Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras.

PubMed

Hashimoto, Ken; Zúniga, Concepción; Nakamura, Jiro; Hanada, Kyo

2015-03-24

Integration of disease-specific programmes into the primary health care (PHC) service has been attempted mostly in clinically oriented disease control such as HIV/AIDS and tuberculosis but rarely in vector control. Chagas disease is controlled principally by interventions against the triatomine vector. In Honduras, after successful reduction of household infestation by vertical approach, the Ministry of Health implemented community-based vector surveillance at the PHC services (health centres) to prevent the resurgence of infection. This paper retrospectively analyses the effects and process of integrating a Chagas disease vector surveillance system into health centres. We evaluated the effects of integration at six pilot sites in western Honduras during 2008-2011 on; surveillance performance; knowledge, attitude and practice in schoolchildren; reports of triatomine bug infestation and institutional response; and seroprevalence among children under 15 years of age. The process of integration of the surveillance system was analysed using the PRECEDE-PROCEED model for health programme planning. The model was employed to systematically determine influential and interactive factors which facilitated the integration process at different levels of the Ministry of Health and the community. Overall surveillance performance improved from 46 to 84 on a 100 point-scale. Schoolchildren's attitude (risk awareness) score significantly increased from 77 to 83 points. Seroprevalence declined from 3.4% to 0.4%. Health centres responded to the community bug reports by insecticide spraying. As key factors, the health centres had potential management capacity and influence over the inhabitants' behaviours and living environment directly and through community health volunteers. The National Chagas Programme played an essential role in facilitating changes with adequate distribution of responsibilities, participatory modelling, training and, evaluation and advocacy. We found that Chagas disease vector surveillance can be integrated into the PHC service. Health centres demonstrated capacity to manage vector surveillance and improve performance, children's awareness, vector report-response and seroprevalence, once tasks were simplified to be performed by trained non-specialists and distributed among the stakeholders. Health systems integration requires health workers to perform beyond their usual responsibilities and acquire management skills. Integration of vector control is feasible and can contribute to strengthening the preventive capacity of the PHC service.

Identifying the genes underlying quantitative traits: a rationale for the QTN programme

PubMed Central

Lee, Young Wha; Gould, Billie A.; Stinchcombe, John R.

2014-01-01

The goal of identifying the genes or even nucleotides underlying quantitative and adaptive traits has been characterized as the ‘QTN programme’ and has recently come under severe criticism. Part of the reason for this criticism is that much of the QTN programme has asserted that finding the genes and nucleotides for adaptive and quantitative traits is a fundamental goal, without explaining why it is such a hallowed goal. Here we outline motivations for the QTN programme that offer general insight, regardless of whether QTNs are of large or small effect, and that aid our understanding of the mechanistic dynamics of adaptive evolution. We focus on five areas: (i) vertical integration of insight across different levels of biological organization, (ii) genetic parallelism and the role of pleiotropy in shaping evolutionary dynamics, (iii) understanding the forces maintaining genetic variation in populations, (iv) distinguishing between adaptation from standing variation and new mutation, and (v) the role of genomic architecture in facilitating adaptation. We argue that rather than abandoning the QTN programme, we should refocus our efforts on topics where molecular data will be the most effective for testing hypotheses about phenotypic evolution. PMID:24790125

An international survey of medical ethics curricula in Asia.

PubMed

Miyasaka, M; Akabayashi, A; Kai, I; Ohi, G

1999-12-01

Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries. To characterise the medical ethics curricula at Asian medical schools. Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand. A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country. The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties. A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics. Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse.

Computerized microfluidic cell culture using elastomeric channels and Braille displays.

PubMed

Gu, Wei; Zhu, Xiaoyue; Futai, Nobuyuki; Cho, Brenda S; Takayama, Shuichi

2004-11-09

Computer-controlled microfluidics would advance many types of cellular assays and microscale tissue engineering studies wherever spatiotemporal changes in fluidics need to be defined. However, this goal has been elusive because of the limited availability of integrated, programmable pumps and valves. This paper demonstrates how a refreshable Braille display, with its grid of 320 vertically moving pins, can power integrated pumps and valves through localized deformations of channel networks within elastic silicone rubber. The resulting computerized fluidic control is able to switch among: (i) rapid and efficient mixing between streams, (ii) multiple laminar flows with minimal mixing between streams, and (iii) segmented plug-flow of immiscible fluids within the same channel architecture. The same control method is used to precisely seed cells, compartmentalize them into distinct subpopulations through channel reconfiguration, and culture each cell subpopulation for up to 3 weeks under perfusion. These reliable microscale cell cultures showed gradients of cellular behavior from C2C12 myoblasts along channel lengths, as well as differences in cell density of undifferentiated myoblasts and differentiation patterns, both programmable through different flow rates of serum-containing media. This technology will allow future microscale tissue or cell studies to be more accessible, especially for high-throughput, complex, and long-term experiments. The microfluidic actuation method described is versatile and computer programmable, yet simple, well packaged, and portable enough for personal use.

Computerized microfluidic cell culture using elastomeric channels and Braille displays

PubMed Central

Gu, Wei; Zhu, Xiaoyue; Futai, Nobuyuki; Cho, Brenda S.; Takayama, Shuichi

2004-01-01

Computer-controlled microfluidics would advance many types of cellular assays and microscale tissue engineering studies wherever spatiotemporal changes in fluidics need to be defined. However, this goal has been elusive because of the limited availability of integrated, programmable pumps and valves. This paper demonstrates how a refreshable Braille display, with its grid of 320 vertically moving pins, can power integrated pumps and valves through localized deformations of channel networks within elastic silicone rubber. The resulting computerized fluidic control is able to switch among: (i) rapid and efficient mixing between streams, (ii) multiple laminar flows with minimal mixing between streams, and (iii) segmented plug-flow of immiscible fluids within the same channel architecture. The same control method is used to precisely seed cells, compartmentalize them into distinct subpopulations through channel reconfiguration, and culture each cell subpopulation for up to 3 weeks under perfusion. These reliable microscale cell cultures showed gradients of cellular behavior from C2C12 myoblasts along channel lengths, as well as differences in cell density of undifferentiated myoblasts and differentiation patterns, both programmable through different flow rates of serum-containing media. This technology will allow future microscale tissue or cell studies to be more accessible, especially for high-throughput, complex, and long-term experiments. The microfluidic actuation method described is versatile and computer programmable, yet simple, well packaged, and portable enough for personal use. PMID:15514025

Vertical distribution of ozone at the terminator on Mars

NASA Astrophysics Data System (ADS)

Maattanen, Anni; Lefevre, Franck; Guilbon, Sabrina; Listowski, Constantino; Montmessin, Franck

2016-10-01

The SPICAM/Mars Express UV solar occultation dataset gives access to the ozone vertical distribution via the ozone absorption in the Hartley band (220-280 nm). We present the retrieved ozone profiles and compare them to the LMD Mars Global Climate Model (LMD-MGCM) results.Due to the photochemical reactivity of ozone, a classical comparison of local density profiles is not appropriate for solar occultations that are acquired at the terminator, and we present here a method often used in the Earth community. The principal comparison is made via the slant profiles (integrated ozone concentration on the line-of-sight), since the spherical symmetry hypothesis made in the onion-peeling vertical inversion method is not valid for photochemically active species (e.g., ozone) around terminator. For each occultation, we model the ozone vertical and horizontal distribution with high solar zenith angle (or local time) resolution around the terminator and then integrate the model results following the lines-of-sight of the occultation to construct the modeled slant profile. We will also discuss the difference of results between the above comparison method and a comparison using the local density profiles, i.e., the observed ones inverted by using the spherical symmetry hypothesis and the modeled ones extracted from the LMD-MGCM exactly at the terminator. The method and the results will be presented together with the full dataset.SPICAM is funded by the French Space Agency CNES and this work has received funding from the European Union's Horizon 2020 Programme (H2020-Compet-08-2014) under grant agreement UPWARDS-633127.

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania

PubMed Central

Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

2016-01-01

Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827

Insights of health district managers on the implementation of primary health care outreach teams in Johannesburg, South Africa: a descriptive study with focus group discussions.

PubMed

Moosa, Shabir; Derese, Anselme; Peersman, Wim

2017-01-21

Primary health care (PHC) outreach teams are part of a policy of PHC re-engineering in South Africa. It attempts to move the deployment of community health workers (CHWs) from vertical programmes into an integrated generalised team-based approach to care for defined populations in municipal wards. There has little evaluation of PHC outreach teams. Managers' insights are anecdotal. This is descriptive qualitative study with focus group discussions with health district managers of Johannesburg, the largest city in South Africa. This was conducted in a sequence of three meetings with questions around implementation, human resources, and integrated PHC teamwork. There was a thematic content analysis of validated transcripts using the framework method. There were two major themes: leadership-management challenges and human resource challenges. Whilst there was some positive sentiment, leadership-management challenges loomed large: poor leadership and planning with an under-resourced centralised approach, poor communications both within the service and with community, concerns with its impact on current services and resistance to change, and poor integration, both with other streams of PHC re-engineering and current district programmes. Discussion by managers on human resources was mostly on the plight of CHWs and calls for formalisation of CHWs functioning and training and nurse challenges with inappropriate planning and deployment of the team structure, with brief mention of the extended team. Whilst there is positive sentiment towards intent of the PHC outreach team, programme managers in Johannesburg were critical of management of the programme in their health district. Whilst the objective of PHC reform is people-centred health care, its implementation struggles with a centralising tendency amongst managers in the health service in South Africa. Managers in Johannesburg advocated for decentralisation. The implementation of PHC outreach teams is also limited by difficulties with formalisation and training of CHWs and appropriate task shifting to nurses. Change management is required to create true integrate PHC teamwork. Policy review requires addressing these issues.

Exploration geophysics calculator programs for use on Hewlett-Packard models 67 and 97 programmable calculators

USGS Publications Warehouse

Campbell, David L.; Watts, Raymond D.

1978-01-01

Program listing, instructions, and example problems are given for 12 programs for the interpretation of geophysical data, for use on Hewlett-Packard models 67 and 97 programmable hand-held calculators. These are (1) gravity anomaly over 2D prism with = 9 vertices--Talwani method; (2) magnetic anomaly (?T, ?V, or ?H) over 2D prism with = 8 vertices?Talwani method; (3) total-field magnetic anomaly profile over thick sheet/thin dike; (4) single dipping seismic refractor--interpretation and design; (5) = 4 dipping seismic refractors--interpretation; (6) = 4 dipping seismic refractors?design; (7) vertical electrical sounding over = 10 horizontal layers--Schlumberger or Wenner forward calculation; (8) vertical electric sounding: Dar Zarrouk calculations; (9) magnetotelluric planewave apparent conductivity and phase angle over = 9 horizontal layers--forward calculation; (10) petrophysics: a.c. electrical parameters; (11) petrophysics: elastic constants; (12) digital convolution with = 10-1ength filter.

Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

PubMed

Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

2013-06-10

The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes of hemorrhage, hypertension and sepsis. Advocacy for all pregnant HIV-positive women to be on anti-retroviral therapy must extend to improvements in the quality of service offered, better organised obstetric services and integration of clinical HIV care into maternity services. Improved communication and specialist support to peripheral facilities can be facilitated through advances in technology such as mobile phones.

An international survey of medical ethics curricula in Asia.

PubMed Central

Miyasaka, M; Akabayashi, A; Kai, I; Ohi, G

1999-01-01

SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries. OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools. DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand. PARTICIPANTS: A total of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country. MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties. RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics. CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse. PMID:10635508

ACTRIS aerosol vertical profile data and observations: potentiality and first examples of integrated studies with models

NASA Astrophysics Data System (ADS)

Mona, Lucia; Benedetti, Angela; D'Amico, Giuseppe; Myhre, Cathrine Lund; Schulz, Michael; Wandinger, Ulla; Laj, Paolo; Pappalardo, Gelsomina

2016-04-01

The ACTRIS-2 project, funded by Horizon 2020, addresses the scope of integrating state-of-the-art European ground-based stations for long term observations of aerosols, clouds and short lived gases, capitalizing on the work of FP7-ACTRIS. It aims at achieving the construction of a user-oriented RI, unique in the EU-RI landscape for providing 4-D integrated high-quality data from near-surface to high altitude (vertical profiles and total-column) which are relevant to climate and air-quality research. ACTRIS-2 develops and implements, in a large network of stations in Europe and beyond, observational protocols that permit the harmonization of collected data and their dissemination. ACTRIS secures provision and dissemination of a unique set of data and data-products that would not otherwise be available with the same level of quality and standardization. This results from a 10-year plus effort in constructing a research infrastructure capable of responding to community needs and requirements, and has been engaged since the start of the FP5 EU commission program. ACTRIS ensures compliance with reporting requirements (timing, format, traceability) defined by the major global observing networks. EARLINET (European Aerosol research Lidar NETwork), the aerosol vertical profiling component of ACTRIS, is providing since May 2000 vertical profiles of aerosol extinction and backscatter over Europe. A new structure of the EARLINET database has been designed in a more user oriented approach reporting new data products which are more effective for specific uses of different communities. In particular, a new era is starting with the Copernicus program during which the aerosol vertical profiling capability will be fundamental for assimilation and validation purposes. The new data products have been designed thanks to a strong link with EARLINET data users, first of all modeling and satellite communities, established since the beginning of EARLINET and re-enforced within ACTRIS2. The potentiality of the new EARLINET data products and first examples of integrated studies with models will be presented at the conference. Acknowledgments: ACTRIS2 Research Infrastructure Project is funded by the European Union's Horizon 2020 research and innovation programme under the grant agreement n. 654169 and previously under FP7 grant agreement n. 262254.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania.

PubMed

Chaki, Prosper P; Kannady, Khadija; Mtasiwa, Deo; Tanner, Marcel; Mshinda, Hassan; Kelly, Ann H; Killeen, Gerry F

2014-06-25

Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes.

Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

PubMed Central

2014-01-01

Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.

PubMed

Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A

2016-07-01

Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual's area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Analysis of how the health systems context shapes responses to the control of human immunodeficiency virus: case-studies from the Russian Federation.

PubMed Central

Atun, Rifat A.; McKee, Martin; Drobniewski, Francis; Coker, Richard

2005-01-01

OBJECTIVE: To develop a methodology and an instrument that allow the simultaneous rapid and systematic examination of the broad public health context, the health care systems, and the features of disease-specific programmes. METHODS: Drawing on methodologies used for rapid situational assessments of vertical programmes for tackling communicable disease, we analysed programmes for the control human of immunodeficiency virus (HIV) and their health systems context in three regions in the Russian Federation. The analysis was conducted in three phases: first, analysis of published literature, documents and routine data from the regions; second, interviews with key informants, and third, further data collection and analysis. Synthesis of findings through exploration of emergent themes, with iteration, resulted in the identification of the key systems issues that influenced programme delivery. FINDINGS: We observed a complex political economy within which efforts to control HIV sit, an intricate legal environment, and a high degree of decentralization of financing and operational responsibility. Although each region displays some commonalities arising from the Soviet traditions of public health control, there are considerable variations in the epidemiological trajectories, cultural responses, the political environment, financing, organization and service delivery, and the extent of multisectoral work in response to HIV epidemics. CONCLUSION: Within a centralized, post-Soviet health system, centrally directed measures to enhance HIV control may have varying degrees of impact at the regional level. Although the central tenets of effective vertical HIV programmes may be present, local imperatives substantially influence their interpretation, operationalization and effectiveness. Systematic analysis of the context within which vertical programmes are embedded is necessary to enhance understanding of how the relevant policies are prioritized and translated to action. PMID:16283049

Market and organizational factors associated with hospital vertical integration into sub-acute care.

PubMed

Hogan, Tory H; Lemak, Christy Harris; Hearld, Larry R; Sen, Bisakha P; Wheeler, Jack R C; Menachemi, Nir

2018-04-11

Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted. The purpose of this study is to examine the correlates of hospital vertical integration into SAC. Using panel data of U.S. acute care hospitals (2008-2012), we conducted logit regression models to examine environmental and organizational factors associated with hospital vertical integration. Results are reported as average marginal effects. Among 3,775 unique hospitals (16,269 hospital-year observations), 25.7% vertically integrated into skilled nursing facilities during at least 1 year of the study period. One measure of complexity, the availability of skilled nursing facilities in a county (ME = -1.780, p < .001), was negatively associated with hospital vertical integration into SAC. Measures of munificence, percentage of the county population eligible for Medicare (ME = 0.018, p < .001) and rural geographic location (ME = 0.069, p < .001), were positively associated with hospital vertical integration into SAC. Dynamism, when measured as the change county population between 2008 and 2011 (ME = 1.19e-06, p < .001), was positively associated with hospital vertical integration into SAC. Organizational resources, when measured as swing beds (ME = 0.069, p < .001), were positively associated with hospital vertical integration into SAC. Organizational resources, when measured as investor owned (ME = -0.052, p < .1) and system affiliation (ME = -0.041, p < .1), were negatively associated with hospital vertical integration into SAC. Hospital adaption to the changing health care landscape through vertical integration varies across market and organizational conditions. Current Centers for Medicare and Medicaid reimbursement programs do not take these factors into consideration. Vertical integration strategy into SAC may be more appropriate under certain market conditions. Hospital leaders may consider how to best align their organization's SAC strategy with their operating environment.

Social integration and substance use: assessing the effects of an early intervention programme for youth.

PubMed

Brand, Amélie; Guillod, Line; Habersaat, Stéphanie; Panchaud, Evelyne; Stéphan, Philippe; Urben, Sébastien

2018-06-01

Appropriate social integration has been shown to be a protective factor against substance use among adolescents and associated negative consequences. Promoting social integration through early intervention with adolescents using substances is thus necessary and is the aim of the Identification, Assessment and Follow-up of Adolescents with Substance Use (in French, Dépistage - évaluation - parrainage d'adolescents consommateurs de substances (DEPART) programme. The present study aimed to describe this programme and its participants from 2009 to 2013 as well as to assess its effects on social integration. Data from 398 adolescents using substances who attended the DEPART programme were analysed. The results showed that almost 80% of the adolescents admitted to the DEPART programme were boys, with a large proportion using cannabis. Globally, social integration did not increase from admission to discharge from the programme, but a shift was observed for school and professional integration. Additionally, after the intervention, we observed that social integration was more important in younger patients. This study showed that adolescents with problematic substance use mostly consumed soft drugs and that those who were integrated into the DEPART programme at a younger age were more likely to be socially integrated at the end of the programme. © 2016 John Wiley & Sons Australia, Ltd.

A strong TB programme embedded in a developing primary healthcare system is a lose-lose situation: insights from patient and community perspectives in Cambodia.

PubMed

Sundaram, Neisha; James, Richard; Sreynimol, Um; Linda, Pen; Yoong, Joanne; Saly, Saint; Koeut, Pichenda; Eang, Mao Tan; Coker, Richard; Khan, Mishal S

2017-10-01

As exemplified by the situation in Cambodia, disease specific (vertical) health programmes are often favoured when the health system is fragile. The potential of such an approach to impede strengthening of primary healthcare services has been studied from a health systems perspective in terms of access and quality of care. In this bottom-up, qualitative study we investigate patient and community member experiences of health services when a strong tuberculosis (TB) programme is embedded into a relatively underutilized primary healthcare system. We conducted six gender-stratified community focus group discussions (n = 49) and seven mixed-gender focus group discussions with TB patients (n = 45) in three provinces located in urban, peri-urban and rural areas of Cambodia. Our analysis of health-seeking behaviour and experiences for TB and TB-like illness indicates that building a strong vertical TB control programme has had numerous benefits, including awareness of typical symptoms and need to seek care early; confidence in free TB services at public facilities; and willingness to complete treatment. However, there was a clear dichotomy in experiences and behaviour with respect to care-seeking for less severe illness at primary health services, which were generally avoided owing to access barriers and perceived poor quality. The tendency to delay seeking health care until the development of severe symptoms clearly indicative of TB is a major barrier to early diagnosis and treatment of TB. Our study indicates that an imbalance in the strength of vertical and primary health services could be a lose-lose situation as this impedes improvements in health system functioning and constrains progress of vertical disease control programmes. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.

PubMed

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-09-22

Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. We conducted a systematic review of published research to understand factors that may influence the integration of national CBHW programmes into health systems in low- and middle-income countries. To be included in the study, CBHW programmes should have been developed by the government and have standardised training, supervision and incentive structures. A conceptual framework on the integration of health innovations into health systems guided the review. We identified 3410 records, of which 36 were finally selected, and on which an analysis was conducted concerning the themes and pathways associated with different factors that may influence the integration process. Four programmes from Brazil, Ethiopia, India and Pakistan met the inclusion criteria. Different aspects of each of these programmes were integrated in different ways into their respective health systems. Factors that facilitated the integration process included the magnitude of countries' human resources for health problems and the associated discourses about how to address these problems; the perceived relative advantage of national CBHWs with regard to delivering health services over training and retaining highly skilled health workers; and the participation of some politicians and community members in programme processes, with the result that they viewed the programmes as legitimate, credible and relevant. Finally, integration of programmes within the existing health systems enhanced programme compatibility with the health systems' governance, financing and training functions. Factors that inhibited the integration process included a rapid scale-up process; resistance from other health workers; discrimination of CBHWs based on social, gender and economic status; ineffective incentive structures; inadequate infrastructure and supplies; and hierarchical and parallel communication structures. CBHW programmes should design their scale-up strategy differently based on current contextual factors. Further, adoption of a stepwise approach to the scale-up and integration process may positively shape the integration process of CBHW programmes into health systems.

Effect of vertical integration on the utilization of hardwood resources

Treesearch

Jan Wiedenbeck

2002-01-01

The effectiveness of vertical integration in promoting the efficient utilization of the hardwood resource in the eastern United States was assessed during a series of interviews with vertically integrated hardwood manufacturers in the Appalachian region. Data from 19 companies that responded to the 1996 phone survey indicate that: 1) vertically integrated hardwood...

Integrated care: learning between high-income, and low- and middle-income country health systems

PubMed Central

Mounier-Jack, Sandra; Mayhew, Susannah H; Mays, Nicholas

2017-01-01

Abstract Over the past decade, discussion of integrated care has become more widespread and prominent in both high- and low-income health care systems (LMICs). The trend reflects the mismatch between an increasing burden of chronic disease and local health care systems which are still largely focused on hospital-based treatment of individual clinical episodes and also the long-standing proliferation of vertical donor-funded disease-specific programmes in LMICs which have disrupted horizontal, or integrated, care. Integration is a challenging concept to define, in part because of its multiple dimensions and varied scope: from integrated clinical care for individual patients to broader systems integration—or linkage—involving a wide range of interconnected services (e.g. social services and health care). In this commentary, we compare integrated care in high- and lower-income countries. Although contexts may differ significantly between these settings, there are many common features of how integration has been understood and common challenges in its implementation. We discuss the different approaches to, scope of, and impacts of, integration including barriers and facilitators to the processes of implementation. With the burden of disease becoming more alike across settings, we consider what gains there could be from comparative learning between these settings which have constituted two separate strands of research until now. PMID:29194541

Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

PubMed

Banks, D; Parker, E; Wendel, J

2001-03-01

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

Characterization of Vertical Impact Device Acceleration Pulses Using Parametric Assessment: Phase II Accelerated Free-Fall

DTIC Science & Technology

2016-04-30

support contractor , Infoscitex, conducted a series of tests to identify the performance capabilities of the Vertical Impact Device (VID). The VID is a...C. Table 3. AFD Evaluation with Red IMPAC Programmer: Data Summary Showing Means and Standard Deviations Test Cell Drop Ht . (in) Mean Peak

Integrating business continuity, emergency preparedness and emergency response: How these seemingly different disciplines can come together to make a comprehensive integrated programme.

PubMed

Halsne, Julia

2015-01-01

The East Bay Municipal Utility District provides potable water to approximately 1.3 million customers and treats wastewater for approximately 680,000 customers on the eastern side of San Francisco Bay in Northern California. Corporate policy requires the District to create and maintain an active emergency preparedness programme to manage its critical functions during an emergency and protect people, property and the environment. The policy also requires the District to create and maintain a business continuity programme to minimise disruptions of critical business functions and enhance its capability to recover operations. For these programmes to work effectively they must be coordinated. As the programmes at the District have evolved, the natural interrelationship, overlaps and integration have become inherent in their success. To ensure integration and coordination of these programmes, the District has developed management systems to effectively drive towards a seamless overarching programme.

Back School programme for nurses has reduced low back pain levels: A randomised controlled trial.

PubMed

Járomi, Melinda; Kukla, Aniko; Szilágyi, Brigitta; Simon-Ugron, Ágnes; Bobály, Viktória Kovácsné; Makai, Alexandra; Linek, Pawel; Ács, Pongrác; Leidecker, Eleonóra

2018-03-01

(i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques. Millions of nurses around the world suffer from occupational-related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques. A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n = 67, control group n = 70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3 months. The programme consisted of didactic education, spine-strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses' patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0-100 visual analogue scale. The pre-intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%-97.01% (control group: 8.57% pre-intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre-intervention increased from 10.44%-100% correct execution in the experimental group (control group: pre-intervention test 10.00% and postintervention test 11.42%). The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses. We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes. © 2017 John Wiley & Sons Ltd.

Teaching medical ethics to undergraduate students in post‐apartheid South Africa, 2003–2006

PubMed Central

Moodley, Keymanthri

2007-01-01

The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country. PMID:17971474

Teaching medical ethics to undergraduate students in post-apartheid South Africa, 2003 2006.

PubMed

Moodley, Keymanthri

2007-11-01

The apartheid ideology in South Africa had a pervasive influence on all levels of education including medical undergraduate training. The role of the health sector in human rights abuses during the apartheid era was highlighted in 1997 during the Truth and Reconciliation Commission hearings. The Health Professions Council of South Africa (HPCSA) subsequently realised the importance of medical ethics education and encouraged the introduction of such teaching in all medical schools in the country. Curricular reform at the University of Stellenbosch in 1999 presented an unparalleled opportunity to formally introduce ethics teaching to undergraduate students. This paper outlines the introduction of a medical ethics programme at the Faculty of Health Sciences from 2003 to 2006, with special emphasis on the challenges encountered. It remains one of the most comprehensive undergraduate medical ethics programmes in South Africa. However, there is scope for expanding the curricular time allocated to medical ethics. Integrating the curriculum both horizontally and vertically is imperative. Implementing a core curriculum for all medical schools in South Africa would significantly enhance the goals of medical education in the country.

A Physician's Perspective On Vertical Integration.

PubMed

Berenson, Robert A

2017-09-01

Vertical integration has been a central feature of health care delivery system change for more than two decades. Recent studies have demonstrated that vertically integrated health care systems raise prices and costs without observable improvements in quality, despite many theoretical reasons why cost control and improved quality might occur. Less well studied is how physicians view their newfound partnerships with hospitals. In this article I review literature findings and other observations on five aspects of vertical integration that affect physicians in their professional and personal lives: patients' access to physicians, physician compensation, autonomy versus system support, medical professionalism and culture, and lifestyle. I conclude that the movement toward physicians' alignment with and employment in vertically integrated systems seems inexorable but that policy should not promote such integration either intentionally or inadvertently. Instead, policy should address the flaws in current payment approaches that reward high prices and excessive service use-outcomes that vertical integration currently produces. Project HOPE—The People-to-People Health Foundation, Inc.

Reconstructing the archaeological landscape of Southern Dobrogea: integrating imagery

NASA Astrophysics Data System (ADS)

Oltean, I. A.; Hanson, W. S.

2007-10-01

The recent integrated aerial photographic assessment of Southern Dobrogea, Romania) is part of the first author's British Academy funded research programme 'Contextualizing change on the Lower Danube: Roman impact on Daco-Getic landscapes'. This seeks to study the effect of the Roman conquest and occupation on the native Daco-Getic settlement pattern on the Lower Danube. The methodology involves integrating a range of remotely sensed imagery including: low altitude oblique aerial photographs, obtained through traditional aerial reconnaissance; medium altitude vertical photographs produced by German, British and American military reconnaissance during the Second World War, selected from The Aerial Reconnaissance Achive at Keele University; and high altitude de-classified military satellite imagery (Corona) from the 1960s, acquired from the USGS. The value of this approach lies not just in that it enables extensive detailed mapping of large archaeological landscapes in Romania for the first time, but also that it allows the recording of archaeological features permanently destroyed by more recent development across wide areas. This paper presents some results and addresses some of the problems raised by each method of data acquisition.

Vertical integration from the large Hilbert space

NASA Astrophysics Data System (ADS)

Erler, Theodore; Konopka, Sebastian

2017-12-01

We develop an alternative description of the procedure of vertical integration based on the observation that amplitudes can be written in BRST exact form in the large Hilbert space. We relate this approach to the description of vertical integration given by Sen and Witten.

Vertical integration of teaching in Australian general practice--a survey of regional training providers.

PubMed

Stocks, Nigel P; Frank, Oliver; Linn, Andrew M; Anderson, Katrina; Meertens, Sarah

2011-06-06

To examine vertical integration of teaching and clinical training in general practice and describe practical examples being undertaken by Australian general practice regional training providers (RTPs). A qualitative study of all RTPs in Australia, mid 2010. All 17 RTPs in Australia responded. Eleven had developed some vertical integration initiatives. Several encouraged registrars to teach junior doctors and medical students, others encouraged general practitioner supervisors to run multilevel educational sessions, a few coordinated placements, linkages and support across their region. Three RTPs provided case studies of vertical integration. Many RTPs in Australia use vertical integration of teaching in their training programs. RTPs with close associations with universities and rural clinical schools seem to be leading these initiatives.

Vertical Integration of Hospitals and Physicians: Economic Theory and Empirical Evidence on Spending and Quality.

PubMed

Post, Brady; Buchmueller, Tom; Ryan, Andrew M

2017-08-01

Hospital-physician vertical integration is on the rise. While increased efficiencies may be possible, emerging research raises concerns about anticompetitive behavior, spending increases, and uncertain effects on quality. In this review, we bring together several of the key theories of vertical integration that exist in the neoclassical and institutional economics literatures and apply these theories to the hospital-physician relationship. We also conduct a literature review of the effects of vertical integration on prices, spending, and quality in the growing body of evidence ( n = 15) to evaluate which of these frameworks have the strongest empirical support. We find some support for vertical foreclosure as a framework for explaining the observed results. We suggest a conceptual model and identify directions for future research. Based on our analysis, we conclude that vertical integration poses a threat to the affordability of health services and merits special attention from policymakers and antitrust authorities.

The integration of studio cycling into a worksite stress management programme.

PubMed

Clark, Matthew M; Soyring, Jason E; Jenkins, Sarah M; Daniels, Denise C; Berkland, Bridget E; Werneburg, Brooke L; Hagen, Philip T; Lopez-Jimenez, Francisco; Warren, Beth A; Olsen, Kerry D

2014-04-01

High stress is a prevalent problem in the worksite. To reduce stress, improve productivity, reduce absenteeism, and lower healthcare costs, many companies offer exercise classes or stress management programmes. Although physical activity is an important component of stress management, few worksites have integrated physical activity into their comprehensive stress reduction programmes. The purpose of this single-arm pilot project was to examine the potential effectiveness of an integrated exercise (studio cycling) and cognitive-behavioural stress management programme. Eighty-four adults, 75% female, mostly aged 40+ years, participated in an integrated 12-week cycling studio and cognitive-behavioural stress management programme. Participants experienced a significant and clinically meaningful reduction on the Perceived Stress Scale (p < 0.01), rating of current stress level and confidence to manage stress at the programme's end and at a 1-month follow-up. Participants also reported having significantly improved overall health, improved nutritional habits, higher physical activity level, greater confidence in their ability to follow a healthy diet, higher spiritual well-being, improved sleep, receiving more support for maintaining healthy living and improved quality of life at the completion of the 12-week programme and 1-month follow-up. These findings provide further support for an integrated exercise and stress management programme. © 2013 John Wiley & Sons, Ltd.

Combined horizontal and vertical integration of care: a goal of practice-based commissioning.

PubMed

Thomas, Paul; Meads, Geoffrey; Moustafa, Ahmet; Nazareth, Irwin; Stange, Kurt C; Donnelly Hess, Gertrude

2008-01-01

Practice-based commissioning (PBC) in the UK is intended to improve both the vertical and horizontal integration of health care, in order to avoid escalating costs and enhance population health. Vertical integration involves patient pathways to treat named medical conditions that transcend organisational boundaries and connect community-based generalists with largely hospital-sited specialists, whereas horizontal integration involves peer-based and cross-sectoral collaboration to improve overall health. Effective mechanisms are now needed to permit ongoing dialogue between the vertical and horizontal dimensions to ensure that medical and nonmedical care are both used to their best advantage. This paper proposes three different models for combining vertical and horizontal integration - each is a hybrid of internationally recognised ideal types of primary care organisation. Leaders of PBC should consider a range of models and apply them in ways that are relevant to the local context. General practitioners, policy makers and others whose job it is to facilitate horizontal and vertical integration must learn to lead such combined approaches to integration if the UK is to avoid the mistakes of the USA in over-medicalising health issues.

Integration of leprosy in general health system vis-à-vis leprosy endemicity, health situation and socioeconomic development: observations from Chhattisgarh & Kerala.

PubMed

Pandey, Aparna; Rathod, Harish

2010-06-01

This study looked at the integration of leprosy services in the GHS in context of health and socioeconomic situations using predefined indicators. It also looked at clients' perception of MDT services. The Indian states of Chhattisgarh and Kerala, which are at two extremes in leprosy endemicity, health situation and socioeconomic development, have been compared using predefined integration indicators related to the training of health workers, availability of MDT services, maintenance of MDT stock and involvement of Sub-centres in leprosy care. Data was collected by surveys of health facilities, sub-centres and communities in the two states, during 2006-2007. Information was collected by interviewing health personnel and clients, checking of records and on the spot observations using specifically designed formats. Results showed that integration is more inclusive in Chhattisgarh and has reached up to Sub-centre level. Both the community and health systems are sensitive and responsive to leprosy as it is perceived to be a major public health threat. But in Kerala, despite integration, it continues as a vertical programme with dependence on specialists and districts hospitals for diagnosis and treatment. MDT stock management is even poorer. Clients' perception towards MDT services are similar in both states.

Vertical Integration, Monopoly, and the First Amendment.

ERIC Educational Resources Information Center

Brennan, Timothy J.

This paper addresses the relationship between the First Amendment, monopoly of transmission media, and vertical integration of transmission and content provision. A survey of some of the incentives a profit-maximizing transmission monopolist may have with respect to content is followed by a discussion of how vertical integration affects those…

Vertical Integration in Teaching And Learning (VITAL): an approach to medical education in general practice.

PubMed

Dick, Marie-Louise B; King, David B; Mitchell, Geoffrey K; Kelly, Glynn D; Buckley, John F; Garside, Susan J

2007-07-16

There is increasing demand to provide clinical and teaching experiences in the general practice setting. Vertical integration in teaching and learning, whereby teaching and learning roles are shared across all learner stages, has the potential to decrease time demands and stress on general practitioners, to provide teaching skills and experience to GP registrars, and to improve the learning experience for medical students, and may also help meet the increased demand for teaching in general practice. We consider potential advantages and barriers to vertical integration of teaching in general practice, and provide results of focus group discussions with general practice principals and registrars about vertical integration. We recommend further research into the feasibility of using vertical integration to enhance the capacity to teach medical students in general practice.

Vertical Integration of Biochemistry and Clinical Medicine Using a Near-Peer Learning Model

ERIC Educational Resources Information Center

Gallan, Alexander J.; Offner, Gwynneth D.; Symes, Karen

2016-01-01

Vertical integration has been extensively implemented across medical school curricula but has not been widely attempted in the field of biochemistry. We describe a novel curricular innovation in which a near-peer learning model was used to implement vertical integration in our medical school biochemistry course. Senior medical students developed…

Vertical integration and diversification of acute care hospitals: conceptual definitions.

PubMed

Clement, J P

1988-01-01

The terms vertical integration and diversification, although used quite frequently, are ill-defined for use in the health care field. In this article, the concepts are defined--specifically for nonuniversity acute care hospitals. The resulting definitions are more useful than previous ones for predicting the effects of vertical integration and diversification.

Integration of photoactive and electroactive components with vertical cavity surface emitting lasers

DOEpatents

Bryan, R.P.; Esherick, P.; Jewell, J.L.; Lear, K.L.; Olbright, G.R.

1997-04-29

A monolithically integrated optoelectronic device is provided which integrates a vertical cavity surface emitting laser and either a photosensitive or an electrosensitive device either as input or output to the vertical cavity surface emitting laser either in parallel or series connection. Both vertical and side-by-side arrangements are disclosed, and optical and electronic feedback means are provided. Arrays of these devices can be configured to enable optical computing and neural network applications. 9 figs.

Integration of photoactive and electroactive components with vertical cavity surface emitting lasers

DOEpatents

Bryan, Robert P.; Esherick, Peter; Jewell, Jack L.; Lear, Kevin L.; Olbright, Gregory R.

1997-01-01

A monolithically integrated optoelectronic device is provided which integrates a vertical cavity surface emitting laser and either a photosensitive or an electrosensitive device either as input or output to the vertical cavity surface emitting laser either in parallel or series connection. Both vertical and side-by-side arrangements are disclosed, and optical and electronic feedback means are provided. Arrays of these devices can be configured to enable optical computing and neural network applications.

A Star Image Extractor for Small Satellites

NASA Astrophysics Data System (ADS)

Yamada, Yoshiyuki; Yamauchi, Masahiro; Gouda, Naoteru; Kobayashi, Yukiyasu; Tsujimoto, Takuji; Yano, Taihei; Suganuma, Masahiro; Nakasuka, Shinichi; Sako, Nobutada; Inamori, Takaya

We have developed a Star Image Extractor (SIE) which works as an on-board real-time image processor. It is a logic circuit written on an FPGA(Field Programmable Gate Array) device. It detects and extracts only an object data from raw image data. SIE will be required with the Nano-JASMINE 1) satellite. Nano-JASMINE is the small astrometry satellite that observes objects in our galaxy. It will be launched in 2010 and needs two years mission period. Nano-JASMINE observes an object with the TDI (Time Delayed Integration) observation mode. TDI is one of operation modes of CCD detector. Data is obtained, by rotating the imaging system including CCD at a rated synchronized with a vertical charge transfer of CCD. Obtained image data is sent through SIE to the Mission-controller.

Beyond vertical integration--Community based medical education.

PubMed

Kennedy, Emma Margaret

2006-11-01

The term 'vertical integration' is used broadly in medical education, sometimes when discussing community based medical education (CBME). This article examines the relevance of the term 'vertical integration' and provides an alternative perspective on the complexities of facilitating the CBME process. The principles of learner centredness, patient centredness and flexibility are fundamental to learning in the diverse contexts of 'community'. Vertical integration as a structural concept is helpful for academic organisations but has less application to education in the community setting; a different approach illuminates the strengths and challenges of CBME that need consideration by these organisations.

Expenditure tracking and review of reproductive maternal, newborn and child health policy in Pakistan.

PubMed

Malik, Muhammad Ashar; Nahyoun, Abdul Sattar; Rizvi, Arjumand; Bhatti, Zaid Ahmad; Bhutta, Zulfiqar Ahmad

2017-07-01

Since 2001 substantial resources have been allocated to the reproductive, maternal, newborn and child health sector (RMNCH) in Pakistan. Many new programmes have been started and coverage of some existing programmes has been extended to un-served and rural areas. Despite these efforts the Millennium Development Goals (MDGs) 4 and 5 were not achieved (2000-15). Maternal Mortality Ratio was reduced to 170 per 100 000 live births (target 100) by 2013 at an annual reduction rate of 3.6% (1990-2013). Against the target of 46 per 1000 live births, the Under Five Mortality Rate was reduced to 81 per 1000 live births by 2015 at an annual reduction rate of 2.1% (1990-2015). We evaluated the comparative expenditures for the RMNCH sector and analysed impact of public expenditures on the use of the public facilities for the RMNCH services. Expenditure on RMNCH increased by 181% (2000-10), reaching PKR 628.79 billion (US$9.67 billion). The Share of the RMNCH expenditure in the total health expenditure increased from 16 to 21% (2005-10). The share of official development assistance for the RMNCH increased from 36 to 51% (2003-10). Equity was modestly achieved with a greater proportion of the poor using public facilities for the childhood diarrhoea (Concentration Index -0.06 in 2001-02 to - 0.11 in 2010-11) and reduction in the proportion of the rich using the public health facilities for institutional births (Concentration Index 0.30 in 2001-02 to 0.25 in 2010-11). Overall the RMNCH disease control programmes focused on vertical primary health approach and targeted the district health system in the un-served areas. Our findings confirm that diseconomies of scale, donor dependence and supply side perspective could only result in a modest progress towards achieving the MDGs. We call for urgent attention of the policy makers for the integration of the vertical and the routine primary health care and reliance on indigenous sustainable healthcare financing. We also recommend acknowledging economic perspective on health policy and health programmes. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Vertical integration increases opportunities for patient flow.

PubMed

Radoccia, R A; Benvenuto, J A; Blancett, L

1991-08-01

New sources of patients will become more and more important in the next decade as hospitals continue to feel the squeeze of a competitive marketplace. Vertical integration, a distribution tool used in other industries, will be a significant tool for health care administrators. In the following article, the authors explain the vertical integration model that shows promise for other institutions.

Integrated primary care in Germany: the road ahead.

PubMed

Schlette, Sophia; Lisac, Melanie; Blum, Kerstin

2009-04-20

Health care delivery in Germany is highly fragmented, resulting in poor vertical and horizontal integration and a system that is focused on curing acute illness or single diseases instead of managing patients with more complex or chronic conditions, or managing the health of determined populations. While it is now widely accepted that a strong primary care system can help improve coordination and responsiveness in health care, primary care has so far not played this role in the German system. Primary care physicians traditionally do not have a gatekeeper function; patients can freely choose and directly access both primary and secondary care providers, making coordination and cooperation within and across sectors difficult. Since 2000, driven by the political leadership and initiative of the Federal Ministry of Health, the German Bundestag has passed several laws enabling new forms of care aimed to improve care coordination and to strengthen primary care as a key function in the German health care system. These include on the contractual side integrated care contracts, and on the delivery side disease management programmes, medical care centres, gatekeeping and 'community medicine nurses'. Recent policy reforms improved framework conditions for new forms of care. There is a clear commitment by the government and the introduction of selective contracting and financial incentives for stronger cooperation constitute major drivers for change. First evaluations, especially of disease management programmes, indicate that the new forms of care improve coordination and outcomes. Yet the process of strengthening primary care as a lever for better care coordination has only just begun. Future reforms need to address other structural barriers for change such as fragmented funding streams, inadequate payment systems, the lack of standardized IT systems and trans-sectoral education and training of providers.

Integrated primary care in Germany: the road ahead

PubMed Central

Schlette, Sophia; Lisac, Melanie; Blum, Kerstin

2009-01-01

Problem statement Health care delivery in Germany is highly fragmented, resulting in poor vertical and horizontal integration and a system that is focused on curing acute illness or single diseases instead of managing patients with more complex or chronic conditions, or managing the health of determined populations. While it is now widely accepted that a strong primary care system can help improve coordination and responsiveness in health care, primary care has so far not played this role in the German system. Primary care physicians traditionally do not have a gatekeeper function; patients can freely choose and directly access both primary and secondary care providers, making coordination and cooperation within and across sectors difficult. Description of policy development Since 2000, driven by the political leadership and initiative of the Federal Ministry of Health, the German Bundestag has passed several laws enabling new forms of care aimed to improve care coordination and to strengthen primary care as a key function in the German health care system. These include on the contractual side integrated care contracts, and on the delivery side disease management programmes, medical care centres, gatekeeping and ‘community medicine nurses’. Conclusion and discussion Recent policy reforms improved framework conditions for new forms of care. There is a clear commitment by the government and the introduction of selective contracting and financial incentives for stronger cooperation constitute major drivers for change. First evaluations, especially of disease management programmes, indicate that the new forms of care improve coordination and outcomes. Yet the process of strengthening primary care as a lever for better care coordination has only just begun. Future reforms need to address other structural barriers for change such as fragmented funding streams, inadequate payment systems, the lack of standardized IT systems and trans-sectoral education and training of providers. PMID:19513180

Financial incentives for disease management programmes and integrated care in German social health insurance.

PubMed

Greb, Stefan; Focke, Axel; Hessel, Franz; Wasem, Jürgen

2006-10-01

As a result of recent health care reforms sickness funds and health care providers in German social health insurance face increased financial incentives for implementing disease management and integrated care. Sickness funds receive higher payments form the risk adjustment system if they set up certified disease management programmes and induce patients to enrol. If health care providers establish integrated care projects they are able to receive extra-budgetary funding. As a consequence, the number of certified disease management programmes and the number of integrated care contracts is increasing rapidly. However, contracts about disease management programmes between sickness funds and health care providers are highly standardized. The overall share of health care expenses spent on integrated care still is very low. Existing integrated care is mostly initiated by hospitals, is based on only one indication and is not fully integrated. However, opportunity to invest in integrated care may open up innovative processes, which generate considerable productivity gains. What is more, integrated care may serve as gateway for the introduction of more widespread selective contracting.

Vertical integration of medical education: Riverland experience, South Australia.

PubMed

Rosenthal, D R; Worley, P S; Mugford, B; Stagg, P

2004-01-01

Vertical integration of medical education is currently a prominent international topic, resulting from recent strategic initiatives to improve medical education and service delivery in areas of poorly met medical need. In this article, vertical integration of medical education is defined as 'a grouping of curricular content and delivery mechanisms, traversing the traditional boundaries of undergraduate, postgraduate and continuing medical education, with the intent of enhancing the transfer of knowledge and skills between those involved in the learning-teaching process'. Educators closely involved with vertically integrated teaching in the Riverland of South Australia present an analytical description of the educational dynamics of this system. From this analysis, five elements are identified which underpin the process of successful vertical integration: (1) raised educational stakes; (2) local ownership; (3) broad university role; (4) longer attachments; and (5) shared workforce vision. Given the benefits to the Riverland medical education programs described in this paper, it is not surprising that vertical integration of medical education is a popular goal in many rural regions throughout the world. Although different contexts will result in different functional arrangements, it could be argued that the five principles outlined in this article can be applied in any region.

32 CFR 327.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... combination of electronic hardware and software integrated in a variety of forms (firmware, programmable... electronic hardware and computer software integrated in a variety of forms (firmware, programmable software...

32 CFR 327.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... combination of electronic hardware and software integrated in a variety of forms (firmware, programmable... electronic hardware and computer software integrated in a variety of forms (firmware, programmable software...

32 CFR 327.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... combination of electronic hardware and software integrated in a variety of forms (firmware, programmable... electronic hardware and computer software integrated in a variety of forms (firmware, programmable software...

32 CFR 327.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... combination of electronic hardware and software integrated in a variety of forms (firmware, programmable... electronic hardware and computer software integrated in a variety of forms (firmware, programmable software...

Monolithically integrated self-rolled-up microtube-based vertical coupler for three-dimensional photonic integration

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

Yu, Xin; Arbabi, Ehsan; Goddard, Lynford L.

2015-07-20

We demonstrate a self-rolled-up microtube-based vertical photonic coupler monolithically integrated on top of a ridge waveguide to achieve three-dimensional (3D) photonic integration. The fabrication process is fully compatible with standard planar silicon processing technology. Strong light coupling between the vertical coupler and the ridge waveguide was observed experimentally, which may provide an alternative route for 3D heterogeneous photonic integration. The highest extinction ratio observed in the transmission spectrum passing through the ridge waveguide was 23 dB.

Incentives for vertical integration in healthcare: the effect of reimbursement systems.

PubMed

Byrne, M M; Ashton, C M

1999-01-01

In the United States, many healthcare organizations are being transformed into large integrated delivery systems, even though currently available empirical evidence does not provide strong or unequivocal support for or against vertical integration. Unfortunately, the manager cannot delay organizational changes until further research has been completed, especially when further research is not likely to reveal a single, correct solution for the diverse healthcare systems in existence. Managers must therefore carefully evaluate the expected effects of integration on their individual organizations. Vertical integration may be appropriate if conditions facing the healthcare organization provide opportunities for efficiency gains through reorganization strategies. Managers must consider (1) how changes in the healthcare market have affected the dynamics of production efficiency and transaction costs; (2) the likelihood that integration strategies will achieve increases in efficiency or reductions in transaction costs; and (3) how vertical integration will affect other costs, and whether the benefits gained will outweigh additional costs and efficiency losses. This article presents reimbursement systems as an example of how recent changes in the industry may have changed the dynamics and efficiency of production. Evaluation of the effects of vertical integration should allow for reasonable adjustment time, but obviously unsuccessful strategies should not be followed or maintained.

Designing and Evaluating a Professional Development Programme for Basic Technology Integration in English as a Foreign Language (EFL) Classrooms

ERIC Educational Resources Information Center

Ansyari, Muhammad Fauzan

2015-01-01

This study aims to develop and evaluate a professional development programme for technology integration in an Indonesian university's English language teaching setting. The study explored the characteristics of this programme to English lecturers' technological pedagogical content knowledge (TPCK) development. This design-based research employed…

Description and student self-evaluation of a pilot integrated small group learning and simulation programme for medical students in the first clinical year.

PubMed

Levinson, Michele; Kelly, Diane; Zahariou, Krisoula; Johnson, Matthew; Jackman, Christine; Mackenzie, Sara

2017-02-01

Contemporary education for medical students should be student-centred, integrated and contextualised. Small group learning promotes clinical reasoning and skills for lifelong learning. Simulation can provide experiential learning in a safe and controlled environment. We developed a weekly integrated problem-based learning and simulation programme (IPS) over two semesters in the first clinical year to augment clinical placement experience and contextualise theory into work-relevant practice. To evaluate the new programme at Kirkpatrick level 1. An anonymous survey of participating students. The programme was well liked. Students found the programme relevant and that they had a better understanding of patient safety and the assessment of the deteriorating patient. They felt it contributed to integration of theory and practice, clinical reasoning and the acquisition of non-technical skills, particularly affective and communication elements. This IPS programme in the first clinical year can deliver a student-centred curriculum to complement clinical placement that delivers the important requirements of contemporary medical student education. © 2016 Royal Australasian College of Physicians.

Integrated monitoring and evaluation and environmental risk factors for urogenital schistosomiasis and active trachoma in Burkina Faso before preventative chemotherapy using sentinel sites

PubMed Central

2011-01-01

Background Over 1 billion of the world's poorest inhabitants are afflicted by neglected tropical diseases (NTDs). Integrated control programmes aimed at tackling these debilitating NTDs have been recently initiated, mainly using preventative chemotherapy. Monitoring and evaluation (M&E) of these integrated programs presents particular challenges over and above those required for single disease vertical programmes. We used baseline data from the National NTD Control Programme in Burkina Faso in order to assess the feasibility of an integrated survey design, as well as to elucidate the contribution of environmental variables to the risk of either Schistosoma haematobium, trachoma, or both among school-aged children. Methods S. haematobium infection was diagnosed by detecting eggs in urine. A trachoma case was defined by the presence of Trachomatous inflammation-Follicular (TF) and/or Trachomatous inflammation-Intense (TI) in either eye. Baseline data collected from 3,324 children aged 7-11 years in 21 sentinel sites across 11 regions of Burkina Faso were analyzed using simple and multivariable hierarchical binomial logistic regression models fitted by Markov Chain Monte Carlo estimation methods. Probabilities of the risk of belonging to each infection/disease category were estimated as a function of age, gender (individual level), and environmental variables (at sentinel site level, interpolated from national meteorological stations). Results Overall prevalence at the sentinel sites was 11.79% (95% CI: 10.70-12.89) for S. haematobium; 13.30% (12.14-14.45) for trachoma and 0.84% (0.53-1.15) for co-infections. The only significant predictor of S. haematobium infection was altitude. There were significant negative associations between the prevalence of active trachoma signs and minimum temperature, and air pressure. Conditional upon these predictors, these data are consistent with the two pathogens being independent. Conclusions Urogenital schistosomiasis and trachoma constitute public health problems in Burkina Faso. Sentinel site (at school level) surveys for these two NTDs can be implemented simultaneously. However, to support MDA treatment decisions in Burkina Faso, the protocol used in this study would only be applicable to hypoendemic trachoma areas. More research is needed to confirm if these findings can be generalized to West Africa and beyond. PMID:21749703

An integrative review of graduate transition programmes: Developmental considerations for nursing management.

PubMed

Bakon, Shannon; Craft, Judy; Wirihana, Lisa; Christensen, Martin; Barr, Jennie; Tsai, Lily

2018-01-01

Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided. This inconsistency has resulted in a lack of clarity regarding efficacy or superiority of any one programme over another. Innovative multifaceted programs may assist in supporting the graduate registered nurse to transition effectively into the clinical environment. Providing these support programmes may allow nurse managers to recruit new graduates and therefore decrease the staff budget expenditure. No graduate programme was shown to be superior to others yet graduate programmes appear to positively influence the experience of the graduate and increase staff recruitment. Comparative research is needed to ascertain the integral components of these programmes. Copyright © 2017. Published by Elsevier Ltd.

Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

PubMed Central

2011-01-01

Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: [1] Cumberland Ankle Instability Tool (CAIT) scores, [2] Star Excursion Balance Test (SEBT) reach distances, [3] ankle joint plantar flexion during drop landing and drop vertical jumping, and [4] ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors. PMID:21658224

Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report.

PubMed

O'Driscoll, Jeremiah; Kerin, Fearghal; Delahunt, Eamonn

2011-06-09

Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices.

PubMed

Soriano-Arandes, Antoni; Angheben, Andrea; Serre-Delcor, Nuria; Treviño-Maruri, Begoña; Gómez I Prat, Jordi; Jackson, Yves

2016-05-01

Identifying pregnant women infected with Trypanosoma cruzi is one of the major challenges for preventing and controlling Chagas disease (CD) in non-endemic countries. The aim of this paper was to perform a policy evaluation of the current practices of congenital Chagas disease (CCD) control in non-endemic countries and to propose specific targets for enhanced interventions to tackle this emerging health problem outside the endemic areas of Latin America. We conducted a mixed method review of CCD policy strategies by searching the literature in the PubMed, Google Scholar and the World Health Organization (WHO) databases using the key terms 'CCD', 'paediatric Chagas disease' and 'non-endemic countries'; as free text and combined as one phrase to increase the search sensitivity. Reviews, recommendations, guidelines and control/surveillance programme reports were included. Of 427 CCD papers identified in non-endemic countries, 44 matched the inclusion. Although local programmes were launched in different countries with large numbers of Latin American immigrants, there were considerable disparities in terms of the programmes' distribution, delivery, integration and appropriated CCD control strategies. Moreover, Catalonia, Spain is the only region/country with an established systematic monitoring of CCD in pregnant women from Latin American countries. Given the worldwide dissemination of CD, the nature of its vertical transmission, and the gaps of the current strategies in non-endemic countries, there is an urgent need to standardise, expand and reinforce the control measures against CCD transmission. © 2016 John Wiley & Sons Ltd.

Participation in a social and recreational day programme increases community integration and reduces family burden of persons with acquired brain injury.

PubMed

Gerber, Gary J; Gargaro, Judith

2015-01-01

To describe and evaluate a new day programme for persons living with an acquired brain injury (ABI), including persons exhibiting challenging behaviours. Activities were designed to reduce participants' social isolation, increase participation in community activities and increase social and leisure skills. It was expected that community integration would increase and challenging behaviours and family burden would decrease for day programme participants. Pre-post convenience sample design. Sixty-one participants and family members completed questionnaires before starting the day programme and after 6-month participation. Community Integration Questionnaire, Overt Behaviour Scale, Burden Assessment Scale, Goal Attainment Scaling. Participants had increased community integration (p = 0.000) and decreased family burden (p = 0.006). There was a trend to decreased severity of challenging behaviour. Participants and family members were very satisfied. Results suggest that the programme was effective in reducing participants' social isolation and increasing appropriate interpersonal behaviours. Participation increased community integration and reduced burden on family caregivers. ABI day programmes help fill the void left after other rehabilitation services end and provide survivors with opportunities to engage in a variety of activities. Persons living with ABI have need for ongoing social, recreational and life skill coaching services after formal rehabilitation has been completed.

3rd IAGA/ICMA Workshop on Vertical Coupling in the Atmosphere/Ionosphere System/ Abstract

DTIC Science & Technology

2007-01-10

energy and momentum from the lower atmosphere to the upper atmosphere and ionosphere and vice versa. The programme focussed on various aspects and...ICMA Workshop Vertical Coupling in the Atmosphere/Ionosphere System - 6 - The influence of global dependence of gravity wave energy in the troposphere...transport during the polar night of thermospheric odd nitrogen produced by lower- energy electron precipitation and solar extreme UV fluxes. However, at low

Vertically Integrated Models for Carbon Storage Modeling in Heterogeneous Domains

NASA Astrophysics Data System (ADS)

Bandilla, K.; Celia, M. A.

2017-12-01

Numerical modeling is an essential tool for studying the impacts of geologic carbon storage (GCS). Injection of carbon dioxide (CO2) into deep saline aquifers leads to multi-phase flow (injected CO2 and resident brine), which can be described by a set of three-dimensional governing equations, including mass-balance equation, volumetric flux equations (modified Darcy), and constitutive equations. This is the modeling approach on which commonly used reservoir simulators such as TOUGH2 are based. Due to the large density difference between CO2 and brine, GCS models can often be simplified by assuming buoyant segregation and integrating the three-dimensional governing equations in the vertical direction. The integration leads to a set of two-dimensional equations coupled with reconstruction operators for vertical profiles of saturation and pressure. Vertically-integrated approaches have been shown to give results of comparable quality as three-dimensional reservoir simulators when applied to realistic CO2 injection sites such as the upper sand wedge at the Sleipner site. However, vertically-integrated approaches usually rely on homogeneous properties over the thickness of a geologic layer. Here, we investigate the impact of general (vertical and horizontal) heterogeneity in intrinsic permeability, relative permeability functions, and capillary pressure functions. We consider formations involving complex fluvial deposition environments and compare the performance of vertically-integrated models to full three-dimensional models for a set of hypothetical test cases consisting of high permeability channels (streams) embedded in a low permeability background (floodplains). The domains are randomly generated assuming that stream channels can be represented by sinusoidal waves in the plan-view and by parabolas for the streams' cross-sections. Stream parameters such as width, thickness and wavelength are based on values found at the Ketzin site in Germany. Results from the vertically-integrated approach are compared to results using TOUGH2, both in terms of depth-averaged saturation and vertical saturation profiles.

Content and Language Integrated Learning Next in Asia: Evidence of Learners' Achievement in CLIL Education from a Taiwan Tertiary Degree Programme

ERIC Educational Resources Information Center

Yang, Wenhsien

2015-01-01

This study investigates learners' performance in a Taiwanese tertiary content and language integrated learning (CLIL) programme. Learners' English proficiency was measured immediately after entering the programme and before their industrial placement, i.e. after two years. As in previously reported cases, the learners showed a significant…

Sell your practice to grow and compete--the synergism of vertical integration.

PubMed

Robison, D L

1988-01-01

There are many advantages for selling a group practice to achieve vertical integration with a larger entity, including shared medical and management services, and greater efficiency, which results in greater profits. Health care in the 1990s will have a more formalized, structured system, greatly reducing freedoms enjoyed by both physicians and patients. An attractive option for smaller groups or solo practitioners is vertical integration.

Interventions to significantly improve service uptake and retention of HIV-positive pregnant women and HIV-exposed infants along the prevention of mother-to-child transmission continuum of care: systematic review.

PubMed

Vrazo, Alexandra C; Firth, Jacqueline; Amzel, Anouk; Sedillo, Rebecca; Ryan, Julia; Phelps, B Ryan

2018-02-01

Despite the success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programmes, low uptake of services and poor retention pose a formidable challenge to achieving the elimination of vertical HIV transmission in low- and middle-income countries. This systematic review summarises interventions that demonstrate statistically significant improvements in service uptake and retention of HIV-positive pregnant and breastfeeding women and their infants along the PMTCT cascade. Databases were systematically searched for peer-reviewed studies. Outcomes of interest included uptake of services, such as antiretroviral therapy (ART) such as initiation, early infant diagnostic testing, and retention of HIV-positive pregnant and breastfeeding women and their infants. Interventions that led to statistically significant outcomes were included and mapped to the PMTCT cascade. An eight-item assessment tool assessed study rigour. CRD42017063816. Of 686 citations reviewed, 11 articles met inclusion criteria. Ten studies detailed maternal outcomes and seven studies detailed infant outcomes in PMTCT programmes. Interventions to increase access to antenatal care (ANC) and ART services (n = 4) and those using lay cadres (n = 3) were most common. Other interventions included quality improvement (n = 2), mHealth (n = 1), and counselling (n = 1). One study described interventions in an Option B+ programme. Limitations included lack of HIV testing and counselling and viral load monitoring outcomes, small sample size, geographical location, and non-randomized assignment and selection of participants. Interventions including ANC/ART integration, family-centred approaches, and the use of lay healthcare providers are demonstrably effective in increasing service uptake and retention of HIV-positive mothers and their infants in PMTCT programmes. Future studies should include control groups and assess whether interventions developed in the context of earlier 'Options' are effective in improving outcomes in Option B+ programmes. © 2017 John Wiley & Sons Ltd.

Nanowire systems: technology and design

PubMed Central

Gaillardon, Pierre-Emmanuel; Amarù, Luca Gaetano; Bobba, Shashikanth; De Marchi, Michele; Sacchetto, Davide; De Micheli, Giovanni

2014-01-01

Nanosystems are large-scale integrated systems exploiting nanoelectronic devices. In this study, we consider double independent gate, vertically stacked nanowire field effect transistors (FETs) with gate-all-around structures and typical diameter of 20 nm. These devices, which we have successfully fabricated and evaluated, control the ambipolar behaviour of the nanostructure by selectively enabling one type of carriers. These transistors work as switches with electrically programmable polarity and thus realize an exclusive or operation. The intrinsic higher expressive power of these FETs, when compared with standard complementary metal oxide semiconductor technology, enables us to realize more efficient logic gates, which we organize as tiles to realize nanowire systems by regular arrays. This article surveys both the technology for double independent gate FETs as well as physical and logic design tools to realize digital systems with this fabrication technology. PMID:24567471

Industrial approach to piezoelectric damping of large fighter aircraft components

NASA Astrophysics Data System (ADS)

Simpson, John; Schweiger, Johannes

1998-06-01

Different concepts to damp structural vibrations of the vertical tail of fighter aircraft are reported. The various requirements for a vertical tail bias an integrated approach for the design. Several active vibrations suppression concepts had been investigated during the preparatory phase of a research program shared by Daimler-Benz Aerospace Military Aircraft (Dasa), Daimler-Benz Forschung (DBF) and Deutsche Forschungsandstalt fuer Luftund Raumfahrt (DLR). Now in the main phase of the programme, four concepts were finally chosen: two concepts with aerodynamic control surfaces and two concepts with piezoelectric components. One piezo concept approach will be described rigorously, the other concepts are briefly addressed. In the Dasa concept, thin surface piezo actuators are set out carefully to flatten the dynamic portion of the combined static and dynamic maximum bending moment loading case directly in the shell structure. The second piezo concept by DLR involves pre-loaded lead zirconate titanate (PZT)-block actuators at host structure fixtures. To this end a research apparatus was designed and built as a full scale simplified fin box with carbon fiber reinformed plastic skins and an aluminium stringer-rib substructure restrained by relevant aircraft fixtures. It constitutes a benchmark 3D-structural impedance. The engineering design incorporates 7kg of PZT surface actuators. The structural system then should be excited to more than 15mm tip displacement amplitude. This prepares the final step to total A/C integration. Typical analysis methods using cyclic thermal analogies adapted to induced load levels are compared. Commercial approaches leading onto basic state space model interpretation wrt. actuator sizing and positioning, structural integrity constraints, FE-validation and testing are described. Both piezoelectric strategies are aimed at straight open-loop performance related to concept weight penalty and input electric power. The required actuators, power and integration are then enhanced to specification standards. An adapted qualification program plan is used to improve analytical read across, specifications, manufacturing decisions, handling requirements. The next research goals are outlined.

Towards vertical integration in general practice education: literature review and discussion paper.

PubMed

O'Regan, A; Culhane, A; Dunne, C; Griffin, M; Meagher, D; McGrath, D; O'Dwyer, P; Cullen, W

2013-09-01

Medical education policy in Ireland has enabled an increase in undergraduate and postgraduate education activity in general practice. Internationally, 'vertical integration in general practice education' is suggested as a key strategy to support the implementation of this policy development. To review the emerging literature on vertical integration in GP education, specifically to define the concept of 'vertical integration' with regard to education in general practice and to describe its benefits and challenges. We searched 'Pubmed', 'Academic Search Complete', 'Google', and 'MEDLINE' databases using multiple terms related to 'vertical integration' and 'general practice education' for relevant articles published since 2001. Discussion papers, reports, policy documents and position statements were identified from reference lists and retrieved through internet searches. The key components of 'vertical integration' in GP education include continuous educational pathway, all stages in GP education, supporting the continuing educational/professional development needs of learners at each stage and effective curriculum planning and delivery. Many benefits (for GPs, learners and the community) and many challenges (for GPs/practices, learners and GPs in training) have been described. Characteristics of successful implementation include role sharing and collaborative organisational structures. Recent developments in medical education in Ireland, such as the increase in medical school clinical placements in general practice and postgraduate GP training and the introduction of new competence assurance requirements offer an important opportunity to further inform how vertical integration can support increased educational activity in general practice. Describing this model, recognising its benefits and challenges and supporting its implementation in practice are priorities for medical education in Ireland.

The fully integrated biomedical engineering programme at Eindhoven University of Technology.

PubMed

Slaaf, D W; van Genderen, M H P

2009-05-01

The development of a fully integrated biomedical engineering programme (life sciences included from the start) is described. Details are provided about background, implementation, and didactic concept: design centred learning combined with courses. The curriculum has developed into a bachelor-master's programme with two different master's degrees: Master's Degree in Biomedical Engineering and Master's Degree in Medical Engineering. Recently, the programme has adopted semester programming, has included a major and minor in the bachelor's degree phase, and a true bachelor's degree final project. Details about the programme and data about where graduates find jobs are provided in this paper.

[Relevance of medical rehabilitation in disease management programmes].

PubMed

Lüngen, M; Lauterbach, K W

2003-10-01

Disease management programmes will increasingly be introduced in Germany due to the new risk adjustment scheme. The first disease management programmes started in 2003 for breast cancer and diabetes mellitus type II. German rehabilitation will have to face several challenges. Disease management programmes are strongly based on the notion of Evidence so that proof of the efficacy of a care giving task should be present. Verification of the evidence of the specifically German rehabilitation treatments must therefore be given. However, integration of rehabilitation in disease management programmes could lead to changes in the alignment of German rehabilitation. The essence of German rehabilitation, notably its holistic approach, could get lost with integration in disease management programmes.

Vertical integration: hospital ownership of physician practices is associated with higher prices and spending.

PubMed

Baker, Laurence C; Bundorf, M Kate; Kessler, Daniel P

2014-05-01

We examined the consequences of contractual or ownership relationships between hospitals and physician practices, often described as vertical integration. Such integration can reduce health spending and increase the quality of care by improving communication across care settings, but it can also increase providers' market power and facilitate the payment of what are effectively kickbacks for inappropriate referrals. We investigated the impact of vertical integration on hospital prices, volumes (admissions), and spending for privately insured patients. Using hospital claims from Truven Analytics MarketScan for the nonelderly privately insured in the period 2001-07, we constructed county-level indices of prices, volumes, and spending and adjusted them for enrollees' age and sex. We measured hospital-physician integration using information from the American Hospital Association on the types of relationships hospitals have with physicians. We found that an increase in the market share of hospitals with the tightest vertically integrated relationship with physicians--ownership of physician practices--was associated with higher hospital prices and spending. We found that an increase in contractual integration reduced the frequency of hospital admissions, but this effect was relatively small. Taken together, our results provide a mixed, although somewhat negative, picture of vertical integration from the perspective of the privately insured.

Pros and cons of vertical integration between clinical medicine and basic science within a problem-based undergraduate medical curriculum: examples and experiences from Linköping, Sweden.

PubMed

Dahle, L O; Brynhildsen, J; Behrbohm Fallsberg, M; Rundquist, I; Hammar, M

2002-05-01

Problem-based learning (PBL), combined with early patient contact, multiprofessional education and emphasis on development of communications skills, has become the basis for the medical curriculum at the Faculty of Health Sciences in Linköping (FHS), Sweden, which was started in 1986. Important elements in the curriculum are vertical integration, i.e. integration between the clinical and basic science parts of the curriculum and horizontal integration between different subject areas. This article discusses the importance of vertical integration in an undergraduate medical curriculum, according to experiences from the Faculty of Health Sciences in Linköping, and also give examples on how it has been implemented during the latest 15 years. Results and views put forward in published articles concerning vertical integration within undergraduate medical education are discussed in relation to the experiences in Linköping. Vertical integration between basic sciences and clinical medicine in a PBL setting has been found to stimulate profound rather than superficial learning, and thereby stimulates better understanding of important biomedical principles. Integration probably leads to better retention of knowledge and the ability to apply basic science principles in the appropriate clinical context. Integration throughout the whole curriculum entails a lot of time and work in respect of planning, organization and execution. The teachers have to be deeply involved and enthusiastic and have to cooperate over departmental borders, which may produce positive spin-off effects in teaching and research but also conflicts that have to be resolved. The authors believe vertical integration supports PBL and stimulates deep and lifelong learning.

Vertical integration and organizational networks in health care.

PubMed

Robinson, J C; Casalino, L P

1996-01-01

This paper documents the growing linkages between primary care-centered medical groups and specialists and between physicians and hospitals under managed care. We evaluate the two alternative forms of organizational coordination: "vertical integration," based on unified ownership, and "virtual integration," based on contractual networks. Excess capacity and the need for investment capital are major short-term determinants of these vertical versus virtual integration decisions in health care. In the longer term, the principal determinants are economies of scale, risk-bearing ability, transaction costs, and the capacity for innovation in methods of managing care.

A framework for understanding outcomes of integrated care programs for the hospitalised elderly

PubMed Central

Hartgerink, Jacqueline M.; Cramm, Jane M.; van Wijngaarden, Jeroen D.H.; Bakker, Ton J.E.M.; Mackenbach, Johan P.; Nieboer, Anna P.

2013-01-01

Introduction Integrated care has emerged as a new strategy to enhance the quality of care for hospitalised elderly. Current models do not provide insight into the mechanisms underlying integrated care delivery. Therefore, we developed a framework to identify the underlying mechanisms of integrated care delivery. We should understand how they operate and interact, so that integrated care programmes can enhance the quality of care and eventually patient outcomes. Theory and methods Interprofessional collaboration among professionals is considered to be critical in integrated care delivery due to many interdependent work requirements. A review of integrated care components brings to light a distinction between the cognitive and behavioural components of interprofessional collaboration. Results Effective integrated care programmes combine the interacting components of care delivery. These components affect professionals’ cognitions and behaviour, which in turn affect quality of care. Insight is gained into how these components alter the way care is delivered through mechanisms such as combining individual knowledge and actively seeking new information. Conclusion We expect that insight into the cognitive and behavioural mechanisms will contribute to the understanding of integrated care programmes. The framework can be used to identify the underlying mechanisms of integrated care responsible for producing favourable outcomes, allowing comparisons across programmes. PMID:24363635

The Integrated Women's Empowering Programme (IWEP) as an Example for Establishing Basic Structures of a Nationwide Adult Education System in a Poor Country

ERIC Educational Resources Information Center

Sandhaas, Bernd

2008-01-01

Within Ethiopia's overall development strategy, the Integrated Women's Empowerment Programme (IWEP) aims to develop, test and implement a comprehensive nationwide approach to empower women and their households in selected areas of all regions/national states of Ethiopia. The programme provides functional literacy education and livelihood skills…

PCT Databank: A Tool for Planning, Implementation and Monitoring of Integrated Preventive Chemotherapy for Control of Neglected Tropical Diseases (NTD)

PubMed Central

Mikhailov, Alexei; Yajima, Aya; Mbabazi, PS; Gabrielli, Albis F.; Montresor, Antonio; Engels, Dirk

2017-01-01

The integration of vertical control programmes of neglected tropical diseases (NTDs) aims at containing operational cost, simplifies the application of the control measures and extends the intervention coverage. The Preventive Chemotherapy and Transmission Control (PCT) Databank was established by the World Health Organization to facilitate the sharing of data among the different partners involved in control activities and collects and compiles historical and current information on disease-specific epidemiological situation, the geographical overlapping of NTDs and the progress of control activities in all the NTD-endemic countries. The summary of country-specific epidemiological maps and the progress of control activities is available online as the online PCT Databank and Country Profiles. The annual progress of preventive chemotherapy (PC) interventions targeting at specific NTDs is also annually reported in the Weekly Epidemiological Record (WER). In this paper, we elucidated the methodology of data collection, compilation and mapping to establish the PCT Databank and presented the key features of the associated three online outputs, i.e. the online PCT Databank, the Country Profile and the WER. PMID:22357399

A systematic review of vertical integration and quality of care, efficiency, and patient-centered outcomes.

PubMed

Machta, Rachel M; Maurer, Kristin A; Jones, David J; Furukawa, Michael F; Rich, Eugene C

2018-04-02

Small independent practices are increasingly giving way to more complex affiliations between provider organizations and hospital systems. There are several ways in which vertically integrated health systems could improve quality and lower the costs of care. But there are also concerns that integrated systems may increase the price and costs of care without commensurate improvements in quality and outcomes. Despite a growing body of research on vertically integrated health systems, no systematic review that we know of compares vertically integrated health systems (defined as shared ownership or joint management of hospitals and physician practices) to nonintegrated hospitals or physician practices. We conducted a systematic search of the literature published from January 1996 to November 2016. We considered articles for review if they compared the performance of a vertically integrated health system and examined an outcome related to quality of care, efficiency, or patient-centered outcomes. Database searches generated 7,559 articles, with 29 articles included in this review. Vertical integration was associated with better quality, often measured as optimal care for specific conditions, but showed either no differences or lower efficiency as measured by utilization, spending, and prices. Few studies evaluated a patient-centered outcome; among those, most examined mortality and did not identify any effects. Across domains, most studies were observational and did not address the issue of selection bias. Recent evidence suggests the trend toward vertical integration will likely continue as providers respond to changing payment models and market factors. A growing body of research on comparative health system performance suggests that integration of physician practices with hospitals might not be enough to achieve higher-value care. More information is needed to identify the health system attributes that contribute to improved outcomes, as well as which policy levers can minimize anticompetitive effects and maximize the benefits of these affiliations.

Relay Protection and Automation Systems Based on Programmable Logic Integrated Circuits

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

Lashin, A. V., E-mail: LashinAV@lhp.ru; Kozyrev, A. V.

One of the most promising forms of developing the apparatus part of relay protection and automation devices is considered. The advantages of choosing programmable logic integrated circuits to obtain adaptive technological algorithms in power system protection and control systems are pointed out. The technical difficulties in the problems which today stand in the way of using relay protection and automation systems are indicated and a new technology for solving these problems is presented. Particular attention is devoted to the possibility of reconfiguring the logic of these devices, using programmable logic integrated circuits.

Peer learning in the UNSW Medicine program.

PubMed

Scicluna, Helen A; O'Sullivan, Anthony J; Boyle, Patrick; Jones, Philip D; McNeil, H Patrick

2015-10-02

The UNSW Australia Medicine program explicitly structures peer learning in program wide mixing of students where students from two adjoining cohorts complete the same course together, including all learning activities and assessment. The purpose of this evaluation is to explore the student experience of peer learning and determine benefits and concerns for junior and senior students. All medical students at UNSW Australia in 2012 (n = 1608) were invited to complete the Peer Learning Questionnaire consisting of 26 fixed-response items and 2 open-ended items exploring vertical integration and near-peer teaching. Assessment data from vertically integrated and non-vertically integrated courses were compared for the period 2011-2013. We received valid responses from 20 % of medical students (n = 328). Eighty percent of respondents were positive about their experience of vertical integration. Year 1 students reported that second year students provided guidance and reassurance (87.8 %), whilst year 2 students reported that the senior role helped them to improve their own understanding, communication and confidence (84 %). Vertical integration had little effect on examination performance and failure rates. This evaluation demonstrates that vertical integration of students who are one year apart and completing the same course leads to positive outcomes for the student experience of learning. Students benefit through deeper learning and the development of leadership qualities within teams. These results are relevant not only for medical education, but also for other professional higher education programs.

A Rationale for Mixed Methods (Integrative) Research Programmes in Education

ERIC Educational Resources Information Center

Niaz, Mansoor

2008-01-01

Recent research shows that research programmes (quantitative, qualitative and mixed) in education are not displaced (as suggested by Kuhn) but rather lead to integration. The objective of this study is to present a rationale for mixed methods (integrative) research programs based on contemporary philosophy of science (Lakatos, Giere, Cartwright,…

Integrated Teacher Education Programme for Open Distance Learning: A Model for Development and Implementation

ERIC Educational Resources Information Center

Bose, Sutapa

2013-01-01

Teacher education in India, including that offered by the open distance learning (ODL) system to thousands every year, imparts mainly pedagogic knowledge, although the need for integrated teacher education programmes has been underscored. As the Indira Gandhi National Open University (IGNOU), an ODL institution, will develop an integrated Bachelor…

Locomotor, cardiocirculatory and metabolic adaptations to training in Andalusian and Anglo-Arabian horses.

PubMed

Muñoz, A; Santisteban, R; Rubio, M D; Agüera, E I; Escribano, B M; Castejón, F M

1999-02-01

The effects of two training programmes in 20 Andalusian and 12 Anglo-Arabian horses were evaluated by an increasing intensity work test at velocities of 4, 5, 6, 7 and 8 m sec(-1). Heart rate was monitored and blood samples were drawn at rest and after each velocity to analyse packed cell volume, haemoglobin concentration, plasma lactate and potassium levels. Furthermore, the programmes were video-taped and stride length, duration and frequency, stance (restraint and propulsion), swing phase durations and stride vertical component were measured. The training protocol of the Andalusian horses produced significant decreases in the cardiovascular, haematological and metabolic responses to exercise. Locomotory training adaptation consisted of an increased stride frequency and a reduced stride length and vertical stride component. The last variable was the limiting factor of stride length both before and after training in the Andalusian horses. A different training protocol for show-jumping competition in Anglo-Arabian horses failed to show significant differences in the studied parameters to the work test, although an increase in stride length at velocities of over 6 m sec(-1) was observed. Stride vertical component did not have an effect on the physiological response to exercise, either before or after training.

Positioning for capitation in long-term care: a profile of vertical integration strategies in health and social service organizations.

PubMed

Walsh, A M

1998-01-01

During the next decade, the population over age 65 is expected to increase by 11% while the population over age 85 is expected to increase by 42%. These projections suggest that many organizations which currently provide services to the aged will be required to design a range of new products and services for this diverse population. Vertically integrated services provide a viable opportunity to competitively position an organization to respond to the diverse needs of an aged market. Since vertical integration will be essential in negotiating capitate contracts for the aged in the future, this study examined the extent of vertical integration in 116 health and social service organizations in an urban market with an expanding geriatric population.

Horizontal and vertical integration in hospital laboratories and the laboratory information system.

PubMed

Friedman, B A; Mitchell, W

1990-09-01

An understanding of horizontal and vertical integration and their quasi-integration variants is important for pathologists to formulate a competitive strategy for hospital clinical laboratories. These basic organizational concepts, in turn, are based on the need to establish control over critical laboratory inputs and outputs. The pathologist seeks greater control of mission-critical system inputs and outputs to increase the quality and efficiency of the laboratory operations. The LIS produces horizontal integration of the various hospital laboratories by integrating them vertically. Forward vertical quasi-integration of the laboratories is mediated primarily by the LIS through front-end valued-added features such as reporting of results and creating a long-term on-line test result archive. These features increase the value of the information product of pathology for clinicians and increase the cost of switching to another system. The LIS can also serve as a means for customizing the information product of the laboratories to appeal to new market segments such as hospital administrators.

The politics of tuberculosis and HIV service integration in Ghana.

PubMed

Amo-Adjei, Joshua; Kumi-Kyereme, Akwasi; Fosuah Amo, Hannah; Awusabo-Asare, Kofi

2014-09-01

The need to integrate TB/HIV control programmes has become critical due to the comorbidity regarding these diseases and the need to optimise the use of resources. In developing countries such as Ghana, where public health interventions depend on donor funds, the integration of the two programmes has become more urgent. This paper explores stakeholders' views on the integration of TB/HIV control programmes in Ghana within the remits of contingency theory. With 31 purposively selected informants from four regions, semi-structured interviews and observations were conducted between March and May 2012, and the data collected were analysed using the inductive approach. The results showed both support for and opposition to integration, as well as some of the avoidable challenges inherent in combining TB/HIV control. While those who supported integration based their arguments on clinical synergies and the need to promote the efficient use of resources, those who opposed integration cited the potential increase in workload, the clinical complications associated with joint management, the potential for a leadership crisis, and the "smaller the better" propositions to support their stance. Although a policy on TB/HIV integration exists, inadequate 'political will' from the top management of both programmes has trickled down to lower levels, which has stifled progress towards the comprehensive management of TB/HIV and particularly leading to weak data collection and management structures and unsatisfactory administration of co-trimoxazole for co-infected patients. It is our view that the leadership of both programmes show an increased commitment to protocols involving the integration of TB/HIV, followed by a commitment to addressing the 'fears' of frontline service providers to encourage confidence in the process of service integration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vertical and lateral heterogeneous integration

NASA Astrophysics Data System (ADS)

Geske, Jon; Okuno, Yae L.; Bowers, John E.; Jayaraman, Vijay

2001-09-01

A technique for achieving large-scale monolithic integration of lattice-mismatched materials in the vertical direction and the lateral integration of dissimilar lattice-matched structures has been developed. The technique uses a single nonplanar direct-wafer-bond step to transform vertically integrated epitaxial structures into lateral epitaxial variation across the surface of a wafer. Nonplanar wafer bonding is demonstrated by integrating four different unstrained multi-quantum-well active regions lattice matched to InP on a GaAs wafer surface. Microscopy is used to verify the quality of the bonded interface, and photoluminescence is used to verify that the bonding process does not degrade the optical quality of the laterally integrated wells. The authors propose this technique as a means to achieve greater levels of wafer-scale integration in optical, electrical, and micromechanical devices.

Investigation for connecting waveguide in off-planar integrated circuits.

PubMed

Lin, Jie; Feng, Zhifang

2017-09-01

The transmission properties of a vertical waveguide connected by different devices in off-planar integrated circuits are designed, investigated, and analyzed in detail by the finite-difference time-domain method. The results show that both guide bandwidth and transmission efficiency can be adjusted effectively by shifting the vertical waveguide continuously. Surprisingly, the wide guide band (0.385[c/a]∼0.407[c/a]) and well transmission (-6  dB) are observed simultaneously in several directions when the vertical waveguide is located at a specific location. The results are very important for all-optical integrated circuits, especially in compact integration.

Is vertical integration adding value to health systems?

PubMed

Weil, T P

2000-04-01

Vertical integration is a concept used by health systems when attempting to achieve economies of scale, greater coordination of services, and improved market penetration. This article focuses on the actual outcomes of utilizing vertical integration in the health field and then compares these findings with those reported in other industries. This analysis concludes that this organizational model does not work particularly well in the health industry, as illustrated by health alliances' poor fiscal performance when they acquire physician practices or when they start their own HMO plans.

Vertical Distributions of Coccolithophores, PIC, POC, Biogenic Silica, and Chlorophyll a Throughout the Global Ocean.

PubMed

Balch, William M; Bowler, Bruce C; Drapeau, David T; Lubelczyk, Laura C; Lyczkowski, Emily

2018-01-01

Coccolithophores are a critical component of global biogeochemistry, export fluxes, and seawater optical properties. We derive globally significant relationships to estimate integrated coccolithophore and coccolith concentrations as well as integrated concentrations of particulate inorganic carbon (PIC) from their respective surface concentration. We also examine surface versus integral relationships for other biogeochemical variables contributed by all phytoplankton (e.g., chlorophyll a and particulate organic carbon) or diatoms (biogenic silica). Integrals are calculated using both 100 m integrals and euphotic zone integrals (depth of 1% surface photosynthetically available radiation). Surface concentrations are parameterized in either volumetric units (e.g., m -3 ) or values integrated over the top optical depth. Various relationships between surface concentrations and integrated values demonstrate that when surface concentrations are above a specific threshold, the vertical distribution of the property is biased to the surface layer, and when surface concentrations are below a specific threshold, the vertical distributions of the properties are biased to subsurface maxima. Results also show a highly predictable decrease in explained-variance as vertical distributions become more vertically heterogeneous. These relationships have fundamental utility for extrapolating surface ocean color remote sensing measurements to 100 m depth or to the base of the euphotic zone, well beyond the depths of detection for passive ocean color remote sensors. Greatest integrated concentrations of PIC, coccoliths, and coccolithophores are found when there is moderate stratification at the base of the euphotic zone.

Vertical Distributions of Coccolithophores, PIC, POC, Biogenic Silica, and Chlorophyll a Throughout the Global Ocean

PubMed Central

Bowler, Bruce C.; Drapeau, David T.; Lubelczyk, Laura C.; Lyczkowski, Emily

2018-01-01

Abstract Coccolithophores are a critical component of global biogeochemistry, export fluxes, and seawater optical properties. We derive globally significant relationships to estimate integrated coccolithophore and coccolith concentrations as well as integrated concentrations of particulate inorganic carbon (PIC) from their respective surface concentration. We also examine surface versus integral relationships for other biogeochemical variables contributed by all phytoplankton (e.g., chlorophyll a and particulate organic carbon) or diatoms (biogenic silica). Integrals are calculated using both 100 m integrals and euphotic zone integrals (depth of 1% surface photosynthetically available radiation). Surface concentrations are parameterized in either volumetric units (e.g., m−3) or values integrated over the top optical depth. Various relationships between surface concentrations and integrated values demonstrate that when surface concentrations are above a specific threshold, the vertical distribution of the property is biased to the surface layer, and when surface concentrations are below a specific threshold, the vertical distributions of the properties are biased to subsurface maxima. Results also show a highly predictable decrease in explained‐variance as vertical distributions become more vertically heterogeneous. These relationships have fundamental utility for extrapolating surface ocean color remote sensing measurements to 100 m depth or to the base of the euphotic zone, well beyond the depths of detection for passive ocean color remote sensors. Greatest integrated concentrations of PIC, coccoliths, and coccolithophores are found when there is moderate stratification at the base of the euphotic zone. PMID:29576683

Teaching Theory in an Empirically-Oriented Graduate Program.

ERIC Educational Resources Information Center

Warner, R. Stephen

1987-01-01

Stresses that the role of theory is to facilitate cognitive integration, which has a vertical dimension (abstract to concrete) and a horizontal one (across schools and substantive fields). The author emphasizes horizontal integration over upper-level vertical integration to help students communicate across specialities. (Author/DH)

Vertical electro-absorption modulator design and its integration in a VCSEL

NASA Astrophysics Data System (ADS)

Marigo-Lombart, L.; Calvez, S.; Arnoult, A.; Thienpont, H.; Almuneau, G.; Panajotov, K.

2018-04-01

Electro-absorption modulators, either embedded in CMOS technology or integrated with a semiconductor laser, are of high interest for many applications such as optical communications, signal processing and 3D imaging. Recently, the integration of a surface-normal electro-absorption modulator into a vertical-cavity surface-emitting laser has been considered. In this paper we implement a simple quantum well electro-absorption model and design and optimize an asymmetric Fabry-Pérot semiconductor modulator while considering all physical properties within figures of merit. We also extend this model to account for the impact of temperature on the different parameters involved in the calculation of the absorption, such as refractive indices and exciton transition broadening. Two types of vertical modulator structures have been fabricated and experimentally characterized by reflectivity and photocurrent measurements demonstrating a very good agreement with our model. Finally, preliminary results of an electro-absorption modulator vertically integrated with a vertical-cavity surface-emitting laser device are presented, showing good modulation performances required for high speed communications.

A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme.

PubMed

Geurtsen, G J; Martina, J D; Van Heugten, C M; Geurts, A C H

2008-07-01

To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. Prospective cohort study. Twenty-four participants with acquired brain injury (traumatic n = 18; stroke n = 3, tumour n = 2, encephalitis n = 1). Participants had impaired illness awareness, alcohol and drug problems and/or behavioural problems. A skills-oriented programme with modules related to independent living, work, social and emotional well-being. The Community Integration Questionnaire, CES-Depression, EuroQOL, Employability Rating Scale, living situation and work status were scored at the start (T0), end of treatment (T1) and 1-year follow-up (T2). Significant effects on the majority of outcome measures were present at T1. Employability significantly improved at T2 and living independently rose from 42% to over 70%. Participants working increased from 38% to 58% and the hours of work per week increased from 8 to 15. The Brain Integration Programme led to a sustained reduction in experienced problems and improved community integration. It is concluded that even participants with complex problems due to severe brain injury who got stuck in life could improve their social participation and emotional well-being through a residential community reintegration programme.

Downhole measurements in the AND-1B borehole, ANDRILL McMurdo Ice Shelf Project, Antarctica

USGS Publications Warehouse

Morin, R.; Williams, T.; Henrys, S.; Crosby, T.; Hansaraj, D.

2007-01-01

A comprehensive set of downhole measurements was collected in the AND-1B drillhole as part of the on-ice scientific programme defined for the McMurdo Ice Shelf (MIS) Project. Geophysical logs were recorded over two operation phases and consisted of calliper, temperature, fluid conductivity, induction resistivity, magnetic susceptibility, natural gamma activity, acoustic televiewer, borehole deviation, and dipmeter. In addition, two standard vertical seismic profiles (VSP) and one walk-away VSP were obtained. Radioactive logs (porosity and density) were not run because of unstable borehole conditions. Although the total depth of the hole is 1285 metres below seafloor (mbsf), the depth range for in situ measurements was limited by the length of the wireline (1018 mbsf) and by the nullification of some geophysical logs due to the presence of steel casing. A depth correction was derived to account for systematic discrepancies in depth between downhole measurements and cores; consequently, log responses can be directly compared to core properties. The resulting data are amenable to studies of cyclicity and climate, heat flux and fluid flow, and stricture and stress. When integrated with physical properties and fractures measured on the core, this information should play a significant role in addressing many of the scientific objectives of the ANDRILL programme.

Students' perceptions of vertical and horizontal integration in a discipline-based dental school.

PubMed

Postma, T C; White, J G

2017-05-01

Integration is a key concern in discipline-based undergraduate dental curricula. Therefore, this study compared feedback on integration from students who participated in different instructional designs in a Comprehensive Patient Care course. The study was conducted at the University of Pretoria (2009-2011). Third-year cohorts (Cohorts A, B and C) participated in pre-clinical case-based learning, whilst fourth-year cohorts (Cohorts D and E) received didactic teaching in Comprehensive Patient Care. Cohorts A, D and E practised clinical Comprehensive Patient Care in a discipline-based clinic. Cohort B conducted their Comprehensive Patient Care patient examinations in a dedicated facility supervised by dedicated faculty responsible to teach integration. Students had to indicate on visual analogue scales whether the way they were taught at the school helped them to integrate knowledge from the same (horizontal integration) and preceding (vertical integration) year of study. The end-points of the scales were defined as 'definitely' and 'not at all'. Analysis of variance (ANOVA) was employed to measure the differences between cohorts according to the year of study. Third-year case-based learning cohorts rated the horizontal integration close to 80/100 and vertical integration ranging from 64 to 71/100. In year four, Cohort B rated vertical and horizontal integration 9-15% higher (ANOVA, P < 0.05) than Cohorts A and D. In year five, Cohort A rated vertical and horizontal integration 11-18% higher (ANOVA, P < 0.05) than Cohorts D and E. Pre-clinical case-based learning and Comprehensive Patient Care supervised by dedicated faculty were associated with more favourable perceptions about integration in the discipline-based undergraduate dental curriculum. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Juno at the Vertical Integration Facility

NASA Image and Video Library

2011-08-03

At Space Launch Complex 41, the Juno spacecraft, enclosed in an Atlas payload fairing, was transferred into the Vertical Integration Facility where it was positioned on top of the Atlas rocket stacked inside.

Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach.

PubMed

Lopes, Sílvia; Fernandes, Óscar B; Marques, Ana Patrícia; Moita, Bruno; Sarmento, João; Santana, Rui

2017-05-01

Vertical integration is expected to improve communication and coordination between inpatient care and care after discharge. Despite being used across health systems worldwide, evidence about its impact on readmissions is sparse and contradictory. To assess the impact of vertical integration on hospital readmissions. Using difference-in-differences we compared readmissions before and after vertical integration in 6 Portuguese hospitals for years 2004-2013. A control group with 6 similar hospitals not integrated was utilized. Considered outcome was 30-day unplanned readmission. We used logistic regression at the admission level and accounted for patients' risk factors using claims data. Analyses for each hospital and selected conditions were also run. Our results suggest that readmissions decreased overall after vertical integration [odds ratio (OR)=0.900; 95% confidence interval (CI), 0.812-0.997]. Hospital analysis indicated that there was no impact for 2 hospitals (OR=0.960; 95% CI, 0.848-1.087 and OR=0.944; 95% CI, 0.857-1.038), and a positive effect in 4 hospitals (greatest effect: OR=0.811; 95% CI, 0.736-0.894). A positive evolution was observed for a limited number of conditions, with better results for diabetes with complications (OR=0.689; 95% CI, 0.525-0.904), but no impact regarding congestive heart failure (OR=1.067; 95% CI, 0.827-1.377). Merging acute and primary care providers was associated with reduced readmissions, even though improvements were not found for all institutions or condition-specific groups. There are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions.

Upstairs downstairs: vertical integration of a pediatric service.

PubMed

Racine, A D; Stein, R E; Belamarich, P F; Levine, E; Okun, A; Porder, K; Rosenfeld, J L; Schechter, M

1998-07-01

The combined effects of recent changes in health care financing and training priorities have compelled academic medical centers to develop innovative structures to maintain service commitments yet conform to health care marketplace demands. In 1992, a municipal hospital in the Bronx, New York, affiliated with a major academic medical center reorganized its pediatric service into a vertically integrated system of four interdependent practice teams that provided comprehensive care in the ambulatory as well as inpatient settings. One of the goals of the new system was to conserve inpatient resources. To describe the development of a new vertically integrated pediatric service at an inner-city municipal hospital and to test whether its adoption was associated with the use of fewer inpatient resources. A descriptive analysis of the rationale, goals, implementation strategies, and structure of the vertically integrated pediatric service combined with a before-and-after comparison of in-hospital resource consumption. A before-and-after comparison was conducted for two periods: the period before vertical integration, from January 1989 to December 1991, and the period after the adoption of vertical integration, from July 1992 to December 1994. Four measures of inpatient resource use were compared after adjustment for case mix index: mean certified length of stay per case, mean number of radiologic tests per case, mean number of ancillary tests per case, and mean number of laboratory tests per case. Difference-in-differences-in-differences estimators were used to control for institution-wide trends throughout the time period and regional trends in inpatient pediatric practice occurring across institutions. Results. In 1992, the Department of Pediatrics at the Albert Einstein College of Medicine reorganized the pediatric service at Jacobi Medical Center, one of its principal municipal hospital affiliates, into a vertically integrated pediatric service that combines ambulatory and inpatient activities into four interdependent practice teams composed of attending pediatricians, allied health professionals, house officers, and social workers. The new vertically integrated service was designed to improve continuity of care for patients, provide a model of practice for professional trainees, conserve scarce resources, and create a clinical research infrastructure. The vertically integrated pediatric service augmented the role of attending pediatricians, extended the use of allied health professionals from the ambulatory to the inpatient sites, established interdisciplinary practice teams that unified the care of pediatric patients and their families, and used less inpatient resources. Controlling for trends within the study institution and trends in the practice of pediatrics across institutions throughout the time period, the vertical integration was associated with a decline in 0.6 days per case, the use of 0.62 fewer radiologic tests per case, 0.21 fewer ancillary tests per case, and 2.68 fewer laboratory tests per case. We conclude that vertical integration of a pediatric service at an inner-city municipal hospital is achievable; conveys advantages of improved continuity of care, enhanced opportunities for primary care training, and increased participation of senior clinicians; and has the potential to conserve significant amounts of inpatient resources.

Neurogenic Communication Disorders and Paralleling Agraphic Disturbances: Implications for Concerns in Basic Writing.

ERIC Educational Resources Information Center

De Jarnette, Glenda

Vertical and lateral integration are two important nervous system integrations that affect the development of oral behaviors. There are three progressions in the vertical integration process for speech nervous system development: R-complex speech (ritualistic, memorized expressions), limbic speech (emotional expressions), and cortical speech…

Managed care, vertical integration strategies and hospital performance.

PubMed

Wang, B B; Wan, T T; Clement, J; Begun, J

2001-09-01

The purpose of this study is to examine the association of managed care with hospital vertical integration strategies, as well as to observe the relationships of different types of vertical integration with hospital efficiency and financial performance. The sample consists of 363 California short-term acute care hospitals in 1994. Linear structure equation modeling is used to test six hypotheses derived from the strategic adaptation model. Several organizational and market factors are controlled statistically. Results suggest that managed care is a driving force for hospital vertical integration. In terms of performance, hospitals that are integrated with physician groups and provide outpatient services (backward integration) have better operating margins, returns on assets, and net cash flows (p < 0.01). These hospitals are not, however, likely to show greater productivity. Forward integration with a long-term-care facility, on the other hand, is positively and significantly related to hospital productivity (p < 0.001). Forward integration is negatively related to financial performance (p < 0.05), however, opposite to the direction hypothesized. Health executives should be responsive to the growth of managed care in their local market and should probably consider providing more backward integrated services rather than forward integrated services in order to improve the hospital's financial performance in today's competitive health care market.

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

Integration of a waveguide self-electrooptic effect device and a vertically coupled interconnect waveguide

DOEpatents

Vawter, G Allen [Corrales, NM

2008-02-26

A self-electrooptic effect device ("SEED") is integrated with waveguide interconnects through the use of vertical directional couplers. Light initially propagating in the interconnect waveguide is vertically coupled to the active waveguide layer of the SEED and, if the SEED is in the transparent state, the light is coupled back to the interconnect waveguide.

Vertically stacked multi-heterostructures of layered materials for logic transistors and complementary inverters

PubMed Central

Yu, Woo Jong; Li, Zheng; Zhou, Hailong; Chen, Yu; Wang, Yang; Huang, Yu; Duan, Xiangfeng

2014-01-01

The layered materials such as graphene have attracted considerable interest for future electronics. Here we report the vertical integration of multi-heterostructures of layered materials to enable high current density vertical field-effect transistors (VFETs). An n-channel VFET is created by sandwiching few-layer molybdenum disulfide (MoS2) as the semiconducting channel between a monolayer graphene and a metal thin film. The VFETs exhibit a room temperature on-off ratio >103, while at same time deliver a high current density up to 5,000 A/cm2, sufficient for high performance logic applications. This study offers a general strategy for the vertical integration of various layered materials to obtain both p- and n-channel transistors for complementary logic functions. A complementary inverter with larger than unit voltage gain is demonstrated by vertically stacking the layered materials of graphene, Bi2Sr2Co2O8 (p-channel), graphene, MoS2 (n-channel), and metal thin film in sequence. The ability to simultaneously achieve high on-off ratio, high current density, and logic integration in the vertically stacked multi-heterostructures can open up a new dimension for future electronics to enable three-dimensional integration. PMID:23241535

Defense Industrial Base Assessment: U.S. Integrated Circuit Design and Fabrication Capability

DTIC Science & Technology

2009-05-01

in the U.S for the period 2003-2006, with projections to 2011.6 The resulting draft OTE survey was field tested for accuracy and usability with a...custom application specific integrated circuits (ASICs) to field programmable gate arrays (FPGAs). Companies of all sizes can manufacture these IC...able to design one-time Electronically Programmable Gate Arrays (EPGAs) while nine are able to design Field Programmable Gate Arrays (FPGAs). Eight

Leveraging Safety Programs to Improve and Support Security Programs

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

Leach, Janice; Snell, Mark K.; Pratt, R.

2015-10-01

There has been a long history of considering Safety, Security, and Safeguards (3S) as three functions of nuclear security design and operations that need to be properly and collectively integrated with operations. This paper specifically considers how safety programmes can be extended directly to benefit security as part of an integrated facility management programme. The discussion will draw on experiences implementing such a programme at Sandia National Laboratories’ Annular Research Reactor Facility. While the paper focuses on nuclear facilities, similar ideas could be used to support security programmes at other types of high-consequence facilities and transportation activities.

Integrated care.

PubMed

Warwick-Giles, Lynsey; Checkland, Kath

2018-03-19

Purpose The purpose of this paper is to try and understand how several organisations in one area in England are working together to develop an integrated care programme. Weick's (1995) concept of sensemaking is used as a lens to examine how the organisations are working collaboratively and maintaining the programme. Design/methodology/approach Qualitative methods included: non-participant observations of meetings, interviews with key stakeholders and the collection of documents relating to the programme. These provided wider contextual information about the programme. Comprehensive field notes were taken during observations and analysed alongside interview transcriptions using NVIVO software. Findings This paper illustrates the importance of the construction of a shared identity across all organisations involved in the programme. Furthermore, the wider policy discourse impacted on how the programme developed and influenced how organisations worked together. Originality/value The role of leaders from all organisations involved in the programme was of significance to the overall development of the programme and the sustained momentum behind the programme. Leaders were able to generate a "narrative of success" to drive the programme forward. This is of particular relevance to evaluators, highlighting the importance of using multiple methods to allow researchers to probe beneath the surface of programmes to ensure that evidence moves beyond this public narrative.

Integrating mental health into primary care in Sverdlovsk

PubMed Central

2009-01-01

Introduction Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors. Methods This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into primary care, by situation appraisal, policy dialogue, development of educational materials, provision of a training programme and the publication of standards and good practice guidelines to improve the primary care of mental disorders in the Sverdlovsk region of the Russian Federation. Results The multi-component programme has resulted in sustainable training about common mental disorders, not only of family doctors but also of other cadres and levels of professionals, and it has been well integrated with Sverdlovsk's overall programme of health sector reforms. Conclusion It is possible to facilitate the sustainable integration of mental health into primary care within the Russian context. While careful adaptation will be needed, the approach adopted here may also hold useful lessons for policy makers seeking to integrate mental health within primary care in other contexts and settings. PMID:22477885

Integrated vector management for malaria control

PubMed Central

Beier, John C; Keating, Joseph; Githure, John I; Macdonald, Michael B; Impoinvil, Daniel E; Novak, Robert J

2008-01-01

Integrated vector management (IVM) is defined as "a rational decision-making process for the optimal use of resources for vector control" and includes five key elements: 1) evidence-based decision-making, 2) integrated approaches 3), collaboration within the health sector and with other sectors, 4) advocacy, social mobilization, and legislation, and 5) capacity-building. In 2004, the WHO adopted IVM globally for the control of all vector-borne diseases. Important recent progress has been made in developing and promoting IVM for national malaria control programmes in Africa at a time when successful malaria control programmes are scaling-up with insecticide-treated nets (ITN) and/or indoor residual spraying (IRS) coverage. While interventions using only ITNs and/or IRS successfully reduce transmission intensity and the burden of malaria in many situations, it is not clear if these interventions alone will achieve those critical low levels that result in malaria elimination. Despite the successful employment of comprehensive integrated malaria control programmes, further strengthening of vector control components through IVM is relevant, especially during the "end-game" where control is successful and further efforts are required to go from low transmission situations to sustained local and country-wide malaria elimination. To meet this need and to ensure sustainability of control efforts, malaria control programmes should strengthen their capacity to use data for decision-making with respect to evaluation of current vector control programmes, employment of additional vector control tools in conjunction with ITN/IRS tactics, case-detection and treatment strategies, and determine how much and what types of vector control and interdisciplinary input are required to achieve malaria elimination. Similarly, on a global scale, there is a need for continued research to identify and evaluate new tools for vector control that can be integrated with existing biomedical strategies within national malaria control programmes. This review provides an overview of how IVM programmes are being implemented, and provides recommendations for further development of IVM to meet the goals of national malaria control programmes in Africa. PMID:19091038

Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial.

PubMed

Malmberg, Monique; Kleinjan, Marloes; Overbeek, Geertjan; Vermulst, Ad; Monshouwer, Karin; Lammers, Jeroen; Vollebergh, Wilma A M; Engels, Rutger C M E

2014-06-01

To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). General population of 11-15-year-old adolescents in the Netherlands. A total of 3784 students of 23 Dutch secondary schools. Structured digital questionnaires were administered pre-intervention and at 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence). Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214). The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately. © 2014 Society for the Study of Addiction.

Positioning for vertical integration through clinics "without walls".

PubMed

Johnson, B A; Schryver, D L

1994-01-01

Authors Bruce A. Johnson, J.D., M.P.A., and Darrell Schryver, D.P.A., offer the clinic without walls model as a transitory step to full vertical integration. They write that this model "may enable physicians to address the key issues associated with managed care and integration in a more gradual, controlled fashion.

Employment Opportunities for the Handicapped in Programmable Automation.

ERIC Educational Resources Information Center

Swift, Richard; Leneway, Robert

A Computer Integrated Manufacturing System may make it possible for severely disabled people to custom design, machine, and manufacture either wood or metal parts. Programmable automation merges computer aided design, computer aided manufacturing, computer aided engineering, and computer integrated manufacturing systems with automated production…

Integration Models for Indigenous Public Health Curricula

ERIC Educational Resources Information Center

Coombe, Leanne; Lee, Vanessa; Robinson, Priscilla

2017-01-01

All graduates of Master of Public Health (MPH) programmes in Australia are expected to achieve a core set of Indigenous public health competencies designed to train "judgement safe practitioners". A curriculum framework document was developed alongside the competencies to assist programme providers to integrate appropriate Indigenous…

Integration of animal health, food pathogen and foodborne disease surveillance in the Americas.

PubMed

Hulebak, K; Rodricks, J; Smith DeWaal, C

2013-08-01

This paper describes the characteristics of surveillance and the attempts made in the Americas to institute truly integrated surveillance systems that bring together disease surveillance of medically treated clinical populations with disease surveillance for food-production animals. Characteristics of an ideal, integrated food safety system are described. Systematic surveillance programmes in the Americas vary widely in scope and reliability, and none is fully integrated. Estimates of foodborne disease rates, particularly in North America, are becoming increasingly accurate, and programmes such as those promoted by the Pan American Health Organization are gradually leading to improvements in estimates of the foodborne disease burden in Latin America. Linking foodborne diseases to their sources is necessary for reducing disease incidence, and the World Health Organization's Global Foodborne Infections Network is building global capacity in this area. Activities in these areas in the Americas are described in detail. There is now clear recognition that there are dynamic links between infectious diseases occurring in wildlife and livestock and those occurring in humans, and this has led to calls from organisations such as the US National Academy of Sciences and the American Veterinary Medical Association to integrate surveillance programmes for zoonotic and human diseases. Models for the development of such integrated programmes, at local, national and international levels, are described. To be effective, such models must incorporate programmes to capture information from numerous, discrete surveillance systems in a way that allows rapid analysis to identify zoonotic and human disease connections. No effective integration now exists, but there are signals that governments in the Americas are working together towards this goal.

Integrating Equity in a Public Health Funding Strategy.

PubMed

Joseph, Kristy T; Rice, Ketra; Li, Chunyu

2016-01-01

Equity can be valuable to guide decision makers about where to target funds; however, there are few studies for modeling vertical equity in public health program funding strategies. This case study modeled vertical equity in the funding strategy of the Centers for Disease Control and Prevention's Colorectal Cancer Control Program. To integrate vertical equity by using historical funding and health data, we (a) examined the need for colorectal cancer screening, (b) conducted multiple regressions to examine the relationship between factors of need and funding of states, (c) stratified states into similar need groups, (d) estimated vertical equity within groups, and (e) assessed equity in the funding distribution. Certain states with similar needs had high relative funding, whereas other states with similar needs had low relative funding. The methods used to integrate vertical equity in this case study could be applied in publicly funded programs to potentially minimize inequities and improve outcomes.

Analysis of photonic spot profile converter and bridge structure on SOI platform for horizontal and vertical integration

NASA Astrophysics Data System (ADS)

Majumder, Saikat; Jha, Amit Kr.; Biswas, Aishik; Banerjee, Debasmita; Ganguly, Dipankar; Chakraborty, Rajib

2017-08-01

Horizontal spot size converter required for horizontal light coupling and vertical bridge structure required for vertical integration are designed on high index contrast SOI platform in order to form more compact integrated photonic circuits. Both the structures are based on the concept of multimode interference. The spot size converter can be realized by successive integration of multimode interference structures with reducing dimension on horizontal plane, whereas the optical bridge structure consists of a number of vertical multimode interference structure connected by single mode sections. The spot size converter can be modified to a spot profile converter when the final single mode waveguide is replaced by a slot waveguide. Analysis have shown that by using three multimode sections in a spot size converter, an Gaussian input having spot diameter of 2.51 μm can be converted to a spot diameter of 0.25 μm. If the output single mode section is replaced by a slot waveguide, this input profile can be converted to a flat top profile of width 50 nm. Similarly, vertical displacement of 8μm is possible by using a combination of two multimode sections and three single mode sections in the vertical bridge structure. The analyses of these two structures are carried out for both TE and TM modes at 1550 nm wavelength using the semi analytical matrix method which is simple and fast in computation time and memory. This work shows that the matrix method is equally applicable for analysis of horizontally as well as vertically integrated photonic circuit.

Marshfield Clinic, physician networks, and the exercise of monopoly power.

PubMed Central

Greenberg, W

1998-01-01

OBJECTIVE: Antitrust enforcement can improve the performance of large, vertically integrated physician-hospital organizations (PHOs). Objective: To examine the recent court decisions in the Blue Cross and Blue Shield United of Wisconsin v. Marshfield Clinic antitrust case to understand better the benefits and costs of vertical integration in healthcare. SUMMARY AND CONCLUSIONS: Vertical integration in the Marshfield Clinic may have had the benefits of reducing transactions and uncertainty costs while improving the coordination between ambulatory and inpatient visits, but at the cost of Marshfield Clinic's monopolizing of physician services and foreclosing of HMO entry in northwest Wisconsin. The denial of hospital staff privileges to non-Marshfield Clinic physicians combined with certificate-of-need regulations impeded physician entry and solidified Marshfield Clinic's monopoly position. Enforcement efforts of recent antitrust guidelines by the U.S. Department of Justice and the Federal Trade Commission will need to address carefully the benefits and costs of vertically integrated systems. PMID:9865229

Can Vertical Integration Reduce Hospital Readmissions? A Difference-in-Differences Approach

PubMed Central

Fernandes, Óscar B.; Marques, Ana Patrícia; Moita, Bruno; Sarmento, João; Santana, Rui

2017-01-01

Background: Vertical integration is expected to improve communication and coordination between inpatient care and care after discharge. Despite being used across health systems worldwide, evidence about its impact on readmissions is sparse and contradictory. Objective: To assess the impact of vertical integration on hospital readmissions. Research Design, Subjects, and Measures: Using difference-in-differences we compared readmissions before and after vertical integration in 6 Portuguese hospitals for years 2004–2013. A control group with 6 similar hospitals not integrated was utilized. Considered outcome was 30-day unplanned readmission. We used logistic regression at the admission level and accounted for patients’ risk factors using claims data. Analyses for each hospital and selected conditions were also run. Results: Our results suggest that readmissions decreased overall after vertical integration [odds ratio (OR)=0.900; 95% confidence interval (CI), 0.812–0.997]. Hospital analysis indicated that there was no impact for 2 hospitals (OR=0.960; 95% CI, 0.848–1.087 and OR=0.944; 95% CI, 0.857–1.038), and a positive effect in 4 hospitals (greatest effect: OR=0.811; 95% CI, 0.736–0.894). A positive evolution was observed for a limited number of conditions, with better results for diabetes with complications (OR=0.689; 95% CI, 0.525–0.904), but no impact regarding congestive heart failure (OR=1.067; 95% CI, 0.827–1.377). Conclusions: Merging acute and primary care providers was associated with reduced readmissions, even though improvements were not found for all institutions or condition-specific groups. There are still challenges to be addressed regarding the success of vertical integration in reducing 30-day hospital readmissions. PMID:28403012

Framework programmable platform for the advanced software development workstation. Integration mechanism design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Reddy, Uday; Ackley, Keith; Futrell, Mike

1991-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software development environment. Guided by this model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated.

Accreditation of Engineering Programmes: European Perspectives and Challenges in a Global Context

ERIC Educational Resources Information Center

Augusti, Giuliano

2007-01-01

The EUR-ACE Socrates-Tempus project (September 2004/March 2006) proposed a decentralized European system for accreditation of engineering programmes in the "Bologna process" area (European Higher Education Area) at the First and Second Cycle (FC and SC) level (but including "Integrated Programmes", i.e. programmes leading…

Implementation of Content and Language Integrated Learning (CLIL) Programmes in Public Administration: Russian Students' and Matriculants' Opinion about Their First CLIL Experience

ERIC Educational Resources Information Center

Rubtcova, Mariia; Kaisarova, Valentina

2016-01-01

Content and Language Integrated Learning (CLIL) is a pedagogic approach that has developed in response to the demand for integrating education in both school/university subjects and language skills. Our paper is devoted to the implementation of CLIL programmes in Public Administration within a particular sociolinguistic context: that of Russian…

Integrated Medical Curriculum: Advantages and Disadvantages

PubMed Central

Quintero, Gustavo A.; Vergel, John; Arredondo, Martha; Ariza, María-Cristina; Gómez, Paula; Pinzon-Barrios, Ana-Maria

2016-01-01

Most curricula for medical education have been integrated horizontally and vertically–-vertically between basic and clinical sciences. The Flexnerian curriculum has disappeared to permit integration between basic sciences and clinical sciences, which are taught throughout the curriculum. We have proposed a different form of integration where the horizontal axis represents the defined learning outcomes and the vertical axis represents the teaching of the sciences throughout the courses. We believe that a mere integration of basic and clinical sciences is not enough because it is necessary to emphasize the importance of humanism as well as health population sciences in medicine. It is necessary to integrate basic and clinical sciences, humanism, and health population in the vertical axis, not only in the early years but also throughout the curriculum, presupposing the use of active teaching methods based on problems or cases in small groups. PMID:29349303

An Integrated Approach to Environmental Education: A Case Study

ERIC Educational Resources Information Center

du Preez, Nicolaas P.; Mohr-Swart, Maryna

2004-01-01

In 1994, the Executive Management Committee (EMC) of Technikon Pretoria took a strategic decision to develop educational programmes in environmental management and sustainable development. The EMC also decided to integrate these programmes with the development and implementation of an environmental management policy for Technikon Pretoria. This…

Getting Started: An Integrated Curriculum Programme.

ERIC Educational Resources Information Center

Ashton, Colleen

1998-01-01

Describes the planning and integration of the Earthkeepers Programme into the curriculum at Orchard Park Secondary School, Ontario. Benefits included student development of community skills and relationships with the natural world, as well as leadership and responsibility through cross-age teaching of elementary students by high school seniors.…

Disease eradication and health systems development.

PubMed Central

Melgaard, B.; Creese, A.; Aylward, B.; Olivé, J. M.; Maher, C.; Okwo-Bele, J. M.; Lee, J. W.

1998-01-01

This article provides a framework for the design of future eradication programmes so that the greatest benefit accrues to health systems development from the implementation of such programmes. The framework focuses on weak and fragile health systems and assumes that eradication leads to the cessation of the intervention required to eradicate the disease. Five major components of health systems are identified and key elements which are of particular relevance to eradication initiatives are defined. The dearth of documentation which can provide "lessons learned" in this area is illustrated with a brief review of the literature. Opportunities and threats, which can be addressed during the design of eradication programmes, are described and a number of recommendations are outlined. It is emphasized that this framework pertains to eradication programmes but may be useful in attempts to coordinate vertical and horizontal disease control activities for maximum mutual benefits. PMID:10063670

Communicable disease control programmes and health systems: an analytical approach to sustainability.

PubMed

Shigayeva, Altynay; Coker, Richard J

2015-04-01

There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Instantaneous relationship between solar inertial and local vertical local horizontal attitudes

NASA Technical Reports Server (NTRS)

Vickery, S. A.

1977-01-01

The instantaneous relationship between the Solar Inertial (SI) and Local Vertical Local Horizontal (LVLH) coordinate systems is derived. A method is presented for computation of the LVLH to SI rotational transformation matrix as a function of an input LVLH attitude and the corresponding look angles to the sun. Logic is provided for conversion between LVLH and SI attitudes expressed in terms of a pitch, yaw, roll Euler sequence. Documentation is included for a program which implements the logic on the Hewlett-Packard 97 programmable calculator.

Memristor-based programmable logic array (PLA) and analysis as Memristive networks.

PubMed

Lee, Kwan-Hee; Lee, Sang-Jin; Kim, Seok-Man; Cho, Kyoungrok

2013-05-01

A Memristor theorized by Chua in 1971 has the potential to dramatically influence the way electronic circuits are designed. It is a two terminal device whose resistance state is based on the history of charge flow brought about as the result of the voltage being applied across its terminals and hence can be thought of as a special case of a reconfigurable resistor. Nanoscale devices using dense and regular fabrics such as Memristor cross-bar is promising new architecture for System-on-Chip (SoC) implementations in terms of not only the integration density that the technology can offer but also both improved performance and reduced power dissipation. Memristor has the capacity to switch between high and low resistance states in a cross-bar circuit configuration. The cross-bars are formed from an array of vertical conductive nano-wires cross a second array of horizontal conductive wires. Memristors are realized at the intersection of the two wires in the array through appropriate processing technology such that any particular wire in the vertical array can be connected to a wire in the horizontal array by switching the resistance of a particular intersection to a low state while other cross-points remain in a high resistance state. However the approach introduces a number of challenges. The lack of voltage gain prevents logic being cascaded and voltage level degradation affects robustness of the operation. Moreover the cross-bars introduce sneak current paths when two or more cross points are connected through the switched Memristor. In this paper, we propose Memristor-based programmable logic array (PLA) architecture and develop an analytical model to analyze the logic level on the memristive networks. The proposed PLA architecture has 12 inputs maximum and can be cascaded for more input variables with R(off)/R(on) ratio in the range from 55 to 160 of Memristors.

Diel changes in the near-surface biomass of zooplankton and the carbon content of vertical migrants

NASA Astrophysics Data System (ADS)

Hays, Graeme C.; Harris, Roger P.; Head, Robert N.

Zooplankton biomass and the carbon content of vertical migrants were measured in the NE Atlantic (36.5°N, 19.2°W) between 11 and 18 July 1996 as part of the Plankton Reactivity in the Marine Environment (PRIME) programme. The increase in zooplankton biomass near the surface (0-100 m) at night compared to during the day suggested that diel vertical migration was an important feature at this site. For three species of vertically migrant copepods, Pleuromamma pisekii, P. gracilis and P. abdominalis, the carbon content of individuals collected at dusk was significantly less than for individuals collected at dawn, with this reduction being 6.2, 7.3 and 14.8%, respectively. This dawn-dusk reduction in carbon content is consistent with the diel pattern of feeding and fasting exhibited by vertical migrants and supports the suggestion that migrating zooplankton will cause an active export of carbon from the surface layers.

The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes.

PubMed

Konetzka, R Tamara; Stuart, Elizabeth A; Werner, Rachel M

2018-02-07

In this paper we examine empirically the effect of integration on Medicare payment and rehospitalization. We use 2005-2013 data on Medicare beneficiaries receiving post-acute care (PAC) in the U.S. to examine integration between hospitals and the two most common post-acute care settings: skilled nursing facilities (SNFs) and home health agencies (HHA), using two measures of integration-formal vertical integration and informal integration representing preferential relationships between providers without formal relationships. Our identification strategy is twofold. First, we use longitudinal models with a fixed effect for each hospital-PAC pair in a market to test how changes in integration impact patient outcomes. Second, we use an instrumental variable approach to account for patient selection into integrated providers. We find that vertical integration between hospitals and SNFs increases Medicare payments and reduces rehospitalization rates. However, vertical integration between hospitals and HHAs has little effect, nor does informal integration between hospitals and either PAC setting. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

Venus entry probe technology reference mission

NASA Astrophysics Data System (ADS)

van den Berg, M. L.; Falkner, P.; Atzei, A. C.; Phipps, A.; Mieremet, A.; Kraft, S.; Peacock, A.

The Venus Entry Probe is one of ESA's Technology Reference Missions (TRM). TRMs are model science-driven missions that are, although not part of the ESA science programme, able to provide focus to future technology requirements. This is accomplished through the study of several technologically demanding and scientifically meaningful mission concepts, which are strategically chosen to address diverse technological issues. The TRMs complement ESA's current mission specific development programme and allow the ESA Science Directorate to strategically plan the development of technologies that will enable potential future scientific missions. Key technological objectives for future planetary exploration include the use of small orbiters and in-situ probes with highly miniaturized and highly integrated payload suites. The low resource, and therefore low cost, spacecraft allow for a phased strategic approach to planetary exploration. The aim of the Venus Entry Probe TRM (VEP) is to study approaches for low cost in-situ exploration of the Venusian atmosphere. The mission profile consists of two minisats. The first satellite enters low Venus orbit. This satellite contains a highly integrated remote sensing payload suite primarily dedicated to support the in-situ atmospheric measurements of the aerobot. The second minisat enters deep elliptical orbit, deploys the aerobot, and subsequently operates as a data relay, data processing and overall resource allocation satellite. The micro-aerobot consists of a long-duration balloon that will analyze the Venusian middle cloud layer at an altitude of ˜ 55 km, where the environment is relatively benign (T = 20 C and p = 0.45 bars). The balloon will deploy a swarm of active ballast probes, which determine vertical profiles of selected properties of the lower atmosphere. In this presentation, the mission objectives and profile of the Venus Entry Probe TRM will be given as well as the key technological challenges.

Evaluation of Vertical Integrated Nanogenerator Performances in Flexion

NASA Astrophysics Data System (ADS)

Tao, R.; Hinchet, R.; Ardila, G.; Mouis, M.

2013-12-01

Piezoelectric nanowires have attracted great interest as new building blocks of mechanical energy harvesting systems. This paper presents the design improvements of mechanical energy harvesters integrating vertical ZnO piezoelectric nanowires onto a Silicon or plastic membrane. We have calculated the energy generation and conversion performance of ZnO nanowires based vertical integrated nanogenerators in flexion mode. We show that in flexion mode ZnO nanowires are superior to bulk ZnO layer. Both mechanical and electrical effects of matrix materials on the potential generation and energy conversion are discussed, in the aim of guiding further improvement of nanogenerator performance.

Vertical viewing angle enhancement for the 360  degree integral-floating display using an anamorphic optic system.

PubMed

Erdenebat, Munkh-Uchral; Kwon, Ki-Chul; Yoo, Kwan-Hee; Baasantseren, Ganbat; Park, Jae-Hyeung; Kim, Eun-Soo; Kim, Nam

2014-04-15

We propose a 360 degree integral-floating display with an enhanced vertical viewing angle. The system projects two-dimensional elemental image arrays via a high-speed digital micromirror device projector and reconstructs them into 3D perspectives with a lens array. Double floating lenses relate initial 3D perspectives to the center of a vertically curved convex mirror. The anamorphic optic system tailors the initial 3D perspectives horizontally and vertically disperse light rays more widely. By the proposed method, the entire 3D image provides both monocular and binocular depth cues, a full-parallax demonstration with high-angular ray density and an enhanced vertical viewing angle.

Decision rules for allocation of finances to health systems strengthening

PubMed Central

Morton, Alec; Thomas, Ranjeeta; Smith, Peter C.

2017-01-01

A key dilemma in global health is how to allocate funds between disease-specific “vertical projects” on the one hand and “horizontal programmes” which aim to strengthen the entire health system on the other. While economic evaluation provides a way of approaching the prioritisation of vertical projects, it provides less guidance on how to prioritise between horizontal and vertical spending. We approach this problem by formulating a mathematical program which captures the complementary benefits of funding both vertical projects and horizontal programmes. We show that our solution to this math program has an appealing intuitive structure. We illustrate our model by computationally solving two specialised versions of this problem, with illustrations based on the problem of allocating funding for infectious diseases in sub-Saharan Africa. We conclude by reflecting on how such a model may be developed in the future and used to guide empirical data collection and theory development. PMID:27394006

Restoring integrity--A grounded theory of coping with a fast track surgery programme.

PubMed

Jørgensen, Lene Bastrup; Fridlund, Bengt

2016-01-01

The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. The study design used classical grounded theory. The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients' main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme.

Overcoming access barriers to health services through membership-based microfinance organizations: a review of evidence from South Asia

PubMed Central

Saha, Somen; Annear, Peter Leslie

2015-01-01

It is a challenge for the poor to overcome the barriers to accessing health services. Membership-based microfinance with associated health programmes can improve health outcomes for the poor. This study reviewed the evidence published between 1993 and 2013 on the role of membership-based microfinance with associated health programmes in improving health outcomes for the poor in South Asia. A total of 661 papers were identified and 26 selected for inclusion, based on the relevance and rigour of the research methods. Of these 26, five were evidence reviews. Of the remaining 21 papers, 12 were from India, seven from Bangladesh, and one each from Sri Lanka and Indonesia. Three papers addressed more than one theme. Five key themes emerged from the review: (i) the impact of microfinance programmes on the social and economic situation of the poor; (ii) the impact of microfinance programmes on community health; (iii) the impact of integrated microfinance health programmes on raising client awareness; (iv) the impact of integrated microfinance health programmes on financing health care; and (v) the impact of integrated microfinance health programmes on affordable health-care products and services. The review provides new evidence on the pathways through which microfinance helps to improve population health and value for money for such programmes. Among countries with large populations in the informal sector, there is a strong case for policy-makers to support these groups in providing access to life-saving health care among the poor. PMID:25685728

On the recent warming in the subcloud layer entropy and vertically integrated moist static energy over South Asian Monsoon region.

NASA Astrophysics Data System (ADS)

Konduru, R.; Gupta, A.; Matsumoto, J.; Takahashi, H. G.

2017-12-01

In order to explain monsoon circulation, surface temperature gradients described as most traditional concept. However, it cannot explain certain important aspects of monsoon circulation. Later, convective quasi-equilibrium framework and vertically integrated atmospheric energy budget has become recognized theories to explain the monsoon circulation. In this article, same theories were analyzed and observed for the duration 1979-2010 over south Asian summer monsoon region. With the help of NCEP-R2, NOAA 20th Century, and Era-Interim reanalysis an important feature was noticed pertained to subcloud layer entropy and vertical moist static energy. In the last 32 years, subcloud layer entropy and vertically integrated moist static energy has shown significant seasonal warming all over the region with peak over the poleward flank of the cross-equatorial cell. The important reason related to the warming was found to be increase in surface enthalpy fluxes. Instead, other dynamical contributions pertained to the warming was also observed. Increase in positive anomalies of vertical advection of moist static energy over northern Bay of Bengal, Central India, Peninsular India, Eastern Arabian Sea, and Equatorial Indian Ocean was found to be an important dynamic factor contributing for warming of vertically integrated moist static energy. Along with it vertical moist stability has also supported the argument. Similar interpretations were perceived in the AMIP simulation of CCSM4 model. Further modeling experiments on this warming will be helpful to know the exact mechanism behind it.

China’s new-age small farms and their vertical integration: agribusiness or co-ops?

PubMed

Huang, Philip C C

2011-01-01

The future of Chinese agriculture lies not with large mechanized farms but with small capital-labor dual intensifying family farms for livestock-poultry-fish raising and vegetable-fruit cultivation. Chinese food consumption patterns have been changing from the old 8:1:1 pattern of 8 parts grain, 1 part meat, and 1 part vegetables to a 4:3:3 pattern, with a corresponding transformation in agricultural structure. Small family-farming is better suited for the new-age agriculture, including organic farming, than large-scale mechanized farming, because of the intensive, incremental, and variegated hand labor involved, not readily open to economies of scale, though compatible with economies of scope. It is also better suited to the realities of severe population pressure on land. But it requires vertical integration from cultivation to processing to marketing, albeit without horizontal integration for farming. It is against such a background that co-ops have arisen spontaneously for integrating small farms with processing and marketing. The Chinese government, however, has been supporting aggressively capitalistic agribusinesses as the preferred mode of vertical integration. At present, Chinese agriculture is poised at a crossroads, with the future organizational mode for vertical integration as yet uncertain.

Communication strategy for implementing community IMCI.

PubMed

Ford, Neil; Williams, Abimbola; Renshaw, Melanie; Nkum, John

2005-01-01

In resource-poor developing countries, significant improvements in child survival, growth, and development can be made by: (a) shifting from sectoral programmes (for example, in nutrition or immunization) to holistic strategies such as the Integrated Management of Childhood Illnesses (IMCI) and (b) improving household and community care and health-seeking practices as a priority, while concurrently strengthening health systems and the skills of health professionals. This article focuses on household and community learning, and proposes a communication strategy for implementing community IMCI (c-IMCI) that is based on human rights principles such as inclusion, participation, and self-determination. Rather than attempt to change the care practices and health-seeking behaviour of individuals through the design and delivery of messages alone, it proposes an approach that is based on community engagement and discussion to create the social conditions in which individual change is possible. The strategy advocates for the integration of sectoral programmes rather than the development of new holistic programmes, so that integrated programmes are created from "multiple entry points". As integration occurs, the participatory communication processes that are used in sectoral programmes can be enriched and combined, improving the capacity of governments and agencies to engage community members effectively in a process of learning and action related to child health and development.

Accurate pressure gradient calculations in hydrostatic atmospheric models

NASA Technical Reports Server (NTRS)

Carroll, John J.; Mendez-Nunez, Luis R.; Tanrikulu, Saffet

1987-01-01

A method for the accurate calculation of the horizontal pressure gradient acceleration in hydrostatic atmospheric models is presented which is especially useful in situations where the isothermal surfaces are not parallel to the vertical coordinate surfaces. The present method is shown to be exact if the potential temperature lapse rate is constant between the vertical pressure integration limits. The technique is applied to both the integration of the hydrostatic equation and the computation of the slope correction term in the horizontal pressure gradient. A fixed vertical grid and a dynamic grid defined by the significant levels in the vertical temperature distribution are employed.

Integration of Behaviour-Based Safety Programme into Engineering Laboratories and Workshops Conceptually

ERIC Educational Resources Information Center

Koo, Kean Eng; Zain, Ahmad Nurulazam Md; Zainal, Siti Rohaida Mohamed

2012-01-01

The purpose of this conceptual research framework is to develop and integrate a safety training model using a behaviour-based safety training programme into laboratories for young adults, during their tertiary education, particularly in technical and vocational education. Hence, this research will be investigating the outcome of basic safety…

Selectivity of Content and Language Integrated Learning Programmes in German Secondary Schools

ERIC Educational Resources Information Center

Dallinger, Sara; Jonkmann, Kathrin; Hollm, Jan

2018-01-01

Despite its increasing popularity and adoption across Europe, Content and Language Integrated Learning (CLIL) is not without its critics. It has been argued that CLIL programmes are highly selective, that is, the students possess more favourable learning prerequisites than their monolingually taught peers. The present study contributes to this…

Content and Language Integrated Learning and the Inclusion of Immigrant Minority Language Students: A Research Review

ERIC Educational Resources Information Center

Somers, Thomas

2017-01-01

This article addresses the inclusion of immigrant minority language students in Content and Language Integrated Learning (CLIL) bilingual education programmes. It reviews results of research on (1) the reasons, beliefs and attitudes underlying immigrant minority language parents' and students' choice for CLIL programmes; (2) these students'…

Improving Student Teachers' Perceptions on Technology Integration Using a Blended Learning Programme

ERIC Educational Resources Information Center

Edannur, Sreekala; Marie, S. Maria Josephine Arokia

2017-01-01

This study examined student teachers' perceptions about Technology Integration (Blended Learning in this study) before and after their exposure to a Blended Learning Experimental Programme designed for the study for eight weeks. EDMODO (an open access Learning Management System) was used as the teaching learning platform for the implementation of…

University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

ERIC Educational Resources Information Center

Cameron, Craig; Klopper, Christopher

2015-01-01

Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

STEM Learning through Engineering Design: Impact on Middle Secondary Students' Interest towards STEM

ERIC Educational Resources Information Center

Shahali, Edy Hafizan Mohd; Halim, Lilia; Rasul, Mohamad Sattar; Osman, Kamisah; Zulkifeli, Mohd Afendi

2017-01-01

The purpose of this study was to identify students' changes of (i) interest toward STEM subjects and (ii) interest to pursuing STEM career after participating in non-formal integrated STEM education programme. The programme exposed students with integrated STEM education through project based learning involving the application of five phases…

One year of vertical wind profiles measurements at a Mediterranean coastal site of South Italy

NASA Astrophysics Data System (ADS)

Calidonna, Claudia Roberta; Avolio, Elenio; Federico, Stefano; Gullì, Daniel; Lo Feudo, Teresa; Sempreviva, Anna Maria

2015-04-01

In order to develop wind farms projects is challenging to site them on coastal areas both onshore and offshore as suitable sites. Developing projects need high quality databases under a wide range of atmospheric conditions or high resolution models that could resolve the effect of the coastal discontinuity in the surface properties. New parametrizations are important and high quality databases are also needed for formulating them. Ground-based remote sensing devices such as lidars have been shown to be functional for studying the evolution of the vertical wind structure coastal atmospheric boundary layer both on- and offshore. Here, we present results from a year of vertical wind profiles, wind speed and direction, monitoring programme at a site located in the Italian Calabria Region, Central Mediterranean, 600m from the Thyrrenian coastline, where a Lidar Doppler, ZephIr (ZephIr ltd) has been operative since July 2013. The lidar monitors wind speed and direction from 10m up to 300m at 10 vertical levels with an average of 10 minutes and it is supported by a metmast providing: Atmospheric Pressure, Solar Radiation, Precipitation, Relative Humidity, Temperature,Wind Speed and Direction at 10m. We present the characterization of wind profiles during one year period according to the time of the day to transition periods night/day/night classified relating the local scale, breeze scale, to the large scale conditions. The dataset is also functional for techniques for short-term prediction of wind for the renewable energy integration in the distribution grids. The site infrastructure is funded within the Project "Infrastructure of High Technology for Environmental and Climate Monitoring" (I-AMICA) (PONa3_00363) by the Italian National Operative Program (PON 2007-2013) and European Regional Development Fund. Real-time data are show on http://www.i-amica.it/i-amica/?page_id=1122.

Co-integration of nano-scale vertical- and horizontal-channel metal-oxide-semiconductor field-effect transistors for low power CMOS technology.

PubMed

Sun, Min-Chul; Kim, Garam; Kim, Sang Wan; Kim, Hyun Woo; Kim, Hyungjin; Lee, Jong-Ho; Shin, Hyungcheol; Park, Byung-Gook

2012-07-01

In order to extend the conventional low power Si CMOS technology beyond the 20-nm node without SOI substrates, we propose a novel co-integration scheme to build horizontal- and vertical-channel MOSFETs together and verify the idea using TCAD simulations. From the fabrication viewpoint, it is highlighted that this scheme provides additional vertical devices with good scalability by adding a few steps to the conventional CMOS process flow for fin formation. In addition, the benefits of the co-integrated vertical devices are investigated using a TCAD device simulation. From this study, it is confirmed that the vertical device shows improved off-current control and a larger drive current when the body dimension is less than 20 nm, due to the electric field coupling effect at the double-gated channel. Finally, the benefits from the circuit design viewpoint, such as the larger midpoint gain and beta and lower power consumption, are confirmed by the mixed-mode circuit simulation study.

Vertical Integration Spurs American Health Care Revolution.

ERIC Educational Resources Information Center

Phillips, Richard C.

1986-01-01

Under new "managed health care systems," the classical functional separation of risk taker, claims payor, and provider are vertically integrated into a common entity. This evolution should produce a competitive environment with medical care rendered to all Americans on a more cost-effective basis. (CJH)

Should nurses be leaders of integrated health care?

PubMed

Thomas, Paul; While, Alison

2007-09-01

To examine the role of nurses within integrated health care. Healthcare planners are overly concerned with the treatment of diseases and insufficiently focused on social cohesion vertical rather than horizontal integration of healthcare effort. These domains need to be better connected, to avoid medicalization of social problems and socialisation of medical problems. Published literature, related to theories of whole system integration. *When conceptualizing whole system integration it helps to consider research insights to be snapshots of more complex stories-in-evolution, and change to be the result of ongoing community dance where multiple players adapt their steps to each other. *One image that helps to conceptualize integration is that of a railway network. Railway tracks and multiple journeys are equally needed; each requiring a different approach for success. *Traditional nursing values make nurses more attuned to the issues of combined vertical and horizontal integration than medical colleagues. Nurses should lead integration at the interface between horizontal and vertical activities. Nursing managers and universities should support the development of nurses as leaders of whole system integration, in partnership with local healthcare organizations.

Programmable diagnostic devices made from paper and tape.

PubMed

Martinez, Andres W; Phillips, Scott T; Nie, Zhihong; Cheng, Chao-Min; Carrilho, Emanuel; Wiley, Benjamin J; Whitesides, George M

2010-10-07

This paper describes three-dimensional microfluidic paper-based analytical devices (3-D microPADs) that can be programmed (postfabrication) by the user to generate multiple patterns of flow through them. These devices are programmed by pressing single-use 'on' buttons, using a stylus or a ballpoint pen. Pressing a button closes a small space (gap) between two vertically aligned microfluidic channels, and allows fluids to wick from one channel to the other. These devices are simple to fabricate, and are made entirely out of paper and double-sided adhesive tape. Programmable devices expand the capabilities of microPADs and provide a simple method for controlling the movement of fluids in paper-based channels. They are the conceptual equivalent of field-programmable gate arrays (FPGAs) widely used in electronics.

CIRSS vertical data integration, San Bernardino study

NASA Technical Reports Server (NTRS)

Hodson, W.; Christenson, J.; Michel, R. (Principal Investigator)

1982-01-01

The creation and use of a vertically integrated data base, including LANDSAT data, for local planning purposes in a portion of San Bernardino County, California are described. The project illustrates that a vertically integrated approach can benefit local users, can be used to identify and rectify discrepancies in various data sources, and that the LANDSAT component can be effectively used to identify change, perform initial capability/suitability modeling, update existing data, and refine existing data in a geographic information system. Local analyses were developed which produced data of value to planners in the San Bernardino County Planning Department and the San Bernardino National Forest staff.

Quantum Control of a Spin Qubit Coupled to a Photonic Crystal Cavity

DTIC Science & Technology

2012-12-01

Cavities in Monocrystalline Diamond. Physical Review Letters 109, 033604 (2012). 14. Kroutvar, M. et al. Optically programmable electron spin...temperatures, varying the detuning of X− from the cavity. The dashed blue lines in panel a are fits to the reflectivity. The spectra are vertically

47 CFR 76.504 - Limits on carriage of vertically integrated programming.

Code of Federal Regulations, 2014 CFR

2014-10-01

... programming. 76.504 Section 76.504 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... Limits on carriage of vertically integrated programming. (a) Except as otherwise provided in this section... national video programming services owned by the cable operator or in which the cable operator has an...

47 CFR 76.504 - Limits on carriage of vertically integrated programming.

Code of Federal Regulations, 2010 CFR

2010-10-01

... programming. 76.504 Section 76.504 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... Limits on carriage of vertically integrated programming. (a) Except as otherwise provided in this section... national video programming services owned by the cable operator or in which the cable operator has an...

Responses of primate caudal parabrachial nucleus and Kolliker-fuse nucleus neurons to whole body rotation

NASA Technical Reports Server (NTRS)

Balaban, Carey D.; McGee, David M.; Zhou, Jianxun; Scudder, Charles A.

2002-01-01

The caudal aspect of the parabrachial (PBN) and Kolliker-Fuse (KF) nuclei receive vestibular nuclear and visceral afferent information and are connected reciprocally with the spinal cord, hypothalamus, amygdala, and limbic cortex. Hence, they may be important sites of vestibulo-visceral integration, particularly for the development of affective responses to gravitoinertial challenges. Extracellular recordings were made from caudal PBN cells in three alert, adult female Macaca nemestrina through an implanted chamber. Sinusoidal and position trapezoid angular whole body rotation was delivered in yaw, roll, pitch, and vertical semicircular canal planes. Sites were confirmed histologically. Units that responded during rotation were located in lateral and medial PBN and KF caudal to the trochlear nerve at sites that were confirmed anatomically to receive superior vestibular nucleus afferents. Responses to whole-body angular rotation were modeled as a sum of three signals: angular velocity, a leaky integration of angular velocity, and vertical position. All neurons displayed angular velocity and integrated angular velocity sensitivity, but only 60% of the neurons were position-sensitive. These responses to vertical rotation could display symmetric, asymmetric, or fully rectified cosinusoidal spatial tuning about a best orientation in different cells. The spatial properties of velocity and integrated velocity and position responses were independent for all position-sensitive neurons; the angular velocity and integrated angular velocity signals showed independent spatial tuning in the position-insensitive neurons. Individual units showed one of three different orientations of their excitatory axis of velocity rotation sensitivity: vertical-plane-only responses, positive elevation responses (vertical plane plus ipsilateral yaw), and negative elevation axis responses (vertical plane plus negative yaw). The interactions between the velocity and integrated velocity components also produced variations in the temporal pattern of responses as a function of rotation direction. These findings are consistent with the hypothesis that a vestibulorecipient region of the PBN and KF integrates signals from the vestibular nuclei and relay information about changes in whole-body orientation to pathways that produce homeostatic and affective responses.

Substance abuse and batterer programmes in California, USA: factors associated with treatment outcomes.

PubMed

Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H

2015-11-01

The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. © 2014 John Wiley & Sons Ltd.

Field evaluation of the error arising from inadequate time averaging in the standard use of depth-integrating suspended-sediment samplers

USGS Publications Warehouse

Topping, David J.; Rubin, David M.; Wright, Scott A.; Melis, Theodore S.

2011-01-01

Several common methods for measuring suspended-sediment concentration in rivers in the United States use depth-integrating samplers to collect a velocity-weighted suspended-sediment sample in a subsample of a river cross section. Because depth-integrating samplers are always moving through the water column as they collect a sample, and can collect only a limited volume of water and suspended sediment, they collect only minimally time-averaged data. Four sources of error exist in the field use of these samplers: (1) bed contamination, (2) pressure-driven inrush, (3) inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration, and (4) inadequate time averaging. The first two of these errors arise from misuse of suspended-sediment samplers, and the third has been the subject of previous study using data collected in the sand-bedded Middle Loup River in Nebraska. Of these four sources of error, the least understood source of error arises from the fact that depth-integrating samplers collect only minimally time-averaged data. To evaluate this fourth source of error, we collected suspended-sediment data between 1995 and 2007 at four sites on the Colorado River in Utah and Arizona, using a P-61 suspended-sediment sampler deployed in both point- and one-way depth-integrating modes, and D-96-A1 and D-77 bag-type depth-integrating suspended-sediment samplers. These data indicate that the minimal duration of time averaging during standard field operation of depth-integrating samplers leads to an error that is comparable in magnitude to that arising from inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration. This random error arising from inadequate time averaging is positively correlated with grain size and does not largely depend on flow conditions or, for a given size class of suspended sediment, on elevation above the bed. Averaging over time scales >1 minute is the likely minimum duration required to result in substantial decreases in this error. During standard two-way depth integration, a depth-integrating suspended-sediment sampler collects a sample of the water-sediment mixture during two transits at each vertical in a cross section: one transit while moving from the water surface to the bed, and another transit while moving from the bed to the water surface. As the number of transits is doubled at an individual vertical, this error is reduced by ~30 percent in each size class of suspended sediment. For a given size class of suspended sediment, the error arising from inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration depends only on the number of verticals collected, whereas the error arising from inadequate time averaging depends on both the number of verticals collected and the number of transits collected at each vertical. Summing these two errors in quadrature yields a total uncertainty in an equal-discharge-increment (EDI) or equal-width-increment (EWI) measurement of the time-averaged velocity-weighted suspended-sediment concentration in a river cross section (exclusive of any laboratory-processing errors). By virtue of how the number of verticals and transits influences the two individual errors within this total uncertainty, the error arising from inadequate time averaging slightly dominates that arising from inadequate sampling of the cross-stream spatial structure in suspended-sediment concentration. Adding verticals to an EDI or EWI measurement is slightly more effective in reducing the total uncertainty than adding transits only at each vertical, because a new vertical contributes both temporal and spatial information. However, because collection of depth-integrated samples at more transits at each vertical is generally easier and faster than at more verticals, addition of a combination of verticals and transits is likely a more practical approach to reducing the total uncertainty in most field situatio

Expectations of Majlis Amanah Rakyat (MARA) Stakeholders on the Ulul Albab Curriculum at a MARA Junior Science College (MRSM)

ERIC Educational Resources Information Center

Manaf, Umi Kalthom Abdul; Alias, Nurul Fitriah; Azman, Ady Hameme Nor; Rahman, Fadzilah Abdul; Zulkifli, Hafizah

2014-01-01

Ulul Albab is an educational programme of integration between the existing programmes in MARA Junior Science College (MRSM) with the religious school programme including Tahfiz Al-Quran. MRSM Ulul Albab education programme is designed to produce professional experts, entrepreneurs and technocrats that are well versed in the field of religion-based…

Design of a Model for a Professional Development Programme for a Multidisciplinary Science Subject in the Netherlands

ERIC Educational Resources Information Center

Visser, Talitha C.; Coenders, Fer G. M.; Terlouw, Cees; Pieters, Jules M.

2012-01-01

Schools are increasingly integrating multidisciplinary education into their programmes. The Minister of Education, Culture and Science has introduced a new, integrated science subject in secondary education in the Netherlands, called Nature, Life and Technology (NLT). This research note describes the design of a generic model for a professional…

Assessing Readiness for Integration of Electronic Learning into Business Education Programmes in Tertiary Institutions in Ebonyi State

ERIC Educational Resources Information Center

Nwagwu, Lazarus; Azih, Nonye

2015-01-01

The study was conducted to assess readiness for integration of electronic learning into business education programmes in tertiary institutions in Ebonyi State. Two research questions and two hypotheses guided the study. The population was 37 business education lecturers and 748 Business Education Students in tertiary institutions that offer…

Impact of a School Consulting Programme Aimed at Helping Teachers Integrate Students with Behavioural Difficulties into Secondary School: Actors' Points of View

ERIC Educational Resources Information Center

Massé, Line; Couture, Caroline; Levesque, Vanessa; Bégin, Jean-Yves

2013-01-01

A collaborative school consulting programme model, using functional assessment and applied behavioural techniques, was offered to secondary school teachers in two modalities: individual consultation and small-group consultation. The objective was to facilitate the integration of students with behavioural difficulties into mainstream secondary…

Integrating Assessment for Learning in the Teacher Education Programme at the University of Oslo

ERIC Educational Resources Information Center

Brevik, Lisbeth M.; Blikstad-Balas, Marte; Engelien, Kirsti Lyngvaer

2017-01-01

This article provides an analysis of the integration of assessment for learning principles in the newly revised five-year Master of Education programme at the University of Oslo, Norway, across didactic subjects, pedagogy and school practice. The analysis draws on lecture notes, student videos and student exam papers among 143 student teachers,…

An integration programme of poverty alleviation and development with family planning.

PubMed

1997-04-01

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors. full text

VERTICAL INTEGRATION OF THREE-PHASE FLOW EQUATIONS FOR ANALYSIS OF LIGHT HYDROCARBON PLUME MOVEMENT

EPA Science Inventory

A mathematical model is derived for areal flow of water and light hydrocarbon in the presence of gas at atmospheric pressure. Closed-form expressions for the vertically integrated constitutive relations are derived based on a three-phase extension of the Brooks-Corey saturation-...

Vertically Integrating Professional Skills throughout a Mathematics Major

ERIC Educational Resources Information Center

Dziak, Clarice; Leventhal, Brian; Luttman, Aaron; Skufca, Joseph

2014-01-01

In response to a university mandate to include "professional issues" as a component of every major, we have developed a vertically integrated approach to incorporating the study of professional skills and issues into the mathematics curriculum. Beginning in the first year of study, mathematics majors take an inquiry-based course in…

Vertical Integration: Teachers' Knowledge and Teachers' Voice.

ERIC Educational Resources Information Center

Corrie, L.

1995-01-01

Traces the theoretical basis for vertical integration in early school years. Contrasts transmission-based pedagogy with a higher level of teacher control, and acquirer-based pedagogy with a higher level of student control. Suggests that early childhood pedagogy will be maintained when teachers are able to articulate their pedagogical knowledge and…

Serotyping of Salmonella Isolates from Broiler Vertical Integrations in Colombia

USDA-ARS?s Scientific Manuscript database

This study analyzed 106 Salmonella isolates from different points in broiler vertical integrations of two important poultry areas of Colombia. It was possible to identify the presence of Salmonella in five categories: breeder farm (17.9%), hatchery (6.6 %), broiler farm (38.7 %), processing plant (9...

Vertical Integration of Geographic Information Sciences: A Recruitment Model for GIS Education

ERIC Educational Resources Information Center

Yu, Jaehyung; Huynh, Niem Tu; McGehee, Thomas Lee

2011-01-01

An innovative vertical integration model for recruiting to GIS education was introduced and tested following four driving forces: curriculum development, GIS presentations, institutional collaboration, and faculty training. Curriculum development was a useful approach to recruitment, student credit hour generation, and retention-rate improvement.…

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

Lovell, Jack, E-mail: jack.lovell@durham.ac.uk; Culham Centre for Fusion Energy, Culham Science Centre, Abingdon, Oxon OX14 3DB; Naylor, Graham

A new resistive bolometer system has been developed for MAST-Upgrade. It will measure radiated power in the new Super-X divertor, with millisecond time resolution, along 16 vertical and 16 horizontal lines of sight. The system uses a Xilinx Zynq-7000 series Field-Programmable Gate Array (FPGA) in the D-TACQ ACQ2106 carrier to perform real time data acquisition and signal processing. The FPGA enables AC-synchronous detection using high performance digital filtering to achieve a high signal-to-noise ratio and will be able to output processed data in real time with millisecond latency. The system has been installed on 8 previously unused channels of themore » JET vertical bolometer system. Initial results suggest good agreement with data from existing vertical channels but with higher bandwidth and signal-to-noise ratio.« less

A novel mentorship programme for residents integrating academic development, clinical teaching and graduate medical education assessment.

PubMed

Bhatia, Kriti; Takayesu, James Kimo; Nadel, Eric S

2016-02-01

Mentorship fosters career development and growth. During residency training, mentorship should support clinical development along with intellectual and academic interests. Reported resident mentoring programmes do not typically include clinical components. We designed a programme that combines academic development with clinical feedback and assessment in a four-year emergency medicine residency programme. Incoming interns were assigned an advisor. At the conclusion of the intern year, residents actively participated in selecting a mentor for the duration of residency. The programme consisted of quarterly meetings, direct clinical observation and specific competency assessment, assistance with lecture preparation, real-time feedback on presentations, simulation coaching sessions, and discussions related to career development. Faculty participation was recognized as a valuable component of the annual review process. Residents were surveyed about the overall programme and individual components. Over 88 % of the respondents said that the programme was valuable and should be continued. Senior residents most valued the quarterly meetings and presentation help and feedback. Junior residents strongly valued the clinical observation and simulation sessions. A comprehensive mentorship programme integrating clinical, professional and academic development provides residents individualized feedback and coaching and is valued by trainees. Individualized assessment of clinical competencies can be conducted through such a programme.

Review of integrated digital systems: evolution and adoption

NASA Astrophysics Data System (ADS)

Fritz, Lawrence W.

The factors that are influencing the evolution of photogrammetric and remote sensing technology to transition into fully integrated digital systems are reviewed. These factors include societal pressures for new, more timely digital products from the Spatial Information Sciencesand the adoption of rapid technological advancements in digital processing hardware and software. Current major developments in leading government mapping agencies of the USA, such as the Digital Production System (DPS) modernization programme at the Defense Mapping Agency, and the Automated Nautical Charting System II (ANCS-II) programme and Integrated Digital Photogrammetric Facility (IDPF) at NOAA/National Ocean Service, illustrate the significant benefits to be realized. These programmes are examples of different levels of integrated systems that have been designed to produce digital products. They provide insights to the management complexities to be considered for very large integrated digital systems. In recognition of computer industry trends, a knowledge-based architecture for managing the complexity of the very large spatial information systems of the future is proposed.

Monolithic integration of multiple wavelength vertical-cavity surface-emitting lasers by mask molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Saito, Hideaki; Ogura, Ichiro; Sugimoto, Yoshimasa; Kasahara, Kenichi

1995-05-01

The monolithic incorporation and performance of vertical-cavity surface-emitting lasers (VCSELs) emitting at two distinct wavelengths, which were suited for application to wavelength division multiplexing (WDM) systems were reported. The monolithic integration of two-wavelength VCSEL arrays was achieved by using mask molecular beam epitaxy. This method can generate arrays that have the desired integration area size and wavelength separation.

Integration of mass drug administration programmes in Nigeria: The challenge of schistosomiasis.

PubMed Central

Richards, Frank O.; Eigege, Abel; Miri, Emmanuel S.; Jinadu, M. Y.; Hopkins, Donald R.

2006-01-01

PROBLEM: Annual mass drug administration (MDA) with safe oral anthelminthic drugs (praziquantel, ivermectin and albendazole) is the strategy for control of onchocerciasis, lymphatic filariasis (LF) and schistosomiasis. District health officers seek to integrate treatment activities in areas of overlapping disease endemicity, but they are faced with having to merge different programmatic guidelines. APPROACH: We proceeded through the three stages of integrated MDA implementation: mapping the distribution of the three diseases at district level; tailoring district training and logistics based on the results of the mapping exercises; and implementing community-based annual health education and mass treatment where appropriate. During the process we identified the "know-do" gaps in the MDA guidelines for each disease that prevented successful integration of these programmes. LOCAL SETTING: An integrated programme launched in 1999 in Plateau and Nasarawa States in central Nigeria, where all three diseases were known to occur. RELEVANT CHANGES: Current guidelines allowed onchocerciasis and LF activities to be integrated, resulting in rapid mapping throughout the two states, and states-wide provision of over 9.3 million combined ivermectin-albendazole treatments for the two diseases between 2000 and 2004. In contrast, schistosomiasis activities could not be effectively integrated because of the more restrictive guidelines, resulting in less than half of the two states being mapped, and delivery of only 701,419 praziquantel treatments for schistosomiasis since 1999. LESSONS LEARNED: Integration of schistosomiasis into other MDA programmes would be helped by amended guidelines leading to simpler mapping, more liberal use of praziquantel and the ability to administer praziquantel simultaneously with ivermectin and albendazole. PMID:16917658

Integrated disease management: a critical review of foreign and Portuguese experience.

PubMed

Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles

2014-01-01

The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.

[Regional networking of medical and vocational rehabilitation-- the bad Krozingen model].

PubMed

Kinne, G; Elsässer, D; Best, S; Jost, S; Zschache, R

2002-10-01

Regional networking facilitates flexible and individual integration of vocational programmes in medical rehabilitation. We present a pilot project of Theresienklinik II in cooperation with the Education centre for occupation and health (Bildungszentrum Beruf und Gesundheit) in Bad Krozingen. Orthopaedic and cardiac patients who are in danger to lose their capacity to work, participate in an integrated vocational reorientation programme during extended medical rehabilitation. The aim of the pilot project is an early assessment of motivation, work hardening, aptitude and interest, in order to accelerate vocational retraining and reintegration. Within one year 30 patients participated in the programme. Presented are the contents and course of the pilot project. First results show a high patient satisfaction with the programme.

Optical characterization of tissue mimicking phantoms by a vertical double integrating sphere system

NASA Astrophysics Data System (ADS)

Han, Yilin; Jia, Qiumin; Shen, Shuwei; Liu, Guangli; Guo, Yuwei; Zhou, Ximing; Chu, Jiaru; Zhao, Gang; Dong, Erbao; Allen, David W.; Lemaillet, Paul; Xu, Ronald

2016-03-01

Accurate characterization of absorption and scattering properties for biologic tissue and tissue-simulating materials enables 3D printing of traceable tissue-simulating phantoms for medical spectral device calibration and standardized medical optical imaging. Conventional double integrating sphere systems have several limitations and are suboptimal for optical characterization of liquid and soft materials used in 3D printing. We propose a vertical double integrating sphere system and the associated reconstruction algorithms for optical characterization of phantom materials that simulate different human tissue components. The system characterizes absorption and scattering properties of liquid and solid phantom materials in an operating wavelength range from 400 nm to 1100 nm. Absorption and scattering properties of the phantoms are adjusted by adding titanium dioxide powder and India ink, respectively. Different material compositions are added in the phantoms and characterized by the vertical double integrating sphere system in order to simulate the human tissue properties. Our test results suggest that the vertical integrating sphere system is able to characterize optical properties of tissue-simulating phantoms without precipitation effect of the liquid samples or wrinkling effect of the soft phantoms during the optical measurement.

Modeling and Analysis of Hybrid Cellular/WLAN Systems with Integrated Service-Based Vertical Handoff Schemes

NASA Astrophysics Data System (ADS)

Xia, Weiwei; Shen, Lianfeng

We propose two vertical handoff schemes for cellular network and wireless local area network (WLAN) integration: integrated service-based handoff (ISH) and integrated service-based handoff with queue capabilities (ISHQ). Compared with existing handoff schemes in integrated cellular/WLAN networks, the proposed schemes consider a more comprehensive set of system characteristics such as different features of voice and data services, dynamic information about the admitted calls, user mobility and vertical handoffs in two directions. The code division multiple access (CDMA) cellular network and IEEE 802.11e WLAN are taken into account in the proposed schemes. We model the integrated networks by using multi-dimensional Markov chains and the major performance measures are derived for voice and data services. The important system parameters such as thresholds to prioritize handoff voice calls and queue sizes are optimized. Numerical results demonstrate that the proposed ISHQ scheme can maximize the utilization of overall bandwidth resources with the best quality of service (QoS) provisioning for voice and data services.

Microsoft C#.NET program and electromagnetic depth sounding for large loop source

NASA Astrophysics Data System (ADS)

Prabhakar Rao, K.; Ashok Babu, G.

2009-07-01

A program, in the C# (C Sharp) language with Microsoft.NET Framework, is developed to compute the normalized vertical magnetic field of a horizontal rectangular loop source placed on the surface of an n-layered earth. The field can be calculated either inside or outside the loop. Five C# classes with member functions in each class are, designed to compute the kernel, Hankel transform integral, coefficients for cubic spline interpolation between computed values and the normalized vertical magnetic field. The program computes the vertical magnetic field in the frequency domain using the integral expressions evaluated by a combination of straightforward numerical integration and the digital filter technique. The code utilizes different object-oriented programming (OOP) features. It finally computes the amplitude and phase of the normalized vertical magnetic field. The computed results are presented for geometric and parametric soundings. The code is developed in Microsoft.NET visual studio 2003 and uses various system class libraries.

Silicon nitride tri-layer vertical Y-junction and 3D couplers with arbitrary splitting ratio for photonic integrated circuits.

PubMed

Shang, Kuanping; Pathak, Shibnath; Liu, Guangyao; Feng, Shaoqi; Li, Siwei; Lai, Weicheng; Yoo, S J B

2017-05-01

We designed and demonstrated a tri-layer Si₃N₄/SiO₂ photonic integrated circuit capable of vertical interlayer coupling with arbitrary splitting ratios. Based on this multilayer photonic integrated circuit platform with each layer thicknesses of 150 nm, 50 nm, and 150 nm, we designed and simulated the vertical Y-junctions and 3D couplers with arbitrary power splitting ratios between 1:10 and 10:1 and with negligible(< -50 dB) reflection. Based on the design, we fabricated and demonstrated tri-layer vertical Y-junctions with the splitting ratios of 1:1 and 3:2 with excess optical losses of 0.230 dB. Further, we fabricated and demonstrated the 1 × 3 3D couplers with the splitting ratio of 1:1:4 for symmetric structures and variable splitting ratio for asymmetric structures.

Programmable logic construction kits for hyper-real-time neuronal modeling.

PubMed

Guerrero-Rivera, Ruben; Morrison, Abigail; Diesmann, Markus; Pearce, Tim C

2006-11-01

Programmable logic designs are presented that achieve exact integration of leaky integrate-and-fire soma and dynamical synapse neuronal models and incorporate spike-time dependent plasticity and axonal delays. Highly accurate numerical performance has been achieved by modifying simpler forward-Euler-based circuitry requiring minimal circuit allocation, which, as we show, behaves equivalently to exact integration. These designs have been implemented and simulated at the behavioral and physical device levels, demonstrating close agreement with both numerical and analytical results. By exploiting finely grained parallelism and single clock cycle numerical iteration, these designs achieve simulation speeds at least five orders of magnitude faster than the nervous system, termed here hyper-real-time operation, when deployed on commercially available field-programmable gate array (FPGA) devices. Taken together, our designs form a programmable logic construction kit of commonly used neuronal model elements that supports the building of large and complex architectures of spiking neuron networks for real-time neuromorphic implementation, neurophysiological interfacing, or efficient parameter space investigations.

Integration of microbiology and infectious disease teaching courses in an interdisciplinary training programme (Master level) centred on the 'One world, one health' WHO concept.

PubMed

Eveillard, Matthieu; Ruvoen, Nathalie; Lepelletier, Didier; Fradet, Stéphanie; Couvreur, Sébastien; Krempf, Michel; Magras, Catherine

2016-05-01

This report describes the integration of the microbiology and infectious diseases teaching courses in an international Master's level interdisciplinary programme based on the 'One world, one health' WHO concept, and reports the students and teachers' evaluation related to their feelings of about this innovative programme. The integration was evaluated by recording the positioning of these two topics in the five teaching units constituting the programme, and by identifying their contribution in the interactions between the different teaching units. The satisfaction of students was assessed by a quantitative survey, whereas the feelings of students and teachers were assessed by interviews. The study demonstrated that microbiology and infectious diseases were widely involved in interactions between the teaching units, constituting a kind of cement for the programme. The students assigned a mean score of 3.7 to the topics dealing with microbiology and infectious diseases. According to the qualitative data, students and teachers considered that the interdisciplinary approach provided new insights but reported problems of communication, probably inherent to the multiculturalism of the class. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Operationalizing the One Health approach: the global governance challenges.

PubMed

Lee, Kelley; Brumme, Zabrina L

2013-10-01

While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.

[Primary health care: reality or utopia in a developing country?].

PubMed

Abiodun, P O; Wolf, H

1988-07-01

Though it is 20 years since the acceptance, by member nations of WHO, of the concept of primary health care (PHC) as the best and cheapest means of achieving "Health for All in the Year 2000", most developing nations have made little or no progress toward its attainment. This is due, among other things, to a misconception of the meaning of PHC, by both developing and developed nations. While many developing nations see it as a new vertical programme, and therefore fail to integrate it into already existing ones, most developed nations take it, wrongly to mean that the developing nations should return to ancient, primitive medicine, which in earlier times led to high morbidity even in the developed nations. In the developing countries, there is still a disproportionately high concentration of resources in urban areas, and much more emphasis is still being placed on curative than on preventive measures. To achieve "Health for all in the Year 2000", therefore, a reorientation of both the developed and the developing nations is urgently needed.

Integrating ICT in Kenyan Secondary Schools: An Exploratory Case Study of a Professional Development Programme

ERIC Educational Resources Information Center

Tondeur, Jo; Krug, Don; Bill, Mike; Smulders, Maaike; Zhu, Chang

2015-01-01

This study explores the introduction of Information and Communication Technology (ICT) in Kenyan secondary schools. Specifically, it is a case study of four schools with no previous access to ICT. The professional development programme from which data for this study were drawn was designed to support teachers learning to integrate ICT in the…

Dumbing down or Beefing up the Curriculum? Integrating an "Academic Skills Framework" into a First Year Sociology Programme

ERIC Educational Resources Information Center

Keating, Mike; O'Siochru, Cathal; Watt, Sal

2009-01-01

This article describes a C-SAP-funded project evaluating the introduction of a new tutorial programme for first year Sociology students, which sought to integrate a "skills framework" to enable students to develop a range of academic skills alongside their study of the subject. The pegagogical and institutional background to the decision…

Proposing a Master's Programme on Participatory Integrated Assessment of Energy Systems to Promote Energy Access and Energy Efficiency in Southern Africa

ERIC Educational Resources Information Center

Kiravu, Cheddi; Diaz-Maurin, François; Giampietro, Mario; Brent, Alan C.; Bukkens, Sandra G.F.; Chiguvare, Zivayi; Gasennelwe-Jeffrey, Mandu A.; Gope, Gideon; Kovacic, Zora; Magole, Lapologang; Musango, Josephine Kaviti; Ruiz-Rivas Hernando, Ulpiano; Smit, Suzanne; Vázquez Barquero, Antonio; Yunta Mezquita, Felipe

2018-01-01

Purpose: This paper aims to present a new master's programme for promoting energy access and energy efficiency in Southern Africa. Design/methodology/approach: A transdisciplinary approach called "participatory integrated assessment of energy systems" (PARTICIPIA) was used for the development of the curriculum. This approach is based on…

Empowering Language Learners through the Use of a Curriculum-Integrated Information Literacy Programme: An Action Research Project

ERIC Educational Resources Information Center

Alzahrani, Sahar

2017-01-01

This paper implements and evaluates a curriculum-integrated information literacy programme in an Arabic primary school in the United Kingdom to empower learners and develop life-long learning skills. It reports on an action research project with a reflective practice approach used at the beginning of the semester to identify potential problems…

Resistive Switching of Ta2O5-Based Self-Rectifying Vertical-Type Resistive Switching Memory

NASA Astrophysics Data System (ADS)

Ryu, Sungyeon; Kim, Seong Keun; Choi, Byung Joon

2018-01-01

To efficiently increase the capacity of resistive switching random-access memory (RRAM) while maintaining the same area, a vertical structure similar to a vertical NAND flash structure is needed. In addition, the sneak-path current through the half-selected neighboring memory cell should be mitigated by integrating a selector device with each RRAM cell. In this study, an integrated vertical-type RRAM cell and selector device was fabricated and characterized. Ta2O5 as the switching layer and TaOxNy as the selector layer were used to preliminarily study the feasibility of such an integrated device. To make the side contact of the bottom electrode with active layers, a thick Al2O3 insulating layer was placed between the Pt bottom electrode and the Ta2O5/TaOxNy stacks. Resistive switching phenomena were observed under relatively low currents (below 10 μA) in this vertical-type RRAM device. The TaOxNy layer acted as a nonlinear resistor with moderate nonlinearity. Its low-resistance-state and high-resistance-state were well retained up to 1000 s.

Vertically-integrated Approaches for Carbon Sequestration Modeling

NASA Astrophysics Data System (ADS)

Bandilla, K.; Celia, M. A.; Guo, B.

2015-12-01

Carbon capture and sequestration (CCS) is being considered as an approach to mitigate anthropogenic CO2 emissions from large stationary sources such as coal fired power plants and natural gas processing plants. Computer modeling is an essential tool for site design and operational planning as it allows prediction of the pressure response as well as the migration of both CO2 and brine in the subsurface. Many processes, such as buoyancy, hysteresis, geomechanics and geochemistry, can have important impacts on the system. While all of the processes can be taken into account simultaneously, the resulting models are computationally very expensive and require large numbers of parameters which are often uncertain or unknown. In many cases of practical interest, the computational and data requirements can be reduced by choosing a smaller domain and/or by neglecting or simplifying certain processes. This leads to a series of models with different complexity, ranging from coupled multi-physics, multi-phase three-dimensional models to semi-analytical single-phase models. Under certain conditions the three-dimensional equations can be integrated in the vertical direction, leading to a suite of two-dimensional multi-phase models, termed vertically-integrated models. These models are either solved numerically or simplified further (e.g., assumption of vertical equilibrium) to allow analytical or semi-analytical solutions. This presentation focuses on how different vertically-integrated models have been applied to the simulation of CO2 and brine migration during CCS projects. Several example sites, such as the Illinois Basin and the Wabamun Lake region of the Alberta Basin, are discussed to show how vertically-integrated models can be used to gain understanding of CCS operations.

Integrated programmable photonic filter on the silicon-on-insulator platform.

PubMed

Liao, Shasha; Ding, Yunhong; Peucheret, Christophe; Yang, Ting; Dong, Jianji; Zhang, Xinliang

2014-12-29

We propose and demonstrate a silicon-on-insulator (SOI) on-chip programmable filter based on a four-tap finite impulse response structure. The photonic filter is programmable thanks to amplitude and phase modulation of each tap controlled by thermal heaters. We further demonstrate the tunability of the filter central wavelength, bandwidth and variable passband shape. The tuning range of the central wavelength is at least 42% of the free spectral range. The bandwidth tuning range is at least half of the free spectral range. Our scheme has distinct advantages of compactness, capability for integrating with electronics.

Verification of a non-hydrostatic dynamical core using the horizontal spectral element method and vertical finite difference method: 2-D aspects

NASA Astrophysics Data System (ADS)

Choi, S.-J.; Giraldo, F. X.; Kim, J.; Shin, S.

2014-11-01

The non-hydrostatic (NH) compressible Euler equations for dry atmosphere were solved in a simplified two-dimensional (2-D) slice framework employing a spectral element method (SEM) for the horizontal discretization and a finite difference method (FDM) for the vertical discretization. By using horizontal SEM, which decomposes the physical domain into smaller pieces with a small communication stencil, a high level of scalability can be achieved. By using vertical FDM, an easy method for coupling the dynamics and existing physics packages can be provided. The SEM uses high-order nodal basis functions associated with Lagrange polynomials based on Gauss-Lobatto-Legendre (GLL) quadrature points. The FDM employs a third-order upwind-biased scheme for the vertical flux terms and a centered finite difference scheme for the vertical derivative and integral terms. For temporal integration, a time-split, third-order Runge-Kutta (RK3) integration technique was applied. The Euler equations that were used here are in flux form based on the hydrostatic pressure vertical coordinate. The equations are the same as those used in the Weather Research and Forecasting (WRF) model, but a hybrid sigma-pressure vertical coordinate was implemented in this model. We validated the model by conducting the widely used standard tests: linear hydrostatic mountain wave, tracer advection, and gravity wave over the Schär-type mountain, as well as density current, inertia-gravity wave, and rising thermal bubble. The results from these tests demonstrated that the model using the horizontal SEM and the vertical FDM is accurate and robust provided sufficient diffusion is applied. The results with various horizontal resolutions also showed convergence of second-order accuracy due to the accuracy of the time integration scheme and that of the vertical direction, although high-order basis functions were used in the horizontal. By using the 2-D slice model, we effectively showed that the combined spatial discretization method of the spectral element and finite difference methods in the horizontal and vertical directions, respectively, offers a viable method for development of an NH dynamical core.

A Convective Vorticity Vector Associated With Tropical Convection: A 2D Cloud-Resolving Modeling Study

NASA Technical Reports Server (NTRS)

Gao, Shou-Ting; Ping, Fan; Li, Xiao-Fan; Tao, Wei-Kuo

2004-01-01

Although dry/moist potential vorticity is a useful physical quantity for meteorological analysis, it cannot be applied to the analysis of 2D simulations. A convective vorticity vector (CVV) is introduced in this study to analyze 2D cloud-resolving simulation data associated with 2D tropical convection. The cloud model is forced by the vertical velocity, zonal wind, horizontal advection, and sea surface temperature obtained from the TOGA COARE, and is integrated for a selected 10-day period. The CVV has zonal and vertical components in the 2D x-z frame. Analysis of zonally-averaged and mass-integrated quantities shows that the correlation coefficient between the vertical component of the CVV and the sum of the cloud hydrometeor mixing ratios is 0.81, whereas the correlation coefficient between the zonal component and the sum of the mixing ratios is only 0.18. This indicates that the vertical component of the CVV is closely associated with tropical convection. The tendency equation for the vertical component of the CVV is derived and the zonally-averaged and mass-integrated tendency budgets are analyzed. The tendency of the vertical component of the CVV is determined by the interaction between the vorticity and the zonal gradient of cloud heating. The results demonstrate that the vertical component of the CVV is a cloud-linked parameter and can be used to study tropical convection.

Integrating Cognitive Linguistics Insights into Data-Driven Learning: Teaching Vertical Prepositions

ERIC Educational Resources Information Center

Kilimci, Abdurrahman

2017-01-01

The present study investigates the impact of the integration of the Cognitive Linguistics (CL) pedagogy into Data-driven learning (DDL) on the learners' acquisition of two sets of English spatial prepositions of verticality, "over/under" and "above/below." The study followed a quasi-experimental design with a control and an…

Owned vertical integration and health care: promise and performance.

PubMed

Walston, S L; Kimberly, J R; Burns, L R

1996-01-01

This article examines the alleged benefits and actual outcomes of vertical integration in the health sector and compares them to those observed in other sectors of the economy. This article concludes that the organizational models on which these arrangements are based may be poorly adapted to the current environment in health care.

Vertical Integration at Junior and Intermediate Levels. School Research Newsletter.

ERIC Educational Resources Information Center

Marklund, Inger, Ed.; Hanse, Mona-Britt, Ed.

1984-01-01

In recent years, there has been a rapid growth of interest in Sweden in vertically integrated classes in compulsory schools, especially at junior high school and intermediate grade levels. This development is supported in various ways by the curriculum, partly because it puts more emphasis than previous curricula on the occurrence of teaching…

Changes in Quality of Health Care Delivery after Vertical Integration.

PubMed

Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

2015-08-01

To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data were assembled by the health plan's informatics team. Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care-sensitive admissions increased when the acquisition caused disruption in admitting patterns. Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. © Health Research and Educational Trust.

LOGWAR 15: Analysis Report

DTIC Science & Technology

2016-04-01

Vertical Replenishment VTC Video Teleconference WASH Water, Sanitation, and Hygiene WFP World Food Programme WHO World Health Organization...issues Pa rt ic ip an ts Contexts Combat Disease Refugees Insurgency Natural Disaster Contamination Visibility Disposition Distribution Sourcing...requirements; limited shelf life; used by many actors; often in short supply; restrictions on sourcing; contamination concerns (IV solutions) Small in

Simplified models for displaced dark matter signatures

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

Buchmueller, Oliver; De Roeck, Albert; Hahn, Kristian

We propose a systematic programme to search for long-lived neutral particle signatures through a minimal set of displaced =E T searches (dMETs). Here, our approach is to extend the well-established dark matter simpli ed models to include displaced vertices. The dark matter simplified models are used to describe the primary production vertex. A displaced secondary vertex, characterised by the mass of the long-lived particle and its lifetime, is added for the displaced signature. We show how these models can be motivated by, and mapped onto, complete models such as gauge-mediated SUSY breaking and models of neutral naturalness. We also outlinemore » how this approach may be used to extend other simplified models to incorporate displaced signatures and to characterise searches for longlived charged particles. Displaced vertices are a striking signature which is often virtually background free, and thus provide an excellent target for the high-luminosity run of the Large Hadron Collider. The proposed models and searches provide a first step towards a systematic broadening of the displaced dark matter search programme.« less

MRI safety of a programmable shunt assistant at 3 and 7 Tesla.

PubMed

Mirzayan, M Javad; Klinge, Petra M; Samii, Madjid; Goetz, Friedrich; Krauss, Joachim K

2012-06-01

Several new shunt technologies have been developed to optimize hydrocephalus treatment within the past few years. Overdrainage, however, still remains an unresolved problem. One new technology which may reduce the frequency of this complication is the use of a programmable shunt assistant (proSA). Inactive in a horizontal position, it impedes CSF flow in a vertical position according to a prescribed pressure level ranging from 0 to 40 cm H(2)O. We exposed the proSA valve in an ex vivo protocol to MR systems operating at 3 and 7 Tesla to investigate its MRI safety. Following 3 Tesla exposure, no changes in valve settings were noted. Adjustment to any pressure level was possible thereafter. The mean deflection angle was 23 ± 3°. After exposure to 7 Tesla, however, there were unintended pressure changes, and the mechanism for further adjustment of the valves even disintegrated. According to the results of this study, proSA is safe with heteropolar vertical magnet alignment at 3 Tesla. Following 7 Tesla exposure, the valves lost their functional capability.

Simplified models for displaced dark matter signatures

DOE PAGES

Buchmueller, Oliver; De Roeck, Albert; Hahn, Kristian; ...

2017-09-18

We propose a systematic programme to search for long-lived neutral particle signatures through a minimal set of displaced =E T searches (dMETs). Here, our approach is to extend the well-established dark matter simpli ed models to include displaced vertices. The dark matter simplified models are used to describe the primary production vertex. A displaced secondary vertex, characterised by the mass of the long-lived particle and its lifetime, is added for the displaced signature. We show how these models can be motivated by, and mapped onto, complete models such as gauge-mediated SUSY breaking and models of neutral naturalness. We also outlinemore » how this approach may be used to extend other simplified models to incorporate displaced signatures and to characterise searches for longlived charged particles. Displaced vertices are a striking signature which is often virtually background free, and thus provide an excellent target for the high-luminosity run of the Large Hadron Collider. The proposed models and searches provide a first step towards a systematic broadening of the displaced dark matter search programme.« less

Building a global business continuity programme.

PubMed

Lazcano, Michael

2014-01-01

Business continuity programmes provide an important function within organisations, especially when aligned with and supportive of the organisation's goals, objectives and organisational culture. Continuity programmes for large, complex international organisations, unlike those for compact national companies, are more difficult to design, build, implement and maintain. Programmes for international organisations require attention to structural design, support across organisational leadership and hierarchy, seamless integration with the organisation's culture, measured success and demonstrated value. This paper details practical, but sometimes overlooked considerations for building successful global business continuity programmes.

An integrated community-based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia: Recovery, fatality, and nutritional status after discharge.

PubMed

Tadesse, Elazar; Worku, Amare; Berhane, Yemane; Ekström, Eva-Charlotte

2018-04-01

A scaled up and integrated outpatient therapeutic feeding programme (OTP) brings the treatment of severely malnourished children closer to the community. This study assessed recovery from severe acute malnutrition (SAM), fatality, and acute malnutrition up to 14 weeks after admission to a programme integrated in the primary health care system. In this cohort study, 1,048 children admitted to 94 OTPs in Southern Ethiopia were followed for 14 weeks. Independent anthropometric measurements and information on treatment outcome were collected at four home visits. Only 32.7% (248/759) of children with SAM on admission fulfilled the programme recovery criteria at the time of discharge (i.e., gained 15% in weight, or oedema, if present at admission, was resolved at discharge). Of all children admitted to the programme for whom nutritional assessment was done 14 weeks later, 34.6% (321/928) were severely malnourished, and 37.5% (348/928) were moderately malnourished; thus, 72.1% were acutely malnourished. Of the children, 27/982 (2.7%) had died by 14 weeks, of whom all but one had SAM on admission. Children with severe oedema on admission had the highest fatality rate (12.0%, 9/75). The median length of admission to the programme was 6.6 weeks (interquartile range: 5.3, 8.4 weeks). Despite children participating for the recommended duration of the programme, many children with SAM were discharged still acutely malnourished and without reaching programme criteria for recovery. For better outcome of OTP, constraints in service provision by the health system as well as challenges of service utilization by the beneficiaries should be identified and addressed. © 2017 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Promoting interdisciplinary education - the Vienna Doctoral Programme on Water Resource Systems

NASA Astrophysics Data System (ADS)

Blöschl, G.; Carr, G.; Bucher, C.; Farnleitner, A. H.; Rechberger, H.; Wagner, W.; Zessner, M.

2011-11-01

The Vienna Doctoral Programme on Water Resource Systems (DK-WRS) is a programme that aims to educate students in interdisciplinary water science through cutting edge research at an international level. It is funded by the Austrian Science Fund and designed to run over a period of 12 yr during which 80 doctoral students are anticipated to graduate. This paper reports on our experiences of setting up and implementing the Programme. We identify three challenges: integrating the disciplines, maintaining depth in an interdisciplinary programme, and teaching subjects remote to each student's core expertise. To address these challenges we adopted a number of approaches. We use three levels of instruments to foster integration across the disciplines: joint groups (e.g. a joint study programme), joint science questions (e.g. developed in annual symposia), and joint study sites. To maintain depth we apply a system of quality control including regular feedback sessions, theses by journal publications and international study exchange. For simultaneously teaching students from civil and environmental engineering, biology, geology, chemistry, mathematics we use visually explicit teaching, learning by doing, extra mentoring and by cross relating associated subjects. Our initial assessment of the Programme shows some very positive outcomes. Joint science questions formed between students from various disciplines indicate integration is being achieved. The number of successful publications in top journals suggests that depth is maintained. Positive feedback from the students on the variety and clarity of the courses indicates the teaching strategy is working well. Our experiences have shown that implementing and running an interdisciplinary doctoral programme has its challenges and is demanding in terms of time and human resources but seeing interactions progress and watching people grow and develop their way of thinking in an interdisciplinary environment is a valuable reward.

Promoting interdisciplinary education - the Vienna Doctoral Programme on Water Resource Systems

NASA Astrophysics Data System (ADS)

Blöschl, G.; Carr, G.; Bucher, C.; Farnleitner, A. H.; Rechberger, H.; Wagner, W.; Zessner, M.

2012-02-01

The Vienna Doctoral Programme on Water Resource Systems (DK-WRS) is a programme that aims to educate students in interdisciplinary water science through cutting edge research at an international level. It is funded by the Austrian Science Fund and designed to run over a period of 12 yr during which 80 doctoral students are anticipated to graduate. This paper reports on our experiences of setting up and implementing the Programme. We identify three challenges: integrating the disciplines, maintaining depth in an interdisciplinary programme, and teaching subjects remote to each student's core expertise. To address these challenges we adopt a number of approaches. We use three levels of instruments to foster integration across the disciplines: joint groups (e.g. a joint study programme), joint science questions (e.g. developed in annual symposia), and joint study sites. To maintain depth we apply a system of quality control including regular feedback sessions, theses by journal publications and international study exchange. For simultaneously teaching students from civil and environmental engineering, biology, geology, chemistry, mathematics we use visually explicit teaching, learning by doing, extra mentoring and by cross relating associated subjects. Our initial assessment of the Programme shows some very positive outcomes. Joint science questions formed between students from various disciplines indicate integration is being achieved. The number of successful publications in top journals suggests that depth is maintained. Positive feedback from the students on the variety and clarity of the courses indicates the teaching strategy is working well. Our experiences have shown that implementing and running an interdisciplinary doctoral programme has its challenges and is demanding in terms of time and human resources but seeing interactions progress and watching people grow and develop their way of thinking in an interdisciplinary environment is a valuable reward.

Integrating care for older people with complex needs: key insights and lessons from a seven-country cross-case analysis.

PubMed

Wodchis, Walter P; Dixon, Anna; Anderson, Geoff M; Goodwin, Nick

2015-01-01

To address the challenges of caring for a growing number of older people with a mix of both health problems and functional impairment, programmes in different countries have different approaches to integrating health and social service supports. The goal of this analysis is to identify important lessons for policy makers and service providers to enable better design, implementation and spread of successful integrated care models. This paper provides a structured cross-case synthesis of seven integrated care programmes in Australia, Canada, the Netherlands, New Zealand, Sweden, the UK and the USA. All seven programmes involved bottom-up innovation driven by local needs and included: (1) a single point of entry, (2) holistic care assessments, (3) comprehensive care planning, (4) care co-ordination and (5) a well-connected provider network. The process of achieving successful integration involves collaboration and, although the specific types of collaboration varied considerably across the seven case studies, all involved a care coordinator or case manager. Most programmes were not systematically evaluated but the two with formal external evaluations showed benefit and have been expanded. Case managers or care coordinators who support patient-centred collaborative care are key to successful integration in all our cases as are policies that provide funds and support for local initiatives that allow for bottom-up innovation. However, more robust and systematic evaluation of these initiatives is needed to clarify the 'business case' for integrated health and social care and to ensure successful generalization of local successes.

Work package 4 report: Broodfish testing for bacterial infections

USGS Publications Warehouse

Michel, Christian; Elliott, Diane G.; Jansson, Eva; Urdaci, Maria; Midtlyng, Paul J.

2005-01-01

This report summarises current scientific information and experience obtained with various methods for testing of salmonid broodfish or spawn for bacterial kidney disease (BKD - Renibacterium salmoninarum infection) in order to prevent vertical transmission of the organism to the offspring. Assessment is also being performed for Flavobacterium psychrophilum infections causing rainbow trout fry syndrome (RTFS) or bacterial coldwater disease (CWD), and for Piscirickettsia salmonis infection causing salmon rickettsial syndrome (SRS) in salmonid fish species. Methods for screening to document the absence of BKD in fish populations are well established. Some of them have also proven successful for testing individual fish from infected populations in order to avoid vertical transmission of the infectious agent. Several diagnostic methods for flavobacteriosis and piscirickettsiosis have also been established but none of them, as yet, has been validated for use in programmes to prevent vertical transmission of disease. Priority subjects for further research in order to improve the management and control of these vertically transmissible fish diseases are suggested.

A Programmable and Configurable Mixed-Mode FPAA SoC

DTIC Science & Technology

2016-03-17

A Programmable and Configurable Mixed-Mode FPAA SoC Sahil Shah, Sihwan Kim, Farhan Adil, Jennifer Hasler, Suma George, Michelle Collins, Richard...Abstract: The authors present a Floating-Gate based, System-On-Chip large-scale Field- Programmable Analog Array IC that integrates divergent concepts...Floating-Gate, SoC, Command Word Classification This paper presents a Floating-Gate (FG) based, System- On-Chip (SoC) large-scale Field- Programmable

The role of SEA in integrating and balancing high policy objectives in European cohesion funding programmes

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

Jiricka, Alexandra, E-mail: alexandra.jiricka@boku.ac.at; Proebstl, Ulrike, E-mail: ulrike.proebstl@boku.ac.at

Funding programmes for European cohesion policy are a crucial tool to support the sustainability goals of the European Union and national policies of its member states. All these funding programmes require a Strategic Environmental Assessment (SEA) to enhance sustainable development. This article compares five first SEA applications at cohesion policy level to discuss challenges, limitations and benefits of this instrument. In order to support the SEA-process a 'Handbook on SEA for Cohesion Policy 2007-13' (GRDP 2006) was developed. The paper examines the special requirements and challenges at the programme level given the special conditions for stakeholder involvement, integration of SEAmore » in the programme development process and strategies to cope with uncertainties to ensure real compatibility with policy goals. Using action research and in-depth interviews with SEA planners and programme managers enabled us to analyse the suitability of the methodology proposed by the handbook. The results show that some recommendations of the handbook should be changed in order to increase the transparency and to enhance the standard and comparability of the SEA-documents. Overall the SEA proved to be a rather successful tool for the integration of sustainability goals at the EU and national policy levels. Its particular strengths emerged as the process makes uncertainties visible and leads to possible redefinitions while maintaining actual policy goals. - Highlights: Black-Right-Pointing-Pointer Comparing five case studies of first applications of SEA at cohesion policy level. Black-Right-Pointing-Pointer Overall the SEA proved to be a rather successful tool for the integration of sustainability goals. Black-Right-Pointing-Pointer The study makes uncertainties visible and shows how SEA could lead to possible redefinitions.« less

3D hybrid integrated lasers for silicon photonics

NASA Astrophysics Data System (ADS)

Song, B.; Pinna, S.; Liu, Y.; Megalini, L.; Klamkin, J.

2018-02-01

A novel 3D hybrid integration platform combines group III-V materials and silicon photonics to yield high-performance lasers is presented. This platform is based on flip-chip bonding and vertical optical coupling integration. In this work, indium phosphide (InP) devices with monolithic vertical total internal reflection turning mirrors were bonded to active silicon photonic circuits containing vertical grating couplers. Greater than 2 mW of optical power was coupled into a silicon waveguide from an InP laser. The InP devices can also be bonded directly to the silicon substrate, providing an efficient path for heat dissipation owing to the higher thermal conductance of silicon compared to InP. Lasers realized with this technique demonstrated a thermal impedance as low as 6.2°C/W, allowing for high efficiency and operation at high temperature. InP reflective semiconductor optical amplifiers were also integrated with 3D hybrid integration to form integrated external cavity lasers. These lasers demonstrated a wavelength tuning range of 30 nm, relative intensity noise lower than -135 dB/Hz and laser linewidth of 1.5 MHz. This platform is promising for integration of InP lasers and photonic integrated circuits on silicon photonics.

Installation package for integrated programmable electronic controller and hydronic subsystem - solar heating and cooling

NASA Technical Reports Server (NTRS)

1978-01-01

A description is given of the Installation, Operation, and Maintenance Manual and information on the power panel and programmable microprocessor, a hydronic solar pump system and a hydronic heating hot water pumping system. These systems are integrated into various configurations for usages in solar energy management, control and monitoring, lighting control, data logging and other solar related applications.

Encouraging a More Enterprising Researcher: The Implementation of an Integrated Training Programme of Enterprise for Ph.D. and Postdoctoral Researchers

ERIC Educational Resources Information Center

Phillips, Robert A.

2010-01-01

There are an increasing number of university courses throughout the UK and worldwide which deal with enterprise and innovation, including both undergraduate and masters programmes, not just for business school students, but also as modules as part of many other subject areas. However, there is little in the way of integrated enterprise training…

Microelectromechanical mirrors and electrically-programmable diffraction gratings based on two-stage actuation

DOEpatents

Allen, James J.; Sinclair, Michael B.; Dohner, Jeffrey L.

2005-11-22

A microelectromechanical (MEM) device for redirecting incident light is disclosed. The MEM device utilizes a pair of electrostatic actuators formed one above the other from different stacked and interconnected layers of polysilicon to move or tilt an overlying light-reflective plate (i.e. a mirror) to provide a reflected component of the incident light which can be shifted in phase or propagation angle. The MEM device, which utilizes leveraged bending to provide a relatively-large vertical displacement up to several microns for the light-reflective plate, has applications for forming an electrically-programmable diffraction grating (i.e. a polychromator) or a micromirror array.

Integration of health care organizations: using the power strategies of horizontal and vertical integration in public and private health systems.

PubMed

Thaldorf, Carey; Liberman, Aaron

2007-01-01

Integration in health care attempts to provide all elements in a seamless continuum of care. Pressures influencing development of system-wide integration primarily come from unsustainable cost increases in the United States over the later part of the 20th century and the early 21st century. Promoters of health care integration assume that it will lead to increased effectiveness and quality of care while concurrently increasing cost-effectiveness and possibly facilitating cost savings. The primary focus of this literature review is on the Power Strategies of Horizontal and Vertical Integration. The material presented suggests that vertical integration is most effective in markets where the partners involved are larger and dominant in the regions they serve. The research has also found that integrating health care networks had little or no significant effect on improving overall organizational efficiencies or profits. Capital investment in information technologies still is cost prohibitive and outweighs its benefits to integration efficiencies in the private sector; however, there are some indications of improvements in publicly provided health care. Further research is needed to understand the reasons the public sector has had greater success in improving effectiveness and efficiency through integration than the private sector.

Effects of a contrast training programme on jumping, sprinting and agility performance of prepubertal basketball players.

PubMed

Latorre Román, Pedro Ángel; Villar Macias, Francisco Javier; García Pinillos, Felipe

2018-04-01

The purpose of this study was to examine the effects of a 10 week contrast training (CT) programme (isometric + plyometric) on jumping, sprinting abilities and agility performance in prepubertal basketball players. Fifty-eight children from a basketball academy (age: 8.72 ± 0.97 years; body mass index: 17.22 ± 2.48 kg/m 2 ) successfully completed the study. Participants were randomly assigned to experimental groups (EG, n = 30) and control groups (CG, n = 28). The CT programme was included in the experimental group's training sessions - twice a week - as part of their usual weekly training regime. This programme included 3 exercises: 1 isometric and 2 plyometric. Jumping, sprinting and agility performance were assessed before and after the training programme. Significant differences were found in posttest between EG and CG in sprint and T-test: EG showed better results than CG. Furthermore, there were significant differences in posttest-pretest between EG and CG in squat jump, countermovement jump, drop jump, sprint and T-test with the EG showing better results than CG. The CT programme led to increases in vertical jump, sprint and agility levels, so that the authors suggest that prepubertal children exhibit high muscular strength trainability.

An FPGA-based bolometer for the MAST-U Super-X divertor.

PubMed

Lovell, Jack; Naylor, Graham; Field, Anthony; Drewelow, Peter; Sharples, Ray

2016-11-01

A new resistive bolometer system has been developed for MAST-Upgrade. It will measure radiated power in the new Super-X divertor, with millisecond time resolution, along 16 vertical and 16 horizontal lines of sight. The system uses a Xilinx Zynq-7000 series Field-Programmable Gate Array (FPGA) in the D-TACQ ACQ2106 carrier to perform real time data acquisition and signal processing. The FPGA enables AC-synchronous detection using high performance digital filtering to achieve a high signal-to-noise ratio and will be able to output processed data in real time with millisecond latency. The system has been installed on 8 previously unused channels of the JET vertical bolometer system. Initial results suggest good agreement with data from existing vertical channels but with higher bandwidth and signal-to-noise ratio.

Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda.

PubMed

Palmer, Jennifer J; Robert, Okello; Kansiime, Freddie

2017-01-01

Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that government health workers faced to produce good quality surveillance in a crisis; and (d) reluctant engagement between the sleeping sickness programme and humanitarian structures. Despite progressive policy intentions, several entrenched governance norms and practices worked against integration of refugees into the national sleeping sickness surveillance system. Elimination programmes which marginalise forced migrants risk unwittingly contributing to disease spread and reinforce social inequities, so new norms urgently need to be established at local, national and international levels.

Implementing a Standardised Annual Programme Review Process in a Third-Level Institution

ERIC Educational Resources Information Center

Wickham, Sheelagh; Brady, Malcolm; Ingle, Sarah; McMullan, Caroline; Nic Giolla Mhichíl, Mairéad; Walshe, Ray

2017-01-01

Purpose: Ideally, quality should be, and is, an integral element of education, yet capturing and articulating quality is not simple. Programme quality reviews in third-level education can demonstrate quality and identify areas for improvement, offering many potential benefits. However, details on the process of quality programme review are limited…

Context or Key? Language in Four Adult Learning Programmes

ERIC Educational Resources Information Center

Robinson, Clinton

2007-01-01

Context is a key factor in designing and delivering adult learning programmes, and in multilingual environments the choice of language plays a decisive role. Four programmes, two in Asia (Bhutan Myanmar) and two in Africa (Ghana and Uganda), which focus on learning for development, integrate language considerations in different ways, related both…

Practical Elements in Danish Engineering Programmes, Including the European Project Semester

ERIC Educational Resources Information Center

Hansen, Jorgen

2012-01-01

In Denmark, all engineering programmes in HE have practical elements; for instance, at Bachelor's level, an internship is an integrated part of the programme. Furthermore, Denmark has a long-established tradition of problem-based and project-organized learning, and a large part of students' projects, including their final projects, is done in…

An Analysis of Whitewater Rafting Safety Data: Risk Management for Programme Organizers

ERIC Educational Resources Information Center

Hunter, I. Roy

2007-01-01

Many outdoor organizations integrate whitewater rafting into their programmes. Often this is accomplished by contracting with a whitewater outfitter. This paper analyses rafting accident data collected by the American Canoe Association in an effort to suggest ways in which programmes can better manage risk while contracting with outfitters for…

Developing information literacy: a key to evidence-based nursing.

PubMed

Shorten, A; Wallace, M C; Crookes, P A

2001-06-01

This report describes the evaluation of a curriculum-integrated programme designed to help students develop an awareness of the nursing literature, the skills to locate and retrieve it, and skills required in its evaluation; in other words'information literacy'. Positive changes in student performance on objective measures of information-literacy skills were revealed as well as a significant increase in the levels of confidence of the student in performing those skills. Students who had undertaken the information-literacy programme ('programme' students) performed better on a range of objective measures of information literacy, as well as reporting higher levels of confidence in these skills, than students who had not participated in the programme ('non-programme' students). Evaluation of this programme provides evidence of the potential usefulness of a curriculum-integrated approach for the development of information-literacy skills within nursing education. With these underlying skills, students will be better equipped to consolidate and extend their key information-literacy skills to include research appreciation and application. These are vital for effective lifelong learning and a prerequisite to evidence-based practice.

Demand generation and social mobilisation for integrated community case management (iCCM) and child health: Lessons learned from successful programmes in Niger and Mozambique.

PubMed

Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio

2014-12-01

We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care-seeking within 24 hours and care-seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers' ability to assess and treat illnesses can lead to improved care-seeking and utilisation, and community ownership for iCCM.

Integrated health programme: a workplace randomized controlled trial.

PubMed

Tveito, Torill H; Eriksen, Hege R

2009-01-01

This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints, and increase coping in a population of nursing personnel. BACKGROUND. The work group in Norway with most sick leave is healthcare workers. More than 50% of the sick leave is because of subjective health complaints. Work place physical exercise interventions have a documented positive effect on sick leave. After baseline screening, employees who had agreed to participate (n=40) were randomized to an intervention or control group. The intervention group participated in an Integrated Health Programme twice weekly during working hours. The programme consisted of physical exercise, stress management training, health information and an examination of the participants' workplace. The control group was offered the same intervention after the project was finished. This study was carried out from 2001 to 2002. There were no statistically significant effects on sick leave or health-related quality of life. The intervention group reported fewer neck complaints compared to the control group, but otherwise there were no effects on subjective health complaints. However, the subjective effects were large and highly statistically significant, the intervention group reporting improvement in health, physical fitness, muscle pain, stress management, maintenance of health and work situation. The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints, but may be of use to employers wanting to increase employee job satisfaction and well-being.

AFC-Enabled Vertical Tail System Integration Study

NASA Technical Reports Server (NTRS)

Mooney, Helen P.; Brandt, John B.; Lacy, Douglas S.; Whalen, Edward A.

2014-01-01

This document serves as the final report for the SMAAART AFC-Enabled Vertical Tail System Integration Study. Included are the ground rule assumptions which have gone into the study, layouts of the baseline and AFC-enabled configurations, critical sizing information, system requirements and architectures, and assumed system properties that result in an NPV assessment of the two candidate AFC technologies.

Vertical and Horizontal Integration of Laboratory Curricula and Course Projects across the Electronic Engineering Technology Program

ERIC Educational Resources Information Center

Zhan, Wei; Goulart, Ana; Morgan, Joseph A.; Porter, Jay R.

2011-01-01

This paper discusses the details of the curricular development effort with a focus on the vertical and horizontal integration of laboratory curricula and course projects within the Electronic Engineering Technology (EET) program at Texas A&M University. Both software and hardware aspects are addressed. A common set of software tools are…

Vertical integration - Reducing the load on GP teachers.

PubMed

Anderson, Katrina; Thomson, Jennifer

2009-11-01

With the increased medical student numbers in Australia there is an expectation that general practice will train students, junior doctors and registrars, and the teaching burden for busy general practitioners will rise. We discuss the model of vertical integration of general practice education set up at the Australian National University Medical School in the Australian Capital Territory and southeast New South Wales. This model of vertical integration is unique. It could be adapted in a range of vocational settings and spans medical student, prevocational doctor, registrar and international medical graduate teaching. A key aim of these strategies is to reduce the load on the clinical GP teacher as sustaining their contribution is crucial to the future of training in general practice.

INFOMAR - Ireland's National Seabed Mapping Programme: A Tool For Marine Spatial Planning

NASA Astrophysics Data System (ADS)

Furey, T. M.

2016-02-01

INFOMAR is Ireland's national seabed mapping programme and is a key action in the national integrated marine plan, Harnessing Our Ocean Wealth. It comprises a multi-platform approach to delivering marine integrated mapping in 2 phases, over a projected 20 year timeline (2006-2026). The programme has three work strands; Data Acquisition, Data Exchange and Integration, and Value Added Exploitation. The Data Acquisition strand includes collection of hydrographic, oceanographic, geological, habitat and heritage datasets that will underpin future sustainable development and management of Ireland's marine resource. INFOMAR outputs are delivered through the Data Exchange and Integration strand. Uses of these outputs are wide ranging and multipurpose, from management plans for fisheries, aquaculture and coastal protection works, to environmental impact assessments, ocean renewable development and integrated coastal zone management. In order to address the evolution and diversification of maritime user requirements, the programme has realigned and developed outputs and new products, in part, through an innovative research funding initiative. Development is also fostered through the Value Added Exploitation strand. INFOMAR outputs and products serve to underpin delivery of Ireland's statutory obligations and enhance compliance with EU and national legislation. This is achieved through co-operation with the agencies responsible for supporting Ireland's international obligations and for the implementation of marine spatial planning. A strategic national seabed mapping programme such as INFOMAR, provides a critical baseline dataset which underpins development of the marine economy, and improves our understanding of the response of marine systems to pressures, and the effect of cumulative impacts. This paper will focus on the evolution and scope of INFOMAR, and look at examples of outputs being harnessed to serve approaches to the management of activities having an impact on the marine environment.

[Health coaching as a part of integration into the job market--evaluation of a qualification concept].

PubMed

Heinmüller, M; Liel, K; Angerer, P; Gündel, H; Geldermann, B; Gottwald, M; Kimil, A; Limm, H

2014-03-01

The aim of this study is to develop, implement and evaluate an education programme enabling the pedagogic staff of employment promotion agencies to integrate health promotion approaches und activities in vocational training programmes. The evaluation of the education programme is based on Kirkpatrick's 4 levels training evaluation model. Besides the participants' verbal end of session feedback, a standardised questionnaire was used at the end of the education programme and after 3 months practical experience. Process evaluation included the implementation level of the methods learned. From a total of 71 participants, 56 completed the first and 31 the second questionnaire (return rate 79% and 44%, respectively). The participants' mean age was 42 years, 80% were female. Only 22% of them integrated health topics systematically into their daily work. A 3-day basic training followed by case conferences during practical work was developed to transfer knowledge and practical competence in person-to-person talks and group activities (so called FIT-counselling and FIT-group). For 96% of participants, their expectations regarding the education programme were met completely or predominantly. 91% indicated a rise in motivation to work as health coach. When rating the training material, 96% judged it helpful for implementation/transfer. Many participants marked the education programme as being too short and wished more time for the topic of "mental health" and exchange of experiences. The follow-up after 3 months on-the-job training revealed that 84 and 97%, respectively, found FIT-counselling and FIT-groups helpful for their daily work. In all employment promotion agencies FIT-counselling and FIT-groups were implemented. Our results affirm the need for and prove the acceptance of education programmes enabling the pedagogic staff of job-training programmes to deliver health coaching. Periodic case conferences take into account the participants' request for more exchange of experiences, facilitate implementation and contribute to quality and sustainability. Further development of the education programme is ongoing. © Georg Thieme Verlag KG Stuttgart · New York.

Realization of MEMS-IC Vertical Integration Utilizing Smart Bumpless Bonding

NASA Astrophysics Data System (ADS)

Shiozaki, Masayoshi; Moriguchi, Makoto; Sasaki, Sho; Oba, Masatoshi

This paper reports fundamental technologies, properties, and new experimental results of SBB (Smart Bumpless Bonding) to realize MEMS-IC vertical integration. Although conventional bonding technologies have had difficulties integrating MEMS and its processing circuit because of their rough bonding surfaces, fragile structures, and thermal restriction, SBB technology realized the vertical integration without thermal treatment, any adhesive materials including bumps, and chemical mechanical polishing. The SBB technology bonds sealing parts for vacuum sealing and electrodes for electrical connection simultaneously as published in previous experimental study. The plasma CVD SiO2 is utilized to realize vacuum sealing as sealing material. And Au projection studs are formed on each electrode and connected electrically between two wafers by compressive plastic deformation and surface activation. In this paper, new experimental results including vacuum sealing properties, electrical improvement, IC bonding results on the described fundamental concept and properties are reported.

Framework Programmable Platform for the advanced software development workstation: Framework processor design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Ackley, Keith A.; Crump, Wes; Sanders, Les

1991-01-01

The design of the Framework Processor (FP) component of the Framework Programmable Software Development Platform (FFP) is described. The FFP is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software development environment. Guided by the model, this Framework Processor will take advantage of an integrated operating environment to provide automated support for the management and control of the software development process so that costly mistakes during the development phase can be eliminated.

Operational alternatives for LANDSAT in California

NASA Technical Reports Server (NTRS)

Wilson, P.; Gialdini, M. J.

1981-01-01

Data integration is defined and examined as the means of promoting data sharing among the various governmental and private geobased information systems in California. Elements of vertical integration considered included technical factors (such as resolution and classification) and institutional factors (such as organizational control, and legal and political barriers). Attempts are made to fit the theoretical elements of vertical integration into a meaningful structure for looking at the problem from a statewide focus. Both manual (mapped) and machine readable data systems are included. Special attention is given to LANDSAT imagery because of its strong potential for integrated use and its primary in the California Integrated Remote Sensing System program.

Developing asynchronous online interprofessional education.

PubMed

Sanborn, Heidi

2016-09-01

For many health programmes, developing interprofessional education (IPE) has been a challenge. Evidence on the best method for design and implementation of IPE has been slow to emerge, with little research on how to best incorporate IPE in the asynchronous online learning environment. This leaves online programmes with no clear guidance when embarking upon an initiative to integrate IPE into the curriculum. One tool that can be effective at guiding the incorporation of IPE across all learning platforms is the Interprofessional Education Collaborative (IPEC) competencies. A project was designed to integrate the nationally defined IPEC competencies throughout an asynchronous, online baccalaureate nursing completion programme. A programme-wide review led to targeted revision of course and unit-level objectives, learning experiences, and assessments based on the IPEC framework. As a result of this effort, the programme curriculum now provides interprofessional learning activities across all courses. This report provides a method for using the IPEC competencies to incorporate IPE within various asynchronous learning assessments, assuring students learn about, with, and from other professions.

Patient navigation for traumatic brain injury promotes community re-integration and reduces re-hospitalizations.

PubMed

Rosario, Emily R; Espinoza, Laura; Kaplan, Stephanie; Khonsari, Sepehr; Thurndyke, Earl; Bustos, Melissa; Vickers, Kayla; Navarro, Brittney; Scudder, Bonnie

2017-01-01

To determine the effectiveness of a Navigation programme for patients with traumatic brain injury. Prospective programme evaluation. Inpatient rehabilitation facility and community settings. Eighteen individuals who suffered a traumatic brain injury (TBI), were between the ages of 16-70 years, and had a Rancho Score greater than IV. Patient navigation programme focused on identifying and addressing barriers to positive outcomes, including coordination of care and facilitating communication among the family and healthcare providers, psychosocial support, caregiver support, adherence to treatment, education, community resources and financial issues. Functional status, re-hospitalizations, falls, neurobehavioral symptom inventory, neuroendocrine status, activities of daily living, community integration and caregiver burden. There was a significant reduction in re-hospitalization and fall rate when comparing individuals who received navigation services and those who did not. We also observed improved adherence treatment plans and a significant increase in community integration, independence level and functional abilities. This study begins to highlight the effectiveness of a patient navigation programme for individuals with TBI. Future research with a larger sample will continue to help us refine patient navigation for chronic disabling conditions and determine its sustainability.

Integrating the issues of world animal health and world public health into the veterinary curriculum: a Southeast Asian perspective.

PubMed

Zamri-Saad, M; Romziah, S; Kunavongkrit, A; Valdez, C A; Thien, M

2009-08-01

The authors analysed the curricula of five veterinary schools in Southeast Asia to determine how successfully they integrate the issues of global animal health and global public health into their programmes. Two schools offer a five-year programme while the remaining three offer a six-year programme. The core courses within the curricula range from 145 to 224 credit hours, in total. In general, world animal health and world public health are well integrated into the veterinary curriculum. Most curricula allocate approximately 3% of their total credit hours to subjects associated with animal and public health, but other subjects that may contain discussions on these issues range between 6% and 10%. Most veterinary schools in Southeast Asia offer a Master's programme in Veterinary Public Health, with detailed emphasis on animal and public health but focusing principally on topics of local importance. At the same time, undergraduate and post-graduate veterinary students are exposed to current issues in animal and public health through regional and international scientific meetings.

Understanding and quantifying greenhouse gases (GHG) emissions: the UK GHG Emissions and Feedback Programme

NASA Astrophysics Data System (ADS)

Matthiesen, Stephan; Palmer, Paul; Watson, Andrew; Williams, Mathew

2016-04-01

We give an overview over the structure, objectives, and methods of the UK-based Greenhouse Gases Emissions and Feedback Programme. The overarching objective of this research programme is to deliver improved GHG inventories and predictions for the UK, and for the globe at a regional scale. To address this objective, the Programme has developed a comprehensive, multi-year and interlinked measurement and data analysis programme, focussing on the major GHGs carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O). The Programme integrates three UK research consortia with complementary objectives, focussing on observation and modelling in the atmosphere, the oceans, and the terrestrial biosphere: GAUGE (Greenhouse gAs Uk and Global Emissions) will produce robust estimates of the UK GHG budget, using new and existing atmospheric measurement networks and modelling activities at a range of scales. It integrates inter-calibrated information from ground-based, airborne, ferry-borne, balloon-borne, and space-borne sensors, including new sensor technology. The GREENHOUSE (Generating Regional Emissions Estimates with a Novel Hierarchy of Observations and Upscaled Simulation Experiments) project aims to understand the spatio-temporal patterns of biogenic GHG emissions in the UK's landscape of managed and semi-managed ecosystems. It uses existing UK field data and several targeted new measurement campaigns to build regional GHG inventories and improve the capabilities of land surface models. RAGNARoCC (Radiatively active gases from the North Atlantic Region and Climate Change) is an oceanographic project to investigate the air-sea fluxes of GHGs in the North Atlantic region. Through dedicated research cruises as well as data collection from ships of opportunity, it develops a comprehensive budget of natural and anthropogenic components of the carbon cycle in the North Atlantic and a better understanding of why the air-sea fluxes of CO2 vary regionally, seasonally and multi-annually. Integration activities link these three projects to foster knowledge exchange across different scales, methods and sub-disciplines, both within the Programme and with the wider research community. The three projects are integrated to improve our understanding of greenhouse gases across domains and scales. The observational components lay the foundation of new measurement infrastructure that will deliver beyond the lifetime of this Programme. Through the development of robust methods to reduce uncertainties in GHG emissions estimates, the Programme supports regulatory efforts to monitor emissions trends and the efficacy of reduction strategies.

Vertical Ge photodetector base on InP taper waveguide

NASA Astrophysics Data System (ADS)

Amiri, Iraj Sadegh; Ariannejad, M. M.; Azzuhri, S. R. B.; Anwar, T.; Kouhdaragh, V.; Yupapin, P.

2018-06-01

In this work, simulation is conducted to investigate Ge photodetectors monolithically integrated on Si chip. The performance of vertical Germanium photodetector with FDTD Solutions (optical simulation) and electrical simulation has been studied. Selective heteroepitaxy of Ge is functioned in the monolithic integration of Ge photodetectors. The potential of CMOS-compatible monolithic integration of Ge as photodetector is investigated and the performance optimization is presented. Additionally, the investigation is extended to electrical part, particularly in the conversion efficiency as well as operation under low supplied voltage condition.

Nourish and Nurture: World Food Programme Assistance for Early Childhood Education in India's Integrated Child Development Services. Education Sector Monograph No. 3.

ERIC Educational Resources Information Center

Siraj-Blatchford, Iram

Part of UNESCO's Action Research in Family and Early Childhood series, this monograph is based upon a technical report on the Early Childhood Education (ECE) component of the Integrated Child Development Services (ICDS) program in India. This document overviews the ICDS and how better use could be made of World Food Programme (WFP) food aid along…

Topics in programmable automation. [for materials handling, inspection, and assembly

NASA Technical Reports Server (NTRS)

Rosen, C. A.

1975-01-01

Topics explored in the development of integrated programmable automation systems include: numerically controlled and computer controlled machining; machine intelligence and the emulation of human-like capabilities; large scale semiconductor integration technology applications; and sensor technology for asynchronous local computation without burdening the executive minicomputer which controls the whole system. The role and development of training aids, and the potential application of these aids to augmented teleoperator systems are discussed.

Advancing the "One Health" Workforce by Integrating Ecosystem Health Practice into Veterinary Medical Education: The Envirovet Summer Institute

ERIC Educational Resources Information Center

Schwind, Jessica S.; Gilardi, Kirsten V. K.; Beasley, Val R.; Mazet, Jonna A. K.; Smith, Woutrina A.

2016-01-01

Objectives: The objectives of this study were to assess whether the Envirovet programme served to increase the number of practising ecosystem health professionals, as well as to measure the lasting professional and personal impact of the programme on participants. Design: Impact programme evaluation. Setting: An emerging strategy among global…

Constructively Aligning Technologies with Learning and Assessment in a Distance Education Master's Programme

ERIC Educational Resources Information Center

Rogerson-Revell, Pamela

2015-01-01

This paper reports on an action research study investigating the use of online learning activities or "e-tivities" to enhance the learning and assessment experience of students on a distance master's programme. The study suggests that to be successfully integrated in a programme, such activities need to be carefully aligned with learning…

Mergers, networking, and vertical integration: managed care and investor-owned hospitals.

PubMed

Brown, M

1996-01-01

This article links the forces of managed care and investor-owned firms as major factors driving the industry toward consolidation into vertically integrated, merged firms, often financed with investor capital. This relentless pressure to build regional systems of health services has transformed the industry from a charitable, community orientation to one of business, market shares, and profits.

Evaluation of NSF's Program of Grants and Vertical Integration of Research and Education in the Mathematical Sciences (VIGRE)

ERIC Educational Resources Information Center

National Academies Press, 2009

2009-01-01

In 1998, the National Science Foundation (NSF) launched a program of Grants for Vertical Integration of Research and Education in the Mathematical Sciences (VIGRE). These grants were designed for institutions with PhD-granting departments in the mathematical sciences, for the purpose of developing high-quality education programs, at all levels,…

Accountable Care Organizations and Transaction Cost Economics.

PubMed

Mick, Stephen S Farnsworth; Shay, Patrick D

2016-12-01

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development. © The Author(s) 2016.

Evaluating The Role Of Payment Policy In Driving Vertical Integration In The Oncology Market.

PubMed

Alpert, Abby; Hsi, Helen; Jacobson, Mireille

2017-04-01

The health care industry has experienced massive consolidation over the past decade. Much of the consolidation has been vertical (with hospitals acquiring physician practices) instead of horizontal (with physician practices or hospitals merging with similar entities). We documented the increase in vertical integration in the market for cancer care in the period 2003-15, finding that the rate of hospital or health system ownership of practices doubled from about 30 percent to about 60 percent. The two most commonly cited explanations for this consolidation are a 2005 Medicare Part B payment reform that dramatically reduced reimbursement for chemotherapy drugs, and the expansion of hospital eligibility for the 340B Drug Discount Program under the Affordable Care Act (ACA). To evaluate the evidence for these explanations, we used difference-in-differences methods to assess whether consolidation increased more in areas with greater exposure to each policy than in areas with less exposure. We found little evidence that either policy contributed to vertical integration. Rather, increased consolidation in the market for cancer care may be part of a broader post-ACA trend toward integrated health care systems. Project HOPE—The People-to-People Health Foundation, Inc.

Changes in Quality of Health Care Delivery after Vertical Integration

PubMed Central

Carlin, Caroline S; Dowd, Bryan; Feldman, Roger

2015-01-01

Objectives To fill an empirical gap in the literature by examining changes in quality of care measures occurring when multispecialty clinic systems were acquired by hospital-owned, vertically integrated health care delivery systems in the Twin Cities area. Data Sources/Study Setting Administrative data for health plan enrollees attributed to treatment and control clinic systems, merged with U.S. Census data. Study Design We compared changes in quality measures for health plan enrollees in the acquired clinics to enrollees in nine control groups using a differences-in-differences model. Our dataset spans 2 years prior to and 4 years after the acquisitions. We estimated probit models with errors clustered within enrollees. Data Collection/Extraction Methods Data were assembled by the health plan’s informatics team. Principal Findings Vertical integration is associated with increased rates of colorectal and cervical cancer screening and more appropriate emergency department use. The probability of ambulatory care–sensitive admissions increased when the acquisition caused disruption in admitting patterns. Conclusions Moving a clinic system into a vertically integrated delivery system resulted in limited increases in quality of care indicators. Caution is warranted when the acquisition causes disruption in referral patterns. PMID:25529312

Software packager user's guide

NASA Technical Reports Server (NTRS)

Callahan, John R.

1995-01-01

Software integration is a growing area of concern for many programmers and software managers because the need to build new programs quickly from existing components is greater than ever. This includes building versions of software products for multiple hardware platforms and operating systems, building programs from components written in different languages, and building systems from components that must execute on different machines in a distributed network. The goal of software integration is to make building new programs from existing components more seamless -- programmers should pay minimal attention to the underlying configuration issues involved. Libraries of reusable components and classes are important tools but only partial solutions to software development problems. Even though software components may have compatible interfaces, there may be other reasons, such as differences between execution environments, why they cannot be integrated. Often, components must be adapted or reimplemented to fit into another application because of implementation differences -- they are implemented in different programming languages, dependent on different operating system resources, or must execute on different physical machines. The software packager is a tool that allows programmers to deal with interfaces between software components and ignore complex integration details. The packager takes modular descriptions of the structure of a software system written in the package specification language and produces an integration program in the form of a makefile. If complex integration tools are needed to integrate a set of components, such as remote procedure call stubs, their use is implied by the packager automatically and stub generation tools are invoked in the corresponding makefile. The programmer deals only with the components themselves and not the details of how to build the system on any given platform.

Integrity modelling of tropospheric delay models

NASA Astrophysics Data System (ADS)

Rózsa, Szabolcs; Bastiaan Ober, Pieter; Mile, Máté; Ambrus, Bence; Juni, Ildikó

2017-04-01

The effect of the neutral atmosphere on signal propagation is routinely estimated by various tropospheric delay models in satellite navigation. Although numerous studies can be found in the literature investigating the accuracy of these models, for safety-of-life applications it is crucial to study and model the worst case performance of these models using very low recurrence frequencies. The main objective of the INTegrity of TROpospheric models (INTRO) project funded by the ESA PECS programme is to establish a model (or models) of the residual error of existing tropospheric delay models for safety-of-life applications. Such models are required to overbound rare tropospheric delays and should thus include the tails of the error distributions. Their use should lead to safe error bounds on the user position and should allow computation of protection levels for the horizontal and vertical position errors. The current tropospheric model from the RTCA SBAS Minimal Operational Standards has an associated residual error that equals 0.12 meters in the vertical direction. This value is derived by simply extrapolating the observed distribution of the residuals into the tail (where no data is present) and then taking the point where the cumulative distribution has an exceedance level would be 10-7.While the resulting standard deviation is much higher than the estimated standard variance that best fits the data (0.05 meters), it surely is conservative for most applications. In the context of the INTRO project some widely used and newly developed tropospheric delay models (e.g. RTCA MOPS, ESA GALTROPO and GPT2W) were tested using 16 years of daily ERA-INTERIM Reanalysis numerical weather model data and the raytracing technique. The results showed that the performance of some of the widely applied models have a clear seasonal dependency and it is also affected by a geographical position. In order to provide a more realistic, but still conservative estimation of the residual error of tropospheric delays, the mathematical formulation of the overbounding models are currently under development. This study introduces the main findings of the residual error analysis of the studied tropospheric delay models, and discusses the preliminary analysis of the integrity model development for safety-of-life applications.

Tiny surface plasmon resonance sensor integrated on silicon waveguide based on vertical coupling into finite metal-insulator-metal plasmonic waveguide.

PubMed

Lee, Dong-Jin; Yim, Hae-Dong; Lee, Seung-Gol; O, Beom-Hoan

2011-10-10

We propose a tiny surface plasmon resonance (SPR) sensor integrated on a silicon waveguide based on vertical coupling into a finite thickness metal-insulator-metal (f-MIM) plasmonic waveguide structure acting as a Fabry-Perot resonator. The resonant characteristics of vertically coupled f-MIM plasmonic waveguides are theoretically investigated and optimized. Numerical results show that the SPR sensor with a footprint of ~0.0375 μm2 and a sensitivity of ~635 nm/RIU can be designed at a 1.55 μm transmission wavelength.

Achieving universal access and moving towards elimination of new HIV infections in Cambodia

PubMed Central

Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

2014-01-01

Introduction In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections. Methods A literature review of published and unpublished documents, including programme data and presentations, was conducted. Results and discussion Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches. Conclusions Cambodia has tailored its prevention strategy to its own epidemic, established systematic linkages across different services and communities, and achieved nearly universal coverage of HIV services nationwide. Still, the programme must continually (re)prioritize the most effective and efficient interventions, strengthen synergies between programmes, contribute to health system strengthening, and increase domestic funding so that the gains of the previous two decades are sustained, and the goal of zero new infections is reached. PMID:24950749

Vertically integrated logic circuits constructed using ZnO-nanowire-based field-effect transistors on plastic substrates.

PubMed

Kang, Jeongmin; Moon, Taeho; Jeon, Youngin; Kim, Hoyoung; Kim, Sangsig

2013-05-01

ZnO-nanowire-based logic circuits were constructed by the vertical integration of multilayered field-effect transistors (FETs) on plastic substrates. ZnO nanowires with an average diameter of -100 nm were synthesized by thermal chemical vapor deposition for use as the channel material in FETs. The ZnO-based FETs exhibited a high I(ON)/I(OFF) of > 10(6), with the characteristic of n-type depletion modes. For vertically integrated logic circuits, three multilayer FETs were sequentially prepared. The stacked FETs were connected in series via electrodes, and C-PVPs were used for the layer-isolation material. The NOT and NAND gates exhibited large logic-swing values of -93%. These results demonstrate the feasibility of three dimensional flexible logic circuits.

Why students leave in the UK: an integrative review of the international research literature.

PubMed

Cameron, Joan; Roxburgh, Michelle; Taylor, Julie; Lauder, William

2011-04-01

The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community.   Integrative review of the literature. Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society. © 2010 Blackwell Publishing Ltd.

[Is vocational reintegration of young cancer patients possible?].

PubMed

Weiss, J; Kuhn, R; Wentrock, S; Malitz, J; Reuss-Borst, M

2013-12-01

Besides an improvement in quality of life, one of the major targets of rehabilitation programmes is to preserve the ability to work and to integrate the patient into working life again. Cancer in particular is often associated with a loss of employment and joblessness, frequently caused by incomplete rehabilitation. The programme is aimed at young cancer patients aged between 18 and 40 years. In addition to medical rehabilitation, they undergo a specially developed programme which they complete in groups of no more than 5 persons. At baseline and at the end of the 3 weeks rehabilitation, tests on physical and mental capacity are conducted. During rehabilitation, different training programmes concerning mobility at work, fine motor skills and cognitive abilities are held, complemented by an intensive psycho-social training programme. Additionally, patients receive individual social counselling. So far, 34 patients with an average age of 31.8 years have participated in the programme, 65% of them suffering from malignant haematological diseases. The combination of a medical and a vocational rehabilitation programme was judged extremely positively by the participants, which remained the case 6 months after completion of the programme. The rehabilitation programme significantly reduced work incapacity periods: at baseline, only 6% of the participants had not experienced such periods, but after 3 and 6 months, this rate had increased to 61% and 62% respectively. This was accompanied by an increased health-related quality of life and reduced fatigue. With our pilot project we were able to show that such a programme is feasible, can be well integrated into clinical routine and is successful.

Essays on optimal capacity and optimal regulation of interconnection infrastructures

NASA Astrophysics Data System (ADS)

Boffa, Federico

The integration between geographically differentiated markets or between vertically related industries generate effects on welfare that depend on the structure of the underlying markets. My thesis investigates the impact of geographical interconnection on welfare, and illustrates welfare-enhancing modes of regulation of vertically integrated industries and of geographically integrated markets. The first chapter analyzes the effects of interconnection between two formerly fully-separated markets under the assumptions that producers in the two markets are capacity-constrained, and tacitly collude whenever it is rational for them to do so. I find that there exists a set of assumptions under which interconnection brings about greater collusion, hence it reduces overall welfare. The second chapter analyzes the optimal interconnection capacity allocation mechanism for a benevolent electricity regulator when generation is not competitive. The regulator's intervention should not only ensure that interconnection capacity is efficiently allocated to the most efficient firms, but it should also induce a higher welfare in the upstream generation market. In a two-node setting, with one firm per node, I show that the regulatory intervention becomes more effective as the cost asymmetries between the two firms become more pronounced. The third chapter illustrates a regulation mechanism for vertically related industries. Ownership shares of the upstream industry (that displays economies of scale) are allocated to the downstream (competitive) firms in proportion to their shares in the final goods market. I show that the mechanism combines the benefits of vertical integration with those of vertical separation. The advantages of vertical integration consist in avoiding double marginalization, and in internalizing the reduction in average cost resulting from the upstream increase in output; on the other hand, vertical separation allows to preserve the competitiveness of the downstream sector. I also show that this mechanism improves in efficiency with respect to the Demsetz auction, and, finally, that it displays desirable properties as far as collusion and quality levels are concerned. The fourth chapter empirically estimates the benefit of removing the most crucial transmission bottleneck in the Italian electricity market, by building additional transmission capacity. Benefits are found to be relevant.

Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana

PubMed Central

Mensah, Ernest O.; Aikins, Moses K.; Gyapong, Margaret; Anto, Francis; Bockarie, Moses J.; Gyapong, John O.

2016-01-01

Background The global health system has a large arsenal of interventions, medical products and technologies to address current global health challenges. However, identifying the most effective and efficient strategies to deliver these resources to where they are most needed has been a challenge. Targeted and integrated interventions have been the main delivery strategies. However, the health system discourse increasingly favours integrated strategies in the context of functionally merging targeted interventions with multifunctional health care delivery systems with a focus on strengthening country health systems to deliver needed interventions. Neglected Tropical Diseases (NTD) have been identified to promote and perpetuate poverty hence there has been global effort to combat these diseases. The Neglected Tropical Diseases Programme (NTDP) in Ghana has a national programme team and office, however, it depends on the multifunctional health delivery system at the regional and district level to implement interventions. The NTDP seeks further health system integration to accelerate achievement of coverage targets. The study estimated the extent of integration of the NTDP at the national, regional and district levels to provide evidence to guide further integration. Methodology/Principal Findings The research design was a descriptive case study that interviewed key persons involved in the programme at the three levels of the health system as well as extensive document review. Integration was assessed on two planes—across health system functions–stewardship and governance, financing, planning, service delivery, monitoring and evaluation and demand generation; and across three administrative levels of the health system–national, regional and district. A composite measure of integration designated Cumulative Integration Index (CII) with a range of 0.00–1.00 was used to estimate extent of integration at the three levels of the health system. Service delivery was most integrated while financing and planning were least integrated. Extent of integration was partial at all levels of the health system with a CII of 0.48–0.68; however it was higher at the district compared to the national and regional levels. Conclusions/Significance To ensure further integration of the NTDP, planning and finance management activities must be decentralized to involve regional and district levels of the health system. The study provides an empirical measure of extent of integration and indicators to guide further integration. PMID:27203854

Extent of Integration of Priority Interventions into General Health Systems: A Case Study of Neglected Tropical Diseases Programme in the Western Region of Ghana.

PubMed

Mensah, Ernest O; Aikins, Moses K; Gyapong, Margaret; Anto, Francis; Bockarie, Moses J; Gyapong, John O

2016-05-01

The global health system has a large arsenal of interventions, medical products and technologies to address current global health challenges. However, identifying the most effective and efficient strategies to deliver these resources to where they are most needed has been a challenge. Targeted and integrated interventions have been the main delivery strategies. However, the health system discourse increasingly favours integrated strategies in the context of functionally merging targeted interventions with multifunctional health care delivery systems with a focus on strengthening country health systems to deliver needed interventions. Neglected Tropical Diseases (NTD) have been identified to promote and perpetuate poverty hence there has been global effort to combat these diseases. The Neglected Tropical Diseases Programme (NTDP) in Ghana has a national programme team and office, however, it depends on the multifunctional health delivery system at the regional and district level to implement interventions. The NTDP seeks further health system integration to accelerate achievement of coverage targets. The study estimated the extent of integration of the NTDP at the national, regional and district levels to provide evidence to guide further integration. The research design was a descriptive case study that interviewed key persons involved in the programme at the three levels of the health system as well as extensive document review. Integration was assessed on two planes-across health system functions-stewardship and governance, financing, planning, service delivery, monitoring and evaluation and demand generation; and across three administrative levels of the health system-national, regional and district. A composite measure of integration designated Cumulative Integration Index (CII) with a range of 0.00-1.00 was used to estimate extent of integration at the three levels of the health system. Service delivery was most integrated while financing and planning were least integrated. Extent of integration was partial at all levels of the health system with a CII of 0.48-0.68; however it was higher at the district compared to the national and regional levels. To ensure further integration of the NTDP, planning and finance management activities must be decentralized to involve regional and district levels of the health system. The study provides an empirical measure of extent of integration and indicators to guide further integration.

Addressing non-communicable diseases in Malaysia: an integrative process of systems and community

PubMed Central

2014-01-01

The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, “The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014”, and the “NCD Prevention 1Malaysia” (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems. PMID:25080846

Inverse design of near unity efficiency perfectly vertical grating couplers

NASA Astrophysics Data System (ADS)

Michaels, Andrew; Yablonovitch, Eli

2018-02-01

Efficient coupling between integrated optical waveguides and optical fibers is essential to the success of integrated photonics. While many solutions exist, perfectly vertical grating couplers which scatter light out of a waveguide in the direction normal to the waveguide's top surface are an ideal candidate due to their potential to reduce packaging complexity. Designing such couplers with high efficiency, however, has proven difficult. In this paper, we use electromagnetic inverse design techniques to optimize a high efficiency two-layer perfectly vertical silicon grating coupler. Our base design achieves a chip-to-fiber coupling efficiency of over 99% (-0.04 dB) at 1550 nm. Using this base design, we apply subsequent constrained optimizations to achieve vertical couplers with over 96% efficiency which are fabricable using a 65 nm process.

Demand generation and social mobilisation for integrated community case management (iCCM) and child health: Lessons learned from successful programmes in Niger and Mozambique

PubMed Central

Sharkey, Alyssa B; Martin, Sandrine; Cerveau, Teresa; Wetzler, Erica; Berzal, Rocio

2014-01-01

Aim We present the approaches used in and outcomes resulting from integrated community case management (iCCM) programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. Methods We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Results Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. Conclusions iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM. PMID:25520800

Wine biotechnology in South Africa: towards a systems approach to wine science.

PubMed

Moore, John P; Divol, Benoit; Young, Philip R; Nieuwoudt, Hélène H; Ramburan, Viresh; du Toit, Maret; Bauer, Florian F; Vivier, Melané A

2008-11-01

The wine industry in South Africa is over three centuries old and over the last decade has reemerged as a significant competitor in world wine markets. The Institute for Wine Biotechnology (IWBT) was established in partnership with the Department of Viticulture and Oenology at Stellenbosch University to foster basic fundamental research in the wine sciences leading to applications in the broader wine and grapevine industries. This review focuses on the different research programmes of the Institute (grapevine, yeast and bacteria biotechnology programmes, and chemical-analytical research), commercialisation activities (SunBio) and new initiatives to integrate the various research disciplines. An important focus of future research is the Wine Science Research Niche Area programme, which connects the different research thrusts of the IWBT and of several research partners in viticulture, oenology, food science and chemistry. This 'Functional Wine-omics' programme uses a systems biology approach to wine-related organisms. The data generated within the programme will be integrated with other data sets from viticulture, oenology, analytical chemistry and the sensory sciences through chemometrics and other statistical tools. The aim of the programme is to model aspects of the wine making process, from the vineyard to the finished product.

SpaceX: Breaking the Barrier to the Space Launch Vehicle Industry

DTIC Science & Technology

2016-12-22

like FedEx, implemented a unique technique to the industry and found success. SpaceX was also evaluated against guidelines and principles presented by...associated with implementing vertical integration. Musk, following value innovative principles , is using the concept of reusability to decrease the...47 Figure 6: Vertical Integration, Relative Market Share, and Profitability (Buzzell, 1983) ...... 49 Figure 7. SpaceX Capabilities and

Coordination processes and outcomes in the public service: the challenge of inter-organizational food safety coordination in Norway.

PubMed

Lie, Amund

2011-01-01

In 2004 Norway implemented a food safety reform programme aimed at enhancing inter-organizational coordination processes and outcomes. Has this programme affected inter-organizational coordination processes and outcomes, both vertically and horizontally – and if so how? This article employs the concept of inter-organizational coordination as an analytical tool, examining it in the light of two theoretical perspectives and coupling it with the empirical findings. The argument presented is that the chances of strong coordination outcomes may increase if inter-organizational processes feature a clear division of labour, arenas for coordination, active leadership, a lack of major conflicting goals, and shared obligations.

Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

NASA Technical Reports Server (NTRS)

Vicroy, D. D.; Knox, C. E.

1983-01-01

A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modeling required for the DC-10 airplane is described.

[Swimming programme for mentally retarded children and its impact on skills development].

PubMed

Seif Eldin, A G

2005-07-01

People with Down syndrome suffer from many social, psychological and motor function problems. Current research has looked at swimming programmes to assess their impact on such problems. The programme described here was applied for a 3-month period, with music being used as one of the tools. The results were very positive and children showed significant improvement in agility, self-esteem and behaviour patterns. The programme is thus effective in enhancing the integrated development of children with Down syndrome.

[Sustainable Implementation of Evidence-Based Programmes in Health Promotion: A Theoretical Framework and Concept of Interactive Knowledge to Action].

PubMed

Rütten, A; Wolff, A; Streber, A

2016-03-01

This article discusses 2 current issues in the field of public health research: (i) transfer of scientific knowledge into practice and (ii) sustainable implementation of good practice projects. It also supports integration of scientific and practice-based evidence production. Furthermore, it supports utilisation of interactive models that transcend deductive approaches to the process of knowledge transfer. Existing theoretical approaches, pilot studies and thoughtful conceptual considerations are incorporated into a framework showing the interplay of science, politics and prevention practice, which fosters a more sustainable implementation of health promotion programmes. The framework depicts 4 key processes of interaction between science and prevention practice: interactive knowledge to action, capacity building, programme adaptation and adaptation of the implementation context. Ensuring sustainability of health promotion programmes requires a concentrated process of integrating scientific and practice-based evidence production in the context of implementation. Central to the integration process is the approach of interactive knowledge to action, which especially benefits from capacity building processes that facilitate participation and systematic interaction between relevant stakeholders. Intense cooperation also induces a dynamic interaction between multiple actors and components such as health promotion programmes, target groups, relevant organisations and social, cultural and political contexts. The reciprocal adaptation of programmes and key components of the implementation context can foster effectiveness and sustainability of programmes. Sustainable implementation of evidence-based health promotion programmes requires alternatives to recent deductive models of knowledge transfer. Interactive approaches prove to be promising alternatives. Simultaneously, they change the responsibilities of science, policy and public health practice. Existing boundaries within disciplines and sectors are overcome by arranging transdisciplinary teams as well as by developing common agendas and procedures. Such approaches also require adaptations of the structure of research projects such as extending the length of funding. © Georg Thieme Verlag KG Stuttgart · New York.

Clinical validation of robot simulation of toothbrushing - comparative plaque removal efficacy

PubMed Central

2014-01-01

Background Clinical validation of laboratory toothbrushing tests has important advantages. It was, therefore, the aim to demonstrate correlation of tooth cleaning efficiency of a new robot brushing simulation technique with clinical plaque removal. Methods Clinical programme: 27 subjects received dental cleaning prior to 3-day-plaque-regrowth-interval. Plaque was stained, photographically documented and scored using planimetrical index. Subjects brushed teeth 33–47 with three techniques (horizontal, rotating, vertical), each for 20s buccally and for 20s orally in 3 consecutive intervals. The force was calibrated, the brushing technique was video supported. Two different brushes were randomly assigned to the subject. Robot programme: Clinical brushing programmes were transfered to a 6-axis-robot. Artificial teeth 33–47 were covered with plaque-simulating substrate. All brushing techniques were repeated 7 times, results were scored according to clinical planimetry. All data underwent statistical analysis by t-test, U-test and multivariate analysis. Results The individual clinical cleaning patterns are well reproduced by the robot programmes. Differences in plaque removal are statistically significant for the two brushes, reproduced in clinical and robot data. Multivariate analysis confirms the higher cleaning efficiency for anterior teeth and for the buccal sites. Conclusions The robot tooth brushing simulation programme showed good correlation with clinically standardized tooth brushing. This new robot brushing simulation programme can be used for rapid, reproducible laboratory testing of tooth cleaning. PMID:24996973

Clinical validation of robot simulation of toothbrushing--comparative plaque removal efficacy.

PubMed

Lang, Tomas; Staufer, Sebastian; Jennes, Barbara; Gaengler, Peter

2014-07-04

Clinical validation of laboratory toothbrushing tests has important advantages. It was, therefore, the aim to demonstrate correlation of tooth cleaning efficiency of a new robot brushing simulation technique with clinical plaque removal. Clinical programme: 27 subjects received dental cleaning prior to 3-day-plaque-regrowth-interval. Plaque was stained, photographically documented and scored using planimetrical index. Subjects brushed teeth 33-47 with three techniques (horizontal, rotating, vertical), each for 20s buccally and for 20s orally in 3 consecutive intervals. The force was calibrated, the brushing technique was video supported. Two different brushes were randomly assigned to the subject. Robot programme: Clinical brushing programmes were transfered to a 6-axis-robot. Artificial teeth 33-47 were covered with plaque-simulating substrate. All brushing techniques were repeated 7 times, results were scored according to clinical planimetry. All data underwent statistical analysis by t-test, U-test and multivariate analysis. The individual clinical cleaning patterns are well reproduced by the robot programmes. Differences in plaque removal are statistically significant for the two brushes, reproduced in clinical and robot data. Multivariate analysis confirms the higher cleaning efficiency for anterior teeth and for the buccal sites. The robot tooth brushing simulation programme showed good correlation with clinically standardized tooth brushing.This new robot brushing simulation programme can be used for rapid, reproducible laboratory testing of tooth cleaning.

3D optimization of a polymer MOEMS for active focusing of VCSEL beam

NASA Astrophysics Data System (ADS)

Abada, S.; Camps, T.; Reig, B.; Doucet, JB; Daran, E.; Bardinal, V.

2014-05-01

We report on the optimized design of a polymer-based actuator that can be directly integrated on a VCSEL for vertical beam scanning. Its operation principle is based on the vertical displacement of a SU-8 membrane including a polymer microlens. Under an applied thermal gradient, the membrane is shifted vertically due to thermal expansion in the actuation arms induced by Joule effect. This leads to a modification of microlens position and thus to a vertical scan of the laser beam. Membrane vertical displacements as high as 8μm for only 3V applied were recently experimentally obtained. To explain these performances, we developed a comprehensive tri-dimensional thermo-mechanical model that takes into account SU-8 material properties and precise MOEMS geometry. Out-of-plane mechanical coefficients and thermal conductivity were thus integrated in our 3D model (COMSOL Multiphysics). Vertical displacements extracted from these data for different actuation powers were successfully compared to experimental values, validating this modelling tool. Thereby, it was exploited to increase MOEMS electrothermal performance by a factor higher than 5.

Highly efficient gate-tunable photocurrent generation in vertical heterostructures of layered materials

PubMed Central

Yu, Woo Jong; Liu, Yuan; Zhou, Hailong; Yin, Anxiang; Li, Zheng; Huang, Yu

2014-01-01

Layered materials of graphene and MoS2, for example, have recently emerged as an exciting material system for future electronics and optoelectronics. Vertical integration of layered materials can enable the design of novel electronic and photonic devices. Here, we report highly efficient photocurrent generation from vertical heterostructures of layered materials. We show that vertically stacked graphene–MoS2–graphene and graphene–MoS2–metal junctions can be created with a broad junction area for efficient photon harvesting. The weak electrostatic screening effect of graphene allows the integration of single or dual gates under and/or above the vertical heterostructure to tune the band slope and photocurrent generation. We demonstrate that the amplitude and polarity of the photocurrent in the gated vertical heterostructures can be readily modulated by the electric field of an external gate to achieve a maximum external quantum efficiency of 55% and internal quantum efficiency up to 85%. Our study establishes a method to control photocarrier generation, separation and transport processes using an external electric field. PMID:24162001

Field-programmable lab-on-a-chip based on microelectrode dot array architecture.

PubMed

Wang, Gary; Teng, Daniel; Lai, Yi-Tse; Lu, Yi-Wen; Ho, Yingchieh; Lee, Chen-Yi

2014-09-01

The fundamentals of electrowetting-on-dielectric (EWOD) digital microfluidics are very strong: advantageous capability in the manipulation of fluids, small test volumes, precise dynamic control and detection, and microscale systems. These advantages are very important for future biochip developments, but the development of EWOD microfluidics has been hindered by the absence of: integrated detector technology, standard commercial components, on-chip sample preparation, standard manufacturing technology and end-to-end system integration. A field-programmable lab-on-a-chip (FPLOC) system based on microelectrode dot array (MEDA) architecture is presented in this research. The MEDA architecture proposes a standard EWOD microfluidic component called 'microelectrode cell', which can be dynamically configured into microfluidic components to perform microfluidic operations of the biochip. A proof-of-concept prototype FPLOC, containing a 30 × 30 MEDA, was developed by using generic integrated circuits computer aided design tools, and it was manufactured with standard low-voltage complementary metal-oxide-semiconductor technology, which allows smooth on-chip integration of microfluidics and microelectronics. By integrating 900 droplet detection circuits into microelectrode cells, the FPLOC has achieved large-scale integration of microfluidics and microelectronics. Compared to the full-custom and bottom-up design methods, the FPLOC provides hierarchical top-down design approach, field-programmability and dynamic manipulations of droplets for advanced microfluidic operations.

Vertically Integrated MEMS SOI Composite Porous Silicon-Crystalline Silicon Cantilever-Array Sensors: Concept for Continuous Sensing of Explosives and Warfare Agents

NASA Astrophysics Data System (ADS)

Stolyarova, Sara; Shemesh, Ariel; Aharon, Oren; Cohen, Omer; Gal, Lior; Eichen, Yoav; Nemirovsky, Yael

This study focuses on arrays of cantilevers made of crystalline silicon (c-Si), using SOI wafers as the starting material and using bulk micromachining. The arrays are subsequently transformed into composite porous silicon-crystalline silicon cantilevers, using a unique vapor phase process tailored for providing a thin surface layer of porous silicon on one side only. This results in asymmetric cantilever arrays, with one side providing nano-structured porous large surface, which can be further coated with polymers, thus providing additional sensing capabilities and enhanced sensing. The c-Si cantilevers are vertically integrated with a bottom silicon die with electrodes allowing electrostatic actuation. Flip Chip bonding is used for the vertical integration. The readout is provided by a sensitive Capacitance to Digital Converter. The fabrication, processing and characterization results are reported. The reported study is aimed towards achieving miniature cantilever chips with integrated readout for sensing explosives and chemical warfare agents in the field.

What can a participatory approach to evaluation contribute to the field of integrated care?

PubMed

Eyre, Laura; Farrelly, Michael; Marshall, Martin

2017-07-01

Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge. Participatory approaches are characterised by a desire to use social science methods to solve practical problems and a commitment on the part of researchers to substantive and sustained collaboration with relevant stakeholders. We describe how we applied an emerging practical model of participatory research, the researcher-in-residence model, to evaluate a large-scale integrated care programme in the UK. We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms. While there is still much to learn about the benefits and challenges of applying participatory approaches in the health sector, we demonstrate how using such approaches have the potential to help practitioners integrate care more effectively in their daily practice and help progress the academic study of integrated care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Integrating natural and social sciences to inspire public confidence in radioactive waste policy case study - Committee on radioactive waste management

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

Usher, Sam

2007-07-01

Integrating Natural and Social Sciences to Inspire Public Confidence in Radioactive Waste Policy Case Study: Committee on Radioactive Waste Management Implementing effective long-term radioactive waste management policy is challenging, and both UK and international experience is littered with policy and programme failures. Policy must not only be underpinned by sound science and technical rationale, it must also inspire the confidence of the public and other stakeholders. However, in today's modern society, communities will not simply accept the word of scientists for setting policy based purely on technical grounds. This is particularly so in areas where there are significant social andmore » ethical issues, such as radioactive waste disposal. To develop and implement effective policy, governments, waste owners and implementing bodies must develop processes which effectively integrate both complex technical and scientific issues, with equally challenging social and ethical concerns. These integrating processes must marry often intricate technical issues with broad public and stakeholder engagement programmes, in programmes which can expect the highest levels of public scrutiny, and must invariably be delivered within challenging time and budget constraints. This paper considers a model for how such integrating processes can be delivered. The paper reviews, as a case study, how such challenges were overcome by the Committee on Radioactive Waste Management (CoRWM), which, in July 2006, made recommendations to the UK government for the establishment of a long-term radioactive waste policy. Its recommendations were underpinned by sound science, but also engendered public confidence through undertaking the largest and most significant deliberative public and stakeholder engagement programme on a complex policy issue in the UK. Effective decision-making was enabled through the integration of both proven and bespoke methodologies, including Multi-criteria Decision Analysis and Holistic assessments, coupled with an overarching deliberative approach. How this was managed and delivered to programme demonstrates how important effective integration of different issues, interests and world views can be achieved, and the paper looks forward to how the continued integration of both natural and social sciences is essential if public confidence is to be maintained through implementation stages. This paper will be particularly relevant to governments, waste owners and implementing bodies who are responsible for developing and implementing policy. (author)« less

Rehabilitation in children with juvenile chronic arthritis.

PubMed

Häfner, R; Truckenbrodt, H; Spamer, M

1998-05-01

Chronic childhood arthritis impairs joint function and may result in severe physical handicap. Joint pain and inflammation trigger a vicious cycle that often ends in joint damage and fixed deformities. A comprehensive rehabilitation programme must start early to restore loss of function and prevent permanent handicap. It is dominated by a physiotherapeutic regimen consisting of pain relief, movement expansion, training of muscular coordination and finally re-integration of a physiological movement pattern. The approaches of occupational therapy become integrated into the treatment programme, concentrating on joint protection and self-care training. Additional aids support the aim of joint restoration. They include individual splinting, adapted footwear and walking aids. Depending on the child's age and developmental status different aspects of rehabilitation dominate. Small children need adequate mobility to promote their psychosocial development. In later years integration into school life and the peer group becomes important. Adolescents require help for an adequate vocational training and self-care support. Last but not least, parental education and integration of the whole family into the rehabilitation programme markedly improve the patient's prognosis.

Comprehensive gravitational modeling of the vertical cylindrical prism by Gauss-Legendre quadrature integration

NASA Astrophysics Data System (ADS)

Asgharzadeh, M. F.; Hashemi, H.; von Frese, R. RB

2018-01-01

Forward modeling is the basis of gravitational anomaly inversion that is widely applied to map subsurface mass variations. This study uses numerical least-squares Gauss-Legendre quadrature (GLQ) integration to evaluate the gravitational potential, anomaly and gradient components of the vertical cylindrical prism element. These results, in turn, may be integrated to accurately model the complete gravitational effects of fluid bearing rock formations and other vertical cylinder-like geological bodies with arbitrary variations in shape and density. Comparing the GLQ gravitational effects of uniform density, vertical circular cylinders against the effects calculated by a number of other methods illustrates the veracity of the GLQ modeling method and the accuracy limitations of the other methods. Geological examples include modeling the gravitational effects of a formation washout to help map azimuthal variations of the formation's bulk densities around the borehole wall. As another application, the gravitational effects of a seismically and gravimetrically imaged salt dome within the Laurentian Basin are evaluated for the velocity, density and geometric properties of the Basin's sedimentary formations.

Short-Wavelength Light-Emitting Devices With Enhanced Hole Injection Currents

DTIC Science & Technology

2005-05-01

hot-hole injector with appreciably enhancement of the injection current is proposed and developed to be integrated with commonly used vertical...structures of the emitting devices. Second, we develop the alternative design of UV-light sources on the base of lateral p+ - i - n+ superlattice structures...enhancement of the injection current is proposed and developed to be integrated with commonly used vertical structures of the emitting devices. Second

PHOs fall short of expectations. Despite failings, networks may have role as a transition to vertical integration.

PubMed

Jaklevic, M C

1995-10-09

An estimated 3,000 physician-hospital organizations have formed since the early 1980s, most of them in the last two years. But their slow progress in managed-care contracting has many wondering if they're anything more than an expensive fad. Proponents argue that despite their failings, PHOs may have a role as a transition to vertical integration.

Vertical integration models to prepare health systems for capitation.

PubMed

Cave, D G

1995-01-01

Health systems will profit most under capitation if their vertical integration strategy provides operational stability, a strong primary care physician base, efficient delivery of medical services, and geographic access to physicians. Staff- and equity-based systems best meet these characteristics for success because they have one governance structure and a defined mission statement. Moreover, physician bonds are strong because these systems maximize physicians' income potential and control the revenue stream.

Self-management programmes for people living with chronic obstructive pulmonary disease: a call for a reconceptualisation.

PubMed

Jonsdottir, Helga

2013-03-01

To synthesise findings from previously published studies on the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease. Self-management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self-management programmes for people with chronic obstructive pulmonary disease are indecisive. Literature review of (1) previously published systematic reviews and (2) an integrative literature review. Synthesis of findings from previously published systematic reviews (n = 4) of the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007-June 2012 (n = 9). Findings demonstrate that there are few studies on the effectiveness of self-management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health-related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient-centredness exist in self-management programmes, particularly in the more recent articles. The effectiveness of self-management programmes for people with chronic obstructive pulmonary disease remains indecisive. A reconceptualisation of self-management programmes is called for with attention to a family-centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety. © 2013 Blackwell Publishing Ltd.

The HIV epidemic and sexual and reproductive health policy integration: views of South African policymakers.

PubMed

Cooper, Diane; Mantell, Joanne E; Moodley, Jennifer; Mall, Sumaya

2015-03-04

Integration of sexual and reproductive health (SRH) and HIV policies and services delivered by the same provider is prioritised worldwide, especially in sub-Saharan Africa where HIV prevalence is highest. South Africa has the largest antiretroviral treatment (ART) programme in the world, with an estimated 2.7 million people on ART, elevating South Africa's prominence as a global leader in HIV treatment. In 2011, the Southern African HIV Clinicians Society published safer conception guidelines for people living with HIV (PLWH) and in 2013, the South African government published contraceptive guidelines highlighting the importance of SRH and fertility planning services for people living with HIV. Addressing unintended pregnancies, safer conception and maternal health issues is crucial for improving PLWH's SRH and combatting the global HIV epidemic. This paper explores South African policymakers' perspectives on public sector SRH-HIV policy integration, with a special focus on the need for national and regional policies on safer conception for PLWH and contraceptive guidelines implementation. It draws on 42 in-depth interviews with national, provincial and civil society policymakers conducted between 2008-2009 and 2011-2012, as the number of people on ART escalated. Interviews focused on three key domains: opinions on PLWH's childbearing; the status of SRH-HIV integration policies and services; and thoughts and suggestions on SRH-HIV integration within the restructuring of South African primary care services. Data were coded and analysed according to themes. Participants supported SRH-HIV integrated policy and services. However, integration challenges identified included a lack of policy and guidelines, inadequately trained providers, vertical programming, provider work overload, and a weak health system. Participants acknowledged that SRH-HIV integration policies, particularly for safer conception, contraception and cervical cancer, had been neglected. Policymakers supported public sector adoption of safer conception policy and services. Participants interviewed after expanded ART were more positive about safer conception policies for PLWH than participants interviewed earlier. The past decade's HIV policy changes have increased opportunities for SRH-HIV integration. The findings provide important insights for international, regional and national SRH-HIV policy and service integration initiatives.

Improving malaria treatment and prevention in India by aiding district managers to manage their programmes with local information: a trial assessing the impact of Lot Quality Assurance Sampling on programme outcomes.

PubMed

Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary

2014-10-01

This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

Qualitative interviews with mentor mothers living with HIV: potential impacts of role and coping strategies.

PubMed

Dhlamini, Lebohang; Knight, Lucia; van Rooyen, Heidi; van Heerden, Alastair; Jane Rotheram-Borus, Mary

2012-07-11

In South Africa where HIV prevalence is high, mentor mother programmes have been used to promote the health and wellbeing of women enrolled in government programmes preventing vertical transmission. The Masihambisane Project trained mentors to be educators and facilitators as "expert patients" in self-help groups. While this and other similar interventions demonstrate positive outcomes for mothers and their children, the long-term repercussions for mentors delivering the intervention are seldom considered. This article explores the personal impact of being a mentor, the potentially traumatizing effects of repeatedly sharing their experiences of living with HIV and the coping strategies they adopt. Towards the end of the Masihambisane intervention, 10 semi-structured qualitative interviews were conducted with locally recruited mentors living with HIV and were thematically analysed. Mentors found the repeated telling of their stories a painful reminder of adverse personal experiences. In some cases, retelling caused a physical reaction. Mentors relied on coping strategies like taking breaks, writing their experiences down and debriefing sessions. Despite the difficulties associated with their role, some mentors found being advisors and the group sessions therapeutic and empowering. These findings indicate that the inclusion of peer mentors comes with certain responsibilities. While the mentors were resilient and some found the experience therapeutic and empowering found creative ways to cope with secondary trauma, the negative implications cannot be ignored. To effectively deliver a mentor-driven intervention to mothers enrolled in a programme to prevent vertical transmission, the possibilities of secondary trauma should be considered and mentors provided with ongoing counselling, training on coping skills and regular debriefing sessions.

STOVL aircraft simulation for integrated flight and propulsion control research

NASA Technical Reports Server (NTRS)

Mihaloew, James R.; Drummond, Colin K.

1989-01-01

The United States is in the initial stages of committing to a national program to develop a supersonic short takeoff and vertical landing (STOVL) aircraft. The goal of the propulsion community in this effort is to have the enabling propulsion technologies for this type aircraft in place to permit a low risk decision regarding the initiation of a research STOVL supersonic attack/fighter aircraft in the late mid-90's. This technology will effectively integrate, enhance, and extend the supersonic cruise, STOVL and fighter/attack programs to enable U.S. industry to develop a revolutionary supersonic short takeoff and vertical landing fighter/attack aircraft in the post-ATF period. A joint NASA Lewis and NASA Ames research program, with the objective of developing and validating technology for integrated-flight propulsion control design methodologies for short takeoff and vertical landing (STOVL) aircraft, was planned and is underway. This program, the NASA Supersonic STOVL Integrated Flight-Propulsion Controls Program, is a major element of the overall NASA-Lewis Supersonic STOVL Propulsion Technology Program. It uses an integrated approach to develop an integrated program to achieve integrated flight-propulsion control technology. Essential elements of the integrated controls research program are realtime simulations of the integrated aircraft and propulsion systems which will be used in integrated control concept development and evaluations. This paper describes pertinent parts of the research program leading up to the related realtime simulation development and remarks on the simulation structure to accommodate propulsion system hardware drop-in for real system evaluation.

The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

PubMed

Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

2016-09-22

A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring implementation quality and coverage; however analysis and feedback to those implementing malaria elimination in the periphery was not well described. Political commitment and sustained financing contributed to malaria programme success. Consistency of malaria programmes depends on political commitment, human and financial resources, and leadership. Operational capacity of the programme and the overall health system structure and strength are also important aspects. Malaria eradication will require adaptive, well-managed malaria programmes that are able to tailor implementation of evidence-based strategies, founded upon strong sub-national surveillance and response, with adequate funding and human resources.

Content and Language Integrated Learning and the inclusion of immigrant minority language students: A research review

NASA Astrophysics Data System (ADS)

Somers, Thomas

2017-08-01

This article addresses the inclusion of immigrant minority language students in Content and Language Integrated Learning (CLIL) bilingual education programmes. It reviews results of research on (1) the reasons, beliefs and attitudes underlying immigrant minority language parents' and students' choice for CLIL programmes; (2) these students' proficiency in the languages of instruction and their academic achievement; and (3) the effects of first language typology on their second and third language proficiency. The author explores conditions and reasons for the effectiveness of CLIL pedagogy, as well as the comparative suitability of CLIL programmes for immigrant minority language students. The review shows that CLIL programmes provide a means to acquire important linguistic, economic and symbolic capital in order to effect upward social mobility. Findings demonstrate that immigrant minority language students enrolled in CLIL programmes are able to develop equal or superior levels of proficiency in both languages of instruction compared to majority language students; with previous development of first language literacy positively impacting academic language development. CLIL programmes are found to offer immigrant minority language students educational opportunities and effective pedagogical support which existing mainstream monolingual and minority bilingual education programmes may not always be able to provide. In light of these findings, the author discusses shortcomings in current educational policy. The article concludes with recommendations for further research.[Figure not available: see fulltext.

Using the patchwork text assessment as a vehicle for evaluating students' perceptions of their clinical leadership development.

PubMed

Leigh, J A; Rutherford, J; Wild, J; Cappleman, J; Hynes, C

2012-01-01

A shift in universities world wide in providing theoretical post graduate programmes of study underpinned by traditional assessment strategies to work based learning programmes supported by innovative assessment strategies is required if Higher education institutions are to effectively educate contemporary healthcare leaders. Concurrently generating the evidence to evaluate the effectiveness of educational programmes is required by commissioners of healthcare education (DH, 2010). This paper reports on the perceptions of twelve post graduate students attending a clinical leadership masters programme of their leadership development through analysis of the critical commentary provided by students as part of assessment strategy that utilised the Patchwork Text Assessment. Following a thematic content analysis six themes emerged: programme philosophy and its impact on the success of the Patchwork Text Assessment; leadership development targeted against leadership frameworks; application and applicability of learning to the students own healthcare organisation; integrating theory to practice through theoretical development and work based activities; the value of networking; and the importance of multi-professional reflective groups. This study has clearly demonstrated how the success of the Patchwork Text Assessment in promoting deep learning is determined by its integration into the overall philosophy of the programme. Concurrently systems needed to be in place to ensure that Patchwork text Assessment is operationalised effectively and embedded within the day to day management of the programme. Copyright © 2011 Elsevier Ltd. All rights reserved.

Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme.

PubMed

Dennerlein, Jack T; O'Day, Elizabeth Tucker; Mulloy, Deborah F; Somerville, Jackie; Stoddard, Anne M; Kenwood, Christopher; Teeple, Erin; Boden, Leslie I; Sorensen, Glorian; Hashimoto, Dean

2017-05-01

With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Integrating multiple programme and policy approaches to hepatitis C prevention and care for injection drug users: a comprehensive approach.

PubMed

Birkhead, Guthrie S; Klein, Susan J; Candelas, Alma R; O'Connell, Daniel A; Rothman, Jeffrey R; Feldman, Ira S; Tsui, Dennis S; Cotroneo, Richard A; Flanigan, Colleen A

2007-10-01

New York State is home to an estimated 230,000 individuals chronically infected with hepatitis C virus (HCV) and roughly 171,500 active injection drug users (IDUs). HCV/HIV co-infection is common and models of service delivery that effectively meet IDUs' needs are required. A HCV strategic plan has stressed integration. HCV prevention and care are integrated within health and human service settings, including HIV/AIDS organisations and drug treatment programmes. Other measures that support comprehensive HCV services for IDUs include reimbursement, clinical guidelines, training and HCV prevention education. Community and provider collaborations inform programme and policy development. IDUs access 5 million syringes annually through harm reduction/syringe exchange programmes (SEPs) and a statewide syringe access programme. Declines in HCV prevalence amongst IDUs in New York City coincided with improved syringe availability. New models of care successfully link IDUs at SEPs and in drug treatment to health care. Over 7000 Medicaid recipients with HCV/HIV co-infection had health care encounters related to their HCV in a 12-month period and 10,547 claims for HCV-related medications were paid. The success rate of transitional case management referrals to drug treatment is over 90%. Training and clinical guidelines promote provider knowledge about HCV and contribute to quality HCV care for IDUs. Chart reviews of 2570 patients with HIV in 2004 documented HCV status 97.4% of the time, overall, in various settings. New HCV surveillance systems are operational. Despite this progress, significant challenges remain. A comprehensive, public health approach, using multiple strategies across systems and mobilizing multiple sectors, can enhance IDUs access to HCV prevention and care. A holisitic approach with integrated services, including for HCV-HIV co-infected IDUs is needed. Leadership, collaboration and resources are essential.

The use of life review to enhance spiritual well-being in patients with terminal illnesses: An integrative review.

PubMed

Kwan, Cecilia W M; Ng, Marques S N; Chan, Carmen W H

2017-12-01

To conduct an integrative review of the current literature on using life review as an intervention to address the spiritual need of patients with terminal illnesses. Palliative care highlights the holistic approach of care including the spiritual aspect. Life review has been used in palliative nursing intending to enhance patients' emotional and spiritual well-being, and quality of life. However, there is a lack of publications that provide a structured overview on life review programmes and their effectiveness. Integrative review. The Whittemore and Knafl integrative review method was used. Five major online databases were included in our literature search. The keywords used were "life review" and "palliative care, terminal care, terminally ill, death & dying, hospice, spiritual wellbeing, spirituality". Seven primary papers were identified, critically appraised and synthesised in the final review. There are limited clinical studies on life review programmes for patients with terminal illness. The research design of these studies is too widely varied for meta-analysis. Here, we identified two major programmes of life review as an intervention to address the spiritual well-being of patients with terminal illness. However, repeated studies on the effectiveness of these two programmes are lacking. The shorter programme of life review is more likely to be applicable and effective for terminal patients. Further research in this area is required to provide strong evidence on the effectiveness and applicability of life review in patients receiving palliative care. This review adds weight to the need of a better understanding on the use of life review in addressing the spiritual needs of patients with terminal illness. Such understanding would provide evidence for the use of life review as an alternative approach in palliative care delivery. © 2017 John Wiley & Sons Ltd.

An integrated programme after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: effect on emotional and functional dimensions of quality of life.

PubMed

Moullec, G; Ninot, G

2010-02-01

To assess whether a maintenance integrated health care programme is effective in improving functional and emotional dimensions of quality of life in patients with chronic obstructive pulmonary disease (COPD) after a first pulmonary rehabilitation. Prospective controlled trial. Three rehabilitation centres and three patient self-help associations within a health care network in France. Forty patients with moderate to severe COPD. After a first four-week inpatient pulmonary rehabilitation programme, patients took part in a maintenance integrated health care programme or usual care for 12 months. The primary outcomes were the change in functional and emotional dimensions of quality of life measured by the St George's Respiratory Questionnaire (SGRQ), the brief World Health Organization Quality of Life questionnaire (Brief-WHOQOL) and six specific questions using a 10-cm visual analogue scale. Secondary outcomes were change in exercise tolerance measured by six-minute walking test and cycle exercise. At one year, the maintenance intervention (n = 11) produced improvements in functional and emotional dimensions scores of quality of life and exercise tolerance. Patients in the usual aftercare group (n = 16) exhibited maintenance of functional dimension scores of quality of life, but a clinically relevant decline in emotional scores of quality of life and in six-minute walking distance one year after the pulmonary rehabilitation. Patient self-help association seems to be an innovative and efficient organizational structure to support patients with COPD after pulmonary rehabilitation in real-life settings. A distinction between emotional and functional dimensions of quality of life may improve the design and evaluation of integrated health care programmes in patients with COPD.

HELIO: The Heliophysics Integrated Observatory

NASA Technical Reports Server (NTRS)

Bentley, R. D.; Csillaghy, A.; Aboudarham, J.; Jacquey, C.; Hapgood, M. A.; Bocchialini, K.; Messerotti, M.; Brooke, J.; Gallagher, P.; Fox, P.;

Impact of plunging breaking waves on a partially submerged cube

NASA Astrophysics Data System (ADS)

Wang, A.; Ikeda, C.; Duncan, J. H.

2013-11-01

The impact of a deep-water plunging breaking wave on a partially submerged cube is studied experimentally in a tank that is 14.8 m long and 1.2 m wide with a water depth of 0.91 m. The breakers are created from dispersively focused wave packets generated by a programmable wave maker. The water surface profile in the vertical center plane of the cube is measured using a cinematic laser-induced fluorescence technique with movie frame rates ranging from 300 to 4,500 Hz. The pressure distribution on the front face of the cube is measured with 24 fast-response sensors simultaneously with the wave profile measurements. The cube is positioned vertically at three heights relative to the mean water level and horizontally at a distance from the wave maker where a strong vertical water jet is formed. The portion of the water surface between the contact point on the front face of the cube and the wave crest is fitted with a circular arc and the radius and vertical position of the fitted circle is tracked during the impact. The vertical acceleration of the contact point reaches more than 50 times the acceleration of gravity and the pressure distribution just below the free surface shows a localized high-pressure region with a very high vertical pressure gradient. This work is supported by the Office of Naval Research under grant N000141110095.

The Brazilian school feeding programme: an example of an integrated programme in support of food and nutrition security.

PubMed

Sidaner, Emilie; Balaban, Daniel; Burlandy, Luciene

2013-06-01

The present paper analyses the advances and challenges of the school feeding programme in Brazil (PNAE), as part of the Brazilian experience building up an integrated food and nutrition security national system. It explores the role of policy and regulatory frameworks in constructing quality service delivery and intersectoral integration. Review of PNAE and federal government technical documents and studies, legislation, minutes of meetings and official documents of the National Council of Food and Nutrition Security from 2003 to 2011. Food insecurity has decreased significantly in Brazil in the last decade, indicating that appropriate choices were made in terms of public policies and institutional arrangements, which other countries can learn from. Brazil food and nutrition security system; school feeding; school food. Brazil's integrated food and nutrition security policy approach promoted intersectorality in the food system, articulating actions to guarantee access to healthy food and to strengthen family farming. The quality of school meals has progressively improved; in particular, the availability of fruits and vegetables increased. However, national standards regarding menu composition have not yet been met. Regulations were an important factor, along with the policy approach linking food production, nutrition, health and education. Challenges are related to conflict of interests and to farmers' insufficient capacity to meet supply requirements and comply with technical procedures. Local food production, school meals and nutrition education can be linked through integrated programmes and policies, improving access to healthier foods. Government leadership, strong legislation, civil society participation and intersectoral decision making are determinant.

Framework Programmable Platform for the Advanced Software Development Workstation (FPP/ASDW). Demonstration framework document. Volume 1: Concepts and activity descriptions

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Dewitte, Paul S.; Crump, John W.; Ackley, Keith A.

1992-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at effectively combining tool and data integration mechanisms with a model of the software development process to provide an intelligent integrated software development environment. Guided by the model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated. The Advanced Software Development Workstation (ASDW) program is conducting research into development of advanced technologies for Computer Aided Software Engineering (CASE).

Programmable Automated Welding System (PAWS)

NASA Technical Reports Server (NTRS)

Kline, Martin D.

1994-01-01

An ambitious project to develop an advanced, automated welding system is being funded as part of the Navy Joining Center with Babcock & Wilcox as the prime integrator. This program, the Programmable Automated Welding System (PAWS), involves the integration of both planning and real-time control activities. Planning functions include the development of a graphical decision support system within a standard, portable environment. Real-time control functions include the development of a modular, intelligent, real-time control system and the integration of a number of welding process sensors. This paper presents each of these components of the PAWS and discusses how they can be utilized to automate the welding operation.

Developments in veterinary herd health programmes on dairy farms: a review.

PubMed

Noordhuizen, J P; Wentink, G H

2001-11-01

This review article addresses some major developments in herd health programmes for dairy farms over the last decades. It focuses particularly on herd health and production management programmes that use protocols and monitoring activities. The article further emphasizes the need for merging herd health programmes with quantitative epidemiological principles and methods. Subsequently, this article points to the latest developments regarding quality assurance in the dairy sector and some quality management methods. Quality should be regarded in its broadest sense. The importance of integrating veterinary herd health programmes and quality (risk) management support at a dairy farm level is stressed. Examples are provided.

Design of microcontroller based system for automation of streak camera.

PubMed

Joshi, M J; Upadhyay, J; Deshpande, P P; Sharma, M L; Navathe, C P

2010-08-01

A microcontroller based system has been developed for automation of the S-20 optical streak camera, which is used as a diagnostic tool to measure ultrafast light phenomenon. An 8 bit MCS family microcontroller is employed to generate all control signals for the streak camera. All biasing voltages required for various electrodes of the tubes are generated using dc-to-dc converters. A high voltage ramp signal is generated through a step generator unit followed by an integrator circuit and is applied to the camera's deflecting plates. The slope of the ramp can be changed by varying values of the capacitor and inductor. A programmable digital delay generator has been developed for synchronization of ramp signal with the optical signal. An independent hardwired interlock circuit has been developed for machine safety. A LABVIEW based graphical user interface has been developed which enables the user to program the settings of the camera and capture the image. The image is displayed with intensity profiles along horizontal and vertical axes. The streak camera was calibrated using nanosecond and femtosecond lasers.

Design of microcontroller based system for automation of streak camera

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

Joshi, M. J.; Upadhyay, J.; Deshpande, P. P.

2010-08-15

A microcontroller based system has been developed for automation of the S-20 optical streak camera, which is used as a diagnostic tool to measure ultrafast light phenomenon. An 8 bit MCS family microcontroller is employed to generate all control signals for the streak camera. All biasing voltages required for various electrodes of the tubes are generated using dc-to-dc converters. A high voltage ramp signal is generated through a step generator unit followed by an integrator circuit and is applied to the camera's deflecting plates. The slope of the ramp can be changed by varying values of the capacitor and inductor.more » A programmable digital delay generator has been developed for synchronization of ramp signal with the optical signal. An independent hardwired interlock circuit has been developed for machine safety. A LABVIEW based graphical user interface has been developed which enables the user to program the settings of the camera and capture the image. The image is displayed with intensity profiles along horizontal and vertical axes. The streak camera was calibrated using nanosecond and femtosecond lasers.« less

An Investigation of Learning Efficacy, Management Difficulties and Improvements in Tertiary CLIL (Content and Language Integrated Learning) Programmes in Taiwan: A Survey of Stakeholder Perspectives

ERIC Educational Resources Information Center

Yang, Wenhsien

2016-01-01

In 2011, Taiwan's Ministry of Education conducted a national-scale appraisal of 92 CLIL programmes. However, we lack an effective model for examining by precisely how much improvement in the quality of the CLIL programmes will rise as a consequence of the increased language proficiency and the acquisition of disciplinary knowledge. To gain greater…

Academic Workload Planning for Open and Distance Learning (ODL) Universities: The Experience of National Open University of Nigeria (NOUN)

ERIC Educational Resources Information Center

Inegbedion, Juliet Obhajajie

2017-01-01

The quality of the programmes and courses in ODL depends on the academics that plan the programmes, develop the curriculum, manage courses and programmes and carry out administrative duties. It is observed that the academics often complain of work overload. It also appears there is a mix-up in integrating the mode of planning workload in the…

Vertical integration strategies: revenue effects in hospital and Medicare markets.

PubMed

Cody, M

1996-01-01

The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.

The social control of energy: A case for the promise of decentralized solar technologies

NASA Astrophysics Data System (ADS)

Gilmer, R. W.

1980-05-01

Decentralized solar technology and centralized electric utilities were contrasted in the ways they assign property rights in capital and energy output; in the assignment of operational control; and in the means of monitoring, policing, and enforcing property rights. An analogy was drawn between the decision of an energy consumer to use decentralized solar and the decision of a firm to vertically integrate, that is, to extend the boundary of a the firm to vertically integrate, that is, to extend the boundary of the firm by making inputs or further processing output. Decentralized solar energy production offers the small energy consumer the chance to cut ties to outside suppliers--to vertically integrate energy production into the home or business. The development of this analogy provides insight into important noneconomic aspects of solar energy, and it points clearly to the lighter burdens of social management offered by decentralized solar technology.

A partnership model of early intervention in psychosis programme--a Canadian experience.

PubMed

Oyewumi, Lamidi Kola; Savage, Troy

2009-08-01

To describe how a new partnership model of early intervention in psychosis, early intervention in psychosis (EIP) programme delivery in Canada attracted the interest of the community and acquired government funding. The process by which a few individuals used a conceptual framework of integrated, collaborative, flexible and recovery focused principles to engage community partners and attract government funding is described. The establishment of a small EIP programme and its expansion to a regional programme serving an area of 20,000 square kilometers and a population of approximately 500,000 people were achieved. A programme specific logic prototype was developed. A synergy of public, private and academic services emerged with an infrastructure for ongoing cohesiveness and productivity. Annual clinic visits increased from 641 in 2002 to 1904 in 2007 and annual new patients enrollments grew from 46 to 128 within the same period. Staffing grew from an interdisciplinary staff of 1.5 full-time equivalent (FTE) to the current 10.0 FTE. A carefully orchestrated programme organization that is inclusive rather than exclusive can produce a balance of evidence-based best practices in client focused service, community mental health integration and academic productivity. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

Future launcher demonstrator. Challenge and pathfinder

NASA Astrophysics Data System (ADS)

Kleinau, W.; Guerra, L.; Parkinson, R. C.; Lieberherr, J. F.

1996-02-01

For future and advanced launch vehicles emphasis is focused on single-stage-to-orbit (SSTO) concepts and on completely reusable versions with the goal to reduce the recurrent launch cost, to improve the mission success probability and also safety for the space transportation of economically attractive payloads into Low Earth Orbit. Both issues, the SSTO launcher and the low cost reusability are extremely challenging and cannot be proven by studies and on-ground tests alone. In-flight demonstration tests are required to verify the assumptions and the new technologies, and to justify the new launcher-and operations-concepts. Because a number of SSTO launch vehicles are currently under discussion in terms of configurations and concepts such as winged vehicles for vertical or horizontal launch and landing (from ground or a flying platform), or wingless vehicles for vertical take-off and landing, and also in terms of propulsion (pure rockets or a combination of air breathing and rocket engines), an experimental demonstrator vehicle appears necessary in order to serve as a pathfinder in this area of multiple challenges. A suborbital Reusable Rocket Launcher Demonstrator (RRLD) has been studied recently by a European industrial team for ESA. This is a multipurpose, evolutionary demonstrator, conceived around a modular approach of incremental improvements of subsystems and materials, to achieve a better propellant mass fraction i.e. a better performance, and specifically for the accomplishment of an incremental flight test programme. While the RRLD basic test programme will acquire knowledge about hypersonic flight, re-entry and landing of a cryogenic rocket propelled launcher — and the low cost reusability (short turnaround on ground) in the utilization programme beyond basic testing, the RRLD will serve as a test bed for generic testing of technologies required for the realization of an SSTO launcher. This paper will present the results of the European RRLD study which proposes a winged suborbital rocket launcher operations & technology demonstrator for vertical take-off and horizontal landing — using primarily conventional technology and materials as a first step towards the challenging goal of a reusable SSTO ETO launch vehicle.

75 FR 27613 - Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... primary matters to be considered include: --Adoption of the agenda --Work of other bodies and... Scheme --Programme on the integration of women in the maritime sector --Institutional development and... Goals --Work programme --Any other business --Election of the Chairman and Vice-Chairman for 2011...

In-situ Testing of the EHT High Gain and Frequency Ultra-Stable Integrators

NASA Astrophysics Data System (ADS)

Miller, Kenneth; Ziemba, Timothy; Prager, James; Slobodov, Ilia; Lotz, Dan

2014-10-01

Eagle Harbor Technologies (EHT) has developed a long-pulse integrator that exceeds the ITER specification for integration error and pulse duration. During the Phase I program, EHT improved the RPPL short-pulse integrators, added a fast digital reset, and demonstrated that the new integrators exceed the ITER integration error and pulse duration requirements. In Phase II, EHT developed Field Programmable Gate Array (FPGA) software that allows for integrator control and real-time signal digitization and processing. In the second year of Phase II, the EHT integrator will be tested at a validation platform experiment (HIT-SI) and tokamak (DIII-D). In the Phase IIB program, EHT will continue development of the EHT integrator to reduce overall cost per channel. EHT will test lower cost components, move to surface mount components, and add an onboard Field Programmable Gate Array and data acquisition to produce a stand-alone system with lower cost per channel and increased the channel density. EHT will test the Phase IIB integrator at a validation platform experiment (HIT-SI) and tokamak (DIII-D). Work supported by the DOE under Contract Number (DE-SC0006281).

ROBOCAL: Gamma-ray isotopic hardware/software interface

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

Hurd, J.R.; Bonner, C.A.; Ostenak, C.A.

1989-01-01

ROBOCAL, presently being developed at the Los Alamos National Laboratory, is a full-scale prototypical robotic system for remotely performing calorimetric and gamma-ray isotopics measurements of nuclear materials. It features a fully automated vertical stacker-retriever for storing and retrieving packaged nuclear materials from a multi-drawer system, and a fully automated, uniquely integrated gantry robot for programmable selection and transfer of nuclear materials to calorimetric and gamma-ray isotopic measurement stations. Since ROBOCAL is to require almost no operator intervention, a mechanical control system is required in addition to a totally automated assay system. The assay system must be a completely integrated datamore » acquisition and isotopic analysis package fully capable of performing state-of-the-art homogeneous and heterogeneous analyses on many varied matrices. The TRIFID assay system being discussed at this conference by J. G. Fleissner of the Rocky Flats Plant has been adopted because of its many automated features. These include: MCA/ADC setup and acquisition; spectral storage and analysis utilizing an expert system formalism; report generation with internal measurement control printout; user friendly screens and menus. The mechanical control portion consists primarily of two detector platforms and a sample platform, each with independent movement. Some minor modifications and additions are needed with TRIFID to interface the assay and mechanical portions with the CimRoc 4000 software controlling the robot. 6 refs., 5 figs., 3 tabs.« less

A community continuity programme: volunteer faculty mentors and continuity learning.

PubMed

McGeehan, John; English, Richard; Shenberger, Keith; Tracy, Gerald; Smego, Raymond

2013-02-01

Longitudinal generalist preceptorship experiences early in medical education can have beneficial effects on how students practise the art and science of medicine, regardless of their eventual career choices. We evaluated the first 2 years of implementation of an integrated, regional campus-based, early clinical experience programme, the Community Continuity Program, at our new community-based medical school that is under the supervision of volunteer primary care faculty members acting as continuity mentors (CMs). Curricular components for years 1 and 2 consisted of three annual 1-week community-based experiences with CMs, extensive physical diagnosis practice, interprofessional learning activities, a multigenerational family care experience, a mandatory Community Health Research Project (CHRP) in year 1 and a mandatory Quality Improvement Project in year 2. Outcome measures included student, faculty member and programme evaluations, student reflective narratives in portal-based e-journals, a Liaison Committee on Medical Education (LCME) self-study student survey and serial level-of-empathy surveys.   Students found all elements of this integrated community experience programme beneficial and worthwhile, especially the CMs and the use of standardised and real-life patients. CMs noted effective and professional student-patient interactions. The number of reflective e-journal postings per student during year1 ranged from 14 to 81 (mean, 47). Serial empathy questionnaires administered over 2 years demonstrated preservation of student empathy, and students believed that the programme had a positive effect on their personal level of empathy.   An integrative, longitudinal, community-based, early clinical experience programme driven by volunteer CMs provides patient-centered instruction for preclinical students in the clinical, social, behavioural, ethical and research foundations of medicine. © Blackwell Publishing Ltd 2013.

Description of the computations and pilot procedures for planning fuel-conservative descents with a small programmable calculator

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

Vicroy, D.D.; Knox, C.E.

A simplified flight management descent algorithm was developed and programmed on a small programmable calculator. It was designed to aid the pilot in planning and executing a fuel conservative descent to arrive at a metering fix at a time designated by the air traffic control system. The algorithm may also be used for planning fuel conservative descents when time is not a consideration. The descent path was calculated for a constant Mach/airspeed schedule from linear approximations of airplane performance with considerations given for gross weight, wind, and nonstandard temperature effects. The flight management descent algorithm and the vertical performance modelingmore » required for the DC-10 airplane is described.« less

Vertically integrated, three-dimensional nanowire complementary metal-oxide-semiconductor circuits.

PubMed

Nam, SungWoo; Jiang, Xiaocheng; Xiong, Qihua; Ham, Donhee; Lieber, Charles M

2009-12-15

Three-dimensional (3D), multi-transistor-layer, integrated circuits represent an important technological pursuit promising advantages in integration density, operation speed, and power consumption compared with 2D circuits. We report fully functional, 3D integrated complementary metal-oxide-semiconductor (CMOS) circuits based on separate interconnected layers of high-mobility n-type indium arsenide (n-InAs) and p-type germanium/silicon core/shell (p-Ge/Si) nanowire (NW) field-effect transistors (FETs). The DC voltage output (V(out)) versus input (V(in)) response of vertically interconnected CMOS inverters showed sharp switching at close to the ideal value of one-half the supply voltage and, moreover, exhibited substantial DC gain of approximately 45. The gain and the rail-to-rail output switching are consistent with the large noise margin and minimal static power consumption of CMOS. Vertically interconnected, three-stage CMOS ring oscillators were also fabricated by using layer-1 InAs NW n-FETs and layer-2 Ge/Si NW p-FETs. Significantly, measurements of these circuits demonstrated stable, self-sustained oscillations with a maximum frequency of 108 MHz, which represents the highest-frequency integrated circuit based on chemically synthesized nanoscale materials. These results highlight the flexibility of bottom-up assembly of distinct nanoscale materials and suggest substantial promise for 3D integrated circuits.

A highly accurate analytical solution for the surface fields of a short vertical wire antenna lying on a multilayer ground

NASA Astrophysics Data System (ADS)

Parise, M.

2018-01-01

A highly accurate analytical solution is derived to the electromagnetic problem of a short vertical wire antenna located on a stratified ground. The derivation consists of three steps. First, the integration path of the integrals describing the fields of the dipole is deformed and wrapped around the pole singularities and the two vertical branch cuts of the integrands located in the upper half of the complex plane. This allows to decompose the radiated field into its three contributions, namely the above-surface ground wave, the lateral wave, and the trapped surface waves. Next, the square root terms responsible for the branch cuts are extracted from the integrands of the branch-cut integrals. Finally, the extracted square roots are replaced with their rational representations according to Newton's square root algorithm, and residue theorem is applied to give explicit expressions, in series form, for the fields. The rigorous integration procedure and the convergence of square root algorithm ensure that the obtained formulas converge to the exact solution. Numerical simulations are performed to show the validity and robustness of the developed formulation, as well as its advantages in terms of time cost over standard numerical integration procedures.

Introduction of vertical integration and case-based learning in anatomy for undergraduate physical therapy and occupational therapy students.

PubMed

Parmar, Suresh K; Rathinam, Bertha A D

2011-01-01

The purpose of the present pilot study was to evaluate the benefits of innovative teaching methodologies introduced to final year occupational and physical therapy students in Christian Medical College in India. Students' satisfactions along the long-term retention of knowledge and clinical application of the respiratory anatomy have been assessed. The final year undergraduate physical therapy and occupational therapy students had respiratory anatomy teaching over two sessions. The teaching involved case-based learning and integrated anatomy lectures (vertical integration) with the Anatomy department. Pretest and immediate and follow-up post-tests were conducted to assess the effectiveness of the innovative methods. A feedback questionnaire was marked to grade case-based learning. The method of integrated and case-based teaching was appreciated and found to be useful in imparting knowledge to the students. Students retained the gained knowledge adequately and the same was inferred by statistically significant improvement in both post-test scores. Vertical integration of anatomy in the final year reinforces their existing knowledge of anatomy. Case-based learning may facilitate the development of effective and clinically sound therapists. Copyright © 2011 American Association of Anatomists.

Gender counts: A systematic review of evaluations of gender-integrated health interventions in low- and middle-income countries.

PubMed

Schriver, Brittany; Mandal, Mahua; Muralidharan, Arundati; Nwosu, Anthony; Dayal, Radhika; Das, Madhumita; Fehringer, Jessica

2017-11-01

As a result of new global priorities, there is a growing need for high-quality evaluations of gender-integrated health programmes. This systematic review examined 99 peer-reviewed articles on evaluations of gender-integrated (accommodating and transformative) health programmes with regard to their theory of change (ToC), study design, gender integration in data collection, analysis, and gender measures used. Half of the evaluations explicitly described a ToC or conceptual framework (n = 50) that guided strategies for their interventions. Over half (61%) of the evaluations used quantitative methods exclusively; 11% used qualitative methods exclusively; and 28% used mixed methods. Qualitative methods were not commonly detailed. Evaluations of transformative interventions were less likely than those of accommodating interventions to employ randomised control trials. Two-thirds of the reviewed evaluations reported including at least one specific gender-related outcome (n = 18 accommodating, n = 44 transformative). To strengthen evaluations of gender-integrated programmes, we recommend use of ToCs, explicitly including gender in the ToC, use of gender-sensitive measures, mixed-method designs, in-depth descriptions of qualitative methods, and attention to gender-related factors in data collection logistics. We also recommend further research to develop valid and reliable gender measures that are globally relevant.

Two-dimensional non-volatile programmable p-n junctions

NASA Astrophysics Data System (ADS)

Li, Dong; Chen, Mingyuan; Sun, Zhengzong; Yu, Peng; Liu, Zheng; Ajayan, Pulickel M.; Zhang, Zengxing

2017-09-01

Semiconductor p-n junctions are the elementary building blocks of most electronic and optoelectronic devices. The need for their miniaturization has fuelled the rapid growth of interest in two-dimensional (2D) materials. However, the performance of a p-n junction considerably degrades as its thickness approaches a few nanometres and traditional technologies, such as doping and implantation, become invalid at the nanoscale. Here we report stable non-volatile programmable p-n junctions fabricated from the vertically stacked all-2D semiconductor/insulator/metal layers (WSe2/hexagonal boron nitride/graphene) in a semifloating gate field-effect transistor configuration. The junction exhibits a good rectifying behaviour with a rectification ratio of 104 and photovoltaic properties with a power conversion efficiency up to 4.1% under a 6.8 nW light. Based on the non-volatile programmable properties controlled by gate voltages, the 2D p-n junctions have been exploited for various electronic and optoelectronic applications, such as memories, photovoltaics, logic rectifiers and logic optoelectronic circuits.

Two-dimensional non-volatile programmable p-n junctions.

PubMed

Li, Dong; Chen, Mingyuan; Sun, Zhengzong; Yu, Peng; Liu, Zheng; Ajayan, Pulickel M; Zhang, Zengxing

2017-09-01

Semiconductor p-n junctions are the elementary building blocks of most electronic and optoelectronic devices. The need for their miniaturization has fuelled the rapid growth of interest in two-dimensional (2D) materials. However, the performance of a p-n junction considerably degrades as its thickness approaches a few nanometres and traditional technologies, such as doping and implantation, become invalid at the nanoscale. Here we report stable non-volatile programmable p-n junctions fabricated from the vertically stacked all-2D semiconductor/insulator/metal layers (WSe 2 /hexagonal boron nitride/graphene) in a semifloating gate field-effect transistor configuration. The junction exhibits a good rectifying behaviour with a rectification ratio of 10 4 and photovoltaic properties with a power conversion efficiency up to 4.1% under a 6.8 nW light. Based on the non-volatile programmable properties controlled by gate voltages, the 2D p-n junctions have been exploited for various electronic and optoelectronic applications, such as memories, photovoltaics, logic rectifiers and logic optoelectronic circuits.

Polio programme: let us declare victory and move on.

PubMed

Vashisht, Neetu; Puliyel, Jacob

2012-01-01

It was hoped that following polio eradication, immunisation could be stopped. However the synthesis of polio virus in 2002, made eradication impossible. It is argued that getting poor countries to expend their scarce resources on an impossible dream over the last 10 years was unethical. Furthermore, while India has been polio-free for a year, there has been a huge increase in non-polio acute flaccid paralysis (NPAFP). In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated. The principle of primum-non-nocere was violated. The authors suggest that the huge bill of US$ 8 billion spent on the programme, is a small sum to pay if the world learns to be wary of such vertical programmes in the future.

A typology of longitudinal integrated clerkships.

PubMed

Worley, Paul; Couper, Ian; Strasser, Roger; Graves, Lisa; Cummings, Beth-Ann; Woodman, Richard; Stagg, Pamela; Hirsh, David

2016-09-01

Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases.

PubMed

Nishtar, Sania; Faruqui, Azhar M A; Mattu, Mohamad A; Mohamud, Khalif Bile; Ahmed, Ashfaq

2004-12-01

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of cardiovascular diseases (CVD) as part of a comprehensive and integrated non-communicable Disease (NCD) prevention effort. In this programme, surveillance of cardiovascular risk factors is part of an integrated population-based NCD surveillance system. The population approach to CVD prevention is a priority area in this programme with a focus on broad policy measures and behavioural change communication. The former include revision of the current policy on diet and nutrition to expand its focus on under-nutrition; the development of a physical activity policy; strategies to limit the production of, and access to, ghee as a medium for cooking and agricultural and fiscal policies that increase the demand for, and make healthy food more accessible. The programme focuses attention on improving the quality of prevention programmes within primary and basic health sites and integrates concerted primary and secondary prevention programmes into health services as part of a comprehensive and sustainable, scientifically valid, and resource-sensitive programme for all categories of healthcare providers. It promotes screening for raised blood pressure at the population level and screening for dyslipidaemia and diabetes in high-risk groups only. It highlights the need to ensure the availability of aspirin, beta blockers, thiazides, ACE inhibitors, statins and penicillin at all levels of healthcare. The programme points out the need to conduct clinical end-point trials in the native Pakistani setting to define cost-effective therapeutic strategies for primary and secondary prevention of CVDs. Emphasis is laid on building capacity of health systems in support of CVD prevention and control and building a coalition or network of organizations to add momentum to CVD prevention and control efforts.

AAO2: a general purpose CCD controller for the AAT

NASA Astrophysics Data System (ADS)

Waller, Lew; Barton, John; Mayfield, Don; Griesbach, Jason

2004-09-01

The Anglo-Australian Observatory has developed a 2nd generation optical CCD controller to replace an earlier controller used now for almost twenty years. The new AAO2 controller builds on the considerable experience gained with the first controller, the new technologies now available and the techniques developed and successfully implemented in AAO's IRIS2 detector controller. The AAO2 controller has been designed to operate a wide variety of detectors and to achieve as near to detector limited performance as possible. It is capable of reading out CCDs with one, two or four output amplifiers, each output having its own video processor and high speed 16-bit ADC. The video processor is a correlated double sampler that may be switched between low noise dual slope integration or high speed clamp and sample modes. Programmable features include low noise DAC biases, horizontal clocks with DAC controllable levels and slopes and vertical clocks with DAC controllable arbitrary waveshapes. The controller uses two DSPs; one for overall control and the other for clock signal generation, which is highly programmable, with downloadable sequences of waveform patterns. The controller incorporates a precision detector temperature controller and provides accurate exposure time control. Telemetry is provided of all DAC generated voltages, many derived voltages, power supply voltages, detector temperature and detector identification. A high speed, full duplex fibre optic interface connects the controller to a host computer. The modular design uses six to ten circuit boards, plugged in to common backplanes. Two backplanes separate noisy digital signals from low noise analog signals.

Kosmos 856 and Kosmos 914 measurements of high-energy diffuse gamma rays

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

Kalinkin, L.F.; Nagornykh, Y.I.

1982-09-01

The measurements by the Kosmos 856 and Kosmos 914 satellites of diffuse cosmic ..gamma.. rays with photon energies above 100 MeV are discussed. Integrated energy spectra for the 100--4000 MeV energy range are given for galactic lattitudes Vertical BarbVertical Bar< or =30/sup 0/ and Vertical BarbVertical Bar>30/sup 0/. The form of the spectra suggests that at high lattitudes there may still be some contribution from the galactic component.

Restoring integrity—A grounded theory of coping with a fast track surgery programme

PubMed Central

Jørgensen, Lene Bastrup; Fridlund, Bengt

2016-01-01

Aims and objectives The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Background Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. Design The study design used classical grounded theory. Methods The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Results Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients’ main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. Conclusion In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme. PMID:26751199

[Public Health as an Applied, Multidisciplinary Subject: Is Research-Based Learning the Answer to Challenges in Learning and Teaching?

PubMed

Gerhardus, A; Schilling, I; Voss, M

2017-03-01

Public health education aims at enabling students to deal with complex health-related challenges using appropriate methods based on sound theoretical understanding. Virtually all health-related problems in science and practice require the involvement of different disciplines. However, the necessary interdisciplinarity is only partly reflected in the curricula of public health courses. Also theories, methods, health topics, and their application are often taught side-by-side and not together. For students, it can become an insurmountable challenge to integrate the different disciplines ("horizontal integration") and theories, methods, health topics, and their application ("vertical integration"). This situation is specific for education in public health but is representative for other interdisciplinary fields as well. Several approaches are available to achieve the horizontal integration of different disciplines and vertical integration of theories, methods, health topics, and their application. A curriculum that is structured by topics, rather than disciplines might be more successful in integrating different disciplines. Vertical integration can be achieved by research-based learning. Research-based learning places a student-led research project at the centre of teaching. Students choose a topic and a research question, raise their own questions for theories and methods and will hopefully cross the seeming chasm between science and practice. Challenges of research-based learning are enhanced demands on students, teachers and curriculum design. © Georg Thieme Verlag KG Stuttgart · New York.

Spherical integral transforms of second-order gravitational tensor components onto third-order gravitational tensor components

NASA Astrophysics Data System (ADS)

Šprlák, Michal; Novák, Pavel

2017-02-01

New spherical integral formulas between components of the second- and third-order gravitational tensors are formulated in this article. First, we review the nomenclature and basic properties of the second- and third-order gravitational tensors. Initial points of mathematical derivations, i.e., the second- and third-order differential operators defined in the spherical local North-oriented reference frame and the analytical solutions of the gradiometric boundary-value problem, are also summarized. Secondly, we apply the third-order differential operators to the analytical solutions of the gradiometric boundary-value problem which gives 30 new integral formulas transforming (1) vertical-vertical, (2) vertical-horizontal and (3) horizontal-horizontal second-order gravitational tensor components onto their third-order counterparts. Using spherical polar coordinates related sub-integral kernels can efficiently be decomposed into azimuthal and isotropic parts. Both spectral and closed forms of the isotropic kernels are provided and their limits are investigated. Thirdly, numerical experiments are performed to test the consistency of the new integral transforms and to investigate properties of the sub-integral kernels. The new mathematical apparatus is valid for any harmonic potential field and may be exploited, e.g., when gravitational/magnetic second- and third-order tensor components become available in the future. The new integral formulas also extend the well-known Meissl diagram and enrich the theoretical apparatus of geodesy.

Ultra-low crosstalk, CMOS compatible waveguide crossings for densely integrated photonic interconnection networks.

PubMed

Jones, Adam M; DeRose, Christopher T; Lentine, Anthony L; Trotter, Douglas C; Starbuck, Andrew L; Norwood, Robert A

2013-05-20

We explore the design space for optimizing CMOS compatible waveguide crossings on a silicon photonics platform. This paper presents simulated and experimental excess loss and crosstalk suppression data for vertically integrated silicon nitride over silicon-on-insulator waveguide crossings. Experimental results show crosstalk suppression exceeding -49/-44 dB with simulation results as low as -65/-60 dB for the TE/TM mode in a waveguide crossing with a 410 nm vertical gap.

The Utilization of Starute Decelerators for Improved Upper Atmosphere Measurements

DTIC Science & Technology

1974-12-01

34 ECOM-5489, May 1973. 17. Miller, Walter B., and Donald R. Veazey , "An Integrated Error Description of Active and Passive Balloon Tracking Systems," ECOM...20. Miller, Walter B., and Donald R. Veazey , "Vertical Efficiency of Active and Passive Balloon Tracking Systems from a Standpoint of Integrated Error...5542, May 1974. 60. Miller, Walter B., and Donald R. Veazey , "On Increasing Vertical Efficiency of a Passive Balloon Tracking Device by Optimal Choice

Vertical integration of biochemistry and clinical medicine using a near-peer learning model.

PubMed

Gallan, Alexander J; Offner, Gwynneth D; Symes, Karen

2016-11-12

Vertical integration has been extensively implemented across medical school curricula but has not been widely attempted in the field of biochemistry. We describe a novel curricular innovation in which a near-peer learning model was used to implement vertical integration in our medical school biochemistry course. Senior medical students developed and facilitated a case-based small group session for first year biochemistry students. Students were surveyed before and after the session on their attitudes about biochemistry, as well as the effectiveness of the session. Prior to the session, the students believed biochemistry was more important to understanding the basic science of medicine than it was to understanding clinical medicine or becoming a good physician. The session improved students' attitudes about the importance of biochemistry in clinical medicine, and after the session they now believe that understanding biochemistry is equally important to the basic sciences as clinical medicine. Students would like more sessions and believe the senior student facilitators were knowledgeable and effective teachers. The facilitators believe they improved their teaching skills. This novel combination of near-peer learning and vertical integration in biochemistry provided great benefit to both first year and senior medical students, and can serve as a model for other institutions. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):507-516, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

Disability management in a sample of Australian self-insured companies.

PubMed

Westmorland, M; Buys, N; Clements, N

2002-09-20

Disability management (DM) is a term developed in North America and refers to the prevention and management of injury and illness in the workplace. The purpose of this paper is to report findings of an Australian study that examined whether self-insured employers in that country have implemented integrated DM programmes. Key principles underpinning such programmes are explored to identify the extent to which Australian employers have adopted them. Data was collected from 29 self-insured Australian companies in three Australian States using a structured interview format with additional open-ended questions. It was found that companies have in place, to varying degrees, some of the key elements of disability management programmes. However, these elements were often not well integrated in a comprehensive disability management approach. The focus on workplace-based, early intervention in the area of return to work for injured employees was particularly strong, but there was little evidence of formal labour-management committee structures responsible for implementing DM programmes. If the concept of DM is relevant to the Australian environment then this study would suggest that self-insured companies need to undertake further work to develop integrated approaches to preventing and managing disability in the workplace. Several limitations of this study are highlighted and it is concluded that further work in this area is needed.

Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life.

PubMed

Lambeek, Ludeke C; van Mechelen, Willem; Knol, Dirk L; Loisel, Patrick; Anema, Johannes R

2010-03-16

To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. Population based randomised controlled trial. Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals). 134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain. Patients were randomly assigned to usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly. The integrated care programme substantially reduced disability due to chronic low back pain in private and working life. Trial registration Current Controlled Trials ISRCTN28478651.

Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock.

PubMed

Li, Albert S; Berger, Kenneth I; Schwartz, David R; Slater, William R; Goldfarb, David S

2014-04-12

In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists-a cardiologist, a pulmonologist, and a nephrologist-jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient's presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students' minds.

Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock

PubMed Central

2014-01-01

Background In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. Methods An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists—a cardiologist, a pulmonologist, and a nephrologist—jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient’s presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. Results Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. Conclusions Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students’ minds. PMID:24725336

Low-voltage organic electronics based on a gate-tunable injection barrier in vertical graphene-organic semiconductor heterostructures.

PubMed

Hlaing, Htay; Kim, Chang-Hyun; Carta, Fabio; Nam, Chang-Yong; Barton, Rob A; Petrone, Nicholas; Hone, James; Kymissis, Ioannis

2015-01-14

The vertical integration of graphene with inorganic semiconductors, oxide semiconductors, and newly emerging layered materials has recently been demonstrated as a promising route toward novel electronic and optoelectronic devices. Here, we report organic thin film transistors based on vertical heterojunctions of graphene and organic semiconductors. In these thin heterostructure devices, current modulation is accomplished by tuning of the injection barriers at the semiconductor/graphene interface with the application of a gate voltage. N-channel devices fabricated with a thin layer of C60 show a room temperature on/off ratio >10(4) and current density of up to 44 mAcm(-2). Because of the ultrashort channel intrinsic to the vertical structure, the device is fully operational at a driving voltage of 200 mV. A complementary p-channel device is also investigated, and a logic inverter based on two complementary transistors is demonstrated. The vertical integration of graphene with organic semiconductors via simple, scalable, and low-temperature fabrication processes opens up new opportunities to realize flexible, transparent organic electronic, and optoelectronic devices.

Noninvasive Label-Free Detection of Micrometastases in the Lymphatics with Ultrasound-Guided Photoacoustic Imaging

DTIC Science & Technology

2015-10-01

imaging can be used to guide dissection. We have also successfully integrated a programmable ultrasound machine (Verasonics Vantage ) and tunable pulsed...Mobile HE) with the programmable ultrasound machine (Verasonics Vantage ). We have synchronized the signals to enable interleaved acquisition of US

Conceptualizing Programme Evaluation

ERIC Educational Resources Information Center

Hassan, Salochana

2013-01-01

The main thrust of this paper deals with the conceptualization of theory-driven evaluation pertaining to a tutor training programme. Conceptualization of evaluation, in this case, is an integration between a conceptualization model as well as a theoretical framework in the form of activity theory. Existing examples of frameworks of programme…

Gyro Systems (Selected Pages),

DTIC Science & Technology

1982-03-19

of the oil wells, etc. With the aid of gyro systems determine the direction of meridian and true vertical, measure the angular velocities and the...integrating gyroscopes, gyrostabilizers, course gyro systems, gyroscopic sensors of the direction of the true vertical and inertial systems. The action of...direction of the true vertical are the gyro stabilizer, corrected with the aid of the inductive or magnetic detector, the physical pendulum, the local

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

PubMed

Maher, Dermot

2010-07-05

The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways of joint planning and joint funding of integrated delivery as part of strengthened health systems. As both a danger and an opportunity, the global financial crisis may entail disaster or recovery for global health sector efforts for HIV and tuberculosis epidemic control. Review of policies and progress in control paves the way for identification of synergies between the two programmes, within strengthened health services. The silver lining in the global economic crisis could be better control of the HIV and tuberculosis epidemics, better overall health system performance and outcomes, and better value for money.

Interdisciplinary Social Science: An Example of Vertical and Horizontal Integrative Strategies

NASA Astrophysics Data System (ADS)

Durlabhji, Subhash

2005-03-01

A "Concept-Centered" strategy for Integrative Studies was proposed and implemented in the creation of the book Power in Focus: Perspectives from Multiple Disciplines. Essays on the ubiquitous concept of Power were solicited internationally and a final cut of ten essays from ten different disciplines, written specifically for this project, were included. This provides an example of what might be called Horizontal Integration, as it cut across multiple disciplines. One of the essays in the volume provides an example of Vertical Integration, as it applies a psychodynamic hypothesis concerning the development of Power relations among humans across hierarchical levels, from the child to the family to other groups and institutions in society, including finally entire nations and regions of the world.

Integration of MATLAB Simulink(Registered Trademark) Models with the Vertical Motion Simulator

NASA Technical Reports Server (NTRS)

Lewis, Emily K.; Vuong, Nghia D.

2012-01-01

This paper describes the integration of MATLAB Simulink(Registered TradeMark) models into the Vertical Motion Simulator (VMS) at NASA Ames Research Center. The VMS is a high-fidelity, large motion flight simulator that is capable of simulating a variety of aerospace vehicles. Integrating MATLAB Simulink models into the VMS needed to retain the development flexibility of the MATLAB environment and allow rapid deployment of model changes. The process developed at the VMS was used successfully in a number of recent simulation experiments. This accomplishment demonstrated that the model integrity was preserved, while working within the hard real-time run environment of the VMS architecture, and maintaining the unique flexibility of the VMS to meet diverse research requirements.

Post-acute care and vertical integration after the Patient Protection and Affordable Care Act.

PubMed

Shay, Patrick D; Mick, Stephen S

2013-01-01

The anticipated changes resulting from the passage of the Patient Protection and Affordable Care Act-including the proposed adoption of bundled payment systems and the promotion of accountable care organizations-have generated considerable controversy as U.S. healthcare industry observers debate whether such changes will motivate vertical integration activity. Using examples of accountable care organizations and bundled payment systems in the American post-acute healthcare sector, this article applies economic and sociological perspectives from organization theory to predict that as acute care organizations vary in the degree to which they experience environmental uncertainty, asset specificity, and network embeddedness, their motivation to integrate post-acute care services will also vary, resulting in a spectrum of integrative behavior.

Ground-based aerosol measurements during CHARMEX/ADRIMED campaign at Granada station

NASA Astrophysics Data System (ADS)

Granados-Muñoz, Maria Jose; Bravo-Aranda, Juan Antonio; Navas-Guzman, Francisco; Guerro-Rascado, Juan Luis; Titos, Gloria; Lyamani, Hassan; Valenzuela, Antonio; Cazorla, Alberto; Olmo, Francisco Jose; Mallet, Marc; Alados-Arboledas, Lucas

2015-04-01

In the framework of ChArMEx/ADRIMED (Chemistry-Aerosol Mediterranean Experiment, http://charmex.lsce.ipsl.fr/; Aerosol Direct Radiative Impact on the regional climate in the MEDiterranean region) projects, a field experiment based on in situ and remote sensing measurements from surface and airborne platforms was performed. The ADRIMED project aimed to capture the high complexity of the Mediterranean region by using an integrated approach based on intensive experimental field campaign and spaceborne observations, radiative transfer calculations and climate modelling with Regional Climate Models better adapted than global circulation models. For this purpose, measurements were performed at different surface super-sites (including Granada station) over the Occidental Mediterranean region during summer 2013 for creating an updated database of the physical, chemical, optical properties and the vertical distribution of the major "Mediterranean aerosols". Namely, measurements at Granada station were performed on 16 and 17 July 2013, in coincidence with the overpasses of the ATR aircraft over the station. The instrumentation used for the campaign includes both remote sensing instruments (a multiwavelength Raman lidar and a sun photometer) and in-situ measurements (a nephelometer, a Multi-Angle Absorption Photometer (MAAP), an Aerodynamic particle sizer (APS), a high volume sampler of PM10 and an aethalometer). During the measurement period a mineral dust event was detected, with similar dust load on both days. According to in-situ measurements, the event reached the surface level on 16 of June. Vertically resolved lidar measurements indicated presence of mineral dust layers up to 5 km asl both on 16 and 17 June 2013. Temporal evolution analysis indicated that on 17 June the dust layer decoupled from the boundary layer and disappeared around 14:00 UTC. In addition, lidar and sun-photometer data were used to retrieve volume concentration profiles by means of LIRIC (Lidar-Radiometer Inversion Code algorithm) [Chaikovsky et al., 2008]. The retrieved volume concentration profiles were compared with data from ATR flights above the station at 14:30 UTC on 16 June and 07:30 UTC on 17 June, obtaining in general good agreement in the location of the aerosol layers and discrepancies in the volume concentration values ranging between 15 and 40 µm3/cm3 for the coarse mode. References: Chaikovsky, A., O. Dubovik, et a., (2008), Software package for the retrieval of aerosol microphysical properties in the vertical column using combined lidar/photometer data, Tech. Rep., Institute of Physics, National Academy of Sciences of Belarus. Acknowledgments: EARLINET lidar measurements are supported by the 7th Framework Programme project Aerosols, Clouds, and Trace Gases Research Infrastructure Network (ACTRIS) (grant agreement no. 262254). The field campaign was performed in the framework of work package 4 on aerosol-radiation-climate interactions of the coordinated programme ChArMEx.

Optical programmable metamaterials

NASA Astrophysics Data System (ADS)

Gong, Cheng; Zhang, Nan; Dai, Zijie; Liu, Weiwei

2018-02-01

We suggest and demonstrate the concept of optical programmable metamaterials which can configure the device's electromagnetic parameters by the programmable optical stimuli. In such metamaterials, the optical stimuli produced by a FPGA controlled light emitting diode array can switch or combine the resonance modes which are coupled in. As an example, an optical programmable metamaterial terahertz absorber is proposed. Each cell of the absorber integrates four meta-rings (asymmetric 1/4 rings) with photo-resistors connecting the critical gaps. The principle and design of the metamaterials are illustrated and the simulation results demonstrate the functionalities for programming the metamaterial absorber to change its bandwidth and resonance frequency.

Biosurveillance Technology: Providing Situational Awareness through Increased Information Sharing

DTIC Science & Technology

2011-09-01

Sri Lanka, there are “separate vertical programmes [sic] to control and monitor malaria , filariasis, leprosy, respiratory diseases, human rabies...Biohazard Detection System CAP Common Alerting Protocol CDC Centers for Disease Control and Prevention CDC HAN Centers for Disease Control and Prevention...LCDHD Preparedness Program running, I always had complete and total faith that you had everything under control and you would excel at every task. To

The Cyberspace Development Dogfight: Tightening the Acquisitions Turn Circle

DTIC Science & Technology

2009-06-01

only attempted to rebrand their poor processes with this new jargon. One programmer, Steve Yegge, likened ‘Agile’ to fad diets , in that there are...were previously possible.[3] The reforms of the 1990’s reduced the “stovepipe” effect where organizations tended to limit communication vertically...efficiency rather than time-to-field efficiency or mission- effectiveness efficiency, although the JUONs process attempts to mitigate this. This is

Efficiency in the United States electric industry: Transaction costs, deregulation, and governance structures

NASA Astrophysics Data System (ADS)

Peterson, Carl

Transaction costs economics (TCE) posits that firms have an incentive to bypass the market mechanisms in situations where the cost of using the market is prohibitive. Vertical integration, among other governance mechanisms, can be used to minimize the transactions costs associated with the market mechanism. The study analyses different governance mechanisms, which range from complete vertical integration to the use of market mechanisms, for firms in the US electric sector. This sector has undergone tremendous change in the past decade including the introduction of retail competition in some jurisdictions. As a result of the push toward deregulation of the industry, vertically integration, while still significant in the sector, has steadily been replaced by alternative governance structures. Using a sample of 136 investor-owned electric utilities that reported data the US Federal Energy Regulatory Commission between 1996 and 2002, this study estimates firm level efficiency using Data Envelopment Analysis (DEA) and relates these estimates to governance structure and public policies. The analysis finds that vertical integration is positively related to firm efficiency, although in a non-linear fashion suggesting that hybrid governance structures tend to be associated with lower efficiency scores. In addition, while some evidence is found for negative short-term effects on firm efficiency from the choice to deregulate, this result is sensitive to DEA model choice. Further, competition in retail markets is found to be positively related to firm level efficiency, but the retreat from deregulation, which occurred after 2000, is negatively associated with firm-level efficiency. These results are important in the ongoing academic and public policy debates concerning deregulation of the electric section and indicate that vertical economies remain in the industry, but that competition has provided incentives for improving firm level efficiency.

Comparing the role of absolute sea-level rise and vertical tectonic motions in coastal flooding, Torres Islands (Vanuatu)

NASA Astrophysics Data System (ADS)

Ballu, Valérie; Bouin, Marie-Noëlle; Siméoni, Patricia; Crawford, Wayne C.; Calmant, Stephane; Boré, Jean-Michel; Kanas, Tony; Pelletier, Bernard

2011-08-01

Since the late 1990s, rising sea levels around the Torres Islands (north Vanuatu, southwest Pacific) have caused strong local and international concern. In 2002-2004, a village was displaced due to increasing sea incursions, and in 2005 a United Nations Environment Programme press release referred to the displaced village as perhaps the world's first climate change "refugees." We show here that vertical motions of the Torres Islands themselves dominate the apparent sea-level rise observed on the islands. From 1997 to 2009, the absolute sea level rose by 150 + /-20 mm. But GPS data reveal that the islands subsided by 117 + /-30 mm over the same time period, almost doubling the apparent gradual sea-level rise. Moreover, large earthquakes that occurred just before and after this period caused several hundreds of mm of sudden vertical motion, generating larger apparent sea-level changes than those observed during the entire intervening period. Our results show that vertical ground motions must be accounted for when evaluating sea-level change hazards in active tectonic regions. These data are needed to help communities and governments understand environmental changes and make the best decisions for their future.

Comparing the role of absolute sea-level rise and vertical tectonic motions in coastal flooding, Torres Islands (Vanuatu).

PubMed

Ballu, Valérie; Bouin, Marie-Noëlle; Siméoni, Patricia; Crawford, Wayne C; Calmant, Stephane; Boré, Jean-Michel; Kanas, Tony; Pelletier, Bernard

2011-08-09

Since the late 1990s, rising sea levels around the Torres Islands (north Vanuatu, southwest Pacific) have caused strong local and international concern. In 2002-2004, a village was displaced due to increasing sea incursions, and in 2005 a United Nations Environment Programme press release referred to the displaced village as perhaps the world's first climate change "refugees." We show here that vertical motions of the Torres Islands themselves dominate the apparent sea-level rise observed on the islands. From 1997 to 2009, the absolute sea level rose by 150 + /-20 mm. But GPS data reveal that the islands subsided by 117 + /-30 mm over the same time period, almost doubling the apparent gradual sea-level rise. Moreover, large earthquakes that occurred just before and after this period caused several hundreds of mm of sudden vertical motion, generating larger apparent sea-level changes than those observed during the entire intervening period. Our results show that vertical ground motions must be accounted for when evaluating sea-level change hazards in active tectonic regions. These data are needed to help communities and governments understand environmental changes and make the best decisions for their future.

Sport-specific biomechanical responses to an ACL injury prevention programme: A randomised controlled trial.

PubMed

Taylor, Jeffrey B; Ford, Kevin R; Schmitz, Randy J; Ross, Scott E; Ackerman, Terry A; Shultz, Sandra J

2018-04-19

Anterior cruciate ligament (ACL) injury prevention programmes have not been as successful at reducing injury rates in women's basketball as in soccer. This randomised controlled trial (ClinicalTrials.gov #NCT02530333) compared biomechanical adaptations in basketball and soccer players during jump-landing activities after an ACL injury prevention programme. Eighty-seven athletes were cluster randomised into intervention (6-week programme) and control groups. Three-dimensional biomechanical analyses of drop vertical jump (DVJ), double- (SAG-DL) and single-leg (SAG-SL) sagittal, and double- (FRONT-DL) and single-leg (FRONT-SL) frontal plane jump landing tasks were tested before and after the intervention. Peak angles, excursions, and joint moments were analysed using two-way MANCOVAs of post-test scores while controlling for pre-test scores. During SAG-SL the basketball intervention group exhibited increased peak knee abduction angles (p = .004) and excursions (p = .003) compared to the basketball control group (p = .01) and soccer intervention group (p = .01). During FRONT-SL, the basketball intervention group exhibited greater knee flexion excursion after training than the control group (p = .01), but not the soccer intervention group (p = .11). Although women's soccer players exhibit greater improvements in knee abduction kinematics than basketball players, these athletes largely exhibit similar biomechanical adaptations to ACL injury prevention programmes.

Integrating genomic selection into dairy cattle breeding programmes: a review.

PubMed

Bouquet, A; Juga, J

2013-05-01

Extensive genetic progress has been achieved in dairy cattle populations on many traits of economic importance because of efficient breeding programmes. Success of these programmes has relied on progeny testing of the best young males to accurately assess their genetic merit and hence their potential for breeding. Over the last few years, the integration of dense genomic information into statistical tools used to make selection decisions, commonly referred to as genomic selection, has enabled gains in predicting accuracy of breeding values for young animals without own performance. The possibility to select animals at an early stage allows defining new breeding strategies aimed at boosting genetic progress while reducing costs. The first objective of this article was to review methods used to model and optimize breeding schemes integrating genomic selection and to discuss their relative advantages and limitations. The second objective was to summarize the main results and perspectives on the use of genomic selection in practical breeding schemes, on the basis of the example of dairy cattle populations. Two main designs of breeding programmes integrating genomic selection were studied in dairy cattle. Genomic selection can be used either for pre-selecting males to be progeny tested or for selecting males to be used as active sires in the population. The first option produces moderate genetic gains without changing the structure of breeding programmes. The second option leads to large genetic gains, up to double those of conventional schemes because of a major reduction in the mean generation interval, but it requires greater changes in breeding programme structure. The literature suggests that genomic selection becomes more attractive when it is coupled with embryo transfer technologies to further increase selection intensity on the dam-to-sire pathway. The use of genomic information also offers new opportunities to improve preservation of genetic variation. However, recent simulation studies have shown that putting constraints on genomic inbreeding rates for defining optimal contributions of breeding animals could significantly reduce achievable genetic gain. Finally, the article summarizes the potential of genomic selection to include new traits in the breeding goal to meet societal demands regarding animal health and environmental efficiency in animal production.

Reusable EGaIn-Injected Substrate-Integrated-Waveguide Resonator for Wireless Sensor Applications

PubMed Central

Memon, Muhammad Usman; Lim, Sungjoon

2015-01-01

The proposed structure in this research is constructed on substrate integrated waveguide (SIW) technology and has a mechanism that produces 16 different and distinct resonant frequencies between 2.45 and 3.05 GHz by perturbing a fundamental TE10 mode. It is a unique method for producing multiple resonances in a radio frequency planar structure without any extra circuitry or passive elements is developed. The proposed SIW structure has four vertical fluidic holes (channels); injecting eutectic gallium indium (EGaIn), also known commonly as liquid metal (LM), into these vertical channels produces different resonant frequencies. Either a channel is empty, or it is filled with LM. In total, the combination of different frequencies produced from four vertical channels is 16. PMID:26569257

Preliminary performance of a vertical-attitude takeoff and landing, supersonic cruise aircraft concept having thrust vectoring integrated into the flight control system

NASA Technical Reports Server (NTRS)

Robins, A. W.; Beissner, F. L., Jr.; Domack, C. S.; Swanson, E. E.

1985-01-01

A performance study was made of a vertical attitude takeoff and landing (VATOL), supersonic cruise aircraft concept having thrust vectoring integrated into the flight control system. Those characteristics considered were aerodynamics, weight, balance, and performance. Preliminary results indicate that high levels of supersonic aerodynamic performance can be achieved. Further, with the assumption of an advanced (1985 technology readiness) low bypass ratio turbofan engine and advanced structures, excellent mission performance capability is indicated.

Vertical integration and optimal reimbursement policy.

PubMed

Afendulis, Christopher C; Kessler, Daniel P

2011-09-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients' best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism.

Impact of flight systems integration on future aircraft design

NASA Technical Reports Server (NTRS)

Hood, R. V.; Dollyhigh, S. M.; Newsom, J. R.

1984-01-01

Integrations trends in aircraft are discussed with an eye to manifestations in future aircraft designs through interdisciplinary technology integration. Current practices use software changes or small hardware fixes to solve problems late in the design process, e.g., low static stability to upgrade fuel efficiency. A total energy control system has been devised to integrate autopilot and autothrottle functions, thereby eliminating hardware, reducing the software, pilot workload, and cost, and improving flight efficiency and performance. Integrated active controls offer reduced weight and larger payloads for transport aircraft. The introduction of vectored thrust may eliminate horizontal and vertical stabilizers, and location of the thrust at the vehicle center of gravity can provide vertical takeoff and landing capabilities. It is suggested that further efforts will open a new discipline, aeroservoelasticity, and tests will become multidisciplinary, involving controls, aerodynamics, propulsion and structures.

Vertical integration and optimal reimbursement policy

PubMed Central

Afendulis, Christopher C.

2011-01-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients’ best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism. PMID:21850551

Development and testing of the Junkeeper Control Corporation integrated programmable electronic controller and hydronics package

NASA Technical Reports Server (NTRS)

Hankins, J. D.

1979-01-01

Additional developmental work on the existing programmable electronic controller and hydronic package for use with solar heating and cooling systems is summarized. The controller/hydronics subsystems passed all acceptance tests and performance criteria. The subsystems were shown marketable for public use.

Teachers' Perceptions of a Community Participation Programme for Preschoolers with Autism

ERIC Educational Resources Information Center

Mak, Candice; Zhang, Kaili Chen

2013-01-01

Preschoolers with autism face a number of challenges in integrating into different community activities owing to behavioural, communication and emotional concerns. Since the year 2009, the Hong Kong Heep Hong Society has developed a training programme for enhancing community participation among individuals with autism. The current project reports…

Introducing Programmable Logic to Undergraduate Engineering Students in a Digital Electronics Course

ERIC Educational Resources Information Center

Todorovich, E.; Marone, J. A.; Vazquez, M.

2012-01-01

Due to significant technological advances and industry requirements, many universities have introduced programmable logic and hardware description languages into undergraduate engineering curricula. This has led to a number of logistical and didactical challenges, in particular for computer science students. In this paper, the integration of some…

Art-Informed Pedagogy: Tools for Social Transformation

ERIC Educational Resources Information Center

McGregor, Catherine

2012-01-01

How might an arts-informed pedagogy in a leadership development programme work to inspire, create and educate the leaders needed for creating more socially just and inclusive communities? This self-study explores how a post-secondary educator has integrated arts-informed approaches to teaching and learning in a leadership development programme at…

Ways into Integrating Science

ERIC Educational Resources Information Center

Boulter, Caroline

2005-01-01

The ideas in this article arose from the National Union of Teachers' professional development programme "Putting life into science -- primary science and citizenship" that the author ran with Will Ord from SAPERE. As with other NUT "Teacher 2Teacher" programmes, this course had two major inputs, in January and June, with the intervening time…

Integrated Learning with International Banking Executives

ERIC Educational Resources Information Center

Zinke, Sabine; Briault, Steve

2007-01-01

The article describes an in-house executive development programme run by the authors in a leading banking group in the CEE region. The programme attempts to follow a systemic approach to learning and contains a mix of elements including action learning, classroom teaching, study, peer support and feedback and "learning visits" to…

Religion and Spirituality within Counselling/Clinical Psychology Training Programmes: A Systematic Review

ERIC Educational Resources Information Center

Jafari, Simon

2016-01-01

In recent years, there have been increasing efforts to attend to religious and spiritual issues within clinical/counselling psychology. However, there is limited research demonstrating how successfully such content is integrated into existing training programmes. This investigation sought to review primary research literature related to training…

Leading through Partnership: Enhancing the Teach First Leadership Programme

ERIC Educational Resources Information Center

Blandford, Sonia

2014-01-01

Teach First works in partnership with government, business organisations, higher education institutions (providers of Initial Teacher Training, ITT) and schools to offer a two-year integrated Qualified Teacher Status (QTS) Leadership Development Programme; the first cohort of students were accepted in 2003. Its delivery of an integrated…

Mentoring Beginning Teachers in Primary Schools: Research Review

ERIC Educational Resources Information Center

Spooner-Lane, Rebecca

2017-01-01

While mentoring programmes have proven to be successful in reducing attrition and improving teaching ability in beginning teachers, there remains a lack of research delineating the key components of effective mentoring programmes in primary education. This integrative research review examines empirical studies conducted since 2000 on the nature…

The effect of a 3-month supervised exercise programme on gait parameters of patients with peripheral arterial disease and intermittent claudication.

PubMed

King, Stephanie; Vanicek, Natalie; Mockford, Katherine A; Coughlin, Patrick A

2012-10-01

The management of peripheral arterial disease with intermittent claudication includes angioplasty, pharmaceutical therapy, risk factor modification and exercise therapy. Supervised exercise programmes are used sporadically but may improve the distance that an individual with claudication can walk. The purpose of this study was to evaluate the effectiveness of a 3-month supervised exercise programme on improving gait parameters in patients with intermittent claudication. 12 participants were recruited (mean (SD) - age: 67.3 (6.8) years, height: 1.67 (0.09) m, mass: 79.4 (14.0) kg, ankle brachial pressure index: 0.73 (0.17)) from the local vascular unit and enrolled in a supervised exercise programme. Kinematic and kinetic data were collected at the following time points: pain-free walking, initial claudication pain, absolute claudication pain and after a patient-defined rest period. Data were collected before and after the 3-month supervised exercise programme. No significant differences were found in any of the gait parameters post-intervention including pain-free walking speed (P=0.274), peak hip extension (P=0.125), peak ankle plantarflexion (P=0.254), or first vertical ground reaction force peak (P=0.654). No significant gait differences were found across different levels of pain pre- or post-intervention. The lack of improvement post-intervention observed suggests that the current exercise protocol was not tailored to elicit significant improvements in patients with intermittent claudication, specifically. The results indicate that exercise programmes may show improved results post-intervention if they are longer in duration and varied in intensity. Further research into more detailed muscle and biomechanical adaptations is needed to inform exercise programmes specific to this population. Copyright © 2012 Elsevier Ltd. All rights reserved.

Enhancing frontline clinical leadership in an acute hospital trust.

PubMed

Phillips, Natasha; Byrne, Geraldine

2013-09-01

To report on a leadership programme for ward managers in one National Health Service Trust that aimed to enhance their contribution to the delivery of the organisation's key objectives to support excellent patient experience. Effective ward leadership has been recognised as vital to the quality of care, resource management and interprofessional working. However, there is evidence that, at present, front-line nurse leaders are ill equipped to lead effectively and lack confidence in their ability to do so. The project aimed to provide a tailored programme for ward managers to develop their portfolio of skills to perform this pivotal role. The course contained two key elements: an integrated teaching programme to enhance leadership knowledge and skills and action learning to facilitate application to individual's own leadership practice. Both were underpinned by a change project where each individual identified, undertook and evaluated an innovation in practice. Twenty-two ward managers completed the leadership programme. Participants completed semi-structured questionnaires after each taught module. Action learning was evaluated through a combined structured and semi-structured questionnaire. All participants evaluated the programme as increasing their repertoire of leadership skills. Following completion of the programme, ward managers continue to work together as an evolving community of practice. Ward managers' development is enhanced by a programme integrating theory, action learning and completion of a ward-based project. Ward managers cannot be effectively developed in isolation. Leadership development is best supported where the organisation is also committed to developing. A leadership development programme that incorporates knowledge from within the organisation with external expertise can be an effective method to enhance front-line clinical leadership. © 2013 Blackwell Publishing Ltd.

Framework Programmable Platform for the Advanced Software Development Workstation: Preliminary system design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Ackley, Keith A.; Crump, John W., IV; Henderson, Richard; Futrell, Michael T.

1991-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software environment. Guided by the model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated. The focus here is on the design of components that make up the FPP. These components serve as supporting systems for the Integration Mechanism and the Framework Processor and provide the 'glue' that ties the FPP together. Also discussed are the components that allow the platform to operate in a distributed, heterogeneous environment and to manage the development and evolution of software system artifacts.

On vertical profile of ozone at Syowa

NASA Technical Reports Server (NTRS)

Chubachi, Shigeru

1994-01-01

The difference in the vertical ozone profile at Syowa between 1966-1981 and 1982-1988 is shown. The month-height cross section of the slope of the linear regressions between ozone partial pressure and 100-mb temperature is also shown. The vertically integrated values of the slopes are in close agreement with the slopes calculated by linear regression of Dobson total ozone on 100-mb temperature in the period of 1982-1988.

Aerodynamic Loads at Mach Numbers from 0.70 to 2.22 on an Airplane Model Having a Wing and Canard of Triangular Plan Form and Either Single or Twin Vertical Tails Supplement I-Tabulated Data for the Model with Single Vertical Tails. Supplement 1; Tabulated Data for the Model with Single Vertical Tail

NASA Technical Reports Server (NTRS)

Peterson, Victor L.; Menees, Gene P.

1961-01-01

Tabulated results of a wind-tunnel investigation of the aerodynamic loads on a canard airplane model with a single vertical tail are presented for Mach numbers from 0.70 to 2.22. The Reynolds number for the measurements was 2.9 x 10(exp 6) based on the wing mean aerodynamic chord. The results include local static pressure coefficients measured on the wing, body, and vertical tail for angles of attack from -4 deg to + 16 deg, angles of sideslip of 0 deg and 5.3 deg, vertical-tail settings of 0 deg and 5 deg, and nominal canard deflections of 0 deg and 10 deg. Also included are section force and moment coefficients obtained from integrations of the local pressures and model-component force and moment coefficients obtained from integrations of the section coefficients. Geometric details of the model and the locations of the pressure orifices are shown. An index to the data contained herein is presented and definitions of nomenclature are given.

Programmable resistive-switch nanowire transistor logic circuits.

PubMed

Shim, Wooyoung; Yao, Jun; Lieber, Charles M

2014-09-10

Programmable logic arrays (PLA) constitute a promising architecture for developing increasingly complex and functional circuits through nanocomputers from nanoscale building blocks. Here we report a novel one-dimensional PLA element that incorporates resistive switch gate structures on a semiconductor nanowire and show that multiple elements can be integrated to realize functional PLAs. In our PLA element, the gate coupling to the nanowire transistor can be modulated by the memory state of the resistive switch to yield programmable active (transistor) or inactive (resistor) states within a well-defined logic window. Multiple PLA nanowire elements were integrated and programmed to yield a working 2-to-4 demultiplexer with long-term retention. The well-defined, controllable logic window and long-term retention of our new one-dimensional PLA element provide a promising route for building increasingly complex circuits with nanoscale building blocks.

Abutment misfit in implant-supported prostheses manufactured by casting technique: An integrative review

PubMed Central

Pereira, Lorena M. S.; Sordi, Mariane B.; Magini, Ricardo S.; Calazans Duarte, Antônio R.; M. Souza, Júlio C.

2017-01-01

The aim of this study was to perform an integrative review of the literature on the clinically usual prosthesis-abutment misfit over implant-supported structures manufactured by conventional casting technique. The present integrative review used the PRISMA methodology. A bibliographical search was conducted on the following electronic databases: MEDLINE/PubMed (National Library of Medicine), Scopus (Elsevier), ScienceDirect (Elsevier), Web of Science (Thomson Reuters Scientific), Latin American and Caribbean Center on Health Sciences Information (BIREME), and Virtual Health Library (BVS). A total of 11 relevant studies were selected for qualitative analysis. The prosthetic-abutment vertical misfit considered clinically usual ranged from 50 to 160 μm. The vertical misfit depends on several steps during technical manufacturing techniques, which includes the materials and technical procedures. Lower values in misfit are recorded when precious metal or titanium alloys are utilized. Although a vertical misfit mean value of 100 μm has been considered clinically usual, most of the previous studies included in this revision showed lower mean values. PMID:29279686

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

PubMed Central

2010-01-01

Background Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. Discussion This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Summary Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children. PMID:20478054

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective.

PubMed

Maclean, Lynne M; Clinton, Kathryn; Edwards, Nancy; Garrard, Michael; Ashley, Lisa; Hansen-Ketchum, Patti; Walsh, Audrey

2010-05-17

Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective. This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs. Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

Integrated approach to e-learning enhanced both subjective and objective knowledge of aEEG in a neonatal intensive care unit.

PubMed

Poon, W B; Tagamolila, V; Toh, Y P; Cheng, Z R

2015-03-01

Various meta-analyses have shown that e-learning is as effective as traditional methods of continuing professional education. However, there are some disadvantages to e-learning, such as possible technical problems, the need for greater self-discipline, cost involved in developing programmes and limited direct interaction. Currently, most strategies for teaching amplitude-integrated electroencephalography (aEEG) in neonatal intensive care units (NICUs) worldwide depend on traditional teaching methods. We implemented a programme that utilised an integrated approach to e-learning. The programme consisted of three sessions of supervised protected time e-learning in an NICU. The objective and subjective effectiveness of the approach was assessed through surveys administered to participants before and after the programme. A total of 37 NICU staff (32 nurses and 5 doctors) participated in the study. 93.1% of the participants appreciated the need to acquire knowledge of aEEG. We also saw a statistically significant improvement in the subjective knowledge score (p = 0.041) of the participants. The passing rates for identifying abnormal aEEG tracings (defined as ≥ 3 correct answers out of 5) also showed a statistically significant improvement (from 13.6% to 81.8%, p < 0.001). Among the participants who completed the survey, 96.0% felt the teaching was well structured, 77.8% felt the duration was optimal, 80.0% felt that they had learnt how to systematically interpret aEEGs, and 70.4% felt that they could interpret normal aEEG with confidence. An integrated approach to e-learning can help improve subjective and objective knowledge of aEEG.

Social Ecological Model Analysis for ICT Integration

ERIC Educational Resources Information Center

Zagami, Jason

2013-01-01

ICT integration of teacher preparation programmes was undertaken by the Australian Teaching Teachers for the Future (TTF) project in all 39 Australian teacher education institutions and highlighted the need for guidelines to inform systemic ICT integration approaches. A Social Ecological Model (SEM) was used to positively inform integration…

Inventory of available data elements for the San Bernardino, California region

NASA Technical Reports Server (NTRS)

Christenson, J.; Michel, R.

1981-01-01

Elements of data sets that are available to be integrated for the San Bernardino vertical data integration project are given. Each of the data sets has specified for it the ownership, validity, accuracy and technical requirements for integration.

Integrated Research on Disaster Risk - A Review

NASA Astrophysics Data System (ADS)

Beer, T.

2016-12-01

Integrated Research on Disaster Risk, generally known as IRDR, is a decade-long research programme co-sponsored by the International Council for Science (ICSU), the International Social Science Council (ISSC), and the United Nations International Strategy for Disaster Reduction (UNISDR). It is a global, multi-disciplinary approach to dealing with the challenges brought by natural disasters, mitigating their impacts, and improving related policy-making mechanisms. The home page is at: http://www.irdrinternational.org/The research programme was named Integrated Research on Disaster Risk to indicate that it is addressing the challenge of natural and human-induced environmental hazards. In November 2008 and May 2009 respectively, both the ISSC and the UNISDR agreed to join the ICSU in co-sponsoring the IRDR programme. Although the approaches in the sciences vary, the IRDR programme approaches the issues of natural and human-induced hazards and disasters from several perspectives: from the hazards to the disasters, and from the human exposures and vulnerabilities back to the hazards. This coordinated and multi-dimensional approach takes the IRDR programme beyond approaches that have traditionally been undertaken To meet its research objectives the IRDR established four core projects, comprising working groups of experts from diverse disciplines, to formulate new methods in addressing the shortcomings of current disaster risk research. Assessment of Integrated Research on Disaster Risk (AIRDR) Disaster Loss Data (DATA) Forensic Investigations of Disasters (FORIN) Risk Interpretation and Action (RIA) Dr Tom Beer was a member of both the scoping and planning groups and was a member of the committee to undertake a mid-term review of IRDR with the terms of reference being to examine and to report by November 2016. 1. Strategic planning and implementation 2. Governance 3. Secretariat, funding and operations 4. Stakeholders and partnerships 5. Communication, visibility and influence 6. Future development His talk will give an overview of the history and science of IRDR and some of the outcomes of the mid-term review.

A palliative care link nurse programme in Mulago Hospital, Uganda: an evaluation using mixed methods.

PubMed

Downing, Julia; Batuli, Mwazi; Kivumbi, Grace; Kabahweza, Josephine; Grant, Liz; Murray, Scott A; Namukwaya, Elizabeth; Leng, Mhoira

2016-04-08

Integrating palliative care (PC) and empowering the health care workforce is essential to achieve universal access to PC services. In 2010, 46% of patients in Mulago Hospital, Uganda had a life limiting illness, of whom 96% had PC needs. The university/hospital specialist PC unit (Makerere/Mulago Palliative Care Unit -MPCU) implemented a link-nurse model to empower hospital nurses to provide generalist PC. Over two years, 27 link nurses were trained and mentored and 11 clinical protocols developed. The aim of the study was to evaluate the impact of the palliative care link nurse programme at Mulago Hospital An evaluation approach utilising mixed methods was used integrating qualitative and quantitative data including: pre and post course assessment confidence ratings; course evaluation forms; audit of clinical guidelines availability; review of link-nurse activity sheets/action plans; review of MPCU patient documentation; Most Significant Change (MSC); individual and focus group interviews. A significant difference was seen in nurses' confidence after the training (p < 0.001). From July 2012 to December 2013, link nurses identified 2447 patients needing PC, of whom they cared for 2113 (86%) and referred 334 (14%) to MPCU. Clinical guidelines/protocols were utilised in 50% of wards. Main themes identified include: change in attitude; developing new skills and knowledge; change in relationships; improved outcomes of care, along with the challenges that they experienced in integrating PC. Since the start of the programme there has been an increase in PC patients seen at the hospital (611 in 2011 to 1788 in 2013). The link-nurse programme is a practical model for integrating PC into generalist services. Recommendations have been made for ongoing development and expansion of the programme as an effective health systems strengthening approach in similar healthcare contexts, as well as the improvement in medical and nursing education.

The influence of health system organizational structure and culture on integration of health services: the example of HIV service monitoring in South Africa.

PubMed

Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

2016-11-01

Administrative integration of disease control programmes (DCPs) within the district health system has been a health sector reform priority in South Africa for two decades. The reforms entail district managers assuming authority for the planning and monitoring of DCPs in districts, with DCP managers providing specialist support. There has been little progress in achieving this, and a dearth of research exploring why. Using a case study of HIV programme monitoring and evaluation (M&E), this article explores whether South Africa's health system is configured to support administrative integration. The article draws on data from document reviews and interviews with 54 programme and district managers in two of nine provinces, exploring their respective roles in decision-making regarding HIV M&E system design and in using HIV data for monitoring uptake of HIV interventions in districts. Using Mintzberg's configurations framework, we describe three organizational parameters: (a) extent of centralization (whether district managers play a role in decisions regarding the design of the HIV M&E system); (b) key part of the organization (extent to which sub-national programme managers vs district managers play the central role in HIV monitoring in districts); and (c) coordination mechanisms used (whether highly formalized and rules-based or more output-based to promote agency). We find that the health system can be characterized as Mintzberg's machine bureaucracy. It is centralized and highly formalized with structures, management styles and practices that promote programme managers as lead role players in the monitoring of HIV interventions within districts. This undermines policy objectives of district managers assuming this leadership role. Our study enhances the understanding of organizational factors that may limit the success of administrative integration reforms and suggests interventions that may mitigate this. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Integrated care programmes for adults with chronic conditions: a meta-review.

PubMed

Martínez-González, Nahara Anani; Berchtold, Peter; Ullman, Klara; Busato, André; Egger, Matthias

2014-10-01

To review systematic reviews and meta-analyses of integrated care programmes in chronically ill patients, with a focus on methodological quality, elements of integration assessed and effects reported. Meta-review of systematic reviews and meta-analyses identified in Medline (1946-March 2012), Embase (1980-March 2012), CINHAL (1981-March 2012) and the Cochrane Library of Systematic Reviews (issue 1, 2012). Methodological quality assessed by the 11-item Assessment of Multiple Systematic Reviews (AMSTAR) checklist; elements of integration assessed using a published list of 10 key principles of integration; effects on patient-centred outcomes, process quality, use of healthcare and costs. Twenty-seven systematic reviews were identified; conditions included chronic heart failure (CHF; 12 reviews), diabetes mellitus (DM; seven reviews), chronic obstructive pulmonary disease (COPD; seven reviews) and asthma (five reviews). The median number of AMSTAR checklist items met was five: few reviewers searched for unpublished literature or described the primary studies and interventions in detail. Most reviews covered comprehensive services across the care continuum or standardization of care through inter-professional teams, but organizational culture, governance structure or financial management were rarely assessed. A majority of reviews found beneficial effects of integration, including reduced hospital admissions and re-admissions (in CHF and DM), improved adherence to treatment guidelines (DM, COPD and asthma) or quality of life (DM). Few reviews showed reductions in costs. Systematic reviews of integrated care programmes were of mixed quality, assessed only some components of integration of care, and showed consistent benefits for some outcomes but not others. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care.

Quality control of goji (fruits of Lycium barbarum L. and L. chinense Mill.): A value chain analysis perspective.

PubMed

Yao, Ruyu; Heinrich, Michael; Wang, Zigui; Weckerle, Caroline S

2018-06-14

Goji (fruits of Lycium barbarum L. and L. chinense Mill., Solanaceae) have been used as a traditional food and medicine for hundreds of years in Asian countries and are now consumed globally. Quality of herbal medicines is critical for safe use and has been shown to be affected by value chains. Using a value chain (VC) framework, we aim at understanding the influence of different VC types on goji quality and revenue of stakeholders. Participant observation and semi-structured interviews were conducted during five months of fieldwork in the main production areas in China with a total of 65 stakeholders. Quality of goji, behaviour and financial performance of stakeholders was documented and analysed for different VCs. Ten different types of VCs were identified. VCs with vertical integration and horizontal collaboration were found to have a more coherent quality control and better goji quality as well as improved stakeholders' financial performance. Vertical integration at different levels was found for independent farmer-based VCs, horizontal collaboration was found in the cooperative-based VCs. Full vertically integrated VCs were found in large-scale production. Goji quality and stakeholders' revenues are linked with different types of VCs which mirror stakeholders' behaviour driven by target markets. Considering their positive influence on quality and revenues, well-developed vertically integrated value chains are likely to become more important in the near future. Copyright © 2018. Published by Elsevier B.V.

The Diagnosis and application of a convective vorticity vector associated with convective systems

NASA Astrophysics Data System (ADS)

Gao, S.; Zhou, Y.; Tao, W.

2005-05-01

Although dry/moist potential vorticity is a very useful and powerful physical quantity in the large scale dynamics, it is not a quite ideal dynamical tool for the study of convective systems or severe storms. A new convective vorticity vector (CVV) is introduced in this study to identify the development of convective systems or severe storms. The daily Aviation (AVN) Model Data is used to diagnose the distribution of the CVV associated with rain storms occurred in the period of Meiyu in 1998. The results have clearly demonstrated that the CVV is an effective vector for indicating the convective actions along the Meiyu front. The CVV also is used to diagnose a 2-D cloud-resolving simulation data associated with 2-D tropical convection. The cloud model is forced by the vertical velocity, zonal wind, horizontal advection, and sea surface temperature obtained from the Tropical cean-Global tmosphere (TOGA) Coupled Ocean-Atmosphere Response Experiment (COARE) and is integrated for a selected 10-day period. The CVV has zonal and vertical components in the 2-D x-z frame. Analysis of zonally averaged and mass-integrated quantities shows that the correlation coefficient between the vertical component of the CVV and the sum of the cloud hydrometeor mixing ratios is 0.81, whereas the correlation coefficient between the zonal component and the sum of the mixing ratios is only 0.18. This indicates that the vertical component of the CVV is closely associated with tropical convection. The tendency equation for the vertical component of the CVV is derived and the zonally averaged and mass-integrated tendency budgets are analyzed. The tendency of the vertical component of the CVV is determined by the interaction between the vorticity and the zonal gradient of cloud heating. The results demonstrate that the vertical component of the CVV is a cloud-linked parameter and can be used to study tropical convection.

Programmable LED-based integrating sphere light source for wide-field fluorescence microscopy.

PubMed

Rehman, Aziz Ul; Anwer, Ayad G; Goldys, Ewa M

2017-12-01

Wide-field fluorescence microscopy commonly uses a mercury lamp, which has limited spectral capabilities. We designed and built a programmable integrating sphere light (PISL) source which consists of nine LEDs, light-collecting optics, a commercially available integrating sphere and a baffle. The PISL source is tuneable in the range 365-490nm with a uniform spatial profile and a sufficient power at the objective to carry out spectral imaging. We retrofitted a standard fluorescence inverted microscope DM IRB (Leica) with a PISL source by mounting it together with a highly sensitive low- noise CMOS camera. The capabilities of the setup have been demonstrated by carrying out multispectral autofluorescence imaging of live BV2 cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Integrating DNA strand-displacement circuitry with DNA tile self-assembly

PubMed Central

Zhang, David Yu; Hariadi, Rizal F.; Choi, Harry M.T.; Winfree, Erik

2013-01-01

DNA nanotechnology has emerged as a reliable and programmable way of controlling matter at the nanoscale through the specificity of Watson–Crick base pairing, allowing both complex self-assembled structures with nanometer precision and complex reaction networks implementing digital and analog behaviors. Here we show how two well-developed frameworks, DNA tile self-assembly and DNA strand-displacement circuits, can be systematically integrated to provide programmable kinetic control of self-assembly. We demonstrate the triggered and catalytic isothermal self-assembly of DNA nanotubes over 10 μm long from precursor DNA double-crossover tiles activated by an upstream DNA catalyst network. Integrating more sophisticated control circuits and tile systems could enable precise spatial and temporal organization of dynamic molecular structures. PMID:23756381

The definition of community integration: perspectives of people with brain injuries.

PubMed

McColl, M A; Carlson, P; Johnston, J; Minnes, P; Shue, K; Davies, D; Karlovits, T

1998-01-01

Despite considerable attention to community integration and related topics in the past decades, a clear definition of community integration continues to elude researchers and service providers. Common to most discussions of the topic, however, are three ideas: that integration involves relationships with others, independence in one's living situation and activities to fill one's time. The present study sought to expand this conceptualization of community integration by asking people with brain injuries for their own perspectives on community integration. This qualitative study resulted in a definition of community integration consisting of nine indicators: orientation, acceptance, conformity, close and diffuse relationships, living situation, independence, productivity and leisure. These indicators were empirically derived from the text of 116 interviews with people with moderate-severe brain injuries living in the community. Eighteen adults living in supported living programmes were followed for 1 year, to track their evolving definition of integration and the factors they felt were related to integration. The study also showed a general trend toward more positive evaluation over the year, and revealed that positive evaluation was frequently related to meeting new people and freedom from staff supervision. These findings are interpreted in the light of recommendations for community programmes.

Expanding Opportunities to Learn to Support Inclusive Education through Drama-Enhanced Literacy Practices

ERIC Educational Resources Information Center

Kilinc, Sultan; Farrand, Kathleen; Chapman, Kathryn; Kelley, Michael; Millinger, Jenny; Adams, Korbi

2017-01-01

This study examines how the Early Years Educators at Play (EYEPlay) professional development (PD) programme supported inclusive learning settings for all children, including English language learners and students with disabilities. The EYEPlay PD model is a year-long programme that integrates drama strategies into literacy practices within…

Monitoring and Stimulating Development of Integrated Professional Skills in University Study Programmes

ERIC Educational Resources Information Center

Wahlgren, Marie; Ahlberg, Anders

2013-01-01

In Swedish higher education, quality assurance mainly focuses on course module outcomes. With this in mind we developed a qualitative method to monitor and stimulate progression of learning in two modularized engineering study programmes. A set of core professional values and skills were triangulated through interviews with students, teachers,…

Second Chance Programmes: A Response to Educational Needs in Compulsory Education

ERIC Educational Resources Information Center

Asin, Antonio Sanchez; Peinado, Jose Luis Boix

2008-01-01

This paper asks whether the integrated training provision currently offered through the different Spanish Second Chance Programmes (SCPs) constitutes a valid response to the educational needs and deficits known to exist among those young people who do not satisfactorily complete the Compulsory Secondary Education stage (ESO). The objectives of the…

Teaching Discrete and Programmable Logic Design Techniques Using a Single Laboratory Board

ERIC Educational Resources Information Center

Debiec, P.; Byczuk, M.

2011-01-01

Programmable logic devices (PLDs) are used at many universities in introductory digital logic laboratories, where kits containing a single high-capacity PLD replace "standard" sets containing breadboards, wires, and small- or medium-scale integration (SSI/MSI) chips. From the pedagogical point of view, two problems arise in these…

Android: Call C Functions with the Native Development Kit (NDK)

DTIC Science & Technology

2016-09-01

guide is intended to assist programmers with how to attach an NDK plugin to an Android Integrated Development Environment and how to call C functions...written in Java to interact with native C/C++. This guide is intended to take programmers through adding an NDK package into an Android Studio

Making Sense of Curriculum--The Transition into Science and Engineering University Programmes

ERIC Educational Resources Information Center

Ulriksen, Lars; Holmegaard, Henriette T.; Madsen, Lene Møller

2017-01-01

Research on students' transition, retention and experiences in science, technology, engineering and mathematics (STEM) has increasingly focused on identity formation and on students' integration in the study programmes. However, studies focusing on the role of the curriculum in this process at the level of higher education are scarce. The present…

A flight cylinder bioassay as a simple, effective quality control test for Cydia pomonella

USDA-ARS?s Scientific Manuscript database

Assessment of quality of the sterile male insects that are being mass-reared for release in area-wide integrated pest management programmes that include a sterile insect technique component is crucial for the success of these programmes. Routine monitoring of sterile male quality needs to be carried...

Art and Science Education Collaboration in a Secondary Teacher Preparation Programme

ERIC Educational Resources Information Center

Medina-Jerez, William; Dambekalns, Lydia; Middleton, Kyndra V.

2012-01-01

Background and purpose: The purpose of this study was to record and measure the level of involvement and appreciation that prospective teachers in art and science education programmes demonstrated during a four-session integrated activity. Art and science education prospective teachers from a Rocky Mountain region university in the US worked in…

Sole Fighter Mentality: Stakeholder Agency in CLIL Programmes in Queensland

ERIC Educational Resources Information Center

Smala, Simone

2014-01-01

This study presents an insight into content and language integrated learning (CLIL) practices in the Australian state of Queensland. The article comprises four main sections. The first section outlines the context of CLIL in Australia and Queensland; there follows a brief review of the literature on stakeholders in CLIL programmes, such as…

Integrating Computer-Assisted Translation Tools into Language Learning

ERIC Educational Resources Information Center

Fernández-Parra, María

2016-01-01

Although Computer-Assisted Translation (CAT) tools play an important role in the curriculum in many university translator training programmes, they are seldom used in the context of learning a language, as a good command of a language is needed before starting to translate. Since many institutions often have translator-training programmes as well…

Control of intestinal parasitic infections in Seychelles: a comprehensive and sustainable approach.

PubMed Central

Albonico, M.; Shamlaye, N.; Shamlaye, C.; Savioli, L.

1996-01-01

Intestinal parasitic infections have been perceived as a public health problem in Seychelles for decades. A comprehensive strategy to reduce morbidity and, in the long term, transmission of intestinal parasites has been implemented successfully since 1993. Management of the programme is integrated into the well established primary health care system, with control activities being undertaken through existing health facilities. The strategy is based on periodic chemotherapy of schoolchildren, intense health education and improvement of sanitation and safe water supply. The initial objectives of the control programme were met after 2 years of activities, with an overall reduction in prevalence of intestinal parasitic infections of 44%. The intensity of infection with Trichuris trichiura, the commonest parasite, was halved (from 780 to 370 eggs per g of faeces). The programme's integrated approach, in concert with political commitment and limited operational costs, is a warranty for the future sustainability of control activities. The programme can be seen as a model for other developing countries, even where health and socioeconomic conditions are different and the control of parasitic infections will need a much longer-term commitment. PMID:9060217

Introducing integrated product and process development into the education of science and engineering undergraduates: a lecture course with an accompanying case-study programme at the ETH chemistry department.

PubMed

Fenner, K; Jödicke, G; Alean-Kirkpatrick, P; Hungerbühler, K

2001-04-01

Increased quality requirements in the development of chemical products and a growing awareness within society of the activities of chemical companies present a new challenge to the education of young scientists. Nowadays, the teaching of chemists, chemical engineers and environmental scientists at universities has to go beyond the traditional, discipline-orientated knowledge acquisition. The students also have to learn to work and communicate in interdisciplinary teams, to solve application-oriented tasks and to integrate scientific, economical, ecological and social aspects into their work. For this reason, a case-study programme was launched at the chemistry department of the Swiss Federal Institute of Technology. In this paper, we describe the organisational aspects of the programme, its inclusion into academic and industrial environments and summarise some of the scientific methodologies applied. One of the seven case-studies, an assessment of a modern insecticide, is presented in more detail. Finally, we discuss how far the case-study programme is suitable for introducing a new mode of knowledge production to universities.

Integrating Educational Technologies into Teacher Education: A Case Study

ERIC Educational Resources Information Center

Rawlins, Peter; Kehrwald, Benjamin

2014-01-01

This article is a case study of an integrated, experiential approach to improving pre-service teachers' understanding and use of educational technologies in one New Zealand teacher education programme. The study examines the context, design and implementation of a learning activity which integrated student-centred approaches, experiential…

Postirradiation Effects In Integrated Circuits

NASA Technical Reports Server (NTRS)

Shaw, David C.; Barnes, Charles E.

1993-01-01

Two reports discuss postirradiation effects in integrated circuits. Presents examples of postirradiation measurements of performances of integrated circuits of five different types: dual complementary metal oxide/semiconductor (CMOS) flip-flop; CMOS analog multiplier; two CMOS multiplying digital-to-analog converters; electrically erasable programmable read-only memory; and semiconductor/oxide/semiconductor octal buffer driver.

Integration of GaAs vertical-cavity surface emitting laser on Si by substrate removal

NASA Astrophysics Data System (ADS)

Yeh, Hsi-Jen J.; Smith, John S.

1994-03-01

The successful integration of strained quantum well InGaAs vertical-cavity surface-emitting lasers (VCSELs) on both Si and Cu substrates was described using a GaAs substrate removal technique. The GaAs VCSEL structure was metallized and bonded to the Si substrate after growth. The GaAs substrate was then removed by selective chemical wet etching. Finally, the bonded GaAs film metallized on the top (emitting) side and separate lasers were defined. This is the first time a VCSEL had been integrated on a Si substrate with its substrate removed. The performance enhancement of GaAs VCSELs bonded on good thermal conductors are demonstrated.

Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial.

PubMed

Winter, Laraine; Moriarty, Helene J; Robinson, Keith; Piersol, Catherine V; Vause-Earland, Tracey; Newhart, Brian; Iacovone, Delores Blazer; Hodgson, Nancy; Gitlin, Laura N

2016-01-01

Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. Interviews and intervention sessions were conducted in homes or by telephone. Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.

[Development of a French-language online health policy course: an international collaboration].

PubMed

Hébert, Réjean; Coppieters, Yves; Pradier, Christian; Williams-Jones, Bryn; Brahimi, Cora; Farley, Céline

2017-01-01

To present the process and challenges of developing an online competency-based course on public health policy using a collaborative international approach. Five public health experts, supported by an expert in educational technology, adopted a rigorous approach to the development of the course: a needs analysis, identification of objectives and competencies, development of a pedagogical scenario for each module and target, choice of teaching methods and learning activities, material to be identified or developed, and the responsibilities and tasks involved. The 2-credit (90-hour) graduate course consists of six modules including an integration module. The modules start with a variety of case studies: tobacco law (neutral packaging), supervised injection sites, housing, integrated services for the frail elderly, a prevention programme for mothers from disadvantaged backgrounds, and the obligatory use of bicycle helmets. In modules 1, 3, 4 and 5, students learn about different stages of the public policy development process: emergence, formulation and adoption, implementation and evaluation. Module 2 focuses on the importance of values and ideologies in public policy. The integration module allows the students to apply the knowledge learned and addresses the role of experts in public policy and ethical considerations. The course has been integrated into the graduate programmes of the participating universities and allows students to follow, at a distance, an innovative training programme.

Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?

PubMed

Chilundo, Baltazar Gm; Cliff, Julie L; Mariano, Alda Re; Rodríguez, Daniela C; George, Asha

2015-12-01

In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded 'old' CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Our analysis represents a nuanced assessment of the various domains that influence CHW programme sustainability, highlighting strategic areas such as CHW payment and programme financing. These organizational and contextual determinants of sustainability are central to CHW programme strengthening and iCCM policy support. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Relaunch of the official community health worker programme in Mozambique: is there a sustainable basis for iCCM policy?

PubMed Central

Chilundo, Baltazar GM; Cliff, Julie L; Mariano, Alda RE; Rodríguez, Daniela C; George, Asha

2015-01-01

Background: In Mozambique, integrated community case management (iCCM) of diarrhoea, malaria and pneumonia is embedded in the national community health worker (CHW) programme, mainstreaming it into government policy and service delivery. Since its inception in 1978, the CHW programme has functioned unevenly, was suspended in 1989, but relaunched in 2010. To assess the long-term success of iCCM in Mozambique, this article addresses whether the current CHW programme exhibits characteristics that facilitate or impede its sustainability. Methodology: We undertook a qualitative case study based on document review (n = 54) and key informant interviews (n = 21) with respondents from the Ministry of Health (MOH), multilateral and bilateral agencies and non-governmental organizations (NGOs) in Maputo in 2012. Interviews were mostly undertaken in Portuguese and all were coded using NVivo. A sustainability framework guided thematic analysis according to nine domains: strategic planning, organizational capacity, programme adaptation, programme monitoring and evaluation, communications, funding stability, political support, partnerships and public health impact. Results: Government commitment was high, with the MOH leading a consultative process in Maputo and facilitating successful technical coordination. The MOH made strategic decisions to pay CHWs, authorize their prescribing abilities, foster guidance development, support operational planning and incorporate previously excluded ‘old’ CHWs. Nonetheless, policy negotiations excluded certain key actors and uncertainty remains about CHW integration into the civil service and their long-term retention. In addition, reliance on NGOs and donor funding has led to geographic distortions in scaling up, alongside challenges in harmonization. Finally, dependence on external funding, when both external and government funding are declining, may hamper sustainability. Conclusions: Our analysis represents a nuanced assessment of the various domains that influence CHW programme sustainability, highlighting strategic areas such as CHW payment and programme financing. These organizational and contextual determinants of sustainability are central to CHW programme strengthening and iCCM policy support. PMID:26516151

[The significance of hierarchy in postgraduate education].

PubMed

Rupprecht, H

1999-01-01

There are structures of hierarchy in the postgraduate education. The postgraduate education is organized as a programme the young doctor has to absolve. The instruction and the control of the implementation of that programme must be carried out by a competent and experienced older physician, who is responsible for the correctness of that, the young doctor has to learn in his postgraduate education. The older physician unequivocally is integrated in the hierarchy above the young doctor legitimated by his knowledge, his experience and his personality. The hierarchy demonstrates itself as an indication of the moral integrity of the community and of each only individual.

Reprogrammable field programmable gate array with integrated system for mitigating effects of single event upsets

NASA Technical Reports Server (NTRS)

Ng, Tak-kwong (Inventor); Herath, Jeffrey A. (Inventor)

2010-01-01

An integrated system mitigates the effects of a single event upset (SEU) on a reprogrammable field programmable gate array (RFPGA). The system includes (i) a RFPGA having an internal configuration memory, and (ii) a memory for storing a configuration associated with the RFPGA. Logic circuitry programmed into the RFPGA and coupled to the memory reloads a portion of the configuration from the memory into the RFPGA's internal configuration memory at predetermined times. Additional SEU mitigation can be provided by logic circuitry on the RFPGA that monitors and maintains synchronized operation of the RFPGA's digital clock managers.

The relative roles of ANC and EPI in the continuous distribution of LLINs: a qualitative study in four countries.

PubMed

Theiss-Nyland, Katherine; Koné, Diakalia; Karema, Corine; Ejersa, Waqo; Webster, Jayne; Lines, Jo

2017-05-01

The continuous distribution of long-lasting insecticidal nets (LLINs) for malaria prevention, through the antenatal care (ANC) and the Expanded Programme on Immunizations (EPI), is recommended by the WHO to improve and maintain LLIN coverage. Despite these recommendations, little is known about the relative strengths and weaknesses of the ANC and EPI-based LLIN distribution. This study aimed to explore and compare the roles of the ANC and EPI for LLIN distribution in four African countries. In a qualitative evaluation of continuous distribution through the ANC and EPI, semi-structured, individual and group interviews were conducted in Kenya, Malawi, Mali, and Rwanda. Respondents included national, sub-national, and facility-level health staff, and were selected to capture a range of roles related to malaria, ANC and EPI programmes. Policies, guidelines, and data collection tools were reviewed as a means of triangulation to assess the structure of LLIN distribution, and the methods of data collection and reporting for malaria, ANC and EPI programmes. In the four countries visited, distribution of LLINs was more effectively integrated through ANC than through EPI because of a) stronger linkages and involvement between malaria and reproductive health programmes, as compared to malaria and EPI, and b) more complete programme monitoring for ANC-based distribution, compared to EPI-based distribution. Opportunities for improving the distribution of LLINs through these channels exist, especially in the case of EPI. For both ANC and EPI, integrated distribution of LLINs has the potential to act as an incentive, improving the already strong coverage of both these essential services. The collection and reporting of data on LLINs distributed through the ANC and EPI can provide insight into the performance of LLIN distribution within these programmes. Greater attention to data collection and use, by both the global malaria community, and the integrated programmes, can improve this distribution channel strength and effectiveness. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016; all rights reserved.

Evaluating process and clinical outcomes of a primary care mental health integration project in rural Rwanda: a prospective mixed-methods protocol.

PubMed

Smith, Stephanie L; Misago, Claire Nancy; Osrow, Robyn A; Franke, Molly F; Iyamuremye, Jean Damascene; Dusabeyezu, Jeanne D'Arc; Mohand, Achour A; Anatole, Manzi; Kayiteshonga, Yvonne; Raviola, Giuseppe J

2017-02-28

Integrating mental healthcare into primary care can reduce the global burden of mental disorders. Yet data on the effective implementation of real-world task-shared mental health programmes are limited. In 2012, the Rwandan Ministry of Health and the international healthcare organisation Partners in Health collaboratively adapted the Mentoring and Enhanced Supervision at Health Centers (MESH) programme, a successful programme of supported supervision based on task-sharing for HIV/AIDS care, to include care of neuropsychiatric disorders within primary care settings (MESH Mental Health). We propose 1 of the first studies in a rural low-income country to assess the implementation and clinical outcomes of a programme integrating neuropsychiatric care into a public primary care system. A mixed-methods evaluation will be conducted. First, we will conduct a quantitative outcomes evaluation using a pretest and post-test design at 4 purposively selected MESH MH participating health centres. At least 112 consecutive adults with schizophrenia, bipolar disorder, depression or epilepsy will be enrolled. Primary outcomes are symptoms and functioning measured at baseline, 8 weeks and 6 months using clinician-administered scales: the General Health Questionnaire and the brief WHO Disability Assessment Scale. We hypothesise that service users will experience at least a 25% improvement in symptoms and functioning from baseline after MESH MH programme participation. To understand any outcome improvements under the intervention, we will evaluate programme processes using (1) quantitative analyses of routine service utilisation data and supervision checklist data and (2) qualitative semistructured interviews with primary care nurses, service users and family members. This evaluation was approved by the Rwanda National Ethics Committee (Protocol #736/RNEC/2016) and deemed exempt by the Harvard University Institutional Review Board. Results will be submitted for peer-reviewed journal publication, presented at conferences and disseminated to communities served by the programme. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Norwegian healthy body image programme: study protocol for a randomized controlled school-based intervention to promote positive body image and prevent disordered eating among Norwegian high school students.

PubMed

Sundgot-Borgen, Christine; Bratland-Sanda, Solfrid; Engen, Kethe M E; Pettersen, Gunn; Friborg, Oddgeir; Torstveit, Monica Klungland; Kolle, Elin; Piran, Niva; Sundgot-Borgen, Jorunn; Rosenvinge, Jan H

2018-03-06

Body dissatisfaction and disordered eating raise the risk for eating disorders. In the prevention of eating disorders, many programmes have proved partly successful in using cognitive techniques to combat such risk factors. However, specific strategies to actively promote a positive body image are rarely used. The present paper outlines a protocol for a programme integrating the promotion of a positive body image and the prevention of disordered eating. Using a cluster randomized controlled mixed methods design, 30 high schools and 2481 12th grade students were allocated to the Healthy Body Image programme or to a control condition. The intervention comprised three workshops, each of 90 min with the main themes body image, media literacy, and lifestyle. The intervention was interactive in nature, and were led by trained scientists. The outcome measures include standardized instruments administered pre-post intervention, and at 3 and 12 months follow-ups, respectively. Survey data cover feasibility and implementation issues. Qualitative interviews covers experiential data about students' benefits and satisfaction with the programme. The present study is one of the first in the body image and disordered eating literature that integrates a health promotion and a disease prevention approach, as well as integrating standardized outcome measures and experiential findings. Along with mediator and moderator analyses it is expected that the Healthy Body Image programme may prove its efficacy. If so, plans are made with respect to further dissemination as well as communicating the findings to regional and national decision makers in the education and health care services. The study was registered and released at ClinicalTrials.gov 21th August 2016 with the Clinical Trial.gov ID: PRSNCT02901457 . In addition, the study is approved by the Regional Committee for Medical and Health Research Ethics.

Leadership and governance of community health worker programmes at scale: a cross case analysis of provincial implementation in South Africa.

PubMed

Schneider, Helen; Nxumalo, Nonhlanhla

2017-09-15

National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significant challenges to the integration and support of such programmes, and they require coordination and stewardship at all levels of the health system. This paper explores the leadership and governance tasks of large-scale CHW programmes at sub-national level, through the case of national reforms to South Africa's community based sector, referred to as the Ward Based Outreach Team (WBOT) strategy. A cross case analysis of leadership and governance roles, drawing on three case studies of adoption and implementation of the WBOTs strategy at provincial level (Western Cape, North West and Gauteng) was conducted. The primary case studies mapped system components and assessed implementation processes and contexts. They involved teams of researchers and over 200 interviews with stakeholders from senior to frontline, document reviews and analyses of routine data. The secondary, cross case analysis specifically focused on the issues and challenges facing, and strategies adopted by provincial and district policy makers and managers, as they engaged with the new national mandate. From this key sub-national leadership and governance roles were formulated. Four key roles are identified and discussed: 1. Negotiating a fit between national mandates and provincial and district histories and strategies of community based services 2. Defining new organisational and accountability relationships between CHWs, local health services, communities and NGOs 3. Revising and developing new aligned and integrated planning, human resource, financing and information systems 4. Leading change by building new collective visions, mobilising political, including budgetary, support and designing implementation strategies. This analysis, from real-life systems, adds to understanding of the processes involved in developing CHW programmes at scale, and specifically the negotiated and multilevel nature of leadership and governance in such programmes, spanning analytic, managerial, technical and political roles.

Overdrainage and shunt technology. A critical comparison of programmable, hydrostatic and variable-resistance valves and flow-reducing devices.

PubMed

Aschoff, A; Kremer, P; Benesch, C; Fruh, K; Klank, A; Kunze, S

1995-04-01

When vertical body position is simulated, conventional differential pressure valves show an absolutely unphysiological flow, which is 2-170 times the normal liquor production rate. Although this is compensated in part by the resistance of the silicon tubes, which may produce up to 94% of the resistance of the complete shunt system, a negative intracranial pressure (ICP) of up to 30-44 cmH2O is an unavoidable consequence, which can be followed by subdural hematomas, slit ventricles, and other well-known complications. Modern shunt technology offers programmable, hydrostatic, and "flow-controlled" valves and anti-siphon devices; we have tested 13 different designs from 7 manufacturers (56 specimens), using the "Heidelberg Valve Test Inventory" with 16 subtests. "Programmable" valves reduce, but cannot exclude, unphysiological flow rates: even in the highest position and in combination with a standard catheter typical programmable Medos-Hakim valves allow a flow of 93-232 ml/h, Sophy SU-8-valves 86-168 ml/h with 30 cmH2O. The effect of hydrostatic valves (Hakim-Lumbar, Chhabra) can be inactivated by movements of daily life. The weight of the metal balls in most valves was too low for adequate flow reduction. Antisiphon devices are highly dependent on external, i.e. subcutaneous, pressure which has unpredictable influences on shunt function, and clinically is sometimes followed by shunt insufficiency. Two new Orbis-Sigma valves showed relatively physiological flow rates even when the vertical position (30 cmH2O) was simulated. One showed an insufficient flow (5.7 ml/h), and one was primarily obstructed. These have by far the smallest outlet of all valves. Additionally, the ruby pin tends to stick. Therefore, a high susceptibility to obliterations and blockade is unavoidable. Encouraging results obtained in pediatric patients contrast with disappointing experiences in some German and Swedish hospitals, which suggests that our laboratory findings are confirmed by clinical results. The concept of strict flow limitation seems to be inadaequate for adult patients, who need a relatively high flow during (nocturnal) ICP crises. The problem of shunt overdrainage remains unsolved.

Mechanical Model of Traditional Thai Massage for Integrated Healthcare.

PubMed

Rattanaphan, Salinee; Srichandr, Panya

2015-01-01

In this study, a mechanical model was developed, aiming to provide standardized and programmable traditional Thai massage (TTM) therapy to patients. The TTM was modeled and integrated into a mechanical hand (MH) system, and a prototype massage chair was built and tested for user satisfaction. Three fundamental principles of Thai massage were integrated: pull, press, and pin. Based on these principles, the mechanics of Thai massage was studied and a mathematical model was developed to describe the dynamics and conditions for the design and prototyping of an MH. On average, it was found that users were satisfied with the treatment and felt that the treatment was similar to that performed by human hands. According to the interview results, users indicated that they were likely to utilize the MH as an alternative to traditional massage. Therefore, integrated TTM with an MH may help healthcare providers deliver standardized, programmable massage therapy to patients as opposed to variable, inconsistent human massage.

Vertical waveguides integrated with silicon photodetectors: Towards high efficiency and low cross-talk image sensors

NASA Astrophysics Data System (ADS)

Tut, Turgut; Dan, Yaping; Duane, Peter; Yu, Young; Wober, Munib; Crozier, Kenneth B.

2012-01-01

We describe the experimental realization of vertical silicon nitride waveguides integrated with silicon photodetectors. The waveguides are embedded in a silicon dioxide layer. Scanning photocurrent microscopy is performed on a device containing a waveguide, and on a device containing the silicon dioxide layer, but without the waveguide. The results confirm the waveguide's ability to guide light onto the photodetector with high efficiency. We anticipate that the use of these structures in image sensors, with one waveguide per pixel, would greatly improve efficiency and significantly reduce inter-pixel crosstalk.

Influence of light-dark schedules and stocking density on behaviour, risk of leg problems and occurrence of chronic fear in broilers.

PubMed

Sanotra, G S; Lund, J Damkjer; Vestergaard, K S

2002-07-01

1. The aims of this study were to determine (1) the effect of light-dark schedules on the walking ability, the risk of tibial dyschondroplasia (TD) as well as the duration of tonic immobility (TI) reactions in commercial broiler flocks and (2) the effect of a daily dark period and reduced density on the behaviour of broiler chickens. 2. Experiment 1. Group 1 had a 2 to 8 h daily dark period from 2 to 26 d of age (light-dark programme A) at a stocking density of 28.4 chicks/m2. Group 2 had 8 h of darkness daily from 2 to 38 d of age (light-dark programme B) at 24 chicks/m2. The control group had 24 h continuous light at 28.4 chicks/m2. 3. Experiment 2. Behaviour was studied with and without a daily 8 h dark period and at high (30 chicks/m2) and low (18 chicks/m2) stocking densities. 4. Programme B reduced the prevalence of impaired walking ability, corresponding to gait score > 2, when compared with controls. The effect on walking ability corresponding to gait score > 0 approached significance. 5. Both light-dark programmes reduced the occurrence of TD. Programme B (combined with reduced stocking density), however, had the greater effect. 6. Both light-dark programmes reduced the duration of TI, compared with controls (mean = 426 s) Programme B resulted in a larger reduction (alpha = -156.9 s) than programme A (alpha = -117.0). 7. The proportions of chicks drinking, eating, pecking, scratching, standing and performing vertical wing-shakes increased--both when the 8 h dark period and the reduced stocking density were applied separately and in combination (experiment 2). 8. For all behaviours, except standing, the effect of the dark period was largest in broilers kept at the high stocking density (d 40).

Effect of integrated care for sick listed patients with chronic low back pain: economic evaluation alongside a randomised controlled trial.

PubMed

Lambeek, Ludeke C; Bosmans, Judith E; Van Royen, Barend J; Van Tulder, Maurits W; Van Mechelen, Willem; Anema, Johannes R

2010-11-30

To evaluate the cost effectiveness, cost utility, and cost-benefit of an integrated care programme compared with usual care for sick listed patients with chronic low back pain. Economic evaluation alongside a randomised controlled trial with 12 months' follow-up. Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals) in the Netherlands, 2005-9. 134 adults aged 18-65 sick listed because of chronic low back pain: 66 were randomised to integrated care and 68 to usual care. Integrated care consisted of a workplace intervention based on participatory ergonomics, with involvement of a supervisor, and a graded activity programme based on cognitive behavioural principles. Usual care was provided by general practitioners and occupational physicians according to Dutch guidelines. The primary outcome was duration until sustainable return to work. The secondary outcome was quality adjusted life years (QALYs), measured using EuroQol. Total costs in the integrated care group (£13 165, SD £13 600) were significantly lower than in the usual care group (£18 475, SD £13 616). Cost effectiveness planes and acceptability curves showed that integrated care was cost effective compared with usual care for return to work and QALYs gained. The cost-benefit analyses showed that every £1 invested in integrated care would return an estimated £26. The net societal benefit of integrated care compared with usual care was £5744. Implementation of an integrated care programme for patients sick listed with chronic low back pain has a large potential to significantly reduce societal costs, increase effectiveness of care, improve quality of life, and improve function on a broad scale. Integrated care therefore has large gains for patients and society as well as for employers.

Promoting research integrity in the geosciences

NASA Astrophysics Data System (ADS)

Mayer, Tony

2015-04-01

Conducting research in a responsible manner in compliance with codes of research integrity is essential. The geosciences, as with all other areas of research endeavour, has its fair share of misconduct cases and causes celebres. As research becomes more global, more collaborative and more cross-disciplinary, the need for all concerned to work to the same high standards becomes imperative. Modern technology makes it far easier to 'cut and paste', to use Photoshop to manipulate imagery to falsify results at the same time as making research easier and more meaningful. So we need to promote the highest standards of research integrity and the responsible conduct of research. While ultimately, responsibility for misconduct rests with the individual, institutions and the academic research system have to take steps to alleviate the pressure on researchers and promote good practice through training programmes and mentoring. The role of the World Conferences on Research Integrity in promoting the importance of research integrity and statements about good practice will be presented and the need for training and mentoring programmes will be discussed

The effects of isolated and integrated 'core stability' training on athletic performance measures: a systematic review.

PubMed

Reed, Casey A; Ford, Kevin R; Myer, Gregory D; Hewett, Timothy E

2012-08-01

Core stability training, operationally defined as training focused to improve trunk and hip control, is an integral part of athletic development, yet little is known about its direct relation to athletic performance. This systematic review focuses on identification of the association between core stability and sports-related performance measures. A secondary objective was to identify difficulties encountered when trying to train core stability with the goal of improving athletic performance. A systematic search was employed to capture all articles related to athletic performance and core stability training that were identified using the electronic databases MEDLINE, CINAHL and SPORTDiscus™ (1982-June 2011). A systematic approach was used to evaluate 179 articles identified for initial review. Studies that performed an intervention targeted toward the core and measured an outcome related to athletic or sport performances were included, while studies with a participant population aged 65 years or older were excluded. Twenty-four in total met the inclusionary criteria for review. Studies were evaluated using the Physical Therapy Evidence Database (PEDro) scale. The 24 articles were separated into three groups, general performance (n = 8), lower extremity (n = 10) and upper extremity (n = 6), for ease of discussion. In the majority of studies, core stability training was utilized in conjunction with more comprehensive exercise programmes. As such, many studies saw improvements in skills of general strengths such as maximum squat load and vertical leap. Surprisingly, not all studies reported measurable increases in specific core strength and stability measures following training. Additionally, investigations that targeted the core as the primary goal for improved outcome of training had mixed results. Core stability is rarely the sole component of an athletic development programme, making it difficult to directly isolate its affect on athletic performance. The population biases of some studies of athletic performance also confound the results. Targeted core stability training provides marginal benefits to athletic performance. Conflicting findings and the lack of a standardization for measurement of outcomes and training focused to improve core strength and stability pose difficulties. Because of this, further research targeted to determine this relationship is necessary to better understand how core strength and stability affect athletic performance.

Embedding operational research into national disease control programme: lessons from 10 years of experience in Indonesia

PubMed Central

Mahendradhata, Yodi; Probandari, Ari; Widjanarko, Bagoes; Riono, Pandu; Mustikawati, Dyah; Tiemersma, Edine W.; Alisjahbana, Bachti

2014-01-01

There is growing recognition that operational research (OR) should be embedded into national disease control programmes. However, much of the current OR capacity building schemes are still predominantly driven by international agencies with limited integration into national disease control programmes. We demonstrated that it is possible to achieve a more sustainable capacity building effort across the country by establishing an OR group within the national tuberculosis (TB) control programme in Indonesia. Key challenges identified include long-term financial support, limited number of scientific publications, and difficulties in documenting impact on programmatic performance. External evaluation has expressed concerns in regard to utilisation of OR in policy making. Efforts to address this concern have been introduced recently and led to indications of increased utilisation of research evidence in policy making by the national TB control programme. Embedding OR in national disease control programmes is key in establishing an evidence-based disease control programme. PMID:25361728

Developing INFOMAR's Seabed Mapping Data to Support a Sustainable Marine Economy

NASA Astrophysics Data System (ADS)

Judge, M. T.; Guinan, J.

2016-02-01

As Ireland's national seabed mapping programme, INFOMAR1 (INtegrated mapping FOr the sustainable development of Ireland's MARine resource) enters its eleventh year it continues to provide pivotal seabed mapping data products, e.g. databases, charts and physical habitat maps to support Ireland's Integrated Marine Plan. The programme, jointly coordinated by the Geological Survey of Ireland and the Marine Institute, has gained a world class reputation for developing seabed mapping technologies, infrastructure and expertise. In the government's current Integrated Marine Plan, the programme's critical role in marine spatial planning enabling infrastructural development, research and education has been cited2. INFOMAR's free data policy supports a thriving maritime economy by promoting easy access to seabed mapping datasets that underpin; maritime safety, security and surveillance, governance, business development, research and technology innovation and infrastructure. The first hydrographic surveys of the national marine mapping programme mapped the extent of Ireland's deepest offshore area, whilst in recent years the focus has been to map the coastal and shallow areas. Targeted coastal areas include 26 bays and 3 priority areas for which specialised equipment, techniques and vessels are required. This talk will discuss how the INFOMAR programme has evolved to address the scientific and technological challenges of seabed mapping across a range of water depths; particularly the challenges associated with addressing inshore data gaps. It will describe how the data converts to bathymetric and geological maps detailing seabed characteristics and habitats. We will expand on how maps are: incorporated into collaborative marine projects such as EMODnet, commercialised to identify marine resources and used as marine decision support tools that drive policy and promote protection of the vastly under discovered marine area.

Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain.

PubMed

Jessep, Sally A; Walsh, Nicola E; Ratcliffe, Julie; Hurley, Michael V

2009-06-01

Chronic knee pain is a major cause of disability in the elderly. Management guidelines recommend exercise and self-management interventions as effective treatments. The authors previously described a rehabilitation programme integrating exercise and self-management [Enabling Self-management and Coping with Arthritic knee Pain through Exercise (ESCAPE-knee pain)] that produced short-term improvements in pain and physical function, but sustaining these improvements is difficult. Moreover, the programme is untried in clinical environments, where it would ultimately be delivered. To establish the feasibility of ESCAPE-knee pain and compare its clinical effectiveness and costs with outpatient physiotherapy. Pragmatic, randomised controlled trial. Outpatient physiotherapy department and community centre. Sixty-four people with chronic knee pain. Outpatient physiotherapy compared with ESCAPE-knee pain. The primary outcome was physical function assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included pain, objective functional performance, anxiety, depression, exercise-related health beliefs and healthcare utilisation. All outcomes were assessed at baseline and 12 months after completing the interventions (primary endpoint). ANCOVA investigated between-group differences. Both groups demonstrated similar improvements in clinical outcomes. Outpatient physiotherapy cost pound 130 per person and the healthcare utilisation costs of participants over 1 year were pound 583. The ESCAPE-knee pain programme cost pound 64 per person and the healthcare utilisation costs of participants over 1 year were pound 320. ESCAPE-knee pain can be delivered as a community-based integrated rehabilitation programme for people with chronic knee pain. Both ESCAPE-knee pain and outpatient physiotherapy produced sustained physical and psychosocial benefits, but ESCAPE-knee pain cost less and was more cost-effective.

Outcomes and process evaluation of a programme integrating physical activity into the primary school mathematics curriculum: The EASY Minds pilot randomised controlled trial.

PubMed

Riley, Nicholas; Lubans, David R; Morgan, Philip J; Young, Myles

2015-11-01

This study evaluated the feasibility of the 'Encouraging Activity to Stimulate Young (EASY) Minds' programme, a school-based intervention for integrating physical activity (PA) into mathematics lessons. Randomised controlled trial. Two classes from a single school (n = 54) were randomised to receive either the 6-week EASY Minds intervention (n = 27) or follow their usual school programme (n = 27). The intervention involved the embedding of PA across the pre-existing mathematics programme for 3 × 60 min sessions per week. Changes in PA were measured using accelerometers and 'on task' behaviour was measured using momentary time sampling observation. Using intention-to-treat analysis, significant intervention effects were found for MVPA (9.7%, 95%CI = 7.6, 11.8, p ≤ 0.001) and sedentary time (-22.4%, CI = -24.9, -12.2, p ≤ 0.001) for the intervention group during Mathematics lessons (9.30 am-10.30 am). Significant intervention effects were also shown for MVPA 8.7% (95% CI = 5.8, 11.6, p ≤ 0.001 and sedentary time -18.6% (95% CI = -24.9, -12.2, p ≤ 0.001) across the whole school day. Furthermore, children displayed significantly greater 'on-task' behaviour across the intervention period with a 19.9% (95%CI = 2.4, 37.4, p ≤ 0.03) mean difference between groups. The EASY Minds programme demonstrated that integrating movement across the primary mathematics syllabus is feasible and efficacious in enhancing school based-PA and improving on-task behaviour in mathematics lessons. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Primary health care and immunisation in Iran.

PubMed

Nasseri, K; Sadrizadeh, B; Malek-Afzali, H; Mohammad, K; Chamsa, M; Cheraghchi-Bashi, M T; Haghgoo, M; Azmoodeh, M

1991-05-01

The Primary Health Care (PHC) network of Iran consists of a rural and an urban branch. While the rural branch presently covers a sizeable portion of the rural population, the urban PHC project is in its early stages of implementation. The Expanded Programme on Immunisation (EPI) in Iran, which started as an independent and vertical project in early 1983, is being gradually integrated into the PHC network as the latter expands. Results of the second PHC programme review of Iran shows that immunisation coverage of children has improved appreciably since the first PHC review, especially for BCG which stands at 56.3%. Complete immunisation at first birthday in the rural areas with the PHC services is 44.1%, whereas for urban areas other than Teheran it is 28.1%. While the high coverage in the rural areas is attributed to the 'active' approach and vigilance of the providers of immunisation (i.e. the community health workers and the vaccinators of the mobile teams), the higher coverage in the capital city of Teheran is attributed to the involvement of private paediatricians and the generally higher social, economic, and educational status as well as higher interest of mothers. It is noticed that the results of cluster sampling for determination of immunisation coverage in large metropolitan areas of the developing world must be interpreted with much care. The reason is that in these areas extreme fluctuations in the crude birth rate are common and therefore results tend to over-represent the attributes of the segment of population with lower birth rate. It is also argued that complete immunisation might not be the best indicator for assessing the progress of the immunisation efforts. These and other findings are discussed in detail. are discussed in detail.

Integrated prevalence mapping of schistosomiasis, soil-transmitted helminthiasis and malaria in lakeside and island communities in Lake Victoria, Uganda.

PubMed

Kabatereine, Narcis B; Standley, Claire J; Sousa-Figueiredo, Jose C; Fleming, Fiona M; Stothard, J Russell; Talisuna, Ambrose; Fenwick, Alan

2011-12-13

It is widely advocated that integrated strategies for the control of neglected tropical diseases (NTDs) are cost-effective in comparison to vertical disease-specific programmes. A prerequisite for implementation of control interventions is the availability of baseline data of prevalence, including the population at risk and disease overlap. Despite extensive literature on the distribution of schistosomiasis on the mainland in Uganda, there has been a knowledge gap for the prevalence of co-infections with malaria, particularly for island communities in Lake Victoria. In this study, nine lakeshore and island districts were surveyed for the prevalence of NTDs and malaria, as well as educational and health infrastructure. A total of 203 communities were surveyed, including over 5000 school-age children. Varying levels of existing health infrastructure were observed between districts, with only Jinja District regularly treating people for NTDs. Community medicine distributors (CMD) were identified and trained in drug delivery to strengthen capacity. Prevalence levels of intestinal schistosomiasis and soil-transmitted helminthiasis were assessed via Kato-Katz thick smears of stool and malaria prevalence determined by microscopy of fingerprick blood samples. Prevalence levels were 40.8%, 26.04% and 46.4%, respectively, while the prevalence of co-infection by Schistosoma mansoni and Plasmodium spp. was 23.5%. Socio-economic status was strongly associated as a risk factor for positive infection status with one or more of these diseases. These results emphasise the challenges of providing wide-scale coverage of health infrastructure and drug distribution in remote lakeshore communities. The data further indicate that co-infections with malaria and NTDs are common, implying that integrated interventions for NTDs and malaria are likely to maximize cost-effectiveness and sustainability of disease control efforts.

Integrated prevalence mapping of schistosomiasis, soil-transmitted helminthiasis and malaria in lakeside and island communities in Lake Victoria, Uganda

PubMed Central

2011-01-01

Background It is widely advocated that integrated strategies for the control of neglected tropical diseases (NTDs) are cost-effective in comparison to vertical disease-specific programmes. A prerequisite for implementation of control interventions is the availability of baseline data of prevalence, including the population at risk and disease overlap. Despite extensive literature on the distribution of schistosomiasis on the mainland in Uganda, there has been a knowledge gap for the prevalence of co-infections with malaria, particularly for island communities in Lake Victoria. In this study, nine lakeshore and island districts were surveyed for the prevalence of NTDs and malaria, as well as educational and health infrastructure. Results A total of 203 communities were surveyed, including over 5000 school-age children. Varying levels of existing health infrastructure were observed between districts, with only Jinja District regularly treating people for NTDs. Community medicine distributors (CMD) were identified and trained in drug delivery to strengthen capacity. Prevalence levels of intestinal schistosomiasis and soil-transmitted helminthiasis were assessed via Kato-Katz thick smears of stool and malaria prevalence determined by microscopy of fingerprick blood samples. Prevalence levels were 40.8%, 26.04% and 46.4%, respectively, while the prevalence of co-infection by Schistosoma mansoni and Plasmodium spp. was 23.5%. Socio-economic status was strongly associated as a risk factor for positive infection status with one or more of these diseases. Conclusions These results emphasise the challenges of providing wide-scale coverage of health infrastructure and drug distribution in remote lakeshore communities. The data further indicate that co-infections with malaria and NTDs are common, implying that integrated interventions for NTDs and malaria are likely to maximize cost-effectiveness and sustainability of disease control efforts. PMID:22166365

Iterative current mode per pixel ADC for 3D SoftChip implementation in CMOS

NASA Astrophysics Data System (ADS)

Lachowicz, Stefan W.; Rassau, Alexander; Lee, Seung-Minh; Eshraghian, Kamran; Lee, Mike M.

2003-04-01

Mobile multimedia communication has rapidly become a significant area of research and development constantly challenging boundaries on a variety of technological fronts. The processing requirements for the capture, conversion, compression, decompression, enhancement, display, etc. of increasingly higher quality multimedia content places heavy demands even on current ULSI (ultra large scale integration) systems, particularly for mobile applications where area and power are primary considerations. The ADC presented in this paper is designed for a vertically integrated (3D) system comprising two distinct layers bonded together using Indium bump technology. The top layer is a CMOS imaging array containing analogue-to-digital converters, and a buffer memory. The bottom layer takes the form of a configurable array processor (CAP), a highly parallel array of soft programmable processors capable of carrying out complex processing tasks directly on data stored in the top plane. This paper presents a ADC scheme for the image capture plane. The analogue photocurrent or sampled voltage is transferred to the ADC via a column or a column/row bus. In the proposed system, an array of analogue-to-digital converters is distributed, so that a one-bit cell is associated with one sensor. The analogue-to-digital converters are algorithmic current-mode converters. Eight such cells are cascaded to form an 8-bit converter. Additionally, each photo-sensor is equipped with a current memory cell, and multiple conversions are performed with scaled values of the photocurrent for colour processing.

49 CFR 178.345-3 - Structural integrity.

Code of Federal Regulations, 2014 CFR

2014-10-01

... accelerative force equal to 0.35 times the vertical reaction at the suspension assembly of a trailer; or the... the suspension assembly of a trailer, and the horizontal pivot of the upper coupler (fifth wheel) or... normal operating accelerative force equal to 0.35 times the vertical reaction at the suspension assembly...

49 CFR 178.345-3 - Structural integrity.

Code of Federal Regulations, 2012 CFR

2012-10-01

... accelerative force equal to 0.35 times the vertical reaction at the suspension assembly of a trailer; or the... the suspension assembly of a trailer, and the horizontal pivot of the upper coupler (fifth wheel) or... normal operating accelerative force equal to 0.35 times the vertical reaction at the suspension assembly...

49 CFR 178.345-3 - Structural integrity.

Code of Federal Regulations, 2013 CFR

2013-10-01

... accelerative force equal to 0.35 times the vertical reaction at the suspension assembly of a trailer; or the... the suspension assembly of a trailer, and the horizontal pivot of the upper coupler (fifth wheel) or... normal operating accelerative force equal to 0.35 times the vertical reaction at the suspension assembly...

Verticality perception during and after galvanic vestibular stimulation.

PubMed

Volkening, Katharina; Bergmann, Jeannine; Keller, Ingo; Wuehr, Max; Müller, Friedemann; Jahn, Klaus

2014-10-03

The human brain constructs verticality perception by integrating vestibular, somatosensory, and visual information. Here we investigated whether galvanic vestibular stimulation (GVS) has an effect on verticality perception both during and after application, by assessing the subjective verticals (visual, haptic and postural) in healthy subjects at those times. During stimulation the subjective visual vertical and the subjective haptic vertical shifted towards the anode, whereas this shift was reversed towards the cathode in all modalities once stimulation was turned off. Overall, the effects were strongest for the haptic modality. Additional investigation of the time course of GVS-induced changes in the haptic vertical revealed that anodal shifts persisted for the entire 20-min stimulation interval in the majority of subjects. Aftereffects exhibited different types of decay, with a preponderance for an exponential decay. The existence of such reverse effects after stimulation could have implications for GVS-based therapy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Integrated null-flux suspension and multiphase propulsion system for magnetically-levitated vehicles

DOEpatents

Rote, Donald M.; He, Jianliang; Johnson, Larry R.

1994-01-01

A propulsion and stabilization system comprising a series of FIG. 8 coils mounted vertically on the walls of the guideway to provide suspension, lateral guidance and propulsion of a magnetically levitated vehicle. This system further allows for altering the magnetic field effects by changing the relative position of the loops comprising the FIG. 8 coils either longitudinally and/or vertically with resulting changes in the propulsion, the vertical stability, and the suspension.

Integrated null-flux suspension and multiphase propulsion system for magnetically-levitated vehicles

DOEpatents

Rote, D.M.; He, J.; Johnson, L.R.

1994-01-04

A propulsion and stabilization system are described comprising a series of coils mounted vertically on the walls of the guideway to provide suspension, lateral guidance, and propulsion of a magnetically levitated vehicle. This system further allows for altering the magnetic field effects by changing the relative position of the loops comprising the coils either longitudinally and/or vertically with resulting changes in the propulsion, the vertical stability, and the suspension. 8 figures.

Integrated null-flux suspension and multiphase propulsion system for magnetically-levitated vehicles

DOEpatents

Rote, D.M.; He, Jianliang; Johnson, L.R.

1992-01-01

This report discusses a propulsion and stabilization system comprising a series of figure 8 coils mounted vertically on the walls of the guideway to provide suspension, lateral guidance and propulsion of a magnetically levitated vehicle. This system further allows for altering the magnetic field effects by changing the relative position of the loops comprising the figure 8 coils either longitudinally and/or vertically with resulting changes in the propulsion, the vertical stability, and the suspension.

Aerodynamic Loads at Mach Numbers from 0.70 to 2.22 on an Airplane Model Having a Wing and Canard of Triangular Plan Form and Either Single or Twin Vertical Tails. Supplement 2; Tabulated Data for the Model with Twin Vertical Tails

NASA Technical Reports Server (NTRS)

Peterson, Victor L.; Menees, Gene P.

1961-01-01

Tabulated results of a wind-tunnel investigation of the aerodynamic loads on a canard airplane model with twin vertical tails are presented for Mach numbers from 0.70 to 2.22. The Reynolds number for the measurements was 2.9 x 10(exp 6) based on the wing mean aerodynamic chord. The results include local static-pressure coefficients measured on the wing, body, and one of the vertical tails for angles of attack from -4 degrees to 16 degree angles of sideslip of 0 degrees and 5.3 degrees, and nominal canard deflections of O degrees and 10 degrees. Also included are section force and moment coefficients obtained from integrations of the local pressures and model-component force and moment coefficients obtained from integrations of the section coefficients. Geometric details of the model are shown and the locations of the pressure orifices are shown. An index to the data contained herein is presented and definitions of nomenclature are given. Detailed descriptions of the model and experiments and a brief discussion of some of the results are given. Tabulated results of measurements of the aerodynamic loads on the same canard model but having a single vertical tail instead of twin vertical tails are presented.

Integrated Vertical Bloch Line (VBL) memory

NASA Technical Reports Server (NTRS)

Katti, R. R.; Wu, J. C.; Stadler, H. L.

1991-01-01

Vertical Bloch Line (VBL) Memory is a recently conceived, integrated, solid state, block access, VLSI memory which offers the potential of 1 Gbit/sq cm areal storage density, data rates of hundreds of megabits/sec, and submillisecond average access time simultaneously at relatively low mass, volume, and power values when compared to alternative technologies. VBLs are micromagnetic structures within magnetic domain walls which can be manipulated using magnetic fields from integrated conductors. The presence or absence of BVL pairs are used to store binary information. At present, efforts are being directed at developing a single chip memory using 25 Mbit/sq cm technology in magnetic garnet material which integrates, at a single operating point, the writing, storage, reading, and amplification functions needed in a memory. The current design architecture, functional elements, and supercomputer simulation results are described which are used to assist the design process.

Implicit, Stand-Alone or Integrated Skills Education for Undergraduates: A Longitudinal Analysis of Programme Outcomes

ERIC Educational Resources Information Center

MacVaugh, Jason; Jones, Anna; Auty, Stephanie

2014-01-01

This paper reports the findings of a longitudinal investigation into the effectiveness of skills education programmes within business and management undergraduate degree courses. During the period between 2005 and 2011, a large business school in the south-west of England was developed and implemented two distinct approaches to skills education.…

Schools for the Future: Subtle Shift or Seismic Change?

ERIC Educational Resources Information Center

Sutherland, Rosamund; Sutherland, Joanna; Fellner, Chris; Siccolo, Matt; Clark, Lindsey

2014-01-01

This paper centres around a discussion of the design and rebuild of a secondary school in Birmingham (England) as part of the Building Schools of the Future (BSF) Programme. The BSF Programme was influenced by a vision of future schooling in which learning environments are transformed by the integration of ICT into teaching and learning practices.…

Preparing Pre-Service Teachers to Integrate Technology into K-12 Instruction: Evaluation of a Technology-Infused Approach

ERIC Educational Resources Information Center

Admiraal, Wilfried; van Vugt, Felix; Kranenburg, Frans; Koster, Bob; Smit, Ben; Weijers, Sanne; Lockhorst, Ditte

2017-01-01

The quality of how technology is addressed in teacher education programmes is conditional for how student teachers apply technology in secondary schools after their graduation. Two technology-infused courses of one teacher education programme were evaluated. In line with studies on the development of pre-service teachers' technological,…

Distance Education MBA Students: An Investigation into the Use of an Orientation Course to Address Academic and Social Integration Issues

ERIC Educational Resources Information Center

Kanuka, Heather; Jugdev, Kam

2006-01-01

Distance education programmes warrant the use of innovative intervention practices to enhance student learning experiences. Academic and social empathy by faculty has been shown to enhance student retention in programmes along with their critical thinking abilities. Using Holmberg's theory of teaching-learning conversations as the guiding…

Maximising Leadership Capacity and School Improvement through Re-Alignment of Children's Services

ERIC Educational Resources Information Center

Tarpey, Christine; Poultney, Val

2015-01-01

This article emerges from work undertaken with leaders from a local authority who took part in a programme entitled "Advanced Leadership in Integrated Children's Services Environment" or ALICSE programme. The aim of this course was to engage leaders and managers in thinking differently about their roles and to consider how they could…

An Undergraduate Course and Laboratory in Digital Signal Processing with Field Programmable Gate Arrays

ERIC Educational Resources Information Center

Meyer-Base, U.; Vera, A.; Meyer-Base, A.; Pattichis, M. S.; Perry, R. J.

2010-01-01

In this paper, an innovative educational approach to introducing undergraduates to both digital signal processing (DSP) and field programmable gate array (FPGA)-based design in a one-semester course and laboratory is described. While both DSP and FPGA-based courses are currently present in different curricula, this integrated approach reduces the…

Literacy in Multilingual and Multicultural Contexts: Effective Approaches to Adult Learning and Education

ERIC Educational Resources Information Center

Hanemann, Ulrike, Ed.; Scarpino, Cassandra, Ed.

2016-01-01

This compilation includes programmes which promote language and culture as resources and see them as an added value rather than a challenge for literacy teaching and learning. It also includes programmes designed to support migrants and refugees by equipping them for integration into mainstream society while strengthening their literacy skills in…

"Living the Curriculum": Integrating Sport Education into a Physical Education Teacher Education Programme

ERIC Educational Resources Information Center

Deenihan, J. T.; McPhail, Ann; Young, Ann-Marie

2011-01-01

This study recognizes the paucity of research regarding how pre-service teachers learn to use Sport Education (SE) in their Physical Education Teacher Education (PETE) programmes (Stran and Curtner-Smith, 2010). The study provides an opportunity in PETE where pre-service teachers "live the curriculum" (Oslin et al., 2001) and experience…

Seven Years of Linking Scottish Schools and Industry with SSTN

ERIC Educational Resources Information Center

Whittington, Gary; Lowson, Sandra

2007-01-01

The Scottish Science and Technology Network (SSTN) is a major collaboration between Careers Scotland and Scottish industry to promote science and technology via an on-line and integrated learning programme. An initial two-year pilot project has grown considerably and has now been running for over 7 years. The SSTN programme is a web-based…

When Work Comes First: Young Adults in Vocational Education and Training in Norway

ERIC Educational Resources Information Center

Tønder, Anna Hagen; Aspøy, Tove Mogstad

2017-01-01

Since reforms implemented in 1994, vocational education and training (VET) in Norway has been integrated and standardized as part of upper-secondary education. When young people enter upper-secondary education at the age of 15 or 16, they can choose either a vocational programme or a general academic programme. The standard model in vocational…

Reading Partridge's "The Goblet Club" as an Integral Part of a Secondary School's Anti-Bullying Programme

ERIC Educational Resources Information Center

De Wet, Corene

2017-01-01

Notwithstanding legislation and individual schools' codes of conduct prohibiting bullying, bullying is an escalating problem in South African schools. It seems as if existing anti-bullying policies, programmes and intervention strategies are failing to address the scourge. Bibliotherapy has been identified as a way to strengthen schools' existing…

Mainstream Students' Attitudes to Possible Inclusion in Unified Sports with Students Who Have an Intellectual Disability

ERIC Educational Resources Information Center

Townsend, Michael; Hassall, John

2007-01-01

Background: Schools in New Zealand do not normally include students with intellectual disability in their sports programmes. This study examined regular students' attitudes towards the possible inclusion of students with an intellectual disability in an integrated sports programme within their school. Materials and Methods: A total of 170 school…

Health programmes for school employees: improving quality of life, health and productivity.

PubMed

Kolbe, Lloyd J; Tirozzi, Gerald N; Marx, Eva; Bobbitt-Cooke, Mary; Riedel, Sara; Jones, Jack; Schmoyer, Michael

2005-01-01

School health programmes in the 21st century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st century: school administrators, employees, and policymakers must be informed about the need and the means to do so; school employee health programmes must become part of the culture of education and the expectation of educators; and colleges that prepare school administrators and other school employees must provide the pre-service and in-service training, research, development, and leadership to make it happen. This article outlines ten actions that can be taken by school districts to build or improve school employee health programmes, and a list of websites that provides more detailed information about such programmes.

Intersectoral approaches and integrated services in achieving the right to health for refugees upon resettlement: a scoping review protocol.

PubMed

Javadi, Dena; Langlois, Etienne V; Ho, Shirley; Friberg, Peter; Tomson, Göran

2017-08-30

Global insecurity and climate change are exacerbating the need for improved management of refugee resettlement services. International standards hold states responsible for the protection of the right of non-citizens to an adequate standard of physical and mental health while recognising the importance of social determinants of health. However, programmes to protect refugees' right to health often lack coordination and monitoring. This paper describes the protocol for a scoping review to explore barriers and facilitators to the integration of health services for refugees; the content, process and actors involved in protecting refugee health; and the extent to which intersectoral approaches are leveraged to protect refugees' right to health on resettlement, especially for vulnerable groups such as women and children. Peer-reviewed (through four databases including MEDLINE, Web of Science, Global Health and PsycINFO) and grey literature were searched to identify programmes and interventions designed to promote refugee health in receiving countries. Two reviewers will screen articles and abstract data. Two frameworks for integration and intersectoral action will be applied to understand how and why certain approaches work while others do not and to identify the actors involved in achieving success at different levels of integration as defined by these frameworks. Findings from the scoping review will be shared in relevant conferences and meetings. A brief will be created with lessons learnt from successful programmes to inform decision making in design of refugee programmes and services. Ethical approval is not required as human subjects are not involved. Registered on Open Science Framework at https://osf.io/gt9ck/. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Integrated approach to e-learning enhanced both subjective and objective knowledge of aEEG in a neonatal intensive care unit

PubMed Central

Poon, Woei Bing; Tagamolila, Vina; Toh, Ying Pin Anne; Cheng, Zai Ru

2015-01-01

INTRODUCTION Various meta-analyses have shown that e-learning is as effective as traditional methods of continuing professional education. However, there are some disadvantages to e-learning, such as possible technical problems, the need for greater self-discipline, cost involved in developing programmes and limited direct interaction. Currently, most strategies for teaching amplitude-integrated electroencephalography (aEEG) in neonatal intensive care units (NICUs) worldwide depend on traditional teaching methods. METHODS We implemented a programme that utilised an integrated approach to e-learning. The programme consisted of three sessions of supervised protected time e-learning in an NICU. The objective and subjective effectiveness of the approach was assessed through surveys administered to participants before and after the programme. RESULTS A total of 37 NICU staff (32 nurses and 5 doctors) participated in the study. 93.1% of the participants appreciated the need to acquire knowledge of aEEG. We also saw a statistically significant improvement in the subjective knowledge score (p = 0.041) of the participants. The passing rates for identifying abnormal aEEG tracings (defined as ≥ 3 correct answers out of 5) also showed a statistically significant improvement (from 13.6% to 81.8%, p < 0.001). Among the participants who completed the survey, 96.0% felt the teaching was well structured, 77.8% felt the duration was optimal, 80.0% felt that they had learnt how to systematically interpret aEEGs, and 70.4% felt that they could interpret normal aEEG with confidence. CONCLUSION An integrated approach to e-learning can help improve subjective and objective knowledge of aEEG. PMID:25820847

Intersectoral approaches and integrated services in achieving the right to health for refugees upon resettlement: a scoping review protocol

PubMed Central

Javadi, Dena; Langlois, Etienne V; Ho, Shirley; Friberg, Peter; Tomson, Göran

2017-01-01

Introduction Global insecurity and climate change are exacerbating the need for improved management of refugee resettlement services. International standards hold states responsible for the protection of the right of non-citizens to an adequate standard of physical and mental health while recognising the importance of social determinants of health. However, programmes to protect refugees’ right to health often lack coordination and monitoring. This paper describes the protocol for a scoping review to explore barriers and facilitators to the integration of health services for refugees; the content, process and actors involved in protecting refugee health; and the extent to which intersectoral approaches are leveraged to protect refugees’ right to health on resettlement, especially for vulnerable groups such as women and children. Methods and analysis Peer-reviewed (through four databases including MEDLINE, Web of Science, Global Health and PsycINFO) and grey literature were searched to identify programmes and interventions designed to promote refugee health in receiving countries. Two reviewers will screen articles and abstract data. Two frameworks for integration and intersectoral action will be applied to understand how and why certain approaches work while others do not and to identify the actors involved in achieving success at different levels of integration as defined by these frameworks. Ethics and dissemination Findings from the scoping review will be shared in relevant conferences and meetings. A brief will be created with lessons learnt from successful programmes to inform decision making in design of refugee programmes and services. Ethical approval is not required as human subjects are not involved. Trial registration number Registered on Open Science Framework at https://osf.io/gt9ck/. PMID:28855201

Quantitative assessment of four men using above-elbow prosthetic control.

PubMed

Popat, R A; Krebs, D E; Mansfield, J; Russell, D; Clancy, E; Gill-Body, K M; Hogan, N

1993-07-01

We studied the relationship between kinematically unconstrained activities of daily living (ADL) tasks and a kinematically constrained task in above-elbow (AE) amputee subjects using myoelectrically controlled prostheses. Four men, 24 to 49 years old, with unilateral AE amputation wore a prosthesis interfaced to a programmable controller to emulate two different elbow control schemes, conventional velocity and a new "natural" controller. Subjects were timed during three ADL tasks--cutting meat, donning socks, and rolling dough--with both controllers. The prosthesis emulator was then connected to a crank device with a handle, and the subjects turned the crank from bottom to top positions in a vertical plane using each controller. Synergistic shoulder-elbow joint coordination required for crank turning was quantified as the maximum slope of the change in elbow torque versus the change in crank-angle. Performance between the two controllers differed significantly for the crank test but not for ADL tasks. One subject did not complete all crank turning tests. Positive canonical correlation of 0.77 was found between time and crank domain measures. We conclude that biomechanical assessments should be integrated with time-based clinical tests to comprehensively evaluate performance of AE amputee subjects with a myoelectric device.

On-chip skin color detection using a triple-well CMOS process

NASA Astrophysics Data System (ADS)

Boussaid, Farid; Chai, Douglas; Bouzerdoum, Abdesselam

2004-03-01

In this paper, a current-mode VLSI architecture enabling on read-out skin detection without the need for any on-chip memory elements is proposed. An important feature of the proposed architecture is that it removes the need for demosaicing. Color separation is achieved using the strong wavelength dependence of the absorption coefficient in silicon. This wavelength dependence causes a very shallow absorption of blue light and enables red light to penetrate deeply in silicon. A triple-well process, allowing a P-well to be placed inside an N-well, is chosen to fabricate three vertically integrated photodiodes acting as the RGB color detector for each pixel. Pixels of an input RGB image are classified as skin or non-skin pixels using a statistical skin color model, chosen to offer an acceptable trade-off between skin detection performance and implementation complexity. A single processing unit is used to classify all pixels of the input RGB image. This results in reduced mismatch and also in an increased pixel fill-factor. Furthermore, the proposed current-mode architecture is programmable, allowing external control of all classifier parameters to compensate for mismatch and changing lighting conditions.

[Stakeholder representations of the role of the intermediate level of the DRC health system].

PubMed

Mbeva, Jean Bosco Kahindo; Karemere, Hermès; Schirvel, Carole; Porignon, Denis

2014-01-01

Intermediate health care structures in the DRC were designed during the setting-up of primary health care in a perspective of health district support. This study was designed to describe stakeholder representations of the intermediate level of the DRC health system during the first 30 years of the primary health care system. This case study was based on inductive analysis of data from 27 key informant interviews.. The intermediate level of the health system, lacking sufficient expertise and funding during the 1980s, was confined to inspection and control functions, answering to the central level of the Ministry of health and provincial authorities. Since the 1990s, faced with the pressing demand for support from health district teams, whose self-management had to deal with humanitarian emergencies, the need to integrate vertical programmes, and cope with the logistics of many different actors, the intermediate heath system developed methods and tools to support heath districts. This resulted in a subsidiary model of the intermediate level, the perceived efficacy of which varies according to the province over recent years. The "subsidiary" model of the intermediary health system level seems a good alternative to the "control" model in DRC.

FRAMEWORK FOR THE INTEGRATION OF HEALTH AND ECOLOIGCAL RISK ASSESSMENT

EPA Science Inventory

The World Health Organization's International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency have developed a collaborative partnership to foster integration; of assessment approa...

Evaluating the Integration of Key Skills and NVQs into an Undergraduate Degree Programme: A Case Study from the Graduate Apprenticeship Initiative.

ERIC Educational Resources Information Center

Thomas, Sarah; Grimes, Darren

2003-01-01

Graduate apprenticeships in a British college's hospitality management course involved integration of key skills and National Vocational Qualifications units. Qualitative and quantitative data from seven students indicated they felt that integration enabled formal recognition of competency, provided valuable managerial experience, and facilitated…

Field-Programmable Gate Array-based fluxgate magnetometer with digital integration

NASA Astrophysics Data System (ADS)

Butta, Mattia; Janosek, Michal; Ripka, Pavel

2010-05-01

In this paper, a digital magnetometer based on printed circuit board fluxgate is presented. The fluxgate is pulse excited and the signal is extracted by gate integration. We investigate the possibility to perform integration on very narrow gates (typically 500 ns) by using digital techniques. The magnetometer is based on field-programmable gate array (FPGA) card: we will show all the advantages and disadvantages, given by digitalization of fluxgate output voltage by means of analog-to-digital converter on FPGA card, as well as digitalization performed by external digitizer. Due to very narrow gate, it is shown that a magnetometer entirely based on a FPGA card is preferable, because it avoids noise due to trigger instability. Both open loop and feedback operative mode are described and achieved results are presented.

Will integrated surveillance systems for vectors and vector-borne diseases be the future of controlling vector-borne diseases? A practical example from China.

PubMed

Wu, Y; Ling, F; Hou, J; Guo, S; Wang, J; Gong, Z

2016-07-01

Vector-borne diseases are one of the world's major public health threats and annually responsible for 30-50% of deaths reported to the national notifiable disease system in China. To control vector-borne diseases, a unified, effective and economic surveillance system is urgently needed; all of the current surveillance systems in China waste resources and/or information. Here, we review some current surveillance systems and present a concept for an integrated surveillance system combining existing vector and vector-borne disease monitoring systems. The integrated surveillance system has been tested in pilot programmes in China and led to a 21·6% cost saving in rodent-borne disease surveillance. We share some experiences gained from these programmes.

METHODS FOR DETERMINING THE MECHANICAL INTEGRITY OF CLASS II INJECTION WELLS

EPA Science Inventory

The mechanical integrity of injection wells must be determined to insure that there is no significant leak in the casing, tubing or packer, and that there is no significant fluid movement through vertical channels adjacent to the injection well. Methods for mechanical integrity t...

Comparing the role of absolute sea-level rise and vertical tectonic motions in coastal flooding, Torres Islands (Vanuatu)

PubMed Central

Ballu, Valérie; Bouin, Marie-Noëlle; Siméoni, Patricia; Crawford, Wayne C.; Calmant, Stephane; Boré, Jean-Michel; Kanas, Tony; Pelletier, Bernard

2011-01-01

Since the late 1990s, rising sea levels around the Torres Islands (north Vanuatu, southwest Pacific) have caused strong local and international concern. In 2002–2004, a village was displaced due to increasing sea incursions, and in 2005 a United Nations Environment Programme press release referred to the displaced village as perhaps the world’s first climate change “refugees.” We show here that vertical motions of the Torres Islands themselves dominate the apparent sea-level rise observed on the islands. From 1997 to 2009, the absolute sea level rose by 150 + /-20 mm. But GPS data reveal that the islands subsided by 117 + /-30 mm over the same time period, almost doubling the apparent gradual sea-level rise. Moreover, large earthquakes that occurred just before and after this period caused several hundreds of mm of sudden vertical motion, generating larger apparent sea-level changes than those observed during the entire intervening period. Our results show that vertical ground motions must be accounted for when evaluating sea-level change hazards in active tectonic regions. These data are needed to help communities and governments understand environmental changes and make the best decisions for their future. PMID:21795605

Effects of a suicide prevention programme for hospitalised patients with mental illness in South Korea.

PubMed

Jun, Won Hee; Lee, Eun Ju; Park, Jeong Soon

2014-07-01

To investigate the effects of a suicide prevention programme on the levels of depression, self-esteem, suicidal ideation and spirituality in patients with mental illness. Instances of suicide have significant correlations with depression, low self-esteem, suicidal ideation and a low level of spirituality in the victims. Therefore, addressing depression, low self-esteem and suicidal ideation as suicide risk factors and increasing levels of spirituality can constitute an effective programme to prevent suicide among patients with mental illness. The study was a quasi-experimental study with a nonequivalent control group, nonsynchronised design. The study sample consisted of 45 patients with mental illness who had been admitted to the psychiatric unit in a university hospital in South Korea. The patients were assigned to control and experimental groups of 23 and 22 members, respectively. The suicide prevention programme was conducted with the experimental group over four weeks and included eight sessions (two per week). The control group received only routine treatments in the hospital. The experimental group that participated in the programme had significantly decreased mean scores for depression and suicidal ideation compared with the control group. However, there were no significant differences in the mean scores for self-esteem and spirituality between the groups. The suicide prevention programme might be usefully applied as a nursing intervention for patients hospitalised in psychiatric wards or clinics where the goals are to decrease depression and suicidal ideation. Typical treatments for hospitalised patients with mental illness are not enough to prevent suicide. Intervention for suicide prevention needs to apply an integrated approach. The suicide prevention programme using an integrated approach is more effective in reducing depression and suicidal ideation in patients with mental illness than applying routine treatments in the hospital. © 2013 John Wiley & Sons Ltd.

Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

PubMed Central

Baillie, Lesley; Gallini, Andrew; Corser, Rachael; Elworthy, Gina; Scotcher, Ann; Barrand, Annabelle

2014-01-01

Introduction Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services. Theory and methods The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n = 17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions. Discussion and conclusions A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other's roles and build relationships and trust. PMID:24868193

Comparison of Cryopreserved Human Sperm between Ultra Rapid Freezing and Slow Programmable Freezing: Effect on Motility, Morphology and DNA Integrity.

PubMed

Tongdee, Pattama; Sukprasert, Matchuporn; Satirapod, Chonticha; Wongkularb, Anna; Choktanasiri, Wicham

2015-05-01

Cryopreservation of sperm is common methods to preserve male fertility. Sperm freezing, suggest slow programmable freezing caused lower change of sperm morphology than sperm freezing in vapor of liquid nitrogen. Ultra rapid freezing is easy to be worked on, less time, low cost and does not need high experience. To compare the effect on sperm motility, morphology and DNA integrity of post-thawed sperm after ultra rapid freezing and slow programmable freezing methods. Experimental study at laboratory of infertility unit, Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital. Thirty-seven semen samples with normal semen analysis according to World Health Organization (WHO) 1999 [normal sperm volume ( 2 ml) and normal sperm concentration (≥ 20 x10(6)/ml) and sperm motility (≥ 50%)]. Semen samples were washed. Then each semen sample was divided into six cryovials. Two cryovials, 0.5 ml each, were cryopreserved by slow programmable freezing. Four 0.25 ml containing cryovials, were cryopreserved by ultra rapidfreezing method. After cryopreservationfor 1 month, thawedprocess was carried out at room temperature. Main outcomes are sperm motility was determined by Computer-Assisted Semen Analysis (CASA), sperm morphology was determined by eosin-methylene blue staining and sperm DNA integrity was assessed by TUNEL assay. Sperm motility was reduced significantly by both methods, from 70.4 (9.0)% to 29.1 (12.3)% in slowprogrammable freezing and to 19.7 (9.8)% in ultra rapid freezing (p < 0.05). Sperm motility decreased significantly more by ultra rapid freezing (p < 0.001). The percentage of normal sperm morphology and DNA integrity were also reduced significantly by both methods. However, no significant difference between the two methods was found (p > 0.05). Cryopreservation of human sperm for 1 month significantly decreased sperm motility, morphology and DNA integrity in both methods. However sperm motility was decreased more by ultra rapid freezing.

Vertical ecology of the pelagic ocean: classical patterns and new perspectives.

PubMed

Sutton, T T

2013-12-01

Applications of acoustic and optical sensing and intensive, discrete-depth sampling, in concert with collaborative international research programmes, have substantially advanced knowledge of pelagic ecosystems in the 17 years since the 1996 Deepwater Fishes Symposium of the Fisheries Society of the British Isles. Although the epipelagic habitat is the best-known, and remote sensing and high-resolution modelling allow near-synoptic investigation of upper layer biophysical dynamics, ecological studies within the mesopelagic and deep-demersal habitats have begun to link lower and upper trophic level processes. Bathypelagic taxonomic inventories are far from complete, but recent projects (e.g. MAR-ECO and CMarZ, supported by the Census of Marine Life programme) have quantitatively strengthened distribution patterns previously described for fishes and have provided new perspectives. Synthesis of net and acoustic studies suggests that the biomass of deep-pelagic fishes may be two to three orders of magnitude greater than the total global commercial fisheries landings. Discrete-depth net sampling has revealed relatively high pelagic fish biomass below 1000 m in some regions, and that gelatinous zooplankton may be key energy vectors for deep-pelagic fish production. Lastly, perhaps, the most substantive paradigm shift is that vertical connectivity among fishes across classical depth zones is prevalent- suggesting that a whole-water column approach is warranted for deep ocean conservation and management. © 2013 The Fisheries Society of the British Isles.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence.

PubMed

Bosch-Capblanch, Xavier; Marceau, Claudine

2014-12-01

To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi-component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming-up of CHW, micro-franchising or social franchising. On-site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers' basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Large, multi-faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations.

Training, supervision and quality of care in selected integrated community case management (iCCM) programmes: A scoping review of programmatic evidence

PubMed Central

Bosch–Capblanch, Xavier; Marceau, Claudine

2014-01-01

Aim To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM) programmes and to draw lessons learned from existing evaluations of those programmes. Methods Scoping review of reports from 29 selected iCCM programmes purposively provided by stakeholders containing any information relevant to understand quality of care issues. Results The number of people reached by iCCM programmes varied from the tens of thousands to more than a million. All programmes aimed at improving access of vulnerable populations to health care, focusing on the main childhood illnesses, managed by Community Health Workers (CHW), often selected bycommunities. Training and supervision were widely implemented, in different ways and intensities, and often complemented with tools (eg, guides, job aids), supplies, equipment and incentives. Quality of care was measured using many outcomes (eg, access or appropriate treatment). Overall, there seemed to be positive effects for those strategies that involved policy change, organisational change, standardisation of clinical practices and alignment with other programmes. Positive effects were mostly achieved in large multi–component programmes. Mild or no effects have been described on mortality reduction amongst the few programmes for which data on this outcome was available to us. Promising strategies included teaming–up of CHW, micro–franchising or social franchising. On–site training and supervision of CHW have been shown to improve clinical practices. Effects on caregivers seemed positive, with increases in knowledge, care seeking behaviour, or caregivers’ basic disease management. Evidence on iCCM is often of low quality, cannot relate specific interventions or the ways they are implemented with outcomes and lacks standardisation; this limits the capacity to identify promising strategies to improve quality of care. Conclusion Large, multi–faceted, iCCM programmes, with strong components of training, supervision, which included additional support of equipment and supplies, seemed to improve selected quality of care outcomes. However, current evaluation and reporting practices need to be revised in a new research agenda to address the methodological challenges of iCCM evaluations. PMID:25520793

A programmable microfluidic static droplet array for droplet generation, transportation, fusion, storage, and retrieval.

PubMed

Jin, Si Hyung; Jeong, Heon-Ho; Lee, Byungjin; Lee, Sung Sik; Lee, Chang-Soo

2015-01-01

We present a programmable microfluidic static droplet array (SDA) device that can perform user-defined multistep combinatorial protocols. It combines the passive storage of aqueous droplets without any external control with integrated microvalves for discrete sample dispensing and dispersion-free unit operation. The addressable picoliter-volume reaction is systematically achieved by consecutively merging programmable sequences of reagent droplets. The SDA device is remarkably reusable and able to perform identical enzyme kinetic experiments at least 30 times via automated cross-contamination-free removal of droplets from individual hydrodynamic traps. Taking all these features together, this programmable and reusable universal SDA device will be a general microfluidic platform that can be reprogrammed for multiple applications.

Degree of vertical integration between the undergraduate program and clinical internship with respect to cervical and cranial diagnostic and therapeutic procedures taught at the canadian memorial chiropractic college.

PubMed

Leppington, Charmody; Gleberzon, Brian; Fortunato, Lisa; Doucet, Nicolea; Vandervalk, Kyle

2012-01-01

The purpose of this study was to determine if diagnostic and therapeutic procedures for the cervical and cranial spine taught to students during the undergraduate program at Canadian Memorial Chiropractic College are required to be used during their internship by their supervising clinicians and, if so, to what extent these procedures are used. Course manuals and course syllabi from the Applied Chiropractic and Clinical Diagnosis faculty of the undergraduate chiropractic program for the academic year 2009-2010 were consulted and a list of all diagnostic and therapeutic procedures for the cranial and cervical spine was compiled. This survey asked clinicians to indicate if they themselves used or if they required the students they were supervising to use each procedure listed and, if so, to what extent each procedure was used. Demographic information of each clinician was also obtained. In general, most diagnostic procedures of the head and neck were seldom used, with the exception of postural observation and palpation. By contrast, most cervical orthopaedic tests were often used, with the exception of tests for vertigo. Most therapeutic procedures were used frequently with the exception of prone cervical and "muscle" adjustments. There was a low degree of vertical integration for cranial procedures as compared to a much higher degree of vertical integration for cervical procedures between the undergraduate and clinical internship programs taught. Vertical integration is an important element of curricular planning and these results may be helpful to aid educators to more appropriately allocate classroom instruction.

Fabrication of Single, Vertically Aligned Carbon Nanotubes in 3D Nanoscale Architectures

NASA Technical Reports Server (NTRS)

Kaul, Anupama B.; Megerian, Krikor G.; Von Allmen, Paul A.; Baron, Richard L.

2010-01-01

Plasma-enhanced chemical vapor deposition (PECVD) and high-throughput manufacturing techniques for integrating single, aligned carbon nanotubes (CNTs) into novel 3D nanoscale architectures have been developed. First, the PECVD growth technique ensures excellent alignment of the tubes, since the tubes align in the direction of the electric field in the plasma as they are growing. Second, the tubes generated with this technique are all metallic, so their chirality is predetermined, which is important for electronic applications. Third, a wafer-scale manufacturing process was developed that is high-throughput and low-cost, and yet enables the integration of just single, aligned tubes with nanoscale 3D architectures with unprecedented placement accuracy and does not rely on e-beam lithography. Such techniques should lend themselves to the integration of PECVD grown tubes for applications ranging from interconnects, nanoelectromechanical systems (NEMS), sensors, bioprobes, or other 3D electronic devices. Chemically amplified polyhydroxystyrene-resin-based deep UV resists were used in conjunction with excimer laser-based (lambda = 248 nm) step-and-repeat lithography to form Ni catalyst dots = 300 nm in diameter that nucleated single, vertically aligned tubes with high yield using dc PECVD growth. This is the first time such chemically amplified resists have been used, resulting in the nucleation of single, vertically aligned tubes. In addition, novel 3D nanoscale architectures have been created using topdown techniques that integrate single, vertically aligned tubes. These were enabled by implementing techniques that use deep-UV chemically amplified resists for small-feature-size resolution; optical lithography units that allow unprecedented control over layer-to-layer registration; and ICP (inductively coupled plasma) etching techniques that result in near-vertical, high-aspect-ratio, 3D nanoscale architectures, in conjunction with the use of materials that are structurally and chemically compatible with the high-temperature synthesis of the PECVD-grown tubes. The techniques offer a wafer-scale process solution for integrating single PECVD-grown nanotubes into novel architectures that should accelerate their integration in 3D electronics in general. NASA can directly benefit from this technology for its extreme-environment planetary missions. Current Si transistors are inherently more susceptible to high radiation, and do not tolerate extremes in temperature. These novel 3D nanoscale architectures can form the basis for NEMS switches that are inherently less susceptible to radiation or to thermal extremes.

Reconfigurable lattice mesh designs for programmable photonic processors.

PubMed

Pérez, Daniel; Gasulla, Ivana; Capmany, José; Soref, Richard A

2016-05-30

We propose and analyse two novel mesh design geometries for the implementation of tunable optical cores in programmable photonic processors. These geometries are the hexagonal and the triangular lattice. They are compared here to a previously proposed square mesh topology in terms of a series of figures of merit that account for metrics that are relevant to on-chip integration of the mesh. We find that that the hexagonal mesh is the most suitable option of the three considered for the implementation of the reconfigurable optical core in the programmable processor.

A versatile pulse programmer for pulsed nuclear magnetic resonance spectroscopy.

NASA Technical Reports Server (NTRS)

Tarr, C. E.; Nickerson, M. A.

1972-01-01

A digital pulse programmer producing the standard pulse sequences required for pulsed nuclear magnetic resonance spectroscopy is described. In addition, a 'saturation burst' sequence, useful in the measurement of long relaxation times in solids, is provided. Both positive and negative 4 V trigger pulses are produced that are fully synchronous with a crystal-controlled time base, and the pulse programmer may be phase-locked with a maximum pulse jitter of 3 ns to the oscillator of a coherent pulse spectrometer. Medium speed TTL integrated circuits are used throughout.

"I Was Told That My First Duty Was to Forget Physiology, Which Had No Relation to Medicine"

ERIC Educational Resources Information Center

Walsh, Kieran

2016-01-01

There has been much recent commentary on integration in health care professional education. This commentary is of importance to physiology education as integration often touches on integration between preclinical and clinical sciences. There are different forms of integration, from horizontal to vertical to spiral, and different theories underpin…

A systematic review of economic evaluations of CHW interventions aimed at improving child health outcomes.

PubMed

Nkonki, L; Tugendhaft, A; Hofman, K

2017-02-28

Evidence of the cost-effectiveness of community health worker interventions is pertinent for decision-makers and programme planners who are turning to community services in order to strengthen health systems in the context of the momentum generated by strategies to support universal health care, the post-2015 Sustainable Development Goal agenda.We conducted a systematic review of published economic evaluation studies of community health worker interventions aimed at improving child health outcomes. Four public health and economic evaluation databases were searched for studies that met the inclusion criteria: National Health Service Economic Evaluation Database (NHS EED), Cochrane, Paediatric Economic Evaluation Database (PEED), and PubMed. The search strategy was tailored to each database.The 19 studies that met the inclusion criteria were conducted in either high income countries (HIC), low- income countries (LIC) and/or middle-income countries (MIC). The economic evaluations covered a wide range of interventions. Studies were grouped together by intended outcome or objective of each study. The data varied in quality. We found evidence of cost-effectiveness of community health worker (CHW) interventions in reducing malaria and asthma, decreasing mortality of neonates and children, improving maternal health, increasing exclusive breastfeeding and improving malnutrition, and positively impacting physical health and psychomotor development amongst children.Studies measured varied outcomes, due to the heterogeneous nature of studies included; a meta-analysis was not conducted. Outcomes included disease- or condition -specific outcomes, morbidity, mortality, and generic measures (e.g. disability-adjusted life years (DALYs)). Nonetheless, all 19 interventions were found to be either cost-effective or highly cost-effective at a threshold specific to their respective countries.There is a growing body of economic evaluation literature on cost-effectiveness of CHW interventions. However, this is largely for small scale and vertical programmes. There is a need for economic evaluations of larger and integrated CHW programmes in order to achieve the post-2015 Sustainable Development Goal agenda so that appropriate resources can be allocated to this subset of human resources for health. This is the first systematic review to assess the cost-effectiveness of community health workers in delivering child health interventions.

High Density Memory Based on Quantum Device Technology

NASA Technical Reports Server (NTRS)

vanderWagt, Paul; Frazier, Gary; Tang, Hao

1995-01-01

We explore the feasibility of ultra-high density memory based on quantum devices. Starting from overall constraints on chip area, power consumption, access speed, and noise margin, we deduce boundaries on single cell parameters such as required operating voltage and standby current. Next, the possible role of quantum devices is examined. Since the most mature quantum device, the resonant tunneling diode (RTD) can easily be integrated vertically, it naturally leads to the issue of 3D integrated memory. We propose a novel method of addressing vertically integrated bistable two-terminal devices, such as resonant tunneling diodes (RTD) and Esaki diodes, that avoids individual physical contacts. The new concept has been demonstrated experimentally in memory cells of field effect transistors (FET's) and stacked RTD's.

Van der Waals epitaxial growth and optoelectronics of large-scale WSe2/SnS2 vertical bilayer p-n junctions.

PubMed

Yang, Tiefeng; Zheng, Biyuan; Wang, Zhen; Xu, Tao; Pan, Chen; Zou, Juan; Zhang, Xuehong; Qi, Zhaoyang; Liu, Hongjun; Feng, Yexin; Hu, Weida; Miao, Feng; Sun, Litao; Duan, Xiangfeng; Pan, Anlian

2017-12-04

High-quality two-dimensional atomic layered p-n heterostructures are essential for high-performance integrated optoelectronics. The studies to date have been largely limited to exfoliated and restacked flakes, and the controlled growth of such heterostructures remains a significant challenge. Here we report the direct van der Waals epitaxial growth of large-scale WSe 2 /SnS 2 vertical bilayer p-n junctions on SiO 2 /Si substrates, with the lateral sizes reaching up to millimeter scale. Multi-electrode field-effect transistors have been integrated on a single heterostructure bilayer. Electrical transport measurements indicate that the field-effect transistors of the junction show an ultra-low off-state leakage current of 10 -14 A and a highest on-off ratio of up to 10 7 . Optoelectronic characterizations show prominent photoresponse, with a fast response time of 500 μs, faster than all the directly grown vertical 2D heterostructures. The direct growth of high-quality van der Waals junctions marks an important step toward high-performance integrated optoelectronic devices and systems.

Computational aspects of the nonlinear normal mode initialization of the GLAS 4th order GCM

NASA Technical Reports Server (NTRS)

Navon, I. M.; Bloom, S. C.; Takacs, L.

1984-01-01

Using the normal modes of the GLAS 4th Order Model, a Machenhauer nonlinear normal mode initialization (NLNMI) was carried out for the external vertical mode using the GLAS 4th Order shallow water equations model for an equivalent depth corresponding to that associated with the external vertical mode. A simple procedure was devised which was directed at identifying computational modes by following the rate of increase of BAL sub M, the partial (with respect to the zonal wavenumber m) sum of squares of the time change of the normal mode coefficients (for fixed vertical mode index) varying over the latitude index L of symmetric or antisymmetric gravity waves. A working algorithm is presented which speeds up the convergence of the iterative Machenhauer NLNMI. A 24 h integration using the NLNMI state was carried out using both Matsuno and leap-frog time-integration schemes; these runs were then compared to a 24 h integration starting from a non-initialized state. The maximal impact of the nonlinear normal mode initialization was found to occur 6-10 hours after the initial time.

Molecular Beam Epitaxy Growth of AlGaAs/GaAs Vertical Cavity Surface Emitting Lasers and the Performance of PIN Photodetector/Vertical Cavity Surface Emitting Laser Integrated Structures

NASA Astrophysics Data System (ADS)

Wang, Y. H.; Hasnain, G.; Tai, K.; Wynn, J. D.; Weir, B. E.; Choquette, K. D.; Cho, A. Y.

1991-12-01

An all-epitaxial planar top emitting AlGaAs/GaAs multi-quantum well laser is fabricated and characterized. The constructed vertical cavity surface emitting laser (VCSEL) consists of GaAs/Al0.2Ga0.8As (100/80 Å) quantum wells sandwiched between two doped distributed Bragg reflectors characterized by a two-step composition profile. Two Ga and two Al cells are used to facilitate the growth of mirror profile. The gain-guided VCSEL is found to generate continuous wave at a characteristic temperature of 210°K up to 90°C, and can be amplitude modulated at frequencies above 5 GHz. Thresholds as low as 2 mA, and a CW power more than 1.5 mW, are obtained at room temperature. Monolithic integration of a PIN photodetector on top of the VCSEL is demonstrated and discussed. The integrated photodetector shows an effective linear responsivity to the laser emission of 0.25 A/W.

INTEGRATED RISK ASSESSMENT - RESULTS FROM AN INTERNATIONAL WORKSHOP

EPA Science Inventory

The WHO International Programme on Chemical Safety and international partners have developed a framework for integrated assessment of human health and ecological risks and four case studies. An international workshop was convened to consider how ecological and health risk assess...

[The IPT integrative program of psychological therapy for schizophrenia patients: new perspectives].

PubMed

Pomini, Valentino

2004-04-01

The integrated psychological treatment for schizophrenic patients IPT is composed by six modules that can be implemented either separately or in an articulated way. In that case, the treatment begins with a cognitive remediation phase which is followed by a social skills training phase. In the first phase, exercises specifically focalize on selective attention, memory, logical reasoning, perception and communication skills. The second phase of the program offers three other modules that train other skills: 1) social skills, 2) emotional management, 3) interpersonal problem solving. The IPT program belong to the so called second generation of social skills training programmes. It has been validated by numerous controlled studies, either in its complete form or in partial forms containing only one ore more of its sub-programmes. The results of these studies are globally positive. They show that IPT is an interesting therapeutic contribution for the rehabilitation practice with schizophrenic patients. A third generation of social skills training has been elaborated on the basis of the current IPT program. These new adjunctions to the IPT tend to favour the utilization in the real life of the competencies trained in the sessions, either by adding specific homeworks, in-vivo or booster sessions, or by designating new programmes directed to specific rehabilitation objectives, such as the integration in a apartment, the management of leisure times or the return to a workplace. These new programmes have been studied. They are promising and seem to be a useful complement to the original IPT.

Fibre Optic Connections And Method For Using Same

DOEpatents

Chan, Benson; Cohen, Mitchell S.; Fortier, Paul F.; Freitag, Ladd W.; Hall, Richard R.; Johnson, Glen W.; Lin, How Tzu; Sherman, John H.

2004-03-30

A package is described that couples a twelve channel wide fiber optic cable to a twelve channel Vertical Cavity Surface Emitting Laser (VCSEL) transmitter and a multiple channel Perpendicularly Aligned Integrated Die (PAID) receiver. The package allows for reduction in the height of the assembly package by vertically orienting certain dies parallel to the fiber optic cable and horizontally orienting certain other dies. The assembly allows the vertically oriented optoelectronic dies to be perpendicularly attached to the horizontally oriented laminate via a flexible circuit.

The Irish Seabed Mapping Programme: INFOMAR - Integrated Mapping Survey for the Sustainable Developments of Ireland's Marine Resources. Progress to Date.

NASA Astrophysics Data System (ADS)

Sacchetti, F.; Benetti, S.; Fitzpatrick, F.

2006-12-01

During the last six years, the Geological Survey of Ireland and the Marine Institute of Ireland worked together on the multimillion Irish National Seabed Survey project with the purpose of mapping the Irish marine territory using a suite of remote sensing equipment, from multibeam to seismic, achieving 87% coverage of the marine zone. Ireland was the first country in the world to carry out an extensive mapping project of their extended Exclusive Economic Zone. The Irish National Seabed Survey is now succeeded by the multiyear INFOMAR Programme. INFOMAR will concentrate initially on mapping twenty-six selected priority bays, three sea areas and the fisheries-protection "Biologically Sensitive Area", and then will complete 100% mapping of the remainder of the EEZ. Designed to incorporate all elements of an integrated mapping programme, the key data acquisition will include hydrography, oceanographic, geological and heritage data. These data sets discharge Ireland's obligations under international treaties to which she is signatory and the uses of these data are vast and multipurpose: from management plans for inshore fishing, aquaculture, coastal protection and engineering works, to environmental impact assessments related to licensing activity and support to the evolving needs of integrated coastal zone management. INFOMAR also includes a data management, exchange and integration programme for the establishment of a National Marine Data Discovery and Exchange Service; providing improved dissemination of information to researchers, policy makers, the public and private sector and the adoption of standard operating procedures in data management to facilitate inter-agency data integration. During the first year of activity, INFOMAR carried out an integrated survey from the national research vessel, the RV Celtic Explorer, acquiring hydrographic, geophysical and groundtruthing data from Bantry and Dunmanus Bays, located off the South West coast of Ireland. Airborne LiDAR (Light Detection And Ranging) and small-vessel mapping surveys have also been carried out, giving detailed bathymetric, topographic and habitat information for the shoaler waters and inshore areas. This presentation will focus both on the general framework and scope of INFOMAR and the initial results and experiences of this year's survey.