Enhanced recovery after surgery in children: Promising, evidence-based multidisciplinary care.

PubMed

Rove, Kyle O; Edney, John C; Brockel, Megan A

2018-06-01

Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children. © 2018 John Wiley & Sons Ltd.

Monitoring needs and goal-directed fluid therapy within an enhanced recovery program.

PubMed

Minto, Gary; Scott, Michael J; Miller, Timothy E

2015-03-01

Patients having major abdominal surgery need perioperative fluid supplementation; however, enhanced recovery principles mitigate against many of the factors that traditionally led to relative hypovolemia in the perioperative period. An estimate of fluid requirements for abdominal surgery can be made but individualization of fluid prescription requires consideration of clinical signs and hemodynamic variables. The literature supports goal-directed fluid therapy. Application of this evidence to justify stroke volume optimization in the setting of major surgery within an enhanced recovery program is controversial. This article places the evidence in context, reviews controversies, and suggests implications for current practice and future research. Copyright © 2015 Elsevier Inc. All rights reserved.

40 CFR 145.23 - Program description.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and any State administrative or judicial review procedures. (d) Copies of the permit form(s... reviewing the wells for compliance with applicable monitoring, reporting, construction, and financial... for Class II enhanced oil recovery or enhanced gas recovery wells transitioning to Class VI injection...

40 CFR 145.23 - Program description.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and any State administrative or judicial review procedures. (d) Copies of the permit form(s... reviewing the wells for compliance with applicable monitoring, reporting, construction, and financial... for Class II enhanced oil recovery or enhanced gas recovery wells transitioning to Class VI injection...

40 CFR 145.23 - Program description.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and any State administrative or judicial review procedures. (d) Copies of the permit form(s... reviewing the wells for compliance with applicable monitoring, reporting, construction, and financial... for Class II enhanced oil recovery or enhanced gas recovery wells transitioning to Class VI injection...

40 CFR 145.23 - Program description.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and any State administrative or judicial review procedures. (d) Copies of the permit form(s... reviewing the wells for compliance with applicable monitoring, reporting, construction, and financial... for Class II enhanced oil recovery or enhanced gas recovery wells transitioning to Class VI injection...

Activities of the Oil Implementation Task Force; Contracts for field projects and supporting research on enhanced oil recovery, July--September 1990

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

Tiedemann, H.A.

1991-05-01

The report contains a general introduction and background to DOE's revised National Energy Strategy Advanced Oil Recovery Program and activities of the Oil Implementation Task Force; a detailed synopsis of the symposium, including technical presentations, comments and suggestions; a section of technical information on deltaic reservoirs; and appendices containing a comprehensive listing of references keyed to general deltaic and geological aspects of reservoirs and those relevant to six selected deltaic plays. Enhanced recovery processes include chemical floodings, gas displacement, thermal recovery, geoscience, and microbial recovery.

Recovery Act: States Could Provide More Information on Education Programs to Enhance the Public's Understanding of Fund Use. Report to the Republican Leader, U.S. Senate. GAO-10-807

ERIC Educational Resources Information Center

Ashby, Cornelia M.

2010-01-01

The American Recovery and Reinvestment Act of 2009 (Recovery Act) provides $70.3 billion for three education programs--the State Fiscal Stabilization Fund (SFSF), Title I of the Elementary and Secondary Education Act (Title I), and Individuals with Disabilities Education Act (IDEA). The Act requires recipients to be accountable for how these funds…

Enhancing mutual accountability to promote quality, safety, and nurses' recovery from substance use disorders.

PubMed

Horton-Deutsch, Sara; McNelis, Angela; O'Haver Day, Pamela

2011-12-01

Year after year, the public view nurses at the top of the list of the most honest and ethical professionals. However, nurses impaired with substance use disorders are subject to the tremendous stigma associated with addiction. Successful treatment programs protect public safety and support nurses' recovery and reentry into practice. The purpose of this study was to explore the nurses' experience in an alternative-to-discipline treatment program, the Indiana State Nurses Assistance Program (ISNAP), administered by the Indiana State Nurses Association. For this study, focus groups were used to capture nurses' experience with the ISNAP, a nurse-monitoring program for substance use. Three focus groups were conducted with 25 participants. The overall theme of the focus groups was enhancing mutual accountability. Nurses' views were grouped into four major areas of importance, including accountability, clear expectations, addressing individual concerns, and educating others about substance use disorders. Nurses described how each of these factors supported and impeded their recovery. The findings support the need for further education and research on how to best promote and sustain recovery. 2011 Elsevier Inc. All rights reserved.

Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery.

PubMed

Grant, Michael C; Hanna, Andrew; Benson, Andrew; Hobson, Deborah; Wu, Christopher L; Yuan, Christina T; Rosen, Michael; Wick, Elizabeth C

2018-03-01

Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A call for new standard of care in perioperative gynecologic oncology practice: Impact of enhanced recovery after surgery (ERAS) programs.

PubMed

Miralpeix, Ester; Nick, Alpa M; Meyer, Larissa A; Cata, Juan; Lasala, Javier; Mena, Gabriel E; Gottumukkala, Vijaya; Iniesta-Donate, Maria; Salvo, Gloria; Ramirez, Pedro T

2016-05-01

Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. However, there is a paucity of data on ERAS programs in gynecologic surgery. We reviewed the published literature on ERAS programs in colorectal surgery, general gynecologic surgery, and gynecologic oncology surgery to evaluate the impact of such programs on outcomes, and to identify key elements in establishing a successful ERAS program. ERAS programs are associated with shorter length of hospital stay, a reduction in overall health care costs, and improvements in patient satisfaction. We suggest an ERAS program for gynecologic oncology practice involving preoperative, intraoperative, and postoperative strategies including; preadmission counseling, avoidance of preoperative bowel preparation, use of opioid-sparing multimodal perioperative analgesia (including loco-regional analgesia), intraoperative goal-directed fluid therapy (GDT), and use of minimally invasive surgical techniques with avoidance of routine use of nasogastric tube, drains and/or catheters. Postoperatively, it is important to encourage early feeding, early mobilization, timely removal of tubes and drains, if present, and function oriented multimodal analgesia regimens. Successful implementation of an ERAS program requires a multidisciplinary team effort and active participation of the patient in their goal-oriented functional recovery program. However, future outcome studies should evaluate the efficacy of an intervention within the pathway, include objective measures of symptom burden and control, study measures of functional recovery, and quantify outcomes of the program in relation to the rates of adherence to the key elements of care in gynecologic oncology such as oncologic outcomes and return to intended oncologic therapy (RIOT). Copyright © 2016 Elsevier Inc. All rights reserved.

Contracts for field projects and supporting research on enhanced oil recovery. Progress review number 83, quarter ending June 30, 1995

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

NONE

Summaries of 41 research projects on enhanced recovery are presented under the following sections: (1) chemical flooding; (2) gas displacement; (3) thermal recovery; (4) geoscience technology; (5) resource assessment technology; and (6) reservoir classes. Each presentation gives the title of the project, contract number, research facility, contract date, expected completion data, amount of the award, principal investigator, and DOE program manager, and describes the objectives of the project and a summary of the technical progress.

Guidance on Enhancing Education through Technology (Ed Tech) Program Funds Made Available under the American Recovery and Reinvestment Act of 2009

ERIC Educational Resources Information Center

US Department of Education, 2009

2009-01-01

The purpose of this guidance is to provide comprehensive information on the Enhancing Education through Technology funds made available under the American Recovery and Reinvestment Act of 2009 (ARRA). The guidance provides the U.S. Department of Education's interpretation of various statutory provisions and does not impose any requirements beyond…

Solar Thermal Enhanced Oil Recovery, (STEOR) Volume 1: Executive summary

NASA Astrophysics Data System (ADS)

Elzinga, E.; Arnold, C.; Allen, D.; Garman, R.; Joy, P.; Mitchell, P.; Shaw, H.

1980-11-01

Thermal enhanced oil recovery is widely used in California to aid in the production of heavy oils. Steam injection either to stimulate individual wells or to drive oil to the producing wells, is by far the major thermal process today and has been in use for over 20 years. Since steam generation at the necessary pressures (generally below 4000 kPa (580 psia)) is within the capabilities of present day solar technology, it is logical to consider the possibilities of solar thermal enhanced oil recovery (STEOR). The present project consisted of an evaluation of STEOR. Program objectives, system selection, trade-off studies, preliminary design, cost estimate, development plan, and market and economic analysis are summarized.

Maximizing Social Model Principles in Residential Recovery Settings

PubMed Central

Polcin, Douglas; Mericle, Amy; Howell, Jason; Sheridan, Dave; Christensen, Jeff

2014-01-01

Abstract Peer support is integral to a variety of approaches to alcohol and drug problems. However, there is limited information about the best ways to facilitate it. The “social model” approach developed in California offers useful suggestions for facilitating peer support in residential recovery settings. Key principles include using 12-step or other mutual-help group strategies to create and facilitate a recovery environment, involving program participants in decision making and facility governance, using personal recovery experience as a way to help others, and emphasizing recovery as an interaction between the individual and their environment. Although limited in number, studies have shown favorable outcomes for social model programs. Knowledge about social model recovery and how to use it to facilitate peer support in residential recovery homes varies among providers. This article presents specific, practical suggestions for enhancing social model principles in ways that facilitate peer support in a range of recovery residences. PMID:25364996

Contracts for field projects and supporting research on enhanced oil recovery. Progress review No. 82, quarterly report, January--March 1995

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

NONE

This document consists of a list of projects supporting work on oil recovery programs. A publications list and index of companies and institutions is provided. The remaining portion of the document provides brief descriptions on projects in chemical flooding, gas displacement, thermal recovery, geoscience, resource assessment, and reservoir class field demonstrations.

Endangered Species. Management Improvements Could Enhance Recovery Program. Report to the Chairman, Subcommittee on Fisheries and Wildlife Conservation and the Environment, Committee on Merchant Marine and Fisheries, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. Resources, Community, and Economic Development Div.

Extinction of animal and plant species has become a serious problem that threatens to become more acute in coming years. The endangered species program was established to prevent further extinctions and ultimately recover species designated as threatened or endangered through the development and implementation of species recovery plans. Concerned…

ARRA Investments in Technology, Innovation, and K-12 Reform: The Digital Education Funding Cliff. A Preliminary Report on State Administration of the American Recovery & Reinvestment Act of 2009: Enhancing Education Through Technology Program

ERIC Educational Resources Information Center

State Educational Technology Directors Association, 2010

2010-01-01

This is the first in a forthcoming series of reports documenting state administration of educational technology funding included in the "American Recovery and Reinvestment Act of 2009" (ARRA). The ARRA included a $650 million allocation in ESEA Title II, Part D, commonly referred to as the "Enhancing Education through Technology…

Implementation Costs of an Enhanced Recovery After Surgery Program in the United States: A Financial Model and Sensitivity Analysis Based on Experiences at a Quaternary Academic Medical Center.

PubMed

Stone, Alexander B; Grant, Michael C; Pio Roda, Claro; Hobson, Deborah; Pawlik, Timothy; Wu, Christopher L; Wick, Elizabeth C

2016-03-01

Despite positive results from several international Enhanced Recovery After Surgery (ERAS) protocols, the United States has been slow to adopt ERAS protocols, in part due to concern regarding the expenses of such a program. We sought to evaluate the potential annual net cost savings of implementing a US-based ERAS program. Using data from existing publications and experience with an ERAS program, a model of net financial costs was developed for surgical groups of escalating numbers of annual cases. Our example scenario provided a financial analysis of the implementation of an ERAS program at a United States academic institution based on data from the ERAS Program for Colorectal Surgery at The Johns Hopkins Hospital. Based on available data from the United States, ERAS programs lead to reductions in lengths of hospital stay that range from 0.7 to 2.7 days and substantial direct cost savings. Using example data from a quaternary hospital, the considerable cost of $552,783 associated with implementation of an ERAS program was offset by even greater savings in the first year of nearly $948,500, yielding a net savings of $395,717. Sensitivity analysis across several caseload and direct cost scenarios yielded similar savings in 20 of the 27 projections. Enhanced Recovery After Surgery protocols have repeatedly led to reduction in length of hospital stay and improved surgical outcomes. A financial model, based on published data and experience, projects that investment in an ERAS program can also lead to net financial savings for US hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Wide Area Recovery and Resiliency Program (WARRP) Interim Clearance Strategy for Environments Contaminated with Hazardous Chemicals

DTIC Science & Technology

2012-07-01

on the cleanup of specific sites: those containing only cesium-137 (Goiania) and those containing 137Cs and other radionuclides ( Chernobyl ...targets and consider initiatives to enhance the quality of life of the residents of the contaminated areas. Recovery experience from the Chernobyl

Effectiveness of a program to facilitate recovery for people with long-term mental illness in Japan.

PubMed

Chiba, Rie; Miyamoto, Yuki; Kawakami, Norito; Harada, Naoko

2014-09-01

Recovery is defined as the process of developing new meaning and purpose in life as one grows beyond the catastrophic effects of mental illness. This study aimed to develop a program to facilitate recovery and examine its effectiveness in a randomized controlled trial. The program was developed with three components that enhance benefit finding, personal meaning, and a sense of happiness. Sixty-three participants with long-term mental illness were randomly allocated to the intervention group (n = 32) or the control group (n = 31). The intervention group attended eight 2-h group sessions, with one held every week. Recovery was assessed at baseline, post-intervention, and at a three-month follow-up. In the per-protocol analysis, after excluding those who dropped out, the intervention group showed significant improvement in recovery compared with the control group (P < 0.05). In the intention-to-treat analysis, a repeated measures analysis of variance did not show any significant intervention effect (time × group) (P > 0.05). The program had the potential to facilitate recovery. © 2013 Wiley Publishing Asia Pty Ltd.

40 CFR 144.26 - Inventory requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... “Inventory of Injection Wells,” OMB No. 158-R0170. (b) Additional contents. For EPA administered programs...) Class II enhanced recovery wells; (ii) Class IV wells; (iii) The following Class V wells: (A) Sand or... (40 CFR 146.5 (e)(11)) (C) Geothermal energy recovery wells [§ 146.5(e)(12)]; (D) Brine return flow...

Special Focus Areas for Hazardous Waste Cleanups under the Resource Conservation and Recovery Act (RCRA)

EPA Pesticide Factsheets

In order to manage the new and changing needs of the RCRA Corrective Action Program, EPA is constantly exploring program enhancements, alternate exposure pathways, and new technologies available to protect human health and environment.

Space station ECLSS integration analysis: Simplified General Cluster Systems Model, ECLS System Assessment Program enhancements

NASA Technical Reports Server (NTRS)

Ferguson, R. E.

1985-01-01

The data base verification of the ECLS Systems Assessment Program (ESAP) was documented and changes made to enhance the flexibility of the water recovery subsystem simulations are given. All changes which were made to the data base values are described and the software enhancements performed. The refined model documented herein constitutes the submittal of the General Cluster Systems Model. A source listing of the current version of ESAP is provided in Appendix A.

Molecular, Cellular and Functional Events in Axonal Sprouting after Stroke

PubMed Central

Kathirvelu, Balachander; Schweppe, Catherine A; Nie, Esther H

2016-01-01

Stroke is the leading cause of adult disability. Yet there is a limited degree of recovery in this disease. One of the mechanisms of recovery is the formation of new connections in the brain and spinal cord after stroke: post-stroke axonal sprouting. Studies indicate that post-stroke axonal sprouting occurs in mice, rats, primates and humans. Inducing post-stroke axonal sprouting in specific connections enhances recovery; blocking axonal sprouting impairs recovery. Behavioral activity patterns after stroke modify the axonal sprouting response. A unique regenerative molecular program mediates this aspect of tissue repair in the CNS. The types of connections that are formed after stroke indicate three patterns of axonal sprouting after stroke: Reactive, Reparative and Unbounded Axonal Sprouting. These differ in mechanism, location, relationship to behavioral recovery and, importantly, in their prospect for therapeutic manipulation to enhance tissue repair. PMID:26874223

A qualitative study to understand the barriers and enablers in implementing an enhanced recovery after surgery program.

PubMed

Pearsall, Emily A; Meghji, Zahida; Pitzul, Kristen B; Aarts, Mary-Anne; McKenzie, Marg; McLeod, Robin S; Okrainec, Allan

2015-01-01

Explore the barriers and enablers to adoption of an Enhanced Recovery after Surgery (ERAS) program by the multidisciplinary perioperative team responsible for the care of elective colorectal surgical patients. ERAS programs include perioperative interventions that when used together have led to decreased length of stay while increasing patient recovery and satisfaction. Despite the known benefits of ERAS programs, uptake remains slow. Semistructured interviews were conducted with general surgeons, anesthesiologists, and ward nurses at 7 University of Toronto-affiliated hospitals to identify potential barriers and enablers to adoption of 18 ERAS interventions. Grounded theory was used to thematically analyze the transcribed interviews. Nineteen general surgeons, 18 anesthesiologists, and 18 nurses participated. The mean time of each interview was 18 minutes. Lack of manpower, poor communication and collaboration, resistance to change, and patient factors were cited by most as barriers. Discipline-specific issues were identified although most related to resistance to change. Overall, interviewees were supportive of implementation of a standardized ERAS program and agreed that a standardized guideline based on best evidence; standardized order sets; and education of the staff, patients, and families are essential. Multidisciplinary perioperative staff supported the implementation of an ERAS program at the University of Toronto-affiliated hospitals. However, major barriers were identified, including the need for patient education, increased communication and collaboration, and better evidence for ERAS interventions. Identifying these barriers and enablers is the first step toward successfully implementing an ERAS program.

78 FR 75268 - Fisheries Off West Coast States; Pacific Coast Groundfish Fishery; Trawl Rationalization Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... toward environmental conservation and economic sustainability before cost recovery. NMFS should... fleet's flexibility and economic efficiency will enhance the trawl rationalization program's durability... before economic benefits have been adequately realized and while fishermen are struggling to pay...

Recovery Audit Contractor medical necessity readiness: one health system's journey.

PubMed

Scott, Judith A; Camden, Mindy

2011-01-01

To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

A Randomized Controlled Trial of an Online Relapse Prevention Program for Adolescents in Substance Abuse Treatment

ERIC Educational Resources Information Center

Trudeau, Kimberlee J.; Black, Ryan A.; Kamon, Jody L.; Sussman, Steve

2017-01-01

Background: An Internet-based relapse prevention supplement to adolescent substance abuse treatment programming is a promising modality to reinforce treatment gains and enhance recovery; however, an evidence base is lacking. Objective: To assess the efficacy of the online Navigating my Journey (NmJ) program. Methods: 129 adolescent-aged…

Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Colorectal Surgery.

PubMed

Ban, Kristen A; Gibbons, Melinda M; Ko, Clifford Y; Wick, Elizabeth C; Cannesson, Maxime; Scott, Michael J; Grant, Michael C; Wu, Christopher L

2018-04-11

The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery (ISCR), which is a national effort to disseminate best practices in perioperative care to more than 750 hospitals across multiple procedures in the next 5 years. The program will integrate evidence-based processes central to enhanced recovery and prevention of surgical site infection, venous thromboembolic events, catheter-associated urinary tract infections with socioadaptive interventions to improve surgical outcomes, patient experience, and perioperative safety culture. The objectives of this review are to evaluate the evidence supporting anesthesiology components of colorectal (CR) pathways and to develop an evidence-based CR protocol for implementation. Anesthesiology protocol components were identified through review of existing CR enhanced recovery pathways from several professional associations/societies and expert feedback. These guidelines/recommendations were supplemented by evidence made further literature searches. Anesthesiology protocol components were identified spanning the immediate preoperative, intraoperative, and postoperative phases of care. Components included carbohydrate loading, reduced fasting, multimodal preanesthesia medication, antibiotic prophylaxis, blood transfusion, intraoperative fluid management/goal-directed fluid therapy, normothermia, a standardized intraoperative anesthesia pathway, and standard postoperative multimodal analgesic regimens.

The role of complaint management in the service recovery process.

PubMed

Bendall-Lyon, D; Powers, T L

2001-05-01

Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

Environmental Development Plan (EDP). Enhanced gas recovery, FY 1977

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

Not Available

1978-03-01

This Enhanced Gcs Recovery EDP addresses the environmental impacts of enhanced gas recovery processes in shale and sandstone, methane drainage from coalbeds, and methane recovery from geopressured aquifers. The EDP addresses planning in two basic areas: environmental research and environmental assessment. Environmental research can be categorized as follows: characterization of pollutants from EGR processes; selective application of monitoring and measuring techniques; evaluation of control/mitigation techniques; and evaluation of the synergistic impacts of the development of EGR techniques. Environmental assessment activities scheduled by EDP include: assessment of ecological impacts; assessment of socioeconomic effects; EIA/EIS preparation; evaluation of control technology needs; andmore » analysis of applicable and proposed emission, effluent, and health and safety standards. The EGR EDP includes an EGR technology overview (Section 2), a discussion of EGR environmental issues and requirements (Section 3), an environmental action plan (Section 4), an environmental management strategy for the EGR program (Section 5), and supporting appendices which present information on Federal legislation applicable to EGR technology, a summary of ongoing and completed research, and future research and assessment projects.« less

Enhanced recovery program (ERP) in major laryngeal surgery: building a protocol and testing its feasibility.

PubMed

Gemma, M; Toma, S; Lira Luce, F; Beretta, L; Braga, M; Bussi, M

2017-12-01

Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®. Twenty-four patients undergoing major laryngeal surgery (total and partial laryngectomies or surgical removal of oropharyngeal tumour with muscle flap reconstruction) were treated according to such an ERP protocol, which differed under several respects from our previous standard practice (described in 70 consecutive patients who underwent major laryngeal surgery before ERP implementation. The adherence rate to the different ERP items is reported. Adherence to ERP items was high. Nutritional assessment, antibiotic prophylaxis, postoperative nausea and vomit (PONV) prophylaxis and postoperative speech therapy targets were applied as required in 100% of cases. Some ERP items (antibiotic prophylaxis, intraoperative infusion rate, and postoperative speech therapy) were already frequently implemented before ERP adoption. Postoperative medical complications occurred in 8.3% of patients. Our expert opinion-based ERP protocol for major laryngeal surgery proved feasible. The degree of benefit deriving from its implementation has yet to be assessed. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

"But she is a woman and this is a man's job": lessons for participatory research and participatory recovery.

PubMed

Krajeski, R L; Peterson, K J

1999-03-01

This article examines the leadership potentials of local women in dealing with disaster recovery, and measures to be undertaken to enhance their role despite cultural and social discriminations. Interaction with these women was conducted at community based organizations. The authors believe that women who have the knowledge have an edge in providing services to disaster victims. Gender inequality, inadequate education, and training were some of the reasons some sectors regard women as unfit for the job. In spite of the prejudice, these women have contributed creative rather than traditional solutions to disaster recovery and tend to be client and community-centered. Local women had faced barriers when leading a disaster recovery program, while professional recovery experts view these women as victims. Government and nongovernmental organizations do not acknowledge the efforts contributed by these women, often leaving them out of meetings and conferences. Encouragement, support, and confidence given by established organizations to these women would surely prompt them to lead an organized and successful local disaster recovery program.

Intrathecal Morphine for Laparoscopic Segmental Colonic Resection as Part of an Enhanced Recovery Protocol: A Randomized Controlled Trial.

PubMed

Koning, Mark V; Teunissen, Aart Jan W; van der Harst, Erwin; Ruijgrok, Elisabeth J; Stolker, Robert Jan

2018-02-01

Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered. Exclusion criteria were patients in whom contraindications to spinal anesthesia were present, conversion to open surgery, and gastric and rectal surgery. The intervention group received single-shot intrathecal bupivacaine/morphine (12.5 mg/300 μg), with an altered dose for older patients. The control group received a sham procedure and a bolus of piritramide (0.1 mg/kg). Both groups received standardized general anesthesia and a patient-controlled intravenous analgesia pump as postoperative analgesia. All patients were treated according to an ERAS protocol. A decrease in days to "fit for discharge" was the primary outcome. Fifty-six patients were enrolled. Intervention group patients were fit for discharge earlier (median of 3 vs 4 days, P = 0.044). Furthermore, there was a significant decrease in opioid use and lower pain scores on the first postoperative day in the intervention group. There were no differences in adverse events (except for more pruritus), time to mobilization, fluid administration, or patient satisfaction. This randomized controlled trial shows that intrathecal morphine is a more effective method of postoperative analgesia in laparoscopic surgery than intravenous opioids within an ERAS program. Recovery is faster and less painful with intrathecal morphine. Other studies have confirmed these results, although data on faster recovery are new and require confirmation in future trials. This study was registered at ClinicalTrials.gov, identifier NCT02284282.

The power of theater to promote individual recovery and social change.

PubMed

Faigin, David A; Stein, Catherine H

2010-03-01

Although theatrical activities are used in a variety of therapeutic settings, little attention has been paid to the ways that theater can enhance the recovery process and community integration for people living with psychiatric disabilities. Community-based theater involving people with psychiatric disabilities offers unique opportunities for personal growth, social connection, and advocacy efforts. This Open Forum posits that theater has the power to both facilitate individual recovery and improve the social conditions of people living with mental illness. Critical elements of theatrical activities that relate to processes of recovery and community integration are examined. Implications for future research and program development are discussed.

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

PubMed

Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

2018-01-01

Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and surgeons in identifying the best practices to implement in the surgical care of TKA and THA patients.

Interagency Biological Restoration Demonstration (IBRD): a collaborative approach to biological incident recovery.

PubMed

Crockett, Katie

2011-09-01

Following the terrorist attacks in 2001, much time and effort has been put toward improving catastrophic incident response. But recovery--the period following initial response that focuses on the long-term viability of the affected area--has received less attention. Recognizing the importance of being able to recover an area following a catastrophic incident, the Department of Defense, through its Defense Threat Reduction Agency (DTRA), and the Department of Homeland Security, through its Science and Technology Directorate (DHS S&T), created the Interagency Biological Restoration Demonstration (IBRD) program. IBRD was a 4-year program jointly managed and funded by DTRA and DHS S&T, the goal of which was to reduce the time and resources necessary to recover a wide urban area from an intentional release of Bacillus anthracis. Specific program objectives included understanding the social, economic, and operational interdependencies that affect recovery; establishing long-term coordination between the Departments of Defense and Homeland Security; developing strategic recovery/restoration plans; identifying and demonstrating technologies that support recovery; and exercising recovery activities and technology solutions. IBRD has made important first steps toward improving national preparedness in the area biological incident recovery. Specifically, IBRD has helped enhance the efficacy and efficiency of recovering large urban areas by developing consequence management guidance; identifying key S&T capabilities and integrating them with planning and guidance documents; and establishing key relationships across the federal interagency, federal-to-regional, civilian-to-military, and public-to-private stakeholders. Upon completion of IBRD in fall 2010, both DTRA and DHS S&T planned follow-on programs.

A Peer-Led Electronic Mental Health Recovery App in an Adult Mental Health Service: Study Protocol for a Pilot Trial.

PubMed

Gulliver, Amelia; Banfield, Michelle; Reynolds, Julia; Miller, Sarah; Galati, Connie; Morse, Alyssa R

2017-12-07

There is growing demand for peer workers (people who use their own lived experience to support others in their recovery) to work alongside consumers to improve outcomes and recovery. Augmenting the workforce with peer workers has strong capacity to enhance mental health and recovery outcomes and make a positive contribution to the workforce within mental health systems and to the peer workers themselves. Technology-based applications are highly engaging and desirable methods of service delivery. This project is an exploratory proof-of-concept study, which aims to determine if a peer worker-led electronic mental (e-mental) health recovery program is a feasible, acceptable, and effective adjunct to usual treatment for people with moderate to severe mental illness. The study design comprises a recovery app intervention delivered by a peer worker to individual consumers at an adult mental health service. Evaluation measures will be conducted at post-intervention. To further inform the acceptability and feasibility of the model, consumers will be invited to participate in a focus group to discuss the program. The peer worker, peer supervisor, and key staff at the mental health service will also be individually interviewed to further evaluate the feasibility of the program within the health service and further inform its future development. The program will be delivered over a period of approximately 4 months, commencing June 2017. If the peer worker-led recovery app is found to be feasible, acceptable, and effective, it could be used to improve recovery in mental health service consumers. ©Amelia Gulliver, Michelle Banfield, Julia Reynolds, Sarah Miller, Connie Galati, Alyssa R Morse. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 07.12.2017.

State-Wide Evaluation of the New Hampshire ESEA Title II, Part D Grant Program. Interim Report

ERIC Educational Resources Information Center

Knestis, Kirk; Smoke-Zur, Naomi; Higgins, Cathy

2010-01-01

The Title II-D grant program, "Enhancing Education Through Technology," (EETT) provides financial assistance to higher poverty school districts that have the greatest need for technology support or have been identified as being in need of improvement. In 2009, the American Reinvestment and Recovery Act (ARRA) provided an additional $650…

State-Wide Evaluation of the New Hampshire ESEA Title II, Part D Grant Program. Final Report

ERIC Educational Resources Information Center

Knestis, Kirk; Smoke-Zur, Naomi; Gibson, Rachel; Pike, Jessica Yusaitis; Higgins, Cathy

2011-01-01

The Title II-D grant program, "Enhancing Education Through Technology," (EETT) provides financial assistance to higher poverty school districts that have the greatest need for technology support or have been identified as being in need of improvement. In 2009, the American Reinvestment and Recovery Act (ARRA) provided an additional $650…

Accelerated Recovery Within Standardized Recovery Pathways After Esophagectomy: A Prospective Cohort Study Assessing the Effects of Early Discharge on Outcomes, Readmissions, Patient Satisfaction, and Costs.

PubMed

Schmidt, Henner M; El Lakis, Mustapha A; Markar, Sheraz R; Hubka, Michal; Low, Donald E

2016-09-01

After esophagectomy, some patients exceed targeted discharge goal within enhanced recovery after surgery programs. This study reviews the demographics, outcomes, cost, readmission rates, and patient satisfaction for the accelerated recovery (AR) group. Between 2010 and 2013, 137 consecutive esophagectomy patients were compared according to the length of hospital stay: AR 5 to 6 days, targeted recovery (TR) 7 to 8 days, and delayed recovery (DR) 9 days or more. The AR patients increased from 3% to 46% during the study period. The AR patients were younger, but all groups were comparable regarding comorbidities (Charlson, American Society of Anesthesiologists, and Eastern Cooperative Oncology Group score), cancer stage, and treatment approach. The AR patients were more likely to have neoadjuvant therapy, shorter operations, and less blood loss. The DR patients were more likely to have complications (40% AR versus 45% TR versus 90% DR, p < 0.001). Inhospital and 90-day mortality was 1.5%. All AR patients were discharged home (100% AR versus 87% TR versus 63% DR, p < 0.001), and 30-day readmission rates were comparable between groups (14% AR versus 19% TR versus 5% DR, p = 0.122). Overall mean costs ($38,385 AR versus $41,607 TR versus $61,199 DR, p < 0.001) as well as readmission costs ($7,470 AR versus $27,695 TR versus $33,398 DR, p = 0.202) were lower in the AR group. Patient satisfaction scores were comparable between groups. Accelerated recovery is achievable in a significant proportion of patients undergoing esophagectomy. Accelerated recovery is associated with decreased treatment costs but does not lead to increased readmissions or decreased patient satisfaction. Enhanced recovery after surgery programs should be designed to accommodate patients appropriate for AR. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Quantitative and Qualitative Evaluations of the Enhanced Logo-autobiography Program for Korean-American Women.

PubMed

Sung, Kyung Mi; Bernstein, Kunsook

2017-12-01

This study extends Bernstein et al.'s (2016) investigation of the effects of the Enhanced Logo-autobiography Program on Korean-American women's depressive symptoms, coping strategies, purpose in life, and posttraumatic growth by analyzing quantitative and qualitative data. This study's participants significantly improved on quantitative measures of depression, coping strategies, purpose in life, and post-traumatic growth at eight weeks post-intervention and follow-up. The qualitative content analysis revealed 17 themes with five essential themes. The program's activity to promote purpose in life through posttraumatic growth facilitated participants' recovery from traumatic experiences. Standardized guidelines are needed to conduct this program in Korean community centers.

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols.

PubMed

Piccioni, Federico; Segat, Matteo; Falini, Stefano; Umari, Marzia; Putina, Olga; Cavaliere, Lucio; Ragazzi, Riccardo; Massullo, Domenico; Taurchini, Marco; Del Naja, Carlo; Droghetti, Andrea

2018-03-01

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors' experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy.

Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols

PubMed Central

Piccioni, Federico; Segat, Matteo; Falini, Stefano; Umari, Marzia; Putina, Olga; Cavaliere, Lucio; Ragazzi, Riccardo; Massullo, Domenico; Taurchini, Marco; Droghetti, Andrea

2018-01-01

Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique that allows a faster recovery after thoracic surgery. Although enhanced recovery after surgery (ERAS) principles seem reasonably applicable to thoracic surgery, there is little literature on the application of such a strategy in this context. In regard to pain management, ERAS pathways promote the adoption of a multimodal strategy, tailored to the patients. This approach is based on combining systemic and loco-regional analgesia to favour opioid-sparing strategies. Thoracic paravertebral block is considered the first-line loco-regional technique for VATS. Other techniques include intercostal nerve block and serratus anterior plane block. Nonsteroidal anti-inflammatory drugs and paracetamol are essential part of the multimodal treatment of pain. Also, adjuvant drugs can be useful as opioid-sparing agents. Nevertheless, the treatment of postoperative pain must take into account opioid agents too, if necessary. All above is useful for careful planning and execution of a multimodal analgesic treatment to enhance the recovery of patients. This article summarizes the most recent evidences from literature and authors’ experiences on perioperative multimodal analgesia principles for implementing an ERAS program after VATS lobectomy. PMID:29629202

Microbial enhanced oil recovery and wettability research program

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

Thomas, C.P.; Bala, G.A.; Duvall, M.L.

1991-07-01

This report covers research results for the microbial enhanced oil recovery (MEOR) and wettability research program conducted by EG G Idaho, Inc. at the Idaho National Engineering Laboratory (INEL). The isolation and characterization of microbial species collected from various locations including target oil field environments is underway to develop more effective oil recovery systems for specific applications. The wettability research is a multi-year collaborative effort with the New Mexico Petroleum Recovery Research Center (NMPRRC), to evaluate reservoir wettability and its effects on oil recovery. Results from the wettability research will be applied to determine if alteration of wettability is amore » significant contributing mechanism for MEOR systems. Eight facultatively anaerobic surfactant producing isolates able to function in the reservoir conditions of the Minnelusa A Sands of the Powder River Basin in Wyoming were isolated from naturally occurring oil-laden environments. Isolates were characterized according to morphology, thermostability, halotolerance, growth substrates, affinity to crude oil/brine interfaces, degradative effects on crude oils, and biochemical profiles. Research at the INEL has focused on the elucidation of microbial mechanisms by which crude oil may be recovered from a reservoir and the chemical and physical properties of the reservoir that may impact the effectiveness of MEOR. Bacillus licheniformis JF-2 (ATCC 39307) has been used as a benchmark organism to quantify MEOR of medium weight crude oils (17.5 to 38.1{degrees}API) the capacity for oil recovery of Bacillus licheniformis JF-2 utilizing a sucrose-based nutrient has been elucidated using Berea sandstone cores. Spacial distribution of cells after microbial flooding has been analyzed with scanning electron microscopy. Also the effect of microbial surfactants on the interfacial tensions (IFT) of aqueous/crude oil systems has been measured. 87 refs., 60 figs., 15 tabs.« less

Internal contamination of an irradiator discovered during security enhancement.

PubMed

Harvey, R P

2014-08-01

High-risk radioactive sources regulated under Increased Controls Regulations have been protected by licensed facilities, but the federal government has placed significant emphasis on these sources and has developed initiatives to assist radioactive material licensees. The Department of Energy's Global Threat Reduction Initiative (GTRI) Domestic Threat Reduction Program is a voluntary federally funded program for security enhancements of high-risk radiological material. During the hardening or security enhancement process by the United States Department of Energy (U.S. DOE) contractors, a small amount of radioactive contamination was discovered in a Cesium irradiator. Ultimately, it was decided to pursue disposal with U.S. DOE's Off-Site Recovery Program (OSRP). Radiological devices may have a leaking source or known internal contamination that may cause difficulty during security enhancement. If the licensee understands this, it may provide facilities the opportunity to plan and prepare for unusual circumstances.

40 CFR 300.205 - Planning and coordination structure.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS NATIONAL OIL AND HAZARDOUS SUBSTANCES... appropriate federal, state, and local officials to enhance the contingency planning of those officials and to assure pre-planning of joint response efforts, including appropriate procedures for mechanical recovery...

Pharmacotherapy and motor recovery after stroke.

PubMed

Viale, Luciano; Catoira, Natalia Paola; Di Girolamo, Guillermo; González, Claudio Daniel

2018-01-01

Stroke is one of the most prevalent neurological diseases worldwide, especially among the elderly population. There are various mechanisms that enhance motor recovery after a stroke. In clinical practice, we have the opportunity to enhance plasticity by designing specific rehabilitation programs. Areas covered: There are a variety of drugs commonly administered to people after the acute phase of a stroke. These drugs may modify motor performance. Herein reviewed is the evidence concerning motor enhancement or decline in stroke patients, produced by drugs commonly used in rehabilitation settings. An extensive review of animal and human studies is performed. Expert commentary: Many of the clinical trials carried out were underpowered. Modest evidence supports the claim that there are agents that can affect motor rehabilitation after a stroke. Amphetamine-like agents, serotonin reuptake inhibitors, and levodopa might improve motor outcomes, while antipsychotics, some antiepileptic drugs, and GABAmimetic drugs could impair the recovery process. To draw definite recommendations, more comprehensive knowledge about the efficacy, long-term effects, and safety of these drugs is required. There are also other interesting molecules that open a promising field for basic and clinical research, in the search for new therapeutic options.

Goal-directed Fluid Therapy Does Not Reduce Primary Postoperative Ileus after Elective Laparoscopic Colorectal Surgery: A Randomized Controlled Trial.

PubMed

Gómez-Izquierdo, Juan C; Trainito, Alessandro; Mirzakandov, David; Stein, Barry L; Liberman, Sender; Charlebois, Patrick; Pecorelli, Nicolò; Feldman, Liane S; Carli, Franco; Baldini, Gabriele

2017-07-01

Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Patients were assigned randomly to receive intraoperative goal-directed fluid therapy (goal-directed fluid therapy group) or fluid therapy based on traditional principles (control group). Primary postoperative ileus was the primary outcome. One hundred twenty-eight patients were included and analyzed (goal-directed fluid therapy group: n = 64; control group: n = 64). The incidence of primary postoperative ileus was 22% in the goal-directed fluid therapy and 22% in the control group (relative risk, 1; 95% CI, 0.5 to 1.9; P = 1.00). Intraoperatively, patients in the goal-directed fluid therapy group received less intravenous fluids (mainly less crystalloids) but a greater volume of colloids. The increase of stroke volume and cardiac output was more pronounced and sustained in the goal-directed fluid therapy group. Length of hospital stay, 30-day postoperative morbidity, and mortality were not different. Intraoperative goal-directed fluid therapy compared with fluid therapy based on traditional principles does not reduce primary postoperative ileus in patients undergoing laparoscopic colorectal surgery in the context of an Enhanced Recovery After Surgery program. Its previously demonstrated benefits might have been offset by advancements in perioperative care.

The mirror therapy program enhances upper-limb motor recovery and motor function in acute stroke patients.

PubMed

Lee, Myung Mo; Cho, Hwi-Young; Song, Chang Ho

2012-08-01

The purpose of this study was to evaluate the effects of the mirror therapy program on upper-limb motor recovery and motor function in patients with acute stroke. Twenty-six patients who had an acute stroke within 6 mos of study commencement were assigned to the experimental group (n = 13) or the control group (n = 13). Both experimental and control group members participated in a standard rehabilitation program, but only the experimental group members additionally participated in mirror therapy program, for 25 mins twice a day, five times a week, for 4 wks. The Fugl-Meyer Assessment, Brunnstrom motor recovery stage, and Manual Function Test were used to assess changes in upper-limb motor recovery and motor function after intervention. In upper-limb motor recovery, the scores of Fugl-Meyer Assessment (by shoulder/elbow/forearm items, 9.54 vs. 4.61; wrist items, 2.76 vs. 1.07; hand items, 4.43 vs. 1.46, respectively) and Brunnstrom stages for upper limb and hand (by 1.77 vs. 0.69 and 1.92 vs. 0.50, respectively) were improved more in the experimental group than in the control group (P < 0.05). In upper-limb motor function, the Manual Function Test score (by shoulder item, 5.00 vs. 2.23; hand item, 5.07 vs. 0.46, respectively) was significantly increased in the experimental group compared with the control group (P < 0.01). No significant differences were found between the groups for the coordination items in Fugl-Meyer Assessment. This study confirms that mirror therapy program is an effective intervention for upper-limb motor recovery and motor function improvement in acute stroke patients. Additional research on mirror therapy program components, intensity, application time, and duration could result in it being used as a standardized form of hand rehabilitation in clinics and homes.

Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial.

PubMed

Sütbeyaz, Serap; Yavuzer, Gunes; Sezer, Nebahat; Koseoglu, B Füsun

2007-05-01

To evaluate the effects of mirror therapy, using motor imagery training, on lower-extremity motor recovery and motor functioning of patients with subacute stroke. Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months. Rehabilitation education and research hospital. A total of 40 inpatients with stroke (mean age, 63.5 y), all within 12 months poststroke and without volitional ankle dorsiflexion. Thirty minutes per day of the mirror therapy program, consisting of nonparetic ankle dorsiflexion movements or sham therapy, in addition to a conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks. The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), walking ability (Functional Ambulation Categories [FAC]), and motor functioning (motor items of the FIM instrument). The mean change score and 95% confidence interval (CI) of the Brunnstrom stages (mean, 1.7; 95% CI, 1.2-2.1; vs mean, 0.8; 95% CI, 0.5-1.2; P=.002), as well as the FIM motor score (mean, 21.4; 95% CI, 18.2-24.7; vs mean, 12.5; 95% CI, 9.6-14.8; P=.001) showed significantly more improvement at follow-up in the mirror group compared with the control group. Neither MAS (mean, 0.8; 95% CI, 0.4-1.2; vs mean, 0.3; 95% CI, 0.1-0.7; P=.102) nor FAC (mean, 1.7; 95% CI, 1.2-2.1; vs mean, 1.5; 95% CI, 1.1-1.9; P=.610) showed a significant difference between the groups. Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and motor functioning in subacute stroke patients.

Saving wild tigers: a case study in biodiversity loss and challenges to be met for recovery beyond 2010.

PubMed

Seidensticker, John

2010-12-01

Wild tigers are being annihilated. Tiger range countries and their partners met at the 1st Asian Ministerial Conference on Tiger Conservation in January 2010 to mandate the creation of the Global Tiger Recovery Program to double the number of tigers by 2022. Only 3200-3600 wild adult tigers remain, approximately half of the population estimated a decade ago. Tigers now live in only 13 countries, all of which are experiencing severe environmental challenges and degradation from the effects of human population growth, brisk economic expansion, rapid urbanization, massive infrastructure development and climate change. The overarching challenge of tiger conservation, and the conservation of biodiversity generally, is that there is insufficient demand for the survival of wild tigers living in natural landscapes. This allows the criminal activities of poaching wild tigers and their prey and trafficking in tiger derivatives to flourish and tiger landscapes to be diminished. The Global Tiger Recovery Program will support scaling up of practices already proven effective in one or more tiger range countries that need wider policy support, usually resources, and new transnational actions that enhance the effectiveness of individual country actions. The program is built on robust National Tiger Recovery Priorities that are grouped into themes: (i) strengthening policies that protect tigers; (ii) protecting tiger conservation landscapes; (iii) scientific management and monitoring; (iv) engaging communities; (v) cooperative management of international tiger landscapes; (vi) eliminating transnational illegal wildlife trade; (vii) persuading people to stop consuming tiger; (viii) enhancing professional capacity of policy-makers and practitioners; and (ix) developing sustainable, long-term financing mechanisms for tiger and biodiversity conservation. © 2010 ISZS, Blackwell Publishing and IOZ/CAS.

Enhanced recovery of unconventional gas. Volume II. The program. [Tight gas basins; Devonian shale; coal seams; geopressured aquifers

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

Kuuskraa, V.A.; Brashear, J.P.; Doscher, T.M.

1978-10-01

This study was conducted to assist public decision-makers in selecting among many choices to obtain new gas supplies by addressing 2 questions: 1) how severe is the need for additional future supplies of natural gas, and what is the economic potential of providing part of future supply through enhanced recovery from unconventional natural gas resources. The study also serves to assist the DOE in designing a cost-effective R and D program to stimulate industry to recover this unconventional gas and to produce it sooner. Tight gas basins, Devonian shale, methane from coal seams, and methane from geopressured aquifers are considered.more » It is concluded that unconventional sources, already providing about 1 Tcf per year, could provide from 3 to 4 Tcf in 1985 and from 6 to 8 Tcf in 1990 (at $1.75 and $3.00 per Mcf, respectively). However, even with these additions to supply, gas supply is projected to remain below 1977 usage levels. (DLC)« less

Daidzein Augments Cholesterol Homeostasis via ApoE to Promote Functional Recovery in Chronic Stroke

PubMed Central

Kim, Eunhee; Woo, Moon-Sook; Qin, Luye; Ma, Thong; Beltran, Cesar D.; Bao, Yi; Bailey, Jason A.; Corbett, Dale; Ratan, Rajiv R.; Lahiri, Debomoy K.

2015-01-01

Stroke is the world's leading cause of physiological disability, but there are currently no available agents that can be delivered early after stroke to enhance recovery. Daidzein, a soy isoflavone, is a clinically approved agent that has a neuroprotective effect in vitro, and it promotes axon growth in an animal model of optic nerve crush. The current study investigates the efficacy of daidzein on neuroprotection and functional recovery in a clinically relevant mouse model of stroke recovery. In light of the fact that cholesterols are essential lipid substrates in injury-induced synaptic remodeling, we found that daidzein enhanced the cholesterol homeostasis genetic program, including Lxr and downstream transporters, Apoe, Abca1, and Abcg1 genes in vitro. Daidzein also elevated the cholesterol homeostasis genes in the poststroke brain with Apoe, the highest expressing transporter, but did not affect infarct volume or hemispheric swelling. Despite the absence of neuroprotection, daidzein improved motor/gait function in chronic stroke and elevated synaptophysin expression. However, the daidzein-enhanced functional benefits and synaptophysin expression were abolished in Apoe-knock-out mice, suggesting the importance of daidzein-induced ApoE upregulation in fostering stroke recovery. Dissociation between daidzein-induced functional benefits and the absence of neuroprotection further suggest the presence of nonoverlapping mechanisms underlying recovery processes versus acute pathology. With its known safety in humans, early and chronic use of daidzein aimed at augmenting ApoE may serve as a novel, translatable strategy to promote functional recovery in stroke patients without adverse acute effect. SIGNIFICANCE STATEMENT There have been recurring translational failures in treatment strategies for stroke. One underlying issue is the disparity in outcome analysis between animal and clinical studies. The former mainly depends on acute infarct size, whereas long-term functional recovery is an important outcome in patients. In an attempt to identify agents that promote functional recovery, we discovered that an FDA-approved soy isoflavone, daidzein, improved stroke-induced behavioral deficits via enhancing cholesterol homeostasis in chronic stroke, and this occurs without causing adverse effects in the acute phase. With its known safety in humans, the study suggests that the early and chronic use of daidzein serves as a potential strategy to promote functional recovery in stroke patients. PMID:26558782

Daidzein Augments Cholesterol Homeostasis via ApoE to Promote Functional Recovery in Chronic Stroke.

PubMed

Kim, Eunhee; Woo, Moon-Sook; Qin, Luye; Ma, Thong; Beltran, Cesar D; Bao, Yi; Bailey, Jason A; Corbett, Dale; Ratan, Rajiv R; Lahiri, Debomoy K; Cho, Sunghee

2015-11-11

Stroke is the world's leading cause of physiological disability, but there are currently no available agents that can be delivered early after stroke to enhance recovery. Daidzein, a soy isoflavone, is a clinically approved agent that has a neuroprotective effect in vitro, and it promotes axon growth in an animal model of optic nerve crush. The current study investigates the efficacy of daidzein on neuroprotection and functional recovery in a clinically relevant mouse model of stroke recovery. In light of the fact that cholesterols are essential lipid substrates in injury-induced synaptic remodeling, we found that daidzein enhanced the cholesterol homeostasis genetic program, including Lxr and downstream transporters, Apoe, Abca1, and Abcg1 genes in vitro. Daidzein also elevated the cholesterol homeostasis genes in the poststroke brain with Apoe, the highest expressing transporter, but did not affect infarct volume or hemispheric swelling. Despite the absence of neuroprotection, daidzein improved motor/gait function in chronic stroke and elevated synaptophysin expression. However, the daidzein-enhanced functional benefits and synaptophysin expression were abolished in Apoe-knock-out mice, suggesting the importance of daidzein-induced ApoE upregulation in fostering stroke recovery. Dissociation between daidzein-induced functional benefits and the absence of neuroprotection further suggest the presence of nonoverlapping mechanisms underlying recovery processes versus acute pathology. With its known safety in humans, early and chronic use of daidzein aimed at augmenting ApoE may serve as a novel, translatable strategy to promote functional recovery in stroke patients without adverse acute effect. There have been recurring translational failures in treatment strategies for stroke. One underlying issue is the disparity in outcome analysis between animal and clinical studies. The former mainly depends on acute infarct size, whereas long-term functional recovery is an important outcome in patients. In an attempt to identify agents that promote functional recovery, we discovered that an FDA-approved soy isoflavone, daidzein, improved stroke-induced behavioral deficits via enhancing cholesterol homeostasis in chronic stroke, and this occurs without causing adverse effects in the acute phase. With its known safety in humans, the study suggests that the early and chronic use of daidzein serves as a potential strategy to promote functional recovery in stroke patients. Copyright © 2015 the authors 0270-6474/15/3515113-14$15.00/0.

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment

PubMed Central

Gonzales, Rachel; Douglas Anglin, M.; Glik, Deborah C.

2014-01-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12–24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems. PMID:24038196

Exploring the feasibility of text messaging to support substance abuse recovery among youth in treatment.

PubMed

Gonzales, Rachel; Douglas Anglin, M; Glik, Deborah C

2014-02-01

This exploratory study examined treatment involved youth opinions about (i) the utility of using text messaging to support recovery behaviors after treatment; (ii) important types of text messages that could help youth self-manage their substance use behaviors after treatment; and (iii) programmatic or logistical areas associated with text messaging programs. Eight focus groups were conducted with 67 youth (aged 12-24) enrolled in outpatient and residential publicly funded substance abuse treatment programs around Los Angeles County, California. Results highlight that 70% of youth positively endorsed text messaging as a viable method of intervention during aftercare, 20% expressed ambivalent feelings, and 10% conveyed dislike. Thematic data exploration revealed seven themes related to the types of text messages youth recommend for helping youth avoid relapse after treatment, including positive appraisal (90%), lifestyle change tips (85%), motivational reinforcing (80%), coping advice (75%), confidence boosters (65%), inspiration encouragement (55%), and informational resources (50%). Youth opinions about key logistical features of text messaging programs, including frequency, timing, sender, and length are also examined. Findings offer insight for the development and enhancement of recovery support interventions with substance abusing youth. Results imply text messaging may serve as a promising opportunity for recovery support for young people with substance abuse problems.

Pilot proficiency testing study for second tier congenital adrenal hyperplasia newborn screening.

PubMed

De Jesús, Víctor R; Simms, David A; Schiffer, Jarad; Kennedy, Meredith; Mei, Joanne V; Hannon, W Harry

2010-11-11

Congenital adrenal hyperplasia (CAH) is caused by inherited defects in steroid biosynthesis. The Newborn Screening Quality Assurance Program (NSQAP) initiated a pilot, dried-blood spot (DBS)-based proficiency testing program designed to investigate materials and laboratory performance for second tier CAH screening by tandem mass spectrometry (MS/MS). The ratio of 17-α-hydroxyprogesterone (17-OHP), androstenedione (4-AD) and cortisol is used as an indicator of CAH in laboratory protocols for second tier analysis of DBS specimens. DBS prepared by NSQAP contained a range of steroid concentrations resulting in different clinical ratios. Laboratories received blind-coded DBS specimens and reported results to NSQAP for evaluation. Quantitative values reported by participants for 17-OHP, 4-AD, and cortisol, reflected small differences in their analytical methods. Average quantitative values for 17-OHP increased from 81% to 107% recovery over the 3.5-year period; cortisol recoveries increased from 61.9% to 89.5%; and 4-AD recoveries decreased from 184% to 68%. Laboratory participation in the CAH second tier proficiency testing program has resulted in improved analyte recoveries and enhanced sample preparation methodologies. NSQAP services for the second tier CAH analysis in DBS demonstrate the need for surveillance to ensure harmonization and continuous improvements, and to achieve sustained high-performance of newborn screening laboratories worldwide. Published by Elsevier B.V.

A conservation plan for native fishes of the Lower Colorado River

USGS Publications Warehouse

Minckley, W.L.; Marsh, P.C.; Deacon, J.E.; Dowling, T.E.; Hedrick, P.W.; Matthews, W.J.; Mueller, G.

2003-01-01

The native fish fauna of the lower Colorado River, in the western United States, includes four “big-river” fishes that are federally listed as endangered. Existing recovery implementation plans are inadequate for these critically imperiled species. We describe a realistic, proactive management program founded on demographic and genetic principles and crafted to avoid potential conflicts with nonnative sport fisheries. In this program, native species would breed and their progeny grow in isolated, protected, off-channel habitats in the absence of nonnative fishes. Panmictic adult populations would reside in the main channel and connected waters, exchanging reproductive adults and repatriated subadults with populations occupying isolated habitats. Implementation of the plan would greatly enhance recovery potential of the four listed fishes.

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: CBR Workshop After Action Report

DTIC Science & Technology

2012-01-01

Laboratories Walker Ray Walker Engineering Solutions, LLC Williams Patricia Denver Office of Emergency Management Wood- Zika Annmarie Lawrence Livermore...llnl.gov AnnMarie Wood- Zika woodzika1@llnl.gov Pacific Northwest National Laboratory Ann Lesperance ann.lesperance@pnnl.gov Jessica Sandusky

76 FR 11402 - Recovery of Delinquent Debts-Treasury Offset Program Enhancements

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-02

... rule easier to understand, e.g. grouping and order of sections, use of headings, paragraphing? When..., Income taxes, Old-Age, Survivors, and Disability Insurance, Reporting and recordkeeping requirements..., 416, and 422 as set forth below: PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950...

Involuntary psychiatric hospitalisation, stigma stress and recovery: a 2-year study.

PubMed

Xu, Z; Lay, B; Oexle, N; Drack, T; Bleiker, M; Lengler, S; Blank, C; Müller, M; Mayer, B; Rössler, W; Rüsch, N

2018-01-31

Compulsory admission can be experienced as devaluing and stigmatising by people with mental illness. Emotional reactions to involuntary hospitalisation and stigma-related stress may affect recovery, but longitudinal data are lacking. We, therefore, examined the impact of stigma-related emotional reactions and stigma stress on recovery over a 2-year period. Shame and self-contempt as emotional reactions to involuntary hospitalisation, stigma stress, self-stigma and empowerment, as well as recovery were assessed among 186 individuals with serious mental illness and a history of recent involuntary hospitalisation. More shame, self-contempt and stigma stress at baseline were correlated with increased self-stigma and reduced empowerment after 1 year. More stigma stress at baseline was associated with poor recovery after 2 years. In a longitudinal path analysis more stigma stress at baseline predicted poorer recovery after 2 years, mediated by decreased empowerment after 1 year, controlling for age, gender, symptoms and recovery at baseline. Stigma stress may have a lasting detrimental effect on recovery among people with mental illness and a history of involuntary hospitalisation. Anti-stigma interventions that reduce stigma stress and programs that enhance empowerment could improve recovery. Future research should test the effect of such interventions on recovery.

30 CFR 250.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What must I do for enhanced recovery operations... Gas Production Requirements Other Requirements § 250.1165 What must I do for enhanced recovery operations? (a) You must promptly initiate enhanced oil and gas recovery operations for all reservoirs where...

30 CFR 550.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What must I do for enhanced recovery operations... Requirements. Other Requirements § 550.1165 What must I do for enhanced recovery operations? (a) [Reserved] (b) Before initiating enhanced recovery operations, you must submit a proposed plan to the BSEE Regional...

30 CFR 550.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false What must I do for enhanced recovery operations... Requirements. Other Requirements § 550.1165 What must I do for enhanced recovery operations? (a) [Reserved] (b) Before initiating enhanced recovery operations, you must submit a proposed plan to the BSEE Regional...

30 CFR 550.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What must I do for enhanced recovery operations... Requirements. Other Requirements § 550.1165 What must I do for enhanced recovery operations? (a) [Reserved] (b) Before initiating enhanced recovery operations, you must submit a proposed plan to the BSEE Regional...

30 CFR 250.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false What must I do for enhanced recovery operations... Gas Production Requirements Other Requirements § 250.1165 What must I do for enhanced recovery operations? (a) You must promptly initiate enhanced oil and gas recovery operations for all reservoirs where...

30 CFR 250.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false What must I do for enhanced recovery operations... Gas Production Requirements Other Requirements § 250.1165 What must I do for enhanced recovery operations? (a) You must promptly initiate enhanced oil and gas recovery operations for all reservoirs where...

Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

PubMed

Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

2015-10-01

The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

30 CFR 250.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2010 CFR

2010-07-01

... promptly initiate enhanced oil and gas recovery operations for all reservoirs where these operations would... similar recovery operations intended to increase the ultimate recovery of oil and gas from a reservoir... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What must I do for enhanced recovery operations...

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Qualified enhanced oil recovery costs. 1.43-4... TAXES Credits Against Tax § 1.43-4 Qualified enhanced oil recovery costs. (a) Qualifying costs—(1) In... “qualified enhanced oil recovery costs” if the amounts are paid or incurred with respect to an asset which is...

26 CFR 1.43-1 - The enhanced oil recovery credit-general rules.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 1 2010-04-01 2010-04-01 true The enhanced oil recovery credit-general rules. 1... INCOME TAXES Credits Against Tax § 1.43-1 The enhanced oil recovery credit—general rules. (a) Claiming the credit—(1) In general. The enhanced oil recovery credit (the “credit”) is a component of the...

Virtual reality and brain computer interface in neurorehabilitation

PubMed Central

Dahdah, Marie; Driver, Simon; Parsons, Thomas D.; Richter, Kathleen M.

2016-01-01

The potential benefit of technology to enhance recovery after central nervous system injuries is an area of increasing interest and exploration. The primary emphasis to date has been motor recovery/augmentation and communication. This paper introduces two original studies to demonstrate how advanced technology may be integrated into subacute rehabilitation. The first study addresses the feasibility of brain computer interface with patients on an inpatient spinal cord injury unit. The second study explores the validity of two virtual environments with acquired brain injury as part of an intensive outpatient neurorehabilitation program. These preliminary studies support the feasibility of advanced technologies in the subacute stage of neurorehabilitation. These modalities were well tolerated by participants and could be incorporated into patients' inpatient and outpatient rehabilitation regimens without schedule disruptions. This paper expands the limited literature base regarding the use of advanced technologies in the early stages of recovery for neurorehabilitation populations and speaks favorably to the potential integration of brain computer interface and virtual reality technologies as part of a multidisciplinary treatment program. PMID:27034541

Enhanced terrestrial weathering/runoff and surface ocean carbonate production during the recovery stages of the Paleocene-Eocene thermal maximum

NASA Astrophysics Data System (ADS)

Kelly, D. Clay; Zachos, James C.; Bralower, Timothy J.; Schellenberg, Stephen A.

2005-12-01

The carbonate saturation profile of the oceans shoaled markedly during a transient global warming event known as the Paleocene-Eocene thermal maximum (PETM) (circa 55 Ma). The rapid release of large quantities of carbon into the ocean-atmosphere system is believed to have triggered this intense episode of dissolution along with a negative carbon isotope excursion (CIE). The brevity (120-220 kyr) of the PETM reflects the rapid enhancement of negative feedback mechanisms within Earth's exogenic carbon cycle that served the dual function of buffering ocean pH and reducing atmospheric greenhouse gas levels. Detailed study of the PETM stratigraphy from Ocean Drilling Program Site 690 (Weddell Sea) reveals that the CIE recovery period, which postdates the CIE onset by ˜80 kyr, is represented by an expanded (˜2.5 m thick) interval containing a unique planktic foraminiferal assemblage strongly diluted by coccolithophore carbonate. Collectively, the micropaleontological and sedimentological changes preserved within the CIE recovery interval reflect a transient state when ocean-atmosphere chemistry fostered prolific coccolithophore blooms that suppressed the local lysocline to relatively deeper depths. A prominent peak in the abundance of the clay mineral kaolinite is associated with the CIE recovery interval, indicating that continental weathering/runoff intensified at this time as well (Robert and Kennett, 1994). Such parallel stratigraphic changes are generally consonant with the hypothesis that enhanced continental weathering/runoff and carbonate precipitation helped sequester carbon during the PETM recovery period (e.g., Dickens et al., 1997; Zachos et al., 2005).

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

Harrison, T.D.

Sandia National Laboratories, Albuquerque (SNLA), is currently conducting a program to predict the performance and measure the characteristics of commercially available solar collectors that have the potential for use in industrial process heat and enhance oil recovery applications. The thermal performance predictions for the AAI solar line-focusing slat-type collector for five cities in the US are presented. (WHK)

Influence of enhanced recovery after surgery programs on laparoscopy-assisted gastrectomy for gastric cancer: a systematic review and meta-analysis of randomized control trials.

PubMed

Li, Zhengyan; Wang, Qian; Li, Bofei; Bai, Bin; Zhao, Qingchuan

2017-11-23

This meta-analysis is aimed to evaluate the feasibility and safety of enhanced recovery after surgery (ERAS) programs in gastric cancer patients undergoing laparoscopy-assisted gastrectomy (LAG). We performed a meta-analysis of randomized control trials involving either enhanced recovery after surgery (ERAS)/fast track surgery (FTS) for patients underwent LAG. EMBASE, Pubmed, Web of science, and Cochrane Library were searched. Primary outcomes included the length of postoperative hospital stay, cost of hospitalization, postoperative complications, and readmission rate. Five randomized control trials were eligible for analysis. There were 159 cases in FTS group and 156 cases in conventional care group. Compared with conventional care group, FTS group relates to shorter postoperative hospital stay (WMD - 2.16; 95% CI - 3.05 to - 1.26, P < 0.00001), less cost of hospitalization (WMD - 4.72; 95% CI - 6.88 to - 2.55, P < 0.00001), shorter time to first flatus (WMD - 9.72; 95% CI - 13.75 to - 5.81, P < 0.00001), lower level of C-reaction protein on postoperative days 3 or 4 (WMD - 19.66; 95% CI - 28.98 to - 10.34, P < 0.00001), higher level of albumin on postoperative day 4 (WMD 3.45; 95% CI 2.01 to 4.89, P < 0.00001), and postoperative day 7 (WMD 5.63; 95% CI 1.01 to 10.24, P = 0.02). Regarding postoperative complications, no significant differences were observed between FTS group and conventional care group (OR 0.63, 95% CI 0.37 to 1.09, P = 0.10). The readmission rate of FTS group was comparable to conventional care group (WMD 3.14; 95% CI 0.12 to 81.35, P = 0.49). Among patients undergoing LAG, FTS is associated with shorter postoperative hospital stay, rapid postoperative recovery, and decreased cost without increasing complications or readmission rate. The combined effects of the two methods could further accelerate clinical recovery of gastric cancer patients.

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

PubMed Central

Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

2018-01-01

Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and surgeons in identifying the best practices to implement in the surgical care of TKA and THA patients. PMID:29468091

How to introduce a program of Enhanced Recovery after Surgery? The experience of the CAPIO group.

PubMed

Verrier, J-F; Paget, C; Perlier, F; Demesmay, F

2016-12-01

The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction. These will ultimately assess adaptation of structures within these new organizations. In this article, we share our insights based on experience gained over the past six years by surgical teams of the CAPIO group. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Outcomes of a brief program, REORDER, to promote consumer recovery and family involvement in care.

PubMed

Dixon, Lisa B; Glynn, Shirley M; Cohen, Amy N; Drapalski, Amy L; Medoff, Deborah; Fang, Li Juan; Potts, Wendy; Gioia, Deborah

2014-01-01

The Recovery-Oriented Decisions for Relatives' Support (REORDER) intervention is an innovative, manualized protocol utilizing shared decision-making principles with persons who have serious mental illnesses to promote recovery and encourage consideration of family involvement in care. This study compared REORDER to enhanced treatment as usual in a randomized design. Participants included 226 veterans with serious mental illness whose relatives had low rates of contact with treatment staff. REORDER involved up to three consumer sessions followed by up to three relative educational sessions if the consumer and relative consented. Individuals were assessed at baseline and six months later. Eighty-five percent of the 111 randomly assigned REORDER participants attended at least one REORDER consumer session; of those, 59% had at least one family session. REORDER participants had significantly reduced paranoid ideation and increased recovery at follow-up. Participation in REORDER led to marked increases in family participation and improved consumer outcomes.

Activities of the Oil Implementation Task Force, reporting period March--August 1991; Contracts for field projects and supporting research on enhanced oil recovery, reporting period October--December 1990

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

Not Available

Activities of DOE's Oil Implementation Task Force for the period March--August 1991 are reviewed. Contracts for fields projects and supporting research on enhanced oil recovery are discussed, with a list of related publications given. Enhanced recovery processes covered include chemical flooding, gas displacement, thermal recovery, and microbial recovery.

40 CFR 147.1952 - Aquifer exemptions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... accordance with §§ 144.7(b) and 146.4 of this chapter at the time of program promulgation. EPA may in the... II enhanced recovery injection activities only. (1) The Sugar Run and Bradford series of oil... Bradford series of oil producing sands of the Lewis Run Field in McKean County. (4) The Bradford series of...

40 CFR 144.21 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recovery and hydrocarbon storage) and III wells. 144.21 Section 144.21 Protection of Environment... hydrocarbon storage) and III wells. (a) An existing Class I, II (except enhanced recovery and hydrocarbon... decision; or (9) For Class II wells (except enhanced recovery and hydrocarbon storage), five years after...

40 CFR 144.21 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recovery and hydrocarbon storage) and III wells. 144.21 Section 144.21 Protection of Environment... hydrocarbon storage) and III wells. (a) An existing Class I, II (except enhanced recovery and hydrocarbon... decision; or (9) For Class II wells (except enhanced recovery and hydrocarbon storage), five years after...

Adaptive management of large aquatic ecosystem recovery programs in the United States.

PubMed

Thom, Ronald; St Clair, Tom; Burns, Rebecca; Anderson, Michael

2016-12-01

Adaptive management (AM) is being employed in a number of programs in the United States to guide actions to restore aquatic ecosystems because these programs are both expensive and are faced with significant uncertainties. Many of these uncertainties are associated with prioritizing when, where, and what kind of actions are needed to meet the objectives of enhancing ecosystem services and recovering threatened and endangered species. We interviewed nine large-scale aquatic ecosystem restoration programs across the United States to document the lessons learned from implementing AM. In addition, we recorded information on ecological drivers (e.g., endangered fish species) for the program, and inferred how these drivers reflected more generic ecosystem services. Ecosystem services (e.g., genetic diversity, cultural heritage), albeit not explicit drivers, were either important to the recovery or enhancement of the drivers, or were additional benefits associated with actions to recover or enhance the program drivers. Implementing programs using AM lessons learned has apparently helped achieve better results regarding enhancing ecosystem services and restoring target species populations. The interviews yielded several recommendations. The science and AM program must be integrated into how the overall restoration program operates in order to gain understanding and support, and effectively inform management decision-making. Governance and decision-making varied based on its particular circumstances. Open communication within and among agency and stakeholder groups and extensive vetting lead up to decisions. It was important to have an internal agency staff member to implement the AM plan, and a clear designation of roles and responsibilities, and long-term commitment of other involved parties. The most important management questions and information needs must be identified up front. It was imperative to clearly identify, link and continually reinforce the essential components of an AM plan, including objectives, constraints, uncertainties, hypotheses, management actions, decision criteria and triggers, monitoring, and research. Some employed predictive models and the results of research on uncertainties to vet options for actions. Many relied on best available science and professional judgment to decide if adjustments to actions were needed. All programs emphasized the need to be nimble enough to be responsive to new information and make necessary adjustments to management action implementation. We recommend that ecosystem services be explicit drivers of restoration programs to facilitate needed funding and communicate to the general public and with the global efforts on restoring and conserving ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost-Benefit Analysis of the Implementation of an Enhanced Recovery Program in Liver Surgery.

PubMed

Joliat, Gaëtan-Romain; Labgaa, Ismaïl; Hübner, Martin; Blanc, Catherine; Griesser, Anne-Claude; Schäfer, Markus; Demartines, Nicolas

2016-10-01

Enhanced recovery after surgery (ERAS) programs have been shown to ease the postoperative recovery and improve clinical outcomes for various surgery types. ERAS cost-effectiveness was demonstrated for colorectal surgery but not for liver surgery. The present study aim was to analyze the implementation costs and benefits of a specific ERAS program in liver surgery. A dedicated ERAS protocol for liver surgery was implemented in our department in July 2013. The subsequent year all consecutive patients undergoing liver surgery were treated according to this protocol (ERAS group). They were compared in terms of real in-hospital costs with a patient series before ERAS implementation (pre-ERAS group). Mean costs per patient were compared with a bootstrap T test. A cost-minimization analysis was performed. Seventy-four ERAS patients were compared with 100 pre-ERAS patients. There were no significant pre- and intraoperative differences between the two groups, except for the laparoscopy number (n = 18 ERAS, n = 9 pre-ERAS, p = 0.010). Overall postoperative complications were observed in 36 (49 %) and 64 patients (64 %) in the ERAS and pre-ERAS groups, respectively (p = 0.046). The median length of stay was significantly shorter for the ERAS group (8 vs. 10 days, p = 0.006). The total mean costs per patient were €38,726 and €42,356 for ERAS and pre-ERAS (p = 0.467). The cost-minimization analysis showed a total mean cost reduction of €3080 per patient after ERAS implementation. ERAS implementation for liver surgery induced a non-significant decrease in cost compared to standard care. Significant decreased complication rate and hospital stay were observed in the ERAS group.

Factors associated with sustainability of 2 quality improvement programs after achieving early implementation success. A qualitative case study.

PubMed

Ament, Stephanie M C; Gillissen, Freek; Moser, Albine; Maessen, José M C; Dirksen, Carmen D; von Meyenfeldt, Maarten F; van der Weijden, Trudy

2017-12-01

Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological levels of the health care system and demands continuous effort in the postimplementation phase. © 2017 John Wiley & Sons, Ltd.

Chemically enhanced in situ recovery

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

Sale, T.; Pitts, M.; Wyatt, K.

1996-08-01

Chemically enhanced recovery is a promising alternative to current technologies for management of subsurface releases of organic liquids. Through the inclusion of surfactants, solvents, polymers, and/or alkaline agents to a waterflood, the transport of targeted organic compounds can be increased and rates of recovery enhanced. By far, the vast majority of work done in the field of chemically enhanced recovery has been at a laboratory scale. The following text focuses on chemically enhanced recovery from a field application perspective with emphasis given to chlorinated solvents in a low permeability setting. While chlorinated solvents are emphasized, issues discussed are also relevantmore » to organic liquids less dense than water such as petroleum products. Topics reviewed include: (1) Description of technology; (2) General technology considerations; (3) Low permeability media considerations; (4) Cost and reliability considerations; (5) Commercial availability; and (6) Case histories. Through this paper an appreciation is developed of both the potential and limitations of chemically enhanced recovery. Excluded from the scope of this paper is the in situ destruction of organic compounds through processes such as chemical or biological oxidation, chemically enhanced recovery of inorganic compounds, and ex situ soil treatment processes. 11 refs., 2 figs., 1 tab.« less

Development of a recovery education program for inpatient mental health providers.

PubMed

Chen, Shu-Ping; Krupa, Terry; Lysaght, Rosemary; McCay, Elizabeth; Piat, Myra

2014-12-01

Mental health system transformation toward a recovery-orientation has created a demand for education to equip providers with recovery competencies. This report describes the development of a recovery education program designed specifically for inpatient providers. Part 1 of the education is a self-learning program introducing recovery concepts and a recovery competency framework; Part 2 is a group-learning program focusing on real-life dilemmas and applying the Appreciative Inquiry approach to address these clinical dilemmas. A pilot study with a pretest/posttest design was used to evaluate the program. Participants included 26 inpatient multidisciplinary providers from 3 hospitals. The results showed participants' improvement on recovery knowledge (z = -2.55, p = .011) after the self-learning program. Evaluations of the group-learning program were high (4.21 out of 5). These results support continued efforts to refine the program. Inpatient providers could use this program to lead interprofessional practice in promoting recovery. (c) 2014 APA, all rights reserved.

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on measurement to maintain and improve quality of enhanced recovery pathways for elective colorectal surgery.

PubMed

Moonesinghe, S Ramani; Grocott, Michael P W; Bennett-Guerrero, Elliott; Bergamaschi, Roberto; Gottumukkala, Vijaya; Hopkins, Thomas J; McCluskey, Stuart; Gan, Tong J; Mythen, Michael Monty G; Shaw, Andrew D; Miller, Timothy E

2017-01-01

This article sets out a framework for measurement of quality of care relevant to enhanced recovery pathways (ERPs) in elective colorectal surgery. The proposed framework is based on established measurement systems and/or theories, and provides an overview of the different approaches for improving clinical monitoring, and enhancing quality improvement or research in varied settings with different levels of available resources. Using a structure-process-outcome framework, we make recommendations for three hierarchical tiers of data collection. Core, Quality Improvement, and Best Practice datasets are proposed. The suggested datasets incorporate patient data to describe case-mix, process measures to describe delivery of enhanced recovery and clinical outcomes. The fundamental importance of routine collection of data for the initiation, maintenance, and enhancement of enhanced recovery pathways is emphasized.

Flow in porous media, phase behavior and ultralow interfacial tensions: mechanisms of enhanced petroleum recovery. Final technical report

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

Davis, H.T.; Scriven, L.E.

1982-01-01

A major program of university research, longer-ranged and more fundamental in approach than industrial research, into basic mechanisms of enhancing petroleum recovery and into underlying physics, chemistry, geology, applied mathematics, computation, and engineering science has been built at Minnesota. The 1982 outputs of the interdisciplinary team of investigators were again ideas, instruments, techniques, data, understanding and skilled people: forty-one scientific and engineering papers in leading journals; four pioneering Ph.D. theses; numerous presentations to scientific and technical meetings, and to industrial, governmental and university laboratories; vigorous program of research visits to and from Minnesota; and two outstanding Ph.D.'s to research positionsmore » in the petroleum industry, one to a university faculty position, one to research leadership in a governmental institute. This report summarizes the 1982 papers and theses and features sixteen major accomplishments of the program during that year. Abstracts of all forty-five publications in the permanent literature are appended. Further details of information transfer and personnel exchange with industrial, governmental and university laboratories appear in 1982 Quarterly Reports available from the Department of Energy and are not reproduced here. The Minnesota program continues in 1983, notwithstanding earlier uncertainty about the DOE funding which finally materialized and is the bulk of support. Supplemental grants-in-aid from nine companies in the petroleum industry are important, as are the limited University and departmental contributions. 839 references, 172 figures, 29 tables.« less

Flow in porous media, phase and ultralow interfacial tensions: Mechanisms of enhanced petroleum recovery

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

Davis, H.T.; Scriven, L.E.

1991-07-01

A major program of university research, longer-ranged and more fundamental in approach than industrial research, into basic mechanisms of enhancing petroleum recovery and into underlying physics, chemistry, geology, applied mathematics, computation, and engineering science has been built at Minnesota. The original focus was surfactant-based chemical flooding, but the approach taken was sufficiently fundamental that the research, longer-ranged than industrial efforts, has become quite multidirectional. Topics discussed are volume controlled porosimetry; fluid distribution and transport in porous media at low wetting phase saturation; molecular dynamics of fluids in ultranarrow pores; molecular dynamics and molecular theory of wetting and adsorption; new numericalmore » methods to handle initial and boundary conditions in immiscible displacement; electron microscopy of surfactant fluid microstructure; low cost system for animating liquid crystallites viewed with polarized light; surfaces of constant mean curvature with prescribed contact angle.« less

Four-Year Evolution of a Thrombophylaxis Protocol in an Enhanced Recovery After Surgery (ERAS) Program: Recent Results in 485 Patients.

PubMed

Blanchet, Marie-Cécile; Frering, Vincent; Gignoux, Benoît; Matussière, Yann; Oudar, Philippe; Noël, Romain; Mirabaud, Alban

2018-05-12

"Enhanced recovery after surgery" (ERAS) protocols may reduce morbidity, length of hospital stay (LOS), and costs. During the 4-year evolution of a bariatric ERAS protocol, we found that administration of thrombophylaxis selectively to high-risk morbidly obese patients (assessed postoperatively by Caprini score ≥ 3) undergoing omega loop gastric bypass ("mini" gastric bypass) or sleeve gastrectomy resulted in safe outcomes. Both procedures proved equally effective with this protocol. The vast majority of rapidly mobilized, low-risk patients did not appear to require antithrombotic heparin. Similar to other reported ERAS outcomes, our recent year's results in 485 patients included a mean LOS of 1.08 ± 0.64 days (range 1-14), with 460 (95.0%) discharged on day 1 and 99.6% by day 2. There were 13 30-day complications (2.7%), two reinterventions (0.4%), and no hemorrhages.

Mental health consumer participation in education: a structured literature review.

PubMed

Arblaster, Karen; Mackenzie, Lynette; Willis, Karen

2015-10-01

Consumer participation in design, delivery and evaluation of occupational therapy educational programs is a recently introduced requirement for accreditation. It aligns with the principle of recovery, which underpins Australian mental health policy. Graduates' capabilities for recovery-oriented practice are thought to be enhanced through learning from consumers' lived experience. This structured literature review evaluates the current evidence for mental health consumer participation in health professional education to inform occupational therapy educators. Searches were completed in five online databases, one journal and published reading lists on the topic. Studies were included if they addressed mental health consumer participation in health professional education programs, were published in peer reviewed journals between 2000 and 2014 and were in English. Articles were critically reviewed, and analysed for key findings related to stages of the educational process and recovery-oriented practice capabilities. An emerging body of evidence for consumer participation in mental health education was identified. Studies are characterised by a lack of quality and a low to medium level of evidence. Findings relate to design, planning, delivery and evaluation of education as well as to most aspects of recovery-oriented practice. Emphases on exploratory research and proximal outcomes, and a reliance on published outcome measurement instruments designed for other purposes are key limitations in this body of evidence. This study identifies a weak evidence base for the requirement for consumer participation in occupational therapy programs, specifically related to mental health curricula. A research agenda is proposed in response. © 2015 Occupational Therapy Australia.

Impact of enhanced recovery after surgery programs on pancreatic surgery: A meta-analysis.

PubMed

Ji, Hai-Bin; Zhu, Wen-Tao; Wei, Qiang; Wang, Xiao-Xiao; Wang, Hai-Bin; Chen, Qiang-Pu

2018-04-21

To evaluate the impact of enhanced recovery after surgery (ERAS) programs on postoperative complications of pancreatic surgery. Computer searches were performed in databases (including PubMed, Cochrane Library and Embase) for randomized controlled trials or case-control studies describing ERAS programs in patients undergoing pancreatic surgery published between January 1995 and August 2017. Two researchers independently evaluated the quality of the studies' extracted data that met the inclusion criteria and performed a meta-analysis using RevMan5.3.5 software. Forest plots, demonstrating the outcomes of the ERAS group vs the control group after pancreatic surgery, and funnel plots were used to evaluate potential publication bias. Twenty case-control studies including 3694 patients, published between January 1995 and August 2017, were selected for the meta-analysis. This study included the ERAS group ( n = 1886) and the control group ( n = 1808), which adopted the traditional perioperative management. Compared to the control group, the ERAS group had lower delayed gastric emptying rates [odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.48-0.72, P < 0.00001], lower postoperative complication rates (OR = 0.57, 95%CI: 0.45-0.72, P < 0.00001), particularly for the mild postoperative complications (Clavien-Dindo I-II) (OR = 0.71, 95%CI: 0.58-0.88, P = 0.002), lower abdominal infection rates (OR = 0.70, 95%CI: 0.54-0.90, P = 0.006), and shorter postoperative length of hospital stay (PLOS) (WMD = -4.45, 95%CI: -5.99 to -2.91, P < 0.00001). However, there were no significant differences in complications, such as, postoperative pancreatic fistulas, moderate to severe complications (Clavien-Dindo III- V), mortality, readmission and unintended reoperation, in both groups. The perioperative implementation of ERAS programs in pancreatic surgery is safe and effective, can decrease postoperative complication rates, and can promote recovery for patients.

Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer.

PubMed

Carli, Franco; Brown, Russell; Kennepohl, Stephan

2012-08-01

Postoperative complications represent a major concern for elderly patients. We report a case of a medically complex and frail 88-yr-old woman with endometrial cancer who was scheduled for a robotic-assisted total abdominal hysterectomy. In addition to her cardiac morbidity she presented with several risk factors for neurocognitive decline, including prior episodes of postoperative delirium. The patient underwent functional, nutritional, and neuropsychological assessments prior to a three-week prehabilitation home-based program consisting of strength and endurance exercises as well as nutritional optimization. Remarkably, there were no episodes of postoperative confusion, and over the following eight weeks, she continued to show sustained improvement in exercise tolerance (as per the six-minute walk test), cognitive function (as per the Repeatable Battery for the Assessment of Neuropsychological Status), and overall functional capacity (Short Form-36). This report provides suggestive evidence that a prehabilitation program optimized the health of this elderly patient and may have prevented a further episode of postoperative delirium. Prehabilitation protocols should be evaluated in clinical trials to evaluate their efficacy and the target populations who may benefit and to elucidate the underlying mechanisms responsible for enhanced recovery in the perioperative setting.

Short-term quality of life in patients undergoing colonic surgery using enhanced recovery after surgery program versus conventional perioperative management.

PubMed

Wang, Hao; Zhu, Dexiang; Liang, Li; Ye, Lechi; Lin, Qi; Zhong, Yunshi; Wei, Ye; Ren, Li; Xu, Jianmin; Qin, Xinyu

2015-11-01

Enhanced recovery after surgery (ERAS) integrates evidence-based interventions to reduce surgical stress and accelerate rehabilitation. Our study was to compare the short-term quality of life (QOL) in patients undergoing open colonic surgery using ERAS program or conventional management. A prospective study of 57 patients using ERAS program and 60 patients using conventional management was conducted. The clinical characteristics of all patients were recorded. QOL was evaluated longitudinally using the questionnaires (EORTC QLQ-C30 and QLQ-CR29) pre- and postoperatively. Generalized estimating equation was used to do the analysis in order to determine the effective impact of correlative factors on the postoperative QOL, including age, sex, BMI, ASA grade, tumor location, tumor size, pTNM stage, recovery program and length of time after surgery. The morbidity in ERAS and control group was 17.5 versus 26.7 % (p = 0.235). The patients in ERAS group had much faster rehabilitation and less hospital stay. In the primary statistical analysis, the scores of global QOL (on POD3, POD6, POD10, POD14, POD21), physical functioning (on POD3, POD6, POD10, POD14, POD21), role functioning (on POD6, POD10, POD14, POD21), emotional functioning (on POD3, POD6, POD10, POD14, POD21), cognitive functioning (on POD3, POD6) and social functioning (on POD3, POD6, POD10, POD14, POD21, POD28) were higher in ERAS group than in control group, which suggested that the patients in ERAS group had a better life status. However, the scores of pain (on POD10, POD14, POD21), appetite loss (on POD3, POD6), constipation (on POD3, POD6, POD10), diarrhea (on POD3, POD10), financial difficulties (on POD10, POD14, POD21), perspective of future health (on POD6, POD10, POD14), gastrointestinal tract problems (on POD3, POD6, POD10) and defecation problems (on POD6, POD10, POD14) were lower in ERAS group than in control group, which revealed that the patients in ERAS group suffered less symptoms. In the further generalized estimating equation analysis, the result showed that recovery program and length of time after surgery had independently positive impact on the patient's postoperative QOL. Short-term QOL in patients undergoing colonic cancer using ERAS program was better than that using conventional management.

40 CFR 256.31 - Recommendations for developing and implementing resource conservation and recovery programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... implementing resource conservation and recovery programs. 256.31 Section 256.31 Protection of Environment... SOLID WASTE MANAGEMENT PLANS Resource Conservation and Resource Recovery Programs § 256.31 Recommendations for developing and implementing resource conservation and recovery programs. (a) In order to...

40 CFR 144.22 - Existing Class II enhanced recovery and hydrocarbon storage wells.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and hydrocarbon storage wells. 144.22 Section 144.22 Protection of Environment ENVIRONMENTAL... of Underground Injection by Rule § 144.22 Existing Class II enhanced recovery and hydrocarbon storage wells. (a) An existing Class II enhanced recovery or hydrocarbon storage injection well is authorized by...

40 CFR 144.22 - Existing Class II enhanced recovery and hydrocarbon storage wells.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and hydrocarbon storage wells. 144.22 Section 144.22 Protection of Environment ENVIRONMENTAL... of Underground Injection by Rule § 144.22 Existing Class II enhanced recovery and hydrocarbon storage wells. (a) An existing Class II enhanced recovery or hydrocarbon storage injection well is authorized by...

13 CFR 120.398 - America's Recovery Capital (ARC) Loan Program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false America's Recovery Capital (ARC... BUSINESS LOANS Special Purpose Loans America's Recovery Capital (business Stabilization) Loan Program-Arc Loan Program § 120.398 America's Recovery Capital (ARC) Loan Program. (a) Purpose. The purpose of the...

13 CFR 120.398 - America's Recovery Capital (ARC) Loan Program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false America's Recovery Capital (ARC... BUSINESS LOANS Special Purpose Loans America's Recovery Capital (business Stabilization) Loan Program-Arc Loan Program § 120.398 America's Recovery Capital (ARC) Loan Program. (a) Purpose. The purpose of the...

13 CFR 120.398 - America's Recovery Capital (ARC) Loan Program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false America's Recovery Capital (ARC... BUSINESS LOANS Special Purpose Loans America's Recovery Capital (business Stabilization) Loan Program-Arc Loan Program § 120.398 America's Recovery Capital (ARC) Loan Program. (a) Purpose. The purpose of the...

13 CFR 120.398 - America's Recovery Capital (ARC) Loan Program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false America's Recovery Capital (ARC... BUSINESS LOANS Special Purpose Loans America's Recovery Capital (business Stabilization) Loan Program-Arc Loan Program § 120.398 America's Recovery Capital (ARC) Loan Program. (a) Purpose. The purpose of the...

41 CFR 109-45.1004 - Recovery and use of precious metals through the DOD Precious Metals Recovery Program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... precious metals through the DOD Precious Metals Recovery Program. 109-45.1004 Section 109-45.1004 Public... PERSONAL PROPERTY 45.10-Recovery of Precious Metals § 109-45.1004 Recovery and use of precious metals through the DOD Precious Metals Recovery Program. DOE operates its own precious metals pool and therefore...

41 CFR 109-45.1004 - Recovery and use of precious metals through the DOD Precious Metals Recovery Program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... precious metals through the DOD Precious Metals Recovery Program. 109-45.1004 Section 109-45.1004 Public... PERSONAL PROPERTY 45.10-Recovery of Precious Metals § 109-45.1004 Recovery and use of precious metals through the DOD Precious Metals Recovery Program. DOE operates its own precious metals pool and therefore...

Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Total Knee Arthroplasty.

PubMed

Soffin, Ellen M; Gibbons, Melinda M; Ko, Clifford Y; Kates, Stephen L; Wick, Elizabeth; Cannesson, Maxime; Scott, Michael J; Wu, Christopher L

2018-06-08

Enhanced recovery after surgery (ERAS) has rapidly gained popularity in a variety of surgical subspecialities. A large body of literature suggests that ERAS leads to superior outcomes, improved patient satisfaction, reduced length of hospital stay, and cost benefits, without affecting rates of readmission after surgery. These patterns have been described for patients undergoing elective total knee arthroplasty (TKA); however, adoption of ERAS to orthopedic surgery has lagged behind other surgical disciplines. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute (AI) for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. The program comprises a national effort to incorporate best practice in perioperative care and improve patient safety, for over 750 hospitals and multiple procedures over the next 5 years, including orthopedic surgery. We have conducted a full evidence review of anesthetic interventions to derive anesthesiology-related components of an evidence-based ERAS pathway for TKA. A PubMed search was performed for each protocol component, focusing on the highest levels of evidence in the literature. Search findings are summarized in narrative format. Anesthesiology components of care were identified and evaluated across the pre-, intra-, and postoperative phases. A summary of the best available evidence, together with recommendations for inclusion in ERAS protocols for TKA, is provided. There is extensive evidence in the literature, and from society guidelines to support the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery goals for TKA.

Nutrition management in enhanced recovery after abdominal pancreatic surgery.

PubMed

Márquez Mesa, Elena; Baz Figueroa, Caleb; Suárez Llanos, José Pablo; Sanz Pereda, Pablo; Barrera Gómez, Manuel Ángel

Multimodal rehabilitation programs are perioperative standardized strategies with the objective of improving patient recovery, and decreasing morbidity, hospital stay and health cost. The nutritional aspect is an essential component of multimodal rehabilitation programs and therefore nutritional screening is recommended prior to hospital admission, avoiding pre-surgical fasting, with oral carbohydrate overload and early initiation of oral intake after surgery. However, there are no standardized protocols of diet progression after pancreatic surgery. A systematic review was been performed of papers published between 2006 and 2016, describing different nutritional strategies after pancreatic surgery and its possible implications in postoperative outcome. The studies evaluated are very heterogeneous, so conclusive results could not be drawn on the diet protocol to be implemented, its influence on clinical variables, or the need for concomitant artificial nutrition. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Enhancing Functional Performance using Sensorimotor Adaptability Training Programs

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Brady, R.; Audas, C.; Ruttley, T. M.; Cohen, H. S.

2009-01-01

During the acute phase of adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform functional tasks. The goal of this project is to develop a sensorimotor adaptability (SA) training program designed to facilitate recovery of functional capabilities when astronauts transition to different gravitational environments. The project conducted a series of studies that investigated the efficacy of treadmill training combined with a variety of sensory challenges designed to increase adaptability including alterations in visual flow, body loading, and support surface stability.

Protection of West Indian manatees (Trichechus manatus) in Florida. Final report

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

Reynolds, J.E.; Gluckman, C.J.

1988-05-01

Research and management actions necessary for the recovery of endangered West Indian manatees (Trichechus manatus) have received considerable attention over the past decade from many individuals, institutions, and agencies. A new Manatee Recovery Plan is being developed by the United States Fish and Wildlife Service and promises to provide research goals and timetables to enhance further recovery of manatees in Florida. Recommendations are made in the following areas; implementing local, site-specific management plans that specifically address manatee protection and habitat conservation; increasing research funding to allow better assessment of manatee critical habitat, life history parameters, mortality, and movement patterns; acquiringmore » or restricting access to critical manatee habitat to create a system of reserves; expanding enforcement capability to protect manatees and their habitat; and coordinating education and awareness programs that target specific user groups.« less

Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment

PubMed Central

Stange, Jonathan P.; Sylvia, Louisa G.; da Silva Magalhães, Pedro Vieira; Miklowitz, David J.; Otto, Michael W.; Frank, Ellen; Yim, Christine; Berk, Michael; Dougherty, Darin D.; Nierenberg, Andrew A.; Deckersbach, Thilo

2016-01-01

Background Little is known about predictors of recovery from bipolar depression. Aims We investigated affective instability (a pattern of frequent and large mood shifts over time) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychosocial treatment for acute depression. Method A total of 252 out-patients with DSM-IV bipolar I or II disorder and who were depressed enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and were randomised to one of three types of intensive psychotherapy for depression (n = 141) or a brief psychoeducational intervention (n = 111). All analyses were by intention-to-treat. Results Degree of instability of symptoms of depression and mania predicted a lower likelihood of recovery and longer time until recovery, independent of the concurrent effects of symptom severity. Affective instability did not moderate the effects of psychosocial treatment on recovery from depression. Conclusions Affective instability may be a clinically relevant characteristic that influences the course of bipolar depression. PMID:26795426

Results of a national survey about perioperative care in gastric resection surgery.

PubMed

Bruna, Marcos; Navarro, Carla; Báez, Celia; Ramírez, José Manuel; Ortiz, María Ángeles

2018-04-23

Enhanced recovery after surgery programs in abdominal surgery are being established progressively. The aim of this study is to evaluate the application of different perioperative care measures in gastric surgery by Spanish surgeons. A descriptive study of 162 surveys answered from September to December 2017 about the management and perioperative care in non-bariatric gastric resection surgery. Antibiotic and antithrombotic prophylaxis are always used by 96.9 and 99.4%, respectively; 62.7% recommend a fasting time for liquids greater than 6hours and only 3% use preoperative carbohydrate drinks. Only 32.4 and 13.3% of subtotal and total gastrectomies are performed laparoscopically; 56.8% use epidural analgesia and drains are always placed by 53.8% in total gastrectomy. Nasogastric tubes are used selectively by 34.6% and always by 11.3%. Bladder catheters are removed during the first 48hours by 77.2%. In the first 24 postoperative hours, less than 20% indicate oral intake and 15.4% mobilize their patients; 49.3% indicate walking after the first 24hours; 30.4% apply a clinical pathway for the care of these patients and only 15.2% used an enhanced recovery after surgery protocol. The implementation of enhanced recovery after surgery measures in non-bariatric gastric resection surgery is not widespread in our country. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial.

PubMed

Jones, C; Eddleston, J; McCairn, A; Dowling, S; McWilliams, D; Coughlan, E; Griffiths, R D

2015-10-01

Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009). Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression. Copyright © 2015 Elsevier Inc. All rights reserved.

American Society for Enhanced Recovery: Advancing Enhanced Recovery and Perioperative Medicine.

PubMed

Gan, Tong J; Scott, Michael; Thacker, Julie; Hedrick, Traci; Thiele, Robert H; Miller, Timothy E

2018-06-01

As the population ages, the increasing surgical volume and complexity of care are expected to place additional care delivery burdens in the perioperative setting. In this age of integrated multidisciplinary care of the surgical patients, there is increasing recognition that an evidence-based perioperative pathway is associated with the optimal outcomes. These pathways, collectively referred to as Enhanced Recovery Pathways, have resulted in shortened length of hospital stay, reduced complications, and variance in outcomes, as well as earlier return to baseline activities. The American Society for Enhanced Recovery (ASER) is a multispecialty, nonprofit international organization, dedicated to the practice of enhanced recovery in perioperative patients through education and research. Perioperative Quality Initiatives were formed whose intent is to organize a series of consensus conferences on topics of interest related to perioperative medicine. The journal affiliation between American Society for Enhanced Recovery and Anesthesia & Analgesia will enable these evidence-based practices to be disseminated widely and swiftly to the practicing perioperative health care professionals so they can be adopted to improve the quality of perioperative surgical care.

Polymeric nanospheres as a displacement fluid in enhanced oil recovery

NASA Astrophysics Data System (ADS)

Hendraningrat, Luky; Zhang, Julien

2015-12-01

This paper presents the investigation of using nanoscale polyacrylamide-based spheres (nanospheres) as a displacement fluid in enhanced oil recovery (EOR). Coreflood experiments were conducted to evaluate the impact of nanospheres and its concentration dispersed in model formation water on oil recovery during a tertiary oil recovery process. The coreflood results showed that nanospheres can enhance residual oil recovery in the sandstone rock samples and its concentration showed a significant impact into incremental oil. By evaluating the contact angle, it was observed that wettability alteration also might be involved in the possible oil displacement mechanism in this process together with fluid behavior and permeability to water that might divert injected fluid into unswept oil areas and enhance the residual oil recovery. These investigations promote nanospheres aqueous disperse solution as a potential displacement fluid in EOR.

National Weatherization Assistance Program Characterization Describing the Recovery Act Period

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

Tonn, Bruce Edward; Rose, Erin M.; Hawkins, Beth A.

This report characterizes the U.S. Department of Energy s Weatherization Assistance Program (WAP) during the American Recovery and Reinvestment Act of 2009 (Recovery Act) period. This research was one component of the Recovery Act evaluation of WAP. The report presents the results of surveys administered to Grantees (i.e., state weatherization offices) and Subgrantees (i.e., local weatherization agencies). The report also documents the ramp up and ramp down of weatherization production and direct employment during the Recovery Act period and other challenges faced by the Grantees and Subgrantees during this period. Program operations during the Recovery Act (Program Year 2010) aremore » compared to operations during the year previous to the Recovery Act (Program Year 2008).« less

A recovery-based outreach program in rural Victoria.

PubMed

Prabhu, Radha; Browne, Mark Oakley

2007-04-01

A recovery-based outreach program for people with severe mental illness in regional Victoria is described. The paper covers a description of the program, the services provided and outcomes achieved. The program emphasized active collaboration between patients and clinicians as outlined in the collaborative recovery model and recognized that recovery from mental illness is an individual, personal process. The program provided service to 108 people over 3 years and had a positive impact on clinicians, patients and carers. The benefits of recovery orientation, multidisciplinary teams, collaborative relationships and carer involvement are discussed. The paper highlights the need for a focus on recovery and comprehensive care for people with severe mental illness.

Armed Forces Radiobiology Research Institute Annual Research Report, Fiscal Year 1984.

DTIC Science & Technology

1984-01-01

thromboxane B2, cyclic AMP and GMP, ACTH, beta -endorphin, cortisol/corticosterone, and complement in bio- logical fluids and tissues. Mediators will...immunomodulators are being tested for their ability to enhance the *recovery of hemopoiesis following irradiation. These include glucan , detoxified...endotoxin, and selected agents from the Biological Response Modifiers Program (NCI, Frederick, MD). Glucan has proved to be very effective in stimulating

[Present situation and prospect of enhanced recovery after surgery in pancreatic surgery].

PubMed

Feng, Mengyu; Zhang, Taiping; Zhao, Yupei

2017-05-25

Enhanced recovery after surgery is a multimodal perioperative strategy according to the evidence-based medicine and multidisciplinary collaboration, aiming to improve the restoration of functional capacity after surgery by reducing surgical stress, optimal control of pain, early oral diet and early mobilization. Compared with other sub-specialty in general surgery, pancreatic surgery is characterized by complex disease, highly difficult procedure and more postoperative complications. Accordingly, pancreatic surgery shares a slow development in enhanced recovery after surgery. In this review, the feasibility, safety, application progress, prospect and controversy of enhanced recovery after surgery in pancreatic surgery are discussed.

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Code of Federal Regulations, 2011 CFR

2011-04-01

... tangible property is used directly in a qualified enhanced oil recovery project and is essential to the... gas and water from the oil after it is produced are used directly in the project and are essential to... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Qualified enhanced oil recovery costs. 1.43-4...

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Code of Federal Regulations, 2012 CFR

2012-04-01

... tangible property is used directly in a qualified enhanced oil recovery project and is essential to the... gas and water from the oil after it is produced are used directly in the project and are essential to... 26 Internal Revenue 1 2012-04-01 2012-04-01 false Qualified enhanced oil recovery costs. 1.43-4...

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... tangible property is used directly in a qualified enhanced oil recovery project and is essential to the... gas and water from the oil after it is produced are used directly in the project and are essential to... 26 Internal Revenue 1 2013-04-01 2013-04-01 false Qualified enhanced oil recovery costs. 1.43-4...

40 CFR 147.1953 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1953 Section 147.1953 Protection of... enhanced recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure...

40 CFR 147.1953 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1953 Section 147.1953 Protection of... enhanced recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure...

26 CFR 1.43-4 - Qualified enhanced oil recovery costs.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the anticipated use in a project or activity is a reasonable method. (b) Costs defined—(1) Qualified... used in the tertiary recovery method. Therefore, the storage tank is used directly in the project and... qualified tertiary recovery method. As part of the enhanced oil recovery project, K drills injection wells...

76 FR 57807 - Medicaid Program; Recovery Audit Contractors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-16

... for Medicare & Medicaid Services 42 CFR Part 455 Medicaid Program; Recovery Audit Contractors; Final... 42 CFR Part 455 [CMS-6034-F] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY... costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State...

Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program.

PubMed

Muñoz, José Luis; Alvarez, María Oliva; Cuquerella, Vicent; Miranda, Elena; Picó, Carlos; Flores, Raquel; Resalt-Pereira, Marta; Moya, Pedro; Pérez, Ana; Arroyo, Antonio

2018-03-08

C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program. We conducted a prospective study including 134 patients who underwent laparoscopic colorectal surgery within an ERAS program between 2015 and 2017. The primary endpoint investigated was anastomotic leak. CRP, PCT, and WBC count were determined in the blood sample extracted on postoperative day 1 (POD 1), POD 2 and POD 3. Anastomotic leak (AL) was detected in 6 patients (4.5%). Serum levels of CRP and PCT, but not WBC, determined on POD 1, POD 2, and POD 3 were significantly higher in patients who had AL in the postoperative course. Using ROC analysis, the best AUC of the CRP and PCT levels was on POD 3 (0.837 and 0.947, respectively). A CRP cutoff level at 163 mg/l yielded 85% sensitivity, 80% specificity, and 99% negative predictive value (NPV). A PCT cutoff level at 2.5 ng/ml achieved 85% sensitivity, 95% specificity, 44% positive predictive value, and 99% NPV. CRP and PCT are relevant markers for detecting postoperative AL after laparoscopic colorectal surgery. Furthermore, they can ensure an early discharge with a low probability of AL when an ERAS program is performed.

Biological enhancement of hydrocarbon extraction

DOEpatents

Brigmon, Robin L [North Augusta, SC; Berry, Christopher J [Aiken, SC

2009-01-06

A method of microbial enhanced oil recovery for recovering oil from an oil-bearing rock formation is provided. The methodology uses a consortium of bacteria including a mixture of surfactant producing bacteria and non-surfactant enzyme producing bacteria which may release hydrocarbons from bitumen containing sands. The described bioprocess can work with existing petroleum recovery protocols. The consortium microorganisms are also useful for treatment of above oil sands, ground waste tailings, subsurface oil recovery, and similar materials to enhance remediation and/or recovery of additional hydrocarbons from the materials.

20 CFR 416.575 - When will we begin cross-program recovery from your current monthly benefits?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When will we begin cross-program recovery... benefits? (a) We will begin collecting the overpayment balance by cross-program recovery from your current... monthly benefits than the amount stated in the notice, we will not begin cross-program recovery until we...

20 CFR 408.933 - When will we begin cross-program recovery from your current monthly benefits?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When will we begin cross-program recovery... Title II Benefits § 408.933 When will we begin cross-program recovery from your current monthly benefits... notice, we will not begin cross-program recovery from your current monthly benefits. (b) If within that...

Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1).

PubMed

Patel, Santosh; Lutz, Jan M; Panchagnula, Umakanth; Bansal, Sujesh

2012-04-01

Colorectal surgery is commonly performed for colorectal cancer and other pathology such as diverticular and inflammatory bowel disease. Despite significant advances, such as laparoscopic techniques and multidisciplinary recovery programs, morbidity and mortality remain high and vary among surgical centers. The use of scoring systems and assessment of functional capacity may help in identifying high-risk patients and predicting complications. An understanding of perioperative factors affecting colon blood flow and oxygenation, suppression of stress response, optimal fluid therapy, and multimodal pain management are essential. These fundamental principles are more important than any specific choice of anesthetic agents. Anesthesiologists can significantly contribute to enhance recovery and improve the quality of perioperative care.

[Biological experiments on "Kosmos-1887"].

PubMed

Alpatov, A M; I'lin, E A; Antipov, V V; Tairbekov, M G

1989-01-01

In the 13-ray space flight on Kosmos-1887 various experiments in the field of cell biology, genetics, biorhythm, developmental biology and regeneration were performed using bacteria, protozoa, plants, worms, insects, fish and amphibia. Paramecia showed enhanced cell proliferation, spheroidization and diminished protein content. Experiments on fruit-flies, newt oocytes and primate lymphocytes confirmed involvement of the cell genetic apparatus in responses to microgravity. Beetles exhibited a reduction of the length of the spontaneous period of freely running circadian rhythms. Carausius morosus developed latent changes in early embryogenesis which manifested at later stages of ontogenesis. Exposure to microgravity did not prevent recovery of injured tissues; moreover their regeneration may be accelerated after recovery. Biology research programs in future biosatellite flights are discussed.

Enhanced multimaterial 4D printing with active hinges

NASA Astrophysics Data System (ADS)

Akbari, Saeed; Hosein Sakhaei, Amir; Kowsari, Kavin; Yang, Bill; Serjouei, Ahmad; Yuanfang, Zhang; Ge, Qi

2018-06-01

Despite great progress in four-dimensional (4D) printing, i.e. three-dimensional (3D) printing of active (stimuli-responsive) materials, the relatively low actuation force of the 4D printed structures often impedes their engineering applications. In this study, we use multimaterial inkjet 3D printing technology to fabricate shape memory structures, including a morphing wing flap and a deployable structure, which consist of active and flexible hinges joining rigid (non-active) parts. The active hinges, printed from a shape memory polymer (SMP), lock the structure into a second temporary shape during a thermomechanical programming process, while the flexible hinges, printed from an elastomer, effectively increase the actuation force and the load-bearing capacity of the printed structure as reflected in the recovery ratio. A broad range of mechanical properties such as modulus and failure strain can be achieved for both active and flexible hinges by varying the composition of the two base materials, i.e. the SMP and the elastomer, to accommodate large deformation induced during programming step, and enhance the recovery in the actuating step. To find the important design parameters, including local deformation, shape fixity and recovery ratio, we conduct high fidelity finite element simulations, which are able to accurately predict the nonlinear deformation of the printed structures. In addition, a coupled thermal-electrical finite element analysis was performed to model the heat transfer within the active hinges during the localized Joule heating process. The model predictions showed good agreement with the measured temperature data and were used to find the major parameters affecting temperature distribution including the applied voltage and the convection rate.

Integrated programs for women with substance use issues and their children: a qualitative meta-synthesis of processes and outcomes.

PubMed

Sword, Wendy; Jack, Susan; Niccols, Alison; Milligan, Karen; Henderson, Joanna; Thabane, Lehana

2009-11-20

There is a need for services that effectively and comprehensively address the complex needs of women with substance use issues and their children. A growing body of literature supports the relevance of integrated treatment programs that offer a wide range of services in centralized settings. Quantitative studies suggest that these programs are associated with positive outcomes. A qualitative meta-synthesis was conducted to provide insight into the processes that contribute to recovery in integrated programs and women's perceptions of benefits for themselves and their children. A comprehensive search of published and unpublished literature to August 2009 was carried out for narrative reports of women's experiences and perceptions of integrated treatment programs. Eligibility for inclusion in the meta-synthesis was determined using defined criteria. Quality assessment was then conducted. Qualitative data and interpretations were extracted from studies of adequate quality, and were synthesized using a systematic and iterative process to create themes and overarching concepts. A total of 15 documents were included in the meta-synthesis. Women experienced a number of psychosocial processes during treatment that played a role in their recovery and contributed to favourable outcomes. These included: development of a sense of self; development of personal agency; giving and receiving of social support; engagement with program staff; self-disclosure of challenges, feelings, and past experiences; recognizing patterns of destructive behaviour; and goal setting. A final process, the motivating presence of children, sustained women in their recovery journeys. Perceived outcomes included benefits for maternal and child well-being, and enhanced parenting capacity. A number of distinct but interconnected processes emerged as being important to women's addiction recovery. Women experienced individual growth and transformative learning that led to a higher quality of life and improved interactions with their children. The findings support the need for programs to adopt practices that focus on improving maternal health and social functioning in an environment characterized by empowerment, safety, and connections. Women's relationships with their children require particular attention as positive parenting practices and family relationships can alter predispositions toward substance use later in life, thereby impacting favourably on the cycle of addiction and dysfunctional parenting.

Mobile critical care recovery program (m-CCRP) for acute respiratory failure survivors: study protocol for a randomized controlled trial.

PubMed

Khan, Sikandar; Biju, Ashok; Wang, Sophia; Gao, Sujuan; Irfan, Omar; Harrawood, Amanda; Martinez, Stephanie; Brewer, Emily; Perkins, Anthony; Unverzagt, Frederick W; Lasiter, Sue; Zarzaur, Ben; Rahman, Omar; Boustani, Malaz; Khan, Babar

2018-02-07

Patients admitted to intensive care units (ICU) with acute respiratory failure (ARF) face chronic complications that can impede return to normal daily function. A mobile, collaborative critical care model may enhance the recovery of ARF survivors. The Mobile Critical Care Recovery Program (m-CCRP) study is a two arm, randomized clinical trial. We will randomize 620 patients admitted to the ICU with acute respiratory failure requiring mechanical ventilation in a 1:1 ratio to one of two arms (310 patients per arm) - m-CCRP intervention versus attention control. Those in the intervention group will meet with a care coordinator after hospital discharge in predetermined intervals to aid in the recovery process. Baseline assessments and personalized goal setting will be used to develop an individualized care plan for each patient after discussion with an interdisciplinary team. The attention control arm will receive printed material and telephone reminders emphasizing mobility and management of chronic conditions. Duration of the intervention and follow-up is 12 months post-randomization. Our primary aim is to assess the efficacy of m-CCRP in improving the quality of life of ARF survivors at 12 months. Secondary aims of the study are to evaluate the efficacy of m-CCRP in improving function (cognitive, physical, and psychological) of ARF survivors and to determine the efficacy of m-CCRP in reducing acute healthcare utilization. The proposed randomized controlled trial will evaluate the efficacy of a collaborative critical care recovery program in accomplishing the Institute of Healthcare Improvement's triple aims of better health, better care, at lower cost. We have developed a collaborative critical care model to promote ARF survivors' recovery from the physical, psychological, and cognitive impacts of critical illness. In contrast to a single disease focus and clinic-based access, m-CCRP represents a comprehensive, accessible, mobile, ahead of the curve intervention, focused on the multiple aspects of the unique recovery needs of ARF survivors. NCT03053245 , clinicaltrials.gov, registered February 1, 2017.

An examination of stress, coping, and adaptation in nurses in a recovery and monitoring program.

PubMed

Bowen, Marie Katherine; Taylor, Kathleen P; Marcus-Aiyeku, Ulanda; Krause-Parello, Cheryl A

2012-10-01

Addiction rates in nurses are higher than in the general population. The relationship between stress, coping, and adaptation in nurses (N = 82) enrolled in a recovery and monitoring program in the state of New Jersey was examined. Social support, a variable tested as a mediator of this relationship, was also examined. Participants completed the Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, and Psychological General Well-Being Index. Negative relationships were found between stress and social support and stress and well-being, and a positive relationship was found between social support and well-being (all ps < .05). The direct relationship between stress and well-being was decreased in the presence of social support. The findings of this research suggest that, to assist nurses, an increased awareness of stress and its injurious effects on overall well-being must be identified so proactive measures can be implemented to prevent potential untoward consequences. Ultimately, methods to strengthen social support and social networks will enhance the probability of sustained recovery, relapse prevention, and safe reentry into nursing practice. Implications for behavioral health providers and health care practitioners are discussed.

Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

PubMed

Siletz, Anaar; Childers, Christopher P; Faltermeier, Claire; Singer, Emily S; Hu, Q Lina; Ko, Clifford Y; Kates, Stephen L; Maggard-Gibbons, Melinda; Wick, Elizabeth

2018-01-01

Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Perioperative care was divided into components or "bins." For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials. Observational studies were included when higher levels of evidence were not available. Existing guidelines for perioperative care were also incorporated. For convenience, the components of care that are under the auspices of anesthesia providers will be reported separately. Recommendations for an evidence-based protocol were synthesized based on review of this evidence. Eleven bins were identified. Preoperative risk factor bins included nutrition, diabetes mellitus, tobacco use, and anemia. Perioperative management bins included thromboprophylaxis, timing of surgery, fluid management, drain placement, early mobilization, early alimentation, and discharge criteria/planning. This review provides the evidence basis for an ERP for perioperative care of patients with hip fracture.

The Columbia Debris Loan Program; Examples of Microscopic Analysis

NASA Technical Reports Server (NTRS)

Russell, Rick; Thurston, Scott; Smith, Stephen; Marder, Arnold; Steckel, Gary

2006-01-01

Following the tragic loss of the Space Shuttle Columbia NASA formed The Columbia Recovery Office (CRO). The CRO was initially formed at the Johnson Space Center after the conclusion of recovery operations on May 1,2003 and then transferred .to the Kennedy Space Center on October 6,2003 and renamed The Columbia Recovery Office and Preservation. An integral part of the preservation project was the development of a process to loan Columbia debris to qualified researchers and technical educators. The purposes of this program include aiding in the advancement of advanced spacecraft design and flight safety development, the advancement of the study of hypersonic re-entry to enhance ground safety, to train and instruct accident investigators and to establish an enduring legacy for Space Shuttle Columbia and her crew. Along with a summary of the debris loan process examples of microscopic analysis of Columbia debris items will be presented. The first example will be from the reconstruction following the STS- 107 accident and how the Materials and Proessteesa m used microscopic analysis to confirm the accident scenario. Additionally, three examples of microstructural results from the debris loan process from NASA internal, academia and private industry will be presented.

Facilitating College Students' Recovery through the Use of Collegiate Recovery Programs

ERIC Educational Resources Information Center

DePue, M. Kristina; Hagedorn, W. Bryce

2015-01-01

This article describes an untapped resource that counselors can use to help serve the multiple needs of college students recovering from addiction: collegiate recovery programs. The authors provide detailed information about the collegiate recovery population and give examples of successful programs. Implications for future research are discussed,…

Electrophilic acid gas-reactive fluid, proppant, and process for enhanced fracturing and recovery of energy producing materials

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

Fernandez, Carlos A.; Heldebrant, David J.; Bonneville, Alain

An electrophilic acid gas-reactive fracturing fluid, proppant, and process are detailed. The fluid expands in volume to provide rapid and controlled increases in pressure that enhances fracturing in subterranean bedrock for recovery of energy-producing materials. The proppant stabilizes fracture openings in the bedrock to enhance recovery of energy-producing materials.

Nutrition adequacy in enhanced recovery after surgery: a single academic center experience.

PubMed

Gillis, Chelsia; Nguyen, Thi Haiyen; Liberman, A Sender; Carli, Francesco

2015-06-01

A prospective observational study was initiated to determine the prevalence of nutrition risk before surgery and assess nutrition adequacy of food choices after elective colorectal surgery. Patient-Generated Subjective Global Assessment was used to screen all preoperative clinic patients (n = 70) scheduled for elective colorectal surgery. Adequacy of dietary intake (n = 40) was determined for the first 3 postoperative days by estimating total energy and protein intake from leftover food at each meal based on standard hospital portions with food composition tables. Food access questionnaire provided a rationale for observed food intake. All patients received Enhanced Recovery After Surgery (ERAS) and room service system care. Before surgery, 63% of patients were considered well-nourished, 29% suspected or moderately undernourished, and 8% severely undernourished. Fifty-one percent of patients scored > 4 on the Patient-Generated Subjective Global Assessment, indicating requirement for dietary intervention or symptom management. On average, 77% ± 27%, 63% ± 28%, and 92% ± 39% of energy requirements were met on postoperative days 1, 2, and 3, respectively; conversely, 55% ± 24%, 43% ± 16%, and 45% ± 12% of protein requirements were met. Most common reasons for missed meals included loss of appetite and feelings of fatigue or worry. Preoperative nutrition risk tended to result in a greater 30-day hospital readmission rate compared to well-nourished patients (P = .07). A third of patients scheduled for elective colorectal surgery were at nutrition risk. An acceptable intake of dietary protein was not achieved during the first 3 days of hospitalization. Preoperative nutrition education, as part of Enhanced Recovery Programs, may be useful to optimize nutrition status before surgery to mitigate clinical consequences associated with undernutrition and empower patients to make adequate food choices for recovery. NCT 01727570. © 2014 American Society for Parenteral and Enteral Nutrition.

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study.

PubMed

Decker, Kathleen P; Peglow, Stephanie L; Samples, Carl R

2014-05-16

A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. This was a pilot study of the program and was not randomized. A retrospective record review of 643 veterans in an inpatient mental health recovery and rehabilitation program was analyzed to determine if participants of Natural Recovery had a different rate of treatment completion than those who elected to participate in the core program alone. Univariate and multivariate analyses were conducted on: participation in the Natural Recovery Program; co-morbid psychiatric disorders; and legal, medical, and psychiatric issues. Participation in Natural Recovery was significantly associated with successful treatment completion when analyzed by univariate analysis (p = 0.01). Other significant variables associated with successful completion included: no co-morbid psychiatric diagnosis, fewer prior suicide attempts, and no homelessness prior to admission. Binary logistic regression demonstrated that participation in Natural Recovery was associated with improved treatment completion, even when other variables were considered (p = 0.01). Treatment retention was longer for patients who participated in Natural Recovery, even if they did not complete treatment. The Natural Recovery Program was associated with improved outcomes, as measured by treatment retention in the first 60 days and by treatment completion. Participants of Natural Recovery with co-morbid psychiatric disorders completed treatment at a higher rate than those with co-morbid psychiatric disorders who participated in the core program. Patients reported high satisfaction with the program. This program may be a valuable adjunct to residential treatment.

Participation in a novel treatment component during residential substance use treatment is associated with improved outcome: a pilot study

PubMed Central

2014-01-01

Background A person-centered substance use treatment component, the Natural Recovery Program, was developed. The Natural Recovery Program is comprised of small group therapy combined with pursuit of hobbies. Methods This was a pilot study of the program and was not randomized. A retrospective record review of 643 veterans in an inpatient mental health recovery and rehabilitation program was analyzed to determine if participants of Natural Recovery had a different rate of treatment completion than those who elected to participate in the core program alone. Univariate and multivariate analyses were conducted on: participation in the Natural Recovery Program; co-morbid psychiatric disorders; and legal, medical, and psychiatric issues. Results Participation in Natural Recovery was significantly associated with successful treatment completion when analyzed by univariate analysis (p = 0.01). Other significant variables associated with successful completion included: no co-morbid psychiatric diagnosis, fewer prior suicide attempts, and no homelessness prior to admission. Binary logistic regression demonstrated that participation in Natural Recovery was associated with improved treatment completion, even when other variables were considered (p = 0.01). Treatment retention was longer for patients who participated in Natural Recovery, even if they did not complete treatment. Conclusions The Natural Recovery Program was associated with improved outcomes, as measured by treatment retention in the first 60 days and by treatment completion. Participants of Natural Recovery with co-morbid psychiatric disorders completed treatment at a higher rate than those with co-morbid psychiatric disorders who participated in the core program. Patients reported high satisfaction with the program. This program may be a valuable adjunct to residential treatment. PMID:24886745

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Working Group: Multi-Agency Coordination After Action Report

DTIC Science & Technology

2012-02-23

Kaski Charles Denver Office of Emergency Management Kellar Scott Arapahoe County/NCR Coordinator Krebs Kathleen Clear Creek County Krugman Jim USDA...Mower John Cubic Applications, Inc. Mueller Matt Denver Office of Emergency Management Ridley Teri WARRP Rubenstein Mike Jefferson County...Office of Emergency Management: Scott Field Denver Office of Emergency Management: Pat Williams Douglas County: Fran Santagata Douglas County: Steve

Implementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a health system.

PubMed

Gramlich, Leah M; Sheppard, Caroline E; Wasylak, Tracy; Gilmour, Loreen E; Ljungqvist, Olle; Basualdo-Hammond, Carlota; Nelson, Gregg

2017-05-19

Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system. The ultimate intent of this work is to allow for the development of a model for spread, scale, and sustainability of ERAS in Alberta Health Services (AHS). ERAS for colorectal surgery was implemented at two sites and then spread to four additional sites. The ERAS Interactive Audit System (EIAS) was used to assess compliance with the guidelines, length of stay, readmissions, and complications. Data sources informing knowledge translation included surveys, focus groups, interviews, and other qualitative data sources such as minutes and status updates. The QUERI model and TDF were used to thematically analyze 189 documents with 2188 quotes meeting the inclusion criteria. Data sources were analyzed for barriers or enablers, organized into a framework that included individual to organization impact, and areas of focus for guideline implementation. Compliance with the evidence-based guidelines for ERAS in colorectal surgery at baseline was 40%. Post implementation compliance, consistent with adoption of best practice, improved to 65%. Barriers and enablers were categorized as clinical practice (22%), individual provider (26%), organization (19%), external environment (7%), and patients (25%). In the Alberta context, 26% of barriers and enablers to ERAS implementation occurred at the site and unit levels, with a provider focus 26% of the time, a patient focus 26% of the time, and a system focus 22% of the time. Using the ERAS care system and applying the QUERI model and TDF allow for identification of strategies that can support diffusion and sustainment of innovation of Enhanced Recovery After Surgery across multiple sites within a health care system.

Optimising recovery after surgery: Predictors of early discharge and hospital readmission.

PubMed

Carter, Jonathan; Philp, Shannon; Wan, King M

2016-10-01

Fast track surgery (FTS) programs minimise the stress response after surgery and allow for enhanced recovery. To document the frequency and incidence of adverse events in patients enrolled on a FTS program and to investigate factors associated with shorter length of stay and readmission to hospital. A seven-year updated surgical audit of patients undergoing laparotomy for suspected or confirmed malignancy on a FTS program. Five hundred and fifty patients comprise the study group. Average age and body mass index (BMI) were 55 years and 28, respectively. Mean length of stay (LOS) was 3.4 days with 194 (35%) patients discharged on day 2. Six (1%) patients had confirmed venous thromboembolism (VTE), three of whom were diagnosed on pre-operative imaging. Overall, transfusion rate was 5%. Adverse events in decreasing frequency were hospital readmission (4%) and significant wound infection (3%). All other adverse events were uncommon with rates <0.5%. Factors associated with a discharge on or after day 3 include age, pathology, Eastern Cooperative Oncology Group performance status, incision type, operating time, blood transfusion and cyclo-oxygenase 2 inhibitors. Factors associated with hospital readmission include longer operating time, performance of lymph node sampling/dissection, longer LOS, development of wound infection, febrile morbidity, return to the operating room, unplanned intensive care unit admission and presence of other complications. Patients managed by a FTS protocol can expect enhanced outcomes when compared to historical controls. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Biochemically enhanced oil recovery and oil treatment

DOEpatents

Premuzic, Eugene T.; Lin, Mow

1994-01-01

This invention relates to the preparation of new, modified organisms, through challenge growth processes, that are viable in the extreme temperature, pressure and pH conditions and salt concentrations of an oil reservoir and that are suitable for use in microbial enhanced oil recovery. The modified microorganisms of the present invention are used to enhance oil recovery and remove sulfur compounds and metals from the crude oil.

Design and field demonstration of a low-NOx burner for TEOR (thermally enhanced oil recovery) steamers

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

England, G.C.; Kwan, Y.; Payne, R.

1984-10-01

The paper discusses a program that addresses the need for advanced NOx control technology for thermally enhanced oil recovery (TEOR) steam generators. A full-scale (60 million Btu/hr) burner system has been developed and tested, the concept for which was based on fundamental studies. Test results are included for full-scale burner performance in an experimental test furnace, and in a field-operating steam generator which was subsequently retrofitted in a Kern County, California, oilfield. (NOTE: NOx control techniques including low-NOx burners, postflame NH/sub 3/ injection, or other postflame treatment methods--e.g., selective catalytic reduction--have been considered in order to comply with regulations. Themore » level of NOx control required to meet both growth and air quality goals has typically been difficult to achieve with available technology while maintaining acceptable CO and particulate emissions as well as practical flame conditions within the steamer.)« less

Preliminary development of an intelligent computer assistant for engine monitoring

NASA Technical Reports Server (NTRS)

Disbrow, James D.; Duke, Eugene L.; Ray, Ronald J.

1989-01-01

As part of the F-18 high-angle-of-attack vehicle program, an AI method was developed for the real time monitoring of the propulsion system and for the identification of recovery procedures for the F404 engine. The aim of the development program is to provide enhanced flight safety and to reduce the duties of the propulsion engineers. As telemetry data is received, the results are continually displayed in a number of different color graphical formats. The system makes possible the monitoring of the engine state and the individual parameters. Anomaly information is immediately displayed to the engineer.

Nutrition for recovery in aquatic sports.

PubMed

Burke, Louise M; Mujika, Iñigo

2014-08-01

Postexercise recovery is an important topic among aquatic athletes and involves interest in the quality, quantity, and timing of intake of food and fluids after workouts or competitive events to optimize processes such as refueling, rehydration, repair, and adaptation. Recovery processes that help to minimize the risk of illness and injury are also important but are less well documented. Recovery between workouts or competitive events may have two separate goals: (a) restoration of body losses and changes caused by the first session to restore performance for the next and (b) maximization of the adaptive responses to the stress provided by the session to gradually make the body become better at the features of exercise that are important for performance. In some cases, effective recovery occurs only when nutrients are supplied, and an early supply of nutrients may also be valuable in situations in which the period immediately after exercise provides an enhanced stimulus for recovery. This review summarizes contemporary knowledge of nutritional strategies to promote glycogen resynthesis, restoration of fluid balance, and protein synthesis after different types of exercise stimuli. It notes that some scenarios benefit from a proactive approach to recovery eating, whereas others may not need such attention. In fact, in some situations it may actually be beneficial to withhold nutritional support immediately after exercise. Each athlete should use a cost-benefit analysis of the approaches to recovery after different types of workouts or competitive events and then periodize different recovery strategies into their training or competition programs.

Evaluation of a Group-Based Trauma Recovery Program in Gaza: Students' Subjective Experiences

ERIC Educational Resources Information Center

Barron, Ian; Abdullah, Ghassan

2012-01-01

Internationally, evaluation of group-based trauma recovery programs has relied upon normative outcome measures, with no studies systematically analyzing children's subjective experience for program development. In contrast, the current study explored children's experience of a Gazan recovery program "in their own words." Twenty-four…

Money management, mental health, and psychiatric disability: a recovery-oriented model for improving financial skills.

PubMed

Elbogen, Eric B; Tiegreen, Joshua; Vaughan, Colleen; Bradford, Daniel W

2011-01-01

Although money management skills are essential for independent functioning in the community, when viewed from the framework of psychosocial rehabilitation, there have been few systematic models for teaching money management skills to consumers with psychiatric disabilities based on a recovery orientation. For those diagnosed with psychiatric disabilities, better money management has consistently been shown to be associated with superior quality of life, fewer hospitalizations, and greater self-efficacy. Consumers frequently indicate that learning how to budget and staying out of debt are among their top goals for recovery with mental illness. The current paper reviews the issues of money management and mental health among people with psychiatric disabilities and proposes a recovery-oriented approach to increasing money management skills to increase community functioning among consumers. Published literature, clinical cases, and financial literacy resources. Improving money management can lead to a number of benefits by helping consumers with psychiatric disabilities: 1) gain more knowledge about disability benefits, 2) improve basic financial skills, and 3) reduce vulnerability to financial exploitation. Future work on incorporating this model into psychiatric rehabilitation programs would address skills consumers can use in living, working, and social environments in a way that enhances consumer choice and promotes recovery.

Retrospective cohort study of an enhanced recovery programme in oesophageal and gastric cancer surgery

PubMed Central

Gatenby, PAC; Shaw, C; Hine, C; Scholtes, S; Koutra, M; Andrew, H; Hacking, M; Allum, WH

2015-01-01

Introduction Enhanced recovery programmes have been established in some areas of elective surgery. This study applied enhanced recovery principles to elective oesophageal and gastric cancer surgery. Methods An enhanced recovery programme for patients undergoing open oesophagogastrectomy, total and subtotal gastrectomy for oesophageal and gastric malignancy was designed. A retrospective cohort study compared length of stay on the critical care unit (CCU), total length of inpatient stay, rates of complications and in-hospital mortality prior to (35 patients) and following (27 patients) implementation. Results In the cohort study, the median total length of stay was reduced by 3 days following oesophagogastrectomy and total gastrectomy. The median length of stay on the CCU remained the same for all patients. The rates of complications and mortality were the same. Conclusions The standardised protocol reduced the median overall length of stay but did not reduce CCU stay. Enhanced recovery principles can be applied to patients undergoing major oesophagogastrectomy and total gastrectomy as long as they have minimal or reversible co-morbidity. PMID:26414360

76 FR 16438 - Reallocation of American Recovery and Reinvestment Act Capital Funds-Capital Fund Grant Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Recovery and Reinvestment Act Capital Funds--Capital Fund Grant Program Under the American Recovery and...: Notice. SUMMARY: The American Recovery and Reinvestment Act of 2009 (the Recovery Act) included a $4...). The Recovery Act required that $3 billion of these funds be distributed as formula funds and the...

Feasibility Assessment of CO2 Sequestration and Enhanced Recovery in Gas Shale Reservoirs

NASA Astrophysics Data System (ADS)

Vermylen, J. P.; Hagin, P. N.; Zoback, M. D.

2008-12-01

CO2 sequestration and enhanced methane recovery may be feasible in unconventional, organic-rich, gas shale reservoirs in which the methane is stored as an adsorbed phase. Previous studies have shown that organic-rich, Appalachian Devonian shales adsorb approximately five times more carbon dioxide than methane at reservoir conditions. However, the enhanced recovery and sequestration concept has not yet been tested for gas shale reservoirs under realistic flow and production conditions. Using the lessons learned from previous studies on enhanced coalbed methane (ECBM) as a starting point, we are conducting laboratory experiments, reservoir modeling, and fluid flow simulations to test the feasibility of sequestration and enhanced recovery in gas shales. Our laboratory work investigates both adsorption and mechanical properties of shale samples to use as inputs for fluid flow simulation. Static and dynamic mechanical properties of shale samples are measured using a triaxial press under realistic reservoir conditions with varying gas saturations and compositions. Adsorption is simultaneously measured using standard, static, volumetric techniques. Permeability is measured using pulse decay methods calibrated to standard Darcy flow measurements. Fluid flow simulations are conducted using the reservoir simulator GEM that has successfully modeled enhanced recovery in coal. The results of the flow simulation are combined with the laboratory results to determine if enhanced recovery and CO2 sequestration is feasible in gas shale reservoirs.

An evidence-based review of enhanced recovery interventions in knee replacement surgery

PubMed Central

Alazzawi, S; Nizam, I; Haddad, FS

2013-01-01

Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements. PMID:24025284

An evidence-based review of enhanced recovery interventions in knee replacement surgery.

PubMed

Ibrahim, M S; Alazzawi, S; Nizam, I; Haddad, F S

2013-09-01

Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient's postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. A thorough literature search of the electronic healthcare databases (MEDLINE(®), Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.

Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators.

PubMed

Petros, Ryan; Solomon, Phyllis

2015-11-01

Illness self-management (ISM) programs for adults with serious mental illness offer strategies to increase self-directed recovery activities to maximize wellness and increase independence from the service delivery system. This article describes five of the most popular ISM programs: Pathways to Recovery, The Recovery Workbook, Building Recovery of Individual Dreams and Goals through Education and Support, Wellness and Recovery Action Planning, and Illness Management and Recovery. It provides guidance for administrators, practitioners, and consumers for the purposes of selecting the program or programs providing the best fit. The framework for describing the five programs encompasses four contextual domains that supplement empirical evidence for a more comprehensive evaluation: structure, value orientation toward recovery, methods of teaching, and educational content. Contextual domains distinguish programs from one another, including length and time commitment, requisite resources, inclusion of group support, utilization of medical language and pathology, degree of traditional didactic education, and prioritization of consumer-driven self-exploration. The authors also searched PsycINFO, Google Scholar, and Cochrane Reviews for empirical evidence and evaluated the five programs on the strength of the evidence and the effectiveness of the intervention. Evidence of program effectiveness was found to range from low to moderate. However, empirical evidence alone is insufficient for selecting among the five programs, and contextual domains may offer the most relevant guidance by matching program features with goals of consumers, practitioners, and administrators.

From recovery programs to recovery-oriented practice? A qualitative study of mental health professionals' experiences when facilitating a recovery-oriented rehabilitation program.

PubMed

Dalum, Helle Stentoft; Pedersen, Inge Kryger; Cunningham, Harry; Eplov, Lene Falgaard

2015-12-01

The recovery model has influenced mental health services and fostered new standards for best practice. However, knowledge about how mental health care professionals (HCPs) experience recovery-oriented programs is sparse. This paper explores HCPs' experiences when facilitating a recovery-oriented rehabilitation program. The research question is how do HCPs experience a change in their attitude and practice when applying recovery-oriented programs? This paper draws on semi-structured in-depth qualitative interviews conducted with 16 HCPs experienced in facilitating a recovery-oriented rehabilitation program in either the USA or Denmark. Three themes emerged from the HCPs' reflections on changes in attitudes and practices: "Hopeful Attitude" captures a change in the HCPs' attitude toward a more positive view on the future for clients' living with mental illness; "A New Focus in the Dialogue With Clients" thematizes how the HCPs focus more on the individual's own goal for recovery rather than disease-induced goals in the dialog with clients; "A Person-Centered Role" comprises a shift in the professional role whereby the HCPs value the client's own ideas in addition to the professional's standards. This study supports the theory of the recovery model by its empirical findings and indications that when facilitating a recovery-oriented program, HCPs experience recovery-oriented changes in their attitude toward life with mental illness, and it alters their professional practice toward a stronger focus on client's own goals during treatment. More studies are needed to further clarify how changes in HCPs' attitudes translate into changes in mental health practices. Copyright © 2015 Elsevier Inc. All rights reserved.

Biochemically enhanced oil recovery and oil treatment

DOEpatents

Premuzic, E.T.; Lin, M.

1994-03-29

This invention relates to the preparation of new, modified organisms, through challenge growth processes, that are viable in the extreme temperature, pressure and pH conditions and salt concentrations of an oil reservoir and that are suitable for use in microbial enhanced oil recovery. The modified microorganisms of the present invention are used to enhance oil recovery and remove sulfur compounds and metals from the crude oil. 62 figures.

Diploma Recovery: High School Graduates' Perceptions of Online Credit Recovery Programming

ERIC Educational Resources Information Center

Currier, Clay W.

2017-01-01

This phenomenological case study explored student experiences in a technology-based credit recovery program at several central Texas high schools. Students shared their perceptions about utilizing technology-based credit recovery environments. Participants in this study were ten high school graduates who had completed credit recovery courses at…

26 CFR 1.43-0 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... unaffected reservoir volume. (3) Terminated projects. (4) Change in tertiary recovery method. (5) Examples.... (g) Examples. § 1.43-2Qualified enhanced oil recovery project. (a) Qualified enhanced oil recovery project. (b) More than insignificant increase. (c) First injection of liquids, gases, or other matter. (1...

Space Station Freedom environmental database system (FEDS) for MSFC testing

NASA Technical Reports Server (NTRS)

Story, Gail S.; Williams, Wendy; Chiu, Charles

1991-01-01

The Water Recovery Test (WRT) at Marshall Space Flight Center (MSFC) is the first demonstration of integrated water recovery systems for potable and hygiene water reuse as envisioned for Space Station Freedom (SSF). In order to satisfy the safety and health requirements placed on the SSF program and facilitate test data assessment, an extensive laboratory analysis database was established to provide a central archive and data retrieval function. The database is required to store analysis results for physical, chemical, and microbial parameters measured from water, air and surface samples collected at various locations throughout the test facility. The Oracle Relational Database Management System (RDBMS) was utilized to implement a secured on-line information system with the ECLSS WRT program as the foundation for this system. The database is supported on a VAX/VMS 8810 series mainframe and is accessible from the Marshall Information Network System (MINS). This paper summarizes the database requirements, system design, interfaces, and future enhancements.

Microbial enhanced oil recovery: Entering the log phase

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

Bryant, R.S.

1995-12-31

Microbial enhanced oil recovery (MEOR) technology has advanced internationally since 1980 from a laboratory-based evaluation of microbial processes to field applications. In order to adequately support the decline in oil production in certain areas, research on cost-effective technologies such as microbial enhanced oil recovery processes must focus on both near-term and long-term applications. Many marginal wells are desperately in need of an inexpensive improved oil recovery technology today that can assist producers in order to prevent their abandonment. Microbial enhanced waterflooding technology has also been shown to be an economically feasible technology in the United States. Complementary environmental research andmore » development will also be required to address any potential environmental impacts of microbial processes. In 1995 at this conference, the goal is to further document and promote microbial processes for improved oil recovery and related technology for solving environmental problems.« less

Mirror therapy enhances upper extremity motor recovery in stroke patients.

PubMed

Mirela Cristina, Luca; Matei, Daniela; Ignat, Bogdan; Popescu, Cristian Dinu

2015-12-01

The purpose of this study was to evaluate the effects of mirror therapy program in addition with physical therapy methods on upper limb recovery in patients with subacute ischemic stroke. 15 subjects followed a comprehensive rehabilitative treatment, 8 subjects received only control therapy (CT) and 7 subjects received mirror therapy (MT) for 30 min every day, five times a week, for 6 weeks in addition to the conventional therapy. Brunnstrom stages, Fugl-Meyer Assessment (upper extremity), the Ashworth Scale, and Bhakta Test (finger flexion scale) were used to assess changes in upper limb motor recovery and motor function after intervention. After 6 weeks of treatment, patients in both groups showed significant improvements in the variables measured. Patients who received MT showed greater improvements compared to the CT group. The MT treatment results included: improvement of motor functions, manual skills and activities of daily living. The best results were obtained when the treatment was started soon after the stroke. MT is an easy and low-cost method to improve motor recovery of the upper limb.

Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises.

PubMed

Han, Byung In; Song, Hyun Seok; Kim, Ji Soo

2011-12-01

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals.

Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

PubMed Central

Song, Hyun Seok; Kim, Ji Soo

2011-01-01

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals. PMID:22259614

26 CFR 1.43-2 - Qualified enhanced oil recovery project.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 1 2014-04-01 2013-04-01 true Qualified enhanced oil recovery project. 1.43-2 Section 1.43-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME... the tertiary recovery method; or (ii) Test or experimental injections. (2) Example. The following...

26 CFR 1.43-2 - Qualified enhanced oil recovery project.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 1 2011-04-01 2009-04-01 true Qualified enhanced oil recovery project. 1.43-2 Section 1.43-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY INCOME TAX INCOME... the tertiary recovery method; or (ii) Test or experimental injections. (2) Example. The following...

Narcotics reduction, quality and safety in gynecologic oncology surgery in the first year of enhanced recovery after surgery protocol implementation.

PubMed

Bergstrom, Jennifer E; Scott, Marla E; Alimi, Yewande; Yen, Ting-Tai; Hobson, Deborah; Machado, Karime K; Tanner, Edward J; Fader, Amanda N; Temkin, Sarah M; Wethington, Stephanie; Levinson, Kimberly; Sokolinsky, Sam; Lau, Brandyn; Stone, Rebecca L

2018-06-01

Enhanced Recovery After Surgery (ERAS) programs are mechanisms for achieving value-based improvements in surgery. This report provides a detailed analysis of the impact of an ERAS program on patient outcomes as well as quality and safety measures during implementation on a gynecologic oncology service at a major academic medical center. A retrospective review of gynecologic oncology patients undergoing elective laparotomy during the implementation phase of an ERAS program (January 2016 through December 2016) was performed. Patient demographics, surgical variables, postoperative outcomes, and adherence to core safety measures, including antimicrobial and venous thromboembolism (VTE) prophylaxis, were compared to a historical patient cohort (January 2015 through December 2015). Statistical analyses were performed using t-tests, Wilcoxon rank sum tests, and Chi squared tests. The inaugural 109 ERAS program participants were compared to a historical patient cohort (n=158). There was no difference in BMI, race, malignancy, or complexity of procedure between cohorts. ERAS patients required less narcotics (70.7 vs 127.4, p=0.007, oral morphine equivalents) and PCA use (32.1% vs. 50.6%, p=0.002). Despite this substantial reduction in narcotics, ERAS patients did not report more pain and in fact reported significantly less pain by postoperative day 3. There were no differences in length of stay (5days), complication rates (13.8% vs. 20.3%, p=0.17) or 30-day readmission rates (9.5 vs 11.9%, p=0.54) between ERAS and historical patients, respectively. Compliance with antimicrobial prophylaxis was 97.2%. However, 33.9% of ERAS patients received substandard preoperative VTE prophylaxis. ERAS program implementation resulted in reductions in narcotic requirements and PCA use without changes in length of stay or readmission rates. Compliance should be diligently audited during the implementation phase of ERAS programs, with special attention to adherence to pre-existing core safety measures. Copyright © 2018 Elsevier Inc. All rights reserved.

C-Reactive Protein and Procalcitonin as Early Markers of Septic Complications after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Within an Enhanced Recovery After Surgery Program.

PubMed

Muñoz, José Luis; Ruiz-Tovar, Jaime; Miranda, Elena; Berrio, Diana Lorena; Moya, Pedro; Gutiérrez, Manuel; Flores, Raquel; Picó, Carlos; Pérez, Ana

2016-05-01

The performance of most bariatric procedures within an Enhanced Recovery After Surgery (ERAS) programs has resulted in considerable advantages, including a reduction in the length of hospital stay to 2 to 3 days. However, some postoperative complications can appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 and 48 hours after laparoscopic sleeve gastrectomy (LSG) as bariatric procedure, for predicting septic complications, such a surgical site infection (SSI), in the postoperative course. A prospective study of 115 morbidly obese patients who underwent LSG within an ERAS program between 2012 and 2015 was conducted. Blood analysis was performed 24 and 48 hours after surgery. Acute-phase parameters (C-reactive protein [CRP], procalcitonin, and fibrinogen) and WBC count were investigated. Septic complications were observed in 13 patients (11.3%). Using receiver operating characteristic analysis at 24 hours postoperatively, a cutoff level of CRP at 70 mg/L achieved 85% sensitivity and 90% specificity for predicting SSI, and a cutoff level of procalcitonin at 0.2 ng/mL achieved 70% sensitivity and 90% specificity. At 48 hours postoperatively, a cutoff level of CRP at 150 mg/L and procalcitonin at 0.95 ng/mL achieved 100% sensitivity and 100% specificity for predicting SSI. The use of CRP and procalcitonin in the first day and especially in the second day postoperative can predict septic complications after LSG. This is most useful for patients within an ERAS program who will be discharged early. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Towards the integration of mental practice in rehabilitation programs. A critical review

PubMed Central

Malouin, Francine; Jackson, Philip L.; Richards, Carol L.

2013-01-01

Many clinical studies have investigated the use of mental practice (MP) through motor imagery (MI) to enhance functional recovery of patients with diverse physical disabilities. Although beneficial effects have been generally reported for training motor functions in persons with chronic stroke (e.g., reaching, writing, walking), attempts to integrate MP within rehabilitation programs have been met with mitigated results. These findings have stirred further questioning about the value of MP in neurological rehabilitation. In fact, despite abundant systematic reviews, which customarily focused on the methodological merits of selected studies, several questions about factors underlying observed effects remain to be addressed. This review discusses these issues in an attempt to identify factors likely to hamper the integration of MP within rehabilitation programs. First, the rationale underlying the use of MP for training motor function is briefly reviewed. Second, three modes of MI delivery are proposed based on the analysis of the research protocols from 27 studies in persons with stroke and Parkinson's disease. Third, for each mode of MI delivery, a general description of MI training is provided. Fourth, the review discusses factors influencing MI training outcomes such as: the adherence to MI training, the amount of training and the interaction between physical and mental rehearsal; the use of relaxation, the selection of reliable, valid and sensitive outcome measures, the heterogeneity of the patient groups, the selection of patients and the mental rehearsal procedures. To conclude, the review proposes a framework for integrating MP in rehabilitation programs and suggests research targets for steering the implementation of MP in the early stages of the rehabilitation process. The challenge has now shifted towards the demonstration that MI training can enhance the effects of regular therapy in persons with subacute stroke during the period of spontaneous recovery. PMID:24065903

Enhanced recovery pathways in pancreatic surgery: State of the art

PubMed Central

Pecorelli, Nicolò; Nobile, Sara; Partelli, Stefano; Cardinali, Luca; Crippa, Stefano; Balzano, Gianpaolo; Beretta, Luigi; Falconi, Massimo

2016-01-01

Pancreatic surgery is being offered to an increasing number of patients every year. Although postoperative outcomes have significantly improved in the last decades, even in high-volume centers patients still experience significant postoperative morbidity and full recovery after surgery takes longer than we think. In recent years, enhanced recovery pathways incorporating a large number of evidence-based perioperative interventions have proved to be beneficial in terms of improved postoperative outcomes, and accelerated patient recovery in the context of gastrointestinal, genitourinary and orthopedic surgery. The role of these pathways for pancreatic surgery is still unclear as high-quality randomized controlled trials are lacking. To date, non-randomized studies have shown that care pathways for pancreaticoduodenectomy and distal pancreatectomy are safe with no difference in postoperative morbidity, leading to early discharge and no increase in hospital readmissions. Hospital costs are reduced due to better organization of care and resource utilization. However, further research is needed to clarify the effect of enhanced recovery pathways on patient recovery and post-discharge outcomes following pancreatic resection. Future studies should be prospective and follow recent recommendations for the design and reporting of enhanced recovery pathways. PMID:27605881

American tertiary clinic-referred bipolar II disorder versus bipolar I disorder associated with hastened depressive recurrence.

PubMed

Dell'Osso, Bernardo; Shah, Saloni; Do, Dennis; Yuen, Laura D; Hooshmand, Farnaz; Wang, Po W; Miller, Shefali; Ketter, Terence A

2017-12-01

Bipolar disorder (BD) is a chronic, frequently comorbid condition characterized by high rates of mood episode recurrence and suicidality. Little is known about prospective longitudinal characterization of BD type II (BD II) versus type I (BD I) in relation to time to depressive recurrence and recovery from major depressive episode. We therefore assessed times to depressive recurrence/recovery in tertiary clinic-referred BD II versus I patients. Outpatients referred to Stanford BD Clinic during 2000-2011 were assessed with Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation and with Clinical Monitoring Form during up to 2 years of naturalistic treatment. Prevalence and clinical correlates of bipolar subtype in recovered (euthymic ≥8 weeks) and depressed patients were assessed. Kaplan-Meier analyses assessed the relationships between bipolar subtype and longitudinal depressive severity, and Cox proportional hazard analyses assessed the potential mediators. BD II versus BD I was less common among 105 recovered (39.0 vs. 61.0%, p = 0.03) and more common among 153 depressed (61.4 vs. 38.6%, p = 0.006) patients. Among recovered patients, BD II was associated with 6/25 (24.0%) baseline unfavorable illness characteristics/mood symptoms/psychotropics and hastened depressive recurrence (p = 0.015). Among depressed patients, BD II was associated with 8/25 (33.0%) baseline unfavorable illness characteristics/mood symptoms/psychotropics, but only non-significantly associated with delayed depressive recovery. BD II versus BD I was significantly associated with current depression and hastened depressive recurrence, but only non-significantly associated with delayed depressive recovery. Research on bipolar subtype relationships with depressive recurrence/recovery is warranted to enhance clinical management of BD patients.

Face Time: Educating Face Transplant Candidates

PubMed Central

Lamparello, Brooke M.; Bueno, Ericka M.; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C.; Pomahac, Bohdan

2013-01-01

Objective: Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. Methods: We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. Results: We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Conclusions: Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. Practice Implications: As face transplantation continues to develop, programs must create sound education programs that address patients’ needs and concerns to facilitate optimal care. PMID:23861990

Face time: educating face transplant candidates.

PubMed

Lamparello, Brooke M; Bueno, Ericka M; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C; Pomahac, Bohdan

2013-01-01

Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. As face transplantation continues to develop, programs must create sound education programs that address patients' needs and concerns to facilitate optimal care.

What Do Final Year Medical Students Understand by the Concept of Recovery? A Descriptive Qualitative Study.

PubMed

Newton-Howes, Giles; Beverley, Georgia; Ellis, Pete M; Gordon, Sarah; Levack, William

2018-06-01

Traditional teaching in psychiatry does little to address recovery concepts. The aim of this study was to evaluate the incorporation of a recovery-focused teaching program for medical students in psychiatry. Recovery, as understood by medical students who had participated in a recovery-focused teaching program, was assessed by thematic analysis of recovery-focused assessment reflections. Six major themes emerged from the recovery reflections from final year medical students are as follows: (1) recovery as a person-centered approach, (2) the need for social integration, (3) non-diagnostic framing of mental illness, (4) tensions between the medical model and personal recovery, (5) a patient's willingness to engage with mental health services, and (6) the development of a positive sense of self. A recovery teaching program was associated with students expressing knowledge of recovery principles and positive attitudes towards people with experience of mental illness. Psychiatric placements for medical students may benefit from a recovery focus.

Carbon Capture and Sequestration (CCS)

DTIC Science & Technology

2009-06-19

tons of CO2 underground each year to help recover oil and gas resources (enhanced oil recovery , or EOR).1 Also, potentially large amounts of CO2 ... CO2 will be used for enhanced gas recovery at a nearby natural gas field. See http://www.vattenfall.com/www/co2_en/ co2_en/Gemeinsame_Inhalte...for enhanced oil recovery (EOR).18 Transporting CO2 in pipelines is similar to transporting petroleum products like natural gas and oil; it requires

78 FR 38806 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

... enhanced oil recovery credit. DATES: Written comments should be received on or before August 26, 2013 to be... Oil Recovery Credit. OMB Number: 1545-1292. Regulation Project Number: PS-97-91 and PS-101-90 (TD 8448). Abstract: This regulation provides guidance concerning the costs subject to the enhanced oil recovery...

40 CFR 147.503 - Existing Class II (except enhanced recovery and hydrocarbon storage) wells authorized by rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class II (except enhanced recovery and hydrocarbon storage) wells authorized by rule. 147.503 Section 147.503 Protection of... recovery and hydrocarbon storage) wells authorized by rule. Maximum injection pressure. To meet the...

40 CFR 147.503 - Existing Class II (except enhanced recovery and hydrocarbon storage) wells authorized by rule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class II (except enhanced recovery and hydrocarbon storage) wells authorized by rule. 147.503 Section 147.503 Protection of... recovery and hydrocarbon storage) wells authorized by rule. Maximum injection pressure. To meet the...

Clinical evidence of traditional vs fast track recovery methodologies after total arthroplasty for osteoarthritic knee treatment. A retrospective observational study

PubMed Central

Castorina, Sergio; Guglielmino, Claudia; Castrogiovanni, Paola; Szychlinska, Marta Anna; Ioppolo, Francesco; Massimino, Paolo; Leonardi, Pietro; Maci, Christian; Iannuzzi, Maurizio; Di Giunta, Angelo; Musumeci, Giuseppe

2017-01-01

Summary Background During the last years, programs to enhance postoperative recovery and decrease morbidity after total knee arthroplasty, have been developed across a variety of surgical procedures and referred to as “Fast-Track Surgery”. In this study we aimed to find some answers in the management of osteoarthritic patients subjected to total knee arthroplasty, by using the Fast-Track methodology. To this purpose we evaluated parameters such as early mobilization of patients, better pain management, bleeding, possible complications, reduced hospitalization time, an overall improved recovery and patient satisfaction. Methods 132 patients were selected, of which, 95 treated with “Fast Track” method and 37 treated with traditional method (control group). All the patients were hospitalized and underwent the same rehabilitation program for the first three days after surgery. Results In both groups, the parameters of pain and deformity demonstrated the most rapid improvement, while those of function and movement were normalized as gradual and progressive improvement over the next 2 months. The different functional test used (Barthel, MRC, VAS) showed that the mean values were significantly greater in Fast Track group when compared to the control. Conclusion The results of the study confirm that the application of the Fast Track protocol in orthopaedics after total knee replacement results in rapid post-surgery recovery. Level of evidence IV. Case series, low-quality cohort or case-control studies. PMID:29387645

Enhancing Propriospinal Relays to Improve Functional Recovery After SCI

DTIC Science & Technology

2017-10-01

injury to the spinal cord. We have completed experiments for subtask 1 – 4 of specific aim 1 and subtasks 1 for specific aim 2. This Aim 2 of the...previously observed PAP2 to induce robust regeneration in a dorsal hemisection model and thought it might enhance regeneration and sprouting after the more...spontaneous recovery is often observed after incomplete injuries, leading to partial recovery over time. Spontaneous recovery is thought to be

Combined polymer-curcumin conjugate and ependymal progenitor/stem cell treatment enhances spinal cord injury functional recovery.

PubMed

Requejo-Aguilar, Raquel; Alastrue-Agudo, Ana; Cases-Villar, Marta; Lopez-Mocholi, Eric; England, Richard; Vicent, María J; Moreno-Manzano, Victoria

2017-01-01

Spinal cord injury (SCI) suffers from a lack of effective therapeutic strategies. Animal models of acute SCI have provided evidence that transplantation of ependymal stem/progenitor cells of the spinal cord (epSPCs) induces functional recovery, while systemic administration of the anti-inflammatory curcumin provides neuroprotection. However, functional recovery from chronic stage SCI requires additional enhancements in available therapeutic strategies. Herein, we report on a combination treatment for SCI using epSPCs and a pH-responsive polymer-curcumin conjugate. The incorporation of curcumin in a pH-responsive polymeric carrier mainchain, a polyacetal (PA), enhances blood bioavailability, stability, and provides a means for highly localized delivery. We find that PA-curcumin enhances neuroprotection, increases axonal growth, and can improve functional recovery in acute SCI. However, when combined with epSPCs, PA-curcumin also enhances functional recovery in a rodent model of chronic SCI. This suggests that combination therapy may be an exciting new therapeutic option for the treatment of chronic SCI in humans. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol.

PubMed

Murphy, Jacqueline; Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni; Leal, José

2018-03-14

Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures.We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation.Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be disseminated in a peer-reviewed academic journal and at conferences. CRD42017059473. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

PubMed Central

Siletz, Anaar; Faltermeier, Claire; Singer, Emily S.; Hu, Q. Lina; Ko, Clifford Y.; Kates, Stephen L.; Maggard-Gibbons, Melinda; Wick, Elizabeth

2018-01-01

Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or “bins.” For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials. Observational studies were included when higher levels of evidence were not available. Existing guidelines for perioperative care were also incorporated. For convenience, the components of care that are under the auspices of anesthesia providers will be reported separately. Recommendations for an evidence-based protocol were synthesized based on review of this evidence. Results: Eleven bins were identified. Preoperative risk factor bins included nutrition, diabetes mellitus, tobacco use, and anemia. Perioperative management bins included thromboprophylaxis, timing of surgery, fluid management, drain placement, early mobilization, early alimentation, and discharge criteria/planning. Conclusions: This review provides the evidence basis for an ERP for perioperative care of patients with hip fracture. PMID:29844947

Developing a supportive-educative program for patients with advanced heart failure within Orem's general theory of nursing.

PubMed

Jaarsma, T; Halfens, R; Senten, M; Abu Saad, H H; Dracup, K

1998-01-01

Recovery from heart failure and coping with the effects of this serious condition has a major impact on the self-care demand of patients with heart failure. To prevent potential self-care deficits, education and support are important issues in nursing care. The purpose of this article is to describe the development of a supportive-educative program that is designed to enhance self-care abilities of patients with heart failure. To structure nursing care for these patients and their families in a consistent systematized way, Orem's general theory of nursing is used as a frame of reference.

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

36 CFR 72.43 - Fundable elements: Recovery Action Program grants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Fundable elements: Recovery Action Program grants. 72.43 Section 72.43 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Development, Rehabilitation and Innovation § 72.43 Fundable elements: Recovery Action Program grants...

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: Waste Management Workshop After Action Report

DTIC Science & Technology

2012-03-01

approximately 2,300 curies of 137Cs (CsCl), and 1.5 tons of Ammonium nitrate / Fuel oil (ANFO). The explosive and the shielded CsCl sources are packaged into...previous findings. Experts also presented case studies on Hurricane Katrina, The British Petroleum (BP) Oil Spill, Fukushima Japan, Foot and Mouth...containers, conduct environmental monitoring. The waste streams were very organized into distinct categories. 1) oil , gasoline, pesticides, 2) batteries

Further Validation of Simulated Dynamic Interface Testing Techniques as a Tool in the Forecasting of Air Vehicle Deck Limits

DTIC Science & Technology

2010-01-01

UAV Autonomy program which includes intelligent reasoning for autonomy, technologies to enhance see and avoid capabilities, object identification ...along the ship’s base recovery course (BRC). The pilot then flies toward the stern of the ship, aligning his approach path with the ship’s lineup line...quiescent point identification . CONCLUSIONS The primary goal for conducting dynamic interface analysis is to expand existing operating envelopes and

Implementing program-wide awareness about recovery in a large mental health and addictions program.

PubMed

McVanel-Viney, Sarah; Younger, Jodi; Doyle, Winnie; Kirkpatrick, Helen

2006-01-01

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.

A comparative approach to assess drivers of success in mammalian conservation recovery programs.

PubMed

Crees, Jennifer J; Collins, Amy C; Stephenson, P J; Meredith, Helen M R; Young, Richard P; Howe, Caroline; Price, Mark R Stanley; Turvey, Samuel T

2016-08-01

The outcomes of species recovery programs have been mixed; high-profile population recoveries contrast with species-level extinctions. Each conservation intervention has its own challenges, but to inform more effective management it is imperative to assess whether correlates of wider recovery program success or failure can be identified. To contribute to evidence-based improvement of future conservation strategies, we conducted a global quantitative analysis of 48 mammalian recovery programs. We reviewed available scientific literature and conducted semistructured interviews with conservation professionals involved in different recovery programs to investigate ecological, management, and political factors associated with population recoveries or declines. Identifying and removing threats was significantly associated with increasing population trend and decreasing conservation dependence, emphasizing that populations are likely to continue to be compromised in the absence of effective threat mitigation and supporting the need for threat monitoring and adaptive management in response to new and potential threats. Lack of habitat and small population size were cited as limiting factors in 56% and 42% of recovery programs, respectively, and both were statistically associated with increased longer term dependence on conservation intervention, demonstrating the importance of increasing population numbers quickly and restoring and protecting habitat. Poor stakeholder coordination and management were also regularly cited by respondents as key weaknesses in recovery programs, indicating the importance of effective leadership and shared goals and management plans. Project outcomes were not influenced by biological or ecological variables such as body mass or habitat, which suggests that these insights into correlates of conservation success and failure are likely to be generalizable across mammals. © 2016 Society for Conservation Biology.

Electrophilic acid gas-reactive fluid, proppant, and process for enhanced fracturing and recovery of energy producing materials

DOEpatents

Fernandez, Carlos A.; Heldebrant, David J.; Bonneville, Alain H. R.; Jung, Hun Bok; Carroll, Kenneth

2016-09-20

An electrophilic acid gas-reactive fracturing and recovery fluid, proppant, and process are detailed. The fluid expands in volume to provide rapid and controlled increases in pressure that enhances fracturing in subterranean bedrock for recovery of energy-producing materials. Proppants stabilize openings in fractures and fissures following fracturing.

30 CFR 250.1165 - What must I do for enhanced recovery operations?

Code of Federal Regulations, 2011 CFR

2011-07-01

... reservoirs where these operations would result in an increase in ultimate recovery of oil or gas under sound... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What must I do for enhanced recovery operations... ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL...

Implementing enhanced recovery in gynaecology oncology.

PubMed

Rooth, Carolyn; Sidhu, Amar

Enhanced recovery involves the adoption of a selected number of evidence-based interventions used together and implemented in a 'fast track' care pathway during preoperative management, surgery itself and throughout the immediate postoperative period. Aimed at promoting effective patient recovery after surgery, this has been shown to improve the patient experience and facilitate early patient discharge following major surgery in some clinical areas (Department of Health, 2010). Applied to the clinical management and nursing care of women affected by gynaecological malignancies in one London tertiary referral centre hospital, enhanced recovery has been seen to improve patient experience and shorten the length of overall hospital stay. Implementation requires careful planning, appointment of key practitioners and commitment of the multidisciplinary team to realise successful outcomes. The authors' experience suggests that challenges are associated with changing practice and that while careful planning is essential, successes are to be gained, which significantly benefit patients, staff and the NHS Trust. In sharing this experience of implementing enhanced recovery, the authors hope to encourage others to consider application of this innovative strategy.

Pore Structure and Diagenetic Controls on Relative Permeability: Implications for Enhanced Oil Recovery and CO2 Storage

NASA Astrophysics Data System (ADS)

Feldman, J.; Dewers, T. A.; Heath, J. E.; Cather, M.; Mozley, P.

2016-12-01

Multiphase flow in clay-bearing sandstones of the Morrow Sandstone governs the efficiency of CO2 storage and enhanced oil recovery at the Farnsworth Unit, Texas. This formation is the target for enhanced oil recovery and injection of one million metric ton of anthropogenically-sourced CO2. The sandstone hosts eight major flow units that exhibit distinct microstructural characteristics due to diagenesis, including: "clean" macro-porosity; quartz overgrowths constricting some pores; ghost grains; intergranular porosity filled by microporous authigenic clay; and feldspar dissolution. We examine the microstructural controls on macroscale (core scale) relative permeability and capillary pressure behavior through: X-ray computed tomography, Robomet.3d, and focused ion beam-scanning electron microscopy imaging of the pore structure of the major flow units of the Morrow Sandstone; relative permeability and capillary pressure in the laboratory using CO2, brine, and oil at reservoir pressure and effective stress conditions. The combined data sets inform links between patterns of diagenesis and multiphase flow. These data support multiphase reservoir simulation and performance assessment by the Southwest Regional Partnership on Carbon Sequestration (SWP). Funding for this project is provided by the U.S. Department of Energy's National Energy Technology Laboratory through the SWP under Award No. DE-FC26-05NT42591. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

76 FR 2752 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

...-90 (T.D. 8448) Enhanced Oil Recovery Credit. Abstract: This regulation provides guidance concerning the costs subject to the enhanced oil recovery credit, the circumstances under which the credit is...

Effect of rhythm on the recovery from intense exercise.

PubMed

Eliakim, Michal; Bodner, Ehud; Meckel, Yoav; Nemet, Dan; Eliakim, Alon

2013-04-01

Motivational music (music that stimulates physical activity) was previously shown to enhance the recovery from intense exercise. The aim of the present study was to isolate the effect of rhythm (presumed to be the most effective factor of motivational music) on the recovery from intense exercise. Ten young adult active men (age: 26.1 ± 1.7 years) performed 6-minute run at peak oxygen consumption speed, at 3 separate visits (random order). At 1 visit, no music was played during the recovery after exercise. In the other visits, participants listened to motivational music that was previously shown to enhance recovery (a Western CD collection of greatest hits of all times converted to dance style, 140 b·min, strong bit, played by portable MP3 device using headphones at a volume of 70 dB) or only to the rhythm beats derived from the same songs. Mean heart rate (HR), rating of perceived exertion (RPE), number of steps (measured by step counter) and blood lactate concentrations were determined at 3, 6, 9, 12, and 15 minutes of the recovery. There was no difference in HR changes during the recovery at all conditions. Compared with the recovery without music, listening to motivational music during recovery was associated with significant greater number of steps, lower absolute lactate levels, and greater mean decrease of RPE. Listening only to rhythm beats, derived from the same music, during the recovery was associated with significant greater number of steps and lower absolute lactate levels compared to recovery without music. Music was significantly more effective than rhythm only in the absolute mean number of steps. The beneficial effect of both music and rhythm was greater toward the end of the recovery period. Results suggest that listening to music during nonstructured recovery can be used by professional athletes to enhance recovery from intense exercise. Rhythm plays a very important role in the effect of music on recovery and can be used to enhance nonstructured recovery when music is unavailable or when cultural barriers and individual music preferences may apply. The optimal music and rhythm selection is yet to be determined.

41 CFR 109-45.1002-3 - Precious metals recovery program monitor.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Precious metals recovery program monitor. 109-45.1002-3 Section 109-45.1002-3 Public Contracts and Property Management Federal... Metals § 109-45.1002-3 Precious metals recovery program monitor. The DPMO shall be the precious metals...

20 CFR 404.545 - When will we begin cross-program recovery from current monthly benefits?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When will we begin cross-program recovery from current monthly benefits? 404.545 Section 404.545 Employees' Benefits SOCIAL SECURITY... we begin cross-program recovery from current monthly benefits? (a) We will begin collecting the...

41 CFR 109-45.1002-3 - Precious metals recovery program monitor.

Code of Federal Regulations, 2010 CFR

2010-07-01

... program monitor. 109-45.1002-3 Section 109-45.1002-3 Public Contracts and Property Management Federal... UTILIZATION AND DISPOSAL 45-SALE, ABANDONMENT, OR DESTRUCTION OF PERSONAL PROPERTY 45.10-Recovery of Precious Metals § 109-45.1002-3 Precious metals recovery program monitor. The DPMO shall be the precious metals...

Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program.

PubMed

Pedrazzani, Corrado; Menestrina, Nicola; Moro, Margherita; Brazzo, Gianluca; Mantovani, Guido; Polati, Enrico; Guglielmi, Alfredo

2016-11-01

Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program. From March 2014 to March 2015, 48 patients were treated by laparoscopic resection and ERAS program for colorectal cancer and diverticular disease at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust. Among these, 24 patients received local wound infiltration plus TAP block (TAP block group) and 24 patients received local wound infiltration (control group). No differences were observed in baseline patient characteristics, clinical variables and surgical procedures between the two groups. Local wound infiltration plus TAP block allowed to achieve pain control despite a reduced use of opioid analgesics (P = 0.009). The adoption of TAP block resulted beneficial on the prevention of postoperative nausea (P = 0.002) and improvement of essential outcomes of ERAS program as recovery of bowel function (P = 0.005), urinary catheter removal (P = 0.003) and capability to tolerate oral diet (P = 0.027). TAP block plus local wound infiltration in the setting of laparoscopic colorectal surgery and ERAS program guarantees a reduced use of opioid analgesics and good pain control allowing the improvement of essential items of enhanced recovery pathways.

Impact of Illness Management and Recovery Programs on Hospital and Emergency Room Use by Medicaid Enrollees

PubMed Central

Salyers, Michelle P.; Rollins, Angela L.; Clendenning, Daniel; McGuire, Alan B.; Kim, Edward

2011-01-01

Objective Illness management and recovery is a structured program that helps consumers with severe mental illness learn effective ways to manage illness and pursue recovery goals. This study examined the impact of the program on health service utilization. Methods This was a retrospective cohort study of five assertive community treatment (ACT) teams in Indiana that implemented illness management and recovery. With Medicaid claims data from July 1, 2003, to June 30, 2008, panel data were created with person-months as the level of analysis, resulting in 14,261 observations, for a total of 498 unique individuals. Zero-inflated negative binomial regression models were used to predict hospitalization days and emergency room visits, including covariates of demographic characteristics, employment status, psychiatric diagnosis, and concurrent substance use disorder. The main predictor variables of interest were receipt of illness management and recovery services, dropout from the program, and program graduation status. Results Consumers who received some illness management and recovery services had fewer hospitalization days than those receiving only ACT. Graduates had fewer emergency room visits than did ACT-only consumers. Conclusions This is the first study to examine the impact of illness management and recovery on service utilization. Controlling for a number of background variables, the study showed that illness management and recovery programs were associated with reduced inpatient hospitalization and emergency room use over and above ACT. PMID:21532077

Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

PubMed Central

Chen, Jia-Ching; Shaw, Fu-Zen

2014-01-01

Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into “a training package”, based on the patient’s functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

40 CFR 147.903 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.903 Section 147.903 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1653 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1653 Section 147.1653 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.303 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.303 Section 147.303 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.2153 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.2153 Section 147.2153 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.103 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.103 Section 147.103 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.903 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.903 Section 147.903 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.303 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.303 Section 147.303 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.253 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.253 Section 147.253 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1353 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1353 Section 147.1353 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1453 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1453 Section 147.1453 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1153 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1153 Section 147.1153 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1353 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1353 Section 147.1353 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.253 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.253 Section 147.253 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.103 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.103 Section 147.103 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1653 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1653 Section 147.1653 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1153 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1153 Section 147.1153 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.1453 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.1453 Section 147.1453 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

40 CFR 147.2153 - Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Existing Class I, II (except enhanced recovery and hydrocarbon storage) and III wells authorized by rule. 147.2153 Section 147.2153 Protection of... recovery and hydrocarbon storage) and III wells authorized by rule. Maximum injection pressure. The owner...

Recovering Servicemembers and Veterans: Sustained Leadership Attention and Systematic Oversight Needed to Resolve Persistent Problems Affecting Care and Benefits

DTIC Science & Technology

2012-11-01

Freedom OND Operation New Dawn PTSD posttraumatic stress disorder RCP Recovery Coordination Program Recovering Warrior...Hotel Aftermath,” Washington Post (Washington, D.C.: Feb. 19, 2007); and “ Hospital Investigates Former Aid Chief,” Washington Post (Washington, D.C...the Federal Recovery Coordination Program (FRCP), the Recovery Coordination Program ( RCP ), and the Interagency Program Office. (See fig. 1.) Figure 1

The Role of Recovery Capital in the Community Reentry of Prisoners with Substance Use Disorders

ERIC Educational Resources Information Center

Lyons, Thomas; Lurigio, Arthur J.

2010-01-01

This article examines the concept of recovery capital, which is based on a socioeconomic understanding of addiction. Substance abuse treatment programs, especially those in the criminal justice system, should recognize the important relationship between abstinence and recovery capital. A program is described which fosters recovery capital among…

Cleanups In My Community (CIMC) - Recovery Act Funded Cleanups, National Layer

EPA Pesticide Factsheets

This data layer provides access to Recovery Act Funded Cleanup sites as part of the CIMC web service. The American Recovery and Reinvestment Act was signed into law by President Obama on February 17th, 2009 and all reporting on ARRA for these 3 programs was complete as of 2013. Out of the five EPA programs that distributed recovery act funding, three of them were cleanup programs: Brownfields, Superfund and Leaking Underground Storage Tanks. CIMC provides information on site cleanups that received ARRA Recovery Act funding for Superfund and Brownfields, but not Leaking Underground Storage Tanks. Data for Brownfields came from the ACRES database. Data for Superfund came from the Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) database. Data in CIMC no longer need to be updated for the ARRA program. For information on all EPA Recovery Act funded work, please see: http://archive.epa.gov/recovery/web/html/ and http://epamap17.epa.gov/arra/.

A review on applications of nanotechnology in the enhanced oil recovery part B: effects of nanoparticles on flooding

NASA Astrophysics Data System (ADS)

Cheraghian, Goshtasp; Hendraningrat, Luky

2016-11-01

Chemical flooding is of increasing interest and importance due to high oil prices and the need to increase oil production. Research in nanotechnology in the petroleum industry is advancing rapidly, and an enormous progress in the application of nanotechnology in this area is to be expected. The nanotechnology has been widely used in several other industries, and the interest in the oil industry is increasing. Nanotechnology has the potential to profoundly change enhanced oil recovery and to improve mechanism of recovery, and it is chosen as an alternative method to unlock the remaining oil resources and applied as a new enhanced oil recovery method in last decade. This paper therefore focuses on the reviews of the application of nanotechnology in chemical flooding process in oil recovery and reviews the applications of nanomaterials for improving oil recovery that have been proposed to explain oil displacement by polymer flooding within oil reservoirs, and also this paper highlights the research advances of polymer in oil recovery. Nanochemical flooding is an immature method from an application point of view.

Continuous wound infiltration or epidural analgesia for pain prevention after hepato-pancreato-biliary surgery within an enhanced recovery program (POP-UP trial): study protocol for a randomized controlled trial.

PubMed

Mungroop, Timothy H; Veelo, Denise P; Busch, Olivier R; van Dieren, Susan; van Gulik, Thomas M; Karsten, Tom M; de Castro, Steve M; Godfried, Marc B; Thiel, Bram; Hollmann, Markus W; Lirk, Philipp; Besselink, Marc G

2015-12-09

Postoperative pain prevention is essential for the recovery of surgical patients. Continuous (thoracic) epidural analgesia (CEA) is routinely practiced for major abdominal surgery, but evidence is conflicting on its benefits in this setting. Potential disadvantages of epidural analgesia are a) perioperative hypotension, frequently requiring additional intravenous fluid boluses or prolonged use of vasopressors; b) relatively high failure rates, with periods of inadequate analgesia; and c) the risk of rare but serious, at times persistent, neurologic complications (hematoma and abscess). In recent years, continuous (subfascial) wound infiltration (CWI) plus patient-controlled analgesia (PCA) has been suggested as a safe and reliable alternative, which does not have the previously mentioned disadvantages, but evidence from multicenter trials targeting a specific surgical population is lacking. We hypothesize that CWI+PCA is equally as effective as CEA, without the mentioned disadvantages. POP-UP is a randomized controlled noninferiority multicenter trial, recruiting adult patients scheduled for elective hepato-pancreato-biliary surgery via laparotomy in an enhanced recovery setting. A total of 102 patients are being randomly allocated to CWI+PCA or (P)CEA. Our primary endpoint is the Overall Benefit of Analgesic Score (OBAS), a composite endpoint of pain intensity, opioid-related adverse effects and patient satisfaction, during postoperative days 1 to 5. Secondary endpoints include length of the hospital stay, number of patients with severe pain, and the use of rescue medication. POP-UP is a pragmatic trial that will provide evidence of whether CWI+PCA is noninferior as compared to (P)CEA after elective hepato-pancreato-biliary surgery via laparotomy in an enhanced recovery setting. If this hypothesis is confirmed, this finding could contribute to more widespread implementation of this technique, especially when the described disadvantages of epidural analgesia are less often observed with CWI+PCA. Netherlands Trial Register NTR4948 (registry date 2 January 2015).

26 CFR 1.43-7 - Effective date of regulations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... with a qualified enhanced oil recovery project. The provisions of § 1.43-3 are effective for taxable... January 1, 1992, in connection with a qualified enhanced oil recovery project, taxpayers must take...

Helping Low-Achieving First-Grade Readers: A Program Combining Reading Recovery Tutoring and Small-Group Instruction.

ERIC Educational Resources Information Center

Dorn, Linda; Allen, Anne

1995-01-01

Evaluates an approach that supplemented existing Reading Recovery programs with small-group, early literacy instruction in 28 Arkansas public schools. The program enabled many children to receive timely support. When space became available in Reading Recovery, these children made accelerated progress and were discontinued earlier than children who…

A home for body and soul: Substance using women in recovery

PubMed Central

2013-01-01

Background We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Method Data were gathered about women’s experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Results Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long-term multi-phase recovery, and variety and choice of programming. Conclusion A key barrier to the addiction recovery of women is the present framework of addiction treatment, as well as current drug laws, policies and service delivery systems. The expectation of women is that harm reduction-based recovery services will facilitate safe, supportive transitioning from the point of the decision to access services, through independent living with community integration. PMID:24359089

A home for body and soul: substance using women in recovery.

PubMed

Kruk, Edward; Sandberg, Kathryn

2013-12-20

We report on an in-depth qualitative study of 28 active and former substance addicted women of low or marginal income on the core components of a harm reduction-based addiction recovery program. These women volunteered to be interviewed about their perceptions of their therapeutic needs in their transition from substance addiction to recovery. Data were gathered about women's experiences and essential needs in addiction recovery, what helped and what hindered their past efforts in recovery, and their views of what would constitute an effective woman-centred recovery program. The research was based upon the experience and knowledge of the women in interaction with their communities and with recovery programs. The study was informed by harm reduction practice principles that emphasize the importance of individual experience in knowledge construction, reduction of harm, low threshold access, and the development of a hierarchy of needs in regard to addiction recovery. Three core needs were identified by study participants: normalization and structure, biopsychosocial-spiritual safety, and social connection. What hindered recovery efforts as identified by participants was an inner urban location, prescriptive recovery, invidious treatment, lack of safety, distress-derived distraction, problem-focused treatment, coercive elements of mutual support groups, and social marginalization. What helped included connection in counselling and therapy, multidisciplinary service provision, spirituality focus, opportunities for learning and work, and a safe and flexible structure. Core components of an effective recovery program identified by women themselves stand in contrast to the views of service providers and policymakers, particularly in regard to the need for a rural location for residential programs, low threshold access, multidisciplinary service provision of conventional and complementary modalities and therapies for integrated healing, long-term multi-phase recovery, and variety and choice of programming. A key barrier to the addiction recovery of women is the present framework of addiction treatment, as well as current drug laws, policies and service delivery systems. The expectation of women is that harm reduction-based recovery services will facilitate safe, supportive transitioning from the point of the decision to access services, through independent living with community integration.

Carbon Consequences of Forest Disturbance and Recovery Across the Conterminous United States

NASA Technical Reports Server (NTRS)

Williams, Christopher A.; Collatz, G. James; Masek, Jeffrey; Goward, Samuel N.

2012-01-01

Forests of North America are thought to constitute a significant long term sink for atmospheric carbon. The United States Forest Service Forest Inventory and Analysis (FIA) program has developed a large data base of stock changes derived from consecutive estimates of growing stock volume in the US. These data reveal a large and relatively stable increase in forest carbon stocks over the last two decades or more. The mechanisms underlying this national increase in forest stocks may include recovery of forests from past disturbances, net increases in forest area, and growth enhancement driven by climate or fertilization by CO2 and Nitrogen. Here we estimate the forest recovery component of the observed stock changes using FIA data on the age structure of US forests and carbon stocks as a function of age. The latter are used to parameterize forest disturbance and recovery processes in a carbon cycle model. We then apply resulting disturbance/recovery dynamics to landscapes and regions based on the forest age distributions. The analysis centers on 28 representative climate settings spread about forested regions of the conterminous US. We estimate carbon fluxes for each region and propagate uncertainties in calibration data through to the predicted fluxes. The largest recovery-driven carbon sinks are found in the South central, Pacific Northwest, and Pacific Southwest regions, with spatially averaged net ecosystem productivity (NEP) of about 100 g C / square m / a driven by forest age structure. Carbon sinks from recovery in the Northeast and Northern Lake States remain moderate to large owing to the legacy of historical clearing and relatively low modern disturbance rates from harvest and fire. At the continental scale, we find a conterminous U.S. forest NEP of only 0.16 Pg C/a from age structure in 2005, or only 0.047 Pg C/a of forest stock change after accounting for fire emissions and harvest transfers. Recent estimates of NEP derived from inventory stock change, harvest, and fire data show twice the NEP sink we derive from forest age distributions. We discuss possible reasons for the discrepancies including modeling errors and the possibility of climate and/or fertilization (CO2 or N) growth enhancements.

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: Damage Assessment Building Abandonment After Action Report

DTIC Science & Technology

2012-04-17

nitrate / Fuel oil (ANFO). The explosive and the shielded CsCl sources are packaged into bombs and loaded onto a truck. The total explosive yield in...Transportation Eric Jacobs State of Colorado Laura Johnston Dewberry Carl Miller Colorado Springs OEM John Miller American Red Cross Matthew...the health effects of the contamination will be. Scenario Terrorist obtain approximately 2,300 curies of 137 Cs (CsCl), and 1.5 tons of Ammonium

Enhanced oil recovery utilizing high-angle wells in the Frontier Formation, Badger Basin Field, Park County, Wyoming. Quarterly technical progress report, 1 March 1993--30 June 1993

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

Fortmann, R.G.; Walker, J.P.

1993-07-10

Sierra Energy Company`s targeted goals during the third quarter of this Cooperative Agreement included the following objectives from the Statement of Work: in Phase 2A, completion of subtask 2.1.2--acquire best possible field data in the 3-D seismic program; and initiation of Subtask 2.1.3--process acquired 3-D seismic data. Technical progress is described for these tasks.

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: Private Sector Economic Resiliency & Restoration - Part 2 After Action Report

DTIC Science & Technology

2012-05-15

and strategic reimaging efforts of U. S. and Canadian company-owned restaurants . At the time of Hurricane Katrina, Mr. Helton owned 206 Burger...King Franchises of which 115 were affected by the storm. He shared with participants his story and lessons learned. Mr. Helton then stayed to...Helton owned 115 Burger King Restaurants affected by the hurricane. After making sure his family was secure, Mr. Helton’s next priority was to be

Speaking-related changes in cortical functional connectivity associated with assisted and spontaneous recovery from developmental stuttering.

PubMed

Kell, Christian A; Neumann, Katrin; Behrens, Marion; von Gudenberg, Alexander W; Giraud, Anne-Lise

2018-03-01

We previously reported speaking-related activity changes associated with assisted recovery induced by a fluency shaping therapy program and unassisted recovery from developmental stuttering (Kell et al., Brain 2009). While assisted recovery re-lateralized activity to the left hemisphere, unassisted recovery was specifically associated with the activation of the left BA 47/12 in the lateral orbitofrontal cortex. These findings suggested plastic changes in speaking-related functional connectivity between left hemispheric speech network nodes. We reanalyzed these data involving 13 stuttering men before and after fluency shaping, 13 men who recovered spontaneously from their stuttering, and 13 male control participants, and examined functional connectivity during overt vs. covert reading by means of psychophysiological interactions computed across left cortical regions involved in articulation control. Persistent stuttering was associated with reduced auditory-motor coupling and enhanced integration of somatosensory feedback between the supramarginal gyrus and the prefrontal cortex. Assisted recovery reduced this hyper-connectivity and increased functional connectivity between the articulatory motor cortex and the auditory feedback processing anterior superior temporal gyrus. In spontaneous recovery, both auditory-motor coupling and integration of somatosensory feedback were normalized. In addition, activity in the left orbitofrontal cortex and superior cerebellum appeared uncoupled from the rest of the speech production network. These data suggest that therapy and spontaneous recovery normalizes the left hemispheric speaking-related activity via an improvement of auditory-motor mapping. By contrast, long-lasting unassisted recovery from stuttering is additionally supported by a functional isolation of the superior cerebellum from the rest of the speech production network, through the pivotal left BA 47/12. Copyright © 2017 Elsevier Inc. All rights reserved.

Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol

PubMed Central

Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni

2018-01-01

Introduction Hip and knee replacement represents a significant burden to the UK healthcare system. ‘Enhanced recovery’ pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. Methods and analysis A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures. We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation. Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. Ethics and dissemination This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be disseminated in a peer-reviewed academic journal and at conferences. PROSPERO registration number CRD42017059473. PMID:29540418

78 FR 67799 - Qualification, Service, and Use of Crewmembers and Aircraft Dispatchers

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-12

...This final rule revises the training requirements for pilots in air carrier operations. The regulations enhance air carrier pilot training programs by emphasizing the development of pilots' manual handling skills and adding safety-critical tasks such as recovery from stall and upset. The final rule also requires enhanced runway safety training and pilot monitoring training to be incorporated into existing requirements for scenario-based flight training and requires air carriers to implement remedial training programs for pilots. The FAA expects these changes to contribute to a reduction in aviation accidents. Additionally, the final rule revises recordkeeping requirements for communications between the flightcrew and dispatch; ensures that personnel identified as flight attendants have completed flight attendant training and qualification requirements; provides civil enforcement authority for making fraudulent statements; and, provides a number of conforming and technical changes to existing air carrier crewmember training and qualification requirements. The final rule also includes provisions that provide opportunities for air carriers to modify training program requirements for flightcrew members when the air carrier operates multiple aircraft types with similar design and flight handling characteristics.

The Development of a Collegiate Recovery Program: Applying Social Cognitive Theory within a Social Ecological Framework

ERIC Educational Resources Information Center

Beeson, Eric T.; Whitney, Jennifer M.; Peterson, Holly M.

2017-01-01

Background: Collegiate recovery programs (CRPs) are emerging as a strategy to provide after-care support to students in recovery from substance use disorders (SUDs) at institutions of higher education. CRPs are an innovative strategy for Health Educators to support the personal, academic, and professional goals of students in recovery. Purpose:…

Synthesis of ZnO nanoparticles for oil-water interfacial tension reduction in enhanced oil recovery

NASA Astrophysics Data System (ADS)

Soleimani, Hassan; Baig, Mirza Khurram; Yahya, Noorhana; Khodapanah, Leila; Sabet, Maziyar; Demiral, Birol M. R.; Burda, Marek

2018-02-01

Nanoparticles show potential use in applications associated with upstream oil and gas engineering to increase the performance of numerous methods such as wettability alteration, interfacial tension reduction, thermal conductivity and enhanced oil recovery operations. Surface tension optimization is an important parameter in enhanced oil recovery. Current work focuses on the new economical method of surface tension optimization of ZnO nanofluids for oil-water interfacial tension reduction in enhanced oil recovery. In this paper, zinc oxide (ZnO) nanocrystallites were prepared using the chemical route and explored for enhanced oil recovery (EOR). Adsorption of ZnO nanoparticles (NPs) on calcite (111) surface was investigated using the adsorption locator module of Materials Studio software. It was found that ZnO nanoparticles show maximum adsorption energy of - 253 kcal/mol. The adsorption of ZnO on the rock surface changes the wettability which results in capillary force reduction and consequently increasing EOR. The nanofluids have been prepared by varying the concentration of ZnO nanoparticles to find the optimum value for surface tension. The surface tension (ST) was calculated with different concentration of ZnO nanoparticles using the pendant drop method. The results show a maximum value of ST 35.57 mN/m at 0.3 wt% of ZnO NPs. It was found that the nanofluid with highest surface tension (0.3 wt%) resulted in higher recovery efficiency. The highest recovery factor of 11.82% at 0.3 wt% is due to the oil/water interfacial tension reduction and wettability alteration.

75 FR 37456 - Green Retrofit Program of Title XII of the American Recovery and Reinvestment Act of 2009

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-55] Green Retrofit Program of Title XII of the American Recovery and Reinvestment Act of 2009 AGENCY: Office of the Chief Information... Title of Proposal: Green Retrofit Program of Title XII of the American Recovery and Reinvestment Act of...

Columbia River Basin Fish and Wildlife Program Annual Implementation Work Plan for Fiscal Year 1994.

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

United States. Bonneville Power Administration; Northwest Power Planning Council; Columbia Basin Fish and Wildlife Authority

1994-02-01

This document is part of Bonneville Power Administration`s program to protect, mitigate, and enhance fish and wildlife affected by the development and operation of hydroelectric facilities on the Columbia River and its tributaries. The Fiscal Year 1994 (FY 1994) Annual Implementation Work Plan (AIWP) presents Bonneville Power Administration`s (BPA`s) plan for implementation of the Columbia River Basin Fish and Wildlife Program (Program). The purpose of the Program is to guide BPA and other federal agencies in carrying out their responsibilities to protect, mitigate, and enhance fish and wildlife in the Columbia River Basin. Phase I began the work of salmonmore » recovery with certain fast-track measures completed in August 1991. Phase II dealt with Snake and Columbia river flow and salmon harvest and was completed in December 1991. Phase III dealt with system-wide habitat and salmon production issues and was completed in September 1992. Phase IV planning, focusing on resident fish and wildlife, began in August 1993, and was finished and adopted in November 1993. This report provides summaries of the ongoing and new projects for FY 1994 within the areas of juvenile migration, adult migration, salmon harvest, production and habitat, coordinated implementation, monitoring and evaluation, resident fish, and wildlife.« less

Industrial energy-efficiency improvement program

NASA Astrophysics Data System (ADS)

1980-12-01

The industrial energy efficiency improvement program to accelerate market penetration of new and emerging industrial technologies is described. Practices which will improve energy efficiency, encourage substitution of more plentiful domestic fuels, and enhance recovery of energy and materials from industrial waste streams are enumerated. Specific reports from the chemicals and allied products; primary metals; petroleum and coal products; stone, clay, and glass, paper and allied products; food and kindred products; fabricated metals; transportation equipment; machinery (except electrical); textile mill products; rubber and miscellaneous plastics; electrical and electronic equipment; lumber and wood; and tobacco products are discussed. A summary on progress in the utilization of recovered materials, and an analysis of industrial fuel mix is presented.

Programmed Physical Exertion in Recovery From Sports-Related Concussion: A Randomized Pilot Study.

PubMed

Maerlender, Arthur; Rieman, Wanda; Lichtenstein, Jonathan; Condiracci, C

2015-01-01

Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery.

An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta

PubMed Central

Thanh, Nguyen X.; Chuck, Anderson W.; Wasylak, Tracy; Lawrence, Jeannette; Faris, Peter; Ljungqvist, Olle; Nelson, Gregg; Gramlich, Leah M.

2016-01-01

Background In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. Methods We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions. We estimated the net health care costs/savings and the return on investment (ROI) associated with those impacts for post-ERAS patients using a decision analytic modelling technique. Results We included 331 pre- and 1295 post-ERAS patients in our analyses. ERAS was associated with a reduction in all HSU outcomes except visits to specialists. However, only the reduction in primary LOS was significant. The net health system savings were estimated at $2 290 000 (range $1 191 000–$3 391 000), or $1768 (range $920–$2619) per patient. The probability for the program to be cost-saving was 73%–83%. In terms of ROI, every $1 invested in ERAS would bring $3.8 (range $2.4–$5.1) in return. Conclusion The initial phase of ERAS implementation for colorectal surgery in Alberta is cost-saving. The total savings has the potential to be more substantial when ERAS is spread for other surgical protocols and across additional sites. PMID:28445024

Regional decision-making and competitive funding : metropolitan planning organizations and the transportation investments generating economic recovery program.

DOT National Transportation Integrated Search

2014-08-01

Transportation benefits and economic stimulus were behind the creation of the Transportation Investment Generating Economic Recovery (TIGER) program in 2009. New transportation funding programs exist in a landscape of other programs, and in addition ...

Flow behavior of N2 huff and puff process for enhanced oil recovery in tight oil reservoirs.

PubMed

Lu, Teng; Li, Zhaomin; Li, Jian; Hou, Dawei; Zhang, Dingyong

2017-11-16

In the present work, the potential of N 2 huff and puff process to enhance the recovery of tight oil reservoir was evaluated. N 2 huff and puff experiments were performed in micromodels and cores to investigate the flow behaviors of different cycles. The results showed that, in the first cycle, N 2 was dispersed in the oil, forming the foamy oil flow. In the second cycle, the dispersed gas bubbles gradually coalesced into the continuous gas phase. In the third cycle, N 2 was produced in the form of continuous gas phase. The results from the coreflood tests showed that, the primary recovery was only 5.32%, while the recoveries for the three N 2 huff and puff cycles were 15.1%, 8.53% and 3.22%, respectively.The recovery and the pressure gradient in the first cycle were high. With the increase of huff and puff cycles, and the oil recovery and the pressure gradient rapidly decreased. The oil recovery of N 2 huff and puff has been found to increase as the N 2 injection pressure and the soaking time increased. These results showed that, the properly designed and controlled N 2 huff and puff process can lead to enhanced recovery of tight oil reservoirs.

Engineering the biosynthesis of novel rhamnolipids in Escherichia coli for enhanced oil recovery.

PubMed

Han, L; Liu, P; Peng, Y; Lin, J; Wang, Q; Ma, Y

2014-07-01

The interfacial tension of rhamnolipids and their applications in enhanced oil recovery are dependent on their chemical structures and compositions. To improve their performances of interfacial tension and enhanced oil recovery, the engineered strategies were applied to produce novel rhamnolipids with different chemical structures and compositions. By introducing different key genes for rhamnolipid biosynthesis, Escherichia coli was firstly constructed to produce rhamnolipids that showed different performances in interfacial tension from those from Pseudomonas aeruginosa due to the different fatty acyl compositions. Then, the mutant RhlBs were created by directed evolution and subsequent site-directed mutagenesis and resulted in the production of the novel rhamnolipids with the different performances in interfacial tension as well as enhanced oil recovery. Lastly, computational modelling elucidates that the single amino acid mutation at the position 168 in RhlB would change the volume of binding pocket for substrate and thus affect the selectivity of rhamnolipid formation in E. coli. The novel rhamnolipids that showed the improved performances of interfacial tension and the potential different applications in enhanced oil recovery were successfully produced by engineered E. coli. This study proved that the combination of metabolic engineering and protein engineering is an important engineered strategy to produce many novel metabolites in micro-organisms. © 2014 The Society for Applied Microbiology.

The Impact of an Online Credit Recovery Program on Students in Grades Nine and Ten

ERIC Educational Resources Information Center

Capone, Andrew P.

2017-01-01

Students who fall behind in credits in their first years of high school are at risk of not graduating. William Penn High School (WPHS) offers students who fail courses the opportunity to make up lost credits by using an online option called the WPHS Credit Recovery Program. The WPHS Credit Recovery Program is designed to keep students on the path…

Reading Recovery versus Informal Reading Instruction on the Reading Achievement of Preschoolers at the End of First Grade.

ERIC Educational Resources Information Center

Jelks-Emmanuel, Merry

A study examined the effectiveness of a Reading Recovery program. Subjects, 14 first-grade students who received the Reading Recovery program and 20 first-grade students who did not receive the program, were administered the Iowa Tests of Basic Skills in the spring of 1994. The subject population was comprised of 100% minority students attending…

Using recovery modalities between training sessions in elite athletes: does it help?

PubMed

Barnett, Anthony

2006-01-01

Achieving an appropriate balance between training and competition stresses and recovery is important in maximising the performance of athletes. A wide range of recovery modalities are now used as integral parts of the training programmes of elite athletes to help attain this balance. This review examined the evidence available as to the efficacy of these recovery modalities in enhancing between-training session recovery in elite athletes. Recovery modalities have largely been investigated with regard to their ability to enhance the rate of blood lactate removal following high-intensity exercise or to reduce the severity and duration of exercise-induced muscle injury and delayed onset muscle soreness (DOMS). Neither of these reflects the circumstances of between-training session recovery in elite athletes. After high-intensity exercise, rest alone will return blood lactate to baseline levels well within the normal time period between the training sessions of athletes. The majority of studies examining exercise-induced muscle injury and DOMS have used untrained subjects undertaking large amounts of unfamiliar eccentric exercise. This model is unlikely to closely reflect the circumstances of elite athletes. Even without considering the above limitations, there is no substantial scientific evidence to support the use of the recovery modalities reviewed to enhance the between-training session recovery of elite athletes. Modalities reviewed were massage, active recovery, cryotherapy, contrast temperature water immersion therapy, hyperbaric oxygen therapy, nonsteroidal anti-inflammatory drugs, compression garments, stretching, electromyostimulation and combination modalities. Experimental models designed to reflect the circumstances of elite athletes are needed to further investigate the efficacy of various recovery modalities for elite athletes. Other potentially important factors associated with recovery, such as the rate of post-exercise glycogen synthesis and the role of inflammation in the recovery and adaptation process, also need to be considered in this future assessment.

Sustainability of anaesthesia components of an enhanced recovery program (ERP) in colorectal and orthopaedics surgery.

PubMed

Beloeil, Helene; Slim, Karem

2018-02-15

Sustainability of ERP is a challenge and data are scarce on the subject. The aim of this study was to assess if application of enhanced recovery elements through the Francophone Group of Enhanced Recovery after Surgery (Grace) in the anaesthesia management was sustainable 2 years after its implementation. We conducted a retrospective analysis of the prospective Grace database between October 2014 and October 2016. The evolution of each recommendation item over time was analysed using non-parametric Spearman correlation coefficient. A total of 67 and 43 centres corresponding to 2067 and 3022 patients participated to the Grace audit in colorectal and orthopaedics surgery, respectively. Colorectal surgery: Mean length of stay was 5 (±4) days and readmission rate was 6.6%. Application of most items did not statistically change. It worsened over time for PONV prophylaxis (P=0.01) and prevention of intraoperative hypothermia (P=0.02); and improved for NSAID administration (P=0.01). Orthopaedics surgery: Mean length of stay was 3 (±2) days and readmission rate was 1.7%. There was a trend towards improvement for most items. It reached statistical significance for PONV prophylaxis (P=0.001), limited preoperative fasting (P=0.01). While the use of a perineural catheter (P=0.001) decreased over time, infiltration of the surgical site statistically increased (P=0.05). This study shows on a large scale a trend towards less application of all ERP items over time. Continuous audits should be encouraged to expect further improvements. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Introduction of enhanced recovery for elective caesarean section enabling next day discharge: a tertiary centre experience.

PubMed

Wrench, I J; Allison, A; Galimberti, A; Radley, S; Wilson, M J

2015-05-01

The widespread adoption of enhanced recovery programmes in various surgical specialties has resulted in patient benefits including reduced morbidity, reduced length of stay and an earlier return to normal activities. This evidence, along with the increased financial pressures in the UK National Health Service, has led many units to consider introducing such a programme for obstetric surgery. We report our experience in setting up an enhanced recovery programme for women undergoing elective caesarean section and a prospective analysis of factors that influence length of stay. An enhanced recovery pathway was designed by a multidisciplinary team and introduced in March 2012. Factors influencing length of stay were determined using a log normal model. The proportion of women discharged on Day 1 increased from 1.6% in the first quarter of 2012 to 25.2% in the first quarter of 2014. The 30-day readmission rate was 4.4% for those discharged on Day 1 and 5.6% for Day 2. Earlier gestation, multiple birth, intention to breast feed, longer surgery and more time in the post-anaesthesia recovery unit were all independently associated with a longer postoperative stay. Women presenting for obstetric surgery with the indication "one previous caesarean section" were more likely to leave hospital earlier compared to most other indications. An enhanced recovery programme was successfully introduced into our unit. Many of the interventions were straightforward and could be adopted easily elsewhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

75 FR 69037 - Medicaid Program; Recovery Audit Contractors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... [CMS-6034-P] RIN 0938-AQ19 Medicaid Program; Recovery Audit Contractors AGENCY: Centers for Medicare... Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs... RACs coordinate with other contractors and entities auditing Medicaid providers and with State and...

Enhancing and Promoting Recovery In Attentionally Impaired People Diagnosed With Schizophrenia: Results From A Randomized Controlled Trial Of Attention Shaping In A Partial Hospital Program.

PubMed

Silverstein, Steven M; Roché, Matthew W; Khan, Zaynab; Carson, Sarah J; Malinovsky, Igor; Newbill, William A; Menditto, Anthony A; Wilkniss, Sandra M

2014-01-01

The attentional impairments associated with schizophrenia are well-documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who are being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside of the immediate treatment context to both other treatment groups and real world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments.

Integrated Energy System with Beneficial Carbon Dioxide (CO{sub 2}) Use

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

Sun, Xiaolei; Rink, Nancy

2011-04-30

To address the public concerns regarding the consequences of climate change from anthropogenic carbon dioxide (CO{sub 2}) emissions, the U.S. Department of Energy National Energy Technology Laboratory (DOE-NETL) is actively funding a CO{sub 2} management program to develop technologies capable of reducing the CO{sub 2} emissions from fossil fuel power plants and other industrial facilities. Over the past decade, this program has focused on reducing the costs of carbon capture and storage technologies. Recently, DOE-NETL launched an alternative CO{sub 2} mitigation program focusing on beneficial CO{sub 2} reuse and supporting the development of technologies that mitigate emissions by converting CO{submore » 2} to solid mineral form that can be utilized for enhanced oil recovery, in the manufacturing of concrete or as a benign landfill, in the production of valuable chemicals and/or fuels. This project was selected as a CO{sub 2} reuse activity which would conduct research and development (R&D) at the pilot scale via a cost-shared Cooperative Agreement number DE-FE0001099 with DOE-NETL and would utilize funds setaside by the American Recovery and Reinvestment Act (ARRA) of 2009 for Industrial Carbon Capture and Sequestration R&D,« less

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

7 CFR 1493.130 - Recovery of losses.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF AGRICULTURE EXPORT PROGRAMS CCC EXPORT CREDIT GUARANTEE PROGRAMS CCC Export Credit Guarantee Program (GSM-102) and CCC Intermediate Export Credit Guarantee Program (GSM-103) Operations § 1493.130 Recovery of losses. (a) Notification. Upon payment of loss to the exporter or the exporter's assignee, CCC...

A review on applications of nanotechnology in the enhanced oil recovery part A: effects of nanoparticles on interfacial tension

NASA Astrophysics Data System (ADS)

Cheraghian, Goshtasp; Hendraningrat, Luky

2016-01-01

Chemical enhanced oil recovery is another strong growing technology with the potential of a step change innovation, which will help to secure future oil supply by turning resources into reserves. While Substantial amount of crude oil remains in the reservoir after primary and secondary production, conventional production methods give access to on average only one-third of original oil in place, the use of surfactants and polymers allows for recovery of up to another third of this oil. Chemical flooding is of increasing interest and importance due to high oil prices and the need to increase oil production. Research in nanotechnology in the petroleum industry is advancing rapidly and an enormous progress in the application of nanotechnology in this area is to be expected. Nanotechnology has the potential to profoundly change enhanced oil recovery and to improve mechanism of recovery. This paper, therefore, focuses on the reviews of the application of nano technology in chemical flooding process in oil recovery and reviews the application nano in the polymer and surfactant flooding on the interfacial tension process.

Reading Recovery Program Implementation Year Six, School Year 1995-96. Report of Results and Effectiveness.

ERIC Educational Resources Information Center

Schotanus, Helen; And Others

A study examined the results and effectiveness of the sixth year of the Reading Recovery program in New Hampshire. With the 95 Reading Recovery teachers from previous classes, 38 teachers in the new class, and 4 teacher leaders, a total of 137 teachers taught Reading Recovery during the 1995-96 school year. A total of 693 first-grade children…

Reading Recovery Program Implementation Year Five, School Year 1994-95. Report of Results and Effectiveness.

ERIC Educational Resources Information Center

Schotanus, Helen; And Others

A study examined the results and effectiveness of the fifth year of the Reading Recovery program in New Hampshire. With the 78 Reading Recovery teachers from previous classes, 23 teachers in the new class, and 3 teacher leaders, a total of 104 teachers taught Reading Recovery during the 1994-95 school year. A total of 530 first-grade children…

Stroke Rehabilitation.

PubMed

Belagaje, Samir R

2017-02-01

Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a multidisciplinary approach with judicious use of resources to identify and treat common poststroke sequelae.

Extreme Attributions Predict the Course of Bipolar Depression: Results from the STEP-BD Randomized Controlled Trial of Psychosocial Treatment

PubMed Central

Stange, Jonathan P.; Sylvia, Louisa G.; da Silva Magalhães, Pedro Vieira; Miklowitz, David J.; Otto, Michael W.; Frank, Ellen; Berk, Michael; Nierenberg, Andrew A.; Deckersbach, Thilo

2013-01-01

Objective Little is known about predictors of recovery from bipolar depression or moderators of treatment response. In the present study we investigated attributional style (a cognitive pattern of explaining the causes of life events) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychotherapy for bipolar depression. Method 106 depressed outpatients with DSM-IV bipolar I or II disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were randomized to intensive psychotherapy for depression (n=62), or collaborative care (n=44), a minimal psychoeducational intervention. The primary outcome was recovery status at each study visit as measured by the Clinical Monitoring Form. Attributional style was measured at baseline using the Attributional Style Questionnaire. Data were collected between 1998 and 2005. Results All analyses were by intention to treat. Extreme attributions predicted a lower likelihood of recovery (p=.01, OR=0.93, 95% CI=.88-.98) and longer time until recovery (p<.01, OR=0.96, 95% CI=.93-.99), independent of the effects of initial depression severity. Among individuals with more pessimistic attributional styles, initial depression severity predicted a lower likelihood of recovery (p=.01, OR=0.64, 95% CI=.45-.91) and longer time until recovery (p<.001, OR=0.76, 95% CI=.66-.88). There was no difference in recovery rates between intensive psychotherapy and collaborative care (OR=0.90, 95% CI=0.40-2.01) in the full sample. Conclusions These results suggest that extreme, rigid attributions may be associated with a more severe course of depression, and that evaluating attributional style may help clinicians to identify patients who are at risk for experiencing a more severe course of depression. PMID:23561230

Building addiction recovery capital through online participation in a recovery community.

PubMed

Bliuc, Ana-Maria; Best, David; Iqbal, Muhammad; Upton, Katie

2017-11-01

This study examines how online participation in a community of recovery contributes to personal journeys of recovery. It investigates whether recovery capital building - as indicated by increased levels and quality of online social interactions - and markers of positive identity development predict retention in a recovery program designed around fostering community involvement for early stage recovery addicts. It was predicted that online participation on the group's Facebook page and positive identity development are associated to retention in the program. To map how participants interact online, social network analysis (SNA) based on naturally occurring online data (N = 609) on the Facebook page of a recovery community was conducted. Computerised linguistic analyses evaluated sentiment of the textual data (capturing social identity markers). Linear regression analyses evaluated whether indicators of recovery capital predict program retention. To illustrate the findings in the context of the specific recovery community, presented are two case studies of key participants who moved from the periphery to the centre of the social network. By conducting in-depth interviews with these participants, personal experiences of engagement in the online community of group members who have undergone the most significant changes since joining the community are explored. Retention in the program was determined by a) the number of comment 'likes' and all 'likes' received on the Facebook page; b) position in the social network (degree of centrality); and c) linguistic content around group identity and achievement. Positive online interactions between members of recovery communities support the recovery process through helping participants to develop recovery capital that binds them to groups supportive of positive change. Copyright © 2017 Elsevier Ltd. All rights reserved.

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

7 CFR 227.41 - Recovery of funds.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Recovery of funds. 227.41 Section 227.41 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS NUTRITION EDUCATION AND TRAINING PROGRAM Miscellaneous § 227.41 Recovery of...

Hypospadias surgery in children: improved service model of enhanced recovery pathway and dedicated surgical team.

PubMed

Wong, Y S; Pang, K K; Tam, Y H

2018-05-21

Children in Hong Kong are generally hospitalised for 1 to 2 weeks after hypospadias repairs. In July 2013, we introduced a new service model that featured an enhanced recovery pathway and a dedicated surgical team responsible for all perioperative services. In this study, we investigated the outcomes of hypospadias repair after the introduction of the new service model. We conducted a retrospective study on consecutive children who underwent primary hypospadias repair from January 2006 to August 2016, comparing patients under the old service with those under the new service. Outcome measures included early morbidity, operative success, and completion of enhanced recovery pathway. The old service and new service cohorts comprised 176 and 126 cases, respectively. There was no difference between the two cohorts in types of hypospadias and surgical procedures performed. The median hospital stay was 2 days in the new service cohort compared with 10 days in the old service cohort (P<0.001). Patients experienced less early morbidity (5.6% vs 15.9%; P=0.006) and had a lower operative failure rate (20.2% vs 44.2%; P<0.001) under the new service than the old service. Multivariable analysis revealed that the new service significantly reduced the odds of early morbidity (odds ratio=0.35, 95% confidence interval=0.15-0.85; P=0.02) and operative failure (odds ratio=0.32, 95% confidence interval=0.17-0.59; P<0.001) in comparison with the old service. Of the new service cohort, 111(88.1%) patients successfully completed the enhanced recovery pathway. The enhanced recovery pathway can be implemented safely and effectively to primary hypospadias repair. A dedicated surgical team may play an important role in successful implementation of the enhanced recovery pathway and optimisation of surgical outcomes.

An evaluation of known remaining oil resources in the United States. Appendix, Project on Advanced Oil Recovery and the States

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

Not Available

This volume contains appendices for the following: Overview of improved oil recovery methods (enhanced oil recovery methods and advanced secondary recovery methods); Benefits of improved oil recovery, selected data for the analyzed states; and List of TORIS fields and reservoirs.

The Effect of Graduation Coaches and Credit Recovery Programs on the Dropout Rate of At-Risk Grade 9 Students

ERIC Educational Resources Information Center

Bowling, Jan

2013-01-01

The objective of this study was to identify the characteristics of effective graduation coaches (GCs) and credit recovery programs and explain the influence of a GC and a credit recovery program on Grade 9 students at risk of dropping out. The purpose of this study was to determine whether a high school GC and enrollment in a credit recovery…

Sustainable Materials Management (SMM) Food Recovery Challenge (FRC) Data

EPA Pesticide Factsheets

As part of EPA's Food Recovery Challenge (FRC), organizations pledge to improve their sustainable food management practices and report their results. The FRC is part of EPA's Sustainable Materials Management Program (SMM). SMM seeks to reduce the environmental impact of materials through their entire life cycle. This includes how they are extracted, manufactured, distributed, used, reused, recycled, and disposed. Organizations are encouraged to follow the Food Recovery Hierarchy (https://www.epa.gov/sustainable-management-food/food-recovery-hierarchy) to prioritize their actions to prevent and divert wasted food. Each tier of the Food Recovery Hierarchy focuses on different management strategies for your wasted food. The program started in 2011 and the first data were made available in 2012. The FRC is part of EPA's larger SMM program (https://www.epa.gov/smm). Sustainable Materials Management (SMM) is a systemic approach to using and reusing materials more productively over their entire lifecycles. It represents a change in how our society thinks about the use of natural resources and environmental protection. By looking at a product's entire lifecycle we can find new opportunities to reduce environmental impacts, conserve resources, and reduce costs. There are multiple challenge programs available as part of the SMM program, including the Food Recovery Challenge, the Electronics Challenge, the Federal Green Challenge, and the WasteWise program.

Study on Dynamic Characteristics of Microbial Enhanced Oil Recovery

NASA Astrophysics Data System (ADS)

Zhao, Yang; Shi, Fang; Qin, Wuying; Yan, Jing

2018-01-01

With the rapid development of economy, the demand for oil is increasing day by day. MEOR has the advantages of low cost and no pollution to the environment, attracted widespread attention. In this paper, the dynamic characteristics of microbial enhanced oil recovery were studied by laboratory experiments. The result showed that all the microbial flooding recovery rate could reach more than 5%, and the total recovery could reach more than 35% and if the injection period of microbial composite system was advanced, the whole oil displacement process could be shortened and the workload would be reduced.

A system dynamics approach to develop a recovery model in the Malaysian automotive industry

NASA Astrophysics Data System (ADS)

Mohamad-Ali, N.; Ghazilla, R. A. R.; Abdul-Rashid, S. H.; Sakundarini, N.; Ahmad-Yazid, A.; Stephenie, L.

2017-06-01

Design strategies play a significant role to enhance recovery effectiveness at the end of product life cycle. By reviewing previous study, there are many factors involved to enhance recovery effectiveness but limited to linking design strategies factors in holistic and dynamics view. Proposed method are explained and an initial model for end-of-life vehicles (ELVs) recovery model illustrated in graphical and numerical data is presented. However this is limited to authors understanding and preliminary data which requires collaboration between designers and other stakeholders to develop a model based on actual situation.

Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy: A meta-analysis.

PubMed

Yang, Rui; Tao, Wan; Chen, Yang-Yang; Zhang, Bing-Hong; Tang, Jun-Ming; Zhong, Sen; Chen, Xian-Xiang

2016-12-01

Enhanced recovery after surgery (ERAS) programs are a series of measures being taken during the perioperation to alleviate surgical stress and accelerate the recovery rate of patients. Although several studies reported the efficacy of ERAS in liver surgery, the role of ERAS in laparoscopic hepatectomy is still unclear. This meta-analysis is aimed to evaluate the efficacy and safety of ERAS programs versus traditional care in laparoscopic hepatectomy. We searched PubMed, EMBASE, the Cochrane Library, CNKI, Wang Fang Database and VIP Database for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) concerning using ERAS in laparoscopic hepatectomy. Data collection ended in June 1st, 2016. The main end points were intraoperative blood loss, intraoperative blood transfusion, operative time, the cost of hospitalization, time to first flatus, the time to first diet after surgery, duration of postoperative hospital stay, total postoperative complication rate, gradeⅠcomplication rate, grade Ⅱ-Ⅴcomplication rate. 8 studies with 580 patients were eligible for analysis. There were 292 cases in ERAS group and 288 cases in traditional perioperative care (CTL) group. Compared with CTL group, ERAS group was associated with significantly accelerated of time to first diet after surgery (SMD = -1.79, 95%CI: -3.19 ∼ -0.38, P = 0.01), time to first flatus (MD = -0.51, 95%CI: -0.91 ∼ -0.12, P = 0.01). Meanwhile, it was associated with significantly decreased of duration of the postoperative hospital stay (MD = -3.31, 95%CI: -3.95 ∼ -2.67, P < 0.00001), cost of hospitalization (MD = -1.0, 95%CI: -1.49 ∼ -0.51, P < 0.0001), total postoperative complication rate (OR = 0.34, 95%CI: 0.15-0.75, P = 0.008), gradeⅠcomplication rate (OR = 0.37, 95%CI: 0.22-0.64, P = 0.0003) and gradeⅡ-Ⅴcomplication rate (OR = 0.49, 95%CI: 0.32-0.77, P = 0.002). Whereas there was no significantly difference in intraoperative blood loss (P > 0.05), intraoperative blood transfusion (P > 0.05), operative time (P > 0.05) between ERAS group and CTL group. Application of ERAS in laparoscopic hepatectomy is safe and effective, and it could accelerate the postoperative recovery and lighten the financial burden of patients. Copyright © 2016 IJS Publishing Group Ltd. All rights reserved.

IN SITU STEAM ENHANCED RECOVERY PROCESS - HUGHES ENVIRONMENTAL SYSTEMS, INC. - INNOVATIVE TECHNOLOGY EVALUATION REPORT

EPA Science Inventory

This Innovative Technology Evaluation report summarizes the findings of an evaluation of the in situ Steam Enhanced Recovery Process (SERP) operated by Hughes Environmental Systems, Inc. at the Rainbow Disposal facility in Huntington Beach, California. he technology demonstration...

DEMONSTRATION BULLETIN: IN SITU STEAM ENHANCED RECOVERY PROCESS - HUGHES ENVIRONMENTAL SYSTEMS, INC.

EPA Science Inventory

The Steam Enhanced Recovery Process (SERP) is designed to remove volatile compounds such as halogenated solvents and petroleum hydrocarbons, and semi-volatile compounds from contaminated soils in situ. The vapor pressures of most contaminants will increase by the addition of ste...

IN-SITU THERMAL REMEDIATION: MECHANISMS, PRINCIPLES, AND CASE STUDIES

EPA Science Inventory

Since the early 1990's, thermal methods of enhanced oil recovery have been adapted for the remediation of soils and groundwater. Steam injection and electrical resistance heating have proven to be robust and aggressive techniques for the enhanced recovery of volatile and semivol...

7 CFR 247.24 - Recovery and redistribution of caseload and administrative funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Recovery and redistribution of caseload and...) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS COMMODITY SUPPLEMENTAL FOOD PROGRAM § 247.24 Recovery and redistribution of caseload and administrative funds. (a) May FNS...

Reading Recovery Executive Summary, 1984 to 1998.

ERIC Educational Resources Information Center

Reading Recovery Council of North America, Columbus, OH.

This Executive Summary provides information and details about Reading Recovery, an early intervention program for young readers who are experiencing difficulty in their first year of reading instruction. The summary first explains that Reading Recovery is a one-to-one tutoring program designed to serve the lowest achieving readers in which…

Constructing a resilience index for the Enhanced Critical Infrastructure Protection Program

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

Fisher, R. E.; Bassett, G. W.; Buehring, W. A.

2010-10-14

Following recommendations made in Homeland Security Presidential Directive 7, which established a national policy for the identification and increased protection of critical infrastructure and key resources (CIKR) by Federal departments and agencies, the U.S. Department of Homeland Security (DHS) in 2006 developed the Enhanced Critical Infrastructure Protection (ECIP) program. The ECIP program aimed to provide a closer partnership with state, regional, territorial, local, and tribal authorities in fulfilling the national objective to improve CIKR protection. The program was specifically designed to identify protective measures currently in place in CIKR and to inform facility owners/operators of the benefits of new protectivemore » measures. The ECIP program also sought to enhance existing relationships between DHS and owners/operators of CIKR and to build relationships where none existed (DHS 2008; DHS 2009). In 2009, DHS and its protective security advisors (PSAs) began assessing CIKR assets using the ECIP program and ultimately produced individual protective measure and vulnerability values through the protective measure and vulnerability indices (PMI/VI). The PMI/VI assess the protective measures posture of individual facilities at their 'weakest link,' allowing for a detailed analysis of the most vulnerable aspects of the facilities (Schneier 2003), while maintaining the ability to produce an overall protective measures picture. The PMI has six main components (physical security, security management, security force, information sharing, protective measures assessments, and dependencies) and focuses on actions taken by a facility to prevent or deter the occurrence of an incident (Argonne National Laboratory 2009). As CIKR continue to be assessed using the PMI/VI and owners/operators better understand how they can prevent or deter incidents, academic research, practitioner emphasis, and public policy formation have increasingly focused on resilience as a necessary component of the risk management framework and infrastructure protection. This shift in focus toward resilience complements the analysis of protective measures by taking into account the three other phases of risk management: mitigation, response, and recovery (Figure 1). Thus, the addition of a robust resilience index (RI) to the established PMI/VI provides vital information to owners/operators throughout the risk management process. Combining a pre-incident focus with a better understanding of resilience, as well as potential consequences from damaged CIKR, allows owners/operators to better understand different ways to decrease risk by (1) increasing physical security measures to prevent an incident, (2) supplementing redundancy to mitigate the effects of an incident, and (3) enhancing emergency action and business continuity planning to increase the effectiveness of recovery procedures. Information provided by the RI methodology is also used by facility owners/operators to better understand how their facilities compare to similar sector/subsector sites and to help them make risk-based decisions. This report provides an overview of the RI methodology developed to estimate resilience and provide resilience comparisons for sectors and subsectors. The information will be used to (1) assist DHS in analyzing existing response and recovery methods and programs at facilities and (2) identify potential ways to increase resilience. The RI methodology is based on principles of Appreciative Inquiry, which is 'the coevolutionary search for the best in people, their organizations, and the relevant world around them' (Cooperrider et al. 2005). Appreciative Inquiry identifies the best of 'what is' and helps to envision 'what might be.' The ECIP program and the RI represent a new model (using Appreciative Inquiry principles) for information sharing between government and industry (Fisher and Petit 2010). A 'dashboard' display, which provides an interactive tool - rather than a static report, presents the results of the RI in a convenient format. Additional resilience measures can be modeled to illustrate how such actions would impact the asset's RI value.« less

An app for patient education and self-audit within an enhanced recovery program for bowel surgery: a pilot study assessing validity and usability.

PubMed

Pecorelli, Nicolò; Fiore, Julio F; Kaneva, Pepa; Somasundram, Abarna; Charlebois, Patrick; Liberman, A Sender; Stein, Barry L; Carli, Franco; Feldman, Liane S

2018-05-01

While patient engagement and clinical audit are key components of successful enhanced recovery programs (ERPs), they require substantial resource allocation. The objective of this study was to assess the validity and usability of a novel mobile device application for education and self-reporting of adherence for patients undergoing bowel surgery within an established ERP. Prospectively recruited patients undergoing bowel surgery within an ERP used a novel app specifically designed to provide daily recovery milestones and record adherence to 15 different ERP processes and six patient-reported outcomes (PROs). Validity was measured by the agreement index (Cohen's kappa coefficient for categorical, and interclass correlation coefficient (ICC) for continuous variables) between patient-reported data through the app and data recorded by a clinical auditor. Acceptability and usability of the app were measured by the System Usability Scale (SUS). Forty-five patients participated in the study (mean age 61, 64% male). Overall, patients completed 159 of 179 (89%) of the available questionnaires through the app. Median time to complete a questionnaire was 2 min 49 s (i.q.r. 2'32″-4'36″). Substantial (kappa > 0.6) or almost perfect agreement (kappa > 0.8) and strong correlation (ICC > 0.7) between data collected through the app and by the clinical auditor was found for 14 ERP processes and four PROs. Patient-reported usability was high; mean SUS score was 87 (95% CI 83-91). Only 6 (13%) patients needed technical support to use the app. Forty (89%) patients found the app was helpful to achieve their daily goals, and 34 (76%) thought it increased their motivation to recover after surgery. This novel application provides a tool to record patient adherence to care processes and PROs, with high agreement with traditional clinical audit, high usability, and patient satisfaction. Future studies should investigate the use of mobile device apps as strategies to increase adherence to perioperative interventions.

Recovery Act Education Programs: Funding Retained Teachers, but Education Could More Consistently Communicate Stabilization Monitoring Issues. Report to Congress. GAO-11-804

ERIC Educational Resources Information Center

Scott, George A.

2011-01-01

The American Recovery and Reinvestment Act of 2009 (Recovery Act) provided $70.3 billion for three education programs--the State Fiscal Stabilization Fund (SFSF); Title I, Part A of the Elementary and Secondary Education Act (Title I); and Individuals with Disabilities Education Act (IDEA), Part B. One goal of the Recovery Act was to save and…

The Long-Term Effectiveness of Reading Recovery and the Cost-Efficiency of Reading Recovery Relative to the Learning Disabled Classification Rate

ERIC Educational Resources Information Center

Galluzzo, Charles A.

2010-01-01

There is a great deal of research supporting Reading Recovery as a successful reading intervention program that assists below level first graders readers in closing the gap in reading at the same level of their average peers. There is a lack of research that analyses the cost-effectiveness of the Reading Recovery program compared to the cost in…

The role of massage in sports performance and rehabilitation: current evidence and future direction.

PubMed

Brummitt, Jason

2008-02-01

Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise. RESEARCH STUDIES PERTAINING TO THE FOLLOWING GENERAL CATEGORIES WERE IDENTIFIED AND REVIEWED: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation. Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments.

Managing prairie dogs by managing plague: a vaccine for the future?

USGS Publications Warehouse

Johnson, Terry B.; Rocke, Tonie E.; Gober, Pete; Van Pelt, Bill E.; Miller, Michael W.; Tripp, Daniel W.; Abbott, Rachel C.; Bergman, David L.

2014-01-01

The Black-footed Ferret Recovery Implementation Team Executive Committee is conducting a project to develop,and (hopefully) eventually implement, a plague vaccination program for prairie dogs. The project is a component of the WesternAssociation of Fish and Wildlife Agencies Grasslands Conservation Initiative. An effective, field-worthy vaccine against plaguecould be the biggest breakthrough in recovery efforts for the black-footed ferret since the 1981 rediscovery of wild ferrets nearMeeteetse, Wyoming. If proven efficacious, the vaccine could help agencies and stakeholder cooperators maintain specificpopulations of prairie dogs at robust levels, thus enhancing range-wide conservation of those species, as well recovery of the ferret,while enabling control of other prairie dog populations to resolve site-specific agricultural and human health concerns. The resultsof laboratory and field-testing in the early stages of developing this vaccine are preliminary but mostly encouraging. A plan forbroad-scale application is being developed for possible use when testing has been completed and (if warranted) the vaccine isregistered for governmental use. An overview of all aspects of the project is discussed.

Microbial Activation of Bacillus subtilis-Immobilized Microgel Particles for Enhanced Oil Recovery.

PubMed

Son, Han Am; Choi, Sang Koo; Jeong, Eun Sook; Kim, Bohyun; Kim, Hyun Tae; Sung, Won Mo; Kim, Jin Woong

2016-09-06

Microbially enhanced oil recovery involves the use of microorganisms to extract oil remaining in reservoirs. Here, we report fabrication of microgel particles with immobilized Bacillus subtilis for application to microbially enhanced oil recovery. Using B. subtilis isolated from oil-contaminated soils in Myanmar, we evaluated the ability of this microbe to reduce the interfacial tension at the oil-water interface via production of biosurfactant molecules, eventually yielding excellent emulsification across a broad range of the medium pH and ionic strength. To safely deliver B. subtilis into a permeable porous medium, in this study, these bacteria were physically immobilized in a hydrogel mesh of microgel particles. In a core flooding experiment, in which the microgel particles were injected into a column packed with silica beads, we found that these particles significantly increased oil recovery in a concentration-dependent manner. This result shows that a mesh of microgel particles encapsulating biosurfactant-producing microorganisms holds promise for recovery of oil from porous media.

Effectiveness and implementation of enhanced recovery after surgery programmes: a rapid evidence synthesis.

PubMed

Paton, Fiona; Chambers, Duncan; Wilson, Paul; Eastwood, Alison; Craig, Dawn; Fox, Dave; Jayne, David; McGinnes, Erika

2014-07-22

To assess the evidence on the impact of enhanced recovery programmes for patients undergoing elective surgery in acute hospital settings in the UK. Rapid evidence synthesis. Eight databases were searched from 1990 to March 2013 without language restrictions. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. Systematic reviews, RCTs not included in the systematic reviews, economic evaluations and UK NHS cost analysis, implementation case studies and surveys of patient experience in a UK setting were eligible for inclusion. We assessed the impact of enhanced recovery programmes on health or cost-related outcomes, and assessed implementation case studies and patient experience in UK settings. Studies were quality assessed where appropriate using the Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effects critical appraisal process. 17 systematic reviews and 12 additional RCTs were included. Ten relevant economic evaluations were included. No cost analysis studies were identified. Most of the evidence focused on colorectal surgery. 14 innovation case studies and 15 implementation case studies undertaken in National Health Service settings described factors critical to the success of an enhanced recovery programme. Evidence for colorectal surgery suggests that enhanced recovery programmes may reduce hospital stays by 0.5-3.5 days compared with conventional care. There were no significant differences in reported readmission rates. Other surgical specialties showed greater variation in reductions in length of stay reflecting the limited evidence identified. Findings relating to other outcomes were hampered by a lack of robust evidence and poor reporting. There is consistent, albeit limited, evidence that enhanced recovery programmes can reduce length of patient hospital stay without increasing readmission rates. The extent to which managers and clinicians considering implementing enhanced recovery programmes in UK settings can realise savings will depend on length of stay achieved under their existing care pathway. 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.

Status of the NASA Balloon Program

NASA Technical Reports Server (NTRS)

Needleman, H. C.; Nock, R. S.; Bawcom, D. W.

1993-01-01

The NASA Balloon Program (BP) is examined in an overview of design philosophy, R&D activities, flight testing, and the development of a long-duration balloon for Antarctic use. The Balloon Recovery Program was developed to qualify the use of existing films and to design improved materials and seals. Balloon flights are described for studying the supernova SN1987a, and systems were developed to enhance balloon campaigns including mobile launch vehicles and tracking/data-acquisition systems. The technical approach to long-duration ballooning is reviewed which allows the use of payloads of up to 1350 kg for two to three weeks. The BP is responsible for the development of several candidate polyethylene balloon films as well as design/performance standards for candidate balloons. Specific progress is noted in reliability and in R&D with respect to optimization of structural design, resin blending, and extrusion.

CTUIR Grande Ronde River Watershed Restoration Program McCoy Creek/McIntyre Creek Road Crossing, 1995-1999 Progress Report.

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

Childs, Allen B.

2000-08-01

The Confederated Tribes of the Umatilla Indian Reservation (CTUIR) and Bonneville Power Administration (BPA) entered into a contract agreement beginning in 1996 to fund watershed restoration and enhancement actions and contribute to recovery of fish and wildlife resources and water quality in the Grande Ronde River Basin. The CTUIR's habitat program is closely coordinated with the Grande Ronde Model Watershed Program and multiple agencies and organizations within the basin. The CTUIR has focused during the past 4 years in the upper portions of the Grande Ronde Subbasin (upstream of LaGrande, Oregon) on several major project areas in the Meadow, McCoy,more » and McIntyre Creek watersheds and along the mainstem Grande Ronde River. This Annual Report provides an overview of individual projects and accomplishments.« less

Learning as It Relates to Addiction Recovery: A Case Study of the Learning Experiences of Men in a Faith-Based Addiction Recovery Program

ERIC Educational Resources Information Center

Voigt, Thomas J. K.

2013-01-01

This case study is about learning as it relates to addiction recovery within the Men's Ministry (a pseudonym) program at an urban, faith-based mission, hereafter referred to as WCM (an acronym). The program is free and long-term residential. Its purpose is to be a "life transformation ministry for troubled men whose lives are out of control…

Enhancing the Alignment of the Preclinical and Clinical Stroke Recovery Research Pipeline: Consensus-Based Core Recommendations From the Stroke Recovery and Rehabilitation Roundtable Translational Working Group.

PubMed

Corbett, Dale; Carmichael, S Thomas; Murphy, Timothy H; Jones, Theresa A; Schwab, Martin E; Jolkkonen, Jukka; Clarkson, Andrew N; Dancause, Numa; Weiloch, Tadeusz; Johansen-Berg, Heidi; Nilsson, Michael; McCullough, Louise D; Joy, Mary T

2017-08-01

Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. Guidelines are proposed for the pre-clinical modeling of stroke recovery and for the alignment of pre-clinical studies to clinical trials in stroke recovery.

Extending Rest between Unloading Cycles Does Not Enhance Bone's Long-Term Recovery.

PubMed

Manske, Sarah L; Vijayaraghavan, Surabhi; Tuthill, Alyssa; Brutus, Olivier; Yang, Jie; Gupta, Shikha; Judex, Stefan

2015-10-01

Multiple exposures to unloading are overall more deleterious to the skeleton than is single exposure, although the rate of bone loss may diminish during multiple exposures. Here, we determined whether extending the reambulation (RA) period from 3 wk to 9 wk will mitigate bone loss during three distinct 3-wk hindlimb unloading (HLU) periods and enhance long-term recovery in skeletally mature, genetically heterogeneous mice. Female adult mice (4 months old) were subjected to three cycles of 3-wk unloading with 3-wk or 9-wk RA periods in between. Mice were terminated 46 wk after initiation of the study. Outcome measures for the distal femur were determined from multiple in vivo micro-computed tomography scans and finite-element modeling. Tripling RA duration enhanced trabecular bone recovery in between HLU periods but also increased the rate of loss of bone volume fraction (bone volume/tissue volume) and metaphyseal stiffness during subsequent HLU periods. With shorter RA periods, the magnitude of bone loss decreased by the second HLU period, whereas this decrease was delayed with longer RA periods. RA duration did not affect long-term recovery 46 wk after the start of the experimental protocol, as both HLU groups had similar levels of bone volume/tissue volume, cortical area, and stiffness. Individual cage activity levels were unrelated to the magnitude of bone loss during HLU or bone recovery during RA. These data suggest that extending recovery duration between periods of unloading may provide temporary benefits but is an ineffective long-term strategy for combating the devastation of trabecular morphology and mechanics, as temporarily enhanced recovery is largely cancelled out by greater susceptibility to unloading. They also emphasize that cortical bone is more amenable to long-term recovery than is trabecular bone.

Recovery-promoting professional competencies: perspectives of mental health consumers, consumer-providers and providers.

PubMed

Russinova, Zlatka; Rogers, E Sally; Ellison, Marsha Langer; Lyass, Asya

2011-01-01

The purpose of this study was to empirically validate a set of conceptually derived recovery-promoting competencies from the perspectives of mental health consumers, consumer-providers and providers. A national sample of 603 consumers, 153 consumer-providers and 239 providers completed an anonymous survey via the Internet. The survey evaluated respondents' perceptions about a set of 37 competencies hypothesized to enhance clients' hope and empowerment and inquired about interactions with providers that enhanced clients' recovery process. We used descriptive statistics and ranking to establish the relevance of each competency and generalized linear models and post-hoc tests to examine differences in the consumers', consumer-providers' and providers' assessments of these competencies. Analyses confirmed the recovery relevance of several competencies and their relative importance within each group of study participants. They also revealed that while most competencies tended to have universal significance, others depended more strongly on the client's preferences. Finally, differences in the perceptions of consumers, consumer-providers and providers about the recovery relevance of these competencies were established. The study highlighted the crucial role practitioners play in enhancing recovery from serious mental illnesses through specific strategies and attitudes that acknowledge clients' personhood and foster their hopefulness, empowerment and illness management. It informed the development of a new instrument measuring providers' recovery-promoting competence and provides guidelines for sharpening the recovery focus of a wide range of mental health and rehabilitation services.

Novel approaches to microbial enhancement of oil recovery.

PubMed

Kryachko, Yuriy

2018-01-20

Microbially enhanced oil recovery (MEOR) was shown to be feasible in a number of laboratory experiments and field trials. However, it has not been widely used in the oil industry because necessary conditions cannot always be easily established in an oil reservoir. Novel approaches to MEOR, which are based on newly discovered biosurfactant-mediated MEOR-mechanisms, are discussed in this review. Particularly, the possibility of combining MEOR with chemical enhancement of oil recovery in heterogeneous oil reservoirs, which involves rock surface wettability shifts and emulsion inversions, is discussed. In wider (centimeter/millimeter-scale) rock pores, the activity of (bio)surfactants and microbial cells attached to oil may allow releasing trapped oil blobs through oil-in-water emulsification. After no more oil can be emulsified, the addition of alkali or surfactants, which turn rock surface oil-wet, may help release oil droplets trapped in narrow (micrometer-scale) pores through coalescence of the droplets and water-in-oil emulsification. Experiments demonstrating the possibility of (bio)surfactant-mediated enhancement of immiscible gas-driven oil recovery are also reviewed. Interestingly, very low (bio)surfactant concentrations were shown to be needed for enhancement of immiscible gas-driven oil recovery. Some possible side effects of MEOR, such as unintended bioplugging and microbially influenced corrosion (MIC), are discussed as well. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Responsive copolymers for enhanced petroleum recovery. Annual report

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

McCormick, C.; Hester, R.

1994-08-01

A coordinated research program involving synthesis, characterization, and rheology has been undertaken to develop advanced polymer system which should be significantly more efficient than polymers presently used for mobility control and conformance. Unlike the relatively inefficient, traditional EOR polymers, these advanced polymer systems possess microstructural features responsive to temperature, electrolyte concentration, and shear conditions. Contents of this report include the following chapters. (1) First annual report responsive copolymers for enhanced oil recovery. (2) Copolymers of acrylamide and sodium 3-acrylamido-3-methylbutanoate. (3) Terpolymers of NaAMB, Am, and n-decylacrylamide. (4) Synthesis and characterization of electrolyte responsive terpolymers of acrylamide, N-(4-butyl)phenylacrylamide, and sodium acrylate,more » sodium-2-acrylamido-2-methylpropanesulphonate or sodium-3-acrylamido-3-methylbutanoate. (5) Synthesis and solution properties of associative acrylamido copolymers with pyrensulfonamide fluorescence labels. (6) Photophysical studies of the solution behavior of associative pyrenesulfonamide-labeled polyacrylamides. (7) Ampholytic copolymers of sodium 2-(acrylamido)-2-methylpropanesulfonate with [2-(acrylamido)-2-methypropyl]trimethylammonium chloride. (8) Ampholytic terpolymers of acrylamide with sodium 2-acrylamido-2-methylpropanesulphoante and 2-acrylamido-2-methylpropanetrimethyl-ammonium chloride and (9) Polymer solution extensional behavior in porous media.« less

Microarthroscopy System With Image Processing Technology Developed for Minimally Invasive Surgery

NASA Technical Reports Server (NTRS)

Steele, Gynelle C.

2001-01-01

In a joint effort, NASA, Micro Medical Devices, and the Cleveland Clinic have developed a microarthroscopy system with digital image processing. This system consists of a disposable endoscope the size of a needle that is aimed at expanding the use of minimally invasive surgery on the knee, ankle, and other small joints. This device not only allows surgeons to make smaller incisions (by improving the clarity and brightness of images), but it gives them a better view of the injured area to make more accurate diagnoses. Because of its small size, the endoscope helps reduce physical trauma and speeds patient recovery. The faster recovery rate also makes the system cost effective for patients. The digital image processing software used with the device was originally developed by the NASA Glenn Research Center to conduct computer simulations of satellite positioning in space. It was later modified to reflect lessons learned in enhancing photographic images in support of the Center's microgravity program. Glenn's Photovoltaic Branch and Graphics and Visualization Lab (G-VIS) computer programmers and software developers enhanced and speed up graphic imaging for this application. Mary Vickerman at Glenn developed algorithms that enabled Micro Medical Devices to eliminate interference and improve the images.

Cognitive Remediation: A New Generation of Psychosocial Interventions for People with Schizophrenia

PubMed Central

Eack, Shaun M.

2013-01-01

Schizophrenia is a mental health condition characterized by broad impairments in cognition, which place profound limitations on functional recovery. Social work has an enduring legacy in pioneering the development of novel psychosocial interventions for people with schizophrenia, and this article introduces cognitive remediation, the latest advance in psychosocial treatments for the disorder designed to improve cognition. First, an overview of the nature of cognitive impairments and their functional consequences in schizophrenia is presented, followed by a description of the theoretical basis and key practice principles of cognitive remediation. Next, the latest biopsychosocial evidence for the efficacy of cognitive remediation in schizophrenia is critically reviewed. Finally, a model cognitive remediation program, Cognitive Enhancement Therapy, which was developed and evaluated by a social work-led multidisciplinary team is presented. Cognitive Enhancement Therapy represents a significant advance in cognitive remediation for schizophrenia, and uses a unique holistic approach that extends beyond traditional neurocognitive training to facilitate the achievement of adult social-cognitive milestones and broader functional recovery. It is concluded that cognitive remediation represents an effective next generation of psychosocial interventions that social workers can use to help improve the lives of many people who live with schizophrenia. PMID:23252315

Economic analysis of secondary and enhanced oil recovery techniques in Wyoming

NASA Astrophysics Data System (ADS)

Kara, Erdal

This dissertation primarily aims to theoretically analyze a firm's optimization of enhanced oil recovery (EOR) and carbon dioxide sequestration under different social policies and empirically analyze the firm's optimization of enhanced oil recovery. The final part of the dissertation empirically analyzes how geological factors and water injection management influence oil recovery. The first chapter builds a theoretical model to analyze economic optimization of EOR and geological carbon sequestration under different social policies. Specifically, it analyzes how social policies on sequestration influence the extent of oil operations, optimal oil production and CO2 sequestration. The theoretical results show that the socially optimal policy is a subsidy on the net CO2 sequestration, assuming negative net emissions from EOR. Such a policy is expected to increase a firm's total carbon dioxide sequestration. The second chapter statistically estimates the theoretical oil production model and its different versions. Empirical results are not robust over different estimation techniques and not in line with the theoretical production model. The last part of the second chapter utilizes a simplified version of theoretical model and concludes that EOR via CO2 injection improves oil recovery. The final chapter analyzes how a contemporary oil recovery technology (water flooding of oil reservoirs) and various reservoir-specific geological factors influence oil recovery in Wyoming. The results show that there is a positive concave relationship between cumulative water injection and cumulative oil recovery and also show that certain geological factors affect the oil recovery. Moreover, the curvature of the concave functional relationship between cumulative water injection and oil recovery is reservoir-specific due to heterogeneities among different reservoirs.

[Surgery for pancreatic adenocarcinoma: from established facts to changes in strategy?].

PubMed

Petermann, David; Halkic, Nermin; Demartines, Nicolas

2015-06-17

Pancreatic adenocarcinoma is still an aggressive disease with low survival. Apparently little changes have been made during the last years in the management of this disease, but knowledge and practices are evolving in many fields. Better understanding of the particular biology and genetics of this tumor will probably lead to more efficient targeted therapy. Surgical management with standardized "Enhanced Recovery After Surgery, ERAS" program diminishes postoperative medical morbidity, hospital length of stay and costs. Oncological treatment with more efficient chemotherapy is promising, with the emergence of strategy to perform more neoadjuvant treatments.

Wide Area Recovery and Resiliency Program (WARRP) Knowledge Enhancement Events: Agricultural Waste Disposal Workshop After Action Report

DTIC Science & Technology

2012-07-17

production of milk . Weld produces 57 percent of the milk in Colorado and has become the 17th largest dairy county in the U.S. in cow numbers (almost...engaged in the plan; everyone from the milk producer to the milk processor. 6 “In the event of an outbreak, everyone in this room would have a role...slaughter. Dr. McCarl illustrated the magnitude of the carcass disposal problem, sharing how the problem would be 9 cows wide and stretch the length

The Meaning of Recovery from Co-Occurring Disorder: Views from Consumers and Staff Members Living and Working in Housing First Programming

PubMed Central

Rollins, Angela L.

2015-01-01

The current study seeks to understand the concept of recovery from the perspectives of consumers and staff living and working in a supportive housing model designed to serve those with co-occurring disorder. Interview and focus group data were collected from consumers and staff from four housing programs. Data analyzed using an approach that combined case study and grounded theory methodologies demonstrate that: consumers’ and staff members’ views of recovery were highly compatible and resistant to abstinence-based definitions of recovery; recovery is personal; stability is a foundation for recovery; recovery is a process; and the recovery process is not linear. These themes are more consistent with mental health-focused conceptions of recovery than those traditionally used within the substance abuse field, and they help demonstrate how recovery can be influenced by the organization of services in which consumers are embedded. PMID:26388709

In College and in Recovery: Reasons for Joining a Collegiate Recovery Program

ERIC Educational Resources Information Center

Laudet, Alexandre B.; Harris, Kitty; Kimball, Thomas; Winters, Ken C.; Moberg, D. Paul

2016-01-01

Objective: Collegiate Recovery Programs (CRPs), a campus-based peer support model for students recovering from substance abuse problems, grew exponentially in the past decade, yet remain unexplored. Methods: This mixed-methods study examines students' reasons for CRP enrollment to guide academic institutions and referral sources. Students (N =…

36 CFR 72.52 - Recovery Action Program grant applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Recovery Action Program grant applications. 72.52 Section 72.52 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR URBAN PARK AND RECREATION RECOVERY ACT OF 1978 Grant Selection, Approval and Administration § 72...

Randomized Control Trial of a CBT Trauma Recovery Program in Palestinian Schools

ERIC Educational Resources Information Center

Barron, Ian G.; Abdallah, Ghassan; Smith, Patrick

2013-01-01

The current study aimed to assess the Teaching Recovery Techniques (TRT) trauma recovery program within the context of ongoing violence. Utilizing a randomized controlled trial, 11-14-year-old students in Nablus, Palestine, were allocated by class to intervention or wait-list control conditions. Standardized measures assessed trauma exposure,…

Feasibility of implementing a recovery education center in a Veterans Affairs medical center.

PubMed

Peer, Jason E; Gardner, Mary; Autrey, Sophia; Calmes, Christine; Goldberg, Richard W

2018-04-30

The purpose of this study was to determine the feasibility of implementing a recovery education program in a Veterans Affairs medical center. This case study describes development and implementation of a mental health and wellness curriculum offered through a centralized location. Referral and utilization data (n = 781) from the first 18 months of implementation were used to evaluate feasibility. Access to programming with zero exclusion was prioritized and average time from referral to enrollment was 9.6 days. Fifty-six percent of veterans admitted to mental health services during the 18-month evaluation period were referred to the program, and this level of utilization continued to be sustained. A broad range of classes was available. Opportunities to change classes as recovery goals evolved was encouraged and data indicate veterans actively tailored their individual recovery curriculum. Educational recovery programming was easily incorporated into a large integrated health facility, was well received, and offered greater opportunity for choice and individualization of recovery curriculum. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial.

PubMed

Kairy, Dahlia; Veras, Mirella; Archambault, Philippe; Hernandez, Alejandro; Higgins, Johanne; Levin, Mindy F; Poissant, Lise; Raz, Amir; Kaizer, Franceen

2016-03-01

Telerehabilitation (TR), or the provision of rehabilitation services from a distance using telecommunication tools such as the Internet, can contribute to ensure that patients receive the best care at the right time. This study aims to assess the effect of an interactive virtual reality (VR) system that allows ongoing rehabilitation of the upper extremity (UE) following a stroke, while the person is in their own home, with offline monitoring and feedback from a therapist at a distance. A single-blind (evaluator is blind to group assignment) two-arm randomized controlled trial is proposed, with participants who have had a stroke and are no longer receiving rehabilitation services randomly allocated to: (1) 4-week written home exercise program, i.e. usual care discharge home program or (2) a 4-week home-based TR exercise program using VR in addition to usual care i.e. treatment group. Motor recovery of the UE will be assessed using the Fugl-Meyer Assessment-UE and the Box and Block tests. To determine the efficacy of the system in terms of functional recovery, the Motor Activity Log, a self-reported measure of UE use will be used. Impact on quality of life will be determined using the Stroke Impact Scale-16. Lastly, a preliminary cost-effectiveness analysis will be conducted using costs and outcomes for all groups. Findings will contribute to evidence regarding the use of TR and VR to provide stroke rehabilitation services from a distance. This approach can enhance continuity of care once patients are discharged from rehabilitation, in order to maximize their recovery beyond the current available services. Copyright © 2015 Elsevier Inc. All rights reserved.

SURFACTANT ENHANCED RECOVERY OF TETRACHLOROETHYLENE FROM A POROUS MEDIUM CONTAINING LOW PERMEABILITY LENSES. 2. NUMERICAL SIMULATION. (R825409)

EPA Science Inventory

Abstract

A numerical model of surfactant enhanced solubilization was developed and applied to the simulation of nonaqueous phase liquid recovery in two-dimensional heterogeneous laboratory sand tank systems. Model parameters were derived from independent, small-scale, ...

Biosurfactant and enhanced oil recovery

DOEpatents

McInerney, Michael J.; Jenneman, Gary E.; Knapp, Roy M.; Menzie, Donald E.

1985-06-11

A pure culture of Bacillus licheniformis strain JF-2 (ATCC No. 39307) and a process for using said culture and the surfactant lichenysin produced thereby for the enhancement of oil recovery from subterranean formations. Lichenysin is an effective surfactant over a wide range of temperatures, pH's, salt and calcium concentrations.

25 CFR 226.11 - Royalty payments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Superintendent, applicable to additional oil produced from a lease or leases by enhanced recovery methods, which rate shall not be less than 121/2 percent of the gross proceeds from sale of oil produced by enhanced recovery processes, other than gas injection, after deducting the oil used by Lessee for development and...

78 FR 25426 - Fisheries of the Exclusive Economic Zone Off Alaska; American Fisheries Act, Amendment 80 Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-01

... Community Development Quota Program; Public Workshops AGENCY: National Marine Fisheries Service (NMFS... Development Quota (CDQ) Program. The workshops will address (1) The applicability of cost recovery fees... overview of the potential impacts of cost recovery programs, and (3) an overview of proposed regulatory...

75 FR 21016 - Notice of Proposed Information Collection: Comment Request; The Green Retrofit Program of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... Information Collection: Comment Request; The Green Retrofit Program of the American Recovery and... Retrofit Program authorized by the American Recovery and Revitalization Act of 2009. The legislation.... The Green Retrofit Program is detailed in HUD Notice H 09-02 issued on May 13, 2009. This Notice is...

An evaluation of known remaining oil resources in the United States: Appendix. Volume 10

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

NONE

Volume ten contains the following appendices: overview of improved oil recovery methods which covers enhanced oil recovery methods and advanced secondary recovery methods; the benefits of improved oil recovery, selected data for the analyzed states; and list of TORIS fields and reservoirs.

Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs

PubMed Central

Finch, Andrew J.; Moberg, D. Paul; Krupp, Amanda Lawton

2014-01-01

Data from 17 recovery high schools suggest programs are dynamic and vary in enrollment, fiscal stability, governance, staffing, and organizational structure. Schools struggle with enrollment, funding, lack of primary treatment accessibility, academic rigor, and institutional support. Still, for adolescents having received treatment for substance abuse, recovery schools appear to successfully function as continuing care providers reinforcing and sustaining therapeutic benefits gained from treatment. Small size and therapeutic programming allow for a potentially broader continuum of services than currently exists in most of the schools. Recovery schools thus provide a useful design for continuing care warranting further study and policy support. PMID:24591808

Whey Protein Supplementation Enhances Whole Body Protein Metabolism and Performance Recovery after Resistance Exercise: A Double-Blind Crossover Study

PubMed Central

West, Daniel W. D.; Abou Sawan, Sidney; Mazzulla, Michael; Williamson, Eric; Moore, Daniel R.

2017-01-01

No study has concurrently measured changes in free-living whole body protein metabolism and exercise performance during recovery from an acute bout of resistance exercise. We aimed to determine if whey protein ingestion enhances whole body net protein balance and recovery of exercise performance during overnight (10 h) and 24 h recovery after whole body resistance exercise in trained men. In a double-blind crossover design, 12 trained men (76 ± 8 kg, 24 ± 4 years old, 14% ± 5% body fat; means ± standard deviation (SD)) performed resistance exercise in the evening prior to consuming either 25 g of whey protein (PRO; MuscleTech 100% Whey) or an energy-matched placebo (CHO) immediately post-exercise (0 h), and again the following morning (~10 h of recovery). A third randomized trial, completed by the same participants, involving no exercise and no supplement served as a rested control trial (Rest). Participants ingested [15N]glycine to determine whole body protein kinetics and net protein balance over 10 and 24 h of recovery. Performance was assessed pre-exercise and at 0, 10, and 24 h of recovery using a battery of tests. Net protein balance tended to improve in PRO (P = 0.064; effect size (ES) = 0.61, PRO vs. CHO) during overnight recovery. Over 24 h, net balance was enhanced in PRO (P = 0.036) but not in CHO (P = 0.84; ES = 0.69, PRO vs. CHO), which was mediated primarily by a reduction in protein breakdown (PRO < CHO; P < 0.01. Exercise decreased repetitions to failure (REP), maximal strength (MVC), peak and mean power, and countermovement jump performance (CMJ) at 0 h (all P < 0.05 vs. Pre). At 10 h, there were small-to-moderate effects for enhanced recovery of the MVC (ES = 0.56), mean power (ES = 0.49), and CMJ variables (ES: 0.27–0.49) in PRO. At 24 h, protein supplementation improved MVC (ES = 0.76), REP (ES = 0.44), and peak power (ES = 0.55). In conclusion, whey protein supplementation enhances whole body anabolism, and may improve acute recovery of exercise performance after a strenuous bout of resistance exercise. PMID:28696380

The impact of length of stay on recovery measures in faith-based addiction treatment.

PubMed

Lashley, Mary

2018-03-30

To determine the impact of length of stay among homeless men in faith-based residential addictions recovery on physical activity, depression, self-esteem, and nicotine dependence. A time series design was utilized to measure changes in the four quality measures at program entry and at 3, 6, and 9 months following admission. The sample consisted of 175 homeless residents enrolled in a faith-based residential recovery program. Paired t tests were used to determine the change in average instrument response from admission to each follow-up period. Analysis of variance (ANOVA) and Tukey posthoc tests were used to assess for differences in length of stay between demographic variables. Statistically significant improvements were noted in self-esteem and depressive symptomatology at 3 and 6 months following admission and in physical activity levels at 3 months following admission. Nicotine dependence scores declined at 3 and 6 months but were not statistically significant. Time spent in this faith-based spiritual recovery program had a significant impact on depression, self-esteem, and physical activity. Recommendations for future study include conducting research to analyze the relationship between distinct program elements and quality indicators and comparing faith-based programs to other similar programs and to publicly funded secular recovery programs. © 2018 Wiley Periodicals, Inc.

Making sense of the transition from the Detroit streets to drug treatment.

PubMed

Draus, Paul; Roddy, Juliette; Asabigi, Kanzoni

2015-02-01

In this article we consider the process of adjustment from active street sex work to life in structured substance abuse treatment among Detroit-area women who participated in a semicoercive program administered through a drug court. We examine this transition in terms of changes in daily routines and social networks, drawing on extensive qualitative data to illuminate the ways in which women defined their own situations. Using concepts from Bourdieu and Latour as analytical aids, we analyze the role of daily routines, environments, and networks in producing the shifts in identity that those who embraced the goals of recovery demonstrated. We conclude with a discussion of how the restrictive environments and redundant situations experienced by women in treatment could be paradoxically embraced as a means to achieve expanded opportunity and enhanced individual responsibility because women effectively reassembled their social networks and identities to align with the goals of recovery. © The Author(s) 2014.

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

PubMed

Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Is the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex important for motor recovery in rats with photochemically induced cortical lesions?

PubMed

Takata, Kotaro; Yamauchi, Hideki; Tatsuno, Hisashi; Hashimoto, Keiji; Abo, Masahiro

2006-01-01

To determine whether the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex is important for motor recovery after brain damage in the photochemically initiated thrombosis (PIT) model. We induced PIT in the sensorimotor cortex in rats and examined the recovery of motor function using the beam-walking test. In 24 rats, the right sensorimotor cortex was lesioned after 2 days of training for the beam-walking test (group 1). After 10 days, PIT was induced in the left sensorimotor cortex. Eight additional rats (group 2) received 2 days training in beam walking, then underwent the beam-walking test to evaluate function. After 10 days of testing, the left sensorimotor cortex was lesioned and recovery was monitored by the beam-walking test for 8 days. In group 1 animals, left hindlimb function caused by a right sensorimotor cortex lesion recovered within 10 days after the operation. Right hindlimb function caused by the left-side lesion recovered within 6 days. In group 2, right hindlimb function caused by induction of the left-side lesion after a total of 12 days of beam-walking training and testing recovered within 6 days as with the double PIT model. The training effect may be relevant to reorganization and neuromodulation. Motor recovery patterns did not indicate whether motor recovery was dependent on the ipsilateral cortex surrounding the lesion or the cortex of the contralateral side. The results emphasize the need for selection of appropriate programs tailored to the area of cortical damage in order to enhance motor functional recovery in this model. Copyright 2006 S. Karger AG, Basel.

Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients.

PubMed

Berend, Keith R; Lombardi, Adolph V; Mallory, Thomas H

2004-01-01

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most successful procedures performed in terms of quality-of-life years gained. The long-term goals of arthroplasty, to relieve pain, increase function, provide stability, and obtain durability, are accomplished in the vast majority of cases. The short-term goals, however, have become the target of aggressive peri-operative programs that aim to speed recovery, reduce morbidity and complications, and create a program of efficiency while maintaining the highest level of patient care. The concept of rapid recovery is built upon the burgeoning interest in less-invasive and small-incision surgeries for (THA and TKA). However, the incision size does not appear to be the most critical aspect of the program. This article outlines the specific elements of the rapid-recovery program for lower-extremity arthroplasty patients, including pre-operative patient education, peri-operative nutrition, vitamin and herbal medication supplementation, preemptive analgesia, and post-operative rehabilitation. A holistic peri-operative, rapid-recovery program has lead to a significantly decreased hospital length of stay and significantly lower hospital readmission rates in patients who undergo primary THAs and TKAs. Combining these results with minimally invasive techniques and instrumentation should make recovery even faster.

ENVIRONMENTAL, ECONOMIC AND ENERGY IMPACTS OF MATERIAL RECOVERY FACILITIES - A MITE PROGRAM EVALUATION

EPA Science Inventory

This report documents an evaluation of the environmental, economic, and energy impacts of material recovery facilities (MRFS) conducted under the Municipal Solid Waste Innovative Technology Evaluation (MITE) Program. he MITE Program is sponsored by the U.S. Environmental Protecti...

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

PubMed

McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

EPA Recovery Mapper

EPA Pesticide Factsheets

The EPA Recovery Mapper is an Internet interactive mapping application that allows users to discover information about every American Recovery and Reinvestment Act (ARRA) award that EPA has funded for six programs. By integrating data reported by the recipients of Recovery Act funding and data created by EPA, this application delivers a level of transparency and public accessibility to users interested in EPA's use of Recovery Act monies. The application is relatively easy to use and builds on the same mapping model as Google, Bing, MapQuest and other commonly used mapping interfaces. EPA Recovery Mapper tracks each award made by each program and gives basic Quick Facts information for each award including award name, location, award date, dollar amounts and more. Data Summaries for each EPA program or for each state are provided displaying dollars for Total Awarded, Total Received (Paid), and Total Jobs This Quarter by Recovery for the latest quarter of data released by Recovery.gov. The data are reported to the government and EPA four times a year by the award recipients. The latest quarterly report will always be displayed in the EPA Recovery Mapper. In addition, the application provides many details about each award. Users will learn more about how to access and interpret these data later in this document. Data shown in the EPA Recovery Mapper are derived from information reported back to FederalReporting.gov from the recipients of Recovery Act funding. EPA

Reservoir characterization of the Smackover Formation in southwest Alabama. Final report

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

Kopaska-Merkel, D.C.; Hall, D.R.; Mann, S.D.

1993-02-01

The Upper Jurassic Smackover Formation is found in an arcuate belt in the subsurface from south Texas to panhandle Florida. The Smackover is the most prolific hydrocarbon-producing formation in Alabama and is an important hydrocarbon reservoir from Florida to Texas. In this report Smackover hydrocarbon reservoirs in southwest Alabama are described. Also, the nine enhanced- and improved-recovery projects that have been undertaken in the Smackover of Alabama are evaluated. The report concludes with recommendations about potential future enhanced- and improved-recovery projects in Smackover reservoirs in Alabama and an estimate of the potential volume of liquid hydrocarbons recoverable by enhanced- andmore » improved-recovery methods from the Smackover of Alabama.« less

Reservoir characterization of the Smackover Formation in southwest Alabama

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

Kopaska-Merkel, D.C.; Hall, D.R.; Mann, S.D.

1993-02-01

The Upper Jurassic Smackover Formation is found in an arcuate belt in the subsurface from south Texas to panhandle Florida. The Smackover is the most prolific hydrocarbon-producing formation in Alabama and is an important hydrocarbon reservoir from Florida to Texas. In this report Smackover hydrocarbon reservoirs in southwest Alabama are described. Also, the nine enhanced- and improved-recovery projects that have been undertaken in the Smackover of Alabama are evaluated. The report concludes with recommendations about potential future enhanced- and improved-recovery projects in Smackover reservoirs in Alabama and an estimate of the potential volume of liquid hydrocarbons recoverable by enhanced- andmore » improved-recovery methods from the Smackover of Alabama.« less

75 FR 55678 - Minerals Management: Adjustment of Cost Recovery Fees

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... text to the general cost recovery fee table so that mineral cost recovery fees can be found in one... Coal and Oil Shale) Program's lease renewal fee will increase from $480 to $485; (C) The Mining Law... $2,840; and (D) The Mining Law Administration Program's fee for mineral patent adjudication of 10 or...

Reading Recovery: Success for How Many?

ERIC Educational Resources Information Center

Haenn, Joseph F.

Standard operating procedures of the Reading Recovery program allow for students to be dropped from the program if they have not met the criterion for success after 20 weeks of participation. This paper follows the actions of over 600 first-grade Reading Recovery students in a medium-sized school district over the course of a complete year of…

The Use of Art Therapy in Treatment Programs to Promote Spiritual Recovery from Addiction.

ERIC Educational Resources Information Center

Feen-Calligan, Holly

1995-01-01

Illustrates the relationship between art therapy, spirituality, and recovery supported by the philosophy of Alcoholic Anonymous, and offers a model in which art therapy can be used in treatment programs to facilitate spiritual recovery from addiction. Discusses personal experiences related to the use of art therapy for assisting in addiction…

A Historical Case Study of Dropout Recovery Programs in the State of Oklahoma

ERIC Educational Resources Information Center

Portis, Dennis L., III

2013-01-01

The purpose of this historical case study was to gain an understanding of dropout recovery programs from an interpretive historical perspective. Dropout Recovery is an Oklahoma Department of Career and Technology Education initiative that provides high school dropouts an opportunity to re-enroll in school, gain academic credit, and participate in…

An Evaluation of an Implementation of the Reading Recovery Program.

ERIC Educational Resources Information Center

Denton, Carolyn A.

The effectiveness of the Reading Recovery Program, a literacy intervention for at-risk first-grade students, as it was implemented in 1995-96 in a small rural school district in Texas was studied. Reading Recovery consists of daily individual literacy tutoring sessions taught by a specially trained teacher, and emphasizes active engagement of the…

Reading Recovery: An Effective Intervention Program for Learning Disabled First Graders.

ERIC Educational Resources Information Center

Lyons, Carol A.

A three-part study examining the efficacy of a reading recovery program for learning disabled first grade students is described in this paper. An introduction outlines the Ohio Reading Recovery project and explains the purpose of the study. Part 1 describes the first phase of the study, in which 110 poor readers, including 35 learning disabled…

Exploring the effect of organizational culture on consumer perceptions of agency support for mental health recovery.

PubMed

Clossey, Laurene; Rheinheimer, David

2014-05-01

This research explores the impact of mental health agency culture on consumers' perceptions of agency support for their recovery. This study hypothesized that a constructive organizational culture must be present for consumers to perceive agency support for recovery. A sample of 12 mental health agencies in rural Pennsylvania participated in the research. Agency administrators completed an instrument called the recovery oriented service environment, which measured the number of recovery model program components offered by the agency. Consumers completed the recovery oriented services indicators, which taps into their perception of agency support for recovery. Direct service staff completed the organizational social context, which measured their agency's culture. Results showed that in this sample stronger consumer perceptions of agency support for recovery were correlated with higher ratings of agency constructive culture. The results suggest that agency culture is an important variable to target when implementing recovery model programming.

Effects of recombinant human granulocyte colony-stimulating factor on the hematologic recovery and survival of irradiated mice

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

Tanikawa, S.; Nose, M.; Aoki, Y.

1990-08-01

We studied the effects of intraperitoneal injections of recombinant human granulocyte colony-stimulating factor (rhG-CSF) according to various administration schedules on the recovery of spleen colony-forming units (CFU-S) and peripheral blood counts, and on the survival of irradiated mice. The sooner and more frequently the mice were injected with rhG-CSF after irradiation, the more enhanced the recovery of CFU-S in bone marrow was obtained on day 7. Twice-daily injections of rhG-CSF from day 0 to day 2 significantly enhanced the recovery of platelets and hematocrit, but two injections of rhG-CSF on only day 0 did not. Twice-daily injections of rhG-CSF frommore » day 0 to day 6 enhanced the recovery of platelets more effectively than twice-daily injections of rhG-CSF from day 1 to day 7, and increased the survival of irradiated mice more effectively than any other examined administration schedules. Twice-daily injections of rhG-CSF from day 0 to day 6 were significantly effective in enhancing the survival of mice irradiated with 8.5-, 9.0-, and 9.5-Gy x-rays, although not effective after irradiation of 10.5-Gy x-rays.« less

An Acrylonitrile–Butadiene–Lignin Renewable Skin with Programmable and Switchable Electrical Conductivity for Stress/Strain-Sensing Applications

DOE PAGES

Nguyen, Ngoc A.; Meek, Kelly M.; Bowland, Christopher C.; ...

2017-12-28

We report an approach for programming electrical conductivity of a bio-based leathery skin devised with a layer of 60 nm metallic nanoparticles. Lignin-based renewable shape-memory materials were made, for the first time, to program and restore the materials’ electrical conductivity after repeated deformation up to 100% strain amplitude, at a temperature 60–115 °C above the glass transition temperature (T g) of the rubbery matrix. We cross-linked lignin macromolecules with an acrylonitrile–butadiene rubbery melt in high quantities ranging from 40 to 60 wt % and processed the resulting thermoplastics into thin films. Chemical and physical networks within the polymeric materials significantlymore » enhanced key characteristics such as mechanical stiffness, strain fixity, and temperature-stimulated recovery of shape. The branched structures of the guaiacylpropane-dominant softwood lignin significantly improve the rubber’s T g and produced a film with stored and recoverable elastic work density that was an order of magnitude greater than those of the neat rubber and of samples made with syringylpropane-rich hardwood lignin. The devices could exhibit switching of conductivity before and after shape recovery.« less

An Acrylonitrile–Butadiene–Lignin Renewable Skin with Programmable and Switchable Electrical Conductivity for Stress/Strain-Sensing Applications

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

Nguyen, Ngoc A.; Meek, Kelly M.; Bowland, Christopher C.

We report an approach for programming electrical conductivity of a bio-based leathery skin devised with a layer of 60 nm metallic nanoparticles. Lignin-based renewable shape-memory materials were made, for the first time, to program and restore the materials’ electrical conductivity after repeated deformation up to 100% strain amplitude, at a temperature 60–115 °C above the glass transition temperature (T g) of the rubbery matrix. We cross-linked lignin macromolecules with an acrylonitrile–butadiene rubbery melt in high quantities ranging from 40 to 60 wt % and processed the resulting thermoplastics into thin films. Chemical and physical networks within the polymeric materials significantlymore » enhanced key characteristics such as mechanical stiffness, strain fixity, and temperature-stimulated recovery of shape. The branched structures of the guaiacylpropane-dominant softwood lignin significantly improve the rubber’s T g and produced a film with stored and recoverable elastic work density that was an order of magnitude greater than those of the neat rubber and of samples made with syringylpropane-rich hardwood lignin. The devices could exhibit switching of conductivity before and after shape recovery.« less

Leading a Recovery-oriented Social Enterprise.

PubMed

Raeburn, Toby; Hungerford, Catherine; Sayers, Jan; Escott, Phil; Lopez, Violeta; Cleary, Michelle

2015-05-01

Recovery-oriented mental health services promote the principles of recovery, such as hope and optimism, and are characterized by a personalized approach to developing consumer self-determination. Nurse leaders are increasingly developing such services as social enterprises, but there is limited research on the leadership of these programs. Leading a recovery-oriented mental health nurse social enterprise requires visionary leadership, collaboration with consumers and local health providers, financial viability, and commitment to recovery-focused practice. This article describes the framework of an Australian mental health nursing social enterprise, including the service attributes and leadership lessons that have been learned from developing program sustainability.

Enhanced recovery after laparoscopic colorectal resection with primary anastomosis: accelerated discharge is safe and does not give rise to increased readmission rates.

PubMed

Gash, K J; Greenslade, G L; Dixon, A R

2012-10-01

Enhanced recovery programmes after colorectal surgery are promoted to minimize complications and expedite recovery, thus reducing length of hospital stay where appropriate and improving the overall standard of patient care. There are few published trials of enhanced recovery programmes in the context of laparoscopic colorectal surgery. Data were prospectively collected on all laparoscopic colorectal resections carried out in our institution from May 2004 to November 2009. An informal move to 48-h discharge was introduced in May 2004 and the official enhanced recovery programme was launched in November 2008. We identified all patients with a primary anastomosis discharged within 3 days of surgery. Early outcomes - leaks, complications, readmission rates and returns to theatre - were analysed. In all, 606 resections were performed in this period. Median length of stay was 4 (0-52) days. Of these patients, 279 (46%) met the criteria of accelerated discharge by day 3: 2 (0.7%) were discharged on the day of surgery, 70 (25.1%) within 24 h, 116 (41.6%) within 48 h and 91 (32.6%) by 72h. Age was not a significant factor in determining length of stay. Patients undergoing right hemicolectomy were more likely to be discharged by 24 h than those with left-sided anastomoses, and patients having total mesorectal excision resections were more likely to stay 3 days. The readmission rate was 4%, regardless of day of discharge. Accelerated discharge is feasible and safe. High readmission rates reported in enhanced recovery programmes after open colorectal surgery have not occurred in our laparoscopic experience. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

40 CFR 147.2103 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and hydrocarbon storage wells authorized by rule. 147.2103 Section 147.2103 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... Administrator determines that the owner or operator of an existing enhanced recovery or hydrocarbon storage well...

40 CFR 147.2103 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and hydrocarbon storage wells authorized by rule. 147.2103 Section 147.2103 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... Administrator determines that the owner or operator of an existing enhanced recovery or hydrocarbon storage well...

78 FR 25760 - Proposed Information Collection; Urban Park and Recreation Recovery Program Grants

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-02

...--renovate or redesign existing close-to- home recreation facilities. Innovation--specific activities that... existing programs. Planning--development of a Recovery Action Program plan. The information collection... recreation system goals. Citizen involvement in the development of the Action Plan is required and may...

75 FR 68811 - Recovery Publication, P-395, Fire Management Assistance Grant Program (FMAGP) Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-09

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2010-0066] Recovery Publication, P-395, Fire Management Assistance Grant Program (FMAGP) Guide AGENCY: Federal... Emergency Management Agency (FEMA) is accepting comments on the Fire Management Assistance Grant Program...

A worksite prevention program for construction workers: design of a randomized controlled trial.

PubMed

Oude Hengel, Karen M; Joling, Catelijne I; Proper, Karin I; Blatter, Birgitte M; Bongers, Paulien M

2010-06-14

A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. NTR1278.

A worksite prevention program for construction workers: design of a randomized controlled trial

PubMed Central

2010-01-01

Background A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. Discussion The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. Trial Registration NTR1278 PMID:20546568

Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery.

PubMed

Mayo, Nancy E; Feldman, Liane; Scott, Susan; Zavorsky, Gerald; Kim, Do Jun; Charlebois, Patrick; Stein, Barry; Carli, Francesco

2011-09-01

Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33% improved their physical function, 38% stayed within 20 m of their baseline score, and 29% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have recovered to their baseline walking capacity than those with no change or deterioration (77% vs 59% and 32%; P = .0007). Patients who deteriorated were at greater risk of complications requiring reoperation and/or intensive care management. Significant predictors of poorer recovery included deterioration during prehabilitation, age >75 years, high anxiety, complications requiring intervention, and timing of follow-up assessment. In a group of patients undergoing scheduled colorectal surgery, meaningful changes in functional capacity can be achieved over several weeks of prehabilitation. Patients and those who care for them, especially those with poor physical capacity, should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy. Copyright © 2011 Mosby, Inc. All rights reserved.

Core Flood study for enhanced oil recovery through ex-situ bioaugmentation with thermo- and halo-tolerant rhamnolipid produced by Pseudomonas aeruginosa NCIM 5514.

PubMed

Varjani, Sunita J; Upasani, Vivek N

2016-11-01

The aim of this work was to study the Microbial Enhanced Oil Recovery (MEOR) employing core field model ex-situ bioaugmenting a thermo- and halo-tolerant rhamnolipid produced by Pseudomonas aeruginosa. Thin Layer Chromatography (TLC) revealed that the biosurfactant produced was rhamnolipid type. Nuclear Magnetic Resonance analysis showed that the purified rhamnolipids comprised two principal rhamnolipid homologues, i.e., Rha-Rha-C10-C14:1 and Rha-C8-C10. The rhamnolipid was stable under wide range of temperature (4°C, 30-100°C), pH (2.0-10.0) and NaCl concentration (0-18%, w/v). Core Flood model was designed for oil recovery operations using rhamnolipid. The oil recovery enhancement over Residual Oil Saturation was 8.82% through ex-situ bioaugmentation with rhamnolipid. The thermal stability of rhamnolipid shows promising scope for its application at conditions where high temperatures prevail in oil recovery processes, whereas its halo-tolerant nature increases its application in marine environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

SURFACTANT BASED ENHANCED OIL RECOVERY AND FOAM MOBILITY CONTROL

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

George J. Hirasaki; Clarence A. Miller; Gary A. Pope

2004-07-01

Surfactant flooding has the potential to significantly increase recovery over that of conventional waterflooding. The availability of a large number of surfactants makes it possible to conduct a systematic study of the relation between surfactant structure and its efficacy for oil recovery. Also, the addition of an alkali such as sodium carbonate makes possible in situ generation of surfactant and significant reduction of surfactant adsorption. In addition to reduction of interfacial tension to ultra-low values, surfactants and alkali can be designed to alter wettability to enhance oil recovery. An alkaline surfactant process is designed to enhance spontaneous imbibition in fractured,more » oil-wet, carbonate formations. It is able to recover oil from dolomite core samples from which there was no oil recovery when placed in formation brine. Mobility control is essential for surfactant EOR. Foam is evaluted to improve the sweep efficiency of surfactant injected into fractured reservoirs. UTCHEM is a reservoir simulator specially designed for surfactant EOR. A dual-porosity version is demonstrated as a potential scale-up tool for fractured reservoirs.« less

C-reactive protein, fibrinogen, and procalcitonin levels as early markers of staple line leak after laparoscopic sleeve gastrectomy in morbidly obese patients within an Enhanced Recovery After Surgery (ERAS) program.

PubMed

Ruiz-Tovar, Jaime; Muñoz, Jose Luis; Gonzalez, Juan; Garcia, Alejandro; Ferrigni, Carlos; Jimenez, Montiel; Duran, Manuel

2017-12-01

The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course. A prospective study of 208 morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between 2012 and 2015 was performed. Blood analysis was performed 24 h after surgery. Acute-phase parameters (C-reactive protein, procalcitonin, fibrinogen, and White Blood Cell count) were investigated. Staple line leak appeared in eight patients (3.8%). Using receiver operating characteristic analysis at 24 h postoperatively, a cutoff level of CRP at 9 mg/dL achieved 85% sensitivity and 90% specificity for predicting staple line leak, a cutoff level of procalcitonin at 0.85 ng/mL achieved 70% sensitivity and 90% specificity, and a cutoff level of fibrinogen at 600 mg/dL achieved 80% sensitivity and 87.5% specificity. An elevation of CRP > 9 mg/dL, procalcitonin > 0.85 ng/mL and fibrinogen > 600 mg/dL should alert the surgeon the possibility of occurrence of postoperative staple line leak.

The Impact of Anesthesia-Influenced Process Measure Compliance on Length of Stay: Results From an Enhanced Recovery After Surgery for Colorectal Surgery Cohort.

PubMed

Grant, Michael C; Pio Roda, Claro M; Canner, Joseph K; Sommer, Philip; Galante, Daniel; Hobson, Deborah; Gearhart, Susan; Wu, Christopher L; Wick, Elizabeth

2018-05-17

Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS). Process measure compliance was associated with a stepwise reduction in LOS. Patients who received >4 process measures (high compliance) had a significantly shorter LOS (incident rate ratio [IRR], 0.77; 95% CI, 0.70-0.85); P < .001) compared to low compliance (0-2 process measures) counterparts. Multivariable regression suggests that utilization of multimodal nausea and vomiting prophylaxis (IRR, 0.78; 95% CI, 0.68-0.89; P < .001), scheduled postoperative nonsteroidal pain medication use (IRR, 0.76; 95% CI, 0.67-0.85; P < .001), and strict adherence to a postoperative opioid administration (IRR, 0.58; 95% CI, 0.51-0.67; P < .001) protocol for breakthrough pain were independently associated with reduced LOS. Our findings suggest that increased compliance with process measures directly influenced by the anesthesiologists and in concert with a formal anesthesia protocol is associated with reduced LOS. Engaging anesthesiology colleagues throughout the surgical encounter increases the overall value of perioperative care.

Measuring In-Hospital Recovery After Colorectal Surgery Within a Well-Established Enhanced Recovery Pathway: A Comparison Between Hospital Length of Stay and Time to Readiness for Discharge.

PubMed

Balvardi, Saba; Pecorelli, Nicolò; Castelino, Tanya; Niculiseanu, Petru; Liberman, A Sender; Charlebois, Patrick; Stein, Barry; Carli, Franco; Mayo, Nancy E; Feldman, Liane S; Fiore, Julio F

2018-05-15

Hospital length of stay is often used as a measure of in-hospital recovery but may be confounded by organizational factors. Time to readiness for discharge may provide a superior index of recovery. The purpose of this study was to contribute evidence for the construct validity of time to readiness for discharge and length of stay as measures of in-hospital recovery after colorectal surgery in the context of a well-established enhanced recovery pathway. This was an observational validation study designed according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The study was conducted at a university-affiliated tertiary hospital. A total of 100 consecutive patients undergoing elective colorectal resection (mean age = 65 y; 57% men; 81% laparoscopic) who participated in a randomized controlled trial were included. We tested a priori hypotheses that length of stay and time-to-readiness for discharge are longer in patients undergoing open surgery, with lower physical status, with severe comorbidities, with postoperative complications, undergoing rectal surgery, who are older (≥75 y), who have a new stoma, and who have inflammatory bowel disease. Median time-to-readiness for discharge and length of stay were both 3 days. For both measures, 6 of 8 construct validity hypotheses were supported (hypotheses 1 and 4-8). The use of secondary data from a randomized controlled trial (risk of selection bias) was a limitation. Results may not be generalizable to institutions where patient care is not equally structured. This study contributes evidence to the construct validity of time-to-readiness for discharge and length of stay as measures of in-hospital recovery within enhanced recovery pathways. Our findings suggest that length of stay can be a less resource-intensive and equally construct-valid index of in-hospital recovery compared with time-to-readiness for discharge. Enhanced recovery pathways may decrease process-of-care variances that impact length of stay, allowing more timely discharge once discharge criteria are achieved. See Video Abstract at http://links.lww.com/DCR/A564.

Development of a preprototype times wastewater recovery subsystem: Appendices

NASA Technical Reports Server (NTRS)

Roebelen, G. J., Jr.; Dehner, G. F.

1984-01-01

This Master Test Plan outlines the test program to be performed by Hamilton Standard during the Urine Water Recovery Subsystem Program. Testing is divided into three phases: (1) design support testing; development component testing; and acceptance testing. The completion of this test program verifies the subsystem operation.

Reading Recovery--German Style. Short Report.

ERIC Educational Resources Information Center

Chambers, Gary N.

1995-01-01

This paper describes the Reading Recovery program implemented at a special needs school in Kiel, Germany. The program is intended to offer primary-grade pupils a second chance to obtain reading and writing skills. The highly structured reading program involves isolation of difficulties, work on word structure, learning consonant-vowel combinations…

Learning how to recover from job stress: effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being.

PubMed

Hahn, Verena C; Binnewies, Carmen; Sonnentag, Sabine; Mojza, Eva J

2011-04-01

This quasi-experimental study evaluated the effects of a recovery training program on recovery experiences (psychological detachment from work, relaxation, mastery experiences, and control during off-job time), recovery-related self-efficacy, and well-being outcomes. The training comprised two sessions held one week apart. Recovery experiences, recovery-related self-efficacy, and well-being outcomes were measured before the training (T1) and one week (T2) and three weeks (T3) after the training. A training group consisting of 48 individuals and a waitlist control group of 47 individuals were compared (N = 95). Analyses of covariance revealed an increase in recovery experiences at T2 and T3 (for mastery only at T2). Recovery-related self-efficacy and sleep quality increased at T2 and T3, perceived stress and state negative affect decreased at T3. No training effects were found for emotional exhaustion.

American Recovery and Reinvestment Act (ARRA) statistical summaries.

DOT National Transportation Integrated Search

2012-05-01

The American Recovery and Reinvestment Act (ARRA) Statistical Summaries provide information about the Federal Transit Administrations (FTA) financial investment programs funded through ARRA.This report covers the Urbanized Area Formula Program and...

Water immersion recovery for athletes: effect on exercise performance and practical recommendations.

PubMed

Versey, Nathan G; Halson, Shona L; Dawson, Brian T

2013-11-01

Water immersion is increasingly being used by elite athletes seeking to minimize fatigue and accelerate post-exercise recovery. Accelerated short-term (hours to days) recovery may improve competition performance, allow greater training loads or enhance the effect of a given training load. However, the optimal water immersion protocols to assist short-term recovery of performance still remain unclear. This article will review the water immersion recovery protocols investigated in the literature, their effects on performance recovery, briefly outline the potential mechanisms involved and provide practical recommendations for their use by athletes. For the purposes of this review, water immersion has been divided into four techniques according to water temperature: cold water immersion (CWI; ≤20 °C), hot water immersion (HWI; ≥36 °C), contrast water therapy (CWT; alternating CWI and HWI) and thermoneutral water immersion (TWI; >20 to <36 °C). Numerous articles have reported that CWI can enhance recovery of performance in a variety of sports, with immersion in 10-15 °C water for 5-15 min duration appearing to be most effective at accelerating performance recovery. However, the optimal CWI duration may depend on the water temperature, and the time between CWI and the subsequent exercise bout appears to influence the effect on performance. The few studies examining the effect of post-exercise HWI on subsequent performance have reported conflicting findings; therefore the effect of HWI on performance recovery is unclear. CWT is most likely to enhance performance recovery when equal time is spent in hot and cold water, individual immersion durations are short (~1 min) and the total immersion duration is up to approximately 15 min. A dose-response relationship between CWT duration and recovery of exercise performance is unlikely to exist. Some articles that have reported CWT to not enhance performance recovery have had methodological issues, such as failing to detect a decrease in performance in control trials, not performing full-body immersion, or using hot showers instead of pools. TWI has been investigated as both a control to determine the effect of water temperature on performance recovery, and as an intervention itself. However, due to conflicting findings it is uncertain whether TWI improves recovery of subsequent exercise performance. Both CWI and CWT appear likely to assist recovery of exercise performance more than HWI and TWI; however, it is unclear which technique is most effective. While the literature on the use of water immersion for recovery of exercise performance is increasing, further research is required to obtain a more complete understanding of the effects on performance.

Dataset on experimental investigation of gum arabic coated alumina nanoparticles for enhanced recovery of nigerian medium crude oil.

PubMed

Orodu, Oyinkepreye D; Orodu, Kale B; Afolabi, Richard O; Dafe, Eboh A

2018-08-01

The dataset in this article are related to an experimental Enhanced Oil Recovery (EOR) scheme involving the use of dispersions containing Gum Arabic coated Alumina Nanoparticles (GCNPs) for Nigerian medium crude oil. The result contained in the dataset showed a 7.18% (5 wt% GCNPs), 7.81% (5 wt% GCNPs), and 5.61% (3 wt% GCNPs) improvement in the recovery oil beyond the water flooding stage for core samples A, B, and C respectively. Also, the improvement in recovery of the medium crude oil by the GCNPs dispersions when compared to Gum Arabic polymer flooding was evident in the dataset.

Performance experimental investigation of novel multifunctional nanohybrids on enhanced oil recovery

NASA Astrophysics Data System (ADS)

Gharibshahi, Reza; Jafari, Arezou; Omidkhah, Mohammadreza; Nezhad, Javad Razavi

2018-01-01

The unique characteristics of materials at the nanoscale make them a good candidate to use in the enhanced oil recovery (EOR) processes. Therefore, in this study, the effect of functionalized multi-walled carbon nanotube/silica nanohybrids on the oil recovery factor is investigated experimentally and nanofluids were injected into a glass micromodel for the first time. The nanohybrids synthesized by using sol-gel method. Micromodels as microscale apparatuses considered as 2D porous medium. Because they enable visual observation of phase displacement behavior at the pore scale. Distillated water used as the dispersion medium of nanoparticles for nanofluids preparation. A series of runs designed for flooding operations included water injection, carbon nanotube/water injection and two nanohybrids with different weight of MWCNT to the overall weight of the nanohybrid structure (10% and 70%) into the distilled water. Also, the oil recovery factor was considered as the goal parameter to compare the results. It has been found that functionalized multi-walled carbon nanotube/silica nanohybrids have a great potential in enhanced oil recovery processes. Results showed that addition of nanohybrids into distillate water causes enhancement of sweep efficiency. In other words, the fingering effect decreases and higher surface of porous medium is in contact with the injected fluid. So the higher amount of oil can produce from the porous medium consequently. By injecting nanofluid with 0.1 wt. % of carbon nanotube, the oil recovery factor increases about 11 % in comparison with water injection alone. Also by increasing the weight of MWCNT to the overall weight of the nanohybrid structure from 10% to 70%, the oil recovery factor increases from 35% to 39%.

Developing Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT): protocol for a pilot randomized controlled trial.

PubMed

Watson, Dennis P; Ray, Bradley; Robison, Lisa; Xu, Huiping; Edwards, Rhiannon; Salyers, Michelle P; Hill, James; Shue, Sarah

2017-01-01

There is a lack of evidence-based substance use disorder treatment and services targeting returning inmates. Substance Use Programming for Person-Oriented Recovery and Treatment (SUPPORT) is a community-driven, recovery-oriented approach to substance abuse care which has the potential to address this service gap. SUPPORT is modeled after Indiana's Access to Recovery program, which was closed due to lack of federal support despite positive improvements in clients' recovery outcomes. SUPPORT builds on noted limitations of Indiana's Access to Recovery program. The ultimate goal of this project is to establish SUPPORT as an effective and scalable recovery-oriented system of care. A necessary step we must take before launching a large clinical trial is pilot testing the SUPPORT intervention. The pilot will take place at Public Advocates in Community Re-Entry (PACE), nonprofit serving individuals with felony convictions who are located in Marion County, Indiana (Indianapolis). The pilot will follow a basic parallel randomized design to compare clients receiving SUPPORT with clients receiving standard services. A total of 80 clients within 3 months of prison release will be recruited to participate and randomly assigned to one of the two intervention arms. Quantitative measures will be collected at multiple time points to understand SUPPORT's impact on recovery capital and outcomes. We will also collect qualitative data from SUPPORT clients to better understand their program and post-discharge experiences. Successful completion of this pilot will prepare us to conduct a multi-site clinical trial. The ultimate goal of this future work is to develop an evidence-based and scalable approach to treating substance use disorder among persons returning to society after incarceration. ClinicalTrials.gov (Clinical Trials ID: NCT03132753 and Protocol Number: 1511731907). Registered 28 April 2017.

A meta-analysis of the effectiveness of the opioid receptor antagonist alvimopan in reducing hospital length of stay and time to GI recovery in patients enrolled in a standardized accelerated recovery program after abdominal surgery.

PubMed

Vaughan-Shaw, P G; Fecher, I C; Harris, S; Knight, J S

2012-05-01

Despite accelerated recovery programs and the widespread uptake of laparoscopic surgery, postoperative ileus remains a significant factor affecting length of stay after abdominal surgery. Alvimopan, an opioid-receptor antagonist, may reduce the incidence of postoperative ileus and expedite hospital discharge. The aim of this study was to perform a meta-analysis to determine the role of alvimopan in accelerating GI recovery and hospital discharge after laparoscopic and open abdominal surgery performed within an accelerated recovery program. Cochrane (1999-2010), Embase (1980-2010), MEDLINE (1980-2010), and International Pharmaceutical Abstracts (1970-2010) were searched for relevant double-blinded, randomized controlled trials. Twelve milligrams of alvimopan and placebo were given to patients enrolled in an accelerated recovery program after abdominal surgery. The primary outcomes measured were the length of stay as defined by the writing of the hospital discharge order and GI-3 and GI-2 GI tract recovery. : Three trials were included that reported on a pooled modified intention-to-treat population of 1388 patients; 685 (49%) patients received alvimopan. On meta-analysis, alvimopan reduced time to the hospital discharge order (HR 1.37 (1.21, 1.62), p < 0.0001), GI-3 recovery (HR 1.42 (1.25, 1.62), p < 0.001), and GI-2 recovery (HR 1.49 (1.32, 1.68), p < 0.0001). The search criteria identified only a small number of trials of alvimopan after abdominal surgery with no randomized trials of alvimopan after laparoscopic surgery. In addition, the use of length of hospital stay as the primary outcome measure may be inappropriate, because it is open to many confounding factors. Finally, adverse events, in particular, adverse cardiovascular events, were not considered. Alvimopan 12 mg can further reduce time to GI recovery and hospital discharge in patients undergoing abdominal surgery within an accelerated recovery program. Investigation into the effect of alvimopan following laparoscopic surgery and additional cost-benefit analyses are required to further define the role of this intervention.

Ride 2 Recovery's Project HERO: using cycling as part of rehabilitation.

PubMed

Springer, Barbara A

2013-05-01

Ride 2 Recovery was founded in 2008 by a former world-class cycling competitor and coach to enhance the physical and psychological recovery of our nation's wounded, ill and injured service members and veterans through the sport of cycling. Ride 2 Recovery's most notable endeavor is Project HERO (Healing Exercise Rehabilitation Opportunity) which uses staff members and volunteers to promote cycling as an integral part of rehabilitation at select military facilities to enhance physical, psychological, spiritual and social recovery. Project HERO is directed by a retired military physical therapist that spent the last decade caring for service men and women wounded in Iraq and Afghanistan. This article describes all facets of the Project HERO initiative and highlights the profound impact it has had in the lives of US military members and veterans. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Program in Air Transportation Technology (Joint University Program)

NASA Technical Reports Server (NTRS)

Stengel, Robert F.

1996-01-01

The Joint University Program on Air Transportation Technology was conducted at Princeton University from 1971 to 1995. Our vision was to further understanding of the design and operation of transport aircraft, of the effects of atmospheric environment on aircraft flight, and of the development and utilization of the National Airspace System. As an adjunct, the program emphasized the independent research of both graduate and undergraduate students. Recent principal goals were to develop and verify new methods for design and analysis of intelligent flight control systems, aircraft guidance logic for recovery from wake vortex encounter, and robust flight control systems. Our research scope subsumed problems associated with multidisciplinary aircraft design synthesis and analysis based on flight physics, providing a theoretical basis for developing innovative control concepts that enhance aircraft performance and safety. Our research focus was of direct interest not only to NASA but to manufacturers of aircraft and their associated systems. Our approach, metrics, and future directions described in the remainder of the report.

40 CFR 147.2154 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and hydrocarbon storage wells authorized by rule. 147.2154 Section 147.2154 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... that the owner or operator of an existing enhanced recovery or hydrocarbon storage well may not be in...

40 CFR 147.1954 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and hydrocarbon storage wells authorized by rule. 147.1954 Section 147.1954 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... determines that the owner or operator of an existing enhanced recovery or hydrocarbon storage well may not be...

40 CFR 147.1954 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2010 CFR

2010-07-01

... and hydrocarbon storage wells authorized by rule. 147.1954 Section 147.1954 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... determines that the owner or operator of an existing enhanced recovery or hydrocarbon storage well may not be...

40 CFR 147.2154 - Existing Class II enhanced recovery and hydrocarbon storage wells authorized by rule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and hydrocarbon storage wells authorized by rule. 147.2154 Section 147.2154 Protection of Environment... hydrocarbon storage wells authorized by rule. (a) Maximum injection pressure. (1) To meet the operating... that the owner or operator of an existing enhanced recovery or hydrocarbon storage well may not be in...

20 CFR 437.21 - Payment.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE.... (f) Effect of program income, refunds, and audit recoveries on payment. (1) Grantees and subgrantees... subgrantees must disburse program income, rebates, refunds, contract settlements, audit recoveries and...

The Role of Twelve-Step-Related Spirituality in Addiction Recovery.

PubMed

Dermatis, Helen; Galanter, Marc

2016-04-01

This paper reviews empirical studies conducted on the role of spirituality and religiosity (S/R) characteristics in 12-step recovery among program members followed up after substance abuse treatment and those assessed independent of formal treatment. Aspects of spiritual functioning that change in relation to program participation and those S/R characteristics that were found to mediate the association between program involvement and drinking-related outcomes are discussed. In addition, a review is provided of 12-step program studies investigating S/R-related predictors of clinical outcomes relevant to risk of relapse among members in long-term recovery. To further examine the role of S/R characteristics in recovery, a study was conducted on long-term AA members to assess the relationship of S/R characteristics and AA program involvement to craving for alcohol and emotional distress after controlling for relevant demographic variables. Feeling God's presence daily, believing in a higher power as a universal spirit, and serving as an AA sponsor were all predictive of positive outcomes.

Enhanced recovery after esophageal resection.

PubMed

Vorwald, Peter; Bruna Esteban, Marcos; Ortega Lucea, Sonia; Ramírez Rodríguez, Jose Manuel

2018-03-21

ERAS is a multimodal perioperative care program which replaces traditional practices concerning analgesia, intravenous fluids, nutrition, mobilization as well as a number of other perioperative items, whose implementation is supported by evidence-based best practices. According to the RICA guidelines published in 2015, a review of the literature and the consensus established at a multidisciplinary meeting in 2015, we present a protocol that contains the basic procedures of an ERAS pathway for resective esophageal surgery. The measures involved in this ERAS pathway are structured into 3areas: preoperative, perioperative and postoperative. The consensus document integrates all the analyzed items in a unique time chart. ERAS programs in esophageal resection surgery can reduce postoperative morbidity, mortality, hospitalization and hospital costs. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Participants' Assessment of the Impact of Behavioral Health Self-Direction on Recovery.

PubMed

Croft, Bevin; Parish, Susan

2016-10-01

Self-direction involves managing a flexible budget, selecting and purchasing services and supports to meet individual needs and preferences. An emerging practice in the behavioral health field, self-direction is part of a systemic shift toward person-centered approaches to service provision. To understand the relationship between recovery and self-direction, the authors conducted a content analysis of 30 in-depth interviews with individuals from two self-direction programs in one state. A positive relationship between self-direction and recovery was established. Meeting basic needs for food, clothing, and shelter are important first steps in the recovery process for self-directing participants. Recovery domains were dynamic and interrelated, with gains in independence, self-esteem, and self-confidence facilitating achievement of goals in other domains. To maximize the benefits of self-direction, program administrators may need to develop clearer program implementation standards and address poverty and limited access to appropriate behavioral health services and supports.

Dual role of starvation signaling in promoting growth and recovery

PubMed Central

Leshkowitz, Dena; Barkai, Naama

2017-01-01

Growing cells are subject to cycles of nutrient depletion and repletion. A shortage of nutrients activates a starvation program that promotes growth in limiting conditions. To examine whether nutrient-deprived cells prepare also for their subsequent recovery, we followed the transcription program activated in budding yeast transferred to low-phosphate media and defined its contribution to cell growth during phosphate limitation and upon recovery. An initial transcription wave was induced by moderate phosphate depletion that did not affect cell growth. A second transcription wave followed when phosphate became growth limiting. The starvation program contributed to growth only in the second, growth-limiting phase. Notably, the early response, activated at moderate depletion, promoted recovery from starvation by increasing phosphate influx upon transfer to rich medium. Our results suggest that cells subject to nutrient depletion prepare not only for growth in the limiting conditions but also for their predicted recovery once nutrients are replenished. PMID:29236696

Credit Recovery Programs. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2015

2015-01-01

"Credit recovery programs" allow high school students to recover course credit, through in-school, online, or mixed modes, for classes they previously failed. The WWC reviewed the research on these programs and their impacts on middle school, junior high school, or high school students at risk of dropping out or who have already dropped…

Addressing Student Attrition: Perceptions of a Credit Recovery Program in a Coastal Virginia School District

ERIC Educational Resources Information Center

Gardner, Emmett C.

2017-01-01

This qualitative study explores perceptions of a dropout recovery program implemented in two high schools in Waterway School District from the perspectives of program facilitators, school administrators, and former student participants. Individual interviews, focus group interviews, and an online questionnaire are the sources of data for the…

Development of an Enhanced Recovery After Surgery Guideline and Implementation Strategy Based on the Knowledge-to-action Cycle.

PubMed

McLeod, Robin S; Aarts, Mary-Anne; Chung, Frances; Eskicioglu, Cagla; Forbes, Shawn S; Conn, Lesley Gotlib; McCluskey, Stuart; McKenzie, Marg; Morningstar, Beverly; Nadler, Ashley; Okrainec, Allan; Pearsall, Emily A; Sawyer, Jason; Siddique, Naveed; Wood, Trevor

2015-12-01

Enhanced Recovery After Surgery (ERAS) protocols have been shown to increase recovery, decrease complications, and reduce length of stay. However, they are difficult to implement. To develop and implement an ERAS clinical practice guideline (CPG) at multiple hospitals. A tailored strategy based on the Knowledge-to-action (KTA) cycle was used to develop and implement an ERAS CPG at 15 academic hospitals in Canada. This included an initial audit to identify gaps and interviews to assess barriers and enablers to implementation. Implementation included development of an ERAS guideline by a multidisciplinary group, communities of practice led by multidiscipline champions (surgeons, anesthesiologists, and nurses) both provincially and locally, educational tools, and clinical pathways as well as audit and feedback. The initial audit revealed there was greater than 75% compliance in only 2 of 18 CPG recommendations. Main themes identified by stakeholders were that the CPG must be based on best evidence, there must be increased communication and collaboration among perioperative team members, and patient education is essential. ERAS and Pain Management CPGs were developed by a multidisciplinary team and have been adopted at all hospitals. Preliminary data from more than 1000 patients show that the uptake of recommended interventions varies but despite this, mean length of stay has decreased with low readmission rates and adverse events. On the basis of short-term findings, our results suggest that a tailored implementation strategy based on the KTA cycle can be used to successfully implement an ERAS program at multiple sites.

Cold water immersion enhances recovery of submaximal muscle function after resistance exercise.

PubMed

Roberts, Llion A; Nosaka, Kazunori; Coombes, Jeff S; Peake, Jonathan M

2014-10-15

We investigated the effect of cold water immersion (CWI) on the recovery of muscle function and physiological responses after high-intensity resistance exercise. Using a randomized, cross-over design, 10 physically active men performed high-intensity resistance exercise followed by one of two recovery interventions: 1) 10 min of CWI at 10°C or 2) 10 min of active recovery (low-intensity cycling). After the recovery interventions, maximal muscle function was assessed after 2 and 4 h by measuring jump height and isometric squat strength. Submaximal muscle function was assessed after 6 h by measuring the average load lifted during 6 sets of 10 squats at 80% of 1 repetition maximum. Intramuscular temperature (1 cm) was also recorded, and venous blood samples were analyzed for markers of metabolism, vasoconstriction, and muscle damage. CWI did not enhance recovery of maximal muscle function. However, during the final three sets of the submaximal muscle function test, participants lifted a greater load (P < 0.05, Cohen's effect size: 1.3, 38%) after CWI compared with active recovery. During CWI, muscle temperature decreased ∼7°C below postexercise values and remained below preexercise values for another 35 min. Venous blood O2 saturation decreased below preexercise values for 1.5 h after CWI. Serum endothelin-1 concentration did not change after CWI, whereas it decreased after active recovery. Plasma myoglobin concentration was lower, whereas plasma IL-6 concentration was higher after CWI compared with active recovery. These results suggest that CWI after resistance exercise allows athletes to complete more work during subsequent training sessions, which could enhance long-term training adaptations. Copyright © 2014 the American Physiological Society.

Does the time frame between exercise influence the effectiveness of hydrotherapy for recovery?

PubMed

Halson, Shona L

2011-06-01

An increase in research investigating recovery strategies has occurred alongside the increase in usage of recovery by elite athletes. Because there is inconsistent evidence regarding the benefits of recovery on performance, it is necessary to examine research design to identify possible strategies that enhance performance in different athlete settings. The purpose of this review is to examine available recovery literature specifically related to the time frame between performance assessments to identify considerations for both research design and practical use of recovery techniques.

Perioperative enhanced recovery programmes for gynaecological cancer patients.

PubMed

Lv, Donghao; Wang, Xuan; Shi, Gang

2010-06-16

Gynaecological malignancies contribute to 10 to 15% of cancers in women internationally. In recent years, a trend towards new perioperative care strategies has been documented as "Fast Track (FT) surgery", or "Enhanced Recovery Programmes" to replace some traditional approaches in surgical care. The FT multimodal programmes may enhance the postoperative recovery by means of reducing surgical stress. This systematic review aims to fully assess the beneficial and harmful effects of FT programmes in gynaecological cancer care. To evaluate the beneficial and harmful effects of FT programmes in gynaecological cancer care. We searched the following databases, The Cochrane Gynaecological Cancer Collaborative Review Group's Trial Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 4, 2009, MEDLINE and EMBASE to November 2009. In addition, all reference lists of included trials were searched and experts in the gynaecological oncology community were contacted in an attempt to locate trials. All randomised controlled trials (RCTs) comparing any type of FT programmes for surgery in gynaecological cancer to conventional recovery strategies were included. Two review authors independently screened studies for inclusion. Since no RCTs were identified, data collection and analysis could not be performed. No studies were found that met the inclusion criteria. We currently have no evidence from high quality studies to support or refute the use of perioperative enhanced recovery programmes for gynaecological cancer patients. Further well-designed RCTs with standard FT programmes are needed.

Biosurfactant production by Bacillus subtilis B30 and its application in enhancing oil recovery.

PubMed

Al-Wahaibi, Yahya; Joshi, Sanket; Al-Bahry, Saif; Elshafie, Abdulkadir; Al-Bemani, Ali; Shibulal, Biji

2014-02-01

The fermentative production of biosurfactants by Bacillus subtilis strain B30 and the evaluation of biosurfactant based enhanced oil recovery using core-flood were investigated. Different carbon sources (glucose, sucrose, starch, date molasses, cane molasses) were tested to determine the optimal biosurfactant production. The isolate B30 produced a biosurfactant that could reduce the surface tension and interfacial tension to 26.63±0.45 mN/m and 3.79±0.27 mN/m, respectively in less than 12h in both glucose or date molasses based media. A crude biosurfactant concentration of 0.3-0.5 g/l and critical micelle dilution (CMD) values of 1:8 were observed. The biosurfactants gave stable emulsions with wide range of hydrocarbons including light and heavy crude oil. The biosurfactants were partially purified and identified as a mixture of lipopeptides similar to surfactin, using high performance thin layer chromatography and Fourier transform infrared spectroscopy. The biosurfactants were stable over wide range of pH, salinity and temperatures. The crude biosurfactant preparation enhanced light oil recovery by 17-26% and heavy oil recovery by 31% in core-flood studies. The results are indicative of the potential of the strain for the development of ex situ microbial enhanced oil recovery processes using glucose or date molasses based minimal media. Copyright © 2013 Elsevier B.V. All rights reserved.

Production report: enhanced recovery. [Combustion, steam, soak steam drive, polymer and caustic, micellar/surfactant miscible hydrocarbons and CO/sub 2/

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

Noran, D.

Schemes for producing additional oil using enhanced-recovery (ER) methods are under way throughout the world. The extent and intensity of ER activity is highest in the U.S. with 156 projects, about two-thirds of which are thermal. Venezuela has a strong ER commitment with at least 70 active projects, with a major thrust on steam soak. Significant projects, but limited in number, are under way in Canada, North Africa, Southeast Asia, and elsewhere in Latin America. A breakdown of active U.S. ER projects for 1970, 1973, and 1975 is tabulated for combustion, steam soak, steam drive, polymer and caustic, micellar/surfactant, misciblemore » hydrocarbon, and CO/sub 2/ methods. This Oil and Gas Journal Survey includes seven articles; the first six were prepared by David Noran, Journal Production Editor. The final article on Venezuelan activity was written by Alvaro Franco, Editor and Publisher, Petroleo Internacional. The articles are entitled: U.S. Thermal Recovery Activity Growing Steadily; Operators Accelerate Testing of Micellar/Surfactant Potential; Polymer and Caustic Methods on Rebound; Gas Miscible Projects Move at Slow Pace; Canadian Enhanced-Recovery Activity Moderate, Centers on Thermal Projects; Other Global Enhanced-Recovery Work Sparse; and Thermal Work Humming in Venezuela. Detailed information on each method is tabulated for each article. (MCW)« less

Partnering to enhance interprofessional service-learning innovations and addictions recovery.

PubMed

Mihalynuk, T V; Soule Odegard, P; Kang, R; Kedzierski, M; Johnson Crowley, N

2007-11-01

Service-learning programs are reported to benefit students, faculty, higher education institutions, community agencies and the relationships among these groups. An interprofessional service-learning paradigm may strengthen these benefits. Community settings can expose students to social and cultural determinants of health, in addition to those biomedical determinants more commonly addressed in health sciences curricula. These experiences can also enhance student understanding of the complexities underlying treatment and prevention of modern health problems, particularly chronic diseases. The purpose of this initiative was to create and deliver interprofessional service-learning innovations that would enhance student learning and addictions recovery. To address this initiative, the University of Washington's Health Science Partnerships in Interdisciplinary Clinical Education (HSPICE) and the Salvation Army Adult Rehabilitation Center (ARC) began a community-campus partnership in 1997. Innovations took into account student educational objectives established by HSPICE which included: participation in interdisciplinary teams, in conjunction with community partners to identify and reduce population-based health issues, realization and articulation of biases regarding issues faced by the participating community, acquiring an understanding of the broader determinants of health and developing an understanding of why the complexity of population health requires interdisciplinary strategies for cost effectiveness. Findings are reported from evaluations, needs assessments and ongoing feedback of men recovering from addictions, as applied to health education materials and presentations developed for the ARC. Future directions are highlighted, including the need for further research and evaluation efforts aimed at rigorously assessing cost savings and student knowledge, skills and cultural sensitivity, among others.

The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction

PubMed Central

2008-01-01

Background Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce. Purpose To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries. Methods Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise. Results Research studies pertaining to the following general categories were identified and reviewed: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation. Discussion Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage. Conclusion Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments. PMID:21509135

Biomechanics of knee rehabilitation with cycling.

PubMed

McLeod, W D; Blackburn, T A

1980-01-01

The bicycle provides quadriceps rehabilitation while controlling the stresses to the knee ligaments. With pedaling on the bicycle, forces are applied to the anterior cruciate ligament, the capsular ligaments, and the posterior structures of the knee joint as the tibial plateau is posteriorly tilted. The knee muscles can modify their forces. Therefore, by controlling the mode of cycling with varying seat heights and pedal positions, the ligaments can be relieved from these forces during the initial stages of the rehabilitative process. An exercise program can then be designed to apply controlled stress to these structures to enhance the healing and recovery processes.

Recovery of methamphetamine associated cardiomyopathy predicted by late gadolinium enhanced cardiovascular magnetic resonance.

PubMed

Lopez, Javier E; Yeo, Khung; Caputo, Gary; Buonocore, Michael; Schaefer, Saul

2009-11-11

Methamphetamine is known to cause a cardiomyopathy which may be reversible with appropriate medical therapy and cessation of use. Late gadolinium enhancement cardiovascular magnetic resonance (CMR) has been shown to identify fibrosis in ischemic and non-ischemic cardiomyopathies. We present a case of severe methamphetamine-associated cardiomyopathy in which cardiac function recovered after 6 months. Evaluation by CMR using late gadolinium enhancement was notable for an absence of enhancement, suggesting an absence of irreversible myocyte injury and a good prognosis. CMR may be useful to predict recovery in toxin-associated non-ischemic cardiomyopathies.

Recovery of methamphetamine associated cardiomyopathy predicted by late gadolinium enhanced cardiovascular magnetic resonance

PubMed Central

2009-01-01

Methamphetamine is known to cause a cardiomyopathy which may be reversible with appropriate medical therapy and cessation of use. Late gadolinium enhancement cardiovascular magnetic resonance (CMR) has been shown to identify fibrosis in ischemic and non-ischemic cardiomyopathies. We present a case of severe methamphetamine-associated cardiomyopathy in which cardiac function recovered after 6 months. Evaluation by CMR using late gadolinium enhancement was notable for an absence of enhancement, suggesting an absence of irreversible myocyte injury and a good prognosis. CMR may be useful to predict recovery in toxin-associated non-ischemic cardiomyopathies. PMID:19906310

Effects of controlled gas environments in microbial enhancement of plant protein recovery

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

Mudgett, R.E.; Bajracharya, R.

Controlled gas environments were maintained by a novel aeration system in solid substrate fermentations for enhanced protein recovery from pressed alfalfa residues. High O/sub 2/ pressures stimulated biomass and enzyme production by an Aspergillus species, isolated from alfalfa, which produced cellulase and pectinase activities in growth-associated metabolism. High CO/sub 2/ pressures also stimulated enzyme production, but had less effect on biomass production, as established from the dissimilation of plant solids. Cellulase and pectinase activities were generally related to protein recoveries. Recoveries were greater than or equal to 50% higher than those obtained by mechanical extraction, with maximum recoveries of greatermore » than or equal to 70% of crude protein contents. Protein not recovered at high cellulase and pectinase activities were believed to be in structurally bound forms not amenable to recovery by nonproteolytic enzymes. Buffering at pH 8 and autoclaving of residues prior to fermentation had little effect on protein recoveries. Controlled gas environments are seen to offer an interesting potential for optimizing industrial fermentation processes for the production of microbial enzymes.« less

Physiological response to water immersion: a method for sport recovery?

PubMed

Wilcock, Ian M; Cronin, John B; Hing, Wayne A

2006-01-01

Recovery from exercise can be an important factor in performance during repeated bouts of exercise. In a tournament situation, where athletes may compete numerous times over a few days, enhancing recovery may provide a competitive advantage. One method that is gaining popularity as a means to enhance post-game or post-training recovery is immersion in water. Much of the literature on the ability of water immersion as a means to improve athletic recovery appears to be based on anecdotal information, with limited research on actual performance change. Water immersion may cause physiological changes within the body that could improve recovery from exercise. These physiological changes include intracellular-intravascular fluid shifts, reduction of muscle oedema and increased cardiac output (without increasing energy expenditure), which increases blood flow and possible nutrient and waste transportation through the body. Also, there may be a psychological benefit to athletes with a reduced cessation of fatigue during immersion. Water temperature alters the physiological response to immersion and cool to thermoneutral temperatures may provide the best range for recovery. Further performance-orientated research is required to determine whether water immersion is beneficial to athletes.

Recovery of ammonia and phosphate minerals from swine wastewater using gas-permeable membranes

USDA-ARS?s Scientific Manuscript database

Gas-permeable membrane technology is useful to recover ammonia from liquid manures. In this study, phosphorus (P) recovery via magnesium chloride precipitation was enhanced by combining it with ammonia recovery through gas-permeable membranes. Anaerobically digested swine effluent containing approx...

Miconazole enhances nerve regeneration and functional recovery after sciatic nerve crush injury.

PubMed

Lin, Tao; Qiu, Shuai; Yan, Liwei; Zhu, Shuang; Zheng, Canbin; Zhu, Qingtang; Liu, Xiaolin

2018-05-01

Improving axonal outgrowth and remyelination is crucial for peripheral nerve regeneration. Miconazole appears to enhance remyelination in the central nervous system. In this study we assess the effect of miconazole on axonal regeneration using a sciatic nerve crush injury model in rats. Fifty Sprague-Dawley rats were divided into control and miconazole groups. Nerve regeneration and myelination were determined using histological and electrophysiological assessment. Evaluation of sensory and motor recovery was performed using the pinprick assay and sciatic functional index. The Cell Counting Kit-8 assay and Western blotting were used to assess the proliferation and neurotrophic expression of RSC 96 Schwann cells. Miconazole promoted axonal regrowth, increased myelinated nerve fibers, improved sensory recovery and walking behavior, enhanced stimulated amplitude and nerve conduction velocity, and elevated proliferation and neurotrophic expression of RSC 96 Schwann cells. Miconazole was beneficial for nerve regeneration and functional recovery after peripheral nerve injury. Muscle Nerve 57: 821-828, 2018. © 2017 Wiley Periodicals, Inc.

Bacterial community diversity in a low-permeability oil reservoir and its potential for enhancing oil recovery.

PubMed

Xiao, Meng; Zhang, Zhong-Zhi; Wang, Jing-Xiu; Zhang, Guang-Qing; Luo, Yi-Jing; Song, Zhao-Zheng; Zhang, Ji-Yuan

2013-11-01

The diversity of indigenous bacterial community and the functional species in the water samples from three production wells of a low permeability oil reservoir was investigated by high-throughput sequencing technology. The potential of application of indigenous bacteria for enhancing oil recovery was evaluated by examination of the effect of bacterial stimulation on the formation water-oil-rock surface interactions and micromodel test. The results showed that production well 88-122 had the most diverse bacterial community and functional species. The broth of indigenous bacteria stimulated by an organic nutrient activator at aerobic condition changed the wettability of the rock surface from oil-wet to water-wet. Micromodel test results showed that flooding using stimulated indigenous bacteria following water flooding improved oil recovery by 6.9% and 7.7% in fractured and unfractured micromodels, respectively. Therefore, the zone of low permeability reservoir has a great potential for indigenous microbial enhanced oil recovery. Copyright © 2013 Elsevier Ltd. All rights reserved.

Rewiring of regenerated axons by combining treadmill training with semaphorin3A inhibition

PubMed Central

2014-01-01

Background Rats exhibit extremely limited motor function recovery after total transection of the spinal cord (SCT). We previously reported that SM-216289, a semaphorin3A inhibitor, enhanced axon regeneration and motor function recovery in SCT adult rats. However, these effects were limited because most regenerated axons likely do not connect to the right targets. Thus, rebuilding the appropriate connections for regenerated axons may enhance recovery. In this study, we combined semaphorin3A inhibitor treatment with extensive treadmill training to determine whether combined treatment would further enhance the “rewiring” of regenerated axons. In this study, which aimed for clinical applicability, we administered a newly developed, potent semaphorin3A inhibitor, SM-345431 (Vinaxanthone), using a novel drug delivery system that enables continuous drug delivery over the period of the experiment. Results Treatment with SM-345431 using this delivery system enhanced axon regeneration and produced significant, but limited, hindlimb motor function recovery. Although extensive treadmill training combined with SM-345431 administration did not further improve axon regeneration, hindlimb motor performance was restored, as evidenced by the significant improvement in the execution of plantar steps on a treadmill. In contrast, control SCT rats could not execute plantar steps at any point during the experimental period. Further analyses suggested that this strategy reinforced the wiring of central pattern generators in lumbar spinal circuits, which, in turn, led to enhanced motor function recovery (especially in extensor muscles). Conclusions This study highlights the importance of combining treatments that promote axon regeneration with specific and appropriate rehabilitations that promote rewiring for the treatment of spinal cord injury. PMID:24618249

Enhanced recovery pathways in abdominal gynecologic surgery: a systematic review and meta-analysis.

PubMed

de Groot, Jeanny J A; Ament, Stephanie M C; Maessen, José M C; Dejong, Cornelis H C; Kleijnen, Jos M P; Slangen, Brigitte F M

2016-04-01

Enhanced recovery pathways have been widely accepted and implemented for different types of surgery. Their overall effect in abdominal gynecologic surgery is still underdetermined. A systematic review and meta-analysis were performed to provide an overview of current evidence and to examine their effect on postoperative outcomes in women undergoing open gynecologic surgery. Searches were conducted using Embase, Medline, CINAHL, and the Cochrane Library up to 27 June 2014. Reference lists were screened to identify additional studies. Studies were included if at least four individual items of an enhanced recovery pathway were described. Outcomes included length of hospital stay, complication rates, readmissions, and mortality. Quantitative analysis was limited to comparative studies. Effect sizes were presented as relative risks or as mean differences (MD) with 95% confidence intervals (CI). Thirty-one records, involving 16 observational studies, were included. Diversity in reported elements within studies was observed. Preoperative education, early oral intake, and early mobilization were included in all pathways. Five studies, with a high risk of bias, were eligible for quantitative analysis. Enhanced recovery pathways reduced primary (MD -1.57 days, 95% CI CI -2.94 to -0.20) and total (MD -3.05 days, 95% CI -4.87 to -1.23) length of hospital stay compared with traditional perioperative care, without an increase in complications, mortality or readmission rates. The available evidence based on a broad range of non-randomized studies at high risk of bias suggests that enhanced recovery pathways may reduce length of postoperative hospital stay in abdominal gynecologic surgery. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

A review of enhanced recovery for thoracic anaesthesia and surgery.

PubMed

Jones, N L; Edmonds, L; Ghosh, S; Klein, A A

2013-02-01

During the past decade, there has been a dramatic increase in the number of thoracic surgical procedures carried out in the UK. The current financial climate dictates that more efficient use of resources is necessary to meet escalating demands on healthcare. One potential means to achieve this is through the introduction of enhanced recovery protocols, designed to produce productivity savings by driving reduction in length of stay. These have been promoted by government bodies in a number of surgical specialties, including colorectal, gynaecological and orthopaedic surgery. This review focuses on aspects of peri-operative care that might be incorporated into such a programme for thoracic anaesthesia, for which an enhanced recovery programme has not yet been introduced in the UK, and a review of the literature specific to this area of practice has not been published before. We performed a comprehensive search for published work relating to the peri-operative management and optimisation of patients undergoing thoracic surgery, and divided these into appropriate areas of practice. We have reviewed the specific interventions that may be included in an enhanced recovery programme, including: pre-optimisation; minimising fasting time; thrombo-embolic prophylaxis; choice of anaesthetic and analgesic technique and surgical approach; postoperative rehabilitation; and chest drain management. Using the currently available evidence, the design and implementation of an enhanced recovery programme based on this review in selected patients as a package of care may reduce morbidity and length of hospital stay, thus maximising utilisation of available resources. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

Effects of a recovery management intervention on Chinese heroin users' community recovery through the mediation effect of enhanced service utilization

PubMed Central

Wu, F.; Fu, L.M.; Hser, Y.H.

2015-01-01

Background This study investigates whether a recovery management intervention (RMI) can improve the utilization of community drug treatment and wraparound services among heroin users in China and subsequently lead to positive recovery outcomes. Methods Secondary analysis was conducted drawing data from a randomized controlled trial; 100 heroin users with no severe mental health problems were recruited in two Shanghai districts (Hongkou and Yangpu) upon their release from compulsory rehabilitation facilities. A latent variable modeling approach was utilized to test whether the RMI influences heroin users' perceived motivation and readiness for treatment, enhances treatment and wraparound service participation, and, in turn, predicts better recovery outcomes. Results Enrollment in drug treatment and other social service utilization increased significantly as a result of RMI rather than an individual drug user's motivation and readiness for treatment. Increased service utilization thus led to more positive individual recovery outcomes. In addition to this mediation effect through service utilization, the RMI also improved participants' community recovery directly. Conclusions Findings suggest that better drug treatment enrollment, community service utilization and recovery outcomes can be potentially achieved among heroin users in China with carefully designed case management interventions. PMID:24990956

Unstable rocker shoes promote recovery from marathon-induced muscle damage in novice runners.

PubMed

Nakagawa, K; Inami, T; Yonezu, T; Kenmotsu, Y; Narita, T; Kawakami, Y; Kanosue, K

2018-02-01

We recently reported that wearing unstable rocker shoes (Masai Barefoot Technology: MBT) may enhance recovery from marathon race-induced fatigue. However, this earlier study only utilized a questionnaire. In this study, we evaluated MBT utilizing objective physiological measures of recovery from marathon-induced muscle damages. Twenty-five university student novice runners were divided into two groups. After running a full marathon, one group wore MBT shoes (MBT group), and the control group (CON) wore ordinary shoes daily for 1 week following the race. We measured maximal isometric joint torque, muscle hardness (real time tissue elastography of the strain ratio) in the lower limb muscles before, immediately after, and 1, 3, and 8 days following the marathon. We calculated the magnitude of recovery by observing the difference in each value between the first measurement and the latter measurements. Results showed that isometric torques in knee flexion recovered at the first day after the race in the MBT group while it did not recover even at the eighth day in the CON group. Muscle hardness in the gastrocnemius and vastus lateralis showed enhanced recovery in the MBT group in comparison with the CON group. Also for muscle hardness in the tibialis anterior and biceps femoris, the timing of recovery was delayed in the CON group. In conclusion, wearing MBT shoes enhanced recovery in lower leg and thigh muscles from muscle damage induced by marathon running. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preparation and Investigation of Foaming Amphiphilic Fluorinated Nanoparticles for Enhanced Oil Recovery.

PubMed

Wang, Keliang; Wang, Gang; Lu, Chunjing; Pei, Cuiying; Wang, Ying

2017-12-08

Amphiphilic nanoparticles have attracted increasing interest as Pickering emulsifiers owing to the combined advantages of both traditional surfactants and homogeneous particles. Here, foaming amphiphilic fluorinated nanoparticles were prepared for enhanced oil recovery by the toposelective surface modification method. The structure and properties of amphiphilic nanoparticles were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy, a laser diffraction method, fluorescence microscopy, a pendant drop tensiometer, and foamscan. It was found that the amphiphilic fluorinated nanoparticles exhibited significant interfacial activity at the air-water interface and generated stabilized aqueous foams against coalescence and drainage even in the absence of surfactants. When the particle concentration reached 0.6 wt %, the adsorption of the amphiphilic nanoparticles at the interface was saturated and the equilibrium surface tension dropped to around 32.7 mN/m. When the particle concentration reached 0.4 wt %, the Gibbs stability criterion was fulfilled. The amphiphilic nanoparticles foam system has a better plugging capacity and enhanced oil recovery capacity. The results obtained provide fundamental insights into the understanding of the self-assembly behavior and foam properties of amphiphilic fluorinated nanoparticles and further demonstrate the future potential of the amphiphilic nanoparticles used as colloid surfactants for enhanced oil recovery applications.

Preparation and Investigation of Foaming Amphiphilic Fluorinated Nanoparticles for Enhanced Oil Recovery

PubMed Central

Wang, Keliang; Lu, Chunjing; Pei, Cuiying; Wang, Ying

2017-01-01

Amphiphilic nanoparticles have attracted increasing interest as Pickering emulsifiers owing to the combined advantages of both traditional surfactants and homogeneous particles. Here, foaming amphiphilic fluorinated nanoparticles were prepared for enhanced oil recovery by the toposelective surface modification method. The structure and properties of amphiphilic nanoparticles were characterized using Fourier transform infrared spectroscopy, scanning electron microscopy, a laser diffraction method, fluorescence microscopy, a pendant drop tensiometer, and foamscan. It was found that the amphiphilic fluorinated nanoparticles exhibited significant interfacial activity at the air–water interface and generated stabilized aqueous foams against coalescence and drainage even in the absence of surfactants. When the particle concentration reached 0.6 wt %, the adsorption of the amphiphilic nanoparticles at the interface was saturated and the equilibrium surface tension dropped to around 32.7 mN/m. When the particle concentration reached 0.4 wt %, the Gibbs stability criterion was fulfilled. The amphiphilic nanoparticles foam system has a better plugging capacity and enhanced oil recovery capacity. The results obtained provide fundamental insights into the understanding of the self-assembly behavior and foam properties of amphiphilic fluorinated nanoparticles and further demonstrate the future potential of the amphiphilic nanoparticles used as colloid surfactants for enhanced oil recovery applications. PMID:29292747

Characteristics of students participating in Collegiate Recovery Programs: A national survey

PubMed Central

Laudet, Alexandre B.; Harris, Kitty; Kimball, Thomas; Winters, Ken C.; Moberg, D. Paul

2014-01-01

Relapse rates are high among individuals with substance use disorders (SUD), and for young people pursuing a college education, the high rates of substance use on campus can jeopardize recovery. Collegiate Recovery Programs (CRPs) are an innovative campus-based model of recovery support that is gaining popularity but remains under-investigated. This study reports on the first nationwide survey of CRP-enrolled students (N = 486 from 29 different CRPs). Using an online survey, we collected information on background, SUD and recovery history, and current functioning. Most students (43% females, mean age = 26) had used multiple substances, had high levels of SUD severity, high rates of treatment and 12-step participation. Fully 40% smoke. Many reported criminal justice involvement and periods of homelessness. Notably, many reported being in recovery from, and currently engaging in multiple behavioral addictions-e.g., eating disorders, and sex and love addiction. Findings highlight the high rates of co-occurring addictions in this under-examined population and underline the need for treatment, recovery support programs and college health services to provide integrated support for mental health and behavioral addictions to SUD-affected young people. PMID:25481690

45 CFR 1157.21 - Payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL... program income, refunds, and audit recoveries on payment. (1) Grantees and subgrantees shall disburse... disburse program income, rebates, refunds, contract settlements, audit recoveries and interest earned on...

45 CFR 1174.21 - Payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL... program income, refunds, and audit recoveries on payment. (1) Grantees and subgrantees shall disburse... disburse program income, rebates, refunds, contract settlements, audit recoveries and interest earned on...

Notification: EPA Oversight of Delegated State Resource Conservation and Recovery Act Programs

EPA Pesticide Factsheets

Project #OPE-FY16-0033, September 19, 2016. The EPA OIG plans to begin preliminary research on the EPA's oversight of authorized state hazardous waste programs that fall under the Resource Conservation and Recovery Act.

20 CFR 408.930 - Are title II and title XVI benefits subject to adjustment to recover title VIII overpayments?

Code of Federal Regulations, 2012 CFR

2012-04-01

... SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Underpayments and Overpayments... recover title VIII overpayments? (a) Definitions—(1) Cross-program recovery. Cross-program recovery is the...

20 CFR 408.930 - Are title II and title XVI benefits subject to adjustment to recover title VIII overpayments?

Code of Federal Regulations, 2013 CFR

2013-04-01

... SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Underpayments and Overpayments... recover title VIII overpayments? (a) Definitions—(1) Cross-program recovery. Cross-program recovery is the...

20 CFR 408.930 - Are title II and title XVI benefits subject to adjustment to recover title VIII overpayments?

Code of Federal Regulations, 2010 CFR

2010-04-01

... SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Underpayments and Overpayments... recover title VIII overpayments? (a) Definitions—(1) Cross-program recovery. Cross-program recovery is the...

20 CFR 408.930 - Are title II and title XVI benefits subject to adjustment to recover title VIII overpayments?

Code of Federal Regulations, 2014 CFR

2014-04-01

... SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Underpayments and Overpayments... recover title VIII overpayments? (a) Definitions—(1) Cross-program recovery. Cross-program recovery is the...

20 CFR 408.930 - Are title II and title XVI benefits subject to adjustment to recover title VIII overpayments?

Code of Federal Regulations, 2011 CFR

2011-04-01

... SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Underpayments and Overpayments... recover title VIII overpayments? (a) Definitions—(1) Cross-program recovery. Cross-program recovery is the...

A Cluster Analytic Approach to Identifying Predictors and Moderators of Psychosocial Treatment for Bipolar Depression: Results from STEP-BD

PubMed Central

Deckersbach, Thilo; Peters, Amy T.; Sylvia, Louisa G.; Gold, Alexandra K.; da Silva Magalhaes, Pedro Vieira; Henry, David B.; Frank, Ellen; Otto, Michael W.; Berk, Michael; Dougherty, Darin D.; Nierenberg, Andrew A.; Miklowitz, David J.

2016-01-01

Background We sought to address how predictors and moderators of psychotherapy for bipolar depression – identified individually in prior analyses – can inform the development of a metric for prospectively classifying treatment outcome in intensive psychotherapy (IP) versus collaborative care (CC) adjunctive to pharmacotherapy in the Systematic Treatment Enhancement Program (STEP-BD) study. Methods We conducted post-hoc analyses on 135 STEP-BD participants using cluster analysis to identify subsets of participants with similar clinical profiles and investigated this combined metric as a moderator and predictor of response to IP. We used agglomerative hierarchical cluster analyses and k-means clustering to determine the content of the clinical profiles. Logistic regression and Cox proportional hazard models were used to evaluate whether the resulting clusters predicted or moderated likelihood of recovery or time until recovery. Results The cluster analysis yielded a two-cluster solution: 1) “less-recurrent/severe” and 2) “chronic/recurrent.” Rates of recovery in IP were similar for less-recurrent/severe and chronic/recurrent participants. Less-recurrent/severe patients were more likely than chronic/recurrent patients to achieve recovery in CC (p = .040, OR = 4.56). IP yielded a faster recovery for chronic/recurrent participants, whereas CC led to recovery sooner in the less-recurrent/severe cluster (p = .034, OR = 2.62). Limitations Cluster analyses require list-wise deletion of cases with missing data so we were unable to conduct analyses on all STEP-BD participants. Conclusions A well-powered, parametric approach can distinguish patients based on illness history and provide clinicians with symptom profiles of patients that confer differential prognosis in CC vs. IP. PMID:27289316

Hydration during intense exercise training.

PubMed

Maughan, R J; Meyer, N L

2013-01-01

Hydration status has profound effects on both physical and mental performance, and sports performance is thus critically affected. Both overhydration and underhydration - if sufficiently severe - will impair performance and pose a risk to health. Athletes may begin exercise in a hypohydrated state as a result of incomplete recovery from water loss induced in order to achieve a specific body mass target or due to incomplete recovery from a previous competition or training session. Dehydration will also develop in endurance exercise where fluid intake does not match water loss. The focus has generally been on training rather than on competition, but sweat loss and fluid replacement in training may have important implications. Hypohydration may impair training quality and may also increase stress levels. It is unclear whether this will have negative effects (reduced training quality, impaired immunity) or whether it will promote a greater adaptive response. Hypohydration and the consequent hyperthermia, however, can enhance the effectiveness of a heat acclimation program, resulting in improved endurance performance in warm and temperate environments. Drinking in training may be important in enhancing tolerance of the gut when athletes plan to drink in competition. The distribution of water between body water compartments may also be important in the initiation and promotion of cellular adaptations to the training stimulus. Copyright © 2013 Nestec Ltd., Vevey/S. Karger AG, Basel.

Characterizing differential poststroke corticomotor drive to the dorsi- and plantarflexor muscles during resting and volitional muscle activation.

PubMed

Palmer, Jacqueline A; Zarzycki, Ryan; Morton, Susanne M; Kesar, Trisha M; Binder-Macleod, Stuart A

2017-04-01

Imbalance of corticomotor excitability between the paretic and nonparetic limbs has been associated with the extent of upper extremity motor recovery poststroke, is greatly influenced by specific testing conditions such as the presence or absence of volitional muscle activation, and may vary across muscle groups. However, despite its clinical importance, poststroke corticomotor drive to lower extremity muscles has not been thoroughly investigated. Additionally, whereas conventional gait rehabilitation strategies for stroke survivors focus on paretic limb foot drop and dorsiflexion impairments, most contemporary literature has indicated that paretic limb propulsion and plantarflexion impairments are the most significant limiters to poststroke walking function. The purpose of this study was to compare corticomotor excitability of the dorsi- and plantarflexor muscles during resting and active conditions in individuals with good and poor poststroke walking recovery and in neurologically intact controls. We found that plantarflexor muscles showed reduced corticomotor symmetry between paretic and nonparetic limbs compared with dorsiflexor muscles in individuals with poor poststroke walking recovery during active muscle contraction but not during rest. Reduced plantarflexor corticomotor symmetry during active muscle contraction was a result of reduced corticomotor drive to the paretic muscles and enhanced corticomotor drive to the nonparetic muscles compared with the neurologically intact controls. These results demonstrate that atypical corticomotor drive exists in both the paretic and nonparetic lower limbs and implicate greater severity of corticomotor impairments to plantarflexor vs. dorsiflexor muscles during muscle activation in stroke survivors with poor walking recovery. NEW & NOTEWORTHY The present study observed that lower-limb corticomotor asymmetry resulted from both reduced paretic and enhanced nonparetic limb corticomotor excitability compared with neurologically intact controls. The most asymmetrical corticomotor drive was observed in the plantarflexor muscles of individuals with poor poststroke walking recovery. This suggests that neural function of dorsi- and plantarflexor muscles in both paretic and nonparetic limbs may play a role in poststroke walking function, which may have important implications when developing targeted poststroke rehabilitation programs to improve walking ability. Copyright © 2017 the American Physiological Society.

Recovery Act: Planned Efforts and Challenges in Evaluating Compliance with Maintenance of Effort and Similar Provisions. Report to the Republican Leader, U.S. Senate. GAO-10-247

ERIC Educational Resources Information Center

Dodaro, Gene L.

2009-01-01

To help prevent the substitution of federal funds for state, local, or private funds, the American Recovery and Reinvestment Act of 2009 (Recovery Act) contains maintenance of effort and similar provisions requiring that recipients maintain certain levels of spending for selected programs. This report provides information on selected programs in…

Power partial-discard strategy to obtain improved performance for simulated moving bed chromatography.

PubMed

Chung, Ji-Woo; Kim, Kyung-Min; Yoon, Tae-Ung; Kim, Seung-Ik; Jung, Tae-Sung; Han, Sang-Sup; Bae, Youn-Sang

2017-12-22

A novel power partial-discard (PPD) strategy was developed as a variant of the partial-discard (PD) operation to further improve the separation performance of the simulated moving bed (SMB) process. The PPD operation varied the flow rates of discard streams by introducing a new variable, the discard amount (DA) as well as varying the reported variable, discard length (DL), while the conventional PD used fixed discard flow rates. The PPD operations showed significantly improved purities in spite of losses in recoveries. Remarkably, the PPD operation could provide more enhanced purity for a given recovery or more enhanced recovery for a given purity than the PD operation. The two variables, DA and DL, in the PPD operation played a key role in achieving the desired purity and recovery. The PPD operations will be useful for attaining high-purity products with reasonable recoveries. Copyright © 2017 Elsevier B.V. All rights reserved.

The home stroke rehabilitation and monitoring system trial: a randomized controlled trial.

PubMed

Linder, Susan M; Rosenfeldt, Anson B; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Bay, Curtis R; Wolf, Steven L; Alberts, Jay L

2013-01-01

Because many individuals poststroke lack access to the quality and intensity of rehabilitation to improve upper extremity motor function, a home-based robotic-assisted upper extremity rehabilitation device is being paired with an individualized home exercise program. The primary aim of this project is to determine the effectiveness of robotic-assisted home therapy compared with a home exercise program on upper extremity motor recovery and health-related quality of life for stroke survivors in rural and underserved locations. The secondary aim is to explore whether initial degree of motor function of the upper limb may be a factor in predicting the extent to which patients with stroke may be responsive to a home therapy approach. We hypothesize that the home exercise program intervention, when enhanced with robotic-assisted therapy, will result in significantly better outcomes in motor function and quality of life. A total of 96 participants within six-months of a single, unilateral ischemic, or hemorrhagic stroke will be recruited in this prospective, single-blind, multisite randomized clinical trial. The primary outcome is the change in upper extremity function using the Action Research Arm Test. Secondary outcomes include changes in: upper extremity function (Wolf Motor Function Test), upper extremity impairment (upper extremity portion of the Fugl-Meyer Test), self-reported quality of life (Stroke Impact Scale), and affect (Centers for Epidemiologic Studies Depression Scale). Similar or greater improvements in upper extremity function using the combined robotic home exercise program intervention compared with home exercise program alone will be interpreted as evidence that supports the introduction of in-home technology to augment the recovery of function poststroke. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Training for disaster recovery: a review of training programs for social workers after the tsunami.

PubMed

Rowlands, Allison

2006-01-01

This paper describes a range of training programs for social workers and other recovery workers following the Indian Ocean Tsunami of December 2004. These programs were developed and implemented by the author in Singapore, and with collaboration from Indonesian colleagues, in Indonesia. The content is outlined and the rationale behind the development of the programs is presented. The theoretical bases for the diversity of interventions are argued. A course module for both undergraduate and postgraduate social work education is also described, as inclusion of crisis and disaster recovery management in professional courses is necessary to prepare practitioners for their inevitable involvement in responding to emergencies.

SHPPS 2006 School Health Policies and Programs Study--Crisis Preparedness, Response, and Recovery

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief presents data on crisis preparedness, response, and recovery as it pertains to health services, mental health and social services, nutrition…

The effects of spiritual practices on recovery from substance abuse.

PubMed

Carter, T M

1998-10-01

Twelve-step programs have stressed the importance of spiritual practices for over four decades. The spiritual principles embodied in the twelve-step programs may be key in their success of recovering addicts/alcoholics with an overall recovery rate of 34%. A literature search revealed little available data on spiritual principles and practices and their effects on long-term recovery from substance abuse. This study compared two groups of recovering addicts, those with one year of recovery and those with less than one year and a history of relapse. Spiritual practices were measured using a five-point Likert scale questionnaire. The results of the study indicated a relationship between spiritual practices and long-term recovery from substance abuse.

METHODOLOGICAL PLURALISM AND MIXED METHODOLOGY TO STRENGTHEN COMMUNITY PSYCHOLOGY RESEARCH: AN EXAMPLE FROM OXFORD HOUSE

PubMed Central

May, Emily M.; Hunter, Bronwyn A.; Jason, Leonard A.

2017-01-01

This article evaluates how a plurality of research methods has served a research program that has functioned in a much-needed area of research: the role of housing and recovery residences in addiction recovery. The review focuses on one mutually supportive recovery residence model, called Oxford House, which represents more than 1,700 democratic, self-governing residences. To date, there has been no comprehensive evaluation of the research methods used with Oxford House or any other recovery residence. In this article, research methods, including study designs and data analyses, are summarized for 114 peer-reviewed empirical studies that included data on Oxford Houses or Oxford House residents. This review of a pluralistic research program can inform community researchers about the value of recovery residences, the many ways in which recovery residences may be assessed, and the benefits of using multiple methods. Implications for future recovery residence research are discussed. PMID:28839344

METHODOLOGICAL PLURALISM AND MIXED METHODOLOGY TO STRENGTHEN COMMUNITY PSYCHOLOGY RESEARCH: AN EXAMPLE FROM OXFORD HOUSE.

PubMed

May, Emily M; Hunter, Bronwyn A; Jason, Leonard A

2017-01-01

This article evaluates how a plurality of research methods has served a research program that has functioned in a much-needed area of research: the role of housing and recovery residences in addiction recovery. The review focuses on one mutually supportive recovery residence model, called Oxford House, which represents more than 1,700 democratic, self-governing residences. To date, there has been no comprehensive evaluation of the research methods used with Oxford House or any other recovery residence. In this article, research methods, including study designs and data analyses, are summarized for 114 peer-reviewed empirical studies that included data on Oxford Houses or Oxford House residents. This review of a pluralistic research program can inform community researchers about the value of recovery residences, the many ways in which recovery residences may be assessed, and the benefits of using multiple methods. Implications for future recovery residence research are discussed.

Outcomes of an illness self-management group using wellness recovery action planning.

PubMed

Starnino, Vincent R; Mariscal, Susana; Holter, Mark C; Davidson, Lori J; Cook, Karen S; Fukui, Sadaaki; Rapp, Charles A

2010-01-01

The aim of this preliminary study was to examine the impact of participation in an illness self-management recovery program (Wellness Recovery Action Planning-WRAP) on the ability of individuals with severe mental illnesses to achieve key recovery related outcomes. A total of 30 participants from three mental health centers were followed immediately before and after engaging in a 12-week WRAP program. Three paired sample t-tests were conducted to determine the effectiveness of WRAP on hope, recovery orientation, and level of symptoms. A significant positive time effect was found for hope and recovery orientation. Participants showed improvement in symptoms, but the change was slightly below statistical significance. These preliminary results offer promising evidence that the use of WRAP has a positive effect on self-reported hope and recovery-related attitudes, thereby providing an effective complement to current mental health treatment.

Treatment of Functional Impairment in Patients with Bipolar Disorder.

PubMed

Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Vieta, Eduard

2017-01-01

Traditionally, functional impairment has received little attention in bipolar disorder, despite the fact that many patients experience significant impairments in daily life. In the last decade, research has changed its focus from clinical remission to functional recovery in bipolar patients as a priority. A literature review of this topic will allow us provide an overview of the relevance of functional impairment as well as the potential factors that can predict or contribute to low functioning in bipolar disorder (BD). Treatment approaches should consider not only euthymia as a goal but also cognitive and functional improvement of patients with such a complex disorder. Functional remediation and psychoeducation among psychological interventions may help to enhance functioning. The combination of cognitive enhancers and cognitive/functional remediation programs may help in improving cognitive and functional impairments. Early interventions are essential to prevent cognitive deficits and disability.

34 CFR 80.21 - Payment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... program income, refunds, and audit recoveries on payment. (1) Grantees and subgrantees shall disburse repayments to and interest earned on a revolving fund before requesting additional cash payments for the same... disburse program income, rebates, refunds, contract settlements, audit recoveries and interest earned on...

Listening to Consumer Perspectives to Inform Addictions and Housing-Related Practice and Research

PubMed Central

Farquhar, Stephanie A.; Ryder, Marianne; Henderlong, Derek; Lowe, Robert A.; Amann, Ted

2014-01-01

The study, funded by the Northwest Health Foundation of Portland, Oregon and the National Institute on Drug Abuse (NIDA), was conducted as part of the HEARTH collaborative (Housing, Employment and Recovery Together for Health). HEARTH, established in 2010, is a community-academic partnership involving partners from Portland State University (PSU), Oregon Health and Science University (OHSU), and Central City Concern (CCC). Using the approaches of community-based participatory research (CBPR), these diverse stakeholders collaborated to co-develop research of direct relevance to the local community and to national academic and policy communities. This study employed qualitative methods and community-based participatory research principles to solicit personal experiences with housing, employment, and recovery programs. We recruited interview participants via CCC-operated housing programs, including Alcohol and Drug Free Community Housing (ADFC), family housing, transitional housing, and non-ADFC (low barrier) housing units. The manuscript presents interview themes based on the five broad categories of interview questions: housing, employment programs, recovery programs, definitions of recovery, and definitions of success. Co-authors describe recommendations for practice and research protocol based on our findings. Our results highlight the importance of involving consumers in the development, data collection, and analysis of research, and present the unique perspectives of those who experience homelessness, recovery, and the programs designed to assist them. PMID:25580474

Listening to Consumer Perspectives to Inform Addictions and Housing-Related Practice and Research.

PubMed

Farquhar, Stephanie A; Ryder, Marianne; Henderlong, Derek; Lowe, Robert A; Amann, Ted

2014-06-01

The study, funded by the Northwest Health Foundation of Portland, Oregon and the National Institute on Drug Abuse (NIDA), was conducted as part of the HEARTH collaborative (Housing, Employment and Recovery Together for Health). HEARTH, established in 2010, is a community-academic partnership involving partners from Portland State University (PSU), Oregon Health and Science University (OHSU), and Central City Concern (CCC). Using the approaches of community-based participatory research (CBPR), these diverse stakeholders collaborated to co-develop research of direct relevance to the local community and to national academic and policy communities. This study employed qualitative methods and community-based participatory research principles to solicit personal experiences with housing, employment, and recovery programs. We recruited interview participants via CCC-operated housing programs, including Alcohol and Drug Free Community Housing (ADFC), family housing, transitional housing, and non-ADFC (low barrier) housing units. The manuscript presents interview themes based on the five broad categories of interview questions: housing, employment programs, recovery programs, definitions of recovery, and definitions of success. Co-authors describe recommendations for practice and research protocol based on our findings. Our results highlight the importance of involving consumers in the development, data collection, and analysis of research, and present the unique perspectives of those who experience homelessness, recovery, and the programs designed to assist them.

A Christian faith-based recovery theory: understanding God as sponsor.

PubMed

Timmons, Shirley M

2012-12-01

This article reports the development of a substantive theory to explain an evangelical Christian-based process of recovery from addiction. Faith-based, 12-step, mutual aid programs can improve drug abstinence by offering: (a) an intervention option alone and/or in conjunction with secular programs and (b) an opportunity for religious involvement. Although literature on religion, spirituality, and addiction is voluminous, traditional 12-step programs fail to explain the mechanism that underpins the process of Christian-based recovery (CR). This pilot study used grounded theory to explore and describe the essence of recovery of 10 former crack cocaine-addicted persons voluntarily enrolled in a CR program. Data were collected from in-depth interviews during 4 months of 2008. Audiotapes were transcribed verbatim, and the constant comparative method was used to analyze data resulting in the basic social process theory, understanding God as sponsor. The theory was determined through writing theoretical memos that generated key elements that allow persons to recover: acknowledging God-centered crises, communicating with God, and planning for the future. Findings from this preliminary study identifies important factors that can help persons in recovery to sustain sobriety and program administrators to benefit from theory that guides the development of evidence-based addiction interventions.

Recovery of ammonia and production of high-grade phosphates from digester effluents (municipal and livestock)

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) recovery of anaerobically digested swine wastewater and side-stream municipal wastewater via magnesium precipitation was enhanced by combining it with the recovery of ammonia (NH3) through gas-permeable membranes and low-rate aeration. The low-rate aeration stripped the natural carbon...

Uptake of enhanced recovery practices by SAGES members: a survey.

PubMed

Keller, Deborah S; Delaney, Conor P; Senagore, Anthony J; Feldman, Liane S

2017-09-01

The SAGES Surgical Multimodal Accelerated Recovery Trajectory (SMART) Enhanced Recovery Task Force aims to increase awareness and provide tools for members to successfully implement enhanced recovery pathways (ERPs) to improve clinical outcomes and patient satisfaction. An initial step was to survey SAGES member on their knowledge, use, and impediments to enhanced recovery. An online survey designed by SMART committee members to define SAGES member's awareness and use of enhanced recovery principles and practice was emailed to all SAGES members. Reminders were sent 2 and 3 weeks later, encouraging completion of the survey. The web-based survey included 48 questions and took an estimated 20 min to complete. A total of 229 members completed the survey. Respondents were primarily general/MIS surgeons (82.6%) working in an urban location (85.5%), with a bell-shaped age distribution (median 35-44). Almost half regularly used some elements of ERPs (48.7%), but 30% were unfamiliar with the concept. Wide variety in the specific ERP elements used and discharge criteria were reported. The majority had to create and implement their own plan (70.4%). Roadblocks to implementation were inconsistencies with partners/covering physicians (56.3%), nursing education (46.6%), and resources (34.7%). When implemented, members saw improvements in length of stay (88%), patient satisfaction (54.7%), postoperative pain (53.3%), time to return of bowel function (52.7%), and readmissions (16.7%). A need for education and standardization was especially seen in preoperative care, with 74.4% fasting patients from midnight the night before surgery. Wide variations were also reported in pain management practices. An overwhelming majority (89%) reported that having a protocol endorsed by a national organization, such as SAGES, would help with implementation. From this survey of SAGES members, there is a need for education, tools, and standardized protocols to increase awareness, support implementation, and encourage wider utilization of ERP. The overwhelming majority stated having a protocol endorsed by a national organization, such as SAGES, would facilitate implementation.

77 FR 11127 - Medicaid Program; Announcement of Medicaid Recovery Audit Contractors (RACs) Contingency Fee Update

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... Medicare Recovery Auditor. Further, we indicated in the final rule that we would make States aware of any... Medicare has increased the maximum contingency fee paid to Recovery Auditors by 5 percent for the recovery... highest fee paid to a Medicare Recovery Auditor, unless the State submits, and CMS approves, an exception...

An insight into the molecular mechanism of the temporary enhancement effect of isopulegol decanoate on the skin.

PubMed

Liu, Xiaochang; Liu, Meiying; Liu, Chao; Quan, Peng; Zhao, Yongshan; Fang, Liang

2017-08-30

Chemical enhancers are widely used to facilitate drug permeation in transdermal drug delivery system (TDDS) and the effect of chemical enhancers is desired to be temporary. Though temporary enhancement effect of chemical enhancers has been widely discussed, there is still a lack of knowledge about the molecular mechanism of temporary enhancement effect. Using the skin permeation of flurbiprofen as a probe, the temporary enhancement effect of isopulegol decanoate (ISO-10) was evaluated with in vitro permeation experiment and confocal laser scanning microscopy (CLSM). In addition, molecular mechanism of skin recovery was explored with skin retention of ISO-10, attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR), molecular dynamic (MD) simulation and transepidermal water loss (TEWL). Temporary enhancement effect of ISO-10 was observed by the permeation of flurbiprofen after the treatment of 180min. Furthermore, temporary enhancement effect of ISO-10 on the diffusion of intercellular lipid in the stratum cornuem (SC) was observed by ATR-FTIR, molecular dynamic (MD) simulation. The SC barrier function recovered with the existence of ISO-10 in the lipid bilayer as indicated by the retention study and TEWL. In conclusion, the lipid bilayer accepted the enhancer as a new component to form a new stable arrangement, resulted the recovery of the skin barrier function. This work processed a novel mechanism of the recovery of skin barrier function after the addition of chemical enhancers. Copyright © 2017 Elsevier B.V. All rights reserved.

Responsive copolymers for enhanced petroleum recovery. Quarterly technical progress report, December 21, 1994--March 22, 1995

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

McCormick, C.; Hester, R.

The purpose of this study is to extend the concept of micellar polymerization to more complex systems, and to explore the responsive nature of hydrophobically modified polyelectrolytes by tailoring the microstructure. The synthesis of hydrophobically modified acrylamide/acrylic acid copolymer is described. These types of polymers are of interest as thickening agents utilized in enhanced oil recovery.

The development of recent high-power ultrasonic transducers for Near-well ultrasonic processing technology.

PubMed

Wang, Zhenjun; Xu, Yuanming

2017-07-01

With the reduction of crude oil throughout the world, enhance oil recovery technology has become a major oil research topics, which can greatly increase the recovery ratio of the crude oil before the dawning of renewable energy era. Near-well ultrasonic processing technology, as one new method, has attracted more attention for Enhanced Oil Recovery due to its low cost, good applicability and no environmental pollution in recent rears. There are two important relevant aspects about Near-well ultrasonic processing technology: (a) how to enhance the oil flow through the rocks into the pumping pool and (b) how to reduce the oil viscosity so that it can be easier to pump. Therefore, how to design a high-power ultrasonic equipment with excellent performance is crucial for Near-well ultrasonic processing technology. In this paper, recent new high-power ultrasonic transducers for Near-well ultrasonic processing technology are summarized. Each field application of them are also given. The purpose of this paper is to provide reference for the further development of Near-well ultrasonic processing technology. With the reduction of crude oil throughout the world, enhance oil recovery technology has become a major oil research topics, which can greatly increase the recovery ratio of the crude oil before the dawning of renewable energy era. Near-well ultrasonic processing technology, as one new method, has attracted more attention for Enhanced Oil Recovery due to its low cost, good applicability and no environmental pollution in recent rears. There are two important relevant aspects about Near-well ultrasonic processing technology: (a) how to enhance the oil flow through the rocks into the pumping pool and (b) how to reduce the oil viscosity so that it can be easier to pump. Therefore, how to design a high-power ultrasonic equipment with excellent performance is crucial for Near-well ultrasonic processing technology. In this paper, recent new high-power ultrasonic transducers for Near-well ultrasonic processing technology are summarized. Each field application of them are also given. The purpose of this paper is to provide reference for the further development of Near-well ultrasonic processing technology. Copyright © 2017 Elsevier B.V. All rights reserved.

The cost effectiveness of a tailored, web-based care program to enhance postoperative recovery in gynecologic patients in comparison with usual care: protocol of a stepped wedge cluster randomized controlled trial.

PubMed

Bouwsma, Esther Va; Anema, Johannes R; Vonk Noordegraaf, Antonie; Knol, Dirk L; Bosmans, Judith E; Schraffordt Koops, Steven E; van Kesteren, Paul Jm; van Baal, W Marchien; Lips, Jos P; Emanuel, Mark H; Scholten, Petrus C; Mozes, Alexander; Adriaanse, Albert H; Brölmann, Hans Am; Huirne, Judith Af

2014-06-18

The length of recovery after benign gynecological surgery and return to work frequently exceeds the period that is recommended or expected by specialists. A prolonged recovery is associated with a poorer quality of life. In addition, costs due to prolonged sick leave following gynecological surgery cause a significant financial burden on society. The objective of our study was to present the protocol of a stepped wedge cluster randomized controlled trial to evaluate the cost effectiveness of a new care program for patients undergoing hysterectomy and/or adnexal surgery for benign disease, compared to the usual care. The care program under study, designed to improve convalescence and to prevent delayed return to work, targets two levels. At the hospital level, guidelines will be distributed among clinical staff in order to stimulate evidence-based patient education. At the patient level, additional perioperative guidance is provided by means of an eHealth intervention, equipping patients with tailored convalescence advice, and an occupational intervention is available for those patients at risk of prolonged sick leave. Due to the stepped wedge design of the trial, the care program will be sequentially rolled out among the 9 participating hospitals, from which the patients are recruited. Eligible for this study are employed women, 18-65 years of age, who are scheduled for hysterectomy and/or laparoscopic adnexal surgery. The primary outcome is full sustainable return to work. The secondary outcomes include general recovery, quality of life, self-efficacy, coping, and pain. The data will be collected by means of self-reported electronic questionnaires before surgery and at 2, 6, 12, 26, and 52 weeks after surgery. Sick leave and cost data are measured by monthly sick leave calendars, and cost diaries during the 12 month follow-up period. The economic evaluation will be performed from the societal perspective. All statistical analyses will be conducted according to the intention-to-treat principle. The enrollment of the patients started October 2011. The follow-up period will be completed in August 2014. Data cleaning or analysis has not begun as of this article's submission. We hypothesize the care program to be effective by means of improving convalescence and reducing costs associated with productivity losses following gynecological surgery. The results of this study will enable health care policy makers to decide about future implementation of this care program on a broad scale. Netherlands Trial Register: NTR2933; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2933 (Archived by WebCite at http://www.webcitation.org/6Q7exPG84).

C-reactive protein as early predictor of complications after minimally invasive colorectal resection.

PubMed

Pedrazzani, Corrado; Moro, Margherita; Mantovani, Guido; Lazzarini, Enrico; Conci, Simone; Ruzzenente, Andrea; Lippi, Giuseppe; Guglielmi, Alfredo

2017-04-01

Minimally invasive surgery (MIS) and enhanced recovery programs have been increasingly adopted in colorectal surgery. The aim of this prospective observational study was to evaluate the usefulness of the C-reactive protein (CRP) concentration measured on postoperative day 3 (POD-3) as an early predictor of severe complications after minimally invasive colorectal resection. From January 2014 to December 2015, 160 patients underwent resection of colorectal disease by MIS at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust. Among these, CRP measurement was available on POD-3 in 143 patients. Conversion from laparoscopic to open surgery was necessary in 18 patients (12.6%). The mean POD-3 CRP concentration was significantly higher in patients who did than did not require conversions (205.6 ± 89.6 mg/L versus 104.6 ± 85.8 mg/L, respectively; P < 0.001), even in the absence of postoperative complications, and these patients were therefore excluded from the subsequent analysis. No deaths occurred during the study period, but complications occurred in 39 patients (31.2%). Among these, 24 patients (61.5%) developed surgery-related complications. A POD-3 CRP concentration of 120 mg/L was highly reliable for excluding the occurrence of surgery-related and severe complications. The negative predictive values for excluding surgery-related and severe complications was 86.8% and 97.7%, respectively. Assessment of the POD-3 CRP concentration after colorectal MIS is clinically significant for excluding the occurrence of surgery-related and severe complications. This measurement is a largely available, inexpensive, and easy-to-use tool that allows early and safe discharge in the setting of colorectal MIS and enhanced recovery programs. Copyright © 2016 Elsevier Inc. All rights reserved.

75 FR 7448 - Species Recovery Grants to Tribes Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... principal objective of the Program is to support recovery efforts that directly benefit threatened or... management, research, monitoring, and outreach activities or any combination thereof. For FY 2010, NOAA... (NMFS) jurisdiction depends in large part on working cooperatively with other management partners...

Substance Abuse among the Deaf Population: An Overview of Current Strategies, Programs and Barriers to Recovery.

ERIC Educational Resources Information Center

Lane, Katherine E.

1989-01-01

The paper analyzes the problem of alcohol and drug abuse among the deaf population focusing on: precipitating factors leading to substance abuse; barriers to recovery; and descriptions of several treatment centers, programs, and services. (JDD)

Long-Term Effectiveness of the Reading Recovery Early Reading Intervention Program in a Rural School District

ERIC Educational Resources Information Center

Vaughan, Adam Warren

2011-01-01

There are many programs that specialize in teaching students the necessary strategies for reading. But which ones will have the greatest impact and provide lasting skills to struggling students? The purpose of this study was to assess the effectiveness of the Reading Recovery early intervention program on the lowest performing first grade students…

Deferred Cost Recovery for Higher Education: Student Loan Programs in Developing Countries. World Bank Discussion Papers, No. 137.

ERIC Educational Resources Information Center

Albrecht, Douglas; Ziderman, Adrian

This study analyzes the experience of existing higher education student loan programs in developing countries in order to understand their role in fostering cost recovery. Detailed financial analyses of 24 loan programs shows that present value of the repayments collected constitutes a small percentage of the loan value disbursed. In general,…

Accelerated enhanced Recovery following Minimally Invasive colorectal cancer surgery (RecoverMI): a study protocol for a novel randomised controlled trial

PubMed Central

Price, Brandee A; Bednarski, Brian K; You, Y Nancy; Manandhar, Meryna; Dean, E Michelle; Alawadi, Zeinab M; Bryce Speer, B; Gottumukkala, Vijaya; Weldon, Marla; Massey, Robert L; Wang, Xuemei; Qiao, Wei; Chang, George J

2017-01-01

Introduction Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments. While a few studies have shown that discharge within the first 24 hours after minimally invasive colectomy is possible, the safety, feasibility and patient acceptability of a protocol for short-stay colectomy for colorectal cancer have not previously been evaluated in a prospective randomised study. Moreover, given the potential for some patients to experience a delay in recovery of bowel function after colectomy, close outpatient monitoring may be necessary to ensure safe implementation. Methods and analysis In order to address this gap, we propose a prospective randomised trial of accelerated enhanced Recovery following Minimally Invasive colorectal cancer surgery (RecoverMI) that leverages the combination of minimally invasive surgery with enhanced recovery protocols and early coordinated outpatient remote televideo conferencing technology (TeleRecovery) to improve postoperative patien-provider communication, enhance postoperative treatment navigation and optimise postdischarge care. We hypothesise that RecoverMI can be safely incorporated into multidisciplinary practice to improve patient outcomes and reduce the overall 30-day duration of hospitalisation while preserving the quality of the patient experience. Ethics and dissemination RecoverMI has received institutional review board approval and funding from the American Society of Colorectal Surgeons (ASCRS; LPG103). Results from RecoverMI will be published in a peer-reviewed publication and be used to inform a multisite trial. Trial registration number NCT02613728; Pre-results. PMID:28729319

Rate and Predictors of Employment among Formerly Polysubstance Dependent Urban Individuals in Recovery

PubMed Central

Laudet, Alexandre B

2012-01-01

Employment is a key functioning index in addiction services and consistently emerges as a goal among persons in recovery. Research on employment in the addictions has focused on treatment populations and/or welfare recipients; little is known of employment rates or their predictors among persons in recovery. This study seeks to fill this gap, capitalizing on a sample (N = 311) of urban individuals at various stages of recovery. Fewer than half (44.5%) were employed; in logistic regressions, male gender and Caucasian race enhanced the odds of employment whereas having a comorbid chronic physical and/or mental health condition halved the odds. Implications center on the need to identify effective strategies to enhance employability among women and minorities, and for integrated care for persons with multiple chronic conditions. PMID:22873190

Using Carbon Dioxide to Enhance Recovery of Methane from Gas Hydrate Reservoirs: Final Summary Report

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

McGrail, B. Peter; Schaef, Herbert T.; White, Mark D.

2007-09-01

Carbon dioxide sequestration coupled with hydrocarbon resource recovery is often economically attractive. Use of CO2 for enhanced recovery of oil, conventional natural gas, and coal-bed methane are in various stages of common practice. In this report, we discuss a new technique utilizing CO2 for enhanced recovery of an unconventional but potentially very important source of natural gas, gas hydrate. We have focused our attention on the Alaska North Slope where approximately 640 Tcf of natural gas reserves in the form of gas hydrate have been identified. Alaska is also unique in that potential future CO2 sources are nearby, and petroleummore » infrastructure exists or is being planned that could bring the produced gas to market or for use locally. The EGHR (Enhanced Gas Hydrate Recovery) concept takes advantage of the physical and thermodynamic properties of mixtures in the H2O-CO2 system combined with controlled multiphase flow, heat, and mass transport processes in hydrate-bearing porous media. A chemical-free method is used to deliver a LCO2-Lw microemulsion into the gas hydrate bearing porous medium. The microemulsion is injected at a temperature higher than the stability point of methane hydrate, which upon contacting the methane hydrate decomposes its crystalline lattice and releases the enclathrated gas. Small scale column experiments show injection of the emulsion into a CH4 hydrate rich sand results in the release of CH4 gas and the formation of CO2 hydrate« less

Music listening enhances cognitive recovery and mood after middle cerebral artery stroke.

PubMed

Särkämö, Teppo; Tervaniemi, Mari; Laitinen, Sari; Forsblom, Anita; Soinila, Seppo; Mikkonen, Mikko; Autti, Taina; Silvennoinen, Heli M; Erkkilä, Jaakko; Laine, Matti; Peretz, Isabelle; Hietanen, Marja

2008-03-01

We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke, but little is known about the effects of an enriched sound environment on recovery from neural damage in humans. In humans, music listening activates a wide-spread bilateral network of brain regions related to attention, semantic processing, memory, motor functions, and emotional processing. Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups. The potential role of music in neurological rehabilitation, however, has not been systematically investigated. This single-blind, randomized, and controlled trial was designed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke. In the acute recovery phase, 60 patients with a left or right hemisphere middle cerebral artery (MCA) stroke were randomly assigned to a music group, a language group, or a control group. During the following two months, the music and language groups listened daily to self-selected music or audio books, respectively, while the control group received no listening material. In addition, all patients received standard medical care and rehabilitation. All patients underwent an extensive neuropsychological assessment, which included a wide range of cognitive tests as well as mood and quality of life questionnaires, one week (baseline), 3 months, and 6 months after the stroke. Fifty-four patients completed the study. Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups. The music group also experienced less depressed and confused mood than the control group. These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood. The neural mechanisms potentially underlying these effects are discussed.

Energy Recovery Hydropower: Prospects for Off-Setting Electricity Costs for Agricultural, Municipal, and Industrial Water Providers and Users; July 2017 - September 2017

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

Levine, Aaron L.; Curtis, Taylor L.; Johnson, Kurt

Energy recovery hydropower is one of the most cost-effective types of new hydropower development because it is constructed utilizing existing infrastructure, and it is typically able to complete Federal Energy Regulatory Commission (FERC) review in 60 days. Recent changes in federal and state policy have supported energy recovery hydropower. In addition, some states have developed programs and policies to support energy recovery hydropower, including resource assessments, regulatory streamlining initiatives, and grant and loan programs to reduce project development costs. This report examines current federal and state policy drivers for energy recovery hydropower, reviews market trends, and looks ahead at futuremore » federal resource assessments and hydropower reform legislation.« less

The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden

PubMed Central

Melin-Johansson, Christina; Öhlén, Joakim; Koinberg, Ingalill; Berg, Linda; Nolbris, Margaretha Jenholt

2015-01-01

The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs. PMID:28462312

Enhanced Photoelectrocatalytic Decomplexation of Cu-EDTA and Cu Recovery by Persulfate Activated by UV and Cathodic Reduction.

PubMed

Zeng, Huabin; Liu, Shanshan; Chai, Buyu; Cao, Di; Wang, Yan; Zhao, Xu

2016-06-21

In order to enhance Cu-EDTA decomplexation and copper cathodic recovery via the photoelectrocatalytic (PEC) process, S2O8(2-) was introduced into the PEC system with a TiO2/Ti photoanode. At a current density of 0.2 mA/cm(2) and initial solution pH of 3.0, the decomplexation ratio of Cu complexes was increased from 47.5% in the PEC process to 98.4% with 5 mM S2O8(2-) addition into the PEC process (PEC/S2O8(2-)). Correspondently, recovery percentage of Cu was increased to 98.3% from 47.4% within 60 min. It was observed that nearly no copper recovery occurred within the initial reaction period of 10 min. Combined with the analysis of ESR and electrochemical LSV curves, it was concluded that activation of S2O8(2-) into SO4(·-) radicals by cathodic reduction occurred, which was prior to the reduction of liberated Cu(2+) ions. UV irradiation of S2O8(2-) also led to the production of SO4(·-). The generated SO4(·-) radicals enhanced the oxidation of Cu-EDTA. After the consumption of S2O8(2-), the Cu recovery via cathodic reduction proceeded quickly. Acidification induced by the transformation of SO4(·-) to OH· favored the copper cathodic recovery. The combined PEC/S2O8(2-) process was also efficient for the TOC removal from a real electroplating wastewater with the Cu recovery efficiency higher than 80%.

Deprivation and Recovery of Sleep in Succession Enhances Reflexive Motor Behavior

PubMed Central

Sprenger, Andreas; Weber, Frederik D.; Machner, Bjoern; Talamo, Silke; Scheffelmeier, Sabine; Bethke, Judith; Helmchen, Christoph; Gais, Steffen; Kimmig, Hubert; Born, Jan

2015-01-01

Sleep deprivation impairs inhibitory control over reflexive behavior, and this impairment is commonly assumed to dissipate after recovery sleep. Contrary to this belief, here we show that fast reflexive behaviors, when practiced during sleep deprivation, is consolidated across recovery sleep and, thereby, becomes preserved. As a model for the study of sleep effects on prefrontal cortex-mediated inhibitory control in humans, we examined reflexive saccadic eye movements (express saccades), as well as speeded 2-choice finger motor responses. Different groups of subjects were trained on a standard prosaccade gap paradigm before periods of nocturnal sleep and sleep deprivation. Saccade performance was retested in the next morning and again 24 h later. The rate of express saccades was not affected by sleep after training, but slightly increased after sleep deprivation. Surprisingly, this increase augmented even further after recovery sleep and was still present 4 weeks later. Additional experiments revealed that the short testing after sleep deprivation was sufficient to increase express saccades across recovery sleep. An increase in speeded responses across recovery sleep was likewise found for finger motor responses. Our findings indicate that recovery sleep can consolidate motor disinhibition for behaviors practiced during prior sleep deprivation, thereby persistently enhancing response automatization. PMID:26048955

Polymer as permeability modifier in porous media for enhanced oil recovery

NASA Astrophysics Data System (ADS)

Parsa, Shima; Weitz, David

2017-11-01

We use confocal microscopy to directly visualize the changes in morphology and mobilization of trapped oil ganglia within a 3D micromodel of porous media upon polymer flooding. Enhanced oil recovery is achieved in polymer flooding with large molecular weight at concentrations close or higher than a critical concentration of polymer. We also measure the fluctuations of the velocity of the displacing fluid and show that the velocities change upon polymer flooding in the whole medium. The changes in the fluid velocities are heterogeneous and vary in different pores, hence only providing enough pressure gradient across a few of the trapped oil ganglia and mobilize them. Our measurements show that polymer flooding is an effective method for enhancing oil recovery due to retention of polymer on the solid surfaces and changing the resistances of the available paths to water.

Close-form expression of one-tap normalized LMS carrier phase recovery in optical communication systems

NASA Astrophysics Data System (ADS)

Xu, Tianhua; Jacobsen, Gunnar; Popov, Sergei; Li, Jie; Liu, Tiegen; Zhang, Yimo

2016-10-01

The performance of long-haul high speed coherent optical fiber communication systems is significantly degraded by the laser phase noise and the equalization enhanced phase noise (EEPN). In this paper, the analysis of the one-tap normalized least-mean-square (LMS) carrier phase recovery (CPR) is carried out and the close-form expression is investigated for quadrature phase shift keying (QPSK) coherent optical fiber communication systems, in compensating both laser phase noise and equalization enhanced phase noise. Numerical simulations have also been implemented to verify the theoretical analysis. It is found that the one-tap normalized least-mean-square algorithm gives the same analytical expression for predicting CPR bit-error-rate (BER) floors as the traditional differential carrier phase recovery, when both the laser phase noise and the equalization enhanced phase noise are taken into account.

Temperature and electrical memory of polymer fibers

NASA Astrophysics Data System (ADS)

Yuan, Jinkai; Zakri, Cécile; Grillard, Fabienne; Neri, Wilfrid; Poulin, Philippe

2014-05-01

We report in this work studies of the shape memory behavior of polymer fibers loaded with carbon nanotubes or graphene flakes. These materials exhibit enhanced shape memory properties with the generation of a giant stress upon shape recovery. In addition, they exhibit a surprising temperature memory with a peak of generated stress at a temperature nearly equal to the temperature of programming. This temperature memory is ascribed to the presence of dynamical heterogeneities and to the intrinsic broadness of the glass transition. We present recent experiments related to observables other than mechanical properties. In particular nanocomposite fibers exhibit variations of electrical conductivity with an accurate memory. Indeed, the rate of conductivity variations during temperature changes reaches a well defined maximum at a temperature equal to the temperature of programming. Such materials are promising for future actuators that couple dimensional changes with sensing electronic functionalities.

Recovery and Borderline Personality Disorder: A Description of the Innovative Open Borders Program.

PubMed

Mortimer-Jones, Sheila; Morrison, Paul; Munib, Ahmed; Paolucci, Francesco; Neale, Sonia; Bostwick, Amanda; Hungerford, Catherine

2016-09-01

Although Recovery-oriented approaches to delivering mental health services are now promoted in health services across the globe, there is an ongoing need to adapt these approaches to meet the unique needs of consumers with a diagnosis of borderline personality disorder. The lived experience of borderline personality disorder includes emotional dysregulation, intense and unstable relationships, self-harming behaviours, fear of abandonment, and a limited capacity to cope with stress. These experiences present a range of challenges for those who deliver Recovery-oriented services and advocate the principles of empowerment and self-determination. This paper describes a novel crisis intervention program, "Open Borders," which has been established to meet the unique needs of people with a borderline personality disorder diagnosis. Open Borders is a Recovery-oriented model that is run at a public, state-wide residential facility for mental health consumers in Western Australia, and offers alternative pathways to achieving mental health Recovery, including self-referral and short-term admission to a residential facility. The aims of the program are to break the cycle of hospital admission, reduce rates of self-harm, and support the complex Recovery journey of consumers with a diagnosis of borderline personality disorder. Open Borders provides an exemplar for other health service organisations seeking to establish Recovery-oriented crisis intervention alternatives.

ACHP | Recovery Act Section 106 Training

Science.gov Websites

Working with Section 106 Federal, State, & Tribal Programs Training & Education Publications Search skip specific nav links Home arrow Training and Education arrow Recovery Act Section 106 Training RECOVERY ACT SECTION 106 TRAINING 2009 Recovery Act Section 106 Seminar Schedule Registration Forms General

Athletic trainers' and physical therapists' perceptions of the effectiveness of psychological skills within sport injury rehabilitation programs.

PubMed

Hamson-Utley, J Jordan; Martin, Scott; Walters, Jason

2008-01-01

Psychological skills are alleged to augment sport-injury rehabilitation; however, implementation of mental imagery within rehabilitation programs is limited. To examine attitudes of athletic trainers (ATs) and physical therapists (PTs) on the effectiveness of mental imagery, goal setting, and positive self-talk to improve rehabilitation adherence and recovery speed of injured athletes. The ATs and PTs were contacted via electronic or physical mailings to complete a single administration survey that measured their beliefs about the effectiveness of psychological skills for increasing adherence and recovery speed of injured athletes undergoing rehabilitation. Professional member databases of the National Athletic Trainers' Association and the American Physical Therapy Association. Of the 1000 ATs and 1000 PTs who were selected randomly, 309 ATs (age = 34.18 +/- 8.32 years, years in profession = 10.67 +/- 7.34) and 356 PTs (age = 38.58 +/- 7.51 years, years in profession = 13.18 +/- 6.17) responded. The Attitudes About Imagery (AAI) survey measures attitudes about psychological skills for enhancing adherence and recovery speed of injured athletes. The AAI includes demographic questions and 15 items on a 7-point Likert scale measuring attitudes about the effectiveness of mental imagery, self-talk, goal setting, and pain control on rehabilitation adherence and recovery speed of injured athletes. Test-retest reliability ranged from .60 to .84 and Cronbach alphas ranged from .65 to .90. We calculated 1-way analyses of variance to determine whether differences existed in attitudes as a result of the professionals' education, training experience, and interest. Mean differences were found on attitudes about effectiveness of psychological skills for those who reported formal training and those who reported interest in receiving formal training (P < .05). In addition, ATs held more positive attitudes than PTs on 9 of 15 AAI items (P < .05). Overall, ATs and PTs held positive attitudes on the effectiveness of psychological skills to augment the rehabilitation process. Clinical implications regarding the use of mental skills are discussed.

Effectiveness of post‐match recovery strategies in rugby players

PubMed Central

Gill, N D; Beaven, C M; Cook, C

2006-01-01

Objectives To examine the effectiveness of four interventions on the rate and magnitude of muscle damage recovery, as measured by creatine kinase (CK). Methods 23 elite male rugby players were monitored transdermally before, immediately after, 36 hours after, and 84 hours after competitive rugby matches. Players were randomly assigned to complete one of four post‐match strategies: contrast water therapy (CWT), compression garment (GAR), low intensity active exercise (ACT), and passive recovery (PAS). Results Significant increases in CK activity in transdermal exudate were observed as a result of the rugby match (p<0.01). The magnitude of recovery in the PAS intervention was significantly worse than in the ACT, CWT, and GAR interventions at the 36 and 84 hour time points (p<0.05). Conclusions An enhanced rate and magnitude of recovery was observed in the ACT, CWT, and GAR treatment groups when compared with the PAS group. Low impact exercise immediately post‐competition, wearing compression garments, or carrying out contrast water therapy enhanced CK clearance more than passive recovery in young male athletes. PMID:16505085

Study to determine the technical and economic feasibility of reclaiming chemicals used in micellar polymer and low tension surfactant flooding. Final report. [Ultrafiltration membranes and reverse osmosis membranes

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

Stephens, R.H.; Himmelblau, A.; Donnelly, R.G.

1978-02-01

Energy Resources Company has developed a technology for use with enhanced oil recovery to achieve emulsion breaking and surfactant recovery. By using ultrafiltration membranes, the Energy Resources Company process can dewater an oil-in-water type emulsion expected from enhanced oil recovery projects to the point where the emulsion can be inverted and treated using conventional emulsion-treating equipment. By using a tight ultrafiltration membrane or a reverse osmosis membrane, the Energy Resources Company process is capable of recovering chemicals such as surfactants used in micellar polymer flooding.

CO 2 Storage and Enhanced Oil Recovery: Bald Unit Test Site, Mumford Hills Oil Field, Posey County, Indiana

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

Frailey, Scott M.; Krapac, Ivan G.; Damico, James R.

2012-03-30

The Midwest Geological Sequestration Consortium (MGSC) carried out a small-scale carbon dioxide (CO 2) injection test in a sandstone within the Clore Formation (Mississippian System, Chesterian Series) in order to gauge the large-scale CO 2 storage that might be realized from enhanced oil recovery (EOR) of mature Illinois Basin oil fields via miscible liquid CO 2 flooding.

Research Progress in Carbon Dioxide Storage and Enhanced Oil Recovery

NASA Astrophysics Data System (ADS)

Wang, Keliang; Wang, Gang; Lu, Chunjing

2018-02-01

With the rapid development of global economy, human beings have become highly dependent upon fossil fuel such as coal and petroleum. Much fossil fuel is consumed in industrial production and human life. As a result, carbon dioxide emissions have been increasing, and the greenhouse effects thereby generated are posing serious threats to environment of the earth. These years, increasing average global temperature, frequent extreme weather events and climatic changes cause material disasters to the world. After scientists’ long-term research, ample evidences have proven that emissions of greenhouse gas like carbon dioxide have brought about tremendous changes to global climate. To really reduce carbon dioxide emissions, governments of different countries and international organizations have invested much money and human resources in performing research related to carbon dioxide emissions. Manual underground carbon dioxide storage and carbon dioxide-enhanced oil recovery are schemes with great potential and prospect for reducing carbon dioxide emissions. Compared with other schemes for reducing carbon dioxide emissions, aforementioned two schemes exhibit high storage capacity and yield considerable economic benefits, so they have become research focuses for reducing carbon dioxide emissions. This paper introduces the research progress in underground carbon dioxide storage and enhanced oil recovery, pointing out the significance and necessity of carbon dioxide-driven enhanced oil recovery.

Rigorous Screening Technology for Identifying Suitable CO2 Storage Sites II

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

George J. Koperna Jr.; Vello A. Kuuskraa; David E. Riestenberg

2009-06-01

This report serves as the final technical report and users manual for the 'Rigorous Screening Technology for Identifying Suitable CO2 Storage Sites II SBIR project. Advanced Resources International has developed a screening tool by which users can technically screen, assess the storage capacity and quantify the costs of CO2 storage in four types of CO2 storage reservoirs. These include CO2-enhanced oil recovery reservoirs, depleted oil and gas fields (non-enhanced oil recovery candidates), deep coal seems that are amenable to CO2-enhanced methane recovery, and saline reservoirs. The screening function assessed whether the reservoir could likely serve as a safe, long-term CO2more » storage reservoir. The storage capacity assessment uses rigorous reservoir simulation models to determine the timing, ultimate storage capacity, and potential for enhanced hydrocarbon recovery. Finally, the economic assessment function determines both the field-level and pipeline (transportation) costs for CO2 sequestration in a given reservoir. The screening tool has been peer reviewed at an Electrical Power Research Institute (EPRI) technical meeting in March 2009. A number of useful observations and recommendations emerged from the Workshop on the costs of CO2 transport and storage that could be readily incorporated into a commercial version of the Screening Tool in a Phase III SBIR.« less

Surfactant enhanced recovery of tetrachloroethylene from a porous medium containing low permeability lenses. 2. Numerical simulation.

PubMed

Rathfelder, K M; Abriola, L M; Taylor, T P; Pennell, K D

2001-04-01

A numerical model of surfactant enhanced solubilization was developed and applied to the simulation of nonaqueous phase liquid recovery in two-dimensional heterogeneous laboratory sand tank systems. Model parameters were derived from independent, small-scale, batch and column experiments. These parameters included viscosity, density, solubilization capacity, surfactant sorption, interfacial tension, permeability, capillary retention functions, and interphase mass transfer correlations. Model predictive capability was assessed for the evaluation of the micellar solubilization of tetrachloroethylene (PCE) in the two-dimensional systems. Predicted effluent concentrations and mass recovery agreed reasonably well with measured values. Accurate prediction of enhanced solubilization behavior in the sand tanks was found to require the incorporation of pore-scale, system-dependent, interphase mass transfer limitations, including an explicit representation of specific interfacial contact area. Predicted effluent concentrations and mass recovery were also found to depend strongly upon the initial NAPL entrapment configuration. Numerical results collectively indicate that enhanced solubilization processes in heterogeneous, laboratory sand tank systems can be successfully simulated using independently measured soil parameters and column-measured mass transfer coefficients, provided that permeability and NAPL distributions are accurately known. This implies that the accuracy of model predictions at the field scale will be constrained by our ability to quantify soil heterogeneity and NAPL distribution.

Protein supplementation may enhance the spontaneous recovery of neurological alterations in patients with ischaemic stroke.

PubMed

Aquilani, Roberto; Scocchi, Marco; Iadarola, Paolo; Franciscone, Piero; Verri, Manuela; Boschi, Federica; Pasini, Evasio; Viglio, Simona

2008-12-01

To determine whether protein supplementation could enhance neurological recovery in subacute patients with ischaemic stroke. Alimentation-independent patients with ischaemic stroke were randomly allocated to either 21 days of protein supplementation (protein-supplemented group; n=20) or to a spontaneous diet only (control group; n=21) in order to investigate the recovery of neurological changes (measured using the National Institute of Health (NIH) Stroke Scale). Tertiary care rehabilitation in Italy. Forty-two patients (27 male and 15 female; 66.4 +/- 11 years) 16 +/-2 days after the acute event. Supplementation with a hyperproteic nutritional formula (10% protein). NIH Stroke Scale and protein intake. At admission to rehabilitation, both groups of patients were homogeneous for demographic, clinical and functional characteristics. After 21 days from the start of the protocol, the NIH Stroke Scale was found to be enhanced in the group with supplemental proteins (-4.4 +/- 1.5 score versus -3 +/- 1.4 of control group; P<0.01). When expressed as difference (triangle up) between baseline and 21 days, the NIH Stroke Scale correlated negatively with change in protein intake (g/day) (r=-0.50, P= 0.001) and positively with change in carbohydrate/protein ratio (r = +0.40, P=0.01) Protein supplementation may enhance neurological recovery in subacute patients with ischaemic stroke.

The Impact of Reading Recovery on the Reading Achievement of First Grade Students

ERIC Educational Resources Information Center

Case, Marguerite

2015-01-01

There are so many different intervention programs for educators to use to increase the reading achievement of below grade level students, that it can often be difficult to choose the appropriate one for the students. Most programs are scripted and are used with small groups of students. Reading Recovery is not a scripted program and is taught in a…

A Qualitative Analysis of African American Female High School Graduates' Perceptions of Participating in an Asynchronous Credit Recovery Program

ERIC Educational Resources Information Center

Waters, Eric L.

2010-01-01

Asynchronous online credit recovery programs have been implemented in public schools across the United States for a variety of reasons. In this case, African American female students who are deficient in course credits towards high school graduation have taken advantage of this relatively new e-programming mechanism as a means to capture course…

Enhanced malignant transformation is accompanied by increased survival recovery after ionizing radiation in Chinese hamster embryo fibroblasts

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

Boothman, D.A.

Transformed Chinese hamster embryo fibroblasts (CHEF), which gradually increase in tumor-forming ability in nude mice, were isolated from normal diploid CHEF/18 cells. Transformed CHEF cells (i.e., T30-4 > 21-2M3 > 21-2 > normal CHEF/18) showed gradual increases in potentially lethal damage (PLD) survival recovery. {beta}-Lapachone and camptothecin, modulators of topoisomerase I (Topo I) activity, not only prevented survival recovery in normal as well as in tumor cells, but enhanced unscheduled DNA synthesis. These seemingly conflicting results are due to the fact that Topo I activity can be modulated by inhibitors to convert single-stranded DNA lesions into double-stranded breaks. Increases inmore » unscheduled DNA synthesis may result from a continual supply of free ends, on which DNA repair processes may act. Altering Topo I activity with modulators appears to increase X-ray lethality via a DNA lesion modification suicide pathway. Cells down-regulate Topo I immediately after ionizing radiation to prevent Topo I-mediated lesion modification and to enhance survival recovery. 16 refs., 3 figs., 1 tab.« less

Enhancing recovery of ammonia from swine manure anaerobic digester effluent using gas-permeable membrane technology.

PubMed

Dube, P J; Vanotti, M B; Szogi, A A; García-González, M C

2016-03-01

Gas-permeable membrane technology is useful to recover ammonia from manure. In this study, the technology was enhanced using aeration instead of alkali chemicals to increase pH and the ammonium (NH4(+)) recovery rate. Digested effluents from covered anaerobic swine lagoons containing 1465-2097 mg NH4(+)-N L(-1) were treated using submerged membranes (0.13 cm(2) cm(-3)), low-rate aeration (120 mL air L-manure(-1) min(-1)) and nitrification inhibitor (22 mg L(-1)) to prevent nitrification. The experiment included a control without aeration. The pH of the manure with aeration rose from 8.6 to 9.2 while the manure without aeration decreased from 8.6 to 8.1. With aeration, 97-99% of the NH4(+) was removed in about 5 days of operation with 96-98% recovery efficiency. In contrast, without aeration it took 25 days to treat the NH4(+). Therefore, the recovery of NH4(+) was five times faster with the low-rate aeration treatment. This enhancement could reduce costs by 70%. Published by Elsevier Ltd.

Grazer removal and nutrient enrichment as recovery enhancers for overexploited rocky subtidal habitats.

PubMed

Guarnieri, Giuseppe; Bevilacqua, Stanislao; Vignes, Fabio; Fraschetti, Simonetta

2014-07-01

Increasing anthropogenic pressures are causing long-lasting regime shifts from high-diversity ecosystems to low-diversity degraded ones. Understanding the effects of multiple threats on ecosystems, and identifying processes allowing for the recovery of biodiversity, are the current major challenges in ecology. In several temperate marine areas, large parts of rocky subtidal habitats characterised by high diversity have been completely degraded to barren grounds by overfishing, including illegal date mussel fishing. Bare areas are characterized by the dominance of sea urchins whose grazing perpetuates the impact of overfishing. We investigated experimentally the separate and combined effects of nutrient enrichment and sea urchin exclusion on the recovery of barren grounds. Our results indicate that the two factors have a synergistic effect leading to the re-establishment of erect macroalgal canopies, enhancing the structural complexity of subtidal assemblages. In particular, in the overfished system considered here, the recovery of disturbed assemblages could occur only if sea urchins are removed. However, the recolonization of barren grounds by erect macroalgae is further enhanced under enriched conditions. This study demonstrates that the recovery of dramatically depleted marine habitats is possible, and provides useful indications for specific management actions, which at present are totally lacking, to achieve the restoration of barren grounds caused by human activity.

Enhanced recovery after surgery in gastric resections.

PubMed

Bruna Esteban, Marcos; Vorwald, Peter; Ortega Lucea, Sonia; Ramírez Rodríguez, Jose Manuel

2017-02-01

Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery. The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge. The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Enhanced Motor Recovery After Stroke With Combined Cortical Stimulation and Rehabilitative Training Is Dependent on Infarct Location.

PubMed

Boychuk, Jeffery A; Schwerin, Susan C; Thomas, Nagheme; Roger, Alexandra; Silvera, Geoffrey; Liverpool, Misha; Adkins, DeAnna L; Kleim, Jeffrey A

2016-02-01

Cortical electrical stimulation of the motor cortex in combination with rehabilitative training (CS/RT) has been shown to enhance motor recovery in animal models of focal cortical stroke, yet in clinical trials, the effects are much less robust. The variability of stroke location in human patient populations that include both cortical and subcortical brain regions may contribute to the failure to find consistent effects clinically. This study sought to determine whether infarct location influences the enhanced motor recovery previously observed in response to CS/RT. The efficacy of CS/RT to promote improvements in motor function was examined in 2 different rat models of stroke that varied the amount and location of cortical and subcortical damage. Ischemic infarctions were induced by injecting the vasoconstricting peptide endothelin-1 either (1) onto the middle cerebral artery (MCA) producing damage to the frontal cortex and lateral striatum or (2) into a subcortical region producing damage to the posterior thalamus and internal capsule (subcortical capsular ischemic injury [SCII]). Daily CS/RT or RT alone was then given for 20 days, during which time performance on a skilled reaching task was assessed. Animals with MCA occlusion infarctions exhibited enhanced improvements on a skilled reaching task in response to CS/RT relative to RT alone. No such enhancement was observed in animals with SCII infarctions across the 20 days of treatment. The efficacy of CS for enhancing motor recovery after stroke may depend in part on the extent and location of the ischemic infarct. © The Author(s) 2015.

40 CFR 256.31 - Recommendations for developing and implementing resource conservation and recovery programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommendations for developing and implementing resource conservation and recovery programs. 256.31 Section 256.31 Protection of Environment... are identified. These studies should review various technological approaches, environmental...

40 CFR 256.31 - Recommendations for developing and implementing resource conservation and recovery programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommendations for developing and implementing resource conservation and recovery programs. 256.31 Section 256.31 Protection of Environment... are identified. These studies should review various technological approaches, environmental...

40 CFR 256.31 - Recommendations for developing and implementing resource conservation and recovery programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommendations for developing and implementing resource conservation and recovery programs. 256.31 Section 256.31 Protection of Environment... are identified. These studies should review various technological approaches, environmental...

40 CFR 256.31 - Recommendations for developing and implementing resource conservation and recovery programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommendations for developing and implementing resource conservation and recovery programs. 256.31 Section 256.31 Protection of Environment... are identified. These studies should review various technological approaches, environmental...

Helicopter collision avoidance and brown-out recovery with HELLAS

NASA Astrophysics Data System (ADS)

Seidel, Christian; Schwartz, Ingo; Kielhorn, Peter

2008-10-01

EADS Germany is the world market leader in commercial and military Helicopter Laser Radar (HELLAS) Obstacle Warning Systems. The HELLAS-Warning System has been introduced into the market in 2000, is in service at German Federal Police and Royal Thai Air Force. HELLAS was also successfully evaluated by the Foreign Comparative Test Program (FCT) of the U.S. Army and other governmental agencies. Currently the successor system for military applications, HELLAS-Awareness, is in qualification phase. It will have extended sensor performance, enhanced real-time data processing capabilities and advanced human machine interface (HMI) features. Flight tests on NH90 helicopter have been successfully performed. Helicopter series integration is scheduled to begin from 2009. We will give an outline of the new sensor unit concerning detection technology and helicopter integration aspects. The system provides a widespread field of view with additional dynamic line of sight steering and a large detection range in combination with a high frame rate. We will show the HMI representations. This HELLAS system is the basis for a 3 dimensional see-and-remember-system for brown-out recovery. When landing in sandy or dusty areas the downwash of the helicopter rotor causes clouds of visually-restrictive material that can completely obstruct the pilot's outside reference, resulting in a complete loss of situational awareness and spatial orientation of the pilot which can end up in total loss of aircraft control and dangerous accidents. The brown-out recovery system presented here creates an augmented enhanced synthetic vision of the landing area with the surrounding which is based on HELLAS range image data as well as altimeter and inertial reference information.

Biodegradable toughened nanohybrid shape memory polymer for smart biomedical applications.

PubMed

Biswas, Arpan; Singh, Akhand Pratap; Rana, Dipak; Aswal, Vinod K; Maiti, Pralay

2018-05-31

A polyurethane nanohybrid has been prepared through the in situ polymerization of an aliphatic diisocyanate, ester polyol and a chain extender in the presence of two-dimensional platelets. Polymerization within the platelet galleries helps to intercalate, generate diverse nanostructure and improve the nano to macro scale self-assembly, which leads to a significant enhancement in the toughness and thermal stability of the nanohybrid in comparison to pure polyurethane. The extensive interactions, the reason for property enhancement, between nanoplatelets and polymer chains are revealed through spectroscopic measurements and thermal studies. The nanohybrid exhibits significant improvement in the shape memory phenomena (91% recovery) at the physiological temperature, which makes it suitable for many biomedical applications. The structural alteration, studied through temperature dependent small angle neutron scattering and X-ray diffraction, along with unique crystallization behavior have extensively revealed the special shape memory behavior of this nanohybrid and facilitated the understanding of the molecular flipping in the presence of nanoplatelets. Cell line studies and subsequent imaging testify that this nanohybrid is a superior biomaterial that is suitable for use in the biomedical arena. In vivo studies on albino rats exhibit the potential of the shape memory effect of the nanohybrid as a self-tightening suture in keyhole surgery by appropriately closing the lips of the wound through the recovery of the programmed shape at physiological temperature with faster healing of the wound and without the formation of any scar. Further, the improved biodegradable nature along with the rapid self-expanding ability of the nanohybrid at 37 °C make it appropriate for many biomedical applications including a self-expanding stent for occlusion recovery due to its tough and flexible nature.

Survival rate and expression of Heat-shock protein 70 and Frost genes after temperature stress in Drosophila melanogaster lines that are selected for recovery time from temperature coma.

PubMed

Udaka, Hiroko; Ueda, Chiaki; Goto, Shin G

2010-12-01

In this study, we investigated the physiological mechanisms underlying temperature tolerance using Drosophila melanogaster lines with rapid, intermediate, or slow recovery from heat or chill coma that were established by artificial selection or by free recombination without selection. Specifically, we focused on the relationships among their recovery from heat or chill coma, survival after severe heat or cold, and survival enhanced by rapid cold hardening (RCH) or heat hardening. The recovery time from heat coma was not related to the survival rate after severe heat. The line with rapid recovery from chill coma showed a higher survival rate after severe cold exposure, and therefore the same mechanisms are likely to underlie these phenotypes. The recovery time from chill coma and survival rate after severe cold were unrelated to RCH-enhanced survival. We also examined the expression of two genes, Heat-shock protein 70 (Hsp70) and Frost, in these lines to understand the contribution of these stress-inducible genes to intraspecific variation in recovery from temperature coma. The line showing rapid recovery from heat coma did not exhibit higher expression of Hsp70 and Frost. In addition, Hsp70 and Frost transcription levels were not correlated with the recovery time from chill coma. Thus, Hsp70 and Frost transcriptional regulation was not involved in the intraspecific variation in recovery from temperature coma. Copyright © 2010 Elsevier Ltd. All rights reserved.

Coteaching Recovery to Mental Health Care Professionals.

PubMed

Larsen, Christine; Lange, Mads; Jørgensen, Kim; Kistrup, Kristen; Petersen, Lone

2018-06-01

In 2010, the Regional Council of the Capital Region of Denmark endorsed a vision of mental health services based on personal recovery, rehabilitation, and the involvement of caregivers. Programs to achieve this vision include hiring peer support workers, a Recovery College, and service user participation at the organizational level. This column describes a cornerstone of these initiatives-an education program in the recovery model for mental health professionals. In 2013-2014, the Capital Region implemented 148 workshops on recovery-oriented services for all practitioner staff in mental health services in the region. The workshops featured a coteaching model, with both a mental health professional and an individual with lived experience serving as trainers. This model showed promise and should be expanded, including more targeted training for specific services. Such an expansion could be included in a national strategy for user involvement and recovery-oriented practice set to launch in 2018.

Ecto-domain phosphorylation promotes functional recovery from spinal cord injury

PubMed Central

Suehiro, Kenji; Nakamura, Yuka; Xu, Shuai; Uda, Youichi; Matsumura, Takafumi; Yamaguchi, Yoshiaki; Okamura, Hitoshi; Yamashita, Toshihide; Takei, Yoshinori

2014-01-01

Inhibition of Nogo-66 receptor (NgR) can promote recovery following spinal cord injury. The ecto-domain of NgR can be phosphorylated by protein kinase A (PKA), which blocks activation of the receptor. Here, we found that infusion of PKA plus ATP into the damaged spinal cord can promote recovery of locomotor function. While significant elongation of cortical-spinal axons was not detectable even in the rats showing enhanced recovery, neuronal precursor cells were observed in the region where PKA plus ATP were directly applied. NgR1 was expressed in neural stem/progenitor cells (NSPs) derived from the adult spinal cord. Both an NgR1 antagonist NEP1-40 and ecto-domain phosphorylation of NgR1 promote neuronal cell production of the NSPs, in vitro. Thus, inhibition of NgR1 in NSPs can promote neuronal cell production, which could contribute to the enhanced recovery of locomotor function following infusion of PKA and ATP. PMID:24826969

Three approaches for estimating recovery factors in carbon dioxide enhanced oil recovery

USGS Publications Warehouse

Verma, Mahendra K.

2017-07-17

PrefaceThe Energy Independence and Security Act of 2007 authorized the U.S. Geological Survey (USGS) to conduct a national assessment of geologic storage resources for carbon dioxide (CO2) and requested the USGS to estimate the “potential volumes of oil and gas recoverable by injection and sequestration of industrial carbon dioxide in potential sequestration formations” (42 U.S.C. 17271(b)(4)). Geologic CO2 sequestration associated with enhanced oil recovery (EOR) using CO2 in existing hydrocarbon reservoirs has the potential to increase the U.S. hydrocarbon recoverable resource. The objective of this report is to provide detailed information on three approaches that can be used to calculate the incremental recovery factors for CO2-EOR. Therefore, the contents of this report could form an integral part of an assessment methodology that can be used to assess the sedimentary basins of the United States for the hydrocarbon recovery potential using CO2-EOR methods in conventional oil reservoirs.

Engineering development of selective agglomeration: Task 5, Bench- scale process testing

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

Not Available

1991-09-01

Under the overall objectives of DOE Contract ``Engineering Development of Selective Agglomeration,`` there were a number of specific objectives in the Task 5 program. The prime objectives of Task 5 are highlighted below: (1) Maximize process performance in pyritic sulfur rejection and BTU recovery, (2) Produce a low ash product, (3) Compare the performance of the heavy agglomerant process based on diesel and the light agglomerant process using heptane, (4) Define optimum processing conditions for engineering design, (5) Provide first-level evaluation of product handleability, and (6) Explore and investigate process options/ideas which may enhance process performance and/or product handleability.

Engineering development of selective agglomeration: Task 5, Bench- scale process testing

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

Not Available

1991-09-01

Under the overall objectives of DOE Contract Engineering Development of Selective Agglomeration,'' there were a number of specific objectives in the Task 5 program. The prime objectives of Task 5 are highlighted below: (1) Maximize process performance in pyritic sulfur rejection and BTU recovery, (2) Produce a low ash product, (3) Compare the performance of the heavy agglomerant process based on diesel and the light agglomerant process using heptane, (4) Define optimum processing conditions for engineering design, (5) Provide first-level evaluation of product handleability, and (6) Explore and investigate process options/ideas which may enhance process performance and/or product handleability.

LDSD POST2 Modeling Enhancements in Support of SFDT-2 Flight Operations

NASA Technical Reports Server (NTRS)

White, Joseph; Bowes, Angela L.; Dutta, Soumyo; Ivanov, Mark C.; Queen, Eric M.

2016-01-01

Program to Optimize Simulated Trajectories II (POST2) was utilized to develop trajectory simulations characterizing all flight phases from drop to splashdown for the Low-Density Supersonic Decelerator (LDSD) project's first and second Supersonic Flight Dynamics Tests (SFDT-1 and SFDT-2) which took place June 28, 2014 and June 8, 2015, respectively. This paper describes the modeling improvements incorporated into the LDSD POST2 simulations since SFDT-1 and presents how these modeling updates affected the predicted SFDT-2 performance and sensitivity to the mission design. The POST2 simulation flight dynamics support during the SFDT-2 launch, operations, and recovery is also provided.

Effect of chewing gum on the postoperative recovery of gastrointestinal function

PubMed Central

Ge, Wei; Chen, Gang; Ding, Yi-Tao

2015-01-01

Postoperative gastrointestinal dysfunction remains a source of morbidity and the major determinant of length of stay after abdominal operation. There are many different reasons for postoperative gastrointestinal dysfunction such as stress response, perioperative interventions, bowel manipulation and so on. The mechanism of enhanced recovery from postoperative gastrointestinal dysfunction with the help of chewing gum is believed to be the cephalic-vagal stimulation of digestion which increases the promotability of neural and humoral factors that act on different parts of the gastrointestinal tract. Recently, there were a series of randomized controlled trials to confirm the role of chewing gum in the recovery of gastrointestinal function. The results suggested that chewing gum enhanced early recovery of bowel function following abdominal surgery expect the gastrointestinal surgery. However, the effect of chewing gum in gastrointestinal surgery was controversial. PMID:26550107