A review on economic emission dispatch problems using quantum computational intelligence

NASA Astrophysics Data System (ADS)

Mahdi, Fahad Parvez; Vasant, Pandian; Kallimani, Vish; Abdullah-Al-Wadud, M.

2016-11-01

Economic emission dispatch (EED) problems are one of the most crucial problems in power systems. Growing energy demand, limitation of natural resources and global warming make this topic into the center of discussion and research. This paper reviews the use of Quantum Computational Intelligence (QCI) in solving Economic Emission Dispatch problems. QCI techniques like Quantum Genetic Algorithm (QGA) and Quantum Particle Swarm Optimization (QPSO) algorithm are discussed here. This paper will encourage the researcher to use more QCI based algorithm to get better optimal result for solving EED problems.

Efficient dispatching in a terminal city network

DOT National Transportation Integrated Search

2001-01-01

This report describes new optimization and simulation tools to address several problems in transportation, specifically driver dispatching and tour formation in full truckload trucking. In this segment of transportation industry, one of the problems ...

Distributed problem solving by pilots and dispatchers

NASA Technical Reports Server (NTRS)

Orasanu, Judith; Wich, Mike; Fischer, Ute; Jobe, Kim; Mccoy, Elaine; Beatty, Roger; Smith, Phil

1993-01-01

The study addressed the following question: Are flight planning problems solved differently by PILOTS and DISPATCHERS when they work alone versus when they work together? Aspect of their performance that were of interest include the following: Problem perception and definition; Problem solving strategies and information use; Options considered; Solution and rational; and errors.

Improving emergency medical dispatching with emphasis on mass-casualty incidents.

PubMed

Kleinoscheg, Gabriel; Burgsteiner, Harald; Bernroider, Martin; Kiechle, Günter; Obermayer, Maria

2014-01-01

Dispatching ambulances is a demanding and stressful task for dispatchers. This is especially true in case of mass-casualty incidents. Therefore, the aim of this work was to investigate if and to what extent the dispatch operation of the Red Cross Salzburg can be optimized on such occasions with a computerized system. The basic problem of a dynamic multi-vehicle Dial-a-Ride Problem with time windows was enhanced according to the requirements of the Red Cross Salzburg. The general objective was to minimize the total mileage covered by ambulances and the waiting time of patients. Furthermore, in case of emergencies suitable adaptions to a plan should be carried out automatically. Consequently, the problem is solved by using the Adaptive Large Neighborhood Search. Evaluation results indicate that the system outperforms a human dispatcher by between 2.5% and 36% within 1 minute of runtime concerning total costs. Moreover, the system's response time in case that a plan has to be updated is less than 1 minute on average.

Multi-objective optimal dispatch of distributed energy resources

NASA Astrophysics Data System (ADS)

Longe, Ayomide

This thesis is composed of two papers which investigate the optimal dispatch for distributed energy resources. In the first paper, an economic dispatch problem for a community microgrid is studied. In this microgrid, each agent pursues an economic dispatch for its personal resources. In addition, each agent is capable of trading electricity with other agents through a local energy market. In this paper, a simple market structure is introduced as a framework for energy trades in a small community microgrid such as the Solar Village. It was found that both sellers and buyers benefited by participating in this market. In the second paper, Semidefinite Programming (SDP) for convex relaxation of power flow equations is used for optimal active and reactive dispatch for Distributed Energy Resources (DER). Various objective functions including voltage regulation, reduced transmission line power losses, and minimized reactive power charges for a microgrid are introduced. Combinations of these goals are attained by solving a multiobjective optimization for the proposed ORPD problem. Also, both centralized and distributed versions of this optimal dispatch are investigated. It was found that SDP made the optimal dispatch faster and distributed solution allowed for scalability.

Real-time OHT Dispatching Mechanism for the Interbay Automated Material Handling System with Shortcuts and Bypasses

NASA Astrophysics Data System (ADS)

Pan, Cong; Zhang, Jie; Qin, Wei

2017-05-01

As a key to improve the performance of the interbay automated material handling system (AMHS) in 300 mm semiconductor wafer fabrication system, the real-time overhead hoist transport (OHT) dispatching problem has received much attention. This problem is first formulated as a special form of assignment problem and it is proved that more than one solution will be obtained by Hungarian algorithm simultaneously. Through proposing and strictly proving two propositions related to the characteristics of these solutions, a modified Hungarian algorithm is designed to distinguish these solutions. Finally, a new real-time OHT dispatching method is carefully designed by implementing the solution obtained by the modified Hungarian algorithm. The experimental results of discrete event simulations show that, compared with conventional Hungarian algorithm dispatching method, the proposed dispatching method that chooses the solution with the maximum variance respectively reduces on average 4 s of the average waiting time and average lead time of wafer lots, and its performance is rather stable in multiple different scenarios of the interbay AMHS with different quantities of shortcuts. This research provides an efficient real-time OHT dispatching mechanism for the interbay AMHS with shortcuts and bypasses.

Economic dispatch optimization for system integrating renewable energy sources

NASA Astrophysics Data System (ADS)

Jihane, Kartite; Mohamed, Cherkaoui

2018-05-01

Nowadays, the use of energy is growing especially in transportation and electricity industries. However this energy is based on conventional sources which pollute the environment. Multi-source system is seen as the best solution to sustainable development. This paper proposes the Economic Dispatch (ED) of hybrid renewable power system. The hybrid system is composed of ten thermal generators, photovoltaic (PV) generator and wind turbine generator. To show the importance of renewable energy sources (RES) in the energy mix we have ran the simulation for system integrated PV only and PV plus wind. The result shows that the system with renewable energy sources (RES) is more compromising than the system without RES in terms of fuel cost.

Mobile phone use for contacting emergency services in life-threatening circumstances.

PubMed

Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

2012-03-01

The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Multi-objective generation scheduling with hybrid energy resources

NASA Astrophysics Data System (ADS)

Trivedi, Manas

In economic dispatch (ED) of electric power generation, the committed generating units are scheduled to meet the load demand at minimum operating cost with satisfying all unit and system equality and inequality constraints. Generation of electricity from the fossil fuel releases several contaminants into the atmosphere. So the economic dispatch objective can no longer be considered alone due to the environmental concerns that arise from the emissions produced by fossil fueled electric power plants. This research is proposing the concept of environmental/economic generation scheduling with traditional and renewable energy sources. Environmental/economic dispatch (EED) is a multi-objective problem with conflicting objectives since emission minimization is conflicting with fuel cost minimization. Production and consumption of fossil fuel and nuclear energy are closely related to environmental degradation. This causes negative effects to human health and the quality of life. Depletion of the fossil fuel resources will also be challenging for the presently employed energy systems to cope with future energy requirements. On the other hand, renewable energy sources such as hydro and wind are abundant, inexhaustible and widely available. These sources use native resources and have the capacity to meet the present and the future energy demands of the world with almost nil emissions of air pollutants and greenhouse gases. The costs of fossil fuel and renewable energy are also heading in opposite directions. The economic policies needed to support the widespread and sustainable markets for renewable energy sources are rapidly evolving. The contribution of this research centers on solving the economic dispatch problem of a system with hybrid energy resources under environmental restrictions. It suggests an effective solution of renewable energy to the existing fossil fueled and nuclear electric utilities for the cheaper and cleaner production of electricity with hourly emission targets. Since minimizing the emissions and fuel cost are conflicting objectives, a practical approach based on multi-objective optimization is applied to obtain compromised solutions in a single simulation run using genetic algorithm. These solutions are known as non-inferior or Pareto-optimal solutions, graphically illustrated by the trade-off curves between criterions fuel cost and pollutant emission. The efficacy of the proposed approach is illustrated with the help of different sample test cases. This research would be useful for society, electric utilities, consultants, regulatory bodies, policy makers and planners.

Testing of Strategies for the Acceleration of the Cost Optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ponciroli, Roberto; Vilim, Richard B.

The general problem addressed in the Nuclear-Renewable Hybrid Energy System (N-R HES) project is finding the optimum economical dispatch (ED) and capacity planning solutions for the hybrid energy systems. In the present test-problem configuration, the N-R HES unit is composed of three electrical power-generating components, i.e. the Balance of Plant (BOP), the Secondary Energy Source (SES), and the Energy Storage (ES). In addition, there is an Industrial Process (IP), which is devoted to hydrogen generation. At this preliminary stage, the goal is to find the power outputs of each one of the N-R HES unit components (BOP, SES, ES) andmore » the IP hydrogen production level that maximizes the unit profit by simultaneously satisfying individual component operational constraints. The optimization problem is meant to be solved in the Risk Analysis Virtual Environment (RAVEN) framework. The dynamic response of the N-R HES unit components is simulated by using dedicated object-oriented models written in the Modelica modeling language. Though this code coupling provides for very accurate predictions, the ensuing optimization problem is characterized by a very large number of solution variables. To ease the computational burden and to improve the path to a converged solution, a method to better estimate the initial guess for the optimization problem solution was developed. The proposed approach led to the definition of a suitable Monte Carlo-based optimization algorithm (called the preconditioner), which provides an initial guess for the optimal N-R HES power dispatch and the optimal installed capacity for each one of the unit components. The preconditioner samples a set of stochastic power scenarios for each one of the N-R HES unit components, and then for each of them the corresponding value of a suitably defined cost function is evaluated. After having simulated a sufficient number of power histories, the configuration which ensures the highest profit is selected as the optimal one. The component physical dynamics are represented through suitable ramp constraints, which considerably simplify the numerical solving. In order to test the capabilities of the proposed approach, in the present report, the dispatch problem only is tackled, i.e. a reference unit configuration is assumed, and each one of the N-R HES unit components is assumed to have a fixed installed capacity. As for the next steps, the main improvement will concern the operation strategy of the ES facility. In particular, in order to describe a more realistic battery commitment strategy, the ES operation will be regulated according to the electricity price forecasts.« less

Information processing in an urban fire department communication system.

PubMed

Siegel, J; Weitzman, D O

1975-09-01

One of the most important functions of any fire department is to provide selective contact with fire fighting units and to dispatch these units based on information gathered from street alarm boxes and telephones. This paper is concerned with the problem of dispatching tactical response information to remote fire fighting units and with the effect of workload on the dispatch function.

Ability of the medical priority dispatch system protocol to predict the acuity of "unknown problem" dispatch response levels.

PubMed

Clawson, Jeff; Olola, Christopher; Heward, Andy; Patterson, Brett; Scott, Greg

2008-01-01

To determine if Medical Priority Dispatch System's (MPDS's) Protocol 32-Unknown Problem interrogation-based differential dispatch coding distinguishes the acuity of patients as found at the scene by responders, when little (if any) clinical information is known. "Unknown problem" situations (i.e., all cases not fitting into any other chief complaint group) constitute 5-8% of all calls to dispatch centers. From the total patient encounters (n=599,107) in the aggregate data of one year (September 2005 to August 2006), we examined 3,947 (0.7%) encounters initially coded as "unknown problem" by the London Ambulance Service Communications Center for the scene presence of cardiac arrest (CA) and paramedic-determined high-acuity (blue-in [BI]/"lights and siren") findings. Odds ratios (ORs) with 95% confidence intervals (95% CIs) and p-values were used to assess the degree of associations between determinant codes and case outcomes (i.e., CA/BI). Statistically significant association between clinical dispatch determinant codes and case outcomes was observed in the "life status questionable" (LSQ; DELTA-1 [D-1]) and the "standing, sitting, moving, or talking" (BRAVO-1 [B-1]) code pair for the CA outcome (OR [95% CI]: 0.11 [0, 0.63], p=0.005) and for the BI outcome (OR [95% CI]: 0.47 [0.28, 0.77], p=0.003). The LSQ and all three code pairs (i.e., B-1; "community alarm notifications" [B-2]; and "unknown status" [B-3]) also demonstrated significant associations both with the CA outcome (OR [95% CI]: 0.43 [0.23, 0.81], p=0.010) and with the BI outcome (OR [95% CI]: 0.74 [0.56, 0.97], p=0.033). All the determinant code levels yielded significant association between BI and CA cases. This dispatch protocol for unknown problems successfully differentiates dispatch coding of low-acuity and non-CA patients only when specific situational information such as the patient's standing, sitting, moving, or talking can be determined during the interrogation process. Also, emergency medical dispatcher (EMD) reliance on caller-volunteered information to identify predefined critical situations does not appear to add to the protocol's ability to differentiate high-acuity and CA patients. LSQ proved to be a better predictor of both CA and BI outcomes, when compared with the BRAVO-level determinant codes within the "unknown problem" chief complaint. The B-3 (completely unknown) determinant code is a better predictor of severe outcomes than nearly all of the clinically similar BRAVO determinant codes in the entire MPDS protocol. Hence, the B-3 coding should be considered-in terms of its predictability for severe outcome-as falling somewhere between a typical DELTA and a typical BRAVO determinant code.

An Approximate Dynamic Programming Mode for Optimal MEDEVAC Dispatching

DTIC Science & Technology

2015-03-26

over the myopic policy. This indicates the ADP policy is efficiently managing resources by 28 not immediately sending the nearest available MEDEVAC...DISPATCHING THESIS Presented to the Faculty Department of Operational Sciences Graduate School of Engineering and Management Air Force Institute of Technology...medical evacuation (MEDEVAC) dispatch policies. To solve the MDP, we apply an ap- proximate dynamic programming (ADP) technique. The problem of deciding

Particle swarm optimization with recombination and dynamic linkage discovery.

PubMed

Chen, Ying-Ping; Peng, Wen-Chih; Jian, Ming-Chung

2007-12-01

In this paper, we try to improve the performance of the particle swarm optimizer by incorporating the linkage concept, which is an essential mechanism in genetic algorithms, and design a new linkage identification technique called dynamic linkage discovery to address the linkage problem in real-parameter optimization problems. Dynamic linkage discovery is a costless and effective linkage recognition technique that adapts the linkage configuration by employing only the selection operator without extra judging criteria irrelevant to the objective function. Moreover, a recombination operator that utilizes the discovered linkage configuration to promote the cooperation of particle swarm optimizer and dynamic linkage discovery is accordingly developed. By integrating the particle swarm optimizer, dynamic linkage discovery, and recombination operator, we propose a new hybridization of optimization methodologies called particle swarm optimization with recombination and dynamic linkage discovery (PSO-RDL). In order to study the capability of PSO-RDL, numerical experiments were conducted on a set of benchmark functions as well as on an important real-world application. The benchmark functions used in this paper were proposed in the 2005 Institute of Electrical and Electronics Engineers Congress on Evolutionary Computation. The experimental results on the benchmark functions indicate that PSO-RDL can provide a level of performance comparable to that given by other advanced optimization techniques. In addition to the benchmark, PSO-RDL was also used to solve the economic dispatch (ED) problem for power systems, which is a real-world problem and highly constrained. The results indicate that PSO-RDL can successfully solve the ED problem for the three-unit power system and obtain the currently known best solution for the 40-unit system.

Do emergency medical services dispatch nature and severity codes agree with paramedic field findings?

PubMed

Neely, K W; Eldurkar, J A; Drake, M E

2000-02-01

Emergency medical services (EMS) systems increasingly seek to triage patients to alternative EMS resources. Emergency medical services dispatchers may be asked to perform this triage. New protocols may be necessary. Alternatively, existing protocols may be sufficient for this task. For an existing dispatch protocol to be sufficient, it at least must accurately categorize patient condition and severity based on an external standard. To examine the extent to which nature codes (NCs), or patient condition codes, and severity codes (SCs) currently assigned in one urban 911 center agree with paramedic field findings. The null hypothesis was that there is no routine agreement (75%) between dispatcher-assigned NC or SC and paramedic-assigned NC or SC for the same patient using the same protocol. Emergency medical services dispatch nature and severity code data and matching out-of-hospital data were prospectively gathered over six months. Dispatch data included the NC: caller-identified problem, and the SC: dispatcher-assessed severity. Each NC is modified by one of three SCs (1, 3, or 9): 1 is emergent, 3 is urgent, and 9 is neither. Paramedics verified and/or corrected dispatcher-assigned NCs and SCs using the same dispatch protocol. One thousand forty usable cases fell into 33 unique NC/SC combinations. The designation of SC 1 was assigned 275 times, SC 3 was assigned 736 times, and SC 9 was assigned 24 times. The SC was missing five times. The overall NC agreement was 0.70 (95% CI = 0.697 to 0.703). The overall SC agreement was 0.65 (95% CI = 0.645 to 0.655). The NC agreement exceeded 75% for ten (59%) NC/SC combinations. The SC agreement exceeded 75% for five (29%) NC/SC combinations. There was both NC and SC agreement for four (24%) combinations: urgent breathing problems, urgent diabetic problems, urgent falls, and urgent overdoses. The greatest NC/SC disagreement occurred within emergent and urgent traffic crashes. Paramedics adjusted SC toward lower severity 29% of the time and toward higher severity 5.4% of the time. There was no upward SC adjustment for eight (47%) combinations. Certain dispatcher-assigned NC and SC codes and NC/SC combinations achieved the study threshold. Overall agreement failed to achieve the threshold. The lowest SC level was rarely assigned, preventing a meaningful analysis of all severity levels.

Hybrid robust predictive optimization method of power system dispatch

DOEpatents

Chandra, Ramu Sharat [Niskayuna, NY; Liu, Yan [Ballston Lake, NY; Bose, Sumit [Niskayuna, NY; de Bedout, Juan Manuel [West Glenville, NY

2011-08-02

A method of power system dispatch control solves power system dispatch problems by integrating a larger variety of generation, load and storage assets, including without limitation, combined heat and power (CHP) units, renewable generation with forecasting, controllable loads, electric, thermal and water energy storage. The method employs a predictive algorithm to dynamically schedule different assets in order to achieve global optimization and maintain the system normal operation.

Examining the Fundamental Obstructs of Adopting Cloud Computing for 9-1-1 Dispatch Centers in the USA

ERIC Educational Resources Information Center

Osman, Abdulaziz

2016-01-01

The purpose of this research study was to examine the unknown fears of embracing cloud computing which stretches across measurements like fear of change from leaders and the complexity of the technology in 9-1-1 dispatch centers in USA. The problem that was addressed in the study was that many 9-1-1 dispatch centers in USA are still using old…

Multicriteria meta-heuristics for AGV dispatching control based on computational intelligence.

PubMed

Naso, David; Turchiano, Biagio

2005-04-01

In many manufacturing environments, automated guided vehicles are used to move the processed materials between various pickup and delivery points. The assignment of vehicles to unit loads is a complex problem that is often solved in real-time with simple dispatching rules. This paper proposes an automated guided vehicles dispatching approach based on computational intelligence. We adopt a fuzzy multicriteria decision strategy to simultaneously take into account multiple aspects in every dispatching decision. Since the typical short-term view of dispatching rules is one of the main limitations of such real-time assignment heuristics, we also incorporate in the multicriteria algorithm a specific heuristic rule that takes into account the empty-vehicle travel on a longer time-horizon. Moreover, we also adopt a genetic algorithm to tune the weights associated to each decision criteria in the global decision algorithm. The proposed approach is validated by means of a comparison with other dispatching rules, and with other recently proposed multicriteria dispatching strategies also based on computational Intelligence. The analysis of the results obtained by the proposed dispatching approach in both nominal and perturbed operating conditions (congestions, faults) confirms its effectiveness.

New scheduling rules for a dynamic flexible flow line problem with sequence-dependent setup times

NASA Astrophysics Data System (ADS)

Kia, Hamidreza; Ghodsypour, Seyed Hassan; Davoudpour, Hamid

2017-09-01

In the literature, the application of multi-objective dynamic scheduling problem and simple priority rules are widely studied. Although these rules are not efficient enough due to simplicity and lack of general insight, composite dispatching rules have a very suitable performance because they result from experiments. In this paper, a dynamic flexible flow line problem with sequence-dependent setup times is studied. The objective of the problem is minimization of mean flow time and mean tardiness. A 0-1 mixed integer model of the problem is formulated. Since the problem is NP-hard, four new composite dispatching rules are proposed to solve it by applying genetic programming framework and choosing proper operators. Furthermore, a discrete-event simulation model is made to examine the performances of scheduling rules considering four new heuristic rules and the six adapted heuristic rules from the literature. It is clear from the experimental results that composite dispatching rules that are formed from genetic programming have a better performance in minimization of mean flow time and mean tardiness than others.

Integrated Canada-U.S. Power Sector Modeling with the Regional Energy Deployment System (ReEDS)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martinez, A.; Eurek, K.; Mai, T.

2013-02-01

The electric power system in North America is linked between the United States and Canada. Canada has historically been a net exporter of electricity to the United States. The extent to which this remains true will depend on the future evolution of power markets, technology deployment, and policies. To evaluate these and related questions, we modify the Regional Energy Deployment System (ReEDS) model to include an explicit representation of the grid-connected power system in Canada to the continental United States. ReEDS is unique among long-term capacity expansion models for its high spatial resolution and statistical treatment of the impact ofmore » variable renewable generation on capacity planning and dispatch. These unique traits are extended to new Canadian regions. We present example scenario results using the fully integrated Canada-U.S. version of ReEDS to demonstrate model capabilities. The newly developed, integrated Canada-U.S. ReEDS model can be used to analyze the dynamics of electricity transfers and other grid services between the two countries under different scenarios.« less

The Proposal of the Model for Developing Dispatch System for Nationwide One-Day Integrative Planning

NASA Astrophysics Data System (ADS)

Kim, Hyun Soo; Choi, Hyung Rim; Park, Byung Kwon; Jung, Jae Un; Lee, Jin Wook

The problems of dispatch planning for container truck are classified as the pickup and delivery problems, which are highly complex issues that consider various constraints in the real world. However, in case of the current situation, it is developed by the control system so that it requires the automated planning system under the view of nationwide integrative planning. Therefore, the purpose of this study is to suggest model to develop the automated dispatch system through the constraint satisfaction problem and meta-heuristic technique-based algorithm. In the further study, the practical system is developed and evaluation is performed in aspect of various results. This study suggests model to undergo the study which promoted the complexity of the problems by considering the various constraints which were not considered in the early study. However, it is suggested that it is necessary to add the study which includes the real-time monitoring function for vehicles and cargos based on the information technology.

The Analysis and Discussion in the Effective Application of the Dispatcher Training Based on Case Teaching Method with the Cause from the Action of the Gap Protection of Main Transformer

NASA Astrophysics Data System (ADS)

Yuanyuan, Xu; Zhengmao, Zhang; Xiang, Fang; Yuanshuai, Xu; Xinxin, Song

2018-03-01

The combination of theory and practice is a difficult problem on dispatcher training. Through a typical example of case, this paper provides an effective case teaching method for dispatcher training, and combines the theoretical discussion of the rule of experience with cases and achieves vividness. It helps students to understand and catch the key points of the theory, and improve their practical skills.

Paediatric medical emergency calls to a Danish Emergency Medical Dispatch Centre: a retrospective, observational study.

PubMed

Andersen, Kasper; Mikkelsen, Søren; Jørgensen, Gitte; Zwisler, Stine Thorhauge

2018-01-05

Little is known regarding paediatric medical emergency calls to Danish Emergency Medical Dispatch Centres (EMDC). This study aimed to investigate these calls, specifically the medical issues leading to them and the pre-hospital units dispatched to the paediatric emergencies. We performed a retrospective, observational study on paediatric medical emergency calls managed by the EMDC in the Region of Southern Denmark in February 2016. We reviewed audio recordings of emergency calls and ambulance records to identify calls concerning patients ≤ 15 years. We examined EMDC dispatch records to establish how the medical issues leading to these calls were classified and which pre-hospital units were dispatched to the paediatric emergencies. We analysed the data using descriptive statistics. Of a total of 7052 emergency calls in February 2016, 485 (6.9%) concerned patients ≤ 15 years. We excluded 19 and analysed the remaining 466. The reported medical issues were commonly classified as: "seizures" (22.1%), "sick child" (18.9%) and "unclear problem" (12.9%). The overall most common pre-hospital response was immediate dispatch of an ambulance with sirens and lights with a supporting physician-manned mobile emergency care unit (56.4%). The classification of medical issues and the dispatched pre-hospital units varied with patient age. We believe our results might help focus the paediatric training received by emergency medical dispatch staff on commonly encountered medical issues, such as the symptoms and conditions pertaining to the symptom categories "seizures" and "sick child". Furthermore, the results could prove useful in hypothesis generation for future studies examining paediatric medical emergency calls. Almost 7% of all calls concerned patients ≤ 15 years. Medical issues pertaining to the symptom categories "seizures", "sick child" and "unclear problem" were common and the calls commonly resulted in urgent pre-hospital responses.

Energy Policies for Resilience and National Security.

DTIC Science & Technology

1981-10-01

consequences: cancer , sterility, and gross birth defects...for many years after...release." [Joint Committee on Defense Production 1977:1:29] Since many of these...emergency generators, and thirteen other establishments, mainly medical , needed emergency generators repaired. Con Ed dispatched 18 of its 50 portable...scrap metal were il- licitly dug up and sold from a waste dump in Beatty, Nevada [NRC 1976a]. "Vast quantities of cannabis resin were smuggled into

A Real-Time Greedy-Index Dispatching Policy for using PEVs to Provide Frequency Regulation Service

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ke, Xinda; Wu, Di; Lu, Ning

This article presents a real-time greedy-index dispatching policy (GIDP) for using plug-in electric vehicles (PEVs) to provide frequency regulation services. A new service cost allocation mechanism is proposed to award PEVs based on the amount of service they provided, while considering compensations for delayed-charging and reduction of battery lifetime due to participation of the service. The GIDP transforms the optimal dispatch problem from a high-dimensional space into a one-dimensional space while preserving the solution optimality. When solving the transformed problem in real-time, the global optimality of the GIDP solution can be guaranteed by mathematically proved “indexability”. Because the GIDP indexmore » can be calculated upon the PEV’s arrival and used for the entire decision making process till its departure, the computational burden is minimized and the complexity of the aggregator dispatch process is significantly reduced. Finally, simulation results are used to evaluate the proposed GIDP, and to demonstrate the potential profitability from providing frequency regulation service by using PEVs.« less

A Real-Time Greedy-Index Dispatching Policy for using PEVs to Provide Frequency Regulation Service

DOE PAGES

Ke, Xinda; Wu, Di; Lu, Ning

2017-09-18

This article presents a real-time greedy-index dispatching policy (GIDP) for using plug-in electric vehicles (PEVs) to provide frequency regulation services. A new service cost allocation mechanism is proposed to award PEVs based on the amount of service they provided, while considering compensations for delayed-charging and reduction of battery lifetime due to participation of the service. The GIDP transforms the optimal dispatch problem from a high-dimensional space into a one-dimensional space while preserving the solution optimality. When solving the transformed problem in real-time, the global optimality of the GIDP solution can be guaranteed by mathematically proved “indexability”. Because the GIDP indexmore » can be calculated upon the PEV’s arrival and used for the entire decision making process till its departure, the computational burden is minimized and the complexity of the aggregator dispatch process is significantly reduced. Finally, simulation results are used to evaluate the proposed GIDP, and to demonstrate the potential profitability from providing frequency regulation service by using PEVs.« less

A Modified Artificial Bee Colony Algorithm Application for Economic Environmental Dispatch

NASA Astrophysics Data System (ADS)

Tarafdar Hagh, M.; Baghban Orandi, Omid

2018-03-01

In conventional fossil-fuel power systems, the economic environmental dispatch (EED) problem is a major problem that optimally determines the output power of generating units in a way that cost of total production and emission level be minimized simultaneously, and at the same time all the constraints of units and system are satisfied properly. To solve EED problem which is a non-convex optimization problem, a modified artificial bee colony (MABC) algorithm is proposed in this paper. This algorithm by implementing weighted sum method is applied on two test systems, and eventually, obtained results are compared with other reported results. Comparison of results confirms superiority and efficiency of proposed method clearly.

Modeling work of the dispatching service of high-rise building as queuing system

NASA Astrophysics Data System (ADS)

Dement'eva, Marina; Dement'eva, Anastasiya

2018-03-01

The article presents the results of calculating the performance indicators of the dispatcher service of a high-rise building as a queuing system with an unlimited queue. The calculation was carried out for three models: with a single control room and brigade of service, with a single control room and a specialized service, with several dispatch centers and specialized services. The aim of the work was to investigate the influence of the structural scheme of the organization of the dispatcher service of a high-rise building on the amount of operating costs and the time of processing and fulfilling applications. The problems of high-rise construction and their impact on the complication of exploitation are analyzed. The composition of exploitation activities of high-rise buildings is analyzed. The relevance of the study is justified by the need to review the role of dispatch services in the structure of management of the quality of buildings. Dispatching service from the lower level of management of individual engineering systems becomes the main link in the centralized automated management of the exploitation of high-rise buildings. With the transition to market relations, the criterion of profitability at the organization of the dispatching service becomes one of the main parameters of the effectiveness of its work. A mathematical model for assessing the efficiency of the dispatching service on a set of quality of service indicators is proposed. The structure of operating costs is presented. The algorithm of decision-making is given when choosing the optimal structural scheme of the dispatching service of a high-rise building.

A Multiobjective Interval Programming Model for Wind-Hydrothermal Power System Dispatching Using 2-Step Optimization Algorithm

PubMed Central

Jihong, Qu

2014-01-01

Wind-hydrothermal power system dispatching has received intensive attention in recent years because it can help develop various reasonable plans to schedule the power generation efficiency. But future data such as wind power output and power load would not be accurately predicted and the nonlinear nature involved in the complex multiobjective scheduling model; therefore, to achieve accurate solution to such complex problem is a very difficult task. This paper presents an interval programming model with 2-step optimization algorithm to solve multiobjective dispatching. Initially, we represented the future data into interval numbers and simplified the object function to a linear programming problem to search the feasible and preliminary solutions to construct the Pareto set. Then the simulated annealing method was used to search the optimal solution of initial model. Thorough experimental results suggest that the proposed method performed reasonably well in terms of both operating efficiency and precision. PMID:24895663

A multiobjective interval programming model for wind-hydrothermal power system dispatching using 2-step optimization algorithm.

PubMed

Ren, Kun; Jihong, Qu

2014-01-01

Wind-hydrothermal power system dispatching has received intensive attention in recent years because it can help develop various reasonable plans to schedule the power generation efficiency. But future data such as wind power output and power load would not be accurately predicted and the nonlinear nature involved in the complex multiobjective scheduling model; therefore, to achieve accurate solution to such complex problem is a very difficult task. This paper presents an interval programming model with 2-step optimization algorithm to solve multiobjective dispatching. Initially, we represented the future data into interval numbers and simplified the object function to a linear programming problem to search the feasible and preliminary solutions to construct the Pareto set. Then the simulated annealing method was used to search the optimal solution of initial model. Thorough experimental results suggest that the proposed method performed reasonably well in terms of both operating efficiency and precision.

Design of a cooperative problem-solving system for enroute flight planning: An empirical study of its use by airline dispatchers

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Mccoy, C. Elaine; Layton, Charles; Orasanu, Judith; Chappel, Sherry; Palmer, EV; Corker, Kevin

1993-01-01

In a previous report, an empirical study of 30 pilots using the Flight Planning Testbed was reported. An identical experiment using the Flight Planning Testbed (FPT), except that 27 airline dispatchers were studied, is described. Five general questions were addressed in this study: (1) under what circumstances do the introduction of computer-generated suggestions (flight plans) influence the planning behavior of dispatchers (either in a beneficial or adverse manner); (2) what is the nature of such influences (i.e., how are the person's cognitive processes changed); (3) how beneficial are the general design concepts underlying FPT (use of a graphical interface, embedding graphics in a spreadsheet, etc.); (4) how effective are the specific implementation decisions made in realizing these general design concepts; and (5) how effectively do dispatchers evaluate situations requiring replanning, and how effectively do they identify appropriate solutions to these situations.

A new algorithm for real-time optimal dispatch of active and reactive power generation retaining nonlinearity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roy, L.; Rao, N.D.

1983-04-01

This paper presents a new method for optimal dispatch of real and reactive power generation which is based on cartesian coordinate formulation of economic dispatch problem and reclassification of state and control variables associated with generator buses. The voltage and power at these buses are classified as parametric and functional inequality constraints, and are handled by reduced gradient technique and penalty factor approach respectively. The advantage of this classification is the reduction in the size of the equality constraint model, leading to less storage requirement. The rectangular coordinate formulation results in an exact equality constraint model in which the coefficientmore » matrix is real, sparse, diagonally dominant, smaller in size and need be computed and factorized once only in each gradient step. In addition, Lagragian multipliers are calculated using a new efficient procedure. A natural outcome of these features is the solution of the economic dispatch problem, faster than other methods available to date in the literature. Rapid and reliable convergence is an additional desirable characteristic of the method. Digital simulation results are presented on several IEEE test systems to illustrate the range of application of the method visa-vis the popular Dommel-Tinney (DT) procedure. It is found that the proposed method is more reliable, 3-4 times faster and requires 20-30 percent less storage compared to the DT algorithm, while being just as general. Thus, owing to its exactness, robust mathematical model and less computational requirements, the method developed in the paper is shown to be a practically feasible algorithm for on-line optimal power dispatch.« less

An optimization method for condition based maintenance of aircraft fleet considering prognostics uncertainty.

PubMed

Feng, Qiang; Chen, Yiran; Sun, Bo; Li, Songjie

2014-01-01

An optimization method for condition based maintenance (CBM) of aircraft fleet considering prognostics uncertainty is proposed. The CBM and dispatch process of aircraft fleet is analyzed first, and the alternative strategy sets for single aircraft are given. Then, the optimization problem of fleet CBM with lower maintenance cost and dispatch risk is translated to the combinatorial optimization problem of single aircraft strategy. Remain useful life (RUL) distribution of the key line replaceable Module (LRM) has been transformed into the failure probability of the aircraft and the fleet health status matrix is established. And the calculation method of the costs and risks for mission based on health status matrix and maintenance matrix is given. Further, an optimization method for fleet dispatch and CBM under acceptable risk is proposed based on an improved genetic algorithm. Finally, a fleet of 10 aircrafts is studied to verify the proposed method. The results shows that it could realize optimization and control of the aircraft fleet oriented to mission success.

An Optimization Method for Condition Based Maintenance of Aircraft Fleet Considering Prognostics Uncertainty

PubMed Central

Chen, Yiran; Sun, Bo; Li, Songjie

2014-01-01

An optimization method for condition based maintenance (CBM) of aircraft fleet considering prognostics uncertainty is proposed. The CBM and dispatch process of aircraft fleet is analyzed first, and the alternative strategy sets for single aircraft are given. Then, the optimization problem of fleet CBM with lower maintenance cost and dispatch risk is translated to the combinatorial optimization problem of single aircraft strategy. Remain useful life (RUL) distribution of the key line replaceable Module (LRM) has been transformed into the failure probability of the aircraft and the fleet health status matrix is established. And the calculation method of the costs and risks for mission based on health status matrix and maintenance matrix is given. Further, an optimization method for fleet dispatch and CBM under acceptable risk is proposed based on an improved genetic algorithm. Finally, a fleet of 10 aircrafts is studied to verify the proposed method. The results shows that it could realize optimization and control of the aircraft fleet oriented to mission success. PMID:24892046

A genetic algorithm for dynamic inbound ordering and outbound dispatching problem with delivery time windows

NASA Astrophysics Data System (ADS)

Kim, Byung Soo; Lee, Woon-Seek; Koh, Shiegheun

2012-07-01

This article considers an inbound ordering and outbound dispatching problem for a single product in a third-party warehouse, where the demands are dynamic over a discrete and finite time horizon, and moreover, each demand has a time window in which it must be satisfied. Replenishing orders are shipped in containers and the freight cost is proportional to the number of containers used. The problem is classified into two cases, i.e. non-split demand case and split demand case, and a mathematical model for each case is presented. An in-depth analysis of the models shows that they are very complicated and difficult to find optimal solutions as the problem size becomes large. Therefore, genetic algorithm (GA) based heuristic approaches are designed to solve the problems in a reasonable time. To validate and evaluate the algorithms, finally, some computational experiments are conducted.

Symbiotic organisms search algorithm for dynamic economic dispatch with valve-point effects

NASA Astrophysics Data System (ADS)

Sonmez, Yusuf; Kahraman, H. Tolga; Dosoglu, M. Kenan; Guvenc, Ugur; Duman, Serhat

2017-05-01

In this study, symbiotic organisms search (SOS) algorithm is proposed to solve the dynamic economic dispatch with valve-point effects problem, which is one of the most important problems of the modern power system. Some practical constraints like valve-point effects, ramp rate limits and prohibited operating zones have been considered as solutions. Proposed algorithm was tested on five different test cases in 5 units, 10 units and 13 units systems. The obtained results have been compared with other well-known metaheuristic methods reported before. Results show that proposed algorithm has a good convergence and produces better results than other methods.

Solving the dynamic ambulance relocation and dispatching problem using approximate dynamic programming

PubMed Central

Schmid, Verena

2012-01-01

Emergency service providers are supposed to locate ambulances such that in case of emergency patients can be reached in a time-efficient manner. Two fundamental decisions and choices need to be made real-time. First of all immediately after a request emerges an appropriate vehicle needs to be dispatched and send to the requests’ site. After having served a request the vehicle needs to be relocated to its next waiting location. We are going to propose a model and solve the underlying optimization problem using approximate dynamic programming (ADP), an emerging and powerful tool for solving stochastic and dynamic problems typically arising in the field of operations research. Empirical tests based on real data from the city of Vienna indicate that by deviating from the classical dispatching rules the average response time can be decreased from 4.60 to 4.01 minutes, which corresponds to an improvement of 12.89%. Furthermore we are going to show that it is essential to consider time-dependent information such as travel times and changes with respect to the request volume explicitly. Ignoring the current time and its consequences thereafter during the stage of modeling and optimization leads to suboptimal decisions. PMID:25540476

Transmission dispatch and congestion management in open market systems

NASA Astrophysics Data System (ADS)

Fang, Risheng

This thesis is located in the domain of electricity supply industry restructuring. It deals with emerging issues, whose understanding is essential to advancing knowledge of open access transmission theory and proceeds to develop approaches for solving the transmission dispatch and congestion management problem. An overview of current trends and experiences in utility restructuring and the main models for restructuring, as well as the classifications of system operators, is first presented. A fully unbundled competitive electricity market model, called the bilateral/multilateral trades model, is then developed. A survey of current research in transmission dispatch and congestion management is included with discussion of transmission capacity and ancillary services. A methodology for the power dispatch problem in a structure dominated by bilateral and multilateral transmission contracts is presented. Group structures are mathematically formulated and explored and three basic types of curtailment strategies proposed for use by market participants. A more complex model is then developed, which takes into account the co-existence of bilateral and multilateral contracts with pool type dynamic supplies and demands based on bids and market clearing prices. An integrated dispatch strategy to reconcile all three types of transactions (bilateral, multilateral and pool) is then developed. Prioritization of electricity transactions and related curtailment strategies are explored and a mechanism for coordination between market participants to achieve additional economic advantages is described. A theory of security based rescheduling is presented in order to investigate the security-related aspects of operation in an unbundled and deregulated system. The impact of post-contingency corrective capability on optimal rescheduling results has been identified and the advantage of incorporating post-contingency corrective rescheduling into the objective function demonstrated. Finally, integrated congestion management procedures in real-time system operation and in forward energy markets are developed. Market price response and coordination of dispatch by the ISO are incorporated to achieve an overall strategy.

Identifying causes of laboratory turnaround time delay in the emergency department.

PubMed

Jalili, Mohammad; Shalileh, Keivan; Mojtahed, Ali; Mojtahed, Mohammad; Moradi-Lakeh, Maziar

2012-12-01

Laboratory turnaround time (TAT) is an important determinant of patient stay and quality of care. Our objective is to evaluate laboratory TAT in our emergency department (ED) and to generate a simple model for identifying the primary causes for delay. We measured TATs of hemoglobin, potassium, and prothrombin time tests requested in the ED of a tertiary-care, metropolitan hospital during a consecutive one-week period. The time of different steps (physician order, nurse registration, blood-draw, specimen dispatch from the ED, specimen arrival at the laboratory, and result availability) in the test turnaround process were recorded and the intervals between these steps (order processing, specimen collection, ED waiting, transit, and within-laboratory time) and total TAT were calculated. Median TATs for hemoglobin and potassium were compared with those of the 1990 Q-Probes Study (25 min for hemoglobin and 36 min for potassium) and its recommended goals (45 min for 90% of tests). Intervals were compared according to the proportion of TAT they comprised. Median TATs (170 min for 132 hemoglobin tests, 225 min for 172 potassium tests, and 195.5 min for 128 prothrombin tests) were drastically longer than Q-Probes reported and recommended TATs. The longest intervals were ED waiting time and order processing.  Laboratory TAT varies among institutions, and data are sparse in developing countries. In our ED, actions to reduce ED waiting time and order processing are top priorities. We recommend utilization of this model by other institutions in settings with limited resources to identify their own priorities for reducing laboratory TAT.

Management of chest pain in the French emergency healthcare system: the prospective observational EPIDOULTHO study.

PubMed

Charpentier, Sandrine; Beaune, Sebastien; Joly, Luc Marie; Khoury, Abdo; Duchateau, François-Xavier; Briot, Raphael; Renaud, Bertrand; Ageron, François-Xavier

2017-07-18

The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013. Data on diagnostic and therapeutic management and disposition were collected. An in-hospital follow-up was performed. In total, 1339 patients were included: 537 from SAMU, 187 attended by a MICU and 615 in EDs. Diagnosing ACS was the main diagnostic strategy of the French emergency care system, diagnosed in 16% of SAMU patients, 25% of MICU patients and 10% of ED patients. Among patients calling the SAMU, 76 (14%) received only medical advice, 15 (8%) patients remained at home after being seen by a MICU and 454 (74%) were discharged from an ED. Management of chest pain at the three levels of the French medical emergency system is mainly oriented towards ruling out ACS. The strategy of diagnostic management is based on minimizing missed diagnoses of ACS.

Chance-constrained economic dispatch with renewable energy and storage

DOE PAGES

Cheng, Jianqiang; Chen, Richard Li-Yang; Najm, Habib N.; ...

2018-04-19

Increased penetration of renewables, along with uncertainties associated with them, have transformed how power systems are operated. High levels of uncertainty means that it is not longer possible to guarantee operational feasibility with certainty, instead constraints are required to be satisfied with high probability. We present a chance-constrained economic dispatch model that efficiently integrates energy storage and high renewable penetration to satisfy renewable portfolio requirements. Specifically, it is required that wind energy contributes at least a prespecified ratio of the total demand and that the scheduled wind energy is dispatchable with high probability. We develop an approximated partial sample averagemore » approximation (PSAA) framework to enable efficient solution of large-scale chanceconstrained economic dispatch problems. Computational experiments on the IEEE-24 bus system show that the proposed PSAA approach is more accurate, closer to the prescribed tolerance, and about 100 times faster than sample average approximation. Improved efficiency of our PSAA approach enables solution of WECC-240 system in minutes.« less

Chance-constrained economic dispatch with renewable energy and storage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheng, Jianqiang; Chen, Richard Li-Yang; Najm, Habib N.

Increased penetration of renewables, along with uncertainties associated with them, have transformed how power systems are operated. High levels of uncertainty means that it is not longer possible to guarantee operational feasibility with certainty, instead constraints are required to be satisfied with high probability. We present a chance-constrained economic dispatch model that efficiently integrates energy storage and high renewable penetration to satisfy renewable portfolio requirements. Specifically, it is required that wind energy contributes at least a prespecified ratio of the total demand and that the scheduled wind energy is dispatchable with high probability. We develop an approximated partial sample averagemore » approximation (PSAA) framework to enable efficient solution of large-scale chanceconstrained economic dispatch problems. Computational experiments on the IEEE-24 bus system show that the proposed PSAA approach is more accurate, closer to the prescribed tolerance, and about 100 times faster than sample average approximation. Improved efficiency of our PSAA approach enables solution of WECC-240 system in minutes.« less

How well do General EMS 911 dispatch protocols predict ED resource utilization for pediatric patients?

PubMed

Fessler, Stephanie J; Simon, Harold K; Yancey, Arthur H; Colman, Michael; Hirsh, Daniel A

2014-03-01

The use of Emergency Medical Services (EMS) for low-acuity pediatric problems is well documented. Attempts have been made to curb potentially unnecessary transports, including using EMS dispatch protocols, shown to predict acuity and needs of adults. However, there are limited data about this in children. The primary objective of this study is to determine the pediatric emergency department (PED) resource utilization (surrogate of acuity level) for pediatric patients categorized as "low-acuity" by initial EMS protocols. Records of all pediatric patients classified as "low acuity" and transported to a PED in winter and summer of 2010 were reviewed. Details of the PED visit were recorded. Patients were categorized and compared based on chief complaint group. Resource utilization was defined as requiring any prescription medications, labs, procedures, consults, admission or transfer. "Under-triage" was defined as a "low-acuity" EMS transport subsequently requiring emergent interventions. Of the 876 eligible cases, 801 were included; 392/801 had no resource utilization while 409 of 801 had resource utilization. Most (737/801) were discharged to home; however, 64/801 were admitted, including 1 of 801 requiring emergent intervention (under-triage rate 0.12%). Gastroenterology and trauma groups had a significant increase in resource utilization, while infectious disease and ear-nose-throat groups had decreased resource utilization. While this EMS system did not well predict overall resource utilization, it safely identified most low-acuity patients, with a low under-triage rate. This study identifies subgroups of patients that could be managed without emergent transport and can be used to further refine current protocols or establish secondary triage systems. © 2013.

Analysis of dispatching rules in a stochastic dynamic job shop manufacturing system with sequence-dependent setup times

NASA Astrophysics Data System (ADS)

Sharma, Pankaj; Jain, Ajai

2014-12-01

Stochastic dynamic job shop scheduling problem with consideration of sequence-dependent setup times are among the most difficult classes of scheduling problems. This paper assesses the performance of nine dispatching rules in such shop from makespan, mean flow time, maximum flow time, mean tardiness, maximum tardiness, number of tardy jobs, total setups and mean setup time performance measures viewpoint. A discrete event simulation model of a stochastic dynamic job shop manufacturing system is developed for investigation purpose. Nine dispatching rules identified from literature are incorporated in the simulation model. The simulation experiments are conducted under due date tightness factor of 3, shop utilization percentage of 90% and setup times less than processing times. Results indicate that shortest setup time (SIMSET) rule provides the best performance for mean flow time and number of tardy jobs measures. The job with similar setup and modified earliest due date (JMEDD) rule provides the best performance for makespan, maximum flow time, mean tardiness, maximum tardiness, total setups and mean setup time measures.

An empirical evaulation of computerized tools to aid in enroute flight planning

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Mccoy, C. Elaine; Layton, Charles

1993-01-01

The paper describes an experiment using the Flight Planning Testbed (FPT) in which 27 airline dispatchers were studied. Five general questions was addresses in the study: Under what circumstances does the introduction of computer-generated suggestions (flight plans) influence the planning behavior of dispatchers; what is the nature of such influences; How beneficial are the general design concepts underlying FPT; How effective are the specific implementation decisions made in realizing these general design concepts; How effectively do dispatchers evaluate situations requiring replanning and how effectively do they identify appropriate solutions to these situations. The study leaves little doubt that the introduction of computer-generated suggestions for solving a flight planning problem can have a marked impact on the cognitive processes of the user and on the ultimate plan selected.

An online dispatcher training simulator function for real-time analysis and training

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vadari, S.V.; Montstream, M.J.; Ross, H.B. Jr.

1995-11-01

Today`s power systems have become so complex that it is not easy for the system dispatcher to realistically predict the results of outages. The situation is compounded whenever the power grid is not in its normal configuration due to maintenance switching or equipment failure. The authors feel that the DTS is an excellent tool that can be used to teach the dispatcher how to react under these conditions. In this paper, the authors present an on-line implementation of the DTS which allows the user to initialize the DTS to an EMS disturbance using data that was captured at the timemore » of the disturbance; and place the DTS in a playback mode and go back to specific times in the scenario. The former feature allows the analyst to investigate EMS disturbances and then train the various dispatchers to be able to recognize such disturbances and to recover from them when they occur. The latter feature allows the instructor (with the trainee) to review and re-experience desired portions of the scenario. It is the authors` feeling that these two features will help the EMS operational staff understand their power system better and help their dispatchers in dealing with operational problems associated with the proper running of the system.« less

A tutorial description of an interior point method and its applications to security-constrained economic dispatch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vargas, L.S.; Quintana, V.H.; Vannelli, A.

This paper deals with the use of Successive Linear Programming (SLP) for the solution of the Security-Constrained Economic Dispatch (SCED) problem. The authors tutorially describe an Interior Point Method (IPM) for the solution of Linear Programming (LP) problems, discussing important implementation issues that really make this method far superior to the simplex method. A study of the convergence of the SLP technique and a practical criterion to avoid oscillatory behavior in the iteration process are also proposed. A comparison of the proposed method with an efficient simplex code (MINOS) is carried out by solving SCED problems on two standard IEEEmore » systems. The results show that the interior point technique is reliable, accurate and more than two times faster than the simplex algorithm.« less

Review of Reactive Power Dispatch Strategies for Loss Minimization in a DFIG-based Wind Farm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Baohua; Hu, Weihao; Hou, Peng

This study reviews and compares the performance of reactive power dispatch strategies for the loss minimization of Doubly Fed Induction Generator (DFIG)-based Wind Farms (WFs). Twelve possible combinations of three WF level reactive power dispatch strategies and four Wind Turbine (WT) level reactive power control strategies are investigated. All of the combined strategies are formulated based on the comprehensive loss models of WFs, including the loss models of DFIGs, converters, filters, transformers, and cables of the collection system. Optimization problems are solved by a Modified Particle Swarm Optimization (MPSO) algorithm. The effectiveness of these strategies is evaluated by simulations onmore » a carefully designed WF under a series of cases with different wind speeds and reactive power requirements of the WF. The wind speed at each WT inside the WF is calculated using the Jensen wake model. The results show that the best reactive power dispatch strategy for loss minimization comes when the WF level strategy and WT level control are coordinated and the losses from each device in the WF are considered in the objective.« less

Review of Reactive Power Dispatch Strategies for Loss Minimization in a DFIG-based Wind Farm

DOE PAGES

Zhang, Baohua; Hu, Weihao; Hou, Peng; ...

2017-06-27

This study reviews and compares the performance of reactive power dispatch strategies for the loss minimization of Doubly Fed Induction Generator (DFIG)-based Wind Farms (WFs). Twelve possible combinations of three WF level reactive power dispatch strategies and four Wind Turbine (WT) level reactive power control strategies are investigated. All of the combined strategies are formulated based on the comprehensive loss models of WFs, including the loss models of DFIGs, converters, filters, transformers, and cables of the collection system. Optimization problems are solved by a Modified Particle Swarm Optimization (MPSO) algorithm. The effectiveness of these strategies is evaluated by simulations onmore » a carefully designed WF under a series of cases with different wind speeds and reactive power requirements of the WF. The wind speed at each WT inside the WF is calculated using the Jensen wake model. The results show that the best reactive power dispatch strategy for loss minimization comes when the WF level strategy and WT level control are coordinated and the losses from each device in the WF are considered in the objective.« less

Multicriteria Selection of Optimal Location of TCSC in a Competitive Energy Market

NASA Astrophysics Data System (ADS)

Alomoush, Muwaffaq I.

2010-05-01

The paper investigates selection of the best location of thyristor-controlled series compensator (TCSC) in a transmission system from many candidate locations in a competitive energy market such that the TCSC causes a net valuable impact on congestion management outcome, transmission utilization, transmission losses, voltage stability, degree of fulfillment of spot market contracts, and system security. The problem is treated as a multicriteria decision-making process such that the candidate locations of TCSC are the alternatives and the conflicting objectives are the outcomes of the dispatch process, which may have different importance weights. The paper proposes some performance indices that the dispatch decision-making entity can use to measure market dispatch outcomes of each alternative. Based on agreed-upon preferences, the measures presented may help the decision maker compare and rank dispatch scenarios to ultimately decide which location is the optimal one. To solve the multicriteria decision, we use the preference ranking organization method for enrichment evaluations (PROMETHEE), which is a multicriteria decision support method that can handle complex conflicting-objective decision-making processes.

Determining the Optimal Solution for Quadratically Constrained Quadratic Programming (QCQP) on Energy-Saving Generation Dispatch Problem

NASA Astrophysics Data System (ADS)

Lesmana, E.; Chaerani, D.; Khansa, H. N.

2018-03-01

Energy-Saving Generation Dispatch (ESGD) is a scheme made by Chinese Government in attempt to minimize CO2 emission produced by power plant. This scheme is made related to global warming which is primarily caused by too much CO2 in earth’s atmosphere, and while the need of electricity is something absolute, the power plants producing it are mostly thermal-power plant which produced many CO2. Many approach to fulfill this scheme has been made, one of them came through Minimum Cost Flow in which resulted in a Quadratically Constrained Quadratic Programming (QCQP) form. In this paper, ESGD problem with Minimum Cost Flow in QCQP form will be solved using Lagrange’s Multiplier Method

A Feeder-Bus Dispatch Planning Model for Emergency Evacuation in Urban Rail Transit Corridors

PubMed Central

Wang, Yun; Yan, Xuedong; Zhou, Yu; Zhang, Wenyi

2016-01-01

The mobility of modern metropolises strongly relies on urban rail transit (URT) systems, and such a heavy dependence causes that even minor service interruptions would make the URT systems unsustainable. This study aims at optimally dispatching the ground feeder-bus to coordinate with the urban rails’ operation for eliminating the effect of unexpected service interruptions in URT corridors. A feeder-bus dispatch planning model was proposed for the collaborative optimization of URT and feeder-bus cooperation under emergency situations and minimizing the total evacuation cost of the feeder-buses. To solve the model, a concept of dummy feeder-bus system is proposed to transform the non-linear model into traditional linear programming (ILP) model, i.e., traditional transportation problem. The case study of Line #2 of Nanjing URT in China was adopted to illustrate the model application and sensitivity analyses of the key variables. The modeling results show that as the evacuation time window increases, the total evacuation cost as well as the number of dispatched feeder-buses decrease, and the dispatched feeder-buses need operate for more times along the feeder-bus line. The number of dispatched feeder-buses does not show an obvious change with the increase of parking spot capacity and time window, indicating that simply increasing the parking spot capacity would cause huge waste for the emergent bus utilization. When the unbalanced evacuation demand exists between stations, the more feeder-buses are needed. The method of this study will contribute to improving transportation emergency management and resource allocation for URT systems. PMID:27676179

Development of a surveillance case definition for heat-related illness using 911 medical dispatch data.

PubMed

Bassil, Kate L; Cole, Donald C; Moineddin, Rahim; Gournis, Effie; Schwartz, Brian; Craig, Alan M; Lou, W Y Wendy; Rea, Elizabeth

2008-01-01

The adverse effects of hot weather on public health are of increasing concern. A surveillance system using 911 medical dispatch data for the detection of heat-related illness (HRI) could provide new information on the impact of excessive heat on the population. This paper describes how we identified medical dispatch call codes, called "determinants", that could represent HRI events. Approximately 500 medical dispatch determinants were reviewed in focus groups composed of Emergency Medical Services (EMS) paramedics, dispatchers, physicians, and public health epidemiologists. Each group was asked to select those determinants that might adequately represent HRI. Selections were then assessed empirically using correlations with daily mean temperature over the study period (June 1-August 31,2005). The focus groups identified 12 determinant groupings and ranked them according to specificity for HRI. Of these, "Heat/cold exposure" was deemed the most specific. The call determinant groupings with the clearest positive associations with daily mean temperature empirically were "Heat/cold exposure" (Spearman's correlation coefficient (SCC) 0.71, p < 0.0001) and "Unknown problem (man down)" (SCC 0.21, p = 0.04). Within each grouping, the determinant "Unknown status (3rd party caller)" showed significant associations, SCC = 0.34 (p = 0.001) and SCC = 0.22 (p = 0.03) respectively. Clinically-informed expertise and empirical evidence both contributed to identification of a group of 911 medical dispatch call determinants that plausibly represent HRI events. Once evaluated prospectively, these may be used in public health surveillance to better understand environmental health impacts on human populations and inform targeted public health interventions.

Model Predictive Control-based Optimal Coordination of Distributed Energy Resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mayhorn, Ebony T.; Kalsi, Karanjit; Lian, Jianming

2013-01-07

Distributed energy resources, such as renewable energy resources (wind, solar), energy storage and demand response, can be used to complement conventional generators. The uncertainty and variability due to high penetration of wind makes reliable system operations and controls challenging, especially in isolated systems. In this paper, an optimal control strategy is proposed to coordinate energy storage and diesel generators to maximize wind penetration while maintaining system economics and normal operation performance. The goals of the optimization problem are to minimize fuel costs and maximize the utilization of wind while considering equipment life of generators and energy storage. Model predictive controlmore » (MPC) is used to solve a look-ahead dispatch optimization problem and the performance is compared to an open loop look-ahead dispatch problem. Simulation studies are performed to demonstrate the efficacy of the closed loop MPC in compensating for uncertainties and variability caused in the system.« less

Model Predictive Control-based Optimal Coordination of Distributed Energy Resources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mayhorn, Ebony T.; Kalsi, Karanjit; Lian, Jianming

2013-04-03

Distributed energy resources, such as renewable energy resources (wind, solar), energy storage and demand response, can be used to complement conventional generators. The uncertainty and variability due to high penetration of wind makes reliable system operations and controls challenging, especially in isolated systems. In this paper, an optimal control strategy is proposed to coordinate energy storage and diesel generators to maximize wind penetration while maintaining system economics and normal operation performance. The goals of the optimization problem are to minimize fuel costs and maximize the utilization of wind while considering equipment life of generators and energy storage. Model predictive controlmore » (MPC) is used to solve a look-ahead dispatch optimization problem and the performance is compared to an open loop look-ahead dispatch problem. Simulation studies are performed to demonstrate the efficacy of the closed loop MPC in compensating for uncertainties and variability caused in the system.« less

Distributed Optimal Consensus Over Resource Allocation Network and Its Application to Dynamical Economic Dispatch.

PubMed

Li, Chaojie; Yu, Xinghuo; Huang, Tingwen; He, Xing; Chaojie Li; Xinghuo Yu; Tingwen Huang; Xing He; Li, Chaojie; Huang, Tingwen; He, Xing; Yu, Xinghuo

2018-06-01

The resource allocation problem is studied and reformulated by a distributed interior point method via a -logarithmic barrier. By the facilitation of the graph Laplacian, a fully distributed continuous-time multiagent system is developed for solving the problem. Specifically, to avoid high singularity of the -logarithmic barrier at boundary, an adaptive parameter switching strategy is introduced into this dynamical multiagent system. The convergence rate of the distributed algorithm is obtained. Moreover, a novel distributed primal-dual dynamical multiagent system is designed in a smart grid scenario to seek the saddle point of dynamical economic dispatch, which coincides with the optimal solution. The dual decomposition technique is applied to transform the optimization problem into easily solvable resource allocation subproblems with local inequality constraints. The good performance of the new dynamical systems is, respectively, verified by a numerical example and the IEEE six-bus test system-based simulations.

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Impact of Uncertainty from Load-Based Reserves and Renewables on Dispatch Costs and Emissions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Bowen; Maroukis, Spencer D.; Lin, Yashen

2016-11-21

Aggregations of controllable loads are considered to be a fast-responding, cost-efficient, and environmental-friendly candidate for power system ancillary services. Unlike conventional service providers, the potential capacity from the aggregation is highly affected by factors like ambient conditions and load usage patterns. Previous work modeled aggregations of controllable loads (such as air conditioners) as thermal batteries, which are capable of providing reserves but with uncertain capacity. A stochastic optimal power flow problem was formulated to manage this uncertainty, as well as uncertainty in renewable generation. In this paper, we explore how the types and levels of uncertainty, generation reserve costs, andmore » controllable load capacity affect the dispatch solution, operational costs, and CO2 emissions. We also compare the results of two methods for solving the stochastic optimization problem, namely the probabilistically robust method and analytical reformulation assuming Gaussian distributions. Case studies are conducted on a modified IEEE 9-bus system with renewables, controllable loads, and congestion. We find that different types and levels of uncertainty have significant impacts on dispatch and emissions. More controllable loads and less conservative solution methodologies lead to lower costs and emissions.« less

Attitudes and beliefs of emergency department staff regarding alcohol-related presentations.

PubMed

Indig, Devon; Copeland, Jan; Conigrave, Katherine M; Rotenko, Irene

2009-01-01

This study examined emergency department (ED) staff attitudes and beliefs about alcohol-related ED presentations in order to recommend improved detection and brief intervention strategies. The survey was conducted at two inner-Sydney hospital EDs in 2006 to explore ED clinical staff's attitudes, current practice and barriers for managing alcohol-related ED presentations. The sample included N=78 ED staff (54% nurses, 46% doctors), representing a 30% response rate. Management of alcohol-related problems was not routine among ED staff, with only 5% usually formally screening for alcohol problems, only 16% usually conducting brief interventions, and only 27% usually providing a referral to specialist treatment services. Over 85% of ED staff indicated that lack of patient motivation made providing alcohol interventions very difficult. Significant predictors of good self-reported practice among ED staff for patients with alcohol problems included: being a doctor, being confident and having a sense of responsibility towards managing patients with alcohol-related problems. This study reported that many staff lack the confidence or sense of clinical responsibility to fully and appropriately manage ED patients with alcohol-related problems. ED staff appear to require additional training, resources and support to enhance their management of patients with alcohol-related problems.

Comprehensive Anti-error Study on Power Grid Dispatching Based on Regional Regulation and Integration

NASA Astrophysics Data System (ADS)

Zhang, Yunju; Chen, Zhongyi; Guo, Ming; Lin, Shunsheng; Yan, Yinyang

2018-01-01

With the large capacity of the power system, the development trend of the large unit and the high voltage, the scheduling operation is becoming more frequent and complicated, and the probability of operation error increases. This paper aims at the problem of the lack of anti-error function, single scheduling function and low working efficiency for technical support system in regional regulation and integration, the integrated construction of the error prevention of the integrated architecture of the system of dispatching anti - error of dispatching anti - error of power network based on cloud computing has been proposed. Integrated system of error prevention of Energy Management System, EMS, and Operation Management System, OMS have been constructed either. The system architecture has good scalability and adaptability, which can improve the computational efficiency, reduce the cost of system operation and maintenance, enhance the ability of regional regulation and anti-error checking with broad development prospects.

Automatic programming via iterated local search for dynamic job shop scheduling.

PubMed

Nguyen, Su; Zhang, Mengjie; Johnston, Mark; Tan, Kay Chen

2015-01-01

Dispatching rules have been commonly used in practice for making sequencing and scheduling decisions. Due to specific characteristics of each manufacturing system, there is no universal dispatching rule that can dominate in all situations. Therefore, it is important to design specialized dispatching rules to enhance the scheduling performance for each manufacturing environment. Evolutionary computation approaches such as tree-based genetic programming (TGP) and gene expression programming (GEP) have been proposed to facilitate the design task through automatic design of dispatching rules. However, these methods are still limited by their high computational cost and low exploitation ability. To overcome this problem, we develop a new approach to automatic programming via iterated local search (APRILS) for dynamic job shop scheduling. The key idea of APRILS is to perform multiple local searches started with programs modified from the best obtained programs so far. The experiments show that APRILS outperforms TGP and GEP in most simulation scenarios in terms of effectiveness and efficiency. The analysis also shows that programs generated by APRILS are more compact than those obtained by genetic programming. An investigation of the behavior of APRILS suggests that the good performance of APRILS comes from the balance between exploration and exploitation in its search mechanism.

Secure provision of reactive power ancillary services in competitive electricity markets

NASA Astrophysics Data System (ADS)

El-Samahy, Ismael

The research work presented in this thesis discusses various complex issues associated with reactive power management and pricing in the context of new operating paradigms in deregulated power systems, proposing appropriate policy solutions. An integrated two-level framework for reactive power management is set forth, which is both suitable for a competitive market and ensures a secure and reliable operation of the associated power system. The framework is generic in nature and can be adopted for any electricity market structure. The proposed hierarchical reactive power market structure comprises two stages: procurement of reactive power resources on a seasonal basis, and real-time reactive power dispatch. The main objective of the proposed framework is to provide appropriate reactive power support from service providers at least cost, while ensuring a secure operation of the power system. The proposed procurement procedure is based on a two-step optimization model. First, the marginal benefits of reactive power supply from each provider, with respect to system security, are obtained by solving a loadability-maximization problem subject to transmission security constraints imposed by voltage and thermal limits. Second, the selected set of generators is determined by solving an optimal power flow (OPF)-based auction. This auction maximizes a societal advantage function comprising generators' offers and their corresponding marginal benefits with respect to system security, and considering all transmission system constraints. The proposed procedure yields the selected set of generators and zonal price components, which would form the basis for seasonal contracts between the system operator and the selected reactive power service providers. The main objective of the proposed reactive power dispatch model is to minimize the total payment burden on the Independent System Operator (ISO), which is associated with reactive power dispatch. The real power generation is decoupled and assumed to be fixed during the reactive power dispatch procedures; however, the effect of reactive power on real power is considered in the model by calculating the required reduction in real power output of a generator due to an increase in its reactive power supply. In this case, real power generation is allowed to be rescheduled, within given limits, from the already dispatched levels obtained from the energy market clearing process. The proposed dispatch model achieves the main objective of an ISO in a competitive electricity market, which is to provide the required reactive power support from generators at least cost while ensuring a secure operation of the power system. The proposed reactive power procurement and dispatch models capture both the technical and economic aspects of power system operation in competitive electricity markets; however, from an optimization point of view, these models represent non-convex mixed integer non-linear programming (MINLP) problems due to the presence of binary variables associated with the different regions of reactive power operation in a synchronous generator. Such MINLP optimization problems are difficult to solve, especially for an actual power system. A novel Generator Reactive Power Classification (GRPC) algorithm is proposed in this thesis to address this issue, with the advantage of iteratively solving the optimization models as a series of non-linear programming (NLP) sub-problems. The proposed reactive power procurement and dispatch models are implemented and tested on the CIGRE 32-bus system, with several case studies that represent different practical operating scenarios. The developed models are also compared with other approaches for reactive power provision, and the results demonstrate the robustness and effectiveness of the proposed model. The results clearly reveal the main features of the proposed models for optimal provision of reactive power ancillary service, in order to suit the requirements of an ISO under today's stressed system conditions in a competitive market environment.

Economic environmental dispatch using BSA algorithm

NASA Astrophysics Data System (ADS)

Jihane, Kartite; Mohamed, Cherkaoui

2018-05-01

Economic environmental dispatch problem (EED) is an important issue especially in the field of fossil fuel power plant system. It allows the network manager to choose among different units the most optimized in terms of fuel costs and emission level. The objective of this paper is to minimize the fuel cost with emissions constrained; the test is conducted for two cases: six generator unit and ten generator unit for the same power demand 1200Mw. The simulation has been computed in MATLAB and the result shows the robustness of the Backtracking Search optimization Algorithm (BSA) and the impact of the load demand on the emission.

Team formation and breakup in multiagent systems

NASA Astrophysics Data System (ADS)

Rao, Venkatesh Guru

The goal of this dissertation is to pose and solve problems involving team formation and breakup in two specific multiagent domains: formation travel and space-based interferometric observatories. The methodology employed comprises elements drawn from control theory, scheduling theory and artificial intelligence (AI). The original contribution of the work comprises three elements. The first contribution, the partitioned state-space approach is a technique for formulating and solving co-ordinated motion problem using calculus of variations techniques. The approach is applied to obtain optimal two-agent formation travel trajectories on graphs. The second contribution is the class of MixTeam algorithms, a class of team dispatchers that extends classical dispatching by accommodating team formation and breakup and exploration/exploitation learning. The algorithms are applied to observation scheduling and constellation geometry design for interferometric space telescopes. The use of feedback control for team scheduling is also demonstrated with these algorithms. The third contribution is the analysis of the optimality properties of greedy, or myopic, decision-making for a simple class of team dispatching problems. This analysis represents a first step towards the complete analysis of complex team schedulers such as the MixTeam algorithms. The contributions represent an extension to the literature on team dynamics in control theory. The broad conclusions that emerge from this research are that greedy or myopic decision-making strategies for teams perform well when specific parameters in the domain are weakly affected by an agent's actions, and that intelligent systems require a closer integration of domain knowledge in decision-making functions.

Bed rest during pregnancy

MedlinePlus

... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: ... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: ...

Compulsory Use of the Backboard is Associated with Increased Frequency of Thoracolumbar Imaging.

PubMed

Clemency, Brian M; Tanski, Christopher T; Gibson Chambers, Jennifer; O'Brien, Michael; Knapp, Andrew S; Clark, Alexander J; McGoff, Patrick; Innes, Johanna; Lindstrom, Heather A; Hostler, David

2018-02-15

Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients. The objective of this study was to determine if this protocol change was associated with decreased backboard utilization and ED thoracolumbar spine imaging. This was a retrospective before-and-after chart review of subjects transported by a single emergency medical services (EMS) agency to one of four EDs for emergency calls dispatched as motor vehicle collisions (MVC). EMS and ED data were included for all calls within a 6-month interval before and after the protocol change. The protocol change was implemented in the second half of 2015. Subject demographics, backboard use, and spine imaging were reviewed for the intervals January-June 2015 and January-June 2016. There were 818 subjects in the before period and 796 subjects in the after period. Subjects were similar in terms of gender, age and type of MVC in both periods. A backboard was utilized for 440 (54%) subjects in the before period and 92 (12%) subjects in the after period (p < 0.001). ED thoracic spine imaging was performed on 285 (35%) subjects in the before period, and 235 (30%) subjects in the after period (p = 0.02). ED lumbar spine imaging was performed for 335 (41%) subjects in the before period, and 281 (35%) subjects in the after period (p = 0.02). A shift from a spinal immobilization protocol to a spinal motion restriction protocol was associated with a decrease in backboard utilization by EMS providers and a decrease in thoracolumbar spine imaging by ED providers.

Dynamic Harmony Search with Polynomial Mutation Algorithm for Valve-Point Economic Load Dispatch

PubMed Central

Karthikeyan, M.; Sree Ranga Raja, T.

2015-01-01

Economic load dispatch (ELD) problem is an important issue in the operation and control of modern control system. The ELD problem is complex and nonlinear with equality and inequality constraints which makes it hard to be efficiently solved. This paper presents a new modification of harmony search (HS) algorithm named as dynamic harmony search with polynomial mutation (DHSPM) algorithm to solve ORPD problem. In DHSPM algorithm the key parameters of HS algorithm like harmony memory considering rate (HMCR) and pitch adjusting rate (PAR) are changed dynamically and there is no need to predefine these parameters. Additionally polynomial mutation is inserted in the updating step of HS algorithm to favor exploration and exploitation of the search space. The DHSPM algorithm is tested with three power system cases consisting of 3, 13, and 40 thermal units. The computational results show that the DHSPM algorithm is more effective in finding better solutions than other computational intelligence based methods. PMID:26491710

Dynamic Harmony Search with Polynomial Mutation Algorithm for Valve-Point Economic Load Dispatch.

PubMed

Karthikeyan, M; Raja, T Sree Ranga

2015-01-01

Economic load dispatch (ELD) problem is an important issue in the operation and control of modern control system. The ELD problem is complex and nonlinear with equality and inequality constraints which makes it hard to be efficiently solved. This paper presents a new modification of harmony search (HS) algorithm named as dynamic harmony search with polynomial mutation (DHSPM) algorithm to solve ORPD problem. In DHSPM algorithm the key parameters of HS algorithm like harmony memory considering rate (HMCR) and pitch adjusting rate (PAR) are changed dynamically and there is no need to predefine these parameters. Additionally polynomial mutation is inserted in the updating step of HS algorithm to favor exploration and exploitation of the search space. The DHSPM algorithm is tested with three power system cases consisting of 3, 13, and 40 thermal units. The computational results show that the DHSPM algorithm is more effective in finding better solutions than other computational intelligence based methods.

The use of hospital emergency departments for nonurgent health problems: a national perspective.

PubMed

Cunningham, P J; Clancy, C M; Cohen, J W; Wilets, M

1995-11-01

The use of the hospital emergency department (ED) for nonurgent health problems has been a subject of considerable controversy, in part because there is no widely accepted definition of "nonurgent." Elimination or substantial reduction in nonurgent ED use is frequently offered as a strategy for reducing health expenditures. Previous studies, often limited to individual hospitals or communities, have limited generalizability and do not permit examination of multiple factors likely to influence nonurgent ED utilization or examination of ED use for nonurgent problems in the context of overall outpatient utilization. This analysis of the 1987 National Medical Expenditure Survey (NMES) provides a nationally representative examination of nonurgent ED utilization that describes the frequency of ED use for nonurgent problems, characteristics of individuals that are associated with an increased likelihood of nonurgent ED use, the use of other outpatient physician services, and expenditures associated with nonurgent ED visits.

Parallel dispatch: a new paradigm of electrical power system dispatch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Jun Jason; Wang, Fei-Yue; Wang, Qiang

Modern power systems are evolving into sociotechnical systems with massive complexity, whose real-time operation and dispatch go beyond human capability. Thus, the need for developing and applying new intelligent power system dispatch tools are of great practical significance. In this paper, we introduce the overall business model of power system dispatch, the top level design approach of an intelligent dispatch system, and the parallel intelligent technology with its dispatch applications. We expect that a new dispatch paradigm, namely the parallel dispatch, can be established by incorporating various intelligent technologies, especially the parallel intelligent technology, to enable secure operation of complexmore » power grids, extend system operators U+02BC capabilities, suggest optimal dispatch strategies, and to provide decision-making recommendations according to power system operational goals.« less

Lessons learned from the aeromedical disaster relief activities following the great East Japan earthquake.

PubMed

Matsumoto, Hisashi; Motomura, Tomokazu; Hara, Yoshiaki; Masuda, Yukiko; Mashiko, Kunihiro; Yokota, Hiroyuki; Koido, Yuichi

2013-04-01

Since 2001, a Japanese national project has developed a helicopter emergency medical service (HEMS) system ("doctor-helicopter") and a central Disaster Medical Assistance Team (DMAT) composed of mobile and trained medical teams for rapid deployment during the response phase of a disaster. In Japan, the DMAT Research Group has focused on command and control of doctor-helicopters in future disasters. The objective of this study was to investigate the effectiveness of such planning, as well as the problems encountered in deploying the doctor-helicopter fleet with DMAT members following the March 11, 2011 Great East Japan Earthquake. This study was undertaken to examine the effectiveness of aeromedical disaster relief activities following the Great East Japan Earthquake and to evaluate the assembly and operations of 15 doctor-helicopter teams dispatched for patient evacuation with medical support. Fifteen DMATs from across Japan were deployed from March 11th through March 13th to work out of two doctor-helicopter base hospitals. The dispatch center at each base hospital directed its own doctor-helicopter fleet under the command of DMAT headquarters to transport seriously injured or ill patients out of hospitals located in the disaster area. Disaster Medical Assistance Teams transported 149 patients using the doctor-helicopters during the first five days after the earthquake. The experiences and problems encountered point to the need for DMATs to maintain direct control over 1) communication between DMAT headquarters and dispatch centers; 2) information management concerning patient transportation; and 3) operation of the doctor-helicopter fleet during relief activities. As there is no rule of prioritization for doctor-helicopters to refuel ahead of other rotorcraft, many doctor-helicopters had to wait in line to refuel. The "doctor-helicopter fleet" concept was vital to Japan's disaster medical assistance and rescue activities. The smooth and immediate dispatch of the doctor-helicopter fleet must occur under the direct control of the DMAT, independent from local government authority. Such a command and control system for dispatching the doctor-helicopter fleet is strongly recommended, and collaboration with local government authorities concerning refueling priority should be addressed.

Emergency Department Use for Dental Problems among Homeless Individuals: A Population-Based Cohort Study.

PubMed

Figueiredo, Rafael; Dempster, Laura; Quiñonez, Carlos; Hwang, Stephen W

2016-01-01

To evaluate emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). A random sample of 1,189 homeless was recruited from shelters and meal programs. Emergency department visits for non-traumatic dental problems (ICD-10-CA codes K00-K14) were identified using participants' health insurance number, during 2005-2009. Age- and sex-matched controls were selected from low-income neighborhoods. Homeless and matched controls had 182 and 10 ED visits for dental problems, respectively. Homeless people were more significantly more likely (OR=2.27, p=.007) to make ED visit for dental problems compared with controls. Over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. The high rate of ED visits for dental problems by people who are homeless suggests that access to dental care is inadequate. The large number of repeat visits indicates that ED settings are ineffective for treatment of dental problems.

Cancellations of (helicopter-transported) mobile medical team dispatches in the Netherlands.

PubMed

Giannakopoulos, Georgios F; Lubbers, Wouter D; Christiaans, Herman M T; van Exter, Pieternel; Bet, Piet; Hugen, Paul J C; Innemee, Gerard; Schubert, Edo; de Lange-Klerk, Elly S M; Goslings, J Carel; Jukema, Gerrolt N

2010-08-01

The trauma centre of the Trauma Center Region North-West Netherlands (TRNWN) has consensus criteria for Mobile Medical Team (MMT) scene dispatch. The MMT can be dispatched by the EMS-dispatch centre or by the on-scene ambulance crew and is transported by helicopter or ground transport. Although much attention has been paid to improve the dispatch criteria, the MMT is often cancelled after being dispatched. The aim of this study was to assess the cancellation rate and the noncompliant dispatches of our MMT and to identify factors associated with this form of primary overtriage. By retrospective analysis of all MMT dispatches in the period from 1 July 2006 till 31 December 2006 using chart review, we conducted a consecutive case review of 605 dispatches. Four hundred and sixty seven of these were included for our study, collecting data related to prehospital triage, patient's condition on-scene and hospital course. Average age was 35.9 years; the majority of the patients were male (65.3%). Four hundred and thirty patients were victims of trauma, sustaining injuries in most cases from blunt trauma (89.3%). After being dispatched, the MMT was cancelled 203 times (43.5%). Statistically significant differences between assists and cancellations were found for overall mortality, mean RTS, GCS and ISS, mean hospitalization, length and amount of ICU admissions (p < 0.001). All dispatches were evaluated by using the MMT-dispatch criteria and mission appropriateness criteria. Almost 26% of all dispatches were neither appropriate, nor met the dispatch criteria. Fourteen missions were appropriate, but did not meet the dispatch criteria. The remaining 318 dispatches had met the dispatch criteria, of which 135 (30.3%) were also appropriate. The calculated additional costs of the cancelled dispatches summed up to a total of 34,448 euro, amounting to 2.2% of the total MMT costs during the study period. In our trauma system, the MMT dispatches are involved with high rates of overtriage. After being dispatched, the MMT is cancelled in almost 50% of all cases. We found an undertriage rate of 4%, which we think is acceptable. All cancellations were justified. The additional costs of the cancelled missions were within an acceptable range. According to this study, it seems to be possible to reduce the overtriage rate of the MMT dispatches, without increasing the undertriage rate to non-acceptable levels.

Helicopter-based emergency medical services for a sparsely populated region: A study of 42,500 dispatches.

PubMed

Østerås, Ø; Brattebø, G; Heltne, J-K

2016-05-01

The Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km(2) . Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region. Data from all HEMS dispatches during 2004-2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons. A total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on-scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions. One third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10-year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted. © 2015 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Learning, Attention/Hyperactivity, and Conduct Problems as Sequelae of Excessive Daytime Sleepiness in a General Population Study of Young Children

PubMed Central

Calhoun, Susan L.; Fernandez-Mendoza, Julio; Vgontzas, Alexandros N.; Mayes, Susan D.; Tsaoussoglou, Marina; Rodriguez-Muñoz, Alfredo; Bixler, Edward O.

2012-01-01

Study Objectives: Although excessive daytime sleepiness (EDS) is a common problem in children, with estimates of 15%; few studies have investigated the sequelae of EDS in young children. We investigated the association of EDS with objective neurocognitive measures and parent reported learning, attention/hyperactivity, and conduct problems in a large general population sample of children. Design: Cross-sectional. Setting: Population based. Participants: 508 children from The Penn State Child Cohort. Interventions: N/A. Measurements and Results: Children underwent a 9-h polysomnogram, comprehensive neurocognitive testing, and parent rating scales. Children were divided into 2 groups: those with and without parent-reported EDS. Structural equation modeling was used to examine whether processing speed and working memory performance would mediate the relationship between EDS and learning, attention/hyperactivity, and conduct problems. Logistic regression models suggest that parent-reported learning, attention/hyperactivity, and conduct problems, as well as objective measurement of processing speed and working memory are significant sequelae of EDS, even when controlling for AHI and objective markers of sleep. Path analysis demonstrates that processing speed and working memory performance are strong mediators of the association of EDS with learning and attention/hyperactivity problems, while to a slightly lesser degree are mediators from EDS to conduct problems. Conclusions: This study suggests that in a large general population sample of young children, parent-reported EDS is associated with neurobehavioral (learning, attention/hyperactivity, conduct) problems and poorer performance in processing speed and working memory. Impairment due to EDS in daytime cognitive and behavioral functioning can have a significant impact on children's development. Citation: Calhoun SL; Fernandez-Mendoza J; Vgontzas AN; Mayes SD; Tsaoussoglou M; Rodriguez-Muñoz A; Bixler EO. Learning, attention/hyperactivity, and conduct problems as sequelae of excessive daytime sleepiness in a general population study of young children. SLEEP 2012;35(5):627-632. PMID:22547888

Collective neurodynamic optimization for economic emission dispatch problem considering valve point effect in microgrid.

PubMed

Wang, Tiancai; He, Xing; Huang, Tingwen; Li, Chuandong; Zhang, Wei

2017-09-01

The economic emission dispatch (EED) problem aims to control generation cost and reduce the impact of waste gas on the environment. It has multiple constraints and nonconvex objectives. To solve it, the collective neurodynamic optimization (CNO) method, which combines heuristic approach and projection neural network (PNN), is attempted to optimize scheduling of an electrical microgrid with ten thermal generators and minimize the plus of generation and emission cost. As the objective function has non-derivative points considering valve point effect (VPE), differential inclusion approach is employed in the PNN model introduced to deal with them. Under certain conditions, the local optimality and convergence of the dynamic model for the optimization problem is analyzed. The capability of the algorithm is verified in a complicated situation, where transmission loss and prohibited operating zones are considered. In addition, the dynamic variation of load power at demand side is considered and the optimal scheduling of generators within 24 h is described. Copyright © 2017 Elsevier Ltd. All rights reserved.

Eastern Renewable Generation Integration Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bloom, Aaron; Townsend, Aaron; Palchak, David

2016-08-01

The Eastern Interconnection (EI) is one of the largest power systems in the world, and its size and complexity have historically made it difficult to study in high levels of detail in a modeling environment. In order to understand how this system might be impacted by high penetrations (30% of total annual generation) of wind and solar photovoltaic (PV) during steady state operations, the National Renewable Energy Laboratory (NREL) and the U.S. Department of Energy (DOE) conducted the Eastern Renewable Generation Integration Study (ERGIS). This study investigates certain aspects of the reliability and economic efficiency problem faced by power systemmore » operators and planners. Specifically, the study models the ability to meet electricity demand at a 5-minute time interval by scheduling resources for known ramping events, while maintaining adequate reserves to meet random variation in supply and demand, and contingency events. To measure the ability to meet these requirements, a unit commitment and economic dispatch (UC&ED) model is employed to simulate power system operations. The economic costs of managing this system are presented using production costs, a traditional UC&ED metric that does not include any consideration of long-term fixed costs. ERGIS simulated one year of power system operations to understand regional and sub-hourly impacts of wind and PV by developing a comprehensive UC&ED model of the EI. In the analysis, it is shown that, under the study assumptions, generation from approximately 400 GW of combined wind and PV capacity can be balanced on the transmission system at a 5-minute level. In order to address the significant computational burdens associated with a model of this detail we apply novel computing techniques to dramatically reduce simulation solve time while simultaneously increasing the resolution and fidelity of the analysis. Our results also indicate that high penetrations of wind and PV (collectively variable generation (VG)), significantly impact the operation of traditional generating resources and cause these resources to be used less frequently and operate across a broader output range because wind and PV have lower operating costs and variable output levels.« less

Adolescent and Parent Attitudes Toward Screening for Suicide Risk and Mental Health Problems in the Pediatric Emergency Department

PubMed Central

O’Mara, Roisin M.; Hill, Ryan M.; Cunningham, Rebecca M.; King, Cheryl A.

2016-01-01

Objective The objective of this study was to investigate adolescent and parent attitudes toward screening adolescents for suicide risk and other mental health problems in the emergency department (ED). Methods Two hundred ninety-four adolescents and 300 parents completed questionnaires about the importance of screening for suicide risk and other mental health problems in the ED, what would be helpful if the screen was positive, their concerns about screening in the ED, whether they believe screening should be a routine part of an ED visit, and whether they would complete a screening during the current visit if offered the opportunity. Results Overall, parents and adolescents reported positive attitudes toward screening for suicide risk and other mental health problems in the ED, with the majority responding that it should be a routine part of ED care. Suicide risk and drug and alcohol misuse were rated as more important to screen for than any of the other mental health problems by both parents and adolescents. Adolescent females and mothers were more supportive of screening for suicide risk and mental health problems in the ED than male adolescents and fathers. Descriptive data regarding screening concerns and follow-up preferences are reported. Conclusions Study results suggest overall positive support for screening for suicide risk and other mental health problems in the ED, with some important preferences, concerns, and parent versus adolescent and male versus female differences. PMID:22743751

[Dispatchers' impressions and actual quality of cardiopulmonary resuscitation during telephone-assisted bystander cardiopulmonary resuscitation: a pooled analysis of 94 simulated, manikin-based scenarios].

PubMed

van Tulder, Raphael; Roth, Dominik; Laggner, Roberta; Krammel, Mario; Schriefl, Christoph; Kienbacher, Calvin; Novosad, Heinz; Chwojka, Constantin Christof; Sterz, Fritz; Havel, Christof; Schreiber, Wolfgang; Herkner, Harald

2017-02-01

The quality of telephone-assisted cardiopulmonary resuscitation (CPR) needs improvement. This study investigates whether a dispatchers' perception is an adequate measure of the actual quality of CPR provided by laypersons. Individual participant data from 3 randomized simulation trials, with identical methodology but different interventions, were combined for this analysis. Professional dispatchers gave telephone assistance to laypersons, who each provided 10 minutes of CPR on a manikin. Dispatchers were requested to classify the quality of providers' CPR as adequate or inadequate. Based on actual readings from manikins we classified providers' performance as adequate at 5-6 cm for depth and 100-120 compressions per minute (cpm) for rate. We calculated metrics of dispatcher accuracy. Six dispatchers rated the performance of 94 laypersons (38 women [42%]) with a mean (SD) age of 37 (14) years. In 905 analyzed minutes of telephone-assisted CPR, the mean compression depth and rate was 41 (13) mm and 98 (24) cpm, respectively. Analysis of dispatchers' diagnostic test accuracy for adequate compression depth yielded a sensitivity of 65% (95 CI 36%-95%) and specificity of 42% (95% CI, 32%-53%). Analysis of their assessment of adequate compression rate yielded a sensitivity of 75% (95% CI, 64%-86%) and specificity of 42% (95% CI, 32%-52%). Although dispatchers always underestimated the actual values of CPR parameters, the female dispatchers evaluations were less inaccurate than the evaluations of make dispatchers; the dispatchers overall (males and females together) underestimated the adequacy of female laypersons' CPR performance to a greater degree than female dispatchers did. The ability of dispatchers to estimate the quality of telephone-assisted CPR is limited. Dispatchers estimates of CPR adequacy needs to be studied further in order to find ways that telephone-assisted CPR might be improved.

The importance of distinguishing between the different eating disorders (sub)types when assessing emotion regulation strategies.

PubMed

Danner, Unna N; Sternheim, Lot; Evers, Catharine

2014-03-30

People with eating disorders (ED) have difficulties regulating their emotions adaptively. Little is known about differences and similarities between different types of ED and how these regulation difficulties relate to other emotional problems. The present study examines maladaptive (suppression) and adaptive (cognitive reappraisal) emotion regulation strategies in women with different ED and relationships with anxiety and depression levels. In 32 women with AN restrictive subtype (ANR), 32 with AN binge-purge subtype (ANBP), 30 with bulimia nervosa (BN), 29 with binge eating disorder (BED), and 64 healthy women, the ERQ (emotion regulation) as well as STAI-T (anxiety), BDI-SF (depression), and EDDS (eating pathology) were administered. Women across different ED subtypes were inclined to suppress emotions and lacked the capacity to reappraise emotions (except women with ANBP). Correlational relations of suppression and reappraisal with anxiety and depression levels differed across ED groups. Emotion regulation problems were found across ED subtypes. However, the types of emotion regulation problems, and the effect of coexisting other emotional problems such as anxiety and depression may differ across ED subtypes. These findings illustrate the importance to of considering ED subtypes in emotion regulation research rather than consider ED as a whole. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The Mathematics of Dispatchability, Revisited

NASA Technical Reports Server (NTRS)

Morris, Paul

2016-01-01

Dispatchability is an important property for the efficient execution of temporal plans where the temporal constraints are represented as a Simple Temporal Network (STN). It has been shown that every STN may be reformulated as a dispatchable STN, and dispatchability ensures that the temporal constraints need only be satisfied locally during execution. Recently, it has also been shown that Simple Temporal Networks with Uncertainty, augmented with wait edges, are Dynamically Controllable provided every projection is dispatchable. Thus, dispatchability has considerable theoretical as well as practical significance. One thing that hampers further work in this area is the underdeveloped theory. Moreover, the existing foundation is inadequate in certain respects. In this paper, we develop a new mathematical theory of dispatchability and its relationship to execution. We also provide several characterizations of dispatchability, including characterizations in terms of the structural properties of the STN graph. This facilitates the potential application of the theory to other areas.

The Mathematics of Dispatchability Revisited

NASA Technical Reports Server (NTRS)

Morris, Paul

2016-01-01

Dispatchability is an important property for the efficient execution of temporal plans where the temporal constraints are represented as a Simple Temporal Network (STN). It has been shown that every STN may be reformulated as a dispatchable STN, and dispatchability ensures that the temporal constraints need only be satisfied locally during execution. Recently it has also been shown that Simple Temporal Networks with Uncertainty, augmented with wait edges, are Dynamically Controllable provided every projection is dispatchable. Thus, the dispatchability property has both theoretical and practical interest. One thing that hampers further work in this area is the underdeveloped theory. The existing definitions are expressed in terms of algorithms, and are less suitable for mathematical proofs. In this paper, we develop a new formal theory of dispatchability in terms of execution sequences. We exploit this to prove a characterization of dispatchability involving the structural properties of the STN graph. This facilitates the potential application of the theory to uncertainty reasoning.

A Hyper-Heuristic Ensemble Method for Static Job-Shop Scheduling.

PubMed

Hart, Emma; Sim, Kevin

2016-01-01

We describe a new hyper-heuristic method NELLI-GP for solving job-shop scheduling problems (JSSP) that evolves an ensemble of heuristics. The ensemble adopts a divide-and-conquer approach in which each heuristic solves a unique subset of the instance set considered. NELLI-GP extends an existing ensemble method called NELLI by introducing a novel heuristic generator that evolves heuristics composed of linear sequences of dispatching rules: each rule is represented using a tree structure and is itself evolved. Following a training period, the ensemble is shown to outperform both existing dispatching rules and a standard genetic programming algorithm on a large set of new test instances. In addition, it obtains superior results on a set of 210 benchmark problems from the literature when compared to two state-of-the-art hyper-heuristic approaches. Further analysis of the relationship between heuristics in the evolved ensemble and the instances each solves provides new insights into features that might describe similar instances.

Transmission Loss Calculation using A and B Loss Coefficients in Dynamic Economic Dispatch Problem

NASA Astrophysics Data System (ADS)

Jethmalani, C. H. Ram; Dumpa, Poornima; Simon, Sishaj P.; Sundareswaran, K.

2016-04-01

This paper analyzes the performance of A-loss coefficients while evaluating transmission losses in a Dynamic Economic Dispatch (DED) Problem. The performance analysis is carried out by comparing the losses computed using nominal A loss coefficients and nominal B loss coefficients in reference with load flow solution obtained by standard Newton-Raphson (NR) method. Density based clustering method based on connected regions with sufficiently high density (DBSCAN) is employed in identifying the best regions of A and B loss coefficients. Based on the results obtained through cluster analysis, a novel approach in improving the accuracy of network loss calculation is proposed. Here, based on the change in per unit load values between the load intervals, loss coefficients are updated for calculating the transmission losses. The proposed algorithm is tested and validated on IEEE 6 bus system, IEEE 14 bus, system IEEE 30 bus system and IEEE 118 bus system. All simulations are carried out using SCILAB 5.4 (www.scilab.org) which is an open source software.

Marginal Loss Calculations for the DCOPF

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eldridge, Brent; O'Neill, Richard P.; Castillo, Andrea R.

2016-12-05

The purpose of this paper is to explain some aspects of including a marginal line loss approximation in the DCOPF. The DCOPF optimizes electric generator dispatch using simplified power flow physics. Since the standard assumptions in the DCOPF include a lossless network, a number of modifications have to be added to the model. Calculating marginal losses allows the DCOPF to optimize the location of power generation, so that generators that are closer to demand centers are relatively cheaper than remote generation. The problem formulations discussed in this paper will simplify many aspects of practical electric dispatch implementations in use today,more » but will include sufficient detail to demonstrate a few points with regard to the handling of losses.« less

A Distributed Algorithm for Economic Dispatch Over Time-Varying Directed Networks With Delays

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Tao; Lu, Jie; Wu, Di

In power system operation, economic dispatch problem (EDP) is designed to minimize the total generation cost while meeting the demand and satisfying generator capacity limits. This paper proposes an algorithm based on the gradient-push method to solve the EDP in a distributed manner over communication networks potentially with time-varying topologies and communication delays. It has been shown that the proposed method is guaranteed to solve the EDP if the time-varying directed communication network is uniformly jointly strongly connected. Moreover, the proposed algorithm is also able to handle arbitrarily large but bounded time delays on communication links. Numerical simulations are usedmore » to illustrate and validate the proposed algorithm.« less

14 CFR 65.67 - Aircraft dispatcher certification courses: Personnel.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Aircraft dispatcher certification courses....67 Aircraft dispatcher certification courses: Personnel. (a) Each applicant for an aircraft dispatcher certification course must meet the following personnel requirements: (1) Each applicant must have...

14 CFR 65.67 - Aircraft dispatcher certification courses: Personnel.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Aircraft dispatcher certification courses....67 Aircraft dispatcher certification courses: Personnel. (a) Each applicant for an aircraft dispatcher certification course must meet the following personnel requirements: (1) Each applicant must have...

14 CFR 65.67 - Aircraft dispatcher certification courses: Personnel.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Aircraft dispatcher certification courses....67 Aircraft dispatcher certification courses: Personnel. (a) Each applicant for an aircraft dispatcher certification course must meet the following personnel requirements: (1) Each applicant must have...

14 CFR 65.67 - Aircraft dispatcher certification courses: Personnel.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Aircraft dispatcher certification courses....67 Aircraft dispatcher certification courses: Personnel. (a) Each applicant for an aircraft dispatcher certification course must meet the following personnel requirements: (1) Each applicant must have...

14 CFR 65.67 - Aircraft dispatcher certification courses: Personnel.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Aircraft dispatcher certification courses....67 Aircraft dispatcher certification courses: Personnel. (a) Each applicant for an aircraft dispatcher certification course must meet the following personnel requirements: (1) Each applicant must have...

Emergency medical service in the stroke chain of survival.

PubMed

Chenaitia, Hichem; Lefevre, Oriane; Ho, Vanessa; Squarcioni, Christian; Pradel, Vincent; Fournier, Marc; Toesca, Richard; Michelet, Pierre; Auffray, Jean Pierre

2013-02-01

The Emergency Medical Services (EMS) play a primordial role in the early management of adults with acute ischaemic stroke (AIS). The aim of this study was to evaluate the role and effectiveness of the EMS in the stroke chain of survival in Marseille. A retrospective observational study was conducted in patients treated for AIS or transient ischaemic attack in three emergency departments and at the Marseille stroke centre over a period of 12 months. In 2009, of 1034 patients ultimately presenting a diagnosis of AIS or transient ischaemic attack, 74% benefited from EMS activation. Dispatchers correctly diagnosed 57% of stroke patients. The symptoms most frequently reported included limb weakness, speech problems and facial paresis. Elements resulting in misdiagnosis by dispatchers were general discomfort, chest pain, dyspnoea, fall or vertigo. Stroke patients not diagnosed by emergency medical dispatchers but calling within 3 h of symptom onset accounted for 20% of cases. Our study demonstrates that public intervention programmes must stress the urgency of recognizing stroke symptoms and the importance of calling EMS through free telephone numbers. Further efforts are necessary to disseminate guidelines for healthcare providers concerning stroke recognition and the new therapeutic possibilities in order to increase the likelihood of acute stroke patients presenting to a stroke team early enough to be eligible for acute treatment. In addition, EMS dispatchers should receive further training about atypical stroke symptoms, and 'Face Arm Speech Test' tests must be included in the routine questionnaires used in emergency medical calls concerning elderly persons.

Variables influencing presenting symptoms of patients with eating disorders at psychiatric outpatient clinics.

PubMed

Tseng, Mei-Chih Meg; Chen, Kuan-Yu; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

2016-04-30

Eating disorders (EDs) have been underdiagnosed in many clinical settings. This study investigates the influence of clinical characteristics on presenting symptoms of patients with EDs. Psychiatric outpatients, aged 18-45, were enrolled sequentially and received a two-phase survey for EDs in August 2010-January 2013. Their primary reasons for seeking psychiatric help were obtained at their first encounter with outpatient psychiatrists. Patients' clinical and demographic characteristics were compared according to presenting symptoms with or without eating/weight problems. Of 2140 patients, 348 (16.3%) were diagnosed with an ED (22.6% of women and 6.3% of men). The three most common reasons for seeking psychiatric help were eating/weight problems (46.0%), emotional problems (41.3%), and sleep disturbances (19.3%). The multivariate analyses suggest that when patients with EDs presented symptoms that were less related to eating/weight problems, they were significantly more likely to be those having diagnoses other than anorexia nervosa or bulimia nervosa and less severe degree of binge-eating. Further, patients with EDs who demonstrated more impulsive behaviors and poorer functioning were less likely to report their eating problems when visiting psychiatric clinics. Thus, ED should be assessed routinely in patients with complex psychopathology to facilitate comprehensive treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impacts of temperature change on ambulance dispatches and seasonal effect modification.

PubMed

Cheng, Jian; Xu, Zhiwei; Zhao, Desheng; Xie, Mingyu; Yang, Huihui; Wen, Liying; Li, Kesheng; Su, Hong

2016-12-01

Ambulance dispatch is a proxy of acute health outcomes, and growing epidemiological evidence documented its relation to extreme temperature events. Research, however, on short-term temperature change and ambulance dispatches is scarce. We aimed to investigate the effect of short-term temperature change on ambulance dispatches and potential modification by season. Daily data on ambulance dispatch and weather factors were collected in Huainan, a Chinese inland city from December 2011 through December 2013. A Poison generalized linear regression model combined with distributed lag nonlinear model was constructed to examine the association of temperature change between neighboring days (TCN) with ambulance dispatches. The effect modification by season was also examined. There were 48,700 ambulance attendances during the study period. A statistically significant association of TCN with ambulance dispatches was observed. Temperature rise between neighboring days (TCN > 0) was associated with elevated adverse risk of ambulance dispatches, and the effects appeared to be acute (lag0, on the current day) and could last for at least a week, while temperature drop between neighboring days (TCN < 0) had a protective effect. For a 1 °C increase of TCN at lag0 and lag06 (on the 7-day moving average), the risk of ambulance dispatches increased by 2 % (95 % CI 1-3 %) and 7 (95 % CI 1-13 %), respectively. Extreme TCN increase (95th percentile, 3.3 °C vs. 0 °C) at lag0 and lag05 was accompanied by 6 (95 % CI 3-8 %) and 27 % (95 % CI 12-44 %) increase in ambulance dispatches. Ambulance dispatches were more vulnerable to extremely great temperature rise in summer and autumn. TCN was adopted for the first time to quantify the impact of short-term temperature change on ambulance dispatches. Temperature drop between neighboring days (TCN < 0) had a protective effect on ambulance dispatches, while temperature rise between neighboring days (TCN > 0) could acutely trigger the increase in ambulance dispatches, and TCN effect differs by season.

Dispatcher Recognition of Stroke Using the National Academy Medical Priority Dispatch System

PubMed Central

Buck, Brian H; Starkman, Sidney; Eckstein, Marc; Kidwell, Chelsea S; Haines, Jill; Huang, Rainy; Colby, Daniel; Saver, Jeffrey L

2009-01-01

Background Emergency Medical Dispatchers (EMDs) play an important role in optimizing stroke care if they are able to accurately identify calls regarding acute cerebrovascular disease. This study was undertaken to assess the diagnostic accuracy of the current national protocol guiding dispatcher questioning of 911 callers to identify stroke, QA Guide v 11.1 of the National Academy Medical Priority Dispatch System (MPDS). Methods We identified all Los Angeles Fire Department paramedic transports of patients to UCLA Medical Center during the 12 month period from January to December 2005 in a prospectively maintained database. Dispatcher-assigned MPDS codes for each of these patient transports were abstracted from the paramedic run sheets and compared to final hospital discharge diagnosis. Results Among 3474 transported patients, 96 (2.8%) had a final diagnosis of stroke or transient ischemic attack. Dispatchers assigned a code of potential stroke to 44.8% of patients with a final discharge diagnosis of stroke or TIA. Dispatcher identification of stroke showed a sensitivity of 0.41, specificity of 0.96, positive predictive value of 0.45, and negative predictive value of 0.95. Conclusions Dispatcher recognition of stroke calls using the widely employed MPDS algorithm is suboptimal, with failure to identify more than half of stroke patients as likely stroke. Revisions to the current national dispatcher structured interview and complaint identification algorithm for stroke may facilitate more accurate recognition of stroke by EMDs. PMID:19390065

A Hybrid Multilevel Storage Architecture for Electric Power Dispatching Big Data

NASA Astrophysics Data System (ADS)

Yan, Hu; Huang, Bibin; Hong, Bowen; Hu, Jing

2017-10-01

Electric power dispatching is the center of the whole power system. In the long run time, the power dispatching center has accumulated a large amount of data. These data are now stored in different power professional systems and form lots of information isolated islands. Integrating these data and do comprehensive analysis can greatly improve the intelligent level of power dispatching. In this paper, a hybrid multilevel storage architecture for electrical power dispatching big data is proposed. It introduces relational database and NoSQL database to establish a power grid panoramic data center, effectively meet power dispatching big data storage needs, including the unified storage of structured and unstructured data fast access of massive real-time data, data version management and so on. It can be solid foundation for follow-up depth analysis of power dispatching big data.

Psychiatric emergencies in children and adolescents: an Emergency Department audit.

PubMed

Starling, Jean; Bridgland, Kim; Rose, Donna

2006-12-01

To describe a cohort of children presenting to a paediatric emergency department with mental health problems. An Emergency Department (ED) computerized record system and hospital records were used to obtain data on children who presented to a paediatric ED with mental health problems. There were 291 presentations of 231 children in a 10-month period, about one per day. They were a small (0.8%) but complicated part of the ED workload. Most were first presentations and came voluntarily to ED. There were a wide variety of presenting symptoms including self-harm, suicide attempts, behavioural disorders and medical disorders with associated psychological problems. Acute psychosis was rare. Many children with mental health problems were seen for the first time in ED. With the growing awareness of mental health problems in this age group, it is likely that such presentations will increase. Paediatric and psychiatry services have an opportunity to work together to provide early intervention services for what is potentially a very accessible population.

A proposed simulation optimization model framework for emergency department problems in public hospital

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2015-12-01

The Emergency Department (ED) is a very complex system with limited resources to support increase in demand. ED services are considered as good quality if they can meet the patient's expectation. Long waiting times and length of stay is always the main problem faced by the management. The management of ED should give greater emphasis on their capacity of resources in order to increase the quality of services, which conforms to patient satisfaction. This paper is a review of work in progress of a study being conducted in a government hospital in Selangor, Malaysia. This paper proposed a simulation optimization model framework which is used to study ED operations and problems as well as to find an optimal solution to the problems. The integration of simulation and optimization is hoped can assist management in decision making process regarding their resource capacity planning in order to improve current and future ED operations.

Chronic Pain in the Emergency Department: A Pilot Mixed-Methods Cross-Sectional Study Examining Patient Characteristics and Reasons for Presentations.

PubMed

Poulin, Patricia A; Nelli, Jennifer; Tremblay, Steven; Small, Rebecca; Caluyong, Myka B; Freeman, Jeffrey; Romanow, Heather; Stokes, Yehudis; Carpino, Tia; Carson, Amanda; Shergill, Yaadwinder; Stiell, Ian G; Taljaard, Monica; Nathan, Howard; Smyth, Catherine E

2016-01-01

Background . Chronic pain (CP) accounts for 10-16% of emergency department (ED) visits, contributing to ED overcrowding and leading to adverse events. Objectives . To describe patients with CP attending the ED and identify factors contributing to their visit. Methods . We used a mixed-method design combining interviews and questionnaires addressing pain, psychological distress, signs of opioid misuse, and disability. Participants were adults who attended the EDs of a large academic tertiary care center for their CP problem. Results . Fifty-eight patients (66% women; mean age 46.5, SD = 16.9) completed the study. The most frequently cited reason (60%) for ED visits was inability to cope with pain. Mental health problems were common, including depression (61%) and anxiety (45%). Participants had questions about the etiology of their pain, concerns about severe pain-related impairment, and problems with medication renewals or efficacy and sometimes felt invalidated in the ED. Although most participants had a primary care physician, the ED was seen as the only or best option when pain became unmanageable. Conclusions . Patients with CP visiting the ED often present with complex difficulties that cannot be addressed in the ED. Better access to interdisciplinary pain treatment is needed to reduce the burden of CP on the ED.

Fast Transformation of Temporal Plans for Efficient Execution

NASA Technical Reports Server (NTRS)

Tsamardinos, Ioannis; Muscettola, Nicola; Morris, Paul

1998-01-01

Temporal plans permit significant flexibility in specifying the occurrence time of events. Plan execution can make good use of that flexibility. However, the advantage of execution flexibility is counterbalanced by the cost during execution of propagating the time of occurrence of events throughout the flexible plan. To minimize execution latency, this propagation needs to be very efficient. Previous work showed that every temporal plan can be reformulated as a dispatchable plan, i.e., one for which propagation to immediate neighbors is sufficient. A simple algorithm was given that finds a dispatchable plan with a minimum number of edges in cubic time and quadratic space. In this paper, we focus on the efficiency of the reformulation process, and improve on that result. A new algorithm is presented that uses linear space and has time complexity equivalent to Johnson s algorithm for all-pairs shortest-path problems. Experimental evidence confirms the practical effectiveness of the new algorithm. For example, on a large commercial application, the performance is improved by at least two orders of magnitude. We further show that the dispatchable plan, already minimal in the total number of edges, can also be made minimal in the maximum number of edges incoming or outgoing at any node.

Handling of drug-related emergencies: an evaluation of emergency medical dispatch.

PubMed

Tonje, Lorem; Elisabeth, Saether; Lars, Wik

2009-02-01

Documenting the quality of emergency dispatch centres handling of emergency calls regarding intoxicated unconscious patients. Interview with eight emergency dispatch centre directors and a nationwide survey among 313 dispatchers in Norway were performed. In addition, a customized scoring system was used to evaluate dispatcher log recordings of real cases. The recordings were compared with information from corresponding ambulance records. Ninety-nine percent of the dispatchers stated that they used the Norwegian protocol for medical emergencies and 89% of them found it useful. The interviews, the survey, and the recordings, however, documented frequent deviation from the protocol. This instructs ambulance dispatch for any unconscious patient, but 21% stated that they would not dispatch any resource for an unconscious patient without further survey in alcohol-related cases. This was significantly more often (P<0.05) than for the narcotic, combination and prescription - drug-related cases with 4, 10 and 7%, respectively. The recordings revealed deviation from the protocol with dispatchers only determining the patients' level of consciousness and respiratory status in 64 and 70% of the cases, respectively. For 16% of the cases, the dispatcher did not ask the caller about consciousness at all, even though these patients later were found with reduced consciousness. On the basis of the interviews and the survey, cases were handled according to guidelines. The log recordings, however, disclosed deviation from the protocol. Alcohol intoxication was associated with higher rate of deviation from the protocol compared with other intoxications.

The effect of work shift configurations on emergency medical dispatch center response.

PubMed

Montassier, Emmanuel; Labady, Julien; Andre, Antoine; Potel, Gilles; Berthier, Frederic; Jenvrin, Joel; Penverne, Yann

2015-01-01

It has been proved that emergency medical dispatch centers (EMDC) save lives by promoting an appropriate allocation of emergency medical service resources. Indeed, optimal dispatcher call duration is pivotal to reduce the time gap between the time a call is placed and the delivery of medical care. However, little is known about the impact of work shift configurations (i.e., work shift duration and work shift rotation throughout the day) and dispatcher call duration. Thus, the objective of our study was to assess the effect of work shift configurations on dispatcher call duration. During a 1-year study period, we analyzed the dispatcher call durations for medical and trauma calls during the 4 different work shift rotations (day, morning, evening, and night) and during the 10-hour work shift of each dispatcher in the EMDC of Nantes. We extracted dispatcher call durations from our advanced telephone system, configured with CC Pulse + (Genesys, Alcatel Lucent), and collected them in a custom designed database (Excel, Microsoft). Afterward, we analyzed these data using linear mixed effects models. During the study period, our EMDC received 408,077 calls. Globally, the mean dispatcher call duration was 107 ± 45 seconds. Based on multivariate linear mixed effects models, the dispatcher call duration was affected by night work shift and work shift duration greater than 8 hours, increasing it by about 10 ± 1 seconds and 4 ± 1 seconds, respectively (both p < 0.001). Our study showed that there was a statistically significant difference in dispatcher call duration over work shift rotation and duration, with longer durations seen over night shifts and shifts over 8 hours. While these differences are small and may not have clinical significance, they may have implications for EMDC efficiency.

Erectile dysfunction in the elderly male

PubMed Central

Gökçe, Mehmet İlker; Yaman, Önder

2017-01-01

Erectile dysfunction (ED) is a health problem which mainly effects elderly men and this problem has become a more important health problem with the increased life expectancy. The basic risk factors of ED are hypertension, dyslipidemia, diabetes mellitus, and atherosclerotic heart disease which also have a higher incidence in the elderly men. The aim of this review article is to highlight the age-related changes in ED together with recommendations for patient evaluation and treatment PMID:28861293

Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study.

PubMed

Bakke, Håkon Kvåle; Steinvik, Tine; Ruud, Håkon; Wisborg, Torben

2017-03-07

Emergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical services (EMS) crews identified the same first aid measures as indicated. For 18 months, the crew on the first EMS crew responding to trauma calls used a standard form to assess bystander first aid. Audio recordings of the corresponding telephone calls from bystanders to the EMCC were reviewed. A total of 311 trauma calls were included. The on-scene EMS crew identified needs for the following first-aid measures: free airway in 26 patients, CPR in 6 patients, and hypothermia prevention in 179 patients. EMCC dispatchers advised these measures, respectively, in 16 (62%), 5 (83%), and 54 (30%) of these cases. Dispatcher guidance was not correlated with correctly performed bystander first aid. For potentially life saving first aid measures, all (20/20) callers who received dispatcher guidance attempted first aid, while only some few (4/22) of the callers who did not receive dispatcher guidance did not attempt first aid. Overall, the EMCC dispatchers had low sensitivity and specificity for correctly identifying trauma patients requiring first-aid measures. Dispatcher guidance did not significantly influence whether on-scene bystander first aid was performed correctly or attempted in this study setting, with a remarkably high willingness to perform first-aid. However, the findings for potentially lifesaving measures suggests that there may be differences that this study was unable to detect. This study found a high rate of first-aid willingness and performance, even without dispatcher prompting, and a low precision in dispatcher advice. This underlines the need for further knowledge about how to increase EMCC dispatchers' possibility to identify trauma patients in need of first aid. The correlation between EMCC-guidance and bystander first aid should be investigated in study settings with lower spontaneous first-aid rates.

Multi-time Scale Joint Scheduling Method Considering the Grid of Renewable Energy

NASA Astrophysics Data System (ADS)

Zhijun, E.; Wang, Weichen; Cao, Jin; Wang, Xin; Kong, Xiangyu; Quan, Shuping

2018-01-01

Renewable new energy power generation prediction error like wind and light, brings difficulties to dispatch the power system. In this paper, a multi-time scale robust scheduling method is set to solve this problem. It reduces the impact of clean energy prediction bias to the power grid by using multi-time scale (day-ahead, intraday, real time) and coordinating the dispatching power output of various power supplies such as hydropower, thermal power, wind power, gas power and. The method adopts the robust scheduling method to ensure the robustness of the scheduling scheme. By calculating the cost of the abandon wind and the load, it transforms the robustness into the risk cost and optimizes the optimal uncertainty set for the smallest integrative costs. The validity of the method is verified by simulation.

Surrogate-Assisted Genetic Programming With Simplified Models for Automated Design of Dispatching Rules.

PubMed

Nguyen, Su; Zhang, Mengjie; Tan, Kay Chen

2017-09-01

Automated design of dispatching rules for production systems has been an interesting research topic over the last several years. Machine learning, especially genetic programming (GP), has been a powerful approach to dealing with this design problem. However, intensive computational requirements, accuracy and interpretability are still its limitations. This paper aims at developing a new surrogate assisted GP to help improving the quality of the evolved rules without significant computational costs. The experiments have verified the effectiveness and efficiency of the proposed algorithms as compared to those in the literature. Furthermore, new simplification and visualisation approaches have also been developed to improve the interpretability of the evolved rules. These approaches have shown great potentials and proved to be a critical part of the automated design system.

Women and sexual problems

MedlinePlus

... Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 20. ... Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier ...

Erectile dysfunction. A guide to diagnosis and management.

PubMed

Arduca, Paul

2003-06-01

Erectile dysfunction (ED) is a common age related problem best managed in general practice. The incidence of ED will thus increase as men live longer. It is only in the past decade that the pathophysiology of ED has been well understood. This article discusses the mechanisms of normal erectile function and dysfunction and the assessment and management of ED. The success of currently available and newly emerging oral agents has revolutionised the management of ED. However, the majority of men with ED remain undiagnosed and untreated and patients are often unable to distinguish between a problem of ED, desire or libido. It is particularly important for general practitioners to enquire about ED in middle aged and older men, diabetics and patients with vascular disease. Appropriate management goes beyond management of the actual condition, and involves addressing lifestyle and psychosocial issues.

The Role of Maternal Distress in the Report of Behavioral and Emotional Problems among Children with Chronic Disabilities.

PubMed

Silberg, Tamar; Brezner, Amichai; Gal, Gilad; Ahonniska-Assa, Jaana; Levav, Miriam

2016-01-01

Assessments of psychological symptoms in children often rely on caregivers' (usually mothers') reports. However, the reliability may be affected by the caregivers' own emotional distress (ED). The main objectives of this study were to assess the variability in ED of mothers of children with chronic physical disabilities, and its association with the ratings of their children's emotional and behavioral problems. Medical data of children diagnosed with chronic disabilities were analyzed (N = 72). Mothers completed the 12-item General Health Questionnaire (12-GHQ) to measure ED and the Child Behavior Checklist (CBCL) to assess children's emotional and behavioral problems Mothers' ED scores were compared with communitybased counterparts with similar socio-demographic characteristics (N = 657) from the Israel National Health Survey (INHS). Mothers of children with chronic physical disabilities had higher levels of ED compared to mothers in the general population. About 20% of the sample mothers had 12-GHQ scores compatible with DSM- IV depression or anxiety disorders. No differences in ED were found according to the type of child's disability or IQ score. Marked differences in CBCL scores were reported by mothers with high versus low ED, controlling for baseline maternal and child characteristics. High levels of maternal ED were associated with mothers' reports on child's behavioral and emotional problems.This may contaminate the reliability of parental reports on their child's psychological state.

Nonurgent patients in emergency departments: rational or irresponsible consumers? Perceptions of professionals and patients.

PubMed

Durand, Anne-Claire; Palazzolo, Sylvie; Tanti-Hardouin, Nicolas; Gerbeaux, Patrick; Sambuc, Roland; Gentile, Stéphanie

2012-09-25

For several decades, overcrowding in emergency departments (EDs) has been intensifying due to the increased number of patients seeking care in EDs. Demand growth is partly due to misuse of EDs by patients who seek care for nonurgent problems. This study explores the reasons why people with nonurgent complaints choose to come to EDs, and how ED health professionals perceive the phenomenon of "nonurgency". Semi-structured interviews were conducted in 10 EDs with 87 nonurgent patients and 34 health professionals. Interviews of patients revealed three themes: (1) fulfilled health care needs, (2) barriers to primary care providers (PCPs), and (3) convenience. Patients chose EDs as discerning health consumers: they preferred EDs because they had difficulties obtaining a rapid appointment. Access to technical facilities in EDs spares the patient from being overwhelmed with appointments with various specialists. Four themes were identified from the interviews of health professionals: (1) the problem of defining a nonurgent visit, (2) explanations for patients' use of EDs for nonurgent complaints, (3) consequences of nonurgent visits, and (4) solutions to counter this tendency. Studies on the underlying reasons patients opt for the ED, as well as on their decision-making process, are lacking. The present study highlighted discrepancies between the perceptions of ED patients and those of health professionals, with a special focus on patient behaviour. To explain the use of ED, health professionals based themselves on the acuity and urgency of medical problems, while patients focused on rational reasons to initiate care in the ED (accessibility to health care resources, and the context in which the medical problem occurred). In spite of some limitations due to the slightly outdated nature of our data, as well as the difficulty of categorizing nonurgent situations, our findings show the importance of conducting a detailed analysis of the demand for health care. Understanding it is crucial, as it is the main determining factor in the utilization of health care resources, and provides promising insights into the phenomenon of ED usage increase. For reforms to be successful, the process of decision-making for unscheduled patients will have to be thoroughly investigated.

Prenatal care in your second trimester

MedlinePlus

... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: ... JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016: ...

Mortality among members of a heavy construction equipment operators union with potential exposure to diesel exhaust emissions.

PubMed Central

Wong, O; Morgan, R W; Kheifets, L; Larson, S R; Whorton, M D

1985-01-01

A historical prospective mortality study was conducted on a cohort of 34 156 male members of a heavy construction equipment operators union with potential exposure to diesel exhaust emissions. This cohort comprised all individuals who were members of the International Union of Operating Engineers, Locals 3 and 3A, for at least one year between 1 January 1964 and 31 December 1978. The mortality experience of the entire cohort and several subcohorts was compared with that of United States white men, adjusted for age and calendar time. The comparison statistic was the commonly used standardised mortality ratio (SMR). Historical environmental measurements did not exist, but partial work histories were available for some cohort members through the union dispatch computer tapes. An attempt was made to relate mortality experience to the union members' dispatch histories. Overall mortality for the entire cohort and several subgroups was significantly lower than expected. When cause specific mortality was examined, however, the study provided suggestive evidence for the existence of several potential health problems in this cohort. Mortality from liver cancer for the entire cohort was significantly high. Although mortality from lung cancer for the entire cohort was similar to expected, a positive trend by latency was observed for lung cancer. A significant excess of mortality from lung cancer was found among the retirees and the group for whom no dispatch histories were available. Other dispatch groups showed no evidence of lung cancer excess. In addition, the total cohort experienced significant mortality excess from emphysema and accidental deaths. PMID:2410010

Prevalence of sexual problems and its association with social, psychological and physical factors among men in a Malaysian population: a cross-sectional study.

PubMed

Quek, Kia Fatt; Sallam, Atiya Abdul; Ng, Chai Heng; Chua, Chong Beng

2008-01-01

Sexual problems are common in the general population. Studies have shown that most of these sexual problems are related to their social lives, medical illnesses, and psychological status. Among the sexual problems in men, premature ejaculation (PE) is one of the most frequent, yet it is the least well-understood of the sexual dysfunctions of men. To determine the prevalence of sexual problem particularly PE and erectile dysfunction (ED) among people living in urban areas and to investigate the characteristics associated with these sexual problems in a Malaysian population. The PE which is defined as an intravaginal ejaculation latency time less than 2 minutes was assessed in the ED and non-ED group. The Hospital Anxiety and Depression scale is used as a measure of the psychological status [30]. The ED status was assessed using the International Index of Erectile Function questionnaire. The prevalence of self-reported sexual problems for ED and PE were 41.6% and 22.3%, respectively. In those subjects with ED, 33.5% reported to have PE. Of the total of 430 subjects, anxiety was present in 8.1%, while depression was 5.3%. The prevalence of PE accounted for 25% anxiety and 14.6% for depression respectively in the population. EDs were associated with diabetes and hypertension (OR [95% CI]: 5.33 [2.33, 10.16], 3.40 [1.76, 6.57], P < 0.05), respectively, while factors associated with PE were anxiety and depression (OR [95% CI]: 1.29 [0.68, 2.45], 1.39 [0.69, 2.78]), respectively. Prevalence of ED is associated with medical symptoms such as diabetes and hypertension and a rise in the prevalence of age while psychological distress such as anxiety and depression also contribute to a higher PE rate.

Forecasting Electricity Prices in an Optimization Hydrothermal Problem

NASA Astrophysics Data System (ADS)

Matías, J. M.; Bayón, L.; Suárez, P.; Argüelles, A.; Taboada, J.

2007-12-01

This paper presents an economic dispatch algorithm in a hydrothermal system within the framework of a competitive and deregulated electricity market. The optimization problem of one firm is described, whose objective function can be defined as its profit maximization. Since next-day price forecasting is an aspect crucial, this paper proposes an efficient yet highly accurate next-day price new forecasting method using a functional time series approach trying to exploit the daily seasonal structure of the series of prices. For the optimization problem, an optimal control technique is applied and Pontryagin's theorem is employed.

Dispatcher assistance and automated external defibrillator performance among elders.

PubMed

Ecker, R; Rea, T D; Meischke, H; Schaeffer, S M; Kudenchuk, P; Eisenberg, M S

2001-10-01

Automated external defibrillators (AEDs) provide an opportunity to improve survival in out-of-hospital, ventricular fibrillation (VF) cardiac arrest by enabling laypersons not trained in rhythm recognition to deliver lifesaving therapy. The potential role of emergency dispatchers in the layperson use of AEDs is uncertain. This study was performed to examine whether dispatcher telephone assistance affected AED skill performance during a simulated VF cardiac arrest among a cohort of older adults. The hypothesis was that dispatcher assistance would increase the proportion who were able to correctly deliver a shock, but might require additional time. One hundred fifty community-dwelling persons aged 58-84 years were recruited from eight senior centers in King County, Washington. All participants had received AED training approximately six months previously. For this study, the participants were randomized to AED operation with or without dispatcher assistance during a simulated VF cardiac arrest. The proportions who successfully delivered a shock and the time intervals from collapse to shock were compared between the two groups. The participants who received dispatcher assistance were more likely to correctly deliver a shock with the AED during the simulated VF cardiac arrest (91% vs 68%, p = 0.001). Among those who were able to deliver a shock, the participants who received dispatcher assistance required a longer time interval from collapse to shock [median (25th, 75th percentile) = 193 seconds (165, 225) for dispatcher assistance, and 148 seconds (138, 166) for no dispatcher assistance, p = 0.001]. Among older laypersons previously trained in AED operation, dispatcher assistance may increase the proportion who can successfully deliver a shock during a VF cardiac arrest.

Non-suicidal self-injury in patients with eating disorder: associations with identity formation above and beyond anxiety and depression.

PubMed

Claes, Laurence; Luyckx, Koen; Bijttebier, Patricia; Turner, Brianna; Ghandi, Amarendra; Smets, Jos; Norre, Jan; Van Assche, Leen; Verheyen, Els; Goris, Yvienne; Hoksbergen, Ingrid; Schoevaerts, Katrien

2015-03-01

In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Erectile dysfunction in hemodialysis patients.

PubMed

Gorsane, Imen; Amri, Nadia; Younsi, Fathi; Helal, Imed; Kheder, Adel

2016-01-01

Erectile dysfunction (ED) is a common problem seen among patients on hemodialysis (HD), but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5%) and diabetes (41.6%). The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH), follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%), the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.

Preeclampsia

MedlinePlus

... preeclampsia makes a woman a higher risk for future problems such as: Heart disease Diabetes Kidney disease ... medical problems in pregnancy. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

Effects of Dispatcher-assisted Cardiopulmonary Resuscitation on Survival Outcomes in Infants, Children, and Adolescents with Out-of-hospital Cardiac Arrests.

PubMed

Ro, Young Sun; Shin, Sang Do; Song, Kyoung Jun; Hong, Ki Jeong; Ahn, Ki Ok; Kim, Do Kyun; Kwak, Young Ho

2016-11-01

We studied the effect of a dispatcher-assisted cardiopulmonary resuscitation (CPR) program on paediatric out-of-hospital cardiac arrest (OHCA) outcomes by age groups. All emergency medical services (EMS)-treated paediatric OHCAs in Korea were enrolled between 2012 and 2014, excluding cases witnessed by EMS providers and those with unknown outcomes. The cases were divided into three groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no-bystander CPR. The endpoint was survival until discharge from hospital. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across age groups. A total of 1529 patients (32.8% bystander CPR with dispatcher assistance, 17.3% without dispatcher assistance, and 54.6% no-bystander CPR) were included. Both bystander CPR groups were more likely to have higher rate of survival to discharge (8.8% and 12.1%) compared to no-bystander CPR (3.9%). The adjusted OR (95% CI) for survival to discharge were 1.77 (1.04-3.00) in bystander CPR with dispatcher assistance and 2.86 (1.61-5.08) in without dispatcher assistance compared with no-bystander CPR. By age groups, the adjusted OR (95% CI) in bystander CPR with and without dispatcher assistance were 2.18 (1.07-4.42) and 2.27 (1.01-5.14) for the group aged 9-18 years; 2.32 (0.64-8.44) and 6.21 (1.83-21.01) for the group aged 1-8 years; 1.06 (0.41-2.77) and 2.00 (0.64-6.18) for the group aged 0-12 months, respectively. Bystander CPR, regardless of dispatcher assistance, was associated with improved survival outcomes after OHCA in the paediatric population. However, the associations between dispatcher-assisted bystander CPR and survival outcomes varied by age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Comparison of Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD) relating to cardiac arrest calls.

PubMed

Hardeland, Camilla; Olasveengen, Theresa M; Lawrence, Rob; Garrison, Danny; Lorem, Tonje; Farstad, Gunnar; Wik, Lars

2014-05-01

Prompt emergency medical service (EMS) system activation with rapid delivery of pre-hospital treatment is essential for patients suffering out-of-hospital cardiac arrest (OHCA). The two most commonly used dispatch tools are Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD). We compared cardiac arrest call processing using these two dispatch tools in two different dispatch centres. Observational study of adult EMS confirmed (non-EMS witnessed) OHCA calls during one year in Richmond, USA (MPD) and Oslo, Norway (CBD). Patients receiving CPR prior to call, interrupted calls or calls where the caller did not have access to the patients were excluded from analysis. Dispatch logs, ambulance records and digitalized dispatcher and caller voice recordings were compared. The MPDS-site processed 182 cardiac arrest calls and the CBD-site 232, of which 100 and 140 calls met the inclusion criteria, respectively. The recognition of cardiac arrest was not different in the MPD and CBD systems; 82% vs. 77% (p=0.42), and pre-EMS arrival CPR instructions were offered to 81% vs. 74% (p=0.22) of callers, respectively. Time to ambulance dispatch was median (95% confidence interval) 15 (13, 17) vs. 33 (29, 36) seconds (p<0.001) and time to chest compression delivery; 4.3 (3.7, 4.9) vs. 3.7 (3.0, 4.1)min for the MPD and CBD systems, respectively (p=0.05). Pre-arrival CPR instructions were offered faster and more frequently in the CBD system, but in both systems chest compressions were delayed 3-4min. Earlier recognition of cardiac arrest and improved CPR instructions may facilitate earlier lay rescuer CPR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Stability of power systems coupled with market dynamics

NASA Astrophysics Data System (ADS)

Meng, Jianping

This Ph.D. thesis presented here spans two relatively independent topics. The first part, Chapter 2 is self-contained, and is dedicated to studies of new algorithms for power system state estimation. The second part, encompassing the remaining chapters, is dedicated to stability analysis of power system coupled with market dynamics. The first part of this thesis presents improved Newton's methods employing efficient vectorized calculations of higher order derivatives in power system state estimation problems. The improved algorithms are proposed based on an exact Newton's method using the second order terms. By efficiently computing an exact gain matrix, combined with a special optimal multiplier method, the new algorithms show more reliable convergence compared with the existing methods of normal equations, orthogonal decomposition, and Hachtel's sparse tableau. Our methods are able to handle ill-conditioned problems, yet show minimal penalty in computational cost for well-conditioned cases. These claims are illustrated through the standard IEEE 118 and 300 bus test examples. The second part of the thesis focuses on stability analysis of market/power systems. The work presented is motivated by an emerging problem. As the frequency of market based dispatch updates increases, there will inevitably be interaction between the dynamics of markets determining the generator dispatch commands, and the physical response of generators and network interconnections, necessitating the development of stability analysis for such coupled systems. We begin with numeric tests using different market models, with detailed machine/exciter/turbine/governor dynamics, in the New England 39 bus test system. A progression of modeling refinements are introduced, including such non-ideal effects as time delays. Electricity market parameter identification algorithms are also studied based on real time data from the PJM electricity market. Finally our power market model is augmented by optimal power flow constraints, allowing study of the so-called congestion problem. These studies show that understanding of potential modes of instability in such coupled systems is of crucial importance both in designing suitable rules for power markets, and in designing physical generator controls that are complementary to market-based dispatch.

Emergency medical dispatch : national standard curriculum ready

DOT National Transportation Integrated Search

1996-05-01

This Traffic Tech describes the recently updated "Emergency Medical Dispatch: National Standard Curriculum," which was developed in 1972. Emergency service providers use these uniform standards to develop or select an emergency medical dispatch progr...

Ambulance dispatches to schools during a 5-year period in Fukui Prefecture.

PubMed

Takinami, Yoshikazu; Maeda, Shinji

2017-01-01

To determine the characteristics and trends of medical emergencies during school activities by analyzing information provided by fire departments. During a 5-year period from January 2009 to December 2013, all nine fire departments in Fukui Prefecture handled 850 emergencies at schools. We investigated the 850 cases with the age range of 0-63 years. It was found that 21.5% of ambulance dispatches to schools were on weekends and there were more dispatches for non-faculty members of all age groups on weekends than on weekdays. The percentage of weekend dispatches was particularly high for students aged ≥19 years. Emergency calls for junior high school students and younger students accounted for the majority of weekday calls. There were a total of 524 ambulance dispatches for the three categories "sprains, contusions, dislocations, and fractures" ( n = 245), "seizures, epilepsy, and syncope" ( n = 171), and "cuts, bruises, lacerations, trauma, amputations, and burns" ( n = 108), with dispatches for these three categories accounting for 61.6% of all dispatches. Almost all dispatches for "heat stroke and dehydration" were during school hours and were concentrated between the months of July and September. Heat stroke was most common among high school students and most often occurred during the summer/fall season and on weekends. Heat stroke was the fourth most frequent condition that required an ambulance dispatch after the above three conditions. Heat stroke is predictable, indicating that it is necessary to prevent heat stroke during high school club activities.

Real -time dispatching modelling for trucks with different capacities in open pit mines / Modelowanie w czasie rzeczywistym przewozów ciężarówek o różnej ładowności w kopalni odkrywkowej

NASA Astrophysics Data System (ADS)

Ahangaran, Daryoush Kaveh; Yasrebi, Amir Bijan; Wetherelt, Andy; Foster, Patrick

2012-10-01

Application of fully automated systems for truck dispatching plays a major role in decreasing the transportation costs which often represent the majority of costs spent on open pit mining. Consequently, the application of a truck dispatching system has become fundamentally important in most of the world's open pit mines. Recent experiences indicate that by decreasing a truck's travelling time and the associated waiting time of its associated shovel then due to the application of a truck dispatching system the rate of production will be considerably improved. Computer-based truck dispatching systems using algorithms, advanced and accurate software are examples of these innovations. Developing an algorithm of a computer- based program appropriated to a specific mine's conditions is considered as one of the most important activities in connection with computer-based dispatching in open pit mines. In this paper the changing trend of programming and dispatching control algorithms and automation conditions will be discussed. Furthermore, since the transportation fleet of most mines use trucks with different capacities, innovative methods, operational optimisation techniques and the best possible methods for developing the required algorithm for real-time dispatching are selected by conducting research on mathematical-based planning methods. Finally, a real-time dispatching model compatible with the requirement of trucks with different capacities is developed by using two techniques of flow networks and integer programming.

Distributed Optimal Dispatch of Distributed Energy Resources Over Lossy Communication Networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Junfeng; Yang, Tao; Wu, Di

In this paper, we consider the economic dispatch problem (EDP), where a cost function that is assumed to be strictly convex is assigned to each of distributed energy resources (DERs), over packet dropping networks. The goal of a standard EDP is to minimize the total generation cost while meeting total demand and satisfying individual generator output limit. We propose a distributed algorithm for solving the EDP over networks. The proposed algorithm is resilient against packet drops over communication links. Under the assumption that the underlying communication network is strongly connected with a positive probability and the packet drops are independentmore » and identically distributed (i.i.d.), we show that the proposed algorithm is able to solve the EDP. Numerical simulation results are used to validate and illustrate the main results of the paper.« less

Long-term Internship through Cooperative Education with Regional Industries

NASA Astrophysics Data System (ADS)

Takahashi, Kenzo; Hase, Hiroyuki

The long term internship is one of special educational programs for graduate students of Graduate School of Engineering in University of Fukui. This is a collaborative program between university and industries where selected post-graduate students are dispatched to companies for a long term and educated in real business environments. It is the final goal of the program to develop sophisticated specialists who would be able to catch the business strategy in industries and solve any problems by themselves. The program is managed in a semester (6 months) and contains 1.5 month prior education of preliminary special knowledge, ethics and secrecy, about 3 month dispatch with long-term internship, and 1.5 month post-education for complementary education and presentation. This paper presents the effect of this program which has been evolving since 2005.

The use of consumer-satisfaction surveys by an air medical program.

PubMed

Hanzely, D; Higgins, B; Popil, V

1993-07-01

Surveys were distributed to referring and receiving hospitals or to EMS agencies that used the air medical service. The respondents were asked to evaluate the dispatcher's, pilot's and flight crew's professionalism and courteousness on a Likert scale and through written comments. Phase 1 of the survey distribution was discontinued after problems were encountered due to the distribution process. Phase 2 consisted of the air medical program mailing surveys directly to the referring and receiving facilities or to the EMS agencies. In terms of courteousness and professionalism, 90% of the respondents' answers fell within the strongly agree to neutral range. Questions regarding pilots and dispatchers were often left unanswered. Two areas were identified as needing further work on the part of the medical flight crew: follow-up with referring hospitals on patient outcome and identification of flight physicians vs. flight nurses.

The Brief Sexual Symptom Checklist as a Screening Tool for Sex-Related Problems in the Primary Care Setting: Focus on Erectile Dysfunction.

PubMed

Romero Otero, Javier; García Gómez, Borja; Medina Polo, José; García Rojo, Esther; García Cruz, Eduardo; Peinado, Francois; Sopeña Sutil, Raquel; Bozzini, Giorgio; Rodríguez Antolín, Alfredo

2018-05-16

To assess the performance of the Brief Sexual Symptom Checklist for men (BSSC-M) questionnaire in General Practitioner's (GP) consults in Spain. Multicenter, cross-sectional study conducted in Spain among men ≥50 years, visiting a GP for any reason, and being able to answer self-administered questionnaires. Patients receiving medicines for erectile dysfunction (ED) and those with poor functional status were excluded. Sexual satisfaction was assessed by the BSSC-M, ED by the Sexual Health Inventory for Men (SHIM), and quality of life (QoL) using a 5-point Likert scale. In all, 770 men met all the selection criteria and 556 patients (72.2%) reported sexually related problems, ED being the most frequent (n = 427; 55.5%). The SHIM score decreased progressively with the number of causes of sexual dissatisfaction. Prevalence of ED (SHIM ≤21) was greater in patients who referred problems with erection in the BSSC-M questionnaire (76 vs. 14%; p < 0.001). Multivariate analysis for ED prediction revealed that sexual dissatisfaction, QoL (average or low/very low), and the presence of 3 or more comorbidities significantly influenced the chances of having ED. Our results encourage the use of the BSSC-M for identifying suspicion of ED and other sexual problems in patients > 50 who visit their GP for a routine follow-up. © 2018 S. Karger AG, Basel.

Characteristics and comorbidity of drug and alcohol-related emergency department presentations detected by nursing triage text.

PubMed

Indig, Devon; Copeland, Jan; Conigrave, Katherine M; Arcuri, Anthony

2010-05-01

This study used nursing triage text to detect drug- and alcohol-related emergency department (ED) presentations and describe their patient and service delivery characteristics. Data were reviewed for all ED presentations from 2004 to 2006 (n = 263 937) from two hospitals in Sydney, Australia. Each record included two nursing triage free-text fields, which were searched for more than 100 drug-related and more than 60 alcohol-related terms. Adjusted odds ratios were used to compare the characteristics of drug and alcohol-related ED presentations with all other ED presentation types. Just over 5% of ED presentations were identified as alcohol-related and 2% as drug-related. The most prevalent drug-related ED presentations specified were related to amphetamines (18%), heroin (14%), cannabis (14%) and ecstasy (12%), while nearly half (43%) were drug unspecified. Polydrug use was mentioned in 25% of drug-related and 9% of alcohol-related ED presentations, with the highest rate of polydrug use among ecstasy-related (68%) presentations. Drug- and alcohol-related ED presentations were significantly more likely than other ED presentations to have a mental health diagnosis, with the highest rates found among cannabis-related (OR = 7.6) or amphetamine-related (OR = 7.5) presentations. The ED provides an opportunity for early intervention for patients presenting with comorbid drug and alcohol and mental health problems. Further research is needed to assess the prevalence of drug and alcohol problems in ED patients with mental health problems and to develop effective interventions in that setting.

Problem Solving and Reasoning.

DTIC Science & Technology

1984-02-01

Sloan Foundation (HAS). This paper is a draft of a chapter to appear in R. C. Atkinson, R. Herrnstein, G. Lindzey, and R. D. Luce (Eds.), Stevens ...D. Luce (Eds.), Stevens ’ Handbook of Experimental Psychology, (Revised Edition). New York: John Wiley & Sons. PROBLEM SOLVING AND REASONING James G... LaBerge & S. J. Samuels (Eds.), Perception and comprehension. Hillsdale, NJ: Erlbaum. Anderson, J. R. (1982). Acquisition of cognitive skill

Dispatches from the front: emergency medicine teachers' perceptions of competency-based education.

PubMed

Bandiera, Glen; Lendrum, David

2011-05-01

Controversy exists regarding the applicability of competency-based education during clinical rotations in emergency medicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competency-based education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among front-line teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents. Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups. In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback. EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Z.; Liu, C.; Botterud, A.

Renewable energy resources have been rapidly integrated into power systems in many parts of the world, contributing to a cleaner and more sustainable supply of electricity. Wind and solar resources also introduce new challenges for system operations and planning in terms of economics and reliability because of their variability and uncertainty. Operational strategies based on stochastic optimization have been developed recently to address these challenges. In general terms, these stochastic strategies either embed uncertainties into the scheduling formulations (e.g., the unit commitment [UC] problem) in probabilistic forms or develop more appropriate operating reserve strategies to take advantage of advanced forecastingmore » techniques. Other approaches to address uncertainty are also proposed, where operational feasibility is ensured within an uncertainty set of forecasting intervals. In this report, a comprehensive review is conducted to present the state of the art through Spring 2015 in the area of stochastic methods applied to power system operations with high penetration of renewable energy. Chapters 1 and 2 give a brief introduction and overview of power system and electricity market operations, as well as the impact of renewable energy and how this impact is typically considered in modeling tools. Chapter 3 reviews relevant literature on operating reserves and specifically probabilistic methods to estimate the need for system reserve requirements. Chapter 4 looks at stochastic programming formulations of the UC and economic dispatch (ED) problems, highlighting benefits reported in the literature as well as recent industry developments. Chapter 5 briefly introduces alternative formulations of UC under uncertainty, such as robust, chance-constrained, and interval programming. Finally, in Chapter 6, we conclude with the main observations from our review and important directions for future work.« less

Decreasing the dispatch time of medical reports sent from hospital to primary care with Lean Six Sigma.

PubMed

Basta, Yara L; Zwetsloot, Inez M; Klinkenbijl, Jean H G; Rohof, Thomas; Monster, Mathijs M C; Fockens, Paul; Tytgat, Kristien M A J

2016-10-01

Timely communication is important to ensure high-quality health care. To facilitate this, the Gastro Intestinal Oncology Center Amsterdam (GIOCA) stipulated to dispatch medical reports on the day of the patient's visit. However, with the increasing number of patients, administrative processes at GIOCA were under pressure, and this standard was not met for the majority of patients. The aim and objective of this study was to dispatch 90% of medical reports on the day of the patient's visit by improving the logistic process. To assess the main causes for a prolonged dispatch time and to design improvements actions, the roadmap offered by Lean Six Sigma (LSS) was used, consisting of five phases: Define, Measure, Analyze, Improve and Control (DMAIC roadmap). Initially, 12.3% of the reports were dispatched on the day of the patient's visit. Three causes for a prolonged dispatch time were identified: (1) determining which doctors involved with treatment would compose the report; (2) the reports composed by a senior resident had to be reviewed by a medical specialist; and (3) a medical specialist had to authorize the administration to dispatch the reports. To circumvent these causes, a digital form was implemented in the electronic medical record that could be completed during the multidisciplinary team meeting. After implementation, 90.6% of the reports were dispatched on the day of the visit. The dispatch time of reports sent from hospital to primary care can be significantly reduced using Lean Six Sigma, improving the communication between hospital and primary care. © 2016 John Wiley & Sons, Ltd.

Training requirements for railroad dispatchers : objectives, syllabi and test designs

DOT National Transportation Integrated Search

1998-11-01

This report presents the results of a study to develop railroad dispatcher training objectives, syllabi for three types of training programs and test designs for the three programs. Information about current railroad dispatching methods and training ...

Optimizing Staffing levels and Schedules for Railroad Dispatching Centers

DOT National Transportation Integrated Search

2004-09-01

This report presents the results of a study to explore approaches to establishing staffing levels and schedules for railroad dispatchers. The : work was conducted as follow-up to a prior study that found fatigue among dispatchers, particularly those ...

Dispatch-assisted CPR: where are the hold-ups during calls to emergency dispatchers? A preliminary analysis of caller-dispatcher interactions during out-of-hospital cardiac arrest using a novel call transcription technique.

PubMed

Clegg, Gareth R; Lyon, Richard M; James, Scott; Branigan, Holly P; Bard, Ellen G; Egan, Gerry J

2014-01-01

Survival from out-of-hospital cardiac arrest (OHCA) is dependent on the chain of survival. Early recognition of cardiac arrest and provision of bystander cardiopulmonary resuscitation (CPR) are key determinants of OHCA survival. Emergency medical dispatchers play a key role in cardiac arrest recognition and giving telephone CPR advice. The interaction between caller and dispatcher can influence the time to bystander CPR and quality of resuscitation. We sought to pilot the use of emergency call transcription to audit and evaluate the holdups in performing dispatch-assisted CPR. A retrospective case selection of 50 consecutive suspected OHCA was performed. Audio recordings of calls were downloaded from the emergency medical dispatch centre computer database. All calls were transcribed using proprietary software and voice dialogue was compared with the corresponding stage on the Medical Priority Dispatch System (MPDS). Time to progress through each stage and number of caller-dispatcher interactions were calculated. Of the 50 downloaded calls, 47 were confirmed cases of OHCA. Call transcription was successfully completed for all OHCA calls. Bystander CPR was performed in 39 (83%) of these. In the remaining cases, the caller decided the patient was beyond help (n = 7) or the caller said that they were physically unable to perform CPR (n = 1). MPDS stages varied substantially in time to completion. Stage 9 (determining if the patient is breathing through airway instructions) took the longest time to complete (median = 59 s, IQR 22-82 s). Stage 11 (giving CPR instructions) also took a relatively longer time to complete compared to the other stages (median = 46 s, IQR 37-75 s). Stage 5 (establishing the patient's age) took the shortest time to complete (median = 5.5s, IQR 3-9s). Transcription of OHCA emergency calls and caller-dispatcher interaction compared to MPDS stage is feasible. Confirming whether a patient is breathing and completing CPR instructions required the longest time and most interactions between caller and dispatcher. Use of call transcription has the potential to identify key factors in caller-dispatcher interaction that could improve time to CPR and further research is warranted in this area. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Utilization of Failure Mode and Effects Analysis (FMEA) Method in Increasing the Revenue of Emergency Department; a Prospective Cohort Study.

PubMed

Shahrami, Ali; Rahmati, Farhad; Kariman, Hamid; Hashemi, Behrooz; Rahmati, Majid; Baratloo, Alireza; Forouzanfar, Mohammad Mehdi; Safari, Saeed

2013-01-01

The balance between revenue and cost of an organization/system is essential to maintain its survival and quality of services. Emergency departments (ED) are one of the most important parts of health care delivery system. Financial discipline of EDs, by increasing the efficiency and profitability, can directly affect the quality of care and subsequently patient satisfaction. Accordingly, the present study attempts to investigate failure mode and effects analysis (FMEA) method in identifying the problems leading to the loss of ED revenue and offer solutions to help fix these problems. This prospective cohort study investigated the financial records of ED patients and evaluated the effective errors in reducing the revenue in ED of Imam Hossein hospital, Tehran, Iran, from October 2007 to November 2009. The whole department was divided into one main system and six subsystems, based on FMEA. The study was divided into two phases. In the first phase, the problems leading to the loss of revenue in each subsystem were identified and weighted into four groups using risk priority number (RPN), and the solutions for fixing them were planned. Then, in the second phase, discovered defects in the first phase were fixed according to their priority. Finally, the impact of each solution was compared before and after intervention using the repeated measure ANOVA test. 100 financial records of ED patients were evaluated during the first phase of the study. The average of ED revenue in the six months of the first phase was 73.1±3.65 thousand US dollars/month. 12 types of errors were detected in the predefined subsystems. ED revenue rose from 73.1 to 153.1, 207.06, 240, and 320 thousand US dollars/month after solving first, second, third, and fourth priority problems, respectively (337.75% increase in two years) (p<0.001). 111.0% increase in the ED revenue after solving of first priority problems revealed that they were extremely indispensable in decreasing the revenue (p<0.0001). The findings of the present study revealed that FMEA could be considered as an efficient model for increasing the revenue of emergency department. According to this model, not recording the services by the nursing unit, and lack of specific identifying code for the patients moving from ED to any other department, were the two first priority problems in decreasing our ED revenue.

Utilization of Failure Mode and Effects Analysis (FMEA) Method in Increasing the Revenue of Emergency Department; a Prospective Cohort Study

PubMed Central

Shahrami, Ali; Rahmati, Farhad; Kariman, Hamid; Hashemi, Behrooz; Rahmati, Majid; Baratloo, Alireza; Forouzanfar, Mohammad Mehdi; Safari, Saeed

2013-01-01

Introduction: The balance between revenue and cost of an organization/system is essential to maintain its survival and quality of services. Emergency departments (ED) are one of the most important parts of health care delivery system. Financial discipline of EDs, by increasing the efficiency and profitability, can directly affect the quality of care and subsequently patient satisfaction. Accordingly, the present study attempts to investigate failure mode and effects analysis (FMEA) method in identifying the problems leading to the loss of ED revenue and offer solutions to help fix these problems. Methods: This prospective cohort study investigated the financial records of ED patients and evaluated the effective errors in reducing the revenue in ED of Imam Hossein hospital, Tehran, Iran, from October 2007 to November 2009. The whole department was divided into one main system and six subsystems, based on FMEA. The study was divided into two phases. In the first phase, the problems leading to the loss of revenue in each subsystem were identified and weighted into four groups using risk priority number (RPN), and the solutions for fixing them were planned. Then, in the second phase, discovered defects in the first phase were fixed according to their priority. Finally, the impact of each solution was compared before and after intervention using the repeated measure ANOVA test. Results: 100 financial records of ED patients were evaluated during the first phase of the study. The average of ED revenue in the six months of the first phase was 73.1±3.65 thousand US dollars/month. 12 types of errors were detected in the predefined subsystems. ED revenue rose from 73.1 to 153.1, 207.06, 240, and 320 thousand US dollars/month after solving first, second, third, and fourth priority problems, respectively (337.75% increase in two years) (p<0.001). 111.0% increase in the ED revenue after solving of first priority problems revealed that they were extremely indispensable in decreasing the revenue (p<0.0001). Conclusion: The findings of the present study revealed that FMEA could be considered as an efficient model for increasing the revenue of emergency department. According to this model, not recording the services by the nursing unit, and lack of specific identifying code for the patients moving from ED to any other department, were the two first priority problems in decreasing our ED revenue. PMID:26495327

Understanding how train dispatchers manage and control trains : results of a cognitive task analysis

DOT National Transportation Integrated Search

2001-05-01

This report documents the results of a Cognitive Task Analysis that examined how experienced railroad dispatchers manage and : schedule trains in todays environment. The objective was to understand the cognitive demands placed on railroad dispatch...

Understanding how train dispatchers manage and control trains : results of a cognitive task analysis

DOT National Transportation Integrated Search

2001-05-01

This report documents the results ofaCognitive Task Analysis that examined how experienced railroad dispatchers manage and : schedule trains in today's environment. The objective was to understand the cognitive demands placed on railroad dispatchers ...

Understanding how train dispatchers manage and control trains : results of a cognitive task analysis.

DOT National Transportation Integrated Search

2001-05-01

This report documents the results of a Cognitive Task Analysis that examined how experienced railroad dispatchers manage and schedule trains in todays environment. The objective was to understand the cognitive demands placed on railroad dispatcher...

The characteristics of hospital emergency department visits made by people with mental health conditions who had dental problems.

PubMed

Nalliah, Romesh P; Da Silva, John D; Allareddy, Veerasathpurush

2013-06-01

There is a paucity of knowledge regarding nationally representative estimates of hospital-based emergency department (ED) visits for dental problems made by people with mental health conditions. The authors conducted a study to provide nationwide estimates of hospital-based ED visits attributed to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess made by people with mental health conditions. The authors used the Nationwide Emergency Department Sample, which is a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. ED visits attributable to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess were identified by the emergency care provider by using diagnostic codes in International Classification of Diseases, Ninth Revision, Clinical Modification. The authors examined outcomes, including hospital charges. They used simple descriptive statistics to summarize the data. In 2008, people with mental health conditions made 15,635,253 visits to hospital-based ED in the United States. A diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess represented 63,164 of these ED visits. The breakdown of the ED visits was 34,574 with dental caries, 25,352 with pulpal and periapical lesions, 9,657 with gingival and periodontal lesions, and 2,776 with mouth cellulitis/abscess. The total charge for ED visits in the United States was $55.46 million in 2008. In 2008, people with mental health conditions made 63,164 visits to hospital-based EDs and received a diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions or mouth cellulitis/abscess. These ED visits incurred substantial hospital charges. Programs designed to reduce the number of ED visits made by this population for common dental problems could have a substantial impact in reducing the use of hospital resources. Practical Implications. Clinicians should implement preventive practices for patients with mental health conditions. The authors identified combinations of mental health conditions and dental problems that led to patients with mental health conditions making visits to hospital-based EDs for dental problems more frequently than did patients in the general population.

14 CFR 121.533 - Responsibility for operational control: Domestic operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations... aircraft dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in compliance with this chapter and operations specifications. (c) The aircraft dispatcher is...

14 CFR 121.533 - Responsibility for operational control: Domestic operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations... aircraft dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in compliance with this chapter and operations specifications. (c) The aircraft dispatcher is...

14 CFR 121.533 - Responsibility for operational control: Domestic operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations... aircraft dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in compliance with this chapter and operations specifications. (c) The aircraft dispatcher is...

14 CFR 121.422 - Aircraft dispatchers: Initial and transition ground training.

Code of Federal Regulations, 2011 CFR

2011-01-01

... computations; (iv) Basic airplane performance dispatch requirements and procedures; (v) Flight planning including track selection, flight time analysis, and fuel requirements; and (vi) Emergency procedures. (3... procedures, and other subjects having a bearing on dispatcher duties and responsibilities; (ii) Flight...

14 CFR 121.533 - Responsibility for operational control: Domestic operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations... aircraft dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in compliance with this chapter and operations specifications. (c) The aircraft dispatcher is...

14 CFR 121.422 - Aircraft dispatchers: Initial and transition ground training.

Code of Federal Regulations, 2012 CFR

2012-01-01

... computations; (iv) Basic airplane performance dispatch requirements and procedures; (v) Flight planning including track selection, flight time analysis, and fuel requirements; and (vi) Emergency procedures. (3... procedures, and other subjects having a bearing on dispatcher duties and responsibilities; (ii) Flight...

14 CFR 121.533 - Responsibility for operational control: Domestic operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations... aircraft dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in compliance with this chapter and operations specifications. (c) The aircraft dispatcher is...

14 CFR 121.422 - Aircraft dispatchers: Initial and transition ground training.

Code of Federal Regulations, 2013 CFR

2013-01-01

... computations; (iv) Basic airplane performance dispatch requirements and procedures; (v) Flight planning including track selection, flight time analysis, and fuel requirements; and (vi) Emergency procedures. (3... procedures, and other subjects having a bearing on dispatcher duties and responsibilities; (ii) Flight...

14 CFR 121.422 - Aircraft dispatchers: Initial and transition ground training.

Code of Federal Regulations, 2010 CFR

2010-01-01

... computations; (iv) Basic airplane performance dispatch requirements and procedures; (v) Flight planning including track selection, flight time analysis, and fuel requirements; and (vi) Emergency procedures. (3... procedures, and other subjects having a bearing on dispatcher duties and responsibilities; (ii) Flight...

14 CFR 121.422 - Aircraft dispatchers: Initial and transition ground training.

Code of Federal Regulations, 2014 CFR

2014-01-01

... computations; (iv) Basic airplane performance dispatch requirements and procedures; (v) Flight planning including track selection, flight time analysis, and fuel requirements; and (vi) Emergency procedures. (3... procedures, and other subjects having a bearing on dispatcher duties and responsibilities; (ii) Flight...

Emergency department transport rates of children from the scene of motor vehicle collisions: do booster seats make a difference?

PubMed

House, Darlene R; Huffman, Gretchen; Walthall, Jennifer D H

2012-11-01

Motor vehicle collisions (MVCs) are the leading cause of death and disability among children older than 1 year. Many states currently mandate all children between the ages of 4 and 8 years be restrained in booster seats. The implementation of a booster-seat law is generally thought to decrease the occurrence of injury to children. We hypothesized that appropriate restraint with booster seats would also cause a decrease in emergency department (ED) visits compared with children who were unrestrained. This is an important measure as ED visits are a surrogate marker for injury. The main purpose of this study was to look at the rate of ED visits between children in booster seats compared with those in other or no restraint systems involved in MVCs. Injury severity was compared across restraint types as a secondary outcome of booster-seat use after the implementation of a state law. A prospective observational study was performed including all children 4 to 8 years old involved in MVCs to which emergency medical services was dispatched. Ambulance services used a novel on-scene computer charting system for all MVC-related encounters to collect age, sex, child-restraint system, Glasgow Coma Scale score, injuries, and final disposition. One hundred fifty-nine children were studied with 58 children (35.6%) in booster seats, 73 children in seatbelts alone (45.2%), and 28 children (19.1%) in no restraint system. 76 children (47.7%), 74 by emergency medical services and 2 by private vehicle, were transported to the ED with no significant difference between restraint use (P = 0.534). Utilization of a restraint system did not significantly impact MVC injury severity. However, of those children who either died (n = 2) or had an on-scene decreased Glasgow Coma Scale score (n = 6), 75% (6/8) were not restrained in a booster seat. The use of booster-seat restraints does not appear to be associated with whether a child will be transported to the ED for trauma evaluation.

Expanding the first link in the chain of survival - Experiences from dispatcher referral of callers to AED locations.

PubMed

Fredman, David; Svensson, Leif; Ban, Yifang; Jonsson, Martin; Hollenberg, Jacob; Nordberg, Per; Ringh, Mattias; Rosenqvist, Mårten; Lundén, Margareta; Claesson, Andreas

2016-10-01

Early use of automated external defibrillators (AED) increases survival in cases of out-of-hospital cardiac arrest (OHCA). Dispatchers play important roles in identifying OHCA, dispatching ambulances and providing callers with telephone-assisted cardiopulmonary resuscitation. Guidelines recommend that AED registries be linked to dispatch centres as tools to refer callers to nearby AED. The aim of this study was to investigate to what extent dispatchers, when provided with a tool to display AED locations and accessibility, referred callers to nearby AED. An application providing real-time visualization of AED locations and accessibility was implemented at four dispatch centres in Sweden. Dispatchers were instructed to refer callers to nearby AED when OHCA was suspected. Such cases were prospectively collected, and geographic information systems were used to identify those located ≤100m from an AED. Audio recordings of emergency calls were assessed to evaluate the AED referral rate. Between February and August 2014, 3009 suspected OHCA calls were received. In 6.6% of those calls (200/3009), an AED was ≤100m from the suspected OHCA. The AED was accessible and the caller was not alone on scene in 24% (47/200) of these cases. In two of those 47 cases (4.3%), the dispatcher referred the caller to the AED. Despite a tool for dispatchers to refer callers to a nearby AED, referral was rare. Only a minority of the suspected OHCA cases occurred ≤100m from an AED. We identified AED accessibility and callers being alone on scene as obstacles for AED referral. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Emergency medical dispatch priority in chest pain patients due to life threatening conditions: A cohort study examining circadian variations and impact of the education.

PubMed

Rawshani, Araz; Rawshani, Nina; Gelang, Carita; Andersson, Jan-Otto; Larsson, Anna; Bång, Angela; Herlitz, Johan; Gellerstedt, Martin

2017-06-01

We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest). Among patients who died, a 7-fold increase in odds of missing to give priority 1 was noted at 1.00pm, as compared with midnight. Compared with assistant nurses, odds ratio for dispatchers with no (medical) training was 0.34 (95% CI 0.14 to 0.77). Among patients with an ACS, odds ratio for calls arriving before lunch was 2.02 (95% CI 1.22 to 3.43), compared with midnight. Compared with assistant nurses, odds ratio for operators with no training was 0.23 (95% CI 0.13 to 0.40). Similar associations were noted for those with any LTC. Dispatcher's education was not associated with the patient's survival. In this group of patients, which experience substantial mortality and morbidity, the risk of not obtaining highest dispatch priority was increased up to 7-fold during lunchtime. Dispatch operators without medical education had the lowest risk, compared with nurses and assistant nurses, of missing to give priority 1, at the expense of lower positive predictive value. What is already known about this subject? Use of the emergency medical service (EMS) increases survival among patients with acute coronary syndromes. It is unknown whether the efficiency - as judged by the ability to identify life-threatening cases among patients with chest pain - varies according to the dispatcher's educational level and the time of day. What does this study add? We provide evidence that the dispatcher's education does not influence survival among patients calling the EMS due to chest discomfort. However, medically educated dispatchers are at greatest risk of missing to identify life-threatening cases, which is explained by more parsimonious use of the highest dispatch priority. We also show that the risk of missing life-threatening cases is at highest around lunch time. How might this impact on clinical practice? Dispatch centers are operated differently all over the world and chest discomfort is one of the most frequent symptoms encountered; we provide evidence that it is safe to operate a dispatch center without medically trained personnel, who actually miss fewer cases of acute coronary syndromes. However, non-medically trained dispatchers consume more pre-hospital resources. Copyright © 2017 Elsevier B.V. All rights reserved.

Robust optimization based energy dispatch in smart grids considering demand uncertainty

NASA Astrophysics Data System (ADS)

Nassourou, M.; Puig, V.; Blesa, J.

2017-01-01

In this study we discuss the application of robust optimization to the problem of economic energy dispatch in smart grids. Robust optimization based MPC strategies for tackling uncertain load demands are developed. Unexpected additive disturbances are modelled by defining an affine dependence between the control inputs and the uncertain load demands. The developed strategies were applied to a hybrid power system connected to an electrical power grid. Furthermore, to demonstrate the superiority of the standard Economic MPC over the MPC tracking, a comparison (e.g average daily cost) between the standard MPC tracking, the standard Economic MPC, and the integration of both in one-layer and two-layer approaches was carried out. The goal of this research is to design a controller based on Economic MPC strategies, that tackles uncertainties, in order to minimise economic costs and guarantee service reliability of the system.

14 CFR 121.463 - Aircraft dispatcher qualifications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... aircraft dispatcher for a particular airplane group unless that person has, with respect to an airplane of that group, satisfactorily completed the following: (1) Initial dispatcher training, except that a person who has satisfactorily completed such training for another type airplane of the same group need...

Real-Time Dispatch of Petroleum Tank Trucks.

DTIC Science & Technology

1979-12-01

dispatches for each bulk terminal from which loads are hauled. The dispatchers, located at a central national order processing facility, must each...of an order processor and new capa- bilities to, for instance, trace orders. Also, uniform control of thef order processing function is desirable, if

14 CFR 121.415 - Crewmember and dispatcher training requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... indoctrination ground training for newly hired crewmembers or dispatchers including 40 programmed hours of... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Crewmember and dispatcher training... OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Training Program § 121.415 Crewmember...

Active and Reactive Power Optimal Dispatch Associated with Load and DG Uncertainties in Active Distribution Network

NASA Astrophysics Data System (ADS)

Gao, F.; Song, X. H.; Zhang, Y.; Li, J. F.; Zhao, S. S.; Ma, W. Q.; Jia, Z. Y.

2017-05-01

In order to reduce the adverse effects of uncertainty on optimal dispatch in active distribution network, an optimal dispatch model based on chance-constrained programming is proposed in this paper. In this model, the active and reactive power of DG can be dispatched at the aim of reducing the operating cost. The effect of operation strategy on the cost can be reflected in the objective which contains the cost of network loss, DG curtailment, DG reactive power ancillary service, and power quality compensation. At the same time, the probabilistic constraints can reflect the operation risk degree. Then the optimal dispatch model is simplified as a series of single stage model which can avoid large variable dimension and improve the convergence speed. And the single stage model is solved using a combination of particle swarm optimization (PSO) and point estimate method (PEM). Finally, the proposed optimal dispatch model and method is verified by the IEEE33 test system.

Influence of dispatching rules on average production lead time for multi-stage production systems.

PubMed

Hübl, Alexander; Jodlbauer, Herbert; Altendorfer, Klaus

2013-08-01

In this paper the influence of different dispatching rules on the average production lead time is investigated. Two theorems based on covariance between processing time and production lead time are formulated and proved theoretically. Theorem 1 links the average production lead time to the "processing time weighted production lead time" for the multi-stage production systems analytically. The influence of different dispatching rules on average lead time, which is well known from simulation and empirical studies, can be proved theoretically in Theorem 2 for a single stage production system. A simulation study is conducted to gain more insight into the influence of dispatching rules on average production lead time in a multi-stage production system. We find that the "processing time weighted average production lead time" for a multi-stage production system is not invariant of the applied dispatching rule and can be used as a dispatching rule independent indicator for single-stage production systems.

The multiplicative effect of combining alcohol with energy drinks on adolescent gambling.

PubMed

Vieno, Alessio; Canale, Natale; Potente, Roberta; Scalese, Marco; Griffiths, Mark D; Molinaro, Sabrina

2018-07-01

There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence. Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495). Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37). The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents. Copyright © 2018 Elsevier Ltd. All rights reserved.

14 CFR 121.404 - Compliance dates: Crew and dispatcher resource management training.

Code of Federal Regulations, 2010 CFR

2010-01-01

... approved crew resource management (CRM) or dispatcher resource management (DRM) initial training, as... resource management training. 121.404 Section 121.404 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... § 121.404 Compliance dates: Crew and dispatcher resource management training. After March 19, 1998, no...

14 CFR 121.687 - Dispatch release: Flag and domestic operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Dispatch release: Flag and domestic operations. 121.687 Section 121.687 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...) The dispatch release must contain, or have attached to it, weather reports, available weather...

14 CFR 121.687 - Dispatch release: Flag and domestic operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Dispatch release: Flag and domestic operations. 121.687 Section 121.687 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...) The dispatch release must contain, or have attached to it, weather reports, available weather...

14 CFR 121.687 - Dispatch release: Flag and domestic operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Dispatch release: Flag and domestic operations. 121.687 Section 121.687 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...) The dispatch release must contain, or have attached to it, weather reports, available weather...

14 CFR 121.687 - Dispatch release: Flag and domestic operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Dispatch release: Flag and domestic operations. 121.687 Section 121.687 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...) The dispatch release must contain, or have attached to it, weather reports, available weather...

14 CFR 121.687 - Dispatch release: Flag and domestic operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Dispatch release: Flag and domestic operations. 121.687 Section 121.687 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF...) The dispatch release must contain, or have attached to it, weather reports, available weather...

49 CFR 1242.57 - Dispatching trains (account XX-51-58).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Dispatching trains (account XX-51-58). 1242.57 Section 1242.57 Transportation Other Regulations Relating to Transportation (Continued) SURFACE...-Transportation § 1242.57 Dispatching trains (account XX-51-58). Separate common expenses on the basis of train...

14 CFR 65.61 - Aircraft dispatcher certification courses: Content and minimum hours.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Aircraft dispatcher certification courses: Content and minimum hours. 65.61 Section 65.61 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aircraft dispatcher certification course must: (1) Provide instruction in the areas of knowledge and topics...

14 CFR 65.61 - Aircraft dispatcher certification courses: Content and minimum hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Aircraft dispatcher certification courses: Content and minimum hours. 65.61 Section 65.61 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... aircraft dispatcher certification course must: (1) Provide instruction in the areas of knowledge and topics...

A priority dispatch system for emergency medical services.

PubMed

Slovis, C M; Carruth, T B; Seitz, W J; Thomas, C M; Elsea, W R

1985-11-01

A decision tree priority dispatch system for emergency medical services (EMS) was developed and implemented in Atlanta and Fulton County, Georgia. The dispatch system shortened the average response time from 14.2 minutes to 10.4 minutes for the 30% of patients deemed most urgent (P less than or equal to .05); resulted in a significant increase in the use of advanced life support units for this group (P less than or equal to .02); decreased the number of calls that required a backup ambulance service; and significantly increased conformity to national EMS response time standards for critically ill and injured patients (P less than or equal to .0009). Due to dispatch error, 0.3% of calls were dispatched as least severe but subsequently were found to be most urgent.

Emergency Department Visits for Nontraumatic Dental Problems: A Mixed-Methods Study

PubMed Central

Chi, Donald L.; Schwarz, Eli; Milgrom, Peter; Yagapen, Annick; Malveau, Susan; Chen, Zunqui; Chan, Ben; Danner, Sankirtana; Owen, Erin; Morton, Vickie; Lowe, Robert A.

2015-01-01

Objectives. We documented emergency department (ED) visits for nontraumatic dental problems and identified strategies to reduce ED dental visits. Methods. We used mixed methods to analyze claims in 2010 from a purposive sample of 25 Oregon hospitals and Oregon’s All Payer All Claims data set and interviewed 51 ED dental visitors and stakeholders from 6 communities. Results. Dental visits accounted for 2.5% of ED visits and represented the second-most-common discharge diagnosis in adults aged 20 to 39 years, were associated with being uninsured (odds ratio [OR] = 5.2 [reference: commercial insurance]; 95% confidence interval [CI] = 4.8, 5.5) or having Medicaid insurance (OR = 4.0; 95% CI = 3.7, 4.2), resulted in opioid (56%) and antibiotic (56%) prescriptions, and generated $402 (95% CI = $396, $408) in hospital costs per visit. Interviews revealed health system, community, provider, and patient contributors to ED dental visits. Potential solutions provided by interviewees included Medicaid benefit expansion, care coordination, water fluoridation, and patient education. Conclusions. Emergency department dental visits are a significant and costly public health problem for vulnerable individuals. Future efforts should focus on implementing multilevel interventions to reduce ED dental visits. PMID:25790415

77 FR 64977 - Texas Dispatchable Wind 1, LLC; Supplemental Notice That Initial Market-Based Rate Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER13-70-000] Texas Dispatchable Wind 1, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for... Texas Dispatchable Wind 1 LLC's application for market-based rate authority, with an accompanying rate...

Information needs for increasing log transport efficiency

Treesearch

Timothy P. McDonald; Steven E. Taylor; Robert B. Rummer; Jorge Valenzuela

2001-01-01

Three methods of dispatching trucks to loggers were tested using a log transport simulation model: random allocation, fixed assignment of trucks to loggers, and dispatch based on knowledge of the current status of trucks and loggers within the system. This 'informed' dispatch algorithm attempted to minimize the difference in time between when a logger would...

14 CFR 121.601 - Aircraft dispatcher information to pilot in command: Domestic and flag operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... command: Domestic and flag operations. 121.601 Section 121.601 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.601 Aircraft dispatcher information to pilot in command: Domestic and flag operations. (a) The aircraft dispatcher shall provide the pilot in command all available current reports or...

14 CFR 121.601 - Aircraft dispatcher information to pilot in command: Domestic and flag operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... command: Domestic and flag operations. 121.601 Section 121.601 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.601 Aircraft dispatcher information to pilot in command: Domestic and flag operations. (a) The aircraft dispatcher shall provide the pilot in command all available current reports or...

14 CFR 121.601 - Aircraft dispatcher information to pilot in command: Domestic and flag operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... command: Domestic and flag operations. 121.601 Section 121.601 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.601 Aircraft dispatcher information to pilot in command: Domestic and flag operations. (a) The aircraft dispatcher shall provide the pilot in command all available current reports or...

14 CFR 121.601 - Aircraft dispatcher information to pilot in command: Domestic and flag operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... command: Domestic and flag operations. 121.601 Section 121.601 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.601 Aircraft dispatcher information to pilot in command: Domestic and flag operations. (a) The aircraft dispatcher shall provide the pilot in command all available current reports or...

14 CFR 121.601 - Aircraft dispatcher information to pilot in command: Domestic and flag operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... command: Domestic and flag operations. 121.601 Section 121.601 Aeronautics and Space FEDERAL AVIATION... Flight Release Rules § 121.601 Aircraft dispatcher information to pilot in command: Domestic and flag operations. (a) The aircraft dispatcher shall provide the pilot in command all available current reports or...

77 FR 12104 - Agency Information Collection Activities: Requests for Comments; Clearance of Renewed Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... Courses AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice and request for comments... certification and approval of aircraft dispatcher courses. The FAA uses the information to ensure compliance and..., Subpart C, Aircraft Dispatchers and App. A Aircraft Dispatcher Courses. Form Numbers: There are no FAA...

VIEW OF THE DISPATCH OFFICE IN BUILDING 331. ALL SITEWIDE ...

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

VIEW OF THE DISPATCH OFFICE IN BUILDING 331. ALL SITE-WIDE FIRE ALARM SIGNALS, INCLUDING ALL FIRE PHONES, FIRE PULL BOXES, HEAT AND SMOKE DETECTORS, AND SUPPRESSION SYSTEM FLOW ALARMS, ARE TRANSMITTED TO THE BUILDING 331 DISPATCHER'S OFFICE. (3/77) - Rocky Flats Plant, Vehicle Maintenance Garage & Fire Station, Golden, Jefferson County, CO

Uncertainties that flight crews and dispatchers must consider when calculating the fuel needed for a flight

NASA Technical Reports Server (NTRS)

Trujillo, Anna C.

1996-01-01

In 1993, fuel accounted for approximately 15 percent of an airline's expenses. Fuel consumption increases as fuel reserves increase because of the added weight to the aircraft. Calculating fuel reserves is a function of Federal Aviation Regulations, airline company policy, and factors that impact or are impacted by fuel usage enroute. This research studied how pilots and dispatchers determined the fuel needed for a flight and identified areas where improvements in methods may yield measurable fuel savings by (1) listing the uncertainties that contribute to adding contingency fuel, (2) obtaining the pilots' and dispatchers' perspective on how often each uncertainty occurred, and (3) obtaining pilots' and dispatchers' perspective on the fuel used for each occurrence. This study found that for the majority of the time, pilots felt that dispatchers included enough fuel. As for the uncertainties that flight crews and dispatchers account for, air traffic control accounts for 28% and weather uncertainties account for 58 percent. If improvements can be made in these two areas, a great potential exists to decrease the reserve required, and therefore, fuel usage without jeopardizing safety.

Development and Testing of Emergency Department Patient Transfer Communication Measures

ERIC Educational Resources Information Center

Klingner, Jill; Moscovice, Ira

2012-01-01

Purpose: Communication problems are a major contributing factor to adverse events in hospitals. The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality…

Minimum-Time Consensus-Based Approach for Power System Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Tao; Wu, Di; Sun, Yannan

2016-02-01

This paper presents minimum-time consensus based distributed algorithms for power system applications, such as load shedding and economic dispatch. The proposed algorithms are capable of solving these problems in a minimum number of time steps instead of asymptotically as in most of existing studies. Moreover, these algorithms are applicable to both undirected and directed communication networks. Simulation results are used to validate the proposed algorithms.

Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

PubMed

Ek, Bosse; Svedlund, Marianne

2015-04-01

To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame-free culture are important factors to attract and retain employees. © 2014 John Wiley & Sons Ltd.

A methodology to identify stranded generation facilities and estimate stranded costs for Louisiana's electric utility industry

NASA Astrophysics Data System (ADS)

Cope, Robert Frank, III

1998-12-01

The electric utility industry in the United States is currently experiencing a new and different type of growing pain. It is the pain of having to restructure itself into a competitive business. Many industry experts are trying to explain how the nation as a whole, as well as individual states, will implement restructuring and handle its numerous "transition problems." One significant transition problem for federal and state regulators rests with determining a utility's stranded costs. Stranded generation facilities are assets which would be uneconomic in a competitive environment or costs for assets whose regulated book value is greater than market value. At issue is the methodology which will be used to estimate stranded costs. The two primary methods are known as "Top-Down" and "Bottom-Up." The "Top-Down" approach simply determines the present value of the losses in revenue as the market price for electricity changes over a period of time into the future. The problem with this approach is that it does not take into account technical issues associated with the generation and wheeling of electricity. The "Bottom-Up" approach computes the present value of specific strandable generation facilities and compares the resulting valuations with their historical costs. It is regarded as a detailed and difficult, but more precise, approach to identifying stranded assets and their associated costs. This dissertation develops a "Bottom-Up" quantitative, optimization-based approach to electric power wheeling within the state of Louisiana. It optimally evaluates all production capabilities and coordinates the movement of bulk power through transmission interconnections of competing companies in and around the state. Sensitivity analysis to this approach is performed by varying seasonal consumer demand, electric power imports, and transmission inter-connection cost parameters. Generation facility economic dispatch and transmission interconnection bulk power transfers, specific to each set of parameters, lead to the identification of stranded generation facilities. Stranded costs of non-dispatched and uneconomically dispatched generation facilities can then be estimated to indicate, arguably, the largest portion of restructuring transition costs as the industry is transformed from its present monopolistic structure to a competitive one.

Recommendations in dispatcher-assisted bystander resuscitation from emergency call center.

PubMed

García del Águila, J; López-Messa, J; Rosell-Ortiz, F; de Elías Hernández, R; Martínez del Valle, M; Sánchez-Santos, L; López-Herce, J; Cerdà-Vila, M; Roza-Alonso, C L; Bernardez-Otero, M

2015-01-01

Dispatch-assisted bystander cardiopulmonary resuscitation in out-of-hospital cardiac arrest has been shown as an effective measure to improve the survival of this process. The development of a unified protocol for all dispatch centers of the different emergency medical services can be a first step towards this goal in our environment. The process of developing a recommendations document and the realization of posters of dispatch-assisted cardiopulmonary resuscitation, agreed by different actors and promoted by the Spanish Resuscitation Council, is presented. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.

PubMed

Martins, Fernando Gonini; Abdo, Carmita Helena Najjar

2010-06-01

Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition. Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old. Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student's t-test and logistic regression analyses. The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question. Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men's self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem. Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects' young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young population.

All-Natural Tips to Improve Your Sex Life: Exercise, Diet Changes May Help Reverse ED (Erectile Dysfunction)

MedlinePlus

... your inbox ! All-natural tips to improve your sex life Exercise, diet changes may help reverse ED ... problem , may reverse your ED and improve your sex life. They are easy to adopt and enrich ...

An enhanced artificial bee colony algorithm (EABC) for solving dispatching of hydro-thermal system (DHTS) problem

PubMed Central

Yu, Yi; Hu, Binqi; Liu, Xinglong

2018-01-01

The dispatching of hydro-thermal system is a nonlinear programming problem with multiple constraints and high dimensions and the solution techniques of the model have been a hotspot in research. Based on the advantage of that the artificial bee colony algorithm (ABC) can efficiently solve the high-dimensional problem, an improved artificial bee colony algorithm has been proposed to solve DHTS problem in this paper. The improvements of the proposed algorithm include two aspects. On one hand, local search can be guided in efficiency by the information of the global optimal solution and its gradient in each generation. The global optimal solution improves the search efficiency of the algorithm but loses diversity, while the gradient can weaken the loss of diversity caused by the global optimal solution. On the other hand, inspired by genetic algorithm, the nectar resource which has not been updated in limit generation is transformed to a new one by using selection, crossover and mutation, which can ensure individual diversity and make full use of prior information for improving the global search ability of the algorithm. The two improvements of ABC algorithm are proved to be effective via a classical numeral example at last. Among which the genetic operator for the promotion of the ABC algorithm’s performance is significant. The results are also compared with those of other state-of-the-art algorithms, the enhanced ABC algorithm has general advantages in minimum cost, average cost and maximum cost which shows its usability and effectiveness. The achievements in this paper provide a new method for solving the DHTS problems, and also offer a novel reference for the improvement of mechanism and the application of algorithms. PMID:29324743

An enhanced artificial bee colony algorithm (EABC) for solving dispatching of hydro-thermal system (DHTS) problem.

PubMed

Yu, Yi; Wu, Yonggang; Hu, Binqi; Liu, Xinglong

2018-01-01

The dispatching of hydro-thermal system is a nonlinear programming problem with multiple constraints and high dimensions and the solution techniques of the model have been a hotspot in research. Based on the advantage of that the artificial bee colony algorithm (ABC) can efficiently solve the high-dimensional problem, an improved artificial bee colony algorithm has been proposed to solve DHTS problem in this paper. The improvements of the proposed algorithm include two aspects. On one hand, local search can be guided in efficiency by the information of the global optimal solution and its gradient in each generation. The global optimal solution improves the search efficiency of the algorithm but loses diversity, while the gradient can weaken the loss of diversity caused by the global optimal solution. On the other hand, inspired by genetic algorithm, the nectar resource which has not been updated in limit generation is transformed to a new one by using selection, crossover and mutation, which can ensure individual diversity and make full use of prior information for improving the global search ability of the algorithm. The two improvements of ABC algorithm are proved to be effective via a classical numeral example at last. Among which the genetic operator for the promotion of the ABC algorithm's performance is significant. The results are also compared with those of other state-of-the-art algorithms, the enhanced ABC algorithm has general advantages in minimum cost, average cost and maximum cost which shows its usability and effectiveness. The achievements in this paper provide a new method for solving the DHTS problems, and also offer a novel reference for the improvement of mechanism and the application of algorithms.

Barriers to dispatcher-assisted cardiopulmonary resuscitation in Singapore.

PubMed

Ho, Andrew Fu Wah; Sim, Zariel Jiaying; Shahidah, Nur; Hao, Ying; Ng, Yih Yng; Leong, Benjamin S H; Zarinah, Siti; Teo, Winston K L; Goh, Geraldine Shu Yi; Jaafar, Hamizah; Ong, Marcus E H

2016-08-01

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Hybrid Genetic Programming Algorithm for Automated Design of Dispatching Rules.

PubMed

Nguyen, Su; Mei, Yi; Xue, Bing; Zhang, Mengjie

2018-06-04

Designing effective dispatching rules for production systems is a difficult and timeconsuming task if it is done manually. In the last decade, the growth of computing power, advanced machine learning, and optimisation techniques has made the automated design of dispatching rules possible and automatically discovered rules are competitive or outperform existing rules developed by researchers. Genetic programming is one of the most popular approaches to discovering dispatching rules in the literature, especially for complex production systems. However, the large heuristic search space may restrict genetic programming from finding near optimal dispatching rules. This paper develops a new hybrid genetic programming algorithm for dynamic job shop scheduling based on a new representation, a new local search heuristic, and efficient fitness evaluators. Experiments show that the new method is effective regarding the quality of evolved rules. Moreover, evolved rules are also significantly smaller and contain more relevant attributes.

Modeling and Simulation of Bus Dispatching Policy for Timed Transfers on Signalized Networks

NASA Astrophysics Data System (ADS)

Cho, Hsun-Jung; Lin, Guey-Shii

2007-12-01

The major work of this study is to formulate the system cost functions and to integrate the bus dispatching policy with signal control. The integrated model mainly includes the flow dispersion model for links, signal control model for nodes, and dispatching control model for transfer terminals. All such models are inter-related for transfer operations in one-center transit network. The integrated model that combines dispatching policies with flexible signal control modes can be applied to assess the effectiveness of transfer operations. It is found that, if bus arrival information is reliable, an early dispatching decision made at the mean bus arrival times is preferable. The costs for coordinated operations with slack times are relatively low at the optimal common headway when applying adaptive route control. Based on such findings, a threshold function of bus headway for justifying an adaptive signal route control under various time values of auto drivers is developed.

View west of load dispatch model board; section covers substations ...

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

View west of load dispatch model board; section covers substations from edgerly (right) to thorndale and west yard (left). Instruments at bottom of center board section formerly monitored energy usage and were replaced by a computerized monitoring system. - Thirtieth Street Station, Load Dispatch Center, Thirtieth & Market Streets, Railroad Station, Amtrak (formerly Pennsylvania Railroad Station), Philadelphia, Philadelphia County, PA

What Kinds of Skills Are Necessary for Physicians Involved in International Disaster Response?

PubMed

Noguchi, Norihito; Inoue, Satoshi; Shimanoe, Chisato; Shibayama, Kaoru; Matsunaga, Hitomi; Tanaka, Sae; Ishibashi, Akina; Shinchi, Koichi

2016-08-01

Introduction Physicians are key disaster responders in foreign medical teams (FMTs) that provide medical relief to affected people. However, few studies have examined the skills required for physicians in real, international, disaster-response situations. Problem The objectives of this study were to survey the primary skills required for physicians from a Japanese FMT and to examine whether there were differences in the frequencies of performed skills according to demographic characteristics, previous experience, and dispatch situations to guide future training and certification programs. This cross-sectional survey used a self-administered questionnaire given to 64 physicians with international disaster-response site experience. The questionnaire assessed demographic characteristics (sex, age, years of experience as a physician, affiliation, and specialty), previous experience (domestic disaster-relief experience, international disaster-relief experience, or disaster medicine training experience), and dispatch situation (length of dispatch, post-disaster phase, disaster type, and place of dispatch). In addition, the frequencies of 42 performed skills were assessed via a five-point Likert scale. Descriptive statistics were used to assess the participants' characteristics and total scores as the frequencies of performed skills. Mean scores for surgical skills, health care-related skills, public health skills, and management and coordination skills were compared according to the demographic characteristics, previous experience, and dispatch situations. Fifty-two valid questionnaires (81.3% response rate) were collected. There was a trend toward higher skill scores among those who had more previous international disaster-relief experience (P=.03). The more disaster medicine training experience the participants had, the higher their skill score was (P<.001). Physicians reported involvement in 23 disaster-relief response skills, nine of which were performed frequently. There was a trend toward higher scores for surgical skills, health care-related skills, and management and coordination skills related to more disaster medicine training experience. This study's findings can be used as evidence to boost the frequency of physicians' performed skills by promoting previous experience with international disaster relief and disaster medicine training. Additionally, these results may contribute to enhancing the quality of medical practice in the international disaster relief and disaster training curricula. Noguchi N , Inoue S , Shimanoe C , Shibayama K , Matsunaga H , Tanaka S , Ishibashi A , Shinchi K . What kinds of skills are necessary for physicians involved in international disaster response? Prehosp Disaster Med. 2016;31(4):397-406.

Power management of remote microgrids considering battery lifetime

NASA Astrophysics Data System (ADS)

Chalise, Santosh

Currently, 20% (1.3 billion) of the world's population still lacks access to electricity and many live in remote areas where connection to the grid is not economical or practical. Remote microgrids could be the solution to the problem because they are designed to provide power for small communities within clearly defined electrical boundaries. Reducing the cost of electricity for remote microgrids can help to increase access to electricity for populations in remote areas and developing countries. The integration of renewable energy and batteries in diesel based microgrids has shown to be effective in reducing fuel consumption. However, the operational cost remains high due to the low lifetime of batteries, which are heavily used to improve the system's efficiency. In microgrid operation, a battery can act as a source to augment the generator or a load to ensure full load operation. In addition, a battery increases the utilization of PV by storing extra energy. However, the battery has a limited energy throughput. Therefore, it is required to provide balance between fuel consumption and battery lifetime throughput in order to lower the cost of operation. This work presents a two-layer power management system for remote microgrids. First layer is day ahead scheduling, where power set points of dispatchable resources were calculated. Second layer is real time dispatch, where schedule set points from the first layer are accepted and resources are dispatched accordingly. A novel scheduling algorithm is proposed for a dispatch layer, which considers the battery lifetime in optimization and is expected to reduce the operational cost of the microgrid. This method is based on a goal programming approach which has the fuel and the battery wear cost as two objectives to achieve. The effectiveness of this method was evaluated through a simulation study of a PV-diesel hybrid microgrid using deterministic and stochastic approach of optimization.

Constructing New Theory for Identifying Students with Emotional Disturbance: A Grounded Theory Approach

ERIC Educational Resources Information Center

Barnett, Dori A.

2010-01-01

The problem area explored by this study is the identification of students with emotional and behavioral difficulties for special education supports and services under the criteria for emotional disturbance (ED). A review of the literature indicated that the problem of identifying students with ED was compounded by subjectivity and ambiguity…

Feasibility of a computer-assisted feedback system between dispatch centre and ambulances.

PubMed

Lindström, Veronica; Karlsten, Rolf; Falk, Ann-Charlotte; Castrèn, Maaret

2011-06-01

The aim of the study was to evaluate the feasibility of a newly developed computer-assisted feedback system between dispatch centre and ambulances in Stockholm, Sweden. A computer-assisted feedback system based on a Finnish model was designed to fit the Swedish emergency medical system. Feedback codes were identified and divided into three categories; assessment of patients' primary condition when ambulance arrives at scene, no transport by the ambulance and level of priority. Two ambulances and one emergency medical communication centre (EMCC) in Stockholm participated in the study. A sample of 530 feedback codes sent through the computer-assisted feedback system was reviewed. The information on the ambulance medical records was compared with the feedback codes used and 240 assignments were further analyzed. The used feedback codes sent from ambulance to EMCC were correct in 92% of the assignments. The most commonly used feedback code sent to the emergency medical dispatchers was 'agree with the dispatchers' assessment'. In addition, in 160 assignments there was a mismatch between emergency medical dispatchers and ambulance nurse assessments. Our results have shown a high agreement between medical dispatchers and ambulance nurse assessment. The feasibility of the feedback codes seems to be acceptable based on the small margin of error. The computer-assisted feedback system may, when used on a daily basis, make it possible for the medical dispatchers to receive feedback in a structural way. The EMCC organization can directly evaluate any changes in the assessment protocol by structured feedback sent from the ambulance.

Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: A randomised controlled single-blinded manikin trial.

PubMed

Spelten, Oliver; Warnecke, Tobias; Wetsch, Wolfgang A; Schier, Robert; Böttiger, Bernd W; Hinkelbein, Jochen

2016-08-01

High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR. The aim of this study was to evaluate both principles of T-CPR with respect to CPR quality. Randomised controlled single-blinded manikin trial. University Hospital of Cologne, Germany, 1 July 2012 to 30 September 2012. Sixty laypersons between 18 and 65 years. Medically educated individuals, medical professionals and pregnant women were excluded. Participants were asked to resuscitate a manikin and were randomised into three groups: not dispatcher-assisted (uninstructed) CPR (group 1; U-CPR; n = 20), dispatcher-assisted compression-only CPR (group 2; DACO-CPR; n = 19) and full dispatcher-assisted CPR with rescue ventilation (group 3; DAF-CPR; n = 19). Specific parameters of CPR quality [i.e. no-flow-time (NFT) as well as compression and ventilation parameters] were analysed. To compare different groups we used Student's t test and P less than 0.05 was considered significant. Initial NFT was lowest in the DACO-CPR group (mean 21.3 ± 14.4%), followed by dispatcher-assisted full CPR (mean 49.1 ± 8.5%) and by unassisted CPR (mean 55.0 ± 12.9%). Initial NFT covering the time of instruction was lower in DACO-CPR (12.1 ± 5.4%) as compared to dispatcher-assisted full CPR (20.7 ± 8.1%). Compression depth was similar in all three groups: 40.6 ± 13.0 mm (unassisted CPR), 41.0 ± 12.2 mm (DACO-CPR) and 38.8 ± 15.8 mm (dispatcher-assisted full CPR). Average compression frequency was highest in the DACO-CPR group (65.2 ± 22.4 min) compared with the unassisted CPR group (35.6 ± 24.2 min) and the dispatcher-assisted full CPR group (44.5 ± 10.8 min). Correct rescue ventilation was given in 3.1 ± 11.1% (unassisted CPR) and 1.6 ± 16.1% (dispatcher-assisted full CPR) of all ventilation attempts. Best quality of CPR was achieved by DACO-CPR because of superior compression frequencies and reduced NFT. In contrast, the full dispatcher-assisted CPR with a longer initial instructing phase (initial NFT) did not result in enhanced CPR quality or an optimised compression depth.

Enabling the extended compact genetic algorithm for real-parameter optimization by using adaptive discretization.

PubMed

Chen, Ying-ping; Chen, Chao-Hong

2010-01-01

An adaptive discretization method, called split-on-demand (SoD), enables estimation of distribution algorithms (EDAs) for discrete variables to solve continuous optimization problems. SoD randomly splits a continuous interval if the number of search points within the interval exceeds a threshold, which is decreased at every iteration. After the split operation, the nonempty intervals are assigned integer codes, and the search points are discretized accordingly. As an example of using SoD with EDAs, the integration of SoD and the extended compact genetic algorithm (ECGA) is presented and numerically examined. In this integration, we adopt a local search mechanism as an optional component of our back end optimization engine. As a result, the proposed framework can be considered as a memetic algorithm, and SoD can potentially be applied to other memetic algorithms. The numerical experiments consist of two parts: (1) a set of benchmark functions on which ECGA with SoD and ECGA with two well-known discretization methods: the fixed-height histogram (FHH) and the fixed-width histogram (FWH) are compared; (2) a real-world application, the economic dispatch problem, on which ECGA with SoD is compared to other methods. The experimental results indicate that SoD is a better discretization method to work with ECGA. Moreover, ECGA with SoD works quite well on the economic dispatch problem and delivers solutions better than the best known results obtained by other methods in existence.

Arrhythmias

MedlinePlus

... sign of other heart problems, or an immediate danger to your health. ... patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine . 25th ed. Philadelphia, PA: ...

An Architecture for a Problem-Solving Assessment Authoring and Delivery System

DTIC Science & Technology

2006-06-01

know it works? In J. Willis (Series Ed.) & W. F. Heinecke & L. Blasi (Vol. Eds.), Research methods for educational technology: Vol. 1. Methods of...use of formal assessment in the classroom. In W. Hawley (Ed.) (with D. L. Rollie), The keys to effective schools: Educational reform as continuous

Performance and economy of a fault-tolerant multiprocessor

NASA Technical Reports Server (NTRS)

Lala, J. H.; Smith, C. J.

1979-01-01

The FTMP (Fault-Tolerant Multiprocessor) is one of two central aircraft fault-tolerant architectures now in the prototype phase under NASA sponsorship. The intended application of the computer includes such critical real-time tasks as 'fly-by-wire' active control and completely automatic Category III landings of commercial aircraft. The FTMP architecture is briefly described and it is shown that it is a viable solution to the multi-faceted problems of safety, speed, and cost. Three job dispatch strategies are described, and their results with respect to job-starting delay are presented. The first strategy is a simple First-Come-First-Serve (FCFS) job dispatch executive. The other two schedulers are an adaptive FCFS and an interrupt driven scheduler. Three failure modes are discussed, and the FTMP survival probability in the face of random hard failures is evaluated. It is noted that the hourly cost of operating two FTMPs in a transport aircraft can be as little as one-to-two percent of the total flight-hour cost of the aircraft.

Proportional fair scheduling algorithm based on traffic in satellite communication system

NASA Astrophysics Data System (ADS)

Pan, Cheng-Sheng; Sui, Shi-Long; Liu, Chun-ling; Shi, Yu-Xin

2018-02-01

In the satellite communication network system, in order to solve the problem of low system capacity and user fairness in multi-user access to satellite communication network in the downlink, combined with the characteristics of user data service, an algorithm study on throughput capacity and user fairness scheduling is proposed - Proportional Fairness Algorithm Based on Traffic(B-PF). The algorithm is improved on the basis of the proportional fairness algorithm in the wireless communication system, taking into account the user channel condition and caching traffic information. The user outgoing traffic is considered as the adjustment factor of the scheduling priority and presents the concept of traffic satisfaction. Firstly,the algorithm calculates the priority of the user according to the scheduling algorithm and dispatches the users with the highest priority. Secondly, when a scheduled user is the business satisfied user, the system dispatches the next priority user. The simulation results show that compared with the PF algorithm, B-PF can improve the system throughput, the business satisfaction and fairness.

Microgrid energy dispatching for industrial zones with renewable generations and electric vehicles via stochastic optimization and learning

NASA Astrophysics Data System (ADS)

Zhang, Kai; Li, Jingzhi; He, Zhubin; Yan, Wanfeng

2018-07-01

In this paper, a stochastic optimization framework is proposed to address the microgrid energy dispatching problem with random renewable generation and vehicle activity pattern, which is closer to the practical applications. The patterns of energy generation, consumption and storage availability are all random and unknown at the beginning, and the microgrid controller design (MCD) is formulated as a Markov decision process (MDP). Hence, an online learning-based control algorithm is proposed for the microgrid, which could adapt the control policy with increasing knowledge of the system dynamics and converges to the optimal algorithm. We adopt the linear approximation idea to decompose the original value functions as the summation of each per-battery value function. As a consequence, the computational complexity is significantly reduced from exponential growth to linear growth with respect to the size of battery states. Monte Carlo simulation of different scenarios demonstrates the effectiveness and efficiency of our algorithm.

Study on optimal configuration of the grid-connected wind-solar-battery hybrid power system

NASA Astrophysics Data System (ADS)

Ma, Gang; Xu, Guchao; Ju, Rong; Wu, Tiantian

2017-08-01

The capacity allocation of each energy unit in the grid-connected wind-solar-battery hybrid power system is a significant segment in system design. In this paper, taking power grid dispatching into account, the research priorities are as follows: (1) We establish the mathematic models of each energy unit in the hybrid power system. (2) Based on dispatching of the power grid, energy surplus rate, system energy volatility and total cost, we establish the evaluation system for the wind-solar-battery power system and use a number of different devices as the constraint condition. (3) Based on an improved Genetic algorithm, we put forward a multi-objective optimisation algorithm to solve the optimal configuration problem in the hybrid power system, so we can achieve the high efficiency and economy of the grid-connected hybrid power system. The simulation result shows that the grid-connected wind-solar-battery hybrid power system has a higher comprehensive performance; the method of optimal configuration in this paper is useful and reasonable.

"Exercise dependence"--a problem or natural result of high activity?

PubMed

Phelan, Suzanne; Bond, Dale S; Lang, Wei; Jordan, Dustin; Wing, Rena R

2011-11-01

To compare physical activity (PA) and exercise dependence (ED) in 267 weight-loss maintainers (WLM) and 213 normal-weight (NW) controls. PA and ED assessed via accelerometery and the Exercise Dependence Questionnaire. WLM had higher PA levels and ED scores than those of NW (P< 0.0001). WLM status (P=.006) and higher PA (P=.0001) were independently related to higher ED, although effect sizes were larger for PA. Exercising for weight control was the ED domain that most discriminated WLM from NW. WLM have higher ED scores than do NW, but this is mostly due to exercising for weight control.

Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs.

PubMed

Dami, Fabrice; Fuchs, Vincent; Praz, Laurent; Vader, John-Paul

2010-07-01

In order to improve the quality of our Emergency Medical Services (EMS), to raise bystander cardiopulmonary resuscitation rates and thereby meet what is becoming a universal standard in terms of quality of emergency services, we decided to implement systematic dispatcher-assisted or telephone-CPR (T-CPR) in our medical dispatch center, a non-Advanced Medical Priority Dispatch System. The aim of this article is to describe the implementation process, costs and results following the introduction of this new "quality" procedure. This was a prospective study. Over an 8-week period, our EMS dispatchers were given new procedures to provide T-CPR. We then collected data on all non-traumatic cardiac arrests within our state (Vaud, Switzerland) for the following 12 months. For each event, the dispatchers had to record in writing the reason they either ruled out cardiac arrest (CA) or did not propose T-CPR in the event they did suspect CA. All emergency call recordings were reviewed by the medical director of the EMS. The analysis of the recordings and the dispatchers' written explanations were then compared. During the 12-month study period, a total of 497 patients (both adults and children) were identified as having a non-traumatic cardiac arrest. Out of this total, 203 cases were excluded and 294 cases were eligible for T-CPR. Out of these eligible cases, dispatchers proposed T-CPR on 202 occasions (or 69% of eligible cases). They also erroneously proposed T-CPR on 17 occasions when a CA was wrongly identified (false positive). This represents 7.8% of all T-CPR. No costs were incurred to implement our study protocol and procedures. This study demonstrates it is possible, using a brief campaign of sensitization but without any specific training, to implement systematic dispatcher-assisted cardiopulmonary resuscitation in a non-Advanced Medical Priority Dispatch System such as our EMS that had no prior experience with systematic T-CPR. The results in terms of T-CPR delivery rate and false positive are similar to those found in previous studies. We found our results satisfying the given short time frame of this study. Our results demonstrate that it is possible to improve the quality of emergency services at moderate or even no additional costs and this should be of interest to all EMS that do not presently benefit from using T-CPR procedures. EMS that currently do not offer T-CPR should consider implementing this technique as soon as possible, and we expect our experience may provide answers to those planning to incorporate T-CPR in their daily practice.

Comparison of emergency department crowding scores: a discrete-event simulation approach.

PubMed

Ahalt, Virginia; Argon, Nilay Tanık; Ziya, Serhan; Strickler, Jeff; Mehrotra, Abhi

2018-03-01

According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power. We perform these evaluations by first building a discrete-event simulation model of the ED, validating the results of the simulation model against observations at the ED under consideration, and utilizing the model results to investigate each of the three ED crowding scores under normal operating conditions and under two simulated outbreak scenarios in the ED. We conclude that, for this hospital, both EDWIN and NEDOCS prove to be helpful measures of current ED crowdedness, and both scores demonstrate the ability to anticipate impending crowdedness. Utilizing both EDWIN and NEDOCS scores in combination with the threshold values proposed in this work could provide a real-time alert for clinicians to anticipate impending crowding, which could lead to better preparation and eventually better patient care outcomes.

Human-factors engineering for smart transport: design support for car drivers and train traffic controllers.

PubMed

Lenior, Dick; Janssen, Wiel; Neerincx, Mark; Schreibers, Kirsten

2006-07-01

The theme Smart Transport can be described as adequate human-system symbiosis to realize effective, efficient and human-friendly transport of goods and information. This paper addresses how to attune automation to human (cognitive) capacities (e.g. to take care of information uncertainty, operator trust and mutual man-machine adaptations). An introduction to smart transport is presented, including examples of best practice for engineering human factors in the vehicle ergonomics and train traffic control domain. The examples are representative of an ongoing trend in automation and they show how the human role changes from controller to supervisor. Section 2 focuses on the car driver and systems that support, or sometimes even take over, critical parts of the driving task. Due to the diversity of driver ability, driving context and dependence between driver and context factors, there is a need for personalised, adaptive and integrated support. Systematic research is needed to establish sound systems. Section 3 focuses on the train dispatcher support systems that predict train movements, detect potential conflicts and show the dispatcher the possibilities available to solve the detected problems. Via thorough analysis of both the process to be controlled and the dispatcher's tasks and cognitive needs, support functions were developed as part of an already very complex supervision and control system. The two examples, although from a different field, both show the need for further development in cognitive modelling as well as for the value of sound ergonomics task analysis in design practice.

Understanding drivers of Demand for Emergency Service Trends in Years 2010-2014 in New South Wales: An initial overview of the DESTINY project.

PubMed

Dinh, Michael M; Berendsen Russell, Saartje; Bein, Kendall J; Chalkley, Dane; Muscatello, David; Paoloni, Richard; Ivers, Rebecca

2016-04-01

This study aims to describe the general characteristics and data definitions used in a population-based data set of ED presentations in New South Wales (NSW), used to form the basis of future-trend analyses. Retrospective analysis of the Emergency Department Data Collection registry, which provided clinical and demographic information of ED presentations across all EDs in NSW between 2010 and 2014. Presenting problems and ED diagnoses were classified using broad clinical categories including injury/musculoskeletal, respiratory, cardiovascular, ear nose and throat, and mental health. Presentations were linked by patient to allow for analysis of representations, and population data were obtained from the Australian Bureau of Statistics. There were 11.8 million presentations that were analysed from 150 EDs (80.6% of all EDs). The rate of ED presentations was highest in those aged 85 years and older and appears to increase across all age groups between 2010 and 2014. The most common ED diagnosis categories were injury/musculoskeletal (27.5%) followed by abdominal/gastrointestinal (12.3%), respiratory (9%) and cardiovascular (8%). Both the Systematised Nomenclature of Medicine Clinical Terms (66%) and the International Classification of Diseases (24%) were used to code ED diagnoses. The elderly population had the highest rate of ED attendances. The use of diverse diagnosis classifications and source information systems may present problems with further analysis. Patterns and characteristics of ED presentations in NSW were broadly consistent with those reported in other states in Australia. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Youth With Autism Spectrum Disorder in the Emergency Department.

PubMed

Lytle, Sarah; Hunt, Andrew; Moratschek, Sonal; Hall-Mennes, Marcie; Sajatovic, Martha

2018-05-08

This comprehensive literature review summarizes reports on emergency department (ED) use by youth with autism spectrum disorder (ASD). We conducted a systematic search of the PubMed, PsycINFO, CINAHL, and EMBASE databases (1985-2016), limited to studies published in English. The following search terms were used: autism, autistic, Asperger, emergency department/room/physician/doctor/treatment/medicine, childhood developmental disorders (pervasive), and emergencies. Our search found 332 articles, of which 12 specifically addressed ED services in ASD youth. Abstracts or full text articles were reviewed for relevance. Case reports, review articles, and studies that reported on adults only or that included youth and adults but did not stratify results by age were excluded. Youth (aged 0-17 years) with ASD were up to 30 times more likely to present to the ED than youth without ASD. Individuals with ASD who visited the ED were older, more likely to have public insurance, and more likely to have nonurgent ED visits. For youth with ASD, up to 13% of visits were for behavioral or psychiatric problems, whereas for youth without ASD less than 2% were for psychiatric problems. ASD youth were more likely to present for externalizing problems or psychotic symptoms. Youth with ASD were also likely to have repeat visits to the ED and more likely to be admitted to a psychiatric unit or medical floor than youth without ASD. This review found significant gaps in the literature related to ED service use by youth with ASD. More research is needed to avoid unnecessary ED utilization and hospitalization, reduce medical costs, and improve outcome for youth with ASD. © Copyright 2018 Physicians Postgraduate Press, Inc.

Using Ontological Engineering to Overcome AI-ED Problems: Contribution, Impact and Perspectives

ERIC Educational Resources Information Center

Mizoguchi, Riichiro; Bourdeau, Jacqueline

2016-01-01

This article reflects on the ontology engineering methodology discussed by the paper entitled "Using Ontological Engineering to Overcome AI-ED Problems" published in this journal in 2000. We discuss the achievements obtained in the last 10 years, the impact of our work as well as recent trends and perspectives in ontology engineering for…

Data centers as dispatchable loads to harness stranded power

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Kibaek; Yang, Fan; Zavala, Victor M.

Here, we analyze how traditional data center placement and optimal placement of dispatchable data centers affect power grid efficiency. We use detailed network models, stochastic optimization formulations, and diverse renewable generation scenarios to perform our analysis. Our results reveal that significant spillage and stranded power will persist in power grids as wind power levels are increased. A counter-intuitive finding is that collocating data centers with inflexible loads next to wind farms has limited impacts on renewable portfolio standard (RPS) goals because it provides limited system-level flexibility. Such an approach can, in fact, increase stranded power and fossil-fueled generation. In contrast,more » optimally placing data centers that are dispatchable provides system-wide flexibility, reduces stranded power, and improves efficiency. In short, optimally placed dispatchable computing loads can enable better scaling to high RPS. In our case study, we find that these dispatchable computing loads are powered to 60-80% of their requested capacity, indicating that there are significant economic incentives provided by stranded power.« less

Data centers as dispatchable loads to harness stranded power

DOE PAGES

Kim, Kibaek; Yang, Fan; Zavala, Victor M.; ...

2016-07-20

Here, we analyze how traditional data center placement and optimal placement of dispatchable data centers affect power grid efficiency. We use detailed network models, stochastic optimization formulations, and diverse renewable generation scenarios to perform our analysis. Our results reveal that significant spillage and stranded power will persist in power grids as wind power levels are increased. A counter-intuitive finding is that collocating data centers with inflexible loads next to wind farms has limited impacts on renewable portfolio standard (RPS) goals because it provides limited system-level flexibility. Such an approach can, in fact, increase stranded power and fossil-fueled generation. In contrast,more » optimally placing data centers that are dispatchable provides system-wide flexibility, reduces stranded power, and improves efficiency. In short, optimally placed dispatchable computing loads can enable better scaling to high RPS. In our case study, we find that these dispatchable computing loads are powered to 60-80% of their requested capacity, indicating that there are significant economic incentives provided by stranded power.« less

Asherman syndrome

MedlinePlus

... 6th ed. Philadelphia, PA: Elsevier; 2012:chap 18. Simpson JL, Jauniaux ERM. Early pregnancy loss and stillbirth. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem ...

Solar hybrid power plants: Solar energy contribution in reaching full dispatchability and firmness

NASA Astrophysics Data System (ADS)

Servert, Jorge F.; López, Diego; Cerrajero, Eduardo; Rocha, Alberto R.; Pereira, Daniel; Gonzalez, Lucía

2016-05-01

Renewable energies for electricity generation have always been considered as a risk for the electricity system due to its lack of dispatchability and firmness. Renewable energies penetration is constrained to strong grids or else its production must be limited to ensure grid stability, which is kept by the usage of hydropower energy or fossil-fueled power plants. CSP technology has an opportunity to arise not only as a dispatchable and firm technology, but also as an alternative that improves grid stability. To achieve that objective, solar hybrid configurations are being developed, being the most representative three different solutions: SAPG, ISCC and HYSOL. A reference scenario in Kingdom of Saudi Arabia (KSA) has been defined to compare these solutions, which have been modelled, simulated and evaluated in terms of dispatchability and firmness using ratios defined by the authors. The results show that: a) SAPG obtains the highest firmness KPI values, but no operation constraints have been considered for the coal boiler and the solar energy contribution is limited to 1.7%, b) ISCC provides dispatchable and firm electricity production but its solar energy contribution is limited to a 6.4%, and c) HYSOL presents the higher solar energy contribution of all the technologies considered: 66.0% while providing dispatchable and firm generation in similar conditions as SAPG and ISCC.

Can written information material help to increase treatment motivation in patients with erectile dysfunction? A survey of 1188 men.

PubMed

Günzler, C; Kriston, L; Stodden, V; Leiber, C; Berner, M M

2007-01-01

Although erectile dysfunction (ED) prevalence is high, patients and physicians often have problems discussing this issue. This study examines whether written information material increases motivation to seek treatment in patients with ED. For the study, persons were able to order information material about sexual problems within the context of a public campaign. From a total of 70,000 responders, 8000 persons were asked to fill out an epidemiological questionnaire. The response rate yielded 18.4%, the data of 1188 men with ED were analyzed. As a result of the information material, 28.3% of the untreated men intended to seek treatment and 38.5% of the men who had not spoken with their physician about their problem, planned to do so now. Nearly all responders were satisfied with the information material. These data reflect the usefulness of written information for men with ED. It not only serves as an informational source for patients but may also encourage them to seek treatment.

Optimal Dispatch of Unreliable Electric Grid-Connected Diesel Generator-Battery Power Systems

NASA Astrophysics Data System (ADS)

Xu, D.; Kang, L.

2015-06-01

Diesel generator (DG)-battery power systems are often adopted by telecom operators, especially in semi-urban and rural areas of developing countries. Unreliable electric grids (UEG), which have frequent and lengthy outages, are peculiar to these regions. DG-UEG-battery power system is an important kind of hybrid power system. System dispatch is one of the key factors to hybrid power system integration. In this paper, the system dispatch of a DG-UEG-lead acid battery power system is studied with the UEG of relatively ample electricity in Central African Republic (CAR) and UEG of poor electricity in Congo Republic (CR). The mathematical models of the power system and the UEG are studied for completing the system operation simulation program. The net present cost (NPC) of the power system is the main evaluation index. The state of charge (SOC) set points and battery bank charging current are the optimization variables. For the UEG in CAR, the optimal dispatch solution is SOC start and stop points 0.4 and 0.5 that belong to the Micro-Cycling strategy and charging current 0.1 C. For the UEG in CR, the optimal dispatch solution is of 0.1 and 0.8 that belongs to the Cycle-Charging strategy and 0.1 C. Charging current 0.1 C is suitable for both grid scenarios compared to 0.2 C. It makes the dispatch strategy design easier in commercial practices that there are a few very good candidate dispatch solutions with system NPC values close to that of the optimal solution for both UEG scenarios in CAR and CR.

The appropriateness of emergency medical service responses in the eThekwini district of KwaZulu-Natal, South Africa.

PubMed

Newton, P R; Naidoo, R; Brysiewicz, P

2015-09-19

 Emergency medical services (EMS) are sometimes required to respond to cases that are later found not to be emergencies, resulting in high levels of inappropriate responses. This study evaluated the extent to which this occurs.  All cases dispatched over 72 hours by the eThekwini EMS in Durban, South Africa, were prospectively enrolled in a quantitative descriptive study. Vehicle control forms containing dispatch data were matched and compared with patient report forms containing epidemiological and clinical data to describe the nature and extent of inappropriate responses based on patient need. Data were subjected to simple descriptive analysis, correlations and χ2 testing.  A total of 1 385 cases met the study inclusion criteria. Marked variations existed between dispatch and on-scene priority settings, most notably in the highest priority 'red-code' category, which constituted >56% of cases dispatched yet accounted for <2% at the scene (p<0.001). Conversely, >80% of 'red-code' dispatches required a lower priority response. When comparing resource allocation according to patient interventional needs, >58% of cases required either no intervention or transport only and almost 36% required basic life support intervention only (p<0.001). Moreover, <12% of advanced life support dispatches were for patients found to be 'red code' at the scene.  There is a significant mismatch between the dispatch of EMS resources and actual patient need in the eThekwini district, with significantly high levels of inappropriate emergency responses.

Chronic fatigue in Ehlers-Danlos syndrome-Hypermobile type.

PubMed

Hakim, Alan; De Wandele, Inge; O'Callaghan, Chris; Pocinki, Alan; Rowe, Peter

2017-03-01

Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems. Other problems that commonly contribute to fatigue in EDS include sleep disorders, chronic pain, deconditioning, cardiovascular autonomic dysfunction, bowel and bladder dysfunction, psychological issues, and nutritional deficiencies. While there is no specific pharmacological treatment for fatigue, many medications are effective for specific symptoms (such as headache, menstrual dysfunction, or myalgia) and for co-morbid conditions that result in fatigue, including orthostatic intolerance and insomnia. Comprehensive treatment of fatigue needs to also evaluate for biomechanical problems that are common in EDS, and usually involves skilled physical therapy and attention to methods to prevent deconditioning. In addition to managing specific symptoms, treatment of fatigue in EDS also needs to focus on maintaining function and providing social, physical, and nutritional support, as well as providing on-going medical evaluation of new problems and review of new evidence about proposed treatments. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial

PubMed Central

Bedini, Sarah; Braun, François; Weibel, Laurence; Aussedat, Michel; Pereira, Bruno; Dutheil, Frédéric

2017-01-01

Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: Incoming emergency call, Dispatch and Re-assessment. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i.e. 6 consecutive times, starting 15 minutes after the first life-and-death incoming emergency call between 2 and 5 pm during three types of shift. We measured saliva cortisol every 2 hours over a control day, from 7am to 9pm. Perceived stress was assessed by a visual analog scale. We recruited 22 phone operators aged 36.4+/-10.8 years old (14 women and 8 men). Cortisol values were higher during the Incoming emergency call shift than during the Dispatch (p = .04) and Re-assessment (p = .04) shifts. The increase in cortisol levels was greater in men than in women (p = .009). There were no differences between control values and those of the three shifts. The kinetics of cortisol increased with greater perceived stress overall (p < .001) and for each type of shift (Incoming emergency call, p = .02; Dispatch p = .03; Re-assessment: p < .001). The kinetics of cortisol in response to incoming emergency calls was greater when the call was an absolute emergency (p = .03), and also tended to further increase when a subsequent absolute incoming emergency call was received (p = 0.07). In conclusion, the incoming emergency call shift carries particular risk for dispatchers, who have greater perceived stress and a greater increase in cortisol levels. PMID:28505199

Stress and salivary cortisol in emergency medical dispatchers: A randomized shifts control trial.

PubMed

Bedini, Sarah; Braun, François; Weibel, Laurence; Aussedat, Michel; Pereira, Bruno; Dutheil, Frédéric

2017-01-01

Stress at work is a public health concern. Phone operators in emergency medical dispatch centers are particularly at risk. We aimed to demonstrate that the most stressful time for emergency medical dispatchers is the shift when they receive emergency incoming calls, with cortisol as a biomarker of stress. For each emergency medical dispatcher, we measured outcomes over a control day and during three types of shift: Incoming emergency call, Dispatch and Re-assessment. The pattern of shifts was randomized. Saliva was sampled every 15 minutes for 2 hours, i.e. 6 consecutive times, starting 15 minutes after the first life-and-death incoming emergency call between 2 and 5 pm during three types of shift. We measured saliva cortisol every 2 hours over a control day, from 7am to 9pm. Perceived stress was assessed by a visual analog scale. We recruited 22 phone operators aged 36.4+/-10.8 years old (14 women and 8 men). Cortisol values were higher during the Incoming emergency call shift than during the Dispatch (p = .04) and Re-assessment (p = .04) shifts. The increase in cortisol levels was greater in men than in women (p = .009). There were no differences between control values and those of the three shifts. The kinetics of cortisol increased with greater perceived stress overall (p < .001) and for each type of shift (Incoming emergency call, p = .02; Dispatch p = .03; Re-assessment: p < .001). The kinetics of cortisol in response to incoming emergency calls was greater when the call was an absolute emergency (p = .03), and also tended to further increase when a subsequent absolute incoming emergency call was received (p = 0.07). In conclusion, the incoming emergency call shift carries particular risk for dispatchers, who have greater perceived stress and a greater increase in cortisol levels.

Interpersonal Problem Areas and Alexithymia in Adolescent Girls with Loss of Control Eating

PubMed Central

Berger, Sarah Shafer; Elliott, Camden; Ranzenhofer, Lisa M.; Shomaker, Lauren B.; Hannallah, Louise; Field, Sara E.; Young, Jami F.; Sbrocco, Tracy; Wilfley, Denise E.; Yanovski, Jack A.; Tanofsky-Kraff, Marian

2014-01-01

This study investigated the links among interpersonal problem areas, depression, and alexithymia in adolescent girls at high-risk for excessive weight gain and binge eating disorder. Participants were 56 girls (Mage = 14.30, SD = 1.56; 53% non-Hispanic White) with a body mass index (BMI, kg/m2) between the 75th and 97th percentiles (MBMI-z = 1.57, SD = 0.32). By design, all participants reported loss of control eating patterns in the past month. Adolescents were individually interviewed prior to participating in a group interpersonal psychotherapy obesity and eating disorder prevention program, termed IPT for the prevention of excessive weight gain (IPT-WG). Participants’ interpersonal problem areas were coded by trained raters. Participants also completed questionnaires assessing depression and alexithymia. Primary interpersonal problem areas were categorized as interpersonal deficits (as defined in the eating disorders (ED) literature) (n = 29), role disputes (n = 22), or role transitions (n = 5). Girls with interpersonal deficits-ED had greater depressive symptoms and alexithymia than girls with role disputes (ps ≤ 0.01). However, girls with role transitions did not differ from girls with interpersonal deficits-ED or role disputes. Interpersonal problem area had an indirect association with depression via alexithymia; interpersonal deficits-ED were related to greater alexithymia, which in turn, was related to greater depressive symptoms (p = 0.01). Among girls at-risk for excess weight gain and eating disorders, those with interpersonal deficits-ED appear to have greater distress as compared to girls with role disputes or role transitions. Future research is required to elucidate the impact of interpersonal problem areas on psychotherapy outcomes. PMID:24139852

Amniotic fluid

MedlinePlus

Burton GJ, Sibley CP, Jauniaux ERM. Placental anatomy and physiology. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 1. ...

Mallory-Weiss tear

MedlinePlus

... the liver and problems with blood clotting make future bleeding episodes more likely to occur. ... Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

Difficulty eating and significant weight loss in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

PubMed

Baeza-Velasco, Carolina; Van den Bossche, Thomas; Grossin, Daniel; Hamonet, Claude

2016-06-01

Joint Hypermobility Syndrome, also known as Ehlers-Danlos Syndrome Hypermobility Type (JHS/EDS-HT), is a heritable disorder of connective tissue, common but poorly known by the medical community. Although generalized joint hypermobility and fragility of tissues have been described as core features, recent research highlights the multisystemic nature of JHS/EDS-HT, which presents with a wide range of articular and extra-articular symptoms. Among these, gastrointestinal problems, temporomandibular disorders, and smell and taste abnormalities are common among those affected, having significant implications for eating. The present work reviews the literature linking JHS/EDS-HT and eating problems. Two illustrative case reports, in which JHS/EDS-HT manifestations contribute to developing and maintaining disturbed eating behaviors and significant weight loss, are presented.

Feminist approaches to Anorexia Nervosa: a qualitative study of a treatment group.

PubMed

Holmes, Su; Drake, Sarah; Odgers, Kelsey; Wilson, Jon

2017-01-01

Eating disorders (EDs) are now often approached as biopsychosocial problems. But it has been suggested by scholars interested in sociocultural factors that all is not equal within this biospsychosocial framework, with the 'social' aspects of the equation relegated to secondary factors within ED treatment contexts. Although sociocultural influences are well-established as risk factors for EDs, the exploration of whether or how such perspectives are useful in treatment has been little explored. In responding to this context, this article seeks to discuss and evaluate a 10 week closed group intervention based on feminist approaches to EDs at a residential eating disorder clinic in the East of England. The data was collected via one-to-one qualitative interviews and then analysed using thematic discourse analysis. The participants suggested that the groups were helpful in enabling them to situate their problem within a broader cultural and group context, that they could operate as a form of 'protection' from ideologies regarding femininity, and that a focus on the societal contexts for EDs could potentially reduce feelings of self-blame. At the same time, the research pointed to the complexities of participants considering societal rather than individualised explanations for their problems, whilst it also confronted the implications of ambivalent responses toward feminism. Highly visible sociocultural factors in EDs - such as gender - may often be overlooked in ED clinical contexts. Although based on limited data, this research raises questions about the marginalisation of sociocultural factors in treatment, and the benefits and challenges including the latter may involve.

Real-Time, Wide Area Dispatch of Mobil Tank Trucks

DTIC Science & Technology

1987-01-01

human dispatchers it assists. Using CAD, Mobil has substantially re- duced costs and staff while improving customer service. I n the spring of 1985, a...process by establishing the Mobil order response center (MORC). To use MORC, the customer dials a toll-free number, available 24 hours a day, seven...MATS Figwe 3: Mobil light products order and dispatch information flow. Customers call an audio re- sponse computer system named MORC ( Mobil order

Clean Energy Generation and Dispatch in Reformed Wholesale Electricity Markets: Experience in the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Shengru; Hurlbut, David J; Li, Ma

In recent years, the US electricity market has undergone several stages of reform, and gradually formed the market where the wholesale electricity price is determined by the supply and demand. The US electricity market also changes along with the rapid development of clean energy, forming a number of the market mechanisms that is specifically developed for clean energy power generation characteristics. On the basis of discussing the pricing mechanism of US electricity market, this paper analyzes the experience and practice of encouraging renewable energy development policy and clean energy dispatch from the angle of market mechanism and dispatching decision, andmore » puts forward the reference for clean energy dispatching in China.« less

Project Integrate: Translating Screening and Brief Interventions for Alcohol Problems to a Community Hospital Emergency Department

ERIC Educational Resources Information Center

Mello, Michael J.; Baird, Janette; Nirenberg, Ted D.; Smith, Jennifer C.; Woolard, Robert H.; Dinwoodie, Robert G.

2009-01-01

Screening and brief intervention (SBI) for alcohol problems in the emergency department (ED) is effective. The objective of this study was to examine the translation of SBI into a busy community ED environment. The authors assessed key stakeholders views of SBI delivery model, then utilized feedback to adapt model. Adoption of SBI was recorded,…

Miscarriage

MedlinePlus

... Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2017:chap 41. Ellenson LH, Pirog EC. The ... Pathologic Basis of Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 22. Hobel CJ, Williams J. ...

Validation of the Inventory of Interpersonal Problems (IIP-64): a comparison of Swedish female outpatients with anorexia nervosa or bulimia nervosa and controls.

PubMed

Lindberg, Karolin; Nevonen, Lauri; Gustafsson, Sanna Aila; Nyman-Carlsson, Erika; Norring, Claes

2018-04-27

The aim of the study was to explore the psychometric properties of the Inventory of Interpersonal Problems (IIP-64) and to compare levels of interpersonal distress in Swedish female outpatients with anorexia nervosa or bulimia nervosa with age- and gender-matched controls. Totally, 401 participants were included; anorexia nervosa (n = 74), bulimia nervosa (n = 85) and controls (n = 242). All participants completed the IIP-64. The eating disorder (ED) patients also filled out the Eating Disorder Inventory-2/3 (EDI). Internal consistency of IIP-64 was acceptable to high. Principal component analyses with varimax rotation of the IIP-64 subscales confirmed the circumplex structure with two underlying orthogonal dimensions; affiliation and dominance. Significant correlations between EDI-3 composite scales ineffectiveness and interpersonal problems and IIP-64 were found. ED patients reported higher levels of interpersonal distress than controls on all but one subscale (intrusive/needy). IIP-64 can be considered to have acceptable to good reliability and validity in a Swedish ED sample. IIP-64 can be a useful complement in assessment of interpersonal problems in ED.

Substance Use as a Risk Factor for Sleep Problems Among Adolescents Presenting to the Emergency Department.

PubMed

Zhabenko, Olena; Austic, Elizabeth; Conroy, Deirdre A; Ehrlich, Peter; Singh, Vijay; Epstein-Ngo, Quyen; Cunningham, Rebecca M; Walton, Maureen A

2016-01-01

To determine correlates of sleep problems among adolescents. Specifically, to assess the relative strength of associations between sleep problems and dating victimization, reasons for emergency department (ED) visit, depression, unhealthy alcohol use, and other drug use (marijuana, nonmedical use of prescription opioids, stimulants, and tranquilizers). A total of 1852 adolescents aged 14 to 20 years presenting for care to the University of Michigan Emergency Department, Ann Arbor, Michigan, during 2011-2012, self-administered a computerized health survey. Sleep problems were identified if any of the 4 items on the Sleep Problems Questionnaire were rated by a patient as greater than 3 on a 0 to 5 scale. Adolescents who were too sick to be screened in the ED were eligible to participate in the study during their inpatient stay. Exclusion criteria for baseline included insufficient cognitive orientation precluding informed consent, not having parent/guardian present if younger than 18 years, medical severity precluding participation, active suicidal/homicidal ideation, non-English-speaking, deaf/visually impaired, or already participated in this study on a prior visit. 23.5% of adolescents reported clinically significant sleep problems. Female gender, depression, dating victimization, tobacco use, nonmedical use of prescription medication, and an ED visit for medical reasons were each associated with sleep problems among adolescents, even while controlling for age, other types of drug use, receiving public assistance, and dropping out of school. These exploratory findings indicate that ED-based screening and brief intervention approaches addressing substance use and/or dating victimization may need to account for previously undiagnosed sleep problems.

Chorionic villus sampling

MedlinePlus

... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: ... Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, ...

Preterm labor

MedlinePlus

... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: ... Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, ...

Delivery presentations

MedlinePlus

... Labor - delivery presentation; Occiput posterior; Occiput anterior; Brow presentation References Lanni SM, Gherman R, Gonik B. Malpresentations. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, ...

Impact of a Clinical Pharmacy Specialist in an Emergency Department for Seniors.

PubMed

Shaw, Paul B; Delate, Thomas; Lyman, Alfred; Adams, Jody; Kreutz, Heather; Sanchez, Julia K; Dowd, Mary Beth; Gozansky, Wendolyn

2016-02-01

This study assesses outcomes associated with the implementation of an emergency department (ED) for seniors in which a clinical pharmacy specialist, with specialized geriatric training that included medication management training, is a key member of the ED care team. This was a retrospective cohort analysis of patients aged 65 years or older who presented at an ED between November 1, 2012, and May 31, 2013. Three groups of seniors were assessed: treated by the clinical pharmacy specialist in the ED for seniors, treated in the ED for seniors but not by the clinical pharmacy specialist, and not treated in the ED for seniors. Outcomes included rates of an ED return visit, mortality and hospital admissions, and follow-up total health care costs. Multivariable regression modeling was used to adjust for any potential confounders in the associations between groups and outcomes. A total of 4,103 patients were included, with 872 (21%) treated in the ED for seniors and 342 (39%) of these treated by the clinical pharmacy specialist. Groups were well matched overall in patient characteristics. Patients who received medication review and management by the clinical pharmacy specialist did not experience a reduction in ED return visits, mortality, cost of follow-up care, or hospital admissions compared with the other groups. Of the patients treated by the clinical pharmacy specialist, 154 (45.0%) were identified as having at least 1 medication-related problem. Although at least 1 medication-related problem was identified in almost half of patients treated by the clinical pharmacy specialist in the ED for seniors, incorporation of a clinical pharmacy specialist into the ED staff did not improve clinical outcomes. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Energy drink use frequency among an international sample of people who use drugs: Associations with other substance use and well-being.

PubMed

Peacock, Amy; Bruno, Raimondo; Ferris, Jason; Winstock, Adam

2017-05-01

The study aims were to identify: i.) energy drink (ED), caffeine tablet, and caffeine intranasal spray use amongst a sample who report drug use, and ii.) the association between ED use frequency and demographic profile, drug use, hazardous drinking, and wellbeing. Participants (n=74,864) who reported drug use completed the online 2014 Global Drug Survey. They provided data on demographics, ED use, and alcohol and drug use, completed the Alcohol Use Disorders Identification Test (AUDIT) and Personal Wellbeing Index (PWI), and reported whether they wished to reduce alcohol use. Lifetime ED, caffeine tablet and intranasal caffeine spray use were reported by 69.2%, 24.5% and 4.9%. Median age of ED initiation was 16 years. For those aged 16-37, median years using EDs increased from 4 to 17 years of consumption, where it declined thereafter. Greater ED use frequency was associated with: being male; under 21 years of age; studying; and past year caffeine tablet/intranasal spray, tobacco, cannabis, amphetamine, MDMA, and cocaine use. Past year, infrequent (1-4days) and frequent (≥5days) past month ED consumers reported higher AUDIT scores and lower PWI scores than lifetime abstainers; past month consumers were less likely to report a desire to reduce alcohol use. ED use is part of a complex interplay of drug use, alcohol problems, and poorer personal wellbeing, and ED use frequency may be a flag for current/future problems. Prospective research is required exploring where ED use fits within the trajectory of other alcohol and drug use. Copyright © 2017 Elsevier B.V. All rights reserved.

Pre-recorded instructional audio vs. dispatchers' conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study.

PubMed

Birkun, Alexei; Glotov, Maksim; Ndjamen, Herman Franklin; Alaiye, Esther; Adeleke, Temidara; Samarin, Sergey

2018-01-01

To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation. It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio ( n =57); or (2) verbal dispatcher assistance ( n =52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the first compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded. There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P >0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the first compression (86.0±14.3 vs. 91.2±14.2 s, P <0.05), higher compression rate (94.9±26.4 vs. 89.1±32.8 min -1 ) and number of compressions provided (170.2±48.0 vs. 156.2±60.7). When provided by untrained persons in the simulated settings, the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.

Predictive Ability of an Emergency Medical Dispatch Stroke Diagnostic Tool in Identifying Hospital-Confirmed Strokes.

PubMed

Clawson, Jeff J; Scott, Greg; Gardett, Isabel; Youngquist, Scott; Taillac, Peter; Fivaz, Conrad; Olola, Christopher

2016-08-01

Early hospital notification of a possible stroke arriving via emergency medical services (EMS) can prepare stroke center personnel for timely treatment, especially timely administration of tissue plasminogen activator. Stroke center notification from the emergency dispatch center-before responders reach the scene-may promote even earlier and faster system activation, meaning that stroke center teams may be ready to receive patients as soon as the ambulance arrives. This study evaluates the use of a Medical Priority Dispatch System (MPDS; Priority Dispatch Corp., Salt Lake City, UT) Stroke Diagnostic Tool (SDxT) to identify possible strokes early by comparing the tools' results to on-scene and hospital findings. The retrospective descriptive study utilized stroke data from 3 sources: emergency medical dispatch, EMS, and emergency department/hospital. A total of 830 cases were collected between June 2012 and December 2013, of which 603 (72.7%) had matching dispatch records. Of the 603 cases, 304 (50.4%) were handled using MPDS Stroke Protocol 28. The SDxT had an 86.4% ability (OR [95% CI]: 2.3 [1.5, 3.5]) to effectively identify strokes among all the hospital-confirmed stroke cases (sensitivity), and a 26.6% ability to effectively identify nonstrokes among all the hospital-confirmed nonstroke cases (specificity). The SDxT demonstrated a very high sensitivity, compared to similar tools used in the field and at dispatch. The specificity was somewhat low, but this was expected-and is intended in the creation of protocols to be used over the phone in emergency situations. The tool is a valuable method for identifying strokes early and may allow early hospital notification. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A novel protocol for dispatcher assisted CPR improves CPR quality and motivation among rescuers-A randomized controlled simulation study.

PubMed

Rasmussen, Stinne Eika; Nebsbjerg, Mette Amalie; Krogh, Lise Qvirin; Bjørnshave, Katrine; Krogh, Kristian; Povlsen, Jonas Agerlund; Riddervold, Ingunn Skogstad; Grøfte, Thorbjørn; Kirkegaard, Hans; Løfgren, Bo

2017-01-01

Emergency dispatchers use protocols to instruct bystanders in cardiopulmonary resuscitation (CPR). Studies changing one element in the dispatcher's protocol report improved CPR quality. Whether several changes interact is unknown and the effect of combining multiple changes previously reported to improve CPR quality into one protocol remains to be investigated. We hypothesize that a novel dispatch protocol, combining multiple beneficial elements improves CPR quality compared with a standard protocol. A novel dispatch protocol was designed including wording on chest compressions, using a metronome, regular encouragements and a 10-s rest each minute. In a simulated cardiac arrest scenario, laypersons were randomized to perform single-rescuer CPR guided with the novel or the standard protocol. a composite endpoint of time to first compression, hand position, compression depth and rate and hands-off time (maximum score: 22 points). Afterwards participants answered a questionnaire evaluating the dispatcher assistance. The novel protocol (n=61) improved CPR quality score compared with the standard protocol (n=64) (mean (SD): 18.6 (1.4)) points vs. 17.5 (1.7) points, p<0.001. The novel protocol resulted in deeper chest compressions (mean (SD): 58 (12)mm vs. 52 (13)mm, p=0.02) and improved rate of correct hand position (61% vs. 36%, p=0.01) compared with the standard protocol. In both protocols hands-off time was short. The novel protocol improved motivation among rescuers compared with the standard protocol (p=0.002). Participants guided with a standard dispatch protocol performed high quality CPR. A novel bundle of care protocol improved CPR quality score and motivation among rescuers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

View west within the periphery of the load dispatch model ...

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

View west within the periphery of the load dispatch model board, operator's console is at lower center and button board is at lower right of the photograph; section of model board shown covers substation from Perryman (left) to Frankford (right); instruments at right center of photograph formerly monitored energy usage and were replaced by computerized monitoring system. - Thirtieth Street Station, Load Dispatch Center, Thirtieth & Market Streets, Railroad Station, Amtrak (formerly Pennsylvania Railroad Station), Philadelphia, Philadelphia County, PA

Evaluating the CO 2 emissions reduction potential and cost of power sector re-dispatch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Steinberg, Daniel C.; Bielen, David A.; Townsend, Aaron

Prior studies of the U.S. electricity sector have recognized the potential to reduce carbon dioxide (CO2) emissions by substituting generation from coal-fired units with generation from under-utilized and lower-emitting natural gas-fired units; in fact, this type of 're-dispatch' was invoked as one of the three building blocks used to set the emissions targets under the Environmental Protection Agency's Clean Power Plan. Despite the existence of surplus natural gas capacity in the U.S., power system operational constraints not often considered in power sector policy analyses, such as transmission congestion, generator ramping constraints, minimum generation constraints, planned and unplanned generator outages, andmore » ancillary service requirements, could limit the potential and increase the cost of coal-to-gas re-dispatch. Using a highly detailed power system unit commitment and dispatch model, we estimate the maximum potential for re-dispatch in the Eastern Interconnection, which accounts for the majority of coal capacity and generation in the U.S. Under our reference assumptions, we find that maximizing coal-to-gas re-dispatch yields emissions reductions of 230 million metric tons (Mt), or 13% of power sector emissions in the Eastern Interconnection, with a corresponding average abatement cost of $15-$44 per metric ton of CO2, depending on the assumed supply elasticity of natural gas.« less

Cholesterol and lifestyle

MedlinePlus

... normal range. These healthy habits may help prevent future heart attacks and other health problems. Eat foods ... with health and disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine . 25th ed. Philadelphia, PA: ...

Interior view of Dispatch Office and counter, facing south ...

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

Interior view of Dispatch Office and counter, facing south - International Longshoremen's & Warehousemen's Union Hall, Naval Civil Engineering Laboratory, Port Hueneme Road, Port Hueneme, Ventura County, CA

International perspectives on emergency department crowding.

PubMed

Pines, Jesse M; Hilton, Joshua A; Weber, Ellen J; Alkemade, Annechien J; Al Shabanah, Hasan; Anderson, Philip D; Bernhard, Michael; Bertini, Alessio; Gries, André; Ferrandiz, Santiago; Kumar, Vijaya Arun; Harjola, Veli-Pekka; Hogan, Barbara; Madsen, Bo; Mason, Suzanne; Ohlén, Gunnar; Rainer, Timothy; Rathlev, Niels; Revue, Eric; Richardson, Drew; Sattarian, Mehdi; Schull, Michael J

2011-12-01

The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes. © 2011 by the Society for Academic Emergency Medicine.

Eating Disorder Psychopathology as a Marker of Psychosocial Distress and Suicide Risk in Female and Male Adolescent Psychiatric Inpatients

PubMed Central

Zaitsoff, Shannon L.; Grilo, Carlos M.

2009-01-01

Objective To examine psychosocial correlates of specific aspects of eating disorder (ED) psychopathology (i.e., dietary restriction, body dissatisfaction, binge eating, and self-induced vomiting) in psychiatrically-hospitalized adolescent girls and boys. Method Four hundred and ninety-two psychiatric inpatients (286 girls and 206 boys), aged 12 to 19 years, completed self-report measures of psychosocial and behavioral functioning including measures of suicide risk and ED psychopathology. Associations between ED psychopathology and psychosocial functioning were examined separately by sex and after controlling for depressive/negative affect using Beck Depression Inventory scores. Results Among boys and girls, after controlling for depressive/negative affect, ED psychopathology was significantly associated with anxiety, low self-esteem, and current distress regarding childhood abuse. Among girls, after controlling for depressive/negative affect, ED psychopathology was significantly related to hopelessness and suicidality. Among boys, after controlling for depressive/negative affect, ED psychopathology was positively related to self-reported history of sexual abuse and various externalizing problems (drug abuse, violence, and impulsivity). Conclusion In psychiatrically hospitalized adolescents, ED psychopathology may be an important marker of broad psychosocial distress and behavioral problems among girls and boys although the nature of the specific associations differs by sex. PMID:20152294

The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures.

PubMed

Guan, Yong; Wendong, Sun; Zhao, Shengtian; Liu, Tongyan; Liu, Yuqiang; Zhang, Xiulin; Yuan, Mingzhen

2015-01-01

Erectile dysfunction (ED) is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5) questionnaire. Nocturnal penile tumescence (NPT) testing confirmed the occurrence of ED in 96 (80%) patients on whom penile duplex ultrasound and neurophysiological testing were further performed. Of these ED patients 29 (30%) were demonstrated only with vascular abnormality, 41 (42.7%) were detected only with neural abnormality, 26 (27.1%) revealed mixed abnormalities. Of the 55 patients (29+26) with vascular problems, 7 patients (12.7%) with abnormal arterial response to intracavernous injection of Bimix (15mg papaverine and 1mg phentolamine), 31 (56.4%) with corporal veno-occlusive dysfunction and 17 (30.9%) had both problems. Of the 67 (41+26) patients with abnormal neurophysiological outcomes, 51 (76.1%) with abnormal bulbocavernosus re?ex (BCR), 20 (29.9%) with pathological pudendal nerve evoked potentials (PDEPs) and 25 (37.3%) with abnormal posterior tibial somatosensory nerve evoked potentials (PTSSEPs). Our observation indicated that neurogenic factors are important for the generation of ED in patients with pelvic fracture; venous impotence is more common than arteriogenic ED.

76 FR 29335 - Qualification, Service, and Use of Crewmembers and Aircraft Dispatchers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

...On January 12, 2009, the FAA published a notice of proposed rulemaking on qualification, service, and use of crewmembers and aircraft dispatchers. Because of the complexity of the issues and the concerns raised by commenters, the FAA is issuing this supplemental notice of proposed rulemaking. The FAA proposes to amend the regulations for crewmember and aircraft dispatcher training programs in domestic, flag, and supplemental operations. The proposed regulations enhance traditional training programs by requiring the use of flight simulation training devices for flightcrew members and including additional training and evaluation requirements for all crewmembers and aircraft dispatchers in areas that are critical to safety. The proposal also reorganizes and revises the qualification, training, and evaluation requirements. The proposed changes are intended to contribute significantly to reducing aviation accidents.

Tooth formation - delayed or absent

MedlinePlus

... missing teeth they never developed. Cosmetic or orthodontic dentistry can correct this problem. Causes Specific diseases can ... process. In: Dean JA, ed. McDonald and Avery's Dentistry for the Child and Adolescent . 10th ed. St. ...

Application of the Pareto principle to identify and address drug-therapy safety issues.

PubMed

Müller, Fabian; Dormann, Harald; Pfistermeister, Barbara; Sonst, Anja; Patapovas, Andrius; Vogler, Renate; Hartmann, Nina; Plank-Kiegele, Bettina; Kirchner, Melanie; Bürkle, Thomas; Maas, Renke

2014-06-01

Adverse drug events (ADE) and medication errors (ME) are common causes of morbidity in patients presenting at emergency departments (ED). Recognition of ADE as being drug related and prevention of ME are key to enhancing pharmacotherapy safety in ED. We assessed the applicability of the Pareto principle (~80 % of effects result from 20 % of causes) to address locally relevant problems of drug therapy. In 752 cases consecutively admitted to the nontraumatic ED of a major regional hospital, ADE, ME, contributing drugs, preventability, and detection rates of ADE by ED staff were investigated. Symptoms, errors, and drugs were sorted by frequency in order to apply the Pareto principle. In total, 242 ADE were observed, and 148 (61.2 %) were assessed as preventable. ADE contributed to 110 inpatient hospitalizations. The ten most frequent symptoms were causally involved in 88 (80.0 %) inpatient hospitalizations. Only 45 (18.6 %) ADE were recognized as drug-related problems until discharge from the ED. A limited set of 33 drugs accounted for 184 (76.0 %) ADE; ME contributed to 57 ADE. Frequency-based listing of ADE, ME, and drugs involved allowed identification of the most relevant problems and development of easily to implement safety measures, such as wall and pocket charts. The Pareto principle provides a method for identifying the locally most relevant ADE, ME, and involved drugs. This permits subsequent development of interventions to increase patient safety in the ED admission process that best suit local needs.

Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy.

PubMed

Smith, Silas W; Braun, James; Portelli, Ian; Malik, Sidrah; Asaeda, Glenn; Lancet, Elizabeth; Wang, Binhuan; Hu, Ming; Lee, David C; Prezant, David J; Goldfrank, Lewis R

2016-06-01

We aimed to evaluate emergency medical services (EMS) data as disaster metrics and to assess stress in surrounding hospitals and a municipal network after the closure of Bellevue Hospital during Hurricane Sandy in 2012. We retrospectively reviewed EMS activity and call types within New York City's 911 computer-assisted dispatch database from January 1, 2011, to December 31, 2013. We evaluated EMS ambulance transports to individual hospitals during Bellevue's closure and incremental recovery from urgent care capacity, to freestanding emergency department (ED) capability, freestanding ED with 911-receiving designation, and return of inpatient services. A total of 2,877,087 patient transports were available for analysis; a total of 707,593 involved Manhattan hospitals. The 911 ambulance transports disproportionately increased at the 3 closest hospitals by 63.6%, 60.7%, and 37.2%. When Bellevue closed, transports to specific hospitals increased by 45% or more for the following call types: blunt traumatic injury, drugs and alcohol, cardiac conditions, difficulty breathing, "pedestrian struck," unconsciousness, altered mental status, and emotionally disturbed persons. EMS data identified hospitals with disproportionately increased patient loads after Hurricane Sandy. Loss of Bellevue, a public, safety net medical center, produced statistically significant increases in specific types of medical and trauma transports at surrounding hospitals. Focused redeployment of human, economic, and social capital across hospital systems may be required to expedite regional health care systems recovery. (Disaster Med Public Health Preparedness. 2016;10:333-343).

Interior detail of dispatch boards in main hall, facing west ...

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

Interior detail of dispatch boards in main hall, facing west - International Longshoremen's & Warehousemen's Union Hall, Naval Civil Engineering Laboratory, Port Hueneme Road, Port Hueneme, Ventura County, CA

Erectile Dysfunction in the Older Adult Male.

PubMed

Mola, Joanna R

2015-01-01

Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options.

Application of a Design Morphology to the MX/OCC Definition of a Fault Detection and Dispatch System.

DTIC Science & Technology

1980-09-01

morphology appears to be effective on an unstructured problem and provides a useful vehicle for clearly defining the functions and tasks that meet the needs...approach used is a structured decision process which was successfully demonstrated in FY 78 on relatively simple mechanical equipment and has now been...including achievement of practical conclusions from the large scale optimization procedures. This design morphology provided a useful vehicle for

A Markov Decision Process Model for the Optimal Dispatch of Military Medical Evacuation Assets

DTIC Science & Technology

2014-03-27

further background on MEDEVAC and provides a review of pertinent literature . Section 3 provides a de- scription of the problem for which we develop our...best medical evacuation system possible, for those who follow in your footsteps . Special thanks goes to my wife and two children for their...order to generate the computational results necessary to make this paper a success. Lastly, I would like to thank the US Army Medical Evacuation

Restoration and Humanitarian Aid Delivery on Interdependent Transportation and Communication Networks After an Extreme Event

DTIC Science & Technology

2015-03-26

Transportation and Communication network Restoration and Distribution (TCRD) problem. In Chapter 4, we conduct computational tests on realistic networks using a...speed and overall demand fulfillment when deciding how many machines to dispatch. We found that there exist certain key communciation entities and...ACM symposium on Theory of Computing . ACM. 16. Holgúın-Veras, José, Jaller, Miguel, Van Wassenhove, Luk N, Pérez, Noel, & Wachtendorf, Tricia. 2012

Constructing probabilistic scenarios for wide-area solar power generation

DOE PAGES

Woodruff, David L.; Deride, Julio; Staid, Andrea; ...

2017-12-22

Optimizing thermal generation commitments and dispatch in the presence of high penetrations of renewable resources such as solar energy requires a characterization of their stochastic properties. In this study, we describe novel methods designed to create day-ahead, wide-area probabilistic solar power scenarios based only on historical forecasts and associated observations of solar power production. Each scenario represents a possible trajectory for solar power in next-day operations with an associated probability computed by algorithms that use historical forecast errors. Scenarios are created by segmentation of historic data, fitting non-parametric error distributions using epi-splines, and then computing specific quantiles from these distributions.more » Additionally, we address the challenge of establishing an upper bound on solar power output. Our specific application driver is for use in stochastic variants of core power systems operations optimization problems, e.g., unit commitment and economic dispatch. These problems require as input a range of possible future realizations of renewables production. However, the utility of such probabilistic scenarios extends to other contexts, e.g., operator and trader situational awareness. Finally, we compare the performance of our approach to a recently proposed method based on quantile regression, and demonstrate that our method performs comparably to this approach in terms of two widely used methods for assessing the quality of probabilistic scenarios: the Energy score and the Variogram score.« less

Constructing probabilistic scenarios for wide-area solar power generation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Woodruff, David L.; Deride, Julio; Staid, Andrea

Optimizing thermal generation commitments and dispatch in the presence of high penetrations of renewable resources such as solar energy requires a characterization of their stochastic properties. In this study, we describe novel methods designed to create day-ahead, wide-area probabilistic solar power scenarios based only on historical forecasts and associated observations of solar power production. Each scenario represents a possible trajectory for solar power in next-day operations with an associated probability computed by algorithms that use historical forecast errors. Scenarios are created by segmentation of historic data, fitting non-parametric error distributions using epi-splines, and then computing specific quantiles from these distributions.more » Additionally, we address the challenge of establishing an upper bound on solar power output. Our specific application driver is for use in stochastic variants of core power systems operations optimization problems, e.g., unit commitment and economic dispatch. These problems require as input a range of possible future realizations of renewables production. However, the utility of such probabilistic scenarios extends to other contexts, e.g., operator and trader situational awareness. Finally, we compare the performance of our approach to a recently proposed method based on quantile regression, and demonstrate that our method performs comparably to this approach in terms of two widely used methods for assessing the quality of probabilistic scenarios: the Energy score and the Variogram score.« less

Analyzing the Effect of Multi-fuel and Practical Constraints on Realistic Economic Load Dispatch using Novel Two-stage PSO

NASA Astrophysics Data System (ADS)

Chintalapudi, V. S.; Sirigiri, Sivanagaraju

2017-04-01

In power system restructuring, pricing the electrical power plays a vital role in cost allocation between suppliers and consumers. In optimal power dispatch problem, not only the cost of active power generation but also the costs of reactive power generated by the generators should be considered to increase the effectiveness of the problem. As the characteristics of reactive power cost curve are similar to that of active power cost curve, a nonconvex reactive power cost function is formulated. In this paper, a more realistic multi-fuel total cost objective is formulated by considering active and reactive power costs of generators. The formulated cost function is optimized by satisfying equality, in-equality and practical constraints using the proposed uniform distributed two-stage particle swarm optimization. The proposed algorithm is a combination of uniform distribution of control variables (to start the iterative process with good initial value) and two-stage initialization processes (to obtain best final value in less number of iterations) can enhance the effectiveness of convergence characteristics. Obtained results for the considered standard test functions and electrical systems indicate the effectiveness of the proposed algorithm and can obtain efficient solution when compared to existing methods. Hence, the proposed method is a promising method and can be easily applied to optimize the power system objectives.

Flair-fleet location and information reporting

NASA Technical Reports Server (NTRS)

Norman, E. R.; Dunlap, M. E.

1974-01-01

The FLAIR system, as now produced, automatically updates each vehicle's location and corresponding officer's status once each two seconds and presents this information to police dispatchers in the command and control center. The position of all vehicles available for assignment is displayed on a color video map at each dispatcher's console to an accuracy of 50 feet. This gives the dispatcher a continuous picture of the deployment of the total available force and thus complete command and control of all police under his responsibility.

An Overview of the Automated Dispatch Controller Algorithms in the System Advisor Model (SAM)

DOE Office of Scientific and Technical Information (OSTI.GOV)

DiOrio, Nicholas A

2017-11-22

Three automatic dispatch modes have been added to the battery model within the System Adviser Model. These controllers have been developed to perform peak shaving in an automated fashion, providing users with a way to see the benefit of reduced demand charges without manually programming a complicated dispatch control. A flexible input option allows more advanced interaction with the automated controller. This document will describe the algorithms in detail and present brief results on its use and limitations.

Sample EP Flow Analysis of Severely Damaged Networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Werley, Kenneth Alan; McCown, Andrew William

These are slides for a presentation at the working group meeting of the WESC SREMP Software Product Integration Team on sample EP flow analysis of severely damaged networks. The following topics are covered: ERCOT EP Transmission Model; Zoomed in to Houston and Overlaying StreetAtlas; EMPACT Solve/Dispatch/Shedding Options; QACS BaseCase Power Flow Solution; 3 Substation Contingency; Gen. & Load/100 Optimal Dispatch; Dispatch Results; Shed Load for Low V; Network Damage Summary; Estimated Service Areas (Potential); Estimated Outage Areas (potential).

Health, emergency department use, and early identification of young children exposed to trauma.

PubMed

Roberts, Yvonne Humenay; Huang, Cindy Y; Crusto, Cindy A; Kaufman, Joy S

2014-05-01

Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency departments (EDs) are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters). Describe the prevalence of physical health symptoms, ED use, and health-related problems in young children (birth through 5 years) affected by trauma, and to predict whether or not children experiencing trauma are more likely to be affected by health-related problems. Community-based, cross-sectional survey of 208 young children. Traumatic events were assessed by the Traumatic Events Screening Inventory - Parent Report Revised. Child health symptoms and health-related problems were measured using the Caregiver Information Questionnaire, developed by ORC Macro (Atlanta, GA). Seventy-two percent of children had experienced at least one type of traumatic event. Children exposed to trauma were also experiencing recent health-related events, including visits to the ED (32.2%) and the doctor (76.9%) for physical health symptoms, and recurring physical health problems (40.4%). Children previously exposed to high levels of trauma (four or more types of events) were 2.9 times more likely to report having had recently visited the ED for health purposes. Preventing recurrent trauma or recognizing early trauma exposure is difficult, but essential if long-term negative consequences are to be mitigated or prevented. Within EDs, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury, and mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

"Exercise Dependence"--A Problem or Natural Result of High Activity?

ERIC Educational Resources Information Center

Phelan, Suzanne; Bond, Dale S.; Lang, Wei; Jordan, Dustin; Wing, Rena R.

2011-01-01

Objectives: To compare physical activity (PA) and exercise dependence (ED) in 267 weight-loss maintainers (WLM) and 213 normal-weight (NW) controls. Methods: PA and ED assessed via accelerometery and the Exercise Dependence Questionnaire. Results: WLM had higher PA levels and ED scores than those of NW (P less than 0.0001). WLM status (P = 0.006)…

Review for the Korean Health Professionals and International Cooperation Doctors Dispatched to Peru by the Korea International Cooperation Agency (KOICA).

PubMed

Kim, Bongyoung

2015-04-01

South Korea dispatches Korean nationals to partner developing countries as an Official Development Assistance (ODA) project through the Korea International Cooperation Agency (KOICA). In the health sector, KOICA dispatches international cooperation doctors (ICDs), nurses, physical therapists, radiologic technologists, nutritionists, medical laboratory technologists, occupational therapists, and dental hygienists. A total of 216 ICDs were dispatched over 19 times from 1995 until 2013. There were 19 areas of specialties among the ICDs. The most common specialty was internal medicine (61/216, 28.2%), the second most common specialty was general surgery (43/216, 19.9%), followed by oriental medicine (27/216, 12.5%), pediatrics (17/216, 7.9%), orthopedics (16/216, 7.4%), family medicine (16/216, 7.4%), and odontology (14/216, 6.5%). The ICDs have worked in 21 countries. KOICA dispatched the highest number of ICDs to Asia (97/216, 44.9%), followed by Africa (50/216, 23.1%), Latin America (34/216, 15.7%), the commonwealth of independent states (31/216, 14.4%), and Oceania (4/216, 1.9%). Nobody was dispatched to the Middle East. A total of 134 KOICA health professionals were dispatched to Peru from 1996 until October 1, 2014. Of these, 19.4% (26/134) were ICDs, 44.8% (60/216) were nurses, 20.1% (27/134) were physical therapists, 6.7% (9/134) were radiologic technologists, 2.2% (3/134) were nutritionists, and 6.7% (9/134) were medical laboratory. ICDs' specialties comprised internal medicine (13/26, 50%), family medicine (8/26, 30.8%), pediatrics (2/26, 7.7%), otorhinolaryngology (1/26, 3.8%), orthopedics (1/26, 3.8%), and oriental medicine (1/26, 3.8%). Most of the dispatched health professionals worked at institutions that were supported by KOICA. For this reason, the proportion of health professionals who worked at public health centers (PHCs) was the highest (58.2%, 78/134) when classified by workplace type. Other KOICA health professionals worked at hospitals, governmental organizations (GOs), or schools.

Dispatching power system for preventive and corrective voltage collapse problem in a deregulated power system

NASA Astrophysics Data System (ADS)

Alemadi, Nasser Ahmed

Deregulation has brought opportunities for increasing efficiency of production and delivery and reduced costs to customers. Deregulation has also bought great challenges to provide the reliability and security customers have come to expect and demand from the electrical delivery system. One of the challenges in the deregulated power system is voltage instability. Voltage instability has become the principal constraint on power system operation for many utilities. Voltage instability is a unique problem because it can produce an uncontrollable, cascading instability that results in blackout for a large region or an entire country. In this work we define a system of advanced analytical methods and tools for secure and efficient operation of the power system in the deregulated environment. The work consists of two modules; (a) contingency selection module and (b) a Security Constrained Optimization module. The contingency selection module to be used for voltage instability is the Voltage Stability Security Assessment and Diagnosis (VSSAD). VSSAD shows that each voltage control area and its reactive reserve basin describe a subsystem or agent that has a unique voltage instability problem. VSSAD identifies each such agent. VS SAD is to assess proximity to voltage instability for each agent and rank voltage instability agents for each contingency simulated. Contingency selection and ranking for each agent is also performed. Diagnosis of where, why, when, and what can be done to cure voltage instability for each equipment outage and transaction change combination that has no load flow solution is also performed. A security constrained optimization module developed solves a minimum control solvability problem. A minimum control solvability problem obtains the reactive reserves through action of voltage control devices that VSSAD determines are needed in each agent to obtain solution of the load flow. VSSAD makes a physically impossible recommendation of adding reactive generation capability to specific generators to allow a load flow solution to be obtained. The minimum control solvability problem can also obtain solution of the load flow without curtailing transactions that shed load and generation as recommended by VSSAD. A minimum control solvability problem will be implemented as a corrective control, that will achieve the above objectives by using minimum control changes. The control includes; (1) voltage setpoint on generator bus voltage terminals; (2) under load tap changer tap positions and switchable shunt capacitors; and (3) active generation at generator buses. The minimum control solvability problem uses the VSSAD recommendation to obtain the feasible stable starting point but completely eliminates the impossible or onerous recommendation made by VSSAD. This thesis reviews the capabilities of Voltage Stability Security Assessment and Diagnosis and how it can be used to implement a contingency selection module for the Open Access System Dispatch (OASYDIS). The OASYDIS will also use the corrective control computed by Security Constrained Dispatch. The corrective control would be computed off line and stored for each contingency that produces voltage instability. The control is triggered and implemented to correct the voltage instability in the agent experiencing voltage instability only after the equipment outage or operating changes predicted to produce voltage instability have occurred. The advantages and the requirements to implement the corrective control are also discussed.

Nipple problems

MedlinePlus

... Abnormal discharge from the nipple Normal female breast anatomy References Hunt KK, Mittendorf EA. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 20th ed. Philadelphia, PA: Elsevier; 2017: ...

Diaphragmatic hernia

MedlinePlus

... is no known prevention. Couples with a family history of this problem may want to seek genetic counseling. ... In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016: ...

Lung problems and volcanic smog

MedlinePlus

... Saunders; 2016:chap 74. Feldman JN, Tilling RI. Volcanic eruptions, hazards, and mitigations. In: Auerbach PS, ed. Wilderness ... 2011:chap 15. Jay G, King K, Cattamanchi S. Volcanic eruptions. In: Cittione GR, ed. Ciottone's Disaster Medicine . 2nd ...

Deer Velvet

MedlinePlus

... activity (as an aphrodisiac), and treat male sexual performance problems (erectile dysfunction, ED). Women use deer velvet to reduce the dose of ... combinations, deer velvet is used to improve athletic performance; to improve ... reproductive disorders including premenstrual syndrome (PMS), ED, and ...

Bidirectionality and gender differences in emotional disturbance associations with obesity among Taiwanese schoolchildren.

PubMed

Chiang, Po-Huang; Huang, Lin-Yuan; Lo, Yuan-Ting; Lee, Meei-Shyuan; Wahlqvist, Mark L

2013-10-01

Childhood obesity is associated with psychological problems, but little is known about its association with emotional disturbance (ED) in the educational setting, especially by gender. In the population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 of children aged 6-13 (n=2283), we have considered whether ED is associated with obesity by gender. Schoolchildren were assessed with the modified scale for assessing emotional disturbance questionnaires. For some subscales, boys and girls had ED associations with obesity which were bidirectional. With normal weight as referent and relevant adjustments, the significant ED subscales predictable by obesity were relationship problems (RP) in boys (odds ratio, OR=1.89 with 95% CI: 1.08-3.30) and inappropriate behavior (IB) in girls (OR=2.88: 95% CI: 1.47-5.61). Conversely, with 'no-specific-ED' as referent, obesity was predictable by fully-adjusted specific-EDs in the same subscales, namely RP in boys (OR=1.88 with 95% CI: 1.13-3.13) and IB in girls (OR=3.03: 95% CI: 1.57-5.85). Child obesity prevalence showed no trend with school grade from 1 to 6, but for aggregate ED and most of its subscales the prevalence increased with grade (P for trend <0.01). Thus, there is some dissociation of obesity and ED as judged by their trend presence with school grade. Where obesity and ED occurred together (for inability-to-learn and unhappiness or depression), there were upward trends with grade (P<0.01). There are probably some selected bidirectional pathogenicities for obesity-ED associations with different expression in boys and girls and during elementary education. This provides some policy direction while mechanisms and causality require elucidation. Copyright © 2013 Elsevier Ltd. All rights reserved.

A tailored e-learning program to improve handover in the chain of emergency care: a pre-test post-test study.

PubMed

Ebben, Remco H A; van Grunsven, Pierre M; Moors, Marie Louise; Aldenhoven, Peter; de Vaan, Jordan; van Hout, Roger; van Achterberg, Theo; Vloet, Lilian C M

2015-04-16

To standardize patient handover in the chain of emergency care a handover guideline was developed. The main guideline recommendation is to use the DeMIST model (Demographics, Mechanism of Injury/illness, Injury/Illness, Signs, Treatment given) to structure pre-hospital notification and handover. To benefit from the new guideline, guideline adherence is necessary. As adherence to guidelines in emergency care settings is variable, there is a need to systematically implement the new guideline. For implementation of the guideline we developed a e-learning program tailored to influencing factors. The aim of the study was to evaluate the effectiveness of this e-learning program to improve emergency care professionals' adherence to the handover guideline during pre-hospital notification and handover in the chain of emergency medical service (EMS), emergency medical dispatch (EMD), and emergency department (ED). A prospective pre-test post-test study was conducted. The intervention was a tailored e-learning program that was offered to ambulance crew and emergency medical dispatchers (n=88). Data on adherence included pre-hospital notifications and handovers and were collected through observations and audiotapes before and after the e-learning program. Data were analyzed using X(2)-tests and t-tests. In total, 78/88 (88.6%) professionals followed the e-learning program. During pre- and post-test, 146 and 169 handovers were observed respectively. After the e-learning program, no significant difference in the number of handovers with the DeMIST model (77.9% vs. 73.1%, p=.319) and the number of handovers with the correct sequence of the DeMIST model (69.9% vs. 70.5%, p=.159) existed. During the handover, the number of questions by ED staff and interruptions significantly increased from 49.0% to 68.9% and from 15.2% to 52.7% respectively (both p=.000). Most handovers were performed after patient transfer, this did not change after the intervention (p=.167). The number of handovers where information was documented during handover slightly increased from 26.9% to 29.3% (p=.632). The tailored e-learning program did not improve adherence to a handover guideline in the chain of emergency care. Results show a relatively high baseline adherence rate to usage and correct sequence of the DeMIST model. Improvements in the handover process can be made on the documentation of information during handover, the number of interruptions and questions, and the handover moment.

Child, caregiver, and family characteristics associated with emergency department use by children who remain at home after a child protective services investigation

PubMed Central

Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

2012-01-01

Objectives To examine emergency department (ED) use among children involved with child protective services (CPS) in the U.S. but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method We analyzed data on 4,001 children in the National Survey of Child and Adolescent Well-being. Multivariate models compared rates of ED use for whether the family received CPS services or did not receive CPS services as well as child characteristics, caregiver characteristics and caregiver/family psychological variables. Results ED use among children who remained at home receiving CPS services was similar to that of children who did not receive CPS services (35.6% and 37.4%, respectively). In multivariate modeling, children with families who received CPS services, children six years or older, and children without a chronic health problem were less likely to use the ED. Children who remained at home in families identified with numerous stressors and, therefore, likely at high risk for future abuse and neglect were 1.73 times (95% CI, 1.14–2.63) more likely to have repeat ED use than children in low risk families. Conclusion Children who remain at home after a CPS evaluation are at high risk for ED use. Future research should focus on the health problems that precipitate an ED visit as well as the relationship between primary care and ED use. PMID:22265905

Binge drinking among young adults in an urban tertiary care emergency department in Israel.

PubMed

Levinson, Daphna; Rosca, Paola; Vilner, Doron; Brimberg, Idit; Stall, Yael; Rimon, Ayelet

2017-07-01

Alcohol use is a major preventable public health problem with serious health and social consequences especially among youth. In Israel, alcohol use has become an emerging problem during the last decade, and its use has increased among adolescents and young adults. Binge drinking is the common pattern of alcohol consumption among young adults who drink for recreational purposes. The present survey was conducted among 16-35 years old visitors to the ED. The aim was specifically to identify binge drinkers in order to assess the scope of the need for a brief counseling intervention among young people who arrive intoxicated to a large tertiary care urban ED in Israel. The survey was conducted throughout a 1 week period (24 h per day) at the general EDs in a large, tertiary care center, situated in Tel Aviv. During the survey week, 946 individuals, aged 16-35, visited the ED and 573 (63%) of them were approached for an interview. 89% of those approached agreed to be interviewed. Consenting patients [N = 348] were asked whether they drink any alcohol, how often they drink and how much. About one fifth of those interviewed were in the habit of consuming more than four units of alcohol per occasion. Drinking several times a week or every day was reported by 19% of the males and 26% of the females. Frequency of the drinking episodes was highly correlated with the number of units of drink per occasion. The study found a very high rate of binge drinking among ED visitors, and this suggests a need for large scale ED-based interventions. As binge drinkers are at elevated risk for accidents, violence and related problems, effective ED-based interventions could make an important contribution to public health. Accordingly, Israel is in the process of assessing the effectiveness of a large-scale ED-based counseling intervention. Trial registration number 0230-13-TLV.

26 CFR 49.4253-5 - Exemption for items otherwise taxed.

Code of Federal Regulations, 2011 CFR

2011-04-01

... otherwise taxed. A dispatch, message, or conversation transmitted by toll telephone, telegraph, or... considered to be one dispatch, message, or conversation, and is subject to only one payment of tax under...

26 CFR 49.4253-5 - Exemption for items otherwise taxed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... otherwise taxed. A dispatch, message, or conversation transmitted by toll telephone, telegraph, or... considered to be one dispatch, message, or conversation, and is subject to only one payment of tax under...

Best practices in bus dispatch.

DOT National Transportation Integrated Search

2012-06-01

In 2007, the National Center for Transit Research (NCTR) sponsored a study to examine best practices in : extraboard operator management. In most transit agencies, extraboard manpower is managed by the : dispatch function, but extraboard management i...

An investigation of the use of temporal decomposition in space mission scheduling

NASA Technical Reports Server (NTRS)

Bullington, Stanley E.; Narayanan, Venkat

1994-01-01

This research involves an examination of techniques for solving scheduling problems in long-duration space missions. The mission timeline is broken up into several time segments, which are then scheduled incrementally. Three methods are presented for identifying the activities that are to be attempted within these segments. The first method is a mathematical model, which is presented primarily to illustrate the structure of the temporal decomposition problem. Since the mathematical model is bound to be computationally prohibitive for realistic problems, two heuristic assignment procedures are also presented. The first heuristic method is based on dispatching rules for activity selection, and the second heuristic assigns performances of a model evenly over timeline segments. These heuristics are tested using a sample Space Station mission and a Spacelab mission. The results are compared with those obtained by scheduling the missions without any problem decomposition. The applicability of this approach to large-scale mission scheduling problems is also discussed.

Evaluation of Human Reliability in Selected Activities in the Railway Industry

NASA Astrophysics Data System (ADS)

Sujová, Erika; Čierna, Helena; Molenda, Michał

2016-09-01

The article focuses on evaluation of human reliability in the human - machine system in the railway industry. Based on a survey of a train dispatcher and of selected activities, we have identified risk factors affecting the dispatcher`s work and the evaluated risk level of their influence on the reliability and safety of preformed activities. The research took place at the authors` work place between 2012-2013. A survey method was used. With its help, authors were able to identify selected work activities of train dispatcher's risk factors that affect his/her work and the evaluated seriousness of its influence on the reliability and safety of performed activities. Amongst the most important finding fall expressions of unclear and complicated internal regulations and work processes, a feeling of being overworked, fear for one's safety at small, insufficiently protected stations.

Robust optimization-based DC optimal power flow for managing wind generation uncertainty

NASA Astrophysics Data System (ADS)

Boonchuay, Chanwit; Tomsovic, Kevin; Li, Fangxing; Ongsakul, Weerakorn

2012-11-01

Integrating wind generation into the wider grid causes a number of challenges to traditional power system operation. Given the relatively large wind forecast errors, congestion management tools based on optimal power flow (OPF) need to be improved. In this paper, a robust optimization (RO)-based DCOPF is proposed to determine the optimal generation dispatch and locational marginal prices (LMPs) for a day-ahead competitive electricity market considering the risk of dispatch cost variation. The basic concept is to use the dispatch to hedge against the possibility of reduced or increased wind generation. The proposed RO-based DCOPF is compared with a stochastic non-linear programming (SNP) approach on a modified PJM 5-bus system. Primary test results show that the proposed DCOPF model can provide lower dispatch cost than the SNP approach.

Cluster analyses of association of weather, daily factors and emergent medical conditions.

PubMed

Malkić, Jasmin; Sarajlić, Nermin; Smrke, Barbara U R; Smrke, Dragica

2013-03-01

The goal of this study was to evaluate associations between the meteorological conditions and the number of emergency cases for five distinctive causes of dispatch groups reported to SOS dispatch centre in Uppsala, Sweden. Center's responsibility include alerting to 17 ambulances in whole Uppsala County, area of 8,209 km2 with around 320,000 inhabitants representing the target patient group. Source of the medical data for this study is the database of dispatch data for the year of 2009, while the metrological data have been provided from Uppsala University Department of Earth Sciences yearly weather report. Medical and meteorological data were summoned into the unified data space where each point represents a day with its weather parameters and dispatch cause group cardinality. DBSCAN data mining algorithm was implemented to five distinctive groups of dispatch causes after the data spaces have gone through the variance adjustment and the principal component analyses. As the result, several point clusters were discovered in each of the examined data spaces indicating the distinctive conditions regarding the weather and daily cardinality of the dispatch cause, as well as the associations between these two. Most interesting finding is that specific type of winter weather formed a cluster only around the days with the high count of breathing difficulties, while one of the summer weather clusters made similar association with the days with low number of cases. Findings were confirmed by confidence level estimation based on signal to noise ratio for the observed data points.

Randomized Controlled Trial of Mailed Personalized Feedback for Risky Drinkers in the Emergency Department: The Impact on Alcohol Consumption, Alcohol-Related Injuries, and Repeat Emergency Department Presentations.

PubMed

Havard, Alys; Shakeshaft, Anthony P; Conigrave, Katherine M

2015-07-01

Due to the difficulty encountered in disseminating resource-intensive emergency department (ED)-based brief alcohol interventions into real-world settings, this study evaluated the effect of a mailed personalized feedback intervention for problem drinking ED patients. At 6-week follow-up, this intervention was associated with a statistically significant reduction in alcohol consumption among patients with alcohol-involved ED presentations. This study aimed to evaluate the effects of this intervention over time. A randomized controlled trial was conducted among problem drinking ED patients, defined as those scoring 8 or more on the Alcohol Use Disorders Identification Test. Participants in the intervention group received mailed personalized feedback regarding their alcohol consumption. The control group received no feedback. Follow-up interviews were conducted over the phone, postal survey, or email survey 6 weeks and 6 months after baseline screening, and repeat ED presentations over 12-month follow-up were ascertained via linked ED records. Six-month follow-up interviews were completed with 210 participants (69%), and linked ED records were obtained for 286 participants (94%). The intervention had no effect on alcohol consumption, while findings regarding alcohol-related injuries and repeat ED presentations remain inconclusive. Further research in which the receipt of feedback is improved and a booster intervention is provided is recommended. Copyright © 2015 by the Research Society on Alcoholism.

Identification and Management of Information Problems by Emergency Department Staff

PubMed Central

Murphy, Alison R.; Reddy, Madhu C.

2014-01-01

Patient-care teams frequently encounter information problems during their daily activities. These information problems include wrong, outdated, conflicting, incomplete, or missing information. Information problems can negatively impact the patient-care workflow, lead to misunderstandings about patient information, and potentially lead to medical errors. Existing research focuses on understanding the cause of these information problems and the impact that they can have on the hospital’s workflow. However, there is limited research on how patient-care teams currently identify and manage information problems that they encounter during their work. Through qualitative observations and interviews in an emergency department (ED), we identified the types of information problems encountered by ED staff, and examined how they identified and managed the information problems. We also discuss the impact that these information problems can have on the patient-care teams, including the cascading effects of information problems on workflow and the ambiguous accountability for fixing information problems within collaborative teams. PMID:25954457

Chemically Enhanced Trust: Potential Law Enforcement and Military Applications for Oxytocin

DTIC Science & Technology

2007-12-01

Breaking Cooperative Relationships, ed. Diego Gambetta, 213-237. Oxford: Basil Blackwell, 1988, 218. 17 Niklas Luhmann. “Familiarity, Confidence, Trust...Problems and Alternatives.” In Trust: Making and Breaking Cooperative Relationships, ed. Diego Gambetta, 94-107. Oxford: Basil Blackwell, 1988, 95...Relationships, ed. Diego Gambetta, 94-107. Oxford: Basil Blackwell, 1988, 166. 171 Karen S. Cook, Russell Hardin and Margaret Levi. Cooperation Without

A coordination theory for intelligent machines

NASA Technical Reports Server (NTRS)

Wang, Fei-Yue; Saridis, George N.

1990-01-01

A formal model for the coordination level of intelligent machines is established. The framework of the coordination level investigated consists of one dispatcher and a number of coordinators. The model called coordination structure has been used to describe analytically the information structure and information flow for the coordination activities in the coordination level. Specifically, the coordination structure offers a formalism to (1) describe the task translation of the dispatcher and coordinators; (2) represent the individual process within the dispatcher and coordinators; (3) specify the cooperation and connection among the dispatcher and coordinators; (4) perform the process analysis and evaluation; and (5) provide a control and communication mechanism for the real-time monitor or simulation of the coordination process. A simple procedure for the task scheduling in the coordination structure is presented. The task translation is achieved by a stochastic learning algorithm. The learning process is measured with entropy and its convergence is guaranteed. Finally, a case study of the coordination structure with three coordinators and one dispatcher for a simple intelligent manipulator system illustrates the proposed model and the simulation of the task processes performed on the model verifies the soundness of the theory.

Best practices in bus dispatch [summary].

DOT National Transportation Integrated Search

2012-01-01

In 2007, the National Center for Transit Research : sponsored a study of best practices in extraboard : operator management, finding that in most transit : agencies, extraboard manpower is managed by : dispatchers as one of their many functions. This...

The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures

PubMed Central

Guan, Yong; Wendong, Sun; Zhao, Shengtian; Liu, Tongyan; Liu, Yuqiang; Zhang, Xiulin; Yuan, Mingzhen

2015-01-01

ABSTRACT Erectile dysfunction (ED) is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5) questionnaire. Nocturnal penile tumescence (NPT) testing confirmed the occurrence of ED in 96 (80%) patients on whom penile duplex ultrasound and neurophysiological testing were further performed. Of these ED patients 29 (30%) were demonstrated only with vascular abnormality, 41 (42.7%) were detected only with neural abnormality, 26 (27.1%) revealed mixed abnormalities. Of the 55 patients (29+26) with vascular problems, 7 patients (12.7%) with abnormal arterial response to intracavernous injection of Bimix (15mg papaverine and 1mg phentolamine), 31 (56.4%) with corporal veno-occlusive dysfunction and 17 (30.9%) had both problems. Of the 67 (41+26) patients with abnormal neurophysiological outcomes, 51 (76.1%) with abnormal bulbocavernosus reflex (BCR), 20 (29.9%) with pathological pudendal nerve evoked potentials (PDEPs) and 25 (37.3%) with abnormal posterior tibial somatosensory nerve evoked potentials (PTSSEPs). Our observation indicated that neurogenic factors are important for the generation of ED in patients with pelvic fracture; venous impotence is more common than arteriogenic ED. PMID:26689522

Exploring the limits of EDS microanalysis: rare earth element analyses

NASA Astrophysics Data System (ADS)

Ritchie, N. W. M.; Newbury, D. E.; Lowers, H.; Mengason, M.

2018-01-01

It is a great time to be a microanalyst. After a few decades of incremental progress in energy-dispersive X-ray spectrometry (EDS), the last decade has seen the accuracy and precision surge forward. Today, the question is not whether EDS is generally useful but to identify the types of problems for which wavelength-dispersive X-ray spectrometry remains the better choice. The full extent of EDS’s capabilities has surprised many. Low Z, low energy, and trace element detection have been demonstrated even in the presence of extreme peak interferences. In this paper, we will summarise the state-of-the-art and investigate a challenging problem domain, the analysis of minerals bearing multiple rare-earth elements.

Contribution of Interpersonal Problems to Eating Disorder Psychopathology via Negative Affect in Treatment-seeking Men and Women: Testing the Validity of the Interpersonal Model in an Understudied Population.

PubMed

Ivanova, Iryna V; Tasca, Giorgio A; Proulx, Geneviève; Bissasda, Hany

2017-07-01

Research on the psychosocial correlates and theoretical frameworks of men presenting with eating disorders (ED) psychopathology is limited. This study compared treatment-seeking men and women in terms of their levels of interpersonal functioning (affiliation and dominance), regulation of negative emotions (negative affect and instability) and ED psychopathology. The study also investigated the validity of the interpersonal model of ED in men. Results from the cross-sectional data of 388 participants (137 men and 251 women) demonstrated that the structural models fit and that paths were invariant across men and women. There were significant indirect effects of interpersonal functioning on ED psychopathology, mediated through negative affect and instability, for both men and women. Negative affect and instability partially explain the relationship between interpersonal problems and ED psychopathology in treatment-seeking men and women. Current findings highlight the need to evaluate the validity of the model using longitudinal designs to test whether men and women are likely to benefit equally from interpersonal therapies for ED. Copyright © 2016 John Wiley & Sons, Ltd. Negative affect and instability mediated the relationship between interpersonal problems and eating disorder psychopathology for treatment-seeking men and women. There were no gender differences between levels of negative affect, emotional instability and interpersonal dysfunction, but women reported slightly higher eating concerns than men. Interpersonal model is a framework that is applicable to understanding and potentially treating men with eating disorders. Copyright © 2016 John Wiley & Sons, Ltd.

Technical assistance for law-enforcement communications: Case study report

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Methods developed to improve police communications systems are described. Use of queueing analysis shows several ways of improving time of response to inquiries made from the field for license plate checks and for information on current wants and warrants, through a state multiple switcher network. Design criteria for more efficient centralized switching equipment are developed. A message load problem experienced in a dispatch center is analyzed, showing that communications could be improved by adding communications channels, not by adding people.

[Modeling and implementation method for the automatic biochemistry analyzer control system].

PubMed

Wang, Dong; Ge, Wan-cheng; Song, Chun-lin; Wang, Yun-guang

2009-03-01

In this paper the system structure The automatic biochemistry analyzer is a necessary instrument for clinical diagnostics. First of is analyzed. The system problems description and the fundamental principles for dispatch are brought forward. Then this text puts emphasis on the modeling for the automatic biochemistry analyzer control system. The objects model and the communications model are put forward. Finally, the implementation method is designed. It indicates that the system based on the model has good performance.

Barriers to surge capacity of an overcrowded emergency department for a serious foodborne disease outbreak.

PubMed

Lee, Wen-Huei; Ghee, Chew; Wu, Kuan-Han; Hung, Shih-Chiang

2010-10-01

The purpose of this study was to investigate barriers to surge capacity of an overcrowded emergency department (ED) for a foodborne disease outbreak (FBDO) and to identify solutions to the problems. The emergency response of an overcrowded ED to a serious FBDO with histamine fish poisoning was reviewed. The ED of a tertiary academic medical centre (study hospital) with 1600 acute beds in southern Taiwan. Among the 346 patients in the outbreak, 333 (96.2%) were transferred to the study hospital without prehospital management within about 2 h. The most common symptoms were dizziness (58.9%), nausea and vomiting (36.3%). 181 patients (54.4%) received intravenous fluid infusion and blood tests were ordered for 82 (24.6%). All patients were discharged except one who required admission. The prominent problems with surge capacity of the study hospital were shortage of spare space in the ED, lack of biological incident response plan, poor command system, inadequate knowledge and experience of medical personnel to manage the FBDO. Patients with FBDO could arrive at the hospital shortly after exposure without field triage and management. The incident command system and emergency operation plan of the study hospital did not address the clinical characteristics of the FBDO and the problem of ED overcrowding. Further planning and training of foodborne disease and surge capacity would be beneficial for hospital preparedness for an FBDO.

Adjusting the fairshare policy to prevent computing power loss

NASA Astrophysics Data System (ADS)

Dal Pra, Stefano

2017-10-01

On a typical WLCG site providing batch access to computing resources according to a fairshare policy, the idle time lapse after a job ends and before a new one begins on a given slot is negligible if compared to the duration of typical jobs. The overall amount of these intervals over a time window increases with the size of the cluster and the inverse of job duration and can be considered equivalent to an average number of unavailable slots over that time window. This value has been investigated for the Tier-1 at CNAF, and observed to occasionally grow and reach up to more than the 10% of the about 20,000 available computing slots. Analysis reveals that this happens when a sustained rate of short jobs is submitted to the cluster and dispatched by the batch system. Because of how the default fairshare policy works, it increases the dynamic priority of those users mostly submitting short jobs, since they are not accumulating runtime, and will dispatch more of their jobs at the next round, thus worsening the situation until the submission flow ends. To address this problem the default behaviour of the fairshare have been altered by adding a correcting term to the default formula for the dynamic priority. The LSF batch system, currently adopted at CNAF, provides a way to define its value by invoking a C function, which returns it for each user in the cluster. The correcting term works by rounding up to a minimum defined runtime the most recently done jobs. Doing so, each short job looks almost like a regular one and the dynamic priority value settles to a proper value. The net effect is a reduction of the dispatching rate of short jobs and, consequently, the average number of available slots greatly improves. Furthermore, a potential starvation problem, actually observed at least once is also prevented. After describing short jobs and reporting about their impact on the cluster, possible workarounds are discussed and the selected solution is motivated. Details on the most critical aspects of the implementation are explained and the observed results are presented.

Evaluation of a Dispatcher's Route Optimization Decision Aid to Avoid Aviation Weather Hazards

NASA Technical Reports Server (NTRS)

Dorneich, Michael C.; Olofinboba, Olu; Pratt, Steve; Osborne, Dannielle; Feyereisen, Thea; Latorella, Kara

2003-01-01

This document describes the results and analysis of the formal evaluation plan for the Honeywell software tool developed under the NASA AWIN (Aviation Weather Information) 'Weather Avoidance using Route Optimization as a Decision Aid' project. The software tool aims to provide airline dispatchers with a decision aid for selecting optimal routes that avoid weather and other hazards. This evaluation compares and contrasts route selection performance with the AWIN tool to that of subjects using a more traditional dispatcher environment. The evaluation assesses gains in safety, in fuel efficiency of planned routes, and in time efficiency in the pre-flight dispatch process through the use of the AWIN decision aid. In addition, we are interested in how this AWIN tool affects constructs that can be related to performance. The construct of Situation Awareness (SA), workload, trust in an information system, and operator acceptance are assessed using established scales, where these exist, as well as through the evaluation of questionnaire responses and subject comments. The intention of the experiment is to set up a simulated operations area for the dispatchers to work in. They will be given scenarios in which they are presented with stored company routes for a particular city-pair and aircraft type. A diverse set of external weather information sources is represented by a stand-alone display (MOCK), containing the actual historical weather data typically used by dispatchers. There is also the possibility of presenting selected weather data on the route visualization tool. The company routes have not been modified to avoid the weather except in the case of one additional route generated by the Honeywell prototype flight planning system. The dispatcher will be required to choose the most appropriate and efficient flight plan route in the displayed weather conditions. The route may be modified manually or may be chosen from those automatically displayed.

Airline Transport Pilot, Aircraft Dispatcher, and Flight Navigator Knowledge Test Guide

DOT National Transportation Integrated Search

1995-01-01

The Flight Standards Service of the Federal Aviation Administration (FAA) has developed this guide to help applicants meet the knowledge requirements for airline transport pilot, aircraft dispatcher, and flight navigator certification. This guide con...

Aircraft Dispatcher - Practical Test Standards

DOT National Transportation Integrated Search

1995-06-01

The Flight Standards Service of the FAA has developed this practical : test book as a standard to be used by FAA inspectors and designated : examiners when conducting the aircraft dispatcher practical test. : Instructors are expected to use this book...

Effect of an emergency department-based electronic system for musculoskeletal consultation on facilitating care for common injuries.

PubMed

Mears, Simon C; Pantle, Hardin A; Bessman, Edward S; Lifchez, Scott D

2015-05-01

Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED. The authors hypothesized that select injuries could be safely managed in the ED by using an electronic system to ensure appropriate follow-up care. Using Kaizen methodology, a multidisciplinary group (including ED staff, orthopedics, plastic surgery, pediatrics, nursing, radiology, therapy, and administration) met to improve care for select musculoskeletal injuries. A system was agreed on in which ED providers managed select musculoskeletal injuries without subspecialist consultation. Follow-up was organized using an electronic system, which facilitated communication between the ED staff and the secretarial staff of the subspecialist departments. Over a 1-year period, 150 patients were treated using this system. Charts and radiographs were reviewed for missed injuries. Radiographic review revealed 2 missed injuries. One patient had additional back pain and a lumbar spine fracture was found during the subspecialist follow-up visit; it was treated nonoperatively. Another patient appeared to have scapholunate widening on the injury radiograph that was not appreciated in the ED. Of the 150 patients, 51 were seen in follow-up by a subspecialist at the authors' institution. An electronic system to organize follow-up with a subspecialist allowed the ED providers to deliver safe and effective care for simple musculoskeletal injuries. Copyright 2015, SLACK Incorporated.

The impacts of electricity dispatch protocols on the emission reductions due to wind power and carbon tax.

PubMed

Yu, Yang; Rajagopal, Ram

2015-02-17

Two dispatch protocols have been adopted by electricity markets to deal with the uncertainty of wind power but the effects of the selection between the dispatch protocols have not been comprehensively analyzed. We establish a framework to compare the impacts of adopting different dispatch protocols on the efficacy of using wind power and implementing a carbon tax to reduce emissions. We suggest that a market has high potential to achieve greater emission reduction by adopting the stochastic dispatch protocol instead of the static protocol when the wind energy in the market is highly uncertain or the market has enough adjustable generators, such as gas-fired combustion generators. Furthermore, the carbon-tax policy is more cost-efficient for reducing CO2 emission when the market operates according to the stochastic protocol rather than the static protocol. An empirical study, which is calibrated according to the data from the Electric Reliability Council of Texas market, confirms that using wind energy in the Texas market results in a 12% CO2 emission reduction when the market uses the stochastic dispatch protocol instead of the 8% emission reduction associated with the static protocol. In addition, if a 6$/ton carbon tax is implemented in the Texas market operated according to the stochastic protocol, the CO2 emission is similar to the emission level from the same market with a 16$/ton carbon tax operated according to the static protocol. Correspondingly, the 16$/ton carbon tax associated with the static protocol costs 42.6% more than the 6$/ton carbon tax associated with the stochastic protocol.

The linguistic and interactional factors impacting recognition and dispatch in emergency calls for out-of-hospital cardiac arrest: a mixed-method linguistic analysis study protocol

PubMed Central

Riou, Marine; Ball, Stephen; Williams, Teresa A; Whiteside, Austin; O’Halloran, Kay L; Bray, Janet; Perkins, Gavin D; Cameron, Peter; Fatovich, Daniel M; Inoue, Madoka; Bailey, Paul; Brink, Deon; Smith, Karen; Della, Phillip; Finn, Judith

2017-01-01

Introduction Emergency telephone calls placed by bystanders are crucial to the recognition of out-of-hospital cardiac arrest (OHCA), fast ambulance dispatch and initiation of early basic life support. Clear and efficient communication between caller and call-taker is essential to this time-critical emergency, yet few studies have investigated the impact that linguistic factors may have on the nature of the interaction and the resulting trajectory of the call. This research aims to provide a better understanding of communication factors impacting on the accuracy and timeliness of ambulance dispatch. Methods and analysis A dataset of OHCA calls and their corresponding metadata will be analysed from an interdisciplinary perspective, combining linguistic analysis and health services research. The calls will be transcribed and coded for linguistic and interactional variables and then used to answer a series of research questions about the recognition of OHCA and the delivery of basic life-support instructions to bystanders. Linguistic analysis of calls will provide a deeper understanding of the interactional dynamics between caller and call-taker which may affect recognition and dispatch for OHCA. Findings from this research will translate into recommendations for modifications of the protocols for ambulance dispatch and provide directions for further research. Ethics and dissemination The study has been approved by the Curtin University Human Research Ethics Committee (HR128/2013) and the St John Ambulance Western Australia Research Advisory Group. Findings will be published in peer-reviewed journals and communicated to key audiences, including ambulance dispatch professionals. PMID:28694349

Optimized dispatch in a first-principles concentrating solar power production model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wagner, Michael J.; Newman, Alexandra M.; Hamilton, William T.

Concentrating solar power towers, which include a steam-Rankine cycle with molten salt thermal energy storage, is an emerging technology whose maximum effectiveness relies on an optimal operational and dispatch policy. Given parameters such as start-up and shut-down penalties, expected electricity price profiles, solar availability, and system interoperability requirements, this paper seeks a profit-maximizing solution that determines start-up and shut-down times for the power cycle and solar receiver, and the times at which to dispatch stored and instantaneous quantities of energy over a 48-h horizon at hourly fidelity. The mixed-integer linear program (MIP) is subject to constraints including: (i) minimum andmore » maximum rates of start-up and shut-down, (ii) energy balance, including energetic state of the system as a whole and its components, (iii) logical rules governing the operational modes of the power cycle and solar receiver, and (iv) operational consistency between time periods. The novelty in this work lies in the successful integration of a dispatch optimization model into a detailed techno-economic analysis tool, specifically, the National Renewable Energy Laboratory's System Advisor Model (SAM). The MIP produces an optimized operating strategy, historically determined via a heuristic. Using several market electricity pricing profiles, we present comparative results for a system with and without dispatch optimization, indicating that dispatch optimization can improve plant profitability by 5-20% and thereby alter the economics of concentrating solar power technology. While we examine a molten salt power tower system, this analysis is equally applicable to the more mature concentrating solar parabolic trough system with thermal energy storage.« less

49 CFR 241.9 - Prohibition against extraterritorial dispatching; exceptions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... emergency situation, a railroad may require or permit one of its dispatchers located outside the United... or by electronic mail. (3) A list of the States that make up the FRA regions and the street and e...

Task Decomposition Model for Dispatchers in Dynamic Scheduling of Demand Responsive Transit Systems

DOT National Transportation Integrated Search

2000-06-01

Since the passage of ADA, the demand for paratransit service is steadily increasing. Paratransit companies are relying on computer automation to streamline dispatch operations, increase productivity and reduce operator stress and error. Little resear...

Impact of data link technology on railroad dispatching operations

DOT National Transportation Integrated Search

2004-10-01

This study examined data link communication as an alternative channel to voice radio for railroad dispatchers. The goal was to compare how data link affected performance compared to voice radio only communications on measures related to safety, produ...

SMART operational field test evaluation : dispatchers survey report : final report

DOT National Transportation Integrated Search

1997-06-01

The Suburban Mobility Authority for Regional Transportation (SMART) has installed an automaticscheduling and dispatch system (ASD) in Southeast Michigan in accordance with their plans toimplement ITS as a site for an operational field test. The purpo...

An analysis of the job of railroad train dispatcher.

DOT National Transportation Integrated Search

1974-04-01

This report constitutes a detailed study of the job of railroad train dispatcher, conducted to provide a data base for the derivation of criteria of job knowledge, skills and training consonant with safe operations. Documentation was reviewed; specia...

Treatment of cardiac arrest with rapid defibrillation by police in King County, Washington.

PubMed

Becker, Linda; Husain, Sofia; Kudenchuk, Peter; Doll, Ann; Rea, Tom; Eisenberg, Mickey

2014-01-01

Improving survival from out-of-hospital cardiac arrest is an ongoing challenge for emergency medical services (EMS). Various strategies for shortening the time from collapse to defibrillation have been used, and one is to equip police officers with defibrillators. Objective. We evaluated the programmatic implementation of police defibrillation to determine if such a program could improve the process of care in a high-functioning and mature EMS system. We conducted a prospective observational study of implementation of a police defibrillation in two police departments in King County, Washington, from March 1, 2010 to March 31, 2012. The program was designed to dispatch police specifically to cases with a high suspicion of cardiac arrest, defined as a patient who was unconscious and not breathing normally. We included all nontraumatic out-of-hospital cardiac arrest events that occurred prior to EMS arrival and within the city limits of the two cities. We collected both EMS and police dispatch reports to document times of call receipt, dispatch, and arrival of both agencies. We obtained rhythm recordings when the automated external defibrillators (AEDs) were used by the police. Descriptive statistics were used to measure frequency of police dispatch and to compare times to treatment between patients with a police response and those without. During the study period there were 231 cases of cardiac arrest that occurred prior to EMS arrival eligible for police response in the study communities. Police were dispatched to 124 (54%) of these cases. Of the 124, the police arrived before EMS 37 times, or 16% of the 231 cases. Police performed CPR in 29 of these cases and applied the AED in 21 of them. Of the 21 cases in which the AED was applied for cardiac arrest, a shock was delivered on first analysis for 6 patients. Although the response interval between dispatch to scene arrival was similar for EMS and police (4.5 minutes versus 4.6 minutes respectively, p = 0.08), police were dispatched considerably slower than EMS (1.8 minutes versus 0.6 minutes, p < 0.001). In the current programmatic implementation, police had a measurable but limited involvement in resuscitation. Efforts to address dispatch challenges may improve police involvement.

Minimizing Uncertainties Impact in Decision Making with an Applicability Study for Economic Power Dispatch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Hong; Wang, Shaobu; Fan, Rui

This report summaries the work performed under the LDRD project on the preliminary study on knowledge automation, where specific focus has been made on the investigation of the impact of uncertainties of human decision making onto the optimization of the process operation. At first the statistics on signals from the Brain-Computing Interface (BCI) is analyzed so as to obtain the uncertainties characterization of human operators during the decision making phase using the electroencephalogram (EEG) signals. This is then followed by the discussions of an architecture that reveals the equivalence between optimization and closed loop feedback control design, where it hasmore » been shown that all the optimization problems can be transferred into the control design problem for closed loop systems. This has led to a “closed loop” framework, where the structure of the decision making is shown to be subjected to both process disturbances and controller’s uncertainties. The latter can well represent the uncertainties or randomness occurred during human decision making phase. As a result, a stochastic optimization problem has been formulated and a novel solution has been proposed using probability density function (PDF) shaping for both the cost function and the constraints using stochastic distribution control concept. A sufficient condition has been derived that guarantees the convergence of the optimal solution and discussions have been made for both the total probabilistic solution and chanced constrained optimization which have been well-studied in optimal power flows (OPF) area. A simple case study has been carried out for the economic dispatch of powers for a grid system when there are distributed energy resources (DERs) in the system, and encouraging results have been obtained showing that a significant savings on the generation cost can be expected.« less

[Disaster relief through inter-professional collaboration --from the standpoint of a dietitian].

PubMed

Inamura, Yukiko

2013-01-01

The present study examined disaster relief efforts by registered and other dietitians following the Great East Japan Earthquake to identify related problems. Based on this, the study discussed what is required to develop a "disaster relief system through inter-professional collaboration" to cope with unanticipated disasters. On March 15, 2011, the Japan Dietetic Association (JDA) independently established the "Great East Japan Earthquake relief emergency headquarters". The association along with these volunteers was committed to the establishment of a system for disaster relief activities with the support of Iwate, Miyagi, and Fukushima Prefectures: the number of registered volunteers was 978; a total of 1,588 dietitians were dispatched; and 602 became involved in relief work in the disaster-stricken areas. Registered and other dietitians dispatched for disaster relief provided support and home care for evacuation centers, elderly facilities, and temporary housing, including dietary and nutrition advice and consultation, in cooperation and collaboration with administrative dietitians in disaster areas, registered and other dietitians of disaster headquarters in disaster-stricken prefectures, the Primary Care for All Teams (PCAT) of the Japan Primary Care Association, disaster medical assistance teams (DMATs), and volunteer groups. Through the course of the relief activities, the following problems were identified: difficulties in responding to varying needs in different phases, nutritional measures (population-based and high-risk approaches), nutritional disparities among evacuation centers, necessity of a section to collect ever-changing information on disaster areas in a comprehensive manner, importance of working cooperatively to establish a support system, and differences in volunteers' support skills. To facilitate disaster relief through inter-professional collaboration, it is necessary for many different organizations to understand each other's capabilities in the event of a disaster, methods to share problems, needs, and information among them and with new members, and the importance of local coordinators.

Computer-aided dispatch--traffic management center field operational test final detailed test plan : WSDOT deployment

DOT National Transportation Integrated Search

2003-10-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : WSDOT deployment". This document defines the objective, approach,...

A preliminary examination of railroad dispatcher workload, stress, and fatigue

DOT National Transportation Integrated Search

2001-05-01

This report presents the methods, findings and recommendations from a field study that examined the sources and levels of railroad dispatcher workload, stress, and fatigue. The study was initiated in response to concerns raised by two Federal Railroa...

Computer-aided dispatch--traffic management center field operational test : Washington State final report

DOT National Transportation Integrated Search

2006-05-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch - Traffic Management Center Integration Field Operations Test in the State of Washington. The document discusses evaluation findings in the foll...

Analyzing railroad dispatchers' strategies : a cognitive task analysis of a distributed planning task

DOT National Transportation Integrated Search

1998-10-11

This paper describes a preliminary cognitive task analysis (CTA) that is being conducted to examine how experienced train dispatchers manage and schedule trains. The CTA uses ethnographic field observations and structured interview techniques. The ob...

Innovative telecommunications for law enforcement

NASA Technical Reports Server (NTRS)

Sohn, R. L.

1976-01-01

The operation of computer-aided dispatch, mobile digital communications, and automatic vehicle location systems used in law enforcement is discussed, and characteristics of systems used by different agencies are compared. With reference to computer-aided dispatch systems, the data base components, dispatcher work load, extent of usage, and design trends are surveyed. The capabilities, levels of communication, and traffic load of mobile digital communications systems are examined. Different automatic vehicle location systems are distinguished, and two systems are evaluated. Other aspects of the application of innovative technology to operational command, control, and communications systems for law enforcement agencies are described.

Characteristics of service requests and service processes of fire and rescue service dispatch centers: analysis of real world data and the underlying probability distributions.

PubMed

Krueger, Ute; Schimmelpfeng, Katja

2013-03-01

A sufficient staffing level in fire and rescue dispatch centers is crucial for saving lives. Therefore, it is important to estimate the expected workload properly. For this purpose, we analyzed whether a dispatch center can be considered as a call center. Current call center publications very often model call arrivals as a non-homogeneous Poisson process. This bases on the underlying assumption of the caller's independent decision to call or not to call. In case of an emergency, however, there are often calls from more than one person reporting the same incident and thus, these calls are not independent. Therefore, this paper focuses on the dependency of calls in a fire and rescue dispatch center. We analyzed and evaluated several distributions in this setting. Results are illustrated using real-world data collected from a typical German dispatch center in Cottbus ("Leitstelle Lausitz"). We identified the Pólya distribution as being superior to the Poisson distribution in describing the call arrival rate and the Weibull distribution to be more suitable than the exponential distribution for interarrival times and service times. However, the commonly used distributions offer acceptable approximations. This is important for estimating a sufficient staffing level in practice using, e.g., the Erlang-C model.

Epidemiology of Eye-Related Emergency Department Visits.

PubMed

Channa, Roomasa; Zafar, Syed Nabeel; Canner, Joseph K; Haring, R Sterling; Schneider, Eric B; Friedman, David S

2016-03-01

Determining the epidemiology of eye-related emergency department (ED) visits on a national level can assist policymakers in appropriate allocation of resources. To study ED visits related to ocular conditions for all age groups across the United States. Nationally representative data from the US Nationwide Emergency Department Sample (NEDS) were used to analyze ED visits from January 1, 2006, to December 31, 2011 (6 years). All patients with eye problems presenting to EDs across the United States were eligible for inclusion. A weighted count of 11 929 955 ED visits were categorized as possibly emergent (emergent), unlikely to be emergent (nonemergent), or could not be determined. Data were analyzed from March 1 to May 30, 2015. Population-based incidence rates of eye-related ED visits, incidence rates of eye injuries, relative proportions of emergent vs nonemergent eye-related ED visits among different age groups, and independent factors associated with emergent vs nonemergent visits. From 2006 to 2011, 11 929 955 ED visits (male patients, 54.2%; mean [SD] age, 31 [22] years) for ocular problems across the United States were categorized as emergent (41.2%), nonemergent (44.3%), or could not determine (14.5%). Corneal abrasions (13.7%) and foreign body in the external eye (7.5%) were the leading diagnoses in the emergent category. More than 4 million visits were for conjunctivitis (28.0%), subconjunctival hemorrhages (3.0%), and styes (3.8%). Emergent visits were significantly more likely to occur among males (odds ratio [OR], 2.00; 95% CI, 2.00-2.01), patients in the highest income quartile (OR, 1.47; 95% CI, 1.46-1.49), older patients (OR, 2.38; 95% CI, 2.38-2.44), and patients with private insurance (OR, 1.29; 95% CI, 1.28-1.30). Mean annual inflation-adjusted charges for all eye-related ED visits totaled $2.0 billion. Across the United States, nonemergent conditions accounted for almost half of all eye-related ED visits. Interventions to facilitate management of these cases outside the ED could make ED resources more available for truly emergent ophthalmic and medical issues.

Personal Characteristics and Experience of Primary Care Predicting Frequent Use of Emergency Department: A Prospective Cohort Study.

PubMed

Hudon, Catherine; Sanche, Steven; Haggerty, Jeannie L

2016-01-01

A small number of patients frequently using the emergency department (ED) account for a disproportionate amount of the total ED workload and are considered using this service inappropriately. The aim of this study was to identify prospectively personal characteristics and experience of organizational and relational dimensions of primary care that predict frequent use of ED. This study was conducted among parallel cohorts of the general population and primary care patients (N = 1,769). The measures were at baseline (T1), 12 (T2) and 24 months (T3): self-administered questionnaire on current health, health behaviours and primary care experience in the previous year. Use of medical services was confirmed using administrative databases. Mixed effect logistic regression modeling identified characteristics predicting frequent ED utilization. A higher likelihood of frequent ED utilization was predicted by lower socioeconomic status, higher disease burden, lower perceived organizational accessibility, higher number of reported healthcare coordination problems and not having a complete annual check-up, above and beyond adjustment for all independent variables. Personal characteristics such as low socioeconomic status and high disease burden as well as experience of organizational dimensions of primary care such as low accessibility, high healthcare coordination problems and low comprehensiveness of care are prospectively associated with frequent ED utilization. Interventions developed to prevent inappropriate ED visits, such as case management for example, should tailor low socioeconomic status and patients with high disease burden and should aim to improve experience of primary care regarding accessibility, coordination and comprehensiveness.

Microgrid to enable optimal distributed energy retail and end-user demand response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jin, Ming; Feng, Wei; Marnay, Chris

In the face of unprecedented challenges in environmental sustainability and grid resilience, there is an increasingly held consensus regarding the adoption of distributed and renewable energy resources such as microgrids (MGs), and the utilization of flexible electric loads by demand response (DR) to potentially drive a necessary paradigm shift in energy production and consumption patterns. However, the potential value of distributed generation and demand flexibility has not yet been fully realized in the operation of MGs. This study investigates the pricing and operation strategy with DR for a MG retailer in an integrated energy system (IES). Based on co-optimizing retailmore » rates and MG dispatch formulated as a mixed integer quadratic programming (MIQP) problem, our model devises a dynamic pricing scheme that reflects the cost of generation and promotes DR, in tandem with an optimal dispatch plan that exploits spark spread and facilitates the integration of renewables, resulting in improved retailer profits and system stability. Main issues like integrated energy coupling and customer bill reduction are addressed during pricing to ensure rates competitiveness and customer protection. By evaluating on real datasets, the system is demonstrated to optimally coordinate storage, renewables, and combined heat and power (CHP), reduce carbon dioxide emission while maintaining profits, and effectively alleviate the PV curtailment problem. Finally, the model can be used by retailers and MG operators to optimize their operations, as well as regulators to design new utility rates in support of the ongoing transformation of energy systems.« less

Microgrid to enable optimal distributed energy retail and end-user demand response

DOE PAGES

Jin, Ming; Feng, Wei; Marnay, Chris; ...

2018-06-07

In the face of unprecedented challenges in environmental sustainability and grid resilience, there is an increasingly held consensus regarding the adoption of distributed and renewable energy resources such as microgrids (MGs), and the utilization of flexible electric loads by demand response (DR) to potentially drive a necessary paradigm shift in energy production and consumption patterns. However, the potential value of distributed generation and demand flexibility has not yet been fully realized in the operation of MGs. This study investigates the pricing and operation strategy with DR for a MG retailer in an integrated energy system (IES). Based on co-optimizing retailmore » rates and MG dispatch formulated as a mixed integer quadratic programming (MIQP) problem, our model devises a dynamic pricing scheme that reflects the cost of generation and promotes DR, in tandem with an optimal dispatch plan that exploits spark spread and facilitates the integration of renewables, resulting in improved retailer profits and system stability. Main issues like integrated energy coupling and customer bill reduction are addressed during pricing to ensure rates competitiveness and customer protection. By evaluating on real datasets, the system is demonstrated to optimally coordinate storage, renewables, and combined heat and power (CHP), reduce carbon dioxide emission while maintaining profits, and effectively alleviate the PV curtailment problem. Finally, the model can be used by retailers and MG operators to optimize their operations, as well as regulators to design new utility rates in support of the ongoing transformation of energy systems.« less

Care of the elderly in emergency departments: conclusions and recommendations.

PubMed

Sanders, A B

1992-07-01

Little attention is being paid to the special needs of elderly persons in emergency departments. Emergency health care professionals feel less comfortable caring for elderly than for nonelderly patients. The social and personal concerns of the elderly frequently are not addressed in ED encounters. There is a paucity of research and education in geriatric emergency medicine. Overall principles of care for elderly patients seeking emergency care have not been defined as they have for other special populations such as children. The disease-oriented model used for caring for nonelderly adult patients in EDs may not be appropriate for elderly patients. The emergency care of the elderly requires significantly more health care resources than does that of the nonelderly. Compared with nonelderly patients, elderly patients seeking emergency care are four times more likely to use ambulance services, five times more likely to be admitted to the hospital, five times more likely to be admitted to an intensive care bed, and six times more likely to receive comprehensive emergency services. Although 12% of the population is 65 years or older, this group accounted for 36% of all ambulance patient transports to EDs, 43% of all hospital ED admissions, and 48% of all critical care admissions from EDs. These problems are particularly important at this time because many hospitals and their EDs are faced with significant problems of overcrowding and inadequate resources to meet the health care needs of the communities they serve. Although the elderly are the fastest-growing segment of the population, little or no planning is ongoing to meet the emergency health care needs of the elderly in the future. The task force has provided specific recommendations for addressing these problems.

Erectile Dysfunction Among Patients on Methadone Maintenance Therapy and Its Association With Quality of Life.

PubMed

Teoh, Joni Bing Fei; Yee, Anne; Danaee, Mahmoud; Ng, Chong Guan; Sulaiman, Ahmad Hatim Bin

Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL). Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF. The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain. Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.

Computer-aided dispatch--traffic management center field operational test : state of Utah final report

DOT National Transportation Integrated Search

2006-07-01

This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch Traffic Management Center Integration Field Operations Test in the State of Utah. The document discusses evaluation findings in the followin...

Computer-aided dispatch--traffic management center field operational test final test plans : state of Utah

DOT National Transportation Integrated Search

2004-01-01

The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : state of Utah". This document defines the objective, approach, an...

Understanding how train dispatchers manage and control trains : results of a cognitive task analysis

DOT National Transportation Integrated Search

1999-03-01

This report documents the results of a preliminary Cognitive Task Analysis (CTA) that examined how experienced train dispatchers manage and : schedule trains in today's environment The objective was to understand the cognitive demands placed on train...

49 CFR 228.17 - Dispatcher's record of train movements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 228.17 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Records and Reporting § 228..., telephone, radio, or any other electrical or mechanical device to dispatch, report, transmit, receive, or...

Can basic life support personnel safely determine that advanced life support is not needed?

PubMed

Cone, D C; Wydro, G C

2001-01-01

To determine whether firefighter/emergency medical technicians-basic (FF/EMT-Bs) staffing basic life support (BLS) ambulances in a two-tiered emergency medical services (EMS) system can safely determine when advanced life support (ALS) is not needed. This was a prospective, observational study conducted in two academic emergency departments (EDs) receiving patients from a large urban fire-based EMS system. Runs were studied to which ALS and BLS ambulances were simultaneously dispatched, with the patient transported by the BLS unit. Prospectively established criteria for potential need for ALS were used to determine whether the FF/EMT-B's decision to cancel the ALS unit was safe, and simple outcomes (admission rate, length of stay, mortality) were examined. In the system studied, BLS crews may cancel responding ALS units at their discretion; there are no protocols or medical criteria for cancellation. A convenience sample of 69 cases was collected. In 52 cases (75%), the BLS providers indicated that they cancelled the responding ALS unit because they did not feel ALS was needed. Of these, 40 (77%) met study criteria for ALS: 39 had potentially serious chief complaints, nine had abnormal vital signs, and ten had physical exam findings that warranted ALS. Forty-five (87%) received an intervention immediately upon ED arrival that could have been provided in the field by an ALS unit, and 16 (31%) were admitted, with a median length of stay of 3.3 days (range 1.1-73.4 days). One patient died. Firefighter/EMT-Bs, working without protocols or medical criteria, cannot always safely determine which patients may require ALS intervention.

Do dispatcher instructions facilitate bystander-initiated cardiopulmonary resuscitation and improve outcomes in patients with out-of-hospital cardiac arrest? A comparison of family and non-family bystanders.

PubMed

Fujie, Keiko; Nakata, Yoshio; Yasuda, Susumu; Mizutani, Taro; Hashimoto, Koichi

2014-03-01

Bystander-initiated cardiopulmonary resuscitation (CPR) has been reported to increase the possibility of survival in patients with out-of-hospital cardiopulmonary arrest (OHCA). We evaluated the effects of CPR instructions by emergency medical dispatchers on the frequency of bystander CPR and outcomes, and whether these effects differed between family and non-family bystanders. We conducted a retrospective cohort study, using Utstein-style records of OHCA taken in a rural area of Japan between January 2004 and December 2009. Of the 559 patients with non-traumatic OHCA witnessed by laypeople, 231 (41.3%) were given bystander CPR. More OHCA patients received resuscitation when the OHCA was witnessed by non-family bystanders than when it was witnessed by family members (61.4% vs. 34.2%). The patients with non-family-witnessed OHCA were more likely to be given conventional CPR (chest compression plus rescue breathing) or defibrillation with an AED than were those with family-witnessed OHCA. Dispatcher instructions significantly increased the provision of bystander CPR regardless of who the witnesses were. Neurologically favorable survival was increased by CPR in non-family-witnessed, but not in family-witnessed, OHCA patients. No difference in survival rate was observed between the cases provided with dispatcher instructions and those not provided with the instructions. Dispatcher instructions increased the frequency of bystander CPR, but did not improve the rate of neurologically favorable survival in patients with witnessed OHCA. Efforts to enhance the frequency and quality of resuscitation, especially by family members, are required for dispatcher-assisted CPR. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Limitations in Prehospital Communication Between Trauma Helicopter, Ambulance Services, and Dispatch Centers.

PubMed

Harmsen, Annelieke Maria Karien; Giannakopoulos, Georgios; Franschman, Gaby; Christiaans, Herman; Bloemers, Frank

2017-04-01

Prehospital communication with Emergency Medical Services (EMS) is carried out in hectic situations. Proper communication among all medical personal is required to enhance collaboration, to provide the best care and enable shared situational awareness. The objective of this article was to give insight into current Dutch prehospital emergency care communication among all EMS and evaluate the usage of a new physician staffed helicopter EMS (P-HEMS) cancellation model. Trauma-related P-HEMS dispatches between November 1, 2014 and May 31, 2015 for the Lifeliner 1 were included; a random sample of 100 dispatches was generated. Tape recordings on all verbal prehospital communication between the dispatch center, EMS, and P-HEMS were transcribed and analyzed. Qualitative content analysis was performed, using open coding to code key messages. Ninety-two tape recordings were analyzed. The most frequent reason for P-HEMS dispatch was suspicion of brain injury (24%). The cancellation model was followed in 66%, overruled in 9%, and not applicable in 25%. The main reason for not adhering to the model was hemodynamic stability. In 5% of P-HEMS dispatches, a complete ABCD (airway, breathing, circulation, disability) methodology was used for handover, in 9% a complete Situation-Background-Assessment-Recommendation technique, in 2% a complete Mechanism-Injuries-Signs-Treatment method was used. The other handovers were incomplete. Prehospital handover between EMS on-scene and P-HEMS often entails insufficient information. The cancellation model for P-HEMS is frequently used and promotes adequate information transfer. To increase joined decision-making, more patient and situational information needs to be handed over. Standardization of prehospital trauma handovers will facilitate this and improve trauma patient's outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Air ambulance tasking: mechanism of injury, telephone interrogation or ambulance crew assessment?

PubMed

Wilmer, Ian; Chalk, Graham; Davies, Gareth Edward; Weaver, Anne Elizabeth; Lockey, David John

2015-10-01

The identification of serious injury is critical to the tasking of air ambulances. London's Air Ambulance (LAA) is dispatched by a flight paramedic based on mechanism of injury (MOI), paramedical interrogation of caller (INT) or land ambulance crew request (REQ).This study aimed to demonstrate which of the dispatch methods was most effective (in accuracy and time) in identifying patients with serious injury. A retrospective review of 3 years of data (to December 2010) was undertaken. Appropriate dispatch was defined as the requirement for LAA to escort the patient to hospital or for resuscitation on-scene. Inaccurate dispatch was where LAA was cancelled or left the patient in the care of the land ambulance crew. The χ(2) test was used to calculate p values; with significance adjusted to account for multiple testing. There were 2203 helicopter activations analysed: MOI 18.9% (n=417), INT 62.4% (n=1375) and REQ 18.7% (n=411). Appropriate dispatch rates were MOI 58.7% (245/417), INT 69.7% (959/1375) and REQ 72.2% (297/411). INT and REQ were both significantly more accurate than MOI (p<0.0001). There was no significant difference in accuracy between INT and REQ (p=0.36). Combining MOI and INT remotely identified 80.2% of patients, with an overtriage rate of 32.8%. Mean time to dispatch (in minutes) was MOI 4, INT 8 and REQ 21. Telephone interrogation of the caller by a flight paramedic is as accurate as ground ambulance crew requests, and both are significantly better than MOI in identifying serious injury. Overtriage remains an issue with all methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Pre-recorded instructional audio vs. dispatchers’ conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study

PubMed Central

Birkun, Alexei; Glotov, Maksim; Ndjamen, Herman Franklin; Alaiye, Esther; Adeleke, Temidara; Samarin, Sergey

2018-01-01

BACKGROUND: To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation (CPR) guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation. METHODS: It was a prospective, blind, randomised controlled study involving 109 medical students without previous CPR training. In a standardized mannequin scenario, after the step of dispatcher-assisted cardiac arrest recognition, the participants performed compression-only resuscitation guided over the telephone by either: (1) the pre-recorded instructional audio (n=57); or (2) verbal dispatcher assistance (n=52). The simulation video records were reviewed to assess the CPR performance using a 13-item checklist. The interval from call reception to the first compression, total number and rate of compressions, total number and duration of pauses after the first compression were also recorded. RESULTS: There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score (5.6±2.2 vs. 5.1±1.9, P>0.05) or individual criteria of the CPR performance checklist. The recording-assisted group demonstrated significantly shorter time interval from call receipt to the first compression (86.0±14.3 vs. 91.2±14.2 s, P<0.05), higher compression rate (94.9±26.4 vs. 89.1±32.8 min-1) and number of compressions provided (170.2±48.0 vs. 156.2±60.7). CONCLUSION: When provided by untrained persons in the simulated settings, the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR. Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.

Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.

PubMed

Ringh, Mattias; Rosenqvist, Mårten; Hollenberg, Jacob; Jonsson, Martin; Fredman, David; Nordberg, Per; Järnbert-Pettersson, Hans; Hasselqvist-Ax, Ingela; Riva, Gabriel; Svensson, Leif

2015-06-11

Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiac arrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital cardiac arrest. We conducted a blinded, randomized, controlled trial in Stockholm from April 2012 through December 2013. A mobile-phone positioning system that was activated when ambulance, fire, and police services were dispatched was used to locate trained volunteers who were within 500 m of patients with out-of-hospital cardiac arrest; volunteers were then dispatched to the patients (the intervention group) or not dispatched to them (the control group). The primary outcome was bystander-initiated CPR before the arrival of ambulance, fire, and police services. A total of 5989 lay volunteers who were trained in CPR were recruited initially, and overall 9828 were recruited during the study. The mobile-phone positioning system was activated in 667 out-of-hospital cardiac arrests: 46% (306 patients) in the intervention group and 54% (361 patients) in the control group. The rate of bystander-initiated CPR was 62% (188 of 305 patients) in the intervention group and 48% (172 of 360 patients) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001). A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiac arrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.).

The linguistic and interactional factors impacting recognition and dispatch in emergency calls for out-of-hospital cardiac arrest: a mixed-method linguistic analysis study protocol.

PubMed

Riou, Marine; Ball, Stephen; Williams, Teresa A; Whiteside, Austin; O'Halloran, Kay L; Bray, Janet; Perkins, Gavin D; Cameron, Peter; Fatovich, Daniel M; Inoue, Madoka; Bailey, Paul; Brink, Deon; Smith, Karen; Della, Phillip; Finn, Judith

2017-07-09

Emergency telephone calls placed by bystanders are crucial to the recognition of out-of-hospital cardiac arrest (OHCA), fast ambulance dispatch and initiation of early basic life support. Clear and efficient communication between caller and call-taker is essential to this time-critical emergency, yet few studies have investigated the impact that linguistic factors may have on the nature of the interaction and the resulting trajectory of the call. This research aims to provide a better understanding of communication factors impacting on the accuracy and timeliness of ambulance dispatch. A dataset of OHCA calls and their corresponding metadata will be analysed from an interdisciplinary perspective, combining linguistic analysis and health services research. The calls will be transcribed and coded for linguistic and interactional variables and then used to answer a series of research questions about the recognition of OHCA and the delivery of basic life-support instructions to bystanders. Linguistic analysis of calls will provide a deeper understanding of the interactional dynamics between caller and call-taker which may affect recognition and dispatch for OHCA. Findings from this research will translate into recommendations for modifications of the protocols for ambulance dispatch and provide directions for further research. The study has been approved by the Curtin University Human Research Ethics Committee (HR128/2013) and the St John Ambulance Western Australia Research Advisory Group. Findings will be published in peer-reviewed journals and communicated to key audiences, including ambulance dispatch professionals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Death of a child in the emergency department.

PubMed

O'Malley, Patricia J; Barata, Isabel A; Snow, Sally K

2014-07-01

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED.

The Effects of Noise on Performance

DTIC Science & Technology

1989-06-01

Performance" by C. S. Harris in W. D. Ward (Ed.) Proceedings of the International Congress on Noise as a Public Health Problem (EPA 550/9-73-008), 1973, U.S...141a duration tracking for primary task. Suggestion 35 at 1-9s Intervals Secondary task-response ot addivity for secondary 55 time task decrement. 95...In G. Rossi (Ed.) Pro eedings of the Fourth International Congress on Noise as a Public Health Problem, Vol- 2. Milan: Centro Ricerche e Studi

Erectile Dysfunction in Brazilian Primary Health Care: Dealing with Medicalization

PubMed Central

Modesto, Antônio Augusto Dall’Agnol; Couto, Marcia Thereza

2017-01-01

Erectile dysfunction (ED) is a common sexual problem and has been attracting growing interest from the field of medicine. The pharmaceutical industry works together with medical associations to popularize the theme, emphasizing individual enhancement and medication, besides reinforcing an idea of a male sexuality defined by the ability to have an erection and penetrate. Patients worried about erection problems search for general practitioners (GPs), frequently without a clear complaint, and a comprehensive primary health care (PHC) must be capable of dealing with these issues considering medicalization and disease mongering. This article discusses how PHC physicians take (and might take) care of men with erection problems, and how users perceive it and search for help in two cities in the State of São Paulo, Brazil. The qualitative research, performed in five PHC services, included semistructured interviews with 16 GPs and 15 adult male users. The adult male users were invited by their doctors during consultations where questions about prostate, ED, or other sexual problems arose. Interviews were transcribed and submitted for content analysis. In addition, the five participating services were observed with help of a specific script. Results indicate that ED is frequently a hidden agenda and that doctors have trouble approaching the problem, usually focusing on the biological aspects. Based on empirical data and literature, this work indicates some measures to qualify the care of men with ED in PHC which includes contemplating users’ questions, respecting their autonomy, avoiding an antidrug stance, and considering drug and nondrug approaches as a continuum of resources. PMID:29076407

Emergency department throughput, crowding, and financial outcomes for hospitals.

PubMed

Handel, Daniel A; Hilton, Joshua A; Ward, Michael J; Rabin, Elaine; Zwemer, Frank L; Pines, Jesse M

2010-08-01

Emergency department (ED) crowding has been identified as a major public health problem in the United States by the Institute of Medicine. ED crowding not only is associated with poorer patient outcomes, but it also contributes to lost demand for ED services when patients leave without being seen and hospitals must go on ambulance diversion. However, somewhat paradoxically, ED crowding may financially benefit hospitals. This is because ED crowding allows hospitals to maximize occupancy with well-insured, elective patients while patients wait in the ED. In this article, the authors propose a more holistic model of hospital flow and revenue that contradicts this notion and offer suggestions for improvements in ED and hospital management that may not only reduce crowding and improve quality, but also increase hospital revenues. Also proposed is that increased efficiency and quality in U.S. hospitals will require changes in systematic microeconomic and macroeconomic incentives that drive the delivery of health services in the United States. Finally, the authors address several questions to propose mutually beneficial solutions to ED crowding that include the realignment of hospital incentives, changing culture to promote flow, and several ED-based strategies to improve ED efficiency.

3D analysis of semiconductor devices: A combination of 3D imaging and 3D elemental analysis

NASA Astrophysics Data System (ADS)

Fu, Bianzhu; Gribelyuk, Michael A.

2018-04-01

3D analysis of semiconductor devices using a combination of scanning transmission electron microscopy (STEM) Z-contrast tomography and energy dispersive spectroscopy (EDS) elemental tomography is presented. 3D STEM Z-contrast tomography is useful in revealing the depth information of the sample. However, it suffers from contrast problems between materials with similar atomic numbers. Examples of EDS elemental tomography are presented using an automated EDS tomography system with batch data processing, which greatly reduces the data collection and processing time. 3D EDS elemental tomography reveals more in-depth information about the defect origin in semiconductor failure analysis. The influence of detector shadowing and X-rays absorption on the EDS tomography's result is also discussed.

14 CFR Special Federal Aviation... - Alternative Communications and Dispatching Procedures

Code of Federal Regulations, 2010 CFR

2010-01-01

... Procedures Federal Special Federal Aviation Regulation 80 Aeronautics and Space FEDERAL AVIATION... No. 80 Special Federal Aviation Regulation 80—Alternative Communications and Dispatching Procedures 1. Applicability. This Special Federal Aviation Regulation applies to each holder of an air carrier or operating...

14 CFR Special Federal Aviation... - Alternative Communications and Dispatching Procedures

Code of Federal Regulations, 2011 CFR

2011-01-01

... Procedures Federal Special Federal Aviation Regulation 80 Aeronautics and Space FEDERAL AVIATION... No. 80 Special Federal Aviation Regulation 80—Alternative Communications and Dispatching Procedures 1. Applicability. This Special Federal Aviation Regulation applies to each holder of an air carrier or operating...

77 FR 64498 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... Dispatchable Wind 1, LLC. Description: TEXAS DISPATCHABLE WIND 1, LLC MBR Application to be effective 10/10... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice.../12. Docket Numbers: ER12-2619-001. Applicants: Eligo Energy, LLC. Description: Amendment to...

Emergency Medical Dispatch. National Standard Curriculum. Instructor Guide. Trainee Guide.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This guide contains all instructor materials and requirements for the National Highway Traffic Safety Administration (NHTSA), Emergency Medical Dispatch (EMD) National Standard Curriculum. It includes lesson plans, instructional aids, and tools and supporting information designed to elevate trained and experienced public safety telecommunicators…

Evaluation of transit operations : data applications of Tri-Met's automated bus dispatching system

DOT National Transportation Integrated Search

2001-02-01

This paper presents an analysis of operating performance for Tri-Met, the transit provider for the Portland, Oregon metropolitan area. The analysis draws on data recovered by Tri-Met's automated Bus Dispatching System (BDS) and focuses on two main su...

Highballing with flimsies : working under train orders on the Espee's coast line

DOT National Transportation Integrated Search

1990-01-01

In classic timetable and train-order territory, the study focuses on several dimensions of train : dispatchers' work, viewed through the other end of the telescope, i.e., from the perspective of the : dispatched train crewmembers and others in the fi...

Dispatching demand response transit service maximizing productivity and service quality guidebook : final report, March 2009.

DOT National Transportation Integrated Search

2009-03-01

The ability of transit agencies to staff dispatch effectively and use technology to its full advantage is critical : in responding proactively as service changes occur and in making sound routing decisions. Sound routing : decisions result in improve...

14 CFR 121.535 - Responsibility for operational control: Flag operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations...— (1) Monitoring the progress of each flight; (2) Issuing necessary instructions and information for...

14 CFR 121.535 - Responsibility for operational control: Flag operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations...— (1) Monitoring the progress of each flight; (2) Issuing necessary instructions and information for...

14 CFR 121.535 - Responsibility for operational control: Flag operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations...— (1) Monitoring the progress of each flight; (2) Issuing necessary instructions and information for...

14 CFR 121.535 - Responsibility for operational control: Flag operations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations...— (1) Monitoring the progress of each flight; (2) Issuing necessary instructions and information for...

14 CFR 121.535 - Responsibility for operational control: Flag operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... dispatcher are jointly responsible for the preflight planning, delay, and dispatch release of a flight in... AND OPERATIONS OPERATING REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations...— (1) Monitoring the progress of each flight; (2) Issuing necessary instructions and information for...

Socializing problems and low self-esteem enhance interpersonal models of eating disorders: Evidence from a clinical sample.

PubMed

Raykos, Bronwyn C; McEvoy, Peter M; Fursland, Anthea

2017-09-01

The present study evaluated the relative clinical validity of two interpersonal models of the maintenance of eating disorders, IPT-ED (Rieger et al., ) and the interpersonal model of binge eating (Wilfley, MacKenzie, Welch, Ayres, & Weissman, ; Wilfley, Pike, & Striegel-Moore, ). While both models propose an indirect relationship between interpersonal problems and eating disorder symptoms via negative affect, IPT-ED specifies negative social evaluation as the key interpersonal problem, and places greater emphasis on the role of low self-esteem as an intermediate variable between negative social evaluation and eating pathology. Treatment-seeking individuals (N = 306) with a diagnosed eating disorder completed measures of socializing problems, generic interpersonal problems, self-esteem, eating disorder symptoms, and negative affect (depression and anxiety). Structural equation models were run for both models. Consistent with IPT-ED, a significant indirect pathway was found from socializing problems to eating disorder symptoms via low self-esteem and anxiety symptoms. There was also a direct pathway from low self-esteem to eating disorder symptoms. Using a socializing problems factor in the model resulted in a significantly better fit than a generic interpersonal problems factor. Inconsistent with both interpersonal models, the direct pathway from socializing problems to eating disorder symptoms was not supported. Interpersonal models that included self-esteem and focused on socializing problems (rather than generic interpersonal problems) explained more variance in eating disorder symptoms. Future experimental, prospective, and treatment studies are required to strengthen the case that these pathways are causal. © 2017 Wiley Periodicals, Inc.

Why Do Patients With Cancer Visit Emergency Departments? Results of a 2008 Population Study in North Carolina

PubMed Central

Mayer, Deborah K.; Travers, Debbie; Wyss, Annah; Leak, Ashley; Waller, Anna

2011-01-01

Purpose Emergency departments (EDs) in the United States are used by patients with cancer for disease or treatment-related problems and unrelated issues. The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) collects information about ED visits through a statewide database. Patients and Methods After approval by the institutional review board, 2008 NC DETECT ED visit data were acquired and cancer-related visits were identified. Descriptive statistics and logistic regressions were performed. Of 4,190,911 ED visits in 2008, there were 37,760 ED visits by 27,644 patients with cancer. Results Among patients, 77.2% had only one ED visit in 2008, the mean age was 64 years, and there were slightly more men than women. Among visits, the payor was Medicare for 52.4% and Medicaid for 12.1%. More than half the visits by patients with cancer occurred on weekends or evenings, and 44.9% occurred during normal hours. The top three chief complaints were related to pain, respiratory distress, and GI issues. Lung, breast, prostate, and colorectal cancers were identified in 26.9%, 6.3%, 6%, and 7.7% of visits, respectively, with diagnosis. A total of 63.2% of visits resulted in hospital admittance. When controlling for sex, age, time of day, day of week, insurance, and diagnosis position, patients with lung cancer were more likely to be admitted than patients with other types of cancer. Conclusion To the best of our knowledge, this is the first study to provide a population-based snapshot of ED visits by patients with cancer in North Carolina. Efforts that target clinical problems and specific populations may improve delivery of quality cancer care and avoid ED visits. PMID:21606431

Tertiary paediatric emergency department use in children and young people with cerebral palsy.

PubMed

Meehan, Elaine; Reid, Susan M; Williams, Katrina; Freed, Gary L; Babl, Franz E; Sewell, Jillian R; Rawicki, Barry; Reddihough, Dinah S

2015-10-01

The aim of this study was to describe the pattern of tertiary paediatric emergency department (ED) use in children and young people with cerebral palsy (CP). A retrospective analysis of ED data routinely collected at the two tertiary paediatric hospitals in Victoria, Australia, cross-matched with the Victorian Cerebral Palsy Register. Data pertaining to the ED presentations of 2183 registered individuals born 1993-2008 were obtained. Between 2008 and 2012, 37% (n = 814) of the CP cohort had 3631 tertiary paediatric ED presentations. Overall, 40% (n = 332) of presenters were residing in inner metropolitan Melbourne; 44% (n = 356) in outer Melbourne; and 13% (n = 108) in regional Victoria. Presenters were more likely than non-presenters to be younger, non-ambulant and have epilepsy. In total, 71% of presentations were triaged as Australasian Triage Scale 1-3 (urgent), and 44% resulted in a hospital admission. Disorders of the respiratory, neurological and gastrointestinal systems, and medical device problems were responsible for 72% of presentations. Many of the tertiary paediatric ED presentations in this group were appropriate based on the high admission rate and the large proportion triaged as urgent. However, there is evidence that some families are bypassing local services and travelling long distances to attend the tertiary paediatric ED, even for less urgent complaints that do not require hospital admission. Alternative pathways of care delivery, and strategies to promote the management of common problems experienced by children and young people with CP in non-paediatric EDs or primary care settings, may go some way towards reducing unnecessary tertiary paediatric ED use in this group. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Development and implementation of a dynamic TES dispatch control component in a PV-CSP techno-economic performance modelling tool

NASA Astrophysics Data System (ADS)

Hansson, Linus; Guédez, Rafael; Larchet, Kevin; Laumert, Bjorn

2017-06-01

The dispatchability offered by thermal energy storage (TES) in concentrated solar power (CSP) and solar hybrid plants based on such technology presents the most important difference compared to power generation based only on photovoltaics (PV). This has also been one reason for recent hybridization efforts of the two technologies and the creation of Power Purchase Agreement (PPA) payment schemes based on offering higher payment multiples during daily hours of higher (peak or priority) demand. Recent studies involving plant-level thermal energy storage control strategies are however to a large extent based on pre-determined approaches, thereby not taking into account the actual dynamics of thermal energy storage system operation. In this study, the implementation of a dynamic dispatch strategy in the form of a TRNSYS controller for hybrid PV-CSP plants in the power-plant modelling tool DYESOPT is presented. In doing this it was attempted to gauge the benefits of incorporating a day-ahead approach to dispatch control compared to a fully pre-determined approach determining hourly dispatch only once prior to annual simulation. By implementing a dynamic strategy, it was found possible to enhance technical and economic performance for CSP-only plants designed for peaking operation and featuring low values of the solar multiple. This was achieved by enhancing dispatch control, primarily by taking storage levels at the beginning of every simulation day into account. The sequential prediction of the TES level could therefore be improved, notably for evaluated plants without integrated PV, for which the predicted storage levels deviated less than when PV was present in the design. While also featuring dispatch performance gains, optimal plant configurations for hybrid PV-CSP was found to present a trade-off in economic performance in the form of an increase in break-even electricity price when using the dynamic strategy which was offset to some extent by a reduction in upfront investment cost. An increase in turbine starts for the implemented strategy however highlights that this is where further improvements can be made.

Weighted Distributions Arising Out of Methods of Ascertainment.

DTIC Science & Technology

1984-07-01

control and statistical problems generated by it. In Applications of Statistics, P. R. Krishnaiah (ed.), North-Holland, 1-26. Patil, 0. P. and Ord, J. K...weighted distributions: A survey of their applications. In Aplications of Statistics, P. R. Krishnaiah (ed.), 383-405, North Holland Publishing Company

The breakdown of an emergency system following a gas explosion in Osaka and the subsequent resolution of problems.

PubMed

Ishida, T; Ohta, M; Sugimoto, T

1985-01-01

Osaka, a modern urban metropolis in Japan, experienced a tragic gas explosion in 1970 when the dispatch room of the City Fire Department was in the process of being moved to a new building. Many unforseen problems arose during this disaster: eg, there was an overall lack of leadership, confusion of communication, a need for triage, and lack of control of mass media. The Osaka Medical Association organized a committee to resolve these problems. Their conclusions and recommendations were that a control headquarters be established at the scene of disaster, the number of ambulances and EMTs be increased, disaster tags be utilized, a special radio frequency be created, and a computer-aided command and control system for fire fighting and ambulance services be introduced. These recommendations have all been followed.

Instituto Nacional de Electrification, Guatemala Load Dispatch Center and Global Communications Center. Feasibility report (Instituto Nacional de Electrificacion, Guatemala Centro Nacional de Despacho de Carga y Sistema Global de Comunicaciones). Export trade information

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1985-07-01

The report presents the results of a feasibility study for the National Load Dispatch Center and Global Communications System Project in Guatemala. The project consists of a communication system which will provide Institute Nacional de Electrificacion (INDE) operations personnel direct voice access to all major power system facilities. In addition, a modern computer based load dispatch center has been configured on a secure and reliable basis to provide automatic generation control of all major interconnected generating plants within Guatemala.

Technical assistance for law-enforcement communications: Case study report two

NASA Technical Reports Server (NTRS)

Reilly, N. B.; Mustain, J. A.

1979-01-01

Two case histories are presented. In one study the feasibility of consolidating dispatch center operations for small agencies is considered. System load measurements were taken and queueing analysis applied to determine numbers of personnel required for each separate agency and for a consolidated dispatch center. Functional requirements were developed and a cost model was designed to compare relative costs of various alternatives including continuation of the present system, consolidation of a manual system, and consolidated computer-aided dispatching. The second case history deals with the consideration of a multi-regional, intrastate radio frequency for improved interregional communications. Sample standards and specifications for radio equipment are provided.

Air Quality Improvements of Increased Integration of Renewables: Solar Photovoltaics Penetration Scenarios

NASA Astrophysics Data System (ADS)

Duran, P.; Holloway, T.; Brinkman, G.; Denholm, P.; Littlefield, C. M.

2011-12-01

Solar photovoltaics (PV) are an attractive technology because they can be locally deployed and tend to yield high production during periods of peak electric demand. These characteristics can reduce the need for conventional large-scale electricity generation, thereby reducing emissions of criteria air pollutants (CAPs) and improving ambient air quality with regard to such pollutants as nitrogen oxides, sulfur oxides and fine particulates. Such effects depend on the local climate, time-of-day emissions, available solar resources, the structure of the electric grid, and existing electricity production among other factors. This study examines the air quality impacts of distributed PV across the United States Eastern Interconnection. In order to accurately model the air quality impact of distributed PV in space and time, we used the National Renewable Energy Lab's (NREL) Regional Energy Deployment System (ReEDS) model to form three unique PV penetration scenarios in which new PV construction is distributed spatially based upon economic drivers and natural solar resources. Those scenarios are 2006 Eastern Interconnection business as usual, 10% PV penetration, and 20% PV penetration. With the GridView (ABB, Inc) dispatch model, we used historical load data from 2006 to model electricity production and distribution for each of the three scenarios. Solar PV electric output was estimated using historical weather data from 2006. To bridge the gap between dispatch and air quality modeling, we will create emission profiles for electricity generating units (EGUs) in the Eastern Interconnection from historical Continuous Emissions Monitoring System (CEMS) data. Via those emissions profiles, we will create hourly emission data for EGUs in the Eastern Interconnect for each scenario during 2006. Those data will be incorporated in the Community Multi-scale Air Quality (CMAQ) model using the Sparse Matrix Operator Kernel Emissions (SMOKE) model. Initial results indicate that PV penetration significantly reduces conventional peak electricity production and that, due to reduced emissions during periods of extremely active photochemistry, air quality could see benefits.

View southeast of computer controlled energy monitoring system. System replaced ...

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

View southeast of computer controlled energy monitoring system. System replaced strip chart recorders and other instruments under the direct observation of the load dispatcher. - Thirtieth Street Station, Load Dispatch Center, Thirtieth & Market Streets, Railroad Station, Amtrak (formerly Pennsylvania Railroad Station), Philadelphia, Philadelphia County, PA

Flexible Energy Scheduling Tool for Integrating Variable Generation | Grid

Science.gov Websites

, security-constrained economic dispatch, and automatic generation control programs. DOWNLOAD PAPER Electric commitment, security-constrained economic dispatch, and automatic generation control sub-models. Each sub resolutions and operating strategies can be explored. FESTIV produces not only economic metrics but also

A biometeorology study of climate and heat-related morbidity in Phoenix from 2001 to 2006

NASA Astrophysics Data System (ADS)

Golden, Jay S.; Hartz, Donna; Brazel, Anthony; Luber, George; Phelan, Patrick

2008-07-01

Heat waves kill more people in the United States than hurricanes, tornadoes, earthquakes, and floods combined. Recently, international attention focused on the linkages and impacts of human health vulnerability to urban climate when Western Europe experienced over 30,000 excess deaths during the heat waves of the summer of 2003—surpassing the 1995 heat wave in Chicago, Illinois, that killed 739. While Europe dealt with heat waves, in the United States, Phoenix, Arizona, established a new all-time high minimum temperature for the region on July 15, 2003. The low temperature of 35.5°C (96°F) was recorded, breaking the previous all-time high minimum temperature record of 33.8°C (93°F). While an extensive literature on heat-related mortality exists, greater understanding of influences of heat-related morbidity is required due to climate change and rapid urbanization influences. We undertook an analysis of 6 years (2001 2006) of heat-related dispatches through the Phoenix Fire Department regional dispatch center to examine temporal, climatic and other non-spatial influences contributing to high-heat-related medical dispatch events. The findings identified that there were no significant variations in day-of-week dispatch events. The greatest incidence of heat-related medical dispatches occurred between the times of peak solar irradiance and maximum diurnal temperature, and during times of elevated human comfort indices (combined temperature and relative humidity).

Outcome of patients identified as dead (beyond resuscitation) at the point of the emergency call.

PubMed

Harvey, L; Woollard, M

2004-05-01

Currently, an emergency ambulance is dispatched to all cardiac arrest victims. This study aimed to determine the outcome of patients with a dispatch code of 09B01 ("obvious death") and considers the appropriateness of dispatching a non-emergency response. Dispatch records, patient report forms, and hospital records were reviewed to determine patient outcome. Within the one year study period 141 emergency calls were coded as 09B01. Records were obtained for 59 of these cases (42%). Ambulance crews diagnosed 54 as beyond resuscitation (91.5%, 95% CI 79.5% to 96.2%). Three received resuscitation attempts (5.1%, 95% CI 1.1% to 14.2%): two were subsequently pronounced dead at scene and one on arrival at hospital. Two patients were not in cardiac arrest (3.4%, 95% CI 0.4% to 11.7%): one was a transiently unconscious assault victim, and one had a hand injury after a road accident. Three patients coded as 09B01 were transported to hospital for treatment other than confirmation of death (5.1%, 95% CI 1.1% to 14.2%). Not all patients coded 09B01 by dispatchers are assessed as "dead beyond resuscitation" by attending ambulance crews. Although poor data recovery and a small sample size limited the study, its findings suggest that it is inappropriate to allocate a non-emergency response to 09B01 (obvious death) calls.

Home Care Providers to the Rescue: A Novel First-Responder Programme

PubMed Central

Hansen, Steen M.; Brøndum, Stig; Thomas, Grethe; Rasmussen, Susanne R.; Kvist, Birgitte; Christensen, Anette; Lyng, Charlotte; Lindberg, Jan; Lauritsen, Torsten L. B.; Lippert, Freddy K.; Torp-Pedersen, Christian; Hansen, Poul A.

2015-01-01

Aim To describe the implementation of a novel first-responder programme in which home care providers equipped with automated external defibrillators (AEDs) were dispatched in parallel with existing emergency medical services in the event of a suspected out-of-hospital cardiac arrest (OHCA). Methods We evaluated a one-year prospective study that trained home care providers in performing cardiopulmonary resuscitation (CPR) and using an AED in cases of suspected OHCA. Data were collected from cardiac arrest case files, case files from each provider dispatch and a survey among dispatched providers. The study was conducted in a rural district in Denmark. Results Home care providers were dispatched to 28 of the 60 OHCAs that occurred in the study period. In ten cases the providers arrived before the ambulance service and subsequently performed CPR. AED analysis was executed in three cases and shock was delivered in one case. For 26 of the 28 cases, the cardiac arrest occurred in a private home. Ninety-five per cent of the providers who had been dispatched to a cardiac arrest reported feeling prepared for managing the initial resuscitation, including use of AED. Conclusion Home care providers are suited to act as first-responders in predominantly rural and residential districts. Future follow-up will allow further evaluation of home care provider arrivals and patient survival. PMID:26509532

A biometeorology study of climate and heat-related morbidity in Phoenix from 2001 to 2006.

PubMed

Golden, Jay S; Hartz, Donna; Brazel, Anthony; Luber, George; Phelan, Patrick

2008-07-01

Heat waves kill more people in the United States than hurricanes, tornadoes, earthquakes, and floods combined. Recently, international attention focused on the linkages and impacts of human health vulnerability to urban climate when Western Europe experienced over 30,000 excess deaths during the heat waves of the summer of 2003-surpassing the 1995 heat wave in Chicago, Illinois, that killed 739. While Europe dealt with heat waves, in the United States, Phoenix, Arizona, established a new all-time high minimum temperature for the region on July 15, 2003. The low temperature of 35.5 degrees C (96 degrees F) was recorded, breaking the previous all-time high minimum temperature record of 33.8 degrees C (93 degrees F). While an extensive literature on heat-related mortality exists, greater understanding of influences of heat-related morbidity is required due to climate change and rapid urbanization influences. We undertook an analysis of 6 years (2001-2006) of heat-related dispatches through the Phoenix Fire Department regional dispatch center to examine temporal, climatic and other non-spatial influences contributing to high-heat-related medical dispatch events. The findings identified that there were no significant variations in day-of-week dispatch events. The greatest incidence of heat-related medical dispatches occurred between the times of peak solar irradiance and maximum diurnal temperature, and during times of elevated human comfort indices (combined temperature and relative humidity).

Research on wind power grid-connected operation and dispatching strategies of Liaoning power grid

NASA Astrophysics Data System (ADS)

Han, Qiu; Qu, Zhi; Zhou, Zhi; He, Xiaoyang; Li, Tie; Jin, Xiaoming; Li, Jinze; Ling, Zhaowei

2018-02-01

As a kind of clean energy, wind power has gained rapid development in recent years. Liaoning Province has abundant wind resources and the total installed capacity of wind power is in the forefront. With the large-scale wind power grid-connected operation, the contradiction between wind power utilization and peak load regulation of power grid has been more prominent. To this point, starting with the power structure and power grid installation situation of Liaoning power grid, the distribution and the space-time output characteristics of wind farm, the prediction accuracy, the curtailment and the off-grid situation of wind power are analyzed. Based on the deep analysis of the seasonal characteristics of power network load, the composition and distribution of main load are presented. Aiming at the problem between the acceptance of wind power and power grid adjustment, the scheduling strategies are given, including unit maintenance scheduling, spinning reserve, energy storage equipment settings by the analysis of the operation characteristics and the response time of thermal power units and hydroelectric units, which can meet the demand of wind power acceptance and provide a solution to improve the level of power grid dispatching.

Vehicle coordinated transportation dispatching model base on multiple crisis locations

NASA Astrophysics Data System (ADS)

Tian, Ran; Li, Shanwei; Yang, Guoying

2018-05-01

Many disastrous events are often caused after unconventional emergencies occur, and the requirements of disasters are often different. It is difficult for a single emergency resource center to satisfy such requirements at the same time. Therefore, how to coordinate the emergency resources stored by multiple emergency resource centers to various disaster sites requires the coordinated transportation of emergency vehicles. In this paper, according to the problem of emergency logistics coordination scheduling, based on the related constraints of emergency logistics transportation, an emergency resource scheduling model based on multiple disasters is established.

[Pediatric anesthesia emergence delirium after elective ambulatory surgery: etiology, risk factors and prevalence].

PubMed

Gololobov, Alik; Todris, Liat; Berman, Yakov; Rosenberg-Gilad, Zipi; Schlaeffer, Pnina; Kenett, Ron; Ben-Jacob, Ron; Segal, Eran

2015-04-01

Emergence delirium (ED) is a common problem among children and adults recovering from general anesthesia after surgery. Its symptoms include psychomotor agitation, hallucinations, and aggressive behavior. The phenomenon, which is most probably an adverse effect of general anesthesia agents, harms the recovery process and endangers the physical safety of patients and their health. Ranging between 10% and 80%, the exact prevalence of ED is unknown, and the risk factors of the phenomenon are unclear. The aim of the current retrospective study was to determine the prevalence rate of ED in 3947 children recovering from general anesthesia after short elective ambulatory surgery, and to map the influence of various risk factors on this phenomenon. Data were collected using electronic medical records. ED severity was assessed using the Pediatric Anesthesia Emergence Delirium Scale. Results showed the prevalence of ED among children. ED was significantly correlated with patients' age, type of surgery and premedication. ED was not correlated with severity of pain, type of anesthesia or with patients' sex.

Informing the Design and Evaluation of Superuser Care Management Initiatives: Accounting for Regression-to-the-Mean.

PubMed

Chakravarty, Sujoy; Cantor, Joel C

2016-09-01

Health care spending is concentrated among a small number of high-cost patients, and the popularity of initiatives to improve care and reduce cost among such "superusers" (SUs) is growing. However, SU costs decline naturally over time, even without intervention, a statistical phenomenon known as regression-to-the-mean (RTM). We assess the magnitude of RTM in hospital costs for cohorts of hospital SUs identified on the basis of high inpatient (IP) or emergency department (ED) utilization. We further examine how cost and RTM are associated with patient characteristics including behavioral health (BH) problems, multiple chronic conditions, and indicators of vulnerability. Using longitudinally linked all-payer hospital billing data, we selected patient cohorts with ≥2 IP stays (IP SUs) or ≥6 ED visits (ED SUs) during a 6-month baseline period, and additional subgroups defined by combinations of IP and ED superuse. A total of 289,060 NJ hospital IP and treat-and-release ED patients over 2009-2011. Hospital costs among IP and ED SUs declined 70% and 38%, respectively, over 8 quarters following the baseline period. The decrease occurs more quickly for IP SUs compared with ED SUs. Presence of BH problems was positively associated with costs among patients overall, but the relationship varied by SU cohort. Understanding patterns of RTM among SU populations is important for designing intervention strategies, as there is greater potential for savings among patients with more persistent costs (less RTM). Further, as many SU initiatives lack resources for rigorous evaluation, quantifying the extent of RTM is vital for interpreting program outcomes.

Death of a child in the emergency department.

PubMed

O'Malley, Patricia; Barata, Isabel; Snow, Sally

2014-07-01

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED. Copyright © 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. Published by Mosby, Inc. All rights reserved.

Death of a child in the emergency department.

PubMed

O'Malley, Patricia; Barata, Isabel; Snow, Sally

2014-07-01

The death of a child in the emergency department (ED) is one of the most challenging problems facing ED clinicians. This revised technical report and accompanying policy statement reaffirm principles of patient- and family-centered care. Recent literature is examined regarding family presence, termination of resuscitation, bereavement responsibilities of ED clinicians, support of child fatality review efforts, and other issues inherent in caring for the patient, family, and staff when a child dies in the ED. Appendices are provided that offer an approach to bereavement activities in the ED, carrying out forensic responsibilities while providing compassionate care, communicating the news of the death of a child in the acute setting, providing a closing ritual at the time of terminating resuscitation efforts, and managing the child with a terminal condition who presents near death in the ED. Copyright © 2014 by the American Academy of Pediatrics.

Eating disorders, normative eating self-efficacy and body image self-efficacy: women in recovery homes.

PubMed

Czarlinski, Jennifer A; Aase, Darrin M; Jason, Leonard A

2012-05-01

Although eating disorders (EDs) and ED symptoms are common among individuals in recovery for substance abuse (SA), long-term SA treatment programmes rarely address these problems. The present study examined the prevalence of EDs among women residing in Oxford Houses--low-cost, self-governed recovery homes for SA. Further, among women both with and without an ED diagnosis, the association between duration of Oxford House residency and eating-related self-efficacy scores was examined as an indicator of potential treatment effects on ED symptoms. During a telephone assessment, participants were administered the Structured Clinical Interview for DSM-IV-TR Axis I Disorders and the Eating Disorder Recovery Self-Efficacy Questionnaire. Results indicated that 12 of the 31 women analysed met criteria for an ED (bulimia nervosa, 2; ED not otherwise specified, 10). Differential findings were evident for eating-related self-efficacy measures depending on ED diagnostic status and duration of residency. Potential interpretations, limitations and implications are discussed. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Training Program for Emergency Medical Technician: Dispatcher. 2--Instructor Lesson Plans.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

Intended to assist instructors who wish to conduct a training course for emergency medical technicians (EMTs) serving as dispatchers, this document contains detailed lesson plans organized to structure course presentations. Each lesson plan includes the following elements: unit objectives; suggestions for adapting the lessons to local policies and…

40 CFR 72.92 - Phase I unit allowance surrender.

Code of Federal Regulations, 2010 CFR

2010-07-01

... chapter) for all Phase I units in the dispatch system. (iii) Calculating percentage change in dispatch... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Phase I unit allowance surrender. 72... (CONTINUED) PERMITS REGULATION Compliance Certification § 72.92 Phase I unit allowance surrender. (a) Annual...

40 CFR 72.92 - Phase I unit allowance surrender.

Code of Federal Regulations, 2011 CFR

2011-07-01

... chapter) for all Phase I units in the dispatch system. (iii) Calculating percentage change in dispatch... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Phase I unit allowance surrender. 72... (CONTINUED) PERMITS REGULATION Compliance Certification § 72.92 Phase I unit allowance surrender. (a) Annual...

45 CFR 2105.3 - Action on initial requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sound grounds. (b) Determination will be dispatched within ten days, excluding Saturdays, Sundays, and... initial determination on requests may be delayed up to a total of ten additional days, excluding Saturdays, Sundays, and legal public holidays and notice of such delay shall be dispatched within the first ten days...

77 FR 64500 - Combined Notice of Filings #1

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

...-000. Applicants: Texas Dispatchable Wind 1, LLC. Description: Self-Certification of Texas Dispatchable Wind 1, LLC. Filed Date: 10/11/12. Accession Number: 20121011-5210. Comments Due: 5 p.m. ET 11/1/12... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Combined Notice of Filings 1 Take notice...

49 CFR 241.11 - Prohibition against conducting a railroad operation dispatched by an extraterritorial dispatcher...

Code of Federal Regulations, 2010 CFR

2010-10-01

... opportunity to file a waiver request pursuant to § 241.7. (c) Emergencies. (1) In an emergency situation, a... mail. (3) A list of the States that make up the FRA regions and the street and e-mail addresses and fax...

14 CFR 121.605 - Airplane equipment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

14 CFR 121.605 - Airplane equipment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

14 CFR 121.605 - Airplane equipment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

14 CFR 121.605 - Airplane equipment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

14 CFR 121.605 - Airplane equipment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

78 FR 63172 - Commission Information Collection Activities (FERC-733); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... Electric Reliability Corporation (NERC) and EIA, to fielding and collecting data using a FERC designed... Commission in time to complete the 2014 report to Congress. NERC, as the Electric Reliability Organization... dispatchable and non-dispatchable resources that it needs to conduct its reliability work. Reporting demand...

MIT - Massachusetts Institute of Technology

Science.gov Websites

energy cancer diversity global industry public service Solve The MIT Campaign for a Better World give to produce electricity Drug-carrying nanoparticles could help fight brain cancer Drug-carrying nanoparticles could help fight brain cancer New dispatching approach optimizes a city's taxi fleet New dispatching

14 CFR 121.611 - Dispatch or flight release under VFR.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Dispatch or flight release under VFR. 121.611 Section 121.611 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... operation unless the ceiling and visibility en route, as indicated by available weather reports or forecasts...

14 CFR 121.611 - Dispatch or flight release under VFR.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Dispatch or flight release under VFR. 121.611 Section 121.611 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... operation unless the ceiling and visibility en route, as indicated by available weather reports or forecasts...

14 CFR 121.611 - Dispatch or flight release under VFR.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Dispatch or flight release under VFR. 121.611 Section 121.611 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... operation unless the ceiling and visibility en route, as indicated by available weather reports or forecasts...

14 CFR 121.611 - Dispatch or flight release under VFR.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Dispatch or flight release under VFR. 121.611 Section 121.611 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... operation unless the ceiling and visibility en route, as indicated by available weather reports or forecasts...

14 CFR 121.611 - Dispatch or flight release under VFR.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Dispatch or flight release under VFR. 121.611 Section 121.611 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... operation unless the ceiling and visibility en route, as indicated by available weather reports or forecasts...

14 CFR 121.99 - Communications facilities-domestic and flag operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... communication approved by the FAA certificate holding district office, is available over the entire route. The... communications under normal operating conditions between each airplane and the appropriate dispatch office, and... dispatch office must be independent of any system operated by the United States. (c) Each certificate...

14 CFR 121.99 - Communications facilities-domestic and flag operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... communication approved by the FAA certificate holding district office, is available over the entire route. The... communications under normal operating conditions between each airplane and the appropriate dispatch office, and... dispatch office must be independent of any system operated by the United States. (c) Each certificate...

Reshaping the All-Volunteer Force of the United States to Increase its Utility: A Reassessment of Over Forty Years of Experience

DTIC Science & Technology

2015-05-23

War] and the long campaign to ‘settle’ the Indian problem on the frontier.” Richard W. Stewart , ed., American Military His- tory Volume 1: The United...144. 6 Ibid., 167. 7 Stewart , ed., American Military History Volume I, 17. 5 structure that allowed for quick expansion. “This marked the...11 Stewart , ed., American Military History Volume 1, 304. 12 Ibid., 312. 13 Huntington, 161. The origins

Presentation of eating disorders in the news media: What are the implications for patient diagnosis and treatment?

PubMed

O'Hara, Sarah K; Smith, Katherine Clegg

2007-09-01

Eating disorder (ED) specialists increasingly see anorexia nervosa and bulimia nervosa as complex mental illnesses with both genetic and social roots. The public, however, tends to view EDs more simply as a manifestation of personal or social problems among female, white, young women. This disconnect potentially prevents timely ED diagnosis and reinforces a stigma that limits treatment availability. We examine the presentation of EDs in daily newspapers, an important contributor to shaping public perception of EDs. We analyze 1 year of coverage about EDs by seven daily U.S. newspapers (252 articles), focusing on the messages conveyed about epidemiology, etiology, severity and treatment. The highest proportion of articles about EDs (48%) ran in arts and entertainment sections. Articles primarily covered those who are female, young and white, and mentioned mainly environmental causal factors. Only 8% of patient profiles discussed treatment and recovery within a medical context. News coverage rarely presents EDs as complex medical phenomena, but rather simplifies and sensationalizes these conditions. Educators would benefit from recognizing the news media's role in shaping public perceptions of EDs in ways that differ from clinical perspectives, potentially limiting diagnosis and treatment. Three communication improvements are suggested.

Gene therapy as future treatment of erectile dysfunction

PubMed Central

Yoshimura, Naoki; Kato, Ryuichi; Chencellor, Michael B.; Nelson, Joel B.; Glorioso, Joseph C.

2011-01-01

Importance of the field Erectile dysfunction (ED) is a major men’s health problem. Although the high success rate of treating ED by phosphodiesterase 5 (PDE5) inhibitors has been reported, there are a significant number of ED patients who do not respond to currently available treatment modalities. Areas covered in this review To understand the current status of gene therapy application for ED, gene therapy approaches for ED treatment are reviewed. What the reader will gain Gene therapy strategies that can enhance nitric oxide (NO) production or NO-mediated signaling pathways, growth factor-mediated nerve regeneration or K+ channel activity in the smooth muscle could be promising approaches for the treatment of ED. Although the majority of gene therapy studies are still in the preclinical phase, the first clinical trial using non-viral gene transfer of Ca2+-activated, large-conductance K+ channels into the corpus cavernosum of ED patients showed positive results. Take home message Gene therapy represents an exciting future treatment option for ED, especially for people with severe ED unresponsive to current first-line therapies such as PDE5 inhibitors although the long-term safety of both viral and non-viral gene therapies should be established. PMID:20662742

Erectile Dysfunction after Radical Prostatectomy: Prevalence, Medical Treatments, and Psychosocial Interventions

PubMed Central

Emanu, Jessica C.; Avildsen, Isabelle K.; Nelson, Christian J.

2016-01-01

Purpose of review This review will discuss erectile dysfunction (ED) in prostate cancer patients following radical prostatectomy (RP). It will focus on the prevalence and current treatments for ED as well as the emotional impact of ED and the current psychosocial interventions designed to help patients cope with this side effect. Recent findings While there is a large discrepancy in prevalence rates of ED after RP, several recent studies have cited rates as high as 85%. The concept of “penile rehabilitation” is now the standard of practice to treat ED following RP. However, many men avoid seeking help or utilizing ED treatments. This avoidance is related to the shame, frustration, and distress many men with ED and their partners experience. Recent psychosocial interventions have been developed to facilitate the use of treatments and help men cope with ED. These interventions have shown initial promise, however, continued intervention development is needed to reduce distress and improve long-term erectile function (EF) outcomes. Summary ED is a significant problem following prostate cancer surgery. While there are effective medical treatments, the development of psychosocial interventions should continue to evolve to maximize the assistance we can give to men and their partners. PMID:26808052

Interpersonal problems across anxiety, depression, and eating disorders: a transdiagnostic examination.

PubMed

McEvoy, Peter M; Burgess, Melissa M; Page, Andrew C; Nathan, Paula; Fursland, Anthea

2013-06-01

Integrative models of psychopathology suggest that quality of interpersonal relationships is a key determinant of psychological well-being. However, there is a relative paucity of research evaluating the association between interpersonal problems and psychopathology within cognitive behavioural therapy. Partly, this may be due to lack of brief, well-validated, and easily interpretable measures of interpersonal problems that can be used within clinical settings. The aim of the present study was to evaluate the psychometric properties, factor invariance, and external validity of the Inventory of Interpersonal Problems 32 (IIP-32) across anxiety, depression, and eating disorders. Two treatment-seeking samples with principal anxiety and depressive disorders (AD sample, n = 504) and eating disorders (ED sample, n = 339) completed the IIP-32 along with measures of anxiety, depression, and eating disorder symptoms, as well as quality of life (QoL). The previously established eight-factor structure of the IIP-32 provided the best fit for both the AD and ED groups, and was robustly invariant across the two samples. The IIP-32 also demonstrated excellent external validity against well-validated measures of anxiety, depression, and eating disorder symptoms, as well as QoL. The IIP-32 provides a clinically useful measure of interpersonal problems across emotional and ED. © Commonwealth of Australia 2012.

Prevalence of problem drinking and characteristics of a single-question screen.

PubMed

Stewart, Scott H; Borg, Keith T; Miller, Peter M

2010-09-01

Hazardous drinking and alcohol use disorders (i.e, abuse and dependence) are common in Emergency Departments (EDs). This study examined 1) the prevalence of these conditions among ED patients and 2) characteristics of a single screening question (having consumed at least five drinks for males or four for females during a single day). Data from the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Logistic regression for clustered data was used to estimate the relative risk for past-year ED use associated with hazardous drinking, abuse, and dependence. Contingency tables were analyzed to estimate the sensitivity and specificity of the single-question screen for detecting these conditions. Hazardous drinking was not associated with ED utilization. Alcohol abuse was associated with a relative risk of 1.3 (95% confidence interval [CI] 1.1-1.5) and alcohol dependence with a relative risk of 1.9 (95% CI 1.6-2.2). For current drinkers, the single question screen was 0.96, 0.85, and 0.90 sensitive for hazardous drinking, alcohol abuse, and alcohol dependence, respectively. Individuals with a positive screen in the past year were considered at least hazardous drinkers, and specificity was 0.80, 0.64, and 0.65 for hazardous drinking, abuse, and dependence, respectively. Specificity was modestly increased in women. Most problem drinkers were hazardous drinkers, but only severe alcohol use disorders were particularly prevalent in the ED. The single heavy-drinking-day item appears sensitive for problem drinking. Positive tests must be followed by additional assessment to differentiate hazardous drinking from alcohol use disorders. Copyright © 2010. Published by Elsevier Inc.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes.

PubMed

Nowak, Dariusz; Jasionowski, Artur

2016-07-29

Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs). The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools. EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1-3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover. EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour.

Analysis of Consumption of Energy Drinks by a Group of Adolescent Athletes

PubMed Central

Nowak, Dariusz; Jasionowski, Artur

2016-01-01

Background: Energy drinks (EDs) have become widely popular among young adults and, even more so, among adolescents. Increasingly, they are consumed by athletes, particularly those who have just begun their sporting career. Uncontrolled and high consumption of EDs, in addition to other sources of caffeine, may pose a threat to the health of young people. Hence, our objective was to analyze the consumption of EDs among teenagers engaged in sports, including quantity consumed, identification of factors influencing consumption, and risks associated with EDs and EDs mixed with alcohol (AmEDs). Methods: The study involved a specially designed questionnaire, which was completed by 707 students, 14.3 years of age on average, attending secondary sports schools. Results: EDs were consumed by 69% of the young athletes, 17% of whom drank EDs quite often: every day or 1–3 times a week. Most respondents felt no effects after drinking EDs, but some reported symptoms, including insomnia, anxiety, tachycardia, nervousness and irritability. The major determinant of the choice of EDs was taste (47%), followed by price (21%). One in ten respondents admitted to consumption of AmEDs. Among the consequences reported were: abdominal pains, nausea, vomiting, amnesia, headache, and hangover. Conclusions: EDs consumption among adolescent athletes was relatively high. Considering the habit of AmEDs and literature data, it is worth emphasizing that it may lead to health problems in the near future, alcohol- or drug-dependence, as well as other types of risk behaviour. PMID:27483299

Associations of Patient Health-Related Problem Solving with Disease Control, Emergency Department Visits, and Hospitalizations in HIV and Diabetes Clinic Samples

PubMed Central

Gemmell, Leigh; Kulkarni, Babul; Klick, Brendan; Brancati, Frederick L.

2007-01-01

Background Patient problem solving and decision making are recognized as essential to effective self-management across multiple chronic diseases. However, a health-related problem-solving instrument that demonstrates sensitivity to disease control parameters in multiple diseases has not been established. Objectives To determine, in two disease samples, internal consistency and associations with disease control of the Health Problem-Solving Scale (HPSS), a 50-item measure with 7 subscales assessing effective and ineffective problem-solving approaches, learning from past experiences, and motivation/orientation. Design Cross-sectional study. Participants Outpatients from university-affiliated medical center HIV (N = 111) and diabetes mellitus (DM, N = 78) clinics. Measurements HPSS, CD4, hemoglobin A1c (HbA1c), and number of hospitalizations in the previous year and Emergency Department (ED) visits in the previous 6 months. Results Administration time for the HPSS ranged from 5 to 10 minutes. Cronbach’s alpha for the total HPSS was 0.86 and 0.89 for HIV and DM, respectively. Higher total scores (better problem solving) were associated with higher CD4 and fewer hospitalizations in HIV and lower HbA1c and fewer ED visits in DM. Health Problem-Solving Scale subscales representing negative problem-solving approaches were consistently associated with more hospitalizations (HIV, DM) and ED visits (DM). Conclusions The HPSS may identify problem-solving difficulties with disease self-management and assess effectiveness of interventions targeting patient decision making in self-care. PMID:17443373

Erectile dysfunction and fruit/vegetable consumption among diabetic Canadian men.

PubMed

Wang, Feng; Dai, Sulan; Wang, Mingdong; Morrison, Howard

2013-12-01

To evaluate the association between fruit/vegetable consumption and erectile dysfunction (ED) among Canadian men with diabetes. Data from the 2011 Survey on Living with Chronic Diseases in Canada - Diabetes Component were analyzed using Statistical Analysis System Enterprise Guide (SAS EG). Respondents were asked a series questions related to their sociodemographics, lifestyle, and chronic health conditions. The association between fruit/vegetable consumption and ED was examined using logistic regression after controlling for potential confounding factors. Bootstrap procedure was used to estimate sample distribution and calculate confidence intervals. Overall, 26.2% of respondents reported having ED. The prevalence increased with age and duration of diabetes. Compared with respondents without ED, those with ED were more likely to be obese, smokers, physically inactive, and either divorced, widowed, or separated. Diabetes complications such as nerve damage, circulation problems, and kidney failure or kidney disease were also significantly associated with ED. After controlling for potential confounding factors, a 10% risk reduction of ED was found with each additional daily serving of fruit/vegetable consumed. ED is common among Canadian men with diabetes. ED was highly associated with age, duration of diabetes, obesity, smoking, and the presence of other diabetes-related complications. Fruit and vegetable consumption might have a protective effect against ED. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Alcopops, taxation and harm: a segmented time series analysis of emergency department presentations.

PubMed

Gale, Marianne; Muscatello, David J; Dinh, Michael; Byrnes, Joshua; Shakeshaft, Anthony; Hayen, Andrew; MacIntyre, Chandini Raina; Haber, Paul; Cretikos, Michelle; Morton, Patricia

2015-05-06

In Australia, a Goods and Services Tax (GST) introduced in 2000 led to a decline in the price of ready-to-drink (RTD) beverages relative to other alcohol products. The 2008 RTD ("alcopops") tax increased RTD prices. The objective of this study was to estimate the change in incidence of Emergency Department (ED) presentations for acute alcohol problems associated with each tax. Segmented regression analyses were performed on age and sex-specific time series of monthly presentation rates for acute alcohol problems to 39 hospital emergency departments across New South Wales, Australia over 15 years, 1997 to 2011. Indicator variables represented the introduction of each tax. Retail liquor turnover controlled for large-scale economic factors such as the global financial crisis that may have influenced demand. Under-age (15-17 years) and legal age (18 years and over) drinkers were included. The GST was associated with a statistically significant increase in ED presentations for acute alcohol problems among 18-24 year old females (0 · 14/100,000/month, 95% CI 0 · 05-0 · 22). The subsequent alcopops tax was associated with a statistically significant decrease in males 15-50 years, and females 15-65 years, particularly in 18-24 year old females (-0 · 37/100,000/month, 95% CI -0 · 45 to -0 · 29). An increase in retail turnover of liquor was positively and statistically significantly associated with ED presentations for acute alcohol problems across all age and sex strata. Reduced tax on RTDs was associated with increasing ED presentations for acute alcohol problems among young women. The alcopops tax was associated with declining presentations in young to middle-aged persons of both sexes, including under-age drinkers.

Chemical Characterization of Bed Material Coatingsby LA-ICP-MS and SEM-EDS

NASA Astrophysics Data System (ADS)

Piispanen, M. H.; Mustonen, A. J.; Tiainen, M. S.; Laitinen, R. S.

Bed material coatings and the consequent agglomeration of bed material are main ash-related problems in FB-boilers. The bed agglomeration is a particular problem when combusting biofuels and waste materials. Whereas SEM-EDS together with automated image processing has proven to be a convenient method to study compositional distribution in coating layers and agglomerates, it is a relatively expensive technique and is not necessarily widely available. In this contribution, we explore the suitability of LA-ICP-MS to provide analogous information of the bed.

Comparison of perceptions of oral health-related quality of life in adolescents affected with ectodermal dysplasias relative to caregivers.

PubMed

Kohli, Richie; Levy, Steven; Kummet, Colleen M; Dawson, Deborah V; Stanford, Clark M

2011-01-01

The objective of this study was to assess the perceived oral health-related quality of life (OHQoL) of adolescents affected with one of the ectodermal dysplasias (EDs). Data were collected from 2003 to 2007 in a cross-sectional study of a convenience sample of individuals affected by ED (n = 35) using the Child Perceptions Questionnaire (CPQ11-14) for children and the Parent-Caregiver Perceptions Questionnaire for their caregivers. The main findings of this study were that individuals who were affected with ED in the older age group (15- to 19-year-olds) perceived more functional problems than younger individuals (11- to 14-year-olds) (p= .04). Females with ED (n = 13) perceived more emotional problems than males (n = 22; p= .01). Although caregivers tended to report slightly higher OHQoL scores (indicating worse OHQoL), no significant differences were observed between children's and parents' total OHQoL and individual domains' median scores (p > .05). Thus, the perceptions of oral health and well-being may vary by age and gender for children who have ED. Caution is warranted concerning using parents as proxies for their children when assessing the child's OHQoL. ©2011 Special Care Dentistry Association and Wiley Periodicals, Inc.

Sex Education Knowledge Differences between Freshmen and Senior College Undergraduates

ERIC Educational Resources Information Center

Franklin, Ruth M.; Dotger, Sharon

2011-01-01

Abstinence sexuality education (sex ed) is the only federally funded sex ed in the United States. The strict curriculum of this education does not educate American adolescents about safer sex practices and leaves a knowledge gap in these adolescents that follows them into college. The Problem: This project aimed to identify sex knowledge…

Development of a dynamic traffic assignment and simulation model for incident and emergency management applications in the Birmingham region : aim 3, emergency dispatchers' survey.

DOT National Transportation Integrated Search

2010-09-01

Traffic congestion is a primary concern during major incident and evacuation scenarios and can create difficulties for emergency vehicles attempting to enter and exit affected areas; however, many of the dispatchers who would be responsible for direc...

Airline Transport Pilot, Aircraft Dispatcher, and Flight Navigator. Question Book. Expires September 1, 1991.

ERIC Educational Resources Information Center

Federal Aviation Administration (DOT), Washington, DC.

This question book was developed by the Federal Aviation Administration (FAA) for testing applicants who are preparing for certification as airline transport pilots, aircraft dispatchers, or flight navigators. The publication contains several innovative features that are a departure from previous FAA publications related to air carrier personnel…

Dispatch No. 107 of 7 August 1989.

PubMed

1989-01-01

This Order prohibits the cutting, exploitation, and deforestation of "Pino Laso (Decussocarpus rospigliosii)" and other species of the family Podocarpaceae on all public and private property in Venezuela, except in limited and controlled circumstances. The preamble to the Dispatch states that trees of this species help to protect the sources of most of the country's water.

40 CFR 72.33 - Identification of dispatch system.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Permit Applications § 72.33 Identification of dispatch system. (a... approval of the petition, all provisions of the Acid Rain Program applicable to an affected source or an... provision of the Acid Rain Program and shall not change the liability of the owners and operators of an...

40 CFR 72.33 - Identification of dispatch system.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Permit Applications § 72.33 Identification of dispatch system. (a... approval of the petition, all provisions of the Acid Rain Program applicable to an affected source or an... provision of the Acid Rain Program and shall not change the liability of the owners and operators of an...

40 CFR 72.33 - Identification of dispatch system.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Permit Applications § 72.33 Identification of dispatch system. (a... approval of the petition, all provisions of the Acid Rain Program applicable to an affected source or an... provision of the Acid Rain Program and shall not change the liability of the owners and operators of an...

40 CFR 72.33 - Identification of dispatch system.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Permit Applications § 72.33 Identification of dispatch system. (a... approval of the petition, all provisions of the Acid Rain Program applicable to an affected source or an... provision of the Acid Rain Program and shall not change the liability of the owners and operators of an...

40 CFR 72.33 - Identification of dispatch system.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) PERMITS REGULATION Acid Rain Permit Applications § 72.33 Identification of dispatch system. (a... approval of the petition, all provisions of the Acid Rain Program applicable to an affected source or an... provision of the Acid Rain Program and shall not change the liability of the owners and operators of an...

14 CFR 121.615 - Dispatch or flight release over water: Flag and supplemental operations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Dispatch or flight release over water: Flag and supplemental operations. 121.615 Section 121.615 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR CARRIERS AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS OPERATING...

14 CFR 121.613 - Dispatch or flight release under IFR or over the top.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Dispatch or flight release under IFR or over the top. 121.613 Section 121.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... appropriate weather reports or forecasts, or any combination thereof, indicate that the weather conditions...

14 CFR 121.613 - Dispatch or flight release under IFR or over the top.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Dispatch or flight release under IFR or over the top. 121.613 Section 121.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... appropriate weather reports or forecasts, or any combination thereof, indicate that the weather conditions...

14 CFR 121.613 - Dispatch or flight release under IFR or over the top.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Dispatch or flight release under IFR or over the top. 121.613 Section 121.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... appropriate weather reports or forecasts, or any combination thereof, indicate that the weather conditions...

14 CFR 121.613 - Dispatch or flight release under IFR or over the top.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Dispatch or flight release under IFR or over the top. 121.613 Section 121.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... appropriate weather reports or forecasts, or any combination thereof, indicate that the weather conditions...

14 CFR 121.613 - Dispatch or flight release under IFR or over the top.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Dispatch or flight release under IFR or over the top. 121.613 Section 121.613 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT... appropriate weather reports or forecasts, or any combination thereof, indicate that the weather conditions...

46 CFR 401.710 - Operating requirements for holders of Certificates of Authorization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of America and the Minister of Transport of Canada”, effective July 7, 1970, as amended; (c) Provide continuous arrangements and facilities for the efficient dispatching of pilotage service on a first-come, first-serve basis to vessels that give notice of pilotage service requirements to the pilotage dispatch...

The Australian electricity market's pre-dispatch process: Some observations on its efficiency using ordered probit model

NASA Astrophysics Data System (ADS)

Zainudin, Wan Nur Rahini Aznie; Becker, Ralf; Clements, Adam

2015-12-01

Many market participants in Australia Electricity Market had cast doubts on whether the pre-dispatch process in the electricity market is able to give them good and timely quantity and price information. In a study by [11], they observed a significant bias (mainly indicating that the pre-dispatch process tends to underestimate spot price outcomes), a seasonality features of the bias across seasons and/or trading periods and changes in bias across the years in our sample period (1999 to 2007). In a formal setting of an ordered probit model we establish that there are some exogenous variables that are able to explain increased probabilities of over- or under-predictions of the spot price. It transpires that meteorological data, expected pre-dispatch prices and information on past over- and under-predictions contribute significantly to explaining variation in the probabilities for over- and under-predictions. The results allow us to conjecture that some of the bids and re-bids provided by electricity generators are not made in good faith.

On Why It Is Impossible to Prove that the BDX90 Dispatcher Implements a Time-sharing System

NASA Technical Reports Server (NTRS)

Boyer, R. S.; Moore, J. S.

1983-01-01

The Software Implemented Fault Tolerance SIFT system, is written in PASCAL except for about a page of machine code. The SIFT system implements a small time sharing system in which PASCAL programs for separate application tasks are executed according to a schedule with real time constraints. The PASCAL language has no provision for handling the notion of an interrupt such as the B930 clock interrupt. The PASCAL language also lacks the notion of running a PASCAL subroutine for a given amount of time, suspending it, saving away the suspension, and later activating the suspension. Machine code was used to overcome these inadequacies of PASCAL. Code which handles clock interrupts and suspends processes is called a dispatcher. The time sharing/virtual machine idea is completely destroyed by the reconfiguration task. After termination of the reconfiguration task, the tasks run by the dispatcher have no relation to those run before reconfiguration. It is impossible to view the dispatcher as a time-sharing system implementing virtual BDX930s running concurrently when one process can wipe out the others.

Generating short-term probabilistic wind power scenarios via nonparametric forecast error density estimators: Generating short-term probabilistic wind power scenarios via nonparametric forecast error density estimators

DOE PAGES

Staid, Andrea; Watson, Jean -Paul; Wets, Roger J. -B.; ...

2017-07-11

Forecasts of available wind power are critical in key electric power systems operations planning problems, including economic dispatch and unit commitment. Such forecasts are necessarily uncertain, limiting the reliability and cost effectiveness of operations planning models based on a single deterministic or “point” forecast. A common approach to address this limitation involves the use of a number of probabilistic scenarios, each specifying a possible trajectory of wind power production, with associated probability. We present and analyze a novel method for generating probabilistic wind power scenarios, leveraging available historical information in the form of forecasted and corresponding observed wind power timemore » series. We estimate non-parametric forecast error densities, specifically using epi-spline basis functions, allowing us to capture the skewed and non-parametric nature of error densities observed in real-world data. We then describe a method to generate probabilistic scenarios from these basis functions that allows users to control for the degree to which extreme errors are captured.We compare the performance of our approach to the current state-of-the-art considering publicly available data associated with the Bonneville Power Administration, analyzing aggregate production of a number of wind farms over a large geographic region. Finally, we discuss the advantages of our approach in the context of specific power systems operations planning problems: stochastic unit commitment and economic dispatch. Here, our methodology is embodied in the joint Sandia – University of California Davis Prescient software package for assessing and analyzing stochastic operations strategies.« less

Deaths following prehospital safety incidents: an analysis of a national database.

PubMed

Yardley, Iain E; Donaldson, Liam J

2016-10-01

Ensuring patient safety in the prehospital environment is difficult due to the unpredictable nature of the workload and the uncontrolled situations that care is provided in. Studying previous safety incidents can help understand risks and take action to mitigate them. We present an analysis of safety incidents related to patient deaths in ambulance services in England. All incidents related to a patient death reported to the National Reporting and Learning System from an ambulance service between 1 June 2010 and 31 October 2012 were subjected to thematic analysis to identify the failings that led to the incident. Sixty-nine incidents were analysed, equating to one safety incident-related death per 168 000 calls received. Just three event categories were identified: delayed response (59%, 41/69), shortfalls in clinical care (35%, 24/69) and injury during transit (6%, 4/69). Primary failures differed for the categories: problems with dispatch caused the majority of delays in response, with equipment problems and bad weather accounting for the remainder. Failure to provide necessary care was predominantly caused by clinical misjudgements by ambulance staff and equipment issues underlay incidents that led to a patient injury. Improvements intended to address safety related mortality in the ambulance service should include ensuring adequate equipping and resourcing of ambulance services, improving coordination and decision-making during dispatch and supporting individual staff members in the difficult decisions they are faced with. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Generating short-term probabilistic wind power scenarios via nonparametric forecast error density estimators: Generating short-term probabilistic wind power scenarios via nonparametric forecast error density estimators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Staid, Andrea; Watson, Jean -Paul; Wets, Roger J. -B.

Forecasts of available wind power are critical in key electric power systems operations planning problems, including economic dispatch and unit commitment. Such forecasts are necessarily uncertain, limiting the reliability and cost effectiveness of operations planning models based on a single deterministic or “point” forecast. A common approach to address this limitation involves the use of a number of probabilistic scenarios, each specifying a possible trajectory of wind power production, with associated probability. We present and analyze a novel method for generating probabilistic wind power scenarios, leveraging available historical information in the form of forecasted and corresponding observed wind power timemore » series. We estimate non-parametric forecast error densities, specifically using epi-spline basis functions, allowing us to capture the skewed and non-parametric nature of error densities observed in real-world data. We then describe a method to generate probabilistic scenarios from these basis functions that allows users to control for the degree to which extreme errors are captured.We compare the performance of our approach to the current state-of-the-art considering publicly available data associated with the Bonneville Power Administration, analyzing aggregate production of a number of wind farms over a large geographic region. Finally, we discuss the advantages of our approach in the context of specific power systems operations planning problems: stochastic unit commitment and economic dispatch. Here, our methodology is embodied in the joint Sandia – University of California Davis Prescient software package for assessing and analyzing stochastic operations strategies.« less

Bystander capability to activate speaker function for continuous dispatcher assisted CPR in case of suspected cardiac arrest.

PubMed

Steensberg, Alvilda T; Eriksen, Mette M; Andersen, Lars B; Hendriksen, Ole M; Larsen, Heinrich D; Laier, Gunnar H; Thougaard, Thomas

2017-06-01

The European Resuscitation Council Guidelines 2015 recommend bystanders to activate their mobile phone speaker function, if possible, in case of suspected cardiac arrest. This is to facilitate continuous dialogue with the dispatcher including (if required) cardiopulmonary resuscitation instructions. The aim of this study was to measure the bystander capability to activate speaker function in case of suspected cardiac arrest. In 87days, a systematic prospective registration of bystander capability to activate the speaker function, when cardiac arrest was suspected, was performed. For those asked, "can you activate your mobile phone's speaker function", audio recordings were examined and categorized into groups according to the bystanders capability to activate speaker function on their own initiative, without instructions, or with instructions from the emergency medical dispatcher. Time delay was measured, in seconds, for the bystanders without pre-activated speaker function. 42.0% (58) was able to activate the speaker function without instructions, 2.9% (4) with instructions, 18.1% (25) on own initiative and 37.0% (51) were unable to activate the speaker function. The median time to activate speaker function was 19s and 8s, with and without instructions, respectively. Dispatcher assisted cardiopulmonary resuscitation with activated speaker function, in cases of suspected cardiac arrest, allows for continuous dialogue between the emergency medical dispatcher and the bystander. In this study, we found a 63.0% success rate of activating the speaker function in such situations. Copyright © 2017 Elsevier B.V. All rights reserved.

Modeling and Analysis of Wholesale Electricity Market Design. Understanding the Missing Money Problem. December 2013 - January 2015

DOE Office of Scientific and Technical Information (OSTI.GOV)

Papalexopoulos, A.; Hansen, C.; Perrino, D.

This project examined the impact of renewable energy sources, which have zero incremental energy costs, on the sustainability of conventional generation. This “missing money” problem refers to market outcomes in which infra-marginal energy revenues in excess of operations and maintenance (O&M) costs are systematically lower than the amortized costs of new entry for a marginal generator. The problem is caused by two related factors: (1) conventional generation is dispatched less, and (2) the price that conventional generation receives for its energy is lower. This lower revenue stream may not be sufficient to cover both the variable and fixed costs ofmore » conventional generation. In fact, this study showed that higher wind penetrations in the Electric Reliability Council of Texas (ERCOT) system could cause many conventional generators to become uneconomic.« less

Advertising emergency department wait times.

PubMed

Weiner, Scott G

2013-03-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised.

The survival benefit of dual dispatch of EMS and fire-fighters in out-of-hospital cardiac arrest may differ depending on population density--a prospective cohort study.

PubMed

Nordberg, Per; Jonsson, Martin; Forsberg, Sune; Ringh, Mattias; Fredman, David; Riva, Gabriel; Hasselqvist-Ax, Ingela; Hollenberg, Jacob

2015-05-01

Outcome after out-of-hospital cardiac arrest (OHCA) varies between contexts. Dual dispatching of fire-fighters or police in addition to emergency medical services (EMS) has the potential to increase survival, but the effect in urban vs. rural areas is unknown. The aim of this study was to determine the effects of dual dispatching on response times and outcome in regions with different population density. The study design was a prospective cohort study of EMS-treated OHCAs from 2004 (historical controls, only EMS dispatch) and 2006-2009 (intervention, dual dispatch of EMS and fire-fighters), with data on exact geographical coordinates. Patients were divided into four subgroups depending on population density: rural (<250 persons/km2), suburban (250-2999/km2), urban (3000-5999/km2) and downtown (≥6000/km2). Totally, 2513 OHCAs were included (historical controls, n=571 and intervention, n=1942). Median time to arrival of first unit shortened significantly in all subgroups, ranging from 0.8 to 3.2 min, with the main time gain in the rural area. There were significant differences in 30-day survival between the historical controls vs. the intervention group in the suburban population (3.1% vs. 7.0%, p=0.02) and in downtown (4.1 vs. 14.6, p=0.04). In the urban population the difference was 2.7 vs. 6.9% (p=0.06) and in the rural population (4.7 vs. 5.3, p=0.82). Dual dispatch of fire-fighters and EMS in OHCA significantly reduced response times in all studied regions. The 30-day survival increased significantly in the downtown and suburban populations, while a limited impact was seen in the rural areas. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Support and monitoring of families after child abuse detection based on parental characteristics at the Emergency Department.

PubMed

Diderich, H M; Pannebakker, F D; Dechesne, M; Buitendijk, S E; Oudesluys-Murphy, A M

2015-03-01

The 'Hague Protocol' enables professionals at the adult Emergency Department (ED) to detect child abuse based on three parental characteristics: (i) suicide attempt or self-harm, (ii) domestic violence or (iii) substance abuse, and to refer them to the Reporting Centre for Child Abuse and Neglect (RCCAN). This study investigates what had happened to the families three months after this referral. ED referrals based on parental characteristics (N = 100) in which child abuse was confirmed after investigation by the RCCAN were analysed. Information was collected regarding type of child abuse, reason for reporting, duration of problems prior to the ED referral, previous involvement of support services or other agencies, re-occurrence of the problems and outcome of the RCCAN monitoring according to professionals and the families. Of the 100 referred cases, 68 families were already known to the RCCAN, the police or family support services, prior to the ED referral. Of the 99 cases where information was available, existing support was continued or intensified in 31, a Child Protection Services (CPS) report had to be made in 24, new support was organized for 27 cases and in 17 cases support was not necessary, because the domestic problems were already resolved. Even though the RCCAN is mandated to monitor all referred families after three months, 31 cases which were referred internally were not followed up. Before referral by the ED two thirds of these families were already known to organizations. Monitoring may help provide a better, more sustained service and prevent and resolve domestic problems. A national database could help to link data and to streamline care for victims and families. We recommend a Randomized Controlled Trial to test the effectiveness of this Protocol in combination with the outcomes of the provided family support. © 2014 John Wiley & Sons Ltd.

Improving the Energy Market: Algorithms, Market Implications, and Transmission Switching

NASA Astrophysics Data System (ADS)

Lipka, Paula Ann

This dissertation aims to improve ISO operations through a better real-time market solution algorithm that directly considers both real and reactive power, finds a feasible Alternating Current Optimal Power Flow solution, and allows for solving transmission switching problems in an AC setting. Most of the IEEE systems do not contain any thermal limits on lines, and the ones that do are often not binding. Chapter 3 modifies the thermal limits for the IEEE systems to create new, interesting test cases. Algorithms created to better solve the power flow problem often solve the IEEE cases without line limits. However, one of the factors that makes the power flow problem hard is thermal limits on the lines. The transmission networks in practice often have transmission lines that become congested, and it is unrealistic to ignore line limits. Modifying the IEEE test cases makes it possible for other researchers to be able to test their algorithms on a setup that is closer to the actual ISO setup. This thesis also examines how to convert limits given on apparent power---as is in the case in the Polish test systems---to limits on current. The main consideration in setting line limits is temperature, which linearly relates to current. Setting limits on real or apparent power is actually a proxy for using the limits on current. Therefore, Chapter 3 shows how to convert back to the best physical representation of line limits. A sequential linearization of the current-voltage formulation of the Alternating Current Optimal Power Flow (ACOPF) problem is used to find an AC-feasible generator dispatch. In this sequential linearization, there are parameters that are set to the previous optimal solution. Additionally, to improve accuracy of the Taylor series approximations that are used, the movement of the voltage is restricted. The movement of the voltage is allowed to be very large at the first iteration and is restricted further on each subsequent iteration, with the restriction corresponding to the accuracy and AC-feasiblity of the solution. This linearization was tested on the IEEE and Polish systems, which range from 14 to 3375 buses and 20 to 4161 transmission lines. It had an accuracy of 0.5% or less for all but the 30-bus system. It also solved in linear time with CPLEX, while the non-linear version solved in O(n1.11) to O(n1.39). The sequential linearization is slower than the nonlinear formulation for smaller problems, but faster for larger problems, and its linear computational time means it would continue solving faster for larger problems. A major consideration to implementing algorithms to solve the optimal generator dispatch is ensuring that the resulting prices from the algorithm will support the market. Since the sequential linearization is linear, it is convex, its marginal values are well-defined, and there is no duality gap. The prices and settlements obtained from the sequential linearization therefore can be used to run a market. This market will include extra prices and settlements for reactive power and voltage, compared to the present-day market, which is based on real power. An advantage of this is that there is a very clear pool that can be used for reactive power/voltage support payments, while presently there is not a clear pool to take them out of. This method also reveals how valuable reactive power and voltage are at different locations, which can enable better planning of reactive resource construction. Transmission switching increases the feasible region of the generator dispatch, which means there may be a better solution than without transmission switching. Power flows on transmission lines are not directly controllable; rather, the power flows according to how it is injected and the physical characteristics of the lines. Changing the network topology changes the physical characteristics, which changes the flows. This means that sets of generator dispatch that may have previously been infeasible due to the flow exceeding line constraints may be feasible, since the flows will be different and may meet line constraints. However, transmission switching is a mixed integer problem, which may have a very slow solution time. For economic switching, we examine a series of heuristics. We examine the congestion rent heuristic in detail and then examine many other heuristics at a higher level. Post-contingency corrective switching aims to fix issues in the power network after a line or generator outage. In Chapter 7, we show that using the sequential linear program with corrective switching helps solve voltage and excessive flow issues. (Abstract shortened by UMI.).

Male erectile dysfunction: integrating psychopharmacology and psychotherapy.

PubMed

Simopoulos, Eugene F; Trinidad, Anton C

2013-01-01

Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is the most common sexual problem in men. ED arises when there is disruption of the complex interplay between vascular, neurologic, hormonal and psychologic factors necessary for normal erectile function. It may have a significant effect on quality of life and portend undetected cardiovascular disease. Risk factors for development of ED include advancing age, tobacco use, a history of pelvic irradiation or surgery and antipsychotic use (Table 1) [1]. Treatment guidelines continue to evolve for optimal management of ED. In this article, we review diagnostic and treatment strategies for ED relevant to psychiatrists. We present an integrative approach to the treatment of ED based on a review of the urologic and psychiatric literature. ED is multifactorial in origin and responsive to a variety of therapeutic interventions, including psychopharmacology and psychotherapy in which cognitive underpinnings of poor sexual performance, including diminished self-esteem, lack of confidence and perceived failures in the male role, are examined. Psychiatrists can readily perform a basic workup for ED as they integrate both a medical and therapeutic model when confronted with such patients. Copyright © 2013 Elsevier Inc. All rights reserved.

Medicaid dental coverage alone may not lower rates of dental emergency department visits.

PubMed

Fingar, Kathryn R; Smith, Mark W; Davies, Sheryl; McDonald, Kathryn M; Stocks, Carol; Raven, Maria C

2015-08-01

Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. Project HOPE—The People-to-People Health Foundation, Inc.

Erectile dysfunction management options in Nigeria.

PubMed

Afolayan, Anthony Jide; Yakubu, Musa Toyin

2009-04-01

In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.

Identity Processes and Statuses in Patients with and without Eating Disorders.

PubMed

Verschueren, Margaux; Luyckx, Koen; Kaufman, Erin A; Vansteenkiste, Maarten; Moons, Philip; Sleuwaegen, Ellen; Berens, Ann; Schoevaerts, Katrien; Claes, Laurence

2017-01-01

Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Development of Quadratic Programming Algorithm Based on Interior Point Method with Estimation Mechanism of Active Constraints

NASA Astrophysics Data System (ADS)

Hashimoto, Hiroyuki; Takaguchi, Yusuke; Nakamura, Shizuka

Instability of calculation process and increase of calculation time caused by increasing size of continuous optimization problem remain the major issues to be solved to apply the technique to practical industrial systems. This paper proposes an enhanced quadratic programming algorithm based on interior point method mainly for improvement of calculation stability. The proposed method has dynamic estimation mechanism of active constraints on variables, which fixes the variables getting closer to the upper/lower limit on them and afterwards releases the fixed ones as needed during the optimization process. It is considered as algorithm-level integration of the solution strategy of active-set method into the interior point method framework. We describe some numerical results on commonly-used bench-mark problems called “CUTEr” to show the effectiveness of the proposed method. Furthermore, the test results on large-sized ELD problem (Economic Load Dispatching problems in electric power supply scheduling) are also described as a practical industrial application.

49 CFR 234.306 - Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway...

Code of Federal Regulations, 2012 CFR

2012-10-01

... respect to the same highway-rail or pathway grade crossing; appointment of responsible railroad. 234.306... Conditions at Highway-Rail and Pathway Grade Crossings § 234.306 Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway grade crossing; appointment of responsible...

49 CFR 234.306 - Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway...

Code of Federal Regulations, 2013 CFR

2013-10-01

... respect to the same highway-rail or pathway grade crossing; appointment of responsible railroad. 234.306... Conditions at Highway-Rail and Pathway Grade Crossings § 234.306 Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway grade crossing; appointment of responsible...

49 CFR 234.306 - Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway...

Code of Federal Regulations, 2014 CFR

2014-10-01

... respect to the same highway-rail or pathway grade crossing; appointment of responsible railroad. 234.306... Conditions at Highway-Rail and Pathway Grade Crossings § 234.306 Multiple dispatching or maintaining railroads with respect to the same highway-rail or pathway grade crossing; appointment of responsible...

17 CFR 240.17Ad-1 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... or mails the item to, or the item is awaiting pick-up by, the presentor or a person designated by the... transfer agent dispatches or mails the item to, or the item is awaiting pick-up by, the outside registrar... registrar dispatches or mails the item to, or the item is awaiting pick-up by, the presenting transfer agent...

17 CFR 240.17Ad-1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... or mails the item to, or the item is awaiting pick-up by, the presentor or a person designated by the... transfer agent dispatches or mails the item to, or the item is awaiting pick-up by, the outside registrar... registrar dispatches or mails the item to, or the item is awaiting pick-up by, the presenting transfer agent...

Model documentation: Electricity Market Module, Electricity Fuel Dispatch Submodule

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

This report documents the objectives, analytical approach and development of the National Energy Modeling System Electricity Fuel Dispatch Submodule (EFD), a submodule of the Electricity Market Module (EMM). The report catalogues and describes the model assumptions, computational methodology, parameter estimation techniques, model source code, and forecast results generated through the synthesis and scenario development based on these components.

Enteral nutrition - child - managing problems

MedlinePlus

... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

Cognitive, emotional, and behavioral considerations for chronic pain management in the Ehlers-Danlos syndrome hypermobility-type: a narrative review.

PubMed

Baeza-Velasco, Carolina; Bulbena, Antonio; Polanco-Carrasco, Roberto; Jaussaud, Roland

2018-01-22

Ehlers-Danlos syndrome (EDS) hypermobility-type is the most common hereditary disorder of the connective tissue. The tissue fragility characteristic of this condition leads to multi-systemic symptoms in which pain, often severe, chronic, and disabling, is the most experienced. Clinical observations suggest that the complex patient with EDS hypermobility-type is refractory toward several biomedical and physical approaches. In this context and in accordance with the contemporary conceptualization of pain (biopsychosocial perspective), the identification of psychological aspects involved in the pain experience can be useful to improve interventions for this under-recognized pathology. Review of the literature on joint hypermobility and EDS hypermobility-type concerning psychological factors linked to pain chronicity and disability. A comprehensive search was performed using scientific online databases and references lists, encompassing publications reporting quantitative and qualitative research as well as unpublished literature. Despite scarce research, psychological factors associated with EDS hypermobility-type that potentially affect pain chronicity and disability were identified. These are cognitive problems and attention to body sensations, negative emotions, and unhealthy patterns of activity (hypo/hyperactivity). As in other chronic pain conditions, these aspects should be more explored in EDS hypermobility-type, and integrated into chronic pain prevention and management programs. Implications for Rehabilitation Clinicians should be aware that joint hypermobility may be associated with other health problems, and in its presence suspect a heritable disorder of connective tissue such as the Ehlers-Danlos syndrome (EDS) hypermobility-type, in which chronic pain is one of the most frequent and invalidating symptoms. It is necessary to explore the psychosocial functioning of patients as part of the overall chronic pain management in the EDS hypermobility-type, especially when they do not respond to biomedical approaches as psychological factors may be operating against rehabilitation. Further research on the psychological factors linked to pain chronicity and disability in the EDS hypermobility-type is needed.

Learning from Accident and Error: Avoiding the Hazards of Workload, Stress, and Routine Interruptions in the Emergency Department

PubMed Central

Morrison, J. Bradley; Rudolph, Jenny W.

2012-01-01

This article presents a model of how a build-up of interruptions can shift the dynamics of the emergency department (ED) from an adaptive, self-regulating system into a fragile, crisis-prone one. Drawing on case studies of organizational disasters and insights from the theory of high-reliability organizations, the authors use computer simulations to show how the accumulation of small interruptions could have disproportionately large effects in the ED. In the face of a mounting workload created by interruptions, EDs, like other organizational systems, have tipping points, thresholds beyond which a vicious cycle can lead rather quickly to the collapse of normal operating routines and in the extreme to a crisis of organizational paralysis. The authors discuss some possible implications for emergency medicine, emphasizing the potential threat from routine, non-novel demands on EDs and raising the concern that EDs are operating closer to the precipitous edge of crisis as ED crowding exacerbates the problem. PMID:22168187

Characteristics of the Highest Users of Emergency Services in Veterans Affairs Hospitals: Homeless and Non-Homeless.

PubMed

Gundlapalli, Adi V; Jones, Audrey L; Redd, Andrew; Suo, Ying; Pettey, Warren B P; Mohanty, April; Brignone, Emily; Gawron, Lori; Vanneman, Megan; Samore, Matthew H; Fargo, Jamison D

2017-01-01

Efforts are underway to understand recent increases in emergency department (ED) use and to offer case management to those patients identified as high utilizers. Homeless Veterans are thought to use EDs for non-emergent conditions. This study identifies the highest users of ED services in the Department of Veterans Affairs and provides descriptive analyses of these Veterans, the diagnoses for which they were seen in the ED, and differences based on their homeless status. Homeless Veterans were more likely than non-homeless Veterans to have >10 visits in the 2014 calendar year (12% vs. <1%). Homeless versus non-homeless Veterans with >10 visits were more often male, <age 60, and non-married. Non-homeless Veterans with >10 ED visits were often treated for chest and abdominal pain, and back problems, whereas homeless Veterans were frequently treated for mental health/substance use. Tailored case management approaches may be needed to better link homeless Veterans with high ED use to appropriate outpatient care.

Seeing Red, Feeling Blue: The Impact of State Political Leaning on State Identification Rates for Emotional Disturbance

ERIC Educational Resources Information Center

Wiley, Andrew; Siperstein, Gary

2011-01-01

Investigations of why students with emotional disturbance (ED) are underidentified in special education have often focused on economic factors and problems with the definition of ED. The present study focuses on variation in underidentification across states and its relationship to political ideology. State-level political, economic, and…

Developing Scientific Literacy Skills through Interdisciplinary, Technology-Based Global Simulations: GlobalEd 2

ERIC Educational Resources Information Center

Lawless, Kimberly A.; Brown, Scott W.

2015-01-01

GlobalEd 2 (GE2) is a set of technology-mediated, problem-based learning (PBL) simulations for middle-grade students, that capitalises on the multidisciplinary nature of the social sciences as an expanded curricular space for students to learn and apply scientific literacies and concepts, while simultaneously also enriching their understanding of…

Emergency department utilization and subsequent prescription drug overdose death

PubMed Central

Brady, Joanne E.; DiMaggio, Charles J.; Keyes, Katherine M.; Doyle, John J.; Richardson, Lynne D.; Li, Guohua

2015-01-01

Purpose Prescription drug overdose (PDO) deaths are a critical public health problem in the United States. This study aims to assess the association between emergency department (ED) utilization patterns in a cohort of ED patients and the risk of subsequent unintentional PDO mortality. Methods Using data from the New York Statewide Planning and Research Cooperative System for 2006–2010, a nested case-control design was used to examine the relationship between ED utilization patterns in New York State residents of age 18–64 years and subsequent PDO death. Results The study sample consisted of 2732 case patients who died of PDO and 2732 control ED patients who were selected through incidence density sampling. With adjustment for demographic characteristics, and diagnoses of pain, substance abuse, and psychiatric disorders, the estimated odds ratios of PDO death relative to one ED visit or less in the previous year were 4.90 (95% confidence interval [CI]: 4.50–5.34) for those with two ED visits, 16.61 (95% CI: 14.72–18.75) for those with three ED visits, and 48.24 (95% CI: 43.23–53.83) for those with four ED visits or more. Conclusions Frequency of ED visits is strongly associated with the risk of subsequent PDO death. Intervention programs targeting frequent ED users are warranted to reduce PDO mortality. PMID:25935710

Alcohol mixed with energy drinks: Associations with risky drinking and functioning in high school.

PubMed

Tucker, Joan S; Troxel, Wendy M; Ewing, Brett A; D'Amico, Elizabeth J

2016-10-01

Mixing alcohol with energy drinks is associated with heavier drinking and related problems among college students. However, little is known about how high school drinkers who mix alcohol with energy drinks (AmED) compare to those who do not (AwoED). This study compares high school AmED and AwoED users on their alcohol use during middle and high school, as well as key domains of functioning in high school. Two surveys were conducted three years apart in adolescents initially recruited from 16 middle schools in Southern California. The analytic sample consists of 696 past month drinkers. Multivariable models compared AmED and AwoED users on alcohol use, mental health, social functioning, academic orientation, delinquency and other substance use at age 17, and on their alcohol use and related cognitions at age 14. AmED was reported by 13% of past month drinkers. AmED and AwoED users did not differ on alcohol use or cognitions in middle school, but AmED users drank more often, more heavily, and reported more negative consequences in high school. AmED users were also more likely to report poor grades, delinquent behavior, substance use-related unsafe driving, public intoxication, and drug use than AwoED users in high school. Group differences were not found on mental health, social functioning, or academic aspirations. AmED use is common among high school drinkers. The higher risk behavioral profile of these young AmED users, which includes drug use and substance use-related unsafe driving, is a significant cause for concern and warrants further attention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Human-Centered Technologies and Procedures for Future Air Traffic Management

NASA Technical Reports Server (NTRS)

Smith, Philip; Woods, David; McCoy, Elaine; Billings, Charles; Sarter, Nadine; Denning, Rebecca; Dekker, Sidney

1997-01-01

The use of various methodologies to predict the impact of future Air Traffic Management (ATM) concepts and technologies is explored. The emphasis has been on the importance of modeling coordination and cooperation among multiple agents within this system, and on understanding how the interactions among these agents will be influenced as new roles, responsibilities, procedures and technologies are introduced. To accomplish this, we have been collecting data on performance under the current air traffic management system, identifying critical problem areas and looking for examples suggestive of general approaches for solving such problems. Using the results of these field studies, we have developed a set of concrete scenarios centered around future designs, and have studied performance in these scenarios with a set of 40 controllers, dispatchers, pilots and traffic managers.

Enroute flight planning: Evaluating design concepts for the development of cooperative problem-solving concepts

NASA Technical Reports Server (NTRS)

Smith, Philip J.; Mccoy, C. Elaine

1991-01-01

The goals of this research were to develop design concepts to support the task of enroute flight planning. And within this context, to explore and evaluate general design concepts and principles to guide the development of cooperative problem solving systems. A detailed model is to be developed of the cognitive processes involved in flight planning. Included in this model will be the identification of individual differences of subjects. Of particular interest will be differences between pilots and dispatchers. The effect will be studied of the effect on performance of tools that support planning at different levels of abstraction. In order to conduct this research, the Flight Planning Testbed (FPT) was developed, a fully functional testbed environment for studying advanced design concepts for tools to aid in flight planning.

Establishing an NP-staffed minor emergency area.

PubMed

Buchanan, L; Powers, R D

1997-04-01

Patients with problems of high acuity need fully trained emergency physicians and nurses. Some patients with nonurgent problems can be cared for within the emergency department (ED) in a lower-cost setting designed and staffed specifically for this purpose. Staffing a fast track or minor emergency area (MEA) with nurse practitioners (NPs) is one way to satisfy the ED's care needs. One site analysis of the effectiveness of NPs indicates that patients are satisfied with their care, that nurses' interpersonal skills are better than those of physicians, that technical skills are equivalent, that patient outcomes are equivalent or superior and that NPs improve access to care. A nurse practitioner-staffed minor emergency area provides high quality care for approximately 21% of this site's adult emergency department population. Patients are triaged based on set criteria, allowing for short treatment times. The physical layout, triage criteria, and the NPs' scope of practice in the level 1 trauma center's ED are detailed.

The Optimization dispatching of Micro Grid Considering Load Control

NASA Astrophysics Data System (ADS)

Zhang, Pengfei; Xie, Jiqiang; Yang, Xiu; He, Hongli

2018-01-01

This paper proposes an optimization control of micro-grid system economy operation model. It coordinates the new energy and storage operation with diesel generator output, so as to achieve the economic operation purpose of micro-grid. In this paper, the micro-grid network economic operation model is transformed into mixed integer programming problem, which is solved by the mature commercial software, and the new model is proved to be economical, and the load control strategy can reduce the charge and discharge times of energy storage devices, and extend the service life of the energy storage device to a certain extent.

Technical assistance for law-enforcement communications: Grant summary

NASA Technical Reports Server (NTRS)

Reilly, N. B.

1979-01-01

A summary overview of project activities and results are presented. The goals and objectives are reviewed and a description of the approaches used to attain them is given. The feedback received from the seminars conducted as part of the project, and results from a questionnaire about the project are included. Significant findings of the project in such areas as radio channel loading, dispatch system design, training and technology transfer are discussed. Several specific problem areas are identified and evaluated. Specific recommendations for future technical assistance efforts are presented along with an inventory of technical-assistance reports generated throughout the project.

Smart Computer-Assisted Markets

NASA Astrophysics Data System (ADS)

McCabe, Kevin A.; Rassenti, Stephen J.; Smith, Vernon L.

1991-10-01

The deregulation movement has motivated the experimental study of auction markets designed for interdependent network industries such as natural gas pipelines or electric power systems. Decentralized agents submit bids to buy commodity and offers to sell transportation and commodity to a computerized dispatch center. Computer algorithms determine prices and allocations that maximize the gains from exchange in the system relative to the submitted bids and offers. The problem is important, because traditionally the scale and coordination economies in such industries were thought to require regulation. Laboratory experiments are used to study feasibility, limitations, incentives, and performance of proposed market designs for deregulation, providing motivation for new theory.

Relationship between Dongting Lake and surrounding rivers under the operation of the Three Gorges Reservoir, China.

PubMed

Zhan, Lucheng; Chen, Jiansheng; Zhang, Shiyin; Huang, Dewen; Li, Ling

2015-01-01

The natural flow properties of the Yangtze River have been changed completely following the construction of the Three Gorges Dam. The dam's operation has affected the resources and environment in the middle and lower reaches of the Yangtze River, changing the hydrological conditions and ecological environment of the Dongting Lake. During three different dispatching periods of the reservoir, we took triplicate samples of the river and lake water. All the samples were analysed for δ(2)H and δ(18)O to determine the relationship between the lake and the Yangtze River (and other rivers), and to evaluate objectively the influence of the dam's operation on the lake. During the period of water-supply dispatch, the Four Rivers and Miluo River are the main recharge sources of the lake. During the flood-storage dispatching period, the Dongting Lake is recharged largely by the Three Outlets and the Four Rivers, whereas during the period of water-storage dispatch, most of the lake's water originates from the Miluo, Xiang, Zi, and Yuan rivers. Although the Yangtze River only contributes significantly to the lake's recharge through the Three Outlets during the flood-storage dispatching period, the lake discharges large amounts of water into the Yangtze River during all three periods. Through the operation of the reservoir, it should be ensured that the water level of the Dongting Lake is not too low during the dry season, nor too high during the wet season, thus preventing the lake region from future flood and drought disasters.

Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group.

PubMed

Foocharoen, Chingching; Tyndall, Alan; Hachulla, Eric; Rosato, Edoardo; Allanore, Yannick; Farge-Bancel, Dominique; Caramaschi, Paola; Airó, Paolo; Nikolaevna, Starovojtova M; Pereira da Silva, José António; Stamenkovic, Bojana; Riemekasten, Gabriela; Rednic, Simona; Sibilia, Jean; Wiland, Piotr; Tarner, Ingo; Smith, Vanessa; Onken, Anna T; Abdel Atty Mohamed, Walid Ahmed; Distler, Oliver; Morović-Vergles, Jadranka; Himsel, Andrea; de la Peña Lefebvre, Paloma Garcia; Hügle, Thomas; Walker, Ulrich A

2012-02-20

Erectile dysfunction (ED) is common in men with systemic sclerosis (SSc) but the demographics, risk factors and treatment coverage for ED are not well known. This study was carried out prospectively in the multinational EULAR Scleroderma Trial and Research database by amending the electronic data-entry system with the International Index of Erectile Function-5 and items related to ED risk factors and treatment. Centres participating in this EULAR Scleroderma Trial and Research substudy were asked to recruit patients consecutively. Of the 130 men studied, only 23 (17.7%) had a normal International Index of Erectile Function-5 score. Thirty-eight per cent of all participants had severe ED (International Index of Erectile Function-5 score ≤ 7). Men with ED were significantly older than subjects without ED (54.8 years vs. 43.3 years, P < 0.001) and more frequently had simultaneous non-SSc-related risk factors such as alcohol consumption. In 82% of SSc patients, the onset of ED was after the manifestation of the first non-Raynaud's symptom (median delay 4.1 years). ED was associated with severe cutaneous, muscular or renal involvement of SSc, elevated pulmonary pressures and restrictive lung disease. ED was treated in only 27.8% of men. The most common treatment was sildenafil, whose efficacy is not established in ED of SSc patients. Severe ED is a common and early problem in men with SSc. Physicians should address modifiable risk factors actively. More research into the pathophysiology, longitudinal development, treatment and psychosocial impact of ED is needed.

Patient comes back to ED in scrubs and works an entire shift as a temp.

PubMed

2007-05-01

A former patient in a Tampa, FL, ED, returned to the department in scrubs, claimed to be a temp, and was allowed to work despite not having any ID. To avoid similar problems, your ED should have a well-defined set of rules for people who report for work without an ID and/or do not demonstrate the requisite skills to treat patients. No badge, no work" is a good rule, unless the person is well known to you. All ED staff, including physicians and ancillary workers, should be prepared to produce photo ID immediately upon request. If staff cannot reach you, they should be encouraged to report interlopers to security or local police, as they are guilty of trespassing.

Advertising Emergency Department Wait Times

PubMed Central

Weiner, Scott G.

2013-01-01

Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

Higher Dietary Energy Density is Associated with Stunting but not Overweight and Obesity in a Sample of Urban Malaysian Children.

PubMed

Shariff, Zalilah Mohd; Lin, Khor Geok; Sariman, Sarina; Siew, Chin Yit; Yusof, Barakatun Nisak Mohd; Mun, Chan Yoke; Lee, Huang Soo; Mohamad, Maznorila

2016-01-01

Although diets with high energy density are associated with increased risk of overweight and obesity, it is not known whether such diets are associated with undernutrition. This study assessed the relationship between dietary energy density (ED) and nutritional status of 745 urban 1- to 10-year-old children. Dietary intakes were obtained using food recall and record for two days. Dietary energy density was based on food and caloric beverages. Higher dietary ED was associated with lower intakes of carbohydrate, sugar, vitamins C and D, and calcium but higher fat, fiber, iron, and folate intakes. While intakes of fruits and milk/dairy products decreased, meat, fish, and legume intakes increased with higher dietary ED. Stunting, but not other growth problems, was associated with higher dietary ED. Future studies should confirm the cause-and-effect relationship between higher dietary ED and stunting.

Stigmatizing Attitudes and Beliefs About Anorexia and Bulimia Nervosa Among Italian Undergraduates.

PubMed

Caslini, Manuela; Crocamo, Cristina; Dakanalis, Antonios; Tremolada, Martina; Clerici, Massimo; Carrà, Giuseppe

2016-12-01

Stigmatizing attitudes toward eating disorders (EDs) may lead to reduced treatment seeking. We aimed to estimate the prevalence of stigmatizing trends and beliefs related to anorexia nervosa (AN) and bulimia nervosa (BN), and the associations with the experiential knowledge of the problem, in a large sample of Italian undergraduates. A total of 2109 participants completed an online survey including questionnaires related to stigmatizing beliefs toward AN and BN, and personal contacts with people with EDs. Undergraduates reported almost overlapping low levels of stigmatizing trends for AN and BN, apart from personal responsibility and social distance. Those aged 18 to 25 and living with family held higher stigmatizing attitudes. Stigma was lower in underweight participants and in those (12%) reporting a previous ED diagnosis. Although not improving stigmatizing attitudes, 83% of the sample was familiar with people with an ED. Antistigma actions to increase awareness on EDs and to improve treatment-seeking behaviors are needed.

Effects of emergency department expansion on emergency department patient flow.

PubMed

Mumma, Bryn E; McCue, James Y; Li, Chin-Shang; Holmes, James F

2014-05-01

Emergency department (ED) crowding is an increasing problem associated with adverse patient outcomes. ED expansion is one method advocated to reduce ED crowding. The objective of this analysis was to determine the effect of ED expansion on measures of ED crowding. This was a retrospective study using administrative data from two 11-month periods before and after the expansion of an ED from 33 to 53 adult beds in an academic medical center. ED volume, staffing, and hospital admission and occupancy data were obtained either from the electronic health record (EHR) or from administrative records. The primary outcome was the rate of patients who left without being treated (LWBT), and the secondary outcome was total ED boarding time for admitted patients. A multivariable robust linear regression model was used to determine whether ED expansion was associated with the outcome measures. The mean (±SD) daily adult volume was 128 (±14) patients before expansion and 145 (±17) patients after. The percentage of patients who LWBT was unchanged: 9.0% before expansion versus 8.3% after expansion (difference = 0.6%, 95% confidence interval [CI] = -0.16% to 1.4%). Total ED boarding time increased from 160 to 180 hours/day (difference = 20 hours, 95% CI = 8 to 32 hours). After daily ED volume, low-acuity area volume, daily wait time, daily boarding hours, and nurse staffing were adjusted for, the percentage of patients who LWBT was not independently associated with ED expansion (p = 0.053). After ED admissions, ED intensive care unit (ICU) admissions, elective surgical admissions, hospital occupancy rate, ICU occupancy rate, and number of operational ICU beds were adjusted for, the increase in ED boarding hours was independently associated with the ED expansion (p = 0.005). An increase in ED bed capacity was associated with no significant change in the percentage of patients who LWBT, but had an unintended consequence of an increase in ED boarding hours. ED expansion alone does not appear to be an adequate solution to ED crowding. © 2014 by the Society for Academic Emergency Medicine.

14 CFR 121.631 - Original dispatch or flight release, redispatch or amendment of dispatch or flight release.

Code of Federal Regulations, 2011 CFR

2011-01-01

... a flight to continue beyond the ETOPS Entry Point unless— (1) Except as provided in paragraph (d) of... with weather conditions at or above operating minima. (e) Before the ETOPS Entry Point, the pilot in... update the flight plan if needed because of a re-evaluation of aircraft system capabilities. (f) No...

14 CFR 121.631 - Original dispatch or flight release, redispatch or amendment of dispatch or flight release.

Code of Federal Regulations, 2012 CFR

2012-01-01

... a flight to continue beyond the ETOPS Entry Point unless— (1) Except as provided in paragraph (d) of... with weather conditions at or above operating minima. (e) Before the ETOPS Entry Point, the pilot in... update the flight plan if needed because of a re-evaluation of aircraft system capabilities. (f) No...

14 CFR 121.631 - Original dispatch or flight release, redispatch or amendment of dispatch or flight release.

Code of Federal Regulations, 2013 CFR

2013-01-01

... a flight to continue beyond the ETOPS Entry Point unless— (1) Except as provided in paragraph (d) of... with weather conditions at or above operating minima. (e) Before the ETOPS Entry Point, the pilot in... update the flight plan if needed because of a re-evaluation of aircraft system capabilities. (f) No...

14 CFR 121.631 - Original dispatch or flight release, redispatch or amendment of dispatch or flight release.

Code of Federal Regulations, 2014 CFR

2014-01-01

... a flight to continue beyond the ETOPS Entry Point unless— (1) Except as provided in paragraph (d) of... with weather conditions at or above operating minima. (e) Before the ETOPS Entry Point, the pilot in... update the flight plan if needed because of a re-evaluation of aircraft system capabilities. (f) No...

14 CFR 121.631 - Original dispatch or flight release, redispatch or amendment of dispatch or flight release.

Code of Federal Regulations, 2010 CFR

2010-01-01

... a flight to continue beyond the ETOPS Entry Point unless— (1) Except as provided in paragraph (d) of... with weather conditions at or above operating minima. (e) Before the ETOPS Entry Point, the pilot in... update the flight plan if needed because of a re-evaluation of aircraft system capabilities. (f) No...

The St. Louis Post-Dispatch and Early Coverage of Times Beach: Watchdog or Muted Trumpet?

ERIC Educational Resources Information Center

La Pierre, Yvette

Times Beach, Missouri, a small town close to the Meramec River and about 25 miles from St. Louis, is now deserted due to contamination from dioxin, a contaminant generated during the production of some cleansers, herbicides, and pesticides. From November 30, 1982, until the end of January 1983, the "St. Louis Post-Dispatch" ran 55…

1889 Consular Dispatch from Baghdad

ERIC Educational Resources Information Center

Potter, Lee Ann

2007-01-01

In the late summer of 1888, officials at the U.S. Department of State appointed John Henry Haynes of Rowe, Massachusetts, to become the first U.S. consul in Baghdad. At that time, Baghdad--along with all of present day Iraq--was part of the Ottoman Empire, as it had been for more than three centuries. In his fourth dispatch, a single-page,…

Baseline Assessment of the Use of Weather Information in Airline Systems Operations Centers

DTIC Science & Technology

2012-08-01

QicP.------------Qualified.internet.communications.Provider sigMeT.--------significant.Meteorological.information TaF ...conditions, Lifted / K index Aviation Terminal Forecast, TAFs CCFP Dispatch Supervisor 163 Bombardier CRJ100/200 CRJ700 CRJ900 Dash 8-200...ceiling Sabre TAFs , METARs, NOTAMs, AIRMETs WSI winds aloft 6..... after. interviewing,. we. observed. the. dispatchers. to. determine

Designing seasonal initial attack resource deployment and dispatch rules using a two-stage stochastic programming procedure

Treesearch

Yu Wei; Michael Bevers; Erin J. Belval

2015-01-01

Initial attack dispatch rules can help shorten fire suppression response times by providing easy-to-follow recommendations based on fire weather, discovery time, location, and other factors that may influence fire behavior and the appropriate response. A new procedure is combined with a stochastic programming model and tested in this study for designing initial attack...

Dispatches from Flyover Country: Four Appraisals of Impacts of Trump's Immigration Policy on Families, Schools, and Communities

ERIC Educational Resources Information Center

Hamann, Edmund T.; Morgenson, Cara

2017-01-01

A university professor and high school ESL teacher, both based in Lincoln Nebraska, each write two short essays that detail implications of the Trump administration immigration policies for students, teachers, schools, and communities. The first two dispatches come from the transition period (after Trump won but while Obama still presided) while…

Dispatch Control with PEV Charging and Renewables for Multiplayer Game Application

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davis, Nathan; Johnson, Brian; McJunkin, Timothy

This paper presents a demand response model for a hypothetical microgrid that integrates renewable resources and plug-in electric vehicle (PEV) charging systems. It is assumed that the microgrid has black start capability and that external generation is available for purchase while grid connected to satisfy additional demand. The microgrid is developed such that in addition to renewable, non-dispatchable generation from solar, wind and run of the river hydroelectric resources, local dispatchable generation is available in the form of small hydroelectric and moderately sized gas and coal fired facilities. To accurately model demand, the load model is separated into independent residential,more » commercial, industrial, and PEV charging systems. These are dispatched and committed based on a mixed integer linear program developed to minimize the cost of generation and load shedding while satisfying constraints associated with line limits, conservation of energy, and ramp rates of the generation units. The model extends a research tool to longer time frames intended for policy setting and educational environments and provides a realistic and intuitive understanding of beneficial and challenging aspects of electrification of vehicles combined with integration of green electricity production.« less

Economic Dispatch for Microgrid Containing Electric Vehicles via Probabilistic Modeling: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yao, Yin; Gao, Wenzhong; Momoh, James

In this paper, an economic dispatch model with probabilistic modeling is developed for a microgrid. The electric power supply in a microgrid consists of conventional power plants and renewable energy power plants, such as wind and solar power plants. Because of the fluctuation in the output of solar and wind power plants, an empirical probabilistic model is developed to predict their hourly output. According to different characteristics of wind and solar power plants, the parameters for probabilistic distribution are further adjusted individually for both. On the other hand, with the growing trend in plug-in electric vehicles (PHEVs), an integrated microgridmore » system must also consider the impact of PHEVs. The charging loads from PHEVs as well as the discharging output via the vehicle-to-grid (V2G) method can greatly affect the economic dispatch for all of the micro energy sources in a microgrid. This paper presents an optimization method for economic dispatch in a microgrid considering conventional power plants, renewable power plants, and PHEVs. The simulation results reveal that PHEVs with V2G capability can be an indispensable supplement in a modern microgrid.« less

The Preemptive Stocker Dispatching Rule of Automatic Material Handling System in 300 mm Semiconductor Manufacturing Factories

NASA Astrophysics Data System (ADS)

Wang, C. N.; Lin, H. S.; Hsu, H. P.; Wang, Yen-Hui; Chang, Y. P.

2016-04-01

The integrated circuit (IC) manufacturing industry is one of the biggest output industries in this century. The 300mm wafer fabs is the major fab size of this industry. The automatic material handling system (AMHS) has become one of the most concerned issues among semiconductor manufacturers. The major lot delivery of 300mm fabs is used overhead hoist transport (OHT). The traffic jams are happened frequently due to the wide variety of products and big amount of OHTs moving in the fabs. The purpose of this study is to enhance the delivery performance of automatic material handling and reduce the delay and waiting time of product transportation for both hot lots and normal lots. Therefore, this study proposes an effective OHT dispatching rule: preemptive stocker dispatching (PSD). Simulation experiments are conducted and one of the best differentiated preemptive rule, differentiated preemptive dispatching (DPD), is used for comparison. Compared with DPD, The results indicated that PSD rule can reduce average variable delivery time of normal lots by 13.15%, decreasing average variable delivery time of hot lots by 17.67%. Thus, the PSD rule can effectively reduce the delivery time and enhance productivity in 300 mm wafer fabs.

A study on the disaster medical response during the Mauna Ocean Resort gymnasium collapse.

PubMed

Cha, Myeong-Il; Kim, Gi Woon; Kim, Chu Hyun; Choa, Minhong; Choi, Dai Hai; Kim, Inbyung; Wang, Soon Joo; Yoo, In Sool; Yoon, Han Deok; Lee, Kang Hyun; Cho, Suck Ju; Heo, Tag; Hong, Eun Seog

2016-09-01

To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. One hundred fifty-five accident victims treated at 12 hospitals, mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of collapse was disseminated in 4 minutes, dispatch of 4 disaster medical assistance teams took at least 69 minutes to take the decision of dispatch. Four point five percent were treated at the accident site, 56.7% were transferred to 2 hospitals that were nearest to the collapse site, and 42.6% were transferred to hospitals that were poorly prepared to handle disaster victims. In the Gyeongju Mauna Ocean Resort gymnasium collapse, the initial triage and distribution of patients was inefficient and medical assistance arrived late. These problems had also been noted in prior mass casualty incidents.