Science.gov

Sample records for part ii management

  1. Revenue cycle management, Part II.

    PubMed

    Crew, Matt

    2007-01-01

    The proper management of your revenue cycle requires the application of "best practices" and the continual monitoring and measuring of the entire cycle. The correct technology will enable you to gain the insight and efficiencies needed in the ever-changing healthcare economy. The revenue cycle is a process that begins when you negotiate payor contracts, set fees, and schedule appointments and continues until claims are paid in full. Every single step in the cycle carries equal importance. Monitoring all phases and a commitment to continually communicating the results will allow you to achieve unparalleled success. In part I of this article, we explored the importance of contracting, scheduling, and case management as well as coding and clinical documentation. We will now take a closer look at the benefits charge capture, claim submission, payment posting, accounts receivable follow-up, and reporting can mean to your practice.

  2. Sports Concussion Management: part II.

    PubMed

    Terrell, Thomas R; Cox, Conrad B; Bielak, Ken; Casmus, Robert; Laskowitz, Daniel; Nichols, Gregory

    2014-02-01

    Millions of concussions occur every year in the United States. The public interest in concussion has increased after a number of high-profile deaths in high school athletes from sports-related head trauma and in some professional athletes from chronic traumatic encephalopathy. One of the most active areas of research in sports medicine during the last decade has been the evaluation and management of concussion. In this second article of a two-part series, we provide an overview of the latest scientific advances in concussion research. This overview includes an update on the pathobiological changes that occur during concussion and the results of biomechanical studies. In addition, to aid the practicing clinician, we review the literature on proven and currently studied concussion risk factors, including a history of concussion, fatigue, and age. Genetic polymorphisms and biomarkers may provide risk-prediction capability, but at present the research remains inconclusive. Diffusion tensor imaging and functional magnetic resonance imaging are promising technologies that reveal more sophisticated data about the impact of concussion on the brain. We review the existing literature on the application of these neuroimaging modalities to sports concussion. An update from the Fourth International Conference on Concussion in Sport, with highlights of new recommendations, and the presentation of the third edition of the Sports Concussion Assessment Tool to evaluate acute concussion, concludes our review.

  3. Managing changes during a clinical investigation, Part II.

    PubMed

    Donawa, Maria

    2003-10-01

    What are the European requirements for managing changes that may occur during a clinical investigation? Part II of this article discusses these requirements and the development of a standard operating procedure to help ensure consistent compliance.

  4. Diabetic foot ulcers: Part II. Management.

    PubMed

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Pain Management Part II: Pharmacologic Management of Chronic Orofacial Pain

    PubMed Central

    Ganzberg, Steven

    2010-01-01

    The pharmacologic management of chronic orofacial pain involves the use of medications not used routinely in dental practice. Additionally, many drugs are used for long periods of time necessitating careful monitoring for adverse effects and potential drug interactions. This article will review commonly used medications for chronic orofacial pain and highlight important areas of concern. PMID:20843228

  6. Part II--Management of pediatric post-traumatic headaches.

    PubMed

    Pinchefsky, Elana; Dubrovsky, Alexander Sasha; Friedman, Debbie; Shevell, Michael

    2015-03-01

    Post-traumatic headache is one of the most common symptoms occurring after mild traumatic brain injury in children. This is an expert opinion-based two-part review on pediatric post-traumatic headaches. In part II, we focus on the medical management of post-traumatic headaches. There are no randomized controlled trials evaluating the efficacy of therapies specifically for pediatric post-traumatic headaches. Thus, the algorithm we propose has been extrapolated from the primary headache literature and small noncontrolled trials of post-traumatic headache. Most post-traumatic headaches are migraine or tension type, and standard medications for these headache types are used. A multifaceted approach is needed to address all the possible causes of headache and any comorbid conditions that may delay recovery or alter treatment choices. For acute treatment, nonsteroidal anti-inflammatories can be used. If the headaches have migrainous features and nonsteroidal anti-inflammatories are not effective, triptans may be beneficial. Opioids are not indicated. Medication overuse should be avoided. For preventive treatments, some reports indicate that amitriptyline, gabapentin, or topiramate may be beneficial. Amitriptyline is a good choice because it can be used to treat both migraine and tension-type headaches. Nerve blocks, nutraceuticals (e.g. melatonin), and behavioral therapies may also be useful, and lifestyle factors, especially adequate sleep hygiene and strategies to cope with anxiety, should be emphasized. Improved treatment of acute post-traumatic headache may reduce the likelihood of developing chronic headaches, which can be especially problematic to effectively manage and can be functionally debilitating. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Diagnosis and local management of breast cancer: part II.

    PubMed

    Benson, John R

    2011-08-01

    This is the second of a two-part conference report and covers the other main themes of the Second Kyoto Breast Cancer Consensus Conference (KBCCC) including ductal carcinoma in situ, sentinel lymph node biopsy and therapeutic algorithms for local management of breast cancer. Once again, this report emphasizes conclusions from the consensus sessions that were a key feature of the KBCCC.

  8. Managing a Public Library. Parts I and II.

    ERIC Educational Resources Information Center

    Aronoff, Carol; Cart, Michael

    1985-01-01

    Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…

  9. Managing a Public Library. Parts I and II.

    ERIC Educational Resources Information Center

    Aronoff, Carol; Cart, Michael

    1985-01-01

    Discusses factors that contribute to Santa Monica Public Library's excellence, including supportive city government and citizenry, city council, library board, lean top management, and the basic management team. Specific management principles and techniques, public relations, and measures of service at Beverly Hills Public Library are also…

  10. Issue Management by School Superintendents: Final Report. Part II.

    ERIC Educational Resources Information Center

    Huff, Anne S.; Pondy, Louis R.

    Four papers generated by a broader study of issues management in three suburban Chicago school districts are collected here. "Achieving Routine" focuses on the effective routinization of organizational change, in this case a curriculum decision, through the use of administrative mechanisms and the conceptual linkage of the new to…

  11. Managing an Academic Library. Parts I and II.

    ERIC Educational Resources Information Center

    Werner, Gloria; Brudvig, Glenn

    1985-01-01

    Describes management experiences at University of California--Los Angeles (UCLA), University of Minnesota Biomedical Library, and California Institute of Technology. Discussions include development of ORION (UCLA's online technical processing and information system); organizational changes occurring as result of large-scale automation;…

  12. Managing risks in professional and clinical performance dilemmas: Part II.

    PubMed

    Schwab, N C; Pohlman, K J

    2000-08-01

    The primary purpose of the second article in this 2-part series is to describe and illustrate the use of an analytical framework that may assist school nurses to approach and resolve the dilemmas they may face in practice. Part I of the article was published in the April issue of this journal. It defined the terms "professional performance issue" and "clinical performance issue" and described a 5-step framework for analyzing practice dilemmas related to clinical and performance issues. In this article, the framework will be applied to a specific case scenario involving unsafe staffing and delegation.

  13. Financial management and dental school equity, Part II: Tactics.

    PubMed

    Chambers, David W; Bergstrom, Roy

    2004-04-01

    Financial management includes all processes that build organizations' equity through accumulating assets in strategically important areas. The tactical aspects of financial management are budget deployment and monitoring. Budget deployment is the process of making sure that costs are fairly allocated. Budget monitoring addresses issues of effective uses and outcomes of resources. This article describes contemporary deployment and monitoring mechanisms, including revenue positive and marginal analysis, present value, program phases, options logic, activity-based costing, economic value added, cost of quality, variance reconciliation, and balanced scorecards. The way financial decisions are framed affects comparative decision-making and even influences the arithmetic of accounting. Familiarity with these concepts should make it possible for dental educators to more fully participate in discussions about the relationships between budgeting and program strategy.

  14. [Post-polio syndrome. Part II. Therapeutic management].

    PubMed

    Matyja, Ewa

    2012-01-01

    The care of patients with post-polio syndrome ought to be carried out by a multidisciplinary team of specialists, including medical professionals, specialists of rehabilitation, psychologists and social workers. Many therapeutic strategies might be employed to reduce the late effects of polio. Today, the management of post-polio syndrome is based on non-pharmacological intervention, including lifestyle modification, decrease of physical activity, rest periods during the day and an individually tailored training program.

  15. Laboratory Information Management Systems--part II. Implementation.

    PubMed

    McDowall, R D; Pearce, J C; Murkitt, G S

    1988-01-01

    In this, the second of two articles on Laboratory Information Management Systems (LIMS), the stages of the acquisition of a system are discussed. First, the laboratory automation strategy is developed leading to the writing of the requirements specification sent to prospective suppliers. The next step, in conjunction with the chosen supplier, is to write the functional and systems specifications from which the LIMS will be tailored. Once installed the LIMS must be validated and in the event of hardware or software changes, should undergo partial or full re-validation. The education and training of users, and operational considerations are presented before concluding with possible developments of LIMS in the future.

  16. Managing purchasing and inventory with bar codes. Part II.

    PubMed

    Gandy, J

    1986-04-01

    Automated identification systems (bar coding) have proven their worth in a number of diverse manufacturing and materials handling environments. Whether this technology can be broadly applied with equal effectiveness in the health care setting still remains largely unproven. One thing is certain, however. Before bar code technology can be effectively applied in any setting, the materials manager must understand several basic concepts: How materials flow through his physical plant; How, where and in what amounts they are used; and How and when they are expensed. With this information, it is possible to create a systematized approach to materials cost containment, of which bar coding is one element. In the following article, the author illustrates how purchasing and inventory control can be made more time and labor efficient through the use of bar code technology.

  17. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II.

    PubMed

    Assimos, Dean; Krambeck, Amy; Miller, Nicole L; Monga, Manoj; Murad, M Hassan; Nelson, Caleb P; Pace, Kenneth T; Pais, Vernon M; Pearle, Margaret S; Preminger, Glenn M; Razvi, Hassan; Shah, Ojas; Matlaga, Brian R

    2016-10-01

    This Guideline is intended to provide a clinical framework for the surgical management of patients with kidney and/or ureteral stones. The summary presented herein represents Part II of the two-part series dedicated to Surgical Management of Stones: American Urological Association/Endourological Society Guideline. Please refer to Part I for introductory information and a discussion of pre-operative imaging and special cases. A systematic review of the literature (search dates 1/1/1985 to 5/31/2015) was conducted to identify peer-reviewed studies relevant to the surgical management of stones. The review yielded an evidence base of 1,911 articles after application of inclusion/exclusion criteria. These publications were used to create the Guideline statements. Evidence-based statements of Strong, Moderate, or Conditional Recommendation were developed based on benefits and risks/burdens to patients. Additional directives are provided as Clinical Principles and Expert Opinions when insufficient evidence existed. The Panel identified 12 adult Index Patients to represent the most common cases seen in clinical practice. Three additional Index Patients were also created to describe the more commonly encountered special cases, including pediatric and pregnant patients. With these patients in mind, Guideline statements were developed to aid the clinician in identifying optimal management. Proper treatment selection, which is directed by patient- and stone-specific factors, remains the greatest predictor of successful treatment outcomes. This Guideline is intended for use in conjunction with the individual patient's treatment goals. In all cases, patient preferences and personal goals should be considered when choosing a management strategy. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Cervical spine injuries in children, part II: management and special considerations.

    PubMed

    Easter, Joshua S; Barkin, Roger; Rosen, Carlo L; Ban, Kevin

    2011-09-01

    The diagnosis and management of cervical spine injury is more complex in children than in adults. Part I of this series stressed the importance of tailoring the evaluation of cervical spine injuries based on age, mechanism of injury, and physical examination findings. Part II will discuss the role of magnetic resonance imaging (MRI) as well as the management of pediatric cervical spine injuries in the emergency department. Children have several common variations in their anatomy, such as pseudosubluxation of C2-C3, widening of the atlantodens interval, and ossification centers, that can appear concerning on imaging but are normal. Physicians should be alert for signs or symptoms of atlantorotary subluxation and spinal cord injury without radiologic abnormality when treating children with spinal cord injury, as these conditions have significant morbidity. MRI can identify injuries to the spinal cord that are not apparent with other modalities, and should be used when a child presents with a neurologic deficit but normal X-ray study or CT scan. With knowledge of these variations in pediatric anatomy, emergency physicians can appropriately identify injuries to the cervical spine and determine when further imaging is needed. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Acuity and case management: a healthy dose of outcomes, part II.

    PubMed

    Craig, Kathy; Huber, Diane L

    2007-01-01

    This is the second of a 3-part series presenting 2 effective applications-acuity and dosage-that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Part I also featured a specific exemplar, the CM Acuity Tool, and described how to use acuity to identify and score the complexity of a CM case. Appropriate dosage prescription of CM activity was discussed. Part II further explains dosage and presents two acuity instruments, the Acuity Tool and AccuDiff. Details are provided that show how these applications produce opportunities for better communication about CM cases and for more accurate measurement of the right content that genuinely reflects the essentials of CM practice. The information contained in the 3-part series applies to all CM practice settings and contains ideas and recommendations useful to CM generalists, specialists, and supervisors, plus business and outcomes managers. The Acuity Tools Project was developed from frontline CM practice in one large, national telephonic CM company. Dosage: A literature search failed to find research into dosage of a behavioral intervention. The Huber-Hall model was developed and tested in a longitudinal study of CM models in substance abuse treatment and reported in the literature. Acuity: A structured literature search and needs assessment launched the development of the suite of acuity tools. A gap analysis identified that an instrument to assign and measure case acuity specific to CM activities was needed. Clinical experts, quality specialists, and business analysts (n = 7) monitored the development and testing of the tools, acuity concepts, scores, differentials, and their operating principles and evaluated the validity of the Acuity Tools' content related to CM activities. During the pilot phase of

  20. Managing the multi-cultural laboratory, Part II: Tools for managing the differences.

    PubMed

    Ketchum, S M

    1992-01-01

    This second article provides practical advice from managers in a variety of industries who have first-hand experience as multi-cultural managers. It will help laboratory professionals make practical application of two conceptual models in managing their culturally diverse employees. The advice covers such areas as performance standards, interpersonal skills, language issues, and other management practices. The first article explained what is meant by "culture" and featured the research-based model set forth by Dutch social psychologist and management consultant, Dr. Geert Hofstede. His four dimensions of culture (Power Distance, Masculinity/Femininity, Individualism/Collectivism, and Uncertainty Avoidance) provide a useful framework for assessing the different values, attitudes, and behaviors exhibited by those of different cultural backgrounds. In this article, abbreviated reference tables are presented that make these cross-cultural data more useful for management decision making. Laboratory supervisors can use both the models and the advice to challenge their own built-in cultural biases and to meaningfully interpret some of the attitudes and behaviors of culturally diverse coworkers and employees.

  1. Management of Audio-Visual Media Services. Part II. Practical Management Methods.

    ERIC Educational Resources Information Center

    Price, Robert V.

    1978-01-01

    This paper furnishes a framework that allows the local audiovisual administrator to develop a management system necessary for the instructional support of teaching through modern media and educational technology. The structure of this framework rests on organizational patterns which are explained in four categories: complete decentralization,…

  2. Dissecting Diversity Part II

    ERIC Educational Resources Information Center

    Matthews, Frank

    2005-01-01

    This article presents "Dissecting Diversity, Part II," the conclusion of a wide-ranging two-part roundtable discussion on diversity in higher education. The participants were as follows: Lezli Baskerville, J.D., President and CEO of the National Association for Equal Opportunity (NAFEO); Dr. Gerald E. Gipp, Executive Director of the…

  3. Dissecting Diversity Part II

    ERIC Educational Resources Information Center

    Matthews, Frank

    2005-01-01

    This article presents "Dissecting Diversity, Part II," the conclusion of a wide-ranging two-part roundtable discussion on diversity in higher education. The participants were as follows: Lezli Baskerville, J.D., President and CEO of the National Association for Equal Opportunity (NAFEO); Dr. Gerald E. Gipp, Executive Director of the…

  4. Chronic kidney disease certification process manual by the Italian Society of Nephrology (SIN): part II: programme management and clinical information management.

    PubMed

    Quintaliani, Giuseppe; Cappelli, Gianni; Lodetti, Laura; Manno, Corrado; Petrucci, Virgilio; Spinelli, Cosimo; Tarchini, Renzo; Virgilio, Michele; Faini, Mario; Alloatti, Sandro; Cancarini, Giovanni; Zoccali, Carmine

    2009-01-01

    This is the second part of a document describing a voluntary certification process based on Joint Commission International (JCI) criteria developed by the Italian Society of Nephrology (SIN) and JCI representatives. In the first part we discussed standards for clinical care delivery and performance measurements related to chronic kidney disease care. Herein (Part II), we complete the description of Performace measurements and CKD care by describing issues related the management and clinical information management.

  5. Managing the care of health and the cure of disease--Part II: Integration.

    PubMed

    Glouberman, S; Mintzberg, H

    2001-01-01

    The development of appropriate levels of integration in the system of health care and disease cure will require stronger collective cultures and enhanced communication among the key actors. Part II of this paper uses this line of argument to reframe four major issues in this system: coordination of acute cure and of community care, and collaboration in institutions and in the system at large.

  6. Graft-versus-host disease: part II. Management of cutaneous graft-versus-host disease.

    PubMed

    Hymes, Sharon R; Alousi, Amin M; Cowen, Edward W

    2012-04-01

    Dermatologists are ideally suited to manage the various cutaneous sequelae of graft-versus-host disease (GVHD) outlined in part I of this review. However, the complexity of the patient with GVHD, including comorbidities, potential drug interactions related to polypharmacy, and the lack of evidence-based treatment guidelines, are significant challenges to optimizing patient care. In this section, we will provide an outline for the role of the dermatologist in a multispecialty approach to caring for patients with GVHD. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Population-based public health interventions: innovations in practice, teaching, and management. Part II.

    PubMed

    Keller, Linda Olson; Strohschein, Susan; Schaffer, Marjorie A; Lia-Hoagberg, Betty

    2004-01-01

    The Intervention Wheel is a population-based practice model that encompasses three levels of practice (community, systems, and individual/family) and 17 public health interventions. Each intervention and practice level contributes to improving population health. The Intervention Wheel, previously known as the Public Health Intervention Model, was originally introduced in 1998 by the Minnesota Department of Health, Section of Public Health Nursing (PHN). The model has been widely disseminated and used throughout the United States since that time. The evidence supporting the Intervention Wheel was recently subjected to a rigorous critique by regional and national experts. This critical process, which involved hundreds of public health nurses, resulted in a more robust Intervention Wheel and established the validity of the model. The critique also produced basic steps and best practices for each of the 17 interventions. Part I describes the Intervention Wheel, defines population-based practice, and details the recommended modifications and validation process. Part II provides examples of the innovative ways that the Intervention Wheel is being used in public health/PHN practice, education, and administration. The two articles provide a foundation and vision for population-based PHN practice and direction for improving population health.

  8. Managing emergencies and abnormal situations in air traffic control (part II): teamwork strategies.

    PubMed

    Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry

    2010-07-01

    Team performance has been studied in many safety-critical organizations including aviation, nuclear power plant, offshore oil platforms and health organizations. This study looks into teamwork strategies that air traffic controllers employ to manage emergencies and abnormal situations. Two field studies were carried out in the form of observations of simulator training in emergency and unusual scenarios of novices and experienced controllers. Teamwork strategies covered aspects of team orientation and coordination, information exchange, change management and error handling. Several performance metrics were used to rate the efficiency of teamwork and test the construct validity of a prototype model of teamwork. This is a companion study to an earlier investigation of taskwork strategies in the same field (part I) and contributes to the development of a generic model for Taskwork and Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). Suggestions are made on how to use T(2)EAM to develop training programs, assess team performance and improve mishap investigations. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. Mycotoxins revisited: Part II.

    PubMed

    Berger, Kyan J; Guss, David A

    2005-02-01

    Mushrooms are ubiquitous in nature. They are an important source of nutrition, however, certain varieties contain chemicals that can be highly toxic to humans. Industrially cultivated mushrooms are historically very safe, whereas foraging for mushrooms or accidental ingestion of mushrooms in the environment can result in serious illness and death. The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning. Although recognition can be facilitated by identification of a characteristic toxidrome, the presenting manifestations can be variable and have considerable overlap with more common and generally benign clinical syndromes. The goal of this two-part article is to review the knowledge base on this subject and provide information that will assist the clinician in the early consideration, diagnosis and treatment of mushroom poisoning. Part I reviewed the epidemiology and demographics of mushroom poisoning, the physical characteristics of the most toxic varieties, the classification of the toxic species, and presented an overview of the cyclopeptide-containing mushroom class. Part II is focused on the presentation of the other classes of toxic mushrooms along with an up-to-date review of the most recently identified poisonous varieties.

  10. Prognosis and Management of Congenital Hair Shaft Disorders without Fragility-Part II.

    PubMed

    Singh, Gaurav; Miteva, Mariya

    2016-09-01

    Hair shaft disorders are characterized by congenital or acquired abnormalities of the hair shaft. The objective of this study was to review the literature regarding the prognosis and treatment options for hair shaft disorders. We used keywords in the search engines PubMed and Medline to identify all publications in English related to the prognosis and management of hair shaft disorders. Data were extracted from 96 articles that met search criteria. Findings were limited to case reports and small case series, as no studies were found. Disorders that improve in childhood include pili torti, trichorrhexis invaginata, woolly hair, and pili trianguli et canaliculi. Others, such as trichorrhexis nodosa, monilethrix, pili annulati, and pili bifurcati, improve with minoxidil. Oral retinoids have been found to improve hair abnormalities in trichorrhexis invaginata and monilethrix. There is no specific treatment for congenital hair shaft abnormalities. Gentle hair care is the mainstay of care for hair shaft disorders associated with fragility. Practices for gentle care include no brushing, backcombing, chemical products, tight braids, heat exposure, or mechanical grooming. Furthermore, any inherited or congenital disorder requires genetic counseling as part of management.

  11. Carbon Management In the Post-Cap-and-Trade Carbon Economy-Part II

    NASA Astrophysics Data System (ADS)

    DeGroff, F. A.

    2014-12-01

    This is the second installment in our search for a comprehensive economic model to mitigate climate change due to anthropogenic activity. Last year we presented how the unique features of our economic model measure changes in carbon flux due to anthropogenic activity, referred to as carbon quality or CQ, and how the model is used to value such changes in the climate system. This year, our paper focuses on how carbon quality can be implemented to capture the effect of economic activity and international trade on the climate system, thus allowing us to calculate a Return on Climate System (RoCS) for all economic assets and activity. The result is that the RoCS for each public and private economic activity and entity can be calculated by summing up the RoCS for each individual economic asset and activity in which an entity is engaged. Such a macro-level scale is used to rank public and private entities including corporations, governments, and even entire nations, as well as human adaptation and carbon storage activities, providing status and trending insights to evaluate policies on both a micro- and macro-economic level. With international trade, RoCS measures the embodied effects on climate change that will be needed to assess border fees to insure carbon parity on all imports and exports. At the core of our vision is a comprehensive, 'open-source' construct of which our carbon quality metric is the first element. One goal is to recognize each country's endemic resources and infrastructure that affect their ability to manage carbon, while preventing spatial and temporal shifting of carbon emissions that reduce or reverse efforts to mitigate climate change. The standards for calculating the RoCS can be promulgated as part of the Generally Accepted Accounted Principles (GAAP) and the International Financial Reporting Standards (IFRS) to ensure standard and consistent reporting. The value of such insights on the climate system at all levels will be crucial to managing

  12. Diagnosis and management of extensive vascular malformations of the lower limb: part II. Systemic repercussions [corrected], diagnosis, and treatment.

    PubMed

    Redondo, Pedro; Aguado, Leyre; Martínez-Cuesta, Antonio

    2011-11-01

    At least nine types of vascular malformations with specific clinical and radiologic characteristics must be distinguished in the lower limbs: Klippel-Trénaunay syndrome, port-wine stain with or without hypertrophy, cutis marmorata telangiectatica congenita, macrocephaly-capillary malformation, Parkes Weber syndrome, Stewart-Bluefarb syndrome, venous malformation, glomuvenous malformation, and lymphatic malformation. Extensive vascular malformations are often more complex than they appear and require a multidisciplinary therapeutic approach. Vascular malformations may be associated with underlying disease or systemic anomalies. Part II of this two-part series on the diagnosis and management of extensive vascular malformations of the lower limb highlights the systemic repercussions [corrected] (bone, articular, visceral, and hematologic involvement), diagnosis, and treatment of these lesions.

  13. A review and update on the guidelines for the acute management of cervical spinal cord injury - Part II.

    PubMed

    Yue, John K; Chan, Andrew K; Winkler, Ethan A; Upadhyayula, Pavan S; Readdy, William J; Dhall, Sanjay S

    2016-09-01

    Acute traumatic spinal cord injury (SCI) is a debilitating worldwide disease with an estimated annual incidence of 10 to 83 affected individuals per million inhabitants. These injuries typically impact younger individuals and reduce quality-adjusted life years with estimated lifetime costs exceeding $4 million per person. Hence it is critical to establish and refine clear practice guidelines for acute management of SCI. In 2013 the Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) released a revision of the 2002 guidelines for Cervical SCI. In the present report we explore seven subsections for management of specific cervical injury types, review key supporting literature, and provide an update on recent studies since the publication of the 2013 guidelines. Our review finds a paucity of Level I and Level II treatment recommendations for cervical spine injuries, with the exception of subaxial cervical spine injury classification and surgical management for Type II odontoid fractures in the elderly. We recommend the systematic implementation of large randomized controlled studies across diverse demographics and ethnicities, injury mechanisms and morphologies to address pressing limitations in the current literature. The cohesive effort to adopt the 2013 AANS/CNS Guidelines and the National Institutes of Health (NIH)/National Institute of Neurological Disorders and Stroke (NINDS) Common Data Elements for SCI as part of a multicenter international approach will enable reproducible data collection and robust analyses toward achieving this goal.

  14. Skin cancer in solid organ transplant recipients: advances in therapy and management: part II. Management of skin cancer in solid organ transplant recipients.

    PubMed

    Zwald, Fiona O'Reilly; Brown, Marc

    2011-08-01

    The management of skin cancer in solid organ transplant recipients is a challenge to both the dermatologist and transplant physician. Part II of this continuing medical education review offers an approach to the management of this increasing problem. The importance of specialty dermatology clinics providing access to transplant patients, frequent skin cancer screening, patient education, and multidisciplinary care is discussed. The management of low risk squamous cell carcinoma with topical therapies, photodynamic therapy, systemic retinoids, and capecitabine is reviewed. Revision of immunosuppression in the management of high-risk patients is discussed in association with the potential role of sentinel lymph node biopsy for aggressive disease. Finally, management of in-transit and metastatic squamous cell carcinoma is reviewed, with a discussion of the role of more recent innovative therapies, including epidermal growth factor receptor inhibitors in advanced squamous cell carcinoma in solid organ transplant recipients.

  15. COLLABORATE©: A Universal Competency-Based Paradigm for Professional Case Management, Part II: Competency Clarification.

    PubMed

    Treiger, Teresa M; Fink-Samnick, Ellen

    2013-01-01

    The purpose of this second article of a 3-article series is to clarify the competencies for a new paradigm of case management built upon a value-driven foundation that : Applicable to all health care sectors where case management is practiced. In moving forward, the one fact that rings true is that there will be a constant change in our industry. As the health care terrain shifts and new influences continually surface, there will be consequences for case management practice. These impacts require nimble clinical professionals in possession of recognized and firmly established competencies. They must be agile to frame (and reframe) their professional practice to facilitate the best possible outcomes for their patients. Case managers can choose to be Gumby™ or Pokey™. This is exactly the time to define a competency-based case management model, highlighting one sufficiently fluid to fit into any setting of care. The practice of case management transcends the vast array of representative professional disciplines and educational levels. A majority of current models are driven by business priorities rather than the competencies critical to successful practice and quality patient outcomes. This results in a fragmented professional case management identity. Although there is an inherent value in what each discipline brings to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities, including a reflective clinical ladder.

  16. The Healthy Learner Model for Student Chronic Condition Management--Part II: The Asthma Initiative

    ERIC Educational Resources Information Center

    Erickson, Cecelia DuPlessis; Splett, Patricia L.; Mullett, Sara Stoltzfus; Jensen, Charlotte; Belseth, Stephanie Bisson

    2006-01-01

    The Healthy Learner Asthma Initiative (HLAI) was designed as a comprehensive, school-community initiative to improve asthma management and produce healthy learners. National asthma guidelines were translated into components of asthma management in the school setting that defined performance expectations and lead to greater quality and consistency…

  17. Inpatient Standards of Care and the Suicidal Patient Part II: An Integration with Clinical Risk Management.

    ERIC Educational Resources Information Center

    Silverman, Morton M.; And Others

    1994-01-01

    Elaborates on standards of care for assessment, management, and treatment of hospitalized suicidal patients. Attempts to synthesize concepts of minimal standard of care with clinical risk management and clinical judgment. Points out areas of overlap and shows where optimum care diverges from legal standards of care. Tables differentiate…

  18. Report: transboundary hazardous waste management. part II: performance auditing of treatment facilities in importing countries.

    PubMed

    Chang, Tien-Chin; Ni, Shih-Piao; Fan, Kuo-Shuh; Lee, Ching-Hwa

    2006-06-01

    Before implementing the self-monitoring model programme of the Basel Convention in the Asia, Taiwan has conducted a comprehensive 4-year follow-up project to visit the governmental authorities and waste-disposal facilities in the countries that import waste from Taiwan. A total of nine treatment facilities, six of which are reported in this paper, and the five countries where the plants are located were visited in 2001-2002. France, Belgium and Finland primarily handled polychlorinated biphenyl capacitors, steel mill dust and metal waste. The United States accepted metal sludge, mainly electroplating sludge, from Taiwan. Waste printed circuit boards, waste wires and cables, and a mixture of waste metals and electronics were the major items exported to China. Relatively speaking, most treatment plants for hazardous waste paid close attention to environmental management, such as pollution control and monitoring, site zoning, system management regarding occupational safety and hygiene, data management, permits application, and image promotion. Under the tight restrictions formulated by the central environment agency, waste treatment plants in China managed the environmental issues seriously. For example, one of the treatment plants had ISO 14001 certification. It is believed that with continuous implementation of regulations, more improvement is foreseeable. Meanwhile, Taiwan and China should also continuously enhance their collaboration regarding the transboundary management of hazardous waste.

  19. The healthy learner model for student chronic condition management--part II: the asthma initiative.

    PubMed

    Erickson, Cecelia DuPlessis; Splett, Patricia L; Mullett, Sara Stoltzfus; Jensen, Charlotte; Belseth, Stephanie Bisson

    2006-12-01

    The Healthy Learner Asthma Initiative (HLAI) was designed as a comprehensive, school-community initiative to improve asthma management and produce healthy learners. National asthma guidelines were translated into components of asthma management in the school setting that defined performance expectations and lead to greater quality and consistency of asthma care. The HLAI incorporated evidence-based practice and introduced the role of the asthma resource nurse. Leadership, capacity building, and strong partnerships among school nurses, students, families, and health care providers were essential to the implementation and sustainability of the HLAI. Professional school nursing and evaluation were defined as key requisites to a successful initiative. Evaluation results indicated positive effects on nursing practice, fewer asthma visits to the health office, and better attendance among students who received asthma care in the school health office. The HLAI provided the basis for development of the Healthy Learner Model for Student Chronic Condition Management.

  20. Managing Technology Resourcefully: Part II--Working with Your District's Technology

    ERIC Educational Resources Information Center

    Weeks, Richard

    2009-01-01

    A large school district may have a technology department staffed by a chief technology officer who supervises two or more directors of operations, project managers, and technicians. On the other hand, a small district may employ an information technologist who works with technicians, consultants, volunteers with a knack for technology, and…

  1. Life Cycle Program Management & Evaluation: An Heuristic Approach. Parts I and II.

    ERIC Educational Resources Information Center

    Mayeske, George W.

    This monograph was developed to serve as a conceptual guide for extension educators facilitating or conducting life-cycle program management workshops focused on any of the life-cycle stages of problem finding, program design, program development, program implementation, program maintenance and improvement, and program redirection. This second…

  2. Engineering Certification Program Self-Study Course, Construction Inspection - Part II. Engineering Management [Series].

    ERIC Educational Resources Information Center

    Owsley, Fran, Ed.

    This book is a part of a self-study sequence in an engineering certification program. This volume concerns inspection and quality control of concrete structures. Sections titles are Inspection and Quality Control of Concrete; General Guides for Concrete Work; Concrete Floor and Slab Construction; Concrete Formwork; Correct and Incorrect Methods of…

  3. Engineering Certification Program Self-Study Course, Construction Inspection - Part II. Engineering Management [Series].

    ERIC Educational Resources Information Center

    Owsley, Fran, Ed.

    This book is a part of a self-study sequence in an engineering certification program. This volume concerns inspection and quality control of concrete structures. Sections titles are Inspection and Quality Control of Concrete; General Guides for Concrete Work; Concrete Floor and Slab Construction; Concrete Formwork; Correct and Incorrect Methods of…

  4. Novel strategies: challenge loop diuretics and sodium management in heart failure--part II.

    PubMed

    Di Pasquale, Pietro; Sarullo, Filippo M; Paterna, Salvatorew

    2007-01-01

    The conflicting results of diuretic treatments in heart failure (HF) and the importance of Na management in the context of the cardiorenal syndrome and neurohormonal activation in HF have suggested novel and counterintuitive strategies, focused primarily on the use of vasopressin antagonists and hypertonic saline solution with high doses of loop diuretics and their neurohormonal interference. The emerging novel therapies involving direct inhibition of vasopressin receptors appear to show promising results. The use of hypertonic saline solution mixed with a high dose of loop diuretics produces, probably by indirect mechanisms, a reduction or inhibition of the activated neurohormonal systems in HF patients. This treatment opens a new window on the role of sodium management in these patients and on the relation between sodium and the kidney's role and function in heart failure. The authors review the current evidence for these therapies and suggest hypothetical bases for their efficacy.

  5. Caring for children with autism spectrum disorder. Part II: screening, diagnosis, and management.

    PubMed

    Inglese, Melissa Dodd

    2009-02-01

    Recent emphasis on the importance of early identification and intervention for children with autism spectrum disorder (ASD) highlights the need for nurses in the community and primary care settings to learn to screen for ASD in children. In addition, given that ASD now affects 1 in 150 children, it is probable that nurses in a variety of settings, at all practice levels, will encounter children with ASD. Nurses need to be able to support families, educate parents, manage basic issues relevant to ASD, and advocate for these children and their families.

  6. Rickets: Part II.

    PubMed

    Shore, Richard M; Chesney, Russell W

    2013-01-01

    This is the continuation of a two-part review of rickets. This part emphasizes the specific pathophysiology, clinical features, pathoanatomy and radiographic findings of vitamin D deficiency rickets. Other forms of rickets, differential diagnostic considerations and the potential relationship between low levels of vitamin D metabolites and unexplained fractures in infants are also discussed.

  7. The formation, elements of success, and challenges in managing a critical care program: part II.

    PubMed

    St Andre, Arthur

    2015-05-01

    Leaders of critical care services require knowledge and skills not typically acquired during their medical education and training. Leaders possess personality characteristics and evolve and adopt behaviors and knowledge in addition to those useful in the care of patients and rounding with an ICU team. Successful leaders have impeccable integrity, possess a service mentality, are decisive, and speak the truth consistently and accurately. Effective leaders are thoughtful listeners, introspective, develop a range of relationships, and nurture others. They understand group psychology, observe, analyze assumptions, decide, and improve the system of care and the performance of their team members. A leader learns to facilely adapt to circumstance, generate new ideas, and be a catalyst of change. Those most successful further their education as a leader and learn when and where to seek mentorship. Leaders understand their organization and its operational complexities. Leaders learn to participate and knowledgeably contribute to the fiscal aspects of income, expense, budget, and contracts from an institutional and department perspective. Clinician compensation must be commensurate with expectations and be written to motivate and make clear duties that are clinical and nonclinical. A leader understands and plans to address the evolving challenges facing healthcare, especially resource constraints, the emotions and requirements of managing the end of life, the complexities of competing demands and motivations, the bureaucracy of healthcare practice, and reimbursement. Responsibilities to manage and evolve must be met with intelligence, sensitivity, and equanimity.

  8. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II

    PubMed Central

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor–associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet’s and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry. PMID:25562014

  9. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II.

    PubMed

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-06-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet's and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry.

  10. Anesthetic considerations in diabetic patients. Part II: intraoperative and postoperative management of patients with diabetes mellitus.

    PubMed

    Kadoi, Yuji

    2010-10-01

    Some studies have reported that tight glycemic control in diabetic patients undergoing major surgery improves perioperative morbidity and mortality rates. Recently, however, large randomized studies have shown such control increases the mortality rate, since aggressive glycemic control induces more frequent incidences of hypoglycemia. Diabetic patients have cerebral complications during the perioperative period more often than their nondiabetic counterparts. Further, anesthetic agents have some effects on cerebral circulation and cerebrovascular carbon dioxide reactivity. Hence, anesthesiologists should have adequate knowledge about anesthetic agents that maintain the integrity of the cerebral circulation. Patients with diabetes mellitus (DM) have an increased susceptibility to perioperative infections. Recent work confirmed that a combination of intravenous and subcutaneous insulin as a glucose management strategy had beneficial effects identical with intravenous insulin therapy alone on the reduction of infection rates during the postoperative period.

  11. Physiologic aspects of aging: impact on cancer management and decision making, part II.

    PubMed

    Sehl, Mary; Sawhney, Rishi; Naeim, Arash

    2005-01-01

    In this second article of our two-part review, we focus on age-associated physiologic changes involving the nervous, endocrine, hematologic, immune, and musculoskeletal systems, with close attention to the interconnected nature of these systems. There is a well-known connection between the neuroendocrine and immune systems via the hypothalamic-pituitary-adrenal axis and via interaction by means of cytokines, hormones, and neurotransmitters. These changes may lead to a loss of integration and resiliency with age, thus decreasing the ability of the elderly patient with cancer to adapt to stressful circumstances. Prominent changes include decline in memory and cognition, and increased susceptibility to peripheral neuropathy. Hematologic and immune changes like reduced bone marrow reserve and increased susceptibility to infections have far reaching implications for cancer care in the elderly. Gradual decline in hormone levels, and changes in muscle and body composition, can lead to functional decline and frailty. Use of the clinical interventions suggested in this article, along with an appreciation of the interplay of these age-related physiologic changes and their consequences, allows oncology professionals to customize therapy and minimize side effects in the geriatric oncology patient.

  12. Understanding Math - Part II.

    ERIC Educational Resources Information Center

    Wyks, Hollis W.; Austin, Robert J.

    This is the second remedial workbook-text in a two-part series written for deaf students at the secondary level. It covers fractions, geometry formulas, decimals and percents, and time. For the first workbook, see SE 015 827, and for the teacher's guide, see SE 015 829. (DT)

  13. Rockets -- Part II.

    ERIC Educational Resources Information Center

    Leitner, Alfred

    1982-01-01

    If two rockets are identical except that one engine burns in one-tenth the time of the other (total impulse and initial fuel mass of the two engines being the same), which rocket will rise higher? Why? The answer to this question (part 1 response in v20 n6, p410, Sep 1982) is provided. (Author/JN)

  14. Rockets -- Part II.

    ERIC Educational Resources Information Center

    Leitner, Alfred

    1982-01-01

    If two rockets are identical except that one engine burns in one-tenth the time of the other (total impulse and initial fuel mass of the two engines being the same), which rocket will rise higher? Why? The answer to this question (part 1 response in v20 n6, p410, Sep 1982) is provided. (Author/JN)

  15. Stimulus control: Part II

    PubMed Central

    Dinsmoor, James A.

    1995-01-01

    The second part of my tutorial stresses the systematic importance of two parameters of discrimination training: (a) the magnitude of the physical difference between the positive and the negative stimulus (disparity) and (b) the magnitude of the difference between the positive stimulus, in particular, and the background stimulation (salience). It then examines the role these variables play in such complex phenomena as blocking and overshadowing, progressive discrimination training, and the transfer of control by fading. It concludes by considering concept formation and imitation, which are important forms of application, and recent work on equivalence relations. PMID:22478222

  16. Pain management mini-series. Part II. Chronic opioid drug therapy: implications for perioperative anesthesia and pain management.

    PubMed

    Fisher, Robert B; Johnson, Quinn L; Reeves-Viets, Joseph L

    2013-01-01

    In the U.S., there is a growing percentage of chronic pain patients requiring surgery. Chronic pain patients require careful evaluation and planning to achieve appropriate acute pain management. Peri-surgical pain management often requires continuation of previously prescribed chronic pain modalities and careful selection of multimodal acute pain interventions. This article will provide a broad overview of chronic pain, definitions, and current recommendations for the treatment of perioperative pain in patients maintained on opioid therapy.

  17. Review of ultrasound image guidance in external beam radiotherapy part II: intra-fraction motion management and novel applications

    NASA Astrophysics Data System (ADS)

    O'Shea, Tuathan; Bamber, Jeffrey; Fontanarosa, Davide; van der Meer, Skadi; Verhaegen, Frank; Harris, Emma

    2016-04-01

    Imaging has become an essential tool in modern radiotherapy (RT), being used to plan dose delivery prior to treatment and verify target position before and during treatment. Ultrasound (US) imaging is cost-effective in providing excellent contrast at high resolution for depicting soft tissue targets apart from those shielded by the lungs or cranium. As a result, it is increasingly used in RT setup verification for the measurement of inter-fraction motion, the subject of Part I of this review (Fontanarosa et al 2015 Phys. Med. Biol. 60 R77-114). The combination of rapid imaging and zero ionising radiation dose makes US highly suitable for estimating intra-fraction motion. The current paper (Part II of the review) covers this topic. The basic technology for US motion estimation, and its current clinical application to the prostate, is described here, along with recent developments in robust motion-estimation algorithms, and three dimensional (3D) imaging. Together, these are likely to drive an increase in the number of future clinical studies and the range of cancer sites in which US motion management is applied. Also reviewed are selections of existing and proposed novel applications of US imaging to RT. These are driven by exciting developments in structural, functional and molecular US imaging and analytical techniques such as backscatter tissue analysis, elastography, photoacoustography, contrast-specific imaging, dynamic contrast analysis, microvascular and super-resolution imaging, and targeted microbubbles. Such techniques show promise for predicting and measuring the outcome of RT, quantifying normal tissue toxicity, improving tumour definition and defining a biological target volume that describes radiation sensitive regions of the tumour. US offers easy, low cost and efficient integration of these techniques into the RT workflow. US contrast technology also has potential to be used actively to assist RT by manipulating the tumour cell environment and by

  18. Automotive Parts Management Survey.

    ERIC Educational Resources Information Center

    Kuehn, Edward J.

    Members of the automotive parts distribution industry responded to a survey on the specific attitudes, values, knowledge, and skills necessary for students planning to enter the industry, as the basis for revision of an associate degree curriculum in Automotive Parts Management. The survey instrument, sent to 252 industry members (99 responded),…

  19. Strategies to improve the performance of learners in a nursing college. Part II: Issues pertaining to management, attitudes and values.

    PubMed

    Waterson, E; Harms, E; Qupe, L; Maritz, J; Manning, M; Makobe, K; Chabeli, M

    2006-05-01

    This article forms part two of a bigger study that was conducted in a nursing college to explore and describe the reasons for the poor performance of learners. Part one of the study dealt with the issues pertaining to education, while this article (part two) seeks to describe issues pertaining to management, attitudes and values that lead to the poor performance of learners in the nursing college under study. A qualitative, exploratory and descriptive design that was contextual in nature was employed, and three focus groups interviews were conducted. Seven tutors formed one group while other two groups were formed by fourth-year learners following a comprehensive diploma course. All participants voluntarily participated in the study. Data was analyzed using the descriptive method of open coding in accordance with Tesch's protocol (in Creswell, 1994:154-156). Trustworthiness was ensured using the following principles: credibility, conformability, transferability and dependability (Lincoln & Guba 1985:290-326). Findings were categorized into issues pertaining to management, attitudes and values that had an influence on the poor performance of learners as follows: Inadequate resources and study facilities; policies that change frequently; tutors' dissatisfaction with regard to staff development, the lack of involvement by management and lack of management support, staff shortage and maldistribution of staff members; ineffective selection process of learners; inconsistent regulations, and too many of them; policies and procedures resulting in confusion and poor discipline. Attitudes and values: Tutors' lack of motivation and interest, lack of respect by learners and no team work among tutors. Through a conceptualization process and the recommendations by participants, strategies to improve the learners' performance were described. It is recommended that these strategies be submitted to the staff development committee for implementation and future follow-up research be

  20. Pain medication management processes used by oncology outpatients and family caregivers part II: home and lifestyle contexts.

    PubMed

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Controlled parts management

    SciTech Connect

    Boyle, C. M.; Hidalgo, S. P.; Martinez, B. J.

    2004-01-01

    The Controlled Parts Management (CPM) system is based on industry standard practices for managing inventory. CPM is designed to record the movement of any type of inventory in a defined region referred to as an Account or SubAccount. The system is used to track the receiving, processing, storing and transfer of inventory parts. CPM provides information on parts, quantity and the exact location of the inventory. CPM is a barcode-based-part tracking system currently used to track controlled parts that are used in the R&D and testing of weapons; this tracking helps maintain the part pedigree that is required for certification of a weapon or weapon test. CPM includes bar code data collection software programmed into portable bar code readers for automating physical inventory services and remote transaction capture. CPM interfaces to other Engineering systems and supports a 'material content' of a weapons test through the test Bill of Materials and assignment of a unique inventory part in CPM. Additional functionality includes the ability to group or join parts, logically or physically and temporary or permanent, to represent discrete parts, containers, subassemblies and assemblies, and groupings.

  2. [Future Trends in Medical Rehabilitation in the Context of Multimorbidity - Part II: Structural Requirements to Manage an Appropriate Rehabilitative Healthcare].

    PubMed

    Seger, W; Cibis, W; Deventer, A; Grotkamp, S; Lübke, N; Schoenle, P; Schmidt-Ohlemann, M; Schubert, M

    2016-06-14

    Background: Rehabilitative health care is paying increasing attention to multimorbid people with 2 and more coexistent chronic diseases of sociomedical relevance. Methods: Terms, requirements, design, configuration, challenges and supply of sociomedical rehabilitation were described in part I. A project group of the Medical Advisory Board of the Federal Rehabilitation Council describes manifold fields of actions to be taken in the rehabilitation of persons with multimorbidity. Results: The actions proposed range from reviewing existing forms of management to identifying rehabilitative needs and initiating accurately fitting interventions, sensitizing and enlarging competences of involved personnel, considering multimorbidity in guidelines and further research on questions still open. © Georg Thieme Verlag KG Stuttgart · New York.

  3. A review of regulatory decisions for environmental protection: part II - the case-study of contaminated land management in Portugal.

    PubMed

    Rodrigues, S M; Pereira, M E; da Silva, E Ferreira; Hursthouse, A S; Duarte, A C

    2009-01-01

    This paper provides a case-study analysis of the challenges in the implementation of national soil policies, which was developed by the authors in Part I of the review of regulatory decisions for environmental protection [Rodrigues SM, Pereira ME, Ferreira da Silva E, Hursthouse A, Duarte AC. A review of regulatory decisions for environmental management: Part I-challenges in the implementation of national soil policies. Environ Int 2009. doi:10.1016/j.envint.2008.08.007]. The Portuguese case was selected as a case-study since specific regulatory decisions for contaminated land management are still in the early stages of development. Given the gap between the situation at the EU level and the state of Portuguese soil policy development, it is of merit to consider national contaminated land policy regimes already in place within the EU and to see if these provide a suitable basis to define the main challenges and research needs for the implementation of a Portuguese contaminated land management strategy. A framework combining the D-P-S-I-R (drivers-pressures-sources-impacts-responses) structure of policy evaluation with the Source-Pathway-Receptor approach to health risk assessment is proposed to derive an effective regulatory framework for managing contaminated land in Portugal, using available information and only to develop new data and research where knowledge gaps exist. Funding site clean-up and assigning liability were identified as relevant factors currently hampering site remediation. Most relevant research needs for the development of contaminated land management practices in Portugal are those associated to the definition of a risk assessment framework and setting guidelines for the evaluation of risks posed to both humans and ecosystems. Other relevant and innovative features are the integration of soil function analysis into site investigations and the definition of a framework that combines risk assessment with soil function analysis. The analysis of

  4. Is there life after Buckley's formocresol? Part II - Development of a protocol for the management of extensive caries in the primary molar.

    PubMed

    Patchett, C L; Srinivasan, V; Waterhouse, P J

    2006-05-01

    To produce a working clinical protocol for pulp therapy techniques in the extensively carious primary molar. The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. As such, a medicament that can be used to replace formocresol in clinical practice should be identified. Part I of this paper explored the currently available alternative interventions and materials to formocresol in the form of a narrative review following an extensive literature search. Part II now presents the formation of a specialist group to establish an evidence-based protocol, for the management of the extensively carious primary molar. A protocol and key points document have been developed to assist clinicians in their treatment planning. Areas for further postgraduate training are identified.

  5. Classroom Management. The Seventy-eighth Yearbook of the National Society for the Study of Education. Part II.

    ERIC Educational Resources Information Center

    Duke, Daniel L., Ed.

    This collection of essays is intended to give a broad view of what is currently known about the management of classrooms. Contents include "Conceptualizing Classroom Management" by Mauritz Johnson and Harry Brooks; "Making Managerial Decisions in Classrooms" by Walter Doyle; "Authority and the Management of Classroom…

  6. Classroom Management. The Seventy-eighth Yearbook of the National Society for the Study of Education. Part II.

    ERIC Educational Resources Information Center

    Duke, Daniel L., Ed.

    This collection of essays is intended to give a broad view of what is currently known about the management of classrooms. Contents include "Conceptualizing Classroom Management" by Mauritz Johnson and Harry Brooks; "Making Managerial Decisions in Classrooms" by Walter Doyle; "Authority and the Management of Classroom…

  7. Diffuse Cystic Lung Disease. Part II

    PubMed Central

    Vassallo, Robert; Wikenheiser-Brokamp, Kathryn A.; McCormack, Francis X.

    2015-01-01

    The diffuse cystic lung diseases have a broad differential diagnosis. A wide variety of pathophysiological processes spanning the spectrum from airway obstruction to lung remodeling can lead to multifocal cyst development in the lung. Although lymphangioleiomyomatosis and pulmonary Langerhans cell histiocytosis are perhaps more frequently seen in the clinic, disorders such as Birt-Hogg-Dubé syndrome, lymphocytic interstitial pneumonia, follicular bronchiolitis, and light-chain deposition disease are increasingly being recognized. Obtaining an accurate diagnosis can be challenging, and management approaches are highly disease dependent. Unique imaging features, genetic tests, serum studies, and clinical features provide invaluable clues that help clinicians distinguish among the various etiologies, but biopsy is often required for definitive diagnosis. In part II of this review, we present an overview of the diffuse cystic lung diseases caused by lymphoproliferative disorders, genetic mutations, or aberrant lung development and provide an approach to aid in their diagnosis and management. PMID:25906201

  8. Photosensitivity disorders in children: part II.

    PubMed

    Chantorn, Rattanavalai; Lim, Henry W; Shwayder, Tor A

    2012-12-01

    Photosensitivity disorders in children encompass a diverse group of diseases. Some inherited disorders manifest with photosensitivity early in life. Specific extracutaneous association may be the clue to diagnosis in this group of pediatric photodermatoses. Part II of this 2-part review covers hereditary photodermatoses caused by defects in nucleotide excision repair, double strand break repair, or localized or systemic biochemical abnormalities. Diagnosis and management of photoaggravated dermatoses are also discussed. Sun protection strategies are required in all patients with evidence of photosensitivity. Early recognition and prompt diagnosis is essential to minimize the long-term complications associated with inadequate photoprotection. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  9. The Microcomputerization of Business Schools. Part I: General Strategies, Lessons, and Issues. Part II: A Case Study of the UCLA Graduate School of Management.

    ERIC Educational Resources Information Center

    Frand, Jason L.

    Part I (General Strategies, Lessons and Issues) of this two-part analysis of the microcomputerization process describes strategies schools have followed in their microcomputerization efforts and the lessons and issues that have emerged. Part I covers the following: strategies for introducing microcomputers into the curriculum (the saturation,…

  10. Exploring Water Pollution. Part II

    ERIC Educational Resources Information Center

    Rillo, Thomas J.

    1975-01-01

    This is part two of a three part article related to the science activity of exploring environmental problems. Part one dealt with background information for the classroom teacher. Presented here is a suggested lesson plan on water pollution. Objectives, important concepts and instructional procedures are suggested. (EB)

  11. Exploring Water Pollution. Part II

    ERIC Educational Resources Information Center

    Rillo, Thomas J.

    1975-01-01

    This is part two of a three part article related to the science activity of exploring environmental problems. Part one dealt with background information for the classroom teacher. Presented here is a suggested lesson plan on water pollution. Objectives, important concepts and instructional procedures are suggested. (EB)

  12. Integration of Flux-Based Methods and Triad Principles for DNAPL Site Management, Part II: Review of Flux Measurement Methods

    EPA Science Inventory

    Managing dense nonaqueous phase liquid (DNAPL) contaminated sites continues to be among the most pressing environmental problems currently faced. One approach that has recently been investigated for use in DNAPL site characterization and remediation is mass flux (mass per unit ar...

  13. Management of abnormal uterine bleeding by northern, rural and isolated primary care physicians: PART II: What do we need?

    PubMed

    Vigod, Simone N; Stewart, Donna E

    2002-11-20

    BACKGROUND: Abnormal uterine bleeding (AUB) is a common problem that affects one in five women during the pre-menopausal years. It is frequently managed by family physicians, especially in northern, rural and isolated areas where severe shortages of gynecologists exist. METHODS: We surveyed 194 family physicians in northern, rural and isolated areas of Ontario, Canada to determine their educational and resource needs for the management of AUB, with a specific focus on the relevance and feasibility of using clinical practice guidelines (CPGs). RESULTS: Most physicians surveyed did not use CPGs for the management of AUB because they did not know that such guidelines existed. The majority were interested in further education on the management of AUB through mailed CPGs and locally held training courses. A major theme among respondents was the need for more timely and effective gynecological referrals. CONCLUSION: A one-page diagnostic and treatment algorithm for AUB would be easy to use and would place minimal restrictions on physician autonomy. As the majority of physicians had Internet access, we recommend emailing and web posting in addition to mailing this algorithm. Local, hands-on courses including options for endometrial biopsy training would also be helpful for northern, rural and isolated physicians, many of whom cannot readily take time away from their practices.

  14. Management of abnormal uterine bleeding by northern, rural and isolated primary care physicians: PART II: What do we need?

    PubMed Central

    Vigod, Simone N; Stewart, Donna E

    2002-01-01

    Background Abnormal uterine bleeding (AUB) is a common problem that affects one in five women during the pre-menopausal years. It is frequently managed by family physicians, especially in northern, rural and isolated areas where severe shortages of gynecologists exist. Methods We surveyed 194 family physicians in northern, rural and isolated areas of Ontario, Canada to determine their educational and resource needs for the management of AUB, with a specific focus on the relevance and feasibility of using clinical practice guidelines (CPGs). Results Most physicians surveyed did not use CPGs for the management of AUB because they did not know that such guidelines existed. The majority were interested in further education on the management of AUB through mailed CPGs and locally held training courses. A major theme among respondents was the need for more timely and effective gynecological referrals. Conclusion A one-page diagnostic and treatment algorithm for AUB would be easy to use and would place minimal restrictions on physician autonomy. As the majority of physicians had Internet access, we recommend emailing and web posting in addition to mailing this algorithm. Local, hands-on courses including options for endometrial biopsy training would also be helpful for northern, rural and isolated physicians, many of whom cannot readily take time away from their practices. PMID:12443534

  15. Integration of Flux-Based Methods and Triad Principles for DNAPL Site Management, Part II: Review of Flux Measurement Methods

    EPA Science Inventory

    Managing dense nonaqueous phase liquid (DNAPL) contaminated sites continues to be among the most pressing environmental problems currently faced. One approach that has recently been investigated for use in DNAPL site characterization and remediation is mass flux (mass per unit ar...

  16. Review of LCA studies of solid waste management systems – Part II: Methodological guidance for a better practice

    SciTech Connect

    Laurent, Alexis; Clavreul, Julie; Bernstad, Anna; Bakas, Ioannis; Niero, Monia; Gentil, Emmanuel; Christensen, Thomas H.; Hauschild, Michael Z.

    2014-03-01

    Highlights: • We perform a critical review of 222 LCA studies of solid waste management systems. • We analyse the past LCA practice against the ISO standard and ILCD Handbook guidance. • Malpractices exist in many methodological aspects with large variations among studies. • Many of these aspects are important for the reliability of the results. • We provide detailed recommendations to practitioners of waste management LCAs. - Abstract: Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of the provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs.

  17. Hazardous Waste Management - University of California style, part II: Lawrence Livermore National Laboratory's joint venture TSDF Audit Program

    SciTech Connect

    Pearson, H E

    1998-07-22

    Lawrence Livermore National Laboratory's (LLNL's) management assigned the responsibility of conducting TSDF audits to the Waste Certification Office in August of 1994. Prior to this date, there was no mandate for LLNL to audit waste facilities, nor was there a structured program in place for conducting the audits Program development took approximately 10 months. This included writing a TSDF Audit Procedure, writing a Quality Assurance (QA) Plan, developing the required audit check lists, and using the documentation on a trial basis. A typical TSDF audit lasted one full day using three hazardous waste specialists The QA Plan is based on the quality assurance and management system requirements of DOE Order 5700.6C (Quality Assurance) and ASME NQA-1 (Quality Assurance Program Requirements for Nuclear Facilities).

  18. Review of LCA studies of solid waste management systems--part II: methodological guidance for a better practice.

    PubMed

    Laurent, Alexis; Clavreul, Julie; Bernstad, Anna; Bakas, Ioannis; Niero, Monia; Gentil, Emmanuel; Christensen, Thomas H; Hauschild, Michael Z

    2014-03-01

    Life cycle assessment (LCA) is increasingly used in waste management to identify strategies that prevent or minimise negative impacts on ecosystems, human health or natural resources. However, the quality of the provided support to decision- and policy-makers is strongly dependent on a proper conduct of the LCA. How has LCA been applied until now? Are there any inconsistencies in the past practice? To answer these questions, we draw on a critical review of 222 published LCA studies of solid waste management systems. We analyse the past practice against the ISO standard requirements and the ILCD Handbook guidelines for each major step within the goal definition, scope definition, inventory analysis, impact assessment, and interpretation phases of the methodology. Results show that malpractices exist in several aspects of the LCA with large differences across studies. Examples are a frequent neglect of the goal definition, a frequent lack of transparency and precision in the definition of the scope of the study, e.g. an unclear delimitation of the system boundaries, a truncated impact coverage, difficulties in capturing influential local specificities such as representative waste compositions into the inventory, and a frequent lack of essential sensitivity and uncertainty analyses. Many of these aspects are important for the reliability of the results. For each of them, we therefore provide detailed recommendations to practitioners of waste management LCAs.

  19. Distributed mixed-integer fuzzy hierarchical programming for municipal solid waste management. Part II: scheme analysis and mechanism revelation.

    PubMed

    Cheng, Guanhui; Huang, Guohe; Dong, Cong; Xu, Ye; Chen, Jiapei; Chen, Xiujuan; Li, Kailong

    2017-02-16

    As presented in the first companion paper, distributed mixed-integer fuzzy hierarchical programming (DMIFHP) was developed for municipal solid waste management (MSWM) under complexities of heterogeneities, hierarchy, discreteness, and interactions. Beijing was selected as a representative case. This paper focuses on presenting the obtained schemes and the revealed mechanisms of the Beijing MSWM system. The optimal MSWM schemes for Beijing under various solid waste treatment policies and their differences are deliberated. The impacts of facility expansion, hierarchy, and spatial heterogeneities and potential extensions of DMIFHP are also discussed. A few of findings are revealed from the results and a series of comparisons and analyses. For instance, DMIFHP is capable of robustly reflecting these complexities in MSWM systems, especially for Beijing. The optimal MSWM schemes are of fragmented patterns due to the dominant role of the proximity principle in allocating solid waste treatment resources, and they are closely related to regulated ratios of landfilling, incineration, and composting. Communities without significant differences among distances to different types of treatment facilities are more sensitive to these ratios than others. The complexities of hierarchy and heterogeneities pose significant impacts on MSWM practices. Spatial dislocation of MSW generation rates and facility capacities caused by unreasonable planning in the past may result in insufficient utilization of treatment capacities under substantial influences of transportation costs. The problems of unreasonable MSWM planning, e.g., severe imbalance among different technologies and complete vacancy of ten facilities, should be gained deliberation of the public and the municipal or local governments in Beijing. These findings are helpful for gaining insights into MSWM systems under these complexities, mitigating key challenges in the planning of these systems, improving the related management

  20. Management strategies to effect change in intensive care units: lessons from the world of business. Part II. Quality-improvement strategies.

    PubMed

    Gershengorn, Hayley B; Kocher, Robert; Factor, Phillip

    2014-03-01

    The success of quality-improvement projects relies heavily on both project design and the metrics chosen to assess change. In Part II of this three-part American Thoracic Society Seminars series, we begin by describing methods for determining which data to collect, tools for data presentation, and strategies for data dissemination. As Avedis Donabedian detailed a half century ago, defining metrics in healthcare can be challenging; algorithmic determination of the best type of metric (outcome, process, or structure) can help intensive care unit (ICU) managers begin this process. Choosing appropriate graphical data displays (e.g., run charts) can prompt discussions about and promote quality improvement. Similarly, dashboards/scorecards are useful in presenting performance improvement data either publicly or privately in a visually appealing manner. To have compelling data to show, ICU managers must plan quality-improvement projects well. The second portion of this review details four quality-improvement tools-checklists, Six Sigma methodology, lean thinking, and Kaizen. Checklists have become commonplace in many ICUs to improve care quality; thinking about how to maximize their effectiveness is now of prime importance. Six Sigma methodology, lean thinking, and Kaizen are techniques that use multidisciplinary teams to organize thinking about process improvement, formalize change strategies, actualize initiatives, and measure progress. None originated within healthcare, but each has been used in the hospital environment with success. To conclude this part of the series, we demonstrate how to use these tools through an example of improving the timely administration of antibiotics to patients with sepsis.

  1. Radiation necrosis of the mandible: a 10 year study. Part II. Dental factors; onset, duration and management of necrosis

    SciTech Connect

    Murray, C.G.; Herson, J.; Daly, T.E.; Zimmerman, S.

    1980-05-01

    In a review of patients receiving radiation for cancer in the oral region the rate of radiation necrosis of the mandible was found to be similar for patients who had dental extractions before radiation therapy and for the remainder of the dentate population. It was suggested that diseased teeth should be removed prior to irradiation and sufficient healing time should be allowed. Teeth should not be extracted after irradiation. Dental prostheses can be provided for most irradiated patients if adequate care is exercised. The probability of necrosis commencing was highest three to twelve months after the start of therapy; it diminished gradually after that period. The duration of necrosis was depicted as an exponential curve with a constant probability of necrosis termination at each time point after onset. In 46.8% of the patients in study II (1971-1975), the necrosis was healed by conservative means. This was a significant increase over study I (1966-1969), and a complementary reduction in the necessity for surgical intervention was also found.

  2. Alzheimer's disease and vascular dementia: one potentially preventable and modifiable disease? Part II: Management, prevention and future perspective.

    PubMed

    Davey, Dennis A

    2014-01-01

    The management of dementia and mild cognitive impairment (MCI) includes pharmacological, nonpharmacological and caregiver interventions. Acetyl-cholinesterase inhibitors and memantine have a small beneficial effect in mild-to-moderate dementia. Attention is increasingly focused on long-term measures that may prevent, delay or minimize MCI and dementia, including Mediterranean diet, exercise, early active treatment of hypercholesterolaemia hypertension, and diabetes starting in midlife and earlier. High cognitive activity and a high cognitive reserve may prevent or delay the onset of aging-related MCI and dementia. Although the numbers of the elderly with dementia are rapidly increasing worldwide, the incidence of dementia in some countries is decreasing attributable to higher educational levels, decreased vascular risk factors and healthier lifestyles. Prevention of dementia is feasible and reasonable.

  3. Automating Embedded Analysis Capabilities and Managing Software Complexity in Multiphysics Simulation, Part II: Application to Partial Differential Equations

    DOE PAGES

    Pawlowski, Roger P.; Phipps, Eric T.; Salinger, Andrew G.; ...

    2012-01-01

    A template-based generic programming approach was presented in Part I of this series of papers [Sci. Program. 20 (2012), 197–219] that separates the development effort of programming a physical model from that of computing additional quantities, such as derivatives, needed for embedded analysis algorithms. In this paper, we describe the implementation details for using the template-based generic programming approach for simulation and analysis of partial differential equations (PDEs). We detail several of the hurdles that we have encountered, and some of the software infrastructure developed to overcome them. We end with a demonstration where we present shape optimization and uncertaintymore » quantification results for a 3D PDE application.« less

  4. INCOG recommendations for management of cognition following traumatic brain injury, part II: attention and information processing speed.

    PubMed

    Ponsford, Jennie; Bayley, Mark; Wiseman-Hakes, Catherine; Togher, Leanne; Velikonja, Diana; McIntyre, Amanda; Janzen, Shannon; Tate, Robyn

    2014-01-01

    Traumatic brain injury, due to its diffuse nature and high frequency of injury to frontotemporal and midbrain reticular activating systems, may cause disruption in many aspects of attention: arousal, selective attention, speed of information processing, and strategic control of attention, including sustained attention, shifting and dividing of attention, and working memory. An international team of researchers and clinicians (known as INCOG) convened to develop recommendations for the management of attentional problems. The experts selected recommendations from published guidelines and then reviewed literature to ensure that recommendations were current. Decision algorithms incorporating the recommendations based on inclusion and exclusion criteria of published trials were developed. The team then prioritized recommendations for implementation and developed audit criteria to evaluate adherence to these best practices. The recommendations and discussion highlight that metacognitive strategy training focused on functional everyday activities is appropriate. Appropriate use of dual task training, environmental modifications, and cognitive behavioral therapy is also discussed. There is insufficient evidence to support mindfulness meditation and practice on de-contextualized computer-based tasks for attention. Administration of the medication methylphenidate should be considered to improve information-processing speed. The INCOG recommendations for rehabilitation of attention provide up-to-date guidance for clinicians treating people with traumatic brain injury.

  5. Expertise revisited, Part II: Contributory expertise.

    PubMed

    Collins, Harry; Evans, Robert; Weinel, Martin

    2016-04-01

    In Part I of this two part paper we tried to elicit the 'essence' of the notion of interactional expertise by looking at its origins. In Part II we will look at the notion of contributory expertise. The exercise has been triggered by recent discussion of these concepts in this journal by Plaisance and Kennedy and by Goddiksen.

  6. Taking back your turf: understanding the role of law in medical decision making in opioid management (Part II--putting legal/regulatory materials to work for you).

    PubMed

    Bolen, Jennifer

    2005-01-01

    In Part I of this series, I discussed the basic role of the law in the decision-making process for opioid management. I set out three basic rules: 1) read and learn applicable federal and state legal/regulatory materials on using controlled substances to treat pain, 2) stay current on accepted clinical standards of care, and 3) use a compliance program to minimize the potential for abuse and diversion of controlled substances. Here in Part II, I focus on the third rule and offer a few suggestions on developing and maintaining a compliance program. I also discuss using language from legal/regulatory materials in your practice forms in a manner that, once again, allows you to "take back your turf" and prescribe opioids without fear of legal/regulatory sanction (see Disclaimer). Take a minute to review the self-audit questions that follow and see where you stand on your knowledge and use of legal/regulatory matters in your daily practice. More "yes" answers indicate better knowledge of key compliance and documentation issues. More "no" and "I don't know" answers indicate that more work should be done to minimize potential legal/regulatory compliance problems in your practice.

  7. Parkinson's disease management. Part II- discovery of MAO-B inhibitors based on nitrogen heterocycles and analogues.

    PubMed

    Reis, Joana; Encarnação, Igor; Gaspar, Alexandra; Morales, Aliuska; Milhazes, Nuno; Borges, Fernanda

    2012-01-01

    Parkinson's disease (PD) is a neurodegenerative disorder mainly characterized by a progressive neurodegeneration of the dopaminergic neurons. The available pharmacological therapy for PD aims to stop the progress of symptoms, reduce disability, slowing the neurodegenerative process and/or preventing long-term complications along the therapy. The main strategic developments that have led to progress in the medical management of PD have focused on improvements in dopaminergic therapies. Despite all the recent research, there are only a few classes of drugs approved for the treatment of motor related symptoms of PD which primarily act on the dopaminergic neurons system: L-dopa, dopamine agonists, monoamine oxidase-B (MAO-B) and catechol-O-methyl transferase (COMT) inhibitors. Anticholinergic drugs and glutamate antagonists are also available but are not commonly used in routine practice. As no effective therapeutic strategy has yet been attended, other solutions must be investigated. Privileged structures, such as indoles, arylpiperazines, biphenyls and benzopyranes are currently ascribed as helpful approaches. Different families of nitrogen and oxygen heterocycles, such as pyrazoles, hydrazinylthiazoles, xanthones, coumarins or chromones have also been extensively used as scaffolds in medicinal chemistry programs for searching novel MAO-B inhibitors. Nitrogen derivatives play a key role in this subject with several studies pointing out hydrazines, thiazoles or indoles as important scaffolds for the development of novel MAO-B inhibitors. This review comprises an overview of the state of the art on the actual pharmacological therapy for PD followed by a specific focus on the discovery and development of nitrogen-based heterocyclic compounds analogues as promising MAO-B inhibitors.

  8. Local Area Networks: Part II.

    ERIC Educational Resources Information Center

    Dessy, Raymond E., Ed.

    1982-01-01

    Discusses five approaches used by industry/colleges to provide local area network (LAN) capabilities in the analytical laboratory: (1) mixed baseband bus network coupled to a star net; (2) broadband bus network; (3) ring network; (4) star network coupled to broadband net; and (5) simple multiprocessor center. Part I (September issue) focused on…

  9. Roots/Routes: Part II

    ERIC Educational Resources Information Center

    Swanson, Dalene M.

    2009-01-01

    This narrative acts as an articulation of a journey of many routes. Following Part I of the same research journey of rootedness/routedness, it debates the nature of transformation and transcendence beyond personal and political paradoxes informed by neoliberalism and related repressive globalizing discourses. Through a more personal, descriptive,…

  10. Roots/Routes: Part II

    ERIC Educational Resources Information Center

    Swanson, Dalene M.

    2009-01-01

    This narrative acts as an articulation of a journey of many routes. Following Part I of the same research journey of rootedness/routedness, it debates the nature of transformation and transcendence beyond personal and political paradoxes informed by neoliberalism and related repressive globalizing discourses. Through a more personal, descriptive,…

  11. Playing It Safe: Part II.

    ERIC Educational Resources Information Center

    Penman, Kenneth A.; Niccolai, Frances R.

    1985-01-01

    Explains how to prevent outdoor sports injuries; discusses related litigation and specific cases involving playing field turf, tennis, skiing, and pools; and sets out facility design and maintenance considerations and recommendations. A sidebar provides information about injury insurance available to NCAA schools. Part I of this article appeared…

  12. PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART II, MANUAL OF ACCOUNTING AND RELATED FINANCIAL PROCEDURES.

    ERIC Educational Resources Information Center

    FRIEDMAN, BURTON DEAN; AND OTHERS

    THIS DOCUMENT IS THE SECOND PART OF A REPORT, PROGRAM-ORIENTED INFORMATION--A MANAGEMENT SYSTEMS COMPLEX FOR STATE EDUCATION AGENCIES. PART 1, EA 001 170, SUBTITLED "ANALYSIS AND PROPOSALS," CONTAINS AN OUTLINE OF THE NEED FOR A MANAGEMENT SYSTEMS COMPLEX WITHIN EACH STATE EDUCATION AGENCY. THIS DOCUMENT IS A MANUAL PRESENTING THE…

  13. Understanding Radiation Thermometry. Part II

    NASA Technical Reports Server (NTRS)

    Risch, Timothy K.

    2015-01-01

    This document is a two-part course on the theory and practice of radiation thermometry. Radiation thermometry is the technique for determining the temperature of a surface or a volume by measuring the electromagnetic radiation it emits. This course covers the theory and practice of radiative thermometry and emphasizes the modern application of the field using commercially available electronic detectors and optical components. The course covers the historical development of the field, the fundamental physics of radiative surfaces, along with modern measurement methods and equipment.

  14. [Part II: Recognising facial expressions].

    PubMed

    Krolak-Salmon, P; Hénaff, M A; Bertrand, O; Vighetto, A; Mauguière, F

    2006-11-01

    In this second part, we address particularly the question of the neural mechanisms and structures involved in the recognition of facial emotional expressions that are crucial in social cognition. Emotion recognition in others can be critically impaired in some neurodegenerative and neurovascular diseases. That dysfunction sometimes correlated to disabling behavioural disorders and interpersonal communication impairment must be further understood. The results of a series of scalp and intracranial event related potential recordings, as well as recent advances in the literature, are reported. ERPs to facial emotional expressions were thus recorded in multiple subcortical and cortical areas in drug refractory epileptical patients implanted with depth electrodes. The roles of amygdala, insula and prefrontal cortex located at crossroads between perceptive analysis and emotional conceptual knowledge are particularly underlined. Altogether, these studies demonstrate that facial expressions are widely processed in space and time, some structures reacting very early and automatically, others providing a sustained reaction depending on the attention.

  15. Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part II.

    PubMed

    Saavedra Salinas, Miguel Ángel; Barrera Cruz, Antonio; Cabral Castañeda, Antonio Rafael; Jara Quezada, Luis Javier; Arce-Salinas, C Alejandro; Álvarez Nemegyei, José; Fraga Mouret, Antonio; Orozco Alcalá, Javier; Salazar Páramo, Mario; Cruz Reyes, Claudia Verónica; Andrade Ortega, Lilia; Vera Lastra, Olga Lidia; Mendoza Pinto, Claudia; Sánchez González, Antonio; Cruz Cruz, Polita Del Rocío; Morales Hernández, Sara; Portela Hernández, Margarita; Pérez Cristóbal, Mario; Medina García, Gabriela; Hernández Romero, Noé; Velarde Ochoa, María Del Carmen; Navarro Zarza, José Eduardo; Portillo Díaz, Verónica; Vargas Guerrero, Angélica; Goycochea Robles, María Victoria; García Figueroa, José Luis; Barreira Mercado, Eduardo; Amigo Castañeda, Mary Carmen

    2015-01-01

    Pregnancy in women with autoimmune rheumatic diseases is associated with several maternal and fetal complications. The development of clinical practice guidelines with the best available scientific evidence may help standardize the care of these patients. To provide recommendations regarding prenatal care, treatment, and a more effective monitoring of pregnancy in women with lupus erythematosus, rheumatoid arthritis (RA) and antiphospholipid syndrome (APS). Nominal panels were formed for consensus, systematic search of information, development of clinical questions, processing and staging of recommendations, internal validation by peers and external validation of the final document. The quality criteria of the AGREE II instrument were followed. The panels answered 37 questions related to maternal and fetal care in lupus erythematosus, RA and APS, as well as for use of antirheumatic drugs during pregnancy and lactation. The recommendations were discussed and integrated into a final manuscript. Finally, the corresponding algorithms were developed. In this second part, the recommendations for pregnant women with RA, APS and the use of antirheumatic drugs during pregnancy and lactation are presented. We believe that the Mexican clinical practice guidelines for the management of pregnancy in women with RA and APS integrate the best available evidence for the treatment and follow-up of patients with these conditions. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  16. Tubing extrusion made easier, Part II.

    PubMed

    Ferrandino, Mike

    2004-11-01

    An increased understanding of the primary elements will lead to greater control of the extrusion process. In the ongoing quest to produce tubing with consistent properties. Part II of this two-part article makes recommendations on best practice in barrel and screw design, compression ratios and dies.

  17. Unlearning Established Organizational Routines--Part II

    ERIC Educational Resources Information Center

    Fiol, C. Marlena; O'Connor, Edward J.

    2017-01-01

    Purpose: The purpose of Part II of this two-part paper is to uncover important differences in the nature of the three unlearning subprocesses, which call for different leadership interventions to motivate people to move through them. Design/methodology/approach: The paper draws on research in behavioral medicine and psychology to demonstrate that…

  18. An Investigation of Systems Designs and Management Techniques with Implications Toward a Systems Approach to Curriculum Development and Evaluation in Occupational Education As Part of the Phase II Report.

    ERIC Educational Resources Information Center

    Borgen, Joseph A.; Davis, Dwight E.

    As part of the Phase II report of the Illinois Occupational Curriculum Project, this document summarizes efforts made to: (1) gain a familiarity with the terminology and theory of systems modeling, (2) study the application of systems modeling in various management settings, and (3) identify factors to be considered in selecting and developing a…

  19. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed

    Adams, Diane L; Norman, Helen; Burroughs, Valentine J

    2002-06-01

    , disciplinary action and exclusion from participation in government programs. Part II of this article recommends an approach for assessing potential risk, preventing improper billing, and improving financial management of the medical practice.

  20. Epilepsy Care in Developing Countries: Part II of II

    PubMed Central

    Birbeck, Gretchen L

    2010-01-01

    Although 80% of people with epilepsy reside in resource poor, developing countries, epilepsy care in these regions remains limited and the majority of epilepsy patients go untreated. Cost-effective, sustainable epilepsy care services, delivering first-line antiepileptic drugs through established primary health care facilities, are needed to decrease these treatment gaps. Neurologists with local experience and knowledge of the culture, who are willing to serve as educators, policy advisors, and advocates, can make a difference. This is Part II of a two-part article. Part I reviewed the burden of epilepsy and the current state of resources for treatment in developing countries, while Part II will now discuss various aspects of care in these countries. PMID:20944819

  1. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed Central

    Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

    2002-01-01

    , disciplinary action and exclusion from participation in government programs. Part II of this article recommends an approach for assessing potential risk, preventing improper billing, and improving financial management of the medical practice. Images p432-a PMID:12078924

  2. 40 CFR Appendix II to Part 257 - Appendix II to Part 257

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to Part 257 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR CLASSIFICATION OF SOLID WASTE DISPOSAL FACILITIES AND PRACTICES Pt. 257, App. II Appendix II... from 60 days at 15 °C to 40 days at 20 °C, with a volatile solids reduction of at least 38 percent. Air...

  3. 40 CFR Appendix II to Part 257 - Appendix II to Part 257

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to Part 257 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR CLASSIFICATION OF SOLID WASTE DISPOSAL FACILITIES AND PRACTICES Pt. 257, App. II Appendix II... from 60 days at 15 °C to 40 days at 20 °C, with a volatile solids reduction of at least 38 percent. Air...

  4. Globalization in the pharmaceutical industry, Part II.

    PubMed

    Casadio Tarabusi, C; Vickery, G

    1998-01-01

    This is the second of a two-part report on the pharmaceutical industry. Part II begins with a discussion of foreign direct investment and inter-firm networks, which covers international mergers, acquisitions, and minority participation; market shares of foreign-controlled firms; international collaboration agreements (with a special note on agreements in biotechnology); and licensing agreements. The final section of the report covers governmental policies on health and safety regulation, price regulation, industry and technology, trade, foreign investment, protection of intellectual property, and competition.

  5. Neurofibromatosis: part 2--clinical management.

    PubMed

    Batista, Pollyanna Barros; Bertollo, Eny Maria Goloni; Costa, Danielle de Souza; Eliam, Lucas; Cunha, Karin Soares Gonçalves; Cunha-Melo, José Renan; Darrigo Junior, Luiz Guilherme; Geller, Mauro; Gianordoli-Nascimento, Ingrid Faria; Madeira, Luciana Gonçalves; Mendes, Hérika Martins; Miranda, Débora Marques de; Mata-Machado, Nikolas Andre; Morato, Eric Grossi; Pavarino, Érika Cristina; Pereira, Luciana Baptista; Rezende, Nilton Alves de; Rodrigues, Luíza de Oliveira; Sette, Jorge Bezerra Cavalcanti

    2015-06-01

    Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.

  6. Management of a coordinated parts program

    NASA Technical Reports Server (NTRS)

    Krishnan, G. S.

    1997-01-01

    The organization of the management of a parts program is discussed. The organizational structure faced by the parts manager and the advantages and disadvantages of managing a coordinated parts program are analyzed. The reliable operation of an instrument is the key to the success of the mission, together with the management of the parts program. The analysis led to the conclusion that the setting up of the decision support model will aid the parts manager in the decision making and the process control.

  7. Wound healing: part II. Clinical applications.

    PubMed

    Janis, Jeffrey; Harrison, Bridget

    2014-03-01

    Treatment of all wounds requires adequate wound bed preparation, beginning with irrigation and débridement. Complicated or chronic wounds may also require treatment adjuncts or specialized wound healing products. An extensive body of research and development has introduced novel wound healing therapies and scar management options. In this second of a two-part continuing medical education series on wound healing, the reader is offered an update on current wound healing technologies and recommendations for obtaining optimal outcomes.

  8. 10 CFR Appendix II to Part 504 - Fuel Price Computation

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Fuel Price Computation II Appendix II to Part 504 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. II Appendix II to Part 504—Fuel Price Computation (a) Introduction. This appendix provides the equations and...

  9. 10 CFR Appendix II to Part 504 - Fuel Price Computation

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Fuel Price Computation II Appendix II to Part 504 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. II Appendix II to Part... effects of future real price increases for each fuel. The delivered price of an alternate fuel used to...

  10. 10 CFR Appendix II to Part 504 - Fuel Price Computation

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Fuel Price Computation II Appendix II to Part 504 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. II Appendix II to Part... effects of future real price increases for each fuel. The delivered price of an alternate fuel used to...

  11. 10 CFR Appendix II to Part 504 - Fuel Price Computation

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Fuel Price Computation II Appendix II to Part 504 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS EXISTING POWERPLANTS Pt. 504, App. II Appendix II to Part... effects of future real price increases for each fuel. The delivered price of an alternate fuel used to...

  12. Tribal Resource Institute in Business, Engineering, and Science (T.R.I.B.E.S.). Part I, TRIBES Energy and Resource Management Simulation. Part II, Creative Writing--Essays submitted by the T.R.I.B.E.S. Students.

    ERIC Educational Resources Information Center

    Veirs, Val; And Others

    The expository and creaive writing of Native American high school students enrolled in a summer program at Colorado College sponsored by TRIBES (Tribal Resource Institute in Business, Engineering, and Science) is featured in this document. Part 1 presents a simulation problem in energy and resource management followed by reports submitted by 28…

  13. Tribal Resource Institute in Business, Engineering, and Science (T.R.I.B.E.S.). Part I, TRIBES Energy and Resource Management Simulation. Part II, Creative Writing--Essays submitted by the T.R.I.B.E.S. Students.

    ERIC Educational Resources Information Center

    Veirs, Val; And Others

    The expository and creaive writing of Native American high school students enrolled in a summer program at Colorado College sponsored by TRIBES (Tribal Resource Institute in Business, Engineering, and Science) is featured in this document. Part 1 presents a simulation problem in energy and resource management followed by reports submitted by 28…

  14. Medical management of chronic liver diseases (CLD) in children (part II): focus on the complications of CLD, and CLD that require special considerations.

    PubMed

    El-Shabrawi, Mortada H F; Kamal, Naglaa M

    2011-12-01

    Treatment of the causes of many chronic liver diseases (CLDs) may not be possible. In this case, complications must be anticipated, prevented or at least controlled by the best available therapeutic modalities. There are three main goals for the management of portal hypertension: (i) prevention of the first episode of variceal bleeding largely by non-selective β-adrenoceptor antagonists, which is not generally recommended in children; (ii) control of bleeding by using a stepwise approach from the least to most invasive strategies; (iii) and prevention of re-bleeding using bypass operations, with particular enthusiasm for the use of meso-Rex bypass in the pediatric population. Hepatic encephalopathy management also consists of three main aspects: (i) ruling out other causes of encephalopathy; (ii) identifying and treating precipitating factors; and (iii) starting empiric treatment with drugs such as lactulose, rifaximin, sodium benzoate, and flumazenil. Treatment of mild ascites and peripheral edema should begin with the restriction of sodium and water, followed by careful diuresis, then large-volume paracentesis associated with colloid volume expansion in severe cases. Empiric broad spectrum antimicrobial therapy should be used for the treatment of spontaneous bacterial peritonitis, bacterial and fungal sepsis, and cholangitis, after taking appropriate cultures, with appropriate changes in therapy after sensitivity testing. Empirical therapies continue to be the standard practice for pruritus; these consist of bile acid binding agents, phenobarbital (phenobarbitone), ursodeoxycholic acid, antihistamines, rifampin (rifampicin), and carbamazepine. Partial external biliary diversion can be used in refractory cases. Once hepatorenal syndrome is suspected, treatment should be initiated early in order to prevent the progression of renal failure; approaches consist of general supportive measures, management of concomitant complications, screening for sepsis, treatment

  15. Automated Information Management In Public Administration; Present Developments and Impacts. Part I; Conclusions by the Data Bank Panel. Part II; Automated Information Management in Public Administration; Present Developments and Impact (by Klaus Lenk).

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    This report by the Computer Utilization Group which was set up in 1960 by the Organization for Economic Cooperation and Development (OECD) consists of two parts: 1) a brief statement of conclusions, recommendations and suggestions for research by the data bank panel and a list of the panel members and 2) the background report prepared by Klaus…

  16. Prediction of periventricular leukomalacia. Part II

    PubMed Central

    Samanta, Biswanath; Bird, Geoffrey L.; Kuijpers, Marijn; Zimmerman, Robert A.; Jarvik, Gail P.; Wernovsky, Gil; Clancy, Robert R.; Licht, Daniel J.; Gaynor, J. William; Nataraj, Chandrasekhar

    2009-01-01

    Summary Objective The objective of Part II is to analyze the dataset of extracted hemodynamic features (Case 3 of Part I) through computational intelligence (CI) techniques for identification of potential prognostic factors for periventricular leukomalacia (PVL) occurrence in neonates with congenital heart disease. Methods The extracted features (Case 3 dataset of Part I) were used as inputs to CI based classifiers, namely, multi-layer perceptron (MLP) and probabilistic neural network (PNN) in combination with genetic algorithms (GA) for selection of the most suitable features predicting the occurrence of PVL. The selected features were next used as inputs to a decision tree (DT) algorithm for generating easily interpretable rules of PVL prediction. Results Prediction performance for two CI based classifiers, MLP and PNN coupled with GA are presented for different number of selected features. The best prediction performances were achieved with 6 and 7 selected features. The prediction success was 100% in training and the best ranges of sensitivity (SN), specificity (SP) and accuracy (AC) in test were 60-73%, 74-84% and 71-74%, respectively. The identified features when used with the DTalgorithm gave best SN, SP and AC in the ranges of 87-90% in training and 80-87%, 74-79% and 79-82% in test. Among the variables selected in CI, systolic and diastolic blood pressures, and pCO2 figured prominently similar to Part I. Decision tree based rules for prediction of PVL occurrence were obtained using the CI selected features. Conclusions The proposed approach combines the generalization capability of CI based feature selection approach and generation of easily interpretable classification rules of the decision tree. The combination of CI techniques with DT gave substantially better test prediction performance than using CI and DT separately. PMID:19162456

  17. Compounds with anti-influenza activity: present and future of strategies for the optimal treatment and management of influenza. Part II: Future compounds against influenza virus.

    PubMed

    Gasparini, R; Amicizia, D; Lai, P L; Bragazzi, N L; Panatto, D

    2014-12-01

    In the first part of this overview, we described the life cycle of the influenza virus and the pharmacological action of the currently available drugs. This second part provides an overview of the molecular mechanisms and targets of still-experimental drugs for the treatment and management of influenza. Briefly, we can distinguish between compounds with anti-influenza activity that target influenza virus proteins or genes, and molecules that target host components that are essential for viral replication and propagation. These latter compounds have been developed quite recently. Among the first group, we will focus especially on hemagglutinin, M2 channel and neuraminidase inhibitors. The second group of compounds may pave the way for personalized treatment and influenza management. Combination therapies are also discussed. In recent decades, few antiviral molecules against influenza virus infections have been available; this has conditioned their use during human and animal outbreaks. Indeed, during seasonal and pandemic outbreaks, antiviral drugs have usually been administered in mono-therapy and, sometimes, in an uncontrolled manner to farm animals. This has led to the emergence of viral strains displaying resistance, especially to compounds of the amantadane family. For this reason, it is particularly important to develop new antiviral drugs against influenza viruses. Indeed, although vaccination is the most powerful means of mitigating the effects of influenza epidemics, antiviral drugs can be very useful, particularly in delaying the spread of new pandemic viruses, thereby enabling manufacturers to prepare large quantities of pandemic vaccine. In addition, antiviral drugs are particularly valuable in complicated cases of influenza, especially in hospitalized patients. To write this overview, we mined various databases, including Embase, PubChem, DrugBank and Chemical Abstracts Service, and patent repositories.

  18. Managing changes during a clinical investigation, Part I.

    PubMed

    Donawa, Maria

    2003-09-01

    During the course of a clinical investigation, changes may need to be made to the device, the manufacturing process, the investigational plan or other aspects of the investigation. Part I of this article discusses the United States requirements for managing these types of changes. Part II will discuss European requirements and the need for developing a standard operating procedure to help ensure consistent compliance.

  19. A 10-Year Prospective Trial of a Patient Management Algorithm and Screening Examination for Highly Active Individuals with ACL Injury. Part II: Determinants of Dynamic Knee Stability

    PubMed Central

    Hurd, Wendy J.; Axe, Michael J.; Snyder-Mackler, Lynn

    2010-01-01

    Objectives To clarify the determinants of dynamic knee stability early after anterior cruciate ligament (ACL) injury. Materials and Methods 345 consecutive patients who were regular participants in IKDC level I/II sports before injury and had an acute isolated ACL injury from the practice of a single orthopaedic surgeon underwent a screening examination including clinical measures, knee laxity, quadriceps strength, hop testing, and patient self-reported knee function an average of 6 weeks after injury when impairments were resolved. Independent t-tests were performed to evaluate differences in quadriceps strength and anterior knee laxity between potential copers and noncopers. Hierarchical regression was performed to determine the influence of quadriceps strength, pre-injury activity level, and anterior knee laxity on hop test performance, as well as the influence of timed hop, cross-over hop, quadriceps strength, pre-injury activity level, and anterior knee laxity on self-assessed global function. Results Neither anterior knee laxity nor quadriceps strength differed between potential copers and non-copers. Quadriceps strength influenced hop test performance more significantly than pre-injury activity level or anterior knee laxity, but the variance accounted for by quadriceps strength was low (Range: 4-8%). Timed hop performance was the only variable that impacted self-assessed global function. Conclusions Traditional surgical decision making based on passive anterior knee laxity and pre-injury activity level is not supported by the results, as neither are good predictors of dynamic knee stability. Clinical tests that capture neuromuscular adaptations, including the timed hop test, may be useful in predicting function and guiding individualized patient management after ACL injury. PMID:17932399

  20. Polycystic ovary syndrome: a review for dermatologists: Part II. Treatment.

    PubMed

    Buzney, Elizabeth; Sheu, Johanna; Buzney, Catherine; Reynolds, Rachel V

    2014-11-01

    Dermatologists are in a key position to treat the manifestations of polycystic ovary syndrome (PCOS). The management of PCOS should be tailored to each woman's specific goals, reproductive interests, and particular constellation of symptoms. Therefore, a multidisciplinary approach is recommended. In part II of this continuing medical education article, we present the available safety and efficacy data regarding treatments for women with acne, hirsutism, and androgenetic alopecia. Therapies discussed include lifestyle modification, topical therapies, combined oral contraceptives, antiandrogen agents, and insulin-sensitizing drugs. Treatment recommendations are made based on the current available evidence.

  1. 40 CFR Appendix II to Part 261 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 26 2011-07-01 2011-07-01 false II Appendix II to Part 261 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE Appendix II to Part 261 ...

  2. 40 CFR Appendix II to Part 261 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false II Appendix II to Part 261 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) IDENTIFICATION AND LISTING OF HAZARDOUS WASTE Appendix II to Part 261 ...

  3. Scenario analysis of carbon emissions' anti-driving effect on Qingdao's energy structure adjustment with an optimization model, Part II: Energy system planning and management.

    PubMed

    Wu, C B; Huang, G H; Liu, Z P; Zhen, J L; Yin, J G

    2017-03-01

    In this study, an inexact multistage stochastic mixed-integer programming (IMSMP) method was developed for supporting regional-scale energy system planning (EPS) associated with multiple uncertainties presented as discrete intervals, probability distributions and their combinations. An IMSMP-based energy system planning (IMSMP-ESP) model was formulated for Qingdao to demonstrate its applicability. Solutions which can provide optimal patterns of energy resources generation, conversion, transmission, allocation and facility capacity expansion schemes have been obtained. The results can help local decision makers generate cost-effective energy system management schemes and gain a comprehensive tradeoff between economic objectives and environmental requirements. Moreover, taking the CO2 emissions scenarios mentioned in Part I into consideration, the anti-driving effect of carbon emissions on energy structure adjustment was studied based on the developed model and scenario analysis. Several suggestions can be concluded from the results: (a) to ensure the smooth realization of low-carbon and sustainable development, appropriate price control and fiscal subsidy on high-cost energy resources should be considered by the decision-makers; (b) compared with coal, natural gas utilization should be strongly encouraged in order to insure that Qingdao could reach the carbon discharges peak value in 2020; (c) to guarantee Qingdao's power supply security in the future, the construction of new power plants should be emphasised instead of enhancing the transmission capacity of grid infrastructure.

  4. Installation Status Report. Part II - Environment

    DTIC Science & Technology

    1996-01-01

    ITAM C4 Cl C4 C3 Threatened & Endangered Species Management C2 C3 C3 C4 Cultural Resources Management C3 C3 C3 C4 Integrated Pest Management C2...80.95% 19.05% 0.00% 33.33% 57.14% 9.52% INTEGRATED PEST MANAGEMENT 71.43% 28.57% 0.00% 85.71% 14.29% 0.00% RESTORATION 63.16% 36.84% 0.00...SPECIES MANAGEMENT C-l CULTURAL RESOURCES MANAGEMENT C-l INTEGRATED PEST MANAGEMENT C-l ■ogram Environ Mission Compliance >erform Condition Impact

  5. 46 CFR Appendix II to Part 153 - Metric Units Used in Part 153

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Part 153—Metric Units Used in Part 153 Parameter Metric (SI unit) Abbreviation Equivalent to English or... 46 Shipping 5 2014-10-01 2014-10-01 false Metric Units Used in Part 153 II Appendix II to Part 153 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS...

  6. 46 CFR Appendix II to Part 153 - Metric Units Used in Part 153

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Part 153—Metric Units Used in Part 153 Parameter Metric (SI unit) Abbreviation Equivalent to English or... 46 Shipping 5 2013-10-01 2013-10-01 false Metric Units Used in Part 153 II Appendix II to Part 153 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS...

  7. 46 CFR Appendix II to Part 153 - Metric Units Used in Part 153

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Part 153—Metric Units Used in Part 153 Parameter Metric (SI unit) Abbreviation Equivalent to English or... 46 Shipping 5 2011-10-01 2011-10-01 false Metric Units Used in Part 153 II Appendix II to Part 153 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS...

  8. 46 CFR Appendix II to Part 153 - Metric Units Used in Part 153

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Part 153—Metric Units Used in Part 153 Parameter Metric (SI unit) Abbreviation Equivalent to English or... 46 Shipping 5 2012-10-01 2012-10-01 false Metric Units Used in Part 153 II Appendix II to Part 153 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS...

  9. Critical appraisal: dental amalgam update--part II: biological effects.

    PubMed

    Wahl, Michael J; Swift, Edward J

    2013-12-01

    Dental amalgam restorations have been controversial for over 150 years. In Part I of this Critical Appraisal, the clinical efficacy of dental amalgam was updated. Here in Part II, the biological effects of dental amalgam are addressed.

  10. Emergency ventilation of the tracheostomy patient, part II: a story of tracheotomy history and emergency airway management--advocating education for emergency resuscitation.

    PubMed

    Sharp, Deidra Lynn

    2005-01-01

    Over a period of 5000 years, dramatic changes have occurred in airway management, tracheotomy procedure terminology, indications, techniques, instruments, settings where procedures are performed, tube design and patient outcomes. Specialized knowledge and skills necessary to safely care for tracheostomy patients and to provide effective respiratory resuscitation are reviewed. The purpose of this paper is to document the history of the tracheotomy as a backdrop for understanding patient management. Recommendations for staff education regarding emergency ventilation of the tracheostomy patient are presented.

  11. 40 CFR Appendix II to Part 86 - Temperature Schedules

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Temperature Schedules II Appendix II... Appendix II to Part 86—Temperature Schedules (a) Ambient temperature cycle for the diurnal emission portion of the evaporative emission test (see § 86.133). Table I—Temperature Versus Time Sequence Use linear...

  12. 40 CFR Appendix II to Part 86 - Temperature Schedules

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 20 2013-07-01 2013-07-01 false Temperature Schedules II Appendix II... Appendix II to Part 86—Temperature Schedules (a) Ambient temperature cycle for the diurnal emission portion of the evaporative emission test (see § 86.133). Table I—Temperature Versus Time Sequence Use linear...

  13. 40 CFR Appendix II to Part 86 - Temperature Schedules

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 20 2012-07-01 2012-07-01 false Temperature Schedules II Appendix II... Appendix II to Part 86—Temperature Schedules (a) Ambient temperature cycle for the diurnal emission portion of the evaporative emission test (see § 86.133). Table I—Temperature Versus Time Sequence Use linear...

  14. 40 CFR Appendix II to Part 86 - Temperature Schedules

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 19 2011-07-01 2011-07-01 false Temperature Schedules II Appendix II... Appendix II to Part 86—Temperature Schedules (a) Ambient temperature cycle for the diurnal emission portion of the evaporative emission test (see § 86.133). Table I—Temperature Versus Time Sequence Use linear...

  15. Talking about the Weather, Part II.

    ERIC Educational Resources Information Center

    Gibb, Allan A.

    1984-01-01

    This second part of a two-part article highlights some mathematics involved in the study of meteorology. Examples are given of the application of mathematics to the study of the atmosphere, with three problems discussed. (MNS)

  16. Talking about the Weather, Part II.

    ERIC Educational Resources Information Center

    Gibb, Allan A.

    1984-01-01

    This second part of a two-part article highlights some mathematics involved in the study of meteorology. Examples are given of the application of mathematics to the study of the atmosphere, with three problems discussed. (MNS)

  17. Water Pollution: Part I, Municipal Wastewaters; Part II, Industrial Wastewaters.

    ERIC Educational Resources Information Center

    Fowler, K. E. M.

    This publication is an annotated bibliography of municipal and industrial wastewater literature. This publication consists of two parts plus appendices. Part one is entitled Municipal Wastewaters and includes publications in such areas as health effects of polluted waters, federal policy and legislation, biology and chemistry of polluted water,…

  18. 40 CFR Appendixes I-Ii to Part 268 - [Reserved

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 28 2012-07-01 2012-07-01 false I Appendixes I-II to Part 268 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Appendixes I-II to Part 268...

  19. 40 CFR Appendixes I-Ii to Part 268 - [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 27 2011-07-01 2011-07-01 false I Appendixes I-II to Part 268 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Appendixes I-II to Part 268...

  20. 40 CFR Appendixes I-Ii to Part 268 - [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false I Appendixes I-II to Part 268 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Appendixes I-II to Part 268...

  1. 40 CFR Appendixes I-Ii to Part 268 - [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 27 2014-07-01 2014-07-01 false I Appendixes I-II to Part 268 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Appendixes I-II to Part 268...

  2. 40 CFR Appendixes I-Ii to Part 268 - [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 28 2013-07-01 2013-07-01 false I Appendixes I-II to Part 268 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) LAND DISPOSAL RESTRICTIONS Appendixes I-II to Part 268...

  3. Reclaiming Kindergarten: Part II--Questions about Policy

    ERIC Educational Resources Information Center

    Gullo, Dominic F.; Hughes, Kim

    2011-01-01

    Part II of "Reclaiming Kindergarten" continues the discussion related to responding to the crisis in today's kindergarten. In Part II, two policy questions are posed, the answers to which seek to respond to this continuing crisis. The questions center on issues related to engaging families in kindergarten and the need to consider a new early…

  4. Revenue cycle management: part I.

    PubMed

    Crew, Matt

    2006-01-01

    The revenue cycle starts long before a patient is seen and continues until a claim is completely resolved. Each step in the revenue cycle must be clearly defined and easy to follow. Use of various tools such as templates, forms, reports, spreadsheets, and components of your practice management system will help to provide the consistency you need for profitable revenue cycle management.

  5. Minimizing Glovebox Glove Breaches: PART II.

    SciTech Connect

    Cournoyer, M. E.; Andrade, R.M.; Taylor, D. J.; Stimmel, J. J.; Zaelke, R. L.; Balkey, J. J.

    2005-01-01

    As a matter of good business practices, a team of glovebox experts from Los Alamos National Laboratory (LANL) has been assembled to proactively investigate processes and procedures that minimize unplanned breaches in the glovebox, e.g., glove failures. A major part of this effort involves the review of glovebox glove failures that have occurred at the Plutonium Facility and at the Chemical and Metallurgy Research Facility. Information dating back to 1993 has been compiled from formal records. This data has been combined with information obtained from a baseline inventory of about 9,000 glovebox gloves. The key attributes tracked include those related to location, the glovebox glove, type and location of breaches, the worker, and the consequences resulting from breaches. This glovebox glove failure analysis yielded results in the areas of the ease of collecting this type of data, the causes of most glove failures that have occurred, the effectiveness of current controls, and recommendations to improve hazard control systems. As expected, a significant number of breaches involve high-risk operations such as grinding, hammering, using sharps (especially screwdrivers), and assembling equipment. Surprisingly, tasks such as the movement of equipment and material between gloveboxes and the opening of cans are also major contributions of breaches. Almost half the gloves fail within a year of their install date. The greatest consequence for over 90% of glovebox glove failures is alpha contamination of protective clothing. Personnel self-monitoring at the gloveboxes continues to be the most effective way of detecting glovebox glove failures. Glove failures from these tasks can be reduced through changes in procedures and the design of remote-handling apparatus. The Nuclear Materials Technology Division management uses this information to improve hazard control systems to reduce the number of unplanned breaches in the glovebox further. As a result, excursions of contaminants

  6. Designing and Implementing Local Follow-Up Systems. Part II: Conducting Outcomes Evaluation on the Local Level. CETA: Management Information Systems Program.

    ERIC Educational Resources Information Center

    Zornitsky, Jeffrey J.; And Others

    This guide has been developed to help Comprehensive Employment and Training Act (CETA) prime sponsors to meet their responsibility for assessing the effectiveness of their efforts by examining the extent to which CETA participation has enhanced the longer-term income and employability status of former enrollees. As part 2 of the guide, this…

  7. Disks for the Laboratory Part II.

    ERIC Educational Resources Information Center

    Dessy, Raymond E., Ed.

    1985-01-01

    Part 1 presents the chemistry, physics, and engineering technology associated with magnetic and optical disks. This part explores the subjects of archiving, security, validation and certification, and protection. Questions and issues are raised in each of the areas that both users and vendors should be aware. (JN)

  8. Phenomenology of electromagnetic coupling. Part II

    SciTech Connect

    King, R.J.; Ludwigsen, A.P.; Kunz, K.S.

    1985-08-01

    This report is the second of a planned series which summarize efforts at Lawrence Livermore National Laboratory relating to phenomenology studies of back door coupling from several MHz to 10's of GHz. These studies are pertinent to high altitude EMP (HEMP), enhanced HEMP and microwave coupling. Part I dealt with coupling through apertures into large free-standing cavities having, at most, one interior cable. An overview of the effort is given, and a summary of the effects observed in Part I. The main effort since Part I has been devoted to Facilities Development, development of an interior coupling decomposition model and coupling experiments. Projected future effort is discussed.

  9. Evaluation of ADINA. Part II. Operating Characteristics.

    DTIC Science & Technology

    1980-06-08

    Mooney Rivlin material, small/ large deformation i) static ii) dynamic iii) frequency (linear) 3. Spherical shell; elastic, plastic, concrete, small...Neighborhood of Buckling Zone 13 11-8 Typical Negative Stiffness Generated in Neighborhood of Buckling Zone 14 III-1 Rubber Sheet Geometry Material...Properties and Element Model 26 111-2 Global Energy Increment of Rubber Sheet (1st Load Step) 28 111-3 Global Energy Increment of Rubber Sheet (1st Load

  10. Minimal intervention dentistry II: part 3. Management of non-cavitated (initial) occlusal caries lesions--non-invasive approaches through remineralisation and therapeutic sealants.

    PubMed

    Holmgren, C; Gaucher, C; Decerle, N; Doméjean, S

    2014-03-01

    Epidemiological data on dental caries show that prevention and treatment needs have evolved significantly over the past two decades. In younger patients the distribution of caries lesions is mainly found on the occlusal surfaces. The treatment approaches utilised by dentists must evolve to integrate preventive and treatment solutions tailored to the care needs, which are straightforward to implement in the dental office and whose effectiveness is underpinned by scientific evidence. This article aims to describe the principles of non-invasive management of non-cavitated (initial) occlusal caries lesions, based on evidence from recent studies published in the international literature.

  11. Fire prevention on airplanes. Part II

    NASA Technical Reports Server (NTRS)

    Sabatier, J

    1929-01-01

    This part of the report presents a detailed examination of spark prevention, fire extinguishers, and fuel tank location and design. A continued program of investigations and research is also proposed.

  12. Electric injury, Part II: Specific injuries.

    PubMed

    Fish, R M

    2000-01-01

    Electric injury can cause disruption of cardiac rhythm and breathing, burns, fractures, dislocations, rhabdomyolysis, eye and ear injury, oral and gastrointestinal injury, vascular damage, disseminated intravascular coagulation, peripheral and spinal cord injury, and Reflex Sympathetic Dystrophy. Secondary trauma from falls, fires, flying debris, and inhalation injury can complicate the clinical picture. Diagnostic and treatment considerations for electric injuries are described in this article, which is the second part of a three-part series on electric injuries.

  13. Prescription pricing across Canada (Part II).

    PubMed

    Archer, F

    1984-09-01

    The first of a two part article entitled "Prescription Pricing Across Canada" appeared in the June issue of CPJ. The article was prompted by recent press reports of a prescription drug study commissioned by the Saskatchewan government, and the consequent attention-getting headlines. The first article dealt with the Western provinces. The second part discusses prescription pricing in Ontario, Québec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland, and the Northwest Territories.

  14. Local potential evolutions during proton exchange membrane fuel cell operation with dead-ended anode - Part II: Aging mitigation strategies based on water management and nitrogen crossover

    NASA Astrophysics Data System (ADS)

    Abbou, S.; Dillet, J.; Maranzana, G.; Didierjean, S.; Lottin, O.

    2017-02-01

    Proton exchange membrane (PEM) fuel cells operate with dead-ended anode in order to reduce system cost and complexity when compared with hydrogen re-circulation systems. In the first part of this work, we showed that localized fuel starvation events may occur, because of water and nitrogen accumulation in the anode side, which could be particularly damaging to the cell performance. To prevent these degradations, the anode compartment must be purged which may lead to an overall system efficiency decrease because of significant hydrogen waste. In the second part, we present several purge strategies in order to minimize both hydrogen waste and membrane-electrode assembly degradations during dead-ended anode operation. A linear segmented cell with reference electrodes was used to monitor simultaneously the current density distribution along the gas channel and the time evolution of local anode and cathode potentials. To asses MEA damages, Platinum ElectroChemical Surface Area (ECSA) and cell performance were periodically measured. The results showed that dead-end mode operation with an anode plate maintained at a temperature 5 °C hotter than the cathode plate limits water accumulation in the anode side, reducing significantly purge frequency (and thus hydrogen losses) as well as MEA damages. As nitrogen contribution to hydrogen starvation is predominant in this thermal configuration, we also tested a microleakage solution to discharge continuously most the nitrogen accumulating in the anode side while ensuring low hydrogen losses and minimum ECSA losses provided the right microleakage flow rate is chosen.

  15. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee For International Clinical Studies Including Therapeutics (ESCISIT)

    PubMed Central

    Zhang, W; Doherty, M; Bardin, T; Pascual, E; Barskova, V; Conaghan, P; Gerster, J; Jacobs, J; Leeb, B; Lioté, F; McCarthy, G; Netter, P; Nuki, G; Perez‐Ruiz, F; Pignone, A; Pimentão, J; Punzi, L; Roddy, E; Uhlig, T; Zimmermann‐Gòrska, I

    2006-01-01

    Objective To develop evidence based recommendations for the management of gout. Methods The multidisciplinary guideline development group comprised 19 rheumatologists and one evidence based medicine expert representing 13 European countries. Key propositions on management were generated using a Delphi consensus approach. Research evidence was searched systematically for each proposition. Where possible, effect size (ES), number needed to treat, relative risk, odds ratio, and incremental cost‐effectiveness ratio were calculated. The quality of evidence was categorised according to the level of evidence. The strength of recommendation (SOR) was assessed using the EULAR visual analogue and ordinal scales. Results 12 key propositions were generated after three Delphi rounds. Propositions included both non‐pharmacological and pharmacological treatments and addressed symptomatic control of acute gout, urate lowering therapy (ULT), and prophylaxis of acute attacks. The importance of patient education, modification of adverse lifestyle (weight loss if obese; reduced alcohol consumption; low animal purine diet) and treatment of associated comorbidity and risk factors were emphasised. Recommended drugs for acute attacks were oral non‐steroidal anti‐inflammatory drugs (NSAIDs), oral colchicine (ES = 0.87 (95% confidence interval, 0.25 to 1.50)), or joint aspiration and injection of corticosteroid. ULT is indicated in patients with recurrent acute attacks, arthropathy, tophi, or radiographic changes of gout. Allopurinol was confirmed as effective long term ULT (ES = 1.39 (0.78 to 2.01)). If allopurinol toxicity occurs, options include other xanthine oxidase inhibitors, allopurinol desensitisation, or a uricosuric. The uricosuric benzbromarone is more effective than allopurinol (ES = 1.50 (0.76 to 2.24)) and can be used in patients with mild to moderate renal insufficiency but may be hepatotoxic. When gout is associated with the use of diuretics, the

  16. Cutaneous porphyrias part II: treatment strategies.

    PubMed

    Tintle, Suzanne; Alikhan, Ali; Horner, Mary E; Hand, Jennifer L; Davis, Dawn Marie R

    2014-01-01

    The porphyrias are diverse in pathophysiology, clinical presentation, severity, and prognosis, presenting a diagnostic and therapeutic challenge. Although not easily curable, the dermatological manifestations of these diseases, photosensitivity and associated cutaneous pathology, can be effectively prevented and managed. Sun avoidance is essential, and patient education regarding the irreversibility of photocutaneous damage is a necessary corollary. Beyond preventative measures, the care of fragile, vulnerable skin, and pain management, each of the porphyrias has a limited number of unique additional therapeutic options. Many of the treatments have been published only in small case series or anecdotal reports and do not have well-understood nor proven mechanisms of action. This article presents a comprehensive review of available therapeutic options and long-term management recommendations for the cutaneous porphyrias. © 2013 The International Society of Dermatology.

  17. Environmental risks of chemicals and genetically modified organisms: a comparison. Part II: Sustainability and precaution in risk assessment and risk management.

    PubMed

    Steinhäuser, K G

    2001-01-01

    The principles of precaution and sustainability require more consideration in the assessment of environmental risks posed by chemicals and genetically modified organisms. Instead of applying risk reduction measures when there are serious indications for damage, full scientific certainty is often waited for before taking action. The precautionary principle particularly should be applied in those cases in which the extent and probability of damage are uncertain, e.g. in the case of persistent chemicals which are additionally bioaccumulative or highly mobile. Based on these principles, environmental action targets for risks associated with GMOs and chemicals can be developed. Risk management not only includes statutory measures but also instruments designed to influence behaviour indirectly are important to achieve the goals. Particularly for risks of GMOs which provoke fear, risk communication is important. Some rules to which attention should be paid in communication with the public are presented.

  18. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR. Part II.

    PubMed

    Vanhees, L; Geladas, N; Hansen, D; Kouidi, E; Niebauer, J; Reiner, Z; Cornelissen, V; Adamopoulos, S; Prescott, E; Börjesson, M; Bjarnason-Wehrens, B; Björnstad, H H; Cohen-Solal, A; Conraads, V; Corrado, D; De Sutter, J; Doherty, P; Doyle, F; Dugmore, D; Ellingsen, Ø; Fagard, R; Giada, F; Gielen, S; Hager, A; Halle, M; Heidbüchel, H; Jegier, A; Mazic, S; McGee, H; Mellwig, K P; Mendes, M; Mezzani, A; Pattyn, N; Pelliccia, A; Piepoli, M; Rauch, B; Schmidt-Trucksäss, A; Takken, T; van Buuren, F; Vanuzzo, D

    2012-10-01

    In a previous paper, as the first of a series of three on the importance of characteristics and modalities of physical activity (PA) and exercise in the management of cardiovascular health within the general population, we concluded that, in the population at large, PA and aerobic exercise capacity clearly are inversely associated with increased cardiovascular disease risk and all-cause and cardiovascular mortality and that a dose–response curve on cardiovascular outcome has been demonstrated in most studies. More and more evidence is accumulated that engaging in regular PA and exercise interventions are essential components for reducing the severity of cardiovascular risk factors, such as obesity and abdominal fat, high BP, metabolic risk factors, and systemic inflammation. However, it is less clear whether and which type of PA and exercise intervention (aerobic exercise, dynamic resistive exercise, or both) or characteristic of exercise (frequency, intensity, time or duration, and volume) would yield more benefit for each separate risk factor. The present paper, therefore, will review and make recommendations for PA and exercise training in the management of cardiovascular health in individuals with cardiovascular risk factors. The guidance offered in this series of papers is aimed at medical doctors, health practitioners, kinesiologists, physiotherapists and exercise physiologists, politicians, public health policy makers, and individual members of the public. Based on previous and the current literature overviews, recommendations from the European Association on Cardiovascular Prevention and Rehabilitation are formulated regarding type, volume, and intensity of PA and regarding appropriate risk evaluation during exercise in individuals with cardiovascular risk factors.

  19. Compatibility of technologies with regulations in the waste management of H-3, I-129, C-14, and Kr-85. Part II. Analysis

    SciTech Connect

    Trevorrow, L.E.; Kolba, V.M.; Vandegrift, G.F.; Steindler, M.J.

    1983-11-01

    Waste forms of /sup 3/H, /sup 129/I, /sup 14/C, and /sup 85/Kr separated from fuel reprocessing streams and procedures for managing them were analyzed regarding compliance with regulations. Transportation of these wastes in certain DOT-specification packagings would be permissible, but some of these packagings may not be acceptable in some disposal situations. Transportation of gaseous /sup 85/Kr in a currently certified cylinder is possible, but a fuel reprocessor may wish to ship larger quantities per package. Disposal of tritium using a package designed by a DOE contractor and shallow land burial, in accord with the regulations of 10 CFR 61, seems practicable. Although 10 CFR 61 permits shallow land burial of /sup 129/I, the concentration limit requires distribution in a volume that may seem impractical to commercial fuel reprocessors. The concentration limit of 10 CFR 61 for shallow land burial of /sup 14/C requires distribution in a lesser, although still large, volume. For both /sup 129/I and /sup 14/C, management as high-level waste offers the advantage of smaller volumes. Similar advantages may be offered by greater confinement or non-near surface concepts for disposal. The concrete waste forms developed for these nuclides may not meet technical criteria being formulated for geologic disposal. The lack of accommodation of /sup 85/Kr at disposal facilities makes storage of the gaseous form at the fuel reprocessing plant, followed by dispersal after partial decay, seem attractive. Ocean disposal of /sup 129/I and /sup 14/C by the rules of the International Atomic Energy Agency-London Ocean Dumping Convention offers advantages over shallow land burial: higher allowed concentrations, resulting in smaller volumes and fewer packages. These rules, however, thwart ocean disposal of /sup 85/Kr since gaseous forms are banned, and for solid forms, concentration limits would require distribution of radioactivity in very large volumes. 80 references.

  20. Causes of toxicity to Hyalella azteca in a stormwater management facility receiving highway runoff and snowmelt. Part II: salts, nutrients, and water quality.

    PubMed

    Bartlett, A J; Rochfort, Q; Brown, L R; Marsalek, J

    2012-01-01

    The Terraview-Willowfield Stormwater Management Facility (TWSMF) features a tandem of stormwater management ponds, which receive inputs of multiple contaminants from highway and residential runoff. Previous research determined that benthic communities in the ponds were impacted by poor habitat quality, due to elevated sediment concentrations of metals and polycyclic aromatic hydrocarbons (PAHS), and salinity in the overlying water, but did not address seasonal changes, including those caused by the influx of contaminants with the snowmelt. In order to address this issue, water and sediment samples were collected from the TWSMF during the fall and spring, and four-week sediment toxicity tests were conducted with Hyalella azteca. The effects of metals and PAHs are discussed in a companion paper; the effects of road salt, nutrients, and water quality are discussed here. After exposure to fall samples, survival of Hyalella was reduced (64-74% of controls) at three out of four sites, but growth was not negatively affected. After exposure to spring samples, survival was 0-75% of controls at the two sites furthest downstream, and growth was significantly lower in four out of five sites when comparing Hyalella exposed to site water overlying site sediment versus control water overlying site sediment. Toxicity appeared to be related to chloride concentrations: little or no toxicity occurred in fall samples (200 mg Cl(-)/L), and significant effects on survival and growth occurred in spring samples above 1550 mg Cl(-)/L and 380 mg Cl(-)/L, respectively. Sodium chloride toxicity tests showed similar results: four-week LC50s and EC25s (growth) were 1200 and 420 mg Cl(-)/L, respectively. Although water quality and nutrients were associated with effects observed in the TWSMF, chloride from road salt was the primary cause of toxicity in this study. Chloride persists during much of the year at concentrations representing a significant threat to benthic communities in the TWSMF.

  1. Delivery of promise of pheromones: Part II

    USDA-ARS?s Scientific Manuscript database

    This issue contains the remainder of the reviews and research papers on the topic of using semiochemicals in pest management, but with different topics. It leads off with a review article that presents an overview of the prospects and technical details of using semiochemicals for detection and samp...

  2. Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part II: Challenge of engaging the digital customer

    NASA Astrophysics Data System (ADS)

    Avasilcăi, S.; Rusu, G.

    2015-11-01

    To foster the development of innovative products and new technologies, nowadays companies use an open innovation system, encouraging stakeholders to contribute, using the companies’ online platforms for open innovation or social media, bringing and sharing creative solutions and ideas in order to respond to challenging needs the company directly expresses. Accordingly, the current research continues the analysis of the LEGO Group innovation efforts, aiming to provide a case study approach based on describing the most important projects and online instruments company uses to interact with customers and other external stakeholders. Thus, by analysing the experience of the company in developing projects of involving stakeholders in the innovation processes, the article emphasizes the objective of these past projects developed by LEGO Group, outlining their objectives regarding the focus on the product or process innovation, the team management and stakeholders involved in the innovation actions and the results they obtained. Moreover, the case study highlights the features of the most important online instruments LEGO Group uses at the moment for engaging LEGO fans, children, parents, and other external stakeholders in developing new LEGO sets. Thus, LEGO online instruments provide the opportunity for customers to be creative and to respond to LEGO management team challenges. Accordingly, LEGO involve customers in bringing innovative ideas for LEGO sets through LEGO Ideas instrument, which aims to engage customers in submitting projects, voting and supporting ideas and also sharing them on social media. Also, the research emphasizes the role of supporting the open dialogue and interaction with customers and other external stakeholders through LEGO.com Create & Share Galleries instrument, using their creativity to upload innovative models in the public galleries. The continuous challenges LEGO launches for their fans create a long-term connection between company and

  3. Gingival overgrowth: Part 2: management strategies.

    PubMed

    Chesterman, J; Beaumont, J; Kellett, M; Durey, K

    2017-02-10

    The effective and predictable management of gingival overgrowth requires correct diagnosis and consideration of aetiological factors, as discussed in Part 1 (BDJ 2017; 222: 85-91). Initial management should involve cause-related therapy, which may resolve or reduce the lesion. If functional, aesthetic and maintenance complications persist following this phase; further treatment may be required in the form of surgery. This paper discusses management strategies, including management of aetiological factors and surgical techniques.

  4. Searching LEXIS and WESTLAW: Part II.

    ERIC Educational Resources Information Center

    Franklin, Carl

    1986-01-01

    This second of a three-part series compares search features (i.e., truncation symbols, boolean operators, proximity operators, phrase searching, save searches) of two databases providing legal information. Search tips concerning charges and effective searching and tables listing functions of commands and proximity operators for both databases are…

  5. The Metis Nation--Part Two II.

    ERIC Educational Resources Information Center

    Dorian, John

    1978-01-01

    This article deals with historical events involving the Metis people from the time Manitoba entered the Confederation to the conclusion of the 1885 battle at Fish Creek near Batoche, Saskatchewan. Part I is in the Summer, 1978 issue of the Northian. (Author/RTS)

  6. Cutting out the Middleman: Part II.

    ERIC Educational Resources Information Center

    Hansen, Shirley; Crittenden, Chris

    1985-01-01

    The second part of the article published in "American School and University," December 1984 (EA 518 236), outlines specific steps administrators need to take to determine whether or not a direct purchase of natural gas is going to benefit their schools. (MLF)

  7. Cutting out the Middleman: Part II.

    ERIC Educational Resources Information Center

    Hansen, Shirley; Crittenden, Chris

    1985-01-01

    The second part of the article published in "American School and University," December 1984 (EA 518 236), outlines specific steps administrators need to take to determine whether or not a direct purchase of natural gas is going to benefit their schools. (MLF)

  8. Inquiry and Living History, Part II

    ERIC Educational Resources Information Center

    Coatney, Sharon; Smalley, Rachel

    2006-01-01

    In the first part of this article, the authors introduced the living history program. This yearly, weeklong program features living portrayals of famous people, which becomes a catalyst for teaching curricular standards, as well as providing the spark for inquiry. Successful implementation of this program requires providing teachers with…

  9. Inquiry and Living History, Part II

    ERIC Educational Resources Information Center

    Coatney, Sharon; Smalley, Rachel

    2006-01-01

    In the first part of this article, the authors introduced the living history program. This yearly, weeklong program features living portrayals of famous people, which becomes a catalyst for teaching curricular standards, as well as providing the spark for inquiry. Successful implementation of this program requires providing teachers with…

  10. Corporate liability: security and violence--Part II.

    PubMed

    Fiesta, J

    1996-04-01

    A hospital can be held liable for injuries resulting from failure to provide adequate, reasonable security Part II of "corporate Liability: Security and Violence" addresses negligent hiring and supervision practices, injury and domestic violence in the workplace and communication procedures.

  11. 40 CFR Appendix II to Part 86 - Temperature Schedules

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Temperature Schedules II Appendix II... to Part 86—Temperature Schedules (a) Ambient temperature cycle for the diurnal emission portion of the evaporative emission test (see § 86.133). Table I—Temperature Versus Time Sequence Use linear...

  12. LEAD SUBSTITUTION AND ELIMINATION STUDY, PART II

    SciTech Connect

    T. MARTINEZ; M. COURNOYER

    2001-01-01

    Within the Nuclear Materials Technology Division of Los Alamos National Laboratory, lead is used as shielding for a variety of operations, including actinide chemistry, weapons production, radiochemistry, and analytical chemistry. In this study, waste minimization issues associated with replacing lead shielding with non-hazardous materials are addressed. These include institutional program available to support this effort, the hazards and accompanying controls grouped with lead shielding, operations that use lead bricks and how this effects the selection of the substitute. Life cycle management issues are also examined. As a final step, an approach to get buy-in from both technical and budget minded employees is presented.

  13. Child disaster mental health interventions, part II

    PubMed Central

    Pfefferbaum, Betty; Sweeton, Jennifer L.; Newman, Elana; Varma, Vandana; Noffsinger, Mary A.; Shaw, Jon A.; Chrisman, Allan K.; Nitiéma, Pascal

    2014-01-01

    This review summarizes current knowledge on the timing of child disaster mental health intervention delivery, the settings for intervention delivery, the expertise of providers, and therapeutic approaches. Studies have been conducted on interventions delivered during all phases of disaster management from pre event through many months post event. Many interventions were administered in schools which offer access to large numbers of children. Providers included mental health professionals and school personnel. Studies described individual and group interventions, some with parent involvement. The next generation of interventions and studies should be based on an empirical analysis of a number of key areas. PMID:26295009

  14. Nursing home care: part II. Clinical aspects.

    PubMed

    Unwin, Brian K; Porvaznik, Mary; Spoelhof, Gerard David

    2010-05-15

    Understanding the distinctions between the management of clinical problems in nursing homes compared with the community setting helps improve the overall care of nursing home residents. Liberalizing diets helps avoid unintentional weight loss in nursing home residents, although the use of feeding tubes usually does not improve nutrition or decrease aspiration risk. Medical assessment, treatment of comorbidities, and appropriate use of rehabilitation therapies minimize the frequency of falls. Toileting programs may be used to treat incontinence and retention in cooperative patients. Adverse effects and drug interactions should be considered when initiating pharmacologic treatment of overactive bladder. Urinary tract infection and pneumonia are the most common bacterial infections in nursing home residents. Signs and symptoms of infection include fever or hypothermia, and functional decline. Virus identification is recommended for influenza-like illnesses. Nonpharmacologic behavioral management strategies are the preferred treatment for dementia-related problem behaviors. The Beers criteria, which outline potentially inappropriate medication use in older persons, provide guidance for medication use in the nursing home.

  15. Treatment of superficial mycoses: review - part II*

    PubMed Central

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. PMID:24474103

  16. Magnet hospitals: Part II. Institutions of excellence.

    PubMed

    Kramer, M; Schmalenberg, C

    1988-02-01

    The oft repeated charge today is to "focus on those who are succeeding!" That's what this report does. Using the eight characteristics identified by Peters and Waterman in their book In Search of Excellence, the study analyzes 16 magnet hospitals to ascertain to what extent they possess characteristics similar to the 'best run' companies in the corporate community. The authors suggest that these magnet hospitals may be dealing effectively with the nursing shortage by creating organizational conditions conducive to eliminating internal nurse shortage. Part I of this article appeared the January 1988 issue of JONA.

  17. Drugs, money and society (Part II).

    PubMed

    Walley, Tom

    2010-09-01

    Pharmacoeconomics started as marketing but has developed into a valuable tool in the fuller assessment of drug therapies. Its principles are now widely accepted, and many countries have government-funded agencies with responsibility for its application, most notably the National Institute for Health and Clinical Excellence in England. Many clinical pharmacologists are active in this area, and the discipline itself is part of the clinical pharmacology trainees' curriculum. Further developments will include value-based pricing and its use in cost sharing arrangements between health service and manufacturers.

  18. Curriculum Redesign in Veterinary Medicine: Part II.

    PubMed

    Macik, Maria L; Chaney, Kristin P; Turner, Jacqueline S; Rogers, Kenita S; Scallan, Elizabeth M; Korich, Jodi A; Fowler, Debra; Keefe, Lisa M

    2017-01-01

    Curricular review is considered a necessary component for growth and enhancement of academic programs and requires time, energy, creativity, and persistence from both faculty and administration. On a larger scale, a comprehensive redesign effort involves forming a dedicated faculty redesign team, developing program learning outcomes, mapping the existing curriculum, and reviewing the curriculum in light of collected stakeholder data. The faculty of the Texas A&M University College of Veterinary Medicine & Biomedical Sciences (TAMU) recently embarked on a comprehensive curriculum redesign effort through partnership with the university's Center for Teaching Excellence. Using a previously developed evidence-based model of program redesign, TAMU created a process for use in veterinary medical education, which is described in detail in the first part of this article series. An additional component of the redesign process that is understated, yet vital for success, is faculty buy-in and support. Without faculty engagement, implementation of data-driven curricular changes stemming from program evaluation may be challenging. This second part of the article series describes the methodology for encouraging faculty engagement through the final steps of the redesign initiative and the lessons learned by TAMU through the redesign process.

  19. Biosimilars in Dermatology: Current Situation (Part II).

    PubMed

    Puig, L; Carretero, G; Daudén, E; Ferrándiz, C; Marrón, S E; Martorell, A; Pérez-Suárez, B; Rodriguez-Cerdeira, C; Ruiz-Villaverde, R; Sánchez-Carazo, J L; Velasco, M

    2015-09-01

    The first biosimilar version of a biologic agent used to treat psoriasis (infliximab) entered the Spanish market on February 16 of this year, and more biosimilars can be expected to follow in the coming months and years. Logically, this new situation will have economic repercussions and alter prescribing patterns among dermatologists. In this second part of the review, we will look at several somewhat contentious issues, such as the extrapolation of indications, interchangeability, and automatic substitution. We will also review the biosimilars with indications for psoriasis currently in the clinical development pipeline and assess their potential to offer comparable efficacy and safety to the reference product while contributing to the sustainability of the public health care system.

  20. The sociogeometry of inequality: Part II

    NASA Astrophysics Data System (ADS)

    Eliazar, Iddo

    2015-05-01

    The study of socioeconomic inequality is of prime economic and social importance, and the key quantitative gauges of socioeconomic inequality are Lorenz curves and inequality indices - the most notable of the latter being the popular Gini index. In this series of papers we present a sociogeometric framework to the study of socioeconomic inequality. In this part we focus on the gap between the rich and the poor, which is quantified by gauges termed disparity curves. We shift from disparity curves to disparity sets, define inequality indices in terms of disparity sets, and introduce and explore a collection of distance-based and width-based inequality indices stemming from the geometry of disparity sets. We conclude with mean-absolute-deviation (MAD) representations of the inequality indices established in this series of papers, and with a comparison of these indices to the popular Gini index.

  1. Submodeling Simulations in Fusion Welds: Part II

    NASA Astrophysics Data System (ADS)

    Bonifaz, E. A.

    2013-11-01

    In part I, three-dimensional transient non-linear sub modeling heat transfer simulations were performed to study the thermal histories and thermal cycles that occur during the welding process at the macro, meso and micro scales. In the present work, the corresponding non-uniform temperature changes were imposed as load conditions on structural calculations to study the evolution of localized plastic strains and residual stresses at these sub-level scales. To reach the goal, a three-dimensional finite element elastic-plastic model (ABAQUS code) was developed. The sub-modeling technique proposed to be used in coupling phase-field (and/or digital microstructures) codes with finite element codes, was used to mesh a local part of the model with a refined mesh based on interpolation of the solution from an initial, relatively coarse, macro global model. The meso-sub-model is the global model for the subsequent micro sub-model. The strategy used to calculate temperatures, strains and residual stresses at the macro, meso and micro scale level, is very flexible to be used to any number of levels. The objective of this research was to initiate the development of microstructural models to identify fusion welding process parameters for preserving the single crystal nature of gas turbine blades during repair procedures. The multi-scale submodeling approach can be used to capture weld pool features at the macro-meso scale level, and micro residual stress and secondary dendrite arm spacing features at the micro scale level.

  2. Diagnosis and management of primary cicatricial alopecia: part I.

    PubMed

    Otberg, Nina; Wu, Wen-Yu; McElwee, Kevin John; Shapiro, Jerry

    2008-01-01

    In this 2-part article, the authors review the primary cicatricial alopecias. Primary cicatricial alopecia can be defined as predominantly lymphocytic, neutrophilic, or mixed based on the nature of the follicular infiltrate that is present around affected hair follicles. Lymphocytic primary cicatricial alopecias include chronic cutaneous lupus erythematosus (discoid lupus erythematosus), lichen planopilaris, classic pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. In this first part, the authors summarize the classification, epidemiology, diagnostic approach, and patient management of lymphocytic cicatricial alopecias. In part II, the authors will focus on neutrophilic cicatricial alopecias and mixed cicatricial alopecias.

  3. Implementing a predictive modeling program, part II: Use of motivational interviewing in a predictive modeling program.

    PubMed

    Calhoun, Jean; Admire, Kaye S

    2005-01-01

    This is the second article of a two-part series about issues encountered in implementing a predictive modeling program. Part I looked at how to effectively implement a program and discussed helpful hints and lessons learned for case managers who are required to change their approach to patients. In Part II, we discuss the readiness to change model, examine the spirit of motivational interviewing and related techniques, and explore how motivational interviewing is different from more traditional interviewing and assessment methods.

  4. Interpersonal processes in dentistry. Part II.

    PubMed

    Dunstone, S

    1990-06-01

    This paper relates an investigation of dentists' perceptions of their patients to a literature review of the interpersonal processes involved in professional helping. Although the concerns of dentists were markedly similar to those of other helping professionals there was a difference in priority possibly reflecting situational factors. The priority of the dentists' concerns were patient likeability, manageability and prognosis. It has been found that, for other helping professionals, four person-perception processes that occur in everyday life often lead to unfavourable perceptions of clients and work against the motivation to help them. Significant evidence of three of these four processes was found in the constructs described by the dentists. The three processes were: (a) attraction to similarity, (b) personalistic tendency in attributions, and (c) perceptual consequences of the patient's resistance to influence. The fourth process, a tendency to sample negative aspects of patients' behaviour, was not in evidence; on the contrary there was a significant tendency to sample positive aspects of the patients' behaviour by this sample of dentists.

  5. Overactive bladder - 18 years - Part II.

    PubMed

    Truzzi, Jose Carlos; Gomes, Cristiano Mendes; Bezerra, Carlos A; Plata, Ivan Mauricio; Campos, Jose; Garrido, Gustavo Luis; Almeida, Fernando G; Averbeck, Marcio Augusto; Fornari, Alexandre; Salazar, Anibal; Dell'Oro, Arturo; Cintra, Caio; Sacomani, Carlos Alberto Ricetto; Tapia, Juan Pablo; Brambila, Eduardo; Longo, Emilio Miguel; Rocha, Flavio Trigo; Coutinho, Francisco; Favre, Gabriel; Garcia, Jose Antonio; Castano, Juan; Reyes, Miguel; Leyton, Rodrigo Eugenio; Ferreira, Ruiter Silva; Duran, Sergio; Lopez, Vanda; Reges, Ricardo

    2016-01-01

    Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning - as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder - 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.

  6. Adhesive-composite incompatibility, part II.

    PubMed

    Carvalho, Ricardo M; Garcia, Fernanda Cristina P; e Silva, Safira M A; Castro, Fabrício L A

    2005-01-01

    Apart from some questions related to the repairability of resin composite restorations, dentists have always assumed that methacrylate-based resins are compatible with each other. For example, there is no clinically relevant problem in using a microfilled composite to laminate a Class IV restoration made with a hybrid composite, even if they are not of the same brand or manufacturer. In the context of adhesive systems, we have always believed that resin composites, regardless of their type or composition, bond well to all types of bonding agents. However, unexpected debonding of self-cured, core buildup composites that had been bonded with single-bottle adhesive systems was reported about 5 years ago. Subsequent studies demonstrated that there were, indeed, compatibility problems between simplified adhesive systems and self- or dual-cured resin composites. Apparently, when such combinations are used, reduced bond strengths and subsequent failures at the resin-adhesive interface can occur because of adverse reactions between the acidic resin monomers, an integral part of the simplified adhesive systems, and the chemicals involved in the polymerization mechanism of the self- or dual-cured composites, particularly the basic tertiary amines.

  7. DICOM: key concepts--part II.

    PubMed

    Kabachinski, Jeff

    2005-01-01

    The objective of these two installments of IT World was to give a general overview of DICOM and to take a look at different parts of the standard to get a sense of its main themes. We found that the standard provides a common reference for all developers but does not impose a single type of implementation. This allows for innovation. The standard is also built for flexibility, able to adapt to new modalities that have a need to communicate. The speedy acceptance of DICOM by the medical imaging industry is opening new possibilities for healthcare organizations to increase the quality while decreasing the cost of patient care. All of the DICOM networked supporting medical equipment as well as the organization's computer systems made by multiple original equipment manufacturers and located at one site or many sites can communicate by means of DICOM. This gives us the opportunity for medical images to be captured and communicated quicker. The result enables physicians to make diagnoses and treatment decisions sooner. It's all good stuff and even more reason why we should endeavor to understand the basics of DICOM. DICOM is here to stay!

  8. A Physicist for All Seasons: Part II

    NASA Astrophysics Data System (ADS)

    Oppenheimer, Frank

    2013-06-01

    The second part of this interview covers Frank Oppenheimer's move to the University of California at Berkeley and wartime work at the Westinghouse Research Laboratories in Pittsburgh, Pennsylvania, at the electromagnetic-separation plant in Oak Ridge, Tennessee, and at Los Alamos, New Mexico (1941-1945); his postwar research at Berkeley (1945-1947); his appointment at the University of Minnesota in 1947 and firing two years later after being required to testify before the House Un-American Activities Committee; his decade as a rancher in Colorado (1949-1959) and high-school science teacher toward the end of this period; his research at the University of Colorado in Boulder after 1959; his year as a Guggenheim Fellow at University College London in 1965; and his founding of the Exploratorium in San Francisco. California, in 1969. He also discusses his wartime relations with his older brother Robert and postwar events in Robert's life, including his Hearings before the Personnel Security Board of the Atomic Energy Commission in 1954.

  9. Generic drugs in dermatology: part II.

    PubMed

    Payette, Michael; Grant-Kels, Jane M

    2012-03-01

    In part I, we discussed new drug development, reviewed the history of the generic drug industry, described how generic drugs are approved by the US Food and Drug Administration, and defined the concepts of bioequivalence and therapeutic equivalence. Herein, we explore various factors impacting generic drug use across the different parties involved: the prescriber, the pharmacist, the patient, and the payer. We also include original cost analysis of dermatologic brand name and generic drugs and show the potential cost savings that can be achieved through generic substitution. We conclude with a review of the data addressing potential differences in the effectiveness of brand name versus generic drugs in dermatology. The cost of brand name and generic medications is highly variable by pharmacy, state, and payer. We used one source (www.drugstore.com) as an example and for consistency across all medications discussed herein. Prices included here may not reflect actual retail prices across the United States. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  10. Wave Propagation in Polymers, Part II

    NASA Astrophysics Data System (ADS)

    Newlander, David C.; Charest, Jacques A.; Lilly, Martin D.; Eisler, Robert D.

    1999-06-01

    Work reported in a previous study (Wave Propagations in Polymers, Part I, J.A. Charest, M.D. Lilly, 44th ARA Meeting Munich, Germany Sept. 17-20, 1993) discussed gas gun plane wave impact work and the measurements of stress wave profiles in Polycarbonate at around 2 kbars. The wave profiles were obtained using combined carbon and PVDF thin film stress gauges. The results showed amplitude attenuation and dispersion effects which were neither expected nor predictable from available hydrocode models. The data have been revisited using a modified material model and the PUFF74 computer code. These new wave profile calculations show remarkable agreement with the previous experiments in Polycarbonate. The model treats the material as viscoelastic-plastic using methods developed by Bade (Dynamic Response Model for PMMA, W. L. Bade, AVCO Systems Division, TR K500-74-WLB-204, Oct. 1, 1974). The measured and calculated results are quite different from those exhibited by PMMA at similar impact conditions. This work is expected to further our understanding of the processes that control wave propagation in highly-compressible and viscoelastic/viscoplastic media. It is also expected to provide clues on the effects of high strain rates on properties such as the modulus of elasticity, strength, and material loading behavior.

  11. [Conceptual Development in Cognitive Science. Part II].

    PubMed

    Fierro, Marco

    2012-03-01

    Cognitive science has become the most influential paradigm on mental health in the late 20(th) and the early 21(st) centuries. In few years, the concepts, problem approaches and solutions proper to this science have significantly changed. Introduction and discussion of the fundamental concepts of cognitive science divided in four stages: Start, Classic Cognitivism, Connectionism, and Embodying / Enacting. The 2(nd) Part of the paper discusses the above mentioned fourth stage and explores the clinical setting, especially in terms of cognitive psychotherapy. The embodying/enacting stage highlights the role of the body including a set of determined evolutionary movements which provide a way of thinking and exploring the world. The performance of cognitive tasks is considered as a process that uses environmental resources that enhances mental skills and deploys them beyond the domestic sphere of the brain. On the other hand, body and mind are embedded in the world, thus giving rise to cognition when interacting, a process known as enacting. There is a close connection between perception and action, hence the interest in real-time interactions with the world rather than abstract reasoning. Regarding clinics, specifically the cognitive therapy, there is little conceptual discussion maybe due to good results from practice that may led us to consider that theoretical foundations are firm and not problem-raising. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Management Systems and Organizational Analysis: Part II

    ERIC Educational Resources Information Center

    Levine, Donald M.

    1976-01-01

    Briefly reviews the contributions of several psychological researchers whose work represents four major approaches to organizational research, focusing primarily on the organizational theories of Bion, Miller and Rice, and Levinson. (JG)

  13. Mineral scale management. Part II, Fundamental chemistry

    Treesearch

    Alan W. Rudie; Peter W. Hart

    2006-01-01

    The mineral scale that deposits in digesters and bleach plants is formed by a chemical precipitation process.As such, it is accurately modeled using the solubility product equilibrium constant. Although solubility product identifies the primary conditions that must be met for a scale problem to exist, the acid-base equilibria of the scaling anions often control where...

  14. IPCC Working Group II: Impacts and Adaptation Part I

    NASA Astrophysics Data System (ADS)

    Pulwarty, R. S.

    2007-12-01

    The IPCC (as opposed to the UN Framework Convention) defines climate change as" any change in climate over time, whether due to natural variability or as a result of human activity". The IPCC Working Group II (Impacts, Adaptation, Vulnerability) was charged with assessing the scientific, technical, environmental, economic, and social aspects of vulnerability to climate change, and, the negative and positive consequences for ecological systems, socio-economic sectors, and human health. The Working Group II report focused on the following issues for different sectors and regions (e.g. water, agriculture, biodiversity) and communities (coastal, island, etc.): · The role of adaptation in reducing vulnerability and impacts, · Assessment of adaptation capacity, options and constraints, and · Enhancing adaptation practice and operations. This presentation will address the following questions in the context of the results of the IPCC Fourth Assessment Report WG II: · What are the barriers, knowledge gaps, and opportunities for impacts assessments? · How are decisions about adaptation being made, and what types of adaptation strategies are being undertaken? · What are good adaptation practices and how are they learned over time? Examples will be drawn from the freshwater resources, small islands and adaptation chapters to which the presenter contributed. Many lessons have been identified but few have been implemented or evaluated over time. Adaptation occurs in the context of multiple stresses. Adaptation will be important in coping with early impacts in the near-term and continue to be important as our climate changes, regardless of how that change is derived. It is important to note that unmitigated climate change could, in the long term, exceed the capacity of different natural, managed and human systems to adapt. The assessment leads to the following conclusions: · Adaptation to climate change is already taking place, but on a limited basis · Adaptation measures

  15. Correctional Training. Institution Familiarization. Part II: The Training Program.

    ERIC Educational Resources Information Center

    Bureau of Prisons (Dept. of Justice), Washington, DC.

    Designed to assist training coordinators in the initial institution familiarization training for new employees in correctional institutions, this manual consists of two documents: a training coordinator's guide (Part I - CE 017 285) and this document, the training program (Part II). Four training areas are treated: (1) an introduction consisting…

  16. Calculus of Elementary Functions, Part II. Teacher's Commentary. Revised Edition.

    ERIC Educational Resources Information Center

    Herriot, Sarah T.; And Others

    This course is intended for students who have a thorough knowledge of college preparatory mathematics, including algebra, axiomatic geometry, trigonometry, and analytic geometry. This teacher's guide is for Part II of the course. It is designed to follow Part I of the text. The guide contains background information, suggested instructional…

  17. Kick, Glide, Pole! Cross-Country Skiing Fun (Part II)

    ERIC Educational Resources Information Center

    Duoos, Bridget A.

    2012-01-01

    Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

  18. Kick, Glide, Pole! Cross-Country Skiing Fun (Part II)

    ERIC Educational Resources Information Center

    Duoos, Bridget A.

    2012-01-01

    Part I of Kick, Glide, Pole! Cross-Country Skiing Fun, which was published in last issue, discussed how to select cross-country ski equipment, dress for the activity and the biomechanics of the diagonal stride. Part II focuses on teaching the diagonal stride technique and begins with a progression of indoor activities. Incorporating this fun,…

  19. Photoprotection: part II. Sunscreen: development, efficacy, and controversies.

    PubMed

    Jansen, Rebecca; Osterwalder, Uli; Wang, Steven Q; Burnett, Mark; Lim, Henry W

    2013-12-01

    In addition to the naturally occurring, physical, and systemic photoprotective agents reviewed in part I, topical ultraviolet radiation filters are an important cornerstone of photoprotection. Sunscreen development, efficacy, testing, and controversies are reviewed in part II of this continuing medical education article. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  20. Corporate Library Impact, Part II: Methodological Trade-Offs

    ERIC Educational Resources Information Center

    Edgar, William

    2004-01-01

    This article and its accompanying one address the corporate library's contribution to its parent firm. Part I reviews the literature on determining this contribution, revealing the need for a more theoretical approach to this problem. It then presents this approach. This article, Part II, reviews methodological trade-offs in pursuing this new…

  1. EDUCATION AND THE DEVELOPMENT OF IN-RESIDENCE TRAINING PROGRAMS, PART I, PART II.

    ERIC Educational Resources Information Center

    MELICAN, ROBERT L.; PURCELL, FRANCIS P.

    THE TWO PARTS OF THIS DISCUSSION CONSIDER THE DEVELOPMENT OF RESIDENTIAL PROGRAMS FOR VOCATIONAL AND SOCIAL TRAINING TO MEET THE PROBLEMS OF THE LOW-INCOME SCHOOL DROPOUT. PART I REVIEWS THE HISTORICAL BACKGROUND OF RESIDENCY PROGRAMS IN SUCH EDUCATIONAL INSTITUTIONS AS COLLEGES, UNIVERSITIES, CHURCHES, AND SUMMER CAMPS. PART II DEALS WITH THE…

  2. Ontario Universities Benefits Survey, 1991-92. Part I: Benefits Excluding Pensions [and] Part II: Pensions.

    ERIC Educational Resources Information Center

    Council of Senior Administrative Officers--Universities of Ontario, Toronto.

    This report, which combined Part I and Part II of a benefit study, presents data from a survey of Ontario universities concerning fringe benefits offered in 1991-92. Part I is made up of a series of tables displaying the information on particular benefits institution-by-institution. The first five tables cover general aspects of benefits,…

  3. Leveraging Information Technology. Track II: Innovative Management.

    ERIC Educational Resources Information Center

    CAUSE, Boulder, CO.

    Seven papers from the 1987 CAUSE conference's Track II, Innovative Management, are presented. They include: "Is This Creative, or What!" (Kenneth C. Blythe); "Joint Application Design: Can a User Committee Design a System in Four Days?" (Diane Kent, David Smithers); "Making It Happen without Appropriation" (Robert E.…

  4. AT2 DS II - Accelerator System Design (Part II) - CCC Video Conference

    SciTech Connect

    2010-12-17

    Discussion Session - Accelerator System Design (Part II) Tutors: C. Darve, J. Weisend II, Ph. Lebrun, A. Dabrowski, U. Raich Video Conference with the CERN Control Center. Experts in the field of Accelerator science will be available to answer the students questions. This session will link the CCC and SA (using Codec VC).

  5. AT2 DS II - Accelerator System Design (Part II) - CCC Video Conference

    ScienceCinema

    None

    2016-07-12

    Discussion Session - Accelerator System Design (Part II) Tutors: C. Darve, J. Weisend II, Ph. Lebrun, A. Dabrowski, U. Raich Video Conference with the CERN Control Center. Experts in the field of Accelerator science will be available to answer the students questions. This session will link the CCC and SA (using Codec VC).

  6. Recent Economic Perspectives on Political Economy, Part II*

    PubMed Central

    Dewan, Torun; Shepsle, Kenneth A.

    2013-01-01

    In recent years some of the best theoretical work on the political economy of political institutions and processes has begun surfacing outside the political science mainstream in high quality economics journals. This two-part paper surveys these contributions from a recent five-year period. In Part I, the focus is on elections, voting and information aggregation, followed by treatments of parties, candidates, and coalitions. In Part II, papers on economic performance and redistribution, constitutional design, and incentives, institutions, and the quality of political elites are discussed. Part II concludes with a discussion of the methodological bases common to economics and political science, the way economists have used political science research, and some new themes and arbitrage opportunities. PMID:23606754

  7. Recent Economic Perspectives on Political Economy, Part II.

    PubMed

    Dewan, Torun; Shepsle, Kenneth A

    2008-07-01

    In recent years some of the best theoretical work on the political economy of political institutions and processes has begun surfacing outside the political science mainstream in high quality economics journals. This two-part paper surveys these contributions from a recent five-year period. In Part I, the focus is on elections, voting and information aggregation, followed by treatments of parties, candidates, and coalitions. In Part II, papers on economic performance and redistribution, constitutional design, and incentives, institutions, and the quality of political elites are discussed. Part II concludes with a discussion of the methodological bases common to economics and political science, the way economists have used political science research, and some new themes and arbitrage opportunities.

  8. Recovery in soccer : part ii-recovery strategies.

    PubMed

    Nédélec, Mathieu; McCall, Alan; Carling, Chris; Legall, Franck; Berthoin, Serge; Dupont, Gregory

    2013-01-01

    In the formerly published part I of this two-part review, we examined fatigue after soccer matchplay and recovery kinetics of physical performance, and cognitive, subjective and biological markers. To reduce the magnitude of fatigue and to accelerate the time to fully recover after completion, several recovery strategies are now used in professional soccer teams. During congested fixture schedules, recovery strategies are highly required to alleviate post-match fatigue, and then to regain performance faster and reduce the risk of injury. Fatigue following competition is multifactorial and mainly related to dehydration, glycogen depletion, muscle damage and mental fatigue. Recovery strategies should consequently be targeted against the major causes of fatigue. Strategies reviewed in part II of this article were nutritional intake, cold water immersion, sleeping, active recovery, stretching, compression garments, massage and electrical stimulation. Some strategies such as hydration, diet and sleep are effective in their ability to counteract the fatigue mechanisms. Providing milk drinks to players at the end of competition and a meal containing high-glycaemic index carbohydrate and protein within the hour following the match are effective in replenishing substrate stores and optimizing muscle-damage repair. Sleep is an essential part of recovery management. Sleep disturbance after a match is common and can negatively impact on the recovery process. Cold water immersion is effective during acute periods of match congestion in order to regain performance levels faster and repress the acute inflammatory process. Scientific evidence for other strategies reviewed in their ability to accelerate the return to the initial level of performance is still lacking. These include active recovery, stretching, compression garments, massage and electrical stimulation. While this does not mean that these strategies do not aid the recovery process, the protocols implemented up until

  9. Nursing Care of Patients Undergoing Chemotherapy Desensitization: Part II.

    PubMed

    Jakel, Patricia; Carsten, Cynthia; Carino, Arvie; Braskett, Melinda

    2016-04-01

    Chemotherapy desensitization protocols are safe, but labor-intensive, processes that allow patients with cancer to receive medications even if they initially experienced severe hypersensitivity reactions. Part I of this column discussed the pathophysiology of hypersensitivity reactions and described the development of desensitization protocols in oncology settings. Part II incorporates the experiences of an academic medical center and provides a practical guide for the nursing care of patients undergoing chemotherapy desensitization.
.

  10. High Performance Liquid Chromatography/Video Fluorometry. Part II. Applications.

    DTIC Science & Technology

    1981-09-30

    HIGH PERFORMANCE LIQUID CHROMATOGRAPHY /VIDEO FLUOROMETRY. PART...REP«T_N&:-ŗ/ High Performance Liquid Chromatography /Video Fluorometry» Part II. Applications« by | Dennis C./Shelly* Michael P./Vogarty and...Data EnlirtdJ REPORT DOCUMENTATION PAGE t. REPORT NUMBER 2 GOVT ACCESSION NO 4. T1TI.F (and Submit) lP-^fffsyva High Performance Liquid Chromatography

  11. Ethical Research Practices: Collaborative Action Research, Part II

    ERIC Educational Resources Information Center

    Calvin, Chris

    2004-01-01

    This is part II of a case study involving a large federally funded technology grant program implemented across several central Texas school districts and was followed by the researcher-participant at the university level as well as one of the campus sites. Many ethical research questions were raised during this study such as the use of participant…

  12. An analysis of the lumber planning process: Part II

    Treesearch

    Peter Koch

    1956-01-01

    This study is part II of an investigation pertaining to the peripheral-milling process of planing lumber. Some relationships were determined between cutterhead horsepower and various combinations of specimen, cutterhead, and feed factors. Power demand curves were interpreted through comparison with simultaneously taken one micro-second photos of the forming chips....

  13. Current and Future Parts Management at NASA

    NASA Technical Reports Server (NTRS)

    Sampson, Michael J.

    2011-01-01

    This presentation provides a high level view of current and future electronic parts management at NASA. It describes a current perspective of the new human space flight direction that NASA is beginning to take and how that could influence parts management in the future. It provides an overview of current NASA electronic parts policy and how that is implemented at the NASA flight Centers. It also describes some of the technical challenges that lie ahead and suggests approaches for their mitigation. These challenges include: advanced packaging, obsolescence and counterfeits, the global supply chain and Commercial Crew, a new direction by which NASA will utilize commercial launch vehicles to get astronauts to the International Space Station.

  14. Temporomandibular disorders. Part 2: conservative management

    PubMed Central

    Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

    2014-01-01

    Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

  15. Difficult asthma: assessment and management, Part 1.

    PubMed

    Long, Aidan A; Fanta, Christopher H

    2012-01-01

    A minority of asthma patients have disease that proves difficult to control with usual medications and experience ongoing symptoms, poor quality of life, and limitations in activity and/or frequent asthma exacerbations. This group of patients accounts for much of the expense associated with asthma care and is the focus of national and international collaborative study groups. Distinguishing between "difficult-to-manage asthma" and truly "therapy-resistant asthma" is helpful and promotes a systematic consideration of contributory factors. Critical evaluation of factors contributing to difficult-to-manage asthma including adverse environment, comorbidities, nonadherence, and incorrect diagnosis is recommended in a systematic fashion in Part 1 of this contribution.

  16. Pain Management: Part 1: Managing Acute and Postoperative Dental Pain

    PubMed Central

    Becker, Daniel E.

    2010-01-01

    Abstract Safe and effective management of acute dental pain can be accomplished with nonopioid and opioid analgesics. To formulate regimens properly, it is essential to appreciate basic pharmacological principles and appropriate dosage strategies for each of the available analgesic classes. This article will review the basic pharmacology of analgesic drug classes, including their relative efficacy for dental pain, and will suggest appropriate regimens based on pain intensity. Management of chronic pain will be addressed in the second part of this series. PMID:20553137

  17. 40 CFR Appendix II to Part 257 - Appendix II to Part 257

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to Part 257 A. Processes To Significantly Reduce Pathogens Aerobic digestion: The process is... of which temperatures average on a daily basis above 0 °C. Anaerobic digestion: The process is...: Liquid sludge is heated to temperatures of 180 °C for 30 minutes. Thermophilic Aerobic Digestion:...

  18. 40 CFR Appendix II to Part 257 - Appendix II to Part 257

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to Part 257 A. Processes To Significantly Reduce Pathogens Aerobic digestion: The process is... of which temperatures average on a daily basis above 0 °C. Anaerobic digestion: The process is...: Liquid sludge is heated to temperatures of 180 °C for 30 minutes. Thermophilic Aerobic Digestion:...

  19. 40 CFR Appendix II to Part 257 - Appendix II to Part 257

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to Part 257 A. Processes To Significantly Reduce Pathogens Aerobic digestion: The process is... of which temperatures average on a daily basis above 0 °C. Anaerobic digestion: The process is...: Liquid sludge is heated to temperatures of 180 °C for 30 minutes. Thermophilic Aerobic Digestion:...

  20. The Nature of Reinforcement: Part I. (Volume I), Part II. (Volume II).

    ERIC Educational Resources Information Center

    Glaser, Robert, Ed.

    Part One of this report describes the first half of a conference, designed to examine the nature of reinforcement, which was held at the University of Pittsburgh in June 1969. The topics discussed include: "Reward in Human Learning: Theoretical Issues and Strategic Choice Points"; "Are Reinforcement Concepts Able to Provide Reinforcement for…

  1. Parts Obsolescence Management Technology Transition (POMTT)

    DTIC Science & Technology

    2004-08-01

    programs must begin to initially plan for more card real estate availability as component functionality increases and part size decreases over time...commercial viability of these tools. 15 . SUBJECT TERMS obsolescence, proactive management, and commercial tools 16. SECURITY CLASSIFICATION OF...Cycle Cost Forced Redesign Avoidance 10% Material Cost Reduction 5% Design Re-Use 10% -25%- 15 %-10% Reduce Total O&S Costs by 25% (Cumulative) t l t

  2. The Value of Imaging Part II: Value beyond Image Interpretation.

    PubMed

    Duong, Phuong-Anh T; Pastel, David A; Sadigh, Gelareh; Ballard, David; Sullivan, Joseph C; Bresnahan, Brian; Buch, Karen; Duszak, Richard

    2016-01-01

    Although image interpretation is an essential part of radiologists' value, there are other ways in which we contribute to patient care. Part II of the value of imaging series reviews current initiatives that demonstrate value beyond the image interpretation. Standardizing processes, reducing the radiation dose of our examinations, clarifying written reports, improving communications with patients and providers, and promoting appropriate imaging through decision support are all ways we can provide safer, more consistent, and higher quality care. As payers and policy makers push to drive value, research that demonstrates the value of these endeavors, or lack thereof, will become increasingly sought after and supported.

  3. Probabilistic finite-state machines--part II.

    PubMed

    Vidal, Enrique; Thollard, Frank; de la Higuera, Colin; Casacuberta, Francisco; Carrasco, Rafael C

    2005-07-01

    Probabilistic finite-state machines are used today in a variety of areas in pattern recognition or in fields to which pattern recognition is linked. In Part I of this paper, we surveyed these objects and studied their properties. In this Part II, we study the relations between probabilistic finite-state automata and other well-known devices that generate strings like hidden Markov models and n-grams and provide theorems, algorithms, and properties that represent a current state of the art of these objects.

  4. Treatment of cellulite: Part II. Advances and controversies.

    PubMed

    Khan, Misbah H; Victor, Frank; Rao, Babar; Sadick, Neil S

    2010-03-01

    Treatments for localized adiposities range from topical creams to liposuction. Most treatments lack a substantial proof of efficacy. The unpredictable treatment outcome can be related to the fact that cellulite adipose tissue is physiologically and biochemically different from subcutaneous tissue found elsewhere in the body. Part II of this two-part series on cellulite reviews the various treatment options that are currently available for human adipose tissue including, but not limited to, cellulite. It also focuses on newer techniques that can be potentially useful in the future for the treatment of cellulite. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Recent advances in small bowel diseases: Part II

    PubMed Central

    Thomson, Alan BR; Chopra, Angeli; Clandinin, Michael Tom; Freeman, Hugh

    2012-01-01

    As is the case in all areas of gastroenterology and hepatology, in 2009 and 2010 there were many advances in our knowledge and understanding of small intestinal diseases. Over 1000 publications were reviewed, and the important advances in basic science as well as clinical applications were considered. In Part II we review six topics: absorption, short bowel syndrome, smooth muscle function and intestinal motility, tumors, diagnostic imaging, and cystic fibrosis. PMID:22807605

  6. Feedback Flow Control for a Pitching Turret (Part II) (POSTPRINT)

    DTIC Science & Technology

    2010-01-01

    imposes no penalty on the control input. VII. Closed-loop Control Run with an Advanced Controller Three compensators ( LQR regulators with Kalman...AFRL-RB-WP-TP-2010-3024 FEEDBACK FLOW CONTROL FOR A PITCHING TURRET (PART II) (POSTPRINT) T. Vaithianathan and H.A. Carlson Clear...display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YY) 2. REPORT TYPE 3

  7. Feasibility of Screening for Antibiotic Resistance-Part II

    DTIC Science & Technology

    2005-08-01

    antibiotic resistance - T +31 15 28 43000 F +31 152843991 part II Info-DenV@tno.nl Date August 2005 Author(s) M.P. Broekhuijsen, W.C.M. van Dijk...ciprofloxacineresistentie. Beide, De ontworpen methode kan nog verder methoden werden getest op kunstmatig worden verbeterd, en worden toegepast op een resistent ...resultaat te zettn. c otworen ethd erken ood behalen is. Deze mutatie-analysemethode is op de twee kunstmatig resistent gemaalcte tevens geschikter voor

  8. Topics in Finance: Part II--Financial Analysis

    ERIC Educational Resources Information Center

    Laux, Judy

    2010-01-01

    The second article in a series designed to supplement the introductory financial management course, this essay addresses financial statement analysis, including its impact on stock valuation, disclosure, and managerial behavior. [For "Topics in Finance Part I--Introduction and Stockholder Wealth Maximization," see EJ1060345.

  9. Gas Atomization of Amorphous Aluminum Powder: Part II. Experimental Investigation

    NASA Astrophysics Data System (ADS)

    Zheng, Baolong; Lin, Yaojun; Zhou, Yizhang; Lavernia, Enrique J.

    2009-12-01

    The optimal processing parameters that are required to atomize amorphous Al were established on the basis of numerical simulations in part I of this study. In this part II, the characterization of cooling rate experienced by gas-atomized, Al-based amorphous powders was studied via experiments. An experimental investigation was implemented to validate the numerical predictions reported in part I of this study. The cooling rate experienced by the powders, for example, was experimentally determined on the basis of dendrite arm spacing correlations, and the results were compared with the numerical predictions. The experimental studies were completed using commercial Al 2024 as a baseline material and Al90Gd7Ni2Fe1 metallic glass (MG). The results showed that the cooling rate of droplets increases with decreasing particle size, with an increasing proportion of helium in the atomization gas and with increasing melt superheat. The experimental results reported in this article suggest good agreement between experiments and numerical simulations.

  10. The "Pseudocommando" mass murderer: part II, the language of revenge.

    PubMed

    Knoll, James L

    2010-01-01

    In Part I of this article, research on pseudocommandos was reviewed, and the important role that revenge fantasies play in motivating such persons to commit mass murder-suicide was discussed. Before carrying out their mass shootings, pseudocommandos may communicate some final message to the public or news media. These communications are rich sources of data about their motives and psychopathology. In Part II of this article, forensic psycholinguistic analysis is applied to clarify the primary motivations, detect the presence of mental illness, and discern important individual differences in the final communications of two recent pseudocommandos: Seung-Hui Cho (Virginia Tech) and Jiverly Wong (Binghamton, NY). Although both men committed offenses that qualify them as pseudocommandos, their final communications reveal striking differences in their psychopathology.

  11. CE and nanomaterials - Part II: Nanomaterials in CE.

    PubMed

    Adam, Vojtech; Vaculovicova, Marketa

    2017-10-01

    The scope of this two-part review is to summarize publications dealing with CE and nanomaterials together. This topic can be viewed from two broad perspectives, and this article is trying to highlight these two approaches: (i) CE of nanomaterials, and (ii) nanomaterials in CE. The second part aims at summarization of publications dealing with application of nanomaterials for enhancement of CE performance either in terms of increasing the separation resolution or for improvement of the detection. To increase the resolution, nanomaterials are employed as either surface modification of the capillary wall forming open tubular column or as additives to the separation electrolyte resulting in a pseudostationary phase. Moreover, nanomaterials have proven to be very beneficial for increasing also the sensitivity of detection employed in CE or even they enable the detection (e.g., fluorescent tags of nonfluorescent molecules). © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Repair of articular cartilage defects: part II. Treatment options.

    PubMed

    Chen, F S; Frenkel, S R; Di Cesare, P E

    1999-02-01

    Articular cartilage injuries result in numerous clinical symptoms, such as pain and decreased functional levels. Current therapeutic options being used include articular surface debridement, such as chondral shaving, abrasion chondroplasty, and subchondral perforation; soft-tissue arthroplasties, such as perichondrial and periosteal grafts; and osteochondral transplantation. None of these therapies, however, has resulted in the successful regeneration of a hyaline-like tissue that withstands normal joint loading and activity over prolonged periods. As a result, research is also being conducted on alternative therapeutic procedures to enhance the repair process and to stimulate the regeneration of a repair tissue with hyaline-like structural and biologic properties. Part I of this paper, which was published in January, discussed the basic science of cartilage healing. Part II presents the treatment options.

  13. Structure Learning and Statistical Estimation in Distribution Networks - Part II

    SciTech Connect

    Deka, Deepjyoti; Backhaus, Scott N.; Chertkov, Michael

    2015-02-13

    Limited placement of real-time monitoring devices in the distribution grid, recent trends notwithstanding, has prevented the easy implementation of demand-response and other smart grid applications. Part I of this paper discusses the problem of learning the operational structure of the grid from nodal voltage measurements. In this work (Part II), the learning of the operational radial structure is coupled with the problem of estimating nodal consumption statistics and inferring the line parameters in the grid. Based on a Linear-Coupled(LC) approximation of AC power flows equations, polynomial time algorithms are designed to identify the structure and estimate nodal load characteristics and/or line parameters in the grid using the available nodal voltage measurements. Then the structure learning algorithm is extended to cases with missing data, where available observations are limited to a fraction of the grid nodes. The efficacy of the presented algorithms are demonstrated through simulations on several distribution test cases.

  14. [The Mexican consensus on gastroesophageal reflux disease. Part II].

    PubMed

    Huerta-Iga, F; Tamayo-de la Cuesta, J L; Noble-Lugo, A; Hernández-Guerrero, A; Torres-Villalobos, G; Ramos-de la Medina, A; Pantoja-Millán, J P

    2013-01-01

    To update the themes of endoscopic and surgical treatment of Gastroesophageal Reflux Disease (GERD) from the Mexican Consensus published in 2002. Part I of the 2011 Consensus dealt with the general concepts, diagnosis, and medical treatment of this disease. Part II covers the topics of the endoscopic and surgical treatment of GERD. In this second part, an expert in endoscopy and an expert in GERD surgery, along with the three general coordinators of the consensus, carried out an extensive bibliographic review using the Embase, Cochrane, and Medline databases. Statements referring to the main aspects of endoscopic and surgical treatment of this disease were elaborated and submitted to specialists for their consideration and vote, utilizing the modified Delphi method. The statements were accepted into the consensus if the level of agreement was 67% or higher. Twenty-five statements corresponding to the endoscopic and surgical treatment of GERD resulted from the voting process, and they are presented herein as Part II of the consensus. The majority of the statements had an average level of agreement approaching 90%. Currently, endoscopic treatment of GERD should not be regarded as an option, given that the clinical results at 3 and 5 years have not demonstrated durability or sustained symptom remission. The surgical indications for GERD are well established; only those patients meeting the full criteria should be candidates and their surgery should be performed by experts. Copyright © 2012 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  15. Telehealth, disease management, home care and the future--part 2.

    PubMed

    Fazzi, Robert; Ashe, Tim; Doak, Lindsay

    2008-01-01

    In October CARING, Part I of the Phillips Study gave information on the background of the study along with insights into the major technologies studied. Part II will focus on what was clearly the area of greatest interest in the web survey--the impact of telehealth on quality and cost, especially the impact of telehealth on disease management.

  16. PREREM: an interactive data preprocessing code for INREM II. Part I: user's manual. Part II: code structure

    SciTech Connect

    Ryan, M.T.; Fields, D.E.

    1981-05-01

    PREREM is an interactive computer code developed as a data preprocessor for the INREM-II (Killough, Dunning, and Pleasant, 1978a) internal dose program. PREREM is intended to provide easy access to current and self-consistent nuclear decay and radionuclide-specific metabolic data sets. Provision is made for revision of metabolic data, and the code is intended for both production and research applications. Documentation for the code is in two parts. Part I is a user's manual which emphasizes interpretation of program prompts and choice of user input. Part II stresses internal structure and flow of program control and is intended to assist the researcher who wishes to revise or modify the code or add to its capabilities. PREREM is written for execution on a Digital Equipment Corporation PDP-10 System and much of the code will require revision before it can be run on other machines. The source program length is 950 lines (116 blocks) and computer core required for execution is 212 K bytes. The user must also have sufficient file space for metabolic and S-factor data sets. Further, 64 100 K byte blocks of computer storage space are required for the nuclear decay data file. Computer storage space must also be available for any output files produced during the PREREM execution. 9 refs., 8 tabs.

  17. Blade System Design Study. Part II, final project report (GEC).

    SciTech Connect

    Griffin, Dayton A.

    2009-05-01

    As part of the U.S. Department of Energy's Low Wind Speed Turbine program, Global Energy Concepts LLC (GEC)1 has studied alternative composite materials for wind turbine blades in the multi-megawatt size range. This work in one of the Blade System Design Studies (BSDS) funded through Sandia National Laboratories. The BSDS program was conducted in two phases. In the Part I BSDS, GEC assessed candidate innovations in composite materials, manufacturing processes, and structural configurations. GEC also made recommendations for testing composite coupons, details, assemblies, and blade substructures to be carried out in the Part II study (BSDS-II). The BSDS-II contract period began in May 2003, and testing was initiated in June 2004. The current report summarizes the results from the BSDS-II test program. Composite materials evaluated include carbon fiber in both pre-impregnated and vacuum-assisted resin transfer molding (VARTM) forms. Initial thin-coupon static testing included a wide range of parameters, including variation in manufacturer, fiber tow size, fabric architecture, and resin type. A smaller set of these materials and process types was also evaluated in thin-coupon fatigue testing, and in ply-drop and ply-transition panels. The majority of materials used epoxy resin, with vinyl ester (VE) resin also used for selected cases. Late in the project, testing of unidirectional fiberglass was added to provide an updated baseline against which to evaluate the carbon material performance. Numerous unidirectional carbon fabrics were considered for evaluation with VARTM infusion. All but one fabric style considered suffered either from poor infusibility or waviness of fibers combined with poor compaction. The exception was a triaxial carbon-fiberglass fabric produced by SAERTEX. This fabric became the primary choice for infused articles throughout the test program. The generally positive results obtained in this program for the SAERTEX material have led to its being

  18. A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

    ERIC Educational Resources Information Center

    Bleimann, Robert L.; Smith, Lee W.

    1985-01-01

    A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)

  19. 40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Duty Cycles for Laboratory Testing II Appendix II to Part 1054 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld...

  20. 40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Duty Cycles for Laboratory Testing II Appendix II to Part 1054 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld...

  1. 40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Laboratory Testing II Appendix II to Part 1054 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld...

  2. 40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Duty Cycles for Laboratory Testing II Appendix II to Part 1054 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld...

  3. 40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Duty Cycles for Laboratory Testing II Appendix II to Part 1054 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld...

  4. 31 CFR Appendix II(f) to Part 13 - Overhead and Administrative Costs

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Overhead and Administrative Costs II(F) Appendix II(F) to Part 13 Money and Finance: Treasury Office of the Secretary of the Treasury... Pt. 13, App. II(F) Appendix II(F) to Part 13—Overhead and Administrative Costs Date: Select Only...

  5. 31 CFR Appendix II(f) to Part 13 - Overhead and Administrative Costs

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Overhead and Administrative Costs II(F) Appendix II(F) to Part 13 Money and Finance: Treasury Office of the Secretary of the Treasury... Pt. 13, App. II(F) Appendix II(F) to Part 13—Overhead and Administrative Costs Date: Select Only...

  6. 12 CFR Appendix II to Part 27 - Information for Government Monitoring Purposes

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Information for Government Monitoring Purposes II Appendix II to Part 27 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY FAIR HOUSING HOME LOAN DATA SYSTEM Pt. 27, App. II Appendix II to Part 27—Information for Government...

  7. 40 CFR Appendix II to Part 92 - Interpretive Ruling for § 92.705-Remedial Plans

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-Remedial Plans II Appendix II to Part 92 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., App. II Appendix II to Part 92—Interpretive Ruling for § 92.705—Remedial Plans The following is an... manufacturers to better enable them to submit acceptable remedial plans. (2) Section 207(c)(1) requires the...

  8. 10 CFR Appendix II to Part 960 - NRC and EPA Requirements for Preclosure Repository Performance

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false NRC and EPA Requirements for Preclosure Repository Performance II Appendix II to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Pt. 960, App. II Appendix II to Part 960—NRC...

  9. 10 CFR Appendix II to Part 960 - NRC and EPA Requirements for Preclosure Repository Performance

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false NRC and EPA Requirements for Preclosure Repository Performance II Appendix II to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Pt. 960, App. II Appendix II to Part 960—NRC...

  10. 10 CFR Appendix II to Part 960 - NRC and EPA Requirements for Preclosure Repository Performance

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false NRC and EPA Requirements for Preclosure Repository Performance II Appendix II to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Pt. 960, App. II Appendix II to Part 960—NRC...

  11. 10 CFR Appendix II to Part 960 - NRC and EPA Requirements for Preclosure Repository Performance

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false NRC and EPA Requirements for Preclosure Repository Performance II Appendix II to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Pt. 960, App. II Appendix II to Part 960—NRC...

  12. 10 CFR Appendix II to Part 960 - NRC and EPA Requirements for Preclosure Repository Performance

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false NRC and EPA Requirements for Preclosure Repository Performance II Appendix II to Part 960 Energy DEPARTMENT OF ENERGY GENERAL GUIDELINES FOR THE PRELIMINARY SCREENING OF POTENTIAL SITES FOR A NUCLEAR WASTE REPOSITORY Pt. 960, App. II Appendix II to Part 960—NRC...

  13. Mammalian Toxicity of Munitions Compounds. Phase II. Effects of Multiple Doses Part II. 2,4-Dinitrotoluene

    DTIC Science & Technology

    1978-11-01

    II: Effects of Multiple Doses Part !I: 2,4-T)initrotoiuene I Progres Report No. 3 oNovember 1978 by 3I Cheng-Chun Lee U Hirty V. Ellis, III Jo.,n J...Sciences Division November 1978 vii :. •I~~~~AMMALIAN TOXICITY OF MUNITIONS COMPOUNDS ... ... PHASE IIz Effects of Multiple Doses m . ............... PART...161 xi MAMOMALIAN TOXICITY OF MUNITION COMPOUNDS PHASE II: Effects of Multiple Dones PART II: 2,4

  14. 49 CFR Appendix A-Ii to Part 541 - Lines With Antitheft Devices Which Are Exempted in-Part From the Parts-Marking Requirements of...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Lines With Antitheft Devices Which Are Exempted in-Part From the Parts-Marking Requirements of This Standard Pursuant to 49 CFR Part 543 A Appendix A-II... STANDARD Pt. 541, App. A-II Appendix A-II to Part 541—Lines With Antitheft Devices Which Are Exempted...

  15. 49 CFR Appendix A-Ii to Part 541 - Lines With Antitheft Devices Which Are Exempted in-Part From the Parts-Marking Requirements of...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 6 2011-10-01 2011-10-01 false Lines With Antitheft Devices Which Are Exempted in-Part From the Parts-Marking Requirements of This Standard Pursuant to 49 CFR Part 543 A Appendix A-II... STANDARD Pt. 541, App. A-II Appendix A-II to Part 541—Lines With Antitheft Devices Which Are Exempted...

  16. 77 FR 60743 - Proposed Collection; Comment Request for Schedule F, Part II and III (Form 1040)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-04

    ... Internal Revenue Service Proposed Collection; Comment Request for Schedule F, Part II and III (Form 1040... Law 104-13 (44 U.S.C. 3506(c)(2)(A)). Currently, the IRS is soliciting comments concerning Schedule F... Number: Schedule F, Part II and III (Form 1040). Abstract: Schedule F, Part II and III (Form 1040)...

  17. Fast transforms for acoustic imaging--part II: applications.

    PubMed

    Ribeiro, Flávio P; Nascimento, Vítor H

    2011-08-01

    In Part I ["Fast Transforms for Acoustic Imaging-Part I: Theory," IEEE Transactions on Image Processing], we introduced the Kronecker array transform (KAT), a fast transform for imaging with separable arrays. Given a source distribution, the KAT produces the spectral matrix which would be measured by a separable sensor array. In Part II, we establish connections between the KAT, beamforming and 2-D convolutions, and show how these results can be used to accelerate classical and state of the art array imaging algorithms. We also propose using the KAT to accelerate general purpose regularized least-squares solvers. Using this approach, we avoid ill-conditioned deconvolution steps and obtain more accurate reconstructions than previously possible, while maintaining low computational costs. We also show how the KAT performs when imaging near-field source distributions, and illustrate the trade-off between accuracy and computational complexity. Finally, we show that separable designs can deliver accuracy competitive with multi-arm logarithmic spiral geometries, while having the computational advantages of the KAT.

  18. Antiviral medication in sexually transmitted diseases. Part II: HIV.

    PubMed

    Majewska, Anna; Mlynarczyk-Bonikowska, Beata; Malejczyk, Magdalena; Mlynarczyk, Grazyna; Majewski, Slawomir

    2015-01-01

    This is a second part of a review under a main title Antiviral medication in sexually transmitted diseases. In the part we published in Mini Rev Med Chem. 2013,13(13):1837-45, we have described mechanisms of action and mechanism of resistance to antiviral agents used in genital herpes and genital HPV infection. The Part II review focuses on therapeutic options in HIV infection. In 1987, 6 years after the recognition of AIDS, the FDA approved the first drug against HIV--zidovudine. Since then a lot of antiretroviral drugs are available. The most effective treatment for HIV is highly active antiretroviral therapy--a combination of several antiretroviral medicines that cause a reduction of HIV blood concentration and often results in substantial recovery of impaired immunologic function. At present, there are over 20 drugs licensed and used for the treatment of HIV/AIDS, and these drugs are divided into one of six classes. Investigational agents include GS-7340, the prodrug of tenofovir and BMS-663068--the first in a novel class of drugs that blocks the binding of the HIV gp120 to the CD4 receptor.

  19. Bayesian inference for psychology. Part II: Example applications with JASP.

    PubMed

    Wagenmakers, Eric-Jan; Love, Jonathon; Marsman, Maarten; Jamil, Tahira; Ly, Alexander; Verhagen, Josine; Selker, Ravi; Gronau, Quentin F; Dropmann, Damian; Boutin, Bruno; Meerhoff, Frans; Knight, Patrick; Raj, Akash; van Kesteren, Erik-Jan; van Doorn, Johnny; Šmíra, Martin; Epskamp, Sacha; Etz, Alexander; Matzke, Dora; de Jong, Tim; van den Bergh, Don; Sarafoglou, Alexandra; Steingroever, Helen; Derks, Koen; Rouder, Jeffrey N; Morey, Richard D

    2017-07-06

    Bayesian hypothesis testing presents an attractive alternative to p value hypothesis testing. Part I of this series outlined several advantages of Bayesian hypothesis testing, including the ability to quantify evidence and the ability to monitor and update this evidence as data come in, without the need to know the intention with which the data were collected. Despite these and other practical advantages, Bayesian hypothesis tests are still reported relatively rarely. An important impediment to the widespread adoption of Bayesian tests is arguably the lack of user-friendly software for the run-of-the-mill statistical problems that confront psychologists for the analysis of almost every experiment: the t-test, ANOVA, correlation, regression, and contingency tables. In Part II of this series we introduce JASP ( http://www.jasp-stats.org ), an open-source, cross-platform, user-friendly graphical software package that allows users to carry out Bayesian hypothesis tests for standard statistical problems. JASP is based in part on the Bayesian analyses implemented in Morey and Rouder's BayesFactor package for R. Armed with JASP, the practical advantages of Bayesian hypothesis testing are only a mouse click away.

  20. What's new in pediatric dermatology?: part II. Treatment.

    PubMed

    Pride, Howard B; Tollefson, Megha; Silverman, Robert

    2013-06-01

    The field of pediatric dermatology has been rich in new developments. Part II of this continuing medical education article will focus on new therapeutic modalities for several entities encountered in pediatric dermatology. The treatment of atopic dermatitis, exciting advances in the use of propranolol and other beta-blockers for the use of infantile hemangiomas, the use of rapamycin for vascular anomalies, the use of biologics in children, the central nervous system risks of general anesthesia in young children, side effects in the use of isotretinoin, the treatment of tinea capitis, treatment of herpes simplex infections, and the use of technologies such as texting and social media in medicine will be discussed. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Achieving hemostasis in dermatology-Part II: Topical hemostatic agents.

    PubMed

    Glick, Jaimie B; Kaur, Ravneet R; Siegel, Daniel

    2013-07-01

    Bleeding is a common occurrence during any dermatologic surgery that disrupts blood vessels. The complications of excess bleeding can include delayed wound healing, hematoma formation, infection, dehiscence, and necrosis. In part one of this review, we discussed the pre-operative, intra-operative, and post-operative management of patients undergoing dermatologic surgery. In Part two, we discuss traditional and new topical hemostatic agents used to achieve hemostasis in dermatological procedures and surgery. We will evaluate the caustic and non-caustic hemostatic agents as well as hemostatic dressings. The mechanisms of action, side effect profile, and advantages and disadvantages of the topical hemostatic agents are provided. Sources for this article were found searching the English literature in PubMed for the time period 1940 to March 2012. A thorough bibliography search was also performed and key references examined.

  2. Primer of statistics in dental research: Part II.

    PubMed

    Shintani, Ayumi

    2014-04-01

    The Part I of Primer of Statistics in Dental Research covered five topics that are often mentioned in statistical check list of many peer-review journals including (1) statistical graph, (2) how to deal with outliers, (3) p-value and confidence interval, (4) testing equivalence, and (5) multiplicity Adjustment. The Part II of the series covers another set of important topics in dental statistics including (1) selecting the proper statistical tests, (2) repeated measures analysis, (3) epidemiological consideration for causal association, and (4) analysis of agreement. First, a guide in selecting the proper statistical tests based on the research question will be laid out in text and with a table so that researchers choose the univariable statistical test by answering five simple questions. Second, the importance of utilizing repeated measures analysis will be illustrated. This is a key component of data analysis as in many dental studies, observations are considered repeated in a single patient (several teeth are measured in a single patient). Third, concepts of confounding and the use of regression analysis are explained by going over a famous observational cohort study. Lastly, the use of proper agreement analysis vs. correlation for study of agreement will be discussed to avoid a common pitfall in dental research.

  3. Digital Assays Part II: Digital Protein and Cell Assays.

    PubMed

    Basu, Amar S

    2017-08-01

    A digital assay is one in which the sample is partitioned into many containers such that each partition contains a discrete number of biological entities (0, 1, 2, 3, . . .). A powerful technique in the biologist's toolkit, digital assays bring a new level of precision in quantifying nucleic acids, measuring proteins and their enzymatic activity, and probing single-cell genotype and phenotype. Where part I of this review focused on the fundamentals of partitioning and digital PCR, part II turns its attention to digital protein and cell assays. Digital enzyme assays measure the kinetics of single proteins with enzymatic activity. Digital enzyme-linked immunoassays (ELISAs) quantify antigenic proteins with 2 to 3 log lower detection limit than conventional ELISA, making them well suited for low-abundance biomarkers. Digital cell assays probe single-cell genotype and phenotype, including gene expression, intracellular and surface proteins, metabolic activity, cytotoxicity, and transcriptomes (scRNA-seq). These methods exploit partitioning to 1) isolate single cells or proteins, 2) detect their activity via enzymatic amplification, and 3) tag them individually by coencapsulating them with molecular barcodes. When scaled, digital assays reveal stochastic differences between proteins or cells within a population, a key to understanding biological heterogeneity. This review is intended to give a broad perspective to scientists interested in adopting digital assays into their workflows.

  4. Violence in the emergency department: an ethnographic study (part II).

    PubMed

    Lau, Jacqui Bee Chuo; Magarey, Judy; Wiechula, Richard

    2012-07-01

    Violence in the emergency department (ED) is a significant and complex problem worldwide. This is a part II of a 2-part series on an ethnographic study. The study which aimed at exploring the cultural aspects of violence was carried out at a major metropolitan ED for 3 months. This paper presents the findings and discussions of the study. One hundred and three violent incident questionnaires were completed. A total of 242.5h of observation and 34 (33%) interviews with nurses were conducted. From the data analysis, three critical cultural themes (i.e. 'problems and solutions', 'requests and demands' and 'them and us') were identified. The study indicated that the cultural meanings of violence were complex and highly subjective. Factors such as environment, conflicting messages regarding waiting time, and the nurse-patient/relative behaviours and the resulting reciprocal relationships were critical. Nurses' efforts to establish rapport with patients was crucial and needed to occur early. There was usually a 'turning point' that provided an opportunity for the nurse to avoid violence. While violence is a complex issue with many paradoxes, the study indicates that effective interpersonal empathetic communication has a significant role in reducing violence in the ED. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Reforming Science Education: Part II. Utilizing Kieran Egan's Educational Metatheory

    NASA Astrophysics Data System (ADS)

    Schulz, Roland M.

    2009-04-01

    This paper is the second of two parts and continues the conversation which had called for a shift in the conceptual focus of science education towards philosophy of education, with the requirement to develop a discipline-specific “philosophy” of science education. In Part I, conflicting conceptions of science literacy were identified with disparate “visions” tied to competing research programs as well as school-based curricular paradigms. The impasse in the goals of science education and thereto, the contending views of science literacy, were themselves associated with three underlying fundamental aims of education (knowledge-itself; personal development; socialization) which, it was argued, usually undercut the potential of each other. During periods of “crisis-talk” and throughout science educational history these three aims have repeatedly attempted to assert themselves. The inability of science education research to affect long-term change in classrooms was correlated not only to the failure to reach a consensus on the aims (due to competing programs and to the educational ideologies of their social groups), but especially to the failure of developing true educational theories (largely neglected since Hirst). Such theories, especially metatheories, could serve to reinforce science education’s growing sense of academic autonomy and independence from socio-economic demands. In Part II, I offer as a suggestion Egan’s cultural-linguistic theory as a metatheory to help resolve the impasse. I hope to make reformers familiar with his important ideas in general, and more specifically, to show how they can complement HPS rationales and reinforce the work of those researchers who have emphasized the value of narrative in learning science.

  6. Managed care: mastering the moving parts.

    PubMed

    Boyd, Dawn; Finman, Larry

    2010-05-01

    A hospital's success with managed care depends on how thoroughly the hospital understands its interrelated aspects, including: Managed care strategy Contract negotiations. Contract language. Key performance indicators. Modeling. Contract termination provisions. Movement from wholesale to retail health care.

  7. Essentials of Advocacy in Case Management: Part 2: Client Advocacy Model and Case Manager's Advocacy Strategies and Competencies.

    PubMed

    Tahan, Hussein M

    2016-01-01

    This article describes a client advocacy model for use by case managers. It delineates necessary competencies for the case manager and shares important strategies for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is a primary role and necessary competency of professional case managers functioning in various care settings. It is rooted in ethical theory and principles. Successful case managers apply ethical principles of advocacy at every step of the case management process and in the decisions they make. Part II of this two-part article presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Part I already explored the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and the common types of advocacy based on scope, complexity, impact, and reach. Acquiring foundational knowledge, skills, and competencies in what advocacy is and how to effectively enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and health care agencies/providers alike. Case management leaders are urged to use the knowledge shared in this article to develop advocacy training and competency management programs for their case managers.

  8. Repeated-sprint ability - part II: recommendations for training.

    PubMed

    Bishop, David; Girard, Olivier; Mendez-Villanueva, Alberto

    2011-09-01

    Short-duration sprints, interspersed with brief recoveries, are common during most team sports. The ability to produce the best possible average sprint performance over a series of sprints (≤10 seconds), separated by short (≤60 seconds) recovery periods has been termed repeated-sprint ability (RSA). RSA is therefore an important fitness requirement of team-sport athletes, and it is important to better understand training strategies that can improve this fitness component. Surprisingly, however, there has been little research about the best training methods to improve RSA. In the absence of strong scientific evidence, two principal training theories have emerged. One is based on the concept of training specificity and maintains that the best way to train RSA is to perform repeated sprints. The second proposes that training interventions that target the main factors limiting RSA may be a more effective approach. The aim of this review (Part II) is to critically analyse training strategies to improve both RSA and the underlying factors responsible for fatigue during repeated sprints (see Part I of the preceding companion article). This review has highlighted that there is not one type of training that can be recommended to best improve RSA and all of the factors believed to be responsible for performance decrements during repeated-sprint tasks. This is not surprising, as RSA is a complex fitness component that depends on both metabolic (e.g. oxidative capacity, phosphocreatine recovery and H+ buffering) and neural factors (e.g. muscle activation and recruitment strategies) among others. While different training strategies can be used in order to improve each of these potential limiting factors, and in turn RSA, two key recommendations emerge from this review; it is important to include (i) some training to improve single-sprint performance (e.g. 'traditional' sprint training and strength/power training); and (ii) some high-intensity (80-90% maximal oxygen

  9. 40 CFR Appendix II to Part 1039 - Steady-State Duty Cycles

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... II to Part 1039 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Pt. 1039, App. II Appendix II to Part 1039—Steady-State Duty Cycles (a) The following duty cycles apply for...

  10. 40 CFR Appendix II to Part 600 - Sample Fuel Economy Calculations

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Sample Fuel Economy Calculations II Appendix II to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. II Appendix II...

  11. 40 CFR Appendix II to Part 600 - Sample Fuel Economy Calculations

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Sample Fuel Economy Calculations II Appendix II to Part 600 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. II Appendix II...

  12. Thinking in nursing education. Part II. A teacher's experience.

    PubMed

    Ironside, P M

    1999-01-01

    Across academia, educators are investigating teaching strategies that facilitate students' abilities to think critically. Because may these strategies require low teacher-student ratios or sustained involvement over time, efforts to implement them are often constrained by diminishing resources for education, faculty reductions, and increasing number of part-time teachers and students. In nursing, the challenges of teaching and learning critical thinking are compounded by the demands of providing care to patients with increasingly acute and complex problems in a wide variety of settings. To meet these challenges, nurse teachers have commonly used a variety of strategies to teach critical thinking (1). For instance, they often provide students with case studies or simulated clinical situations in classroom and laboratory settings (2). At other times, students are taught a process of critical thinking and given structured clinical assignments, such as care plans or care maps, where they apply this process in anticipating the care a particular patient will require. Accompanying students onto clinical units, teachers typically evaluate critical thinking ability by reviewing a student's preparation prior to the experience and discussing it with the student during the course of the experience. The rationales students provide for particular nursing interventions are taken as evidence of their critical thinking ability. While this approach is commonly thought to be effective, the evolving health care system has placed increased emphasis on community nursing (3,4), where it is often difficult to prespecify learning experiences or to anticipate patient care needs. In addition, teachers are often not able to accompany each student to the clinical site. Thus, the traditional strategies for teaching and learning critical thinking common to hospital-based clinical courses are being challenged, transformed, and extended (5). Part II of this article describes findings that suggest

  13. Part 3: Pharmacogenetic Variability in Phase II Anticancer Drug Metabolism

    PubMed Central

    Deenen, Maarten J.; Cats, Annemieke; Beijnen, Jos H.

    2011-01-01

    Equivalent drug doses may lead to wide interpatient variability in drug response to anticancer therapy. Known determinants that may affect the pharmacological response to a drug are, among others, nongenetic factors, including age, gender, use of comedication, and liver and renal function. Nonetheless, these covariates do not explain all the observed interpatient variability. Differences in genetic constitution among patients have been identified to be important factors that contribute to differences in drug response. Because genetic polymorphism may affect the expression and activity of proteins encoded, it is a key covariate that is responsible for variability in drug metabolism, drug transport, and pharmacodynamic drug effects. We present a series of four reviews about pharmacogenetic variability. This third part in the series of reviews is focused on genetic variability in phase II drug-metabolizing enzymes (glutathione S-transferases, uridine diphosphoglucuronosyl transferases, methyltransferases, sulfotransferases, and N-acetyltransferases) and discusses the effects of genetic polymorphism within the genes encoding these enzymes on anticancer drug therapy outcome. Based on the literature reviewed, opportunities for patient-tailored anticancer therapy are proposed. PMID:21659608

  14. Stem cells in dentistry--Part II: Clinical applications.

    PubMed

    Egusa, Hiroshi; Sonoyama, Wataru; Nishimura, Masahiro; Atsuta, Ikiru; Akiyama, Kentaro

    2012-10-01

    New technologies that facilitate solid alveolar ridge augmentation are receiving considerable attention in the field of prosthodontics because of the growing requirement for esthetic and functional reconstruction by dental implant treatments. Recently, several studies have demonstrated potential advantages for stem-cell-based therapies in regenerative treatments. Mesenchymal stem/stromal cells (MSCs) are now an excellent candidate for tissue replacement therapies, and tissue engineering approaches and chair-side cellular grafting approaches using autologous MSCs represent the clinical state of the art for stem-cell-based alveolar bone regeneration. Basic studies have revealed that crosstalk between implanted donor cells and recipient immune cells plays a key role in determining clinical success that may involve the recently observed immunomodulatory properties of MSCs. Part II of this review first overviews progress in regenerative dentistry to consider the implications of the stem cell technology in dentistry and then highlights cutting-edge stem-cell-based alveolar bone regenerative therapies. Factors that affect stem-cell-based bone regeneration as related to the local immune response are then discussed. Additionally, pre-clinical stem cell studies for the regeneration of teeth and other oral organs as well as possible applications of MSC-based immunotherapy in dentistry are outlined. Finally, the marketing of stem cell technology in dental stem cell banks with a view toward future regenerative therapies is introduced. Copyright © 2012 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  15. Volume II: Ecosystem management: principles and applications.

    Treesearch

    M.E. Jensen; P.S. Bourgeron

    1994-01-01

    This document provides land managers with practical suggestions for implementing ecosystem management. It contains 28 papers organized into five sections: historical perspectives, ecological principles, sampling design, case studies, and implementation strategies.

  16. Quantitative Evaluation of Management Courses: Part 1

    ERIC Educational Resources Information Center

    Cunningham, Cyril

    1973-01-01

    The author describes how he developed a method of evaluating and comparing management courses of different types and lengths by applying an ordinal system of relative values using a process of transmutation. (MS)

  17. Autism and EMF? Plausibility of a pathophysiological link part II.

    PubMed

    Herbert, Martha R; Sage, Cindy

    2013-06-01

    Autism spectrum conditions (ASCs) are defined behaviorally, but they also involve multileveled disturbances of underlying biology that find striking parallels in the physiological impacts of electromagnetic frequency and radiofrequency radiation exposures (EMF/RFR). Part I (Vol 776) of this paper reviewed the critical contributions pathophysiology may make to the etiology, pathogenesis and ongoing generation of behaviors currently defined as being core features of ASCs. We reviewed pathophysiological damage to core cellular processes that are associated both with ASCs and with biological effects of EMF/RFR exposures that contribute to chronically disrupted homeostasis. Many studies of people with ASCs have identified oxidative stress and evidence of free radical damage, cellular stress proteins, and deficiencies of antioxidants such as glutathione. Elevated intracellular calcium in ASCs may be due to genetics or may be downstream of inflammation or environmental exposures. Cell membrane lipids may be peroxidized, mitochondria may be dysfunctional, and various kinds of immune system disturbances are common. Brain oxidative stress and inflammation as well as measures consistent with blood-brain barrier and brain perfusion compromise have been documented. Part II of this paper documents how behaviors in ASCs may emerge from alterations of electrophysiological oscillatory synchronization, how EMF/RFR could contribute to these by de-tuning the organism, and policy implications of these vulnerabilities. It details evidence for mitochondrial dysfunction, immune system dysregulation, neuroinflammation and brain blood flow alterations, altered electrophysiology, disruption of electromagnetic signaling, synchrony, and sensory processing, de-tuning of the brain and organism, with autistic behaviors as emergent properties emanating from this pathophysiology. Changes in brain and autonomic nervous system electrophysiological function and sensory processing predominate, seizures

  18. 12 CFR Appendix B to Part 363 - Illustrative Management Reports

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Illustrative Management Reports B Appendix B to... POLICY ANNUAL INDEPENDENT AUDITS AND REPORTING REQUIREMENTS Pt. 363, App. B Appendix B to Part 363... the holding company level) in Appendix B to part 363 are intended to assist managements of...

  19. 12 CFR Appendix B to Part 363 - Illustrative Management Reports

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Illustrative Management Reports B Appendix B to... POLICY ANNUAL INDEPENDENT AUDITS AND REPORTING REQUIREMENTS Pt. 363, App. B Appendix B to Part 363... the holding company level) in Appendix B to part 363 are intended to assist managements of...

  20. 12 CFR Appendix B to Part 363 - Illustrative Management Reports

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Illustrative Management Reports B Appendix B to... POLICY ANNUAL INDEPENDENT AUDITS AND REPORTING REQUIREMENTS Pt. 363, App. B Appendix B to Part 363... the holding company level) in Appendix B to part 363 are intended to assist managements of...

  1. 12 CFR Appendix B to Part 363 - Illustrative Management Reports

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Illustrative Management Reports B Appendix B to... POLICY ANNUAL INDEPENDENT AUDITS AND REPORTING REQUIREMENTS Pt. 363, App. B Appendix B to Part 363... the holding company level) in Appendix B to part 363 are intended to assist managements of...

  2. TFOS DEWS II Management and Therapy Report.

    PubMed

    Jones, Lyndon; Downie, Laura E; Korb, Donald; Benitez-Del-Castillo, Jose M; Dana, Reza; Deng, Sophie X; Dong, Pham N; Geerling, Gerd; Hida, Richard Yudi; Liu, Yang; Seo, Kyoung Yul; Tauber, Joseph; Wakamatsu, Tais H; Xu, Jianjiang; Wolffsohn, James S; Craig, Jennifer P

    2017-07-01

    The members of the Management and Therapy Subcommittee undertook an evidence-based review of current dry eye therapies and management options. Management options reviewed in detail included treatments for tear insufficiency and lid abnormalities, as well as anti-inflammatory medications, surgical approaches, dietary modifications, environmental considerations and complementary therapies. Following this extensive review it became clear that many of the treatments available for the management of dry eye disease lack the necessary Level 1 evidence to support their recommendation, often due to a lack of appropriate masking, randomization or controls and in some cases due to issues with selection bias or inadequate sample size. Reflecting on all available evidence, a staged management algorithm was derived that presents a step-wise approach to implementing the various management and therapeutic options according to disease severity. While this exercise indicated that differentiating between aqueous-deficient and evaporative dry eye disease was critical in selecting the most appropriate management strategy, it also highlighted challenges, based on the limited evidence currently available, in predicting relative benefits of specific management options, in managing the two dry eye disease subtypes. Further evidence is required to support the introduction, and continued use, of many of the treatment options currently available to manage dry eye disease, as well as to inform appropriate treatment starting points and understand treatment specificity in relation to dry eye disease subtype. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Pregnancy in women with renal disease. Part II: specific underlying renal conditions.

    PubMed

    Vidaeff, Alex C; Yeomans, Edward R; Ramin, Susan M

    2008-08-01

    The obstetric outcome in women with kidney disease has improved in recent years due to continuous progress in obstetrics and neonatology, as well as better medical management of hypertension and renal disease. However, every pregnancy in these women remains a high-risk pregnancy. When considering the interaction between renal disease and pregnancy, maternal outcomes are related to the initial level of renal dysfunction more than to the specific underlying disease. With regards to fetal outcomes, though, a distinction may exist between renal dysfunction resulting from primary renal disease and that in which renal involvement is part of a systemic disease. In part II of this review, some specific causes of renal failure affecting pregnancy are considered.

  4. Information Security Management - Part Of The Integrated Management System

    NASA Astrophysics Data System (ADS)

    Manea, Constantin Adrian

    2015-07-01

    The international management standards allow their integrated approach, thereby combining aspects of particular importance to the activity of any organization, from the quality management systems or the environmental management of the information security systems or the business continuity management systems. Although there is no national or international regulation, nor a defined standard for the Integrated Management System, the need to implement an integrated system occurs within the organization, which feels the opportunity to integrate the management components into a cohesive system, in agreement with the purpose and mission publicly stated. The issues relating to information security in the organization, from the perspective of the management system, raise serious questions to any organization in the current context of electronic information, reason for which we consider not only appropriate but necessary to promote and implement an Integrated Management System Quality - Environment - Health and Operational Security - Information Security

  5. Practice improvement, part II: trends in employment versus private practice.

    PubMed

    Coleman, Mary Thoesen; Roett, Michelle A

    2013-11-01

    A growing percentage of physicians are selecting employment over solo practice, and fewer family physicians have hospital admission privileges. Results from surveys of recent medical school graduates indicate a high value placed on free time. Factors to consider when choosing a practice opportunity include desire for independence, decision-making authority, work-life balance, administrative responsibilities, financial risk, and access to resources. Compensation models are evolving from the simple fee-for-service model to include metrics that reward panel size, patient access, coordination of care, chronic disease management, achievement of patient-centered medical home status, and supervision of midlevel clinicians. When a practice is sold, tangible personal property and assets in excess of liabilities, patient accounts receivable, office building, and goodwill (ie, expected earnings) determine its value. The sale of a practice includes a broad legal review, addressing billing and coding deficiencies, noncompliant contractual arrangements, and potential litigations as well as ensuring that all employment agreements, leases, service agreements, and contracts are current, have been executed appropriately, and meet regulatory requirements. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  6. Discovery of Quantum structure and A Theory of Everything Part I and Part II

    NASA Astrophysics Data System (ADS)

    Zhang, Meggie

    2012-10-01

    (Part I) During my research I discovered logical errors in the logic of science and in mathematics. These errors caused scientists missed out important information when interpreting data. This led me to revisit the method of science and the existing results and able to find new information, which lead to the discovery of photon's structure. A ``particle collision illumination'' experiment then provided direct evidence supported the structure. Analysis of the properties of the structure suggested an organized but not-continuous multi-dimension (n-D) space within. Therefore I formed a hypothesis of a not-continuous n-D space structure. In search for evidence, I turned into crystal technology, and found direct evidence supported the hypotesis, then further particle collision found more evidence support this finding. (Part II) Analysis of single electron buildup revealed star and galaxy formation is from a single particle following a predictable pattern. This pattern is also common in matter formation. Analysis of the quantum structure suggested the formation of a larger structure through the space expansion within the structure. Further experiment results support the finding and result revealed the expansion is through space folding. Result also suggested a violation of energy conservation law that energy is created during the formation of matter, and matter itself is moving from a lower energy state to a higher energy state. When putting all information together, I arrived to a theory of everything which gives explanations to all existing phenomenon in the universe including black hole, dark energy, star formation, consciousness.

  7. NMG documentation. Part II. Programmer`s guide

    SciTech Connect

    Fritsch, F.N.; Dickinson, R.P. Jr.

    1996-07-01

    This is the 2nd of a 3-part report documenting NMG, the Numerical Mathematics Guide. This part is aimed at the programmer and contains Chapter 2, how it works. (Part I is aimed at the user of the system; Part III is aimed at the maintainer of NMG and will receive only limited distribution.)

  8. Conceptual design report: Nuclear materials storage facility renovation. Part 1, Design concept. Part 2, Project management

    SciTech Connect

    1995-07-14

    The Nuclear Materials Storage Facility (NMSF) at the Los Alamos National Laboratory (LANL) was a Fiscal Year (FY) 1984 line-item project completed in 1987 that has never been operated because of major design and construction deficiencies. This renovation project, which will correct those deficiencies and allow operation of the facility, is proposed as an FY 97 line item. The mission of the project is to provide centralized intermediate and long-term storage of special nuclear materials (SNM) associated with defined LANL programmatic missions and to establish a centralized SNM shipping and receiving location for Technical Area (TA)-55 at LANL. Based on current projections, existing storage space for SNM at other locations at LANL will be loaded to capacity by approximately 2002. This will adversely affect LANUs ability to meet its mission requirements in the future. The affected missions include LANL`s weapons research, development, and testing (WRD&T) program; special materials recovery; stockpile survelliance/evaluation; advanced fuels and heat sources development and production; and safe, secure storage of existing nuclear materials inventories. The problem is further exacerbated by LANL`s inability to ship any materials offsite because of the lack of receiver sites for mate rial and regulatory issues. Correction of the current deficiencies and enhancement of the facility will provide centralized storage close to a nuclear materials processing facility. The project will enable long-term, cost-effective storage in a secure environment with reduced radiation exposure to workers, and eliminate potential exposures to the public. This document provides Part I - Design Concept which describes the selected solution, and Part II - Project Management which describes the management system organization, the elements that make up the system, and the control and reporting system.

  9. The Training Manager's Part in Work Motivation

    ERIC Educational Resources Information Center

    Smith, Peter

    1970-01-01

    Various recent attempts have been made in industry to provide the worker with a more challenging work content and thus provide job enrichment and satisfaction. In this article, the author sets out the many factors involved and suggests that the training manager has a vital role to play in overcoming this industrial malaise. (Author/EB)

  10. The Ned IIS project - forest ecosystem management

    Treesearch

    W. Potter; D. Nute; J. Wang; F. Maier; Michael Twery; H. Michael Rauscher; P. Knopp; S. Thomasma; M. Dass; H. Uchiyama

    2002-01-01

    For many years we have held to the notion that an Intelligent Information System (IIS) is composed of a unified knowledge base, database, and model base. The main idea behind this notion is the transparent processing of user queries. The system is responsible for "deciding" which information sources to access in order to fulfil a query regardless of whether...

  11. FPGA-accelerated adaptive optics wavefront control part II

    NASA Astrophysics Data System (ADS)

    Mauch, S.; Barth, A.; Reger, J.; Reinlein, C.; Appelfelder, M.; Beckert, E.

    2015-03-01

    We present progressive work that is based on our recently developed rapid control prototyping system (RCP), designed for the implementation of high-performance adaptive optical control algorithms using a continuous de-formable mirror (DM). The RCP system, presented in 2014, is resorting to a Xilinx Kintex-7 Field Programmable Gate Array (FPGA), placed on a self-developed PCIe card, and installed on a high-performance computer that runs a hard real-time Linux operating system. For this purpose, algorithms for the efficient evaluation of data from a Shack-Hartmann wavefront sensor (SHWFS) on an FPGA have been developed. The corresponding analog input and output cards are designed for exploiting the maximum possible performance while not being constrained to a specific DM and control algorithm due to the RCP approach. In this second part of our contribution, we focus on recent results that we achieved with this novel experimental setup. By presenting results which are far superior to the former ones, we further justify the deployment of the RCP system and its required time and resources. We conducted various experiments for revealing the effective performance, i.e. the maximum manageable complexity in the controller design that may be achieved in real-time without performance losses. A detailed analysis of the hidden latencies is carried out, showing that these latencies have been drastically reduced. In addition, a series of concepts relating the evaluation of the wavefront as well as designing and synthesizing a wavefront are thoroughly investigated with the goal to overcome some of the prevalent limitations. Furthermore, principal results regarding the closed-loop performance of the low-speed dynamics of the integrated heater in a DM concept are illustrated in detail; to be combined with the piezo-electric high-speed actuators in the next step

  12. 40 CFR Appendix II to Part 600 - Sample Fuel Economy Calculations

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Sample Fuel Economy Calculations II... FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. II Appendix II to Part 600—Sample Fuel Economy Calculations (a) This sample fuel economy calculation is applicable...

  13. 40 CFR Appendix II to Part 1068 - Emission-Related Parameters and Specifications

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Emission-Related Parameters and Specifications II Appendix II to Part 1068 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS GENERAL COMPLIANCE PROVISIONS FOR ENGINE PROGRAMS Pt. 1068, App. II Appendix...

  14. 40 CFR Appendix II to Part 600 - Sample Fuel Economy Calculations

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Sample Fuel Economy Calculations II... FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. II Appendix II to Part 600—Sample Fuel Economy Calculations (a) This sample fuel economy calculation is applicable...

  15. 40 CFR Appendix II to Part 600 - Sample Fuel Economy Calculations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Sample Fuel Economy Calculations II... FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR VEHICLES Pt. 600, App. II Appendix II to Part 600—Sample Fuel Economy Calculations (a) This sample fuel economy calculation is applicable...

  16. Topics in Chemical Instrumentation, Cl. Thermoluminescence: Part II. Instrumentation.

    ERIC Educational Resources Information Center

    Manche, Emanuel P.

    1979-01-01

    Presents part two on the use of the detection of thermoluminescence as an analytical tool for the chemistry laboratory and allied science. This part discusses instrumentation used and investigates recent developments in instrumentation for thermoluminescence. (HM)

  17. Topics in Chemical Instrumentation, Cl. Thermoluminescence: Part II. Instrumentation.

    ERIC Educational Resources Information Center

    Manche, Emanuel P.

    1979-01-01

    Presents part two on the use of the detection of thermoluminescence as an analytical tool for the chemistry laboratory and allied science. This part discusses instrumentation used and investigates recent developments in instrumentation for thermoluminescence. (HM)

  18. Coping With the Problems of a Technological Age, Part II.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

    This is another report in a series of programs dealing with the problems of a technological age. It is assumed that teachers will use both parts of this report. Part I deals with the problems of technology and how it affects our lives. It also discusses the energy crisis created, in part, by technology and deals specifically with coal and…

  19. Sporting Goods. Part I: Hunting and Fishing Equipment and Part II: Athletic, Marine, and Camping Equipment. A Distributive Education Manual.

    ERIC Educational Resources Information Center

    Day, Bill D., Comp.

    These manuals were prepared to introduce students to the fundamentals of hunting and fishing (Part I) and sports requiring athletic, marine and camping equipment (Part II). The sports salesman is in the position of offering a service to the customer, and he can best do so by understanding the sports and the variety of products which may be sold to…

  20. 10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement Concerning Acceptance of Travel or Travel Expenses From a Foreign Government Item 1.This statement is to...

  1. 10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement Concerning Acceptance of Travel or Travel Expenses From a Foreign Government Item 1.This statement is to...

  2. 10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement Concerning Acceptance of Travel or Travel Expenses From a Foreign Government Item 1.This statement is to be...

  3. 10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement Concerning Acceptance of Travel or Travel Expenses From a Foreign Government Item 1. This statement is to...

  4. 10 CFR Appendix II to Part 1050 - DOE Form 3735.3-Foreign Travel Statement

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false DOE Form 3735.3-Foreign Travel Statement II Appendix II to.... II Appendix II to Part 1050—DOE Form 3735.3—Foreign Travel Statement EC01OC91.041 Statement Concerning Acceptance of Travel or Travel Expenses From a Foreign Government Item 1.This statement is to...

  5. Addressing future challenges for cancer services: part II.

    PubMed

    Maher, Jane; Radford, Gina

    2016-02-01

    Jane Maher & Gina Radford speak to Gemma Westcott, Commissioning Editor Jane Maher has been Macmillan's Chief Medical Officer since 1999 and now shares the role as Joint Chief Medical Officer with general practitioner Rosie Loftus, reflecting the growing need for specialists and generalists to work more effectively together. She has been an National Health Service (NHS) improvement clinical leader for over 10 years and is a Consultant Clinical Oncologist at Mount Vernon Cancer Centre and Hillingdon Hospital where she has worked for more than 20 years, during which she helped develop nonsurgical oncology services in five district general hospitals. She is a senior Clinical Lecturer at University College London and Visiting Professor in Cancer and Supportive Care at the Centre for Complexity Management at the University of Hertfordshire. Jane chaired the Maher Committee for the Department of Health in 1995, led the UK National Audit of Late Effects Pelvic Radiotherapy for the Royal College of Radiologists (RCR) in 2000 and, most recently, chaired the National Cancer Survivorship Initiative Consequences of Treatment work stream. She co-founded one of the first Cancer Support and Information services in the UK, winning the Nye Bevan award in 1992 and there are now more than 60 units based on this model. She is a member of the Older People and Cancer Clinical Advisory Group. She has written more than 100 published articles and is a UK representative for cancer survivorship in Europe and advises on cancer survivorship programs in Denmark and Canada. Gina Radford is Deputy Chief Medical Officer for England, a post she took up in January 2015. Prior to that, she has held a number of roles in public health, at local and regional level. Most recently she was Centre Director for Anglia and Essex for Public Health England, and as a part of that role helped lead nationally on the public health response to Ebola. She was until very recently Chair of one of the NICE public health

  6. This issue: Managing emergencies part 2.

    PubMed

    Ralston, Mark E

    2005-12-01

    Pediatric toxicologic exposures are common, and the primary care pediatric practitioner must be prepared to handle emergencies related to poisoning and overdose in children and adolescents. Fortunately, many poisonings in children are unintentional, preventable, and benign. For both simple and complex cases, help is available to medical professionals 24/7 from multiple sources, including an improved toxic exposure database, new research, the network of Certified Specialists in Poison Information at our nation's regional poison control centers, and backup medical and clinical toxicologists. The US system of AAPCC-certified poison control centers has been appropriately labeled "a national safety net" serving the public and medical practitioners in the management of pediatric toxicologic exposures. Increased funding to this system will be critical to update its services for the future, including preparation to detect the increasing threat of new public health emergencies such as chemical and biological terrorist attacks.

  7. A Conversation with William A. Fowler Part II

    NASA Astrophysics Data System (ADS)

    Greenberg, John

    2005-06-01

    Physicist William A.Fowler initiated an experimental program in nuclear astrophysics after World War II. He recalls here the Steady State versus Big Bang controversy and his celebrated collaboration with Fred Hoyle and Geoffrey and Margaret Burbidge on nucleosynthesis in stars. He also comments on the shift away from nuclear physics in universities to large accelerators and national laboratories.

  8. Paraeducator Professional Development Curriculum. Module II: Building an Effective Instructional Team. Part Two: Assisting and Supporting the Teacher Through the Use of Effective Classroom Management and Effective Instructional Strategies. Trainer's Manual

    ERIC Educational Resources Information Center

    Northwest Regional Educational Laboratory NWREL, 2005

    2005-01-01

    This two-day institute examines the basic concepts of effective classroom management techniques as well as the use of effective instructional strategies for all students that will help paraeducators to support effective learning and teaching environment. This module addresses two goals: (1) to provide participants with an awareness of basic…

  9. Paraeducator Professional Development Curriculum. Module II: Building an Effective Instructional Team. Part Two: Assisting and Supporting the Teacher Through the Use of Effective Classroom Management and Effective Instructional Strategies. Trainer's Manual

    ERIC Educational Resources Information Center

    Northwest Regional Educational Laboratory NWREL, 2005

    2005-01-01

    This two-day institute examines the basic concepts of effective classroom management techniques as well as the use of effective instructional strategies for all students that will help paraeducators to support effective learning and teaching environment. This module addresses two goals: (1) to provide participants with an awareness of basic…

  10. Reforming Science Education: Part II. Utilizing Kieran Egan's Educational Metatheory

    ERIC Educational Resources Information Center

    Schulz, Roland M.

    2009-01-01

    This paper is the second of two parts and continues the conversation which had called for a shift in the conceptual focus of science education towards philosophy of education, with the requirement to develop a discipline-specific "philosophy" of science education. In Part I, conflicting conceptions of science literacy were identified with…

  11. Mathematics for Junior High School, Volume II (Part 1).

    ERIC Educational Resources Information Center

    Anderson, R. D.; And Others

    This is part one of a two-part SMSG mathematics text for junior high school students. Key ideas emphasized are structure of arithmetic from an algebraic viewpoint, the real number system as a progressing development, and metric and non-metric relations in geometry. Chapter topics include number line and coordinates, equations, scientific notation,…

  12. Mathematics for Junior High School, Volume II (Part 2).

    ERIC Educational Resources Information Center

    Anderson, R. D.; And Others

    This is part two of a two-part SMSG mathematics text for junior high school students. Key ideas emphasized are structure of arithmetic from an algebraic viewpoint, the real number system as a progressing development, and metric and non-metric relations in geometry. Chapter topics include real numbers, similar triangles, variation, non-metric…

  13. Asclepius, Caduceus, and Simurgh as medical symbols; part II. Simurgh.

    PubMed

    Nayernouri, Touraj

    2010-05-01

    In part one of this article I reviewed the history of Asclepius and the Caduceus of Hermes as medical symbols and made a tentative suggestion of using the mythical bird Simurgh as an Iranian symbol of medicine. In this, the second part, I shall describe the evolution of the myth of the Simurgh and discuss the medical relevance of this bird in Iranian history.

  14. Team effort: the nuclear medicine decision making process. Part II.

    PubMed

    Tsuchiyama, S

    1991-06-01

    This two part article examines the nuclear medicine purchase of Baptist Memorial Hospital in Memphis, the largest private hospital in the nation. Part I (May 1991) focused on what their needs were. This concluding installment looks at the committee mechanism itself and the reasoning that went behind their decisions.

  15. Difficult asthma: assessment and management, Part 2.

    PubMed

    Fanta, Christopher H; Long, Aidan A

    2012-01-01

    Patients with severe asthma have considerable morbidity related to their asthma and are at risk for serious, life-threatening exacerbations. Their management requires an intensive and comprehensive approach, including attention to reducing exposure to environmental inciters of airway inflammation and triggers of symptoms, patient education (including an asthma action plan), and opportunity for close patient-provider communication. Approved medical options include the lipoxygenase inhibitor, zileuton; the anti-immunoglobulin E monoclonal antibody, omalizumab; and bronchial thermoplasty. Nonapproved interventions of potential benefit are ultrahigh-dose inhaled corticosteroids, anticholinergic bronchodilators (tiotropium), macrolide antibiotics, and vitamin D supplementation for the vitamin D-deficient patient. Potentially toxic, "steroid-sparing" therapies such as methotrexate, cyclosporine, and etanercept are best reserved for patients participating in clinical trials. Recognition of specific subtypes of patients with therapy-resistant asthma permits more targeted treatment approaches, such as for aspirin-sensitive asthma, persistent eosinophilic asthma, asthma complicated by allergic bronchopulmonary aspergillosis, asthma with persistent airflow obstruction, and asthma with life-threatening (near fatal) asthmatic attacks. Novel therapies based on an improved understanding of the pathobiology of therapy-resistant asthma are greatly needed.

  16. Multimodal pediatric pain management (part 2).

    PubMed

    Friedrichsdorf, Stefan J

    2017-01-20

    Dr Stefan Friedrichsdorf speaks to Commissioning Editor Jade Parker: Stefan Friedrichsdorf, MD, is medical director of the Department of Pain Medicine, Palliative Care and Integrative Medicine at Children's Hospitals and Clinics of Minnesota in Minneapolis/St Paul, MN, USA, home to one of the largest and most comprehensive programs of its kind in the country. The pain and palliative care program is devoted to control acute, chronic/complex and procedural pain for inpatients and outpatients in close collaboration with all pediatric subspecialties at Children's Minnesota. The team also provides holistic, interdisciplinary care for children and teens with life limiting or terminal diseases and their families. Integrative medicine provides and teaches integrative, nonpharmacological therapies (such as massage, acupuncture/acupressure, biofeedback, aromatherapy and self-hypnosis) to provide care that promotes optimal health and supports the highest level of functioning in all individual children's activities. In this second part of the interview they discuss multimodal (opioid-sparing) analgesia for hospitalized children in pain and how analgesics and adjuvant medications, interventions, rehabilitation, psychological and integrative therapies act synergistically for more effective pediatric pain control with fewer side effects than a single analgesic or modality.

  17. Implementing AORN recommended practices for a safe environment of care, part II.

    PubMed

    Kennedy, Lynne

    2014-09-01

    Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment.

  18. 50 CFR Figure 24 to Part 679 - Arctic Management Area

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Arctic Management Area 24 Figure 24 to Part 679 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679...

  19. 50 CFR Figure 24 to Part 679 - Arctic Management Area

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Arctic Management Area 24 Figure 24 to Part 679 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679...

  20. 50 CFR Figure 24 to Part 679 - Arctic Management Area

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Arctic Management Area 24 Figure 24 to Part 679 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679...

  1. 50 CFR Figure 24 to Part 679 - Arctic Management Area

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Arctic Management Area 24 Figure 24 to Part 679 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679...

  2. 50 CFR Figure 24 to Part 679 - Arctic Management Area

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false Arctic Management Area 24 Figure 24 to Part 679 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OF THE EXCLUSIVE ECONOMIC ZONE OFF ALASKA Pt. 679...

  3. Proceedings of the EMU Conference on Foreign Languages for Business and the Professions (Dearborn, Michigan, April 5-7, 1984). Part II: Program Overviews and Components.

    ERIC Educational Resources Information Center

    Voght, Geoffrey M., Ed.

    Part II of the proceedings includes nine presentations. They are: "Business and Foreign Language Tie the Knot at Nazareth College: A Four Year Program Model" (Octave G. Naulleau); "For an Actual Education in International Management" (Alain Eclache and Georges Labet); "A Foreign Language Program for Majors in Hotel and Restaurant Management:…

  4. Management of hypodontia: orthodontic considerations (II).

    PubMed

    Thind, Bikram S; Stirrups, David R; Forgie, Andrew H; Larmour, Colin J; Mossey, Peter A

    2005-05-01

    Patients with congenitally missing teeth (hypodontia) present with complex problems. Meeting their treatment needs requires a joint effort between the disciplines of orthodontics and restorative dentistry. There are a number of options available to restore space generated by missing teeth. In the majority of patients orthodontic treatment will be required before this space can be restored satisfactorily. The second part of this series reviews the orthodontic considerations for various options.

  5. A case study of packaging waste collection systems in Portugal - Part II: Environmental and economic analysis.

    PubMed

    Pires, Ana; Sargedas, João; Miguel, Mécia; Pina, Joaquim; Martinho, Graça

    2017-03-01

    An understanding of the environmental impacts and costs related to waste collection is needed to ensure that existing waste collection schemes are the most appropriate with regard to both environment and cost. This paper is Part II of a three-part study of a mixed packaging waste collection system (curbside plus bring collection). Here, the mixed collection system is compared to an exclusive curbside system and an exclusive bring system. The scenarios were assessed using life cycle assessment and an assessment of costs to the waste management company. The analysis focuses on the collection itself so as to be relevant to waste managers and decision-makers who are involved only in this step of the packaging life cycle. The results show that the bring system has lower environmental impacts and lower economic costs, and is capable of reducing the environmental impacts of the mixed system. However, a sensitivity analysis shows that these results could differ if the curbside collection were to be optimized. From economic and environmental perspectives, the mixed system has few advantages. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Classroom Demonstrations of Polymer Principles Part II. Polymer Formation.

    ERIC Educational Resources Information Center

    Rodriguez, F.; And Others

    1987-01-01

    This is part two in a series on classroom demonstrations of polymer principles. Described is how large molecules can be assembled from subunits (the process of polymerization). Examples chosen include both linear and branched or cross-linked molecules. (RH)

  7. Internal Auditing in Federal, State, and Local Governments (Part II).

    ERIC Educational Resources Information Center

    Knight, Susan; Wilson, Guy

    1981-01-01

    This second part of an annotated bibliography of reports, books, and journal articles concerned with internal auditing in government contexts reviews the available literature for an understanding of the types of internal audit, methods and practices, and other facets. (FM)

  8. Classroom Demonstrations of Polymer Principles Part II. Polymer Formation.

    ERIC Educational Resources Information Center

    Rodriguez, F.; And Others

    1987-01-01

    This is part two in a series on classroom demonstrations of polymer principles. Described is how large molecules can be assembled from subunits (the process of polymerization). Examples chosen include both linear and branched or cross-linked molecules. (RH)

  9. Designing SoTL Studies--Part II: Practicality

    ERIC Educational Resources Information Center

    Bartsch, Robert A.

    2013-01-01

    This chapter suggests solutions to common practical problems in designing SoTL studies. In addition, the advantages and disadvantages of different types of designs are discussed. [Part I available at EJ1029363.

  10. Basic Energy Conservation and Management--Part 2: HVAC

    ERIC Educational Resources Information Center

    Krueger, Glenn

    2012-01-01

    Reducing school district energy expenditures has become a universal goal, and new technologies have brought greater energy efficiencies to the school environment. In Part 1 of this two-part series, the author discussed the steps required to establish an energy conservation and management program with an emphasis on lighting. In this article, he…

  11. Basic Energy Conservation and Management--Part 2: HVAC

    ERIC Educational Resources Information Center

    Krueger, Glenn

    2012-01-01

    Reducing school district energy expenditures has become a universal goal, and new technologies have brought greater energy efficiencies to the school environment. In Part 1 of this two-part series, the author discussed the steps required to establish an energy conservation and management program with an emphasis on lighting. In this article, he…

  12. Management of stage II endometrial adenocarcinoma

    SciTech Connect

    Trimble, E.L.; Jones, H.W. III

    1988-03-01

    Charts of 36 patients with clinical stage II endometrial adenocarcinoma over ten years were reviewed. All were staged before any treatment, in accordance with International Federation of Gynecology and Obstetrics (FIGO) guidelines. Although details of treatment varied, two main protocols were used. Fourteen patients were treated with the standard protocol involving external whole-pelvis radiation, followed by intracavitary cesium and then hysterectomy. In 1981, a modified protocol was introduced, which called for a hysterectomy immediately following intrauterine and vaginal cesium. External radiation therapy was given only to those patients found to have deep myometrial invasion or cervical involvement. Of 14 patients treated by this protocol, seven had no surgical indication for postoperative external radiation. There was no increase in recurrence in these patients, and the five-year survival rate was 76% for patients treated with the modified protocol compared with 65% for those who had standard therapy. Morbidity related to external radiation therapy occurred in two patients with the standard protocol and one patient who received pelvic radiation on the modified protocol.

  13. Tooth resorption part II - external resorption: Case series.

    PubMed

    Fernandes, Marina; de Ataide, Ida; Wagle, Rahul

    2013-03-01

    External tooth resorption usually follows trauma to the periodontal ligament. It can be classified into five categories based on its clinical and histological manifestations. Calcium hydroxide has long been used as an intracanal medicament to slow down the resorption process due to its alkaline pH. A combination of both external and internal resorptions can also occur on the same tooth, making the management more complex. Five case reports of external resorption have been presented in this article along with pertinent review of literature. Successful management was possible in two cases, while extractions had to be advised in 3 cases due to advanced nature of the lesions.

  14. Predictors of performance on the National Board of Chiropractic Examiners Parts I and II*

    PubMed Central

    McCall, Angela R.; Harvey, Richard D.

    2014-01-01

    Objective The purpose of this study was to examine predictors for success on Parts I and II of the National Board of Chiropractic Examiners (NBCE) written examinations. Methods Two validity studies were conducted to examine the criterion validity of Logan College assessments for Part I and II NBCE scores. Both studies consisted of a longitudinal design to examine the validity of entrance grade point average (GPA), in-program chiropractic course content GPA, and an institutional practice exam on Parts I and II of the NBCE. Results Analyses revealed that Part I GPA and practice exam scores combined accounted for 72% of the variance within Part I NBCE scores. Furthermore, every subtest of the Part I NBCE could be reliably predicted by course performance. In the 2nd study, Part I GPA, Part I NBCE score, and Part II GPA accounted for 75% of the variance within Part II NBCE scores. Conclusions Internal training and educational assessments (eg, course grades and practice exams) proved to be strong determinants of NBCE performance above and beyond initial levels of preparedness, thus validating the impact of the chiropractic curriculum on NBCE test achievement. PMID:24611459

  15. Integral pharmacological management of bone mineral disorders in chronic kidney disease (part II): from treatment of phosphate imbalance to control of PTH and prevention of progression of cardiovascular calcification.

    PubMed

    Bover, J; Ureña-Torres, P; Lloret, M J; Ruiz, C; DaSilva, I; Diaz-Encarnacion, M M; Mercado, C; Mateu, S; Fernández, E; Ballarin, J

    2016-07-01

    Chronic kidney disease-mineral and bone disorders (CKD-MBD) are associated with costly complications and dismal hard-outcomes. In two comprehensive articles we review contemporary and future pharmacological options for treatment of phosphate (P) imbalance (part 1) and hyperparathyroidism (this part 2), taking into account CKD-accelerated cardiovascular calcification (CVC) processes. Improvements in CKD-MBD require an integral approach, addressing all three components of the CKD-MBD triad. Here, initial guidance to control hyperparathyroidism is provided, taking into account the presence/absence of CVC. We include also measures for patients at risk of adynamic bone disease or suffering from calciphylaxis. Many epidemiological studies (relating to vitamin D) and thorough analyses of recent randomized clinical trials (of cinacalcet) point towards benefits of attempting to improve biochemical parameters while trying to, at least, avoid progression of CVC by more rational use of intestinal P-binders and low-dose vitamin D derivatives and/or calcimimetics. This approach does not seem to be far away from significantly improving hard-outcomes, at least in the dialysis population. The availability of new drugs and the performance of randomized clinical trials should ultimately lead to define earlier, clearer, and more cost-effective patient stratification and biochemical targets with consequent significant clinical improvements.

  16. Being prepared: bioterrorism and mass prophylaxis: part II.

    PubMed

    Weant, Kyle A; Bailey, Abby M; Fleishaker, Elise L; Justice, Stephanie B

    2014-01-01

    Although several biological agents have been recognized as presenting a significant threat to public health if used in a bioterrorist attack, those that are of greatest importance are known as the Category A agents: Bacillus anthracis (anthrax); variola major (smallpox); Yersinia pestis (plague); Francisella tularensis (tularemia); ribonucleic acid viruses (hemorrhagic fevers); and Clostridium botulinum (botulism toxin). In the previous issue, Part I of this review focused on the clinical presentation and treatment of anthrax, plague, and tularemia. In this second part of this 2-part review of these agents, the focus is on the clinical presentation and treatment of smallpox, viral hemorrhagic fevers, and botulism toxin. The utilization of mass prophylaxis to limit the morbidity and mortality associated with all these agents is also discussed along with the role emergency care personnel play in its implementation.

  17. Mental Retardation Grants; Part II, Research and Demonstration. Fiscal Year 1968.

    ERIC Educational Resources Information Center

    Department of Health, Education, and Welfare, Washington, DC. Secretary's Committee on Mental Retardation.

    Part II of a two-part publication listing mental retardation grants awarded by the U.S. Department of Health, Education, and Welfare in fiscal year 1968 (July 1, 1967, to June 30, 1968), the text includes grants awarded in the areas of research and demonstration. (Part I covers grants in training and construction.) Grants are arranged according to…

  18. Johne's disease in Canada part II: disease impacts, risk factors, and control programs for dairy producers.

    PubMed

    McKenna, Shawn L B; Keefe, Greg P; Tiwari, Ashwani; VanLeeuwen, John; Barkema, Herman W

    2006-11-01

    Part I of this 2-part review examined the clinical stages, pathophysiology, diagnosis, and epidemiology of Johne's disease, providing information relevant to Canada, where available. In Part II, a critical review of the economic impacts of the disease, risk factors, and important control measures are presented to enable Canadian bovine practitioners to successfully implement control strategies and participate in control programs. In cattle positive by enzyme-linked immunosorbant assay, there is a 2.4 times increase in the risk of their being culled, and their lactational 305-day milk production is decreased by at least 370 kg. Reduced slaughter value and premature culling account for losses of CDN dollars 1330 per year per infected 50-cow herd. Research has failed to show a consistent association between Mycobacterium avium subsp. paratuberculosis test status and reduced fertility or risk of clinical or subclinical mastitis. Host level factors include age and level of exposure, along with source of exposure, such as manure, colostrum, or milk. Agent factors involve the dose of infectious agent and strains of bacteria. Environmental management factors influence the persistence of the bacteria and the level of contamination in the environment. Emphasizing a risk factor approach, various control strategies are reviewed, including a number of national control programs currently in place throughout the world, specifically Australia, The Netherlands, and the United States. By reviewing the scientific literature about Johne's disease, control of the disease could be pursued through informed implementation of rational biosecurity efforts and the strategic use of testing and culling.

  19. The spectrum of oculocutaneous disease: Part II. Neoplastic and drug-related causes of oculocutaneous disease.

    PubMed

    Day, Antoinette; Abramson, Amanda K; Patel, Mahir; Warren, Richard B; Menter, M Alan

    2014-05-01

    There are a multitude of diseases that commonly affect both the skin and the eye. Part II of this 2-part series reviews the oculocutaneous manifestations of neoplasms, both benign and malignant, and adverse drug reactions affecting the skin and the eye. Though rare, a number of neoplasms that primarily involve the skin, such as melanoma and basal cell carcinoma, can metastasize to the eye, leading to permanent damage if not properly treated. In addition, periocular neoplasms can irritate the conjunctiva and lid, reducing a patient's ability to see clearly. Neoplastic diseases, such as xeroderma pigmentosum, Sturge-Weber syndrome, and multiple myeloma, can also lead to permanent changes in the eye if not discovered and managed promptly. Furthermore, there are a multitude of drugs, including those commonly used by dermatologists, which can result in permanent damage to the eye. With proper knowledge of the ocular manifestations and treatment recommendations described in this 2-part series, dermatologists with the assistance of their ophthalmology colleagues can help avoid the complications, including permanent blindness, associated with infectious, inflammatory, genetic, neoplastic, and drug-related conditions. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  20. TASKILLAN II - Pilot strategies for workload management

    NASA Technical Reports Server (NTRS)

    Segal, Leon D.; Wickens, Christopher D.

    1990-01-01

    This study focused on the strategies used by pilots in managing their workload level, and their subsequent task performance. Sixteen licensed pilots flew 42 missions on a helicopter simulation, and were evaluated on their performance of the overall mission, as well as individual tasks. Pilots were divided in four groups, defined by the presence or absence of scheduling control over tasks and the availability of intelligence concerning the type and stage of difficulties imposed during the flight. Results suggest that intelligence supported strategies that yielded significant higher performance levels, while scheduling control seemed to have no impact on performance. Both difficulty type and the stage of difficulty impacted performance significantly, with strongest effects for time stresss and difficulties imposed late in the flight.

  1. Data Transfer Capabilities of CD-ROM Software, Part II.

    ERIC Educational Resources Information Center

    Jasco, Peter

    1991-01-01

    Describes and compares several exchange/transfer formats used to upload records into software host programs, including unstructured or plain ASCII; fixed field; delimited ASCII; tagged; MARC (Machine Readable Cataloging); and graphic. It is concluded that CD-ROM producers should strengthen the built-in output management of programs and offer…

  2. The Cash Flow Budget. Part II--Implementation

    ERIC Educational Resources Information Center

    Gehm, Rudy

    1978-01-01

    An "aged accounts payable" (A/P) summary and a cash disbursements journal are advocated as management measures useful in monitoring the cash flow in a college store. Methods for maintaining the A/P summary and for updating the journal are illustrated. (LBH)

  3. The Cash Flow Budget. Part II--Implementation

    ERIC Educational Resources Information Center

    Gehm, Rudy

    1978-01-01

    An "aged accounts payable" (A/P) summary and a cash disbursements journal are advocated as management measures useful in monitoring the cash flow in a college store. Methods for maintaining the A/P summary and for updating the journal are illustrated. (LBH)

  4. Karst geomorphology: From hydrological functioning to palaeoenvironmental reconstructions. Part II

    NASA Astrophysics Data System (ADS)

    De Waele, Jo; Gutierrez, Francisco; Audra, Philippe

    2015-10-01

    In January 2015, the first part of the special issue on karst, entitled "Karst geomorphology: From hydrological functioning to palaeoenvironmental reconstructions" was published (Geomorphology, Vol. 229). This second part of the special issue comprises seven research papers covering a broad geographical canvas including Japan, Slovenia, France, Spain, Croatia, and Poland-Ukraine. Both issues mainly emanate from the contributions presented in the Karst session of the 8th International Conference of Geomorphology (International Association of Geomorphologists), held in Paris in August 2013, enriched with some invited papers.

  5. Operational strategies for dispatchable combined cycle plants, Part II

    SciTech Connect

    Nolan, J.P.; Landis, F.P.

    1996-11-01

    The Brush Cogeneration Facility is a dual-unit, combined cycle, cogeneration plant, operating in a dual cycling, automatically-dispatchable mode. Part I of this report described the contract, including automatic generation control (AGC) by Public Service Company of Colorado (PSCO), and the operation of Unit One. This part of the report covers the operation of Unit Two. Unit two is still in its operating infancy, but is showing that fuel efficiency and low emissions levels are not incompatible with cycling, load-following service. 1 fig.

  6. Biomedical research ethics: an Islamic view part II.

    PubMed

    Afifi, Raafat Y

    2007-12-01

    In part I of this article I discussed why Islam rejects secularization and this is not because the ethical principles embedded in Islam's teachings are archaic and out of touch with current realities. In addition, I pointed out the agreement between general broad principles of research ethics and Islamic teachings concerning life; which showed clearly that Islam has addressed the regulation of ethics in research more than 14 centuries ago. In this part, I will address two controversial issues concerning women's rights and age of consent for children as possible research subjects in a Muslim community.

  7. [Long-acting antipsychotics in the maintenance treatment of schizophrenia. Part II. Management of medications, integration of the multiprofessional team, and perspectives with the formulation of new a new generation of long-acting antipsychotics].

    PubMed

    Bechelli, Luiz Paulo

    2003-01-01

    Among various topics, this second part addresses indication and beginning of treatment, dose inter-individual variability and interval between injections, appointment frequency and special strategies during treatment relapse. Considering that poor adherence to antipsychotic treatment is a major factor in schizophrenic relapse, that the new generation of antipsychotic drugs, despite lower incidence of extrapyramidal side effects and better overall tolerability, did not change this condition in relation to conventional drugs and in view of the superiority of depot antipsychotics in comparison with conventional ones administered orally, the long-acting formulation of new generation antipsychotics can certainly improve the adherence and regularity of the medication regimen and decrease relapse rates in patients with schizophrenia. Furthermore, family participation in treatment is of great importance, as well as the attitude and integration of the medical team in realizing different tasks.

  8. The Need for Ocean Literacy in the Classroom: Part II

    ERIC Educational Resources Information Center

    Schoedinger, Sarah; Cava, Francesca; Jewell, Beth

    2006-01-01

    As mentioned in Part I, certain classroom activities can help students learn about the ocean and empower them to make informed decisions about their impacts on the environment. One such activity focuses on harmful algal blooms (HABs). In this article, the authors include background information on HABs and then present two activities. Activity 1 is…

  9. Searching for the Right Way to Begin Class: Part II

    ERIC Educational Resources Information Center

    Lawry, John D.

    2012-01-01

    Part I, "Searching for the Right Way to Begin Class," described the various iterations of beginning class rituals the author used over the years. Those rituals began with a prayer to the Holy Spirit as was required at the Catholic women's college Marymount in Tarrytown, New York, where he first taught out of graduate school in 1965. That…

  10. Curriculum Guide for Hospitality Education. Part II. Exemplary Project.

    ERIC Educational Resources Information Center

    Kalani, Henry

    This second of a two-part study designed to develop a hospitality education program model for Hawaii's community colleges is based on the primary data gathered in a survey of the hospitality industry characteristics, manpower requirements, and employment demands. (Survey data is reported in volume 1 of the study.) The introductory section of this…

  11. Aesthetic Pursuits: Windows, Frames, Words, Images--Part II

    ERIC Educational Resources Information Center

    Burke, Ken

    2005-01-01

    In Part I of this study (Burke, 2005), the author presented the essentials of Image Presentation Theory--IPT--and its application to the analytical explication of various spatial designs in and psychological responses to images, from the illusions of depth in what is referred to as "windows" in cinema theory to the more patterned abstractions of…

  12. Observations on medical device design, Part II: Good practice.

    PubMed

    Alexander, K; Clarkson, J; Bishop, D

    1999-10-01

    Current guidance on design is inadequate. This second article in a two-part series presents a framework for good design practice that attempts to improve designers' awareness of manufacturing and validation issues. Seven design tactics, derived from observations of current industry practice and design literature, seek to encourage good practice and achieve safer, more profitable devices.

  13. DIY Soundcard Based Temperature Logging System. Part II: Applications

    ERIC Educational Resources Information Center

    Nunn, John

    2016-01-01

    This paper demonstrates some simple applications of how temperature logging systems may be used to monitor simple heat experiments, and how the data obtained can be analysed to get some additional insight into the physical processes. [For "DIY Soundcard Based Temperature Logging System. Part I: Design," see EJ1114124.

  14. Laboratory Animal Housing--Parts I and II.

    ERIC Educational Resources Information Center

    Runkle, Robert S.

    1963-01-01

    In recent years, the use of laboratory animals for bio-medical research has shown marked increase. Economic and efficient housing is a necessity. This two part report established guidelines for design and selection of materials for conventional animal housing. Contents include--(1) production and breeding facilities, (2) quarantine facilities, (3)…

  15. Report cards: Part II--Providers rating MCOs.

    PubMed

    Kaplan, J G

    1998-01-01

    Report cards on health plans and on physicians are becoming an increasingly important way of comparing health care quality from the perspective of consumers and the government. In the conclusion of a two-part article, the author suggests another side of the coin: physicians' own rating of health plans to guide their choices in health plan contracting.

  16. Surface anatomy and surface landmarks for thoracic surgery: Part II.

    PubMed

    Smith, Shona E; Darling, Gail E

    2011-05-01

    Surface anatomy is an integral part of a thoracic surgeon's armamentarium to assist with the diagnosis, staging, and treatment of thoracic pathology. As reviewed in this article, the surface landmarks of the lungs, heart, great vessels, and mediastinum are critical for appropriate patient care and should be learned in conjunction with classic anatomy. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Developing a Positive Self-Concept. Part II.

    ERIC Educational Resources Information Center

    Cibrowski, Lee; Slater, Shirley

    This publication supplements an earlier publication, "What Do You Like about Yourself? Developing a Positive Self-Concept" that presented an introduction to self-concept and included activities that could be used with students of all ages. This particular document, divided into two parts, includes additional ideas and activities that relate to…

  18. The Need for Ocean Literacy in the Classroom: Part II

    ERIC Educational Resources Information Center

    Schoedinger, Sarah; Cava, Francesca; Jewell, Beth

    2006-01-01

    As mentioned in Part I, certain classroom activities can help students learn about the ocean and empower them to make informed decisions about their impacts on the environment. One such activity focuses on harmful algal blooms (HABs). In this article, the authors include background information on HABs and then present two activities. Activity 1 is…

  19. Searching for the Right Way to Begin Class: Part II

    ERIC Educational Resources Information Center

    Lawry, John D.

    2012-01-01

    Part I, "Searching for the Right Way to Begin Class," described the various iterations of beginning class rituals the author used over the years. Those rituals began with a prayer to the Holy Spirit as was required at the Catholic women's college Marymount in Tarrytown, New York, where he first taught out of graduate school in 1965. That…

  20. Curriculum Guide for Hospitality Education. Part II. Exemplary Project.

    ERIC Educational Resources Information Center

    Kalani, Henry

    This second of a two-part study designed to develop a hospitality education program model for Hawaii's community colleges is based on the primary data gathered in a survey of the hospitality industry characteristics, manpower requirements, and employment demands. (Survey data is reported in volume 1 of the study.) The introductory section of this…

  1. Brief Internet and NREN Glossary: Part II (M-Z).

    ERIC Educational Resources Information Center

    Machovec, George S.

    1993-01-01

    Presents the second and final part of a selected glossary of terms commonly used in discussions relating to the Internet and the National Research and Education Network (NREN). Highlights include various network names; organizations; acronyms; user interfaces; network research testbeds; various protocols; remote login; and Wide Area Information…

  2. Solar Energy Education. Reader, Part II. Sun story. [Includes glossary

    SciTech Connect

    Not Available

    1981-05-01

    Magazine articles which focus on the subject of solar energy are presented. The booklet prepared is the second of a four part series of the Solar Energy Reader. Excerpts from the magazines include the history of solar energy, mythology and tales, and selected poetry on the sun. A glossary of energy related terms is included. (BCS)

  3. CONTEMPORARY ARABIC READERS--II. ARABIC ESSAYS, PART 1. TEXTS.

    ERIC Educational Resources Information Center

    MCCARUS, ERNEST N.; AND OTHERS

    INTENDED FOR INTERMEDIATE-LEVEL STUDENTS, "PART 1" OF THIS SECOND VOLUME IN THE "CONTEMPORARY ARABIC READERS" SERIES PRESENTS A COLLECTION OF 20 ESSAYS WRITTEN BY OUTSTANDING ARAB LITERARY FIGURES. SUBJECTS RANGE FROM POLITICAL AND RELIGIOUS PHILOSOPHY IN THE ARAB WORLD TO ECONOMIC DEVELOPMENT AND REFORMS IN AGRICULTURE AND THE WRITING SYSTEM. THE…

  4. CONTEMPORARY ARABIC READERS--II. ARABIC ESSAYS, PART 1. TEXTS.

    ERIC Educational Resources Information Center

    MCCARUS, ERNEST N.; AND OTHERS

    INTENDED FOR INTERMEDIATE-LEVEL STUDENTS, "PART 1" OF THIS SECOND VOLUME IN THE "CONTEMPORARY ARABIC READERS" SERIES PRESENTS A COLLECTION OF 20 ESSAYS WRITTEN BY OUTSTANDING ARAB LITERARY FIGURES. SUBJECTS RANGE FROM POLITICAL AND RELIGIOUS PHILOSOPHY IN THE ARAB WORLD TO ECONOMIC DEVELOPMENT AND REFORMS IN AGRICULTURE AND THE WRITING SYSTEM. THE…

  5. Finding Out about Archaeology: Parts I and II.

    ERIC Educational Resources Information Center

    Archaeological Inst. of America, Boston, MA.

    This packet of materials presents selected, descriptive bibliographies for children and young adults. Instructional materials for the use of teachers and parents are also included. Focusing on the subject of archaeology, part 1 of the annotated bibliography presents instructional materials coded for appropriate grade level use. Each entry…

  6. DIY Soundcard Based Temperature Logging System. Part II: Applications

    ERIC Educational Resources Information Center

    Nunn, John

    2016-01-01

    This paper demonstrates some simple applications of how temperature logging systems may be used to monitor simple heat experiments, and how the data obtained can be analysed to get some additional insight into the physical processes. [For "DIY Soundcard Based Temperature Logging System. Part I: Design," see EJ1114124.

  7. Laboratory Animal Housing--Parts I and II.

    ERIC Educational Resources Information Center

    Runkle, Robert S.

    1963-01-01

    In recent years, the use of laboratory animals for bio-medical research has shown marked increase. Economic and efficient housing is a necessity. This two part report established guidelines for design and selection of materials for conventional animal housing. Contents include--(1) production and breeding facilities, (2) quarantine facilities, (3)…

  8. Aesthetic Pursuits: Windows, Frames, Words, Images--Part II

    ERIC Educational Resources Information Center

    Burke, Ken

    2005-01-01

    In Part I of this study (Burke, 2005), the author presented the essentials of Image Presentation Theory--IPT--and its application to the analytical explication of various spatial designs in and psychological responses to images, from the illusions of depth in what is referred to as "windows" in cinema theory to the more patterned abstractions of…

  9. Evaluation and Treatment of Nuclear Casualties. Part 3. Management of Combined Injuries

    DTIC Science & Technology

    1983-12-01

    bacterial disease. of the Warsaw Pact data by stating mortality and the contact burn had As described in Part Ii of this that an open wound markedly...12.5% with surgery. When the mephenytoin, phenobarbital, and de- serotonin , to 30% with MEA, and wound was inflicted and operated phenythydantoin were...to endogenous flora would help provide guidelines for ensemble." 30 and will require broad-spectrum the management of a combined in- In an integrated

  10. HYLIFE-II tritium management system

    SciTech Connect

    Longhurst, G.R.; Dolan, T.J.

    1993-06-01

    The tritium management system performs seven functions: (1) tritium gas removal from the blast chamber, (2) tritium removal from the Flibe, (3) tritium removal from helium sweep gas, (4) tritium removal from room air, (5) hydrogen isotope separation, (6) release of non-hazardous gases through the stack, (7) fixation and disposal of hazardous effluents. About 2 TBq/s (5 MCi/day) of tritium is bred in the Flibe (Li{sub 2}BeF{sub 4}) molten salt coolant by neutron absorption. Tritium removal is accomplished by a two-stage vacuum disengager in each of three steam generator loops. Each stage consists of a spray of 0.4 mm diameter, hot Flibe droplets into a vacuum chamber 4 m in diameter and 7 m tall. As droplets fall downward into the vacuum, most of the tritium diffuses out and is pumped away. A fraction {Phi}{approx}10{sup {minus}5} of the tritium remains in the Flibe as it leaves the second stage of the vacuum disengager, and about 24% of the remaining tritium penetrates through the steam generator tubes, per pass, so the net leakage into the steam system is about 4.7 MBq/s (11 Ci/day). The required Flibe pumping power for the vacuum disengager system is 6.6 MW. With Flibe primary coolant and a vacuum disengager, an intermediate coolant loop is not needed to prevent tritium from leaking into the steam system. An experiment is needed to demonstrate vacuum disengager operation with Flibe. A secondary containment shell with helium sweep gas captures the tritium permeating out of the Flibe ducts, limiting leaks there to about 1 Ci/day. The tritium inventory in the reactor is about 190 g, residing mostly in the large Flibe recirculation duct walls. The total cost of the tritium management system is 92 M$, of which the vacuum disengagers cost = 56%, the blast chamber vacuum system = 15%, the cryogenic plant = 9%, the emergency air cleanup and waste treatment systems each = 6%, the protium removal system = 3%, and the fuel storage system and inert gas system each = 2%.

  11. Part I. Mechanisms of injury associated with extracorporeal shock wave lithotripsy; Part II. Exsolution of volatiles

    NASA Astrophysics Data System (ADS)

    Howard, Danny Dwayne

    Part I - Shock waves are focused in extracorporeal shock wave lithotripsy (ESWL) machines to strengths sufficient to fracture kidney stones. Substantial side effects-most of them acute-have resulted from this procedure, including injury to soft tissue. The focusing of shock waves through various layers of tissue is a complex process which stimulates many bio-mechano-chemical responses.This thesis presents results of an in vitro study of the initial mechanical stimulus. Planar nitrocellulose membranes of order 10 um thick were used as models of thin tissue structures. Two modes of failure were recorded: Failure due to cavitation collapsing on or near the membranes, and failure induced by altering the structure of shock waves. Tests were done in water at and around F2 to characterize the extent of cavitation damage, and was found to be confined within the focal region, 1.2 cm along the axis of focus.Scattering media were used to simulate the effects of acoustic nonuniformity of tissue and to alter the structure of focusing shock waves. 40 um diameter (average) hollow glass spheres were added to ethylene glycol, glycerine and castor oil to vary the properties of the scattering media. Multiple layer samples of various types of phantom tissue were tested in degassed castor oil to gauge the validity of the scattering media. The scattering media and tissue samples increased the rise time decreased strain rate in a similar fashion. Membranes were damaged by the decreased strain rate and accumulated effects of the altered structure: After about 20 or so shocks immersed in the scattering media and after about 100 shocks behind the tissue samples. The mode of failure was tearing with multiple tears in some cases from about .1 cm to about 3 cm depending of the number of shocks and membrane thickness.Part II - This work examines the exsolution of volatiles-carbon dioxide from water-in a cylindrical test cell under different pressure conditions. Water was supersaturated with

  12. Sentinel lymph node biopsy and melanoma: 2010 update Part II.

    PubMed

    Stebbins, William G; Garibyan, Lilit; Sober, Arthur J

    2010-05-01

    This article will discuss the evidence for and against the therapeutic efficacy of early removal of potentially affected lymph nodes, morbidity associated with sentinel lymph node biopsy and completion lymphadenectomy, current guidelines regarding patient selection for sentinel lymph node biopsy, and the remaining questions that ongoing clinical trials are attempting to answer. The Sunbelt Melanoma Trial and the Multicenter Selective Lymphadenectomy Trials I and II will be discussed in detail. At the completion of this learning activity, participants should be able to discuss the data regarding early surgical removal of lymph nodes and its effect on the overall survival of melanoma patients, be able to discuss the potential benefits and morbidity associated with complete lymph node dissection, and to summarize the ongoing trials aimed at addressing the question of therapeutic value of early surgical treatment of regional lymph nodes that may contain micrometastases. Copyright 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  13. Conceptual Modeling in the Time of the Revolution: Part II

    NASA Astrophysics Data System (ADS)

    Mylopoulos, John

    Conceptual Modeling was a marginal research topic at the very fringes of Computer Science in the 60s and 70s, when the discipline was dominated by topics focusing on programs, systems and hardware architectures. Over the years, however, the field has moved to centre stage and has come to claim a central role both in Computer Science research and practice in diverse areas, such as Software Engineering, Databases, Information Systems, the Semantic Web, Business Process Management, Service-Oriented Computing, Multi-Agent Systems, Knowledge Management, and more. The transformation was greatly aided by the adoption of standards in modeling languages (e.g., UML), and model-based methodologies (e.g., Model-Driven Architectures) by the Object Management Group (OMG) and other standards organizations. We briefly review the history of the field over the past 40 years, focusing on the evolution of key ideas. We then note some open challenges and report on-going research, covering topics such as the representation of variability in conceptual models, capturing model intentions, and models of laws.

  14. Management of Class II malocclusion with ectopic maxillary canines

    PubMed Central

    Mascarenhas, Rohan; Parveen, Shahista; Ansari, Tariq Aziz

    2015-01-01

    Correction of Class II relationship, deep bite and ectopically erupting canines is an orthodontic challenge for the clinician. A 13-year-old male patient presented with Class II malocclusion, ectopically erupting canines, and cross bite with maxillary left lateral incisor. He was treated with a combination of Headgear, Forsus™ fatigue resistant device [FFRD] with fixed mechanotherapy for the management of space deficiency and correction of Class II malocclusions. Headgear was used to distalize upper first molars and also to prevent further downward and forward growth of the maxilla. Then Forsus™ FFRD was used for the advancement of the mandible. The molar and canine relationship were corrected from a Class II to a Class I. The objectives were to establish good occlusion and enable eruption of unerupted canines. All these objectives were achieved and remained stable. PMID:26097371

  15. 41 CFR 102-33.225 - How must we manage aircraft parts?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... aircraft parts? 102-33.225 Section 102-33.225 Public Contracts and Property Management Federal Property... GOVERNMENT AIRCRAFT Managing Government Aircraft and Aircraft Parts Managing Aircraft Parts § 102-33.225 How must we manage aircraft parts? You must manage your aircraft parts by maintaining proper storage...

  16. [Interdisciplinary management of chronic tinnitus (II)].

    PubMed

    Rosanowski, F; Hoppe, U; Köllner, V; Weber, A; Eysholdt, U

    2001-06-01

    Tinnitus is defined as the perception of sound in the absence of any appropriate external stimulation. It is a common, bothersome and hard-to-evaluate symptom and in most cases it cannot be objectified. Its incidence in Germany and the western world is about 10%. About 1-2% of the population are severely disturbed by tinnitus and it may disrupt everyday activities and sleep. Recent theoretical developments favour a neurophysiological approach as an explanation for tinnitus in addition to a psychoacoustic model based on peripheral lesion in the cochlea or auditory nerve. In the neurophysiological model, the processing of the tinnitus signal plays a dominant role in its detection, perception and evaluation. Therefore, attention and other psychological factors become important in the understanding and treatment of tinnitus. Many treatments of chronic tinnitus have been proposed and implemented. Today, cognitive-behavioural treatment is regarded as an important part of an integrative therapy which may be compiled of counselling, relaxation therapy, instrumental (hearing aid, tinnitus masker, tinnitus instrument, tinnitus noiser) and pharmacological tools (lidocaine, neurotransmitters). In well-controlled studies the empirical support for other therapeutical approaches such as acupuncture is weak. This work gives a review of the current knowledge of the etiology, pathogenesis, epidemiology, the interdisciplinary diagnostic approach and treatment of tinnitus and especially focuses on insurance and medico-legal aspects.

  17. Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

    PubMed Central

    Puri, Pankaj; Anand, Anil C.; Saraswat, Vivek A.; Acharya, Subrat K.; Sarin, Shiv K.; Dhiman, Radha K.; Aggarwal, Rakesh; Singh, Shivaram P.; Amarapurkar, Deepak; Arora, Anil; Chhabra, Mohinish; Chetri, Kamal; Choudhuri, Gourdas; Dixit, Vinod K.; Duseja, Ajay; Jain, Ajay K.; Kapoor, Dharmesh; Kar, Premashis; Koshy, Abraham; Kumar, Ashish; Madan, Kaushal; Misra, Sri P.; Prasad, Mohan V.G.; Nagral, Aabha; Puri, Amarendra S.; Jeyamani, R.; Saigal, Sanjiv; Shah, Samir; Sharma, Praveen K.; Sood, Ajit; Thareja, Sandeep; Wadhawan, Manav

    2014-01-01

    The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver. PMID:25755549

  18. GSTARS computer models and their applications, Part II: Applications

    USGS Publications Warehouse

    Simoes, F.J.M.; Yang, C.T.

    2008-01-01

    In part 1 of this two-paper series, a brief summary of the basic concepts and theories used in developing the Generalized Stream Tube model for Alluvial River Simulation (GSTARS) computer models was presented. Part 2 provides examples that illustrate some of the capabilities of the GSTARS models and how they can be applied to solve a wide range of river and reservoir sedimentation problems. Laboratory and field case studies are used and the examples show representative applications of the earlier and of the more recent versions of GSTARS. Some of the more recent capabilities implemented in GSTARS3, one of the latest versions of the series, are also discussed here with more detail. ?? 2008 International Research and Training Centre on Erosion and Sedimentation and the World Association for Sedimentation and Erosion Research.

  19. Wideband, low-frequency springless vibration energy harvesters: part II

    NASA Astrophysics Data System (ADS)

    Bendame, Mohamed; Abdel-Rahman, Eihab; Soliman, Mostafa

    2016-11-01

    This paper concludes a two-part investigation of a novel architecture for vibration energy harvesting (VEH), the springless VEH. In this part, we study vertical springless electromagnetic VEHs where the direction of motion is aligned with the gravitational field. Experimental results show the existence of three topologies in the response of vertical springless VEHs; linear, single-impact, and double-impact. A model, encompassing all three topologies, was developed and validated by comparison to experimental results. We found that vertical springless VEHs demonstrate low frequency harvesting (<20 Hz), widebeand harvesting (bandwidths up to \\text{BW}=11.2 Hz), and an optimal output power of P  =  7.52 mW at a base acceleration of 0.6 g. While horizontal springless VEHs typically offer more output power, the single-impact regime of the vertical springless VEHs offers the simultaneous advantages of wider harvesting bandwidths at lower operating frequencies.

  20. Comparison of microstickies measurement methods. Part II, Results and discussion

    Treesearch

    Mahendra R. Doshi; Angeles Blanco; Carlos Negro; Concepcion Monte; Gilles M. Dorris; Carlos C. Castro; Axel Hamann; R. Daniel Haynes; Carl Houtman; Karen Scallon; Hans-Joachim Putz; Hans Johansson; R. A. Venditti; K. Copeland; H.-M. Chang

    2003-01-01

    In part I of the article we discussed sample preparation procedure and described various methods used for the measurement of microstickies. Some of the important features of different methods are highlighted in Table 1. Temperatures used in the measurement methods vary from room temperature in some cases, 45 °C to 65 °C in other cases. Sample size ranges from as low as...

  1. Ada Integrated Environment II Computer Program Development Specification. Part 1.

    DTIC Science & Technology

    1981-12-01

    No. 6, Part 2, July-August 1978. 18. Rochkind, M. J., The Source Code Control System, IEEE Transactions on Software Engineering, SE-i, December 1975...TRACT (Continue an, reere side It noleearel and identfir &Y block number) The Ada Integrated Environment (AIE) consists of a set of software tools...intended to support design, development and maintenance of embedded computer software . A significant portion of an AIE includes software systems and

  2. Underwater Electromagnetic Sensor Networks, Part II: Localization and Network Simulations.

    PubMed

    Zazo, Javier; Macua, Sergio Valcarcel; Zazo, Santiago; Pérez, Marina; Pérez-Álvarez, Iván; Jiménez, Eugenio; Cardona, Laura; Brito, Joaquín Hernández; Quevedo, Eduardo

    2016-12-17

    In the first part of the paper, we modeled and characterized the underwater radio channel in shallowwaters. In the second part,we analyze the application requirements for an underwaterwireless sensor network (U-WSN) operating in the same environment and perform detailed simulations. We consider two localization applications, namely self-localization and navigation aid, and propose algorithms that work well under the specific constraints associated with U-WSN, namely low connectivity, low data rates and high packet loss probability. We propose an algorithm where the sensor nodes collaboratively estimate their unknown positions in the network using a low number of anchor nodes and distance measurements from the underwater channel. Once the network has been self-located, we consider a node estimating its position for underwater navigation communicating with neighboring nodes. We also propose a communication system and simulate the whole electromagnetic U-WSN in the Castalia simulator to evaluate the network performance, including propagation impairments (e.g., noise, interference), radio parameters (e.g., modulation scheme, bandwidth, transmit power), hardware limitations (e.g., clock drift, transmission buffer) and complete MAC and routing protocols. We also explain the changes that have to be done to Castalia in order to perform the simulations. In addition, we propose a parametric model of the communication channel that matches well with the results from the first part of this paper. Finally, we provide simulation results for some illustrative scenarios.

  3. Underwater Electromagnetic Sensor Networks, Part II: Localization and Network Simulations

    PubMed Central

    Zazo, Javier; Valcarcel Macua, Sergio; Zazo, Santiago; Pérez, Marina; Pérez-Álvarez, Iván; Jiménez, Eugenio; Cardona, Laura; Brito, Joaquín Hernández; Quevedo, Eduardo

    2016-01-01

    In the first part of the paper, we modeled and characterized the underwater radio channel in shallow waters. In the second part, we analyze the application requirements for an underwater wireless sensor network (U-WSN) operating in the same environment and perform detailed simulations. We consider two localization applications, namely self-localization and navigation aid, and propose algorithms that work well under the specific constraints associated with U-WSN, namely low connectivity, low data rates and high packet loss probability. We propose an algorithm where the sensor nodes collaboratively estimate their unknown positions in the network using a low number of anchor nodes and distance measurements from the underwater channel. Once the network has been self-located, we consider a node estimating its position for underwater navigation communicating with neighboring nodes. We also propose a communication system and simulate the whole electromagnetic U-WSN in the Castalia simulator to evaluate the network performance, including propagation impairments (e.g., noise, interference), radio parameters (e.g., modulation scheme, bandwidth, transmit power), hardware limitations (e.g., clock drift, transmission buffer) and complete MAC and routing protocols. We also explain the changes that have to be done to Castalia in order to perform the simulations. In addition, we propose a parametric model of the communication channel that matches well with the results from the first part of this paper. Finally, we provide simulation results for some illustrative scenarios. PMID:27999309

  4. Slag Behavior in Gasifiers. Part II: Constitutive Modeling of Slag

    SciTech Connect

    Massoudi, Mehrdad; Wang, Ping

    2013-02-07

    The viscosity of slag and the thermal conductivity of ash deposits are among two of the most important constitutive parameters that need to be studied. The accurate formulation or representations of the (transport) properties of coal present a special challenge of modeling efforts in computational fluid dynamics applications. Studies have indicated that slag viscosity must be within a certain range of temperatures for tapping and the membrane wall to be accessible, for example, between 1,300 °C and 1,500 °C, the viscosity is approximately 25 Pa·s. As the operating temperature decreases, the slag cools and solid crystals begin to form. Since slag behaves as a non-linear fluid, we discuss the constitutive modeling of slag and the important parameters that must be studied. We propose a new constitutive model, where the stress tensor not only has a yield stress part, but it also has a viscous part with a shear rate dependency of the viscosity, along with temperature and concentration dependency, while allowing for the possibility of the normal stress effects. In Part I, we reviewed, identify and discuss the key coal ash properties and the operating conditions impacting slag behavior.

  5. Fourier Transform Infrared Spectroscopy: Part II. Advantages of FT-IR.

    ERIC Educational Resources Information Center

    Perkins, W. D.

    1987-01-01

    This is Part II in a series on Fourier transform infrared spectroscopy (FT-IR). Described are various advantages of FT-IR spectroscopy including energy advantages, wavenumber accuracy, constant resolution, polarization effects, and stepping at grating changes. (RH)

  6. Fourier Transform Infrared Spectroscopy: Part II. Advantages of FT-IR.

    ERIC Educational Resources Information Center

    Perkins, W. D.

    1987-01-01

    This is Part II in a series on Fourier transform infrared spectroscopy (FT-IR). Described are various advantages of FT-IR spectroscopy including energy advantages, wavenumber accuracy, constant resolution, polarization effects, and stepping at grating changes. (RH)

  7. 40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Duty Cycles for Propulsion Marine...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM SPARK-IGNITION PROPULSION MARINE ENGINES AND VESSELS Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a)...

  8. 40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Propulsion Marine...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM SPARK-IGNITION PROPULSION MARINE ENGINES AND VESSELS Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a)...

  9. 40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Duty Cycles for Propulsion Marine...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM SPARK-IGNITION PROPULSION MARINE ENGINES AND VESSELS Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a)...

  10. 40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Duty Cycles for Propulsion Marine...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM SPARK-IGNITION PROPULSION MARINE ENGINES AND VESSELS Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a)...

  11. 31 CFR Appendix II to Part 13 - Form of Bill for Reimbursement

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Form of Bill for Reimbursement II Appendix II to Part 13 Money and Finance: Treasury Office of the Secretary of the Treasury PROCEDURES FOR... Accounting Office at such reasonable times and places as may be mutually agreed upon by said...

  12. 40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Duty Cycles for Propulsion Marine...) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM SPARK-IGNITION PROPULSION MARINE ENGINES AND VESSELS Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a)...

  13. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 28 2012-07-01 2012-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban...

  14. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 27 2011-07-01 2011-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban...

  15. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 27 2014-07-01 2014-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban...

  16. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 28 2013-07-01 2013-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban...

  17. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban...

  18. 46 CFR Appendix II to Part 150 - Explanation of Figure 1

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... COMPATIBILITY OF CARGOES Pt. 150, App. II Appendix II to Part 150—Explanation of Figure 1 Definition of a..., the inorganic acids. The cargo groups in the compatibility chart are separated into two categories: 1... certain Reactive Groups. Cargo Groups do not react hazardously with one another. Using the Compatibility...

  19. 46 CFR Appendix II to Part 150 - Explanation of Figure 1

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... COMPATIBILITY OF CARGOES Pt. 150, App. II Appendix II to Part 150—Explanation of Figure 1 Definition of a..., the inorganic acids. The cargo groups in the compatibility chart are separated into two categories: 1... certain Reactive Groups. Cargo Groups do not react hazardously with one another. Using the Compatibility...

  20. 46 CFR Appendix II to Part 150 - Explanation of Figure 1

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... COMPATIBILITY OF CARGOES Pt. 150, App. II Appendix II to Part 150—Explanation of Figure 1 Definition of a..., the inorganic acids. The cargo groups in the compatibility chart are separated into two categories: 1... certain Reactive Groups. Cargo Groups do not react hazardously with one another. Using the Compatibility...

  1. 46 CFR Appendix II to Part 150 - Explanation of Figure 1

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... COMPATIBILITY OF CARGOES Pt. 150, App. II Appendix II to Part 150—Explanation of Figure 1 Definition of a..., the inorganic acids. The cargo groups in the compatibility chart are separated into two categories: 1... certain Reactive Groups. Cargo Groups do not react hazardously with one another. Using the Compatibility...

  2. 40 CFR Appendix II to Part 1042 - Steady-State Duty Cycles

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Steady-State Duty Cycles II Appendix II to Part 1042 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW AND IN-USE MARINE COMPRESSION-IGNITION ENGINES AND VESSELS Pt....

  3. 40 CFR Appendix II to Part 258 - List of Hazardous Inorganic and Organic Constituents

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 26 2012-07-01 2011-07-01 true List of Hazardous Inorganic and Organic Constituents II Appendix II to Part 258 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... of Hazardous Inorganic and Organic Constituents Common name 1 CAS RN 2 Chemical abstracts...

  4. 40 CFR Appendix II to Part 258 - List of Hazardous Inorganic and Organic Constituents

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false List of Hazardous Inorganic and Organic Constituents II Appendix II to Part 258 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... 258—List of Hazardous Inorganic and Organic Constituents Common name 1 CAS RN 2 Chemical...

  5. 40 CFR Appendix II to Part 258 - List of Hazardous Inorganic and Organic Constituents

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 26 2013-07-01 2013-07-01 false List of Hazardous Inorganic and Organic Constituents II Appendix II to Part 258 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... 258—List of Hazardous Inorganic and Organic Constituents Common name 1 CAS RN 2 Chemical...

  6. 40 CFR Appendix II to Part 258 - List of Hazardous Inorganic and Organic Constituents

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 25 2014-07-01 2014-07-01 false List of Hazardous Inorganic and Organic Constituents II Appendix II to Part 258 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... 258—List of Hazardous Inorganic and Organic Constituents Common name 1 CAS RN 2 Chemical...

  7. 40 CFR Appendix II to Part 258 - List of Hazardous Inorganic and Organic Constituents

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false List of Hazardous Inorganic and Organic Constituents II Appendix II to Part 258 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... 258—List of Hazardous Inorganic and Organic Constituents Common name 1 CAS RN 2 Chemical...

  8. Managing the multicultural laboratory, Part III: Putting the cross-cultural tools to work.

    PubMed

    Ketchum, S M

    1993-01-01

    This third article provides two case studies that enable laboratory managers to see how the cross-cultural model postulated by Dr. Geert Hofstede can be practically applied to two important issues--staff training and conflict resolution between employees. In addition, the opinions of several managers from a variety of industries are presented to add realism and perspective. This encourages laboratory managers to step outside the laboratory environment and learn from other managers who have years of experience supervising culturally diverse groups of employees. Part I of this series explained what is meant by "culture" and featured the research-based model set forth by Dutch social psychologist and management consultant, Dr. Geert Hofstede. His four dimensions of culture (Power Distance, Masculinity/Femininity, Individualism/Collectivism, and Uncertainty Avoidance) provide a useful framework for understanding the different values, attitudes, and behaviors exhibited by those of different cultural backgrounds. Part II presented advice in the form of 13 anecdotes from experienced cross-cultural managers. Issues of performance management, interpersonal skills, and language and safety were explored in light of the four dimensions. In this third article, abbreviated reference tables adapted from Hofstede's research are presented that make these cross-cultural data more useful for management decision making. Laboratory managers will receive practical, "real world" advice that will help them to positively resolve conflicts and to take full advantage of staff training opportunities.

  9. Tropical Skin Diseases in Children: A Review-Part II.

    PubMed

    García-Romero, Maria Teresa; Lara-Corrales, Irene; Kovarik, Carrie L; Pope, Elena; Arenas, Roberto

    2016-05-01

    Tropical skin diseases are infectious conditions influenced by factors such as nutrition, housing, and the environment. Migration patterns have caused these conditions to be seen all around the world, not only in developing countries. Many of these diseases have a different presentation in childhood, which changes the diagnostic approach and management options. In this article, we review some of the most common tropical mycobacterial, protozoan, parasitic, and viral dermatologic conditions in children, including their epidemiologic, clinical, diagnostic, and therapeutic aspects. © 2016 Wiley Periodicals, Inc.

  10. The museum maze in oral pathology demystifed: part II.

    PubMed

    Patil, Shankargouda; Rao, Roopa S; Ganavi, Bs

    2013-09-01

    Museum technology is perpetually changing due to current requirements and added inventions for our comfort and furbished display of specimens. Hence numerous methods of specimen preservation have been put on trial by diverse people in the medical feld as are the inventions. But only few have caught people's interest and are popularized today. This part provides unique insights into specialized custom-made techniques, evolution of recent advances like plastination and virtual museum that have popularized as visual delights. Plastination gives handy, perennial life-like acrylic specimens, whereas virtual museum takes museum feld to the electronic era making use of computers and virtual environment.

  11. Cancer Chemotherapy: Past, Present, and Future—Part II

    PubMed Central

    Wright, Jane C.

    1984-01-01

    Cancer is of major concern today because of its high mortality. It is estimated that 66 million people in this country will eventually develop cancer; 1983 estimates were 855,000 new cases and 440,000 deaths from cancer. Because of limitations of surgery and radiation therapy in effecting a cure for cancer, chemotherapy has become increasingly important. The developments in the chemical control of cancer in man are encouraging. This two-part paper* covers the historical milestones in the development of the chemical and hormonal control of cancer, present successes with the use of polychemotherapy, and the hopeful trend in research. PMID:6492179

  12. Responsive Persistence Part II. Practices of Postmodern Therapists.

    PubMed

    Sutherland, Olga; Dienhart, Anna; Turner, Jean

    2013-10-01

    This article, a companion to Part I of this series of articles, discusses how therapists informed by social constructionist and postmodern ideas enact persistence in their work with families. Transcripts and video-recordings of therapy interaction facilitated by selected major champions for three postmodern (collaborative) therapies: Michael White (narrative therapy), Harlene Anderson (collaborative language systems approach), and Bill O'Hanlon (solution-oriented therapy) were examined for persistence practices. The article offers a range of possible ways in which postmodern therapists may enact their influence in facilitating generative and helpful conversations with families and remain responsive to clients' preferences and understandings. Implications for family therapy practice, training, and supervision are discussed.

  13. Alkali cold gelation of whey proteins. Part II: Protein concentration.

    PubMed

    Mercadé-Prieto, Ruben; Gunasekaran, Sundaram

    2009-05-19

    The effect of the whey protein isolate (WPI) concentration on the sol-gel-sol transition in alkali cold gelation was investigated at pH 11.6-13 using oscillatory rheometry. The elastic modulus increases quickly with time to reach a local maximum (G'max), followed by a degelation step where the modulus decreases to a minimum value (G'min). Depending on the pH, a second gelation step will occur. At the end of the first gelation step around G'max, the system fulfilled the Winter-Chambon criterion of gelation. The analysis of the maximum moduli with the protein concentration shows that (i) there is a percolation concentration above which an elastic response is observed (approximately 6.8 wt %); (ii) there are two concentration regimes for G''max and G''max above this concentration, where we have considered power-law and percolation equations; (iii) there is a crossover concentration between the two regimes (at approximately 8 wt %) for both G'max and G''max when both moduli are equal, and this value is constant under all conditions tested (G'max=G''max approximately 4 Pa). Therefore, alkali cold gelation is better represented using two concentrations regimes than one, as observed for other biopolymers.

  14. Chronic heart failure part 2: treatment and management.

    PubMed

    Brake, Rebecca; Jones, Ian David

    2017-01-11

    Chronic heart failure is a common and complex clinical syndrome that results from impaired cardiac relaxation or contraction. There have been considerable advances in the management of chronic heart failure; however, the mortality rate remains high. Patients with chronic heart failure may experience multiple debilitating symptoms, such as fatigue, pain, and peripheral oedema. However, breathlessness may be considered the most debilitating symptom. The management of chronic heart failure aims to improve the patient's quality of life by reducing symptoms and supporting the patient to manage their condition. Treatment of patients with chronic heart failure may involve a combination of pharmacological therapy, device implantation and cardiac rehabilitation. This is the second of two articles on chronic heart failure. Part 1 discussed the pathophysiology of chronic heart failure, its causes, assessment, signs and symptoms. Part 2 outlines the treatment and management of patients with the condition, including pharmacological strategies, device implantation, lifestyle modification, cardiac rehabilitation and palliative care.

  15. Dynamic spreading of nanofluids on solids part II: modeling.

    PubMed

    Liu, Kuan-Liang; Kondiparty, Kirtiprakash; Nikolov, Alex D; Wasan, Darsh

    2012-11-27

    Recent studies on the spreading phenomena of liquid dispersions of nanoparticles (nanofluids) have revealed that the self-layering and two-dimensional structuring of nanoparticles in the three-phase contact region exert structural disjoining pressure, which drives the spreading of nanofluids by forming a continuous wedge film between the liquid (e.g., oil) and solid surface. Motivated by the practical applications of the phenomenon and experimental results reported in Part I of this two-part series, we thoroughly investigated the spreading dynamics of nanofluids against an oil drop on a solid surface. With the Laplace equation as a starting point, the spreading process is modeled by Navier-Stokes equations through the lubrication approach, which considers the structural disjoining pressure, gravity, and van der Waals force. The temporal interface profile and advancing inner contact line velocity of nanofluidic films are analyzed through varying the effective nanoparticle concentration, the outer contact angle, the effective nanoparticle size, and capillary pressure. It is found that a fast and spontaneous advance of the inner contact line movement can be obtained by increasing the nanoparticle concentration, decreasing the nanoparticle size, and/or decreasing the interfacial tension. Once the nanofluidic film is formed, the advancing inner contact line movement reaches a constant velocity, which is independent of the outer contact angle if the interfacial tension is held constant.

  16. Histologic features of alopecias: part II: scarring alopecias.

    PubMed

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder.

  17. Active flow control for a NACA-0012 Profile: Part II

    NASA Astrophysics Data System (ADS)

    Oualli, H.; Makadem, M.; Ouchene, H.; Ferfouri, A.; Bouabdallah, A.; Gad-El-Hak, M.

    2016-11-01

    Active flow control is applied to a NACA-0012 profile. The experiments are conducted in a wind tunnel. Using a high-resolution visible-light camera and tomography, flow visualizations are carried out. LES finite-volume 3D code is used to complement the physical experiments. The symmetric wing is clipped into two parts, and those parts extend and retract along the chord according to the same sinusoidal law we optimized last year for the same profile but clipped at an angle of 60 deg, instead of the original 90 deg. The Reynolds number range is extended to 500,000, thus covering the flying regimes of micro-UAVs, UAVs, as well as small aircraft. When the nascent cavity is open and the attack angle is 30 deg, the drag coefficient is increased by 1,300%, as compared to the uncontrolled case. However, when the cavity is covered and Re <=105 , a relatively small frequency, f <= 30 Hz, is required for the drag coefficient to drop to negative values. At the maximum Reynolds number, thrust is generated but only at much higher frequencies, 12 <= f <= 16 kHz.

  18. Collagenolytic (necrobiotic) granulomas: part II--the 'red' granulomas.

    PubMed

    Lynch, Jane M; Barrett, Terry L

    2004-07-01

    A collagenolytic or necrobiotic non-infectious granuloma is one in which a granulomatous infiltrate develops around a central area of altered collagen and elastic fibers. The altered fibers lose their distinct boundaries and exhibit new staining patterns, becoming either more basophilic or eosinophilic. Within the area of altered collagen, there may be deposition of acellular substances such as mucin (blue) or fibrin (red), or there may be neutrophils with nuclear dust (blue), eosinophils (red), or flame figures (red). These color distinctions can be used as a simple algorithm for the diagnosis of collagenolytic granulomas, i.e. 'blue' granulomas vs. 'red' granulomas. Eight diagnoses are included within these two groupings, which are discussed in this two-part article. In the previously published first part, the clinical presentation, pathogenesis and histologic features of the 'blue' collagenolytic granulomas were discussed. These are the lesions of granuloma annulare, Wegener's granulomatosis, and rheumatoid vasculitis. In this second half of the series, the 'red' collagenolytic granulomas are discussed; these are the lesions of necrobiosis lipoidica, necrobiotic xanthogranuloma, rheumatoid nodules, Churg-Strauss syndrome, and eosinophilic cellulitis (Well's Syndrome).

  19. Solar System: Surfing the Edge of Chaos Part II

    NASA Astrophysics Data System (ADS)

    Hayes, Wayne B.; Danforth, C. M.

    2008-05-01

    The orbital positions and masses of the Jovian planets are known only to a few parts in 107. At the 2006 DDA meeting in Halifax, I presented results, recently published in Nature Physics and MNRAS, which demonstrated the existence of both chaotic and near-regular orbits within the current observational error volume. In this talk, joint work with Chris Danforth of the University of Vermont, we present results demonstrating extremely rich structure of Lyapunov times within the uncertainty volume across many two-dimensional slices through initial-condition space. These slices include the Cartesian product of every pair of orbital semi-major axes ap, plus Cartesian products between ap and eccentricity ep for each Jovian planet p. Some of the observed structure is reminiscent of Guzzo's "Web of 3-body resonances", although it is not clear that 3-body resonances are the cause in this case since the structure extends several orders of magnitude below the scale at which Murray + Holman's 3-body resonance theory has been explored. Some of the structure is entirely unlike that seen in Guzzo's Web, and may require further theoretical development to understand. Finally, several "zoom-in” plots, reminiscent of those done for the Mandelbrot set, demonstrate that the structure continues down, at least, to scales of about one part in 109. In all cases, we verify the reliability of our integrations using convergence tests to demonstrate that the picture does not change even when the integration timestep is decreased significantly.

  20. Nanoparticles and the blood coagulation system. Part II: safety concerns.

    PubMed

    Ilinskaya, Anna N; Dobrovolskaia, Marina A

    2013-06-01

    Nanoparticle interactions with the blood coagulation system can be beneficial or adverse depending on the intended use of a nanomaterial. Nanoparticles can be engineered to be procoagulant or to carry coagulation-initiating factors to treat certain disorders. Likewise, they can be designed to be anticoagulant or to carry anticoagulant drugs to intervene in other pathological conditions in which coagulation is a concern. An overview of the coagulation system was given and a discussion of a desirable interface between this system and engineered nanomaterials was assessed in part I, which was published in the May 2013 issue of Nanomedicine. Unwanted pro- and anti-coagulant properties of nanoparticles represent significant concerns in the field of nanomedicine, and often hamper the development and transition into the clinic of many promising engineered nanocarriers. This part will focus on the undesirable effects of engineered nanomaterials on the blood coagulation system. We will discuss the relationship between the physicochemical properties of nanoparticles (e.g., size, charge and hydrophobicity) that determine their negative effects on the blood coagulation system in order to understand how manipulation of these properties can help to overcome unwanted side effects.

  1. Nanoparticles and the blood coagulation system. Part II: safety concerns

    PubMed Central

    Ilinskaya, Anna N; Dobrovolskaia, Marina A

    2014-01-01

    Nanoparticle interactions with the blood coagulation system can be beneficial or adverse depending on the intended use of a nanomaterial. Nanoparticles can be engineered to be procoagulant or to carry coagulation-initiating factors to treat certain disorders. Likewise, they can be designed to be anticoagulant or to carry anticoagulant drugs to intervene in other pathological conditions in which coagulation is a concern. An overview of the coagulation system was given and a discussion of a desirable interface between this system and engineered nanomaterials was assessed in part I, which was published in the May 2013 issue of Nanomedicine. Unwanted pro- and anti-coagulant properties of nanoparticles represent significant concerns in the field of nanomedicine, and often hamper the development and transition into the clinic of many promising engineered nanocarriers. This part will focus on the undesirable effects of engineered nanomaterials on the blood coagulation system. We will discuss the relationship between the physicochemical properties of nanoparticles (e.g., size, charge and hydrophobicity) that determine their negative effects on the blood coagulation system in order to understand how manipulation of these properties can help to overcome unwanted side effects. PMID:23730696

  2. The year's new drugs & biologics 2014 - Part II: trends & challenges.

    PubMed

    Graul, A I; Serebrov, M; Cruces, E; Tracy, M; Dulsat, C

    2015-02-01

    2014 was a year of continued high activity in the pharma and biotech industry, as evidenced in part I of this annual two-part review article published last month in this journal (1). As of December 23, 2014, a total of 55 new chemical and biological entities had reached their first markets worldwide, together with another 29 important new line extensions. Another 19 products were approved for the first time during the year but not yet launched by December 23. Furthermore, during the now-traditional year-end sprint, several regulatory agencies issued last-minute approvals for other compounds that missed the deadline for inclusion in that article, bringing the total of new approvals for the year to a somewhat higher number. In addition to the successful development, registration and launch of new drugs and biologics, there are various other trends and tendencies that serve as indicators of the overall health and status of the industry. These include the pursuit of novel programs designed by regulators to stimulate the development of drugs for diseases that are currently under-treated; the regular and pragmatic culling by companies of their R&D pipelines; and the decision to unify pipelines, portfolios and sales forces through mergers and acquisitions.

  3. Pneumothorax from diagnosis to treatment, hands on course: Part II

    PubMed Central

    Zarogoulidis, Konstantinos; Papaiwannou, Antonis; Lazaridis, George; Karavergou, Anastasia; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios

    2015-01-01

    Pneumothorax is a situation where air is inserted in the pleural space that separates the lung from the chest wall. Pneumothorax can be primary or secondary. There is also a third type called; tensioned. Based on the concentration of air and type of pneumothorax the proper treatment has to be selected. There are cases where the concentration is minimal and observation is enough and more severe cases where surgery is required. Currently there are many techniques used for the biopsy of lung lesions. The bronchoscope (forceps, fine needle aspiration), fine needle aspiration under computed tomography scan and endobronchial ultrasound (EBUS) are commonly used. However, all these techniques have in common a possible side effect; pneumothorax. In our current issue we will focus on the different minimally invasive techniques of pneumothorax management. Moreover, a presentation will be made for several systems that are being used for air or fluid aspiration. PMID:25815302

  4. [Hereditary spherocytosis. Review. Part II. Symptomatology, outcome, complications, and treatment].

    PubMed

    Donato, Hugo; Crisp, Renée Leonor; Rapetti, María Cristina; García, Eliana; Attie, Myriam

    2015-04-01

    Hereditary spherocytosis must always be suspected in children with anemia, hyperbilirubinemia, splenomegaly or cholelithiasis, in the asymptomatic individual with an affected relative, and in the neonate with hyperbilirubinemia with no blood group incompatibility; its early detection is key to avoid kernicterus. Follow-up of these patients is based on periodical control and supply of information on the adequate management of hemolytic or aplastic crisis, and early detection of cholelithiasis. The decision to perform splenectomy is usually associated with quality of life rather than life-threatening risk, and it should result from a consensus between patient, parents and physicians. The postsplenectomy follow-up is based on control of compliance with the prophylactic antibiotic therapy and the early diagnosis of infectious disorders.

  5. Modified sprint interval training protocols. Part II. Psychological responses.

    PubMed

    Townsend, Logan K; Islam, Hashim; Dunn, Emily; Eys, Mark; Robertson-Wilson, Jennifer; Hazell, Tom J

    2017-04-01

    Sprint-interval training (SIT) is a viable method to improve health and fitness. However, researchers have questioned the utility of SIT because of its strenuous nature. The current study aimed to determine if manipulating the sprint and recovery duration, while maintaining the 1:8 work to rest ratio, could uncover a more favourable SIT protocol. Nine healthy active males (age, 23.3 ± 3.0 years; body mass index, 22.4 ± 2.2 kg·m(-2); maximal oxygen consumption, 48.9 ± 5.3 mL·kg(-1)·min(-1)) participated in 3 experimental running SIT sessions: (i) 30:240 (4 × 30-s efforts, 240-s recovery), (ii) 15:120 (8 × 15-s efforts, 120-s recovery), (iii) 5:40 (24 × 5-s efforts, 40-s recovery), and (iv) a final behavioural choice follow-up session. Affect, intentions, task self-efficacy, enjoyment, and preference were evaluated. Midway through exercise, affect became more positive for 5:40 compared with 30:240 (p < 0.05) and postexercise affect was greater for both 5:40 (p = 0.014) and 15:120 (p = 0.015) compared with 30:240. Participants expressed greater intentions to perform 5:40 3 and 5 times/week compared with 15:120 and 30:240 (p < 0.05). Participants felt more confident in their ability to perform 5:40 (p = 0.001) and 15:120 (p = 0.008) compared with 30:240. The 5:40 session was also rated as more enjoyable than 15:120 (p = 0.025) and 30:240 (p = 0.026). All participants preferred the 5:40 protocol. These data suggest that shorter sprints with more repetitions are perceived as more enjoyable and lead to greater intentions to engage in SIT.

  6. Planar LTCC transformers for high voltage flyback converters: Part II.

    SciTech Connect

    Schofield, Daryl; Schare, Joshua M., Ph.D.; Slama, George; Abel, David

    2009-02-01

    This paper is a continuation of the work presented in SAND2007-2591 'Planar LTCC Transformers for High Voltage Flyback Converters'. The designs in that SAND report were all based on a ferrite tape/dielectric paste system originally developed by NASCENTechnoloy, Inc, who collaborated in the design and manufacturing of the planar LTCC flyback converters. The output/volume requirements were targeted to DoD application for hard target/mini fuzing at around 1500 V for reasonable primary peak currents. High voltages could be obtained but with considerable higher current. Work had begun on higher voltage systems and is where this report begins. Limits in material properties and processing capabilities show that the state-of-the-art has limited our practical output voltage from such a small part volume. In other words, the technology is currently limited within the allowable funding and interest.

  7. Indoor Air Quality: part II--what it does.

    PubMed

    Pike-Paris, Ann

    2005-01-01

    Newton, MA. A recent report indicated air quality samples taken from several rooms in the town's North High School had elevated CO2 levels of 2,000 parts per million (ppm) (Viser, 2004). State standards set 800 ppm as the optimum reading. Although not an immediate health issue, high CO2 levels are indicative of poor air circulation--clean air comes in but stale air is not vented out. Safety issues arise in the school setting when chemicals or toxic substances are in use and cannot be vented, therefore posing the health risk (Viser, 2004). Poor Indoor Air Quality (IAQ) in schools can result in decreased academic performance and days lost due to illness in the school age population (Environmental Protection Agency [EPA], 2003). As the school nurse at North High School, what would you do?

  8. Theory of edge radiation. Part II: Advanced applications

    NASA Astrophysics Data System (ADS)

    Geloni, Gianluca; Kocharyan, Vitali; Saldin, Evgeni; Schneidmiller, Evgeni; Yurkov, Mikhail

    2009-08-01

    In this paper we exploit a formalism to describe edge radiation, which relies on Fourier optics techniques [G. Geloni, V. Kocharyan, E. Saldin, E. Schneidmiller, M. Yurkov, Theory of edge radiation. Part I: foundations and basic applications, submitted for publication]. First, we apply our method to develop an analytical model to describe edge radiation in the presence of a vacuum chamber. Such model is based on the solution of the field equation with a tensor Green's function technique. In particular, explicit calculations for a circular vacuum chamber are reported. Second, we consider the use of edge radiation as a tool for electron-beam diagnostics. We discuss coherent edge radiation, extraction of edge radiation by a mirror, and other issues becoming important at high electron energy and long radiation wavelength. Based on this work we also study the impact of edge radiation on X-ray Free-Electron Laser (XFEL) setups and we discuss recent results.

  9. Solar box-cooker: Part II-analysis and simulation

    SciTech Connect

    Thulasi Das, T.C. ); Karmakar, S. ); Rao, D.P. )

    1994-03-01

    Based on the model proposed in the companion paper (Part I), a method is outlined simulation of the solar box-cookers loaded with one, two, or four vessels. The relative importance of various heat-exchange rates in the cooker were examined. The effect of parameters such as the thickness and size of the absorber plate, emissivity of the vessel, insulation thickness, and cooking time were studied. Cookers of three sizes were simulated to assess their adequacy in cooking. The studies indicate that the black paint on the vessels could be avoided if weathered stainless steel or aluminum vessels are used. The cooker with inner dimensions of 0.6 x 0.6 x 0.1 m[sup 3] was found to be adequate to cook lunch and dinner on a clear day even in the winter months. Experimental studies carried out to obtain the heat-transfer coefficients, required for simulation, are presented.

  10. Cervical spondylotic myelopathy: Part II: clinical and imaging considerations *

    PubMed Central

    Burns, SH; O’Connor, SM; Mior, SA

    1991-01-01

    In this, the second of a two part series, we continue to review the recent literature pertaining to cervical spondylotic myelopathy (CSM). Caused by the compromise of the spinal canal resulting from the superimposition of spondylotic changes upon a congenitally narrowed canal, CSM has a predictable radiographic and clinical presentation. The clinical presentation frequently includes both upper and lower motor neuron signs and symptoms. Careful analysis of the plain film images usually reveals a spinal canal measuring 12 mm or less. Additional imaging modalities confirm the diagnosis. This paper presents the clinical and imaging characteristics underlying CSM and stresses the importance of including CSM in the differential diagnosis of patients complaining of neck and leg dysfunctions. ImagesFigure 1Figure 2Figure 3Figure 4

  11. Pharmacokinetics, pharmacodynamics, and pharmacogenomics of immunosuppressants in allogeneic hematopoietic cell transplantation: Part II

    PubMed Central

    McCune, Jeannine S.; Bemer, Meagan J.; Long-Boyle, Janel

    2015-01-01

    Part I of this article included a pertinent review of allogeneic hematopoietic cell transplantation (alloHCT), the role of postgraft immunosuppression in alloHCT, and the pharmacokinetics, pharmacodynamics, and pharmacogenomics of the calcineurin inhibitors and methotrexate. In this article, part II, we review the pharmacokinetics, pharmacodynamics, and pharmacogenomics of mycophenolic acid (MPA), sirolimus, and the antithymocyte globulins (ATG). We then discuss target concentration intervention (TCI) of these postgraft immunosuppressants in alloHCT patients, with a focus on current evidence for TCI and on how TCI may improve clinical management in these patients. Currently, TCI using trough concentrations is conducted for sirolimus in alloHCT patients. There are several studies demonstrating that MPA plasma exposure is associated with clinical outcomes, with an increasing number of alloHCT patients needing TCI of MPA. Compared to MPA, there are fewer pharmacokinetic/dynamic studies of rabbit ATG and horse ATG in alloHCT patients. Future pharmacokinetic/dynamic research of postgraft immunosuppressants should include “–omics” based tools: pharmacogenomics may be used to gain an improved understanding of the covariates influencing pharmacokinetics and proteomics and metabolomics as novel methods to elucidate pharmacodynamic responses. PMID:26620047

  12. Pharmacokinetics, Pharmacodynamics, and Pharmacogenomics of Immunosuppressants in Allogeneic Hematopoietic Cell Transplantation: Part II.

    PubMed

    McCune, Jeannine S; Bemer, Meagan J; Long-Boyle, Janel

    2016-05-01

    Part I of this article included a pertinent review of allogeneic hematopoietic cell transplantation (alloHCT), the role of postgraft immunosuppression in alloHCT, and the pharmacokinetics, pharmacodynamics, and pharmacogenomics of the calcineurin inhibitors and methotrexate. In this article (Part II), we review the pharmacokinetics, pharmacodynamics, and pharmacogenomics of mycophenolic acid (MPA), sirolimus, and the antithymocyte globulins (ATG). We then discuss target concentration intervention (TCI) of these postgraft immunosuppressants in alloHCT patients, with a focus on current evidence for TCI and on how TCI may improve clinical management in these patients. Currently, TCI using trough concentrations is conducted for sirolimus in alloHCT patients. Several studies demonstrate that MPA plasma exposure is associated with clinical outcomes, with an increasing number of alloHCT patients needing TCI of MPA. Compared with MPA, there are fewer pharmacokinetic/dynamic studies of rabbit ATG and horse ATG in alloHCT patients. Future pharmacokinetic/dynamic research of postgraft immunosuppressants should include '-omics'-based tools: pharmacogenomics may be used to gain an improved understanding of the covariates influencing pharmacokinetics as well as proteomics and metabolomics as novel methods to elucidate pharmacodynamic responses.

  13. Parts Quality Management: Direct Part Marking of Data Matrix Symbol for Mission Assurance

    NASA Technical Reports Server (NTRS)

    Moss, Chantrice; Chakrabarti, Suman; Scott, David W.

    2013-01-01

    A United States Government Accountability Office (GAO) review of twelve NASA programs found widespread parts quality problems contributing to significant cost overruns, schedule delays, and reduced system reliability. Direct part marking with Data Matrix symbols could significantly improve the quality of inventory control and parts lifecycle management. This paper examines the feasibility of using direct part marking technologies for use in future NASA programs. A structural analysis is based on marked material type, operational environment (e.g., ground, suborbital, Low Earth Orbit), durability of marks, ease of operation, reliability, and affordability. A cost-benefits analysis considers marking technology (label printing, data plates, and direct part marking) and marking types (two-dimensional machine-readable, human-readable). Previous NASA parts marking efforts and historical cost data are accounted for, including inhouse vs. outsourced marking. Some marking methods are still under development. While this paper focuses on NASA programs, results may be applicable to a variety of industrial environments.

  14. Parts quality management: Direct part marking of data matrix symbol for mission assurance

    NASA Astrophysics Data System (ADS)

    Moss, Chantrice; Chakrabarti, Suman; Scott, David W.

    A United States Government Accountability Office (GAO) review of twelve NASA programs found widespread parts quality problems contributing to significant cost overruns, schedule delays, and reduced system reliability. Direct part marking with Data Matrix symbols could significantly improve the quality of inventory control and parts lifecycle management. This paper examines the feasibility of using direct part marking technologies for use in future NASA programs. A structural analysis is based on marked material type, operational environment (e.g., ground, suborbital, Low Earth Orbit), durability of marks, ease of operation, reliability, and affordability. A cost-benefits analysis considers marking technology (label printing, data plates, and direct part marking) and marking types (two-dimensional machine-readable, human-readable). Previous NASA parts marking efforts and historical cost data are accounted for, including in-house vs. outsourced marking. Some marking methods are still under development. While this paper focuses on NASA programs, results may be applicable to a variety of industrial environments.

  15. Operational Control Procedures for the Activated Sludge Process, Part I - Observations, Part II - Control Tests.

    ERIC Educational Resources Information Center

    West, Alfred W.

    This is the first in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. Part I of this document deals with physical observations which should be performed during each routine control test. Part II…

  16. MONGOLS OF THE TWENTIETH CENTURY, PART II. URALIC AND ALTAIC SERIES, VOLUME 37, PART 2.

    ERIC Educational Resources Information Center

    RUPEN, ROBERT A.

    THIS BIBLIOGRAPHY DIRECTLY SUPPLEMENTS AND IS INTENDED AS AN INTEGRAL PART OF "MONGOLS OF THE TWENTIETH CENTURY, PART I." THE RANGE OF SUBJECT MATTER, HOWEVER, GOES FAR BEYOND THE SPECIFIC CONCERNS OF THE FIRST VOLUME, COVERING GENERAL AND SPECIFIC BIBLIOGRAPHIES, UNSIGNED REPORTS AND DOCUMENTS, ENCYCLOPEDIAS, OFFICIAL HISTORIES,…

  17. Expert Recommendations on Treating Psoriasis in Special Circumstances (Part II).

    PubMed

    Carrascosa, J M; Galán, M; de Lucas, R; Pérez-Ferriols, A; Ribera, M; Yanguas, I

    2016-11-01

    There is insufficient information on how best to treat moderate to severe psoriasis in difficult clinical circumstances. We considered 5 areas where there is conflicting or insufficient evidence: pediatric psoriasis, risk of infection in patients being treated with biologics, psoriasis in difficult locations, biologic drug survival, and impact of disease on quality of life. Following discussion of the issues by an expert panel of dermatologists specialized in the management of psoriasis, participants answered a questionnaire survey according to the Delphi method. Consensus was reached on 66 (70.9%) of the 93 items analyzed; the experts agreed with 49 statements and disagreed with 17. It was agreed that body mass index, metabolic comorbidities, and quality of life should be monitored in children with psoriasis. The experts also agreed that the most appropriate systemic treatment for this age group was methotrexate, while the most appropriate biologic treatment was etanercept. Although it was recognized that the available evidence was inconsistent and difficult to extrapolate, the panel agreed that biologic drug survival could be increased by flexible, individualized dosing regimens, continuous treatment, and combination therapies. Finally, consensus was reached on using the Dermatology Quality of Life Index to assess treatment effectiveness and aid decision-making in clinical practice. The structured opinion of experts guides decision-making regarding aspects of clinical practice for which there is incomplete or conflicting information. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Etanercept in spondyloarthopathies. Part II: safety and pharmacoeconomic issues.

    PubMed

    D'Angelo, Salvatore; Palazzi, Carlo; Cantini, Fabrizio; Lubrano, Ennio; Marchesoni, Antonio; Mathieu, Alessandro; Salvarani, Carlo; Scarpa, Raffaele; Spadaro, Antonio; Olivieri, Ignazio

    2011-01-01

    Etanercept (ETN) and other anti-TNF-α agents have revolutionised the management of spondyloarthropathies (SpA). With the increasingly widespread and prolonged use of these drugs an assessment of their long-term safety is extremely important. An additional concern regarding biological agents is their higher costs compared with conventional drugs. We examined safety data regarding ETN from clinical reports, clinical trials, review articles, databases and registries. In addition, evidence was reviewed about the cost effectiveness of ETN in the treatment of patients with SpA. Our review suggests that ETN is well tolerated as long-term, continuous treatment of SpA with a favourable risk-benefit ratio maintained from 4 to 5 years. Diversity in structure and mode of action could explain some differences in the safety profile of ETN with respect to the other anti-TNF agents. In particular, ETN is less immunogenic and is less likely to induce tuberculosis re-activation than the other TNF-α antagonists. Although ETN is considerably more expensive than conventional therapy, it reduces direct and indirect costs associated to SpA by improving disease activity and quality of life. Recent pharmacoeconomic studies have demonstrated its cost-effectiveness in the treatment of SpA.

  19. Lessons from successful micronutrient programs. Part II: program implementation.

    PubMed

    Deitchler, Megan; Mathys, Ellen; Mason, John; Winichagoon, Pattanee; Tuazon, Ma Antonia

    2004-03-01

    National programs for vitamin A supplementation and iodization of the salt supply were launched and sustained with high (but not universal) coverage in most of the countries studied. Iron programs (requiring daily or weekly supplementation, in contrast to vitamin A), which were distributed mainly through antenatal care, had lower coverage and acceptance. Constraints to supplementation were supply, awareness of health staff and communities, and (for vitamin A) insecurity with phasing out of the national immunization days, which have been a major vehicle for distribution. Administration to women postpartum becomes even more important and needs greater coverage. Iodized salt programs have expanded well, with good interagency collaboration and local management, supported by legislation (which may need strengthening); constraints remain in terms of too many salt producers, inadequate quality, import issues, and prices. More integrated, multifaceted programs are needed, with priority to developing and implementing fortification--especially in finding effective ways to iron-fortify rice. Data are lacking, with fewer surveys once programs start, constraining monitoring and program control and adaptation. Nonetheless, interventions appear to have gone to scale remarkably successfully.

  20. A Linear Stochastic Dynamical Model of ENSO. Part II: Analysis.

    NASA Astrophysics Data System (ADS)

    Thompson, C. J.; Battisti, D. S.

    2001-02-01

    In this study the behavior of a linear, intermediate model of ENSO is examined under stochastic forcing. The model was developed in a companion paper (Part I) and is derived from the Zebiak-Cane ENSO model. Four variants of the model are used whose stabilities range from slightly damped to moderately damped. Each model is run as a simulation while being perturbed by noise that is uncorrelated (white) in space and time. The statistics of the model output show the moderately damped models to be more realistic than the slightly damped models. The moderately damped models have power spectra that are quantitatively quite similar to observations, and a seasonal pattern of variance that is qualitatively similar to observations. All models produce ENSOs that are phase locked to the annual cycle, and all display the `spring barrier' characteristic in their autocorrelation patterns, though in the models this `barrier' occurs during the summer and is less intense than in the observations (inclusion of nonlinear effects is shown to partially remedy this deficiency). The more realistic models also show a decadal variability in the lagged autocorrelation pattern that is qualitatively similar to observations.Analysis of the models shows that the greatest part of the variability comes from perturbations that project onto the first singular vector, which then grow rapidly into the ENSO mode. Essentially, the model output represents many instances of the ENSO mode, with random phase and amplitude, stimulated by the noise through the optimal transient growth of the singular vectors.The limit of predictability for each model is calculated and it is shown that the more realistic (moderately damped) models have worse potential predictability (9-15 months) than the deterministic chaotic models that have been studied widely in the literature. The predictability limits are strongly correlated with the stability of the models' ENSO mode-the more highly damped models having much shorter

  1. Practice improvement, part II: update on patient communication technologies.

    PubMed

    Roett, Michelle A; Coleman, Mary Thoesen

    2013-11-01

    Patient portals (ie, secure web-based services for patient health record access) and secure messaging to health care professionals are gaining popularity slowly. Advantages of web portals include timely communication and instruction, access to appointments and other services, and high patient satisfaction. Limitations include inappropriate use, security considerations, organizational costs, and exclusion of patients who are uncomfortable with or unable to use computers. Attention to the organization's strategic plan and office policies, patient and staff expectations, workflow and communication integration, training, marketing, and enrollment can facilitate optimal use of this technology. Other communication technologies that can enhance patient care include automated voice or text reminders and brief electronic communications. Social media provide another method of patient outreach, but privacy and access are concerns. Incorporating telehealthcare (health care provided via telephone or Internet), providing health coaching, and using interactive health communication applications can improve patient knowledge and clinical outcomes and provide social support. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

  2. Imaging of juvenile idiopathic arthritis. Part II: Ultrasonography and MRI

    PubMed Central

    Grochowska, Elżbieta; Gietka, Piotr; Płaza, Mateusz; Pracoń, Grzegorz; Saied, Fadhil; Walentowska-Janowicz, Marta

    2016-01-01

    Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals in the developmental age. Radiography, which was described in the first part of this publication, is the standard modality in the assessment of this condition. Ultrasound and magnetic resonance imaging enable early detection of the disease which affects soft tissues, as well as bones. Ultrasound assessment involves: joint cavities, tendon sheaths and bursae for the presence of synovitis, intraand extraarticular fat tissue to visualize signs of inflammation, hyaline cartilage, cartilaginous epiphysis and subchondral bone to detect cysts and erosions, and ligaments, tendons and their entheses for signs of enthesopathies and tendinopathies. Magnetic resonance imaging is indicated in children with juvenile idiopathic arthritis for assessment of inflammation in peripheral joints, tendon sheaths and bursae, bone marrow involvement and identification of inflammatory lesions in whole-body MRI, particularly when the clinical picture is unclear. Also, MRI of the spine and spinal cord is used in order to diagnose synovial joint inflammation, bone marrow edema and spondylodiscitis as well as to assess their activity, location, and complications (spinal canal stenosis, subluxation, e.g. in the atlantoaxial region). This article discusses typical pathological changes seen on ultrasound and magnetic resonance imaging. The role of these two methods for disease monitoring, its identification in the pre-clinical stage and establishing its remission are also highlighted. PMID:27679727

  3. Eponyms in cardiothoracic radiology--part II: vascular.

    PubMed

    Mohammed, Tan-Lucien H; Saettele, Megan R; Saettele, Timothy; Patel, Vikas; Kanne, Jeffrey P

    2014-01-01

    Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this second part of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary vasculature, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake.

  4. Simulation of Slag Freeze Layer Formation: Part II: Numerical Model

    NASA Astrophysics Data System (ADS)

    Guevara, Fernando J.; Irons, Gordon A.

    2011-08-01

    The experiments from Part I with CaCl2-H2O solidification in a differentially heated, square cavity were simulated in two dimensions using a control volume technique in a fixed grid. The test conditions and physical properties of the fluid resulted in Prandtl and Rayleigh numbers in the range of 50 and 2.1 × 108, respectively, and the solidification was observed to be planar with dispersed solid particles. In the mathematical model, temperature-dependent viscosity and density functions were employed. To suppress velocities in the solid phase, various models were tested, and a high effective viscosity was found most appropriate. The results compare well with the experiments in terms of solid layer growth, horizontal and vertical velocities, heat transfer coefficients, and temperature distributions. Hydrodynamic boundary layers on the solidified front and on the hot vertical wall tend to be nonsymmetric, as well on the top and bottom adiabatic walls. The high viscosity value imposed on the two-phase zone affects the velocity profile close to the solid front and modifies the heat transfer rate.

  5. Medicine at the crossroads. Part II. Summary of completed project

    SciTech Connect

    1998-05-01

    Medicine at the crossroads (a.k.a. The Future of Medicine) is an 8-part series of one-hour documentaries which examines the scientific and social forces that have shaped the practice of medicine around the world. The series was developed and produced over a five-year period and in eleven countries. Among the major issues examined in the series are the education of medical practitioners and the communication of medical issues. The series also considers the dilemmas of modern medicine, including the treatment of the elderly and the dying, the myth of the quick fix in the face of chronic and incurable diseases such as HIV, and the far-reaching implications of genetic treatments. Finally, the series examines the global progress made in medical research and application, as well as the questions remaining to be answered. These include not only scientific treatment, but accessibility and other critical topics affecting the overall success of medical advances. Medicine at the crossroads is a co-production of Thirteen/WNET and BBC-TV in association with Television Espafiola SA (RTVE) and the Australian Broadcasting Corporation. Stefan Moore of Thirteen/WNET and Martin Freeth of BBC-TV are series producers. George Page is executive in charge of medicine at the crossroads. A list of scholarly advisors and a program synopses is attached.

  6. Malaria in rural Mozambique. Part II: children admitted to hospital.

    PubMed

    Bassat, Quique; Guinovart, Caterina; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

    2008-02-26

    Characterization of severe malaria cases on arrival to hospital may lead to early recognition and improved management. Minimum community based-incidence rates (MCBIRs) complement hospital data, describing the malaria burden in the community. A retrospective analysis of all admitted malaria cases to a Mozambican rural hospital between June 2003 and May 2005 was conducted. Prevalence and case fatality rates (CFR) for each sign and symptom were calculated. Logistic regression was used to identify variables which were independent risk factors for death. MCBIRs for malaria and severe malaria were calculated using data from the Demographic Surveillance System. Almost half of the 8,311 patients admitted during the study period had malaria and 13,2% had severe malaria. Children under two years accounted for almost 60% of all malaria cases. CFR for malaria was 1.6% and for severe malaria 4.4%. Almost 19% of all paediatric hospital deaths were due to malaria. Prostration (55.0%), respiratory distress (41.1%) and severe anaemia (17.3%) were the most prevalent signs among severe malaria cases. Severe anaemia and inability to look for mother's breast were independent risk factors for death in infants younger than eight months. For children aged eight months to four years, the risk factors were malnutrition, hypoglycaemia, chest indrawing, inability to sit and a history of vomiting.MCBIRs for severe malaria cases were highest in children aged six months to two years of age. MCBIRs for severe malaria per 1,000 child years at risk for the whole study period were 27 in infants, 23 in children aged 1 to <5 years and two in children aged > or =5 years. Malaria remains the number one cause of admission in this area of rural Mozambique, predominantly affecting young children, which are also at higher risk of dying. Measures envisaged to protect children during their first two years of life are likely to have a greater impact than at any other age.

  7. Research Summary No. 36-3, Volume I, Part II. Volume I, Part Two

    NASA Technical Reports Server (NTRS)

    1960-01-01

    The Research Summary is a bimonthly report of supporting research and development conducted at the Jet Propulsion Laboratory. This periodical is issued in three volumes. Volume I contains summaries of the work accomplished by the Space Sciences, Systems, Guidance and Control, and Telecommunications Divisions of the Laboratory. Volume II contains summaries of the work accomplished by the Physical Sciences, Engineering Mechanics, Engineering Facilities, and Propulsion Divisions. All work of a classified nature is contained in Volume Ill.

  8. Studies in Enrollment Trends and Patterns. Part II--Summer Quarter: 1940-1964.

    ERIC Educational Resources Information Center

    Schmid, Calvin F.; Watson, F. Jean

    This is the second part of a report on major facets of institutional change at the University of Washington. Part II is a detailed analysis of Summer Quarter students and covers: class differentials in enrollment trends; trends in undergraduate students by major field and college; trends in graduate and professional students by major field and…

  9. Medical Education: Barefoot Doctors, Health Care, Health Education, Nursing Education, Pharmacy Education, Part II.

    ERIC Educational Resources Information Center

    Parker, Franklin

    1987-01-01

    This is Part II of a two-part annotated bibliography of selected references on medical education in the People's Republic of China. The references date from 1913 to 1982. Most of the references are from the 1960's and 1970's. (RH)

  10. An Occupation and Participation Approach to Reading Intervention (OPARI) Part II: Pilot Clinical Application

    ERIC Educational Resources Information Center

    Grajo, Lenin C.; Candler, Catherine

    2016-01-01

    The Occupation and Participation Approach to Reading Intervention (OPARI) is an intervention approach for children with reading difficulties that emphasizes reading as an important occupation of children. Part I presented the theoretical basis of the OPARI. Part II describes a pilot clinical application of the OPARI. Guided by Schkade and…

  11. An Occupation and Participation Approach to Reading Intervention (OPARI) Part II: Pilot Clinical Application

    ERIC Educational Resources Information Center

    Grajo, Lenin C.; Candler, Catherine

    2016-01-01

    The Occupation and Participation Approach to Reading Intervention (OPARI) is an intervention approach for children with reading difficulties that emphasizes reading as an important occupation of children. Part I presented the theoretical basis of the OPARI. Part II describes a pilot clinical application of the OPARI. Guided by Schkade and…

  12. Why does Bangladesh remain so poor? Part II: eight answers.

    PubMed

    Maloney, C

    1985-01-01

    Bangladeshis of varying background all over the country were asked why they think poverty persists to such an extent in Bangladesh. Their answers provide a new perspective on the situation. The initial response often blames outside and natural causes -- floods, droughts, lack of resources, low demand for the country's exports, or historic exploitation. It is true that Bangladesh has virtually no mineral resources except gas. Yet, the soil, water, and human labor add up to a huge potential. The Third Five Year Plan emphasizes use of the soil, irrigation, tanks, rivers, and human labor. These provide the only hope for reducing poverty a little during the next 5 years. Bangladeshis as well as foreign observers most commonly cite overpopulation as the cause of poverty. Population growth is a cause of present poverty in Bangladesh but is not the only cause of poverty. The Third Five Year Plan goal to reduce annual growth to 1.8% is ambitious, but even if it is achieved the population will double in a few decades. As it would most likely be impossible for Bangladesh to support such numbers and maintain political and economic stability, such growth will have to be prevented. Poverty in Bangladesh is party a result of the long history of low urbanization, weak institutions, spotty and inadequate physical infrastructure, and insufficient entrapreneurship. Other reasons cited as causes of persisting poverty include illiteracy, idleness, class exploitation, the selfishness of individuals, and a lack of trust among people. All of the efforts of the poor themselves, various agencies, and the government, as examined in the 1st part of this discussion, fail to indicate any reason to hope that poverty in Bangladesh can be dramatically reduced any time soon. The Third Five Year Plan foresees a possible reduction of the number of those in poverty by 10%. According to the Plan itself, those in or near poverty comprise 85% of the people. The conditions under which the people of some

  13. Is extreme learning machine feasible? A theoretical assessment (part II).

    PubMed

    Lin, Shaobo; Liu, Xia; Fang, Jian; Xu, Zongben

    2015-01-01

    An extreme learning machine (ELM) can be regarded as a two-stage feed-forward neural network (FNN) learning system that randomly assigns the connections with and within hidden neurons in the first stage and tunes the connections with output neurons in the second stage. Therefore, ELM training is essentially a linear learning problem, which significantly reduces the computational burden. Numerous applications show that such a computation burden reduction does not degrade the generalization capability. It has, however, been open that whether this is true in theory. The aim of this paper is to study the theoretical feasibility of ELM by analyzing the pros and cons of ELM. In the previous part of this topic, we pointed out that via appropriately selected activation functions, ELM does not degrade the generalization capability in the sense of expectation. In this paper, we launch the study in a different direction and show that the randomness of ELM also leads to certain negative consequences. On one hand, we find that the randomness causes an additional uncertainty problem of ELM, both in approximation and learning. On the other hand, we theoretically justify that there also exist activation functions such that the corresponding ELM degrades the generalization capability. In particular, we prove that the generalization capability of ELM with Gaussian kernel is essentially worse than that of FNN with Gaussian kernel. To facilitate the use of ELM, we also provide a remedy to such a degradation. We find that the well-developed coefficient regularization technique can essentially improve the generalization capability. The obtained results reveal the essential characteristic of ELM in a certain sense and give theoretical guidance concerning how to use ELM.

  14. Neuromorphic meets neuromechanics, part II: the role of fusimotor drive

    NASA Astrophysics Data System (ADS)

    Jalaleddini, Kian; Minos Niu, Chuanxin; Chakravarthi Raja, Suraj; Sohn, Won Joon; Loeb, Gerald E.; Sanger, Terence D.; Valero-Cuevas, Francisco J.

    2017-04-01

    Objective. We studied the fundamentals of muscle afferentation by building a Neuro-mechano-morphic system actuating a cadaveric finger. This system is a faithful implementation of the stretch reflex circuitry. It allowed the systematic exploration of the effects of different fusimotor drives to the muscle spindle on the closed-loop stretch reflex response. Approach. As in Part I of this work, sensory neurons conveyed proprioceptive information from muscle spindles (with static and dynamic fusimotor drive) to populations of α-motor neurons (with recruitment and rate coding properties). The motor commands were transformed into tendon forces by a Hill-type muscle model (with activation-contraction dynamics) via brushless DC motors. Two independent afferented muscles emulated the forces of flexor digitorum profundus and the extensor indicis proprius muscles, forming an antagonist pair at the metacarpophalangeal joint of a cadaveric index finger. We measured the physical response to repetitions of bi-directional ramp-and-hold rotational perturbations for 81 combinations of static and dynamic fusimotor drives, across four ramp velocities, and three levels of constant cortical drive to the α-motor neuron pool. Main results. We found that this system produced responses compatible with the physiological literature. Fusimotor and cortical drives had nonlinear effects on the reflex forces. In particular, only cortical drive affected the sensitivity of reflex forces to static fusimotor drive. In contrast, both static fusimotor and cortical drives reduced the sensitivity to dynamic fusimotor drive. Interestingly, realistic signal-dependent motor noise emerged naturally in our system without having been explicitly modeled. Significance. We demonstrate that these fundamental features of spinal afferentation sufficed to produce muscle function. As such, our Neuro-mechano-morphic system is a viable platform to study the spinal mechanisms for healthy muscle function—and its

  15. Fundamentals of Trapped Ion Mobility Spectrometry Part II: Fluid Dynamics

    NASA Astrophysics Data System (ADS)

    Silveira, Joshua A.; Michelmann, Karsten; Ridgeway, Mark E.; Park, Melvin A.

    2016-04-01

    Trapped ion mobility spectrometry (TIMS) is a new high resolution (R up to ~300) separation technique that utilizes an electric field to hold ions stationary against a moving gas. Recently, an analytical model for TIMS was derived and, in part, experimentally verified. A central, but not yet fully explored, component of the model involves the fluid dynamics at work. The present study characterizes the fluid dynamics in TIMS using simulations and ion mobility experiments. Results indicate that subsonic laminar flow develops in the analyzer, with pressure-dependent gas velocities between ~120 and 170 m/s measured at the position of ion elution. One of the key philosophical questions addressed is: how can mobility be measured in a dynamic system wherein the gas is expanding and its velocity is changing? We noted previously that the analytically useful work is primarily done on ions as they traverse the electric field gradient plateau in the analyzer. In the present work, we show that the position-dependent change in gas velocity on the plateau is balanced by a change in pressure and temperature, ultimately resulting in near position-independent drag force. That the drag force, and related variables, are nearly constant allows for the use of relatively simple equations to describe TIMS behavior. Nonetheless, we derive a more comprehensive model, which accounts for the spatial dependence of the flow variables. Experimental resolving power trends were found to be in close agreement with the theoretical dependence of the drag force, thus validating another principal component of TIMS theory.

  16. Stress analysis in oral obturator prostheses, part II: photoelastic imaging

    NASA Astrophysics Data System (ADS)

    Pesqueira, Aldiéris Alves; Goiato, Marcelo Coelho; da Silva, Emily Vivianne Freitas; Haddad, Marcela Filié; Moreno, Amália; Zahoui, Abbas; dos Santos, Daniela Micheline

    2014-06-01

    In part I of the study, two attachment systems [O-ring; bar-clip (BC)] were used, and the system with three individualized O-rings provided the lowest stress on the implants and the support tissues. Therefore, the aim of this study was to assess the stress distribution, through the photoelastic method, on implant-retained palatal obturator prostheses associated with different attachment systems: BOC-splinted implants with a bar connected to two centrally placed O-rings, and BOD-splinted implants with a BC connected to two distally placed O-rings (cantilever). One photoelastic model of the maxilla with oral-sinus-nasal communication with three parallel implants was fabricated. Afterward, two implant-retained palatal obturator prostheses with the two attachment systems described above were constructed. Each assembly was positioned in a circular polariscope and a 100-N axial load was applied in three different regions with implants by using a universal testing machine. The results were obtained through photograph record analysis of stress. The BOD system exhibited the highest stress concentration, followed by the BOC system. The O-ring, centrally placed on the bar, allows higher mobility of the prostheses and homogeneously distributes the stress to the region of the alveolar ridge and implants. It can be concluded that the use of implants with O-rings, isolated or connected with a bar, to rehabilitate maxillectomized patients allows higher prosthesis mobility and homogeneously distributes the stress to the alveolar ridge region, which may result in greater chewing stress distribution to implants and bone tissue. The clinical implication of the augmented bone support loss after maxillectomy is the increase of stress in the attachment systems and, consequently, a higher tendency for displacement of the prosthesis.

  17. Surface grafted chitosan gels. Part II. Gel formation and characterization.

    PubMed

    Liu, Chao; Thormann, Esben; Claesson, Per M; Tyrode, Eric

    2014-07-29

    Responsive biomaterial hydrogels attract significant attention due to their biocompatibility and degradability. In order to make chitosan based gels, we first graft one layer of chitosan to silica, and then build a chitosan/poly(acrylic acid) multilayer using the layer-by-layer approach. After cross-linking the chitosan present in the polyelectrolyte multilayer, poly(acrylic acid) is partly removed by exposing the multilayer structure to a concentrated carbonate buffer solution at a high pH, leaving a surface-grafted cross-linked gel. Chemical cross-linking enhances the gel stability against detachment and decomposition. The chemical reaction between gluteraldehyde, the cross-linking agent, and chitosan was followed in situ using total internal reflection Raman (TIRR) spectroscopy, which provided a molecular insight into the complex reaction mechanism, as well as the means to quantify the cross-linking density. The amount of poly(acrylic acid) trapped inside the surface grafted films was found to decrease with decreasing cross-linking density, as confirmed in situ using TIRR, and ex situ by Fourier transform infrared (FTIR) measurements on dried films. The responsiveness of the chitosan-based gels with respect to pH changes was probed by quartz crystal microbalance with dissipation (QCM-D) and TIRR. Highly cross-linked gels show a small and fully reversible behavior when the solution pH is switched between pH 2.7 and 5.7. In contrast, low cross-linked gels are more responsive to pH changes, but the response is fully reversible only after the first exposure to the acidic solution, once an internal restructuring of the gel has taken place. Two distinct pKa's for both chitosan and poly(acrylic acid), were determined for the cross-linked structure using TIRR. They are associated with populations of chargeable groups displaying either a bulk like dissociation behavior or forming ionic complexes inside the hydrogel film.

  18. Fundamentals of Trapped Ion Mobility Spectrometry Part II: Fluid Dynamics.

    PubMed

    Silveira, Joshua A; Michelmann, Karsten; Ridgeway, Mark E; Park, Melvin A

    2016-04-01

    Trapped ion mobility spectrometry (TIMS) is a new high resolution (R up to ~300) separation technique that utilizes an electric field to hold ions stationary against a moving gas. Recently, an analytical model for TIMS was derived and, in part, experimentally verified. A central, but not yet fully explored, component of the model involves the fluid dynamics at work. The present study characterizes the fluid dynamics in TIMS using simulations and ion mobility experiments. Results indicate that subsonic laminar flow develops in the analyzer, with pressure-dependent gas velocities between ~120 and 170 m/s measured at the position of ion elution. One of the key philosophical questions addressed is: how can mobility be measured in a dynamic system wherein the gas is expanding and its velocity is changing? We noted previously that the analytically useful work is primarily done on ions as they traverse the electric field gradient plateau in the analyzer. In the present work, we show that the position-dependent change in gas velocity on the plateau is balanced by a change in pressure and temperature, ultimately resulting in near position-independent drag force. That the drag force, and related variables, are nearly constant allows for the use of relatively simple equations to describe TIMS behavior. Nonetheless, we derive a more comprehensive model, which accounts for the spatial dependence of the flow variables. Experimental resolving power trends were found to be in close agreement with the theoretical dependence of the drag force, thus validating another principal component of TIMS theory.

  19. Overactive bladder – 18 years – Part II

    PubMed Central

    Truzzi, Jose Carlos; Gomes, Cristiano Mendes; Bezerra, Carlos A.; Plata, Ivan Mauricio; Campos, Jose; Garrido, Gustavo Luis; Almeida, Fernando G.; Averbeck, Marcio Augusto; Fornari, Alexandre; Salazar, Anibal; Dell’Oro, Arturo; Cintra, Caio; Sacomani, Carlos Alberto Ricetto; Tapia, Juan Pablo; Brambila, Eduardo; Longo, Emilio Miguel; Rocha, Flavio Trigo; Coutinho, Francisco; Favre, Gabriel; Garcia, José Antonio; Castaño, Juan; Reyes, Miguel; Leyton, Rodrigo Eugenio; Ferreira, Ruiter Silva; Duran, Sergio; López, Vanda; Reges, Ricardo

    2016-01-01

    ABSTRACT Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics – pillars of the overactive bladder pharmacotherapy – started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning – as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder – 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder. PMID:27176185

  20. The intra-uterine device. Part II: technical problems.

    PubMed

    Alexander, I

    1980-10-01

    In discussing the technical problems associated with the IUD, focus is on the basic insertion technique, the technique to use with the various IUDs (Copper 7, Lippes Loop, Copper T models, the Saf-T-coil, and the multiload 250), the timing of the insertion, and removal of the IUD. Bimanual examination of the pelvis must be performed before an IUD is inserted. Prior to starting the insertion, the patient should be given an explanation of what is to be done. As patients are unfamiliar with the appearance of most of the instruments, it is advisable to keep them from view. Having visualized the cervix and fixed the blades of the Cusco speculum in the open position, the cervix can be seized with a single toothed tenaculum or 7 inch Allis forceps. It is generally necessary to steady the cervix with a forcep as it straightens out the canal and uterine flexion. Sounding the uterine cavity will reveal its length and confirm any angulation. On occasion it is impossible to sound the cavity because the internal os is too tight or the endocervical canal has a pinhole external os. Force should be avoided. High fundal placement without perforating the uterus is the objective when inserting any IUD, and this is particularly important with the copper IUDs which depend on a close association of their copper elements to the endometrium. Generally, it is easier to insert a coil towards the end of the period when the cervix is partly dilated and any bleeding that occurs is masked. Insertion following abortion is commonly performed, and encouraging results have been achieved with insertions immediately postpartum. Removal can be done at any time.

  1. The Financial Aid Office's Role in Enrollment Management: Part 2

    ERIC Educational Resources Information Center

    McGhee, Kenneth

    2016-01-01

    Student retention is an important part of a strategic enrollment management plan. Many scholars have written about the challenges of helping students not only enroll in college but also complete their degree programs. Among students pursuing a doctoral degree in higher education administration, student retention is a popular topic. Many doctoral…

  2. The Financial Aid Office's Role in Enrollment Management: Part 2

    ERIC Educational Resources Information Center

    McGhee, Kenneth

    2016-01-01

    Student retention is an important part of a strategic enrollment management plan. Many scholars have written about the challenges of helping students not only enroll in college but also complete their degree programs. Among students pursuing a doctoral degree in higher education administration, student retention is a popular topic. Many doctoral…

  3. Vaccine cold chain: Part 2. Training personnel and program management.

    PubMed

    Rogers, Bonnie; Dennison, Kim; Adepoju, Nikki; Dowd, Shelia; Uedoi, Kenneth

    2010-09-01

    The Centers for Disease Control and Prevention reports that professionals in clinic settings may not be adequately storing and handling vaccine, leading to insufficient immunity of vaccinated individuals. Part 2 of this article provides information about the importance of adequate personnel training and program management policies and procedures needed to implement and maintain an effective vaccine cold chain program.

  4. Part I: Microscopic description of liquid He II. Part II: Uniformly approximated WKB method as used for the calculation of phase shifts in heavy-ion collision problems

    SciTech Connect

    Suebka, P.

    1984-01-01

    In Part I, the excitation spectrum of liquid He II is obtained using the two-body potential consists of a hardcore potential plus an outside attractive potential. The sum of two gaussian potential of Khanna and Das which is similar to the Lennard-Jones potential is chosen as the attractive potential. The t-matrix method due to Brueckner and Sawada is adopted with modifications to replace the interaction potential. The spectrum gives the phonon branch and the roton dip which resemble the excitation spectrum for liquid He II. The temperature dependence of the excitation spectrum enters into calculation through the zero-momentum state occupation number. A better approximation of thermodynamic functions is obtained by extending Landau's theory to the situation where the excitation is a function of temperature as well as of momentum. Our thermodynamic calculations also bear qualitative agreement with measurements on He II as expected.

  5. Malaria in rural Mozambique. Part II: children admitted to hospital

    PubMed Central

    Bassat, Quique; Guinovart, Caterina; Sigaúque, Betuel; Aide, Pedro; Sacarlal, Jahit; Nhampossa, Tacilta; Bardají, Azucena; Nhacolo, Ariel; Macete, Eusébio; Mandomando, Inácio; Aponte, John J; Menéndez, Clara; Alonso, Pedro L

    2008-01-01

    Background Characterization of severe malaria cases on arrival to hospital may lead to early recognition and improved management. Minimum community based-incidence rates (MCBIRs) complement hospital data, describing the malaria burden in the community. Methods A retrospective analysis of all admitted malaria cases to a Mozambican rural hospital between June 2003 and May 2005 was conducted. Prevalence and case fatality rates (CFR) for each sign and symptom were calculated. Logistic regression was used to identify variables which were independent risk factors for death. MCBIRs for malaria and severe malaria were calculated using data from the Demographic Surveillance System. Results Almost half of the 8,311 patients admitted during the study period had malaria and 13,2% had severe malaria. Children under two years accounted for almost 60% of all malaria cases. CFR for malaria was 1.6% and for severe malaria 4.4%. Almost 19% of all paediatric hospital deaths were due to malaria. Prostration (55.0%), respiratory distress (41.1%) and severe anaemia (17.3%) were the most prevalent signs among severe malaria cases. Severe anaemia and inability to look for mother's breast were independent risk factors for death in infants younger than eight months. For children aged eight months to four years, the risk factors were malnutrition, hypoglycaemia, chest indrawing, inability to sit and a history of vomiting. MCBIRs for severe malaria cases were highest in children aged six months to two years of age. MCBIRs for severe malaria per 1,000 child years at risk for the whole study period were 27 in infants, 23 in children aged 1 to <5 years and two in children aged ≥5 years. Conclusion Malaria remains the number one cause of admission in this area of rural Mozambique, predominantly affecting young children, which are also at higher risk of dying. Measures envisaged to protect children during their first two years of life are likely to have a greater impact than at any other age

  6. Managing alcohol related aggression in the emergency department (Part II).

    PubMed

    Cork, Alison; Ferns, Terry

    2008-04-01

    Violence in the emergency department (ED) is a global problem. In our first paper, we highlighted the potential psychological effects of alcohol intoxication, the literatures discussion of alcohol related violence in the emergency department and the importance of developing positive nurse/service user relationships. In this second paper, we discuss personal and organisational strategies clinical nursing staff may consider appropriate to minimise the risk of assault when caring for service users projecting alcohol related aggression.

  7. Managing a Special Library. Parts I and II.

    ERIC Educational Resources Information Center

    Labovitz, Judy; Swanigan, Meryl

    1985-01-01

    Various concepts from "In Search of Excellence" are described in context of authors' personal styles. Discussions address thinking in terms of options, using statistics, learning value of corporate politics, a bias toward action, productivity through people, the "lean-machine" concept, staying close to client, entrepreneurship…

  8. Medical Malpractice in Dermatology-Part II: What To Do Once You Have Been Served with a Lawsuit.

    PubMed

    Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

    2016-12-01

    Facing a malpractice lawsuit can be a daunting and traumatic experience for healthcare practitioners, with most clinicians naïve to the legal landscape. It is crucial for physicians to know and understand the malpractice system and his or her role once challenged with litigation. We present part II of a two-part series addressing the most common medicolegal questions that cause a great deal of anxiety. Part I focused upon risk-management strategies and prevention of malpractice lawsuits, whereas part II provides helpful suggestions and guidance for the physician who has been served with a lawsuit complaint. Herein, we address the best approach concerning what to do and what not to do after receipt of a legal claim, during the deposition, and during the trial phases. We also discuss routine concerns that may arise during the development of the case, including the personal, financial, and career implications of a malpractice lawsuit and how these can be best managed. The defense strategies discussed in this paper are not a guide separate from legal representation to winning a lawsuit, but may help physicians prepare for and cope with a medical malpractice lawsuit. This article is written from a US perspective, and therefore not all of the statements made herein will be applicable in other countries. Within the USA, medical practitioners must be familiar with their own state and local laws and should consult with their own legal counsel to obtain advice about specific questions.

  9. Sorption modelling on illite. Part II: Actinide sorption and linear free energy relationships

    NASA Astrophysics Data System (ADS)

    Bradbury, M. H.; Baeyens, B.

    2009-02-01

    Sorption edge data for Ni(II), Co(II), Eu(III) and Sn(IV) [Bradbury M. H. and Baeyens B. (2009) Sorption modelling on illite. Part I: titration measurements and sorption of Ni(II), Co(II), Eu(III) and Sn(IV), Part I] on purified Na-Illite du Puy are available from some previous work, and some new measurements for Am(III), Th(IV), Pa(V) and U(VI) are presented here. All of these sorption edge measurements have been modelled with a 2 site protolysis non-electrostatic surface complexation and cation exchange (2SPNE SC/CE) sorption model for which the site types, site capacities and protolysis constants were fixed [Bradbury M. H. and Baeyens B. (2009), Part I]. In addition, two further data sets for the sorption of Am(III) and Np(V) on Illite du Puy, obtained from the literature, were also modelled in this work. Thus, surface complexation constants for the strong sites in the 2SPNE SC/CE sorption model for nine metals with valence states from II to VI have been obtained. A linear relationship between the logarithm of strong site metal binding constants, SK x-1, and the logarithm of the corresponding aqueous hydrolysis stability constant, OHK x, extending over nearly 35 orders of magnitude is established here for illite for these nine metals. Such correlations are often termed linear free energy relationships (LFER), and although they are quite common in aqueous phase chemistry, they are much less so in surface chemistry, especially over this large range. The LFER for illite could be described by the equation: logSK=7.9±0.4+(0.83±0.02)logOHKx where, " x" is an integer. A similar relationship has been previously obtained for montmorillonite, thus LFERs relating to the sorption on two of the most important clay minerals present in natural systems have been established. Such an LFER approach is an extremely useful tool for estimating surface complexation constants for metals in a chemically consistent manner. It provides a means of obtaining sorption values for

  10. PROBABILITY BASED CORROSION CONTROL FOR WASTE TANKS - PART II

    SciTech Connect

    Hoffman, E.; Edwards, T.

    2010-12-09

    As part of an ongoing study to evaluate the discontinuity in the corrosion controls at the SRS tank farm, a study was conducted this year to assess the minimum concentrations below 1 molar nitrate, see Figure 1. Current controls on the tank farm solution chemistry are in place to prevent the initiation and propagation of pitting and stress corrosion cracking in the primary steel waste tanks. The controls are based upon a series of experiments performed with simulated solutions on materials used for construction of the tanks, namely ASTM A537 carbon steel (A537). During FY09, an experimental program was undertaken to investigate the risk associated with reducing the minimum molar nitrite concentration required to confidently inhibit pitting in dilute solutions (i.e., less than 1 molar nitrate). The experimental results and conclusions herein provide a statistical basis to quantify the probability of pitting for the tank wall exposed to various solutions with dilute concentrations of nitrate and nitrite. Understanding the probability for pitting will allow the facility to make tank-specific risk-based decisions for chemistry control. Based on previous electrochemical testing, a statistical test matrix was developed to refine and solidify the application of the statistical mixture/amount model to corrosion of A537 steel. A mixture/amount model was identified based on statistical analysis of recent and historically collected electrochemical data. This model provides a more complex relationship between the nitrate and nitrite concentrations and the probability of pitting than is represented by the model underlying the current chemistry control program, and its use may provide a technical basis for the utilization of less nitrite to inhibit pitting at concentrations below 1 molar nitrate. FY09 results fit within the mixture/amount model, and further refine the nitrate regime in which the model is applicable. The combination of visual observations and cyclic

  11. Nurse staffing in a decentralized organization: part II.

    PubMed

    Althaus, J N; Hardyck, N M; Pierce, P B; Rodgers, M S

    1982-04-01

    It must be emphasized that none of the steps described in this planning process emerged overnight. Rather, they were achieved through a process of evolution, sometimes through trial and error, and always with consultation and participation by many members of the hospital nursing staff. Participation by many in the process of planning for a workable staffing system has been essential to its success. Indeed, creative scheduling by the head nurse is possible because of the way in which the system has been organized. The fact that head nurses are responsible for staffing their own units makes it infinitely easier for them to see what they need to make their units operate effectively and efficiently. Creative scheduling includes the possibility of arranging nurses' hours outside the rigid three-shift schedule used by so many hospitals. Many El Camino nurses now report for work at different hours. In addition, the use of flexible work weeks has proven valuable. Some head nurses now allow for a ten-hour, four-day work week; in emergency staffing situations there have, on occasion, been twelve-hour days. Even as this system evolves, it faces change. Just as the requirements for staff cannot be rigid, so must problem solving be flexible and constantly under review. The fact that El Camino believes in constant monitoring of its system is essential to its success. A key philosophical foundation of decentralization is that it must be subject to change. This is no less true in staffing than in other parts of the decentralization structure. By agreeing that change is constant and necessary and that participation is required at all levels of the staffing planning process, we have constructed the outlines of a system that will work in the future as well as it does in the present. Our system centers around the head nurses. It involves their planning; thus it also involves the support of those members of the nursing staff who can provide essential information. But the decisions

  12. Cardiovascular magnetic resonance physics for clinicians: part II

    PubMed Central

    2012-01-01

    This is the second of two reviews that is intended to cover the essential aspects of cardiovascular magnetic resonance (CMR) physics in a way that is understandable and relevant to clinicians using CMR in their daily practice. Starting with the basic pulse sequences and contrast mechanisms described in part I, it briefly discusses further approaches to accelerate image acquisition. It then continues by showing in detail how the contrast behaviour of black blood fast spin echo and bright blood cine gradient echo techniques can be modified by adding rf preparation pulses to derive a number of more specialised pulse sequences. The simplest examples described include T2-weighted oedema imaging, fat suppression and myocardial tagging cine pulse sequences. Two further important derivatives of the gradient echo pulse sequence, obtained by adding preparation pulses, are used in combination with the administration of a gadolinium-based contrast agent for myocardial perfusion imaging and the assessment of myocardial tissue viability using a late gadolinium enhancement (LGE) technique. These two imaging techniques are discussed in more detail, outlining the basic principles of each pulse sequence, the practical steps required to achieve the best results in a clinical setting and, in the case of perfusion, explaining some of the factors that influence current approaches to perfusion image analysis. The key principles of contrast-enhanced magnetic resonance angiography (CE-MRA) are also explained in detail, especially focusing on timing of the acquisition following contrast agent bolus administration, and current approaches to achieving time resolved MRA. Alternative MRA techniques that do not require the use of an endogenous contrast agent are summarised, and the specialised pulse sequence used to image the coronary arteries, using respiratory navigator gating, is described in detail. The article concludes by explaining the principle behind phase contrast imaging techniques

  13. Utilization management in radiology, part 2: perspectives and future directions.

    PubMed

    Duszak, Richard; Berlin, Jonathan W

    2012-10-01

    Increased utilization of medical imaging in the early part of the last decade has resulted in numerous efforts to reduce associated spending. Recent initiatives have focused on managing utilization with radiology benefits managers and real-time order entry decision support systems. Although these approaches might seem mutually exclusive and their application to radiology appears unique, the historical convergence and broad acceptance of both programs within the pharmacy sector may offer parallels for their potential future in medical imaging. In this second installment of a two-part series, anticipated trends in radiology utilization management are reviewed. Perspectives on current and future potential roles of radiologists in such initiatives are discussed, particularly in light of emerging physician payment models.

  14. Parts Quality Management: Direct Part Marking via Data Matrix Symbols for Mission Assurance

    NASA Technical Reports Server (NTRS)

    Moss, Chantrice

    2013-01-01

    A United States Government Accountability Office (GAO) review of twelve NASA programs found widespread parts quality problems contributing to significant cost overruns, schedule delays, and reduced system reliability. Direct part-marking with Data Matrix symbols could significantly improve the quality of inventory control and parts lifecycle management. This paper examines the feasibility of using 15 marking technologies for use in future NASA programs. A structural analysis is based on marked material type, operational environment (e.g., ground, suborbital, orbital), durability of marks, ease of operation, reliability, and affordability. A cost-benefits analysis considers marking technology (data plates, label printing, direct part marking) and marking types (two-dimensional machine-readable, human-readable). Previous NASA parts marking efforts and historical cost data are accounted for, including in-house vs. outsourced marking. Some marking methods are still under development. While this paper focuses on NASA programs, results may be applicable to a variety of industrial environments.

  15. Guidelines for clinical engineering programs--Part I: guidelines for electrical isolation; Part II: performance evaluation of clinical engineering programs.

    PubMed

    Ridgway, M

    1980-01-01

    This series presents guidelines for: electrically isolated inputs and outputs; measuring the performance of hospital biomedical engineering programs; evaluating the risk of electric shock in hospitals; and for isolated power in anesthetizing locations. In Part I, specific recommendations are given for the use of insulated approach, battery-powered monitors in surgery, and for isolation requirements for devices connected to cardiac leads. In Part II, checklists are provided for the self-evaluation of an in-house, biomedical engineering staff. Parts III and IV, in future issues of this Journal, will include discussion of the theoretical electrical hazard potential in reference to the use of isolated power systems. The question of whether isolated power should be required in all anesthetizing locations will be discussed in Part IV.

  16. On Idiosyncratic Systems. Part I. Idiosyncratic Systems. Part II. On Being Creative with Computer Aided Design.

    DTIC Science & Technology

    1977-03-31

    Catholic, good singer, vowel at the end of his name , likes pasta and red wine . Traversing this continuum has the intriguing property of reordering...feeling of transcendence , an aesthetic pleasure , or a good laugh. While one is 1101 Steven Coons, Computer graphics, initrodu ctionu . no less...a t i v - ’ - t , cL l e m s i - i - aesthetics , vol. 10, January 1970, 58—70. ‘.- i : i c~~, I:i tertia t nos ,ri l__liOirt:al ob ts:t,”tsa

  17. Toward understanding and treating violence in America: some contributions from group dynamic and group therapy perspectives: introduction to part II.

    PubMed

    Klein, Robert H; Schermer, Victor L

    2015-04-01

    The co-editors of the journal's two special issues on "Violence in America" from group psychotherapy and mental health standpoints review the articles in Part I and introduce the articles in Part II. The latter includes articles on anger management in groups, group psychotherapy for domestic violence, domestic "homegrown" terrorism, and two general commentaries. The co-editors provide broad reference points for the focus on clinical concerns, levels of treatment, variations in types of perpetrators, screening for groups, and the group-as-a-whole, relational, and social contexts of violence. Whether in small therapy groups, social interventions, or society's management of violence, empathy, boundaries, holding, and containment must be provided in such a way that they prevent violent acts while healing the hurts and shame that underlie violence in all its forms. Therapists' familiarity with these issues in their work can contribute fruitfully to treatment efforts and addressing a pressing social problem.

  18. Synchrotron X-ray CT characterization of titanium parts fabricated by additive manufacturing. Part II. Defects.

    PubMed

    Scarlett, Nicola Vivienne Yorke; Tyson, Peter; Fraser, Darren; Mayo, Sheridan; Maksimenko, Anton

    2016-07-01

    Synchrotron X-ray tomography (SXRT) has been applied to the study of defects within three-dimensional printed titanium parts. These parts were made using the Arcam EBM(®) (electron beam melting) process which uses powdered titanium alloy, Ti64 (Ti alloy with approximately 6%Al and 4%V) as the feed and an electron beam for the sintering/welding. The experiment was conducted on the Imaging and Medical Beamline of the Australian Synchrotron. The samples represent a selection of complex shapes with a variety of internal morphologies. Inspection via SXRT has revealed a number of defects which may not otherwise have been seen. The location and nature of such defects combined with detailed knowledge of the process conditions can contribute to understanding the interplay between design and manufacturing strategy. This fundamental understanding may subsequently be incorporated into process modelling, prediction of properties and the development of robust methodologies for the production of defect-free parts.

  19. Helping Children Cope with Fears and Stress. Part I: Discussion and Activities. Part II: Facilitator's Guide.

    ERIC Educational Resources Information Center

    Robinson, Edward H.; And Others

    How fears, phobias, anxiety and stress develop in elementary school students and how these students can be assisted in coping with fears and stress are discussed in this book. Part 1, "Discussion and Activities," contains six sections. Section 1 presents an overview of fears, and stress in children. Section 2 presents 12 fear-specific activities…

  20. Factors Related to the Pronunciation of Vowel Clusters. Part II (of 3 Parts).

    ERIC Educational Resources Information Center

    Johnson, Dale D.

    Children's pronunciations of vowel clusters in synthetic words were analyzed in relation to common English words containing the same vowel clusters. Subjects were 436 elementary students of both high and low reading levels from a suburban, an urban, and a rural community. Conclusions of the study, reported in Part 2, were (1) pronunciations more…

  1. The Didactics of Biology. A Selected Bibliography for 1979. Part I [and] Part II.

    ERIC Educational Resources Information Center

    Altmann, Antonin, Ed.; Lipertova, Pavla, Ed.

    Selected articles on various aspects of biology teaching published in 1979 have been annotated in this two-part bibliography. Entries from 18 journals representing 11 different countries are presented according to a topic area classification scheme listed in the table of contents. Countries represented include: Australia; Bulgaria; Czechoslovakia;…

  2. The Didactics of Biology. A Selected Bibliography for 1979. Part I [and] Part II.

    ERIC Educational Resources Information Center

    Altmann, Antonin, Ed.; Lipertova, Pavla, Ed.

    Selected articles on various aspects of biology teaching published in 1979 have been annotated in this two-part bibliography. Entries from 18 journals representing 11 different countries are presented according to a topic area classification scheme listed in the table of contents. Countries represented include: Australia; Bulgaria; Czechoslovakia;…

  3. Ontario Universities Benefits Survey 1994-96. Part I: Benefits Excluding Pensions [and] Part II: Pensions.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    This report presents data from a survey of Ontario (Canada) universities concerning employment benefits offered in 1994-96. Part 1 covers benefits other than pensions. Tables display the information on particular benefits institution-by-institution including: administration and insurance plans, communication of benefits, proposed changes, life and…

  4. Ontario Universities Benefits Survey, 1993-94, Part I, Benefits Excluding Pensions [and] Part II: Pensions.

    ERIC Educational Resources Information Center

    Council of Senior Administrative Officers--Universities of Ontario, Toronto.

    This report presents data from a survey of Ontario (Canada) universities concerning employment benefits offered in 1993-94. Part I covers benefits other than pensions. Tables display the information on particular benefits institution-by-institution including: administration and insurance plans, communication of benefits, proposed changes,…

  5. Ontario Universities Benefits Survey 1994-96. Part I: Benefits Excluding Pensions [and] Part II: Pensions.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    This report presents data from a survey of Ontario (Canada) universities concerning employment benefits offered in 1994-96. Part 1 covers benefits other than pensions. Tables display the information on particular benefits institution-by-institution including: administration and insurance plans, communication of benefits, proposed changes, life and…

  6. Research and Development: A Complex Relationship Part I [and] Part II.

    ERIC Educational Resources Information Center

    Pollard, John Douglas Edward

    Part 1 of this document describes the background, format, and early groundwork that went into the development of a test sponsored entirely by private enterprise. The discipline imposed by a financial bottom line imposes special pressures but also offers new opportunities. This private enterprise model is a multi-constructional process where…

  7. COLLABORATE©, Part IV: Ramping Up Competency-Based Performance Management.

    PubMed

    Treiger, Teresa M; Fink-Samnick, Ellen

    The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.

  8. Life cycle inventory for municipal solid waste management. Part 2: MSW management scenarios and modeling.

    PubMed

    Wilson, E J

    2002-02-01

    Evaluating the environmental performance of municipal solid waste management options is a complex task. Part 1 of this study presents the municipal solid waste management program of the Pamplona Region in Spain and explores the operational, economic, and environmental factors of the program. In Part 2, alternative waste management scenarios that include the selective collection of organic material and composting are illustrated. The use of a Life Cycle Inventory model for waste management allows for the comparison of the environmental burdens of the different scenarios. This use of a Life Cycle Inventory model for solid waste management lets program managers and decision makers include energy use, final solid waste, and Greenhouse gas emissions in the decision making process. Additionally, the different management scenarios are evaluated on their ability to fulfil Pamplona regional objectives and meet European Packaging and Landfill Directive targets.

  9. Diagnosis and local management of breast cancer: part I.

    PubMed

    Benson, John R

    2011-08-01

    This is the first of a two-part conference report and focuses primary on newer technologies (e.g., molecular methods for intraoperative nodal assessment and MRI/PET imaging) and surgical management in the context of neoadjuvant chemotherapy. A notable feature of the Second Kyoto Breast Cancer Consensus Conference was a consensus session for which a series of key clinical questions in the aforementioned areas formed the basis for discussion. Preconference questionnaires had been issued to all delegates and the final consensus sessions focused on more controversial and problematic areas where there is divergence of opinion and clinical management.

  10. Trends in Medicare Part D Medication Therapy Management Eligibility Criteria

    PubMed Central

    Wang, Junling; Shih, Ya-Chen Tina; Qin, Yolanda; Young, Theo; Thomas, Zachary; Spivey, Christina A.; Solomon, David K.; Chisholm-Burns, Marie

    2015-01-01

    Background To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. Objectives To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. Methods This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008–2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. Results For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. Conclusion The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans. PMID:26380030

  11. Trends in Medicare Part D Medication Therapy Management Eligibility Criteria.

    PubMed

    Wang, Junling; Shih, Ya-Chen Tina; Qin, Yolanda; Young, Theo; Thomas, Zachary; Spivey, Christina A; Solomon, David K; Chisholm-Burns, Marie

    2015-01-01

    To increase the enrollment rate of medication therapy management (MTM) programs in Medicare Part D plans, the US Centers for Medicare & Medicaid Services (CMS) lowered the allowable eligibility thresholds based on the number of chronic diseases and Part D drugs for Medicare Part D plans for 2010 and after. However, an increase in MTM enrollment rates has not been realized. To describe trends in MTM eligibility thresholds used by Medicare Part D plans and to identify patterns that may hinder enrollment in MTM programs. This study analyzed data extracted from the Medicare Part D MTM Programs Fact Sheets (2008-2014). The annual percentages of utilizing each threshold value of the number of chronic diseases and Part D drugs, as well as other aspects of MTM enrollment practices, were analyzed among Medicare MTM programs that were established by Medicare Part D plans. For 2010 and after, increased proportions of Medicare Part D plans set their eligibility thresholds at the maximum numbers allowable. For example, in 2008, 48.7% of Medicare Part D plans (N = 347:712) opened MTM enrollment to Medicare beneficiaries with only 2 chronic disease states (specific diseases varied between plans), whereas the other half restricted enrollment to patients with a minimum of 3 to 5 chronic disease states. After 2010, only approximately 20% of plans opened their MTM enrollment to patients with 2 chronic disease states, with the remaining 80% restricting enrollment to patients with 3 or more chronic diseases. The policy change by CMS for 2010 and after is associated with increased proportions of plans setting their MTM eligibility thresholds at the maximum numbers allowable. Changes to the eligibility thresholds by Medicare Part D plans might have acted as a barrier for increased MTM enrollment. Thus, CMS may need to identify alternative strategies to increase MTM enrollment in Medicare plans.

  12. Understanding Medicines: Conceptual Analysis of Nurses' Needs for Knowledge and Understanding of Pharmacology (Part I). Understanding Medicines: Extending Pharmacology Education for Dependent and Independent Prescribing (Part II).

    ERIC Educational Resources Information Center

    Leathard, Helen L.

    2001-01-01

    Part I reviews what nurses need to know about the administration and prescription of medicines. Part II addresses drug classifications, actions and effects, and interactions. Also discussed are the challenges pharmacological issues pose for nursing education. (SK)

  13. Fuels and fire in land-management planning: Part 3. Costs and losses for management options.

    Treesearch

    Wayne G. Maxwell; David V. Sandberg; Franklin R. Ward

    1983-01-01

    An approach is illustrated for computing expected costs of fire protection; fuel treatment; fire suppression; damage values; and percent of area lost to wildfire for a management or rotation cycle. Input is derived from Part 1, a method for collecting and classifying the total fuel complex, and Part 2, a method for appraising and rating probable fire behavior. This...

  14. Essentials of Advocacy in Case Management: Part 1: Ethical Underpinnings of Advocacy-Theories, Principles, and Concepts.

    PubMed

    Tahan, Hussein M

    2016-01-01

    This article describes the meaning and underpinnings of advocacy in the field of case management and shares essential principles and concepts for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is vital to case management practice and a primary role of the professional case manager. It is rooted in ethical theory and principles. Successful case managers apply advocacy at every step of the case management process and in every action they take. Part I of this 2-part article explores the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and types of advocacy. Part II then presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Acquiring foundational knowledge, skills, and competencies in what advocacy is equips case managers with the ability and confidence to enact advocacy-related behaviors in the provision of care to achieve desired outcomes for both the clients and health care agencies/providers alike. Case management leaders may use the knowledge shared in this article to develop advocacy training and competency programs for their case managers.

  15. Health care technology assessment: implications for modern medical practice. Part II. Decision making on technology adoption.

    PubMed

    Pierce, Read G; Bozic, Kevin J; Hall, Bruce Lee; Breivis, James

    2007-02-01

    Health care technology assessment, the multidisciplinary evaluation of clinical and economic aspects of technology, has come to have an increasingly important role in health policy and clinical decision-making. In Part I--Understanding Technology Adoption and Analyses--this review addressed the difficult challenges posed by assessment and provided a guide to the methodologies used. Part II presents the factors that drive the technology choices made by patients, by individual physicians, by provider groups, and by hospital administrators.

  16. Models and the dynamics of theory-building in physics. Part II-Case studies

    NASA Astrophysics Data System (ADS)

    Emch, Gérard G.

    In Part I, it was argued that models are best explained by considering the strategies from which they issue. A distinction was proposed between two classes of modeling that contribute to theory-building: H-modeling and L-modeling. Case studies are presented in this Part II to illustrate the characteristic features of these modeling strategies; examples are drawn from classical statistical mechanics and quantum physics.

  17. A Study to Determine the Optimal Frequency for Conducting Periodic Dental Examinations, Recruit Needs. Part II.

    DTIC Science & Technology

    1980-06-01

    HEALTH CARE STUDIES DIVISION REPORT #80-004 A STUDY TO DETERMINE THE OPTIMAL FREQUENCY FOR CONDUCTING PERIODIC DENTAL EXAMINATIONS RECRUIT NEEDS (Part...CONDUCTING PERIODIC DENTAL EXAMINATIONS - RECRUIT July 1979 to June 1980 NEEDS PART II G. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(*) 8. CONTRACT OR GRANT...KEY WORDS (Continue an reveree side if neceeary end Identify by block number) Dental ; Recruits; Care needs; Treatment Time; Age; Oral health 2a *srhA&T

  18. The Mixed Waste Management Facility: Technology selection and implementation plan, Part 2, Support processes

    SciTech Connect

    Streit, R.D.; Couture, S.A.

    1995-03-01

    The purpose of this document is to establish the foundation for the selection and implementation of technologies to be demonstrated in the Mixed Waste Management Facility, and to select the technologies for initial pilot-scale demonstration. Criteria are defined for judging demonstration technologies, and the framework for future technology selection is established. On the basis of these criteria, an initial suite of technologies was chosen, and the demonstration implementation scheme was developed. Part 1, previously released, addresses the selection of the primary processes. Part II addresses process support systems that are considered ``demonstration technologies.`` Other support technologies, e.g., facility off-gas, receiving and shipping, and water treatment, while part of the integrated demonstration, use best available commercial equipment and are not selected against the demonstration technology criteria.

  19. Managing length of stay using patient flow--part 1.

    PubMed

    Cesta, Toni

    2013-02-01

    This month we have discussed the fundamentals of patient flow and its related theories. We reviewed the concepts of demand and capacity management as they apply to the hospital setting. Patient flow requires daily diligence and attention. It should not be something focused on only on busy days, but should be managed each and every day. By taking a proactive approach to patient flow, the number of days your hospital will be bottlenecked can be reduced. Patient flow needs to be part of the daily activities of every case management department and should be factored in as a core role and function in a contemporary case management department. Patient flow needs to be addressed at the patient, departmental, and hospital level. In next month's issue we will continue our discussion on patient flow with a detailed review of specific examples that any case management department can use. We will also review all the departments and disciplines that contribute to patient flow and their role in it.

  20. Dollar$ & $en$e. Part VI: Knowledge management: the state of the art.

    PubMed

    Wilkinson, I

    2001-01-01

    In Part I of this series, I introduced the concept of memes (1). Memes are ideas or concepts--the information world equivalent of genes. The goal of this series of articles is to infect you with memes so you will assimilate, translate, and express them. No matter what our area of expertise or "-ology," we all are in the information business. Our goal is to be in the wisdom business. In the previous articles in this series, I showed that when we convert raw data into wisdom, we are moving along a value chain. Each step in the chain adds a different amount of value to the final product: timely, relevant, accurate, and precise knowledge that then can be applied to create the ultimate product in the value chain--wisdom. In part II of this series, I introduced a set of memes for measuring the cost of adding value (2). In part III of this series, I presented a new set of memes for measuring the added value of knowledge, i.e., intellectual capital (3). In part IV of this series, I discussed practical knowledge management tools for measuring the value of people, structural, and customer capital (4). In part V of this series, I applied intellectual capital and knowledge management concepts at the individual level, to help answer a fundamental question: what is my added value (5)? In the final part of this series, I will review the state of intellectual capital and knowledge management development to date and outline the direction of current knowledge management initiatives and research projects.