band make it an ideal one for proof-of-concept type testing. Other (non- aeronautical) organizations are likely to make claims on the band if it is not being used. The primary conclusion is that there is a real and pressing need for a new aviation data link. vi

  6. The Classic Measure of Disability in Activities of Daily Living Is Biased by Age but an Expanded IADL/ADL Measure Is Not

    PubMed Central

    2010-01-01

    Objectives. To evaluate, by age, the performance of 2 disability measures based on needing help: one using 5 classic activities of daily living (ADL) and another using an expanded set of 14 activities including instrumental activities of daily living (IADL), walking, getting outside, and ADL (IADL/ADL). Methods. Guttman and item response theory (IRT) scaling methods are used with a large (N = 25,470) nationally representative household survey of individuals aged 18 years and older. Results. Guttman scalability of the ADL items increases steadily with age, reaching a high level at ages 75 years and older. That is reflected in an IRT model by age-related differential item functioning (DIF) resulting in age-biased measurement of ADL. Guttman scalability of the IADL/ADL items also increases with age but is lower than the ADL. Although age-related DIF also occurs with IADL/ADL items, DIF is lower in magnitude and balances out without causing age bias. Discussion. An IADL/ADL scale measuring need for help is hierarchical, unidimensional, and unbiased by age. It has greater content validity for measuring need for help in the community and shows greater sensitivity by age than the classic ADL measure. As demand for community services is increasing among adults of all ages, an expanded IADL/ADL measure is more useful than ADL. PMID:20100786

  7. Muscle strength as a predictor of onset of ADL dependence in people aged 75 years.

    PubMed

    Rantanen, Taina; Avlund, Kirsten; Suominen, Harri; Schroll, Marianne; Frändin, Kerstin; Pertti, Era

    2002-06-01

    The aim of this prospective study over 5 years was to examine maximal isometric strength of multiple muscle groups as a predictor of losing independence in activities of daily living (ADL). The participants were from the Nordic Research on Aging (NORA75). These analyses are restricted to 567 people who at baseline were independent in ADL and participated in strength tests, and who five years later participated in follow-up ADL assessments. Tests on maximal isometric strength of hand grip, elbow flexion, knee extension and trunk flexion and extension were done using adjustable dynamometers. For each muscle group tested, three equal groups were formed for men and women separately based on distributions of results. Those who reported being unable or needing help for eating, dressing, bathing, toileting, walking indoors or transferring from a bed or a chair were rated as ADL dependent. Of the 227 initially ADL independent men, 21 (9.3%) became dependent in ADL. In women, the figures were 30 (8.8%) of 340. Multiple logistic regression models were used to predict the risk of ADL dependence in groups based on strength tertiles. After confirming that the association of muscle strength and incident ADL-dependence was similar in men and women, both genders were included in the same analyses adjusted for body weight and height, gender and research locality. Gender specific cut-offs were used for strength tertiles. All the strength tests predicted ADL dependence, with those being in the lowest tertile having two to three times greater risks than those in the highest tertile of strength. Further adjustments for chronic diseases did not materially change the results. Strength tests could be used to identify people who are still independent in ADL but who are at increased risk of becoming dependent because of poor muscle strength, and who could reduce their risk by strengthening exercises. PMID:12475129

  8. A Process for the Representation of openEHR ADL Archetypes in OWL Ontologies.

    PubMed

    Porn, Alex Mateus; Peres, Leticia Mara; Didonet Del Fabro, Marcos

    2015-01-01

    ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test. PMID:26262167

  9. The Link between Cognitive Measures and ADLs and IADL Functioning in Mild Alzheimer's: What Has Gender Got to Do with It?

    PubMed

    Hall, James R; Vo, Hoa T; Johnson, Leigh A; Barber, Robert C; O'Bryant, S E

    2011-01-01

    Objectives. To investigate the link between neurocognitive measures and various aspects of daily living (ADL and IADL) in women and men with mild Alzheimer's disease (AD). Methods. Participants were 202 AD patients (91 male, 111 female) with CDR global scores of ≤1. ADLs and IADLs ratings were obtained from caregivers. Cognitive domains were assessed with neuropsychological testing. Results. Memory and executive functioning were related to IADL scores. Executive functioning was linked to total ADL. Comparisons stratified on gender found attention predicted total ADL score in both men and women. Attention predicted bathing and eating ability in women only. Language predicted IADL functions in men (food preparation) and women (driving). Conclusions. Associations between ADLs/IADLs and memory, learning, executive functioning, and language suggest that even in patients with mild AD, basic ADLs require complex cognitive processes. Gender differences in the domains of learning and memory area were found. PMID:21660245

  10. Modern Statistical Graphs that Provide Insight in Research Results

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Modern statistical graphics offer insight in assessing the results of many common statistical analyses. These ideas, however, are rarely employed in agronomic research articles. This work presents several commonly used graphs, offers one or more alternatives for each, and provides the reasons for pr...

  11. Foamed sand provides improved stimulation results from Devonian Shale

    SciTech Connect

    Strang, D.L.; Norton, J.L.

    1983-11-01

    Generally, water saturations in the Devonian Shale are low. Production records indicate minimal, if any, water in the areas producing gas or gas and oil. This low water saturation appears to be the key to stimulating the shale, especially in the oil-producing areas. The introduction of water in the stimulation fluid appears to reduce the permeability to oil, which is reflected in poorer production. The relative permeability reduction seems to be more of a problem than particle migration or clay swelling and could explain the good initial results from straight nitrogen treatments. However, the lack of a proppant, even with low closure stress, leads to very rapid declines. Water-base stimulation fluids appear to increase water saturation in the Devonian Shale. Use of 90+ quality foam with sand should provide a method of minimizing saturation changes while creating a propped fracture. Initial results indicate this technique provides better sustained production increases in the Devonian Shale. This paper defines areas of production, describes the geology and presents physical data of the Devonian Shale. It also compares results of several types of treatments that have been used in the Devonian Shale. These results indicate 90+ quality foam with sand should provide an improved stimulation technique for this formation.

  12. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    ERIC Educational Resources Information Center

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  13. Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments

    PubMed Central

    Misra, Archan; Cook, Diane

    2016-01-01

    Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional ‘hidden’ context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions. PMID:27042240

  14. Communication of Genetic Test Results to Family and Health Care Providers Following Disclosure of Research Results

    PubMed Central

    Graves, Kristi D.; Sinicrope, Pamela S.; Esplen, Mary Jane; Peterson, Susan K.; Patten, Christi A.; Lowery, Jan; Sinicrope, Frank A.; Nigon, Sandra K.; Borgen, Joyce; Gorin, Sherri Sheinfeld; Keogh, Louise A.; Lindor, Noralane M.

    2014-01-01

    Purpose Few studies have examined methods to promote communication following the return of DNA mismatch repair (MMR) genetic test results obtained during research. The purpose of the present study was to evaluate a telephone protocol for returning research results of MMR gene testing to identify Lynch Syndrome. Methods We invited individuals with known MMR mutations in their family who were enrolled in the Colon Cancer Family Registry at the Mayo Clinic to participate. Participants completed surveys before and 6-months after MMR test result disclosure. Results Among 107 participants, 79% opted to learn their MMR test results; of these, 44 (41%) carried MMR mutations. Post-disclosure, 54% reported screening for any type of cancer. Among carriers, >74% reported communicating results to family; communication was predicted by baseline confidence in coping with the genetic test result (Z=1.97, P=.04). Result disclosure to a physician was predicted by greater perceived cancer risk (Z=2.08, P=.03) and greater intention to share results with family (Z=3.07, P=.002). Conclusions Research vs. clinically-based gene disclosure presents challenges. A telephone disclosure process for the return of research-based results among Lynch syndrome families led to high rates of result uptake and participant communication of results to providers and family members. PMID:24091800

  15. Trends in ADL and IADL Disability in Community-Dwelling Older Adults in Shanghai, China, 1998–2008

    PubMed Central

    2013-01-01

    Objectives. We investigated trends in activities of daily living (ADL) and instrumental activities of daily living (IADL) disability from 1998 to 2008 among elder adults in Shanghai, China. Method. Our data came from 4 waves of the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005, and 2008). ADL and IADL disabilities were recorded dichotomously (difficulty vs. no difficulty). The major independent variable was survey year. Covariates included demographics, socioeconomic conditions, family and social support, and other health conditions. Nested random-effect models were applied to estimate trends over time, referenced to 1998. Results. In comparison with the baseline year (1998), older adults in 2008 had lower odds of being ADL disabled, though the effect was no longer statistically significant when other health conditions were taken into account. Elders in 2003, 2005, and 2008 were 20%–26%, 17%–38%, and 53%–64% less likely to be IADL disabled than those in 1998, respectively, depending on the set of covariates included in the model. Discussion. Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function. PMID:23525547

  16. Algorithm integration using ADL (Algorithm Development Library) for improving CrIMSS EDR science product quality

    NASA Astrophysics Data System (ADS)

    Das, B.; Wilson, M.; Divakarla, M. G.; Chen, W.; Barnet, C.; Wolf, W.

    2013-05-01

    Algorithm Development Library (ADL) is a framework that mimics the operational system IDPS (Interface Data Processing Segment) that is currently being used to process data from instruments aboard Suomi National Polar-orbiting Partnership (S-NPP) satellite. The satellite was launched successfully in October 2011. The Cross-track Infrared and Microwave Sounder Suite (CrIMSS) consists of the Advanced Technology Microwave Sounder (ATMS) and Cross-track Infrared Sounder (CrIS) instruments that are on-board of S-NPP. These instruments will also be on-board of JPSS (Joint Polar Satellite System) that will be launched in early 2017. The primary products of the CrIMSS Environmental Data Record (EDR) include global atmospheric vertical temperature, moisture, and pressure profiles (AVTP, AVMP and AVPP) and Ozone IP (Intermediate Product from CrIS radiances). Several algorithm updates have recently been proposed by CrIMSS scientists that include fixes to the handling of forward modeling errors, a more conservative identification of clear scenes, indexing corrections for daytime products, and relaxed constraints between surface temperature and air temperature for daytime land scenes. We have integrated these improvements into the ADL framework. This work compares the results from ADL emulation of future IDPS system incorporating all the suggested algorithm updates with the current official processing results by qualitative and quantitative evaluations. The results prove these algorithm updates improve science product quality.

  17. Percentage of People with at Least One Activities of Daily Living (ADL) Limitation

    MedlinePlus

    ... ADL) Limitation Percentage of People with at Least One Activities of Daily Living (ADL) Limitation This measure ... Age Group Percentage of People with at Least One Activities of Daily Living Limitation by Age Group ...

  18. Association of early-onset dementia with activities of daily living (ADL) in middle-aged adults with intellectual disabilities: the caregiver's perspective.

    PubMed

    Lin, Lan-Ping; Hsu, Shang-Wei; Hsia, Yi-Chen; Wu, Chia-Ling; Chu, Cordia; Lin, Jin-Ding

    2014-03-01

    Few studies have investigated in detail which factors influence activities of daily living (ADL) in adults with intellectual disabilities (ID) comorbid with/without dementia conditions. The objective of the present study was to describe the relation between early onset dementia conditions and progressive loss of ADL capabilities and to examine the influence of dementia conditions and other possible factors toward ADL scores in adults with ID. This study was part of the "Healthy Aging Initiatives for Persons with an Intellectual Disability in Taiwan: A Social Ecological Approach" project. We analyzed data from 459 adults aged 45 years or older with an ID regarding their early onset symptoms of dementia and their ADL profile based on the perspective of the primary caregivers. Results show that a significant negative correlation was found between dementia score and ADL score in a Pearson's correlation test (r=-0.28, p<0.001). The multiple linear regression model reported that factors of male gender (β=4.187, p<0.05), marital status (β=4.79, p<0.05), education level (primary: β=5.544, p<0.05; junior high or more: β=8.147, p<0.01), Down's syndrome (β=-9.290, p<0.05), severe or profound disability level (β=-6.725, p<0.05; β=-15.773, p<0.001), comorbid condition (β=-4.853, p<0.05) and dementia conditions (β=-9.245, p<0.001) were variables that were able to significantly predict the ADL score (R(2)=0.241) after controlling for age. Disability level and comorbidity can explain 10% of the ADL score variation, whereas dementia conditions can only explain 3% of the ADL score variation in the study. The present study highlights that future studies should scrutinize in detail the reasons for the low explanatory power of dementia for ADL, particularly in examining the appropriateness of the measurement scales for dementia and ADL in aging adults with ID. PMID:24467810

  19. Restoring ADL function after wrist surgery in children with cerebral palsy: a novel Bilateral robot system design.

    PubMed

    Holley, D; Theriault, A; Kamara, S; Anewenter, V; Hughes, D; Johnson, M J

    2013-06-01

    Cerebral palsy is a leading cause of disability in children and reducing its effects on arm function will improve quality of life. Our goal is to train children with CP after wrist tendon transfer surgery using a robotic therapy system consisting of two robot arms and wrist robots. The therapeutic goal is to determine if the robot training combined with surgery intervention improved functional outcomes significantly more than surgery alone. To accomplish this long-term goal we have developed a Bilateral ADL Exercise Robot, BiADLER aimed at training children with CP in reach to grasp coordination on ADLs. Specifically, the robot will provide active training using an assist-as-needed. This paper presents the design concepts. PMID:24187280

  20. Results of advanced battery technology evaluations for electric vehicle applications

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1992-09-01

    Advanced battery technology evaluations are performed under simulated electric-vehicle operating conditions at the Analysis & Diagnostic Laboratory (ADL) of Argonne National Laboratory. The ADL results provide insight Into those factors that limit battery performance and life. The ADL facilities include a test laboratory to conduct battery experimental evaluations under simulated application conditions and a post-test analysis laboratory to determine, In a protected atmosphere if needed, component compositional changes and failure mechanisms. This paper summarizes the performance characterizations and life evaluations conducted during 1991--1992 on both single cells and multi-cell modules that encompass eight battery technologies [Na/S, Li/MS (M=metal), Ni/MH, Ni/Cd, Ni/Zn, Ni/Fe, Zn/Br, and Pb-acid]. These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division, and the Electric Power Research Institute. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The results help identify the most-promising R&D approaches for overcoming battery limitations, and provide battery users, developers, and program managers with a measure of the progress being made in battery R&D programs, a comparison of battery technologies, and basic data for modeling.

  1. Results of advanced batter technology evaluations for electric vehicle applications

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1992-01-01

    Advanced battery technology evaluations are performed under simulated electric-vehicle operating conditions at the Analysis Diagnostic Laboratory (ADL) of Argonne National Laboratory. The ADL results provide insight Into those factors that limit battery performance and life. The ADL facilities include a test laboratory to conduct battery experimental evaluations under simulated application conditions and a post-test analysis laboratory to determine, In a protected atmosphere if needed, component compositional changes and failure mechanisms. This paper summarizes the performance characterizations and life evaluations conducted during 1991--1992 on both single cells and multi-cell modules that encompass eight battery technologies (Na/S, Li/MS (M=metal), Ni/MH, Ni/Cd, Ni/Zn, Ni/Fe, Zn/Br, and Pb-acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division, and the Electric Power Research Institute. The ADL provides a common basis for battery performance characterization and life evaluations with unbiased application of tests and analyses. The results help identify the most-promising R D approaches for overcoming battery limitations, and provide battery users, developers, and program managers with a measure of the progress being made in battery R D programs, a comparison of battery technologies, and basic data for modeling.

  2. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients

    PubMed Central

    Kim, Eun-Kyung; Lee, Dong-Kyu; Kim, Young-Mi

    2015-01-01

    [Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients. PMID:25642076

  3. The tool in the brain: apraxia in ADL. Behavioral and neurological correlates of apraxia in daily living.

    PubMed

    Bieńkiewicz, Marta M N; Brandi, Marie-Luise; Goldenberg, Georg; Hughes, Charmayne M L; Hermsdörfer, Joachim

    2014-01-01

    Humans differ from other animals in the way they can skilfully and precisely operate or invent tools to facilitate their everyday life. Tools have dominated our home, travel and work environment, becoming an integral step for our motor skills development. What happens when the part of the brain responsible for tool use is damaged in our adult life due to a cerebrovascular accident? How does daily life change when we lose the previously mastered ability to make use of the objects around us? How do patients suffering from compromised tool use cope with food preparation, personal hygiene, grooming, housework, or use of home appliances? In this literature review we present a state of the art for single and multiple tool use research, with a focus on the impact that apraxia (impaired ability to perform tool-based actions) and action disorganization syndrome (ADS; impaired ability to carry out multi-step actions) have on activities of daily living (ADL). Firstly, we summarize the behavioral studies investigating the impact of apraxia and other comorbidity syndromes, such as neglect or visual extinction, on ADL. We discuss the hallmarks of the compromised tool use in terms of the sequencing of action steps, conceptual errors committed, spatial motor control, and temporal organization of the movement. In addition, we present an up-to-date overview of the neuroimaging and lesion analyses studies that provide an insight into neural correlates of tool use in the human brain and functional changes in the neural organization following a stroke, in the context of ADL. Finally we discuss the current practice in neurorehabilitation of ADL in apraxia and ADS aiming at increasing patients' independence. PMID:24795685

  4. The tool in the brain: apraxia in ADL. Behavioral and neurological correlates of apraxia in daily living

    PubMed Central

    Bieńkiewicz, Marta M. N.; Brandi, Marie-Luise; Goldenberg, Georg; Hughes, Charmayne M. L.; Hermsdörfer, Joachim

    2014-01-01

    Humans differ from other animals in the way they can skilfully and precisely operate or invent tools to facilitate their everyday life. Tools have dominated our home, travel and work environment, becoming an integral step for our motor skills development. What happens when the part of the brain responsible for tool use is damaged in our adult life due to a cerebrovascular accident? How does daily life change when we lose the previously mastered ability to make use of the objects around us? How do patients suffering from compromised tool use cope with food preparation, personal hygiene, grooming, housework, or use of home appliances? In this literature review we present a state of the art for single and multiple tool use research, with a focus on the impact that apraxia (impaired ability to perform tool-based actions) and action disorganization syndrome (ADS; impaired ability to carry out multi-step actions) have on activities of daily living (ADL). Firstly, we summarize the behavioral studies investigating the impact of apraxia and other comorbidity syndromes, such as neglect or visual extinction, on ADL. We discuss the hallmarks of the compromised tool use in terms of the sequencing of action steps, conceptual errors committed, spatial motor control, and temporal organization of the movement. In addition, we present an up-to-date overview of the neuroimaging and lesion analyses studies that provide an insight into neural correlates of tool use in the human brain and functional changes in the neural organization following a stroke, in the context of ADL. Finally we discuss the current practice in neurorehabilitation of ADL in apraxia and ADS aiming at increasing patients’ independence. PMID:24795685

  5. Audio Development Laboratory (ADL) User Test Planning Guide

    NASA Technical Reports Server (NTRS)

    Romero, Andy

    2012-01-01

    Test process, milestones and inputs are unknowns to first-time users of the ADL. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

  6. Primary care providers' experiences notifying parents of cystic fibrosis newborn screening results.

    PubMed

    Finan, Caitlin; Nasr, Samya Z; Rothwell, Erin; Tarini, Beth A

    2015-01-01

    This study examines primary care provider (PCP) experiences with the initial parental disclosure of cystic fibrosis (CF) newborn screening (NBS) results in order to identify methods to improve parent-provider communication during the CF NBS process. PCPs of infants who received positive CF NBS results participated in semistructured phone interviews. Interviews were analyzed using a qualitative content analysis. PCPs acknowledged the difficulty of "breaking bad news" to parents, and emphasized minimizing parental anxiety and maximizing parental understanding. PCPs used a variety of methods to notify parents, and shared varying information about the significance of the results. Variation in the method of parental notification, information discussed, and attention to parents' emotional needs may limit successful follow-up of children with positive CF NBS results. A multifaceted intervention to improve PCP knowledge, management, and communication could improve provider confidence, optimize information transfer, and minimize parental distress during the initial disclosure of CF NBS results. PMID:25104730

  7. Your Results, Explained: Clarity Provided by Row Percentages Versus Column Percentages.

    PubMed

    Althouse, Andrew D; Raffa, Giuseppe M; Kormos, Robert L

    2016-01-01

    The overwhelming majority of clinical research papers begin their Results section with a series of tables summarizing the distribution of significant demographics, clinical characteristics, and potential outcome variables within their study cohort. However, the presentation of these tables often leaves the reader confused or wanting different information than what is presented. One particularly vexing decision in the presentation of categoric variables is choosing to present the "row percentage" in preference to the "column percentage." This report provides a guide for clinical scientists, some of whom may not have access to statistical support, to summarize their descriptive results in the manner that provides the most clarity for the reader. PMID:26694261

  8. Quick lateral movements of the trunk in a seated position reflect mobility and activities of daily living (ADL) function in frail elderly individuals.

    PubMed

    Iwata, Akira; Higuchi, Yumi; Kimura, Daisuke; Okamoto, Kensuke; Arai, Shin; Iwata, Hiroshi; Fuchioka, Satoshi

    2013-01-01

    A novel and safe performance test for measuring mobility is described. The test, which we have named the Seated Side Tapping test (Side Tapping test), requires the subjects to move their bodies laterally to the left and right in turn as quickly as possible whilst remaining in a seated position. We examined the associations between the results of the new test and those of other mobility tests, ADL, and the use of walking aids. The participants were 75 frail elderly people who were receiving rehabilitation services. Gait speed and the timed up and go (TUG) test were employed as mobility tests, and the participants' use of walking aids was recorded. The ADL score was assessed using the Barthel Index. Significant correlations were found between the side tapping test and gait speed (r=-0.59, p<0.01), and TUG (r=0.63, p<0.01). This test also revealed significant relationships with the ADL scores and the use of walking aids. These results indicate that an ability to perform quick lateral trunk movements in a seated position reflects their mobility during standing. Thus, we concluded that since the side tapping test is simple and safe, it is useful for detecting mobility impairments, ADL levels, and the need for walking aids, especially in frail elderly individuals. PMID:23270712

  9. SO{sub 2} and NOx trading markets: providing flexibility and results

    SciTech Connect

    Sam Napolitano; Melanie LaCount; Daniel Chartier

    2007-06-15

    Experience with the Acid Rain and NOx Budget Trading Programs demonstrates that cap-and-trade programs are an effective means of achieving broad improvements in air quality. Results demonstrate that the combination of mandatory emissions caps, a viable allowance trading market, rigorous emissions monitoring and reporting protocols, and automatic enforcement provide accountability and ensure results in a cost-effective manner. The market developments discussed in this article demonstrate a successful environmental partnership. With a government focused on results and a private sector motivated to innovate, cap-and trade systems deliver environmental results as efficiently and effectively as possible. 3 refs., 4 figs,

  10. Characteristics of Genomic Test Consumers Who Spontaneously Share Results with Their Health Care Provider

    PubMed Central

    Darst, Burcu F.; Madlensky, Lisa; Schork, Nicholas J.; Topol, Eric J.; Bloss, Cinnamon S.

    2013-01-01

    Purpose To evaluate the characteristics of direct-to-consumer (DTC) genomic test consumers who spontaneously shared their test results with their health care provider. Methods Utilizing data from the Scripps Genomic Health Initiative we compared demographic, behavioral, and attitudinal characteristics of DTC genomic test consumers who shared their results with their physician or health care provider versus those who did not share. We also compared genomic risk estimates between the two groups. Results Of 2024 individuals assessed at approximately 6 months post-testing, a total of 540 individuals (26.5%) reported sharing their results with their physician or health care provider. Those who shared were older (p<.001), had a higher income (p=.01), were more likely to be married (p=.005), and more likely to identify with a religion (p=.004). As assessed prior to undergoing testing, sharers also showed higher exercise (p=.003) and lower fat intake (p=.02), and expressed fewer overall concerns about testing (p=.001) and fewer concerns related to the privacy of their genomic information (p=.03). The genomic disease risk estimates disclosed were not associated with sharing. Conclusion In a DTC genomic testing context, physicians and other health care providers may be more likely to encounter patients who are more health conscious and have fewer concerns about the privacy of their genomic information. Genomic risk itself does not appear to be a primary determinant of sharing behavior among consumers. PMID:23384116

  11. Characteristics of genomic test consumers who spontaneously share results with their health care provider.

    PubMed

    Darst, Burcu F; Madlensky, Lisa; Schork, Nicholas J; Topol, Eric J; Bloss, Cinnamon S

    2014-01-01

    The purpose of this study was to evaluate the characteristics of direct-to-consumer (DTC) genomic test consumers who spontaneously shared their test results with their health care provider. Utilizing data from the Scripps Genomic Health Initiative, we compared demographic, behavioral, and attitudinal characteristics of DTC genomic test consumers who shared their results with their physician or health care provider versus those who did not share. We also compared genomic risk estimates between the two groups. Of 2,024 individuals assessed at approximately 6 months post testing, 540 individuals (26.5%) reported sharing their results with their physician or health care provider. Those who shared were older (p < .001), had a higher income (p = .01), were more likely to be married (p = .005), and were more likely to identify with a religion (p = .004). As assessed prior to undergoing testing, sharers also reported higher levels of exercise (p = .003), lower fat intake (p = .02), fewer overall concerns about testing (p = .001), and fewer concerns related to the privacy of their genomic information (p = .03). The genomic disease risk estimates disclosed were not associated with sharing. Thus, in a DTC genomic testing context, physicians and other health care providers may be more likely to encounter patients who are more health conscious and have fewer concerns about the privacy of their genomic information. Genomic risk itself does not appear to be a primary determinant of sharing behavior among consumers. PMID:23384116

  12. Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries

    PubMed Central

    2011-01-01

    Background Most prior studies have focused on short-term (≤ 2 years) functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines. Methods The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs), instrumental ADLs (IADLs), and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop. Results The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6% on ADL abilities, 32.3% on IADL abilities, and 30.9% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline. Conclusions Both the additive and

  13. Results of a survey assessing provider beliefs of adherence barriers to antiplatelet medications.

    PubMed

    Bird, Gary C; Cannon, Christopher P; Kennison, Richard H

    2011-09-01

    The guidelines published by the American College of Cardiology Foundation/American Heart Association provide an evidence-based rationale and continuum of care for patients with unstable angina/non-ST-segment elevation acute coronary syndromes (UA/NSTE-ACS) from acute through to chronic management. Antiplatelet therapy forms an integral part of the care regimen, and a wealth of evidence supports appropriate dual or triple antiplatelet therapy in significantly reducing the frequency of potentially fatal secondary ischemic events. However, as is often the case with long-term therapies, adherence issues become apparent that limit this potential. In this article, we report on the results of a national survey of health care providers involved in the care of UA/NSTE-ACS patients on chronic (posthospital discharge) antiplatelet therapy. Our data reveal that the participants believe costs, lack of patient understanding of their condition or medication, and perception of the value of their therapy are important patient factors that promote nonadherence. Participants indicated that nonadherence occurs more frequently among minority and elderly patients, and less frequently when a caregiver is involved. We also show that deficits of knowledge, competence, and confidence exist in providers who treat patients with UA/NSTE-ACS. These deficits were generally greater in primary/family care providers compared with internal medicine and cardiologists, and for nurse practitioners/physician assistants compared with physicians (MDs/DOs). In addition, providers of all types frequently did not use adherence-improving tools or resources with their staff or patients. Our data suggest that because of its potential impact on patient outcomes, there is a pressing need to improve provider antiplatelet therapy adherence management in UA/NSTE-ACS. PMID:21989034

  14. Geological questions and significant results provided by early ERTS-1 data

    NASA Technical Reports Server (NTRS)

    Carter, W. D.

    1972-01-01

    There are no author-identified significant results in this report. The organization for evaluating the uses of Earth Resources Technology Satellite data of the United States and foreign areas is described. The implementation of a system to disseminate the data to the geographical areas of interest is discussed. Brief descriptions are included of data received for the following areas: (1) east coast, (2) central United States, (3) western mountain areas, (4) west coast areas, and (5) Alaska. It is concluded that the multiband approach is useful with each of the bands providing unique and useful information. The difficulties in handling the data if all seven bands are used are examined.

  15. Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.

    PubMed

    Oravakangas, Rami; Leppilahti, Juhana; Laine, Vesa; Niinimäki, Tuukka

    2016-01-01

    Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation. PMID:26905255

  16. Providing Coaching and Cotinine Results to Preteens to Reduce Their Secondhand Smoke Exposure

    PubMed Central

    Wahlgren, Dennis R.; Liles, Sandy; Jones, Jennifer A.; Hughes, Suzanne C.; Matt, Georg E.; Ji, Ming; Lessov-Schlaggar, Christina N.; Swan, Gary E.; Chatfield, Dale; Ding, Ding

    2011-01-01

    Background: Secondhand smoke exposure (SHSe) poses health risks to children living with smokers. Most interventions to protect children from SHSe have coached adult smokers. This trial determined whether coaching and cotinine feedback provided to preteens can reduce their SHSe. Methods: Two hundred one predominantly low-income families with a resident smoker and a child aged 8 to 13 years who was exposed to two or more cigarettes per day or had a urine cotinine concentration ≥ 2.0 ng/mL were randomized to control or SHSe reduction coaching groups. During eight in-home sessions over 5 months, coaches presented to the child graphic charts of cotinine assay results as performance feedback and provided differential praise and incentives for cotinine reductions. Generalized estimating equations were used to determine the differential change in SHSe over time by group. Results: For the baseline to posttest period, the coaching group had a greater decrease in both urine cotinine concentration (P = .039) and reported child SHSe in the number of cigarettes exposed per day (child report, P = .003; parent report, P = .078). For posttest to month 12 follow-up, no group or group by time differences were obtained, and both groups returned toward baseline. Conclusions: Coaching preteens can reduce their SHSe, although reductions may not be sustained without ongoing counseling, feedback, and incentives. Unlike interventions that coach adults to reduce child SHSe, programs that increase child avoidance of SHSe have the potential to reduce SHSe in all settings in which the child is exposed, without requiring a change in adult smoking behavior. PMID:21474574

  17. Listeria monocytogenes DNA Glycosylase AdlP Affects Flagellar Motility, Biofilm Formation, Virulence, and Stress Responses

    PubMed Central

    Zhang, Ting; Bae, Dongryeoul

    2016-01-01

    ABSTRACT The temperature-dependent alteration of flagellar motility gene expression is critical for the foodborne pathogen Listeria monocytogenes to respond to a changing environment. In this study, a genetic determinant, L. monocytogenes f2365_0220 (lmof2365_0220), encoding a putative protein that is structurally similar to the Bacillus cereus alkyl base DNA glycosylase (AlkD), was identified. This determinant was involved in the transcriptional repression of flagellar motility genes and was named adlP (encoding an AlkD-like protein [AdlP]). Deletion of adlP activated the expression of flagellar motility genes at 37°C and disrupted the temperature-dependent inhibition of L. monocytogenes motility. The adlP null strains demonstrated decreased survival in murine macrophage-like RAW264.7 cells and less virulence in mice. Furthermore, the deletion of adlP significantly decreased biofilm formation and impaired the survival of bacteria under several stress conditions, including the presence of a DNA alkylation compound (methyl methanesulfonate), an oxidative agent (H2O2), and aminoglycoside antibiotics. Our findings strongly suggest that adlP may encode a bifunctional protein that transcriptionally represses the expression of flagellar motility genes and influences stress responses through its DNA glycosylase activity. IMPORTANCE We discovered a novel protein that we named AlkD-like protein (AdlP). This protein affected flagellar motility, biofilm formation, and virulence. Our data suggest that AdlP may be a bifunctional protein that represses flagellar motility genes and influences stress responses through its DNA glycosylase activity. PMID:27316964

  18. Results of an Iridium-Based Data Communication System Providing Internet Access to Polar Expeditions

    NASA Astrophysics Data System (ADS)

    Mohammad, A.; Frost, V.; Braaten, D.

    2003-12-01

    ' W) from June 23-July 17, 2003. We measured the reliability, throughput and general performance of this system over periods of up to 24 hours. This included delay, loss, throughput, call drops/up-time, relative signal strengths, connection time and number of connection retries. The system was also successfully tested while moving across the ice sheet at speeds of up to 30 km/h. We were successful in uploading and downloading large files (.2MB to 7.2MB) to the Internet. In combination with a modified Wi-Fi deployment, wireless Internet access was also provided to the entire NorthGRIP camp for a few days. The field experiments have shown that standard Internet protocols combined with MLPPP and Iridium modems can provide Internet access for polar expeditions at useful data rates. The 4-modem configuration we tested was observed to be >90 % efficient, e.g., a 2.5 MB video file was transferred in 35 min. at 9.524 Kb/s. The system had an average up-time of over 90 % and thus is stable and suitable for autonomous operation. Mobile performance results were very similar to that of stationary systems. While the end-to-end network architecture developed to provide Internet access worked well, the system round trip time is significant ( ˜ 1.8 seconds), which can impair real time interactions.

  19. Sodium oxybate therapy provides multidimensional improvement in fibromyalgia: results of an international phase 3 trial

    PubMed Central

    Spaeth, Michael; Bennett, Robert M; Benson, Beverly A; Wang, Y Grace; Lai, Chinglin; Choy, Ernest H

    2012-01-01

    Background Fibromyalgia is characterised by chronic musculoskeletal pain and multiple symptoms including fatigue, multidimensional function impairment, sleep disturbance and tenderness. Along with pain and fatigue, non-restorative sleep is a core symptom of fibromyalgia. Sodium oxybate (SXB) is thought to reduce non-restorative sleep abnormalities. This study evaluated effects of SXB on fibromyalgia-related pain and other symptoms. Methods 573 patients with fibromyalgia according to 1990 American College of Rheumatology criteria were enrolled at 108 centres in eight countries. Subjects were randomly assigned to placebo, SXB 4.5 g/night or SXB 6 g/night. The primary efficacy endpoint was the proportion of subjects with ≥30% reduction in pain visual analogue scale from baseline to treatment end. Other efficacy assessments included function, sleep quality, effect of sleep on function, fatigue, tenderness, health-related quality of life and subject's impression of change in overall wellbeing. Results Significant improvements in pain, sleep and other symptoms associated with fibromyalgia were seen in SXB treated subjects compared with placebo. The proportion of subjects with ≥30% pain reduction was 42.0% for SXB4.5 g/night (p=0.002) and 51.4% for SXB6 g/night (p<0.001) versus 26.8% for placebo. Quality of sleep (Jenkins sleep scale) improved by 20% for SXB4.5 g/night (p≤0.001) and 25% for SXB6 g/night (p≤0.001) versus 0.5% for placebo. Adverse events with an incidence ≥5% and twice placebo were nausea, dizziness, vomiting, insomnia, anxiety, somnolence, fatigue, muscle spasms and peripheral oedema. Conclusion These results, combined with findings from previous phase 2 and 3 studies, provide supportive evidence that SXB therapy affordsimportant benefits across multiple symptoms in subjects with fibromyalgia. PMID:22294641

  20. Design and initial results from a supported education initiative: the Kansas Consumer as Provider program.

    PubMed

    McDiarmid, Diane; Rapp, Charles; Ratzlaff, Sarah

    2005-01-01

    Despite increased attention to consumer-providers, there remains a lack of models that prepare, support, and sustain consumers in provider roles. This article describes the Consumer as Provider (CAP) Training program at the University of Kansas School of Social Welfare, which creates opportunities for individuals with severe psychiatric disabilities to develop knowledge and skills to be effective as human service providers. CAP fosters a partnership between colleges and community mental health centers where students experience classroom and internship activities. Outcome from a 2-year longitudinal study on CAP graduates indicates increased employability, especially in social services field, and higher post-secondary educational involvement. PMID:16075691

  1. AeroADL: applying the integration of the Suomi-NPP science algorithms with the Algorithm Development Library to the calibration and validation task

    NASA Astrophysics Data System (ADS)

    Houchin, J. S.

    2014-09-01

    A common problem for the off-line validation of the calibration algorithms and algorithm coefficients is being able to run science data through the exact same software used for on-line calibration of that data. The Joint Polar Satellite System (JPSS) program solved part of this problem by making the Algorithm Development Library (ADL) available, which allows the operational algorithm code to be compiled and run on a desktop Linux workstation using flat file input and output. However, this solved only part of the problem, as the toolkit and methods to initiate the processing of data through the algorithms were geared specifically toward the algorithm developer, not the calibration analyst. In algorithm development mode, a limited number of sets of test data are staged for the algorithm once, and then run through the algorithm over and over as the software is developed and debugged. In calibration analyst mode, we are continually running new data sets through the algorithm, which requires significant effort to stage each of those data sets for the algorithm without additional tools. AeroADL solves this second problem by providing a set of scripts that wrap the ADL tools, providing both efficient means to stage and process an input data set, to override static calibration coefficient look-up-tables (LUT) with experimental versions of those tables, and to manage a library containing multiple versions of each of the static LUT files in such a way that the correct set of LUTs required for each algorithm are automatically provided to the algorithm without analyst effort. Using AeroADL, The Aerospace Corporation's analyst team has demonstrated the ability to quickly and efficiently perform analysis tasks for both the VIIRS and OMPS sensors with minimal training on the software tools.

  2. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    PubMed

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics. PMID:24761922

  3. Genome-Wide Analysis of Seed Acid Detergent Lignin (ADL) and Hull Content in Rapeseed (Brassica napus L.).

    PubMed

    Wang, Jia; Jian, Hongju; Wei, Lijuan; Qu, Cunmin; Xu, Xinfu; Lu, Kun; Qian, Wei; Li, Jiana; Li, Maoteng; Liu, Liezhao

    2015-01-01

    A stable yellow-seeded variety is the breeding goal for obtaining the ideal rapeseed (Brassica napus L.) plant, and the amount of acid detergent lignin (ADL) in the seeds and the hull content (HC) are often used as yellow-seeded rapeseed screening indices. In this study, a genome-wide association analysis of 520 accessions was performed using the Q + K model with a total of 31,839 single-nucleotide polymorphism (SNP) sites. As a result, three significant associations on the B. napus chromosomes A05, A09, and C05 were detected for seed ADL content. The peak SNPs were within 9.27, 14.22, and 20.86 kb of the key genes BnaA.PAL4, BnaA.CAD2/BnaA.CAD3, and BnaC.CCR1, respectively. Further analyses were performed on the major locus of A05, which was also detected in the seed HC examination. A comparison of our genome-wide association study (GWAS) results and previous linkage mappings revealed a common chromosomal region on A09, which indicates that GWAS can be used as a powerful complementary strategy for dissecting complex traits in B. napus. Genomic selection (GS) utilizing the significant SNP markers based on the GWAS results exhibited increased predictive ability, indicating that the predictive ability of a given model can be substantially improved by using GWAS and GS. PMID:26673885

  4. Genome-Wide Analysis of Seed Acid Detergent Lignin (ADL) and Hull Content in Rapeseed (Brassica napus L.)

    PubMed Central

    Wei, Lijuan; Qu, Cunmin; Xu, Xinfu; Lu, Kun; Qian, Wei; Li, Jiana; Li, Maoteng; Liu, Liezhao

    2015-01-01

    A stable yellow-seeded variety is the breeding goal for obtaining the ideal rapeseed (Brassica napus L.) plant, and the amount of acid detergent lignin (ADL) in the seeds and the hull content (HC) are often used as yellow-seeded rapeseed screening indices. In this study, a genome-wide association analysis of 520 accessions was performed using the Q + K model with a total of 31,839 single-nucleotide polymorphism (SNP) sites. As a result, three significant associations on the B. napus chromosomes A05, A09, and C05 were detected for seed ADL content. The peak SNPs were within 9.27, 14.22, and 20.86 kb of the key genes BnaA.PAL4, BnaA.CAD2/BnaA.CAD3, and BnaC.CCR1, respectively. Further analyses were performed on the major locus of A05, which was also detected in the seed HC examination. A comparison of our genome-wide association study (GWAS) results and previous linkage mappings revealed a common chromosomal region on A09, which indicates that GWAS can be used as a powerful complementary strategy for dissecting complex traits in B. napus. Genomic selection (GS) utilizing the significant SNP markers based on the GWAS results exhibited increased predictive ability, indicating that the predictive ability of a given model can be substantially improved by using GWAS and GS. PMID:26673885

  5. Integrating earth observations and model results provides earlier Famine Early Warning

    NASA Astrophysics Data System (ADS)

    Brown, M. E.; Funk, C. C.; Galu, G.; Choularton, R.

    2007-12-01

    Remote sensing allows us to detect slowly evolving natural hazards such as agricultural drought. Famine early warning systems transform this data into actionable policy information, enabling humanitarian organizations to respond in a timely and appropriate manner. These life saving responses are increasingly important. In 2006, 1 out of 8 people did not have enough to eat, 22 million more people became undernourished, and 22 countries provided 6.5 billion dollars in food aid. The motivation is strong, therefore, to increase the effectiveness of every dollar of food aid provided, ensuring that the assistance arrives sufficiently early to ward off human and economic catastrophe. Properly interpreted remote sensing information reduces the influence of politics in determining the amount and location of aid delivered. In this talk we will review three recent contributions that earth observations have provided to famine early warning: trend identification, increasingly accurate forecasts of food security conditions, and enhanced integration of biophysical and socio-economic data.

  6. Temperature and vibration results from captive-store flight tests provide a reliability improvement tool

    NASA Astrophysics Data System (ADS)

    Calatayud, Richard; Szymkowiak, Edward A.

    The ALQ-131 electronic countermeasure (ECM) system has provided the United States Air Force with proven self-protection for many of its tactical fighter aircraft. The reliability and maintainability (R&M) improvements of the ALQ-131 Block II has produced a system with an mean time between failures (MTBF) of 120 to 180 h and greater than 95 percent availability for the 390 systems in theater during the Persian Gulf war. Classic R&M approaches have gotten the ALQ-131 to this high standard, but improved understanding of the environment experienced by the system will provide the next steps in reliability improvements. The capture of measured response data will provide a basis for development life cycle and customer warranty tests which will guarantee to the customer that the ALQ-131 system will continue to perform reliably from takeoff to landing and from mission to mission through the life of the system.

  7. Service Providers in Psychology: Results of the 1982 APA Human Resources Survey.

    ERIC Educational Resources Information Center

    VandenBos, Gary R.; Stapp, Joy

    1983-01-01

    Based on a survey of service provider psychologists, describes (1) their age, sex, ethnicity, years since degree licensure, state association membership, and "National Register" listing; (2) primary and secondary employment settings; (3) professional practices; and (4) aspects of independent practice. (GC)

  8. Health Service Providers in Psychology: Results of the 1978 APA Human Resources Survey.

    ERIC Educational Resources Information Center

    Vandenbos, Gary R.; And Others

    1981-01-01

    Describes characteristics, employment setting, and professional practices of health service-provider psychologists. Discusses their current status in psychology, the distribution of health care practitioners, patterns of specialization in service delivery, and populations being served by these practitioners. (Author/MJL)

  9. Tick Bite Prophylaxis: Results From a 2012 Survey of Healthcare Providers.

    PubMed

    Perea, A E; Hinckley, A F; Mead, P S

    2015-08-01

    In a recent national survey, over 30% of healthcare providers (HCPs) reported prescribing tick bite prophylaxis in the previous year. To clarify provider practices, we surveyed HCPs to determine how frequently and for what reasons they prescribed tick bite prophylaxis. We included four questions regarding tick bite prophylaxis in the DocStyles 2012 survey, a computer-administered questionnaire of 2205 US primary care physicians, paediatricians and nurse practitioners. Responses in 14 states with high Lyme disease incidence (high LDI) were compared with responses from other states (low LDI). Overall, 56.4% of 1485 providers reported prescribing tick bite prophylaxis at least once in the previous year, including 73.9% of HCPs in high LDI and 48.2% in low LDI states. The reasons given were 'to prevent Lyme disease' (76.9%), 'patients request it' (40.4%) and 'to prevent other tickborne diseases' (29.4%). Among HCPs who provided prophylaxis, 45.2% did so despite feeling that it was not indicated. Given a hypothetical scenario involving a patient with an attached tick, 38.1% of HCPs from high LDI states and 15.1% from low LDI states would prescribe a single dose of doxycycline; 19.0% from high LDI states and 27.5% from low LDI states would prescribe a full course of doxycycline. HCPs prescribe tick bite prophylaxis frequently in areas where Lyme disease is rare and for tickborne diseases for which it has not been shown effective. HCPs may be unaware of current tick bite prophylaxis guidelines or find them difficult to implement. More information is needed regarding the efficacy of tick bite prophylaxis for diseases other than Lyme disease. PMID:25244410

  10. Changes over time in the ADL status of elderly US veterans.

    PubMed

    Hisnanick, J J

    1994-11-01

    The ageing of the US veteran population has greatly out-paced that of the general US population in the last decade and the demographics of this subgroup have changed relative to the US general population. To address the concerns of policy makers within the US Department of Veterans' Affairs (VA), data on elderly US male veterans and non-veterans from the Longitudinal Survey on Aging in 1984, 1986, 1988, and 1990 were used in a prospective study. Health status or well-being was assessed through changes over time in ADL status, according to the following five categories; (I) the presence of no ADL dependence and not developing a dependence between survey periods, (II) no change in ADL dependence between survey periods, (III) an increase in ADL dependence status between survey periods, (IV) a decrease in ADL dependence between survey periods, and (V) the occurrence of death between survey periods. Using a polytomous logistic regression model, these five categories were assessed in relation to a set of variables representing social, health-care utilization, and socioeconomic characteristics. The estimated coefficients from the model indicate that family income, having worked in the last 12 months, having an increase or no change in levels of physical activity in the past 12 months and the presence of Medicare coverage are inversely associated with moving, over time, into a lower state of health status or well-being. The prior existence of an ADL limitation, the number of doctor and hospital visits in the past 12 months, level of education, having been widowed in the past 12 months and veteran status were all proportionally associated with the likelihood of moving into a lower state of health status or well-being. These findings lead to the conclusion that being a veteran in the US does make a difference in regard to moving into various states of health status or well-being. This difference is supported by the estimated coefficient for veteran status being significant

  11. Large MOEMS diffraction grating results providing an EC-QCL wavelength scan of 20%

    NASA Astrophysics Data System (ADS)

    Grahmann, Jan; Merten, André; Herrmann, Andreas; Ostendorf, Ralf; Bleh, Daniela; Drabe, Christian; Kamenz, Jörg

    2015-02-01

    Experimental results of a large scanning grating with a diameter of 5mm and 1 kHz scan frequency are discussed. An optical diffraction grating is fabricated on a mirror single crystal silicon plate to scan the first diffraction order in the MIR-wavelength range over a quantum cascade laser facet. Special emphasis is on the development of the grating technology module to integrate it with high accuracy and reproducibility into the IPMS AME75 process flow. The principle EC-QCL setup with the scanning grating is described and first measurement results concerning laser output power and tuning range are presented.

  12. Frequency Spectrum for New Aviation Data Links: Initial Study Results

    NASA Technical Reports Server (NTRS)

    Matolak, David W.; Branstetter, James R.

    2004-01-01

    We describe results from an initial study to assess the suitability of various spectral bands for supporting the deployment of new aviation data links (ADL). The study focused on systems and spectral bands that can deliver VHF data link (VDL)-or-higher data rates in a two-way communication setting, including air-ground, ground-air, and air-air modes of operation. In the first part of our paper, we briefly discuss the current situation regarding communications, navigation, and surveillance (CNS) links and existing spectrum, and the well-known need for new aviation data links. We next provide an overview of related systems, and discuss key factors involved in the use of spectrum in various bands for any future integrated CNS data link, addressing primarily the lower few layers of the communications protocol stack. Desired attributes of a new ADL system are discussed, and the beneficial aspects of a particular transmission technique spread spectrum are summarized. We also provide a short list of several example potential spectral regions, and note that while none of the existing systems will likely meet the full range of desired features of a new ADL, several systems and spectral regions offer promise in terms of one or more characteristics. A detailed discussion and evaluation of these spectral regions is proposed as future work. We include a few brief examples to illustrate initial technical results regarding spread spectrum overlay, also a subject for future work.

  13. Vision based assistive technology for people with dementia performing activities of daily living (ADLs): an overview

    NASA Astrophysics Data System (ADS)

    As'ari, M. A.; Sheikh, U. U.

    2012-04-01

    The rapid development of intelligent assistive technology for replacing a human caregiver in assisting people with dementia performing activities of daily living (ADLs) promises in the reduction of care cost especially in training and hiring human caregiver. The main problem however, is the various kinds of sensing agents used in such system and is dependent on the intent (types of ADLs) and environment where the activity is performed. In this paper on overview of the potential of computer vision based sensing agent in assistive system and how it can be generalized and be invariant to various kind of ADLs and environment. We find that there exists a gap from the existing vision based human action recognition method in designing such system due to cognitive and physical impairment of people with dementia.

  14. Measuring Disability: Application of the Rasch Model to Activities of Daily Living (ADL/IADL).

    ERIC Educational Resources Information Center

    Sheehan, T. Joseph; DeChello, Laurie M.; Garcia, Ramon; Fifield, Judith; Rothfield, Naomi; Reisine, Susan

    2001-01-01

    Performed a comparative analysis of Activities of Daily Living (ADL) items administered to 4,430 older adults and Instrumental Activities of Daily Living administered to 605 people with rheumatoid arthritis scoring both with Likert and Rasch measurement models. Findings show the superiority of the Rasch approach over the Likert method. (SLD)

  15. JPSS Cryosphere Algorithms: Integration and Testing in Algorithm Development Library (ADL)

    NASA Astrophysics Data System (ADS)

    Tsidulko, M.; Mahoney, R. L.; Meade, P.; Baldwin, D.; Tschudi, M. A.; Das, B.; Mikles, V. J.; Chen, W.; Tang, Y.; Sprietzer, K.; Zhao, Y.; Wolf, W.; Key, J.

    2014-12-01

    JPSS is a next generation satellite system that is planned to be launched in 2017. The satellites will carry a suite of sensors that are already on board the Suomi National Polar-orbiting Partnership (S-NPP) satellite. The NOAA/NESDIS/STAR Algorithm Integration Team (AIT) works within the Algorithm Development Library (ADL) framework which mimics the operational JPSS Interface Data Processing Segment (IDPS). The AIT contributes in development, integration and testing of scientific algorithms employed in the IDPS. This presentation discusses cryosphere related activities performed in ADL. The addition of a new ancillary data set - NOAA Global Multisensor Automated Snow/Ice data (GMASI) - with ADL code modifications is described. Preliminary GMASI impact on the gridded Snow/Ice product is estimated. Several modifications to the Ice Age algorithm that demonstrates mis-classification of ice type for certain areas/time periods are tested in the ADL. Sensitivity runs for day time, night time and terminator zone are performed and presented. Comparisons between the original and modified versions of the Ice Age algorithm are also presented.

  16. Hospital Readmission among Older Adults Who Return Home with Unmet Need for ADL Disability

    ERIC Educational Resources Information Center

    DePalma, Glen; Xu, Huiping; Covinsky, Kenneth E.; Craig, Bruce A.; Stallard, Eric; Thomas, Joseph, III.; Sands, Laura P.

    2013-01-01

    Purpose: This study determined whether returning to the community from a recent hospitalization with unmet activities of daily living (ADL) need was associated with probability of readmission. Methods: A total of 584 respondents to the 1994, 1999, and/or 2004 National Long-Term Care Surveys (NLTCS) who were hospitalized within 90 days prior to the…

  17. Key results of battery performance and life tests at Argonne National Laboratory

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1991-01-01

    Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory's Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R D programs, compare battery technologies, and provide basic data for modeling and continuing R D to battery users, developers, and program managers.

  18. Key results of battery performance and life tests at Argonne National Laboratory

    SciTech Connect

    DeLuca, W.H.; Gillie, K.R.; Kulaga, J.E.; Smaga, J.A.; Tummillo, A.F.; Webster, C.E.

    1991-12-31

    Advanced battery technology evaluations are performed under simulated electric vehicle operating conditions at Argonne National Laboratory`s & Diagnostic Laboratory (ADL). The ADL provide a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1991 on twelve single cells and eight 3- to 360-cell modules that encompass six battery technologies (Na/S, Li/MS, Ni/MH, Zn/Br, Ni/Fe, and Pb-Acid). These evaluations were performed for the Department of Energy, Office of Transportation Technologies, Electric and Hybrid Propulsion Division. The results measure progress in battery R & D programs, compare battery technologies, and provide basic data for modeling and continuing R & D to battery users, developers, and program managers.

  19. Targeting Adults Who Provide Alcohol to Underage Youth: Results from a National Survey of Local Law Enforcement Agencies

    PubMed Central

    Jones-Webb, Rhonda; Toomey, Traci L.; Lenk, Kathleen M.; Nelson, Toben F.; Erickson, Darin J.

    2014-01-01

    Objective We investigated what local enforcement agencies are doing to target adults who provide alcohol to underage youth; what types of enforcement activities are being conducted to target adult providers; and factors that encourage enforcement activities that target adult providers. Method We surveyed 1056 local law enforcement agencies in the U.S. and measured whether or not the agency conducted enforcement activities that target adults who provide alcohol to underage youth. We also measured whether certain agency and jurisdiction characteristics were associated with enforcement activities that target adults who provide alcohol to underage youth. Results Less than half (42%) of local enforcement agencies conducted enforcement efforts targeting adults who provide alcohol to underage youth. Agencies that conducted the enforcement activities targeting adult providers were significantly more likely to have a full time officer specific to alcohol enforcement, a division specific to alcohol enforcement, a social host law, and to perceive underage drinking was very common. Conclusions Results suggest that targeting social providers (i.e., adults over 21 years of age) will require greater law enforcement resources, implementation of underage drinking laws (e.g., social host policies), and changing perceptions among law enforcement regarding underage drinking. Future studies are needed to identify the most effective enforcement efforts and to examine how enforcement efforts are prospectively linked to alcohol consumption. PMID:25466432

  20. DIRECT secure messaging as a common transport layer for reporting structured and unstructured lab results to outpatient providers.

    PubMed

    Sujansky, Walter; Wilson, Tom

    2015-04-01

    This report describes a grant-funded project to explore the use of DIRECT secure messaging for the electronic delivery of laboratory test results to outpatient physicians and electronic health record systems. The project seeks to leverage the inherent attributes of DIRECT secure messaging and electronic provider directories to overcome certain barriers to the delivery of lab test results in the outpatient setting. The described system enables laboratories that generate test results as HL7 messages to deliver these results as structured or unstructured documents attached to DIRECT secure messages. The system automatically analyzes generated HL7 messages and consults an electronic provider directory to determine the appropriate DIRECT address and delivery format for each indicated recipient. The system also enables lab results delivered to providers as structured attachments to be consumed by HL7 interface engines and incorporated into electronic health record systems. Lab results delivered as unstructured attachments may be printed or incorporated into patient records as PDF files. The system receives and logs acknowledgement messages to document the status of each transmitted lab result, and a graphical interface allows searching and review of this logged information. The described system is a fully implemented prototype that has been tested in a laboratory setting. Although this approach is promising, further work is required to pilot test the system in production settings with clinical laboratories and outpatient provider organizations. PMID:25766489

  1. Results from 1984 airborne Doppler lidar wind measurements

    NASA Technical Reports Server (NTRS)

    Rothermel, Jeffry

    1986-01-01

    Observations made with the revised Airborne Doppler Lidar System (ADLS) during research flights in the summer of 1984 are described. The functioning of the ADLS system is described. The research flights measured the flow around Mt. Shasta about 3 km above the surrounding terrain as well as the flow in the area of the Carquenez Strait in the Sacramento River Valley. The flight tracks are described and the resulting scan radial velocities are shown and discussed. The results demonstrate the success of the modifications made in order to correct major error sources present in the 1981 flights of the ADLS system.

  2. Loneliness in elderly individuals, level of dependence in activities of daily living (ADL) and influential factors.

    PubMed

    Hacihasanoğlu, Rabia; Yildirim, Arzu; Karakurt, Papatya

    2012-01-01

    This study has been carried out to investigate the level of loneliness, determine the level of dependence in the ADL and influential factors in the elderly people. This descriptive, cross-sectional study was conducted in 5 Family Healthcare Centers (FHC) located in central Erzincan, Turkey between March and June 2010. The data of the research was collected using a questionnaire that determined the descriptive and UCLA Loneliness Scale (UCLA-LS). Mean score of the UCLA-LS was determined as 51.59 ± 4.44. It was determined that 2% of the elderly ADL were completely dependent, 14.5% were semi-dependent. Factors such as being old, a widow/divorced, having a lower level of education and/or income, living alone, having a chronic disease, poor self-perceived health, lack of visits by relatives or acquaintances, dissatisfaction with the place of living, and being fully dependent while performing daily activities were determined as factors which increased the level of loneliness. Furthermore, factors such as being old, a female, a widow/divorced, living together with a daughter/son, having a chronic disease and poor self-perceived health were found to be influential in dependency. Elderly people who are alone and dependent in fulfilling their ADL should be monitored more closely. PMID:21514680

  3. Type-specific HPV and Pap test results among low-income, underserved women: providing insights into management strategies

    PubMed Central

    Saraiya, Mona; Benard, Vicki B.; Greek, April A.; Steinau, Martin; Patel, Sonya; Massad, L. Stewart; Sawaya, George F.; Unger, Elizabeth R.

    2015-01-01

    OBJECTIVE The primary cervical cancer screening strategy for women over age 30 is high-risk human papillomavirus (HPV) testing combined with Papanicolaou (Pap) testing (cotesting) every 5 years. This combination strategy is a preventive service that is required by the Affordable Care Act to be covered with no cost-sharing by most health insurance plans. The cotesting recommendation was made based entirely on prospective data from an insured population that may have a lower proportion of women with HPV positive and Pap negative results (ie, discordant results). The discordant group represents a very difficult group to manage. If the frequency of discordant results among underserved women is higher, health care providers may perceive the cotesting strategy to be a less favorable screening strategy than traditional Pap testing every 3 years. STUDY DESIGN The Centers for Disease Control and Prevention’s Cervical Cancer Study was conducted at 15 clinics in 6 federally qualified health centers across Illinois. Providers at these clinics were given the option of cotesting for routine cervical cancer screening. Type-specific HPV detection was performed on residual extracts using linear array. RESULTS Pap test results were abnormal in 6.0% and HPV was positive in 7.2% of the underserved women screened in this study (mean age, 45.1 years). HPV prevalence decreased with age, from 10.3% among 30- to 39-year-olds to 4.5% among 50- to 60-year-olds. About 5% of the women had a combination of a positive HPV test and normal Pap test results; HPV 16/18 was identified in 14% of discordant women. CONCLUSION The rate of discordant results among underserved women was similar to those reported throughout the US in a variety of populations. Typing for HPV 16/18 appears to assist in the management in a small proportion of women with discordant results. PMID:24813971

  4. Making non-discrimination and equal opportunity a reality in Kenya's health provider education system: results of a gender analysis.

    PubMed

    Newman, Constance; Kimeu, Anastasiah; Shamblin, Leigh; Penders, Christopher; McQuide, Pamela A; Bwonya, Judith

    2011-01-01

    IntraHealth International's USAID-funded Capacity Kenya project conducted a performance needs assessment of the Kenya health provider education system in 2010. Various stakeholders shared their understandings of the role played by gender and identified opportunities to improve gender equality in health provider education. Findings suggest that occupational segregation, sexual harassment and discrimination based on pregnancy and family responsibilities present problems, especially for female students and faculty. To grow and sustain its workforce over the long term, Kenyan human resource leaders and managers must act to eliminate gender-based obstacles by implementing existing non-discrimination and equal opportunity policies and laws to increase the entry, retention and productivity of students and faculty. Families and communities must support girls' schooling and defer early marriage. All this will result in a fuller pool of students, faculty and matriculated health workers and, ultimately, a more robust health workforce to meet Kenya's health challenges. PMID:22543441

  5. [Caregiving burden of elderly caregivers who provide at home care for infirm elderly].

    PubMed

    Ueda, T; Hashimoto, M; Kurushima, Y; Goto, H; Nakazono, N; Kosaka, M; Oshio, M; Minase, F; Aoki, N

    1994-06-01

    In order to elucidate the degree of feeling burdened and factors affecting caregiving burden of elderly caregivers, a questionnaire survey was performed on 241 female caregivers of infirm elderly. The surveyed group consisted of 138 caregivers under 60 years of age (young group) and 103 aged 60 and over (old group). The major results of this survey were as follows, 1) Conditions perceived as unfavorable in the old group were related to caregiving assistants, number of the family members and health condition of the caregiver. 2) Greater number of infirm elderly with serious ADL problems and higher average body weight of the elderly cared for were seen for the old group than the young group. 3) The old group had a larger number of problem incidents and expressed more eager desire for transfer of elderly to institutional care than providing the young group. 4) A feeling of burden in daily care appeared larger for night care, body discharge disposal and bathing care of the elderly and was more frequent in those above 70 than under 70 years of age. 5) Hours in bed were longer and range of movement by wheel chair was more limited for infirm elderly as the caregiver's age increased. These results suggest that the above-mentioned unfavorable conditions in elderly caregivers promote a state of becoming bedridden and a lowering of ADL ability of infirm elderly. PMID:8068963

  6. Quit Smoking Experts’ Opinions toward Quality and Results of Quit Smoking Methods Provided in Tobacco Cessation Services Centers in Iran

    PubMed Central

    Heydari, Gholamreza; Masjedi, Mohammadreza; Ebn Ahmady, Arezoo; Leischow, Scott J.; Lando, Harry A.; Shadmehr, Mohammad B.; Fadaizadeh, Lida

    2015-01-01

    Background: One of the core responsibilities of health system is to treat tobacco dependence. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess physicians’ opinions towards quality and result of different quit smoking methods provided in tobacco cessation services centers in Iran. Methods: In this cross-sectional and descriptive study, random sampling of all quit centers at country level was used to obtain a representative sample size of 100 physicians. Physicians completed a self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects, and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: Most experts preferred to use combination quit smoking methods and then Nicotine Replacement Therapy (NRT) with 26 and 23, respectively. The least used methods were quit line and some methods without medication with 3 cases. The method which gained the maximum scores were telephone consultation, acupuncture, Willpower, Champix, combined method, and Interactive Voice Response (IVR) with the mean of 23.3, 23, 22.5, 22, 21.7 and 21.3, respectively. The minimum scores were related to e-cigarette, some methods without medication, and non-NRT medication with the mean of 12.3, 15.8 and 16.2, respectively. There were no significant differences in the mean of scores based on different cities (P = 0.256). Analysis of variance in mean scores showed significant differences in the means scores of different methods (P < 0.000). Conclusions: According to physicians acupuncture, personal methods and Champix are the most effective methods and these methods could be much more feasible and cost effective than other methods. PMID:26425329

  7. Client-centred ADL intervention after stroke: Occupational therapists' experiences.

    PubMed

    Ranner, Maria; von Koch, Lena; Guidetti, Susanne; Tham, Kerstin

    2016-03-01

    Background This study was conducted in the context of a randomized controlled trial evaluating the effect of a client-centred activities in daily living intervention (CADL). The aim of the CADL was to enable agency in daily activities and participation in everyday life among persons with stroke. Objective This qualitative, longitudinal study aimed to describe how occupational therapists (OTs) applied the CADL in their clinical practice by studying their experiences and reflections concerning their interaction with the clients with stroke. Methods Six OTs who conducted the CADL were followed through interviews and observations on four separate occasions over one year. Data were analysed using a grounded theory approach. Results Sharing was the core category showing how the OTs helped their clients to achieve agency in daily activities. Through sharing the situation the OTs strove to obtain an empathetic understanding of the clients' lived experience throughout the whole intervention process in order to enable the clients' ownership of their daily activities. Conclusion The continuity of sharing seems to be the key for a gradual increase in agency. The approach of sharing should preferably be applied by all members of the interprofessional team, including the client and significant others. PMID:26654956

  8. Nintendo Wii rehabilitation ("Wii-hab") provides benefits in Parkinson's disease.

    PubMed

    Herz, Nathan B; Mehta, Shyamal H; Sethi, Kapil D; Jackson, Paula; Hall, Patricia; Morgan, John C

    2013-11-01

    Parkinson's disease (PD) impairs both activities of daily living (ADLs) and motor function and has adverse effects on mood in many patients. While dopaminergic medications are quite helpful for motor and ADLs impairments in PD, complementary therapies are also important in helping patients achieve maximum benefits and quality of life. We hypothesized that the Nintendo Wii (Wii) is a useful tool in improving motor and non-motor aspects in patients with PD, given its ability to drive functional movements and interactive nature. We enrolled twenty subjects with early to mid-stage PD in an open-label within-subjects study design where each subject was evaluated at baseline and then re-evaluated after playing the Wii three times per week for four weeks. Subjects were then re-evaluated one month later after not playing the Wii for a month to see if effects carried over. Subjects demonstrated significant improvements in the primary outcome measure (Nottingham Extended Activities of Daily Living Test (NEADL)), quality of life (PDQ-39) and motor function (UPDRS), and a trend toward improved mood (HAM-D) after four weeks of Wii therapy. Follow-up assessments one month later showed continued improvement for quality of life and UPDRS scores. The results demonstrate that Wii therapy provides short-term motor, non-motor, and quality of life benefits in PD. Further studies are needed to determine if there are long-term benefits of Wii therapy in PD. PMID:23968649

  9. Logistic support provided to Australian disaster medical assistance teams: results of a national survey of team members

    PubMed Central

    Aitken, Peter; Leggat, Peter; Harley, Hazel; Speare, Richard; Leclercq, Muriel

    2012-01-01

    Background It is likely that calls for disaster medical assistance teams (DMATs) continue in response to international disasters. As part of a national survey, the present study was designed to evaluate the Australian DMAT experience and the need for logistic support. Methods Data were collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 Asian Tsunami disaster. Results The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the South East Asian Tsunami affected areas. The DMAT members had significant clinical and international experience. There was unanimous support for dedicated logistic support with 80% (47/59) strongly agreeing. Only one respondent (2%) disagreed with teams being self sufficient for a minimum of 72 hours. Most felt that transport around the site was not a problem (59%; 35/59), however, 34% (20/59) felt that transport to the site itself was problematic. Only 37% (22/59) felt that pre-deployment information was accurate. Communication with local health providers and other agencies was felt to be adequate by 53% (31/59) and 47% (28/59) respectively, while only 28% (17/59) felt that documentation methods were easy to use and reliable. Less than half (47%; 28/59) felt that equipment could be moved easily between areas by team members and 37% (22/59) that packaging enabled materials to be found easily. The maximum safe container weight was felt to be between 20 and 40 kg by 58% (34/59). Conclusions This study emphasises the importance of dedicated logistic support for DMAT and the need for teams to be self sufficient for a minimum period of 72 hours. There is a need for accurate pre deployment information to guide resource prioritisation with clearly labelled pre packaging to assist access on site. Container weights should be restricted to between

  10. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal.

    PubMed

    Ruiz-Casares, Mónica; Cleveland, Janet; Oulhote, Youssef; Dunkley-Hickin, Catherine; Rousseau, Cécile

    2016-01-01

    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers' knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40-49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues. PMID:26789844

  11. Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

    ERIC Educational Resources Information Center

    Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

    2008-01-01

    The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

  12. Challenges in providing counselling to MSM in highly stigmatized contexts: results of a qualitative study from Kenya.

    PubMed

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M; Graham, Susan M; Price, Matt A; Sanders, Eduard J

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

  13. Challenges in Providing Counselling to MSM in Highly Stigmatized Contexts: Results of a Qualitative Study from Kenya

    PubMed Central

    Taegtmeyer, Miriam; Davies, Alun; Mwangome, Mary; van der Elst, Elisabeth M.; Graham, Susan M.; Price, Matt A.; Sanders, Eduard J.

    2013-01-01

    The role of men who have sex with men (MSM) in the African HIV epidemic is gaining recognition yet capacity to address the HIV prevention needs of this group is limited. HIV testing and counselling is not only a critical entry point for biomedical HIV prevention interventions, such as pre-exposure prophylaxis, rectal microbicides and early treatment initiation, but is also an opportunity for focused risk reduction counselling that can support individuals living in difficult circumstances. For prevention efforts to succeed, however, MSM need to access services and they will only do so if these are non-judgmental, informative, focused on their needs, and of clear benefit. This study aimed to understand Kenyan providers' attitudes towards and experiences with counselling MSM in a research clinic targeting this group for HIV prevention. We used in-depth interviews to explore values, attitudes and cognitive and social constructs of 13 counsellors and 3 clinicians providing services to MSM at this clinic. Service providers felt that despite their growing experience, more targeted training would have been helpful to improve their effectiveness in MSM-specific risk reduction counselling. They wanted greater familiarity with MSM in Kenya to better understand the root causes of MSM risk-taking (e.g., poverty, sex work, substance abuse, misconceptions about transmission, stigma, and sexual desire) and felt frustrated at the perceived intractability of some of their clients' issues. In addition, they identified training needs on how to question men about specific risk behaviours, improved strategies for negotiating risk reduction with counselling clients, and improved support supervision from senior counsellors. This paper describes the themes arising from these interviews and makes practical recommendations on training and support supervision systems for nascent MSM HIV prevention programmes in Africa. PMID:23762241

  14. [Outcome mesurement: the case of the "Center of Results" of the public healthcare providers network in Catalonia, Spain].

    PubMed

    Argenter-Giralt, Miquel; Barba-Albós, Genoveva; Román-Martínez, Anna

    2010-02-01

    The health information system in Catalonia has experienced an important evolution but obtaining integrated data to evaluate the health services is still difficult. At the end of 2008 the basis of the information system of the "Center of Results" and a first set of indicators has been approved by the health system stakeholders. The "Center of Results" is assigned to the Catalan Health Service. It has a Direction Board and a Technical Committee to regulate its operation. The "Center of Results" has the mission to measure, evaluate and disseminate the results obtained in health care by the members of the public health services, to facilitate decision making with shared responsibility at the service of the quality of the health care given to the citizens of Catalonia. The "Center of Results" is based on performance principles that determine their operation: to share and to coordinate the existing information, to stimulate the participation and the co-responsibility of the implied agents, continuous improvement of the health information, promotion of good practices in the use of information and its responsible use, efficient instrumentation of technologies and analytical capacity to transform data into information. A participative process has been made to select and prioritize indicators. This process has reached consensus on a set of indicators. These indicators must contribute to assess the impact of the interventions of the health system on the level of the population's health and how results, with an efficient use of the resources, are obtained. PMID:20211350

  15. Knowledge of Healthcare Coverage for Refugee Claimants: Results from a Survey of Health Service Providers in Montreal

    PubMed Central

    Dunkley-Hickin, Catherine

    2016-01-01

    Following changes to the Interim Federal Health (IFH) program in Canada in 2012, this study investigates health service providers’ knowledge of the healthcare coverage for refugee claimants living in Quebec. An online questionnaire was completed by 1,772 staff and physicians from five hospitals and two primary care centres in Montreal. Low levels of knowledge and significant associations between knowledge and occupational group, age, and contact with refugees were documented. Social workers, respondents aged 40–49 years, and those who reported previous contact with refugee claimants seeking healthcare were significantly more likely to have 2 or more correct responses. Rapid and multiple changes to the complex IFH policy have generated a high level of confusion among healthcare providers. Simplification of the system and a knowledge transfer strategy aimed at improving healthcare delivery for IFH patients are urgently needed, proposing easy avenues to access rapidly updated information and emphasizing ethical and clinical issues. PMID:26789844

  16. Direct disk diffusion test using European Clinical Antimicrobial Susceptibility Testing breakpoints provides reliable results compared with the standard method

    PubMed Central

    Stokkou, Sofia; Geginat, Gernot; Schlüter, Dirk

    2015-01-01

    Sepsis represents a life-threatening infection requiring the immediate start of antibacterial treatment to reduce morbidity. Thus, laboratories use direct antimicrobial susceptibility testing (AST) to rapidly generate preliminary results from positive blood cultures. As the direct AST has not yet been published to be evaluated with EUCAST breakpoints, the purpose of the study was to investigate the reliability of the direct agar diffusion test to correctly produce AST results from positive monobacterial blood cultures compared with the VITEK2-based definitive AST, when current EUCAST breakpoints were used. A total of 428 isolates from unselected monobacterial routine blood cultures and 110 challenge strains were included. Direct agar diffusion-based and standard VITEK2-based AST of 2803 bacterium–drug combinations yielded a total clinical category agreement of 95.47% with 1.28% very major errors and 3.42% combined major and minor errors. On the species level, very major errors were observed in the species–drug combinations Enterococcus spp.–high-level gentamicin (10.87%) and Staphylococcus spp.–rifampicin (5%), only. No very major errors occurred with Enterobacteriaceae and Pseudomonas aeruginosa. In most species–drug combinations, the direct agar diffusion test using EUCAST breakpoints precisely predicted the result of the definitive antibiotic susceptibility test and, thus, it can be used to optimize empiric antibiotic therapy until definitive results are available. PMID:25883798

  17. Direct disk diffusion test using European Clinical Antimicrobial Susceptibility Testing breakpoints provides reliable results compared with the standard method.

    PubMed

    Stokkou, Sofia; Geginat, Gernot; Schlüter, Dirk; Tammer, Ina

    2015-03-01

    Sepsis represents a life-threatening infection requiring the immediate start of antibacterial treatment to reduce morbidity. Thus, laboratories use direct antimicrobial susceptibility testing (AST) to rapidly generate preliminary results from positive blood cultures. As the direct AST has not yet been published to be evaluated with EUCAST breakpoints, the purpose of the study was to investigate the reliability of the direct agar diffusion test to correctly produce AST results from positive monobacterial blood cultures compared with the VITEK2-based definitive AST, when current EUCAST breakpoints were used. A total of 428 isolates from unselected monobacterial routine blood cultures and 110 challenge strains were included. Direct agar diffusion-based and standard VITEK2-based AST of 2803 bacterium-drug combinations yielded a total clinical category agreement of 95.47% with 1.28% very major errors and 3.42% combined major and minor errors. On the species level, very major errors were observed in the species-drug combinations Enterococcus spp.-high-level gentamicin (10.87%) and Staphylococcus spp.-rifampicin (5%), only. No very major errors occurred with Enterobacteriaceae and Pseudomonas aeruginosa. In most species-drug combinations, the direct agar diffusion test using EUCAST breakpoints precisely predicted the result of the definitive antibiotic susceptibility test and, thus, it can be used to optimize empiric antibiotic therapy until definitive results are available. PMID:25883798

  18. Buprenorphine provides better anaesthetic conditions than butorphanol for field castration in ponies: results of a randomised clinical trial.

    PubMed

    Rigotti, C; De Vries, A; Taylor, P M

    A prospective, randomised, blinded, clinical trial in 47 ponies compared butorphanol and buprenorphine administered intravenously with detomidine prior to castration under anaesthesia. Detomidine 12 μg/kg intravenously was followed by butorphanol 25 μg/kg (BUT) or buprenorphine 5 μg/kg (BUP) before induction of anaesthesia with intravenous ketamine and diazepam. Quality of sedation, induction and recovery from anaesthesia, response to tactile stimulation, and surgical conditions were scored. If anaesthesia was inadequate 'rescue' was given with intravenous ketamine (maximum three doses) followed by intravenous thiopental and detomidine. Time from induction to first rescue, total ketamine dose and number of rescues were recorded. Postoperative locomotor activity was scored and abnormal behaviour noted. Simple descriptive scales were used for all scoring. Data were analysed using two-way analysis of variance, t tests, Mann-Whitney or Fisher's exact tests as appropriate; P<0.05 was considered statistically significant. Cryptorchid animals did not undergo surgery, but castration was successfully completed in 18 BUT and 20 BUP. More incremental ketamine (P=0.0310) and more rescue drugs (P=0.0165) were required in BUT and more postoperative locomotor activity occurred in BUP (P=0.0001). There were no other differences between groups. Both opioids were suitable for premedication prior to castration but buprenorphine appeared to provide better intraoperative analgesia. PMID:25262056

  19. Staff commitment to providing tobacco dependence in drug treatment: Reliability, validity, and results of a national survey.

    PubMed

    Hunt, Jamie J; Cupertino, A Paula; Gajewski, Byron J; Jiang, Yu; Ronzani, Telmo M; Richter, Kimber P

    2014-06-01

    Although most people in treatment for illicit drug use smoke cigarettes, few facilities offer any form of treatment for tobacco dependence. One reason for this may be that drug treatment staff have varying levels of commitment to treat tobacco. We developed and validated a 14-item Tobacco Treatment Commitment Scale (TTCS), using 405 participants in leadership positions in drug treatment facilities. We first conducted a confirmatory factor analysis to evaluate 4 a priori domains suggested by our original set of 38 items-this did not produce a good fit (comparative fit index [CFI] = 0.782, root mean square error of approximation [RMSEA] = 0.067). We then conducted a series of exploratory factor analyses to produce a more precise and reliable scale. The final confirmatory factor analysis indicated a 3-factor solution, produced a good fit (CFI = 0.950, RMSEA = 0.058), and had substantial unified reliability of 0.975. The final TTCS contained 14 items in 3 domains: "Tobacco is less harmful than other drugs," "It's not our job to treat tobacco," and "Tobacco treatment will harm clients." These constructs account for most of the variance in the survey items and emerged as major sentiments driving staff commitment to providing tobacco services. The TTCS can be used to understand the role of staff attitudes in the adoption of tobacco services in this important treatment setting. PMID:24128292

  20. A gravimetric approach to providing SI traceability for concentration measurement results of mercury vapor at ambient air levels

    NASA Astrophysics Data System (ADS)

    Ent, Hugo; van Andel, Inge; Heemskerk, Maurice; van Otterloo, Peter; Bavius, Wijnand; Baldan, Annarita; Horvat, Milena; Brown, Richard J. C.; Quétel, Christophe R.

    2014-11-01

    Current measurement and calibration capabilities for mercury vapor in air are maintained at levels of 0.2-40 μg Hg m-3. In this work, a mercury vapor generator has been developed to establish metrological traceability to the international system of units (SI) for mercury vapor measurement results ≤15 ng Hg m-3, i.e. closer to realistic ambient air concentrations (1-2 ng Hg m-3) [1]. Innovations developed included a modified type of diffusion cell, a new measurement method to weigh the loss in (mercury) mass of these diffusion cells during use (ca. 6-8 μg mass difference between successive weighings), and a new housing for the diffusion cells to maximize flow characteristics and to minimize temperature variations and adsorption effects. The newly developed mercury vapor generator system was tested by using diffusion cells generating 0.8 and 16 ng Hg min-1. The results also show that the filter system, to produce mercury free air, is working properly. Furthermore, and most importantly, the system is producing a flow with a stable mercury vapor content. Some additional improvements are still required to allow the developed mercury vapor generator to produce SI traceable mercury vapor concentrations, based upon gravimetry, at much lower concentration levels and reduced measurement uncertainties than have been achieved previously. The challenges to be met are especially related to developing more robust diffusion cells and better mass measurement conditions. The developed mercury vapor generator will contribute to more reliable measurement results of mercury vapor at ambient and background air levels, and also to better safety standards and cost reductions in industrial processes, such as the liquefied natural gas field, where aluminum main cryogenic heat exchangers are used which are particularly prone to corrosion caused by mercury.

  1. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England

    PubMed Central

    Krakower, Douglas S.; Oldenburg, Catherine E.; Mitty, Jennifer A.; Wilson, Ira B.; Kurth, Ann E.; Maloney, Kevin M.; Gallagher, Donna; Mayer, Kenneth H.

    2015-01-01

    Background Antiretroviral treatment for HIV-infection before immunologic decline (early ART) and pre-exposure chemoprophylaxis (PrEP) can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited. Methods Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices. Results Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample), 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01–1.34) and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98–11.2) were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06–1.34), whereas female gender (aOR 0.26, 95% CI 0.10–0.71) was associated

  2. Client Perceptions of Occupational Health and Safety Management System Assistance Provided by OSHA On-Site Consultation: Results of a Survey of Colorado Small Business Consultation Clients.

    PubMed

    Autenrieth, Daniel A; Brazile, William J; Gilkey, David P; Reynolds, Stephen J; June, Cathy; Sandfort, Del

    2015-01-01

    The Occupational Safety and Health Administration (OSHA) On-Site Consultation Service provides assistance establishing occupational health and safety management systems (OHSMS) to small businesses. The Safety and Health Program Assessment Worksheet (Revised OSHA Form 33) is the instrument used by consultants to assess an organization's OHSMS and provide feedback on how to improve a system. A survey was developed to determine the usefulness of the Revised OSHA Form 33 from the perspective of Colorado OSHA consultation clients. One hundred and seven clients who had received consultation services within a six-year period responded to the survey. The vast majority of respondents indicated that the Revised OSHA Form 33 accurately reflected their OHSMS and that information provided on the Revised OSHA Form 33 was helpful for improving their systems. Specific outcomes reported by the respondents included increased safety awareness, reduced injuries, and improved morale. The results indicate that the OHSMS assistance provided by OSHA consultation is beneficial for clients and that the Revised OSHA Form 33 can be an effective tool for assessing and communicating OHSMS results to business management. Detailed comments and suggestions provided on the Revised OSHA Form 33 are helpful for clients to improve their OHSMS. PMID:26010810

  3. Toward the Development of a Lupus Interactive Navigator to Facilitate Patients and Their Health Care Providers in the Management of Lupus: Results of Web-Based Surveys

    PubMed Central

    Neville, Carolyn; DaCosta, Deborah; Rochon, Murray; Eng, Davy

    2014-01-01

    Background Systemic lupus erythematosus is an inflammatory autoimmune disease associated with high morbidity and unacceptable mortality. Information and management tools are needed to help persons with lupus cope with their illness and facilitate health care providers in the delivery of care. Objective The objective of the study was to assess the needs and find solutions to support persons with lupus and their health care providers. Methods Web-based surveys were distributed across Canada to persons with lupus and their relatives (n=3119), rheumatologists (n=517), and arthritis health professionals (AHPs) (n=226) by Lupus Canada, the Canadian Rheumatology Association, and the Arthritis Health Professions Association, respectively. Results The survey sample comprised 665 (21.3%) persons with lupus, 98 (19.0%) rheumatologists, and 74 (32.7%) AHPs. Among the participants with lupus, 92.4% were female, the average age was 46.8 (SD 12.7) years, 79.2% were Caucasian, and 58.8% were employed. All Canadian provinces and territories were represented. The majority (43.3%) of respondents were from Ontario. Mean disease duration was 10.2 (SD 9.5) years, and 41.9% rated their global assessment as fair or poor. There was high agreement between lupus participants and health care providers regarding disease-specific information topics. All groups rated topics related to lupus, fatigue, medications, and stress as most important. Ratings differed among lupus participants and their health care providers regarding perceived helpfulness of some of the patient tools, such as the option to view test results. Needs differed for persons with lupus based on age, sex, depression, stress, and disease activity. Differences in health care provider needs were based on amount of experience in treating lupus. Conclusions Information and support tools needed for persons with lupus and their health care providers were identified. These results will help guide us in the development of a Web

  4. Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counseling (PITC) in Malawi

    PubMed Central

    Ahmed, Saeed; Schwarz, Monica; Flick, Robert; Rees, Chris A.; Harawa, Mwelura; Simon, Katie; Robison, Jeff; Kazembe, Peter N.; Kim, Maria H.

    2016-01-01

    Objective To assess implementation of provider-initiated testing and counseling (PITC) for HIV in Malawi. Methods A review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected program data. Results Reported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5,293/5,615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics, and 49.4% (6,871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71), and inadequate number of HIV counselors (32/71) while providers from inpatient units cited the inability to test on weekends. Conclusions Various models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests routine PITC is feasible. These results underscore the need to develop clear, standardized PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure, and human resources. PMID:26806378

  5. Results.

    ERIC Educational Resources Information Center

    Zemsky, Robert; Shaman, Susan; Shapiro, Daniel B.

    2001-01-01

    Describes the Collegiate Results Instrument (CRI), which measures a range of collegiate outcomes for alumni 6 years after graduation. The CRI was designed to target alumni from institutions across market segments and assess their values, abilities, work skills, occupations, and pursuit of lifelong learning. (EV)

  6. Analysis of the NASA/MSFC Airborne Doppler Lidar results from San Gorgonio Pass, California

    NASA Technical Reports Server (NTRS)

    Cliff, W. C.; Skarda, J. R.; Renne, D. S.; Sandusky, W. F.

    1984-01-01

    Two days during July of 1981 the NASA/MSFC Airborne Doppler Lidar System (ADLS) was flown aboard the NASA/AMES Convair 990 on the east side of San Gorgonio Pass California, near Palm Springs, to measure and investigate the accelerated atmospheric wind field discharging from the pass. The vertical and horizontal extent of the fast moving atmospheric flow discharging from the San Gorgonio Pass were examined. Conventional ground measurements were also taken during the tests to assist in validating the ADLS results. This particular region is recognized as a high wind resource region and, as such, a knowledge of the horizontal and vertical extent of this flow was of interest for wind energy applications. The statistics of the atmospheric flow field itself as it discharges from the pass and then spreads out over the desert were also of scientific interests. This data provided the first spatial data for ensemble averaging of spatial correlations to compute longitudinal and lateral integral length scales in the longitudinal and lateral directions for both components.

  7. Cognitive Impairment as a Strong Predictor of Incident Disability in Specific Adl-Iadl Tasks among Community-Dwelling Elders: The Azuchi Study

    ERIC Educational Resources Information Center

    Dodge, Hiroko H.; Kadowaki, Takashi; Hayakawa, Takehito; Yamakawa, Masanobu; Sekikawa, Akira; Ueshima, Hirotugu

    2005-01-01

    Purpose: We examined differential effects of cognitive impairment on each of the activities of daily living (ADL) and instrumental activities of daily living (IADL) tasks. Design and Methods: In a 3-year follow-up of community-dwelling elderly persons in Azuchi, Japan, we assessed cognition by using the Hasegawa Dementia Scale. We examined (a) the…

  8. Risk Factors for Nursing Home Placement in Alzheimer's Disease: A Longitudinal Study of Cognition, ADL, Service Utilization, and Cholinesterase Inhibitor Treatment

    ERIC Educational Resources Information Center

    Wattmo, Carina; Wallin, Asa K.; Londos, Elisabet; Minthon, Lennart

    2011-01-01

    Purpose of the Study: To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). Design and Methods: In an open, 3-year, prospective, multicenter study…

  9. Examination of Children's Recess Physical Activity Patterns Using the Activities for Daily Living-Playground Participation (ADL-PP) Instrument

    ERIC Educational Resources Information Center

    Stellino, Megan Babkes; Sinclair, Christina

    2014-01-01

    Thorough assessment of children's physical activity is essential to efficacious interventions to reduce childhood obesity prevalence. The purpose of this study was to examine children's recess physical activity (RPA) patterns of behavior using the Activities of Daily Living-Playground Participation (ADL-PP: Watkinson et al., 2001)…

  10. Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial

    PubMed Central

    O’Brien, M.A.; Grunfeld, E.; Sussman, J.; Porter, G.; Mobilio, M. Hammond

    2015-01-01

    Background The U.S. Institute of Medicine recommends that cancer patients receive survivorship care plans, but evaluations to date have found little evidence of the effectiveness of such plans. We conducted a qualitative follow-on study to a randomized controlled trial (rct) to understand the experiences of family physicians using survivorship care plans to support the follow-up of breast cancer patients. Methods A subset of family physicians whose patients were enrolled in the parent rct in Ontario and Nova Scotia were eligible for this study. In interviews, the physicians discussed survivorship care plans (intervention) or usual discharge letters (control), and their confidence in providing follow-up cancer care. Results Of 123 eligible family physicians, 18 (10 intervention, 8 control) were interviewed. In general, physicians receiving a survivorship care plan found only the 1-page care record to be useful. Physicians who received only a discharge letter had variable views about the letter’s usefulness; several indicated that it lacked information about potential cancer- or treatment-related problems. Most physicians were comfortable providing care 3–5 years after diagnosis, but desired timely and informative communication with oncologists. Conclusions Although family physicians did not find extensive survivorship care plans useful, discharge letters might not be sufficiently comprehensive for follow-up breast cancer care. Effective strategies for two-way communication between family physicians and oncologists are still lacking. PMID:26300663

  11. Fleet Compliance Results for MY 2010/FY 2011, EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report (Brochure)

    SciTech Connect

    Not Available

    2012-03-01

    This annual report summarizes the compliance results of state and alternative fuel provider fleets covered by the Energy Policy Act of 1992 (EPAct) for model year 2010/fiscal year 2011. The U.S. Department of Energy (DOE) regulates covered state and alternative fuel provider (SFP) fleets under the Energy Policy Act of 1992 (EPAct), as amended. For model year (MY) 2010, the compliance rate for the 2911 covered SFP fleets was 100%. Fleets used either Standard Compliance or Alternative Compliance. The 279 fleets that used Standard Compliance exceeded their aggregate MY 2010 acquisition requirements by 61%. The 12 covered fleets that complied using Alternative Compliance exceeded their aggregate MY 2010 petroleum-use-reduction requirements by 89%. Overall, DOE saw modest decreases from MY 2009 in biodiesel fuel use credits earned and in the number of light-duty vehicles (LDVs) acquired. Compared to years before MY 2009, these rates were far lower. Because covered fleets acquired fewer new vehicles overall in MY 2010, the requirement for alternative fuel vehicles (AFVs), which is proportional to new acquisitions, also dropped.

  12. A European Network of Email and Telephone Help Lines Providing Information and Support on Rare Diseases: Results From a 1-Month Activity Survey

    PubMed Central

    Sanchez de Vega, Rosa; Brignol, Tuy Nga; Mazzucato, Monica; Polizzi, Agata

    2014-01-01

    Background Information on rare diseases are often complex to understand, or difficult to access and additional support is often necessary. Rare diseases helplines work together across Europe to respond to calls and emails from the public at large, including patients, health care professionals, families, and students. Measuring the activity of helplines can help decision makers to allocate adequate funds when deciding to create or expand an equivalent service. Objective Data presented are referred to a monthly user profile analysis, which is one of the activities that each helpline has to carry out to be part of the network. This survey aimed to explore the information requests and characteristics of users of rare diseases helplines in different European countries. Another aim was to analyze these data with respect to users’ characteristics, helpline characteristics, topics of the inquiries, and technologies used to provide information. With this survey, we measure data that are key for planning information services on rare diseases in the context of the development of national plans for rare diseases. Methods A survey was conducted based on all calls, emails, visits, or letters received from November 1 to 30, 2012 to monitor the activity represented by 12 helplines. Data were collected by a common standardized form, using ORPHA Codes for rare diseases, when applicable. No personal data identifying the inquirer were collected. It was a descriptive approach documenting on the number and purpose of inquiries, the number of respondents, the mode of contact, the category of the inquirer in relation to the patient, the inquirer’s gender, age and region of residence, the patient’s age when applicable, the type and duration of response, and the satisfaction as scored by the respondents. Results A total of 1676 calls, emails, or letters were received from November 1 to 30, 2012. Inquiries were mostly about specific diseases. An average of 23 minutes was spent for each

  13. Experiences and meanings of integration of TCAM (Traditional, Complementary and Alternative Medical) providers in three Indian states: results from a cross-sectional, qualitative implementation research study

    PubMed Central

    Nambiar, D; Narayan, V V; Josyula, L K; Porter, J D H; Sathyanarayana, T N; Sheikh, K

    2014-01-01

    Objectives Efforts to engage Traditional, Complementary and Alternative Medical (TCAM) practitioners in the public health workforce have growing relevance for India's path to universal health coverage. We used an action-centred framework to understand how policy prescriptions related to integration were being implemented in three distinct Indian states. Setting Health departments and district-level primary care facilities in the states of Kerala, Meghalaya and Delhi. Participants In each state, two or three districts were chosen that represented a variation in accessibility and distribution across TCAM providers (eg, small or large proportions of local health practitioners, Homoeopaths, Ayurvedic and/or Unani practitioners). Per district, two blocks or geographical units were selected. TCAM and allopathic practitioners, administrators and representatives of the community at the district and state levels were chosen based on publicly available records from state and municipal authorities. A total of 196 interviews were carried out: 74 in Kerala, and 61 each in Delhi and Meghalaya. Primary and secondary outcome measures We sought to understand experiences and meanings associated with integration across stakeholders, as well as barriers and facilitators to implementing policies related to integration of Traditional, Complementary and Alternative (TCA) providers at the systems level. Results We found that individual and interpersonal attributes tended to facilitate integration, while system features and processes tended to hinder it. Collegiality, recognition of stature, as well as exercise of individual personal initiative among TCA practitioners and of personal experience of TCAM among allopaths enabled integration. The system, on the other hand, was characterised by the fragmentation of jurisdiction and facilities, intersystem isolation, lack of trust in and awareness of TCA systems, and inadequate infrastructure and resources for TCA service delivery. Conclusions

  14. For the proposition: for the diagnosis of viral infections, commercial assays provide more reliable results than do in-house assays.

    PubMed

    Gammie, Alistair James

    2008-01-01

    It cannot be disputed that in-house ('home brew') assays have a part to play in the diagnosis of emerging or evolving infections such as avian influenza H5N1. In such circumstances, diagnostic companies can provide Research Use Only (RUO) or analyte specific reagents (ASR) to facilitate development. In contrast, the provision of commercial assays is governed by regulatory approval and subject to regular audit by the relevant regulatory bodies to ensure continued quality process throughout the continuum of product management. From initial design, through to post-launch support, the process has to meet the requirements of the USA Food and Drug Administration (FDA) Quality System Regulation (FDA, 1996) as well as that of the international quality standards, for example ISO 9001 (Int. Standard ISO 9001, 2000). Because of the quality policies that are implemented in the commercial environment, I will argue that, where available, commercial assays should replace in-house methods in order to ensure long term reliability of results. PMID:18306442

  15. The Role of Community Rehabilitation Providers in Employment for Persons with Intellectual and Developmental Disabilities: Results of the 2010-2011 National Survey

    ERIC Educational Resources Information Center

    Domin, Daria; Butterworth, John

    2013-01-01

    Based on the 2010-2011 National Survey of Community Rehabilitation Providers, findings are presented on people with all disabilities and people with intellectual and developmental disabilities (IDD) who are served in employment and nonwork settings by community rehabilitation providers. Findings suggest little change over the past eight years in…

  16. Evidence-Based Practice Knowledge, Use, and Factors that Influence Decisions: Results from an Evidence-Based Practice Survey of Providers in American Indian/Alaska Native Communities

    ERIC Educational Resources Information Center

    Sheehan, Angela; Walrath-Greene, Christine; Fisher, Sylvia; Crossbear, Shannon; Walker, Joseph

    2007-01-01

    Data from the Evidence-based Treatment Survey were used to compare providers serving families in American Indian and Alaska Native communities to their counterparts in non-American Indian/Alaska Native communities on provider characteristics and factors that influence their decision to use evidence-based practices (N = 467). The findings suggest…

  17. The Glittre-ADL test reflects functional performance measured by physical activities of daily living in patients with chronic obstructive pulmonary disease

    PubMed Central

    Karloh, Manuela; Araujo, Cintia L. P.; Gulart, Aline A.; Reis, Cardine M.; Steidle, Leila J. M.; Mayer, Anamaria F.

    2016-01-01

    ABSTRACT Background The Glittre-ADL test (TGlittre) is a valid and reliable test for the evaluation of functional capacity and involves multiple physical activities of daily living (PADL), which are known to be troublesome to patients with Chronic Obstructive Pulmonary Disease (COPD). However, it is still unknown if this test is also able to reflect the functional performance of patients with COPD. Objective To investigate whether the TGlittre reflects the functional performance of COPD patients and whether the necessary time to complete the TGlittre and the PADL varies according to disease severity. Method Thirty-eight patients with COPD (age 65, SD=7 years; forced expiratory volume in the first second 41.3, SD=15.2% predicted) underwent anthropometric and lung function assessments and were submitted to the TGlittre and PADL measurement. Results TGlittre performance correlated significantly (p<0.05) with PADL variables, such as time sitting (r=0.50), walking (r=-0.46), number of steps taken (r=–0.53), walking movement intensity (r=–0.66), walking energy expenditure (r=-0.50), and total energy expenditure (r=–0.33). TGlittre performance was not significantly different in patients among the Global Initiative for COPD (GOLD) spirometric stages, but walking and sitting time were significantly lower and greater, respectively, in severe and very severe patients compared to those with moderate disease (p<0.05). Conclusion The performance on the TGlittre correlates with walking and sitting time and other real life PADL measurements. The severity of the disease is associated with the differences in the level of physical activity in daily life more than in functional capacity. PMID:27437713

  18. EPAct Alternative Fuel Transportation Program: State and Alternative Fuel Provider Fleet Compliance Annual Report; Fleet Compliance Results for MY 2013/FY 2014

    SciTech Connect

    2015-09-01

    Compliance rates for covered state government and alternative fuel provider fleets under the Alternative Fuel Transportation Program (pursuant to the Energy Policy Act or EPAct) are reported for MY 2013/FY 2014 in this publication.

  19. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: results of a qualitative study.

    PubMed

    Jaiantilal, Prafulta; Gutin, Sarah A; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as

  20. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: Results of a qualitative study

    PubMed Central

    Jaiantilal, Prafulta; Gutin, Sarah A.; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Abstract Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges

  1. LabPush: A Pilot Study of Providing Remote Clinics with Laboratory Results via Short Message Service (SMS) in Swaziland, Africa

    PubMed Central

    Jian, Wen-Shan; Hsu, Min-Huei; Sukati, Hosea; Syed-Abdul, Shabbir; Scholl, Jeremiah; Dube, Nduduzo; Hsu, Chun-Kung; Wu, Tai-jung; Lin, Vera; Chi, Tex; Chang, Peter; Li, Yu-Chuan

    2012-01-01

    Background Turnaround time (TAT) is an important indicator of laboratory performance. It is often difficult to achieve fast TAT for blood tests conducted at clinics in developing countries. This is because clinics where the patient is treated are often far away from the laboratory, and transporting blood samples and test results between the two locations creates significant delay. Recent efforts have sought to mitigate this problem by using Short Message Service (SMS) to reduce TAT. Studies reporting the impact of this technique have not been published in scientific literature however. In this paper we present a study of LabPush, a system developed to test whether SMS delivery of HIV related laboratory results to clinics could shorten TAT time significantly. Method LapPush was implemented in six clinics of the Kingdom of Swaziland. SMS results were sent out from the laboratory as a supplement to normal transport of paper results. Each clinic was equipped with a mobile phone to receive SMS results. The laboratory that processes the blood tests was equipped with a system for digital input of results, and transmission of results via SMS to the clinics. Results Laboratory results were received for 1041 different clinical cases. The total number of SMS records received (1032) was higher than that of paper records (965), indicating a higher loss rate for paper records. A statistical comparison of TAT for SMS and paper reports indicates a statistically significant improvement for SMS. Results were more positive for more rural clinics, and an urban clinic with high workload. Conclusion SMS can be used to reduce TAT for blood tests taken at clinics in developing countries. Benefits are likely to be greater at clinics that are further away from laboratories, due to the difficulties this imposes on transport of paper records. PMID:23028543

  2. Providers issue brief: alternative providers.

    PubMed

    Rothouse, M

    1999-06-29

    Access by managed care plan enrollees, scope of practice issues and fee reimbursement by Medicaid and third parties such as insurance carriers is the engine that drives legislation recognizing alternative health care providers--chiropractors, acupuncturists, physical therapists, naturopaths, massage therapists, homeopaths, and dietitians and nutritionists. PMID:11073386

  3. Can repeat injection provide clinical benefit in patients with cervical disc herniation and stenosis when the first epidural injection results only in partial response?

    PubMed

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-07-01

    Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated. One hundred eighty-four patients who underwent transforaminal ESI (TFESI) for treatment of axial neck and radicular arm pain due to HIVD or SS and could be followed up for 1 year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (numeric rating scale (NRS) ≥ 3 after the first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 76) comprised partial responders who did not receive repeat injection at the prescribed interval, but received intermittent injections only for aggravation of pain. Various clinical data were assessed, including total number of injections during 1 year, NRS duration of <3 during 1 year (NRS < 3 duration), and time interval until pain was increased to require additional injections after repeat injection in Group A, or after first injection in Group B (time to reinjection). Groups A and B were compared in terms of total population, HIVD, and SS. In the whole population, HIVD subgroup, and SS subgroup, patients in Group A required significantly fewer injections to obtain satisfactory pain relief during the 1-year follow-up period. Group A showed a significantly longer time to reinjection and longer NRS < 3 than Group B did. Repeat TFESI conducted at 2- to 3-week intervals

  4. Current Practices and the Provider Perspectives on Inconclusive Genetic Test Results for Osteogenesis Imperfecta in Children with Unexplained Fractures: ELSI Implications.

    PubMed

    Youngblom, Emily; Murray, Mitzi Leah; Byers, Peter H

    2016-09-01

    Genetic testing can be used to determine if unexplained fractures in children could have resulted from a predisposition to bone fractures, e.g., osteogenesis imperfecta. However, uncertainty is introduced if a variant of unknown significance (VUS) is identified. Proper interpretation of VUS in these situations is critical because of its influence on clinical care and in court rulings. This study sought to understand how VUS are interpreted and used by practitioners when there is a differential diagnosis including both osteogenesis imperfecta and non-accidental injury.A 15-question survey was emailed to physicians who requested analysis of two genes, COL1A1 and COL1A2, from the University of Washington from 2005-2013 for patient cases involving suspicion of child abuse.Among the 89 participants, responses differed about when genetic testing should be ordered for osteogenesis imperfecta, who should be consulted about utilization of VUS test results, follow-up procedures, and who should receive the VUS results.There are no clear guidelines for how to interpret and follow up on VUS. In the legal setting, misinterpreted VUS could lead to unintended consequences and deleterious ramifications for family members. The need for better practice guidelines to help promote more equitable handling of these sensitive legal cases is clear. PMID:27587455

  5. BPI-ANCA Provides Additional Clinical Information to Anti-Pseudomonas Serology: Results from a Cohort of 117 Swedish Cystic Fibrosis Patients.

    PubMed

    Lindberg, Ulrika; Carlsson, Malin; Hellmark, Thomas; Segelmark, Mårten

    2015-01-01

    Patients with cystic fibrosis (CF) colonized with Pseudomonas aeruginosa (P. aeruginosa) have worse prognosis compared with patients who are not. BPI-ANCA is an anti-neutrophil cytoplasmic antibody against BPI (bactericidal/permeability increasing protein) correlating with P. aeruginosa colonization and adverse long time prognosis. Whether it provides additional information as compared to standard anti-P. aeruginosa serology tests is not known. 117 nontransplanted CF patients at the CF centre in Lund, Sweden, were followed prospectively for ten years. Bacterial colonisation was classified according to the Leeds criteria. IgA BPI-ANCA was compared with assays for antibodies against alkaline protease (AP), Elastase (ELA), and Exotoxin A (ExoA). Lung function and patient outcome, alive, lung transplanted, or dead, were registered. BPI-ANCA showed the highest correlation with lung function impairment with an r-value of 0.44. Forty-eight of the 117 patients were chronically colonized with P. aeruginosa. Twenty of these patients experienced an adverse outcome. Receiver operator curve (ROC) analysis revealed that this could be predicted by BPI-ANCA (AUC = 0.77), (p = 0.002) to a better degree compared with serology tests. BPI-ANCA correlates better with lung function impairment and long time prognosis than anti-P. aeruginosa serology and has similar ability to identify patients with chronic P. aeruginosa. PMID:26273683

  6. Synergistic antidepressant-like effects between a kappa opioid antagonist (LY2444296) and a delta opioid agonist (ADL5859) in the mouse forced swim test.

    PubMed

    Huang, Peng; Tunis, Julia; Parry, Christopher; Tallarida, Ronald; Liu-Chen, Lee-Yuan

    2016-06-15

    Kappa opioid (KOP) receptor antagonists and delta opioid (DOP) receptor agonists have antidepressant-like effects in animal tests and may be useful for treatment-resistant depression in humans. In this study, we examined whether the combination of a KOP receptor antagonist and a DOP receptor agonist would produce a better than additive effect (i.e. synergy). LY2444296 is a short-acting selective nonpeptide KOP receptor antagonist. ADL5859 is a selective nonpeptide DOP receptor agonist which does not produce seizures and EEG disturbances. Each compound and combinations of the two were examined in the forced swim test (FST) one h post injection, a screening test for antidepressant-like effect, in male adult C57BL/6J mice (Jackson Lab). LY2444296 [subcutaneous (s.c.) injection] at 10 and 30mg/kg, but not 3mg/kg, significantly decreased immobility time in a dose-dependent manner. Intraperitoneal (i.p.) injections of ADL5859 also reduced immobility time dose-dependently at doses of 3 and 10mg/kg, but not at 1mg/kg. An analysis was conducted using the method of Tallarida and Raffa (2010), which employed dose equivalence. The relative potency of the drugs was determined to be LY2444296: ADL5859=1:0.28, which was the dose ratio for combination studies. Six combinations of the two compounds were tested in mice at a fixed dose ratio. We found that LY2444296 and ADL5859 yielded significant synergistic effects for the antidepressant-like effect at the combined dose ranging from 3.84mg/kg to 9.0mg/kg. ADL5859 (10mg/kg), LY2444296 (30mg/kg) and their combined dose (3.84mg/kg) had no effects on locomotor activities. Since the two drugs have distinct pharmacological profiles, such a synergism will allow use of lower doses of both drugs to achieve desired antidepressant effects with fewer side effects. PMID:27044434

  7. Can currently available advanced combustion biomass cook-stoves provide health relevant exposure reductions? Results from initial assessment of select commercial models in India.

    PubMed

    Sambandam, Sankar; Balakrishnan, Kalpana; Ghosh, Santu; Sadasivam, Arulselvan; Madhav, Satish; Ramasamy, Rengaraj; Samanta, Maitreya; Mukhopadhyay, Krishnendu; Rehman, Hafeez; Ramanathan, Veerabhadran

    2015-03-01

    Household air pollution from use of solid fuels is a major contributor to the national burden of disease in India. Currently available models of advanced combustion biomass cook-stoves (ACS) report significantly higher efficiencies and lower emissions in the laboratory when compared to traditional cook-stoves, but relatively little is known about household level exposure reductions, achieved under routine conditions of use. We report results from initial field assessments of six commercial ACS models from the states of Tamil Nadu and Uttar Pradesh in India. We monitored 72 households (divided into six arms to each receive an ACS model) for 24-h kitchen area concentrations of PM2.5 and CO before and (1-6 months) after installation of the new stove together with detailed information on fixed and time-varying household characteristics. Detailed surveys collected information on user perceptions regarding acceptability for routine use. While the median percent reductions in 24-h PM2.5 and CO concentrations ranged from 2 to 71% and 10-66%, respectively, concentrations consistently exceeded WHO air quality guideline values across all models raising questions regarding the health relevance of such reductions. Most models were perceived to be sub-optimally designed for routine use often resulting in inappropriate and inadequate levels of use. Household concentration reductions also run the risk of being compromised by high ambient backgrounds from community level solid-fuel use and contributions from surrounding fossil fuel sources. Results indicate that achieving health relevant exposure reductions in solid-fuel using households will require integration of emissions reductions with ease of use and adoption at community scale, in cook-stove technologies. Imminent efforts are also needed to accelerate the progress towards cleaner fuels. PMID:25293811

  8. Coupling 2H and 18O biomarker results provides new insight into palaeohumidity changes in East Africa during the last glacial

    NASA Astrophysics Data System (ADS)

    Hepp, Johannes; Zech, Roland; Tuthorn, Mario; Glaser, Bruno; Rozanski, Kazimierz; Zech, Wolfgang; Zech, Michael

    2015-04-01

    We couple compound-specific δ2H results of leaf wax-derived n-alkanes with compound-specific δ18O results of hemicellulose-derived sugars extracted from the loess-paleosol-sequence Maundi (3° 10'27.5'S, 37° 31'05.8'E) located on the south-eastern slopes of Mt. Kilimanjaro at ~ 2780 m above sea level. This coupled biomarker approach allows inter alia establishing a ca. 100 ka record of the isotopic composition of leaf water. Accordingly, the deuterium-excess of leaf water may serve as a proxy for palaeohumidity. Furthermore, the coupled biomarker approach allows reconstructing the isotopic composition of palaeoprecipitation (by using the slope the local evaporation line derived from a simple Craig-Gordon model). Our results suggest that sedimentary δ2Hleaf-wax records should not be interpreted directly in terms of reflecting δ2Hprec because variable leaf water evaporative enrichment can strongly overprint the δ2Hprec signal. The Maundi δ2Hn-alkane record can be compared with δ2Hwax records from Lake Challa, Lake Tanganyika and Lake Malawi. Accordingly, the Maundi δ2Hn-alkane record is generally in good agreement with the Lake Challa and the Lake Tanganyika δ2Hwax records. However, a clear altitude effect can be seen in the δ2H records (Maundi: 2780 m a.s.l.; Lake Challa: 880 m a.s.l.; Lake Tanganyika: 773 m a.s.l.; Lake Malawi: 474 m a.s.l.). Moreover, the Maundi δ2Hn-alkane record reveals a clear smaller range compared to the other δ2Hwax records. Finally, especially the Lake Malawi δ2Hwax record reveals also clearly different features than the other available δ2Hwax records. These differences resulted in different interpretations of the δ2Hwax records (amount effect vs. source effect). Our coupled δ18Osugar and δ2Hn-alkane approach sheds new light into this discussion. In brief, reconstructed low deuterium-excessleaf-water values during the African Humid Period (AHP) indicate humid climatic conditions. By contrast, higher deuterium

  9. Topical Treatment With an Agent Disruptive to P. acnes Biofilm Provides Positive Therapeutic Response: Results of a Randomized Clinical Trial.

    PubMed

    Bernhardt, Michael J; Myntti, Matthew F

    2016-06-01

    The traditional disease model of acne has been one of follicular plugging due to 'sticky epithelial cells' associated with increased sebum production with deep follicular anaerobic conditions favoring P. acnes- generated inflammation. P. acnes biofilms have been found more frequently in patients with acne than controls. Biofilms are genetically coded to create adhesion to the pilosebaceous unit followed by production of a mucopolysaccharide coating capable of binding to lipid surfaces. Traditional therapies for acne have involved mixtures of oral and topical antibiotics admixed with topical keratolytics and retinoids, which are aimed at traditional bacterial reduction as well as downregulating the inflammatory cascade. These approaches are limited by side effect and compliance/tolerability issues. As the P. acnes biofilm may, in fact, be the instigator of this process, we studied the use of a topical agent designed to reduce the P. acnes biofilm to see if reducing the biofilm would be therapeutically efficacious. We present data of a proprietary topical non-prescription agent with a novel pharmaco mechanism designed to attack the biofilm produced by P. acnes. Our data shows a decrease of inflammatory lesions by 44% and non-inflammatory lesions by 32% after 12 weeks and also provided for a meaningful improvement in the quality of life of the patients in the study. These improvements were achieved with a product that was not associated with burning, chafing, irritation, or erythema, which can be seen with topical treatments. It is apparent from this study that by addressing the biofilm which protects the P. acnes bacteria through the use of the Acne Gel, the incidence of acne symptoms can be greatly reduced, while having no negative impacts on the patients' skin (ClinicalTrials.gov registry number NCT02404285).

    J Drugs Dermatol. 2016;15(6):677-683. PMID:27272073

  10. Providing prescheduled appointments as a strategy for improving follow-up compliance after community-based glaucoma screening: results from an urban underserved population.

    PubMed

    van Zyl, Tavé; Su, Zhuo; Zhou, Elaine; Wong, Ryan K; Mohsenin, Amir; Rogers, Spencer; Tsai, James C; Forster, Susan H

    2015-02-01

    To determine if receiving a prescheduled appointment is associated with an increased likelihood of complying with follow-up eye care among individuals identified as at risk for glaucoma during community-based glaucoma screening in an urban underserved population. This study sampled 362 individuals aged ≥30 years without known glaucoma from low-income, predominantly black/Hispanic neighborhoods in New Haven, Connecticut presenting to one of twelve community-based glaucoma screening events from May 2010 to October 2012. A quasi-experimental design systematically assigned 63 individuals identified as at risk for glaucoma into either intervention or control group with a 1:2 ratio. Individuals in the control group (n = 41) received counseling on glaucoma and a recommendation for obtaining a follow-up appointment at the eye department of a local community health center, which offers affordable health services with income-adjusted fee discounts to uninsured, low-income patients. Those in the intervention group (n = 22) received the same counseling and a prescheduled appointment at the community health center. The overall rate of follow-up compliance within 3 months of screening was 30 % (41 % in the intervention group; 24 % in the control group). Multivariate logistic regression analysis adjusting for sex, age, ethnicity, health insurance status, car access, living situation, and smoking status found that follow-up compliance was significantly associated with intervention (adjusted odds ratio 4.8; 95 % confidence interval 1.1-20.9). Providing prescheduled appointments can improve follow-up compliance after community-based glaucoma screening. This finding may be potentially applicable to community-based health screening for other preventable diseases. PMID:24880821

  11. Family perceptions of shared decision-making with health care providers: results of the National Survey of Children With Special Health Care Needs, 2009-2010.

    PubMed

    Smalley, LaQuanta P; Kenney, Mary Kay; Denboba, Diana; Strickland, Bonnie

    2014-08-01

    The Maternal and Child Health Bureau recently revised its measure of family-provider shared decision-making (SDM) to better align with parents' views and the intent of SDM. We sought to assess achievements in meeting the revised measure; examine socio-demographic/health correlates; and determine the relationships between SDM and access to quality health care. We analyzed data for 40,242 children with special health care needs (CSHCN) from the 2009-2010 National Survey of CSHCN and assessed the prevalence of SDM and association with other US CSHCN socio-demographic/health characteristics using bivariate and multivariate methods. Logistic regression was used to determine associations between SDM and having a medical home and preventive medical/dental visits. Approximately 70% of families of CSHCN perceived themselves as shared decision-makers in their child's care. Families of CSHCN with greater functional limitations had twice the odds of lacking SDM than those never affected. Disparities in attainment rates were noted for families with low versus high income (61 vs. 77%), less versus more than high school education (59 vs. 73%), privately insured versus uninsured (76 vs. 57%), and minority versus white race (63 vs. 74%). CSHCN with medical homes had 6 times greater odds of perceived SDM and as much as one and a half times the odds of receiving preventive care than CSHCN without a medical home. Major differences in family SDM perceptions are associated with having a medical home, particularly when characterized by family-centered care. Populations of concern are those with more functionally limited children and increased socio-economic challenges. PMID:24052119

  12. Repellent Plants Provide Affordable Natural Screening to Prevent Mosquito House Entry in Tropical Rural Settings—Results from a Pilot Efficacy Study

    PubMed Central

    Mng'ong'o, Frank C.; Sambali, Joseph J.; Sabas, Eustachkius; Rubanga, Justine; Magoma, Jaka; Ntamatungiro, Alex J.; Turner, Elizabeth L.; Nyogea, Daniel; Ensink, Jeroen H. J.; Moore, Sarah J.

    2011-01-01

    Sustained malaria control is underway using a combination of vector control, prompt diagnosis and treatment of malaria cases. Progress is excellent, but for long-term control, low-cost, sustainable tools that supplement existing control programs are needed. Conventional vector control tools such as indoor residual spraying and house screening are highly effective, but difficult to deliver in rural areas. Therefore, an additional means of reducing mosquito house entry was evaluated: the screening of mosquito house entry points by planting the tall and densely foliated repellent plant Lantana camara L. around houses. A pilot efficacy study was performed in Kagera Region, Tanzania in an area of high seasonal malaria transmission, where consenting families within the study village planted L. camara (Lantana) around their homes and were responsible for maintaining the plants. Questionnaire data on house design, socioeconomic status, malaria prevention knowledge, attitude and practices was collected from 231 houses with Lantana planted around them 90 houses without repellent plants. Mosquitoes were collected using CDC Light Traps between September 2008 and July 2009. Data were analysed with generalised negative binomial regression, controlling for the effect of sampling period. Indoor catches of mosquitoes in houses with Lantana were compared using the Incidence Rate Ratio (IRR) relative to houses without plants in an adjusted analysis. There were 56% fewer Anopheles gambiae s.s. (IRR 0.44, 95% CI 0.28–0.68, p<0.0001); 83% fewer Anopheles funestus s.s. (IRR 0.17, 95% CI 0.09–0.32, p<0.0001), and 50% fewer mosquitoes of any kind (IRR 0.50, 95% CI 0.38–0.67, p<0.0001) in houses with Lantana relative to controls. House screening using Lantana reduced indoor densities of malaria vectors and nuisance mosquitoes with broad community acceptance. Providing sufficient plants for one home costs US $1.50 including maintenance and labour costs, (30 cents per person). L. camara

  13. Long-acting somatostatin analogues provide significant beneficial effect in patients with refractory small bowel angiodysplasia: Results from a proof of concept open label mono-centre trial

    PubMed Central

    Hall, Barry; Breslin, Niall; McNamara, Deirdre

    2015-01-01

    Introduction Small bowel angiodysplasias account for over 50% of causes of small bowel bleeding and carry a worse prognosis than lesions located elsewhere in the gastrointestinal tract. Re-bleeding rates are high even after first-line endoscopic therapy and are associated with high levels of morbidity for affected patients. Small trials of long-acting somatostatin analogues have shown promising results but have not yet been assessed in patients with refractory small bowel disease. Aim The purpose of this study was to assess the effect of long-acting somatostatin analogues in reducing re-bleeding rates and transfusion requirements, and improving haemoglobin levels in patients with refractory small bowel angiodysplasia. Methods Patients with refractory small bowel angiodysplasia were treated with 20 mg of long-acting octreotide for a minimum of three months. Response was assessed according to: rates of re-bleeding, haemoglobin levels, transfusion requirements, and side effects. Results A total of 24 patients were initially treated and 20 received at least three doses. Rates of complete, partial and non-response were 70%, 20% and 10% respectively. Average haemoglobin rates increased from 9.19 g/dl to 11.35 g/dl (p = 0.0027, 95% confidence interval (CI) −3.5 to −1.1) in the group overall and 70% remained transfusion-free after a mean treatment duration of 8.8 months. The rate of adverse events was higher than previously reported at 30%. Conclusion Long-acting somatostatin analogues offer a therapeutic advantage in a significant proportion of patients with small bowel angiodysplasia. With careful patient selection and close observation, a long-acting somatostatin analogue should be considered in all patients with persistent anaemia attributable to refractory disease in conjunction with other standard treatments. PMID:26966525

  14. Reductions in the mitochondrial DNA diversity of coral reef fish provide evidence of population bottlenecks resulting from Holocene sea-level change.

    PubMed

    Fauvelot, C; Bernardi, G; Planes, S

    2003-07-01

    This study investigated the influence of reproductive strategy (benthic or pelagic eggs) and habitat preferences (lagoon or outer slope) on both diversity and genetic differentiation using a set of populations of seven coral reef fish species over different geographic scales within French Polynesia. We hypothesized that a Holocene sea-level decrease contributed to severe reduction of population size for species inhabiting lagoons and a subsequent decrease of genetic diversity. Conversely, we proposed that species inhabiting stable environments, such as the outer slope, should demonstrate higher genetic diversity but also more structured populations because they have potentially reached a migration-genetic drift equilibrium. Sequences of the 5' end of the mitochondrial DNA (mtDNA) control region were compared among populations sampled in five isolated islands within two archipelagos of French Polynesia. For all the species, no significant divergences among populations were found. Significant differences in mtDNA diversity between lagoonal and outer-slope species were demonstrated both for haplotype diversity and sequence divergence but none were found between species with different egg types. Pairwise mismatch distributions suggested rapid population growth for all the seven species involved in this study, but they revealed different distributions, depending on the habitat preference of the species. Although several scenarios can explain the observed patterns, the hypothesis of population size reduction events relative to Holocene sea-level regression and its consequence on French Polynesia coral reefs is the most parsimonious. Outer-slope species have undergone a probable weak and/or old bottleneck (outer reefs persisted during low sea level, leading to reef area reductions), whereas lagoonal species suffered a strong and/or recent bottleneck since Holocene sea-level regression resulted in the drying out of all the atolls that are maximum 70 meters deep. Since

  15. 21. Providence & Worchester RR: Freight house. Providence, Providence Co., ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. Providence & Worchester RR: Freight house. Providence, Providence Co., RI. Sec. 4119, mp 185.66 (See HAER no. RI-3 for further documentation on this site.) - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  16. The development of Korea's new long-term care service infrastructure and its results: focusing on the market-friendly policy used for expansion of the numbers of service providers and personal care workers.

    PubMed

    Chon, Yongho

    2013-01-01

    One of the main reasons for reforming long-term care systems is a deficient existing service infrastructure for the elderly. This article provides an overview of why and how the Korean government expanded long-term care infrastructure through the introduction of a new compulsory insurance system, with a particular focus on the market-friendly policies used to expand the infrastructure. Then, the positive results of the expansion of the long-term care infrastructure and the challenges that have emerged are examined. Finally, it is argued that the Korean government should actively implement a range of practical policies and interventions within the new system. PMID:23548145

  17. Provide, provide: the economics of aging.

    PubMed

    1998-06-26

    Most older persons face two potentially serious economic problems: (a) declining earning power and (b) declining health that can be partly offset by increased utilization of health care. The decline in earning power is largely attributable to physiological changes and to obsolescence of skills and knowledge. These adverse effects are exacerbated by public and private policies that reduce the incentives of older persons to continue work and increase the cost to employers of employing older workers. The problems of earnings replacement and health care payment are usually discussed separately, but there are several reasons why they should be considered together. First, there are often tradeoffs between the two. Money is money, and for most people there is never enough to go around. This is self-evident where private funds are concerned. Low-income elderly, for instance, frequently must choose between expensive prescription drugs and an adequate diet. For middle-income elderly, the choice may be between saving on medigap insurance or forgoing an airplane trip to a grandchild's graduation. Difficult choices are also inherent in the allocation of public funds. The same tax receipts that could be used to maintain or increase retirement benefits could be used to fund additional care, and vice versa. In discussing these tradeoffs, some analysts assert that people will gladly give up other goods and services for medical care that cures illness, relieves pain, or restores function. Others believe that some people would forgo some health insurance in order to maintain access to other goods and services. A second reason for looking at the two problems together is that they pose similar questions for public policy. How much should each generation provide for its own needs in old age, and how much should be provided by the generations that follow? How much provision should be voluntary, how much compulsory? How much intra-generational redistribution is appropriate after age 65

  18. Why healthcare providers merge.

    PubMed

    Postma, Jeroen; Roos, Anne-Fleur

    2016-04-01

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in the literature by conducting a survey study on mergers among 848 Dutch healthcare executives, of which 35% responded (resulting in a study sample of 239 executives). A total of 65% of the respondents was involved in at least one merger between 2005 and 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increasing competition, more pressure from purchasers, growing financial risks, de-institutionalisation of long-term care and decentralisation of healthcare services to municipalities. Our empirical study shows that healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Also efficiency and financial reasons are important drivers of merger activity in healthcare. We find that motives for merger are related to changes in health policies, in particular to the increasing pressure from competitors, insurers and municipalities. PMID:26055501

  19. NATIONAL HEALTH PROVIDER INVENTORY

    EPA Science Inventory

    The National Health Provider Inventory provides data on services, location, staff, capacity, and other characteristics of selected health care providers in the United States. Information is collected via mail questionnaire with telephone follow up to all providers (100% census) o...

  20. PROVIDING WOMEN, KEPT MEN

    PubMed Central

    Mojola, Sanyu A

    2014-01-01

    This paper draws on ethnographic and interview based fieldwork to explore accounts of intimate relationships between widowed women and poor young men that emerged in the wake of economic crisis and a devastating HIV epidemic among the Luo ethnic group in Western Kenya. I show how the cooptation of widow inheritance practices in the wake of an overwhelming number of widows as well as economic crisis resulted in widows becoming providing women and poor young men becoming kept men. I illustrate how widows in this setting, by performing a set of practices central to what it meant to be a man in this society – pursuing and providing for their partners - were effectively doing masculinity. I will also show how young men, rather than being feminized by being kept, deployed other sets of practices to prove their masculinity and live in a manner congruent with cultural ideals. I argue that ultimately, women’s practice of masculinity in large part seemed to serve patriarchal ends. It not only facilitated the fulfillment of patriarchal expectations of femininity – to being inherited – but also served, in the end, to provide a material base for young men’s deployment of legitimizing and culturally valued sets of masculine practice. PMID:25489121

  1. The effectiveness of providing peer benchmarked feedback to hip replacement surgeons based on patient-reported outcome measures—results from the PROFILE (Patient-Reported Outcomes: Feedback Interpretation and Learning Experiment) trial: a cluster randomised controlled study

    PubMed Central

    Boyce, Maria B; Browne, John P

    2015-01-01

    Objective To test whether providing surgeons with peer benchmarked feedback about patient-reported outcomes is effective in improving patient outcomes. Design Cluster randomised controlled trial. Setting Secondary care—Ireland. Participants Surgeons were recruited through the Irish Institute of Trauma and Orthopaedic Surgery, and patients were recruited in hospitals prior to surgery. We randomly allocated 21 surgeons and 550 patients. Intervention Surgeons in the intervention group received peer benchmarked patient-reported outcome measures (PROMs) feedback and education. Main outcome variable Postoperative Oxford Hip Score (OHS). Results Primary outcome data were available for 11 intervention surgeons with responsibility for 230 patients and 10 control surgeons with responsibility for 228 patients. The mean postoperative OHS for the intervention group was 40.8 (95% CI 39.8 to 41.7) and for the control group was 41.9 (95% CI 41.1 to 42.7). The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.2, p=0.09). Secondary outcomes were the Hip Osteoarthritis Outcome Score (HOOS), EQ-5D and the proportion of patients reporting a problem after surgery. The mean postoperative HOOS for the intervention group was 36.2 and for the control group was 37.1. The adjusted effect estimate was −1.1 (95% CI −2.4 to 0.3, p=0.1). The mean postoperative EQ-5D for the intervention group was 0.85 and for the control group was 0.87. The adjusted effect estimate was −0.02 (95% CI −0.05 to 0.008, p=0.2). 27% of intervention patients and 24% of control patients reported at least one complication after surgery (adjusted OR=1.2, 95% CI 0.6 to 2.3, p=0.6). Conclusions Outcomes for patients operated on by surgeons who had received peer benchmarked PROMs data were not statistically different from the outcomes of patients operated on by surgeons who did not receive feedback. PROMs information alone seems to be insufficient to identify opportunities for quality improvement. Trial

  2. Occupational Therapy in HomEcare Re-ablement Services (OTHERS): results of a feasibility randomised controlled trial

    PubMed Central

    Walker, Marion F; Parry, Ruth H; Latif, Zaid; McGeorge, Ian D; Drummond, Avril E R

    2016-01-01

    Objectives The objective of this study was to test the feasibility of conducting a randomised controlled trial (RCT) of an intervention targeted at activities of daily living (ADL), delivered by an occupational therapist, in homecare reablement. Design Feasibility parallel group RCT. Setting Single-site local authority homecare reablement service. Participants People referred for homecare reablement with ability to consent. Exclusion criteria were as follows: inability to speak English, receiving other community therapy services, needing two or more to assist transfer and receiving end-of-life care. Control ‘Usual care’ was 6 weeks of homecare reablement delivered by social care workers (no routine health professional input). Intervention A targeted ADL programme, delivered by an occupational therapist incorporating goal setting, teaching/practising techniques, equipment/adaptations and provision of advice/support. This was in addition to usual care. Outcome measures Aspects of feasibility including eligibility, recruitment, intervention delivery, attrition and suitability and sensitivity of outcome measures. Participant outcomes were personal and extended ADL, quality of life, falls and use of health and social care services. Results 30 participants were recruited, 15 to each arm, which was 60% of those eligible. Data from 22 (73%) were analysed at 6 months. Of the 15 participants, 13 (86%) received the intervention and were able to set one or more ADL goals. There were improvements from baseline in both groups, although overall improvements were greater in the occupational therapy (OT) intervention group. The biggest threat to feasibility was a change in service configuration during the trial, involving additional occupational therapy input, affecting usual care and recruitment. Conclusions Despite the service reconfiguration, it was feasible to recruit and retain participants, deliver the intervention and collect outcome data that were responsive to

  3. Routine failures in the process for blood testing and the communication of results to patients in primary care in the UK: a qualitative exploration of patient and provider perspectives

    PubMed Central

    Litchfield, Ian; Bentham, Louise; Hill, Ann; McManus, Richard J; Lilford, Richard; Greenfield, Sheila

    2015-01-01

    Background The testing and result communication process in primary care is complex. Its successful completion relies on the coordinated efforts of a range of staff in primary care and external settings working together with patients. Despite the importance of diagnostic testing in provision of care, this complexity renders the process vulnerable in the face of increasing demand, stretched resources and a lack of supporting guidance. Methods We conducted a series of focus groups with patients and staff across four primary care practices using process-improvement strategies to identify and understand areas where either unnecessary delay is introduced, or the process may fail entirely. We then worked with both patients and staff to arrive at practical strategies to improve the current system. Results A total of six areas across the process were identified where improvements could be introduced. These were: (1) delay in phlebotomy, (2) lack of a fail-safe to ensure blood tests are returned to practices and patients, (3) difficulties in accessing results by telephone, (4) role of non-clinical staff in communicating results, (5) routine communication of normal results and (6) lack of a protocol for result communication. Conclusions A number of potential failures in testing and communicating results to patients were identified, and some specific ideas for improving existing systems emerged. These included same-day phlebotomy sessions, use of modern technology methods to proactively communicate routine results and targeted training for receptionists handling sensitive data. There remains an urgent need for further work to test these and other potential solutions. PMID:26251507

  4. What HERA May Provide?

    SciTech Connect

    Jung, Hannes; De Roeck, Albert; Bartels, Jochen; Behnke, Olaf; Blumlein, Johannes; Brodsky, Stanley; Cooper-Sarkar, Amanda; Deak, Michal; Devenish, Robin; Diehl, Markus; Gehrmann, Thomas; Grindhammer, Guenter; Gustafson, Gosta; Khoze, Valery; Knutsson, Albert; Klein, Max; Krauss, Frank; Kutak, Krzysztof; Laenen, Eric; Lonnblad, Leif; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  5. Arizona's Application Service Provider.

    ERIC Educational Resources Information Center

    Jordan, Darla

    2002-01-01

    Describes the U.S.'s first statewide K-12 application service provider (ASP). The ASP, implemented by the Arizona School Facilities Board, provides access to productivity, communications, and education software programs from any Internet-enabled device, whether in the classroom or home. (EV)

  6. Provider 1997 corporate profiles.

    PubMed

    1997-05-01

    As the long term care industry seeks out new products, new solutions, and new ways of providing quality care, it is important for long term care providers to know more about the companies they do business with. The following corporate profiles showcase information about leading companies in the long term health care industry. Some of the areas highlighted include: mission of company, history, product lines, support services. We hope you will find this information useful when making purchasing decisions, and we're confident you'll keep this issue of Provider as a handy reference guide. The information in the following corporate profiles was supplied by the companies. Neither Provider magazine nor the American Health Care Association endorses the products and services listed in this section. Provider magazine and the American Health Care Association disclaim any and all liability related to or arising from the information contained in the profiles. PMID:10166888

  7. Associations of quality of life, pain, and self-reported arthritis with age, employment, bleed rate, and utilization of hemophilia treatment center and health care provider services: results in adults with hemophilia in the HERO study

    PubMed Central

    Forsyth, Angela L; Witkop, Michelle; Lambing, Angela; Garrido, Cesar; Dunn, Spencer; Cooper, David L; Nugent, Diane J

    2015-01-01

    Introduction Severe hemophilia and subsequent hemophilic arthropathy result in joint pain and impaired health-related quality of life (HRQoL). Assessment of HRQoL in persons with hemophilia (PWH), including underlying factors that drive HRQoL differences, is important in determining health care resource allocation and in making individualized clinical decisions. Aim To examine potential associations between HRQoL, pain interference, and self-reported arthritis and age, employment, activity, bleed frequency, and hemophilia treatment center and health care professional utilization. Methods PWH (age ≥18 years) from ten countries completed a 5-point Likert scale on pain interference over the previous 4 weeks, the EQ-5D-3L scale (mobility, usual activities, self-care, pain/discomfort, anxiety/depression) including a health-related visual analog scale (0–100, coded as an 11-point categorical response). Results Pain interference (extreme/a lot) was higher in PWH aged >40 years (31%) compared to those aged 31–40 years (27%) or ≤30 years (21%). In an analysis of eight countries with home treatment, PWH who reported EQ-5D mobility issues were less likely to be employed (53% vs 79%, with no mobility issues). Median annual bleed frequency increased with worsening EQ-5D pain or discomfort. The percentage of PWH with inhibitors reporting visual analog scale scores of 80–90–100 was lower (20%) than those without inhibitors (34%). Median bleed frequency increased with pain. Globally, nurse and social worker involvement increased with disability and pain; physiotherapist utilization was moderate regardless of the extent of disability or pain. Conclusion Increased disability and pain were associated with increased age, lower employment, higher reported bleed frequency, and lower HRQoL. PMID:26604708

  8. Forest cover change in the upper Midwestern United States results from both climate and land use change following European settlement: Historical survey and weather records provide robust support for modeling applications

    NASA Astrophysics Data System (ADS)

    Goring, S. J.; Williams, J. W.; McLachlan, J. S.; Dawson, A.; Dietze, M.; Paciorek, C. J.; Mladenoff, D. J.; Record, S.; Cogbill, C. V.; Hooten, M.; Ruid, M.; Jackson, S. T.

    2013-12-01

    Since European settlement, both climate and human land use have acted on forests in the upper Midwestern United States resulting in changes in forest structure and composition. The extent of these changes has been examined locally and at the state level by examining forest records from the Public Lands Survey System (PLSS), but here we bring together records of changing forest composition with weather records from the mid to late 19th century from the 19th Century Forts and Observer's Database. We are able to assign attribution for taxon range and composition shifts in the region to either land use, climate or both. We see that much of the range contraction in the region seen when comparing Forest Inventory and Analysis data with Public Land Survey System data occurs along the prairie margin, with northern forests showing greater stability in both range and composition suggesting a dominant role for land use in structuring regional vegetation. Modern forests are often less diverse than PLSS forests and the mean minimum dissimilarity between modern and PLSS-era forests is significantly higher than the minimum dissimilarity within either the PLSS-era forests or the modern (FIA) forests, indicating the possiblity that our modern forests have already become 'no-analogue' ecosystems.

  9. Providing a diet deficient in valine but with excess leucine results in a rapid decrease in feed intake and modifies the postprandial plasma amino acid and α-keto acid concentrations in pigs.

    PubMed

    Gloaguen, M; Le Floc'h, N; Corrent, E; Primot, Y; van Milgen, J

    2012-09-01

    Indispensable AA are involved in the control of feed intake. When a diet deficient in Val is offered to pigs, feed intake is typically reduced. This effect is aggravated when dietary Leu is supplied in excess of the requirement. If an unbalanced supply of branched-chain AA (BCAA) is harmful, an anorectic response may serve as a mechanism to prevent this situation. We verified this hypothesis by measuring the voluntary feed intake of a balanced diet offered during the 30-min period 1 h after ingestion of a test meal deficient or not in Val (Val- and Val+) with an excess of Leu. Twelve and four 6-wk-old crossbred female pigs were used in Exp. 1 and 2, respectively. Prior ingestion of the Val- test meal resulted in a 14% reduction in feed intake compared with that observed after ingestion of the Val+ test meal (P = 0.06) in Exp. 1, indicating that the signal to reduce feed intake occurred within 1 h. It is possible that the plasma concentration of the limiting AA serves as a signal for the dietary AA deficiency. We therefore determined the postprandial plasma concentrations of BCAA and their α-keto acids after ingestion of Val- and Val+ in 4 pigs in Exp. 2. After ingestion of the Val- diet, plasma concentrations of Val and its keto acid were reduced compared with values observed after ingestion of the Val+ diet. The peak concentration occurred earlier after ingestion of the Val- diet compared with that of the Val+ diet. Although the plasma concentration increased after the meal, it declined rapidly in pigs offered Val-, and the Val concentration 4 h after ingestion of the meal was even less than that observed in the fasted state. In conclusion, it appears that the pig is able to detect a deficient supply of Val within 1 h after ingestion. The plasma concentration of Val or its concentration relative to the other BCAA during the postprandial period may act as a signal indicating the AA deficiency. PMID:22585822

  10. Testing Provides Crucial Information

    ERIC Educational Resources Information Center

    Morial, Marc H.

    2015-01-01

    The National Urban League president and CEO Marc H. Morial weighs in on what he sees as the need for continued annual assessments of students, rejecting the course of opting out that has taken hold in some places across America. Assessment data provides students with the opportunity to receive personalized supports and necessary interventions to…

  11. The Provident Principal.

    ERIC Educational Resources Information Center

    McCall, John R.

    This monograph offers leadership approaches for school principals. Discussion applies the business leadership theory of Warren Bennis and Burt Nanus to the role of the principal. Each of the booklet's three parts concludes with discussion questions. Part 1, "Visions and Values for the Provident Principal," demonstrates the importance of…

  12. Providers get their due.

    PubMed

    Morrissey, J

    1994-11-01

    Providers are getting their due, but only after employing computer software programs to help sort through the complex managed-care contracts they've negotiated. More and more accounting departments are relying on contract management systems to ensure accurate billing. PMID:10138187

  13. Achieving Provider Engagement

    PubMed Central

    Greenfield, Geva; Pappas, Yannis; Car, Josip; Majeed, Azeem; Harris, Matthew

    2014-01-01

    The literature on integrated care is limited with respect to practical learning and experience. Although some attention has been paid to organizational processes and structures, not enough is paid to people, relationships, and the importance of these in bringing about integration. Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care. Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services. Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda. PMID:25212855

  14. Provider panel presentations.

    PubMed

    Buckelew, Larry C; Harvey, Deborah; Mello, Joe

    2003-08-01

    To wrap up the three big items--attracting talent, the professional nurse role, and our structural disadvantages--I would offer the following take-away thoughts: We ought to do what we can to get our disproportionate share of RNs out of the health care system to work in dialysis. If we work together, we have a shot at making that happen. As an industry, we must exploit our strengths. We have to exploit the pride that comes in the services and the care that we provide. We need to create in a very visual way that difference for nurses who are considering which area of specialty to go into and where to create their careers. We, as providers, have a huge opportunity to create the right environment for our nurses. That's something we own. We have to fix it. We have to create a better place to work for nurses than any place else. We must create a more enriching place for nurses than anywhere else. That's up to us. I know a lot of us on the provider side are doing tons of things to make that happen and we need to keep driving that. We need a level playing field. We've proven the fact that we can deliver clinical outcomes with the best. Now we need help from our biggest customer to make sure we can compete for the resources that are necessary to sustain and improve those clinical outcomes on an ongoing basis. PMID:14533522

  15. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. PMID:26598305

  16. The Provident Sea

    NASA Astrophysics Data System (ADS)

    Cushing, David H.

    1988-09-01

    The Provident Sea describes the history of fish stock management (including whales and seals). The book traces, on the basis of the original scientific material, the history of the management of "the provident sea" up to recent times when problems of over-exploitation have had dramatic effects upon stocks. The need for management arose mainly from the increasing industrialization of capture. Hence the preindustrial fisheries are covered, in particular the old cod fishery on the Grand Bank and the herring fishery in the North Sea, as an essential background to current problems. The origins of fisheries and whaling science are described, as is the development up to 1965 of the science and institution in fisheries, whaling, and sealing. In the sixties and seventies, certain major fishing nations took a heavy harvest of fish stocks using sophisticated and efficient gathering methods. This in turn led to conflict and one consequence was the "Law of the Sea" conference set up to try and resolve these issues.

  17. Consumer-directed personal care: comparing aged and non-aged adult recipient health-related outcomes among those with paid family versus non-relative providers.

    PubMed

    Newcomer, Robert; Kang, Taewoon; Faucett, Julia

    2011-10-01

    Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use (i.e., emergency department and hospital use) among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients (n = 913) in California's In-Home Supportive Services (IHSS) program. This is a consumer-directed PAS program. Outcomes among recipients using relatives (other than spouses or parents) as paid providers are compared with those of recipients having non-relatives as providers. No differences were found by provider-recipient relationships. Non-aged recipients, those in poorer health, those with more than three activities of daily living (ADL) limitations, and those changing providers during the year were all at greater risk for adverse health outcomes. African American, Hispanic, and Asian recipients were at lower risk for injuries and hospital stays than were White recipients. PMID:22106901

  18. What provides cerebral reserve?

    PubMed

    Staff, Roger T; Murray, Alison D; Deary, Ian J; Whalley, Lawrence J

    2004-05-01

    The cerebral reserve hypothesis is a heuristic concept used to explain apparent protection from the onset of cerebral disease and/or cognitive decline in old age. A significant obstacle when investigating the reserve hypothesis is the absence of baseline data with which to compare current cognitive status. We tested the influence of three hypothesized proxies of reserve (education, head size and occupational attainment [OCC]) in 92 volunteers born in 1921, whose cognitive function was measured at age 11 and 79 years, and who underwent brain MRI. The association between each proxy and old age cognitive function was tested, adjusting for variance contributed by childhood mental ability and detrimental age-related pathological changes measured using MRI. The results showed that education and OCC, but not total intracranial volume (TICV), contribute to cerebral reserve and help retain cognitive function in old age. Education was found to contribute between 5 and 6% of the variance found in old age memory function but was found to have no significant association with reasoning abilities. OCC was found to contribute around 5% of the variance found in old age memory function and between 6 and 8% of the variance found in old age reasoning abilities. We conclude that the intellectual challenges experienced during life, such as education and occupation, accumulate reserve and allow cognitive function to be maintained in old age. PMID:15047587

  19. Radiation safety for anesthesia providers.

    PubMed

    Phillips, Gillian; Monaghan, W Patrick

    2011-06-01

    Many modern diagnostic and surgical procedures rely heavily on the use of ionizing radiation. These procedures include computed tomography, nuclear medicine procedures, interventional radiology, and cardiac catheterization and electrophysiology procedures. Recent trends toward increased patient visits and patients with multiple challenging comorbidities have meant that anesthesia providers are increasingly required to provide services in the ancillary areas using ionizing radiation. As a result, anesthesia providers are at a greater-than-ever risk for excessive radiation doses. An overview of some of the basic principles of radiation biology, radiation physics, and radiation protection and specific guidelines related to radiation exposure and pregnancy are described. The effects of radiation exposure are cumulative and permanent, and an understanding of these principles and practices will help anesthesia providers keep their occupational exposure to a minimum. PMID:21751695

  20. 27. Yards north of Branch Avenue Bridge. Providence, Providence Co., ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. Yards north of Branch Avenue Bridge. Providence, Providence Co., RI. Sec. 4116, mp 186.25. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  1. 28. Yards north of Branch Avenue Bridge. Providence, Providence Co., ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. Yards north of Branch Avenue Bridge. Providence, Providence Co., RI. Sec. 4116, mp 186.25. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  2. Ecosystem services provided by bats.

    PubMed

    Kunz, Thomas H; Braun de Torrez, Elizabeth; Bauer, Dana; Lobova, Tatyana; Fleming, Theodore H

    2011-03-01

    Ecosystem services are the benefits obtained from the environment that increase human well-being. Economic valuation is conducted by measuring the human welfare gains or losses that result from changes in the provision of ecosystem services. Bats have long been postulated to play important roles in arthropod suppression, seed dispersal, and pollination; however, only recently have these ecosystem services begun to be thoroughly evaluated. Here, we review the available literature on the ecological and economic impact of ecosystem services provided by bats. We describe dietary preferences, foraging behaviors, adaptations, and phylogenetic histories of insectivorous, frugivorous, and nectarivorous bats worldwide in the context of their respective ecosystem services. For each trophic ensemble, we discuss the consequences of these ecological interactions on both natural and agricultural systems. Throughout this review, we highlight the research needed to fully determine the ecosystem services in question. Finally, we provide a comprehensive overview of economic valuation of ecosystem services. Unfortunately, few studies estimating the economic value of ecosystem services provided by bats have been conducted to date; however, we outline a framework that could be used in future studies to more fully address this question. Consumptive goods provided by bats, such as food and guano, are often exchanged in markets where the market price indicates an economic value. Nonmarket valuation methods can be used to estimate the economic value of nonconsumptive services, including inputs to agricultural production and recreational activities. Information on the ecological and economic value of ecosystem services provided by bats can be used to inform decisions regarding where and when to protect or restore bat populations and associated habitats, as well as to improve public perception of bats. PMID:21449963

  3. The Effect of Guidance regarding Home Exercise and ADL on Adolescent Females Suffering from Adverse Effects after HPV Vaccination in Japanese Multidisciplinary Pain Centers

    PubMed Central

    Ushida, Takahiro; Shibata, Masahiko; Kitahara, Masaki; Yabuki, Shoji; Sumitani, Masahiko; Murakami, Takanori; Iseki, Masako; Hosoi, Masako; Shiokawa, Hiroaki; Tetsunaga, Tomoko; Nishie, Hiroyuki; Fukui, Sei; Kawasaki, Motohiro; Inoue, Sinsuke; Nishihara, Makoto; Aono, Shuichi; Ikemoto, Tatunori; Kawai, Takashi; Arai, Young-Chang

    2016-01-01

    Background. Two prophylactic papillomavirus (HPV) vaccines have been available for primary prevention of cervical cancer. Although serious adverse effects (AE) were rare, more than 230 women have been suffering from severe AEs such as persistent pain and headache in Japan. Our research group started to treat adolescent females suffering from the AEs. Objective. To survey the characteristics of and the effects of cognitive behavioral therapy on adolescent female suffering from the AEs in Japanese multidisciplinary pain centers. Methods. One hundred and forty-five patients suffering from the AEs were reviewed retrospectively and 105 patients of them were provided guidance on home exercise and activities of daily living based partially on a cognitive-behavioral approach. The intensity of pain was rated by the patients using a numerical rating scale (NRS). Furthermore, the Hospital Anxiety and Depression Scale (HADS) and the Pain Catastrophizing Scale (PCS) were used. Results. Eighty out of the 105 patients who received the guidance were followed up, 10 displayed a marked improvement, and 43 showed some improvement. Conclusions. Guidance on home exercise and activities of daily living based on a cognitive-behavioral approach alleviated the AEs that women suffered from after HPV vaccination in Japan.

  4. Sarcopenia-Related Parameters and Incident Disability in Older Persons: Results From the “Invecchiare in Chianti” Study

    PubMed Central

    Rolland, Yves; Abellan Van Kan, Gabor; Bandinelli, Stefania; Vellas, Bruno; Ferrucci, Luigi

    2015-01-01

    Background. Current operational definitions of sarcopenia are based on algorithms’ simultaneous considering measures of skeletal muscle mass and muscle-specific as well as global function. We hypothesize that quantitative and qualitative sarcopenia-related parameters may not be equally predictive of incident disability, thus presenting different clinical relevance. Methods. Data are from 922 elder adults (mean age = 73.9 years) with no activities of daily living (ADL) impairment recruited in the “Invecchiare in Chianti” study. Incident disability in ≥1 ADL defined the outcome of interest. The specific capacities of following sarcopenia-related parameters at predicting incident ADL disability were compared: residuals of skeletal muscle mass, fat-adjusted residuals of skeletal muscle mass, muscle density, ankle extension strength, ratio ankle extension strength/muscle mass, gait speed, and handgrip strength. Results. During the follow-up (median = 9.1 years), 188 (20.4%) incident ADL disability events were reported. Adjusted models showed that only gait speed was significantly associated with the outcome in both men (per standard deviation [SD] = 0.23 m/s increase, hazard ratio [HR] = 0.46, 95% confidence interval [CI] = 0.33–0.63; p < .001) and women (per SD = 0.24 m/s increase, HR = 0.64, 95% CI = 0.50–0.82; p < .001). In women, the fat-adjusted lean mass residual (per SD = 4.41 increase, HR = 0.79, 95% CI = 0.65–0.96; p = .02) and muscle density (per SD = 3.60 increase, HR = 0.76, 95% CI = 0.61–0.93; p = .01) were the only other parameters that predicted disability. In men, several of the tested variables (except muscle mass measures) reported significant results. Conclusions. Gender strongly influences which sarcopenia-related parameters predict disability. Gait speed was a powerful predictor of disability in both men and women, but its nonmuscle-specific nature should impose caution about its inclusion in definitions of sarcopenia. PMID:25320055

  5. Environmental Education Information Providers Directory.

    ERIC Educational Resources Information Center

    1999

    This report directory provides environmental education training resources and related support to education professionals. Surveys were sent to over 60 organizations asking them to self-identify as Environmental Information Providers or Environmental Education Information Providers. This report includes the list of organizations that responded and…

  6. Personal Assistance Providers' Mistreatment of Disabled Adults

    ERIC Educational Resources Information Center

    Oktay, Julianne S.; Tompkins, Catherine J.

    2004-01-01

    This article describes a survey of 84 adults with disabilities who received personal assistance with activities of daily living from family members, informal providers, or agency personnel. Results showed that 30 percent reported mistreatment from their primary provider, and 61 percent reported mistreatment by another provider. Verbal abuse,…

  7. Choosing a primary care provider

    MedlinePlus

    Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor ... A PCP is your main health care provider in non-emergency ... and teach healthy lifestyle choices Identify and treat common ...

  8. Family Day Care Provider Handbook

    ERIC Educational Resources Information Center

    New York State Office of Children and Family Services, 2006

    2006-01-01

    Family day care providers are responsible for creating a high-quality program where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care…

  9. Tackling Disrespectful, Unprofessional Provider Behaviors.

    PubMed

    2016-06-01

    To address problematic provider behaviors that can affect patient safety, physician leaders at Vanderbilt University Medical Center (VUMC) developed the Coworker Observation Reporting System (CORS), a systematized approach for retrieving and addressing concerns about providers reported by staff. To encourage staff members to report concerns, they have to trust that the organization is going to respond, and they also have to feel that they have a certain element of psychological safety. Selected peer messengers share staff complaints with providers, enabling them to offer their perspectives on the issues or events in question. Three years into the implementation of CORS, investigators found that the majority of providers self-correct their behaviors when reports about staff concerns are shared. Additional level 1, level 2, and level 3 interventions are built into the CORS system for providers who fail to self-correct after one or two reports. PMID:27295820

  10. Personal assistance providers' mistreatment of disabled adults.

    PubMed

    Oktay, Julianne S; Tompkins, Catherine J

    2004-08-01

    This article describes a survey of 84 adults with disabilities who received personal assistance with activities of daily living from family members, informal providers, or agency personnel. Results showed that 30 percent reported mistreatment from their primary provider, and 61 percent reported mistreatment by another provider. Verbal abuse, physical abuse, and theft or extortion were the most common forms of mistreatment by primary providers. Verbal abuse, neglect, poor care, and theft were the most common forms of mistreatment by other providers. Adults with lower incomes were the most likely to experience mistreatment. Male providers were more likely to mistreat, as were providers who were inexperienced and who provided more than 50 hours of care per week. PMID:15453056

  11. Types of health care providers

    MedlinePlus

    ... GYN as their primary care provider. Nurse practitioners (NPs) are nurses with graduate training. They can serve ... common concerns and routine screenings) and family planning. NPs can prescribe medications. A physician assistant (PA) can ...

  12. Predeployment Medical Training for Providers.

    PubMed

    Holloway, Michael D

    2016-01-01

    Following the attacks of September 11, 2001, the United States became simultaneously engaged in military conflicts in 2 theaters of operation. At that time there was no organized program to train medical providers assigned to deployable Role 1 or Role 2 aid stations. To fill this gap, the Tactical Combat Medical Care (TCMC) course was developed and instituted at Fort Sam Houston, Texas, in 2004 to provide the training platform for providers in preparation for assignment to and deployment with combat units. The TCMC course has become the standard for prehospital wartime care training. All military healthcare providers (physicians, physician assistants, nurses, combat medics) requiring training to supplement their basic medical education and facility-based experiences are eligible to attend this course. PMID:27215892

  13. Choosing Your Prenatal Care Provider

    MedlinePlus

    ... also called OB) is a doctor who has special education and training to take care of pregnant women ... midwife is a health care provider who has special education and training to take care of women of ...

  14. Choosing a primary care provider

    MedlinePlus

    Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor ... can give you a trusting, ongoing relationship with one medical professional over time. You can choose from ...

  15. Ecosystem services provided by waterbirds.

    PubMed

    Green, Andy J; Elmberg, Johan

    2014-02-01

    Ecosystem services are ecosystem processes that directly or indirectly benefit human well-being. There has been much recent literature identifying different services and the communities and species that provide them. This is a vital first step towards management and maintenance of these services. In this review, we specifically address the waterbirds, which play key functional roles in many aquatic ecosystems, including as predators, herbivores and vectors of seeds, invertebrates and nutrients, although these roles have often been overlooked. Waterbirds can maintain the diversity of other organisms, control pests, be effective bioindicators of ecological conditions, and act as sentinels of potential disease outbreaks. They also provide important provisioning (meat, feathers, eggs, etc.) and cultural services to both indigenous and westernized societies. We identify key gaps in the understanding of ecosystem services provided by waterbirds and areas for future research required to clarify their functional role in ecosystems and the services they provide. We consider how the economic value of these services could be calculated, giving some examples. Such valuation will provide powerful arguments for waterbird conservation. PMID:23786594

  16. Ancillary Services Provided from DER

    SciTech Connect

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  17. Sensor Network Provides Environmental Data

    NASA Technical Reports Server (NTRS)

    2007-01-01

    The National Biocomputation Center, a joint partnership between the Stanford University School of Medicine's Department of Surgery and NASA's Ames Research Center, is the test bed for much of NASA's research in telemedicine, the remote delivery of medical care. In early 2005, researchers at the National Biocomputation Center formed a spinoff company, Intelesense Technologies, to use the telemedicine sensors to provide integrated global monitoring systems. Intelesense uses the systems to better understand how environments and people are linked, monitor and protect natural resources, predict and adapt to environmental changes, provide for sustainable development, reduce the costs and impacts of natural disasters, and provide an effective and intelligent response to such disasters. Current projects range from protecting the environment to tracking emerging infectious diseases like avian influenza (bird flu) and helping people from around the world connect and interact with each other to better understand their environment and themselves.

  18. Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

    PubMed Central

    2011-01-01

    Background Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions. Methods This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology. Results A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection. Conclusions Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring

  19. Mentor Program Provides STEM Options

    ERIC Educational Resources Information Center

    Abdul-alim, Jamaal

    2011-01-01

    The ACE Mentor Program provides early career exposure, mentoring, and scholarships to high school students in an attempt to encourage them to enter one of the three fields that make up the ACE acronym: (1) architecture; (2) construction; and (3) engineering. Founded in 1993 by longtime engineering consultant Charles Thornton, the program is…

  20. Providing Data to Your Board.

    ERIC Educational Resources Information Center

    Dawson, Linda J.

    2002-01-01

    Describes four principles to guide superintendents' presentation of data to their schools boards: Insist the board establish districtwide goals for student achievement; assist the board in receiving customized training on analyzing data related to student-outcome goals; insist the board adopt a code-of-conduct policy on data use; and provide data…

  1. Twitter for travel medicine providers.

    PubMed

    Mills, Deborah J; Kohl, Sarah E

    2016-03-01

    Travel medicine practitioners, perhaps more so than medical practitioners working in other areas of medicine, require a constant flow of information to stay up-to-date, and provide best practice information and care to their patients. Many travel medicine providers are unaware of the popularity and potential of the Twitter platform. Twitter use among our travellers, as well as by physicians and health providers, is growing exponentially. There is a rapidly expanding body of published literature on this information tool. This review provides a brief overview of the ways Twitter is being used by health practitioners, the advantages that are peculiar to Twitter as a platform of social media, and how the interested practitioner can get started. Some key points about the dark side of Twitter are highlighted, as well as the potential benefits of using Twitter as a way to disseminate accurate medical information to the public. This article will help readers develop an increased understanding of Twitter as a tool for extracting useful facts and insights from the ever increasing volume of health information. PMID:26988200

  2. Providing Career Counseling to Lesbian Women.

    ERIC Educational Resources Information Center

    McVannel, Martha Erwin

    The literature on career counseling and lesbian women was reviewed resulting in the identification of 10 maxims regarding providing career counseling to lesbian women. The maxims are as follows: (1) sexual orientation is essential information when providing career counseling; (2) it is important that the workplace be lesbian-affirming; (3) lesbian…

  3. Strengthening patient-provider relationships.

    PubMed

    Wilkinson, Connie Rasmussen; Williams, Marjory

    2002-01-01

    In support of the Veterans Health Administration commitment to the promotion of shared decision-making between providers and patients, this study investigated the relationship between the provision of a patient appointment guidebook, designed to promote and support patient participation in the health care visit, and patient perceptions of primary care visit effectiveness. This study compared perceptions among 277 randomly selected patients randomly assigned to one of two groups. Patients assigned to an intervention group received a patient appointment guidebook along with the standard appointment reminder letter prior to the scheduled routine visit. Patients assigned to a control group received only the standard appointment reminder letter. Patient perceptions were assessed with a follow-up questionnaire designed to measure patient agreement with six statements pertaining to primary care visit effectiveness. No significant differences were noted in the proportion of patients in the two groups that agreed with any of the six statements pertaining to primary care visit effectiveness. Significant differences were noted, however, in the proportion of patients in the groups who received preventive health care interventions of influenza vaccination, pneumococcal vaccination, and gender-specific cancer screening. Approximately 37% of the patients in the intervention group provided positive comments about the patient appointment guidebook, while only 7% provided negative comments. Although statistically inconclusive, the narrative comments indicate that a patient appointment guidebook may assist veterans in preparing for primary care appointments. The lack of significant difference between the two groups on the measures of primary care visit effectiveness may be due, in part, to positive perceptions among the sample in general, as reflected by high levels of agreement and predominantly positive comments for both control and intervention groups. PMID:12048339

  4. Data Service Provider Cost Estimation Tool

    NASA Technical Reports Server (NTRS)

    Fontaine, Kathy; Hunolt, Greg; Booth, Arthur L.; Banks, Mel

    2011-01-01

    The Data Service Provider Cost Estimation Tool (CET) and Comparables Database (CDB) package provides to NASA s Earth Science Enterprise (ESE) the ability to estimate the full range of year-by-year lifecycle cost estimates for the implementation and operation of data service providers required by ESE to support its science and applications programs. The CET can make estimates dealing with staffing costs, supplies, facility costs, network services, hardware and maintenance, commercial off-the-shelf (COTS) software licenses, software development and sustaining engineering, and the changes in costs that result from changes in workload. Data Service Providers may be stand-alone or embedded in flight projects, field campaigns, research or applications projects, or other activities. The CET and CDB package employs a cost-estimation-by-analogy approach. It is based on a new, general data service provider reference model that provides a framework for construction of a database by describing existing data service providers that are analogs (or comparables) to planned, new ESE data service providers. The CET implements the staff effort and cost estimation algorithms that access the CDB and generates the lifecycle cost estimate for a new data services provider. This data creates a common basis for an ESE proposal evaluator for considering projected data service provider costs.

  5. Bayes Analysis Provides Evidence of Pathogenicity for the BRCA1 c.135-1G>T (IVS3-1) and BRCA2 c.7977-1G>C (IVS17-1) Variants Displaying In Vitro Splicing Results of Equivocal Clinical Significance

    PubMed Central

    Spurdle, Amanda B.; Lakhani, Sunil R.; Da Silva, Leonard M.; Balleine, Rosemary L.; Investigators, kConFab; Goldgar, David E.

    2009-01-01

    Although in vitro splicing assays can provide useful information about the clinical interpretation of sequence variants in high-risk cancer genes such as BRCA1 and BRCA2, results can sometimes be difficult to interpret. The BRCA1 c.135-1G>T (IVS3-1G>T) variant has been shown to give rise to an in-frame deletion of exon 5 (BRCA1 c.135_212del) that is predicted to encode 26 amino acids. BRCA2 c.7977-1G>C (IVS17-1G>C) was shown to increase the expression of two naturally occurring transcripts that contain frameshifts (BRCA2, c.7977_8311del (exon 18 deletion); BRCA2, c.7806_8331del (exon 17&18 deletion)). In this study we conducted multifactorial likelihood analysis to evaluate the clinical significance of these two variants, including assessing variant segregation in families by Bayes analysis, and breast tumor pathology features suggestive of positive mutation status. Multifactorial analysis provided strong evidence for causality for both of these variants. The Bayes scores from a single family with BRCA1 c.135-1G>T was 9528:1, and incorporation of pathology features gave an overall likelihood of causality of 28108:1. The Bayes scores from five informative families with BRCA2 c.7977-1G>C was 47401:1, and the combined Bayes-pathology odds of causality was 29389:1. Multifactorial likelihood analysis indicates that the BRCA1 c.135-1G>T and BRCA2 c.7977-1G>C variants are disease-associated mutations which should be managed clinically in the same fashion as classical truncating mutations. PMID:20020529

  6. Knudsen Gas Provides Nanobubble Stability

    NASA Astrophysics Data System (ADS)

    Seddon, James R. T.; Zandvliet, Harold J. W.; Lohse, Detlef

    2011-09-01

    We provide a model for the remarkable stability of surface nanobubbles to bulk dissolution. The key to the solution is that the gas in a nanobubble is of Knudsen type. This leads to the generation of a bulk liquid flow which effectively forces the diffusive gas to remain local. Our model predicts the presence of a vertical water jet immediately above a nanobubble, with an estimated speed of ˜3.3m/s, in good agreement with our experimental atomic force microscopy measurement of ˜2.7m/s. In addition, our model also predicts an upper bound for the size of nanobubbles, which is consistent with the available experimental data.

  7. Perspectives from Marketing Internship Providers

    ERIC Educational Resources Information Center

    Swanson, Scott R.; Tomkovick, Chuck

    2011-01-01

    Internship research published in marketing and business education journals primarily examine student perspectives about internships or reports results based on other business disciplines. To more accurately understand how employers perceive marketing interns and internships, 352 managers located in the Midwestern United States were surveyed.…

  8. Actors: From Audience to Provider

    ERIC Educational Resources Information Center

    Charlier, Bernadette

    2011-01-01

    This article describes and analyzes actors' experiences of distance learning systems in a wide variety of cultural and organizational contexts. In line with the project of this special series of issues, results of research, much of which is longitudinal, allow us to suggest answers to the following questions: Who are the actors of distance…

  9. PROVIDING OPPORTUNITIES FOR DISADVANTAGED CHILDREN.

    ERIC Educational Resources Information Center

    POTTS, ALFRED M.; AND OTHERS

    THE TERM "DISADVANTAGED" IS USED TO REPRESENT ENVIRONMENTS THAT ARE INADEQUATE FOR A FULL LIFE. INCLUDED WOULD BE GROUPS IDENTIFIED AS MIGRANTS, LINGUALLY DISADVANTAGED, CULTURALLY DEPRIVED, AND EDUCATIONALLY DISADVANTAGED. A CULTURALLY DISADVANTAGED CHILD IS UNABLE TO CONFORM TO PRESENT GROUP EXPECTANCIES. THIS WORKSHOP REPORT IS THE RESULT OF…

  10. Concussion management by primary care providers

    PubMed Central

    Pleacher, M D; Dexter, W W

    2006-01-01

    Objective To assess current concussion management practices of primary care providers. Methods An 11 item questionnaire was mailed to primary care providers in the state of Maine, with serial mailings to non‐respondents. Results Over 50% of the questionnaires were completed, with nearly 70% of primary care providers indicating that they routinely use published guidelines as a tool in managing patients with concussion. Nearly two thirds of providers were aware that neuropsychological tests could be used, but only 16% had access to such tests within a week of injury. Conclusions Primary care providers are using published concussion management guidelines with high frequency, but many are unable to access neuropsychological testing when it is required. PMID:16371479

  11. Providing global WLCG transfer monitoring

    NASA Astrophysics Data System (ADS)

    Andreeva, J.; Dieguez Arias, D.; Campana, S.; Flix, J.; Keeble, O.; Magini, N.; Molnar, Z.; Oleynik, D.; Petrosyan, A.; Ro, G.; Saiz, P.; Salichos, M.; Tuckett, D.; Uzhinsky, A.; Wildish, T.

    2012-12-01

    The WLCG[1] Transfers Dashboard is a monitoring system which aims to provide a global view of WLCG data transfers and to reduce redundancy in monitoring tasks performed by the LHC experiments. The system is designed to work transparently across LHC experiments and across the various technologies used for data transfer. Currently each LHC experiment monitors data transfers via experiment-specific systems but the overall cross-experiment picture is missing. Even for data transfers handled by FTS, which is used by 3 LHC experiments, monitoring tasks such as aggregation of FTS transfer statistics or estimation of transfer latencies are performed by every experiment separately. These tasks could be performed once, centrally, and then served to all experiments via a well-defined set of APIs. In the design and development of the new system, experience accumulated by the LHC experiments in the data management monitoring area is taken into account and a considerable part of the code of the ATLAS DDM Dashboard is being re-used. The paper describes the architecture of the Global Transfer monitoring system, the implementation of its components and the first prototype.

  12. Environmental standards provide competitive advantage

    SciTech Connect

    Chynoweth, E.; Kirshner, E.

    1993-04-28

    Quality organizations are breaking new ground with the development of international standards for environmental management. These promise to provide the platform for chemical companies wanting to establish their environmental credibility with a global audience. [open quotes]It will be similar to auditing our customers to ISO 9000[close quote], says the environmental manager for a European chemical firm. [open quote]We will only want to deal with people who have got their environmental act together. And we'll be in a better competitive positions[close quote]. The International Organization for Standardization (ISO;Geneva) has set up a taskforce to develop an environmental management standard, which is expected to be completed by the mid-1990s. Observers think the ISO standard will draw heavily on the British Standard Institute's (BSI;London) environmental management standard, BS7750, which will likely be the first system adopted in the world. Published last year, BS7750 has been extensively piloted in the UK (CW, Sept. 30, 1992, p. 62) and is now set to be revised before being offically adopted by BSI. The UK's Chemical Industries Association (CIA;London) is anxious to prevent a proliferation of standards, and its report on BS7750 pilot projects calls for an approach integrating quality, environment, and health and safety. But standard setters, including ISO, appear to be moving in the opposite direction. In the US, the American national Standards Institute (ANSI;Washington) has started work on an environmental management standard.

  13. Computerized provider order entry systems.

    PubMed

    2001-01-01

    Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use. PMID:11696968

  14. Determinants of feeling hindered by health problems in daily living at 60 years and above.

    PubMed

    Fagerström, Cecilia; Persson, Helen; Holst, Göran; Hallberg, Ingalill R

    2008-09-01

    Although the ability to perform activities of daily living (ADL) is frequently used to identify the impact on daily living caused by health problems such as diseases, impaired eyesight or hearing, it is still not well known what makes people feel hindered in daily living with more or less inability to perform ADL. The aim of this study was to investigate feeling hindered by health problems in daily living among people (n = 958, 60-96 years) in relation to ADL capacity, health problems as well as social and financial resources, sense of coherence and life satisfaction. The data are taken from a baseline survey in one of the four included centres (Blekinge) of the longitudinal multicentre cohort study, The Swedish National Study on Aging and Care. The result showed that people felt hindered by their health problems despite no impairment in ADL capacity. Feeling greatly hindered by health problems was associated with factors linked to mobility but also to fatigue, no help when needed, and avoiding being outdoors due to fear of falling. Factors associated with feeling greatly hindered differed depending on whether people were impaired in ADL capacity or not. In people with excellent ADL capacity feeling hindered was associated with picking up things from the floor and rising from a chair and fatigue, whereas avoiding being outdoors, no help when needed and rising from a chair were found to be associated with feeling hindered by health problems among people with impaired ADL capacity. Combining people's ADL capacity with questions about feeling hindered may provide knowledge of determinant factors of feeling hindered in relation to ADL capacity, impaired or not, to identify people in need of rehabilitation or other interventions. PMID:18840225

  15. Organizational culture associated with provider satisfaction

    PubMed Central

    Scammon, Debra L.; Tabler, Jennifer; Brunisholz, Kimberly; Gren, Lisa H.; Kim, Jaewhan; Tomoaia-Cotisel, Andrada; Day, Julie; Farrell, Timothy W.; Waitzman, Norman J.; Magill, Michael K.

    2014-01-01

    Objectives Assess 1) provider satisfaction with specific elements of PCMH; 2) clinic organizational cultures; 3) associations between provider satisfaction and clinic culture. Methods Cross sectional study with surveys conducted in 2011 with providers and staff in 10 primary care clinics implementing their version of a PCMH: Care by Design™. Measures included the Organizational Culture Assessment Instrument (OCAI) and the American Medical Group Association provider satisfaction survey. Results Providers were most satisfied with quality of care (M=4.14; scale=1–5) and interactions with patients (M=4.12) and least satisfied with time spent working (M=3.47), paper work (M =3.45) and compensation (M=3.35). Culture profiles differed across clinics with family/clan and hierarchical the most common. Significant correlations (p ≤ 0.05) between provider satisfaction and clinic culture archetypes included: family/clan negatively correlated with administrative work; entrepreneurial positively correlated with the Time Spent Working dimension; market/rational positively correlated with how practices were facing economic and strategic challenges; and hierarchical negatively correlated with Relationships with Staff and Resource dimensions. Discussion Provider satisfaction is an important metric for assessing experiences with features of a PCMH model. Conclusions Identification of clinic-specific culture archetypes and archetype associations with provider satisfaction can help inform practice redesign. Attention to effective methods for changing organizational culture is recommended. PMID:24610184

  16. Do Dogs Provide Information Helpfully?

    PubMed Central

    Piotti, Patrizia; Kaminski, Juliane

    2016-01-01

    Dogs are particularly skilful during communicative interactions with humans. Dogs’ abilities to use human communicative cues in cooperative contexts outcompete those of other species, and might be the result of selection pressures during domestication. Dogs also produce signals to direct the attention of humans towards outside entities, a behaviour often referred to as showing behaviour. This showing behaviour in dogs is thought to be something dogs use intentionally and referentially. However, there is currently no evidence that dogs communicate helpfully, i.e. to inform an ignorant human about a target that is of interest to the human but not to the dog. Communicating with a helpful motive is particularly interesting because it might suggest that dogs understand the human’s goals and need for information. In study 1, we assessed whether dogs would abandon an object that they find interesting in favour of an object useful for their human partner, a random novel distractor, or an empty container. Results showed that it was mainly self-interest that was driving the dogs’ behaviour. The dogs mainly directed their behaviour towards the object they had an interest in, but dogs were more persistent when showing the object relevant to the human, suggesting that to some extent they took the humans interest into account. Another possibility is that dogs’ behaviour was driven by an egocentric motivation to interact with novel targets and that the dogs’ neophila might have masked their helpful tendencies. Therefore, in study 2 the dogs had initial access to both objects, and were expected to indicate only one (relevant or distractor). The human partner interacted with the dog using vocal communication in half of the trials, and remaining silent in the other half. Dogs from both experimental groups, i.e. indicating the relevant object or indicating the distractor, established joint attention with the human. However, the human’s vocal communication and the presence

  17. Chemical analyses of provided samples

    NASA Technical Reports Server (NTRS)

    Becker, Christopher H.

    1993-01-01

    Two batches of samples were received and chemical analysis was performed of the surface and near surface regions of the samples by the surface analysis by laser ionization (SALI) method. The samples included four one-inch optics and several paint samples. The analyses emphasized surface contamination or modification. In these studies, pulsed sputtering by 7 keV Ar+ and primarily single-photon ionization (SPI) by coherent 118 nm radiation (at approximately 5 x 10(exp 5) W/cm(sup 2) were used. For two of the samples, also multiphoton ionization (MPI) at 266 nm (approximately 5 x 10(exp 11) W/cm(sup 2) was used. Most notable among the results was the silicone contamination on Mg2 mirror 28-92, and that the Long Duration Exposure Facility (LDEF) paint sample had been enriched in K and Na and depleted in Zn, Si, B, and organic compounds relative to the control paint.

  18. Clandestine abortion in Latin America: provider perspectives.

    PubMed

    Rodriguez, K; Strickler, J

    1999-01-01

    This paper presents the results of in-depth interviews with ten clandestine abortion providers in urban Latin America. Three related issues are addressed: how abortion providers come to this line of work; their major difficulties; and their sources of job satisfaction. A variety of paths bring health professionals to the practice of abortion; common elements are a sense of calling, a desire to help women, personal experience with abortion, and a commitment to political change. Providers describe difficulties that include a lack of medical support, the need for secrecy, and threats of violence, extortion, and prosecution. In spite of difficulties, all providers report a great deal of fulfillment in their work, based on their satisfaction in saving women's lives, maintaining supportive relationships with colleagues, and empowering women. PMID:10374808

  19. Germany Provides Higher Education without the Frills

    ERIC Educational Resources Information Center

    Labi, Aisha

    2009-01-01

    In Germany, tuition is low because state governments shoulder a much higher percentage of university budgets than in the United States. As a result, most German universities provide far fewer amenities and services, and require their professors to teach longer hours to larger numbers of students than their American counterparts. Because they are…

  20. Promoting wellness of peer providers through coaching.

    PubMed

    Brice, George H; Swarbrick, Margaret A; Gill, Kenneth J

    2014-01-01

    Peer wellness coaching is workforce innovation that empowers individuals with mental and substance use disorders to achieve recovery. This article briefly describes how this approach can help peer providers develop self-care skills to improve job tenure and promote satisfaction. Promising results of this new approach are presented. PMID:24102840

  1. Obstetric Provider Maldistribution: Georgia, USA, 2011.

    PubMed

    Spelke, Bridget; Zertuche, Adrienne D; Rochat, Roger

    2016-07-01

    Objectives In 2010, Georgia had the nation's highest maternal mortality rate, sixteenth highest infant mortality rate, and a waning obstetrician/gynecologist (ob/gyn) workforce. Statewide ob/gyn workforce data, however, masked obstetric-specific care shortages and regional variation in obstetric services. The Georgia Maternal and Infant Health Research Group thereby assessed each Georgia region's obstetric provider workforce to identify service-deficient areas. Methods We identified 63 birthing facilities in the 82 Primary Care Service Areas (PCSAs) outside metropolitan Atlanta and interviewed nurse managers and others to assess the age, sex, and expected departure year of each delivering professional. Using accepted annual delivery rates of 155 per obstetrician (OB), 100 per certified nurse midwife (CNM), and 70 per family medicine physician (FP) we converted obstetric providers into "OB equivalents" to standardize obstetric services available in any given area. Using facility births and computed OB equivalents (contemporary and 2020 estimates), we calculated current and projected average annual births per provider (AABP) for each PCSA, categorizing its obstetric provider workforce as "adequate" (AABP < 144), "at risk" (144 ≤ AABP ≤ 166), or "deficient" (AABP > 166). We mapped results using ArcGIS. Results Of 82 surveyed PCSAs, 52 % (43) were deficient in obstetric care; 16 % (13) had a shortage and 37 % (30) lacked obstetric providers entirely. There were no delivering FPs in 89 % (73) of PCSAs and no CNMs in 70 % (56). If Georgia fails to recruit delivering providers, 72 % (58/77) of PCSAs will have deficient or no obstetric care by 2020. Conclusions Obstetric provider shortages in Georgia hinder access to prenatal and delivery services. Care-deficient areas will expand if recruitment and retention of delivering professionals does not improve. PMID:27084367

  2. Do guns provide safety? At what cost?

    PubMed

    Narang, Puneet; Paladugu, Anubha; Manda, Sainath Reddy; Smock, William; Gosnay, Cynthia; Lippmann, Steven

    2010-02-01

    Many people feel that having a gun provides greater safety for them and their family. Actually, having a firearm in the home escalates the risk for death or injury, while using it to shoot someone who endangers the household is much less common. The resultant injuries, deaths, emotional turmoil, and/or disabilities lead to greater utilization of health care and legal/police services. Payment for these expenses is provided by higher insurance premiums and tax rates. This financial aspect has become a part of our country's current political concern over firearm ownership rights, gun violence or regulation, health care costs, the economy, and taxes. PMID:20065902

  3. NASA's EOSDIS: options for data providers

    NASA Astrophysics Data System (ADS)

    Khalsa, Siri J.; Ujhazy, John E.

    1995-12-01

    EOSDIS, the data and information system being developed by NASA to support interdisciplinary earth science research into the 21st century, will do more than manage and distribute data from EOS-era satellites. It will also promote the exchange of data, tools, and research results across disciplinary, agency, and national boundaries. This paper describes the options that data providers will have for interacting with the EOSDIS Core System (ECS), the infrastructure of EOSDIS. The options include: using the ECS advertising service to announce the availability of data at the provider's site; submitting a candidate data set to one of the Distributed Active Archive Centers (DAACs); establishing a data server that will make the data accessible via ECS and establishing Local Information Manager (LIM) which would make the data available for multi-site searches. One additional option is through custom gateway interfaces which would provide access to existing data archives. The gateway, data server, and LIM options require the implementation of ECS code at the provider site to insure proper protocols. The advertisement and ingest options require no part of ECS design to reside at the provider site.

  4. Outpatient provider concentration and commercial colonoscopy prices.

    PubMed

    Pozen, Alexis

    2015-01-01

    The objective was to evaluate the magnitude of various contributors to outpatient commercial colonoscopy prices, including market- and provider-level factors, especially market share. We used adjudicated fee-for-service facility claims from a large commercial insurer for colonoscopies occurring in hospital outpatient department or ambulatory surgery center from October 2005 to December 2012. Claims were matched to provider- and market-level data. Linear fixed effects regressions of negotiated colonoscopy price were run on provider, system, and market characteristics. Markets were defined as counties. There were 178,433 claims from 169 providers (104 systems). The mean system market share was 76% (SD = 0.34) and the mean real (deflated) price was US$1363 (SD = 374), ranging from US$169 to US$2748. For every percentage point increase in a system or individual facility's bed share, relative price increased by 2 to 4 percentage points; this result was stable across a number of specifications. Market population and price were also consistently positively related, though this relation was small in magnitude. No other factor explained price as strongly as market share. Price variation for colonoscopy was driven primarily by market share, of particular concern as the number of mergers increases in wake of the recession and the Affordable Care Act. Whether variation is justified by better quality care requires further research to determine whether quality is subsumed in prices. PMID:25870183

  5. [Reembursing health-care service provider networks].

    PubMed

    Binder, A; Braun, G E

    2015-03-01

    Health-care service provider networks are regarded as an important instrument to overcome the widely criticised fragmentation and sectoral partition of the German health-care system. The first part of this paper incorporates health-care service provider networks in the field of health-care research. The system theoretical model and basic functions of health-care research are used for this purpose. Furthermore already established areas of health-care research with strong relations to health-care service provider networks are listed. The second part of this paper introduces some innovative options for reimbursing health-care service provider networks which can be regarded as some results of network-oriented health-care research. The origins are virtual budgets currently used in part to reimburse integrated care according to §§ 140a ff. SGB V. Describing and evaluating this model leads to real budgets (capitation) - a reimbursement scheme repeatedly demanded by SVR-Gesundheit (German governmental health-care advisory board), for example, however barely implemented. As a final step a direct reimbursement of networks by the German sickness fund is discussed. Advantages and challenges are shown. The development of the different reimbursement schemes is partially based on models from the USA. PMID:25625796

  6. [Violent acts against health care providers].

    PubMed

    Irinyi, Tamás; Németh, Anikó

    2016-07-01

    Violence against health care providers is getting more awareness nowadays. These are usually deliberate actions committed by patients or family members of them resulting in short and long term physical or psychological debilitating harm in the staff members. The causes of the violent acts are usually rooted in patient-related factors, although some characteristics of the professionals and of the workplace may also play some role. The present article presents different definitions of violence and possible reasons for violence against health care providers based on relevant international and national literature. The paper discusses the different forms and frequency of violence, furthermore, details about the effects, consequences and some options for prevention in health care settings are also included. Orv. Hetil., 2016, 157(28), 1105-1109. PMID:27397422

  7. Research Results

    NASA Astrophysics Data System (ADS)

    2011-12-01

    Research on Global Carbon Emission and Sequestration NSFC Funded Project Made Significant Progress in Quantum Dynamics Functional Human Blood Protein Obtained from Rice How Giant Pandas Thrive on a Bamboo Diet New Evidence of Interpersonal Violence from 129,000 Years Ago Found in China Aptamer-Mediated Efficient Capture and Release of T Lymphocytes on Nanostructured Surfaces BGI Study Results on Resequencing 50 Accessions of Rice Cast New Light on Molecular Breeding BGI Reports Study Results on Frequent Mutation of Genes Encoding UMPP Components in Kidney Cancer Research on Habitat Shift Promoting Species Diversification

  8. Research Results

    NASA Astrophysics Data System (ADS)

    2010-10-01

    Relations found between human memories and similar neural patterns Double Star Program Received the IAA Laurels for Team Achievement Award Prof. Piao's Review Paper Published in Nature Arsenic Trioxide Controls the Fate of the PML-RARα Oncoprotein by Directly Binding PML Setdb2 restricts dorsal organizer territory and regulates left-right asymmetry through suppressing fgf8 activity Short-range scattering in quantum dots Single-molecule magnets may find their use in microelectronics β-Arrestin1 Regulates Zebrafish Hematopoiesis through Binding to YY1 and Relieving Polycomb Group Repression Studies shown gene present and absent complementation may contribute to the heterosis of maize Low frequency genetic variation may determine complex diseases Cation-π interaction playing vital roles in the regulation of integrin affinity, signaling, and biological functions Soybean diversity map may provide important basis for breeding Mutations related to Alzheimer's and rare skin disease

  9. Providing Situational Awareness for Pipeline Control Operations

    NASA Astrophysics Data System (ADS)

    Butts, Jonathan; Kleinhans, Hugo; Chandia, Rodrigo; Papa, Mauricio; Shenoi, Sujeet

    A SCADA system for a single 3,000-mile-long strand of oil or gas pipeline may employ several thousand field devices to measure process parameters and operate equipment. Because of the vital tasks performed by these sensors and actuators, pipeline operators need accurate and timely information about their status and integrity. This paper describes a realtime scanner that provides situational awareness about SCADA devices and control operations. The scanner, with the assistance of lightweight, distributed sensors, analyzes SCADA network traffic, verifies the operational status and integrity of field devices, and identifies anomalous activity. Experimental results obtained using real pipeline control traffic demonstrate the utility of the scanner in industrial settings.

  10. Nerve agents: implications for anesthesia providers.

    PubMed

    Hrobak, Paula Kay

    2008-04-01

    Anesthesia providers may be called to treat injuries from chemical weapons or spills, for which prompt treatment is vital. It is therefore important to understand the mechanism of action of nerve agents and the resultant pathophysiology and to be able to quickly recognize the signs and symptoms of nerve agent exposure. This review article addresses the different types of nerve agents that are currently being manufactured as well as the symptomatic and definitive treatment of the patient who presents with acute nerve agent toxicity. This article also reviews the physiology of the neuromuscular junction and the autonomic nervous system receptors that nerve agent toxicity affects. PMID:18478812

  11. DONUT results

    SciTech Connect

    Furukawa, Tomoko

    2008-02-21

    The DONUT experiment succeeded in observing tau-neutrino CC interactions for the first time in 2000. The analysis using total sample is presented in this paper, based on 3.5x10{sup 17} protons on target. The number of identified {nu}{sub {tau}} CC interactions is 9 from 581 neutrino interactions located in the emulsion. The result of the first measurement of {nu}{sub {tau}} CC cross section is consistent with the expectation from the Standard Model.

  12. Main factors providing specificity of repair enzymes.

    PubMed

    Nevinsky, G A

    2011-01-01

    Specific and nonspecific DNA complex formation with human uracil-DNA glycosylase, 8-oxoguanine-DNA glycosylase, and apurine/apyrimidine endonuclease, as well as with E. coli 8-oxoguanine-DNA glycosylase and RecA protein was analyzed using the method of stepwise increase in DNA-ligand complexity. It is shown that high affinity of these enzymes to any DNA (10(-4)-10(-8) M) is provided by a large number of weak additive contacts mainly with DNA internucleoside phosphate groups and in a less degree with bases of nucleotide links "covered" by protein globules. Enzyme interactions with specific DNA links are comparable in efficiency with weak unspecific contacts and provide only for one-two orders of affinity (10(-1)-10(-2) M), but these contacts are extremely important at stages of DNA and enzyme structural adaptation and catalysis proper. Only in the case of specific DNA individual for each enzyme alterations in DNA structure provide for efficient adjustment of reacting enzyme atoms and DNA orbitals with accuracy up to 10-15° and, as a result, for high reaction rate. Upon transition from nonspecific to specific DNA, reaction rate (k(cat)) increases by 4-8 orders of magnitude. Thus, stages of DNA and enzyme structural adaptation as well as catalysis proper are the basis of specificity of repair enzymes. PMID:21568843

  13. Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? Results of the START (Self-Titration With Apidra to Reach Target) Study: a randomized noninferiority trial.

    PubMed

    Harris, Stewart B; Yale, Jean-François; Berard, Lori; Stewart, John; Abbaszadeh, Babak; Webster-Bogaert, Susan; Gerstein, Hertzel C

    2014-01-01

    OBJECTIVE Diabetes self-management is universally regarded as a foundation of diabetes care. We determined whether comparable glycemic control could be achieved by self-titration versus physician titration of a once-daily bolus insulin dose in patients with type 2 diabetes who are unable to achieve optimal glycemia control with a basal insulin. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes, an HbA1c level >7% (53 mmol/mol), and either nocturnal hypoglycemia episodes or an insufficient basal insulin glargine level (with or without oral agents) to achieve a fasting plasma glucose level ≤6 mmol/L (108 mg/dL) were studied. Participants all had bolus insulin glulisine added at breakfast and were allocated to either algorithm-guided patient self-titration or physician titration. The primary outcome was an HbA1c level ≤7% (53 mmol/mol) without severe hypoglycemia. RESULTS After a mean (SD) follow-up of 159.4 days (36.2 days), 28.4% of participants in the self-titration arm vs. 21.2% in the physician titration arm achieved an HbA1c level of ≤7% (53 mmol/mol) without severe hypoglycemia (between-group absolute difference 7.2%; 95% CI -3.2 to 17.7). The lower end of this 95% confidence interval was within the predetermined noninferiority boundary of -5% (P noninferiority = 0.011). CONCLUSIONS In stable patients with type 2 diabetes who are receiving doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-managed titration algorithm is as effective as a physician-managed algorithm. PMID:24170757

  14. Could magnetic resonance provide in vivo histology?

    PubMed Central

    Dominietto, Marco; Rudin, Markus

    2014-01-01

    The diagnosis of a suspected tumor lesion faces two basic problems: detection and identification of the specific type of tumor. Radiological techniques are commonly used for the detection and localization of solid tumors. Prerequisite is a high intrinsic or enhanced contrast between normal and neoplastic tissue. Identification of the tumor type is still based on histological analysis. The result depends critically on the sampling sites, which given the inherent heterogeneity of tumors, constitutes a major limitation. Non-invasive in vivo imaging might overcome this limitation providing comprehensive three-dimensional morphological, physiological, and metabolic information as well as the possibility for longitudinal studies. In this context, magnetic resonance based techniques are quite attractive since offer at the same time high spatial resolution, unique soft tissue contrast, good temporal resolution to study dynamic processes and high chemical specificity. The goal of this paper is to review the role of magnetic resonance techniques in characterizing tumor tissue in vivo both at morphological and physiological levels. The first part of this review covers methods, which provide information on specific aspects of tumor phenotypes, considered as indicators of malignancy. These comprise measurements of the inflammatory status, neo-vascular physiology, acidosis, tumor oxygenation, and metabolism together with tissue morphology. Even if the spatial resolution is not sufficient to characterize the tumor phenotype at a cellular level, this multiparametric information might potentially be used for classification of tumors. The second part discusses mathematical tools, which allow characterizing tissue based on the acquired three-dimensional data set. In particular, methods addressing tumor heterogeneity will be highlighted. Finally, we address the potential and limitation of using MRI as a tool to provide in vivo tissue characterization. PMID:24454320

  15. NAP (davunetide) provides functional and structural neuroprotection.

    PubMed

    Gozes, Illana

    2011-01-01

    NAP (davunetide) is an eight amino acid peptide (NAPVSIPQ) that has been shown to provide potent neuroprotection, in vitro and in vivo. In human clinical trials, NAP has been shown to increase memory scores in patients suffering from amnestic mild cognitive impairment, a precursor to Alzheimer's disease and to enhance functional daily behaviors in schizophrenia patients. NAP is derived from activity-dependent neuroprotective protein (ADNP) a molecule that is essential for brain formation, interacting with chromatin associated protein alpha and the chromatin remodeling complex SWI/SNF and regulating >400 genes during embryonic development. Partial loss in ADNP results in cognitive deficits and pathology of the microtubule associated protein tau (tauopathy) that is ameliorated in part by NAP replacement therapy. Recent studies increased the scope of NAP neuroprotection and provided further insights into the NAP mechanisms of action. Thus, it has been hypothesized that the presence of tau on axonal microtubules renders them notably less sensitive to the microtubule-severing protein katanin, and NAP was shown to protect microtubules from katanin disruption in the face of reduced tau expression. Parallel studies showed that NAP reduced the number of apoptotic neurons through activation of PI-3K/Akt pathway in the cortical plate or both PI-3K/Akt and MAPK/MEK1 kinases in the white matter. The interaction of these disparate yet complementary pathways is the subject of future studies toward human brain neuroprotection in the clinical scenario. PMID:21524250

  16. The Family Day Care Providers' Legal Handbook.

    ERIC Educational Resources Information Center

    Treadwell, Lujuana Wolfe

    Designed specifically for family day care providers in Alameda County, California, this handbook provides legal and business advice thought to be useful as well to providers throughout the United States. A wide range of legal and business issues is covered in 15 brief chapters. Advice is offered on provider-parent contracts, planning for accidents…

  17. Multicultural Nursing: Providing Better Employee Care.

    PubMed

    Rittle, Chad

    2015-12-01

    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided. PMID:26199294

  18. Providing better indoor environmental quality brings economicbenefits

    SciTech Connect

    Fisk, William; Seppanen, Olli

    2007-06-01

    This paper summarizes the current scientific evidence that improved indoor environmental quality can improve work performance and health. The review indicates that work and school work performance is affected by indoor temperature and ventilation rate. Pollutant source removal can sometimes improve work performance. Based on formal statistical analyses of existing research results, quantitative relationships are provided for the linkages of work performance with indoor temperature and outdoor air ventilation rate. The review also indicates that improved health and related financial savings are obtainable from reduced indoor tobacco smoking, prevention and remediation of building dampness, and increased ventilation. Example cost-benefit analyses indicate that many measures to improve indoor temperature control and increase ventilation rates will be highly cost effective, with benefit-cost ratios as high as 80 and annual economic benefits as high as $700 per person.

  19. Novel antifungal drugs against fungal pathogens: do they provide promising results for treatment?

    PubMed

    Gedik, Habip; Şimşek, Funda; Yıldırmak, Taner; Kantürk, Arzu; Arıca, Deniz; Aydın, Demet; Demirel, Naciye; Yokuş, Osman

    2015-06-01

    The febrile neutropenia episodes of hematological patients and their outcomes were evaluated with respect to fungal pathogens and antifungal therapy in this retrospective study. All patients, who were older than 14 years of age and developed at least one neutropenic episode after chemotherapy due to hematological cancer from November 2010 to November 2012, were included into the study. We retrospectively collected demographic, treatment, and survival data of 126 patients with neutropenia and their 282 febrile episodes. The mean Multinational Association for Supportive Care in Cancer score was 17.18 ± 8.27. Systemic antifungal drugs were initiated in 22 patients with 30 culture-proven invasive fungal infections (IFIs), 25 attacks of 19 patients with probable invasive pulmonary aspergillosis (IPA), 42 attacks of 38 patients with possible IPA, and 31 attacks of 30 patients with suspected IFI. Voriconazole (VOR), caspofungin and liposomal amphotericin B were used to treat 72 episodes of 65 patients, 45 episodes of 37 patients and 34 episodes of 32 patients as a first-line therapy, respectively. Unfavorable conditions of our hematology ward are thought to increase the number of cases with invasive pulmonary aspergillosis and VOR use. It should be taken into consideration that increased systemic and per oral VOR usage predisposes patients to colonization and infection with azole-resistant fungal strains. Catheters should be removed in cases where patients' conditions are convenient to remove it. Acute myeloblastic leukemia cases that are more likely to develop invasive fungal infections should be monitored closely for early diagnosis and timely initiation of antifungal drugs which directly correlates with survival rates. PMID:25825558

  20. Aacrao Survey Results: Campuses Provide Supportive Environments for Gay, Lesbian, Bisexual, Transgender (GLBT) Community

    ERIC Educational Resources Information Center

    Journal of American College Health, 2005

    2005-01-01

    A questionnaire about the campus environment for the gay, lesbian, bisexual, and transgendered (GLBT)community yielded responses from 411 institutions in 2003. The findings showed that 382 colleges and universities included sexual orientation in their nondiscrimination policies, up from 347 institutions two years earlier. About 85 percent of the…

  1. Test Results Provide Data Useful to Educators Planning to Improve Schools.

    ERIC Educational Resources Information Center

    Lapointe, Archie

    1987-01-01

    Reviews the range of data gathered by the National Assessment of Educational Progress in 1984 concerning the reading and writing levels of 11th-graders. Discusses observable trends, differences between white and minority student scores, student perceptions about their reading and writing skills, and implications of the data for educational…

  2. ADVANCED PROTEOMICS AND BIOINFORMATICS TOOLS IN TOXICOLOGY RESEARCH: OVERCOMING CHALLENGES TO PROVIDE SIGNIFICANT RESULTS

    EPA Science Inventory

    This presentation specifically addresses the advantages and limitations of state of the art gel, protein arrays and peptide-based labeling proteomic approaches to assess the effects of a suite of model T4 inhibitors on the thyroid axis of Xenopus laevis.

  3. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    ERIC Educational Resources Information Center

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  4. Implementation Challenges and Results

    ERIC Educational Resources Information Center

    Walters, Kirk; Sorensen, Nicholas

    2013-01-01

    This paper describes the implementation of the online and f2f summer algebra courses that were delivered in summers 2011 and 2012. These data will be used to frame the impact results presented in an earlier paper. In particular, the paper will provide a detailed picture of how the online course was structured and the types of supports provided to…

  5. Discussing Diabetes with Your Healthcare Provider

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Diabetes Discussing Diabetes with Your Healthcare Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider ...

  6. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

  7. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

  8. How Do Health Care Providers Diagnose Hypoparathyroidism?

    MedlinePlus

    ... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

  9. Efficient Provider Authentication for Bidirectional Broadcasting Service

    NASA Astrophysics Data System (ADS)

    Ohtake, Go; Hanaoka, Goichiro; Ogawa, Kazuto

    Provider authentication is necessary in bidirectional broadcasting services, and a digital signature scheme is often used to prevent an adversary from attempting impersonation. The cost of secure signing key management is extremely high. In addition, the key has to be updated very often, since it is frequently used. The result is that the verification key also has to be updated very often, and its redistribution cost is huge. These costs are real and substantive problems, especially when the number of users is large. In this paper, we propose a system that dramatically reduces these costs. In the system, the signing key is updated, but the corresponding verification key does not have to be updated. This means that the signing key can be updated without any cost for redistributing the verification key and that the system is secure against the threat of signing key leakage, since the key can be frequently updated. Moreover, we propose a new key management method that divides a conventional key management server's role into two. The use of a key-insulated signature (KIS) scheme enables low-cost and more secure key management with two servers. Finally, to make a bidirectional broadcasting service more secure even if the signing key is leaked, we developed a new strong KIS scheme. We performed an experiment that assessed the cost of our strong KIS scheme and found that it is sufficiently low. Accordingly, a provider authentication system employing this scheme would be more efficient and would have lower key redistribution and network costs in comparison with conventional authentication systems.

  10. CSRQ Center Report on Education Service Providers

    ERIC Educational Resources Information Center

    American Institutes for Research, 2006

    2006-01-01

    This consumer guide, for the first time ever, provides comparative ratings on the effectiveness and quality of seven widely adopted Education Service Providers (ESPs)--nonprofit or for-profit organizations that contract with new or existing public, charter, or private schools and/or school districts to provide comprehensive services. This report…

  11. 5 CFR 890.910 - Provider information.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Provider information. 890.910 Section 890.910 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS..., and FEHB Benefit Payments § 890.910 Provider information. The hospital provider information used...

  12. Provider-Independent Use of the Cloud

    NASA Astrophysics Data System (ADS)

    Harmer, Terence; Wright, Peter; Cunningham, Christina; Perrott, Ron

    Utility computing offers researchers and businesses the potential of significant cost-savings, making it possible for them to match the cost of their computing and storage to their demand for such resources. A utility compute provider enables the purchase of compute infrastructures on-demand; when a user requires computing resources a provider will provision a resource for them and charge them only for their period of use of that resource. There has been a significant growth in the number of cloud computing resource providers and each has a different resource usage model, application process and application programming interface (API)-developing generic multi-resource provider applications is thus difficult and time consuming. We have developed an abstraction layer that provides a single resource usage model, user authentication model and API for compute providers that enables cloud-provider neutral applications to be developed. In this paper we outline the issues in using external resource providers, give examples of using a number of the most popular cloud providers and provide examples of developing provider neutral applications. In addition, we discuss the development of the API to create a generic provisioning model based on a common architecture for cloud computing providers.

  13. 47 CFR 54.1003 - Provider eligibility.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Provider eligibility. 54.1003 Section 54.1003 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Mobility Fund § 54.1003 Provider eligibility. (a) Except as provided in § 54.1004, an applicant shall be an...

  14. Suspension System Provides Independent Translation And Rotation

    NASA Technical Reports Server (NTRS)

    Heeg, Jennifer

    1994-01-01

    Spring suspension provides one translational and one rotational degree of freedom. Suspension used to provide for pitching and plunging movements of airfoil in wind tunnel. Translational freedom provided by two thin, flat steel spring tines, clamped at one end to stationary block fixed to ceiling of wind tunnel, and clamped to movable block at other end.

  15. Group Family Day Care Provider Handbook

    ERIC Educational Resources Information Center

    New York State Office of Children and Family Services, 2006

    2006-01-01

    Group family day care providers need to create high-quality programs where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the group family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care providers:…

  16. Vugs Provide Clues to Martian Past

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This image, taken by the microscopic imager on the Mars Exploration Rover Opportunity, illustrates the shapes of the vugs, or small cavities, located on the region dubbed 'El Capitan.' The region is part of the rock outcrop at Meridiani Planum, Mars, which the rover is currently examining.

    The image provides insight into the nature of the rock matrix -- the rock material surrounding the vugs. Several vugs have disk-like shapes with wide midpoints and tapered ends. This feature is consistent with sulfate minerals that crystallize within a rock matrix, either pushing the matrix grains aside or replacing them. These crystals are then either dissolved in water or eroded by wind activity to produce vugs.

    The rock matrix here exhibits a granular texture, delicately enhanced through wind abrasion. The primary sediment particles making up this granular layer are relatively uniform in size, ranging up to 1 millimeter (.04 inches). Note that some of these grains are well rounded, which could result from transport of rock fragments in air or water, or precipitation of mineral grains in water.

  17. Providing R-Tree Support for Mongodb

    NASA Astrophysics Data System (ADS)

    Xiang, Longgang; Shao, Xiaotian; Wang, Dehao

    2016-06-01

    Supporting large amounts of spatial data is a significant characteristic of modern databases. However, unlike some mature relational databases, such as Oracle and PostgreSQL, most of current burgeoning NoSQL databases are not well designed for storing geospatial data, which is becoming increasingly important in various fields. In this paper, we propose a novel method to provide R-tree index, as well as corresponding spatial range query and nearest neighbour query functions, for MongoDB, one of the most prevalent NoSQL databases. First, after in-depth analysis of MongoDB's features, we devise an efficient tabular document structure which flattens R-tree index into MongoDB collections. Further, relevant mechanisms of R-tree operations are issued, and then we discuss in detail how to integrate R-tree into MongoDB. Finally, we present the experimental results which show that our proposed method out-performs the built-in spatial index of MongoDB. Our research will greatly facilitate big data management issues with MongoDB in a variety of geospatial information applications.

  18. Providing smoking cessation programs to homeless youth: the perspective of service providers.

    PubMed

    Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

    2014-10-01

    There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. PMID:25012554

  19. Provider documentation of patient education: a lean investigation*

    PubMed Central

    Shipman, Jean P.; Lake, Erica W.; Van Der Volgen, Jessica; Doman, Darrin

    2016-01-01

    Purpose The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements. Methods Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers. Conclusions Providers' EHR skills and knowledge levels contribute to non-standardized patient education delivery. PMID:27076805

  20. Vehicle Technologies Program Results

    SciTech Connect

    2009-06-19

    The Vehicle Technologies Program's progress is closely monitored by both internal and external organizations. The Program's results are detailed in a wide range of documents and tools that can be accessed through the PIR website. Descriptions of these materials are provided on this program results page.

  1. Enhancing genomic laboratory reports: A qualitative analysis of provider review.

    PubMed

    Williams, Janet L; Rahm, Alanna Kulchak; Stuckey, Heather; Green, Jamie; Feldman, Lynn; Zallen, Doris T; Bonhag, Michele; Segal, Michael M; Fan, Audrey L; Williams, Marc S

    2016-05-01

    This study reports on the responses of physicians who reviewed provider and patient versions of a genomic laboratory report designed to communicate results of whole genome sequencing. Semi-structured interviews addressed concept communication, elements, and format of example genome reports. Analysis of the coded transcripts resulted in recognition of three constructs around communication of genome sequencing results: (1) Providers agreed that whole genomic sequencing results are complex and they welcomed a report that provided supportive interpretation information to accompany sequencing results; (2) Providers strongly endorsed a report that included active clinical guidance, such as reference to practice guidelines, if available; and (3) Providers valued the genomic report as a resource that would serve as the basis to facilitate communication of genome sequencing results with their patients and families. Providers valued both versions of the report, though they affirmed the need for a provider-oriented report. Critical elements of the report included clear language to explain the result, as well as consolidated yet comprehensive prognostic information with clear guidance over time for the clinical care of the patient. Most importantly, it appears a report with this design has the potential not only to return results but also serves as a communication tool to help providers and patients discuss and coordinate care over time. © 2016 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals, Inc. PMID:26842872

  2. Browsing for the Best Internet Access Provider?

    ERIC Educational Resources Information Center

    Weil, Marty

    1996-01-01

    Highlights points to consider when choosing an Internet Service Provider. Serial Line Internet Protocol (SLIP) and Point to Point Protocol (PPP) are compared regarding price, performance, bandwidth, speed, and technical support. Obtaining access via local, national, consumer online, and telephone-company providers is discussed. A pricing chart and…

  3. Family Day Care Provider Support Services Directory.

    ERIC Educational Resources Information Center

    Galblum, Trudi W.; Boyer-Shesol, Cathy

    This directory profiles numerous organizational support services for family day care providers in the Kansas City metropolitan area. The first chapter, on operating a family day care home, concerns licensing and registration, the processes of starting and marketing a day care business, zoning and municipal regulation, and substitute providers. The…

  4. 24 CFR 206.203 - Providing information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Providing information. 206.203... HOME EQUITY CONVERSION MORTGAGE INSURANCE Servicing Responsibilities § 206.203 Providing information...) and (b) of this chapter pertaining to loan information to mortgagors shall also be applicable...

  5. 24 CFR 203.508 - Providing information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Providing information. 203.508... information. (a) Mortgagees shall provide loan information to mortgagors and arrange for individual loan... responses to inquiries. One or more of the following means of making information readily available...

  6. 24 CFR 235.1001 - Providing information.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Providing information. 235.1001 Section 235.1001 Housing and Urban Development Regulations Relating to Housing and Urban Development... Responsibilities-Homes for Lower Income Families § 235.1001 Providing information. The statement of interest...

  7. Identifying Mentors' Observations for Providing Feedback

    ERIC Educational Resources Information Center

    Hudson, Peter

    2016-01-01

    Mentors' feedback can assist preservice teachers' development; yet feedback tends to be variable from one mentor to the next. What do mentors observe for providing feedback? In this study, 24 mentors observed a final-year preservice teacher through a professionally video-recorded lesson and provided written notes for feedback. They observed the…

  8. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  9. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 7 2014-10-01 2014-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  10. The Children's Home: Providing Services with Options

    ERIC Educational Resources Information Center

    Weaver, Robin

    2007-01-01

    This article describes how The Children's Home of Pittsburgh provides unique, specialized services for infants, children, and their families and seeks to improve not only the range of services available to these special patients, but also the way in which those services are provided. Their innovative healthcare programs have been developed in…

  11. 42 CFR 441.565 - Provider qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Provider qualifications. 441.565 Section 441.565 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... right to train attendant care providers in the specific areas of attendant care needed by the...

  12. 42 CFR 441.565 - Provider qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Provider qualifications. 441.565 Section 441.565 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... right to train attendant care providers in the specific areas of attendant care needed by the...

  13. 42 CFR 441.565 - Provider qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Provider qualifications. 441.565 Section 441.565 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... right to train attendant care providers in the specific areas of attendant care needed by the...

  14. Resources for the Family Day Care Provider.

    ERIC Educational Resources Information Center

    Brown, Jeanne, Ed.; And Others

    The 34 brief articles in this sourcebook for family day care providers are presented mainly in two large sections: (1) management of family day care business, and (2) interaction with children. Many of these articles pose and provide answers to questions that are likely to occur to child caregivers, such as "Does the IRS really expect me to keep…

  15. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Provider qualifications. 410.134 Section 410.134 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage...

  16. Provider Services Network Project. Draft Final Report.

    ERIC Educational Resources Information Center

    Urban and Rural Systems Associates, San Francisco, CA.

    This draft report on the development and testing of a child care Provider Services Network (PSN) model in Santa Clara County, California, includes a handbook (Manual to Optimize a PSN) designed to provide the State Department of Education and regional or local child care coordinating agencies with information needed to develop PSN optimization…

  17. Discussing Diabetes with Your Healthcare Provider

    MedlinePlus

    ... Provider Past Issues / Fall 2009 Table of Contents Diabetes Medicines—Always Discuss Them with Your Healthcare Provider If ... NIHSeniorHealth: Diabetes http://nihseniorhealth.gov/diabetes/toc.html Weekly email updates: MEDLINEPLUS-DIABETES: Subscribe from https://list. ...

  18. Adverse effects of prohibiting narrow provider networks.

    PubMed

    Howard, David H

    2014-08-14

    Many insurers participating in the new insurance exchanges are controlling costs by offering plans with narrow provider networks. Proposed regulations would promote network adequacy, but a pro-provider stance may not be inherently pro-consumer or even pro-patient. PMID:25119604

  19. 48 CFR 5145.303 - Providing material.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 7 2012-10-01 2012-10-01 false Providing material. 5145... REGULATIONS GOVERNMENT PROPERTY 5145.303 Providing material. (S-90) Existing Government material on hand or... contractors if it is determined to be in the best interest of the Government per FAR 45.303-1. If the...

  20. Health Care Provider Initiative Strategic Plan

    ERIC Educational Resources Information Center

    National Environmental Education & Training Foundation, 2012

    2012-01-01

    This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

  1. Learning Providers' Work with Neet Young People

    ERIC Educational Resources Information Center

    Beck, Vanessa

    2015-01-01

    This article investigates the impact of the relationship between learning providers and young people who have experienced Not being in Education, Employment or Training (NEET) on the latters' agency development. Agency is defined as not only bounded but generated by intra-action with relations of force, including learning providers themselves.…

  2. Optimizing Provider Recruitment for Influenza Surveillance Networks

    PubMed Central

    Scarpino, Samuel V.; Dimitrov, Nedialko B.; Meyers, Lauren Ancel

    2012-01-01

    The increasingly complex and rapid transmission dynamics of many infectious diseases necessitates the use of new, more advanced methods for surveillance, early detection, and decision-making. Here, we demonstrate that a new method for optimizing surveillance networks can improve the quality of epidemiological information produced by typical provider-based networks. Using past surveillance and Internet search data, it determines the precise locations where providers should be enrolled. When applied to redesigning the provider-based, influenza-like-illness surveillance network (ILINet) for the state of Texas, the method identifies networks that are expected to significantly outperform the existing network with far fewer providers. This optimized network avoids informational redundancies and is thereby more effective than networks designed by conventional methods and a recently published algorithm based on maximizing population coverage. We show further that Google Flu Trends data, when incorporated into a network as a virtual provider, can enhance but not replace traditional surveillance methods. PMID:22511860

  3. Preceptor development: providing effective feedback, part 2.

    PubMed

    Buck, Brian; Wilkinson, Samaneh T; Phillips, Holly

    2014-06-01

    An integral part of providing effective feedback to pharmacy residents occurs during the evaluation process. Residency evaluation involves measuring and documenting performance as it relates to standardized residency outcomes, goals, and learning objectives. Evaluations may be formative or summative and include the preceptor's evaluation of the resident's performance, the resident's self-assessments, and the resident's evaluation of the preceptor and learning experience. Evaluations are more structured than feedback, and they involve documentation of the verbal feedback that was provided throughout the learning experience. This article will focus on the preceptor's role in providing effective resident evaluations based on specific learning activities. PMID:24958969

  4. ED navigators steer patients to appropriate providers.

    PubMed

    2012-03-01

    At Presbyterian Healthcare Services in Albuquerque, NM, emergency department navigators refer patients with minor ailments to primary care providers or urgent care centers. All patients are triaged by nurse in ED. - Appropriate patients are sent to the hospital's Lean Track area where they are evaluated by a physician or mid-level provider. - Patients who can safely be treated in 12-24 hours are referred to the navigator, who obtains an appointment for them with a primary care provider or urgent care center. PMID:22423392

  5. Compassion fatigue in pediatric palliative care providers.

    PubMed

    Rourke, Mary T

    2007-10-01

    The experience of compassion fatigue is an expected and common response to the professional task of routinely caring for children at the end of life. Symptoms of compassion fatigue often mimic trauma reactions. Implementing strategies that span personal, professional, and organizational domains can help protect health care providers from the damaging effects of compassion fatigue. Providing pediatric palliative care within a constructive and supportive team can help caregivers deal with the relational challenges of compassion fatigue. Finally, any consideration of the toll of providing pediatric palliative care must be balanced with a consideration of the parallel experience of compassion satisfaction. PMID:17933615

  6. Functional Status Assessment of COPD Based on Ability to Perform Daily Living Activities: A Systematic Review of Paper and Pencil Instruments

    PubMed Central

    Monjazebi, Fateme; Dalvandi, Asghar; Ebadi, Abbas; Khankeh, Hamid Reza; Rahgozar, Mahdi; Richter, Jörg

    2016-01-01

    Context: Activity of daily living (ADL) is an important predictor of mortality in patients with chronic obstructive pulmonary disease (COPD). Increasing ADL is important in patients with COPD and assessment of ADL is one of the best ways to evaluate the status of COPD patients. Objectives: The objective of this systematic review was to provide an overview of the psychometric properties of paper and pencil instruments measuring ADL in patients with COPD. Data Sources: English papers published from 1980 to 2014 regarding ADL in patients with COPD were searched in Web of Science, MEDLINE, Google Scholar, Cochrane, PubMed, ProQuest, and CINAHL databases using the following keywords: “COPD”, “ADL”, “activities of daily living”, “daily activities”, “instrument”, “questionnaire”, “paper-and-pencil instruments”, and “measure”. Following the Internet search, manual search was also done to find article references. Study Selection: A total of 186 articles were found. Of those, 31 met the inclusion criteria. Full texts of articles meeting the inclusion criteria were studied. Consensus-based standards for the selection of health measurement instruments”(COSMIN) were used to assess the quality of the studies. Data Extraction: Data extraction form based on research aims developed by researchers and psychometric experts, with 17 questions was used. Results: In these articles, 14 pen and paper instruments were identified for examining ADL in patients with COPD; of which, 4 dealt directly with ADL while 9 assessed other criteria i.e. dyspnea as ADL indicator. The majority of instruments only dealt with two main dimensions of ADL: Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL), and did not consider Advanced Activities of Daily Living (AADL), which is influenced by cultural and motivational factors. Conclusion: Despite several ADL instruments identified, complete psychometric processes have only been done in

  7. Price transparency for MRIs increased use of less costly providers and triggered provider competition.

    PubMed

    Wu, Sze-jung; Sylwestrzak, Gosia; Shah, Christiane; DeVries, Andrea

    2014-08-01

    To encourage patients to select high-value providers, an insurer-initiated price transparency program that focused on elective advanced imaging procedures was implemented. Patients having at least one outpatient magnetic resonance imaging (MRI) scan in 2010 or 2012 were divided according to their membership in commercial health plans participating in the program (the intervention group) or in nonparticipating commercial health plans (the reference group) in similar US geographic regions. Patients in the intervention group were informed of price differences among available MRI facilities and given the option of selecting different providers. For those patients, the program resulted in a $220 cost reduction (18.7 percent) per test and a decrease in use of hospital-based facilities from 53 percent in 2010 to 45 percent in 2012. Price variation between hospital and nonhospital facilities for the intervention group was reduced by 30 percent after implementation. Nonparticipating members residing in intervention areas also observed price reductions, which indicates increased price competition among providers. The program significantly reduced imaging costs. This suggests that patients select lower-price facilities when informed about available alternatives. PMID:25092841

  8. Functional Improvement Among Short-Stay Nursing Home Residents in the MDS 3.0

    PubMed Central

    Wysocki, Andrea; Thomas, Kali S.; Mor, Vincent

    2015-01-01

    Objectives To examine the completeness of the activities of daily living (ADL) items on admission and discharge assessments and the improvement in ADL performance among short-stay residents in the newly adopted Minimum Data Set (MDS) 3.0. Design Retrospective analysis of MDS admission and discharge assessments. Setting Nursing homes from July 1, 2011, to June 30, 2012. Participants New nursing home residents admitted from acute hospitals with corresponding admission and discharge assessments between July 1, 2011, and June 30, 2012, who had a length of stay of 100 days or less. Measurements ADL self-performance items, including bed mobility, transfer, walking in room, walking in corridor, locomotion on unit, locomotion off unit, dressing, eating, toilet use, and personal hygiene, at admission and discharge. Results The ADL self-performance items are complete at both admission and discharge, with less than 1% missing for any item. More than 60% of residents improved over the course of their post-acute stay. New short-stay nursing home residents with conditions such as cognitive impairment, delirium, dementia, heart failure, and stroke showed less improvement in ADL performance during their stay. Conclusion The discharge assessment data in the MDS 3.0 provide new information to researchers and providers to examine and track ADL performance. Nursing homes can identify and track patients who require more intensive therapies or targeted interventions to achieve functional improvement during their stay. Future research can examine facility-level measures to better understand how ADL improvement varies across facilities. PMID:25659622

  9. NASA Provides Assistance to Trapped Chilean Miners

    NASA Video Gallery

    Responding to a request received through the U.S. Department of State from the Chilean minister of health, NASA will provide advice in nutritional and behavioral sciences to assist miners trapped a...

  10. 75 FR 48273 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-10

    ... provider (TSP) provisions under the Food Security Act of 1985. This document correctly amends those... rule published in the Federal Register of Friday, February 12, 2010 (75 FR 6839). In that document,...

  11. Mounting for diodes provides efficient heat sink

    NASA Technical Reports Server (NTRS)

    1964-01-01

    Efficient heat sink is provided by soldering diodes to metal support bars which are brazed to a ceramic base. Electrical connections between diodes on adjacent bars are made flexible by metal strips which aid in heat dissipation.

  12. Network planning from telecom provider's perspective

    NASA Astrophysics Data System (ADS)

    Zhou, Minli; Chen, Ziqing

    2005-11-01

    The network planner of the incumbent telecom service provider faces a series of challenges following technology developments, riding demand changes and utilizing existing resources. It is believed that the telecom planning that was started from the early time for PSTN deployment has been contributed to the foundation for the telecom planning but does not provide enough methodologies to help today's planning activities. The planning work for the provider must make innovation for adapting to the dynamic environment and supporting business development. In this paper, the situations and trends faced by the telecom service provider are first reviewed, the planning system restructure and planning methodologies innovation for meeting present situations are then presented, and the issues and directions are finally summarized.

  13. Are physicians obligated to provide preventive services?

    PubMed

    Belcher, D W

    1990-01-01

    Preventive care is considered a benefit to the patient. Physicians express a positive attitude towards prevention, but their performance of recommended activities is low, as shown in a five-year trial at the Seattle VA Medical Center. The release of the U.S. Preventive Services Task Force's guide to clinical preventive services has provided physicians with authoritative prevention recommendations. While most physicians are specialists with little interest or skill in preventive care, primary care providers do accept an obligation to provide comprehensive care, including prevention. This paper examines the ethical basis for the idea of obligation. External pressures, legal, economic, and organizational, are affecting the physician-patient relationship in ways that encourage a contract mode of medical practice and limit physicians' ability to provide preventive care. As a profession, medicine needs to speak for the health needs of the public. As practitioners, physicians need to seek the welfare of their patients. PMID:2231049

  14. Capitated contracting of integrated health provider organizations.

    PubMed

    Bazzoli, G J; Dynan, L; Burns, L R

    This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on health plan risk contracting with health providers. PMID:10711318

  15. Hospital Providers: The Day After FDA Approval

    PubMed Central

    DeKoven, Mitchell; McCagh, Brian; Zoch, Jeremy

    2005-01-01

    Hospitals have a lot at stake when new biologic drugs and devices hit the market. Cooperation among medical and administrative leaders can help providers avoid some harrowing financial pitfalls – while improving patient satisfaction. PMID:23393477

  16. Soil chemical insights provided through vibrational spectroscopy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vibrational spectroscopy techniques provide a powerful approach to study environmental materials and processes. These multifunctional analysis tools can be used to probe molecular vibrations of solid, liquid, and gaseous samples for characterizing materials, elucidating reaction mechanisms, and exam...

  17. Concrete "Waffle" Provides Laser Beam Accuracy

    ERIC Educational Resources Information Center

    Building Design and Construction, 1978

    1978-01-01

    A massive concrete "waffle," riding on a bed of specially treated gravel and sand inside another building, provides the structural rigidity needed by the University of Rochester's Laboratory for Laser Energetics. (Author)

  18. Providers influence reporting policies, improve financial disclosure.

    PubMed

    Covaleski, M A; Dirsmith, M W

    1985-10-01

    Because of the healthcare provider's increased financial accountability to the public, it is important that healthcare organizations take a more active interest in improving the disclosure policies of their financial activities. To do so, these providers must understand existing reporting requirements, become more actively involved in influencing financial reporting policies, and develop relevant, forward looking information to be communicated to internal groups such as the board of directors and the finance committee. PMID:10273775

  19. Weight management practices among primary care providers.

    PubMed

    Timmerman, G M; Reifsnider, E; Allan, J D

    2000-04-01

    This pilot study examined how primary care providers manage patients with weight problems, an important component of primary care. A convenience sample of 17 nurse practitioners and 15 physicians were surveyed about assessments and interventions used in practice for weight management along with perceived barriers to providing effective weight management. Practice patterns between gender, profession and practice setting of the nurse practitioners were compared. PMID:11930414

  20. Resource measurement by health care providers.

    PubMed

    Suver, J D; Neumann, B R

    1986-01-01

    The need to use health care resources effectively and efficiently has led to increased interest in developing a "should cost" approach to performance measurement. The development of appropriate standards and the separation of fixed costs into surrogate variable and capacity components can provide a useful tool for managers to measure performance. This article develops a framework for evaluating the utilization of fixed costs in providing output. PMID:10280908

  1. Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas.

    PubMed

    Smulian, Elizabeth A; Zahedi, Leilah; Hurvitz, Julie; Talbot, Abigail; Williams, Audra; Julian, Zoë; Zertuche, Adrienne D; Rochat, Roger

    2016-07-01

    Objectives In Georgia, 52 % of the primary care service areas outside metropolitan Atlanta have a deficit of obstetric providers. This study was designed to identify factors associated with the likelihood of Georgia's obstetric trainees (obstetrics and gynecology (OB/GYN) residents and certified nurse midwifery (CNM) students) to practice in areas of Georgia that lack obstetric providers and services, i.e. rural Georgia. Methods Pilot-tested electronic and paper surveys were distributed to all of Georgia's OB/GYN residents (N = 95) and CNM students (N = 28). Mixed-methods survey questions assessed characteristics, attitudes, and incentives that might be associated with trainee desire to practice in areas of Georgia that lack obstetric providers and services. Surveys also gathered information about concerns that may prevent trainees from practicing in shortage areas. Univariate and bivariate analyses were performed, and qualitative themes were abstracted from open-ended questions. Results The survey response rate was 87.8 % (108/123). Overall, 24.4 % (19/78) of residents and 53.6 % (15/28) of CNM students expressed interest in practicing in rural Georgia, and both residents and CNM students were more likely to desire to practice in rural Georgia with the offer of any of six financial incentives (P < 0.001). Qualitative themes highlighted trainees' strong concerns about Georgia's political environment as it relates to reproductive healthcare. Conclusions Increasing state-level, rurally-focused financial incentive programs and emphasizing the role of CNMs may alleviate obstetric provider shortages in Georgia. PMID:27072048

  2. Predictors of Provider-Patient Visit Frequency During Hemodialysis

    PubMed Central

    Slinin, Yelena; Guo, Haifeng; Li, Suying; Liu, Jiannong; Morgan, Benjamin; Ensrud, Kristine; Gilbertson, David T.; Collins, Allan J.; Ishani, Areef

    2013-01-01

    Background/Aims In 2004, the Centers for Medicare & Medicaid Services tied reimbursement for outpatient hemodialysis services to number of times per month providers see their dialysis patients, resulting in increased provider-patient visit frequency. Greater provider-patient visit frequency is associated with lower hospitalization risk for hemodialysis patients. Determinants of visit frequency are uncertain. We aimed to identify patient, provider, and dialysis facility characteristics associated with provider visit frequency. Methods This retrospective cohort study used United States Renal Data System (USRDS) data for point-prevalent patients receiving in-center hemodialysis on January 1, 2006 (n = 144,860). Patient characteristics were defined January 1-June 30, 2006, and provider-patient visit frequency (< 4 vs. ≥ 4 visits/month) July 1-December 31, 2006. Patient characteristics were obtained from the USRDS. Provider data were obtained from the American Medical Association Physician Master File. We determined longitudinal associations between patient, provider, and facility characteristics and provider-patient visit frequency using logistic regression. Results Patient characteristics independently associated with greater provider-patient visit frequency included older age, African American race, longer dialysis duration, higher comorbidity score, Medicaid eligibility, urban residence, better compliance with dialysis, and more hospital days during run-in. Provider characteristics associated with greater provider-patient visit frequency included more years in practice, graduation from a foreign medical school, shorter distance between provider office and dialysis unit, and caring for more dialysis patients; facility characteristics included free-standing, independent status. Conclusion After the Medicare reimbursement policy change, several patient, provider, and facility characteristics were independently associated with greater dialysis provider-patient visit

  3. Emergency preparedness for home healthcare providers.

    PubMed

    Ruder, Shirley

    2012-06-01

    Unfortunately, disasters occur. We cannot always know the effects ahead of time, but we do know that lives can be lost, property damaged, and public health and home care agencies may not be able to provide the normal standard of care. Studies have shown that disaster preparedness content is limited in U.S. nursing programs (). Given the magnitude of recent natural disasters, such as the Japanese earthquake and tsunami in 2011, these findings are alarming. The increasing demands on healthcare providers in response to emergencies force home healthcare clinicians to identify their roles and responsibilities in emergency preparedness. This article discusses 1 model of disaster response and the role of the home healthcare provider at each stage. It further guides home healthcare nurses in creating a personal and professional plan, enabling them to understand how to minimize the impact of disasters and address the needs of their patients and those close to them. PMID:21987023

  4. Preceptor Development: Providing Effective Feedback, Part 2

    PubMed Central

    Wilkinson, Samaneh T.; Phillips, Holly

    2014-01-01

    Abstract An integral part of providing effective feedback to pharmacy residents occurs during the evaluation process. Residency evaluation involves measuring and documenting performance as it relates to standardized residency outcomes, goals, and learning objectives. Evaluations may be formative or summative and include the preceptor’s evaluation of the resident’s performance, the resident’s self-assessments, and the resident’s evaluation of the preceptor and learning experience. Evaluations are more structured than feedback, and they involve documentation of the verbal feedback that was provided throughout the learning experience. This article will focus on the preceptor’s role in providing effective resident evaluations based on specific learning activities. PMID:24958969

  5. Patients Provide Recommendations for Improving Patient Satisfaction.

    PubMed

    Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

    2016-04-01

    National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. PMID:27046182

  6. Care for the Health Care Provider.

    PubMed

    Kunin, Sharon Brown; Kanze, David Mitchell

    2016-03-01

    Pretravel care for the health care provider begins with an inventory, including the destination, length of stay, logistical arrangements, type of lodging, food and water supply, team members, personal medical needs, and the needs of the community to be treated. This inventory should be created and processed well in advance of the planned medical excursion. The key thing to remember in one's planning is to be a health care provider during one's global health care travel and not to become a patient oneself. This article will help demonstrate the medical requirements and recommendations for such planning. PMID:26900113

  7. 2010 Election Results

    NASA Astrophysics Data System (ADS)

    Bamzai, Anjuli; Robinson, Robert; Shirey, Steven

    2010-02-01

    On 3 February 2010, AGU members completed voting for Union and section officers and for directors for the newly approved Board of Directors. Access to voting was provided over the Internet for a period of 31 days. Paper ballots were available upon request. Voting results and analysis were prepared by AGU staff, with results certified by AGU's Tellers Committee on 4 February 2010. Voting was widespread throughout the global base of AGU members. The overall participation rate was 19.2%.

  8. Content and Quality of Information Provided on Canadian Dementia Websites

    PubMed Central

    Dillon, Whitney A.; Prorok, Jeanette C.; Seitz, Dallas P.

    2013-01-01

    Purpose Information about dementia is important for persons with dementia (PWD) and their caregivers and the Internet has become the key source of health information. We reviewed the content and quality of information provided on Canadian websites for Alzheimer’s disease (AD). Methods We used the terms “dementia” and “Alzheimer” in Google to identify Canadian dementia websites. The contents of websites were compared to 16 guideline recommendations provided in Canadian Consensus Conference on Diagnosis and Treatment of Dementia. The quality of information provided on websites was evaluated using the DISCERN instrument. The content and quality of information provided on selected websites were then described. Results Seven websites were identified, three of which provided relatively comprehensive and high-quality information on dementia. Websites frequently provided information about diagnosis of dementia, its natural course, and types of dementia, while other topics were less commonly addressed. The quality of information provided on the websites varied, and many websites had several areas where the quality of information provided was relatively low according to the DISCERN instrument. Conclusions There is variation in the content and quality of dementia websites, although some websites provide high-quality and relatively comprehensive information which would serve as a useful resource for PWD, caregivers, and healthcare providers. Improvements in the content and quality of information provided on AD websites would provide PWD and their caregivers with access to better information. PMID:23440180

  9. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

    PubMed Central

    Lazar, Jalana N.; Johnson-Agbakwu, Crista E.; Davis, Olga I.; Shipp, Michele P.-L.

    2013-01-01

    Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. PMID:24223041

  10. Providing Nursing Care Women and Babies Deserve.

    PubMed

    Ruhl, Catherine; Golub, Zola; Santa-Donato, Anne; Cockey, Carolyn Davis; Bingham, Debra

    2016-01-01

    Nursing Care Women and Babies Deserve describes the core habits of character, also called virtues, that nurses can strive to incorporate into their care of women and newborns. This commentary provides background on the development of Nursing Care Women and Babies Deserve, as well as inspiring examples of how nurses incorporate these virtues into their nursing practice. PMID:27067929

  11. An Immunization Education Program for Childcare Providers

    ERIC Educational Resources Information Center

    Hayney, Mary S.; Bartell, Julie C.

    2005-01-01

    The childhood immunization schedule includes at least 17 scheduled immunizations prior to the age of 24 months. Immunization laws require childcare centers to maintain immunization records and enforce immunization standards for children who attend these centers. Childcare providers generally receive little formal education about infectious…

  12. Lessons from VET Providers Delivering Degrees

    ERIC Educational Resources Information Center

    Callan, Victor J.; Bowman, Kaye

    2015-01-01

    This report is focused on the strategic, capability and operational reasons why traditional vocational education and training (VET) providers move to the delivery of higher education qualifications in their own right, in addition to their vocational qualifications. It is particularly interested in associate and bachelor degrees. By undertaking six…

  13. 75 FR 6839 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-12

    ... provider (TSP) provisions under the Food Security Act of 1985. The Food, Conservation, and Energy Act of... 652. NRCS published an interim final rule in the Federal Register on January 16, 2009 (74 FR 2800), to... practices or systems. On November 29, 2004, NRCS published a final rule (69 FR 69450) on TSP assistance...

  14. 42 CFR 438.214 - Provider selection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Provider selection. 438.214 Section 438.214 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure...

  15. Providence Sponsors Diocesan Teacher Recruiting Campaign.

    ERIC Educational Resources Information Center

    Dygert, William

    2001-01-01

    Addresses the issue of teacher recruitment in Providence, Rhode Island. Explains that the Catholic education staff designed a campaign that involved creating marketing materials, advertising in daily newspapers, and holding job fairs and open houses. Stresses the importance of promoting teaching at Catholic schools as both rewarding and…

  16. GEAR UP: Providing Opportunities or Conflict?

    ERIC Educational Resources Information Center

    Walsh, Rachael

    2008-01-01

    Since 1965 the federal government has attempted to provide low socioeconomic status students with equal access to postsecondary education through the Higher Education Act and its multiplicative programmatic efforts. Implemented as one such program in 1998, the Gaining Early Awareness and Readiness for Undergraduate Programs, or GEAR UP, has been…

  17. Understanding ecosystem services provided by rice fields

    Technology Transfer Automated Retrieval System (TEKTRAN)

    While the concept of ecosystem services is not new, there is revived interest in how these services should be measured, monitored, and valued. Focused research over the last four years has provided insight into the mitigation capabilities of rice fields in the lower Mississippi River Valley of the ...

  18. Higher Education as Child Care Provider.

    ERIC Educational Resources Information Center

    Everts, Joanne; And Others

    1993-01-01

    Discusses employer-sponsored child care, specifically on college and university campuses and briefly reviews history and status of campus children's centers. Describes campus child care provided at University of Nevada, Reno. Shows how important it is for institutions to develop a corporate culture that is truly family friendly. Proposes agenda…

  19. Districtwide System for Providing Individual Student Support

    ERIC Educational Resources Information Center

    Lewis-Palmer, Teri; Bounds, Monica; Sugai, George

    2004-01-01

    Although schools generally provide safe environments, teachers, staff, parents, and students are concerned with the rising level of disruptive, antisocial behavior (Horner, Sugai, Lewis-Palmer, & Todd, 2001). Only a relatively small number of students in a school building engage in the most serious and/or chronic problem behaviors. However, these…

  20. MEDICARE PROVIDER ANALYSIS AND REVIEW DATA (MEDPAR)

    EPA Science Inventory

    MEDPAR files contain information for 100% of Medicare beneficiaries using hospital inpatient services. Data is provided by state and then by Diagnosis Related Groups (DRGs) for all short stay and inpatient hospitals for fiscal years 1998-2000. The following fields are furnished: ...

  1. NUCLEAR REACTOR SLUG PROVIDED WITH THERMOCOUPLE

    DOEpatents

    Kanne, W.R.

    1958-10-14

    A temperature measuring apparatus is described for use in a reactor. In this invention a cylindrlcal fuel slug is provided with an axial bore in which is disposed a thermocouple. The lead wires extend to a remote indicating device which indicates the temperature in the fuel element measured by the thermocouple.

  2. Wholistic Health Care: Challenge to Health Providers.

    ERIC Educational Resources Information Center

    McKay, Susan

    1980-01-01

    Due to the increasing influence of the holistic health movement, health providers will increasingly be challenged to reexamine their roles in patient relationships, increase the extent of interdisciplinary teamwork, emphasize health education and positive health behaviors, examine the usefulness of various alternative therapies, and consider the…

  3. Providing Adaptivity in Moodle LMS Courses

    ERIC Educational Resources Information Center

    Despotovic-Zrakic, Marijana; Markovic, Aleksandar; Bogdanovic, Zorica; Barac, Dusan; Krco, Srdjan

    2012-01-01

    In this paper, we describe an approach to providing adaptivity in e-education courses. The primary goal of the paper is to enhance an existing e-education system, namely Moodle LMS, by developing a method for creating adaptive courses, and to compare its effectiveness with non-adaptive education approach. First, we defined the basic requirements…

  4. Providing for Different Rates of Music Learning.

    ERIC Educational Resources Information Center

    Beer, Alice S.; And Others

    1982-01-01

    Discusses ways that elementary music teachers can design class activities which will meet individual needs of mainstreamed special students. Activities described encompass a wide range of difficulty and provide opportunities for individualized, small-group or out-of-class instruction and for creative response. (AM)

  5. 78 FR 14034 - Health Insurance Providers Fee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-04

    ... applicable to student health insurance, see Student Health Insurance Coverage, 77 FR 16453, 16455-56 (March... definition of covered entity is also Sec. 2520.101-2(c)(2)(ii)(B) (RIN 1210-AB51). See 76 FR 76222. If and... Internal Revenue Service 26 CFR Part 57 RIN 1545-BL20 Health Insurance Providers Fee AGENCY:...

  6. Legislating for Private Providers: White Paper Dilemmas

    ERIC Educational Resources Information Center

    Evans, G. R.

    2011-01-01

    In November 2010, the British Government, modifying one of the proposals in the Browne Report published in October, decided to allow English universities to charge tuition fees of up to 9,000 British Pounds, while removing almost all the public funding previously provided in the form of a block grant. This had consequences the Government should…

  7. Providing a Learning-Centered Instructional Environment.

    ERIC Educational Resources Information Center

    Evans, Ruby

    This paper describes efforts made by the faculty at Santa Fe Community College (Florida) to provide a learning-centered instructional environment for students in an introductory statistics class. Innovation in instruction has been stressed as institutions switch from "teacher-centered classrooms" to "student-centered classrooms." The incorporation…

  8. MDP challenges from a software provider's perspective

    NASA Astrophysics Data System (ADS)

    Ohara, Shuichiro

    2014-10-01

    This industry faces new challenges every day. It gets tougher as process nodes shrink and the data complexity and volume increase. We are a mask data preparation (MDP) software provider, and have been providing MDP systems to mask shops since 1990. As the industry has, MDP software providers also have been facing new challenges over time, and the challenges get tougher as process nodes shrink and the data complexity and volume increase. We discuss such MDP challenges and solutions in this paper from a MDP software provider's perspective. The data volume continuously increases, and it is caused by shrinking the process node. In addition, resolution enhancement techniques (RET) such as optical proximity correction (OPC) and inverse lithography technique (ILT) induce data complexity, and it contributes considerably to the increase in data volume. The growth of data volume and complexity brings challenges to MDP system, such as the computing speed, shot count, and mask process correction (MPC). New tools (especially mask writers) also bring new challenges. Variable-shaped E-beam (VSB) mask writers demand fracturing less slivers and lower figure counts for CD accuracy and write time requirements respectively. Now multibeam mask writers are under development and will definitely bring new challenges.

  9. Providing Empowerment to the Person with AIDS.

    ERIC Educational Resources Information Center

    Haney, Patrick

    1988-01-01

    Describes author's experiences after his own diagnoses of Acquired Immune Deficiency Syndrome (AIDS) Related Complex (ARC) and AIDS itself. Discusses six ways for social workers to provide empowerment to persons with AIDS, which focus on the positive, the healing power of caring, reconnections, direction, victim mindset, and advocacy. (ABL)

  10. Air Systems Provide Life Support to Miners

    NASA Technical Reports Server (NTRS)

    2014-01-01

    Through a Space Act Agreement with Johnson Space Center, Paragon Space Development Corporation, of Tucson, Arizona, developed the Commercial Crew Transport-Air Revitalization System, designed to provide clean air for crewmembers on short-duration space flights. The technology is now being used to help save miners' lives in the event of an underground disaster.

  11. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional...

  12. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional...

  13. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional...

  14. Emergency Food Providers in Southern Illinois.

    ERIC Educational Resources Information Center

    O'Hara, Mary

    This paper examines emergency food provider networks in rural southern Illinois. An overview focuses on recent research reports on hunger in America, official federal emergency food assistance policy and criticisms of that policy, and the role of the private sector in emergency food distribution. The review details the disagreements on policy and…

  15. 75 FR 81832 - Technical Service Provider Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service 7 CFR Part 652 Technical Service Provider Assistance CFR Correction In Title 7 of the Code of Federal Regulations, Parts 400 to 699, revised as of Jan. 1, 2010, on...

  16. Modified algesimeter provides accurate depth measurements

    NASA Technical Reports Server (NTRS)

    Turner, D. P.

    1966-01-01

    Algesimeter which incorporates a standard sensory needle with a sensitive micrometer, measures needle point depth penetration in pain tolerance research. This algesimeter provides an inexpensive, precise instrument with assured validity of recordings in those biomedical areas with a requirement for repeated pain detection or ascertaining pain sensitivity.

  17. Providing Location Information for Colorado Library Resources.

    ERIC Educational Resources Information Center

    Pearson, Karl M., Jr.

    This report examines the feasibility of developing a Colorado statewide union data base to support cataloging, acquisitions, and interlibrary loan functions. It concludes that any data base developed should focus on providing location information for the state's library materials to support patron access to available resources. The title location…

  18. Expanding the School's Role as Care Provider.

    ERIC Educational Resources Information Center

    Baylor, Ellen C.; Snowden, Petra E.

    1992-01-01

    One elementary school located in a depressed area (Norfolk, Virginia) created a computerized service directory and referral system providing immediate, accurate information on available children's services. The principal or counselor accesses the database by indicating individual student characteristics, such as low achievement or family problems,…

  19. Estate Planning: Providing for Your Child's Future.

    ERIC Educational Resources Information Center

    Beyer, Henry A.

    1986-01-01

    Parents who wish their handicapped offspring to be financially provided for after their own deaths need to explore several ways of managing and distributing their assets, including: creating a will; disinheritance (to avoid loss of benefits; joint property and life insurance; and trusts and trustees. (CB)

  20. Providing Programs for the Gifted Handicapped.

    ERIC Educational Resources Information Center

    Maker, C. June

    The two-part text focuses on the provision of educational services for gifted handicapped students. Part I provides a discussion and analysis of principles, issues, and problems in the education of the gifted handicapped. Examined are problems of definition and identification, the development of a realistic self concept, and handicaps as…

  1. 44 CFR 206.393 - Providing assistance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Providing assistance. 206.393 Section 206.393 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Fire Suppression Assistance §...

  2. 44 CFR 206.393 - Providing assistance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Providing assistance. 206.393 Section 206.393 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE Fire Suppression Assistance §...

  3. Providing Access to Justice through Service Learning

    ERIC Educational Resources Information Center

    Kubichek, Mary

    2010-01-01

    In the Casper College Legal Service (CCLS) program, Casper College paralegal students, under supervision of pro bono attorneys, use paralegal skills to provide legal services and work product. CCLS is different from other legal clinics; it is not law school based, bar based, or court based. CCLS is paralegal based.

  4. Lamp modulator provides signal magnitude indication

    NASA Technical Reports Server (NTRS)

    Zeman, J. R.

    1970-01-01

    Lamp modulator provides visible indication of presence and magnitude of an audio signal carrying voice or data. It can be made to reflect signal variations of up to 32 decibels. Lamp life is increased by use of a bypass resistor to prevent filament failure.

  5. Training To Provide for Healthy Rural Aging.

    ERIC Educational Resources Information Center

    Troisi, Joseph

    2001-01-01

    Most of the world's rapidly expanding aging population is in rural areas of developing countries. Geriatric training programs should include social, economic, and psychological aspects of aging as well as medical, and should focus on enabling primary health caregivers to care for older people in their environments. Efforts to provide rural…

  6. 42 CFR 410.134 - Provider qualifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical Nutrition Therapy § 410.134 Provider qualifications. For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional...

  7. Creative Places: How RISD Invigorates Providence

    ERIC Educational Resources Information Center

    Mandle, Roger

    2005-01-01

    Institutions like Rhode Island School of Design (RISD) provide New England with cultural wealth in a variety of ways, including the great art and design housed in their museums and their vibrant faculty and student body, which numbers in RISD's case, 1,900 undergraduates and 375 graduate students from the United States and almost 50 countries.…

  8. Autism Screening Practices among Early Intervention Providers in Indiana

    ERIC Educational Resources Information Center

    Tomlin, Angela; Koch, Steven M; Raches, Christine; Minshawi, Noha F.; Swiezy, Naomi B.

    2013-01-01

    The purpose of this study was to identify current practices in autism spectrum disorder (ASD) screening among early intervention and care providers in Indiana. Participants were asked about their ASD screening practices within the context of overall screening for developmental delays. Results indicated that providers conduct ASD screening less…

  9. "If Only Someone Had Told Me ...": Lessons from Rural Providers

    ERIC Educational Resources Information Center

    Chipp, Cody; Dewane, Sarah; Brems, Christiane; Johnson, Mark E.; Warner, Teddy D.; Roberts, Laura W.

    2011-01-01

    Purpose: Health care providers face challenges in rural service delivery due to the unique circumstances of rural living. The intersection of rural living and health care challenges can create barriers to care that providers may not be trained to navigate, resulting in burnout and high turnover. Through the exploration of experienced rural…

  10. Recipient-Provider Agreement on Enacted Support, Perceived Support, and Provider Personality

    ERIC Educational Resources Information Center

    Cohen, Jay L.; Lakey, Brian; Tiell, Kathy; Neeley, Lynn C.

    2005-01-01

    This study examined agreement between recipients and providers about social support and personality. One hundred daughter caregivers of a parent with Alzheimer's disease and each caregiver's most important support provider independently reported supportive behaviors provided to caregivers, the perceived supportiveness of the provider, and…

  11. 28 CFR 58.27 - Automatic expiration of providers' status as approved providers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Automatic expiration of providers' status...) REGULATIONS RELATING TO THE BANKRUPTCY REFORM ACTS OF 1978 AND 1994 § 58.27 Automatic expiration of providers... approved provider immediately prior to the date it last obtained approval to be an approved provider,...

  12. 28 CFR 58.27 - Automatic expiration of providers' status as approved providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Automatic expiration of providers' status...) REGULATIONS RELATING TO THE BANKRUPTCY REFORM ACTS OF 1978 AND 1994 § 58.27 Automatic expiration of providers... approved provider immediately prior to the date it last obtained approval to be an approved provider,...

  13. Research and Practice Communications Between Oral Health Providers and Prenatal Health Providers: A Bibliometric Analysis.

    PubMed

    Skvoretz, John; Dyer, Karen; Daley, Ellen; Debate, Rita; Vamos, Cheryl; Kline, Nolan; Thompson, Erika

    2016-08-01

    Objectives We aimed to examine scholarly collaboration between oral health and prenatal providers. Oral disease is a silent epidemic with significant public health implications for pregnant women. Evidence linking poor oral health during pregnancy to adverse pregnancy and birth outcomes requires oral health and prenatal providers to communicate on the prevention, treatment and co-management matters pertaining to oral health issues among their pregnant patients. The need for inter-professional collaboration is highlighted by guidelines co-endorsed by the American College of Obstetricians and Gynecologists and the American Dental Association, stressing the importance of oral health care during pregnancy. Methods To assess if interdisciplinary communication occurs between oral health and prenatal disciplines, we conducted a network analysis of research on pregnancy-related periodontal disease. Results Social Network analysis allowed us to identify communication patterns between communities of oral health and prenatal professionals via scientific journals. Analysis of networks of citations linking journals in different fields reveals a core-periphery pattern dominated by oral health journals with some participation from medicine journals. However, an analysis of dyadic ties of citation reveals statistically significant "inbreeding" tendencies in the citation patterns: both medical and oral health journals tend to cite their own kind at greater-than-chance levels. Conclusions Despite evidence suggesting that professional collaboration benefits patients' overall health, findings from this research imply that little collaboration occurs between these two professional groups. More collaboration may be useful in addressing women's oral-systemic health concerns that result in adverse pregnancy outcomes. PMID:27029538

  14. Preconception care by the nonobstetrical provider.

    PubMed

    Frey, Keith A

    2002-05-01

    Clinicians who provide health care to women during their childbearing years have the opportunity to affect pregnancy outcomes positively through preconception care. The goal of preconception care is to identify medical and social conditions that may put the mother or fetus at risk. Key elements include screening for certain infectious diseases, obtaining genetic history, updating immunizations, providing specific nutritional advice, and optimizing health status. Some women, and their partners, may require additional care, including a prepregnancy consultation with an obstetrician or maternal-fetal medicine specialist. The clinician can also offer advice that may enhance conception and encourage either early prenatal care when a pregnancy is achieved or early evaluation for infertility. PMID:12004996

  15. SPACEWAY: Providing affordable and versatile communication solutions

    NASA Astrophysics Data System (ADS)

    Fitzpatrick, E. J.

    1995-08-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  16. SPACEWAY: Providing affordable and versatile communication solutions

    NASA Technical Reports Server (NTRS)

    Fitzpatrick, E. J.

    1995-01-01

    By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.

  17. Providing Real Research Opoportunities to Undergraduates

    NASA Astrophysics Data System (ADS)

    Ragozzine, Darin

    2016-01-01

    The current approach to undergraduate education focuses on teaching classes which provide the foundational knowledge for more applied experiences such as scientific research. Like most programs, Florida Institute of Technology (Florida Tech or FIT) strongly encourages undergraduate research, but is dominated by content-focused courses (e.g., "Physical Mechanics"). Research-like experiences are generally offered through "lab" classes, but these are almost always reproductions of past experiments: contrived, formulaic, and lacking the "heart" of real (i.e., potentially publishable) scientific research. Real research opportunities 1) provide students with realistic insight into the actual scientific process; 2) excite students far more than end-of-chapter problems; 3) provide context for the importance of learning math, physics, and astrophysics concepts; and 4) allow unique research progress for well-chosen problems. I have provided real research opportunities as an "Exoplanet Lab" component of my Introduction to Space Science (SPS1020) class at Florida Tech, generally taken by first-year majors in our Physics, Astronomy & Astrophysics, Planetary Science, and Astrobiology degree programs. These labs are a hybrid between citizen science (e.g., PlanetHunters) and simultaneously mentoring ~60 undergraduates in similar small research projects. These projects focus on problems that can be understood in the context of the course, but which benefit from "crowdsourcing". Examples include: dividing up the known planetary systems and developing a classification scheme and organizing them into populations (Fall 2013); searching through folded light curves to discover new exoplanets missed by previous pipelines (Fall 2014); and fitting n-body models to all exoplanets with known Transit Timing Variations to estimate planet masses (Fall 2015). The students love the fact that they are doing real potentially publishable research: not many undergraduates can claim to have discovered

  18. Muscle Cells Provide Instructions for Planarian Regeneration

    PubMed Central

    Witchley, Jessica N.; Mayer, Mirjam; Wagner, Daniel E.; Owen, Jared H.; Reddien, Peter W.

    2014-01-01

    Regeneration requires both potential and instructions for tissue replacement. In planarians, pluripotent stem cells have the potential to produce all new tissue. The identities of the cells that provide regeneration instructions are unknown. Here, we report that position control genes (PCGs) that control regeneration and tissue turnover are expressed in a subepidermal layer of nonneoblast cells. These subepidermal cells coexpress many PCGs. We propose that these subepidermal cells provide a system of body coordinates and positional information for regeneration, and identify them to be muscle cells of the planarian body wall. Almost all planarian muscle cells express PCGs, suggesting a dual function: contraction and control of patterning. PCG expression is dynamic in muscle cells after injury, even in the absence of neoblasts, suggesting that muscle is instructive for regeneration. We conclude that planarian regeneration involves two highly flexible systems: pluripotent neoblasts that can generate any new cell type and muscle cells that provide positional instructions for the regeneration of any body region. PMID:23954785

  19. Service providers and users discover the Internet.

    PubMed Central

    Lacroix, E M; Backus, J E; Lyon, B J

    1994-01-01

    Although the Internet has evolved over more than twenty years, resources useful to health information professionals have become available on the Internet only recently. A survey conducted by the Regional Medical Libraries of the National Network of Libraries of Medicine in the fall of 1993 indicates that libraries at academic institutions are much more likely to have access to the Internet (72%) than are libraries in hospital environments (24%). Health information professionals who take on the challenge and exploit the Internet's resources find rewards for themselves and their clients. The basic electronic mail capability of the Internet allows colleagues to collaborate, communicate, and participate in daily continuing education. Internet terminal and file-transfer capabilities provide improved access to traditional resources and first-time access to new electronic resources. Through the Internet, online catalogs are available worldwide, and document delivery is faster, cheaper, and more reliable than ever before. Institutions can make organizational, full-text, online, and publication information available through Internet tools such as direct file-transfer protocol (FTP), menu-based Gopher, and hypertext-based Mosaic. The National Library of Medicine (NLM) is among organizations finding new ways to provide service through the Internet. NLM now uses electronic mail to communicate with users, FTP service to distribute publications, and tools such as Gopher and Mosaic to distribute publications and graphics and connect users to online services. The Internet allows service providers and health sciences information professionals to work in a rich, new medium whose potential is just beginning to be explored. At the same time, its characteristics--including lack of formal organization, standards, quality control, and permanence--pose a challenge. PMID:7841912

  20. Icy Schwedeneck field may provide reference

    SciTech Connect

    Not Available

    1985-05-01

    Situated in an icy region of the Baltic Sea, Germany's first offshore field may provide the nation with the reference needed to encroach the arctic market. Production began last winter from one platform in the Schwedeneck-See field, located about three miles off the Baltic Coast. Total reserves have been estimated at more than 18 million bbl. Yearly production by the end of 1986 has been estimated at 294,000 bbl. The first two production platforms were installed in late 1983 in water depths ranging from 50 to 80 ft. Because of the ice hazards inherent in the Baltic, the platforms are concrete designed with steel decks.

  1. Systems and Methods for Providing Insulation

    NASA Technical Reports Server (NTRS)

    Golden, Johnny L. (Inventor)

    2015-01-01

    Systems and methods provide a multi-layer insulation (MLI) that includes a plurality of sealed metalized volumes in a stacked arrangement, wherein the plurality of sealed metalized volumes encapsulate a gas therein, with the gas having one of a thermal insulating property, an acoustic insulating property, or a combination insulating property thereof. The MLI also includes at least one spacer between adjacent sealed metalized volumes of the plurality of sealed metalized volumes and a protective cover surrounding the plurality of sealed metalized volumes.

  2. Computerized systems to provide materials selection advice

    SciTech Connect

    Krisher, A.S.

    1996-07-01

    The rapid advance of computer science has increased the ability to store and retrieve information. These new capabilities are beginning to be applied to the problem of providing sound advice to non-specialist engineers who make materials selection decisions. This paper presents an overview of the large scale systems which exist in finished or near finished form and are (or may soon be) available for use by the public. The paper focuses on systems which transfer knowledge taking into account the many qualifications which enter into the reasoning processes of materials/corrosion specialists. The paper discusses both the strengths and limitations of each system.

  3. Zika Virus: Critical Information for Emergency Providers.

    PubMed

    Shastry, Siri; Koenig, Kristi L; Hirshon, Jon Mark

    2016-08-01

    Zika virus is an arbovirus of the Flaviviridae family. It is primarily a minimally symptomatic mosquito-borne infection. However, with Zika's 2015 to 2016 introduction into the Western Hemisphere and its dramatic and rapid spread, it has become a public health concern, in large part due to congenital abnormalities associated with infection in pregnant women. In early 2016, the World Health Organization declared the microcephaly and other neurologic conditions associated with Zika virus infection a public health emergency of international concern. This article discusses the current epidemiologic and clinical understanding of Zika virus, focusing on critical information needed by emergency providers. PMID:27475021

  4. The financial implications of ACOs for providers.

    PubMed

    Reynolds, James; Roble, Daniel

    2011-10-01

    To prepare for a future in which more and more patients will receive care in ambulatory settings, and acute care service capacity will likely need to be considerably downsized, hospitals should pursue five near-term strategies: Convert primary care practices to medical homes, Develop the IT capabilities required to manage and report on clinical and financial processes and outcomes, Integrate the clinical and financial interests with those of their physicians in improving value, Reduce cost per episode of care through bundled payment initiatives, Nurture key relationships with other providers. PMID:22053645

  5. Power beaming providing a space power infrastructure

    SciTech Connect

    Bamberger, J.A.; Coomes, E.P.

    1992-08-01

    This study, based on two levels of technology, applies the power beaming concept to four planned satellite constellations. The analysis shows that with currently available technology, power beaming can provide mass savings to constellations in orbits ranging from low earth orbit to geosynchronous orbit. Two constellations, space surveillance and tracking system and space based radar, can be supported with current technology. The other two constellations, space-based laser array and boost surveillance and tracking system, will require power and transmission system improvements before their breakeven specific mass is achieved. A doubling of SP-100 conversion efficiency from 10 to 20/% would meet or exceed breakeven for these constellations.

  6. Power beaming providing a space power infrastructure

    NASA Astrophysics Data System (ADS)

    Bamberger, J. A.; Coomes, E. P.

    This study, based on two levels of technology, applies the power beaming concept to four planned satellite constellations. The analysis shows that with currently available technology, power beaming can provide mass savings to constellations in orbits ranging from low earth orbit to geosynchronous orbit. Two constellations, space surveillance and tracking system and space based radar, can be supported with current technology. The other two constellations, space-based laser array and boost surveillance and tracking system, will require power and transmission system improvements before their breakeven specific mass is achieved. A doubling of SP-100 conversion efficiency from 10 to 20 percent would meet or exceed breakeven for these constellations.

  7. Power beaming providing a space power infrastructure

    NASA Astrophysics Data System (ADS)

    Bamberger, J. A.; Coomes, E. P.

    1992-08-01

    This study, based on two levels of technology, applies the power beaming concept to four planned satellite constellations. The analysis shows that with currently available technology, power beaming can provide mass savings to constellations in orbits ranging from low earth orbit to geosynchronous orbit. Two constellations, space surveillance and tracking system and space based radar, can be supported with current technology. The other two constellations, space-based laser array and boost surveillance and tracking system, will require power and transmission system improvements before their breakeven specific mass is achieved. A doubling of SP-100 conversion efficiency from 10 to 20 percent would meet or exceed breakeven for these constellations.

  8. Sensors Provide Early Warning of Biological Threats

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Early Warning Inc. of Troy, New York, licensed powerful biosensor technology from Ames Research Center. Incorporating carbon nanotubes tipped with single strands of nucleic acid from waterborne pathogens, the sensor can detect even minute amounts of targeted, disease causing bacteria, viruses, and parasites. Early Warning features the NASA biosensor in its water analyzer, which can provide advance alert of potential biological hazards in water used for agriculture, food and beverages, showers, and at beaches and lakes -- within hours instead of the days required by conventional laboratory methods.

  9. Making friends for hydro: Providing recreational opportunities

    SciTech Connect

    Cosgrove, J.M. )

    1991-07-01

    One northeastern U.S. utility has been forming friendly ties with the public, offering recreation amenities at its hydro projects. As a result, the company has a strong base of public support as it enters relicensing.

  10. Antenna system providing a spherical radiation pattern

    NASA Technical Reports Server (NTRS)

    Sickles, II, Louis (Inventor)

    1993-01-01

    An antenna system provides a substantially spherical radiation pattern about a structure located above ground level, by locating the individual radiation pattern of each of a plurality of individual antennae, each positioned to have a radiation pattern covering only a portion of the desired sphere, and then applying all antenna signals, during either transmission or reception time intervals, through space-diversity and/or time-diversity apparatus, to cause the patterns of all of the antennae to combine into the desired substantially-spherical pattern. The antennae may have substantially hemispherical patterns, with each antenna of a pair thereof being directed in a direction generally opposite to the other antenna of that pair. Time domain multiple access (TDMA) operation of a master system station, with transmission in different time slots for different portions of the coverage sphere, and selection of the strongest received signal from among all of the plurality N of signals simultaneously received by the plurality N of antennae, can provide the desired spherical radiation pattern in both the transmission and reception modes of operation.

  11. The attentional blink provides episodic distinctiveness

    PubMed Central

    Wyble, Brad; Bowman, Howard; Nieuwenstein, Mark

    2009-01-01

    The attentional blink (Raymond et al 1992) refers to an apparent gap in perception that can be elicited when a second target follows a first at a temporal lag of several hundred milliseconds. . Theoretical and computational work have provided a variety of explanations for early sets of blink data, but more recent data have challenged these accounts by showing that the blink is attenuated when subjects encode entire strings of stimuli (Nieuwenstein & Potter, 2006, Olivers et al 2007, Kawahara et al 2007), are distracted (Olivers & Nieuwenhuis 2005) or are provided with irrelevant motion cues (Arend, Johnston, & Shapiro 2006) while viewing the RSVP stream. In this paper, we describe the Episodic Simultaneous Type Serial Token model (eSTST), a computational account of encoding visual stimuli into working memory which suggests that the attentional blink is a cognitive strategy rather than a resource limitation. This model is composed of neurobiologically plausible neural elements and simulates the attentional blink with a competitive attentional mechanism facilitates the formation of episodically distinct representations within working memory. In addition to the blink, the model addresses the phenomena of repetition blindness and whole report superiority, producing predictions which are supported by experimental work. PMID:19485692

  12. 76 FR 66132 - Proposed Collection; Comment Request for Travel Service Provider and Carrier Service Provider...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... Office of Foreign Assets Control Proposed Collection; Comment Request for Travel Service Provider and... Control (``OFAC'') within the Department of the Treasury is soliciting comments concerning OFAC's Travel...: Travel Service Provider and Carrier Service Provider Submission. OMB Number: 1505-0168. Abstract:...

  13. Reducing Isolation of Family Child Care Providers by Participation in a Provider-Initiated Support Network.

    ERIC Educational Resources Information Center

    Wetherington, Patricia Reish

    Because of the difficulty of finding time for professional and personal development, many family child care (FCC) providers are isolated in their work environment. This practicum study developed a provider-initiated support network to reduce this isolation. The local FCC association provided advertising about the formation of the network. A group…

  14. NASA works for provide business assistance

    NASA Technical Reports Server (NTRS)

    1997-01-01

    The wealth of technology resulting from space exploration is a valuable national resource and an investment in the future. Through NASA's Technology Transfer Program, the John C. Stennis Space Center in South Mississippi contributes to the U.S. economy by working with companies to help them benefit from these technologies. This is called technology transfer. Transferred technology helps fulfill the technical and business needs of the public in the form of new products-called 'spinoffs,'-new applications, new programs, and improved ways of doing business. The possible results are enhanced potential for industrial productivity, creation of jobs, and increased returns on investment for the taxpayer.

  15. Providing Spatial Data for Secondary Analysis

    PubMed Central

    Gutmann, Myron; Witkowski, Kristine; Colyer, Corey; O’Rourke, JoAnne McFarland; McNally, James

    2008-01-01

    Spatially explicit data pose a series of opportunities and challenges for all the actors involved in providing data for long-term preservation and secondary analysis -- the data producer, the data archive, and the data user. We report on opportunities and challenges for each of the three players, and then turn to a summary of current thinking about how best to prepare, archive, disseminate, and make use of social science data that have spatially explicit identification. The core issue that runs through the paper is the risk of the disclosure of the identity of respondents. If we know where they live, where they work, or where they own property, it is possible to find out who they are. Those involved in collecting, archiving, and using data need to be aware of the risks of disclosure and become familiar with best practices to avoid disclosures that will be harmful to respondents. PMID:19122860

  16. Multiagency Initiative to Provide Greenhouse Gas Information

    NASA Astrophysics Data System (ADS)

    Boland, Stacey W.; Duren, Riley M.

    2009-11-01

    Global Greenhouse Gas Information System Workshop; Albuquerque, New Mexico, 20-22 May 2009; The second Greenhouse Gas Information System (GHGIS) workshop brought together 74 representatives from 28 organizations including U.S. government agencies, national laboratories, and members of the academic community to address issues related to the understanding, operational monitoring, and tracking of greenhouse gas emissions and carbon offsets. The workshop was held at Sandia National Laboratories and organized by an interagency collaboration among NASA centers, Department of Energy laboratories, and the U.S. National Oceanic and Atmospheric Administration. It was motivated by the perceived need for an integrated interagency, community-wide initiative to provide information about greenhouse gas sources and sinks at policy-relevant temporal and spatial scales. Such an initiative could significantly enhance the ability of national and regional governments, industry, and private citizens to implement and evaluate effective climate change mitigation policies.

  17. Optical fiber head for providing lateral viewing

    DOEpatents

    Everett, Matthew J.; Colston, Billy W.; James, Dale L.; Brown, Steve; Da Silva, Luiz

    2002-01-01

    The head of an optical fiber comprising the sensing probe of an optical heterodyne sensing device includes a planar surface that intersects the perpendicular to axial centerline of the fiber at a polishing angle .theta.. The planar surface is coated with a reflective material so that light traveling axially through the fiber is reflected transverse to the fiber's axial centerline, and is emitted laterally through the side of the fiber. Alternatively, the planar surface can be left uncoated. The polishing angle .theta. must be no greater than 39.degree. or must be at least 51.degree.. The emitted light is reflected from adjacent biological tissue, collected by the head, and then processed to provide real-time images of the tissue. The method for forming the planar surface includes shearing the end of the optical fiber and applying the reflective material before removing the buffer that circumscribes the cladding and the core.

  18. Generational considerations in providing critical care education.

    PubMed

    Paterson, Tricia

    2010-01-01

    With the current and predicted nursing shortage, much emphasis is placed on recruitment and retention. With an aging workforce, we must recruit, educate, and retain nurses from many different generations. As leaders and educators, we must be aware of generational differences and work with staff to appreciate potential preferences in communication, approach to learning and motivational factors. We are aware that over the next 15 years, many experienced nurses will retire. We must do all we can to recruit and retain nurses from all generations in order to provide a workforce able to meet the needs of our patients and families. Generational preferences should be considered when developing nursing education and in welcoming and accepting new staff into the culture of the nursing unit. PMID:20019512

  19. Hubble Provides Clear Images of Saturn's Aurora

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This is the first image of Saturn's ultraviolet aurora taken by the Space Telescope Imaging Spectrograph (STIS) on board the Hubble Space Telescope in October 1997, when Saturn was a distance of 810 million miles (1.3 billion kilometers) from Earth. The new instrument, used as a camera, provides more than ten times the sensitivity of previous Hubble instruments in the ultraviolet. STIS images reveal exquisite detail never before seen in the spectacular auroral curtains of light that encircle Saturn's north and south poles and rise more than a thousand miles above the cloud tops.

    Saturn's auroral displays are caused by an energetic wind from the Sun that sweeps over the planet, much like the Earths aurora that is occasionally seen in the nighttime sky and similar to the phenomenon that causes fluorescent lamps to glow. But unlike the Earth, Saturn's aurora is only seen in ultraviolet light that is invisible from the Earths surface, hence the aurora can only be observed from space. New Hubble images reveal ripples and overall patterns that evolve slowly, appearing generally fixed in our view and independent of planet rotation. At the same time, the curtains show local brightening that often follow the rotation of the planet and exhibit rapid variations on time scales of minutes. These variations and regularities indicate that the aurora is primarily shaped and powered by a continual tug-of-war between Saturn's magnetic field and the flow of charged particles from the Sun.

    Study of the aurora on Saturn had its beginnings just seventeen years ago. The Pioneer 11 spacecraft observed a far-ultraviolet brightening on Saturn's poles in 1979. The Saturn flybys of the Voyager 1 and 2 spacecraft in the early 1980s provided a basic description of the aurora and mapped for the first time planets enormous magnetic field that guides energetic electrons into the atmosphere near the north and south poles.

    The first images of Saturn's aurora were provided in 1994-5 by the

  20. PDX experimental results

    SciTech Connect

    Meade, D.; Arunasalam, V.; Barnes, C.

    1981-01-01

    The main objectives of the Poloidal Divertor Experiment (PDX) are to: (1) determine the effectiveness of poloidal divertors in controlling impurities in high temperature plasmas, (2) use the poloidal divertor to provide clean plasmas for confinement and high beta studies, and (3) investigate the effect of cross-section shaping on plasma confinement and MHD properties. In this paper, we report the results obtained during initial divertor operation of the PDX.

  1. Do drug advertisements provide therapeutic information?

    PubMed

    Stimson, G V

    1977-03-01

    In this study of advertisements appearing in medical periodicals and by direct mail advertising to general practitioners, Dr. Stimson, a sociologist, concludes that from what is intended to provide therapeutic information hardly any therapeutic information is provided. He reminds the reader of the safeguards which surround all drug advertising by law and by the code of practice of the Association of the British Pharmaceutical Industry but these safeguards do not appear to control real or potential sins of omission. Frequently in these advertisements the literature relating to the drug is quoted but Dr. Stimson found that it was difficult to trace all the papers quoted in different types of medical library. (Some references quoted were to unpublished papers but surely the blame should be shared in this situation?) Dr. Stimson also gives a vivid and fascinating glimpse of what he calls the 'images and stereotypes' of the patients who, it is claimed, would benefit from the drug being advertised. Certainly most general practitioners must be aware that when they prescribe that image is displaced by an individual but the portrait gallery is indeed depressing. However, to balance these advertisements drug companies issue data sheets which must be more informative than advertisements and conform to regulations in their format. Unfortunately data sheets are only issued every 15 months whereas the 'average general practitioner is potentially exposed to 1,300 advertisements every month'. In other words, the data sheet and not the advertisement should be the guideline but it arrives too infrequently to offset the lack of therapeutic information contained in advertisements. PMID:870694

  2. Managing Illinois Libraries: Providing Services Customers Value.

    ERIC Educational Resources Information Center

    Walzer, Norman; Stott, Karen; Sutton, Lori

    Public libraries are an important asset in virtually any size community, but especially in small towns where many social institutions are in decline or have left. Libraries increase the quality of life, help attract new residents, and support the quality of life that is essential to attracting businesses. Results from surveys of library users,…

  3. Providing Campus Environmental Coherence by Landscaping.

    ERIC Educational Resources Information Center

    Pawsey, Maurice R.

    1982-01-01

    A landscaping approach aimed at integrating greatly contrasting building types and materials resulting from unplanned growth used these elements to create design continuity; paving, planting, landscape furniture, planting and lawn protection, signs, lights, placement of posters and notices, and bicycle racks. (MSE)

  4. Polarimeter provides transient response in nanosecond range

    NASA Technical Reports Server (NTRS)

    Johnston, A. R.

    1967-01-01

    Conventional polarimeter with a Senarmont compensator improves transient response and eliminates manual manipulation. A sampled photomultiplier output is fed to a low pass filter, resulting in a signal representing the optical state existing at the instant of sampling. With this technique, an unknown transient-induced retardation can be measured.

  5. Provider-to-Provider Electronic Communication in the Era of Meaningful Use: A Review of the Evidence

    PubMed Central

    Walsh, Colin; Siegler, Eugenia L; Cheston, Erin; O'Donnell, Heather; Collins, Sarah; Stein, Daniel; Vawdrey, David K.; Stetson, Peter D.

    2014-01-01

    Background Electronic communication between providers occurs daily in clinical practice but has not been well studied. Purpose To assess the impact of provider-to-provider electronic communication tools on communication and healthcare outcomes through literature review. Data sources OVID Medline, Pubmed, Google Scholar, CINAHL, and Academic Search Premier. Study Selection Publication in English language peer-reviewed journals. Studies provided quantitative provider-to-provider communication data, provider satisfaction statistics, or EHR communication data. Data Extraction Literature review. Data Synthesis Two reviewers conducted the title review to determine eligible studies from initial search results. Three reviewers independently reviewed titles, abstracts, and full text (where appropriate) against inclusion and exclusion criteria. Limitations Small number of eligible studies; few described trial design (20%). Homogeneous provider-type (physicians). English-only studies. Conclusions Of twenty-five included studies, all focused on physicians; most were observational (68%). Most (60%) described electronic specialist referral tools. Although overall use has been measured, there were no studies of the effectiveness of intra-EHR messaging. Literature describing the effectiveness of provider-to-provider electronic communications is sparse and narrow in scope. Complex care, such as that envisioned for the Patient Centered Medical Home, necessitates further research. PMID:24101544

  6. Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial

    PubMed Central

    Dai, Chin-Ying; Huang, Yu-Hui; Chou, Li-Wei; Wu, Shiao-Chi; Wang, Ray-Yau; Lin, Li-Chan

    2013-01-01

    Introduction The current study aims to investigate the effects of primary caregiver participation in vestibular rehabilitation (VR) on improving the measures of neglect, activities of daily living (ADL), balance, and falls of unilateral neglect (UN) patients. Methods This study is a single-blind randomized controlled trial. Both experimental (n = 24) and control groups (n = 24) received conventional rehabilitation. The experimental group undertook VR for a month. During the first and second weeks, a registered nurse trained the experimental group in VR. The primary caregivers in the experimental group supervised and guided their patients in VR during the third and fourth weeks. The outcome measures were neglect, ADL, balance, and falls. Results The two groups of UN patients showed a significant improvement in neglect, ADL, and balance over time. Based on the generalized estimating equations model, an interaction was observed between groups and times. Significant interactions were observed between the VR group at days 14 and 28 in the areas of neglect, ADL, and balance. No significant difference was observed between the two groups in the number of falls. Conclusion Neglect, ADL, and balance among UN patients with right hemispheric stroke can be improved through the participation of primary caregivers in VR. Trained informal caregivers were recommended to provide VR guidance and supervision to patients who suffer from UN. PMID:23630423

  7. Provider knowledge, attitudes and treatment preferences for early pregnancy failure

    PubMed Central

    Dalton, Vanessa K.; Harris, Lisa H.; Gold, Katherine J.; Kane-Low, Lisa; Schulkin, Jay; Guire, Ken; Fendrick, A. Mark

    2010-01-01

    Objective To describe health care provider knowledge, attitudes and treatment preferences for early pregnancy failure (EPF). Study Design We surveyed 976 obstetrician/gynecologists, midwives and family medicine practitioners on their knowledge and attitudes toward treatment options for EPF, and barriers to adopting misoprostol and office uterine evacuations. We used descriptive statistics to compare practices by provider specialty and logistic regression to identify associations between provider factors and treatment practices. Results Seventy percent of providers have not used misoprostol and 91% have not used an office uterine evacuation to treat EPF in the past 6 months. Beliefs about safety and patient preferences, and prior induced abortion training were significantly associated with use of both of these treatments. Conclusions Increasing education and training on the use of misoprostol and office uterine evacuation, and clarifying patient treatment preferences may increase the willingness of providers to adopt new practices for EPF treatment. PMID:20227674

  8. Synonyms Provide Semantic Preview Benefit in English

    PubMed Central

    Schotter, Elizabeth R.

    2013-01-01

    While orthographic and phonological preview benefits in reading are uncontroversial (see Schotter, Angele, & Rayner, 2012 for a review), researchers have debated the existence of semantic preview benefit with positive evidence in Chinese and German, but no support in English. Two experiments, using the gazecontingent boundary paradigm (Rayner, 1975), show that semantic preview benefit can be observed in English when the preview and target are synonyms (share the same or highly similar meaning, e.g., curlers-rollers). However, no semantic preview benefit was observed for semantic associates (e.g., curlers-styling). These different preview conditions represent different degrees to which the meaning of the sentence changes when the preview is replaced by the target. When this continuous variable (determined by a norming procedure) was used as the predictor in the analyses, there was a significant relationship between it and all reading time measures, suggesting that similarity in meaning between what is accessed parafoveally and what is processed foveally may be an important influence on the presence of semantic preview benefit. Why synonyms provide semantic preview benefit in reading English is discussed in relation to (1) previous failures to find semantic preview benefit in English and (2) the fact that semantic preview benefit is observed in other languages even for non-synonymous words. Semantic preview benefit is argued to depend on several factors—attentional resources, depth of orthography, and degree of similarity between preview and target. PMID:24347813

  9. Providing effective supervision in clinical neuropsychology.

    PubMed

    Stucky, Kirk J; Bush, Shane; Donders, Jacobus

    2010-01-01

    A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology. PMID:20582855

  10. Factors affecting willingness to provide buprenorphine treatment

    PubMed Central

    Netherland, Julie; Botsko, Michael; Egan, James E.; Saxon, Andrew J.; Cunningham, Chinazo O.; Finkelstein, Ruth; Gourevitch, Mark N.; Renner, John A.; Sohler, Nancy; Sullivan, Lynn E.; Weiss, Linda; Fiellin, David A.

    2010-01-01

    Buprenorphine is an effective long-term opioid agonist treatment. As the only pharmacological treatment for opioid dependence readily available in office-based settings, buprenorphine may facilitate a historic shift in addiction treatment from treatment facilities to general medical practices. Although many patients have benefited from the availability of buprenorphine in the United States, almost half of current prescribers are addiction specialists suggesting that buprenorphine treatment has not yet fully penetrated general practice settings. We examined factors affecting willingness to offer buprenorphine treatment among physicians with different levels of prescribing experience. Based on their prescribing practices, physicians were classified as experienced, novice, or as a nonprescriber and asked to assess the extent to which a list of factors impacted their prescription of buprenorphine. Several factors affected willingness to prescribe buprenorphine for all physicians: staff training; access to counseling and alternate treatment; visit time; buprenorphine availability; and pain medications concerns. Compared with other physicians, experienced prescribers were less concerned about induction logistics and access to expert consultation, clinical guidelines, and mental health services. They were more concerned with reimbursement. These data provide important insight into physician concerns about buprenorphine and have implications for practice, education, and policy change that may effectively support widespread adoption of buprenorphine. PMID:18715741

  11. Providing a genitourinary medicine colposcopy service.

    PubMed

    Sonnex, C

    2014-02-01

    Between 15 and 30 years ago, the management of women with abnormal cervical cytology fell within the remit of GU Medicine. This involved performing colposcopy. With the introduction of certification for colposcopists in 1998, most GU Medicine clinicians stopped providing a colposcopy service. As certification is not required for using the colposcope to diagnose and manage other ano-genital conditions, a GU Medicine-based colposcopy service was introduced at Addenbrooke's Hospital, Cambridge, UK, to assess young women with post-coital bleeding (PCB). One of the objectives of this study was to review this service. In 2011, local guidelines were implemented advising referral to the department of GU Medicine for women under the age of 40 years presenting with PCB with or without inter-menstrual bleeding (IMB) and with no history of previous cervical pathology. A case note review was undertaken for 357 consecutive patients to document clinical findings and management and to determine whether this was an appropriate route of referral. Cervical pathology was found to be uncommon and easily treated within the GU Medicine setting. The provision of a colposcopy service by GU Medicine nurse practitioners or doctors is achievable but requires appropriate training. Importantly, once obtained, these skills can be easily and usefully transferred to examining the vulva, penis, anus and anal canal. PMID:23893915

  12. Hubble Provides Complete View of Jupiter's Auroras

    NASA Technical Reports Server (NTRS)

    1998-01-01

    NASA's Hubble Space Telescope has captured a complete view of Jupiter's northern and southern auroras.

    Images taken in ultraviolet light by the Space Telescope Imaging Spectrograph (STIS) show both auroras, the oval-shaped objects in the inset photos. While the Hubble telescope has obtained images of Jupiter's northern and southern lights since 1990, the new STIS instrument is 10 times more sensitive than earlier cameras. This allows for short exposures, reducing the blurring of the image caused by Jupiter's rotation and providing two to five times higher resolution than earlier cameras. The resolution in these images is sufficient to show the 'curtain' of auroral light extending several hundred miles above Jupiter's limb (edge). Images of Earth's auroral curtains, taken from the space shuttle, have a similar appearance. Jupiter's auroral images are superimposed on a Wide Field and Planetary Camera 2 image of the entire planet. The auroras are brilliant curtains of light in Jupiter's upper atmosphere. Jovian auroral storms, like Earth's, develop when electrically charged particles trapped in the magnetic field surrounding the planet spiral inward at high energies toward the north and south magnetic poles. When these particles hit the upper atmosphere, they excite atoms and molecules there, causing them to glow (the same process acting in street lights).

    The electrons that strike Earth's atmosphere come from the sun, and the auroral lights remain concentrated above the night sky in response to the 'solar wind.'

  13. Warm eyes provide superior vision in swordfishes.

    PubMed

    Fritsches, Kerstin A; Brill, Richard W; Warrant, Eric J

    2005-01-11

    Large and powerful ocean predators such as swordfishes, some tunas, and several shark species are unique among fishes in that they are capable of maintaining elevated body temperatures (endothermy) when hunting for prey in deep and cold water . In these animals, warming the central nervous system and the eyes is the one common feature of this energetically costly adaptation . In the swordfish (Xiphias gladius), a highly specialized heating system located in an extraocular muscle specifically warms the eyes and brain up to 10 degrees C-15 degrees C above ambient water temperatures . Although the function of neural warming in fishes has been the subject of considerable speculation , the biological significance of this unusual ability has until now remained unknown. We show here that warming the retina significantly improves temporal resolution, and hence the detection of rapid motion, in fast-swimming predatory fishes such as the swordfish. Depending on diving depth, temporal resolution can be more than ten times greater in these fishes than in fishes with eyes at the same temperature as the surrounding water. The enhanced temporal resolution allowed by heated eyes provides warm-blooded and highly visual oceanic predators, such as swordfishes, tunas, and sharks, with a crucial advantage over their agile, cold-blooded prey. PMID:15649365

  14. Provide thermogravimetric analysis data to performance assessment

    SciTech Connect

    Gdowski, G.

    1998-01-01

    Recent experimental testing has investigated the effect of a deposited mixed salt on the corrosion of carbon steel in high relative humidity air. This result is compared with previous studies where pure sodium chloride was deposited. There are aspects of the degradation process which are significantly different when the different salts are deposited. With deposited sodium chloride, corrosion occurs almost immediately after introduction of 80% RH air. With deposited mixed salts, there is an initial inhibition of corrosion in 80% RH air. After the initial inhibition period, corrosion occurs at localized regions of the specimen. At longer times, the specimen suffers extensive corrosion. A very porous and non-adherent corrosion product forms and readily spalls. The initial inhibition of the corrosion with the deposited mixed salt is most likely due to the bicarbonate component. Bicarbonate is a known inhibitor of general corrosion of carbon steel [Thomas, 1994] and a promoter of localized corrosion at moderate alkalinity when chloride ions are present [Marsh, 1985]. The results of this testing indicate that the bicarbonate component of thin water layers can initially inhibit corrosion of the carbon steel. With time, however, inhibition is lost. A mechanism for this loss of inhibition is suggested. It is plausible that moderately alkaline bicarbonate aqueous solutions could develop on the surface of a waste package due to Yucca Mountain water contacting the waste packages. Aqueous conditions might develop where carbon steel is susceptible to localized corrosion [Dunn, 1998]. The initial test results presented here suggest that the inhibition of general corrosion, and hence, the promotion of localized corrosion of carbon steel by thin aqueous bicarbonate-chloride layers may not be sustainable. Additional testing is underway to further understand the effects of thin aqueous solution chemistry on carbon steel corrosion.

  15. Bacteria Provide Cleanup of Oil Spills, Wastewater

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Through Small Business Innovation Research (SBIR) contracts with Marshall Space Flight Center, Micro-Bac International Inc., of Round Rock, Texas, developed a phototrophic cell for water purification in space. Inside the cell: millions of photosynthetic bacteria. Micro-Bac proceeded to commercialize the bacterial formulation it developed for the SBIR project. The formulation is now used for the remediation of wastewater systems and waste from livestock farms and food manufacturers. Strains of the SBIR-derived bacteria also feature in microbial solutions that treat environmentally damaging oil spills, such as that resulting from the catastrophic 2010 Deepwater Horizon oil rig explosion in the Gulf of Mexico.

  16. Providing and financing aged care in Australia

    PubMed Central

    Ergas, Henry; Paolucci, Francesco

    2011-01-01

    This article focuses on the provision and financing of aged care in Australia. Demand for aged care will increase substantially as a result of population aging, with the number of Australians aged 85 and over projected to increase from 400,000 in 2010 to over 1.8 million in 2051. Meeting this demand will greatly strain the current system, and makes it important to exploit opportunities for increased efficiency. A move to greater beneficiary co-payments is also likely, though its extent may depend on whether aged care insurance and other forms of pre-payment can develop. PMID:22312229

  17. Providers' response to child eating behaviors: A direct observation study.

    PubMed

    Tovar, Alison; Vaughn, Amber E; Fallon, Megan; Hennessy, Erin; Burney, Regan; Østbye, Truls; Ward, Dianne S

    2016-10-01

    Child care providers play an important role in feeding young children, yet little is known about children's influence on providers' feeding practices. This qualitative study examines provider and child (18 months -4 years) feeding interactions. Trained data collectors observed 200 eating occasions in 48 family child care homes and recorded providers' responses to children's meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Providers were predominately female (100%), African-American (75%), and obese (77%) and a third of children were overweight/obese (33%). Commonly observed child behaviors were: verbal and non-verbal refusals, verbal and non-verbal acceptance, being "all done", attempts for praise/attention, and asking for seconds. Children's acceptance of food elicited more autonomy supportive practices vs. coercive controlling. Requests for seconds was the most common behavior, resulting in coercive controlling practices (e.g., insisting child eat certain food or clean plate). Future interventions should train providers on responding to children's behaviors and helping children become more aware of internal satiety and hunger cues. PMID:27328098

  18. Remote Sensing May Provide Unprecedented Hydrological Data

    NASA Technical Reports Server (NTRS)

    Koster, R.; Houser, P.; Engman, E.; Kustas, W.

    1999-01-01

    Basic hydrological research and water resources management may reap tremendous benefits from remote sensing technology, studies are showing. Satellite coverage may allow unprecedented accuracy in the quantification of the global hydrological cycle, for example. Yet despite such benefits, few hydrologists currently use such data. This is partly because the needed tools and algorithms are not fully developed. Such development requires field experiments that combine remotely sensed data with detailed in situ observations. AGU's Remote Sensing in Hydrology Committee has constructed a Web site (http://Iand.gsfc.nasa.gov/RSHC.html) that gives an overview of many such experiments. Included on the site is information on each experiment's overall goal, the types of in situ and remotely sensed measurements taken, relevant climate and vegetation conditions, and so forth. Links to additional relevant Web sites are included. The site is designed to be a suitable starting point for those interested in learning more about remote sensing in hydrology. It lists members of the committee who can be contacted for further information. Hydrologists have recognized the potential of remote sensing technology since the 1970s. It offers a way to avoid the logistical and economic difficulties associated with obtaining continuous in situ measurements of various hydrological variables, difficulties that are particularly pronounced in remote regions. Microwave instruments in particular can potentially provide all-weather, areally averaged estimates of certain variables (such as precipitation, soil moisture, and snow water content) that have been essentially unattainable in the past. In remote sensing, the conversion of emitted and reflected radiances into useful hydrological data is a complex problem. The measured radiances, for example, reflect the integrated character of a pixel area, a scale inconsistent with the point measurements of traditional hydrology. To develop the needed algorithms

  19. Providing Data Access for Interdisciplinary Research

    NASA Astrophysics Data System (ADS)

    Hooper, R. P.; Couch, A.

    2012-12-01

    Developing an interdisciplinary understanding of human and environmental interactions with water requires access to a variety of data kinds collected by various organizations. The CUAHSI Hydrologic Information System (HIS) is a standards-based, services-oriented architecture designed for time-series data. Such data represents an important type of data in water studies. Through the efforts of HIS, a standard transmission language, WaterML2, has been adopted by the Open Geospatial Consortium and is under consideration by the World Meteorologic Organization as an international standards. Web services have also been developed to retrieve data and metadata. HIS is completed with a metadata catalog, hosted by San Diego Supercomputing Center, which indexes more than 20 million time series provided from over 90 different services. This catalog is supported through a hierarchically organized controlled vocabulary that is open for community input and mediation. Data publishers include federal agencies, universities, state agencies, and non-profit organizations such as watershed associations. Accessing data from such a broad spectrum of sources through a uniform service standard promises to truly transform the way in which hydrologic research is done. CUAHSI HIS is a large-scale prototype at this time, but a proposal is under consideration by the National Science Foundation to operationalize HIS through a data facility, tentatively called the CUAHSI Water Data Center. Establishing HIS is an important step to enable research into human-environment interactions with water, but it is only one step. Other data structures will need to be made accessible and interoperable to support this research. Some data—such as two-dimensional GIS coverages—already have widely used standards for transmission and sharing. The US Federal government has long operated a clearinghouse for federal geographic data that is now being augmented with other services such as ArcGIS OnLine. Other data

  20. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M; Stauffer, M

    2000-05-24

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those were questions 35 states considered in 1999, and at least 32 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves. PMID:11073416

  1. Finance, providers issue brief: insurer liability.

    PubMed

    Rothouse, M

    1999-07-01

    When a health plan denies payment for a procedure on grounds that it is not medically necessary or when it refuses a physician-ordered referral to a specialist, has it crossed the line from making an insurance judgment to practicing medicine? If the patient suffers harm as a result of the decision, is the plan liable for medical malpractice? Those are questions 29 states considered in 1998, and at least 35 states are grappling with this year as they seek to respond to physician and patient pressure to curb the power of the managed care industry. Traditionally, health insurers have been protected by state laws banning "the corporate practice of medicine," which means the patient's only recourse is to sue under a "vicarious liability" theory. Now, however, lawmakers are debating legislation to extend the scope of malpractice liability beyond individual practitioners to insurance carriers and plans themselves. PMID:11073388

  2. 28 CFR 58.33 - Minimum qualifications providers shall meet to become and remain approved providers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... component of an instructional course by a telephone or Internet method of delivery, use only instructors who... Internet to deliver a component of an instructional course. A provider shall: (1) Not provide any debtor a... telephone or Internet; (2) Confirm the identity of the debtor before commencing an instructional course...

  3. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  4. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  5. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  6. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  7. 22 CFR 96.14 - Providing adoption services using other providers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Providing adoption services using other... ACCREDITATION OF AGENCIES AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.14 Providing...

  8. Review of Pesticide Education Materials for Health Care Providers Providing Care to Agricultural Workers

    ERIC Educational Resources Information Center

    Hiott, Ann E.; Quandt, Sara A.; Early, Julie; Jackson, David S.; Arcury, Thomas A.

    2006-01-01

    Context: Pesticide exposure is an important environmental and occupational health risk for agricultural workers and their families, but health care providers receive little training in it. Objective: To evaluate the medical resources available to providers caring for patients, particularly farmworkers, exposed to pesticides and to recommend a…

  9. A Providence History Mystery: Discover the History of Providence through Architecture. Second Edition.

    ERIC Educational Resources Information Center

    Jordan, Amy, Ed.

    This workbook, a part of the Providence (Rhode Island) Preservation Society's preservation education curriculum for elementary school students, is designed to help students appreciate the significance and the beauty of Providence's architectural heritage. (Other materials in this program are a handbook entitled, "A New Look at Old Buildings," and…

  10. Use of a preferred provider by employees of the preferred provider.

    PubMed Central

    Diehr, P; Leickly, R; Tatarsky, M; Hermanson, B; Krueger, L; Silberg, N

    1988-01-01

    Little is known about the use of services in a preferred provider organization. We studied Pacific Medical Center (PMC) in Seattle which offered a preferred provider arrangement to its employees who selected a Blue Cross-Blue Shield type of plan. PMC offered to waive copayments and reduce deductibles for those employees when they (or their dependents) used PMC. PMC was thus a preferred provider. In the first 16 months of this program, 632 subjects made at least one claim; of these, 444 (70 percent) used the preferred provider at least once. The use of PMC was highest for male employees (84 percent had at least one visit), next for female employees (74 percent), and lowest for dependents (58 percent). Approximately one-third (32 percent) used PMC exclusively, 30 percent used other providers exclusively, and 37 percent used a combination of PMC and other providers. These may be thought of as best-case estimates, since the subjects--particularly the male employees--had a high level of familiarity with the program and ease of access, while the dependents had high familiarity but less convenient access. Female employees may have used PMC less because of relationships already established with other physicians. Outpatient and inpatient charges were more than twice as high for those who used both PMC and other providers as for those who used one provider exclusively. It may be that the preferred provider arrangement encourages higher charges or, alternatively, that it provides additional flexibility for those who have the most need for care. PMID:3141315

  11. 2012 election results

    NASA Astrophysics Data System (ADS)

    Robinson, Robert; Tetzlaff, Doerthe

    2012-10-01

    On 4 October 2012, AGU members completed voting for the 2013-2014 leadership term. Union officers, Board members, section and focus group officers, and student and early career representatives to the Council were elected. All members who joined or renewed their membership by 1 July 2012 were eligible to vote in this year's leadership election. The vote was held electronically, and access to voting was provided to all eligible voters for a period of 31 days. The voting was conducted by Survey and Ballot Systems, Inc. (SBS). SBS, which offers election planning and management services, provided unique login credentials and other support services for eligible voters throughout the election. Voting results were certified by SBS on 8 October and by the AGU Tellers Committee on 9 October. The overall participation rate was 21.9%, an increase over previous AGU elections.

  12. Martian Colors Provide Clues About Martian Water

    NASA Technical Reports Server (NTRS)

    1999-01-01

    NASA Hubble Space Telescope images of Mars taken in visible and infrared light detail a rich geologic history and provide further evidence for water-bearing minerals on the planet's surface.

    LEFT

    This 'true-color' image of Mars shows the planet as it would look to human eyes. It is clearly more Earth-toned than usually depicted in other astronomical images, including earlier Hubble pictures. The slightly bluer shade along the edges of the disk is due to atmospheric hazes and wispy water ice clouds (like cirrus clouds) in the early morning and late evening Martian sky. The yellowish-pink color of the northern polar cap indicates the presence of small iron-bearing dust particles. These particles are covering or are suspended in the air above the blue-white water ice and carbon dioxide ice, which make up the polar cap.

    Accurate colors are needed to determine the composition and mineralogy of Mars. This can tell how water has influenced the formation of rocks and minerals found on Mars today, as well as the distribution and abundance of ice and subsurface liquid water. Confirmation of the presence of certain oxidized (rusted) minerals (processed by heat or water action) would imply the possibility of different, perhaps much more Earth-like, past Martian climate periods. Because the smallest features visible in this image are only about 14 miles (22 km) across, Hubble can track small-scale variations in the distribution of minerals that do not follow global trends. The image was generated from three separate Wide Field and Planetary Camera 2 images acquired at wavelengths of 410, 502, and 673 nanometers, in March 1997.

    RIGHT

    A false-color picture taken in infrared light reveals features that cannot be seen in visible light. Hubble's unique infrared view pinpoints variations in the abundance and distribution of unknown water-bearing minerals on the planet. While it has been known for decades that small amounts of water-bearing minerals exist on the planet

  13. MARTIAN COLORS PROVIDE CLUES ABOUT MARTIAN WATER

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA Hubble Space Telescope images of Mars taken in visible and infrared light detail a rich geologic history and provide further evidence for water-bearing minerals on the planet's surface. LEFT This 'true-color' image of Mars shows the planet as it would look to human eyes. It is clearly more earth-toned than usually depicted in other astronomical images, including earlier Hubble pictures. The slightly bluer shade along the edges of the disk is due to atmospheric hazes and wispy water ice clouds (like cirrus clouds) in the early morning and late evening Martian sky. The yellowish-pink color of the northern polar cap indicates the presence of small iron-bearing dust particles. These particles are covering or are suspended in the air above the blue-white water ice and carbon dioxide ice, which make up the polar cap. Accurate colors are needed to determine the composition and mineralogy of Mars. This can tell how water has influenced the formation of rocks and minerals found on Mars today, as well as the distribution and abundance of ice and subsurface liquid water. Confirmation of the presence of certain oxidized (rusted) minerals (processed by heat or water action) would imply the possibility of different, perhaps much more Earth-like, past Martian climate periods. Because the smallest features visible in this image are only about 14 miles (22 km) across, Hubble can track small-scale variations in the distribution of minerals that do not follow global trends. The image was generated from three separate Wide Field and Planetary Camera 2 images acquired at wavelengths of 410, 502, and 673 nanometers, in March 1997. RIGHT A false-color picture taken in infrared light reveals features that cannot be seen in visible light. Hubble's unique infrared view pinpoints variations in the abundance and distribution of unknown water-bearing minerals on the planet. While it has been known for decades that small amounts of water-bearing minerals exist on the planet's surface, the

  14. Providing health education to Appalachia populations.

    PubMed

    Denham, Sharon A; Meyer, Michael G; Toborg, Mary A; Mande, Mary J

    2004-01-01

    Since the 1980s, theorists have posited that health education that reflects the cultural realities of communities that health educators targeted for behavioral interventions would be more successful than interventions that are not culturally sensitive. Between 1997 and 2002, 52 focus groups of youth, women, and men were conducted in the Appalachian portions of 10 states to discern cultural themes relevant to health education in Appalachia. Groups occurred within the context of 5 studies funded by institutes within the National Institutes of Health. Findings suggest that an emphasis on family shows immense promise as a culturally sensitive approach to health education. Interventions that use the central role of women in the health of their families may be useful. The study results also suggest that one-on-one approaches to health education may prove a promising technique, attacks on individuals and institutions are not useful strategies, and a preference for realism or "the facts" may be a good way to present information. PMID:15624276

  15. GIRAFFE test results summary

    SciTech Connect

    Yokobori, S.; Arai, K.; Oikawa, H.

    1996-03-01

    A passive system can provide engineered safety features enhancing safety system reliability and plant simplicity. Toshiba has conducted the test Program to demonstrate the feasibility of the SBWR passive safety system using a full-height, integral system test facility GIRAFFE. The test facility GIRAFFE models the SBWR in full height to correctly present the gravity driving head forces with a 1/400 volume scale. The GIRAFFE test Program includes the certification tests of the passive containment cooling system (PCCS) to remove the post-accident decay heat and the gravity driven cooling system (GDCS) to replenish the reactor coolant inventory during a LOCA. The test results have confirmed the PCCS and GDCS design and in addition, have demonstrated the operation of the pCCS with the presence of a lighter-than-steam noncondensable as well as with the presence of a heavier-than-steam, noncondensable. The GIRAFFE test Program has also provided the database to qualify a best estimate thermal-hydraulic computer code TRAC. The post test analysis results have shown that TRAC can accurately predict the PCCS heat removal Performance and the containment pressure response to a LOCA. This paper summarizes the GIRAFFE test results to investigate post-LOCA PCCS heat removal performance and post-test analysis using TRAC.

  16. MOPEX Workshop Results Revisited

    NASA Astrophysics Data System (ADS)

    Leavesley, G. H.

    2003-12-01

    A complementary program to the Prediction in Ungauged Basins (PUB) program is the Model Parameter Estimation Experiment (MOPEX). The primary goal of MOPEX is to develop techniques for the a priori estimation of parameters in land surface parameterization schemes in atmospheric models and in hydrologic models. A recent MOPEX workshop evaluated the use of a priori estimated parameters in eight hydrologic models. A data set of mean areal precipitation, temperature, and potential evapotranspiration was provided for each of 12 basins located predominantly in the southeastern United States. While workshop results provided valuable insight to some problems in a priori parameter estimation within and among models, additional questions remain. Using additional data sets for the 12 basins, alternative parameter estimation techniques are being evaluated to compare the use of distributed values of precipitation and temperature to the use of mean areal values in the original study. Also, the magnitudes of the uncertainty in streamflow prediction resulting from errors in the meteorological variables and their distribution are being compared with the magnitudes of uncertainty associated with errors in parameter estimates of basin physical characteristics. The U.S Geological Survey's distributed-parameter watershed model PRMS was one of the eight models used in the MOPEX workshop and is the model being used to conduct these further studies. Results of this investigation are presented.

  17. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy.

    PubMed

    Stone, Alexander B; Sheinberg, Rosanne; Bertram, Amanda; Seymour, Anastasia Rowland

    2016-04-01

    This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p < .0001). Common reasons cited against using hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use. PMID:27003489

  18. Providing a Turn for the Better

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Engineers are tasked with designing new systems every day to meet changing or unexpected technical requirements. After the tragic explosion of the Space Shuttle Challenger on January 28, 1986, NASA engineers embarked on a complete overhaul of many of their long-standing quality systems and procedures. When the official cause of the accident was determined to be an O-ring failure in the right Solid Rocket Booster, NASA's Shuttle Program initiated a thorough redesign of the rocket boosters' clevis ends, which are the O-ring's mating surfaces. One of the unique systems that NASA engineers developed as a result of this effort included a heating assembly that is coupled to the outside of the rocket boosters. When the assembly is affixed to the external surface of the boosters, the very nature of its design allows for the warming of the O-rings prior to launch. After the engineers completed the assembly's design, however, they found that it was nearly impossible to tighten the spanner nuts required for attaching the system, given the minimum amount of clearance they had in the limited and confined space. Under these circumstances, the standard wrenches typically used for tightening these types of nuts did not work, and there were no other existing devices to solve the problem. NASA engineers embraced the challenge, developing a torque wrench tool adapter that allowed for a full rotation of spanner nuts in confined spaces. The tool, which is similar to an open-ended crowfoot wrench and a fixed-face spanner wrench, contains two dowel pins that center and lock the wrench onto the nut.

  19. Providers' gender and moral reasoning: a proposed agenda for research on providers and patients.

    PubMed

    Wertz, Dorothy C

    1993-04-01

    Women constitute 35% of providers in genetics, at the doctoral level. A survey of 682 geneticists in 19 nations showed that gender was the single most important determinant of ethical decision making. Women were less directive and more observant of patient autonomy than men. The future influx of women into medicine calls for research on provider gender and decisions. Research is also needed on women's and men's perceptions of abortion for genetic reasons, on extended families' views, on agreement between partners and on overall effectiveness of genetic counseling, including communication, elements of provider satisfaction, interpretation of risk and uncertainty after counseling. PMID:11653026

  20. HUBBLE PROVIDES COMPLETE VIEW OF JUPITER'S AURORAS

    NASA Technical Reports Server (NTRS)

    2002-01-01

    NASA's Hubble Space Telescope has captured a complete view of Jupiter's northern and southern auroras. Images taken in ultraviolet light by the Space Telescope Imaging Spectrograph (STIS) show both auroras, the oval- shaped objects in the inset photos. While the Hubble telescope has obtained images of Jupiter's northern and southern lights since 1990, the new STIS instrument is 10 times more sensitive than earlier cameras. This allows for short exposures, reducing the blurring of the image caused by Jupiter's rotation and providing two to five times higher resolution than earlier cameras. The resolution in these images is sufficient to show the 'curtain' of auroral light extending several hundred miles above Jupiter's limb (edge). Images of Earth's auroral curtains, taken from the space shuttle, have a similar appearance. Jupiter's auroral images are superimposed on a Wide Field and Planetary Camera 2 image of the entire planet. The auroras are brilliant curtains of light in Jupiter's upper atmosphere. Jovian auroral storms, like Earth's, develop when electrically charged particles trapped in the magnetic field surrounding the planet spiral inward at high energies toward the north and south magnetic poles. When these particles hit the upper atmosphere, they excite atoms and molecules there, causing them to glow (the same process acting in street lights). The electrons that strike Earth's atmosphere come from the sun, and the auroral lights remain concentrated above the night sky in response to the 'solar wind,' as Earth rotates underneath. Earth's auroras exhibit storms that extend to lower latitudes in response to solar activity, which can be easily seen from the northern U. S. But Jupiter's auroras are caused by particles spewed out by volcanoes on Io, one of Jupiter's moons. These charged particles are then magnetically trapped and begin to rotate with Jupiter, producing ovals of auroral light centered on Jupiter's magnetic poles in both the day and night skies

  1. SALI chemical analysis of provided samples

    NASA Technical Reports Server (NTRS)

    Becker, Christopher H.

    1993-01-01

    SRI has completed the chemical analysis of all the samples supplied by NASA. The final batch of four samples consisted of: one inch diameter MgF2 mirror, control 1200-ID-FL3; one inch diameter neat resin, PMR-15, AO171-IV-55, half exposed and half unexposed; one inch diameter chromic acid anodized, EOIM-3 120-47 aluminum disc; and AO-exposed and unexposed samples of fullerene extract material in powdered form, pressed into In foil for analysis. Chemical analyses of the surfaces were performed by the surface analysis by laser ionization (SALI) method. The analyses emphasize surface contamination or general organic composition. SALI uses nonselective photoionization of sputtered or desorbed atoms and molecules above but close (approximately one mm) to the surface, followed by time-of-flight (TOF) mass spectrometry. In these studies, we used laser-induced desorption by 5-ns pulse-width 355-nm light (10-100 mJ/sq cm) and single-photon ionization (SPI) by coherent 118-nm radiation (at approximately 5 x 10(exp 5) W/sq cm). SPI was chosen primarily for its ability to obtain molecular information, whereas multiphoton ionization (not used in the present studies) is intended primarily for elemental and small molecule information. In addition to these four samples, the Au mirror (EOIM-3 200-11, sample four) was depth profiled again. Argon ion sputtering was used together with photoionization with intense 355-nm radiation (35-ps pulsewidths). Depth profiles are similar to those reported earlier, showing reproducibility. No chromium was found in the sample above noise level; its presence could at most be at the trace level. Somewhat more Ni appears to be present in the Au layer in the unexposed side, indicating thermal diffusion without chemical enhancement. The result of the presence of oxygen is apparently to tie-up/draw out the Ni as an oxide at the surface. The exposed region has a brownish tint appearance to the naked eye.

  2. Any-Willing-Provider laws: their financial effect on HMOs.

    PubMed

    Carroll, Anne; Ambrose, Jan M

    2002-12-01

    Any-Willing-Provider (AWP) legislation requires that health plans accept any health care provider who agrees to conform to the plan's conditions, terms, and reimbursement rates. Many states have adopted such legislation, raising questions about its effect on the managed care market. Those favoring this legislation argue that it will reduce restrictions on choice of provider, while opponents argue that it will reduce competition by increasing administrative and medical costs for managed care plans. Using cross-sectional time-series data for the period 1992-1995 (the period during which many of these laws were enacted), this study investigates the effect that these laws have on HMO financial performance. Our results show that "all-provider" AWP laws have a very limited effect on the financial performance measures we examine. "Pharmacy" AWP laws have a more significant effect, but neither type of law appears to affect the overall profitability of HMOs. PMID:12556022

  3. Surgical Outcomes of Newly Trained ShangRing Circumcision Providers

    PubMed Central

    Lee, Richard K.; Li, Philip S.; Zulu, Robert; Agot, Kawango; Combes, Stephanie; Simba, Raymond O.; Hart, Catherine; Lai, Jaim Jou; Zyambo, Zude; Goldstein, Marc; Feldblum, Paul J.; Barone, Mark A.

    2016-01-01

    Background: Devices can potentially accelerate scale-up of voluntary medical male circumcision in sub-Saharan Africa. Studies have demonstrated advantages of the ShangRing device over conventional circumcision. With the need to train providers rapidly for scale-up, concerns arise about the transferability of techniques and the expertise of new trainees. Methods: We compared outcomes of ShangRing circumcisions conducted in Kenya by experienced providers (experience with more than 100 ShangRing circumcisions) and newly trained providers (trained in Kenya by the experienced providers before the study began). During training, trainees performed at least 7 ShangRing circumcisions and 3 removals. Newly trained providers received intermittent clinical mentoring initially during the study but otherwise conducted circumcisions on their own. Results: Four hundred six and 115 ShangRing procedures were performed by the new trainees and the experienced providers, respectively. The mean duration of circumcisions was 6.2 minutes for both trained and experienced provider groups (P = 0.45), whereas the mean pain score (on an 11-point scale) was 2.5 and 3.2, respectively (P = 0.65). There was no difference in the proportion of participants healed by the day 42 visit (P = 0.13) nor in the incidence of moderate and severe adverse events observed (P = 0.16). Participants in both groups were equally satisfied with final wound cosmesis. Discussion: Results demonstrate that the ShangRing circumcision technique is easy to learn and master. Newly trained providers can safely conduct ShangRing circumcisions in routine service settings. The ShangRing can facilitate rapid rollout of voluntary medical male circumcision for HIV prevention in sub-Saharan Africa. PMID:27331584

  4. 45 CFR 156.235 - Essential community providers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....235 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES... result of violating Federal law: (1) Health care providers defined in section 340B(a)(4) of the PHS...

  5. 45 CFR 156.235 - Essential community providers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....235 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES... result of violating Federal law: (1) Health care providers defined in section 340B(a)(4) of the PHS...

  6. Development of a system to provide diagnostics-while-drilling.

    SciTech Connect

    Wise, Jack LeRoy; Jacobson, Ronald David; Finger, John Travis; Mansure, Arthur James; Knudsen, Steven Dell

    2003-06-01

    This report describes development of a system that provides high-speed, real-time downhole data while drilling. Background of the project, its benefits, major technical challenges, test planning, and test results are covered by relatively brief descriptions in the body of the report, with some topics presented in more detail in the attached appendices.

  7. Depression and burnout symptoms among Air Force family medicine providers.

    PubMed

    Varner, Derrick F; Foutch, Brian K

    2014-05-01

    This study investigated the prevalence of depression and burnout symptoms among family medicine providers on active duty in the US Air Force. Results demonstrated that 84% of those surveyed scored positive for degrees of depression symptoms; only sex differences were significant. PMID:24758978

  8. Quality Perception within Corporate E-Learning Providers in Catalonia

    ERIC Educational Resources Information Center

    Sangra, Albert; Fernandez-Michels, Pedro

    2011-01-01

    Purpose: The paper seeks to describe the Catalan corporate e-learning providers from the perspective of quality perception, quality assessment and quality control. Design/methodology/approach: A literature review reveals key aspects of the definition of quality in e-learning. The results of the review constitute the basis for exploratory research…

  9. A Workforce Design Model: Providing Energy to Organizations in Transition

    ERIC Educational Resources Information Center

    Halm, Barry J.

    2011-01-01

    The purpose of this qualitative study was to examine the change in performance realized by a professional services organization, which resulted in the Life Giving Workforce Design (LGWD) model through a grounded theory research design. This study produced a workforce design model characterized as an organizational blueprint that provides virtuous…

  10. Computer-Aided Techniques for Providing Operator Performance Measures.

    ERIC Educational Resources Information Center

    Connelly, Edward M.; And Others

    This report documents the theory, structure, and implementation of a performance processor (written in FORTRAN IV) that can accept performance demonstration data representing various levels of operator's skill and, under user control, analyze data to provide candidate performance measures and validation test results. The processor accepts two…

  11. Infant Childrearing: Beliefs of Parents and Child Care Providers.

    ERIC Educational Resources Information Center

    Coe, Gwendolyn; And Others

    1996-01-01

    Examined differences in childrearing beliefs and changes in mothers' and fathers' beliefs over a six-month period. Results of Luster Parental Beliefs Survey and Personal Style Inventory indicated significant differences between mothers and fathers in beliefs about spoiling, and between mothers and care providers in beliefs about discipline.…

  12. Literacy Content Knowledge Expertise among Adult Education Providers in Kentucky

    ERIC Educational Resources Information Center

    Henry, Laurie A.

    2013-01-01

    This paper summarizes the results of a literacy content knowledge survey and assessment administered to adult education providers in Kentucky (n=520). This descriptive study focused on two main goals: 1) to obtain a description of Kentucky adult education programs including instructors' backgrounds, professional preparation, and teaching…

  13. Providing Counseling for Individuals with Alzheimer's Disease and Their Caregivers

    ERIC Educational Resources Information Center

    Granello, Paul F.; Fleming, Matthew S.

    2008-01-01

    Alzheimer's disease is a progressive condition that results in brain wasting and eventual death. With its increasing diagnosis rate, counselors will likely acquire clients with Alzheimer's disease or their caregivers. Important background information and several practical counseling methods are provided that may assist counselors working with this…

  14. Using Technology to Provide Differentiated Instruction for Deaf Learners

    ERIC Educational Resources Information Center

    Shepherd, Carol M.; Alpert, Madelon

    2015-01-01

    Knowledge is power. Technological devices provide the new pathway to online learning and student retention. This is especially true for deaf learners, who have difficulty learning with the traditional pedagogies used in teaching. Results of studies have indicated that students using the suggested new technologies become more interested and…

  15. Mobility Assistants: A Perspective on New Service Providers.

    ERIC Educational Resources Information Center

    Wiener, William R.; Uslan, Mark

    1990-01-01

    The article reviews the history of orientation and mobility (OM) training for the visually impaired with emphasis on the increasing need for paraprofessional mobility assistants. Results of interviews with OM specialists (N=64) provided information on types of personnel trained, methods of training, and skills taught to OM assistants. (DB)

  16. Aerobic Activity--Do Physical Education Programs Provide Enough?

    ERIC Educational Resources Information Center

    McGing, Eileen

    1989-01-01

    High school physical education curricula should concentrate less on sport skill development and competition, and more on health-related fitness and aerobic activity. Results are reported from a study of the type and amount of aerobic exercise provided in 29 high school physical education programs in a large metropolitan area. (IAH)

  17. The State of the Psychology Health Service Provider Workforce

    ERIC Educational Resources Information Center

    Michalski, Daniel S.; Kohout, Jessica L.

    2011-01-01

    Numerous efforts to describe the health service provider or clinical workforce in psychology have been conducted during the past 30 years. The American Psychological Association (APA) has studied trends in the doctoral education pathway and the resultant effects on the broader psychology workforce. During this period, the creation and growth of…

  18. ESR teleradiology survey: results.

    PubMed

    2016-08-01

    With recent developments of teleradiology technology and services, it has become necessary to better evaluate its extent and use among different countries in Europe. With this goal in mind, the ESR launched two specific surveys intended to gather the current state of adoption and implementation of teleradiology in clinical practice. A special focus on differentiating between insourcing teleradiology services among partners of the same organisation and outsourcing to external services was an essential part of the design of these surveys. The first survey was addressed to 44 national societies of different countries in Europe, while the second survey was intended for all practicing radiologist ESR members. While the results of these surveys reported here may provide a wealth of information to better understand the trends in adoption of teleradiology in Europe, they only represent a snapshot at a certain point in time. The rapid development of telecommunication tools as well as a fundamental change in practice and healthcare economics will certainly influence these observations in the upcoming years. These data, however, will provide objective and relevant parameters for supporting the efforts of experts and policy makers in promoting appropriate criteria and guidelines for adequate use of teleradiology in clinical practice. Main Messages • Understand concepts and challenges of teleradiology • Provide insight into current trends and solutions for teleradiology • Compare differences in teleradiolgy strategies between countries in Europe • Establish a reference on statistical data of usage of teleradiology in Europe. PMID:27188379

  19. AMT experiment results

    NASA Technical Reports Server (NTRS)

    Abbe, Brian S.; Pinck, Deborah S.

    1995-01-01

    The Advanced Communications Technology Satellite (ACTS) Mobile Terminal (AMT) experiments have provided a terminal technology testbed for the evaluation of K- and Ka-band mobile satellite communications (satcom). Such a system could prove to be highly beneficial for many different commercial and government mobile satcom users. Combining ACTS' highly concentrated spotbeams with the smaller, higher-gain Ka-band antenna technology, results in a system design that can support a much higher throughput capacity than today's commercial configurations. To date, experiments in such diverse areas as emergency medical applications, enhanced Personal Communication Services (PCS), disaster recovery assistance, military applications, and general voice and data services have already been evaluated. Other applications that will be evaluated over the next year include telemedicine, ISDN, and television network return feed. Baseline AMT performance results will be presented, including Bit Error Rate (BER) curves and mobile propagation data characterizing the K- and Ka-band mobile satcom channel. In addition, observations from many of the application-specific experiments will also be provided.

  20. Problems of providing services to people affected by HIV/AIDS: service providers and recipients perspectives.

    PubMed

    Moradi, G; Mohraz, M; Gouya, M M; Dejman, M; Alinaghi, S S; Rahmani, K; Malekafzali-Ardakani, H

    2015-01-01

    This qualitative study aimed to identify the health-care problems of people living with HIV (PLHIV) in 2 large cities: Tehran and Kermanshah. Two main groups of stakeholders - service providers (policy-makers, managers, physicians and counsellors) and service recipients (PLHIV and their relatives) - participated in focus group discussions and in-depth interviews. We identified 24 themes covering the major health problems of PLHIV, including: incomplete and inadequate coverage of health-care services; patients' substance abuse; patients' fear of stigma; occupational burnout of certain service providers; patients' dissatisfaction with some of the services provided by counselling centres/clinics; medical staff's failure to observe confidentiality; and patients' lack of access to required specialized services. The problems and needs identified can inform the design and implementation of health programmes in our country and elsewhere in the Eastern Mediterranean Region. PMID:25907189

  1. [The applicability of results].

    PubMed

    Marín-León, I

    2015-11-01

    The ultimate aim of the critical reading of medical literature is to use the scientific advances in clinical practice or for innovation. This requires an evaluation of the applicability of the results of the studies that have been published, which begins with a clear understanding of these results. When the studies do not provide sufficient guarantees of rigor in design and analysis, the conditions necessary for the applicability of the results are not met; however, the fact that the results are reliable is not enough to make it worth trying to use their conclusions. This article explains how carrying out studies in experimental or artificial conditions often moves them away from the real conditions in which they claim to apply their conclusions. To evaluate this applicability, the article proposes evaluating a set of items that will enable the reader to determine the likelihood that the benefits and risks reported in the studies will yield the least uncertainty in the clinical arena where they aim to be applied. PMID:26454562

  2. Private Companies Providing Health Care Price Data: Who Are They and What Information do They Provide?

    PubMed Central

    Phillips, Kathryn A.; Labno, Anna

    2014-01-01

    Summary There is interest in making health care price information more transparent given the increase in enrollment in high-deductible and consumer-directed health plans, and as policy efforts intensify to engage consumers to obtain high value care. We examine the role of private companies that market price transparency tools, primarily to self-insured employers – an important yet understudied topic. What companies exist? How did they emerge? What information do they provide? Where do they get that information? How does the price and quality information provided compare across companies? PMID:25678764

  3. Selecting a provider: what factors influence patients' decision making?

    PubMed

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

    2011-01-01

    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation. PMID:21495529

  4. Infant Male Circumcision: Healthcare Provider Knowledge and Associated Factors

    PubMed Central

    Starzyk, Erin J.; Kelley, Michele A.; Caskey, Rachel N.; Schwartz, Alan; Kennelly, Joan F.; Bailey, Robert C.

    2015-01-01

    Background and Objectives The emerging science demonstrates various health benefits associated with infant male circumcision and adult male circumcision; yet rates are declining in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend that healthcare providers present evidence-based risk and benefit information for infant male circumcision to parent(s) and guardian(s). The purpose of this study was to assess providers’ level of infant male circumcision knowledge and to identify the associated characteristics. Methods An online survey was administered to healthcare providers in the family medicine, obstetrics, and pediatrics medical specialties at an urban academic health center. To assess infant male circumcision knowledge, a 17 point summary score was constructed to identify level of provider knowledge within the survey. Results Ninety-two providers completed the survey. Providers scored high for the following knowledge items: adverse event rates, protects against phimosis and urinary tract infections, and does not prevent hypospadias. Providers scored lower for items related to more recent research: protection against cervical cancer, genital ulcer disease, bacterial vaginosis, and reduction in HIV acquisition. Two models were constructed looking at (1) overall knowledge about male circumcision, and (2) knowledge about male circumcision reduction in HIV acquisition. Pediatricians demonstrated greater overall infant male circumcision knowledge, while obstetricians exhibited significantly greater knowledge for the HIV acquisition item. Conclusion Providers’ knowledge levels regarding the risks and benefits of infant male circumcision are highly variable, indicating the need for system-based educational interventions. PMID:25635664

  5. Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?

    ERIC Educational Resources Information Center

    Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

    2014-01-01

    We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy…

  6. Female Sexual Health Training for Oncology Providers: New Applications

    PubMed Central

    Wang, Lynn Y; Pierdomenico, Annette; Lefkowitz, Abbe; Brandt, Rachael

    2015-01-01

    Introduction Sexual health care remains an unmet need for women with cancer. Many barriers are described, such as provider discomfort and lack of training; however, there is little evidence-based guidance regarding how to effectively address these obstacles. Aim This pilot study was performed to determine whether brief, targeted sexual health training for oncology providers results in improved provider comfort level and frequency of addressing female cancer-related sexual issues. Methods A brief (30–45 minute), targeted sexual health training program focused on improving comfort level, knowledge and communication skills when addressing breast cancer–related sexual issues was developed by the primary author. Using a pretest-posttest format, this educational program was provided to oncology providers (physicians and nurses/other allied health) from a suburban health-care system. Surveys based on 5-point Likert scales were provided before and 3–6 month post training. Main Outcome Measures Primary endpoints were changes in mean Likert scores for provider comfort level and self-reported frequency of addressing sexual issues. A secondary endpoint was change in mean Likert scores for perception of access to sexual health resources/referrals. Results Eligible respondents included 8 oncologists, 4 surgeons, and 62 nurses/other allied health. For total respondents, comparison of mean Likert scores for survey 1 (n = 71) and survey 2 (n = 36) demonstrated statistically significant increases for all parameters queried, including provider comfort level with bringing up (Pre mean Likert score = 3.4, Post = 4.3, P < 0.0001) and coordinating care (Pre = 3.5, Post = 4.6, P < 0.0001), and frequency of addressing sexual issues for both diagnosis/treatment and surveillance phase (Pre = 2.4, Post = 3.3, P ≤ 0.0052). Conclusion Brief, targeted sexual health training for oncology providers positively correlated with improved provider

  7. Providing Services to Survivors of Domestic Violence: A Comparison of Rural and Urban Service Provider Perceptions

    ERIC Educational Resources Information Center

    Eastman, Brenda J.; Bunch, Shelia Grant

    2007-01-01

    Although there is a considerable body of knowledge about domestic violence, a limited proportion focuses on domestic violence in rural settings. Using a nonprobability purposive sampling technique, 93 providers of domestic violence services from rural and urban localities in North Carolina and Virginia were located and asked to complete a…

  8. Comparing Intentions to Use University-Provided vs Vendor-Provided Multibiometric Authentication in Online Exams

    ERIC Educational Resources Information Center

    Levy, Yair; Ramim, Michelle M.; Furnell, Steven M.; Clarke, Nathan L.

    2011-01-01

    Purpose: Concerns for information security in e-learning systems have been raised previously. In the pursuit for better authentication approaches, few schools have implemented students' authentication during online exams beyond passwords. This paper aims to assess e-learners' intention to provide multibiometric data and use of multibiometrics…

  9. The Reinvention of the FDLP: A Paradigm Shift from Product Provider to Service Provider

    ERIC Educational Resources Information Center

    Arrigo, Paul A.

    2004-01-01

    This article highlights the Government Printing Office's (GPO) successful transition from a producer of print publications to a service provider and how this has affected the role of Federal Depository Libraries in an increasingly electronic service environment. It discusses the identity crisis currently facing Federal Depository Libraries during…

  10. Beyond literacy and numeracy in patient provider communication: Focus groups suggest roles for empowerment, provider attitude and language

    PubMed Central

    Brugge, Doug; Edgar, Timothy; George, Kelly; Heung, Janette; Laws, M Barton

    2009-01-01

    Background Although the number of people living in the United States with limited English proficiency (LEP) is substantial, the impact of language on patients' experience of provider-patient communication has been little explored. Methods We conducted a series of 12 exploratory focus groups in English, Spanish and Cantonese to elicit discussion about patient-provider communication, particularly with respect to the concerns of the health literacy framework, i.e. ability to accurately understand, interpret and apply information given by providers. Within each language, 2 groups had high education and 2 had low education participants to partially account for literacy levels, which cannot be assessed consistently across three languages. Eighty-five (85) adults enrolled in the focus groups. The resulting video tapes were transcribed, translated and analyzed via content analysis. Results We identified 5 themes: 1) language discordant communication; 2) language concordant communication; 3) empowerment; 4) providers' attitudes; 5) issues with the health care system. Despite efforts by facilitators to elicit responses related to cognitive understanding, issues of interpersonal process were more salient, and respondents did not readily separate issues of accurate understanding from their overall narratives of experience with health care and illness. Thematic codes often appeared to be associated with education level, language and/or culture. Conclusion Our most salient finding was that for most of our participants there was no clear demarcation between literacy and numeracy, language interpretation, health communication, interpersonal relations with their provider and the rest of their experience with the health care system. PMID:19772555

  11. Providing Formative Feedback From a Summative Computer-aided Assessment

    PubMed Central

    Sewell, Robert D. E.

    2007-01-01

    Objectives To examine the effectiveness of providing formative feedback for summative computer-aided assessment. Design Two groups of first-year undergraduate life science students in pharmacy and neuroscience who were studying an e-learning package in a common pharmacology module were presented with a computer-based summative assessment. A sheet with individualized feedback derived from each of the 5 results sections of the assessment was provided to each student. Students were asked via a questionnaire to evaluate the form and method of feedback. Assessment The students were able to reflect on their performance and use the feedback provided to guide their future study or revision. There was no significant difference between the responses from pharmacy and neuroscience students. Students' responses on the questionnaire indicated a generally positive reaction to this form of feedback. Conclusions Findings suggest that additional formative assessment conveyed by this style and method would be appreciated and valued by students. PMID:17533442

  12. Apparatus for providing directional permeability measurements in subterranean earth formations

    DOEpatents

    Shuck, Lowell Z.

    1977-01-01

    Directional permeability measurements are provided in a subterranean earth formation by injecting a high-pressure gas from a wellbore into the earth formation in various azimuthal directions with the direction having the largest pressure drop being indicative of the maximum permeability direction. These measurements are provided by employing an inflatable boot containing a plurality of conduits in registry with a like plurality of apertures penetrating the housing at circumferentially spaced-apart locations. These conduits are, in turn, coupled through a valved manifold to a source of pressurized gas so that the high-pressure gas may be selectively directed through any conduit into the earth formation defining the bore with the resulting difference in the pressure drop through the various conduits providing the permeability measurements.

  13. Method for providing uranium with a protective copper coating

    DOEpatents

    Waldrop, Forrest B.; Jones, Edward

    1981-01-01

    The present invention is directed to a method for providing uranium metal with a protective coating of copper. Uranium metal is subjected to a conventional cleaning operation wherein oxides and other surface contaminants are removed, followed by etching and pickling operations. The copper coating is provided by first electrodepositing a thin and relatively porous flash layer of copper on the uranium in a copper cyanide bath. The resulting copper-layered article is then heated in an air or inert atmosphere to volatilize and drive off the volatile material underlying the copper flash layer. After the heating step an adherent and essentially non-porous layer of copper is electro-deposited on the flash layer of copper to provide an adherent, multi-layer copper coating which is essentially impervious to corrosion by most gases.

  14. The Table Access Protocol: Providing standard access to astronomical data

    NASA Astrophysics Data System (ADS)

    Nandrekar-Heinis, D.; Michel, L.; Louys, M.; Bonnarel, F.

    2014-11-01

    In the upcoming era of large scale, geographically distributed, varied sources of astronomical data, a standard, simple and flexible way to access this data is necessary and useful for astronomers across the globe. Most of the modern surveys such as the Sloan Digital Sky Survey (SDSS) are available in well organized tabular formats. The Table Access Protocol (TAP) supports a standard web interface to access this kind of tabular data. Predefined queries and results formats help different data providers to implement these services. TAP also helps various software tools to access data and perform cross-matches seamlessly across different data sources. It is then possible to access data in tools that consume TAP web services. This supports further detailed data analysis on a queried slice of data. This document describes TAP and its utility for astronomers and data scientists. It also provides information on the protocol for data providers and developers.

  15. Method for providing uranium with a protective copper coating

    SciTech Connect

    Jones, E.; Waldrop, F.B.

    1981-08-25

    The present invention is directed to a method for providing uranium metal with a protective coating of copper. Uranium metal is subjected to a conventional cleaning operation wherein oxides and other surface contaminants are removed, followed by etching and pickling operations. The copper coating is provided by first electrodepositing a thin and relatively porous flash layer of copper on the uranium in a copper cyanide bath. The resulting copper-layered article is then heated in an air or inert atmosphere to volatilize and drive off the volatile material underlying the copper flash layer. After the heating step an adherent and essentially non-porous layer of copper is electrodeposited on the flash layer of copper to provide an adherent, multi-layer copper coating which is essentially impervious to corrosion by most gases.

  16. Overview of HERMES results

    NASA Astrophysics Data System (ADS)

    Van Hulse, Charlotte

    2016-03-01

    The HERMES experiment has collected a wealth of deep-inelastic scattering data using the 27.6 GeV polarized lepton beam at HERA and various pure gas targets, both unpolarized and polarized. This allowed for a series of diverse and unique measurements. Among them are measurements that provide information on the threedimensional structure of the nucleon, both in momentum space and in position space. Results of measurements of exclusive ω production on an unpolarized and transversely polarized nucleon target, sensitive to the distribution in transverse-position and longitudinalmomentum space, are discussed as well as the three-dimensional extraction of azimuthal asymmetries measured in semi-inclusive deep-inelastic scattering, sensitive to twist-2 and twist-3 distributions in three-dimensional momentum space.

  17. Negative emotion provides cues for orienting auditory spatial attention

    PubMed Central

    Asutay, Erkin; Västfjäll, Daniel

    2015-01-01

    The auditory stimuli provide information about the objects and events around us. They can also carry biologically significant emotional information (such as unseen dangers and conspecific vocalizations), which provides cues for allocation of attention and mental resources. Here, we investigated whether task-irrelevant auditory emotional information can provide cues for orientation of auditory spatial attention. We employed a covert spatial orienting task: the dot-probe task. In each trial, two task-irrelevant auditory cues were simultaneously presented at two separate locations (left–right or front–back). Environmental sounds were selected to form emotional vs. neutral, emotional vs. emotional, and neutral vs. neutral cue pairs. The participants’ task was to detect the location of an acoustic target that was presented immediately after the task-irrelevant auditory cues. The target was presented at the same location as one of the auditory cues. The results indicated that participants were significantly faster to locate the target when it replaced the negative cue compared to when it replaced the neutral cue. The positive cues did not produce a clear attentional bias. Further, same valence pairs (emotional–emotional or neutral–neutral) did not modulate reaction times due to a lack of spatial attention capture by one cue in the pair. Taken together, the results indicate that negative affect can provide cues for the orientation of spatial attention in the auditory domain. PMID:26029149

  18. Negative emotion provides cues for orienting auditory spatial attention.

    PubMed

    Asutay, Erkin; Västfjäll, Daniel

    2015-01-01

    The auditory stimuli provide information about the objects and events around us. They can also carry biologically significant emotional information (such as unseen dangers and conspecific vocalizations), which provides cues for allocation of attention and mental resources. Here, we investigated whether task-irrelevant auditory emotional information can provide cues for orientation of auditory spatial attention. We employed a covert spatial orienting task: the dot-probe task. In each trial, two task-irrelevant auditory cues were simultaneously presented at two separate locations (left-right or front-back). Environmental sounds were selected to form emotional vs. neutral, emotional vs. emotional, and neutral vs. neutral cue pairs. The participants' task was to detect the location of an acoustic target that was presented immediately after the task-irrelevant auditory cues. The target was presented at the same location as one of the auditory cues. The results indicated that participants were significantly faster to locate the target when it replaced the negative cue compared to when it replaced the neutral cue. The positive cues did not produce a clear attentional bias. Further, same valence pairs (emotional-emotional or neutral-neutral) did not modulate reaction times due to a lack of spatial attention capture by one cue in the pair. Taken together, the results indicate that negative affect can provide cues for the orientation of spatial attention in the auditory domain. PMID:26029149

  19. The spread of state any willing provider laws.

    PubMed Central

    Ohsfeldt, R L; Morrisey, M A; Nelson, L; Johnson, V

    1998-01-01

    OBJECTIVE: To describe the growth of any willing provider (AWP) and freedom of choice (FOC) laws applicable to managed care firms and to explore empirically the determinants of their enactment. STUDY SETTING: A 1996 compendium of state laws and state-level data from the 1991-1994 period. STUDY DESIGN: Pooled cross-section time-series logistic regression of the decision to enact various types of AWP and FOC laws. Analysis uses a public choice framework to examine enactment. Key variables include proxy measures of proponent and opponent strength and the political environment. PRINCIPAL FINDINGS: The model works well for laws affecting hospitals, but performs poorly for physician and pharmacy laws. More providers are associated with the enactment of AWP and FOC laws. More large employers are associated with a reduced likelihood of enactment of some forms of the laws but not others. Conservative states are more likely to enact laws limiting selective contracting with hospitals and physicians. States with greater interparty competition are also more likely to adopt some types of legislation. CONCLUSIONS: The empirical results generally are consistent with the view that AWP and FOC laws are often enacted as a defensive strategy on the part of providers, but additional research is needed to provide a more definitive assessment of the determinants of these laws. Suggestions for future research are provided. PMID:9865232

  20. Applying the balanced scorecard in healthcare provider organizations.

    PubMed

    Inamdar, Noorein; Kaplan, Robert S; Bower, Marvin

    2002-01-01

    Several innovative healthcare executives have recently introduced a new business strategy implementation tool: the Balanced Scorecard. The scorecard's measurement and management system provides the following potential benefits to healthcare organizations: It aligns the organization around a more market-oriented, customer-focused strategy It facilitates, monitors, and assesses the implementation of the strategy It provides a communication and collaboration mechanism It assigns accountability for performance at all levels of the organization It provides continual feedback on the strategy and promotes adjustments to marketplace and regulatory changes. We surveyed executives in nine provider organizations that were implementing the Balanced Scorecard. We asked about the following issues relating to its implementation and effect: 1. The role of the Balanced Scorecard in relation to a well-defined vision, mission, and strategy 2. The motivation for adopting the Balanced Scorecard 3. The difference between the Balanced Scorecard and other measurement systems 4. The process followed to develop and implement the Balanced Scorecard 5. The challenges and barriers during the development and implementation process 6. The benefits gained by the organization from adoption and use. The executives reported that the Balanced Scorecard strategy implementation and performance management tool could be successfully applied in the healthcare sector, enabling organizations to improve their competitive market positioning, financial results, and customer satisfaction. This article concludes with guidelines for other healthcare provider organizations to capture the benefits of the Balanced Scorecard performance management system. PMID:12055900

  1. Invasive prenatal genetic testing: A Catholic healthcare provider's perspective

    PubMed Central

    Bringman, Jay J.

    2014-01-01

    Invasive prenatal testing is performed for a variety of reasons, but the most common indication is for genetic testing of the fetus. Although many times the information obtained from this type of testing results in selective termination of fetuses with genetic diagnoses, the information itself may be morally neutral. Should a Catholic healthcare provider be willing to perform invasive prenatal testing in the setting of uncertainty with respect to the patient's plans following a diagnosis of a genetic abnormality? PMID:25473130

  2. Provider portrayals and patient-provider communication in drama and reality medical entertainment television shows.

    PubMed

    Jain, Parul; Slater, Michael D

    2013-01-01

    Portrayals of physicians on medical dramas have been the subject of research attention. However, such research has not examined portrayals of interactions between physicians and patients, has not compared physician portrayals on medical dramas versus on medical reality programs, and has not fully examined portrayals of physicians who are members of minority groups or who received their education internationally. This study content-analyzes 101 episodes (85 hours) of such programs broadcast during the 2006-2007 viewing season. Findings indicate that women are underrepresented as physicians on reality shows, though they are no longer underrepresented as physicians on dramas. However, they are not as actively portrayed in patient-care interactions as are male physicians on medical dramas. Asians and international medical graduates are underrepresented relative to their proportion in the U.S. physician population, the latter by almost a factor of 5. Many (but certainly not all) aspects of patient-centered communication are modeled, more so on reality programs than on medical dramas. Differences in patient-provider communication portrayals by minority status and gender are reported. Implications for public perception of physicians and expectations regarding provider-patient interaction are discussed. PMID:23581602

  3. CAM Provider Use and Expenditures by Cancer Treatment Phase

    PubMed Central

    Lafferty, William E.; Tyree, Patrick T.; Devlin, Sean M.; Andersen, M. Robyn; Diehr, Paula K.

    2008-01-01

    Objective To assess cancer patients’ utilization of complementary and alternative medical providers and the associated expenditures by specific treatment phases. Study Design Cross-sectional analysis of medical services utilization and expenditures during three therapeutic intervals: an initial treatment phase, continuing care, and end-of-life. Methods Analysis of an insurance claims database that had been matched to the Washington State SEER cancer registry. Results Of 2,900 registry-matched cancer patients 63.2% were female, the median age was 54 years, and 92.7% were white. Breast cancer was the most frequent diagnosis (52.7%), followed by prostate cancer (24.7%), lung cancer (10.1%), colon cancer (7.0%), and hematologic malignancies (5.6%). CAM provider using patients were 26.5% of the overall cohort (18.5% used chiropractors, 7.7% naturopathic physicians, 5.3% massage therapists, and 4.2% saw acupuncturists). The proportion of CAM using patients was similar during each treatment phase. All patients used some conventional care. Female gender, a breast cancer diagnosis, age, and white race were significant predictors of CAM use. Diagnosis of a musculoskeletal problem occurred at sometime during the study for 72.1% of cancer patients. CAM provider visits were 7.2% of total outpatient medical visits and 85.1% of CAM visits resulted in a musculoskeletal diagnosis. Expenditures for CAM providers were 0.3%, 1.0%, and 0.1% of all expenditures during the initial, continuing, and end-of-life phases respectively. Conclusion For cancer patients, musculoskeletal issues were the most commonly listed diagnosis made by a CAM provider. Although expenditures associated with CAM are a small proportion of the total, additional studies are necessary to determine the importance patients place on access to these services. PMID:18471036

  4. Doctors’ opinions of information provided by Libyan pharmaceutical company representatives

    PubMed Central

    Alssageer, Mustafa A.; Kowalski, Stefan R.

    2012-01-01

    Objective To examine the opinions of Libyan doctors regarding the quality of drug information provided by pharmaceutical company representatives (PCRs) during detailing visits. Method An anonymous survey was conducted among 1,000 doctors from selected institutes in Tripoli, Benghazi and Sebha. Doctors were asked questions regarding the quality of information provided during drug-detailing visits. Results A questionnaire return rate of 61% (608 returned questionnaires out of 1,000) was achieved. The majority (n=463, 76%) of surveyed participants graded the quality of information provided as average. Approximately, 40% of respondents indicated that contraindications, precautions, interactions and adverse effects of products promoted by PCRs were never or rarely mentioned during promotional visits, and 65% of respondents indicated that an alternative drug to the promoted product was never or rarely mentioned by the representatives. More than 50% of respondents (n=310, 51%) reported that PCRs were not always able to answer all questions about their products. Only seven respondents (1%) believed that PCRs never exaggerated the uniqueness, efficacy or safety of their product. The majority of respondents (n=342, 56%) indicated that verbal information was not always consistent with written information provided. Seven per cent of respondents (n=43) admitted that they did not know whether or not the verbal information provided by PCRs was consistent with written information. Conclusion Doctors believe that the provision of drug information by PCRs in Libya is incomplete and often exaggerated. Pharmaceutical companies should ensure that their representatives are trained to a standard to provide reliable information regarding the products they promote. PMID:23205141

  5. Determinants of patient choice of healthcare providers: a scoping review

    PubMed Central

    2012-01-01

    Background In several northwest European countries, a demand-driven healthcare system has been implemented that stresses the importance of patient healthcare provider choice. In this study, we are conducting a scoping review aiming to map out what is known about the determinants of patient choice of a wide range of healthcare providers. As far as we know, not many studies are currently available that attempt to draw a general picture of how patients choose a healthcare provider and of the status of research on this subject. This study is therefore a valuable contribution to the growing amount of literature about patient choice. Methods We carried out a specific type of literature review known as a scoping review. Scoping reviews try to examine the breadth of knowledge that is available about a particular topic and therefore do not make selections or apply quality constraints. Firstly, we defined our research questions and searched the literature in Embase, Medline and PubMed. Secondly, we selected the literature, and finally we analysed and summarized the information. Results Our review shows that patients’ choices are determined by a complex interplay between patient and provider characteristics. A variety of patient characteristics determines whether patients make choices, are willing and able to choose, and how they choose. Patients take account of a variety of structural, process and outcome characteristics of providers, differing in the relative importance they attach to these characteristics. Conclusions There is no such thing as the typical patient: different patients make different choices in different situations. Comparative information seems to have a relatively limited influence on the choices made by many patients and patients base their decisions on a variety of provider characteristics instead of solely on outcome characteristics. The assumptions made in health policy about patient choice may therefore be an oversimplification of reality. Several

  6. Pressure locking test results

    SciTech Connect

    DeWall, K.G.; Watkins, J.C.; McKellar, M.G.; Bramwell, D.

    1996-12-01

    The U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, is funding the Idaho National Engineering Laboratory (INEL) in performing research to provide technical input for their use in evaluating responses to Generic Letter 95-07, {open_quotes}Pressure Locking and Thermal Binding of Safety-Related Power-Operated Gate Valves.{close_quotes} Pressure locking and thermal binding are phenomena that make a closed gate valve difficult to open. This paper discusses only the pressure locking phenomenon in a flexible-wedge gate valve; the authors will publish the results of their thermal binding research at a later date. Pressure locking can occur when operating sequences or temperature changes cause the pressure of the fluid in the bonnet (and, in most valves, between the discs) to be higher than the pressure on the upstream and downstream sides of the disc assembly. This high fluid pressure presses the discs against both seats, making the disc assembly harder to unseat than anticipated by the typical design calculations, which generally consider friction at only one of the two disc/seat interfaces. The high pressure of the bonnet fluid also changes the pressure distribution around the disc in a way that can further contribute to the unseating load. If the combined loads associated with pressure locking are very high, the actuator might not have the capacity to open the valve. The results of the NRC/INEL research discussed in this paper show that the relationship between bonnet pressure and pressure locking stem loads appears linear. The results also show that for this valve, seat leakage affects the bonnet pressurization rate when the valve is subjected to thermally induced pressure locking conditions.

  7. Identifying perceived barriers to videoconferencing by rehabilitation medicine providers.

    PubMed

    Mozer, Roslyn; Bradford, Natalie K; Caffery, Liam J; Smith, Anthony C

    2015-12-01

    The aim of this study was to identify barriers to the utilisation of videoconferencing within a multidisciplinary rehabilitation medicine healthcare team, as the first step towards creating a telerehabilitation service. A survey was developed on videoconference use and barriers to use, and distributed to healthcare providers including rehabilitation medicine societies and allied health societies through an anonymous link to SurveyMonkey(®). There were 254 respondents, practicing primarily in Australia (n = 245), in various healthcare roles. One-hundred and fifty-nine (66%) of respondents used videoconferencing regularly, primarily for their own education. Respondents not currently utilising videoconferencing (n = 82, 34%) ranked the reasons for this and provided free-text responses to explain why this modality was not being utilised in practice. Respondents were reluctant to use videoconferencing because of perceived increase in time needed for video consultations compared to face-to-face consultations, concerns with lack of privacy and confidentiality, and a lack of clinical practice guidelines for video consultation. We believe many barriers to videoconferencing by healthcare providers can be managed with appropriate education and targeted training. Future research studies, which focus on standards and clinical practice guidelines for videoconferencing by healthcare providers, may result in increased utilisation of this modality for healthcare delivery in rehabilitation medicine. PMID:26556061

  8. Model of Providing Assistive Technologies in Special Education Schools

    PubMed Central

    Lersilp, Suchitporn; Putthinoi, Supawadee; Chakpitak, Nopasit

    2016-01-01

    Most students diagnosed with disabilities in Thai special education schools received assistive technologies, but this did not guarantee the greatest benefits. The purpose of this study was to survey the provision, use and needs of assistive technologies, as well as the perspectives of key informants regarding a model of providing them in special education schools. The participants were selected by the purposive sampling method, and they comprised 120 students with visual, physical, hearing or intellectual disabilities from four special education schools in Chiang Mai, Thailand; and 24 key informants such as parents or caregivers, teachers, school principals and school therapists. The instruments consisted of an assistive technology checklist and a semi-structured interview. Results showed that a category of assistive technologies was provided for students with disabilities, with the highest being “services”, followed by “media” and then “facilities”. Furthermore, mostly students with physical disabilities were provided with assistive technologies, but those with visual disabilities needed it more. Finally, the model of providing assistive technologies was composed of 5 components: Collaboration; Holistic perspective; Independent management of schools; Learning systems and a production manual for users; and Development of an assistive technology center, driven by 3 major sources such as Government and Private organizations, and Schools. PMID:26234984

  9. Hand Washing Practices Among Emergency Medical Services Providers

    PubMed Central

    Bucher, Joshua; Donovan, Colleen; Ohman-Strickland, Pamela; McCoy, Jonathan

    2015-01-01

    Introduction Hand hygiene is an important component of infection control efforts. Our primary and secondary goals were to determine the reported rates of hand washing and stethoscope cleaning in emergency medical services (EMS) workers, respectively. Methods We designed a survey about hand hygiene practices. The survey was distributed to various national EMS organizations through e-mail. Descriptive statistics were calculated for survey items (responses on a Likert scale) and subpopulations of survey respondents to identify relationships between variables. We used analysis of variance to test differences in means between the subgroups. Results There were 1,494 responses. Overall, reported hand hygiene practices were poor among pre-hospital providers in all clinical situations. Women reported that they washed their hands more frequently than men overall, although the differences were unlikely to be clinically significant. Hygiene after invasive procedures was reported to be poor. The presence of available hand sanitizer in the ambulance did not improve reported hygiene rates but improved reported rates of cleaning the stethoscope (absolute difference 0.4, p=0.0003). Providers who brought their own sanitizer were more likely to clean their hands. Conclusion Reported hand hygiene is poor amongst pre-hospital providers. There is a need for future intervention to improve reported performance in pre-hospital provider hand washing. PMID:26587098

  10. Provider communication on perinatal depression: a population-based study.

    PubMed

    Farr, Sherry L; Ko, Jean Y; Burley, Kim; Gupta, Seema

    2016-02-01

    Women's lack of knowledge on symptoms of perinatal depression and treatment resources is a barrier to receiving care. We sought to estimate the prevalence and predictors of discussing depression with a prenatal care provider. We used the 2011 population-based data from 24 sites participating in the Pregnancy Risk Assessment Monitoring System (n = 32,827 women with recent live births) to examine associations between maternal characteristics and report that a prenatal care provider discussed with her what to do if feeling depressed during or after pregnancy. Overall, 71.9 % of women reported discussing perinatal depression with their prenatal care provider (range 60.7 % in New York City to 85.6 % in Maine). Women were more likely to report a discussion on perinatal depression with their provider if they they were 18-29 years of age than over 35 years of age compared to older (adjusted prevalence ratio [aPR] 18 to 19 y = 1.08, 20 to 24 y = 1.10, 25 to 29 y = 1.09), unmarried (aPR = 1.07) compared to married, had <12 years of education (aPR = 1.05) compared to > 12 years, and had no previous live births (aPR = 1.03) compared to ≥ 1 live births. Research is needed on effective ways to educate women about perinatal depression and whether increased knowledge on perinatal depression results in higher rates of treatment and shorter duration of symptoms. PMID:25578631

  11. 4. View facing southwest showing the Silvertop Diner, Providence Fruit ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. View facing southwest showing the Silvertop Diner, Providence Fruit & Produce Building, and Merchants' Cold Storage Warehouse. - Provisions Warehouse Historic District, Kinsley & Harris Avenues, Providence, Providence County, RI

  12. Effects of neurofeedback and computer-assisted cognitive rehabilitation on relative brain wave ratios and activities of daily living of stroke patients: a randomized control trial

    PubMed Central

    Cho, Hwi-Young; Kim, Ki-Tae; Jung, Jin-Hwa

    2016-01-01

    [Purpose] This study investigated the effects of neurofeedback (NFB) and computer-assisted cognitive rehabilitation (CACR) on the relative brain wave ratios and activities of daily living (ADL) of stroke patients. [Subjects and Methods] Forty-four participants were randomly allocated to the NFB (n=14), CACR (n=14), or control (CON) (n=16) groups. Two expert therapists provided the NFB, CACR, and CON groups with traditional rehabilitation therapy in 30-minute sessions, 5 times a week, for 6 weeks. NFB training was provided only to the NFB group and CACR training was provided only to the CACR group. The CON group received traditional rehabilitation therapy only. Before and after 6 weeks of intervention, brain wave and ADL evaluations were performed, and the results were analyzed. [Results] The relative ratio of beta waves, only showed a significant increase in the frontal and parietal areas of the NFB group. Significant changes in ADL were shown by all three groups after the intervention. However, there were no significant differences between the NFB and CACR groups and the CON group. [Conclusion] Our results suggest that CACR and NFB are effective at improving cognitive function and ADL of stroke patients. PMID:27512287

  13. Effects of neurofeedback and computer-assisted cognitive rehabilitation on relative brain wave ratios and activities of daily living of stroke patients: a randomized control trial.

    PubMed

    Cho, Hwi-Young; Kim, Ki-Tae; Jung, Jin-Hwa

    2016-07-01

    [Purpose] This study investigated the effects of neurofeedback (NFB) and computer-assisted cognitive rehabilitation (CACR) on the relative brain wave ratios and activities of daily living (ADL) of stroke patients. [Subjects and Methods] Forty-four participants were randomly allocated to the NFB (n=14), CACR (n=14), or control (CON) (n=16) groups. Two expert therapists provided the NFB, CACR, and CON groups with traditional rehabilitation therapy in 30-minute sessions, 5 times a week, for 6 weeks. NFB training was provided only to the NFB group and CACR training was provided only to the CACR group. The CON group received traditional rehabilitation therapy only. Before and after 6 weeks of intervention, brain wave and ADL evaluations were performed, and the results were analyzed. [Results] The relative ratio of beta waves, only showed a significant increase in the frontal and parietal areas of the NFB group. Significant changes in ADL were shown by all three groups after the intervention. However, there were no significant differences between the NFB and CACR groups and the CON group. [Conclusion] Our results suggest that CACR and NFB are effective at improving cognitive function and ADL of stroke patients. PMID:27512287

  14. Latest Electroweak Results from CDF

    SciTech Connect

    Lancaster, Mark

    2010-05-01

    The latest results in electroweak physics from proton anti-proton collisions at the Fermilab Tevatron recorded by the CDF detector are presented. The results provide constraints on parton distribution functions, the mass of the Higgs boson and beyond the Standard Model physics.

  15. Genomic analyses provide insights into the history of tomato breeding.

    PubMed

    Lin, Tao; Zhu, Guangtao; Zhang, Junhong; Xu, Xiangyang; Yu, Qinghui; Zheng, Zheng; Zhang, Zhonghua; Lun, Yaoyao; Li, Shuai; Wang, Xiaoxuan; Huang, Zejun; Li, Junming; Zhang, Chunzhi; Wang, Taotao; Zhang, Yuyang; Wang, Aoxue; Zhang, Yancong; Lin, Kui; Li, Chuanyou; Xiong, Guosheng; Xue, Yongbiao; Mazzucato, Andrea; Causse, Mathilde; Fei, Zhangjun; Giovannoni, James J; Chetelat, Roger T; Zamir, Dani; Städler, Thomas; Li, Jingfu; Ye, Zhibiao; Du, Yongchen; Huang, Sanwen

    2014-11-01

    The histories of crop domestication and breeding are recorded in genomes. Although tomato is a model species for plant biology and breeding, the nature of human selection that altered its genome remains largely unknown. Here we report a comprehensive analysis of tomato evolution based on the genome sequences of 360 accessions. We provide evidence that domestication and improvement focused on two independent sets of quantitative trait loci (QTLs), resulting in modern tomato fruit ∼100 times larger than its ancestor. Furthermore, we discovered a major genomic signature for modern processing tomatoes, identified the causative variants that confer pink fruit color and precisely visualized the linkage drag associated with wild introgressions. This study outlines the accomplishments as well as the costs of historical selection and provides molecular insights toward further improvement. PMID:25305757

  16. How do obstetric providers discuss referrals for prenatal genetic counseling?

    PubMed

    Bernhardt, Barbara A; Haunstetter, Carrie Mastromarino; Roter, Debra; Geller, Gail

    2005-04-01

    To investigate referrals of pregnant women to genetic counseling, we analysed transcripts from audiotaped first prenatal visits of 104 patients (72 actual patient visits and 32 simulated patient visits) with 32 providers (obstetricians and nurse-midwives). All patients had at least one indication for referral. Only 10% of visits with actual patients included a genetic counseling referral. When genetic counseling was discussed, it was only briefly described, primarily as an information session. This study shows that the majority of pregnant women with an indication for referral for genetic counseling are not referred. In addition, obstetric providers' inadequate descriptions of prenatal genetic counseling may result in women being poorly prepared for genetic counseling sessions. PMID:15959642

  17. Strengthening the links between health sciences information users and providers.

    PubMed Central

    Silverstein, J L

    1995-01-01

    In 1994, the Hospital Library Service Program of the Central New York Library Resources Council conducted a study to evaluate the usefulness, impacts, and potential services of eleven hospital libraries in a four-county area in New York State; determine the degree to which the libraries comply with Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standard IM.9.2; and provide recommendations for improved services in the member libraries. Two research instruments were used: a survey for hospital-based health sciences professionals and a survey for hospital-based information providers. Results from the two surveys were compared to determine if users' needs were being filled, and to develop plans for improved information services and products. Fourteen recommendations are made that, if implemented, will support the creation of user-defined information products, enhance the library's profile within the hospital, and exploit resource sharing to reduce costs and enhance coordination. PMID:8547898

  18. Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope.

    PubMed

    McMillan, Katharine K; Pugh, Mary Jo; Hamid, Hamada; Salinsky, Martin; Pugh, Jacqueline; Noël, Polly H; Finley, Erin P; Leykum, Luci K; Lanham, Holly J; LaFrance, W Curt

    2014-08-01

    Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory. The results revealed variation in care and two emergent domain themes of frustration and hope. Frustration was manifest in subthemes including Complexity, Patient Acceptance, Uncertainty About Treatment, Need for Evidence-based Treatment, and Failure of Cross-Disciplinary Collaboration between neurologists and mental health providers. Hope encompassed subthemes of Positive Attitudes, Developing Cross-Disciplinary Treatment, and Specific PNES Care. Increased resources for diagnosing, treating, and researching PNES have improved awareness of the disorder. More research is needed to understand patients' and caregivers' perceptions of PNES care. PMID:25128685

  19. Employer-provided health insurance and hospital mergers.

    PubMed

    Garmon, Christopher

    2013-07-01

    This paper explores the impact of employer-provided health insurance on hospital competition and hospital mergers. Under employer-provided health insurance, employer executives act as agents for their employees in selecting health insurance options for their firm. The paper investigates whether a merger of hospitals favored by executives will result in a larger price increase than a merger of competing hospitals elsewhere. This is found to be the case even when the executive has the same opportunity cost of travel as her employees and even when the executive is the sole owner of the firm, retaining all profits. This is consistent with the Federal Trade Commission's findings in its challenge of Evanston Northwestern Healthcare's acquisition of Highland Park Hospital. Implications of the model are further tested with executive location data and hospital data from Florida and Texas. PMID:23347566

  20. Process utility from providing informal care: the benefit of caring.

    PubMed

    Brouwer, Werner B F; van Exel, N Job A; van den Berg, Bernard; van den Bos, Geertruidis A M; Koopmanschap, Marc A

    2005-09-28

    Though economics is usually outcome-oriented, it is often argued that processes matter as well. Utility is not only derived from outcomes, but also from the way this outcome is accomplished. Providing care on a voluntary basis may especially be associated with such process utility. In this paper, we discuss the process utility from providing informal care. We test the hypothesis that informal caregivers derive utility not only from the outcome of informal care, i.e. that the patient is adequately cared for, but also from the process of providing informal care. We present empirical evidence of process utility on the basis of a large sample of Dutch caregivers (n=950). We measure process utility as the difference in happiness between the current situation in which the care recipient is cared for by the caregiver and the hypothetical situation that someone else takes over the care tasks, all other things equal. Other background characteristics on patient and caregiver characteristics, objective and subjective caregiver burden and quality of life are also presented and related to process utility. Our results show that process utility exists and is substantial and therefore important in the context of informal care. Almost half of the caregivers (48.2%) derive positive utility from informal care and on average happiness would decline if informal care tasks were handed over to someone else. Multivariate regression analysis shows that process utility especially relates to caregiver characteristics (age, gender, general happiness, relation to patient and difficulties in performing daily activities) and subjective caregiver burden, whereas it also depends on the number of hours of care provided (objective burden). These results strengthen the idea of supporting the use of informal care, but also that of keeping a close eye on the position of carers. PMID:16098415

  1. Ecosystem function and services provided by the deep sea

    NASA Astrophysics Data System (ADS)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.

    2014-07-01

    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of supporting, provisioning, regulating and cultural services becomes apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses that are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary for fueling surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a wealth of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown that has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and timescales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, which covers the majority of the globe, harbors processes that directly impact humans in a variety of ways; however, the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society. In

  2. Healthcare provider and patient perspectives on diagnostic imaging investigations

    PubMed Central

    Bergh, Anne-Marie; Hoffmann, Willem A.

    2015-01-01

    Background: Much has been written about the patient-centred approach in doctor–patient consultations. Little is known about interactions and communication processes regarding healthcare providers’ and patients’ perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to the imaging investigation itself and then to the post-imaging consultation. Aim and setting: To explore healthcare provider and patient perspectives on interaction and communication processes during diagnostic imaging investigations as part of their clinical journey through a healthcare complex. Methods: A qualitative study was conducted, with two phases of data collection. Twenty-four patients were conveniently selected at a public district hospital complex and were followed throughout their journey in the hospital system, from admission to discharge. The second phase entailed focus group interviews conducted with providers in the district hospital and adjacent academic hospital (medical officers and family physicians, nurses, radiographers, radiology consultants and registrars). Results: Two main themes guided our analysis: (1) provider perspectives; and (2) patient dispositions and reactions. Golden threads that cut across these themes are interactions and communication processes in the context of expectations, experiences of the imaging investigations and the outcomes thereof. Conclusion: Insights from this study provide a better understanding of the complexity of the processes and interactions between providers and patients during the imaging investigations conducted as part of their clinical pathway. The interactions and communication processes are provider–patient centred when a referral for a diagnostic imaging investigation is included. PMID:26245604

  3. Midwifery care and patient-provider communication in maternity decisions

    PubMed Central

    Kozhimannil, Katy B.; Attanasio, Laura B.; Yang, Tony; Avery, Melissa; Declercq, Eugene

    2015-01-01

    Objective To characterize reasons women chose midwives as prenatal care providers and to measure the relationship between midwifery care and patient-provider communication in the U.S. context. Methods Retrospective analysis of data from a nationally-representative survey of women who gave birth in 2011–2012 to a single newborn in a U.S. hospital (n=2400). We used multivariate logistic regression models to characterize women who received prenatal care from a midwife, to describe the reasons for this choice, and to examine the association between midwife-led prenatal care and women’s reports about communication. Results Preference for a female clinician and having a particular clinician assigned was associated with higher odds of midwifery care (AOR=2.65, 95% CI=1.70, 4.14 and AOR=1.63, 95% CI=1.04, 2.58). A woman with midwifery care had lower odds of reporting that she held back questions because her preference for care was different from her provider’s recommendation (AOR=0.46, 95% CI=0.23, 0.89) or because she did not want to be perceived as difficult (AOR=0.48, 95% CI=0.28, 0.81). Women receiving midwifery care also had lower odds of reporting that the provider used medical words were hard for them to understand (AOR=0.58, 95% CI=0.37, 0.91) and not feeling encouraged to discuss all their concerns (AOR=0.54, 95% CI=0.34, 0.89). Conclusions Women whose prenatal care was provided by midwives report better communication compared with those cared for by other types of clinicians. Systems-level interventions, such as assigning a clinician, may improve access to midwifery care and the associated improvements in patient-provider communication in maternity care. PMID:25874874

  4. Total Hip Arthroplasty Performed Through Direct Anterior Approach Provides Superior Early Outcome: Results of a Randomized, Prospective Study.

    PubMed

    Parvizi, Javad; Restrepo, Camilo; Maltenfort, Mitchell G

    2016-07-01

    Studies suggest that total hip arthroplasty (THA) performed through direct anterior (DA) approach has better functional outcomes than other surgical approaches. The immediate to very early outcomes of DA THA are not known. A prospective, randomized study examined the very early outcome of THA performed through DA versus direct lateral approach. The functional outcomes on day 1, day 2, week 6, week 12, 6 months, and 1 year were measured. Patients receiving DA THA had significantly higher functional scores during the early period following surgery. The difference in functional scores leveled out at 6 months. PMID:27241374

  5. A numerical experiment that provides new results regarding the inception of separation in the flow around a circular cylinder

    NASA Astrophysics Data System (ADS)

    Malamataris, Nikolaos; Liakos, Anastasios

    2015-11-01

    The exact value of the Reynolds number regarding the inception of separation in the flow around a circular cylinder is still a matter of research. This work connects the inception of separation with the calculation of a positive pressure gradient around the circumference of the cylinder. The hypothesis is that inception of separation occurs when the pressure gradient becomes positive around the circumference. From the most cited laboratory experiments that have dealt with that subject of inception of separation only Thom has measured the pressure gradient there at very low Reynolds numbers (up to Re=3.5). For this reason, the experimental conditions of his tunnel are simulated in a new numerical experiment. The full Navier Stokes equations in both two and three dimensions are solved with a home made code that utilizes Galerkin finite elements. In the two dimensional numerical experiment, inception of separation is observed at Re=4.3, which is the lowest Reynolds number where inception has been reported computationally. Currently, the three dimensional experiment is under way, in order to compare if there are effects of three dimensional theory of separation in the conditions of Thom's experiments.

  6. Types of Unintended Consequences Related to Computerized Provider Order Entry

    PubMed Central

    Campbell, Emily M.; Sittig, Dean F.; Ash, Joan S.; Guappone, Kenneth P.; Dykstra, Richard H.

    2006-01-01

    Objective To identify types of clinical unintended adverse consequences resulting from computerized provider order entry (CPOE) implementation. Design An expert panel provided initial examples of adverse unintended consequences of CPOE. The authors, using qualitative methods, gathered and analyzed additional examples from five successful CPOE sites. Methods Using a card sort method, the authors developed a categorization scheme for the 79 unintended consequences initially identified and then iteratively modified the scheme to categorize 245 additional adverse consequences resulting from fieldwork. Because the focus centered on consequences requiring prevention or remedial action, the authors did not further analyze reported unintended beneficial (positive) consequences. Results Unintended adverse consequences (UACs) fell into nine major categories (in order of decreasing frequency): 1) more/new work for clinicians; 2) unfavorable workflow issues; 3) never ending system demands; 4) problems related to paper persistence; 5) untoward changes in communication patterns and practices; 6) negative emotions; 7) generation of new kinds of errors; 8) unexpected changes in the power structure; and 9) overdependence on the technology. Clinical decision support features introduced many of these unintended consequences. Conclusion Identifying and understanding the types and in some instances the causes of unintended adverse consequences associated with CPOE will enable system developers and implementers to better manage implementation and maintenance of future CPOE projects. PMID:16799128

  7. Vascular patterns provide therapeutic targets in aggressive neuroblastic tumors

    PubMed Central

    Tadeo, Irene; Bueno, Gloria; Berbegall, Ana P.; Fernández-Carrobles, M. Milagro; Castel, Victoria; García-Rojo, Marcial; Navarro, Samuel; Noguera, Rosa

    2016-01-01

    Angiogenesis is essential for tumor growth and metastasis, nevertheless, in NB, results between different studies on angiogenesis have yielded contradictory results. An image analysis tool was developed to characterize the density, size and shape of total blood vessels and vascular segments in 458 primary neuroblastic tumors contained in tissue microarrays. The results were correlated with clinical and biological features of known prognostic value and with risk of progression to establish histological vascular patterns associated with different degrees of malignancy. Total blood vessels were larger, more abundant and more irregularly-shaped in tumors of patients with associated poor prognostic factors than in the favorable cohort. Tumor capillaries were less abundant and sinusoids more abundant in the patient cohort with unfavorable prognostic factors. Additionally, size of post-capillaries & metarterioles as well as higher sinusoid density can be included as predictive factors for survival. These patterns may therefore help to provide more accurate pre-treatment risk stratification, and could provide candidate targets for novel therapies. PMID:26918726

  8. 45 CFR 162.408 - National Provider System.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... National Provider System. National Provider System. The National Provider System (NPS) shall do the following: (a) Assign a single, unique NPI to a health care provider, provided that— (1) The NPS may assign... care provider. (f) Disseminate NPS information upon approved requests. (g) Assign an NPI to a...

  9. Method for providing oxygen ion vacancies in lanthanide oxides

    DOEpatents

    Kay, D. Alan R.; Wilson, William G.

    1989-12-05

    A method for desulfurization of fuel gases resulting from the incomplete combustion of sulfur containing hydrocarbons whereby the gases are treated with lanthanide oxides containing large numbers of oxygen-ion vacancies providing ionic porosity which enhances the ability of the lanthanide oxides to react more rapidly and completely with the sulfur in the fuel gases whereby the sulfur in such gases is reduced to low levels suitable for fuels for firing into boilers of power plants generating electricity with steam turbine driven generators, gas turbines, fuel cells and precursors for liquid fuels such as methanol and the like.

  10. Overview of MAST results

    NASA Astrophysics Data System (ADS)

    Chapman, I. T.; Adamek, J.; Akers, R. J.; Allan, S.; Appel, L.; Asunta, O.; Barnes, M.; Ben Ayed, N.; Bigelow, T.; Boeglin, W.; Bradley, J.; Brünner, J.; Cahyna, P.; Carr, M.; Caughman, J.; Cecconello, M.; Challis, C.; Chapman, S.; Chorley, J.; Colyer, G.; Conway, N.; Cooper, W. A.; Cox, M.; Crocker, N.; Crowley, B.; Cunningham, G.; Danilov, A.; Darrow, D.; Dendy, R.; Diallo, A.; Dickinson, D.; Diem, S.; Dorland, W.; Dudson, B.; Dunai, D.; Easy, L.; Elmore, S.; Field, A.; Fishpool, G.; Fox, M.; Fredrickson, E.; Freethy, S.; Garzotti, L.; Ghim, Y. C.; Gibson, K.; Graves, J.; Gurl, C.; Guttenfelder, W.; Ham, C.; Harrison, J.; Harting, D.; Havlickova, E.; Hawke, J.; Hawkes, N.; Hender, T.; Henderson, S.; Highcock, E.; Hillesheim, J.; Hnat, B.; Holgate, J.; Horacek, J.; Howard, J.; Huang, B.; Imada, K.; Jones, O.; Kaye, S.; Keeling, D.; Kirk, A.; Klimek, I.; Kocan, M.; Leggate, H.; Lilley, M.; Lipschultz, B.; Lisgo, S.; Liu, Y. Q.; Lloyd, B.; Lomanowski, B.; Lupelli, I.; Maddison, G.; Mailloux, J.; Martin, R.; McArdle, G.; McClements, K.; McMillan, B.; Meakins, A.; Meyer, H.; Michael, C.; Militello, F.; Milnes, J.; Morris, A. W.; Motojima, G.; Muir, D.; Nardon, E.; Naulin, V.; Naylor, G.; Nielsen, A.; O'Brien, M.; O'Gorman, T.; Ono, Y.; Oliver, H.; Pamela, S.; Pangione, L.; Parra, F.; Patel, A.; Peebles, W.; Peng, M.; Perez, R.; Pinches, S.; Piron, L.; Podesta, M.; Price, M.; Reinke, M.; Ren, Y.; Roach, C.; Robinson, J.; Romanelli, M.; Rozhansky, V.; Saarelma, S.; Sangaroon, S.; Saveliev, A.; Scannell, R.; Schekochihin, A.; Sharapov, S.; Sharples, R.; Shevchenko, V.; Silburn, S.; Simpson, J.; Storrs, J.; Takase, Y.; Tanabe, H.; Tanaka, H.; Taylor, D.; Taylor, G.; Thomas, D.; Thomas-Davies, N.; Thornton, A.; Turnyanskiy, M.; Valovic, M.; Vann, R.; Walkden, N.; Wilson, H.; Wyk, L. V.; Yamada, T.; Zoletnik, S.; MAST; MAST Upgrade Teams

    2015-10-01

    The Mega Ampère Spherical Tokamak (MAST) programme is strongly focused on addressing key physics issues in preparation for operation of ITER as well as providing solutions for DEMO design choices. In this regard, MAST has provided key results in understanding and optimizing H-mode confinement, operating with smaller edge localized modes (ELMs), predicting and handling plasma exhaust and tailoring auxiliary current drive. In all cases, the high-resolution diagnostic capability on MAST is complemented by sophisticated numerical modelling to facilitate a deeper understanding. Mitigation of ELMs with resonant magnetic perturbations (RMPs) with toroidal mode number nRMP = 2, 3, 4, 6 has been demonstrated: at high and low collisionality; for the first ELM following the transition to high confinement operation; during the current ramp-up; and with rotating nRMP = 3 RMPs. nRMP = 4, 6 fields cause less rotation braking whilst the power to access H-mode is less with nRMP = 4 than nRMP = 3, 6. Refuelling with gas or pellets gives plasmas with mitigated ELMs and reduced peak heat flux at the same time as achieving good confinement. A synergy exists between pellet fuelling and RMPs, since mitigated ELMs remove fewer particles. Inter-ELM instabilities observed with Doppler backscattering are consistent with gyrokinetic simulations of micro-tearing modes in the pedestal. Meanwhile, ELM precursors have been strikingly observed with beam emission spectroscopy (BES) measurements. A scan in beta at the L-H transition shows that pedestal height scales strongly with core pressure. Gyro-Bohm normalized turbulent ion heat flux (as estimated from the BES data) is observed to decrease with increasing tilt of the turbulent eddies. Fast ion redistribution by energetic particle modes depends on density, and access to a quiescent domain with ‘classical’ fast ion transport is found above a critical density. Highly efficient electron Bernstein wave current drive (1 A W-1) has been achieved

  11. Does the Consumer Assessment of Healthcare Providers and Systems Cultural Competence Survey provide equivalent measurement across English and Spanish versions?

    PubMed Central

    Carle, Adam C.; Weech-Maldonado, Robert

    2012-01-01

    BACKGROUND The English and Spanish versions of the Consumer Assessments of Healthcare Providers and Systems (CAHPS®) Cultural Competence Survey (CAHP-CC) assess patients’ experiences with culturally competent care. The possibility exists that even when Spanish and an English speakers experience the same levels of culturally competent care, responses describing their care may differ. This is called measurement bias. To deliver reliable and valid information across language, responses must provide equivalent measurement across versions. In this study, we examined whether measurement bias on the CAHPS-CC impedes valid measurement across the English and Spanish versions. METHODS We used multiple group (MG) confirmatory factor analyses (CFA) to examine measurement bias across English (n = 851) and Spanish (n = 113) speakers. Participants came from a 2008 sample of two Medicaid managed care plans, in New York and California. RESULTS MG-CFA provided general support for the equivalence of the CAHPS-CC in measuring Doctor Communication-Positive Behaviors, Doctor Communication-Negative Behaviors, Doctor Communication-Preventative Care, Equitable Treatment, and Trust. We did observe statistically significant differences in the thresholds associated with the item asking whether a doctor gave easier to understand instructions. However, analyses indicated that bias did not meaningfully influence conclusions about average experiences using the English and Spanish versions of the CAHPS-CC. CONCLUSIONS Our results support the use of the English and Spanish versions of the CAHPS-CC. Though we found some bias, analyses demonstrated that it did not substantively impact conclusions for the studied domains. Health providers can place confidence in the two different CAHPS-CC translations. PMID:22895229

  12. Perinatal Depression Screening and Intervention: Enhancing Health Provider Involvement

    PubMed Central

    Corder-Mabe, Joan; Austin, Kristin

    2012-01-01

    Abstract Objective The authors of this study collaborated in the analysis of public health survey data in order to inform future statewide interventions that could systematically enhance depression screening and mental health service use for women of reproductive age. The primary objective of the study was to empirically inform and test the program theory components of a motivational interviewing intervention that we anticipate will guide statewide practice and policy priorities. Methods Data were examined from a survey of healthcare practitioners statewide (n=1498) regarding their practices with and perceptions of perinatal depression care for women. Confirmatory factor analysis (CFA) was used to measure two latent constructs: health provider confidence in the ability to diagnose and treat and the importance placed on screening and treatment. Structural equation modeling (SEM) was used to test a program theory supporting motivational interviewing using a model implied relationship between confidence and importance on screening and treatment/referral practices. Results The data fit the model; the model provisionally supports motivational interviewing as an intervention influencing provider attitudes and practices surrounding perinatal depression screening and treatment/referral. Conclusions Ultimately, study findings support statewide public health efforts to expand the role of health providers in recognizing and responding to perinatal depression and suggest that motivational interviewing techniques that augment importance and confidence may lead to enhanced screening and referral/treatment outcomes for pregnant and postpartum women. PMID:22309209

  13. An analysis of zoo and aquarium provided teacher professional development

    NASA Astrophysics Data System (ADS)

    Kubarek-Sandor, Joy

    Informal science institutions are a significant provider of science teacher professional development. As pressure continues to critically analyze the work of teachers and their effectiveness in the classroom, it is important to understand how informal science institutions contribute to effective change in teacher science content knowledge and pedagogy. This research study analyzed zoo and aquarium provided teacher professional development to respond to the research questions: How do zoos and aquaria determine and assess their goals for teacher professional development? How do these goals align with effective teacher change for science content knowledge and pedagogy? Theoretical frameworks for high quality teacher professional development, effective evaluation of teacher professional development, and learning in informal science settings guided the research. The sample for the study was AZA accredited zoos and aquariums providing teacher professional development (N=107). Data collection consisted of an online questionnaire, follow-up interviews, and content analysis of teacher professional development artifacts. Analysis revealed that by and large zoos and aquariums are lacking in their provision of science teacher professional development. Most professional development focuses on content or resources, neglecting pedagogy. Assessments mismatch the goals and rely heavily on self-report and satisfaction measures. The results demonstrate a marked difference between those zoos and aquariums that are larger in capacity versus those that are medium to small in size. This may be an area of research for the future, as well as analyzing the education resources produced by zoos and aquariums as these were emphasized heavily as a way they serve teachers.

  14. Do obstetrical providers counsel women about postpartum pelvic floor dysfunction?

    PubMed Central

    Dessie, Sybil G.; Hacker, Michele R.; Dodge, Laura E.; Elkadry, Eman A.

    2016-01-01

    Objective To assess prenatal counseling practices of obstetrical providers related to postpartum pelvic floor dysfunction at centers with integrated urogynecology services. Study Design A cross-sectional survey was distributed to obstetrical providers through urogynecology colleagues. The survey included questions about level of training as well as counseling practices related to common postpartum pelvic floor symptoms. All statistical tests were two sided, and P values <0.05 were considered statistically significant. Results One hundred ninety-two surveys were received; 19 respondents did not perform their own prenatal counseling and were excluded. Among the remaining 173 respondents, 94 (56.3%) of those who answered the question reported never discussing postpartum urinary incontinence, and 73.7% reported never discussing postpartum fecal incontinence during prenatal counseling. Obstetrics and gynecology residents were significantly less likely than attending physicians to report discussing various pelvic floor dysfunction topics in prenatal counseling. Among those who reported not counseling women regarding pelvic floor dysfunction, the most common reason cited was lack of time (39.9%) followed by lack of sufficient information (30.1%). Conclusion Prenatal counseling of pelvic floor dysfunction risk is lacking at all levels of obstetrical training. Limitations of time and information are the obstacles most often cited by providers. PMID:26126305

  15. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

    NASA Astrophysics Data System (ADS)

    Stanley, Dara A.; Garratt, Michael P. D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

    2015-12-01

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sublethal effects on bees, affecting their foraging behaviour, homing ability and reproductive success. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants, but until now research on pesticide effects has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence to our knowledge that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Bumblebee colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly, these pesticide-exposed colonies produced apples containing fewer seeds, demonstrating a reduced delivery of pollination services. Our results also indicate that reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour, but most likely due to effects at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the functioning of natural ecosystems.

  16. Neonicotinoid pesticide exposure impairs crop pollination services provided by bumblebees

    PubMed Central

    Stanley, Dara A.; Garratt, Michael P.D.; Wickens, Jennifer B.; Wickens, Victoria J.; Potts, Simon G.; Raine, Nigel E.

    2015-01-01

    Recent concern over global pollinator declines has led to considerable research on the effects of pesticides on bees1-5. Although pesticides are typically not encountered at lethal levels in the field, there is growing evidence indicating that exposure to field-realistic levels can have sub-lethal effects on bees affecting their foraging behaviour1,6,7, homing ability8,9 and reproductive success2,5. Bees are essential for the pollination of a wide variety of crops and the majority of wild flowering plants10-12, but until now research on pesticide impacts has been limited to direct effects on bees themselves and not on the pollination services they provide. Here we show the first evidence that pesticide exposure can reduce the pollination services bumblebees deliver to apples, a crop of global economic importance. Colonies exposed to a neonicotinoid pesticide provided lower visitation rates to apple trees and collected pollen less often. Most importantly these pesticide exposed colonies produced apples containing fewer seeds demonstrating a reduced delivery of pollination services. Our results also suggest reduced pollination service delivery is not due to pesticide-induced changes in individual bee behaviour but most likely due to impacts at the colony level. These findings show that pesticide exposure can impair the ability of bees to provide pollination services, with important implications for both the sustained delivery of stable crop yields and the function of natural ecosystems. PMID:26580009

  17. Web Services Provide Access to SCEC Scientific Research Application Software

    NASA Astrophysics Data System (ADS)

    Gupta, N.; Gupta, V.; Okaya, D.; Kamb, L.; Maechling, P.

    2003-12-01

    Web services offer scientific communities a new paradigm for sharing research codes and communicating results. While there are formal technical definitions of what constitutes a web service, for a user community such as the Southern California Earthquake Center (SCEC), we may conceptually consider a web service to be functionality provided on-demand by an application which is run on a remote computer located elsewhere on the Internet. The value of a web service is that it can (1) run a scientific code without the user needing to install and learn the intricacies of running the code; (2) provide the technical framework which allows a user's computer to talk to the remote computer which performs the service; (3) provide the computational resources to run the code; and (4) bundle several analysis steps and provide the end results in digital or (post-processed) graphical form. Within an NSF-sponsored ITR project coordinated by SCEC, we are constructing web services using architectural protocols and programming languages (e.g., Java). However, because the SCEC community has a rich pool of scientific research software (written in traditional languages such as C and FORTRAN), we also emphasize making existing scientific codes available by constructing web service frameworks which wrap around and directly run these codes. In doing so we attempt to broaden community usage of these codes. Web service wrapping of a scientific code can be done using a "web servlet" construction or by using a SOAP/WSDL-based framework. This latter approach is widely adopted in IT circles although it is subject to rapid evolution. Our wrapping framework attempts to "honor" the original codes with as little modification as is possible. For versatility we identify three methods of user access: (A) a web-based GUI (written in HTML and/or Java applets); (B) a Linux/OSX/UNIX command line "initiator" utility (shell-scriptable); and (C) direct access from within any Java application (and with the

  18. Theory in Practice: Helping Providers Address Depression in Diabetes Care

    PubMed Central

    Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie

    2011-01-01

    Introduction A Continuing Education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers’ practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods Participants completed assessments of attitudes, confidence, intentions, and behaviors regarding depression management at three time points: immediately prior to the CE program (baseline), immediately after the CE program (posttest) and six-weeks after the CE program (follow-up). Results Ninety eight providers attended the CE program; 71 completed the baseline assessment; 66 completed the posttest assessment, and 37 completed the 6-week follow-up. Compared to baseline, at posttest providers reported significantly more favorable attitudes, fewer negative attitudes, greater confidence, and greater intention to address depression with their diabetes patients. At six weeks follow-up, there was a marginally significant increase in educating patients about depression, but no other depression management practices changed. Intention to change and confidence predicted some depression practice patterns at follow-up. Fewer barriers were a consistent predictor of depression practice patterns at follow-up. Discussion In the short-term, provider attitudes, confidence, and intentions to address depression with their patients improved. Intention, confidence, and especially barriers are important intervention targets. Lessons for Practice Depression is a common comorbidity of diabetes. Healthcare providers must be better prepared to manage depression in their diabetes patients. Educating health professionals is one approach to improving depression care. Healthcare systems must address barriers to providers’ efforts to manage depression. Continuing education programs should aim to enhance providers’ intentions, confidence, and skills to overcome barriers to addressing depression in clinical care. PMID

  19. Federated query services provided by the Seamless SAR Archive project

    NASA Astrophysics Data System (ADS)

    Baker, S.; Bryson, G.; Buechler, B.; Meertens, C. M.; Crosby, C. J.; Fielding, E. J.; Nicoll, J.; Youn, C.; Baru, C.

    2013-12-01

    The NASA Advancing Collaborative Connections for Earth System Science (ACCESS) seamless synthetic aperture radar (SAR) archive (SSARA) project is a 2-year collaboration between UNAVCO, the Alaska Satellite Facility (ASF), the Jet Propulsion Laboratory (JPL), and OpenTopography at the San Diego Supercomputer Center (SDSC) to design and implement a seamless distributed access system for SAR data and derived data products (i.e. interferograms). A major milestone for the first year of the SSARA project was a unified application programming interface (API) for SAR data search and results at ASF and UNAVCO (WInSAR and EarthScope data archives) through the use of simple web services. A federated query service was developed using the unified APIs, providing users a single search interface for both archives (http://www.unavco.org/ws/brokered/ssara/sar/search). A command line client that utilizes this new service is provided as an open source utility for the community on GitHub (https://github.com/bakerunavco/SSARA). Further API development and enhancements added more InSAR specific keywords and quality control parameters (Doppler centroid, faraday rotation, InSAR stack size, and perpendicular baselines). To facilitate InSAR processing, the federated query service incorporated URLs for DEM (from OpenTopography) and tropospheric corrections (from the JPL OSCAR service) in addition to the URLs for SAR data. This federated query service will provide relevant QC metadata for selecting pairs of SAR data for InSAR processing and all the URLs necessary for interferogram generation. Interest from the international community has prompted an effort to incorporate other SAR data archives (the ESA Virtual Archive 4 and the DLR TerraSAR-X_SSC Geohazard Supersites and Natural Laboratories collections) into the federated query service which provide data for researchers outside the US and North America.

  20. Fault Management Architectures and the Challenges of Providing Software Assurance

    NASA Technical Reports Server (NTRS)

    Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

    2015-01-01

    Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most missions is system complexity due to a need to establish a multi-dimensional structure across hardware, software and spacecraft operations. FM is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. Generally, FM architecture, implementation, and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (V&V) is challenging. A breakout session at the 2012 NASA Independent Verification & Validation (IV&V) Annual Workshop titled "V&V of Fault Management: Challenges and Successes" exposed this issue in terms of V&V for a representative set of architectures. NASA's Software Assurance Research Program (SARP) has provided funds to NASA IV&V to extend the work performed at the Workshop session in partnership with NASA's Jet Propulsion Laboratory (JPL). NASA IV&V will extract FM architectures across the IV&V portfolio and evaluate the data set, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This SARP initiative focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures and associated V&V/IV&V techniques provides a data set that can enable improved assurance that a system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the space community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the research.

  1. Outpatient provider contact prior to unintentional opioid overdose

    PubMed Central

    Lin, Lewei (Allison); Bohnert, Amy; Ilgen, Mark; Pfeiffer, Paul Nelson; Ganoczy, Dara; Blow, Fred

    2015-01-01

    Objectives Prescribed opioid medications are the most commonly implicated substances in unintentional overdoses. Outpatient health care encounters represent a potential opportunity to intervene to reduce opioid overdose risk. This study assessed the timing and type of outpatient provider contacts prior to overdose. Methods This study examined all adult patients nationally in the Veterans Health Administration (VHA) who died from unintentional prescription opioid overdose in fiscal years 2004–2007 and used VHA services anytime within two years of their deaths (n=1,813). For those whose last treatment contact was in an outpatient setting (n=1,457), demographic, clinical and treatment characteristics were compared among patients categorized by the location of their last contact. Results 33% (N=479) of those last seen in outpatient settings were seen within one week and 62% (N=910) within one month of their overdose. A substantial proportion of patients were last seen within one month of death in mental health or substance disorder outpatient settings (30% N=438). The majority of patients did not fill an opioid prescription on their last outpatient visit prior to unintentional opioid overdose. Conclusions The majority of patients who died by unintentional overdose on prescription opioids were seen within a month of their overdose in outpatient settings. These settings may provide an opportunity to prevent patients from dying from prescription opioid overdoses, and interventions to reduce risk should not be limited to visits that resulted in an opioid prescription. PMID:26129993

  2. Logic Regression for Provider Effects on Kidney Cancer Treatment Delivery

    PubMed Central

    Banerjee, Mousumi; Filson, Christopher; Xia, Rong; Miller, David C.

    2014-01-01

    In the delivery of medical and surgical care, often times complex interactions between patient, physician, and hospital factors influence practice patterns. This paper presents a novel application of logic regression in the context of kidney cancer treatment delivery. Using linked data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program and Medicare we identified patients diagnosed with kidney cancer from 1995 to 2005. The primary endpoints in the study were use of innovative treatment modalities, namely, partial nephrectomy and laparoscopy. Logic regression allowed us to uncover the interplay between patient, provider, and practice environment variables, which would not be possible using standard regression approaches. We found that surgeons who graduated in or prior to 1980 despite having some academic affiliation, low volume surgeons in a non-NCI hospital, or surgeons in rural environment were significantly less likely to use laparoscopy. Surgeons with major academic affiliation and practising in HMO, hospital, or medical school based setting were significantly more likely to use partial nephrectomy. Results from our study can show efforts towards dismantling the barriers to adoption of innovative treatment modalities, ultimately improving the quality of care provided to patients with kidney cancer. PMID:24795774

  3. Ecosystem function and services provided by the deep sea

    NASA Astrophysics Data System (ADS)

    Thurber, A. R.; Sweetman, A. K.; Narayanaswamy, B. E.; Jones, D. O. B.; Ingels, J.; Hansman, R. L.

    2013-11-01

    The deep sea is often viewed as a vast, dark, remote, and inhospitable environment, yet the deep ocean and seafloor are crucial to our lives through the services and provisions that they provide. Our understanding of how the deep sea functions remains limited, but when treated synoptically, a diversity of provisioning, regulating and cultural services become apparent. The biological pump transports carbon from the atmosphere into deep-ocean water masses which are separated over prolonged periods, reducing the impact of anthropogenic carbon release. Microbial oxidation of methane keeps another potent greenhouse gas out of the atmosphere while trapping carbon in authigenic carbonates. Nutrient regeneration by all faunal size classes provides the elements necessary to fuel surface productivity and fisheries, and microbial processes detoxify a diversity of compounds. Each of these processes occur on a very small scale, yet considering the vast area over which they occur they become important for the global functioning of the ocean. The deep sea also provides a diversity of resources, including fish stocks, enormous bioprospecting potential, and elements and energy reserves that are currently being extracted and will be increasingly important in the near future. Society benefits from the intrigue and mystery, the strange life forms, and the great unknown which has acted as a muse for inspiration and imagination since near the beginning of civilization. While many functions occur on the scale of microns to meters and time scales up to years, the derived services that result are only useful after centuries of integrated activity. This vast dark habitat, that covers the majority of the globe, harbors processes that directly impact humans in a diversity of ways, however the same traits that differentiate it from terrestrial or shallow marine systems also result in a greater need for integrated spatial and temporal understanding as it experiences increased use by society.

  4. Providing adolescent sexual health care in the pediatric emergency department: views of health care providers

    PubMed Central

    Miller, Melissa K.; Mollen, Cynthia J.; O’Malley, Donna; Owens, Rhea L.; Maliszewski, Genevieve A.; Goggin, Kathy; Patricia, Kelly

    2014-01-01

    Objective The purpose of this study was to explore health care providers’ (HCPs) attitudes and beliefs about adolescent sexual health care provision in the emergency department (ED) and to identify barriers to a role of a health educator-based intervention. Methods We conducted focused, semi-structured interviews of HCPs from the ED and Adolescent Clinic of a children’s hospital. The interview guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, perceived behavioral control, and intention to facilitate care. We used purposive sampling and enrollment continued until themes were saturated. Interviews were recorded and transcribed. Transcripts were analyzed using directed content analysis. Results Twenty-nine interviews were required for saturation. Participants were 12 physicians, 12 nurses, 3 nurse practitioners and 2 social workers; the majority (83%) were female. Intention to facilitate care was influenced by HCP perception of 1) their professional role, 2) the role of the ED (focused vs. expanded care), and 3) need for patient safety. HCPs identified three practice referents: patients/families, peers and administrators, and professional organizations. HCPs perceived limited behavioral control over care delivery because of time constraints, confidentiality issues, and comfort level. There was overall support for a health educator and many felt the educator could help overcome barriers to care. Conclusion Despite challenges unique to the ED, HCPs were supportive of the intervention and perceived the health educator as a resource to improve adolescent care and services. Future research should evaluate efficacy and costs of a health educator in this setting. PMID:24457494

  5. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... protocols between the Federal alert gateway and the CMS provider gateway. (d) Geographic targeting. The CMS... provide profile information on the CMS provider for the Federal alert gateway to maintain at the Federal alert gateway. This profile information must be provided by an authorized CMS provider representative...

  6. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... protocols between the Federal alert gateway and the CMS provider gateway. (d) Geographic targeting. The CMS... provide profile information on the CMS provider for the Federal alert gateway to maintain at the Federal alert gateway. This profile information must be provided by an authorized CMS provider representative...

  7. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... protocols between the Federal alert gateway and the CMS provider gateway. (d) Geographic targeting. The CMS... provide profile information on the CMS provider for the Federal alert gateway to maintain at the Federal alert gateway. This profile information must be provided by an authorized CMS provider representative...

  8. 47 CFR 10.320 - Provider alert gateway requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... protocols between the Federal alert gateway and the CMS provider gateway. (d) Geographic targeting. The CMS... provide profile information on the CMS provider for the Federal alert gateway to maintain at the Federal alert gateway. This profile information must be provided by an authorized CMS provider representative...

  9. Derivative financial instruments and nonprofit health care providers.

    PubMed

    Stewart, Louis J; Owhoso, Vincent

    2004-01-01

    This article examines the extent of derivative financial instrument use among US nonprofit health systems and the impact of these financial instruments on their cash flows, reported operating results, and financial risks. Our examination is conducted through a case study of New Jersey hospitals and health systems. We review the existing literature on interest rate derivative instruments and US hospitals and health systems. This literature describes the design of these derivative financial instruments and the theoretical benefits of their use by large health care provider organizations. Our contribution to the literature is to provide an empirical evaluation of derivative financial instruments usage among a geographically limited sample of US nonprofit health systems. We reviewed the audited financial statements of the 49 community hospitals and multi-hospital health systems operating in the state of New Jersey. We found that 8 percent of New Jersey's nonprofit health providers utilized interest rate derivatives with an aggregate principle value of $229 million. These derivative users combine interest rate swaps and caps to lower the effective interest costs of their long-term debt while limiting their exposure to future interest rate increases. In addition, while derivative assets and liabilities have an immaterial balance sheet impact, derivative related gains and losses are a material component of their reported operating results. We also found that derivative usage among these four health systems was responsible for generating positive cash flows in the range of 1 percent to 2 percent of their total 2001 cash flows from operations. As a result of our admittedly limited samples we conclude that interest rate swaps and caps are effective risk management tools. However, we also found that while these derivative financial instruments are useful hedges against the risks of issuing long-term financing instruments, they also expose derivative users to credit, contract

  10. 34. Boston switch interlocking tower. Central Falls, Providence Co., RI. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. Boston switch interlocking tower. Central Falls, Providence Co., RI. Sec. 4116, mp 190.40. - Northeast Railroad Corridor, Amtrak route between CT & MA state lines, Providence, Providence County, RI

  11. Postmarket Drug Safety Information for Patients and Providers

    MedlinePlus

    ... Information for Patients and Providers Postmarket Drug Safety Information for Patients and Providers Share Tweet Linkedin Pin ... communication to patients and healthcare providers. Latest Safety Information Index to Drug-Specific Information For patients, consumers, ...

  12. 47 CFR 64.636 - Prohibition of default provider freezes.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    .... (a) A default provider freeze prevents a change in an iTRS user's default provider selection unless the iTRS user gives the provider from whom the freeze was requested his or her express consent....

  13. 47 CFR 64.636 - Prohibition of default provider freezes.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    .... (a) A default provider freeze prevents a change in an iTRS user's default provider selection unless the iTRS user gives the provider from whom the freeze was requested his or her express consent....

  14. 42 CFR 476.78 - Responsibilities of providers and practitioners.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...' responsibility to the QIOs to provide photocopies of requested provider records. The payment is in addition to payment already provided for these costs under other provisions of the Social Security Act and is based...

  15. 42 CFR 476.78 - Responsibilities of providers and practitioners..

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...' responsibility to the QIOs to provide photocopies of requested provider records. The payment is in addition to payment already provided for these costs under other provisions of the Social Security Act and is based...

  16. 34 CFR 300.138 - Equitable services provided.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... standards as personnel providing services in the public schools, except that private elementary school and... of services than children with disabilities in public schools. (b) Services provided in...

  17. Safety Observations Achieve Results

    2000-01-16

    The SOAR web application provides a multi-checklist capability where focused observations can be created to address risk-likely work environments, tasks, etc. The SOAR web application has numerous reports to sort the data by key word, multiple factors (i.e., location, team, behavior, checklist, work environment, etc.), and the highest frequency of behaviors and error-likely predecessors, etc. Other performance indicators are also provided.

  18. Results from Neutrino Oscillations Experiments

    SciTech Connect

    Aguilar-Arevalo, Alexis

    2010-09-10

    The interpretation of the results of early solar and atmospheric neutrino experiments in terms of neutrino oscillations has been verified by several recent experiments using both, natural and man-made sources. The observations provide compelling evidence in favor of the existence of neutrino masses and mixings. These proceedings give a general description of the results from neutrino oscillation experiments, the current status of the field, and some possible future developments.

  19. 78 FR 19949 - The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ... Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers; Proposed Rule #0;#0... Remuneration Provided by Certain Health Insurance Providers AGENCY: Internal Revenue Service (IRS), Treasury... application of the $500,000 deduction limitation for remuneration provided by certain health...

  20. Data services providing by the Ukrainian NODC (MHI NASU)

    NASA Astrophysics Data System (ADS)

    Eremeev, V.; Godin, E.; Khaliulin, A.; Ingerov, A.; Zhuk, E.

    2009-04-01

    At modern stage of the World Ocean study information support of investigation based on ad-vanced computer technologies becomes of particular importance. These abstracts are devoted to presentation of several data services developed in the Ukrainian NODC on the base of the Ma-rine Environmental and Information Technologies Department of MHI NASU. The Data Quality Control Service Using experience of international collaboration in the field of data collection and quality check we have developed the quality control (QC) software providing both preliminary(automatic) and expert(manual) data quality check procedures. The current version of the QC software works for the Mediterranean and Black seas and includes the climatic arrays for hydrological and few hydrochemical parameters based on such products as MEDAR/MEDATLAS II, Physical Oceanography of the Black Sea and Climatic Atlas of Oxygen and Hydrogen Sulfide in the Black sea. The data quality check procedure includes metadata control and hydrological and hydrochemical data control. Metadata control provides checking of duplicate cruises and pro-files, date and chronology, ship velocity, station location, sea depth and observation depth. Data QC procedure includes climatic (or range for parameters with small number of observations) data QC, density inversion check for hydrological data and searching for spikes. Using of cli-matic fields and profiles prepared by regional oceanography experts leads to more reliable results of data quality check procedure. The Data Access Services The Ukrainian NODC provides two products for data access - on-line software and data access module for the MHI NASU local net. This software allows select-ing data on rectangle area, on date, on months, on cruises. The result of query is metadata which are presented in the table and the visual presentation of stations on the map. It is possible to see both metadata and data. For this purpose it is necessary to select station in the table of

  1. Rural providers' access to online resources: a randomized controlled trial

    PubMed Central

    Hall, Laura J.; McElfresh, Karen R.; Warner, Teddy D.; Stromberg, Tiffany L.; Trost, Jaren; Jelinek, Devin A.

    2016-01-01

    Objective The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state. Methods In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants' attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen's d statistic to compare pre- and post-study effects sizes. Results Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to “about right amounts of information” at the completion of the study. DynaMed users reported a Cohen's d increase of +1.50 compared to AccessMedicine users' reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen's d. Conclusion Participants in the DynaMed arm of the study used this clinically oriented PoC more heavily than the users of the textbook-based AccessMedicine. In terms of user satisfaction, DynaMed users reported higher levels of satisfaction than the users of AccessMedicine. PMID:26807050

  2. Fault Management Architectures and the Challenges of Providing Software Assurance

    NASA Technical Reports Server (NTRS)

    Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

    2015-01-01

    The satellite systems Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most is system complexity due to a need to establish a multi-dimensional structure across hardware, software and operations. This structure is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. These architecture, implementation and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (VV) is challenging. A breakout session at the 2012 NASA Independent Verification Validation (IVV) Annual Workshop titled VV of Fault Management: Challenges and Successes exposed these issues in terms of VV for a representative set of architectures. NASA's IVV is funded by NASA's Software Assurance Research Program (SARP) in partnership with NASA's Jet Propulsion Laboratory (JPL) to extend the work performed at the Workshop session. NASA IVV will extract FM architectures across the IVV portfolio and evaluate the data set for robustness, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This work focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures, visibility, and associated VVIVV techniques provides a data set that can enable higher assurance that a satellite system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the satellite community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the

  3. Does DFT-SAPT method provide spectroscopic accuracy?

    SciTech Connect

    Shirkov, Leonid; Makarewicz, Jan

    2015-02-14

    Ground state potential energy curves for homonuclear and heteronuclear dimers consisting of noble gas atoms from He to Kr were calculated within the symmetry adapted perturbation theory based on the density functional theory (DFT-SAPT). These potentials together with spectroscopic data derived from them were compared to previous high-precision coupled cluster with singles and doubles including the connected triples theory calculations (or better if available) as well as to experimental data used as the benchmark. The impact of midbond functions on DFT-SAPT results was tested to study the convergence of the interaction energies. It was shown that, for most of the complexes, DFT-SAPT potential calculated at the complete basis set (CBS) limit is lower than the corresponding benchmark potential in the region near its minimum and hence, spectroscopic accuracy cannot be achieved. The influence of the residual term δ(HF) on the interaction energy was also studied. As a result, we have found that this term improves the agreement with the benchmark in the repulsive region for the dimers considered, but leads to even larger overestimation of potential depth D{sub e}. Although the standard hybrid exchange-correlation (xc) functionals with asymptotic correction within the second order DFT-SAPT do not provide the spectroscopic accuracy at the CBS limit, it is possible to adjust empirically basis sets yielding highly accurate results.

  4. CCSI: a database providing chromatin-chromatin spatial interaction information.

    PubMed

    Xie, Xiaowei; Ma, Wenbin; Songyang, Zhou; Luo, Zhenhua; Huang, Junfeng; Dai, Zhiming; Xiong, Yuanyan

    2016-01-01

    Distal regulatory elements have been shown to regulate gene transcription through spatial interactions, and single nucleotide polymorphisms (SNPs) are linked with distal gene expression by spatial proximity, which helps to explain the causal role of disease-associated SNPs in non-coding region. Therefore, studies on spatial interactions between chromatin have created a new avenue for elucidating the mechanism of transcriptional regulation in disease pathogenesis. Recently, a growing number of chromatin interactions have been revealed by means of 3C, 4C, 5C, ChIA-PET and Hi-C technologies. To interpret and utilize these interactions, we constructed chromatin-chromatin spatial interaction (CCSI) database by integrating and annotating 91 sets of chromatin interaction data derived from published literature, UCSC database and NCBI GEO database, resulting in a total of 3,017,962 pairwise interactions (false discovery rate < 0.05), covering human, mouse and yeast. A web interface has been designed to provide access to the chromatin interactions. The main features of CCSI are (i) showing chromatin interactions and corresponding genes, enhancers and SNPs within the regions in the search page; (ii) offering complete interaction datasets, enhancer and SNP information in the download page; and (iii) providing analysis pipeline for the annotation of interaction data. In conclusion, CCSI will facilitate exploring transcriptional regulatory mechanism in disease pathogenesis associated with spatial interactions among genes, regulatory regions and SNPs. Database URL: http://songyanglab.sysu.edu.cn/ccsi. PMID:26868054

  5. Effective Factors in Providing Holistic Care: A Qualitative Study

    PubMed Central

    Zamanzadeh, Vahid; Jasemi, Madineh; Valizadeh, Leila; Keogh, Brian; Taleghani, Fariba

    2015-01-01

    Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses’ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring. PMID:26009677

  6. Providing a food reward reduces inhibitory avoidance learning in zebrafish.

    PubMed

    Manuel, Remy; Zethof, Jan; Flik, Gert; van den Bos, Ruud

    2015-11-01

    As shown in male rats, prior history of subjects changes behavioural and stress-responses to challenges: a two-week history of exposure to rewards at fixed intervals led to slightly, but consistently, lower physiological stress-responses and anxiety-like behaviour. Here, we tested whether similar effects are present in zebrafish (Danio rerio). After two weeks of providing Artemia (brine shrimp; Artemia salina) as food reward or flake food (Tetramin) as control at fixed intervals, zebrafish were exposed to a fear-avoidance learning task using an inhibitory avoidance protocol. Half the number of fish received a 3V shock on day 1 and were tested and sacrificed on day 2; the other half received a second 3V shock on day 2 and were tested and sacrificed on day 3. The latter was done to assess whether effects are robust, as effects in rats have been shown to be modest. Zebrafish that were given Artemia showed less inhibitory avoidance after one shock, but not after two shocks, than zebrafish that were given flake-food. Reduced avoidance behaviour was associated with lower telencepahalic gene expression levels of cannabinoid receptor 1 (cnr1) and higher gene expression levels of corticotropin releasing factor (crf). These results suggest that providing rewards at fixed intervals alters fear avoidance behaviour, albeit modestly, in zebrafish. We discuss the data in the context of similar underlying brain structures in mammals and fish. PMID:26342856

  7. Mental Illness and Prisoners: Concerns for Communities and Healthcare Providers.

    PubMed

    Hoke, Samantha

    2015-01-01

    The United States prison system is the largest in the world. Mental illness is disproportionately represented within this system where half of all incarcerated individuals have a mental illness, compared to 11% of the population. Four of 10 inmates released from prison recidivate and are re-incarcerated within three years. A social hypothesis suggests recidivism is the result of compounding social factors. Mentally ill individuals often find themselves in less than ideal circumstances of compounding social factors such as illicit substances and unemployment. Prison life may provide improved social situations and a rehabilitating environment, yet corrections often fall short of meeting acceptable standards of healthcare. This article provides a brief overview of healthcare in the corrections environment and discusses factors that affect mental healthcare in prisons, such as characteristics of the prison population and social policy. The article also addresses factors impacting mentally ill persons who are incarcerated, including access and barriers to mental health treatment and efforts to reduce recidivism. PMID:26824261

  8. CCSI: a database providing chromatin–chromatin spatial interaction information

    PubMed Central

    Ma, Wenbin; Songyang, Zhou; Luo, Zhenhua; Huang, Junfeng; Dai, Zhiming; Xiong, Yuanyan

    2016-01-01

    Distal regulatory elements have been shown to regulate gene transcription through spatial interactions, and single nucleotide polymorphisms (SNPs) are linked with distal gene expression by spatial proximity, which helps to explain the causal role of disease-associated SNPs in non-coding region. Therefore, studies on spatial interactions between chromatin have created a new avenue for elucidating the mechanism of transcriptional regulation in disease pathogenesis. Recently, a growing number of chromatin interactions have been revealed by means of 3C, 4C, 5C, ChIA-PET and Hi-C technologies. To interpret and utilize these interactions, we constructed chromatin–chromatin spatial interaction (CCSI) database by integrating and annotating 91 sets of chromatin interaction data derived from published literature, UCSC database and NCBI GEO database, resulting in a total of 3 017 962 pairwise interactions (false discovery rate < 0.05), covering human, mouse and yeast. A web interface has been designed to provide access to the chromatin interactions. The main features of CCSI are (i) showing chromatin interactions and corresponding genes, enhancers and SNPs within the regions in the search page; (ii) offering complete interaction datasets, enhancer and SNP information in the download page; and (iii) providing analysis pipeline for the annotation of interaction data. In conclusion, CCSI will facilitate exploring transcriptional regulatory mechanism in disease pathogenesis associated with spatial interactions among genes, regulatory regions and SNPs. Database URL: http://songyanglab.sysu.edu.cn/ccsi PMID:26868054

  9. Noise provides new insights on contrast sensitivity function.

    PubMed

    Chen, Ge; Hou, Fang; Yan, Fang-Fang; Zhang, Pan; Xi, Jie; Zhou, Yifeng; Lu, Zhong-Lin; Huang, Chang-Bing

    2014-01-01

    Sensitivity to luminance difference, or contrast sensitivity, is critical for animals to survive in and interact with the external world. The contrast sensitivity function (CSF), which measures visual sensitivity to spatial patterns over a wide range of spatial frequencies, provides a comprehensive characterization of the visual system. Despite its popularity and significance in both basic research and clinical practice, it hasn't been clear what determines the CSF and how the factors underlying the CSF change in different conditions. In the current study, we applied the external noise method and perceptual template model to a wide range of external noise and spatial frequency (SF) conditions, and evaluated how the various sources of observer inefficiency changed with SF and determined the limiting factors underlying the CSF. We found that only internal additive noise and template gain changed significantly with SF, while the transducer non-linearity and coefficient for multiplicative noise were constant. The 12-parameter model provided a very good account of all the data in the 200 tested conditions (86.5%, 86.2%, 89.5%, and 96.4% for the four subjects, respectively). Our results suggest a re-consideration of the popular spatial vision model that employs the CSF as the front-end filter and constant internal additive noise across spatial frequencies. The study will also be of interest to scientists and clinicians engaged in characterizing spatial vision deficits and/or developing rehabilitation methods to restore spatial vision in clinical populations. PMID:24626135

  10. Payment system reform for health care providers in Korea.

    PubMed

    Kwon, Soonman

    2003-03-01

    Since its introduction in 1977, the national health insurance programme in Korea has paid health care providers on a fee-for-service basis. Regulated fee-for-service payment has resulted in an increased volume and intensity of medical care. It has also distorted the input mix of treatment because physicians have substituted more profitable and uninsured (no coverage) medical services for those with lower margins, as is evidenced by the sharp increase in the caesarean delivery rate. This paper examines two recent supply-side reforms in Korea: Diagnosis Related Group (DRG) and Resource-based Relative Value (RBRV). Since 1997, through a pilot programme covering a selected group of diseases for voluntarily participating health care institutions, the DRG-based prospective payment system has proven to be effective in containing cost with little negative effect on quality. RBRV-based payment was implemented in 2001, but led to an almost uniform increase in fees for physician services without a mechanism to control the volume and expenditure. Challenges and future issues in the reform of the payment system in Korea include the expansion of benefit coverage, quality monitoring and improvement, strategic plans to overcome the strong opposition of providers and the introduction of global budgeting. PMID:12582111

  11. Providing trust and interoperability to federate distributed biobanks.

    PubMed

    Lablans, Martin; Bartholomäus, Sebastian; Uckert, Frank

    2011-01-01

    Biomedical research requires large numbers of well annotated, quality-assessed samples which often cannot be provided by a single biobank. Connecting biobanks, researchers and service providers raises numerous challenges including trust among partners and towards the infrastructure as well as interoperability problems. Therefore we develop a holistic, open-source and easy-to-use IT infrastructure. Our federated approach allows partners to reflect their organizational structures and protect their data sovereignty. The search service and the contact arrangement processes increase data sovereignty without stigmatizing for rejecting a specific cooperation. The infrastructure supports daily processes with an integrated basic sample manager and user-definable electronic case report forms. Interfaces for existing IT systems avoid re-entering of data. Moreover, resource virtualization is supported to make underutilized resources of some partners accessible to those with insufficient equipment for mutual benefit. The functionality of the resulting infrastructure is outlined in a use-case to demonstrate collaboration within a translational research network. Compared to other existing or upcoming infrastructures, our approach has ultimately the same goals, but relies on gentle incentives rather than top-down imposed progress. PMID:21893827

  12. NSSDC provides network access to key data via NDADS

    NASA Technical Reports Server (NTRS)

    Behnke, Jeanne; King, Joseph

    1994-01-01

    The National Space Science Data Center (NSSDC) is making a growing fraction of its most customer-desirable data electronically accessible via both the local and wide area networks. NSSDC is witnessing a great increase in its data dissemination owing to this network accessibility. To provide its customers the best data accessibility, the NSSDC makes data available from a nearline, mass storage system, the NSSDC Data Archive and Dissemination Service (NDADS). The NDADS, the initial version was made available in January 1992, is a customized system of hardware and software that provides users access to the nearline data via ANONYMOUS FTP, an e-mail interface (ARMS), and a C-based software library. In January 1992, the NDADS registered 416 requests for 1,957 files. By December of 1994, NDADS had been populated with 800 gigabytes of electronically accessible data and had registered 1458 requests for 20,887 files. In this report we describe the NDADS system, both hardware and software. Later in the report, we discuss some of the lessons that were learned as a result of operating NDADS, particularly in the area of ingest and dissemination.

  13. Pregnant at work: time for prenatal care providers to act.

    PubMed

    Karkowsky, Chavi Eve; Morris, Liz

    2016-09-01

    Fifty years ago, when a woman became pregnant, she was expected to stop working. Today, however, most women who work are the primary, sole, or co-breadwinner for their families, and their earnings during pregnancy are often essential to their families' economic well-being. Medical data about working during pregnancy are sparse but generally show that both low-risk and high-risk women can tolerate work-related duties well, although some work accommodations (eg, providing a chair for sitting, allowing snacks, or modifying the work schedule) may be necessary. However, some employers refuse to accommodate pregnant women who need adjustments. This can result in a woman being forced to make the choice between working without accommodations and losing her income and health insurance or even her job. Prenatal care providers can play an important role by implementing changes in their own practice, shaping public policy, and conducting research to increase protections for pregnant women and to ensure that they receive medically recommended accommodations while continuing to earn income for their growing families. PMID:27255471

  14. Anaesthesia provider's perception of law: Focus on preventive measures

    PubMed Central

    Attri, Joginder Pal; Momin, Shakil; Kaur, Gagandeep; Sandhu, Kulwinder Singh; Bala, Neeru; Channa, SS

    2015-01-01

    Anaesthesiology is a speciality that delivers most prompt and positive results in medical field. This naturally leads to high expectations among the general public. In the past, patients used to subject themselves to surgery after signing a simple willingness form. But in the present scenario, if any catastrophe occurs, it grabs news headlines, negligence is suspected by laymen in such cases, and these cases land up in a court of law. In the courts, decisions are left to judiciary, which can be potentially influenced by the opinon of general public. This leaves a lot of subjectivity in these decisions. There has been a rising trend in medical negligence cases registered in consumer courts after the decision of the Supreme Court, that the services provided by an anaesthesiologist come under the word “service” of Consumer Protection Act (1986). So the apprehension amongst the anaesthesiologists regarding the legal issues is rising. This article underlines the standard of care, protocols by which anaesthesiologists should abide to avoid legal consequences. Doctors should have legal awareness so that they can defend their cases in courts properly. There is a need to maintain healthy doctor-patient relationship, good record keeping, and to provide a reasonable standard of care. Doctors should keep abreast with the latest development in the medical field. PMID:25788738

  15. Community outreach: providing a comprehensive approach to smoking cessation.

    PubMed

    Clark, June; Hegedus, Patricia

    2002-01-01

    The LEEP Program at the SRHS has completed its first year. Executing the strategic action plans could not have been accomplished without the collaboration of multiple agencies-the ACS, ALA, DHEC, SADAC, and the SRHS. Activities surrounding education, awareness, and the development of support programs during this year have moved us closer to achieving our goal-to develop and implement a systematic educational program including a collaborative community-wide smoking cessation initiative. We had many successes during the first year of the LEEP program. However, future opportunities remain. Offering Freshstart facilitator class twice a year will provide trained facilitators for the every-other-month Freshstart classes at the Gibbs Regional Cancer Center and community smoking cessation classes as needed. Moreover, smokers in the community can attend a smoking cessation support group that began in January 2002. The support group reinforces the safety net of services developed within the first year. Collaboration with other community organizations ensure that continued efforts are made to improve the health and quality-of-life for upstate South Carolina residents. "According to results from the 1994 National Health Interview Supplement (NHIS-2000), 70% of smokers indicated a strong desire to quit" (Westmaas, 2000). It is the role and responsibility of health care institutions to provide the safety net of services to enable patients and the community at large to be successful in their efforts to kick the cigarette habit. PMID:12382696

  16. Providing Multi-Page Data Extraction Services with XWRAPComposer

    SciTech Connect

    Liu, Ling; Zhang, Jianjun; Han, Wei; Pu, Calton; Caverlee, James; Park, Sungkeun; Critchlow, Terence J.; Buttler, David; Coleman, Matthew A.

    2008-04-30

    Dynamic Web data sources – sometimes known collectively as the Deep Web – increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deep Web. To address these challenges, we present DYNABOT, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DYNABOT has three unique characteristics. First, DYNABOT utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DYNABOT employs a modular, self-tuning system architecture for focused crawling of the Deep Web using service class descriptions. Third, DYNABOT incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.

  17. 22 CFR 96.46 - Using providers in Convention countries.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) The agency or person, when acting as the primary provider and using foreign supervised providers to... agreement with the primary provider for the provision of adoption services, discloses to the primary... perform the adoption services it is providing. (b) The agency or person, when acting as the...

  18. 22 CFR 96.46 - Using providers in Convention countries.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) The agency or person, when acting as the primary provider and using foreign supervised providers to... agreement with the primary provider for the provision of adoption services, discloses to the primary... perform the adoption services it is providing. (b) The agency or person, when acting as the...

  19. 47 CFR 54.633 - Health care provider contribution.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care provider contribution. 54.633... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a) Health care provider contribution. All health...

  20. 29 CFR 825.125 - Definition of health care provider.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Definition of health care provider. 825.125 Section 825.125... Definition of health care provider. (a) The Act defines health care provider as: (1) A doctor of medicine or... doctor practices; or (2) Any other person determined by the Secretary to be capable of providing...